2017-08-15T15:00:30-05:00 2016-09-30 861065772 Deloitte Tax LLP 550 S Tryon St Suite 2500 Charlotte NC 28202 990 2015-10-01 562570681 St Luke's Health System Ltd STLU 2087069585 190 E Bannock Boise ID 83712 Peter DiDio Vice-President, Controller 2087069585 2017-08-15 1 John W Sadoff Jr P00540589 7048871500 2015 2021-01-29 14:40:06Z David C Pate MD JD 190 E Bannock Boise ID 83712 331551008 0 X www.stlukesonline.org X 2006 ID Management of the delivery of healthcare services 14 8 15761 1504 0 0 0 226502 281133932 331094700 1973717 121135 0 0 283107649 331442337 2045384 2164854 0 0 179516296 208563330 0 0 0 101545969 120714153 283107649 331442337 0 0 377047700 328419449 383001902 335312035 -5954202 -6892586 X To improve the health of the people in the communities we serve. 0 0 278197513 2164854 331094700 St. Luke's Health System supports and oversees the operations of qualified inpatient and outpatient care services for all of the supported hospital organizations within the St. Luke's Health System, including St. Luke's Regional Medical Center, Ltd., Mountain States Tumor Institute, Inc., St. Luke's Wood River Medical Center, Ltd., St. Luke's Magic Valley Regional Medical Center, Ltd. and St. Luke's McCall, Ltd.In addition, St. Luke's Health Foundation, Ltd., St. Luke's Clinic Coordinated Care, Ltd. (Accountable Care Organization),and Select Medical Network of Idaho, Inc. (Clinical Integration Network) receive administrative and operational support within the St. Luke's Health System. 278197513 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 1 0 0 1 1209 0 1 15761 1 0 0 0 0 0 0 0 0 0 0 X 14 8 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X X Peter DiDio Vice-President Controller 2087069585 190 E Bannock Boise ID 83712 Mr Arthur F Oppenheimer Chairman 3.00 0.00 X X 0 0 0 Ms Brigette Bilyeu Director 3.00 0.00 X 0 0 0 Mr Larry Cope Director 3.00 0.00 X 0 0 0 Luci DiMaggio MD Director 3.00 40.00 X 0 0 0 Mr Alan Horner Director 3.00 0.00 X 0 0 0 Mr Dan Krahn Director 3.00 0.00 X 0 0 0 Mr Bob Lokken Director 3.00 0.00 X 0 0 0 Mr Jon Miller Director 3.00 0.00 X 0 0 0 Mr Rich Raimondi Director 3.00 0.00 X 0 0 0 Mr Thomas Saldin Director 3.00 0.00 X 0 0 0 Ms Karen Vauk Director 3.00 0.00 X 0 0 0 Mr Bill Whitacre Director 3.00 0.00 X 0 0 0 Ms Barbara Wilson Director 3.00 0.00 X 0 0 0 David C Pate MD JD President & CEO 40.00 0.00 X X 1177059 0 25309 Mr Jeffrey S Taylor SR VP/CFO/Treasurer 40.00 12.00 X 563576 0 721926 Ms Christine L Neuhoff VP/Legal Affairs/Secretary 40.00 12.00 X 416920 0 32567 Mr Chris Roth SR VP,Chief Operating Offi 40.00 8.00 X 654179 0 34055 Barton F Hill MD VP,Chief Quality Officer 40.00 0.00 X 445973 0 29489 Ms Maureen O'Keeffe Former VP,Human Resources 40.00 0.00 X 647982 0 32945 David K Seppi MD VP,Executive Medical Direc 40.00 2.00 X 503095 0 34058 Marc S Chasin MD VP,Information Technology 40.00 2.00 X 394499 0 29954 David T Self VP, Business & Network Devlopmt 40.00 0.00 X 280774 0 16521 Mr Peter P DiDio VP,Controller 40.00 0.00 X 269943 0 31636 Mr Jeffrey R Cilek VP,Governmental Affairs 20.00 20.00 X 257810 0 33110 Thomas G Faciszewski MD VP, Supply Chain and Procu 40.00 0.00 X 322115 0 32778 Robert M Mueller VP, Revenue Cycle 40.00 0.00 X 260506 0 30972 Mr Gary L Fletcher Former VP, Chief Operating Officer 0.00 22.00 X 407139 0 1265 6601570 0 1086585 1072 1 1 0 Epic Systems Corporation 1979 Milky Way Verona WI 53593 IT Projects/Consulting 8373523 Compunet Inc 2264 S Bonito Way 150 Meridian ID 83642 IT Projects/Consulting 6027390 WhiteCloud AnalyticsInc PO Box 8005 Boise ID 83707 Healthcare Analytics Services 5529516 En Pointe Technologies 1940 E Mariposa Avenue El Segundo CA 90245 IT Projects/Digital Design 4608427 FMS Inc 4915 S Union Avenue Tulsa OK 74107 Patient A/R Collection Service 3794475 134 160238 66264 226502 Admin. Services 561000 331094700 331094700 331094700 