2017-08-15T15:04:04-05:00 2016-09-30 861065772 Deloitte Tax LLP 550 S Tryon St Suite 2500 Charlotte NC 28202 990 2015-10-01 562570686 St Luke's Magic Valley Regional Medical Center Ltd STLU 2087069585 801 Pole Line Road Twin Falls ID 83301 Peter DiDio Vice-President, Controller 2087069585 2017-08-15 1 John W Sadoff Jr P00540589 7048871500 2015 2021-01-29 14:40:06Z Chris Roth 801 Pole Line Road Twin Falls ID 83301 407601975 0 X www.stlukesonline.org/magic valley X 2006 ID Provide healthcare services to the community. 16 10 0 237 72293 -36462 1138374 649450 379502500 404533264 382050 39747 122955 2165127 381145879 407387588 1055743 3107484 0 0 142987954 155306971 0 0 0 212686268 239465825 356729965 397880280 24415914 9507308 296333994 299103618 143701205 141028828 152632789 158074790 X Improve the health of people in the communities we serve by aligningphysicians and other providers to deliver integrated, patientcentered, quality care. 0 0 362092947 3026972 394052169 Medical & Surgical:St. Luke's Magic Valley is a 186-bed hospital, 700,000 square foothealth care facility with acute care and acute rehabilitation aswell as St. Luke's Canyon View Behavioral Health Services. Withmore than 1,900 employees and more than 200 physicians with28 specialties, St. Luke's Magic Valley provides the most comprehensive health care services in south central Idaho, including: generalacute care services, Inpatient Rehabilitation services, BehavioralHealth Services, cancer services with St. Luke's Mountain StatesTumor Institute (MSTI), Cardiopulmonary and Cardiac Catheterization, CARES (Children At Risk Evaluation Services), Community Connection information and referral database, Diabetes and Nutrition Services, Diagnostic Imaging, Radiology and Women's Imaging Services, Emergency Services, Home Health and Hospice Care, IntensiveCare and Newborn Intensive Care Units, Laboratory Services, MedicalLibrary (open to the public), Maternal-Child Services OB, Pediatricsand Women's Services), Pharmacy, Occupational Health, Adult and Pediatric Rehabilitation (Speech, Occupational, Physical Therapy), ComprehensiveSurgical Services, Magic Valley SAFE KIDS Coalition, Social Servicesand Pastoral Care, Volunteer Services and Auxiliary, and St. Luke's Magic Valley Foundation for gift-giving. At St. Luke's Magic Valley Medical Center, we take great pride in the high quality, skilled, and compassionate care we provide to our patients. This focus on excellence has resulted in honors from national entities, such as Qualis Health and Solucient. These awards recognize that our commitment to safety and performance improvement means enhanced and safer care, and an overall better experience for you, your family, and everyone we serve.During FY'16, St. Luke's Magic Valley Regional Medical Center provided qualified inpatient care for 12,177 admissions covering 43,256 patient days. The hospital also provided care associated with 143,707 outpatient visits.Services at St. Luke's Jerome include a 24-hour emergency department, outpatient surgery, general surgery, diagnostics, maternity services, inpatient physical therapy, intensive care and medical/surgical units. During fiscal year 2016, St. Luke's Jerome provided patient care for 646 admissions covering 2,861 patient days. They also provided patient care associated with 41,249 outpatient visits. 7251571 60621 7891612 Behavioral Health:St. Luke's Canyon View Behavioral Health Services,a 28-bed inpatient facility, provides treatment for adults and seniors.St. Luke's Canyon View offers intensive inpatient programs thataddress acute psychiatric issues in addition to medical detoxificationfrom alcohol and drugs. Canyon View utilizes individual, family, andgroup counseling to address personal, family, emotional, psychiatric, behavioral, and addiction-related problems. Our wide variety ofservices allows Canyon View to carefully match the needs of eachperson who comes to us for help with the most appropriate, cost-effective level of care. Outpatient services are scheduled at convenient hours. The common goal of our programs is to help peoplefind positive solutions to resolve the challenges and crises intheir lives. The hospital is staffed with a diverse group of dedicated, caring professionals. Psychiatrists and other physicians, psychologists, social workers, nurses, therapists, nutritionists, and alcohol/drug counselors work as a team to provide comprehensive, personalized care to each person who comes to us for help.During FY'16, Canyon View had 680 admissions covering 3,811 patient days. 2379466 19892 2589483 Comprehensive Rehabilitation and Therapy ServicesThe Gwen Neilson Anderson Rehabilitation Center at St. Luke'sMagic Valley is a licensed, comprehensive,14-bed acute inpatient rehabilitation center. Our inpatient unit provides state-of-the-art,evidenced-based rehabilitation care for patients requiring:--Intensive physicial, occupational, and/or speech therapy (at least three hours per day). --Specialized 24-hour rehabilitative nursing in an inpatient setting--Daily oversight by a medical doctor who specializes in physical medicine and rehabilitation (a physiatrist). --Individualized case management provided by a licensed social workerOur rehabilitation services are highly coordinated to optimize clinical outcomes and maximize a patient's independence. All members of the rehabilitation team (physicians, therapists, nurses, case workers, etc.) meet daily to ensure that treatments are tailored to each patient's specific diagnosis and unique needs. Our inpatient programs include:--Spinal cord injury--Stroke--Brain injury--Neuromuscular diseases, such as multiple sclerosis, Guilain-Barre syndrome, and cerebral palsy--Orthopedics--Major multiple trauma--Amputation--Arthritis--Medically complex conditionsAll 14 inpatient rehabilitation rooms at St. Luke's are private, and designed specifically to enhance the safety, comfort, and independence of patients recovering from and adapting to a variety of injuries and illnesses. Room features include ADA design, bed-side environmental controls(lights, nurse call light, window shades, etc.), free wireless, broadband internet access, pull-out couch and reclining chair forvisiting family members, and video surveillance capability for patientswith confusion due to brain injury, stroke, or other illness.The rehabilitation gymnasium in the Gwen Neilson AndersonRehabilitation Center contains state-of-the-art equipment and design features. The spacious gym includes private treatment rooms forone-on-one therapy sessions and a large, open space for wheelchairtraining, advanced mobility training, and group interaction. The rehabilitation gym includes the latest in equipment:--LiteGait gait trainer--Bioness Neuroprostheses: H200,L300,and L300 Plus--Saeboflex