2011-11-15T12:58:26-06:00 2010-12-31 990 2010-01-01 440565393 SAINT LUKES NORTHLAND HOSPITAL CORPORATION SAIN 8165327164 601 SOUTH 169 HIGHWAY SMITHVILLE MO 64089 KEVIN TRIMBLE 8165327164 2011-11-15 2010 2016-02-24 21:20:13Z N GARY WAGES 601 SOUTH 169 HIGHWAY SMITHVILLE MO 64089 112902370 0 X WWW.SAINTLUKESHEALTHSYSTEM.ORG X 1989 MO HOSPITAL 12 10 1091 201 224589 10034 365708 222762 111066307 112607841 239943 71767 0 0 111671958 112902370 13520923 14188789 0 0 48135448 49147500 0 0 35556 51789242 52925429 113445613 116261718 -1773655 -3359348 100926585 96862596 55879398 55210702 45047187 41651894 X SAINT LUKE'S NORTHLAND HOSPITAL CORPORATION IS A PART OF SAINT LUKE'S HEALTH SYSTEM, A FAITH BASED, NOT-FOR-PROFIT ALIGNED HEALTH SYSTEM COMMITTED TO THE HIGHEST LEVELS OF EXCELLENCE IN PROVIDING HEALTH CARE AND HEALTH RELATED SERVICES IN A CARING ENVIRONMENT. WE ARE DEDICATED TO ENHANCING THE PHYSICAL, MENTAL, AND SPIRITUAL HEALTH OF THE COMMUNITIES WE SERVE. 0 0 105567372 14188787 112383252 ALL PROGRAM SERVICE EXPENSES WERE INCURRED IN FURTHERANCE OF OUR MISSION, WHICH IS TO ENSURE THE HIGHEST LEVELS OF EXCELLENCE IN PROVIDING HEALTH CARE SERVICES TO ALL PATIENTS IN A CARING ENVIRONMENT. IN 2010, THERE WERE 28,746 PATIENT DAYS AND 1,638 NEWBORN DAYS. IN ADDITION, THE HOSPITAL PROVIDED 81,739 OUTPATIENT AND EMERGENCY SERVICES.AS A VOLUNTARY, NONPROFIT, COMPREHENSIVE ORGANIZATION, SAINT LUKE'S NORTHLAND HOSPITAL IS COMMITTED TO SERVING ALL WHO SEEK OUR SERVICES REGARDLESS OF THEIR SOCIOECONOMIC STATUS. THE HOSPITAL PARTICIPATES IN THE MEDICAID AND MEDICARE PROGRAMS AND HAS CHARITY CARE POLICIES FOR ASSISTING PEOPLE WITHOUT ADEQUATE MEANS TO PAY FOR THEIR CARE.THE BARRY ROAD CAMPUS IS AN 84-BED ACUTE CARE FACILITY LOCATED IN KANSAS CITY, MISSOURI. THE SMITHVILLE CAMPUS PROVIDES URGENT CARE SERVICES TO THE COMMUNITY, AS WELL AS REHABILITATION, MENTAL HEALTH, AND POST-ACUTE CARE SERVICES. BOTH CAMPUSES SERVE THE NORTHERN KANSAS CITY AREA. 105567372 1 1 0 1 0 0 0 0 1 1 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 1 0 1 1 1 0 0 0 0 0 0 0 1 0 0 0 0 1 1 1 1 0 0 1 15 0 1 1091 1 1 1 0 0 0 0 0 0 0 0 0 X 12 10 0 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 0 1 0 X THE ORGANIZATION 8165327164 601 SOUTH 169 HIGHWAY SMITHVILLE MO 64089 X THOMAS L BROWN 1.00 X X 0 0 0 EUGENE RUIZ 1.00 X X 0 0 0 RAHUL JOSHI 1.00 X 0 0 0 GAYDEN F CARRUTH 1.00 X X 0 0 0 H D CLEBERG 1.00 X 0 0 0 WILLIAM GILBIRDS MD 1.00 X 0 152998 31919 KELLEY M MARTIN 1.00 X 0 0 0 WILLIAM PARKS 1.00 X 0 0 0 GINA LAWSON 1.00 X 0 306778 50058 LORA CHEATUM 1.00 X 0 0 0 MICHAEL SHORT 1.00 X 0 0 0 CYNTHIA A TODD-TAKEYAMA 1.00 X 0 0 0 GARY WAGES 40.00 X 353672 0 35841 JULIE MURPHY 40.00 X 165937 0 26589 KEVIN TRIMBLE 40.00 X 204012 0 38126 DON SIPES 5.00 X 0 256614 52488 SARAH BOYD 40.00 X 197017 0 13046 SAMUEL FADARE 40.00 X 226826 0 32907 VANCE JERNSTROM 40.00 X 355978 0 16230 SALVATORE MICELI 40.00 X 330595 0 32147 BENESTO TUMANUT 40.00 X 296171 0 12891 2130208 716390 342242 22 0 1 0 