2015-11-16T10:04:59-06:00 2014-12-31 990 2014-01-01 431707306 ST LUKES OF TRENTON STLU 6603595621 191 IOWA BLVD TRENTON MO 64683 JANET BUCKMAN CHIEF FINANCIAL OFFICER 6603595621 2015-11-16 2014 2016-02-25 16:41:14Z WRIGHT MEMORIAL HOSPITAL GARY JORDAN 191 IOWA BLVD TRENTON MO 64683 29188844 0 X WWW.SAINTLUKESHEALTHSYSTEM.ORG X 1995 MO CRITICAL ACCESS HOSPITAL 10 8 227 21 0 0 156279 50604 28289182 29107135 802 31105 0 0 28446263 29188844 2967 6201 0 0 11554486 11943407 0 0 77828 15888850 16588678 27446303 28538286 999960 650558 13009282 11868810 5004334 3351541 8004948 8517269 X WRIGHT MEMORIAL HOSPITAL IS A FAITH-BASED, NOT-FOR-PROFIT COMMUNITY HOSPITAL COMMITTED TO THE HIGHEST LEVELS OF EXCELLENCE IN PROVIDING HEALTH CARE AND HEALTH RELATED SERVICES IN A CARING ENVIRONMENT. AS A MEMBER OF SAINT LUKE'S HEALTH SYSTEM WE ARE DEDICATED TO ENHANCING THE PHYSICAL, MENTAL AND SPIRITUAL HEALTH OF THE COMMUNITIES WE SERVE. 0 0 24022030 6201 29107135 SAINT LUKE'S HOSPITAL OF TRENTON OPERATES AN ACUTE CARE HOSPITAL IN RURAL MISSOURI AND IS DESIGNATED BY THE STATE OF MISSOURI AND MEDICARE AS A CRITICAL ACCESS HOSPITAL. THE HOSPITAL IS DEDICATED TO PROVIDING BOTH SERVICES AND LEADERSHIP IN CARING FOR THE NEEDY. THE HOSPITAL PARTICIPATES IN THE MEDICAID AND MEDICARE PROGRAMS AND HAS A FINANCIAL ASSISTANE POLICY FOR ASSISTING PEOPLE WITHOUT ADEQUATE MEANS TO PAY FOR THEIR CARE. THE HOSPITAL ENCOURAGES PHYSICIANS PRACTICING IN SPECIALTY AREAS TO PROVIDE SERVICES TO THE HOSPITAL'S RURAL PATIENTS WHO OTHERWISE WOULD HAVE DIFFICULTY ACCESSING SUCH SPECIALTY SERVICES. THE HOSPITAL CONDUCTS COMMUNITY EDUCATION AND OUTREACH SERVICES INCLUDING FREE SEMINARS FOR HEALTHCARE PROFESSIONALS AND STUDENTS. IN ADDITION, THE HOSPITAL PROVIDED CLINICS, SCREENINGS, SUPPORT GROUPS, SOCIAL WORKS SERVICES AND PARTICIPATED IN CHARITABLE EVENTS AND SPONSORSHIPS. 24022030 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 1 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 28 0 1 227 1 0 0 0 0 0 0 0 0 0 0 X 10 8 1 0 1 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 X THE ORGANIZATION 6603595621 191 IOWA BLVD TRENTON MO 64683 X DON SIPES PRESIDENT-DIRECTOR 2.00 50.00 X X 0 427605 61082 WENDELL LENHART CHAIRMAN-DIRECTOR 2.00 X X 0 0 0 BEV HOOKER SECRETARY-DIRECTOR 2.00 X X 0 0 0 CHARLES ROBB TREASURER-DIRECTOR 2.00 50.00 X X 0 932663 246296 SCOTT WILSON DIRECTOR 2.00 X 0 0 0 BONITA PRICE DIRECTOR 2.00 X 0 0 0 MACK WOODARD VICE