Inpatient kit--Dynavision D2--Dynavox Vmax Plus--Empi Vitai Stim--60-inch LCD television with Blu-Ray player and Wii game consoleThe transitional apartment is a fully functional apartment in which patients can practice basic activities of daily living under the supervision of a trained therapist.The activity area offers a place for patients and their visitors togather and engage in therapeutic recreation.During FY'16, the inpatient rehabilitation unit provided qualified inpatient care for 222 admissions covering 2,821 patient days. 371723984 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 16 10 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 1 1 X X Peter DiDio Vice-President Controller 2083711251 190 E Bannock Boise ID 83712 Mr J Robert Alexander Director 2.00 2.00 X 0 0 0 Mr Charles Coiner Chairman 2.00 2.00 X X 0 0 0 D Jeff Fox PhD Srved - 1015 Director 2.00 2.00 X 0 0 0 Mr R Todd Blass Director 2.00 2.00 X 0 0 0 Mr Peter Becker Director 2.00 2.00 X 0 0 0 Ms Cynthia Murphy Director 2.00 2.00 X 0 0 0 Mr Terry Kramer Director 2.00 2.00 X 0 0 0 Ms Jane Miller Director 2.00 2.00 X 0 0 0 Mr Terry Ring Director 2.00 2.00 X 0 0 0 Mr George Kirk Director 2.00 2.00 X 0 0 0 Eric Cassidy DO Director 40.00 2.00 X 0 0 0 Brian Fortuin MD Director 40.00 2.00 X 0 126010 0 Ron E McGarrigle MD Director 40.00 2.00 X 0 57094 0 Robert Wasserstrom MD Director 40.00 2.00 X 0 30250 0 Mr James Angle CEO-SL East Rgn (Srved - 10/15) 40.00 4.00 X X 0 589630 18686 Ms Rosa Davila Director 2.00 2.00 X 0 0 0 Mr Chris Roth SR VP, COO 2.00 46.00 X X 0 654179 34055 David A McClusky MD Director 2.00 40.00 X 0 374126 18934 Mr Jeffrey S Taylor SR VP/CFO/Treasurer 2.00 50.00 X 0 563576 721926 Ms Christine Neuhoff VP/Legal Affairs/Secretary 2.00 50.00 X 0 416920 32567 Mr Mike Fenello Site Administrator 8.00 32.00 X 0 232917 21172 James H Rao MD Physician 40.00 0.00 X 0 495734 21673 Randal L Wraalstad DPM Physician 40.00 0.00 X 0 470486 34483 Timothy A Enders DO Physician 40.00 0.00 X 0 441590 27271 Samuel J Pullen DO Physician 40.00 0.00 X 0 509063 40598 Jonathan D Myers MD Physician 40.00 0.00 X 0 517215 33366 0 5478790 1004731 0 1 1 0 Magic Valley Anesthesiology Associate PL 139 River Vista Place Ste 202 Twin Falls ID 83301 Anesthesia Services 8395465 Physician Center 630 Addison Ave W Ste 100 Twin Falls ID 83301 Medical Services 6845931 Emergency Physicians of Southern IdahoP PO Box 2775 Twin Falls ID 83301 Emergency Medicine Services 5584632 RMJ Safari PLLC 714 N College Road Ste A Twin Falls ID 83301 Medical Services 5558869 Southern Idaho Radiology PA 834 Falls Ave Ste 1020D Twin Falls ID 83301 Imaging Services 4421302 62 234054 415396 649450 Net Patient Revenue 900099 398767128 398767128 5766136 5766136 404533264 113458 113458 59920 10525 49395 49395 49395 130151 203862 -73711 -73711 -73711 Cafeteria/Catering/Ven 900099 1933961 1933961 Daycare Services 624410 109478 109478 Transcription Services 541900 26900 26900 45393 45393 2115732 407387588 404533264 72293 2132581 3107484 3107484 123910371 112631452 11278919 2068165 1786915 281250 20757245 19878532 878713 8571190 7780510 790680 61798951 61186355 612596 590162 590162 135 135 8105296 8072365 32931 201200 19152 182048 2795217 2424178 371039 22092554 22092154 400 1466070 1466070 552302 431699 120603 36825 36825 21611931 13533927 8078004 137014 137014 Supplies 51656893 51025431 631462 Provision For Bad Debt 27452236 27452236 0 Contract Service Expens 8017861 7726087 291774 Repairs Expense 4660590 3533514 1127076 28290588 27402084 888504 397880280 371723984 26156296 0 9276423 1302552 52053343 62288439 80285 77844 6419615 6878580 739921 599252 301008576 73051625 224188850 227956951 2075557 0 1500000 0 296333994 299103618 15701894 14490675 487804 0 127511507 126538153 143701205 141028828 X 152632789 158074790 152632789 158074790 296333994 299103618 X 9507308 19244 -4084551 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 4842353 10440179 15282532 221745708 39512542 182233166 378309 91307 287002 56417387 33447776 22969611 7184640 7184640 227956951 Due to Related Organizations 88969795 Capital Lease 1229039 AP MEDICARE-MEDICAID PROG 20734726 Pension Liability 15604593 126538153 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 1 X 1 X 185.000000000000 1 X 1 1 1 0 1 1 9087049 9087049 0.02450 56805763 41466796 15338967 0.04140 10871342 5520773 5350569 0.01440 76764154 46987569 29776585 0.08030 2278968 157316 2121652 0.00570 4501921 4501921 0.01220 3928888 1564031 2364857 0.00640 231250 231250 0.00060 10941027 1721347 9219680 0.02490 87705181 48708916 38996265 0.10520 1 12995744 0 75395913 87794018 -12398105 X 1 1 2 1 StLuke's Magic Valley Regional Medical Center 801 Pole Line Road Twin Falls ID 83301 www.stlukesonline.org State of Idaho License #14 X X X A 2 St Luke's Jerome 709 N Lincoln Jerome ID 83308 www.stlukesonline.org State of Idaho License #08 X X X X A Facility Reporting Group - A 0 0 1 X X X X X X X X X 15 1 1 0 1 X www.stlukesonline.org/about-st-lukes/supporting-the-community X 1 15 0 1 0 1 X 185.000000000000 400.000000000000 X X X X 1 1 X X X 1 X www.stlukesonline.org/resources/before-your-visit/financial-care X www.stlukesonline.org/resources/before-your-visit/financial-care X www.stlukesonline.org/resources/before-your-visit/financial-care X X X X 1 X 0 X X X 1 X 0 0 Part V, Section B Facility Reporting Group A Facility Reporting Group A consists of: - Facility 1: St.Luke's Magic Valley Regional Medical Center, - Facility 2: St. Luke's Jerome Group A-Facility 1 -- St. Luke's Magic Valley Regional Medical Part V, Section B, line 5: A series of in-depth interviews with people representing the broad interests of our community were conducted in order to assist us in defining, prioritizing, and understanding our most important community health needs. Many representatives participating in our process are individuals who have devoted decades to helping others lead healthier, more independent lives. The representatives we interviewed have significant knowledge of our community. To ensure they came from distinct and varied backgrounds, we included multiple representatives from each of these categories:Category I: Persons with special knowledge of public health. This includes persons from state, local, and/or regional governmental public health departments with knowledge, information, or expertise relevant to the health needs of our community. Category II: Individuals or organizations serving or representing the interests of the medically underserved, low-income, and minority populations in our community. Medically underserved populations include populations experiencing health disparities or at-risk populations not receiving adequate medical care as a result of being uninsured or underinsured or due to geographic, language, financial, or