P1 GROUP INC 16210 W 108TH ST LENEXA KS 66219 MAINTENANCE 1592574 JE DUNN 929 HOLMES KANSAS CITY MO 64106 CONSTRUCTION 953498 CARDIOVASCULAR CONSULTANTS 4330 WORNALL RD SUITE 2000 KANSAS CITY MO 64111 MEDICAL SERVICES 899893 MOBILE CATARACT CARE OF KANSAS CITY LLC 5844 NW BARRY RD SUITE 200 KANSAS CITY MO 64154 MEDICAL SERVICES 622195 AD VIVUM ANESTHESIOLOGY PC 8646 N OREGON AVE KANSAS CITY MO 64154 MEDICAL SERVICES 578794 18 222762 222762 NET PATIENT REVENUE 622110 109256341 109256341 OTHER PROGRAM SERVICES 622110 1219875 1219875 MEDICAL OFFICE RENT 531120 851653 655556 196097 REGIONAL LAB SERVICES 621500 685004 656512 28492 RENT FROM AFFILIATES 531120 594968 594968 112607841 71767 71767 112902370 112383252 224589 71767 14176106 14176106 12683 12683 824176 824176 39196019 38094296 1101723 1298508 1236020 62488 5105797 4795247 310550 2723000 2591961 131039 117488 117488 27006 27006 10861082 9720993 1140089 22040 5162 16878 14627636 14246396 345684 35556 300403 38066 262337 2156372 1809372 347000 79487 68488 10999 88309 61400 26909 2380218 2237405 142813 6455365 6068043 387322 457461 457461 SHARED SERVICES- SLHS 7900008 2657274 5242734 BAD DEBT 6502674 6502674 EICU EXPENSES 224820 224820 725060 563505 161555 116261718 105567372 10658790 35556 164045 45147 12762350 9958964 13548305 13210221 2045366 2153346 1468809 1374187 134667201 69774909 66287381 64892292 89309 105753 925691 1218247 3635329 3904439 100926585 96862596 6920635 6503078 46590916 45328658 2367847 3378966 55879398 55210702 X 44296092 40978147 751095 673747 45047187 41651894 100926585 96862596 X -3359348 -35944 X 0 1 1 X 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 4914 0 0 0 4914 0 EXPLANATION OF OTHER LOBBYING ACTIVITIES: PART II-B, LINE 1I: LINE F-PORTION OF DUES PAID TO HOSPITAL ASSOCIATIONS AND MEDICAL ORGANIZATIONS USED TOWARD LOBBYING ACTIVITIES. 74120 93625 482 67856 100371 72833 70450 605 69768 74120 95720 48400 1010 72297 72833 1.00000 1 0 2433226 2433226 63487458 33878126 29609332 62835566 32184478 30651088 5910951 3712305 2198646 64892292 ESTIMATED 3RD PARTY PAYOR SETTLEMENTS 566258 RESERVE SELF INSURED RISKS 1324000 OTHER NONCURRENT LIABILITIES 122043 OTHER CURRENT LIABILITIES 322350 PAYABLES TO AFFILIATES 1044315 3378966 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: THE INTENDED USE OF ENDOWMENT FUNDS INCLUDES BUT IS NOT LIMITED TO MEDICAL STAFF DEVELOPMENT, GENERAL OPERATIONS OF THE HOSPITAL, AND STUDENT SCHOLARSHIPS. THE ASSETS HELD AT THE UNRELATED ORGANIZATION REPRESENTS THE ORGANIZATION'S SHARE OF NET ASSETS AT SPELMAN MEDICAL FOUNDATION PER SFAS 136. SUCH ASSETS ARE REPORTED IN PART X, LINE 15. PART XI, XII, AND XIII, THE ORGANIZATION'S FINANCIAL STATEMENTS ARE INCLUDED IN THE CONSOLIDATED AUDIT OF SAINT LUKE'S HEALTH SYSTEM. 1 1 X 1 X 133.000000000000 1 X 1 1 1 0 0 8163610 4046005 4117605 0.03750 13326270 12624533 701737 0.00640 21489880 16670538 4819342 0.04390 532617 57 532560 0.00490 34485 0 34485 0.00030 187652 0 187652 0.00170 754754 57 754697 0.00690 22244634 16670595 5574039 0.05080 1579 0 1579 0.00000 1579 1579 0 1677690 0 24377638 29907222 -5529584 X 1 1 1 NORTH OAK MEDICAL PARK LLC RENTAL REAL ESTATE 0.10000 0.71000 2 1 SAINT LUKE'S NORTHLAND HOSPITAL

