2020-07-15T10:31:13-05:00 2019-06-30 470617373 COMMONSPIRIT HEALTH 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 990 2018-07-01 741161938 CHI St Luke's Health Baylor College of Medicine Medical Center CHIS 8323551000 6624 Fannin St 1100 Houston TX 77030 Mark Teresi Interim Chief Financial Officer 2020-07-15 true ANGELA NOEL CPA P01051055 3032989100 2018 2021-01-29 14:40:06Z Baylor St Lukes Medical Center T Douglas Lawson 6624 Fannin St 1100 Houston TX 77030 947145007 false X www.chistlukeshealth.org/baylorstlukes X 1945 TX TO NURTURE THE HEALING MINISTRY OF THE ROMAN CATHOLIC CHURCH BY BRINGING IT NEW LIFE, ENERGY, AND VIABILITY IN THE TWENTY-FIRST CENTURY. FIDELITY TO THE GOSPEL URGES US TO EMPHASIZE HUMAN DIGNITY AND SOCIAL JUSTICE AS IT MOVES TOWARD THE CREATION OF HEALTHIER COMMUNITIES. 12 11 4828 12 5602504 1593435 15036436 2297682 1012116306 911404109 14641196 15542014 15286897 17901155 1057080835 947144960 81693982 34137 0 342197614 366759641 0 0 578661733 589448358 1002553329 956242136 54527506 -9097176 925067730 971454205 141176753 214440728 783890977 757013477 As an affiliate of CommonSpirit Health, we make the healing presence of God known in our world by improving the health of the people we serve, especially those who are vulnerable, while we advance social justice for all. false false 847853412 34137 911404109 SEE SCHEDULE H 847853412 true true false true false false false false true true false false true true true false true false true true false false false false false true true true false true false false false false false false false false false false false false false true true false false false true X 0 0 4828 true true true false false false false false true false false false false false X 12 11 false false false false true true true true true false false true true true true true true false true false X Priscilla Needham 8323552885 6624 Fannin Street STE 2505 HOUSTON TX 77030 Marc Shapiro Chair 1.0 1.0 X X 0 0 0 ROBERT BLAKELY Vice Chair 1.0 0 X X 0 0 0 Clayton Trier BOARD MEMBER/SECRETARY 1.0 1.0 X X 0 0 0 T DOUGLAS LAWSON PHD EX-OFFICIO/CEO CHI St. Luke's Health System 1.0 0.0 X X 1355710 0 146269 PAUL WARDA TREASURER (PARTIAL YEAR) 40.0 0 X X 425707 0 25592 JOHN ANDERSON MD BOARD MEMBER 1.0 0 X 0 0 0 JOHN SCOTT ARNOLDY Board Member 1.0 0 X 0 0 0 DAVID BALDWIN BOARD MEMBER 1.0 0 X 0 0 0 ANTHONY JONES BOARD MEMBER 1.0 0.0 X 0 0 0 Paul Klotman MD EX-OFFICIO/BOARD MEMBER 1.0 1.0 X 0 0 0 Glenn Landon MD Board Member 1.0 0 X 0 0 0 Todd Rosengart MD Board Member 1.0 0 X 0 0 0 JEFF ROSE BOARD MEMBER 1.0 0 X 0 0 0 Sarah Foshee MD Board Member (Partial Year) 1.0 0 X 0 0 0 GAY NORD Ex-Officio Non-voting- PRESIDENT-ST LUKES (Partial) 1.0 49.0 X 727624 0 97893 DAVID OTT MD BOARD MEMBER - non-voting (partial year) 1.0 0 X 8400 0 0 MARK MCGINNIS CFO OF CHI ST. LUKE'S HEALTH SYSTEM 1.0 49.0 X 757960 0 70777 Priscilla Needham TREASURER/VP-FINANCE 9.0 0 X 168089 0 22138 ALENE JACKSON DIRECTOR-PATIENT CARE 50.0 0 X 218099 0 32207 JENNIFER NITSCHMANN MKT SVP-PATIENT CARE SERVICES 40.0 0 X 305101 0 26416 BRENDA BENAVIDEZ RN 40.0 0 X 284119 0 41087 DAVID BERGER SVP-OPERATIONS 50.0 0 X 403950 0 18679 NATALIE LYLES RN 40.0 0 X 238159 0 41291 EBELE NJEAKO RN 40.0 0 X 248269 0 41500 JANINE ONAMBELE RN-II 0 X 231678 0 24464 5372865 0 588313 687 false true true AMN HEALTHCARE 12400 High Bluff Drive San Diego CA 92130 Healthcare consulting 11845157 TEXAS MEDICAL CENTER 6550 Bertner Ave Houston TX 77030 Medical Staff Support 3826985 PERKINS WILL INC 1001 McKinney St 1300 Houston TX 77002 Design Practice 1721344 LIVANOVA USA INC 100 Cyberonics Blvd Houston TX 77058 Technology Services 1354293 ROGERS-OBRIEN CONSTRUCTION CO 11200 Richmond Ave 110 Houston TX 77082 Construction Services 1317713 82 X 0 0 0 0 2297682 0 2297682 Net Patient Services 900099 911171409 911171409 0 0 Medicare/Medicaid 900099 232700 232700 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 911404109 4310686 0 7912 4302774 0 0 0 0 0 0 0 0 3166631 0 0 0 3166631 0 3166631 0 0 3166631 11231375 0 0 47 11231375 -47 11231328 0 0 11231328 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Intercompany Transactions 900099 6323914 0 0 6323914 Laboratory Services 621500 5594592 0 5594592 0 Services Sold 900099 1356155 0 0 1356155 1459863 0 0 1459863 14734524 947144960 911404109 5602504 27840665 X 34137 34137 1891187 661915 1229272 297121208 283323455 13797753 12204873 11629940 574933 35248228 33526911 1721317 20294145 19279438 1014707 975 975 141047 141047 228609472 187603890 41005582 0 372841 372841 16248909 10236813 6012096 231836 231836 29068572 5523029 23545543 448241 125508 322733 411647 391065 20582 11777772 11777772 34510309 32784793 1725516 4374855 4156112 218743 Medical Supplies 219781826 219781826 State Provider Tax 19480024 18506023 974001 Repairs and maintenance 17587674 14070139 3517535 Miscellaneous Expenses 5345182 5070871 274311 1057176 633659 423517 0 956242136 847853412 108388724 0 15825 727920 5550410 3461942 27616054 27066055 136619880 150679329 0 0 0 47021 0 18763454 20481934 2529345 4600739 766754046 187654163 554603532 579099883 0 0 6157214 6663722 0 55814470 53774470 117350525 124898211 925067730 971454205 84178757 97188754 0 0 0 0 0 0 0 0 0 0 0 0 0 56997996 117251974 141176753 214440728 X 754649992 728387752 27553804 26938544 1687181 1687181 783890977 757013477 925067730 971454205 X -9097176 -4105307 -13675017 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED X 0 0 141047 141047 141047 141047 847712365 847712365 847853412 847853412 1000000 1000000 250000 250000 0 0 0 0 1000000 1000000 1000000 1000000 4000000 6000000 5865 27085 95673 141047 269670 250000 250000 250000 250000 1000000 1500000 0 0 0 0 0 77616280 2966951 3427100 2856663 81153668 77329841 2128264 4797238 6639063 77616280 75360004 4200089 6091894 8322146 77329841 109901453 7335578 -407894 41469133 75360004 150599341 5685246 2638659 49021793 109901453 0.271 0.298 0.431 true false 135682200 135682200 306095691 52945858 253149833 16008912 8800043 7208869 193377390 125826269 67551121 115589853 81993 115507860 579099883 Intercompany Receivables 104046945 Investments in Unconsolidated Orgs - Controlling Interest 3611755 Other Assets 17239511 124898211 Misc Liability 434079 Self-Insurance Reserves and Claims 18361936 Intercompany Payables 97099425 Retainage for CIP 815851 Miscellaneous Liability Other Long Term Liabilities Other Current Liabilities 540683 117251974 X Schedule D, Part V, Line 4 Intended uses of endowment funds THE ENDOWMENT FUNDS AND THE PURPOSES FOR WHICH THEY ARE INTENDED, INCLUDE BUT ARE NOT LIMITED TO, APPLIED RESEARCH AND EDUCATION IN BIOMEDICAL ENGINEERING, CARDIOLOGY EDUCATION AND RESEARCH,DEVELOPMENTAL PROGRAMS RELATED TO INTERNAL MEDICINE, NUCLEAR MEDICINE, RADIOLOGY, ORTHOPEDIC RESEARCH AND NURSING EDUCATION. Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote CHI ST. LUKE'S HEALTH BAYLOR ST. LUKE'S MEDICAL CENTER qualifies as a tax-exempt organization under Section 501(a) and is described in Section 501(c)(3) of the Code and is exempt from federal and state income taxes. Management annually reviews its tax positions and has determined that there are no material uncertain tax positions that require recognition in the accompanying consolidated balance sheets. South America 0 2 Program Services MARKETING FEES 198557 Middle East and North Africa 0 0 Program Services MARKETING FEES 55145 Central America and the Caribbean 0 0 Program Services MARKETING FEES 72158 0 2 0 0 0 2 325860 0 325860 true false true false false true true true X true X 300 true X true true true false false 9409 26885742 26885742 0.0281 18789 75431431 58696932 16734499 0.0175 0 0.0 0 28198 102317173 58696932 43620241 0.0456 0 0.0 36055113 5364001 30691112 0.0321 0 0.0 3187195 3187195 0.0033 19486607 19486607 0.0204 0 0 58728915 5364001 53364914 0.0558 0 28198 161046088 64060933 96985155 0.1014 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0 0 0 0 0.0 true 29872629 0 189966639 375572546 -185605907 X true true 1 1 CHI ST LUKE'S HEALTH BAYLOR ST LUKES MED CNTR 6720 BERTNER HOUSTON TX 77030 http://www.chistlukeshealth.org/baylorstlukes 118 X X X X X CHI ST LUKE'S HEALTH BAYLOR ST LUKES MED CNTR 1 false false true X X X X X X X X X 18 true true true true X https://www.chistlukeshealth.org/about-chi-st-lukes-health/healthy-communities X true 18 false true false true X 300.0 300.0 X X X X true true X X X true X http://www.chistlukeshealth.org/financial-assistance X http://www.chistlukeshealth.org/financial-assistance X http://www.chistlukeshealth.org/financial-assistance X X X X X X true X false X X X X true X false false Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - CHI ST. LUKE'S HEALTH BAYLOR ST. LUKE'S MEDICAL CENTER. FOR THE LATEST CHNA THE HOSPITAL WORKED WITH THE EPISCOPAL HEALTH FOUNDATION WHICH HIRED HEALTH RESOURCES IN ACTION, A NONPROFIT PUBLIC HEALTH INSTITUTE, TO CONDUCT KEY INFORMANT INTERVIEWS WITH INFORMANTS IDENTIFIED BY THE HOSPITALS AND TO ANALYZE THOSE INTERVIEWS FOR KEY THEMES. A TOTAL OF 53 KEY INFORMANT INTERVIEWS WERE CONDUCTED. COMMUNITY INPUT ALSO INCLUDED EMAIL AND TELEPHONE SURVEYS OF RESIDENTS, AND FOCUS GROUPS INCLUDING HEALTH CARE STAFF, COMMUNITY ORGANIZATIONS AND OTHER STAKEHOLDERS. PARTICIPANTS REPRESENTED A WIDE RANGE OF COMMUNITY SECTORS, INCLUDING LOCAL PUBLIC HEALTH AND POOR AND MEDICALLY INDIGENT POPULATIONS IN THE COMMUNITY. ORGANIZATIONS REPRESENTED INCLUDE: CATHOLIC CHARITIES-FORT BEND, CHILD ADVOCATES OF FORT BEND, FORT BEND COUNTY HEALTH AND HUMAN SERVICES, FORT BEND REGIONAL COUNCIL ON SUBSTANCE ABUSE, FORT BEND SENIORS, FORT BEND WOMEN'S CENTER, THE ARC OF FORT BEND COUNTY, AIDS FOUNDATION OF HOUSTON, ASSOCIATION FOR THE ADVANCEMENT OF MEXICAN AMERICANS, AVENUE CDC, CHRIST CLINIC, COASTAL AREA HEALTH EDUCATION CENTERS, COMMUNITY HEALTH CHOICE, GREATER HOUSTON PARTNERSHIP, HEALTH CARE FOR THE HOMELESS-HOUSTON, HOPE CLINIC, HOUSTON AREA FOOD BANK, KINDER INSTITUTE, LEGACY COMMUNITY HEALTH, NEIGHBORHOOD CENTERS HEAD START/EARLY HEAD START PROGRAM SERVICES/BAKER RIPLEY, THE ROSE, LIBERTY COUNTY SHERIFF'S OFFICE, TRI COUNTY SERVICES BEHAVIORAL HEALTH CARE, PRAIRIE VIEW A&M, AND EL CENTRO DE CORAZON. Schedule H, Part V, Section B, Line 6a Facility , 1 Facility , 1 - CHI St. Luke's Health Baylor St. Luke's Medial Center. THE HOSPITAL COLLABORATED WITH SEVERAL OTHER HOSPITALS AND HOSPITAL SYSTEMS. CHI ST. LUKE'S FACILITIES INCLUDED: PATIENTS MEDICAL CENTER, SPRINGWOODS VILLAGE HOSPITAL, SUGAR LAND HOSPITAL, THE VINTAGE HOSPITAL, THE WOODLANDS HOSPITAL, AND LAKESIDE HOSPITAL. OTHER PARTICIPATING HOSPITALS WERE HOUSTON METHODIST HOSPITAL, MEMORIAL HERMANN HEALTH SYSTEM, AND TEXAS CHILDREN'S HOSPITAL. Schedule H, Part V, Section B, Line 6b Facility , 1 Facility , 1 - CHI St. Luke's Health Baylor St. Luke's Medial Center. EPISCOPAL HEALTH FOUNDATION Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - CHI ST. LUKE'S HEALTH BAYLOR ST. LUKE'S MEDICAL CENTER. THE SIGNIFICANT COMMUNITY HEALTH NEEDS THE HOSPITAL IS HELPING TO ADDRESS WERE IDENTIFIED IN THE HOSPITAL'S MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT. NEEDS BEING ADDRESSED BY STRATEGIES AND PROGRAMS ARE: ACCESS TO CARE, HUMAN TRAFFICKING, OBESITY, AND BEHAVIORAL HEALTH. THE HOSPITAL WILL TAKE ACTIONS TO HELP ADDRESS EACH OF THE SIGNIFICANT NEEDS. ACCESS TO CARE: DEFINE A PROCEDURE FOR TREATING AND/OR IDENTIFYING TRAFFICKED VICTIMS IN OUR FACILITIES AND COLLABORATING WITH COMMUNITY PARTNERS; PROVIDE EDUCATION FOR STAFF AND COMMUNITY REGARDING SERVICES, CULTURAL DIFFERENCE THAT EFFECT TREATMENT; COLLABORATE WITH COMMUNITY ORGANIZATIONS, CHURCHES, CIVIC GROUPS AND SUPPORT GROUPS TO PRESENT EDUCATIONAL SEMINARS; FOSTER NEW RELATIONSHIPS WITH PRIMARY CARE PROVIDERS AND HEALTHCARE SERVICE PROVIDERS TO ASSIST LINKING HOSPITAL PATIENTS TO MEDICAL HOMES. HUMAN TRAFFICKING: INCREASE PREVENTION AND TREATMENT RESOURCES IN AREAS OF PHYSICAL/SEXUAL ABUSE, HUMAN TRAFFICKING AND VIOLENCE IN SCHOOLS; PARTNER WITH HOUSTON WOMEN'S CENTER TO EDUCATE STAFF ON SIGNS TO RECOGNIZE ABUSED PATIENTS; PARTNER WITH LAW ENFORCEMENT AND SOCIAL SERVICE ORGANIZATIONS TO INCREASE TRAUMA INFORMED CARE TO HUMAN TRAFFICKING VICTIMS. OBESITY: PARTNER WITH SCHOOLS TO PROVIDE RESOURCES AND EDUCATIONAL SUPPORT FOR NUTRITION, OBESITY, AND HEALTHY LIFESTYLES AMONG YOUTH. BEHAVIORAL HEALTH: DEVELOP RESOURCES IN THE EMERGENCY DEPARTMENT TO MANAGE NEEDS OF BEHAVIORAL HEALTH PATIENTS; STRENGTHEN COMMUNITY PARTNERSHIPS TO ADVOCATE FOR ADDITIONAL SUPPORT FOR BEHAVIORAL HEALTH SPECIALISTS TO WORK ALONGSIDE CAREGIVERS. Schedule H, Part V, Section B, Line 13 Facility , 1 Facility , 1 - CHI ST. LUKE'S HEALTH BAYLOR ST. LUKE'S MED CNTR. The patient must have a minimum account balance of thirty-five dollars ($35.00) with the CHI Hospital Organization. Multiple account balances may be combined to reach this amount. Patients/Guarantors with balances below thirty-five dollars ($35) may contact a financial counselor to make monthly installment payment arrangements. The patient must submit a completed Financial Assistance application. Patient Cooperation Standards - A patient must exhaust all other payment options, including private coverage, federal, state and local medical assistance programs, and other forms of assistance provided by third-parties prior to being approved. An applicant for Financial Assistance is responsible for applying to public programs for available coverage. He or she is also expected to pursue public or private health insurance payment options for care provided by a CHI Hospital Organization within a Hospital Facility. A patient's and, if applicable, any Guarantor's cooperation in applying for applicable programs and identifiable funding sources, including COBRA coverage (a federal law allowing for a time-limited extension of employee healthcare benefits), shall be required. If a Hospital Facility determines that COBRA coverage is potentially available, and that a patient is not a Medicare or Medicaid beneficiary, the patient or Guarantor shall provide the Hospital Facility with information necessary to determine the monthly COBRA premium for such patient, and shall cooperate with Hospital Facility staff to determine whether he or she qualifies for Hospital Facility COBRA premium assistance, which may be offered for a limited time to assist in securing insurance coverage. A Hospital Facility shall make affirmative efforts to help a patient or patient's Guarantor apply for public and private programs. 2 Baylor St Lukes Medical Center - Ambulatory Surgery 1977 Butler Blvd HOUSTON TX 77030 Ambulatory Surgery Baylor St Lukes Medical Center Endoscopy 7200 Cambridge 4th floor HOUSTON TX 77030 Endoscopy Schedule H, Part I, Line 3c eligibility criteria to qualify for Financial Assistance Unless eligible for Presumptive Financial Assistance, the following eligibility criteria must be met in order for a patient to qualify for Financial Assistance: * The patient must have a minimum account balance of thirty-five dollars ($35.00) with the CHI Hospital Organization. Multiple account balances may be combined to reach this amount. Patients/Guarantors with balances below thirty-five dollars ($35) may contact a financial counselor to make monthly installment payment arrangements. * The patient's Family Income must be at or below 300% of the FPG. * The patient must comply with Patient Cooperation Standards as described [in the FAP]. * The patient must submit a completed Financial Assistance application. For patients and Guarantors who are unable to provide required documentation, a Hospital Facility may grant Presumptive Financial Assistance based on information obtained from other resources. In particular, presumptive eligibility may be determined on the basis of individual life circumstances that may include: * Recipient of state-funded prescription programs; * Homeless or one who received care from a homeless clinic; * Participation