other barriers.Category III: Additional people located in or serving our community including, but not limited to, health care advocates, nonprofit and community-based organizations, health care providers, community health centers, local school districts, and private businesses.Each potential need was scored by the community representative on a scale of 1 to 10. Higher scores represent potential needs the community representatives believed were important to address with additional resources. Lower scores usually meant our leaders thought our community was healthy in that area already or we had relatively good programs addressing the potential need. These scores were incorporated directly into our health need prioritization process. In addition, we invited the leaders to suggest programs, legislation, or other measures they believed to be effective in addressing the needs.The following community leaders/representatives were contacted:(1) Idaho Department of Health and Welfare(2) Boise VA Medical Center(3) South Central Public Health(4) College of Southern Idaho(5) Family Health Services(6) St. Luke's Behavioral Health(7) Coordinator of the CARES (Children At Risk Evaluation Services) at St. Luke's Magic Valley Regional Medical Center(8) College of Southern Idaho Office on Aging(9) St. Luke's Disease Management Clinic and Physician's Center(10) Jerome Recreation District(11) Jerome School District #264(12) Community Council of Idaho(13) Jerome Senior Center(14) College of Southern Idaho Refugee Center(15) Crisis Center of Magic Valley(16) Twin Falls School District(17) United Way of Magic Valley(18) Twin Falls County(19) La Posada, Inc.(20) South Central Community Action Partnership (SCCAP)(21) Idaho Office for Refugees(22) Idaho Department of Labor: Provided unemployment related information for the area.(23) Substance Abuse and Mental Health Services Administration U.S. Department of Health and Human Services,Region X.(24) Family Residency of Idaho(25) Interfaith Association & Presgytery of the West - Jerome(26) Wellness Tree Community Clinic(27) St. Jerome Catholic Church(28) Jerome County(29) City of Jerome(30) La Perrona Radio Station(31) Valley House Homeless Shelter(32) City of Twin Falls(33) St. Luke's Clinic Cardiology & LDS Church(34) Boys and Girls Club of Magic Valley Group A-Facility 1 -- St. Luke's Magic Valley Regional Medical Part V, Section B, line 6a: St. Luke's Jerome Hospital Group A-Facility 1 -- St. Luke's Magic Valley Regional Medical Part V, Section B, line 11: We organized all of our significant health needs into three groups:Program Group 1: Improve the Prevention and Mangement of Obesity and Diabetes -BMI screening (adults and children) -Times news health fair -KMVT kids fest -YEAH! -Walking challenge -Diabetes management -SLHS Healthy U -Community helath improvement fund Program Group 2: Improve Mental Health and Reduce Suicide -Behvioral health program expansion and integration with primary care -Depression screening -Community health improvement fund Program Group 3: Improve Access to Affordable Health Insurance -Improving access to affordable health care -Financial assistance Group A-Facility 1 -- St. Luke's Magic Valley Regional Medical Part V, Section B, line 16i: A Financial Care application is provided to the patient which contains Patient Financial Advocate contact information. Group A-Facility 2 -- St. Luke's Jerome Part V, Section B, line 5: A series of in-depth interviews with people representing the broad interests of our community were conducted in order to assist us in defining, prioritizing, and understanding our most important community health needs. Many representatives participating in our process are individuals who have devoted decades to helping others lead healthier, more independent lives. The representatives we interviewed have significant knowledge of our community. To ensure they came from distinct and varied backgrounds, we included multiple representatives from each of these categories:Category I: Persons with special knowledge of public health. This includes persons from state, local, and/or regional governmental public health departments with knowledge, information, or expertise relevant to the health needs of our community. Category II: Individuals or organizations serving or representing the interests of the medically underserved, low-income, and minority populations in our community. Medically underserved populations include populations experiencing health disparities or at-risk populations not receiving adequate medical care as a result of being uninsured or underinsured or due to geographic, language, financial, or other barriers.Category III: Additional people located in or serving our community including, but not limited to, health care advocates, nonprofit and community-based organizations, health care providers, community health centers, local school districts, and private businesses.Each potential need was scored by the community representative on a scale of 1 to 10. Higher scores represent potential needs the community representatives believed were important to address with additional resources. Lower scores usually meant our leaders thought our community was healthy in that area already or we had relatively good programs addressing the potential need. These scores were incorporated directly into our health need prioritization process. In addition, we invited the leaders to suggest programs, legislation, or other measures they believed to be effective in addressing the needs.The following community leaders/representatives were contacted:(1) Idaho Department of Health and Welfare(2) Boise VA Medical Center(3) South Central Public Health(4) College of Southern Idaho(5) Family Health Services(6) St. Luke's Behavioral Health(7) Coordinator of the CARES(Children At Risk Evaluation Services) at St. Luke's Magic Valley Regional Medical Center(8) College of Southern Idaho Office on Aging(9) St. Luke's Disease Management Clinic and Physician's Center(10) Jerome Recreation District(11) Jerome School District #264(12) Community Council of Idaho(13) Jerome Senior Center(14) College of Southern Idaho Refugee Center(15) Crisis Center of Magic Valley(16) Twin Falls School District(17) United Way of Magic Valley(18) Twin Falls County(19) La Posada, Inc.(20) South Central Community Action Partnership (SCCAP)(21) Idaho Office for Refugees(22) Idaho Department of Labor: Provided unemployment related information for the area.(23) Substance Abuse and Mental Health Services Administration U.S. Department of Health and Human Services,Region X.