5830 NW BARRY ROAD KANSAS CITY MO 64154

X X X 2 SAINT LUKE'S NORTHLAND HOSPITAL

601 S 169 HIGHWAY SMITHVILLE MO 64089

X X REHABILITATION AND BEHAVIORAL HEALTH NOT REQUIRED 1 1 1 PART I, LINE 7: COST OF CHARITY CARE AND UNREIMBURSED HEALTH SERVICES WERE CALCULATED USING THE APPROPRIATE COST TO CHARGE RATIO FROM THE HOSPITAL'S COST REPORT. PART I, L7 COL(F): OUR TOTAL EXPENSE FROM FORM 990, PART IX, LINE 25, COLUMN (A) WAS $116,261,718. THE BAD DEBT EXPENSE INCLUDED IN THIS AMOUNT WAS $6,502,674. THIS LEFT US WITH A TOTAL EXPENSE OF $109,759,044 FOR PURPOSES OF CALCULATING LINE 7, COLUMN (F). PART III, LINE 4: BAD DEBT EXPENSE IS REPORTED IN ACCORDANCE WITH GENERALLY ACCEPTED ACCOUNTING PRINCIPLES (GAAP). HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION STATEMENT 15 IS FOLLOWED TO THE EXTENT IT ALIGNS WITH GAAP.FINANCIAL STATEMENT FOOTNOTE REGARDING BAD DEBT EXPENSE: THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS, CONSIDERING BUSINESS AND GENERAL ECONOMIC CONDITIONS IN ITS SERVICE AREA, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. THROUGHOUT THE YEAR, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON ITS REVIEW OF ACCOUNTS RECEIVABLE PAYOR COMPOSITION AND AGING, TAKING INTO CONSIDERATION RECENT WRITE-OFF EXPERIENCE BY PAYOR CATEGORY, PAYOR AGREEMENT RATE CHANGES, AND OTHER FACTORS. THE RESULTS OF THESE EVALUATIONS ARE THEN USED TO MAKE ANY MODIFICATIONS TO THE PROVISION FOR BAD DEBTS TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE RECEIVABLES. AFTER AMOUNTS DUE FROM THIRD PARTY PAYORS ARE SATISFIED, THE SYSTEM FOLLOWS ESTABLISHED GUIDELINES FOR PLACING CERTAIN PAST-DUE PATIENT BALANCES WITH EXTERNAL COLLECTION AGENCIES.COSTING METHODOLOGY: THE RATIO OF PATIENT CARE COST TO CHARGES (FROM MEDICARE COST REPORT) IS APPLIED TO THE BAD DEBT EXPENSE FROM OUR FINANCIAL STATEMENTS TO CALCULATE COST OF BAD DEBT ON LINE 2. DISCOUNTS AND ALLOWANCES ARE ACCOUNTED FOR SEPARATELY FROM BAD DEBT EXPENSE. PART III, LINE 8: MEDICARE ALLOWABLE COSTS WERE CALCULATED USING A COST-TO-CHARGE RATIO DIRECTLY FROM THE MEDICARE COST REPORT. SHORTFALLS ARISE FROM PAYMENTS THAT ARE LESS THAN WHAT IT COSTS TO PROVIDE THE CARE AND SERVICES. WE ACCEPT ALL MEDICARE PATIENTS KNOWING THE COST OF PROVIDING THE CARE MAY EXCEED THE FUNDS WE RECEIVE FROM MEDICARE FOR THE SERVICE. OUR SHORTFALL IS CONSIDERED TO BE COMMUNITY BENEFIT. MEDICARE SHORTFALLS MUST BE ABSORBED BY THE HOSPITAL IN ORDER TO CONTINUE TREATING THE ELDERLY IN OUR COMMUNITY. ADDITIONALLY, IT IS IMPLIED IN INTERNAL REVENUE SERVICE REVENUE RULING 69-545 THAT TREATING MEDICARE PATIENTS IS A COMMUNITY BENEFIT. REVENUE RULING 69-545, WHICH ESTABLISHED THE COMMUNITY BENEFIT STANDARD FOR TAX-EXEMPT HOSPITALS, INDICATES THAT PARTICIPATION IN PUBLICLY-FINANCED