in Women, Infants and Children programs (WIC); * Food stamp eligibility; * Subsidized school lunch program eligibility; * Eligibility for other state or local assistance programs (e.g., Medicaid spend-down); * Low income/subsidized housing is provided as a valid address; or * Patient is deceased with no known estate. Schedule H, Part VI, Line 5 PROMOTION OF COMMUNITY HEALTH - ADDITIONAL EXPLANATION CHI ST. LUKE'S HEALTH BAYLOR COLLEGE OF MEDICINE MEDICAL CENTER CONTRIBUTES TO ENHANCING COMMUNITY HEALTH BY DELIVERING SUPERIOR VALUE IN HIGH-QUALITY, COST-EFFECTIVE CARE. AS A COMMUNITY TEACHING HOSPITAL AND A TERTIARY REFERRAL CENTER, CHI ST. LUKE'S SERVES BOTH THE GREATER HOUSTON AREA AND GLOBAL COMMUNITY. THE HOSPITAL ENGAGES IN MEDICAL RESEARCH THAT BEENFITS THE WIDER SOCIETY BY THE PRODUCTION OF NEW MEDEICAL KNOWELDGE. IN COLLABORATION WITH ITS MEDICAL STAFF, CHI ST. LUKE'S IS DEDICATED TO EXCELLENCE AND COMPASSION IN CARING FOR THE WHOLE PERSON - MIND, BODY AND SPIRT. THE HOSPITAL PROMOTES HEALTH FOR THE BENEFIT OF THE COMMUNITY. MEDICAL STAFF PRIVILEGES IN THE HOSPITAL ARE AVAILABLE TO ALL QUALIFIED PHYSICIANS IN THE AREA, CONSISTENT WITH THE SIZE AND NATURE OF ITS FACILITIES. ITS BOARD OF TRUSTEES IS COMPOSED OF CITIZENS IN THE COMMUNITY. EXCESS FUNDS ARE GENERALLY APPLIED TO EXPANSION AND REPLACEMENT OF EXISTING FACILITIES AND EQUIPMENT, AMORTIZATION OF INDEBTEDNESS, IMPROVEMENT IN PATIENT CARE, AND MEDICAL TRAINING, EDUCATION, AND RESEARCH. THE HOSPITAL TREATS PERSONS PAYING THEIR BILLS WITH THE AID OF PUBLIC PROGRAMS LIKE MEDICARE AND MEDICAID. ALL PATIENTS PRESENTING AT THE HOSPITAL FOR EMERGENCY AND OTHER MEDICALLY NECESSARY CARE ARE TREATED REGARDLESS OF THEIR ABILITY TO PAY FOR SUCH TREATMENT. ADDITIONALLY, CHI ST. LUKE'S HEALTH - BAYLOR ST. LUKE'S MEDICAL CENTER WORKED TO FURTHER ITS EXEMPT PURPOSE BY PROMOTING THE HEALTH OF THE COMMUNITY THROUGH A VARIETY OF PROJECTS AND ACTIVITIES. EDUCATION/ STROKE * SENIOR CENTER EDUCATION ARE PHYSICIAN AND NURSE LED EDUCATIONAL PROGRAMS PROVIDED TO PATIENTS AND COMMUNITY MEMBERS OFFERED THROUGHOUT THE YEAR ON VARIOUS STROKE TOPICS, INCLUDING EDUCATION AND PREVENTION. * STROKE SUPPORT GROUP: MEETS MONTHLY NEAR THE HOSPITAL- OPEN TO PATIENTS AND GENERAL PUBLIC. COMMUNITY SCREENINGS: STROKE SCREENING & EDUCATION CONDUCTED THROUGHOUT THE YEAR AT COMMUNITY EVENTS, HEALTH FAIRS AND SCHOOLS. TARGET POPULATION- BROAD COMMUNITY. * PROFESSIONAL COMMUNITY NEUROSCIENCE EDUCATION- MONTHLY PHYSICIAN AND NURSE LED EDUCATIONAL PROGRAMS TO PROVIDE PHYSICIANS, NURSES AND EMS EDUCATION ON VARIOUS TOPICS RELATED TO STROKE. SPEAKER EVENTS OFFERED BOTH AT THE HOSPITAL AND IN THE COMMUNITY. TARGET POPULATION- HEALTHCARE PROFESSIONALS GENERAL COMMUNITY NEUROSCIENCE EDUCATION * PHYSICIAN AND NURSE LED SPEAKER EVENTS ARE OFFERED THROUGHOUT THE YEAR ON A VARIETY OF OTHER TOPICS INCLUDING ATRIAL FIBRILLATION, PARKINSON'S DISEASE, ALZHEIMER'S DISEASE, AND COGNITIVE HEALTH. TARGET POPULATION - BROAD COMMUNITY, THOSE LIVING IN POVERTY, RACIAL, CULTURAL AND ETHNIC MINORITIES, UNINSURED/UNDERINSURED. SCREENING/HYPERTENSION * HYPERTENSION AND STROKE PREVENTION EDUCATION & SCREENING PROGRAMS ARE OFFERED THROUGHOUT THE YEAR AT COMMUNITY EVENTS- INCLUDING HEALTH FAIRS, FESTIVALS, AND IN SCHOOLS. SCREENINGS ARE ALSO DONE TWICE ANNUALLY INSIDE THE HOSPITAL FOR OUR GUESTS, PATIENTS & EMPLOYEES. TARGET POPULATION- BROAD COMMUNITY; THOSE LIVING IN POVERTY; RACIAL, CULTURAL, AND ETHNIC MINORITIES; UNINSURED/UNDERINSURED. * AMERICAN HEART/STROKE WALK - THE HEART WALK IS THE AMERICAN HEART ASSOCIATION'S PREMIERE EVENT FOR RAISING FUNDS TO SAVE LIVES FROM THIS COUNTRY'S NO. 1 AND NO. 5 KILLERS - HEART DISEASE AND STROKE. EMPLOYEES VOLUNTEER ONE DAY IN NOVEMBER TO HELP WITH ACTIVITIES. FOR MORE INFORMATION REGARDING THE HOSPITAL'S ACTIVITIES AND ACCOMPLISHMENTS, PLEASE VISIT HTTP://WWW.CHISTLUKESHEALTH.ORG/BAYLORSTLUKES. Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance THE COST TO CHARGE RATIO METHOD WAS UTILIZED TO DETERMINE FINANCIAL ASSISTANCE AT COST AS WELL AS TO DETERMINE UNREIMBURSED MEDICAID COSTS. TOTAL EXPENSES PER FORM 990, PART IX, LINE 25(A) WERE REDUCED BY BAD DEBT EXPENSE IN THE AMOUNT OF $29,872,629 TO DETERMINE THE PERCENTAGE IN SCHEDULE H, PART I, LINE 7(F). Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount Costing methodology for amounts reported on line 2 is determined using the organization's cost/charge ratio. When discounts are extended to self-pay patients, these patient account discounts are recorded as a reduction in revenue, not as bad debt expense. Schedule H, Part III, Line 3 Bad Debt Expense Methodology CHI ST. LUKE'S HEALTH BAYLOR ST. LUKE'S MEDICAL CENTER ("MEDICAL CENTER") does not believe that any portion of bad debt expense could reasonably be attributed to patients who qualify for financial assistance since amounts due from those individuals' accounts will be reclassified from bad debt expense to charity care within 30 days following the date that the patient is determined to qualify for charity care. Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote Patient service revenue is reported at the amounts that reflect the consideration of the Medical Center expects to be paid in exchange for providing patient care. These amounts are due from patients, third-party payors (including health insurers and government programs), and others and include consideration for retroactive revenue adjustments due to settlement of audits and reviews. Generally, performance obligations for patients receiving inpatient acute care services and outpatient services are recognized over time as services are provided. Performance obligations are generally satisfied over a period less than one year. As such, the Medical Center has elected to apply the optional exemption provided in FASB Accounting Standards Updated (ASU) No. 2015-14, Revenue from Contracts with Customers (topic 606) and is not required to disclose the aggregate amount of the transaction price allocated to performance obligations that are unsatisfied or partially unsatisfied at the end of the reporting period. The Medical Center accepts patients in immediate need of care, regardless of their ability to pay. Patient accounts receivable are reported net of estimated allowances for contractual adjustments, price concessions, and other discounts. The Medical Center determines the transaction price based on standard charges for services provided to uninsured and underinsured patients in accordance with the Medical Center's financial assistance policy, and implicit price concessions provided to uninsured and underinsured patients. The Medical Center determines its estimates of contractual adjustments and discounts based on contractual agreements, its discount policy, and historical experience. The Medical Center determines its estimate of implicit price concessions based on its historical collection experience with these classes of patients using a portfolio approach as a practical expedient to account for patient contracts as collective groups rather than individually. Management relies on the results of detailed reviews of historical write-offs and collections in estimating the collectability of accounts receivable. Updates to the hindsight analysis are performed at least quarterly using primarily a rolling eighteen-month collection history and write-off data. Subsequent changes to estimates of the transaction price are generally recorded as adjustments to net patient revenue in the period of the change. Subsequent changes that are determined to be result of an adverse change in a third-party payor's ability to pay are recorded as bad debt expense in services and other in the accompanying consolidated statements of operations and changes in net assets. Bad debt expense for 2019 was not significant. Agreements with third-party payors typically provide for payments at amounts less than established charges. Net patient revenue includes estimated settlements under payment agreements with third party payors. Settlements with third-party payors are accrued on an estimated basis in the period in which the related services are rendered and adjusted in future periods as final settlements are determined. These settlements are estimated and evaluated based on the terms of the payment agreement with the payor, correspondence from the payor, and historical settlement activity. Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs Using essentially the same Medicare cost report principles as to the allocation of general services costs and "apportionment" methods, the "CHI Workbook" calculates a payers' gross allowable costs by service (so as to facilitate a corresponding comparison between gross allowable costs and ultimate payments received). The term "gross allowable costs" means costs before any deductibles or co-insurance are subtracted. The Medical Center's ultimate reimbursement will be reduced by any applicable copayment/ deductible. Where Medicare is the secondary insurer, amounts due from the insured's primary payer were not subtracted from Medicare allowable costs because the amounts are typically immaterial. Although not presented on the Medicare cost report, in order to facilitate a more accurate understanding of the "true" cost of services (for "shortfall" purposes) the CHI Workbook allows a health care facility not to offset costs that Medicare considers to be non-allowable, but for which the facility can legitimately argue are related to the care of the facility's patients. In addition, although not reportable on the Medicare cost report, the CHI workbook includes the cost of services that are paid via a set fee-schedule rather than being reimbursed based on costs (e.g. outpatient clinical laboratory). Finally, the CHI Workbook allows a facility to include other health care services performed by a separate facility (such as a physician practice) that are maintained on separate books and records (as opposed to the main facility's books and records which has its costs of service included within a cost report). True costs of Medicare computed using this methodology: Total Medicare Revenue: $189,966,639 Total Medicare costs: $375,572,546 Shortfall $185,605,907 The Medical Center believes that excluding Medicare losses from community benefit makes the overall community benefit report more credible for these reasons: Unlike subsidized areas such as burn units or behavioral-health services, Medicare is not a differentiating feature of tax-exempt health care organizations. In fact, for-profit hospitals focus on attracting patients with Medicare coverage, especially in the case of well-paid services that include cardiac and orthopedics. Significant effort and resources are devoted to ensuring that hospitals are reimbursed appropriately by the Medicare program. The Medicare Payment Advisory Commission (MedPAC), an independent Congressional agency, carefully studies Medicare payment and the access to care that Medicare beneficiaries receive. The commission recommends payment adjustments to Congress accordingly. Though Medicare losses are not included by Catholic hospitals as community benefit, the Catholic Health Association guidelines allow hospitals to count as community benefit some programs that specifically serve the Medicare population. For instance, if hospitals operate programs for patients with Medicare benefits that respond to identified community needs, generate losses for the hospital, and meet other criteria, these programs can be included in the CHA framework in Category C as "subsidized health services." Medicare losses are different from Medicaid losses, which are counted in the CHA community benefit framework, because Medicaid reimbursements generally do not receive the level of attention paid to Medicare reimbursement. Medicaid payment is largely driven by what states can afford to pay, and is typically substantially less than what Medicare pays. Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance The organization's billing and collections policy applies to all individuals presenting for emergency or other medically necessary care. The policy contains provisions for collecting amounts due from those patients who the organization knows to qualify for financial assistance either through the traditional financial assistance application process or through presumptive eligibility processes. Before engaging in extraordinary collection actions (ECAs) to obtain payment for EMCare, Hospital Facilities must make reasonable efforts through its billing and collections processes, pursuant to Treas. Reg. §1.501(r)-6(c), to determine whether an individual is eligible for Financial Assistance. In no event will an ECA be initiated prior to 120 days from the date the Facility provides the first post-discharge billing statement (i.e., during the Notification Period) unless all reasonable efforts have been made. Hospital Facilities will not refer accounts for collection where the patient has initially applied for Financial Assistance, and the Hospital Facility has not yet made reasonable efforts with respect to the account. For patients and Guarantors who are unable to provide required documentation, a Hospital Facility may grant Presumptive Financial Assistance based on information obtained from other resources. Patients who qualify for Medicaid are presumed to qualify for full charity write off. Any charges for days or services written off (excluding Medicaid denials related to timeliness of billing, insufficient medical record documentation, missing invoices, authorization, or eligibility issues) as a result of a Medicaid are booked as charity. Some Medicaid plans offer coverage for a limited or restricted list of services. If a patient is eligible for Medicaid, any charges for days or services not covered by the patient's coverage may be written off to charity without a completed application. This does not include any Share of Cost (SOC) or other patient cost-sharing amounts such as deductibles or copayments, as such costs are determined by the state to be an amount that the patient must pay before the patient is eligible for Medicaid. Health and Human Services (HSS) uses the term "Spend Down" instead of Share of Cost. All collection activities conducted by the Facility, a Designated Supplier, or its third-party collection agents will be in conformance with all federal and state laws governing debt collection practices. All third-party agreements governing collection and recovery activities must include a provision requiring compliance with the hospital facilities' financial assistance and billing and collections policy and indemnification for failures as a result of its noncompliance. This includes, but is not limited to, agreements between third parties who subsequently sell or refer debt of the Hospital Facility. Schedule H, Part V, Section B, Line 16a FAP website - CHI ST. LUKE'S HEALTH BAYLOR ST. LUKE'S MED CNTR: Line 16a URL: http://www.chistlukeshealth.org/financial-assistance; Schedule H, Part V, Section B, Line 16b FAP Application website - CHI ST. LUKE'S HEALTH BAYLOR ST. LUKE'S MED CNTR: Line 16b URL: http://www.chistlukeshealth.org/financial-assistance; Schedule H, Part V, Section B, Line 16c FAP plain language summary website - CHI ST. LUKE'S HEALTH BAYLOR ST. LUKE'S MED CNTR: Line 16c URL: http://www.chistlukeshealth.org/financial-assistance; Schedule H, Part VI, Line 2 Needs assessment THE CHNA IS THE PRIMARY WAY BY WHICH THE HOSPITAL FORMALLY ASSESSES COMMUNITY HEALTH NEEDS. Schedule H, Part VI, Line 3 Patient education of eligibility for assistance Notification about the availability of Financial Assistance from CHI Hospital Organizations shall be disseminated by various means, which may include, but not be limited to: * Conspicuous publication of notices in patient bills; * Notices posted in emergency rooms, urgent care