CHAIR-DIRECTOR 2.00 X X 0 0 0 DANETTE RARDON DIRECTOR 2.00 X 0 0 0 TOM WITTEN DIRECTOR 2.00 X 0 0 0 DWIGHT GRIFFIN DIRECTOR 2.00 X 0 0 0 ELAINA HEAD ASSISTANT SECRETARY 40.00 X 52496 0 20131 GARY JORDAN CEO 40.00 X 247385 0 50592 BARBARA BALL CNO 40.00 X 122526 0 22386 JANET BUCKMAN CFO 20.00 20.00 X 0 190503 17893 PAMELA RALLS PHYSICIAN 40.00 X 249617 0 18143 GEORGE GARCIA PHYSICIAN 40.00 X 238265 0 33723 ESGAR GUARIN-NIETO PHYSICIAN 40.00 X 241936 0 31429 AARON HUFFSTUTTER ADV PRACTICE RN 40.00 X 135631 0 16373 JENNIFER BOWE PHYSICIAN 40.00 X 123941 0 18204 1411797 1550771 536252 9 0 1 0 DOCS WHO CARE 1337 SOUTH FOUNTAIN DRIVE OLATHE KS 66061 EMERGENCY DEPT PHYSICIANS 1357163 HAVE A NICE DAY ANESTHESIA ASSOCIATES L 2106 WOODCREST DR CHILLICOTHE MO 64601 ANESTHESIA SERVICES 570000 SHARED MEDICAL SERVICES INC PO BOX 330 COTTAGE GROVE WI 53527 MRI PATIENT SERVICES 173950 PREMIER SPECIALTY NETWORK LLC 1835 E REPUBLIC ROAD SPRINGFIELD MO 65804 PHYSICIAN SERVICES 126584 FAVORITE HEALTHCARE STAFFING PO BOX 803356 KANSAS CITY MO 64180 CONTRACTED PHYSICIANS 108693 5 50604 50604 NET PATIENT REVENUE 622110 27930578 27930578 PHARMACY 622110 752489 752489 EHR MEANINGFUL USE FDS 622110 160053 160053 264015 264015 29107135 31105 31105 29188844 29107135 0 31105 X 6201 6201 515516 515516 8814384 7963604 789982 60798 249889 213295 34966 1628 1748974 1492850 244727 11397 614644 524634 86005 4005 20817 20817 72068 72068 4602571 4352729 249842 2451 576 1875 764032 635925 128107 211602 150177 61425 3202874 2817036 385838 29198 17705 11493 53837 17048 36789 1031884 579958 451926 245993 130143 115850 BAD DEBTS 2471137 2471137 MEDICAL SUPPLIES 2001654 1996725 4929 SHARED SERVICES - SLHS 1793000 590447 1202553 TAXES & LICENSE 8144 7913 231 77416 53927 23489 28538286 24022030 4438428 77828 11474 2069458 3732419 3150511 3902237 58895 425625 403436 373980 429988 6459116 3650983 3452832 2808133 18750 1862441 2177913 13009282 11868810 1585781 1578212 3418553 1773329 5004334 3351541 X 7615068 8152581 389880 364688 8004948 8517269 13009282 11868810 X 650558 -138237 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 13648 0 0 0 13648 0 PART II-B, LINE 1: LINE F - PORTION OF DUES PAID TO VARIOUS HOSPITAL AND RELATED MEDICAL ASSOCIATIONS USED TOWARD LOBBYING ACTIVITIES. 