PROGRAMS, SUCH AS MEDICARE, IS EVIDENCE THAT A HOSPITAL MEETS THE COMMUNITY BENEFIT STANDARD. PART III, LINE 9B: IF A PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE THE ACCOUNT IS ADJUSTED ACCORDINGLY. ANY REMAINING BALANCE WOULD BE COLLECTED UNDER THE DEBT COLLECTION POLICY. OUR COLLECTION POLICIES ARE THE SAME FOR ALL PATIENTS. ALTHOUGH WE ARE NOT LEGALLY BOUND BY THE FAIR DEBT COLLECTION PRACTICES ACT, THE PRINCIPLES ADDRESSED ARE GENERALLY FOLLOWED. PART VI, LINE 2: THE HOSPITAL ASSESSES COMMUNITY NEEDS ON AN ANNUAL BASIS IN NUMEROUS WAYS, INCLUDING THROUGH ITS COMPREHENSIVE, DATA DRIVEN, ANNUAL STRATEGIC PLANNING PROCESS. THE HOSPITAL MEETS WITH STAFF, VOLUNTEERS, PATIENTS, BOARD MEMBERS AND PHYSICIANS. THE FEEDBACK PROVIDED BY THESE GROUPS IS COMMUNICATED TO HOSPITAL MANAGEMENT AND CONSIDERED WHEN DETERMINING THE NEEDS OF THE COMMUNITY.THE HOSPITAL ALSO WORKS WITH THE PATIENT ADVOCATE AND MARKETING DEPARTMENTS TO DETERMINE FEEDBACK RECEIVED FROM THE COMMUNITY REGARDING ITS NEEDS. THIS FEEDBACK IS ALSO COMMUNICATED TO HOSPITAL MANAGEMENT AND EVALUATED DURING THE ANNUAL BUDGET AND STRATEGIC PLANNING PROCESS. PART VI, LINE 3: THE HOSPITAL FOLLOWS THE SAINT LUKE'S HEALTH SYSTEM POLICIES FOR THE UNINSURED. IN ADDITION TO THESE POLICIES, THE HOSPITAL PROVIDES EDUCATION ON FINANCIAL ASSISTANCE ELIGIBILITY TO PATIENTS AND PERSONS WHO MAY BE BILLED FOR SERVICES THROUGH MANY SOURCES INCLUDING THE SLHS WEB SITE, INFORMATION ON BILLING STATEMENTS PERTAINING TO POSSIBLE NEED IN PAYING THEIR BILL, INFORMATION UPON CHECK IN LOCATED IN THE ADMITTING PATIENT PACKETS, ON OUR B-131 RELEASE TO TREAT FORMS SIGNED BY ALL PATIENTS REQUESTING SERVICES, AND VISITS BY SOCIAL WORKER TEAMS WHEN AN IN-PATIENT AS WELL AS FOLLOW UP CALLS TO PATIENTS AFTER DISCHARGE. FINANCIAL ASSISTANCE APPLICATIONS OR MEDICAID APPLICATIONS ARE REQUESTED ON ALL UNINSURED INPATIENTS PRIOR TO DISCHARGE. THE HOSPITAL ALSO CONTRACTS WITH HUMAN ARC, AN ELIGIBILITY ENROLLMENT SERVICE COMPANY THAT SCREENS ALL UNINSURED PATIENTS WITH A BALANCE OVER $2,000, ANY PATIENT IDENTIFIED BY A SOCIAL WORKER AS WELL AS ON ALL PATIENTS THAT REQUEST ASSISTANCE IN APPLYING FOR POSSIBLE MEDICAID OR OTHER GOVERNMENT COVERAGE. PART VI, LINE 4: THE BARRY ROAD CAMPUS IS AN 84-BED ACUTE CARE FACILITY LOCATED IN KANSAS CITY, MISSOURI. THE SMITHVILLE CAMPUS PROVIDES URGENT CARE SERVICES TO THE COMMUNITY, AS WELL AS REHABILITATION, MENTAL HEALTH, AND POST-ACUTE CARE SERVICES. BOTH CAMPUSES SERVE THE NORTHERN KANSAS CITY AREA. PART VI, LINE 6: THE BOARD OF DIRECTORS IS MADE UP OF MEDICAL AND BUSINESS PROFESSIONALS, ALMOST ALL OF WHOM RESIDE IN THE HOSPITAL'S PRIMARY SERVICE AREA. THEY ARE INVOLVED IN THE COMMUNITY NEEDS ASSESSMENT PROCESS, IN FUNDRAISING, AND IN GENERAL STEWARDSHIP.MEDICAL STAFF PRIVILEGES ARE OFFERED TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY. PART VI, LINE 7: THE HOSPITAL IS AFFILIATED WITH SAINT LUKE'S HEALTH SYSTEM, WHICH CONSISTS OF 11 AREA HOSPITALS AND SEVERAL PRIMARY