centers, admitting/registration departments, business offices, and at other public places as a Hospital Facility may elect; and * Publication of a summary of this Policy on the Hospital Facility's website, www.catholichealth.net, and at other places within the communities served by the Hospital Facility as it may elect. Such notices and summary information shall include a contact number and shall be provided in English, Spanish, and other primary languages spoken by the population served by an individual Hospital Facility, as applicable. Referral of patients for Financial Assistance may be made by any member of the CHI Hospital Organization non-medical or medical staff, including physicians, nurses, financial counselors, social workers, case managers, chaplains, and religious sponsors. A request for assistance may be made by the patient or a family member, close friend, or associate of the patient, subject to applicable privacy laws. In addition, Hospital registration clerks are trained to provide consultation to those who have no insurance or potentially inadequate insurance concerning their financial options including application for Medicaid and for assistance under the Financial Assistance Policy. Counselors assist Medicare eligible patients in enrollment by providing referrals to the appropriate government agencies. Once it is determined that the patient does not qualify for any third party funding, the patient is verbally notified about the existence of Financial Assistance Application and additional screening takes place by a Hospital employee to determine if the patient is eligible for charity service prior to discharge. Upon registration (and once all EMTALA requirements are met), patients who are identified as uninsured (and not covered by Medicare or Medicaid) are provided with a packet of information that addresses the Financial Assistance Policy, the plain language summary of that policy, and an application for assistance. Hospital registration clerks read the organization's medical assistance policy to those who appear to be incapable of reading, and provide translators for non-English-speaking individuals. Patients that have been discharged prior to charity screening, such as emergency room patients, receive a written notification of possible eligibility for services. If the patient is determined not to be eligible for government assistance, he/she may notify the hospital that they seek charity assistance. The appropriate charity form is sent to the patient/guarantor for completion and then returned to the hospital for evaluation and qualification. Once determination of eligibility is made, the patient is sent a notice informing him/her if they qualify for full, partial, or no charity care services. Hospital Facilities must make reasonable efforts through its billing and collections processes, pursuant to Treas. Reg. §1.501(r)-6(c), to determine whether any individual is eligible for Financial Assistance. Schedule H, Part VI, Line 4 Community information THE COMMUNITY SERVED BY CHI ST. LUKE'S HEALTH IS DEFINED AS THE CONTIGUOUS ZIP CODES DETERMINED BY BAYLOR ST. LUKE'S HOSPITAL DISCHARGE DATA. LOCATED IN HOUSTON, TEXAS, THE BAYLOR ST. LUKE'S HOSPITAL SERVICE AREA INCLUDES A LARGE METROPOLITAN AREA, AS WELL AS MANY SMALLER SUBURBAN AND RURAL COMMUNITIES. THE HOSPITAL SERVICE AREA INCLUDES 39 TEXAS COUNTIES, WITH THE MAJORITY OF THE SERVICE AREA FOUND WITHIN HARRIS, FORT BEND, BRAZORIA, AND GALVESTON COUNTIES. BAYLOR ST. LUKE'S SERVES AN AREA THAT IS HOME TO A POPULATION OVER TWO MILLION RESIDENTS THAT REPRESENT DIVERSE ETHNICITIES, BACKGROUNDS AND NEEDS. KEY DESCRIPTORS OF THE COMMUNITY INCLUDE: AGE: THE LARGEST POPULATION IN THE COMMUNITY FALLS IN THE AGE CATEGORY OF 18-44 YEARS (38.2%). THE SECOND-LARGEST AGE CATEGORY IS 00-17 YEARS (26.3). THERE IS THE SMALLEST NUMBER OF PERSONS IS IN THE OLDEST TWO CATEGORIES OF 15-64 YEARS (24.2%) AND 65+ YEARS (11.3%). RACE/ETHNICITY: THE MAJORITY OF COMMUNITY RESIDENTS IDENTIFY AS HISPANIC (38.4%) AND WHITE/NON-HISPANIC (32.5%). 17.6% OF THE POPULATION IDENTIFIES AS BLACK/NON-HISPANIC AND 9.5% AS ASIAN/NON-HISPANIC. EDUCATION: 16.9% OF THE POPULATION HAD LESS THAN A HIGH SCHOOL DIPLOMA AND 31.7% HAD A BACHELOR'S DEGREE OR HIGHER. INCOME: 18.2% OF THE POPULATION HAS A HOUSEHOLD INCOME OF LESS THAN $25,000 PER YEAR, WHILE 44.2% HAD AN INCOME OF $75,000 OR MORE. Schedule H, Part VI, Line 5 Promotion of community health The organization's hospital facility(ies) promote health for the benefit of the community. Medical staff privileges in the hospital are available to all qualified physicians in the area, consistent with the size and nature of its facilities. The organization's hospital facility(ies) have an open medical staff. Its board of trustees is composed of prominent citizens in the community. Excess funds are generally applied to expansion and replacement of existing facilities and equipment, amortization of indebtedness, improvement in patient care, and medical training, education, and research. The facility(ies) treat persons paying their bills with the aid of public programs like Medicare and Medicaid. All patients presenting at the hospital for emergency and other medically necessary care are treated regardless of their ability to pay for such treatment. Schedule H, Part VI, Line 6 Affiliated health care system St. Luke's Health System Corporation is a separate legal entity and is a Texas nonprofit medical education corporation under the direction of CHI and a separate board of directors. The System provides direct services and employees to BCMMC for the operation of the Medical Center. All of the Medical Center employees are contracted from the System. The System charges the Medical Center for the wages and benefits paid to these employees, which are reflected as personnel costs in the accompanying consolidated statements of operations. The System provides corporate services for human resources, finance, information management, purchasing, compliance, managed care contracting, legal, risk management, medical records, patient financial services, and quality. Baylor College of Medicine is a separate legal entity and is a Texas nonprofit medical education corporation under the direction of a separate board of directors. The Medical Center executed an Academic Affiliation Agreement with BCM effective January 1, 2014. Under this agreement, as amended, BCM provides oversight and management of major clinical programs, research services, medical directorships, coverage services for key areas, graduate medical education, and miscellaneous services. Schedule H, Part VI, Line 7 State filing of community benefit report TX true SOLEO HEALTH INC 8275 El Rio Street Suite 180 Houston TX 77054 464908851 10619 Program Support PARAGON INFUSION CARE 6721 Portwest Drive Suite 100 Houston TX 77024 061639157 6076 Program Support 0 2 Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds. THE ORGANIZATION GRANTS FUNDS TO OTHER ORGANIZATIONS AND REQUIRES ALL GRANT RECIPIENTS TO MEASURE THEIR SUCCESS IN ATTAINING PROGRAM GOALS. true false false false false false false true false T DOUGLAS LAWSON PHD EX-OFFICIO/CEO CHI St. Luke's Health System 733582 0 443750 0 178378 0 126625 0 19644 0 1501979 0 0 0 PAUL WARDA TREASURER (PARTIAL YEAR) 279258 0 50000 0 96449 0 17123 0 8469 0 451299 0 0 0 GAY NORD Ex-Officio Non-voting- PRESIDENT-ST LUKES (Partial) 672589 0 32423 0 22612 0 77423 0 20470 0 825517 0 0 0 MARK MCGINNIS CFO OF CHI ST. LUKE'S HEALTH SYSTEM 549815 0 127460 0 80685 0 41025 0 29752 0 828737 0 0 0 Priscilla Needham TREASURER/VP-FINANCE 85265 0 25000 0 57824 0 17175 0 4963 0 190227 0 0 0 ALENE JACKSON DIRECTOR-PATIENT CARE 213337 0 3457 0 1305 0 13261 0 18946 0 250306 0 0 0 JENNIFER NITSCHMANN MKT SVP-PATIENT CARE SERVICES 290926 0 8937 0 5238 0 15574 0 10842 0 331517 0 0 0 BRENDA BENAVIDEZ RN 283129 0 0 0 990 0 13033 0 28054 0 325206 0 0 0 DAVID BERGER SVP-OPERATIONS 385833 0 12005 0 