56611 5210 61821 50271 7495 1155 56611 42978 10451 3158 50271 1 53795 14000 39795 4609937 2242306 2367631 1795384 1394677 400707 2808133 BENEFICIAL INTEREST IN NET ASSETS OF WMH FOUNDATION 364688 DUE FROM AFFILIATES 15045 ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS 1592008 OTHER RECEIVABLES 194089 OTHER ASSETS 12083 2177913 DUE TO CHARITABLE TRUST 1370359 DUE TO AFFILIATES 202970 ESTIMATED THIRD-PARTY PAYOR SETTLEMENT 200000 1773329 X 26689422 0 26689422 2499422 2499422 29188844 26067151 0 26067151 2471135 2471135 28538286 PART V, LINE 4: THE INTENDED USE OF ENDOWMENT FUNDS INCLUDES BUT IS NOT LIMITED TO THE GENERAL OPERATIONS OF THE HOSPITAL, CAPITAL EQUIPMENT PURCHASES FOR THE HOSPITAL, AND LOCAL HOME CARE AND HOSPICE SERVICES. THE ASSETS HELD AT THE UNRELATED ORGANIZATION REPRESENT THE ORGANIZATION'S BENEFICIAL INTEREST IN THE NET ASSETS AT WRIGHT MEMORIAL HOSPITAL FOUNDATION. SUCH ASSETS ARE REPORTED IN PART X, LINE 15. PART X, LINE 2: THE HOSPITAL AND THE FOUNDATION ARE NOT-FOR-PROFIT CORPORATIONS AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND ARE EXEMPT FROM FEDERAL INCOME TAXES ON THEIR RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. MANAGEMENT IS NOT AWARE OF ANY UNCERTAINTIES IN INCOME TAX POSITIONS. FOR BOTH ENTITIES, THE YEARS ENDED DECEMBER 31, 2014, 2013, 2012, AND 2011, REMAIN SUBJECT TO EXAMINATION FOR BOTH FEDERAL AND STATE PURPOSES. PART XI, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT NET WITH REVENUE FOR BOOKS; INCLUDED IN EXPENSES FOR TAX 2,471,137. RRG SSA DIVIDEND ALLOCATION 28,285. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT NET WITH REVENUE FOR BOOKS; INCLUDED IN EXPENSES FOR TAX 2,471,137. ROUNDING -2. 1 1 X 1 X 133.000000000000 1 X 1 1 0 0 266040 266040 0.01020 4529360 4313866 215494 0.00830 4795400 4313866 481534 0.01850 9300 9300 0.00040 222 222 0.00000 8629496 6726948 1902548 0.07300 6100 6100 0.00020 8645118 6726948 1918170 0.07360 13440518 11040814 2399704 0.09210 4340 4340 0.00020 4340 4340 0.00020 0 2471137 12050010 12790204 -740194 X 1 1 1 1 WRIGHT MEMORIAL HOSPITAL 191 IOWA BLVD TRENTON MO 64683 413-19 X X X X ST LUKES OF TRENTON 1 0 0 1 X X X X X X X X X 13 1 0 0 1 X WWW.SAINTLUKESHEALTHSYSTEM.ORG X 1 13 1 WWW.SAINTLUKESHEALTHSYSTEM.ORG 0 0 1 X 133.000000000000 200.000000000000 X X 1 1 X X 1 X X X X X X X X 1 X 0 X X X X 1 X 0 0 ST LUKES OF TRENTON PART V, SECTION B, LINE 5: KEY HEALTH CARE SERVICE PROVIDERS OR COMMUNITY MEMBERS IN GRUNDY COUNTY WERE INTERVIEWED TO HELP IDENTIFY UNMET HEALTHCARE AND PUBLIC HEALTH NEEDS WITHIN THE GRUNDY COUNTY AREA. COMMUNITY STAKEHOLDERS