(24) Family Residency of Idaho(25) Interfaith Association & Presgytery of the West - Jerome(26) Wellness Tree Community Clinic(27) St. Jerome Catholic Church(28) Jerome County(29) City of Jerome(30) La Perrona Radio Station(31) Valley House Homeless Shelter(32) City of Twin Falls(33) St. Luke's Clinic Cardiology & LDS Church(34) Boys and Girls Club of Magic Valley Group A-Facility 2 -- St. Luke's Jerome Part V, Section B, line 6a: St. Luke's Magic Valley Medical Center Group A-Facility 2 -- St. Luke's Jerome Part V, Section B, line 11: We organized our significant health needs into the following groups:Group #1: Improve the Prevention and Management of Obesity and Diabetes -BMI Screening (Adults & Children) -St. Luke's Jerome Health Fair -YEAH Program -Walking Challenge -Diabetes Management -SLHS Healthy UGroup #2: Improve Mental Health and Reduce Suicide -Behavioral Health Program Expansion & Integration with Primary Care -Depression ScreeningGroup #3: Improve Access to Affordable Health Insurance -Improving Access to Affordable Health Care -Financial Assistance Group A-Facility 2 -- St. Luke's Jerome Part V, Section B, line 16i: A Financial Care application is provided to the patient which contains Patient Financial Advocate contact information. 12 1 - St Luke's Magic Valley MOB 775 Pole Line Rd W Twin Falls ID 83301 Various Family Medicine & Specialty Physician Clinics 2 - St Luke's Canyon View 228 Shoup Avenue W Twin Falls ID 83301 Psychiatric and Addiction 3 - St Luke's Clinic-Physician Center 2550 Addison Avenue E Twin Falls ID 83301 Family Medicine,Internal Medicine,& Pediatric Physician Clinics 4 - St Luke's Woman's Imaging Center 762 N College Road Twin Falls ID 83301 Women's Imaging Services 5 - St Luke's Clinic-Physician Center 746 N College Road Twin Falls ID 83301 Family Medicine & Specialty Physician Clinic 6 - St Luke's Clinic-Physician Center 730 N College RoadSuite A Twin Falls ID 83301 Family Medicine & ENT Physician Clinics 7 - St Luke's Clinic-OrthoPlastic Surg 714 N College RoadSuite A Twin Falls ID 83301 Orthopedics and Plastic Surgery-Physician Clinic 8 - St Luke's Clinic-Physician Center 550 PolkSuite A Twin Falls ID 83301 Family Medicine-Physician Clinic 9 - St Luke's Clinic-Neurology 738 N College RoadSuite C Twin Falls ID 83301 Neurology and Physical Med.& Rehab-Physician Clinic 10 - Magic Valley Paramedics 121 Aspenwood Twin Falls ID 83301 Ground Paramedic Services 11 - Magic Valley Paramedics 285 Martin St Twin Falls ID 83301 Ground Paramedic Services 12 - Magic Valley Paramedics 708 Shoshone Twin Falls ID 83301 Ground Paramedic Services Part I, Line 3c: (A) St. Luke's does provide charity care services to patients who meet one or both of the following guidelines based on income and expenses: 1. Income. Patients whose family income is equal to or less than 400% of the then current Federal Poverty Guideline are eligible for possible fee elimination or reduction on a sliding scale. 2. Expenses. Patients may be eligible for charity care if his or her allowable medical expenses have so depleted the family's income and resources that he or she is unable to pay for eligible services. The following two qualifications must apply: a. Expenses- The patients allowable medical expenses must be greater than 30% of the family income. Allowable medical expenses are the total of the family medical bills that, if paid, would qualify as deductible medical expenses for Federal income tax purposes without regard to whether the expenses exceed the IRS-required threshold for taking the deduction. Paid and unpaid bills may be included. b. Resources- The patient's excess medical expenses must be greater than available assets. Excess medical expenses are the amount by which allowable medical expenses exceed 30% of the family income. Available assets do not include the primary residence, the first motor vehicle, and a resource exclusion of the first $4,000 of other assets for an individual, or $6,000 for a family of two, and $1,500 for each additional family member. (B) Service Exclusions: 1. Services that are not medically necessary (e.g. cosmetic surgery) are not eligible for charity care. 2. Eligibility for charity care for a patient whose need for services arose from injuries sustained in a motor vehicle accident where the patient, driver, and/or owner of the motor vehicle had a motor vehicle liability policy, and only if a claim for payment has been properly submitted to the motor vehicle liability insurer, where applicable.(C) Eligibility Approval Process: 1. St. Luke's screens patients for other sources of coverage and eligibility in government programs. St. Luke's documents the results of each screening. If St. Luke's determines that a patient is potentially eligible for Medicaid or another government program, then St. Luke's shall encourage the patient to apply for such a program and shall assist the patient in applying for benefits under such a program. 2. The patient must complete a Financial Assistance Application and provide required supporting documentation in order to be eligible. 3. St. Luke's verifies reported family and compares to the latest Poverty Guidelines published by the U.S. Department of Health and Human Services. 4. St. Luke's verifies reported assets. 5. St. Luke's provides a written notice of determination of eligibility to the patient or the responsible party within 10 business days of receiving a completed application and the required supporting documentation. 6. St. Luke's reserves the right to run a credit report on all patients applying for charity care services. (D) Eligibility Period. The determination that an individual is approved for charity care will be effective for six months from the date the application is submitted,unless during that time the patient's family income or insurance status changes to such an extent that the patient becomes ineligible. Part I, Line 6a: St. Luke's Magic Valley Regional Medical Center, Ltd. does not include the activities of any of its other related organizations within its community benefit report. Part I, Line 7: The cost to charge ratio was used for the calculation of charity care at cost, unreimbursed Medicaid and other means-tested programs. Part I, Line 7g: Subsidized services represent unreimbursed costs incurred (excluding impact of unreimbursed Medicare and Medicaid) for the following services:Home CareFamily Practice-Rural Health Training TrackPalliative Care and MedicineBehavioral Health Part I, Ln 7 Col(f): Bad Debt is defined as expenses resulting from services provided to a patient and/or guarantor who,having the requisite financial resources to pay for health care services,has demonstrated an unwillingness to do so. Amount of bad debt expense included in Part IX, line 25,is $27,452,236. Part II, Community Building Activities: The community building activities for St. Luke's Magic Valley Regional Medical Center, Ltd. include the following:Economic Development:Cash donation