229806 229806 108671 -108671 -108671 -108671 331442337 331094700 0 121135 2164854 2164854 5306377 5306377 103649966 82198065 21451901 25680893 25680893 66172890 66172890 7753204 6202563 1550641 15911704 12729364 3182340 461799 461799 442685 442685 126673 126673 4341613 3473290 868323 368329 294663 73666 934970 894618 40352 36678744 29342995 7335749 9917 7934 1983 2297967 1838374 459593 171471 137177 34294 34955079 27964063 6991016 3908017 3126414 781603 Telephone Expense 4941462 3953170 988292 Recruitment Expense 4765981 3812784 953197 Dues/Memberships 1367541 1094034 273507 Purchased Services 1020560 697884 322676 8009641 6411484 1598157 331442337 278197513 53244824 0 216537855 68778752 5407975 3770722 242185 493549 12545714 20686555 442745513 223888158 110994646 218857355 28777075 12964064 1042250 1042250 1500000 1826202 377047700 328419449 92444097 113150275 290557805 222161760 383001902 335312035 X -5954202 -6892586 -5954202 -6892586 377047700 328419449 X 0 -938384 X 0 1 X 1 1 1 X X X 7 St Luke's Regional Medical Cemter Ltd 820161600 3 1 0 0 Mountain States Tumor Institute Inc 820295026 3 1 0 0 St Luke's Wood River Medical Center Ltd 841421665 3 1 0 0 St Luke's Magic Valley Regional Medical Center Ltd 562570686 3 1 0 0 St Luke's Health Foundation Ltd 810600973 7 1 0 0 St Luke's McCall Ltd 273311774 3 1 0 0 St Luke's Clinic Coordinated Care Ltd 455195864 9 1 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 X 0 1 Part IV. Section A Line 1. The governing documents for St. Luke's Health System, Ltd. (SLHS) lists the following entities of which it is the sole member: St. Luke's Regional Medical Center, Ltd. St. Luke's McCall, Ltd. St. Luke's Magic Valley Regional Medical Center, Ltd. St. Luke's Wood River Medical Center, Ltd. In addition, SLHS is the sole member of the following organizations that are not listed within its bylaws, but are listed in Schedule A, Part 1, line 11g: St. Luke's Clinic Coordinated Care, Ltd. St. Luke's Health Foundation, Ltd. Select Medical Network of Idaho, Inc. (dba St. Luke's Health Partners) SLHS provides administrative and management oversight to these entities. Also listed within this section are the following legal entity: Mountain States Tumor Institute, Inc. (Sole member is St. Luke's Regional Medical Center, Ltd.) Effective September 30, 2015, St. Luke's Magic Valley Health Foundation, Ltd. was dissolved. On this same date, its net assets were distributed to St. Luke's Health Foundation, Ltd. In addition, St. Luke's Health System, Ltd. replaced St. Luke's Regional Medical Center, Ltd. as sole member of St. Luke's Health Foundation, Ltd. Part IV. Section D., line 2. With the exception of ex-officio board members, the election or appointment of the members of the board of directors for any of the supported organizations are subject to the approval by the SLHS board of directors. To ensure that SLHS is responsive to the needs of its supported hospital organization, SLHS has established a governing structure where its Board members are representative of the various geographical regions served by its supported organizations. Within the St. Luke's Health System, two regional governing boards, West Region, and East Region, have been established. Within each regional board, various community boards have been charted to ensure that the local communities have involvement with the operations of their respective hospital organizations, as well as to make sure the overall health needs of their communities are addressed. Please refer to our response to the question in Schedule A, Part IV, line 2a for a more detailed description of how the board structures established within the St. Luke's Health System enables the maintaining of a close and continuous working relationship its supported organizations. Section E. Line 3a With the exception of ex-officio board members, the