WERE CONTACTED EITHER IN-PERSON OR OVER-THE-PHONE AND INCLUDE HOSPITAL EXECUTIVES, REPRESENTATIVES FROM COMMUNITY ORGANIZATIONS, AND INDIVIDUALS. ORGANIZATIONS CONSULTED INCLUDE WRIGHT MEMORIAL HOSPITAL EXECUTIVE LEADERS, GRUNDY COUNTY HEALTH DEPARTMENT, EASTVIEW MANOR CARE CENTER, GRUNDY COUNTY LEARNING CENTER, AND MISSOURI DIVISION OF SENIOR AND DISABILITY SERVICES. ST LUKES OF TRENTON PART V, SECTION B, LINE 11: WRIGHT MEMORIAL HOSPITAL IS EITHER ADDRESSING OR IN THE PROCESS OF ADDRESSING EVERY COMMUNITY HEALTH NEED LISTED BELOW. ONE OF THE CORE VALUES OF THE SAINT LUKE'S HEALTH SYSTEM AND WRIGHT MEMORIAL HOSPITAL IS STEWARDSHIP, AND WITH THAT VALUE IS THE RESPONSIBILITY TO LOOK AFTER THE NEEDS OF THE COMMUNITY. ADDRESSING ADULT OBESITYWRIGHT MEMORIAL HOSPITAL EMPLOYS A REGISTERED DIETICIAN TO PROVIDE SERVICES FOR PATIENTS INCLUDING EDUCATION ON NUTRITIONAL SERVICES. THE DIETITIAN PROVIDES PATIENTS WITH EDUCATIONAL MATERIAL AND HELPS CONNECT THEM WITH ADDITIONAL RESOURCES PROVIDED BY THE GRUNDY COUNTY HEALTH DEPARTMENT. WRIGHT MEMORIAL HOSPITAL WILL CONTINUE TO ADDRESS ADULT OBESITY THROUGH A NUMBER OF HEALTHY LIFESTYLE PROGRAMS AND ONGOING COMMUNITY OUTREACH. IN 2014, WRIGHT MEMORIAL HOSPITAL COMPLETED A HALF MILE WALKING TRAIL ON CAMPUS TO IMPROVE PUBLIC ACCESS TO RECREATION AS WELL AS PROMOTE HEALTHY LIFESTYLES WITHIN THE COMMUNITY. WRIGHT MEMORIAL HOSPITAL ALSO SUPPORTS WRIGHT MEMORIAL FOUNDATION IN THEIR ANNUAL 5K AND FOUNDATION GOLF TOURNAMENT, BOTH OF WHICH ENCOURAGE EXERCISE AND HEALTHY LIFESTYLES.ADDRESSING ADULT SMOKINGNEW TELE-HEALTH EQUIPMENT WAS RECENTLY PURCHASED AND PULMONOLOGY SERVICES ARE ALREADY BEING PROVIDED TO PATIENTS THROUGH TELE-MEDICINE AND ON SITE VISITS. THROUGH THE INNOVATIVE USE OF TELE-MEDICINE, PATIENTS IN GRUNDY COUNTY ARE SEEN BY THE SAME SPECIALTY PULMONOLOGIST GROUP THAT WORK AT SAINT LUKE'S HOSPITAL OF KANSAS CITY. WRIGHT MEMORIAL HOSPITAL WILL CONTINUE TO OFFER EDUCATION AND ASSISTANCE TO PROMOTE SMOKING CESSATION IN THE COMMUNITY. SPECIFICALLY, WRIGHT MEMORIAL HOSPITAL WILL REFER PATIENTS RECEIVING PRENATAL CARE TO A SMOKING CESSATION PROGRAM AT THE COUNTY HEALTH DEPARTMENT. THE PROGRAM WILL FOCUS ON THE RISKS OF SMOKING TO BOTH MOTHER AND CHILD, AND PROVIDE INFORMATION ABOUT ADDITIONAL RESOURCES AVAILABLE IN THE COMMUNITY. WRIGHT MEMORIAL HOSPITAL WILL ALSO CONTINUE TO PROVIDE ACCESS TO PULMONOLOGY SERVICES TO COMMUNITY MEMBERS THROUGH TELE-MEDICINE.INCREASING