to Community Connections to fund needed programs in the community and meetings with Planning and Zoning to discuss future developement.Community Support:Select members of St. Luke's Magic Valley staff went through intense disaster readiness training in order to be ready for any disaster that occurs in the region. They took this knowledge and implemented disaster readiness policy and procedure throughout the hospital.Coalition Building:Activities for Coalition Building include involvement of physicianin:-Chamber of Commerce Leadership-Tobacco-Free Coalition-State Board of Medicine-IMA-President of South Central Idaho Community Health Improvement Advocacy: Expenses represent the continued support for Serenity Garden project.The Serenity garden Project was established on June 6, 2009 to provide a dignified burial for fetal remains and give the community a place to visit and grieve their loss.Physician meetings with Genesis Group and county commissioners were held to discuss the Mustard Tree Wellness Clinic operations and funding.Physician meetings with governor and legislators were held to discuss legalization of marijuana and meetings with Idaho Board of Corrections.Other:These are expenses incurred by the organization's staff for implementing and tracking community beneift operations. Part III, Line 2: The Cost to Charge ratio method was used to calculate bad debt expense at cost. Part III, Line 3: St. Luke's Magic Valley Regional Medical has a very robust financial assistance program, therefore, no estimate is made for bad debt attributable to patients eligible under the financial assistance policy. Part III, Line 4: Per the audited financial statements in footnote four. St. Luke's Magic Valley Regional Medical Center, Ltd. grants credit without collateral to its patients, most of whom are local residents and many of whom are insured under third-party agreements. The allowance for estimated uncollectible amounts is determined by analyzing both historical information (write-offs by payor classification), as well as current economic conditions. Part III, Line 8: Our community benefit reports the under-reimbursed services provided to patients by Medicare. St. Luke's Magic Valley Regional Medical Center, Ltd. provides medical care to all patients eligble for Medicare regardless of the shortfall and thereby relieves the Federal Government of the burden for paying the full cost of Medicare. The source of the information is the Medicare Cost Report for fiscal year 2015. The amount is calculated by comparing the total Medicare apportioned costs (allowable costs) to reimbursements received during FY'15. It should be noted that the unreimbursed costs reported within this schedule are significantly less than the amount reported in the annual Community Benefit Report to Twin Falls County ("County"). In the report to the County, unreimbursed costs include program costs allocated to the Medicare Advantage program, along with costs that offset the provider-based physician clinic operations; i.e. professional component billing for physician time and effort. The Medicare Cost Report does not include these components. In addition, the report to the County includes all allocated costs to the Medicare Programs, whereas the Medicare Cost Report reports allowable costsonly. Part III, Line 9b: All subsidiaries within the St. Luke's Health System have policies in place to provide financial assistance to those who meet established criteria and need assistance in paying for the amounts billed for their provided health care services. In addition, the collection policies and practices in place within the St. Luke's Health system provide guidance to patients on how to apply for this assistance. Collection of amounts due may be pursued in cases where the patient is unable to qualify for charity care or financial assistance and the patient has the financial resources to pay for the billed amounts. Part VI, Line 2: A Community Health Needs Assessment (CHNA) was conducted forfiscal year ending 9/30/2016. Information related to the2016 CHNA is shown in the responses to questions 3 and 7 of"Part V, Section B, Facility Policies and Practices".A complete copy of the CHNA assessments for all of the hospitalsoperating within the St. Luke's Health System can be found atthe following website:www.stlukesonline.org/about-st-lukes/supporting-the-community Part VI, Line 3: (A) St. Luke's Magic Valley Regional Medical Center provides notice of the availability of financial assistance via: 1. Signage 2. Patient brochure 3. Billing Statement 4. Written collection action letter 5. Online at www.stlukesonline.org/billing(B) All notices are translated into the following language: Spanish(C) St. Luke's provides individual notice of the availability of financial assistance to a patient expected to incur charges that may not be paid in full by third party coverage, along with an estimate of the patient's liability.(D) For cases in which St. Luke's independently determines patient eligibility for financial assitance, St. Luke's provides written notice of determination that the patient is or is not eligible within 10 business days of receiving a completed application and the required supporting documentation. Part VI, Line 4: St. Luke's Magic Valley Regional Medical Center provides services for eight counties of south central Idaho and Elko County, Nevada. Theprimary service area consists of Gooding, Jerome, and Twin Falls Counties. The criteria used in selecting this area as the community served was to include the entire population of the counties where greater than 70% of the inpatients reside. The residents of these counties comprise about 79% of the inpatients with approximately 66% of the inpatients living in Twin Falls County, 13% in Jerome County, and 8% in Gooding County. All three counties are part of Idaho Health District 5.Both Idaho and our service territory are comprised of about a 96% white population whilethe nation as a whole is 78% white. The Hispanic population in Idaho represents 12% of theoverall population and about 19% of our defined service area. Jerome County isapproximately 34% Hispanic, and Twin Falls County is 15% Hispanic. Idaho experienced a 25% increase in population from 2000 to 2013, ranking it as one offastest growing states in the country. 18 Twin Falls and Jerome Counties have followed thattrend, experiencing a 24% increase in population within that timeframe. 