election or appointment of the members of the board of directors for any of the supported organizations are subject to the approval by the SLHS board of directors. In other words, the supporting organizations can elect and appoint their board members. However, these appointments are subject to the approval of the SLHS Board of directors. Section E. Line 3b To ensure consistency in the execution of its strategic goals across all of its supported organizations' operations, St. Luke's Health System, Ltd., through its board of directors, committees, and management structure, has established various policies, procedures and support functions which include, but are not limited to, the following: (1) Human Resource Policies (2) Financial Assistance Policies (3) Bad Debt and Collections Policies (4) Finance support functions, including payroll processing, accounts payable, supply chain management, procurement, budgeting, financial reporting and treasury. (5) Credentialing of physicians (6) Physician Services Administration (7) Information technology Support (8) Environmental Services (9) Property Management (10) Construction (11) Patient Safety (12) Legal (13) Compliance (14) Internal Audit (15) Risk Management RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED X 126673 126673 126673 126673 331315664 331315664 331442337 331442337 1000000 1000000 250000 250000 0 0 0 0 1000000 1000000 1000000 1000000 4000000 6000000 124790 124854 134293 126673 510610 250000 250000 250000 250000 1000000 1500000 Form 990, Schedule C, Part II-A Affiliated Group List St. Luke's Health System, Ltd. St. Luke's Clinic Coordinated Care, Ltd. St. Luke's Regional Medical Center, Ltd. Mountain States Tumor Institute, Inc. St. Luke's McCall, Ltd. St. Luke's Wood River Medical Center, Ltd. St. Luke's Magic Valley Regional Medical Center, Ltd. St. Luke's Health Foundation, Ltd. 4088390 4088390 60354996 2820543 57534453 619675 619675 299763707 221067615 78696092 77918745 77918745 218857355 Due to Related Organizations 90467972 Professional Liability 9829171 Workers Compensation 3293594 Health Insurance IBNR 11276780 LT DISABILITY 3612145 SERP PLAN ACCR'D TAX GROSSUP 140658 SERP DC PLAN 1865148 SERP LIABILITY 21331696 ANNUAL EMPLOYER CONTRIBUTION PLAN 11534552 ESL LIABILITY 9774133 457 PLAN LIABILITY 30540769 ST DISABILITY 7576000 CAPITAL LEASE 20920394 UNEMPLOYMENT RESERVE -1252 222161760 X Part X, Line 2: Explanation: Footnote Disclosure-Uncertain Tax Positions Under FIN #48 (Source: Consolidated Financial Statements-St. Luke's Health System) Income Taxes: The Health System is a not-for-profit corporation and is recognized as tax-exempt pursuant to Section 501(c)(3) of the Internal Revenue Code of 1986, as amended. The Health System accounts for uncertain tax positions in accordance with ASC Topic 740. Income tax liabilities are recorded for the impact of positions taken on income tax returns, which management believes are not more likely than not to be sustained on tax audit. Management is not aware of any uncertain tax positions that should be recorded. Unrelated Business Income: The Health System is subject to federal excise tax on its unrelated business taxable income (UBTI). As of September 30, 2016, the company had approximately $6,810 UBTI Net Operating Losses incurred from operating losses incurred from 1997 to 2016 which expire in years 2017 to 2037. The Health System does not believe that it is more likely than not they will utilize these losses prior to their expiration and as such has provided a full valuation allowance against these losses. 