ACCESS TO MENTAL HEALTH PROVIDERS AND SERVICESWRIGHT MEMORIAL HOSPITAL CURRENTLY EMPLOYS A PSYCHIATRIC MENTAL HEALTH CLINICAL NURSE SPECIALIST (PMHCNS) WHO COMES TO WRIGHT VIA TELE-HEALTH PROGRAM ONCE A MONTH TO TREAT PATIENTS WITH MENTAL HEALTH NEEDS. IN ADDITION TO THE MONTHLY VISITS, THE SPECIALIST IS ALSO CREATING SPECIFIC DAYS TO SEE NEW PATIENTS. IN EMERGENCY SITUATIONS, WRIGHT MEMORIAL HOSPITAL HAS THE ABILITY TO PROVIDE PATIENTS WITH EMERGENT TELE-PHYSIC AND PLACEMENT SERVICES.IN PARTNERSHIP WITH MISSOURI COMMUNITY MENTAL HEALTH LIAISONS, WRIGHT MEMORIAL HOSPITAL WORKS TO ASSURE CONTINUITY OF CARE FOR PERSONS WITH MENTAL ILLNESS. THIS INVOLVES COORDINATION BETWEEN MENTAL HEALTH PROVIDERS AND EXISTING COMMUNITY RESOURCES, RESULTING IN A REDUCED NEED FOR EMERGENCY DEPARTMENT SERVICES.HELPING CHILDREN IN POVERTYASIDE FROM PROVIDING MEDICAL CARE TO INDIGENT POPULATIONS IN GRUNDY COUNTY, WRIGHT MEMORIAL HOSPITAL ALSO PROVIDES COMMUNITY HEALTH IMPROVEMENT SERVICES, FINANCIAL AND IN-KIND CONTRIBUTIONS, AND COMMUNITY BENEFIT OPERATIONS. ONE SUCH CONTRIBUTION WAS TOWARDS THE BACKPACK BUDDIES PROGRAM WITH WRIGHT CONTRIBUTING ITEMS FOR THE BACKPACK. IN ADDITION, WRIGHT SPONSORS A RAFFLE TO HELP SUPPORT THE BACKPACK BUDDIES PROGRAM AND PARTICIPATES IN ITEM COLLECTION FOR THE LOCAL FOOD PANTRY. A LACK OF PRIMARY CARE ACCESS AND PHYSICIANSA SHORTAGE OF PRIMARY CARE PHYSICIANS IS ALWAYS AN ISSUE IN RURAL AMERICA AND WRIGHT MEMORIAL HOSPITAL IS STRIVING TO IMPROVE ACCESS FOR COUNTY RESIDENTS. ONE SUCH WAY THAT WRIGHT IS ACHIEVING THIS IS BY INCREASING THE TELE-HEALTH SERVICES OFFERED AS WELL AS THE CAPACITY OF CERTAIN SPECIALTIES IN THE SPECIALTY CLINIC. THE OTHER IS BY CONTINUALLY RECRUITING FAMILY PRACTICE PHYSICIANS AND NURSE PRACTITIONERS TO THE AREA TO PROVIDE INPATIENT CONSULTS. WRIGHT MEMORIAL HOSPITAL HAS DEVELOPED A PROVIDER RECRUITMENT PLAN TO MEET THE ANTICIPATED SERVICE AREA NEEDS.PREVENTABLE HOSPITALIZATIONSIN ORDER TO DECREASE THE AMOUNT OF PREVENTABLE HOSPITALIZATIONS IN GRUNDY COUNTY EDUCATION IS CRITICAL FOR AT RISK POPULATIONS. ONE WAY THAT WRIGHT MEMORIAL HOSPITAL IS TRYING TO ACHIEVE THIS AIM IS THROUGH ENGAGEMENT AND SPONSORSHIP OF COMMUNITY EDUCATION EVENTS. ONE SUCH EVENT INVOLVES CARDIOVASCULAR CONSULTANTS PROVIDING INSTRUCTION ON CARDIAC DISEASE AND PREVENTION TECHNIQUES. WRIGHT MEMORIAL HOSPITAL IS IN THE PROCESS OF DEVELOPING AN INPATIENT TELE-HEALTH PROGRAM FOR CONSULTS TO