19 St. Luke's MagicValley is working to manage the volume and scope of services in order to meet the needs of agrowing population. Over the past ten years the 45 to 64 year old age group was the fastest growing segment ofour community. Currently, about 14% of the people in our community are over the age of65.The official United States poverty rate increased from 12.5% in 2003 to 15.6% in 2013. Ourservice area poverty rate is now about the same as the national average due to a substantialdecrease over the last three years. The poverty rate in our community for children under theage of 18 is also about the same as the national average. Although poverty has starteddeclining in our service area, poverty rates are still above the levels they were at prior to therecession in 2008.Median income in the United States has risen by 20% since 2003 and at approximately thesame rate in our service area during that period. However, median income in our service areais well below the national median and lower than Idaho's median income. Part VI, Line 5: The people who serve on the various boards for subsidiaries within the St. Lukes Health System are local citizens who have a vested interest in the health of their communities. These committed leaders volunteer on our boards because they are dedicated to ensuring that the people of southern Idaho and the surrounding area have access to the most advanced, most comprehensive health care possible. St. Luke's believes that locally owned and governed hospitals can take the best measure of community health care needs. We are grateful to our board leadership for giving generously of their time and talents and bringing to the table their unique perspectives and intimate knowledge of their communities. St. Luke's would not be the organization it is today without our volunteer board members. The vision of dedicated community leaders has guided St. Luke's for many decades,and will continue to guide us well into the future.As a not-for-profit organization,100% of St. Luke's revenue after expenses is reinvested in the organization to serve the community in the form of staff, buildings,or new technology.Also,St. Luke's Magic Valley Regional Medical Center, Ltd. (SLMV) maintains an open medical staff. Any physician can apply for practicing privileges as long as they meet the standards for SLMV. Part VI, Line 6: As the only Idaho-based not-for-profit health system, St. Luke's Health System is part of the communities we serve, with local physicians and boards who further our organization's mission "To improve the health of people in our region." Working together,we share resources, skills,and knowledge to provide the best possible care,no matter which of our hospitals provide that care. Each St. Luke's Health System hospital is nationally recognized for excellence in patient care,with prestigious awards and designations reflecting the exceptional care that is synonymous with the St. Luke's name. St. Luke's Health System provides facilities and services across the region,covering a 150-mile radius that encompasses southern and central Idaho,northern Nevada, and eastern Oregon-bringing care close to home and family. The following entities are part of the St. Luke's Health System:(1) St. Luke's Regional Medical Center, Ltd. with the following locations: --St. Luke's Boise Hospital --St. Luke's Meridian Hospital --St. Luke's Childrens Hospital --St. Luke's Boise/Meridian/Nampa/Caldwell/Fruitland Physician Clinics --St. Luke's Nampa Emergency Department/Urgent Care --St. Luke's Eagle Urgent Care --St. Luke's Elmore Hospital with physician clinic --St. Luke's Fruitland Emergency Department/Urgent Care(2) St. Luke's Wood River Medical Center, Ltd. which consists of a critical access hospital located in Ketchum, Idaho as well as various physician clinics(3) St. Luke's Magic Valley Regional Medical Center, Ltd. which consists of the following: --St. Luke's Magic Valley Hospital-Twin Falls,Idaho --Various St. Luke's Physician Clinics in Twin Falls --Canyon View-(Behavioral Health) --St. Luke's Jerome Hospital-Jerome,Idaho --Various Physician clinics in Jerome(4) St. Luke's McCall, Ltd. which consists of a critical access hospital located in McCall,Idaho as well as various physician clinics.(5) Mountain States Tumor Institute (MSTI) is the region's largest provider of cancer services and a nationally recognized leader in cancer research. MSTI provides advanced care to thousands of cancer patients each year at clinics in Boise, Fruitland, Meridian, Nampa, and Twin Falls, Idaho. MSTI is home to Idaho's only cancer treatment center for children, only federally sponsored center for hemophilia, and only blood and marrow transplant program. MSTI's services and therapies include breast care services, blood and marrow transplant, chemotherapy, genetic counseling, hematology, hemophilia treatment, hospice, integrative medicine, marrow donor center, mobile mammography, mole mapping, nutritional counseling, PET/CT scanning, patient/family support, pediatric oncology, radiation therapy, rehabilitation, research and clinical trials, Schwartz Center Rounds for Caregivers, spiritual care, support groups/classes, tumor boards, and Wound Ostomy, and Continence Nursing. MSTI is expanding as rapidly as today's cancer treatment. Patients can now visit a MSTI clinic or Breast Cancer detection center at 13 different locations in southwest Idaho and Eastern Oregon. Locations include Boise, Meridian, Nampa, Twin Falls, and Fruitland.St. Luke's physician clinics and services are provided in partnership with area physicians and other health care professionals. These include:Cardiovascular; Child Abuse and Neglect Evaluation; Endocrinology; Ear, Nose,and Throat; Family Medicine; Gastroenterology; General Surgery; Hypertensive Disease; Internal Medicine; Maternal/Fetal Medicine; Medical Imaging; Metabolic and Bariatric Surgery; Nephrology; Neurology; Neurosurgery; Obstetrics/Gynecology; Occupational Medicine; Orthopedics; Outpatient Rehabilitation; Plastic Surgery; Psychiatry and Addiction; Pulmonary Medicine; Sleep Disorders;and Urology. In addition, St. Luke's works with other regional facilities through management service contracts. These facilities include:(1) Challis Area Health Center(2) North Canyon Medical Center(3) Salmon River Clinic(4) Weiser Memorial Hospital Part VI, Line 7, Reports Filed With States ID 1 St Luke's Health Foundation Ltd 190 East Bannock Street Boise ID 83712 810600973 501(c)(3) 639942 Provide support for overall operational needs of St. Luke's Health Foundation, Ltd. College of Southern Idaho 315 Falls Avenue Twin Falls ID 83303 820388193 501(c)(3) 157220 Fundings for support of Health Occupations, Head Start/Early Head Start program, Foster Grantparent Program, Dental Program, that are working to improve the health of people in the community Wellness Tree Community Clinic 173 Martin Street Twin Falls ID 83301 261249939 501(c)(3) 40000 Provide funds for car seats for low income patients Twin Falls County 425 Shoshone Street North Twin Falls ID 83303 826000318 115 29000 Funds were used to buy carseats for low