1 Family Medicine Residency of Idaho Inc 777 North Raymond Street Boise ID 83712 205934739 501(c)(3) 956010 Support the family residency program in Idaho University of Washington PO Box 94224 Seattle WA 98124 916001537 501(c)(3) 595667 Support the education and retention of internal medicine and psychiatry residents for the state of Idaho Boise State University 1910 University Drive Boise ID 83725 826010706 501(c)(3) 113650 Provide financial support for general programs and scholarships Susan G Komen for the Cure 6901 West Emerald StreetSuite 209 Boise ID 83704 752462834 501(c)(3) 30000 Support of the Race for the Cure American Heart Association 270 South Orchard Street Suite B Boise ID 83705 135613797 501(c)(3) 30000 Support wellness programs United Way 2340 South Vista Avenue Boise ID 83705 820299013 501(c)(3) 25000 Support Promise Neighborhoods Killebrew Thompson Memorial PO Box 232 Sun Valley ID 83353 820341683 501(c)(3) 22500 To provide funding for cancer research Idaho Children's Trust Fund PO Box 2015 Boise ID 83701 826000995 170(c)(1) 20000 Support Treasure Valley Initiative to reduce child sexual abuse Idaho Association of Commerce and Industry PO Box 369 Boise ID 83701 820312975 501(c)(6) 15000 Support prosperity for the State of Idaho Idaho Foodbank 3562 South TK Avenue Boise ID 83705 820425400 501(c)(3) 10000 Support the School Pantry Ronald McDonald House 101 East Warm Springs Avenue Boise ID 83712 943030996 501(c)(3) 10000 Support the "Share a Night" program Idaho Governor's Cup PO Box 7807 Boise ID 83707 208277116 501(c)(3) 8000 To support scholarships for students who attend Idaho colleges American Cancer Society 2676 Vista Avenue Boise ID 83705 841316555 501(c)(3) 7500 Support Relays for Life including Middleton and Making Strides Against Breast Cancer Cascade Food Pantry PO Box 700 Cascade ID 83611 273420371 501(c)(3) 5784 Support the Pride of the Pantry plots St Luke's McCall Foundation Incorporated 100 State Street McCall ID 83638 820384205 501(c)(3) 5500 Support the Salmon River Transit - Connecting U 13 2 Part I, Line 2: The organization endeavors to monitor its grants to ensure that such grants are used for proper purposes and not otherwise diverted from their intended use. This is accomplished by requesting recipient organizations to affirm that funds must be used solely in accordance with the grant request and budget on which the grant was based and that funds not expended for the stated purpose are to be returned to the organization. Reports are requested from time to time as deemed appropriate. X 1 1 X X X X 0 1 0 0 0 0 0 0 0 David C Pate MD JD President & CEO 1139835 0 0 0 37224 0 16180 0 9129 0 1202368 0 0 0 Mr Jeffrey S Taylor SR VP/CFO/Treasurer 517797 0 0 0 45779 0 705980 0 15946 0 1285502 0 0 0 Ms Christine L Neuhoff VP/Legal Affairs/Secretary 397661 0 0 0 19259 0 16180 0 16387 0 449487 0 0 0 Mr Chris Roth SR VP,Chief Operating Offi 634949 0 0 0 19230 0 16180 0 17875 0 688234 0 0 0 Barton F Hill MD VP,Chief Quality Officer 401417 0 0 0 44556 0 16180 0 13309 0 475462 0 0 0 Ms Maureen O'Keeffe Former VP,Human Resources 347541 0 0 0 300441 0 24410 0 8535 0 680927 0 0 0 David K Seppi MD VP,Executive Medical Direc 454200 0 0 0 48895 0 12065 0 21993 0 537153 0 0 0 Marc S Chasin MD VP,Information Technology 375612 0 0 0 18887 0 12065 0 17889 0 424453 0 0 0 David T Self VP, Business & Network Devlopmt 254524 0 0 0 26250 0 9008 0 7513 0 297295 0 0 0 Mr Peter P DiDio VP,Controller 251072 0 0 0 18871 0 13829 0 17807 0 301579 0 0 0 Mr Jeffrey R Cilek VP,Governmental Affairs 225997 0 0 0 31813 0 19938 0 13172 0 290920 0 0 0 Thomas G Faciszewski MD VP, Supply Chain and Procu 296411 0 0 0 25704 0 11298 0 21480 0 354893 0 0 0 Robert M Mueller VP, Revenue Cycle 223760 0 0 0 36746 0 11816 0 19156 0 291478 0 0 0 Mr Gary L Fletcher Former VP, Chief Operating Officer 162531 0 0 0 244608 0 880 0 385 0 408404 0 0 0 Part I, Line 1a Supplemental Executive Retirement Plan (SERP) Explanation: St. Luke's has agreed to directly or indirectly pay all taxes caused by the vesting of accruals of the adjusted benefit prior to termination of employment. The payment shall be