IMPROVE ACCESS TO SPECIALTY CARE AND ENSURE A BETTER CONTINUUM OF CARE WHICH WILL RESULT IN REDUCED READMISSIONS. INCREASED ACCESS TO PRIMARY CARE WILL BE REALIZED THROUGH EXTENDED CLINIC HOURS. ST LUKES OF TRENTON PART V, SECTION B, LINE 16I: THE HOSPITAL FOLLOWS THE SAINT LUKE'S HEALTH SYSTEM POLICIES FOR FINANCIAL ASSISTANCE, PATIENT BILLING AND COLLECTION. IN ADDITION TO THESE POLICIES,THE HOSPITAL PROVIDES EDUCATION ON FINANCIAL ASSISTANCE ELIGIBILITY TO PATIENTS AND PERSONS WHO MAY BE BILLED FOR SERVICES THROUGH MANY SOURCES INCLUDING THE SLHS WEB SITE, INFORMATION ON BILLING STATEMENTS, INFORMATION UPON CHECK-IN LOCATED IN THE ADMITTING PATIENT PACKETS, ON OUR B-131 RELEASE TO TREAT FORMS SIGNED BY ALL PATIENTS REQUESTING SERVICES, VISITS WITH INPATIENTS BY SOCIAL WORKER TEAMS, AND FOLLOW-UP CALLS TO PATIENTS AFTER DISCHARGE. FINANCIAL ASSISTANCE APPLICATIONS OR MEDICAID APPLICATIONS ARE REQUESTED ON ALL UNINSURED INPATIENTS PRIOR TO DISCHARGE. THE HOSPITAL ALSO CONTRACTS WITH ELIGIBILITY ENROLLMENT COMPANIES TO SCREEN ALL UNINSURED PATIENTS, ANY PATIENTS IDENTIFIED BY OUR SOCIAL WORKER OR CASE MANAGEMENT TEAMS, AND ALL PATIENTS THAT REQUEST ASSISTANCE IN APPLYING FOR MEDICAID OR OTHER GOVERNMENT COVERAGE. THE ELIGIBILITY ENROLLMENT SERVICE ALSO PROVIDES PATIENTS WITH INFORMATION ON FINANCIAL ASSISTANCE. ST LUKES OF TRENTON PART V, SECTION B, LINE 20E: SEE RESPONSE TO LINE 16I. PART V, SECTION B, LINE 9 AS PERMITTED BY IRS TRANSITION RULES, THE ORGANIZATION ADOPTED ITS IMPLEMENTATION STRATEGY BY MAY 15, 2014 AND THEREFORE IS DEEMED TO SATISFY THE REQUIREMENT TO ADOPT THE STRATEGY IN THE SAME YEAR THE CHNA WAS COMPLETED AND MADE WIDELY AVAILABLE, 2013. PART V, SECTION B, LINE 16 FINANCIAL ASSISTANCE POLICY WEBSITE AVAILABILITY ST LUKES OF TRENTON PART V, SECTION B, LINE 16A WEBSITE: WWW.SAINTLUKESHEALTHSYSTEM.ORG ST LUKES OF TRENTON PART V, SECTION B, LINE 16B WEBSITE: WWW.SAINTLUKESHEALTHSYSTEM.ORG ST LUKES OF TRENTON PART V, SECTION B, LINE 16C WEBSITE: WWW.SAINTLUKESHEALTHSYSTEM.ORG 1 WRIGHT MEMORIAL PHYSICIANS GROUP 189 IOWA BLVD TRENTON MO 64683 RURAL HEALTH CLINIC PART I, LINE 7: COST OF CHARITY CARE AND UNREIMBURSED HEALTH SERVICES WERE CALCULATED USING THE APPROPRIATE COST TO CHARGE RATIO. PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 2,471,137. PART II, COMMUNITY BUILDING ACTIVITIES: OUR HOSPITAL SPONSORS OR PARTICIPATES IN MANY COMMUNITY BUILDING ACTIVITIES WHICH PROMOTE THE