income individuals Twin Falls Community Foundation Inc PO Box 5632 Twin Falls ID 83303 261119702 501(c)(3) 25000 MaVTEC Trails Enhancement South Central District Health 513 North Main Street Hailey ID 83333 820335043 115 22000 Support implementation of community health activities Volunteers Against ViolenceInc DBA Crisis Center of Magic Valley PO Box 2444 Twin Falls ID 83303 820372006 501(c)(3) 20000 Provide funding to support counseling for victims Interfaith Volunteer Caregivers of Magic Valley 459 Locust Street NorthSuite 106 No A Twin Falls ID 83301 841417706 501(c)(3) 15000 Provide non-medical services to the elderly, disabled, chronically ill Boys and Girls Club of Magic Valley 999 Frontier Road Twin Falls ID 83301 943176622 501(c)(3) 13000 Operate boys and girls club for local youth with emphasis on youth at risk Jubilee HouseInc 315 Grandview Drive Twin Falls ID 83303 208750670 501(c)(3) 10000 Full Life Recovery Program helping women heal from addiction Community Council of Idaho 317 Happy Day Boulevard No 250 Caldwell ID 83607 820299736 501(c)(3) 10000 Support implementation of community health activities Living Independence Network Corporation 1878 West Overland Road Boise ID 83705 820426465 501(c)(3) 9000 Providing services to disabled citizens such as independent living programs, peer counseling and support services Hospice Visions 209 Shoup Avenue West Twin Falls ID 83301 820483284 501(c)(3) 8000 Funding for scholarships Helping Hearts and HandsInc 237 Main Street Gooding ID 83330 208322514 501(c)(3) 8000 Assistance of food and clothing to needy families Twin Falls Senior Citizens Federation Inc PO Box 23 Twin Falls ID 83303 820342197 501(c)(3) 7250 Support senior citizen center established to provide meals and activities for Twin Falls area senior citizens. 15 0 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. 0 1 0 0 0 0 0 0 0 Mr James Angle CEO-SL East Rgn (Srved - 10/15) 0 569040 0 0 0 20590 0 7950 0 10736 0 608316 0 0 Mr Chris Roth SR VP, COO 0 634949 0 0 0 19230 0 16180 0 17875 0 688234 0 0 David A McClusky MD Director 0 371571 0 2000 0 555 0 4115 0 14819 0 393060 0 0 Mr Jeffrey S Taylor SR VP/CFO/Treasurer 0 517797 0 0 0 45779 0 705980 0 15946 0 1285502 0 0 Ms Christine Neuhoff VP/Legal Affairs/Secretary 0 397661 0 0 0 19259 0 16180 0 16387 0 449487 0 0 Mr Mike Fenello Site Administrator 0 231784 0 0 0 1133 0 3623 0 17549 0 254089 0 0 James H Rao MD Physician 0 148570 0 310990 0 36174 0 7441 0 14232 0 517407 0 0 Randal L Wraalstad DPM Physician 0 265730 0 185924 0 18832 0 16180 0 18303 0 504969 0 0 Timothy A Enders DO Physician 0 271659 0 132905 0 37026 0 12065 0 15206 0 468861 0 0 Samuel J Pullen DO Physician 0 475846 0 14718 0 18499 0 12065 0 28533 0 549661 0 0 Jonathan D Myers MD Physician 0 372168 0 126493 0 18554 0 16180 0 17186 0 550581 0 0 Part I, Line 3 Compensation for the organization's CEO is determined by St. Luke's Health System, Ltd. (System), sole member of St. Luke's Magic Valley Regional Medical Center, Ltd. (SLMVRMC). The System board approves the compensation amount per the recommendation of its compensation committee,and the decision is then reviewed and ratified by the board of directors for SLMVRMC. In determining compensation for the CEO, the System board utilizes the following criteria: Compensation Committee Independent compensation consultant Compensation survey or study Approval by the board or compensation committee Part I, Line 4b 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 Form 990, Part VI, Section A, line 6 St. Luke's Health System, Ltd. is the sole member of St. Luke's Magic Valley Regional Medical Center, Ltd. Form 990, Part VI, Section A, line 7a The President and CEO of St. Luke's Magic Valley Regional Medical Center, Ltd.,(Corporation) is cooperatively selected by the Corporation and St. Luke's Health System,Ltd. St. Luke's Health System is the sole member of the Corporation. Form 990, Part VI, Section A, line 7b St. Luke's Health System, Ltd. (Member) maintains approval and implementation authority over St. Luke's Magic Valley Regional Medical Center, Ltd. (Corporation). Actions requiring approval authority may be initiated by either the Corporation or its Member, but must be approved by both the Corporation (by action of its Board of Directors) and the Member. Actions requiring approval authority of the Member include: (a) Amendment to the Articles of Incorporation; (b) Amendment to the Bylaws of the Corporation; (c) Appointment of members of the Corporation's Board of Directors, other than ex officio directors; (d) Removal of an individual from the Corporation's Board of Directors if and when removal is requested by the Corporation's Board of Directors, which request may only be made if the Director is failing to meet the reasonable expectations for service on the Corporation's Board of Directors that are established by the Member and are uniform for the Corporation and for all of the other hospitals for which the Member then serves as the sole corporate member. (e) Approval of operating and capital budgets of the Corporation, and deviations to an approved budget over the amounts established from time to time by the Member; and (f) Approval of the strategic/tactical plans and goals and objectives of the Corporation. Implementation Authority means those actions which the Member may take without the approval or recommendation of the Corporation. This authority will not be utilized until there has been appropriate communication between the Member and the Corporation's Board of Directors and its Chief Executive Officer. Actions requiring implementation authority include: (a) Changes to the Statements of mission, philosophy, and values of the Corporation; (b) Removal of an individual from the Corporation's Board of Directors if and when the Member determines in good faith that the Director is failing to meet the Approved Board of Member Expectations. This authority to remove Directors shall not be used merely because there is a difference in business judgment between the Director and the Corporation or the Member,and shall never be used to remove one or more Directors from the Corporation's Board of Directors in order to change a decision made by the Corporation's Board of Directors; (c) Employment and termination of the Chief Executive Officer of the Corporation; (d) Appointment of the auditor for the Corporation and the coordination of the Corporation's annual audit; (e) Sales, lease, exchange, mortgage, pledge, creation of a security interest in or other disposition of real or personal property of the Corporation if such property has a fair market value in excess of a limit set from time to time by the Member and that is not otherwise contained in an Approved Budget; (f) Sale, merger, consolidation, change of membership, sale of all or substantially all of the assets of the corporation, or closure of any facility operated by the Corporation; (g) The dissolution of the Corporation; (h) Incurrence of debt by or for the Corporation in accordance with requirements established from time to time by the Member and that is not otherwise contained in an Approved Budget; and (i) Authority to establish policies to promote and develop an integrated, cohesive health care delivery system across all corporations for which the Member serves as the corporate member. 