AND SPECIALTY CARE PRACTICES, AND PROVIDES A RANGE OF INPATIENT, OUTPATIENT, AND HOME CARE SERVICES. FOUNDED AS A FAITH-BASED, NOT-FOR-PROFIT ORGANIZATION, OUR MISSION INCLUDES A COMMITMENT TO THE HIGHEST LEVELS OF EXCELLENCE IN HEALTH CARE AND THE ADVANCEMENT OF MEDICAL RESEARCH AND EDUCATION. THE HEALTH SYSTEM IS AN ALIGNED ORGANIZATION IN WHICH THE PHYSICIANS AND HOSPITALS ASSUME RESPONSIBILITY FOR ENHANCING THE PHYSICAL, MENTAL, AND SPIRITUAL HEALTH OF PEOPLE IN THE METROPOLITAN KANSAS CITY AREA AND THE SURROUNDING REGION. 1 SAINT LUKE'S MEDICAL GROUP - AFFILIATED 501(C)(3) 6750 ANTIOCH SUITE 210 SHAWNEE MISSION KS 66204 431598353 501(C)(3) 2576337 OPERATING FUNDS SPELMAN MEDICAL FOUNDATION 5810 NW BARRY ROAD KANSAS CITY MO 64154 431270223 501(C)(3) 12750 CONTRIBUTION ST LUKES HOSPITAL OF KANSAS CITY - AFFILIATED 501(C)(3) 4401 WORNALL ROAD KANSAS CITY MO 64111 440545297 501(C)(3) 10400000 OPERATING FUNDS SLCC INC 4330 WORNALL ROAD SUITE 2000 KANSAS CITY MO 64111 271994652 501(C)(3) 1135709 OPERATING FUNDS NORTHLAND HEALTHCARE ACCESS PO BOX 14414 PARKVILLE MO 64152 431578121 501(C)(3) 20000 CONTRIBUTION 5 0 ADVANCED EDUCATION IN MEDICAL FIELD - SCHOLARSHIP 12 12000 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: SCHOLARSHIPS ARE GIVEN TO HIGH SCHOOL GRADUATES PURSUING ADVANCED EDUCATION IN THE MEDICAL FIELD BASED ON ACADEMICS. GRANTS ARE ALSO PROVIDED TO QUALIFIED 501(C)(3) CHARITIES. ALL DONEE INFORMATION IS KEPT AS PART OF THE HOSPITAL BOOKS AND RECORDS. 0 0 0 0 0 0 0 1 0 WILLIAM GILBIRDS MD 0 125502 0 19170 0 8326 0 6368 0 25551 0 184917 0 0 GINA LAWSON 0 166850 0 137829 0 2099 0 14700 0 35358 0 356836 0 0 GARY WAGES 293427 0 50 0 60195 0 12250 0 23591 0 389513 0 32400 0 JULIE MURPHY 152200 0 50 0 13687 0 22375 0 4214 0 192526 0 10353 0 KEVIN TRIMBLE 179601 0 472 0 23939 0 12328 0 25798 0 242138 0 11188 0 DON SIPES 0 221426 0 50 0 35138 0 32699 0 19789 0 309102 0 18033 SARAH BOYD 196251 0 250 0 516 0 7009 0 6037 0 210063 0 0 0 SAMUEL FADARE 216366 0 10050 0 410 0 9250 0 23657 0 259733 0 0 0 VANCE JERNSTROM 355245 0 50 0 683 0 5523 0 10707 0 372208 0 0 0 SALVATORE MICELI 229646 0 100417 0 532 0 9800 0 22347 0 362742 0 0 0 BENESTO TUMANUT 290759 0 50 0 5362 0 5160 0 7731 0 309062 0 0 0 PART I, LINE 7 EMPLOYED PHYSICIANS ARE ELIGIBLE FOR BONUSES BASED ON PRODUCTIVITY AND OTHER PERFORMANCE MEASURES. SUPPLEMENTAL INFORMATION PART III PART II: DON SIPES, GINA LAWSON, AND WILLIAM GILBIRDS DID NOT RECEIVE COMPENSATION FOR DUTIES AS A DIRECTOR OR OFFICER OF THE FILING ORGANIZATION BUT RECEIVED COMPENSATION FROM RELATED ORGANIZATIONS FOR SERVICES RENDERED TO THE RELATED ORGANIZATIONS. NORTHLAND WOMEN'S HEALTHCARE WILLIAM GILBIRD'S SPOUSE IS A >35% OWNER OF NORTHLAND WOMEN'S HEALTHCARE 365000 PROFESSIONAL MEDICAL SERVICES 0 FORM 990, PART VI, SECTION A, LINE 3 AS PART OF AN INTEGRATED HEALTH SYSTEM, THE ORGANIZATION ROUTINELY DELEGATED VARIOUS MANAGEMENT AND SUPPORT FUNCTIONS TO RELATED ENTITIES. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE CORPORATE MEMBER IS SAINT LUKE'S HEALTH SYSTEM, A 501(C)(3) ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A THE GOVERNING BODY IS ELECTED BY THE SOLE CORPORATE MEMBER, FORM 990, PART VI, SECTION A, LINE 7B THE SOLE MEMBER HAS SPECIFIED RESERVE POWERS OVER MAJOR DECISIONS SUCH AS AMENDMENTS TO ARTICLES AND BYLAWS, DEBT, BUDGETS, CAPITAL EXPENDITURES AND STRATEGIC OPERATING DECISIONS. FORM 990, PART VI, SECTION B, LINE 11 THE 990 IS PREPARED JOINTLY BY ACCOUNTING STAFF OF THE ENTITY AND SAINT LUKE'S HEALTH SYSTEM (SYSTEM) TAX STAFF. THE RETURN IS REVIEWED BY THE ENTITY'S CFO OR CEO. THE 990 DRAFT WAS ALSO PRESENTED TO THE AUDIT COMMITTEE OF THE SYSTEM BOARD OF DIRECTORS FOR REVIEW. THE 990 WAS MADE AVAILABLE TO THE ORGANIZATION'S BOARD MEMBERS FOR VIEWING BEFORE FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C SAINT LUKE'S HEALTH SYSTEM AND ITS AFFILIATES, INCLUDING THE FILING ORGANIZATION, HAVE COMPREHENSIVE WRITTEN CONFLICT OF INTEREST POLICIES APPLICABLE TO ALL DIRECTORS, OFFICERS, AND EMPLOYEES. ANY ACTUAL, POSSIBLE OR PERCEIVED CONFLICT OF INTEREST IS EXPECTED TO BE HANDLED THROUGH FULL AND TIMELY DISCLOSURE OF ANY SUCH INTEREST, TOGETHER WITH ABSENCE OF PERSUASION IN ANY DISCUSSION AND IN ANY VOTE WHEREIN THE INTEREST IS INVOLVED. DISCLOSURE IS TO BE MADE WHEN THE INTEREST ARISES, AT ANY TIME THE INTEREST BECOMES A MATTER OF GOVERNING BOARD ACTION, AND THEN ANNUALLY THROUGH COMPLETION OF A CONFLICT OF INTEREST QUESTIONNAIRE. THE SYSTEM COMPLIANCE OFFICER OR THE SYSTEM VICE PRESIDENT OF HUMAN RESOURCES REVIEWS COMPLETED QUESTIONNAIRES AND FURTHER INVESTIGATES POSSIBLE CONFLICTS OF INTEREST. A REPORT IS PROVIDED TO THE AUDIT COMMITTEE OF THE SYSTEM BOARD OF DIRECTORS AND ANY IDENTIFIED CONFLICT OF INTEREST IS REPORTED TO THE APPLICABLE ENTITY. FORM 990, PART VI, SECTION B, LINE 15A ANNUALLY, THE SAINT LUKE'S HEALTH SYSTEM BOARD OF DIRECTORS' COMPENSATION COMMITTEE REVIEWS, DISCUSSES, SETS AND APPROVES COMPENSATION FOR THE ORGANIZATION'S TOP MANAGEMENT EXECUTIVE. INDEPENDENT, EXTERNAL DIRECTORS SERVE ON THE COMPENSATION COMMITTEE. AN INDEPENDENT COMPENSATION CONSULTING FIRM ANNUALLY PROVIDES A WRITTEN REPORT AND REASONABLENESS OPINION. THE CONSULTANT REVIEWS THE SYSTEM'S EXECUTIVE TOTAL COMPENSATION PHILOSOPHY AND ANALYZES MARKET COMPETITIVENESS (IN TOTAL AND BY EACH COMPENSATION ELEMENT) FOR THE EXECUTIVES USING APPROPRIATE COMPARABILITY DATA. COMPENSATION COMMITTEE ACTIONS ARE CONTEMPORANEOUSLY DOCUMENTED. THE PROCESS SATISFIES THE REBUTTABLE PRESUMPTION PROCEDURE. COMPENSATION FOR OFFICERS NOT REVIEWED BY THE COMPENSATION COMMITTEE IS SET/APPROVED ANNUALLY BY SAINT LUKE'S HEALTH SYSTEM EXECUTIVE MANAGEMENT BASED ON MARKET COMPENSATION SURVEYS AND COMPARABILITY DATA PROVIDED BY AN INDEPENDENT COMPENSATION CONSULTING FIRM. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE NOT PUBLICLY AVAILABLE. FORM 990, PART VII, COLUMN E DON SIPES, GINA LAWSON, AND WILLIAM GILBIRDS DID NOT RECEIVE COMPENSATION FOR DUTIES AS A DIRECTOR OR OFFICER OF THE FILING ORGANIZATION BUT RECEIVED COMPENSATION FROM RELATED ORGANIZATIONS FOR SERVICES RENDERED TO THE RELATED ORGANIZATIONS. THESE INDIVIDUALS WORKED 40 HOURS OR MORE PER WEEK FOR ALL RELATED ORGANIZATIONS. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: RISK RETENTION GROUP SSA DIVIDENDS -53,613. PENSION LIABILITY TRANSFER TO SAINT LUKE'S HEALTH SYSTEM -79,103. EQUITY IN AFFILIATES 200,370. CHANGE IN INTEREST IN ASSETS OF THE FOUNDATION - SFAS 136 -103,598. TOTAL TO FORM 990, PART XI, LINE 5: -35,944. JOINT VENTURE FORM 990, PART VI, SECTION B, LINE 16B THE ORGANIZATION HAS PROCEDURES IN PLACE TO ENSURE THE VENTURE OPERATES IN A MANNER CONSISTENT WITH THE ORGANIZATION'S EXEMPT MISSION AND FOR THE VENTURE TO NOT ENGAGE IN POLITICAL CANDIDATE CAMPAIGN ACTIVITY OR OTHER ACTIVITIES THAT WOULD JEOPARDIZE THE ORGANIZATION'S EXEMPTION. TAX EXEMPT BOND LIABILITIES FORM 990, PART X, BALANCE SHEET, LINE 20 THE AMOUNT REPORTED AS TAX-EXEMPT BONDS IS THE PORTION OF SAINT LUKE'S HEALTH SYSTEM BONDS ALLOCATED TO SAINT LUKE'S NORTHLAND HOSPITAL. REQUIRED INFORMATION FOR THE BONDS, INCLUDING SCHEDULE K, IS REPORTED IN THE SAINT LUKE'S HEALTH SYSTEM (EIN: 43-1747502) IRS FORM 990. SLN MEDICAL SPECIALISTS LLC 5830 NW BARRY ROAD KANSAS CITY MO 64154 260178220 PHYSICIAN SERVICES - BILLING MO 0 0 N/A SAINT LUKES HEALTH SYSTEM 10920 ELM AVENUE KANSAS CITY MO 64134 431747502 HEALTH SYSTEM KS 501(C)(3) 509(A)(3) - TYPE 1 ST LUKES HOSPITAL OF KANSAS CITY 0 SAINT LUKES HOSPITAL OF KANSAS CITY 4401 WORNALL ROAD KANSAS CITY MO 64111 440545297 HEALTH CARE MO 501(C)(3) 170B1AIII N/A 0 SAINT LUKES SOUTH HOSPITAL INC 12300 METCALF AVE OVERLAND PARK KS 66213 481203262 HEALTH CARE KS 501(C)(3) 170B1AIII SAINT LUKES HEALTH SYSTEM 0 SAINT LUKES EAST HOSPITAL 100 NE ST LUKES BLVD LEES SUMMIT MO 64086 562488077 HEALTH CARE MO 501(C)(3) 170B1AIII SAINT LUKES HEALTH SYSTEM 0 SAINT LUKES MEDICAL GROUP 6750 ANTIOCH SUITE 210 SHAWNEE MISSION KS 66204 431598353 HEALTH CARE MO 501(C)(3) 170B1AIII SAINT LUKES HEALTH SYSTEM 0 CRITTENTON 10918 ELM AVE KANSAS CITY MO 64134 440545808 HEALTH CARE MO 501(C)(3) 170B1AIII SAINT LUKES HOSPITAL 0 SAINT LUKES HEALTH SYSTEM HOME CARE AND HOSPICE 3100 BROADWAY SUITE 1000 KANSAS CITY MO 64111 431127200 HEALTH CARE MO 501(C)(3) 170B1AIII SAINT LUKES HEALTH SYSTEM 0 SAINT LUKES HOSPITAL OF TRENTON 701 EAST FIRST TRENTON MO 64683 431707306 HEALTH CARE MO 501(C)(3) 170B1AIII SAINT LUKES HEALTH SYSTEM 0 SAINT LUKES HOSPITAL OF GARNETT 421 SOUTH MAPLE GARNETT KS 66032 742849611 HEALTH CARE KS 501(C)(3) 170B1AIII SAINT LUKES HEALTH SYSTEM 0 CABOT WESTSIDE HEALTH CENTER 2121 SUMMIT KANSAS CITY MO 64108 440546280 HEALTH CARE MO 501(C)(3) 170B1AIII SAINT LUKES HEALTH SYSTEM 0 MIDWEST EAR INSTITUTE INC 4200 PENNSYLVANIA SUITE 100 KANSAS CITY MO 64111 480905027 HEALTH CARE KS 501(C)(3) 170B1AIII SAINT LUKES HOSPITAL 0 SAINT LUKES HOSPITAL OF CHILLICOTHE 100 CENTRAL STREET CHILLICOTHE MO 64601 431735565 HEALTH CARE MO 501(C)(3) 