HEATH OF OUR COMMUNITY. THE HOSPITAL PARTICIPATES IN EDUCATIONAL OFFERINGS AND SPONSORS MULTIPLE COMMUNITY EVENTS TO BENEFIT VARIOUS COMMUNITY ORGANIZATIONS. WE ALSO ENCOURAGE OUR EMPLOYEES TO SERVE ON COMMUNITY BOARDS AND VOLUNTEER FOR ACTIVITIES THAT PROMOTE HEALTH IN THE COMMUNITY. PART III, LINE 4: BAD DEBT EXPENSE IS REPORTED IN ACCORDANCE WITH GENERALLY ACCEPTED ACCOUNTING PRINCIPLES (GAAP). HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION STATEMENT 15 IS FOLLOWED TO THE EXTENT IT ALIGNS WITH GAAP.FINANCIAL STATEMENT FOOTNOTE REGARDING BAD DEBT EXPENSE: SEE PAGE 8, NOTE A, SECTION 2 OF THE ATTACHED FINANCIALS STATEMENTS.BAD DEBT IS REPORTED IN THIS FORM 990 CONSISTENT WITH FINANCIAL STATEMENTS. PART III, LINE 9B: IF A PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE THE ACCOUNT IS ADJUSTED ACCORDINGLY. ANY REMAINING BALANCE WOULD BE COLLECTED UNDER THE DEBT COLLECTION POLICY. OUR COLLECTION POLICIES ARE THE SAME FOR ALL PATIENTS. ALTHOUGH WE ARE NOT LEGALLY BOUND BY THE FAIR DEBT COLLECTION PRACTICES ACT, THE PRINCIPLES ADDRESSED ARE GENERALLY FOLLOWED. PART VI, LINE 2: IN ADDITION TO ITS CHNA, THE HOSPITAL ASSESSES COMMUNITY NEEDS ON AN ANNUAL BASIS IN NUMEROUS WAYS, INCLUDING THROUGH ITS COMPREHENSIVE, DATA DRIVEN, ANNUAL STRATEGIC PLANNING PROCESS. THE HOSPITAL MEETS WITH STAFF, VOLUNTEERS, PATIENTS, BOARD MEMBERS AND PHYSICIANS. THE HOSPITAL ALSO WORKS WITH THE PATIENT ADVOCATE AND MARKETING DEPARTMENTS TO DETERMINE FEEDBACK RECEIVED FROM THE COMMUNITY REGARDING ITS NEEDS. THE FEEDBACK PROVIDED BY THESE GROUPS IS COMMUNICATED TO HOSPITAL MANAGEMENT AND CONSIDERED WHEN DETERMINING THE NEEDS OF THE COMMUNITY. PART VI, LINE 3: SEE RESPONSE TO SCHEDULE H, PART V, LINE 16I. PART VI, LINE 4: WRIGHT MEMORIAL HOSPITAL IS LOCATED IN GRUNDY COUNTY, MISSOURI IN THE NORTHWEST AREA OF MISSOURI. THE HOSPITAL'S PRIMARY SERVICE AREA IS THE IMMEDIATE COUNTY AND ALL CONTIGUOUS SURROUNDING COUNTIES. PART VI, LINE 5: THE BOARD OF DIRECTORS IS MADE UP OF MEDICAL AND BUSINESS PROFESSIONALS, ALL OF WHOM RESIDE IN THE HOSPITAL'S PRIMARY SERVICE AREA, PLUS TWO REPRESENTATIVES OF SAINT LUKE'S HEALTH SYSTEM. MEDICAL STAFF PRIVILEGES ARE OFFERED TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY. PART VI, LINE 6: THE HOSPITAL IS AFFILIATED WITH SAINT LUKE'S HEALTH SYSTEM, WHICH CONSISTS OF 10 AREA HOSPITALS, AND SEVERAL PRIMARY AND SPECIALTY CARE PRACTICES, AND PROVIDES A RANGE OF INPATIENT, OUTPATIENT, AND