6112 0 16375 0 2304 0 422629 0 0 0 NATALIE LYLES RN 229873 0 2000 0 6286 0 13089 0 28202 0 279450 0 0 0 EBELE NJEAKO RN 243468 0 2000 0 2801 0 13380 0 28120 0 289769 0 0 0 JANINE ONAMBELE RN-II 227183 0 2000 0 2495 0 0 0 24464 0 256142 0 0 0 Schedule J, Part I, Line 4a Severance or change-of-control payment Compensation for Baylor St. Luke's Medical Center is determined by Catholic Health Initiatives, an affiliate of St. Luke's Health System Corporation. The following disclosure explains CHI's processes in determinting compensation for St. Luke's Medical Center employees. During the calendar year 2018, post-termination payments were addressed in executive employment agreements for Catholic Health Initiatives and related organizations' employees at the level of Vice President and above, including the MBO CEOs. These employment agreements require that in order for the executive to receive post-termination payments, these individuals must execute a general release and settlement agreement. Post-termination payment arrangements are periodically reviewed for overall reasonableness in light of the executive's overall compensation package. The following reportable individuals received severance payments from Catholic Health Initiatives (a Related Organization) during the 2018 calendar year, and these severance payments were included in the individual's W-2 income and reportable compensation on Schedule J: Richelle Webb Dixon - $18,462 Paul Warda - $93,750 Schedule J, Part I, Line 7 Non-fixed payments ST. LUKE'S EXECUTIVES HAVE A NUMBER OF ANNUAL AND LONG TERM GOALS. FINANCIAL PERFORMANCE, QUALITY, PEOPLE, CUSTOMER SERVICE, AND GROWTH ARE EXAMPLES OF AREAS WHERE PERFORMANCE INDICATORS MAY BE ESTABLISHED. PERFORMANCE ON ALL GOALS IS EXAMINED BY THE SYSTEM BOARD AND AN AWARD LEVEL IS DETERMINED BASED ON OVERALL PERFORMANCE AGAINST TARGETS OR GOALS. IF AN AWARD IS GRANTED, IT IS EXPRESSED AS A PERCENTAGE OF THE INDIVIDUAL'S BASE INCOME. Schedule J, Part II COMPENSATION FROM AN UNRELATED ORGANIZATION OR INDIVIDUAL NAME - T. DOUGLAS LAWSON, PHD, COMPENSATION FROM UNRELATED ORGANIZATION - 1501979.000000, NAME OF UNRELATED ORGANIZATION - CATHOLIC HEALTH INITIATIVES, TYPE OF COMPENSATION - OFFICER SALARY Schedule J, Part II COMPENSATION FROM AN UNRELATED ORGANIZATION OR INDIVIDUAL NAME - MARK MCGINNIS, COMPENSATION FROM UNRELATED ORGANIZATION - 828737.000000, NAME OF UNRELATED ORGANIZATION - CATHOLIC HEALTH INITIATIVES & ST. LUKE'S HEALTH SYSTEM CORP, TYPE OF COMPENSATION - OFFICER SALARY Form 990, Part V, Line 1a FORM 1096 REPORTING Payments to vendors are made by Catholic Health Initiatives, an affiliate of St. Luke's Health System Corporation, on Baylor St. Luke's Medical Center's behalf. Therefore, no Form 1099s are issued by the organization. CHI files the form 1099s and complies with the backup withholding rules for reportable payments to vendors and gaming winnings. The 1099s issued by CHI on behalf of the organization are reported to the IRS. Form 990, Part VI, Line 14 WRITTEN DOCUMENT RETENTION AND DESTRUCTION POLICY ST LUKE'S HEALTH SYSTEM CORPORATION AND RELATED ENTITIES HAVE A WRITTEN GENERAL POLICY RELATED TO DOCUMENT RETENTION AND DESTRUCTION. DOCUMENTS AND RECORDS ARE RETAINED FOR VARIOUS FEDERAL, STATE OR OTHER JURISDICTION STATUTES FOR MEDICAL OR FINANCIAL REVIEW ON A DEPARTMENT BY-DEPARTMENT BASIS. Form 990, Part VI, Line 12c Conflict of Interest Policy b) Board evaluation of transactions involving an officer / board member conflict of interest - I. The board carefully scrutinizes and must in good faith approve or disapprove any transaction in which CHI or a CHI entity is a party and in which the trustee or a corporate officer either: 1. Has a material financial interest; or 2. Is a trustee or corporate officer of the other party (other than a CHI affiliated organization). II. The board must approve the transaction by a majority of the trustees on the board (not counting any interested trustee). In reviewing such transactions between CHI or CHI entities and vendors or other contractors who are, or are affiliated with, trustees or corporate officers, the board acts no more or less favorably than it would in reviewing transactions with unrelated third parties. The transaction is not approved unless the board determines that the transaction is fair to CHI or the CHI entity. III. A conflicted trustee or corporate officer is not permitted to use his or her personal influence with respect to the approval or disapproval of the conflicted transaction. However, if requested, such trustee or corporate officer is not prevented from briefly stating his or her position in the matter, nor from answering pertinent questions from trustees, as his or her knowledge may be relevant. The trustee or corporate officer is excused from the meeting during discussion and vote on the conflict of interest. c) Board evaluation of non-transactional conflicts - I. The board carefully reviews and scrutinizes any non-transactional conflict of interest (e.g., disclosure of nonpublic information, competition with CHI or a CHI entity, failure to disclose a corporate opportunity, excessive gifts or entertainment, etc.). II. In such circumstances, by a majority vote of the disinterested trustees, the board takes whatever action is deemed appropriate with respect to the trustee or corporate officer under the circumstances (including possible disciplinary or corrective action) to best protect the interests of CHI or the CHI entity. The board is encouraged to consult with the general counsel of CHI or his or her designee when considering disciplinary or corrective action. III. The conflicted trustee or corporate officer is not permitted to use his or her personal influence with respect to the conflict matter. However, if requested, such trustee or corporate officer is not prevented from briefly stating his or her position in the matter, nor from answering pertinent questions from trustees, as his or her knowledge may be relevant. The trustee or corporate officer is excused from the meeting during discussion and vote on the conflict of interest. d) Record of proceedings - with respect to board member and officer conflicts of interest, minutes of the board are expected to reflect the identity of the individual making the disclosure, the nature of the disclosure, discussion regarding any proposed transaction, the decision made by the board, and that the interested trustee or corporate officer was excused during the discussion, and that the interested trustee abstained from voting. D. Conflicts reporting: All conflicts of interest are reported by CHI as required by law, regulations, and policy. Form 990, Part VI, Line 1a Delegate broad authority to a committee Pursuant to Section 8.5 of the Bylaws of CHI St. Luke's Health Baylor College of Medicine Medical Center, the Executive Committee is composed of the board chair, at least one BCM Appointee, and at least one St. Luke's Appointee, and the President, who shall serve as an ex officio voting member of the Executive Committee. Each individual appointed to the Executive Committee shall serve for a term of one year or until his or her successor is duly appointed by the Board of Directors. The Executive Committee shall consist of only voting board members of the Corporation. Pursuant to Section 8.1 of the Corporation's bylaws, committees, such as the executive committee, that are granted the authority to act on behalf of the board of directors may include only voting board members of the corporation. Further, pursuant to Section 8.5 of the Corporation's bylaws, the executive committee has and may exercise such powers as may be delegated to it by the board of directors. The Executive Committee also possesses the power to transact routine business of the corporation in the interim period between regularly scheduled meetings of the board of directors. Form 990, Part VI, Line 6 Classes of members or stockholders According to the bylaws, both CHI ST. LUKE'S HEALTH SYSTEM CORPORATION, A TEXAS NONPROFIT CORPORATION, AND Baylor College of Medicine SHALL BE MEMBERS OF CHI ST. LUKE'S HEALTH BAYLOR COLLEGE OF MEDICINE MEDICAL CENTER. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body According to the organization's bylaws, directors shall be appointed or refused by the corporate member. The corporate member may appoint one or more individuals to the board of directors, and may at any time remove, with or without cause, any member of the board of directors. According to the organization's bylaws, directors of the corporation shall be appointed by the corporate member no later than June 30 of each year. The names and qualifications of each individual accepted by the board of directors shall be submitted to the corporate member, who shall appoint or refuse each nominee in accordance with the corporate member's bylaws and with endorsement of the senior vice president of operations. The corporate member may unilaterally appoint one or more individuals to the board of directors should the board fail to furnish the corporate member with a list of individuals qualified to serve on the board of directors of the corporation. (CHCF Reserved Rights) Except as otherwise provided in the Corporation's Articles of Incorporation or the laws of the State of organization, Catholic Health Care Federation ("CHCF") shall have such rights as are reserved to the Corporate Member, acting in its capacity as the membership body of CHCF, under the Governance Matrix. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders In addition to the other actions specified in the Bylaws requiring the approval of both Corporate Members, the following actions shall require the prior approval of solely Baylor College of Medicine ("BCM"): (a) Any substantial change to the mission, values, purpose, or general character of the Corporation; (b) Incurrence of debt by the Corporation that results in the Corporation maintaining an equivalent Moody's rating of BBB or lower; (c) Admission of any new members of the Corporation; (d) Merger, consolidation, reorganization, dissolution, or bankruptcy of the Corporation; (e) Changes in tax-exempt status of the Corporation or any change that causes a change in the Corporation's tax-exempt status; (f) Transfer of membership interests in the Corporation other than as permitted by the Membership Agreement; (g) Agreements with an annual value of $2.5 million or more (or amendments to agreements) with affiliates of the Corporate Members (i.e., any agreement between the Corporation, on the one hand, and CHI St. Luke's, BCM or any of their respective Affiliates, on the other hand); provided, however, that the Corporation shall be permitted, without approval of BCM to enter into any agreements as may be provided in the Membership Agreement; (h) Sale of substantially all of the assets of the Corporation; (i) Any change to the name of the Medical Center; (j) Any changes to the Corporation's medical staff bylaws that would affect academic accreditation, the medical staff leadership appointment process; (k) Any material changes to the Corporation's medical staff appointment process that adversely affects BCM; (l) Approval of the Corporation's strategic plans; (m) Elimination of any of the Corporation's service lines or programs required for academic accreditation of BCM and not due to financial exigency; (n) Sale or conveyance of any real property or building located at the Medical Center; (o) Subject to the Membership Agreement, additional capital contribution or other contributions or assumption or guarantee of debt by BCM; and (p) Approval of the Master Facility Plan as relevant to the Medical Center, In addition to the other actions specified in the Bylaws requiring the approval of both Corporate Members, the following actions shall require the prior approval of soley St. Luke's Health System Corporation ("CHI St. Luke's"): (a) Any substantial change to the mission, values, purpose, or general character of the Corporation; (b) Admission of any new members of the Corporation; (c) Merger, consolidation, reorganization, dissolution, or bankruptcy of the Corporation; (d) Changes in tax-exempt status of the Corporation or any change that causes a change in the Corporation's tax-exempt status; (e) Transfer of membership interests in the Corporation other than as permitted by the Membership Agreement; (t) Agreements with an annual value of $2.5 million or more (or amendments to agreements) with affiliates of the Corporate Members (i.e., any agreement between the Corporation, on the one hand, and CHI St. Luke's, BCM or any of their respective Affiliates, on the other hand); provided, however, that the Corporation shall be permitted, without approval of BCM, to enter into any agreements as may be provided in the Membership Agreement; (g) Sale of substantially all of the assets of the Corporation; (h) Consistent with the President search process set forth in Section 7.2.1 of the Bylaws, the appointment and removal of the Corporation's President; (i) Approval of the Corporation's strategic plans; (j) Any change to the Corporation's facility name; (k) Any changes to the Corporation's medical staff bylaws that affect academic accreditation or the medical staff leadership appointment process; and (l) Other reserve powers as required by GAAP to effect economic consolidation on CHPs financial statements; provided, however, that, in the spirit of the Corporate Members' agreement in the Membership Agreement, any such additional reserve powers will be minimized to the maximum extent possible so as to limit to the maximum extent possible the impact on the Corporate Members' rights and obligations set forth in the Membership Agreement. Form 990, Part VI, Line 11b Review of form 990 by governing body THE RETURN WAS MADE AVAILABLE TO THE OFFICERS AND DIRECTORS BEFORE FILING. SUBSEQUENT TO THE RETURN BEING PROVIDED TO THE BOARD, THE TAX DEPARTMENT FILES THE RETURN WITH THE APPROPRIATE FEDERAL AND STATE AGENCIES, MAKING ANY NON-SUBSTANTIVE CHANGES NECESSARY TO EFFECT E-FILING. ANY SUCH CHANGES ARE NOT RESUBMITTED TO THE BOARD. Form 990, Part VI, Line 12c Conflict of interest policy The organization has a conflicts of interest ("COI") policy (the "policy") in place to maintain the integrity of its activities. Through February 7, 2019, conflicts were administered solely through Catholic Health Initiatives' ("CHI") Governance Policy No. 1 (described below). On February 8, 2019, in connection with the alignment of the Catholic Health Ministries of CHI and Dignity Health, the CommonSpirit Health Board of Stewardship Trustees approved CommonSpirit Health Corporate Responsibility Policy No. G-001, a CommonSpirit Health conflicts of interest policy. This policy stipulates that, at minimum, the pre-closing CHI COI policies and pre-closing Dignity Health COI policies identify the individuals that are covered under the new policy. In addition, subject to certain exceptions, pre-closing CHI COI policies shall continue to apply to the CHI entities and the individuals who were subject to the Pre-Closing CHI COI policies; and the Pre-Closing Dignity Health COI policies shall continue to apply to the Dignity Health entities and the individuals who were subject to the Pre-Closing Dignity Health COI policies. Until CommonSpirit Health adopts a single process for identifying and managing conflicts of interest for all system entities, the following individuals shall be subject to the Pre-Closing CHI COI policies from and after the effective date of Corporate Responsibility Policy No. G-001: 1. Members of the CommonSpirit Health Board of Stewardship Trustees and members of the committees of the Board of Stewardship Trustees; 2. Corporate officers of CommonSpirit Health; 3. Members of the Board of Directors of Dignity Health and members of the committees of the Board of Directors of Dignity Health. CHI Governance Policy No. 1: The policy applies to the following persons: members of the CHI board of stewardship trustees and its committees; members of any CHI direct affiliate or subsidiary (each a CHI entity) board and their committees; employees of CHI entities, and all CHI researchers (as defined in the policy). Disclosure, review and management of perceived, potential or actual conflicts of interest are accomplished through a defined COI disclosure review process. A. Disclosure obligations: 1. Ongoing: Each person is required to promptly and fully disclose to his/her direct manager, supervisor, medical staff office, board or board committee chair any situation or circumstance that may create a conflict of interest. The person must disclose the actual or potential conflict as soon as she/he becomes aware of it. In any situation in which the person is in doubt it is expected that full disclosure be made to permit an impartial and objective determination as to the existence of a conflict. 