170B1AIII SAINT LUKES HEALTH SYSTEM 0 CUSHING MEMORIAL HOSPITAL CORP 711 MARSHALL LEAVENWORTH KS 66048 480543792 HEALTH CARE KS 501(C)(3) 170B1AIII SAINT LUKES HEALTH SYSTEM 0 SAINT LUKES CANCER INSTITUTE LLC 4323 WORNALL RD PEET 1 KANSAS CITY MO 64111 431933950 HEALTH CARE MO 501(C)(3) 170B1AIII SAINT LUKES HEALTH SYSTEM 0 SAINT LUKES CARE 10920 ELM AVENUE KANSAS CITY MO 64134 260185090 HEALTH CARE MO 501(C)(3) 170B1AIII SAINT LUKES HEALTH SYSTEM 0 MEDICAL PLAZA IMAGING ASSOCIATES LLC 4401 WORNALL ROAD KANSAS CITY MO 64111 431609584 HEALTH CARE MO 501(C)(3) 170B1AIII SAINT LUKES HEALTH SYSTEM 0 SAINT LUKES COLLEGE OF HEALTH SCIENCES 8320 WARD PARKWAY SUITE 300 KANSAS CITY MO 64114 272716128 POST SECONDARY NURSING EDUCATION MO 501(C)(3) 170B1AIII SAINT LUKES HOSPITAL 0 SLCC INC 4330 WORNALL ROAD SUITE 2000 KANSAS CITY MO 64111 271994652 HEALTH CARE KS APPLYING FOR 501(C)( APPLYING FOR 170B1AI SAINT LUKES HEALTH SYSTEM 0 MEDICAL PLAZA PARTNERS LP 4320 WORNALL RD SUITE 410 KASAS CITY MO 64111 431357824 OWN AND OPERATE MEDICAL OFFICE BUILDING MO N/A MEDICAL PARK ASSOCIATES A LP 601 S 169 HWY SMITHVILLE MO 64089 431311049 OWN AND OPERATE MEDICAL OFFICE BUILDING MO SPELMAN DEVELOPMENT CORP RELATED 7982 94040 0 0 0.08250 SAINT LUKE'S SURGICENTER LEE'S SUMMIT LLC 11221 ROE AVE SUITE 230 OVERLAND PARK KS 66211 470853481 HEALTH CARE MO N/A SAINT LUKE'S SOUTH SURGICENTERLLC 11221 ROE AVE SUITE 230 OVERLAND PARK KS 66211 201721929 HEALTH CARE KS N/A FAMILY ADVOCATES LLC 10918 ELM AVE KASAS CITY MO 64134 202739036 FOSTER CARE MO N/A SAINT LUKE'S CARDIOLOGY SERVICES 10920 ELM AVE KASAS CITY MO 64134 263726426 HEALTH CARE MO N/A SAINT LUKE'S-GI DIAGNOSTICS LLC 4321 WASHINGTON SUITE 5700 KASAS CITY MO 64111 274142549 HEALTH CARE MO N/A SPELMAN DEVELOPMENT CORPORATION 601 S 169 HIGHWAY SMITHVILLE MO 64089 431296007 MEDICAL OFFICE BUILDING RENTALS MO N/A C 4886 1722970 1.00000 SAINT LUKE'S HEALTH SYSTEM RISK RETENTION GROUP 1327 C ASHLEY RD SUITE 200 CHARLESTON SC 29407 371471890 INSURANCE SC N/A C ST LUKE'S HEALTH VENTURES INC 4320 WORNALL RD SUITE 410 KANSAS CITY MO 64111 431278476 ACCOUNTING MO N/A C MEDICAL PLAZA MANAGEMENT INC 4320 WORNALL RD SUITE 410 KANSAS CITY MO 64111 431352317 MEDICAL OFFICE BUILDING MANAGEMENT MO N/A C VENTURE FINANCIAL SERVICES INC 6158 RAYTOWN TRAFFICWAY RAYTOWN MO 64133 431605740 COLLECTIONS MO N/A C 0 1 0 0 0 0 0 0 1 1 0 0 0 1 1 1 0 0 MEDICAL PARK ASSOCIATES J 187297 HOSPITAL PAID FMV RENT TO MPA TRANSACTIONS WITH RELATED ORGANIZATIONS SCHEDULE R, PART V, LINE 1 SAINT LUKE'S HEALTH SYSTEM (SYSTEM) AND ITS AFFILIATED ENTITIES OPERATE AS A HIGHLY INTEGRATED HEALTH CARE DELIVERY SYSTEM. THE SYSTEM MANAGES AND OPERATES RELATED HOSPITALS AND THEIR AFFILIATES AS A COMMON MISSION ORIENTED HEALTH CARE SYSTEM IN ORDER TO BETTER SERVE THE HEALTH-RELATED NEEDS OF GREATER KANSAS CITY AND SURROUNDING AREAS. AS A RESULT, THERE ARE NUMEROUS INTERCOMPANY INTERACTIONS INCLUDING CENTRALIZED SUPPORT SERVICES AND SHARING OF RESOURCES AND COSTS.