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 board 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. St. Luke's Health System is committed to providing the highest quality medical care to all people regardless of their ability to pay. To keep that commitment, St. Luke's puts a great deal of time and effort into recruiting and retaining the top physicians in a variety of medical fields. Our relationships with physicians range from having privileges at the hospital to full employment. For those physicians who choose to be employed, St. Luke's must offer competitive pay and benefits. Physician compensation is based on a range of criteria and can be influenced by a number of variables including: -Community need for medical specialty -Experience -Productivity -Geography -National surveys adjusted for local conditions -Willingness to serve regardless of patients' ability to pay -Duration of relationship and contractual terms -Performance on quality metrics To ensure physician compensation and benefits remain within industry standards and legal requirements for not-for-profit institutions, St. Luke's has a Physician Arrangements policy that specifies circumstances requiring a third-party valuation and also periodically uses third-party consulting firms to review St. Luke's physician compensation arrangements. Given the growing national shortage of physicians, recruiting and retaining physicians is more critical than ever to guarantee that people seeking care at St. Luke's will continue to have access to the physicians and specialists they need regardless of their insurance status or insurance provider. 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, which contains financial information, is available for public inspection. Form 990, Part XI, line 9: Defined Benefit Plan Adjustment -4,084,551. Form 990 Part VII Section A Allocation of Compensation and Hours: The total hours worked and compensation reported for the following individuals represent services rendered to organizations within the St. Luke's Health System: James Angle: St. Luke's Magic Valley Regional Medical Center, Ltd. St. Luke's Wood River Medical Center, Ltd. St. Luke's Clinic Coordinated Care, Ltd. Brian Fortuin, M.D.: St. Luke's Magic Valley Regional Medical Center, Ltd. St. Luke's Wood River Medical Center, Ltd. Robert Wasserstrom, M.D. St. Luke's Magic Valley Regional Medical Center, Ltd. St. Luke's Wood River Medical Center, Ltd. Ron E. McGarrigle, M.D. St. Luke's Magic Valley Regional Medical Center, Ltd. St. Luke's Wood River Medical Center, Ltd. David A. McClusky, M.D. St. Luke's Magic Valley Regional Medical Center, Ltd. St. Luke's Wood River Medical Center, Ltd. Eric Cassidy, D.O. St. Luke's Magic Valley Regional Medical Center, Ltd. St. Luke's Wood River Medical Center, Ltd. 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 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. Also, it should be noted that the hours reported for the directors (employed by St. Luke's), 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. Part VII: Section A Compensation of Physician Board Members The following physician board members are members of various physician practices that contract with St. Luke's Magic Valley Regional Medical Center, Ltd. (SLMV) for the purpose of providing physician services to SLMV patients: Eric Cassidy, D.O. Emergency Physicians of Southern Idaho, PLLC Brian Fortuin, M.D. Idaho Medicine Associates Ron McGarrigle, M.D. Magic Valley Anesthesiology Associates Robert Wasserstrom, M.D. Southern Idaho Radiology These physicians work at least 40 hours per week on behalf of these practices for physician services provided to St. Luke's patients. During CY'15, SLMV made payments to these practices for the following amounts: Physician Practice Amount Paid Emergency Physicians of Southern Idaho $5,584,632 Idaho Medicine Associates, LLC $3,008,373 Magic Valley Anesthesia Associates $8,395,465 Southern Idaho Radiology $4,752,712 Dr. Fortuin is also a member of St. Luke's Magic Valley Sleep Institute, LLC (Sleep Institute), a physician practice that contracts with SLMV to provide physician services to SLMV patients. During CY'15 SLMV made payments totaling $253,098. During CY'15, Dr. Fortuin was compensated directly by SLMV for serving as chair for the Magic Valley Physician Leadership Council. The amount paid for these services was $126,010 and is reported in Part VII, Section A. During CY'15, Dr. McGarrigle was compensated directly by SLMV for serving as chair for the Magic Valley Physician Leadership Council. The amount paid for these services was $57,094 and is reported in Part VII, Section A. During CY'15, Dr. Wasserstrom was compensated directly by SLMV for serving as chair for the Magic Valley Physician Leadership Council. The amount paid for these services was $30,250 and is reported in Part VII, Section A. Form 990 Part V, Line 1&2 During tax reporting year 2016 accounts payable and payroll process were consolidated to the supporting organization level (St. Luke's Health System, Ltd). Therefore, corresponding reporting for 1099's and W-2's occurs at that level. Magic Valley Paramedics LLC PO Box 409 Twin Falls ID 83303 200997728 Paramedic Services ID 3959492 1471556 St Luke's Magic Valley Regional Medical Center Ltd St Luke's ClinicLLC PO Box 409 Twin Falls ID 83301 820527710 Physician Services ID 94455064 61183748 St Luke's Magic Valley Regional Medical Center Ltd Magic Health Partners LLC PO Box 409 Twin Falls ID 83301 820507483 Admin.Services for Non-Provider Based Physician Groups ID 75256 70290 St Luke's Magic Valley Regional Medical Center Ltd 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 0 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 0 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 0 St Luke's Health System Ltd 190 E Bannock Boise ID 83712 562570681 Supporting Organization ID 501(c)(3) 11-3 N/A 0 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 0 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 0 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 0 0 0 1 0 0 0 0 0 0 0 0 0 1 0 1 1 0 0 0 St Luke's Health Foundation Ltd C 234054 Contribution St Luke's Health Foundation Ltd P 639942 Subsidy