made in such a manner which results in the executive having no personal outlay for taxes resulting from or related to the adjusted benefit for any associated taxes. Part I, Line 4b During CY'15, the following individual participated in a supplemental non-qualified executive retirement plan: SERP SERP-Gross Up Total Maureen O'Keeffe $142,223 $115,194 $257,417 During CY'15, Jeffrey S. Taylor was a participant in the supplemental non-qualified executive retirement plan. There were no additional benefits were accrued during CY'15 on behalf of the participant. Part II-Column (c) During CY'15 the following individual participated in the basic pension plan. Due to enhanced benefits adopted in 2015 and changes in actuarial assumptions this individual experienced a increase in the vested balance of the plan. Jeffrey Taylor $681,570 White Cloud Analytics Board Member has ownership interest in White Cloud Analytics. 5665685 White Cloud is under contract with St. Luke's Health System,Ltd. to provide various analytical services. 0 Form 990, Part VI, Section B, line 11 The Form 990(Form)is reviewed by an independent public accounting firm based on audited financial statements and with the assistance of the organization's finance and accounting staff. A complete copy of the Form 990 is made available to the Board of Directors prior to filing. Form 990, Part VI, Section B, line 12c The organization annually reviews the conflict of interest policy with each board member and also with new board members. Persons covered under the policy include officers, directors, senior executives, non-director members of Board committees and others as identified by a senior executive. At all levels the board is responsible for assessing, reviewing, and resolving any conflicts of interest that have been disclosed by a covered person, or a conflict of interest disclosed by a covered person with respect to a covered person other than himself/herself. Where a conflict exists, the affected parties must recuse themselves from participating in any discussion related to the conflict. Form 990, Part VI, Section B, line 15 Executive compensation is set by St. Luke's boards of directors and is reviewed annually. Compensation levels are based on an independent analysis of comparable pay packages offered at similar institutions across the country, with the goal of placing executives in the 50th percentile of those surveyed. These surveys are usually done every two years, with the most recent compensation survey completed during calendar year 2016. Form 990, Part VI, Section C, line 19 The organization's governing documents, conflict of interest policy, and financial statements are not available to the public. Form 990 is available for public inspection, which contains financial information. Form 990, Part XI, line 9: Change in Minimum Liability-Supplemental Executive Retirement Plan(SERP) -961,581. Capital contribution from St. Luke's Health Foundation 23,197. Form 990 Part VII Section A Allocation of Compensation and Hours: The total hours worked and compensation reported for Jeff Taylor, Chris Roth, Christine Neuhoff, David Seppi, M.D., and Jeff Cilek represents services rendered to the following organizations within the St. Luke's Health System: Jeff Taylor: St. Luke's Health System, Ltd. St. Luke's Regional Medical Center, Ltd. Mountain States Tumor Institute, Inc. St. Luke's McCall, Ltd. St. Luke's Magic Valley Regional Medical Center, Ltd. St. Luke's Wood River Medical Center, Ltd. St. Luke's Clinic Coordinated Care, Ltd. Chris Roth: St. Luke's Health System, Ltd. St. Luke's Health Foundation, Ltd. St. Luke's Magic Valley Regional Medical Center, Ltd. St. Luke's Wood River Medical Center, Ltd. St. Luke's Clinic Coordinate Care, Ltd. Christine Neuhoff: St. Luke's Health System, Ltd. St. Luke's Regional Medical Center, Ltd. Mountain States