2. Periodic written: In addition to the ongoing disclosure obligation, periodic written conflict of interest disclosure forms must be completed as follows: a) Initially: 1) Upon hiring (employees), 2) Appointment (board / committee members), 3) Upon consideration of affiliation with research sponsor (researchers). b) Annually: 1) Board / committee members, 2) Employees at the level vice president or above, 3) Researchers, 4) Supply chain employees at the level of vice president and above and those employees involved in contracting regardless of employment level, 5) Other employees as determined by CommonSpirit Health leadership. 3. Failure to disclose - an individual who fails to disclose a perceived, potential, or actual conflict of interest, or all material facts surrounding an actual or potential conflict or fails to abide by the final decision regarding the conflict may be subject to disciplinary or corrective actions such as termination of employment, removal from a board or committee, loss or restriction of clinical privileges, or restrictions on research activities in accordance with applicable laws, regulations, rules, contracts, and bylaws. B. Conflicts review: 1. No disclosed conflicts: In the absence of perceived, potential or actual conflicts of interest, no follow-up conflicts review is required or performed. 2. Disclosure of perceived, potential or actual conflicts: a) Are initially reviewed by national or regional legal or corporate responsibility team members (depending upon the role of the individual disclosing the actual or potential conflict) to determine whether an actual or potential for a conflict may exist. b) If it is determined that a potential or actual conflict may exist, I. In the case of board or committee members or officers, issues are elevated to the executive committee of the board or board chair. II. In the case of other persons, conflicts issues are elevated to the conflicts of interest review committee ("C-CIRC"). C. Conflicts determination and management: 1. Matters elevated to C-CIRC: a) The C-CIRC determines whether a disclosed or otherwise identified interest is a conflict of interest. If the C-CIRC determines that a COI exists, and adequate controls are not in place to mitigate the conflict, the C-CIRC facilitates development of a COI management plan designed to mitigate the conflict. Designated entity staff are responsible for monitoring the COI management plan and for documenting monitoring activities. Notwithstanding the foregoing, at its sole discretion, an entity may reject a person's request to enter into the relationship in question, or require the relationship be sufficiently altered to avoid a potential conflict of interest. b) Appeal - if a person does not agree with a determination made by the C-CIRC, its interpretation of the COI policy, still seeks an exemption or exception, or seeks further clarification of the C-CIRC 's decision, the individual may appeal the decision through his or her manager for reconsideration by the C-CIRC, and the C-CIRC will review and issue a final determination based upon any new or additional information presented. 2. Matters elevated to the executive committee or board chair: a) Determination of existence of conflict - the board chair or his or her designee performs any further investigation of any conflict of interest disclosures as he or she may deem appropriate. If the conflict involves the board chair, the vice chair assumes the chair's role outlined in the COI policy. Based on review and evaluation of the relevant facts and circumstances, the board chair makes an initial determination as to whether a conflict of interest exists and whether, pursuant to the COI policy, review and approval or other action by the board is required. A written record of the board chair's determination, including relevant facts and circumstances, is made. The board chair then makes an appropriate report to the executive committee of the board concerning the COI review, evaluation and determination. If a difference of opinion exists between the board chair and another trustee as to whether the facts and circumstances of a given situation constitute a conflict of interest or whether board review and approval or other action is required under the COI policy, the matter is submitted to the board's executive committee, which makes a final determination as to the matter presented. That determination, including relevant facts and circumstances, is reflected in the executive committee minutes and is reported to the board. (Continued on Schedule O) Form 990, Part VI, Line 15b Process to establish compensation of other employees COMPENSATION FOR THE OTHER OFFICERS OF THE ORGANIZATION WAS ESTABLISHED BY THE HUMAN RESOURCES DIRECTOR USING COMPENSATION SURVEYS OR STUDIES BASED ON GEOGRAPHICAL LOCATION. Form 990, Part VI, Line 19 Required documents available to the public The organization's financial statements, conflict of interest policy and governing documents are available to the public upon request. Form 990, Part VIII, Line 11d Other Miscellaneous Revenue Other Miscellaneous Revenue - Total Revenue: 1459863, Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 1459863; Form 990, Part IX, Line 11g Other Fees Other Fees for Services - Total Expense: 82152848, Program Service Expense: 67509458, Management and General Expenses: 14643390, Fundraising Expenses: 0; Purchased Services - Total Expense: 63804648, Program Service Expense: 52319811, Management and General Expenses: 11484837, Fundraising Expenses: 0; Contract Labor - Total Expense: 56999929, Program Service Expense: 46739942, Management and General Expenses: 10259987, Fundraising Expenses: 0; Contract Services - Total Expense: 18130767, Program Service Expense: 14867229, Management and General Expenses: 3263538, Fundraising Expenses: 0; Consulting - Total Expense: 7521280, Program Service Expense: 6167450, Management and General Expenses: 1353830, Fundraising Expenses: 0; Form 990, Part XI, Line 9 Other changes in net assets or fund balances Other changes in Net Assets - -550016; Noncontrolling interest in ownership changes - -13125001; ST LUKE'S MEDICAL TOWER CORPORATION 6624 FANNIN ST STE 1100 HOUSTON TX 77030 760531713 PROPERTY MGMT TX 501(c)(3) Type I CHI-SLHBCM true CHI St Luke's Health Baylor College of Medicine Medical Center Condominium Assoc 6624 Fannin STE 1100 Houston TX 77030 465079545 Condo Assoc TX CHI-SLHBCM C Corporation 0 0 1 true St Luke's Episcopal Hospital Physician Hospital Organization Inc 6720 Bertner MC4-262 Houston TX 77030 760377932 PHO TX CHI-SLHBCM C Corporation 0 0 1 true The Texas Heart Institute at St Luke's Episcopal Hospital Denton A Cooley B uilding Comdominium Association 6624 Fannin STE 1100 Houston TX 77030 900064009 Condo Assoc TX CHI-SLHBCM C Corporation 0 0 1 true false false false false false false false false false false false false false false false false false false false