Tumor Institute, Inc. St. Luke's McCall, Ltd. St. Luke's Magic Valley Regional Medical Center, Ltd. St. Luke's Wood River Medical Center, Ltd. St. Luke's Clinic Coordinated Care, Ltd. David Seppi, M.D. St. Luke's Health System, Ltd. St. Luke's Clinic Coordinated Care, Ltd. Jeff Cilek: St. Luke's Health System, Ltd. St. Luke's Health Foundation, Ltd. Also, it should be noted that the hours reported for the officers, key employees, and highest paid employees are based on a minimum 40 hour work week. However, due to the demands of their roles within the St. Luke's Health System, the hours worked by these individuals often exceed the minimum required 40 hours. In addition, Luci Dimaggio, M.D. is a member of a physician practice that has a professional service agreement with a related organization within the St. Luke's Health System. This individual works at least 40 hours per week on behalf of this practice for St. Luke's Magic Valley Regional Medical Center, Ltd. respectively. The practice with which they are affiliated, rather than the physicians, receive payments for their services to St. Luke's patients. The amounts paid to the practices during CY'15 are as follows: Board Member: Luci Dimaggio, M.D. Practice Name: Idaho Medicine Associates Contracting Related Organization: St. Luke's Magic Valley Regional Medical Center, Ltd. Amount Paid to the Practice: $ 3,008,373 St Luke's Regional Medical Center Ltd 190 E Bannock Boise ID 83712 820161600 Healthcare Services ID 501(c)(3) 3 St Luke's Health System Ltd 1 Mountain States Tumor Institute Inc 100 E Idaho Boise ID 83712 820295026 Healthcare Services ID 501(c)(3) 3 St Luke's Regional Medical Center Ltd 1 St Luke's Wood River Medical Center Ltd 190 E Bannock Boise ID 83712 841421665 Healthcare Services ID 501(c)(3) 3 St Luke's Health System Ltd 1 St Luke's Health Foundation Ltd 190 E Bannock Boise ID 83712 810600973 Fundraising ID 501(c)(3) 7 St Luke's Health System Ltd 1 St Luke's Magic Valley Regional Medical Center Ltd 801 Pole Line Road Twin Falls ID 83301 562570686 Healthcare Services ID 501(c)(3) 3 St Luke's Health System Ltd 1 St Luke's McCall Ltd 190 E Bannock Boise ID 83712 273311774 Healthcare Services ID 501(c)(3) 3 St Luke's Health System Ltd 1 St Luke's Clinic Coordinated Care Ltd 190 E Bannock Boise ID 83712 455195864 Accountable Care Organization ID 501(c)(3) 9 St Luke's Health System Ltd 1 Select Medical Network of Idaho Inc PO Box 1990 Boise ID 83701 810594024 Provider Network ID St Luke's Health System Ltd C 482144 1217522 1.00000 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 1 1 0 1 St Luke's Regional Medical Center Ltd Q 210008974 Pro Rata Overhead Allocation St Luke's Wood River Medical Center Ltd Q 8817715 Pro Rata Overhead Allocation St Luke's Magic Valley Regional Medical Center Ltd Q 64715020 Pro Rata Overhead Allocation St Luke's McCall Ltd Q 16064976 Pro Rata Overhead Allocation Mountain State Tumor Institue Inc Q 30269788 Pro Rata Overhead Allocation St Luke's Health Foundation Ltd Q 49624 Pro Rata Overhead Allocation Select Medical Network of Idaho Inc Q 297999 Pro Rata Overhead Allocation Select Medical Network of Idaho Inc P 5371377 Per Management Agreement St Luke's Health Foundation Ltd O 1344746 Salaries & Wages paid by SLHS St Luke's Health Foundation Ltd S 160238 Donations specified for SLHS Mountain State Tumor Institue Inc O 55793657 Salaries & Wages paid by SLHS St Luke's Health Foundation Ltd S 23197 Capital Contribution St Luke's Regional Medical Center Ltd O 646432513 Salaries & Wages paid by SLHS St Luke's Wood River Medical Center Ltd O 35596376 Salaries & Wages paid by SLHS St Luke's McCall Ltd O 20383891 Salaries & Wages paid by SLHS St Luke's Magic Valley Regional Medical Center Ltd O 155306970 Salaries & Wages paid by SLHS St Luke's Clinic Coordinated Care Ltd O 636991 Salaries & Wages paid by SLHS