HOME CARE SERVICES. FOUNDED AS A FAITH-BASED, NOT-FOR-PROFIT ORGANIZATION, OUR MISSION INCLUDES A COMMITMENT TO THE HIGHEST LEVELS OF EXCELLENCE IN HEALTH CARE AND THE ADVANCEMENT OF MEDICAL RESEARCH AND EDUCATION. THE HEALTH SYSTEM IS AN ALIGNED ORGANIZATION IN WHICH THE PHYSICIANS AND HOSPITALS ASSUME RESPONSIBILITY FOR ENHANCING THE PHYSICAL, MENTAL, AND SPIRITUAL HEALTH OF PEOPLE IN THE METROPOLITAN KANSAS CITY AREA AND THE SURROUNDING REGION. 0 1 0 0 0 0 0 1 0 DON SIPES PRESIDENT-DIRECTOR 0 266388 0 43570 0 117647 0 41153 0 19929 0 488687 0 19120 CHARLES ROBB TREASURER-DIRECTOR 0 507904 0 106935 0 317824 0 217740 0 28556 0 1178959 0 97471 GARY JORDAN CEO 194448 0 33411 0 19526 0 26115 0 24477 0 297977 0 15201 0 JANET BUCKMAN CFO 0 171000 0 18586 0 917 0 7756 0 10137 0 208396 0 0 PAMELA RALLS PHYSICIAN 224945 0 23653 0 1019 0 10013 0 8130 0 267760 0 0 0 GEORGE GARCIA PHYSICIAN 196198 0 40984 0 1083 0 14685 0 19038 0 271988 0 0 0 ESGAR GUARIN-NIETO PHYSICIAN 209923 0 30594 0 1419 0 7722 0 23707 0 273365 0 0 0 AARON HUFFSTUTTER ADV PRACTICE RN 116741 0 2171 0 16719 0 2440 0 13933 0 152004 0 0 0 PART I, LINE 4B 457(F) PLAN PARTICIPANT AND AMOUNT INCLUDED IN COLUMN C FOR THE PLAN: CHARLES ROBB - $94,040 PART I, LINE 7 THE ORGANIZATION HAS ADOPTED A MANAGEMENT INCENTIVE COMPENSATION PLAN FOR CERTAIN MEMBERS OF SENIOR AND MIDDLE MANAGEMENT TO PROMOTE EFFECTIVE MANAGEMENT OF OPERATIONS, QUALITY OF CARE AND SERVICE, AND OPTIMAL USE OF RESOURCES. THE INCENTIVES ARE CALCULATED AS A PERCENTAGE OF BASE SALARY CONTINGENT ON ACHIEVING QUALITY, PATIENT SATISFACTION, EMPLOYEE RETENTION, FINANCIAL AND OTHER OPERATIONAL PERFORMANCE TARGETS ESTABLISHED BY THE BOARD'S COMPENSATION COMMITTEE ON AN ANNUAL BASIS. INCENTIVE AWARDS ARE PAID AT THE DISCRETION OF THE BOARD OF DIRECTORS AND DO NOT ACCRUE TO THE BENEFIT OF THE INDIVIDUALS UNTIL AFTER FINANCIAL RESULTS HAVE BEEN DETERMINED FOR THE CALENDAR YEAR. THIS INCENTIVE COMPENSATION IS EVALUATED AS PART OF THE REVIEW OF MARKET COMPETITIVE DATA AND REASONABLENESS OF OVERALL COMPENSATION AND BENEFITS. PART I, LINE 3 ANNUALLY, THE SAINT LUKE'S HEALTH SYSTEM BOARD OF DIRECTORS' COMPENSATION COMMITTEE REVIEWS, DISCUSSES, SETS AND APPROVES COMPENSATION FOR THE ORGANIZATION'S TOP MANAGEMENT EXECUTIVE AND CFO. INDEPENDENT, EXTERNAL DIRECTORS SERVE ON THE COMPENSATION COMMITTEE. AN INDEPENDENT COMPENSATION CONSULTING FIRM ANNUALLY PROVIDES A WRITTEN REPORT AND REASONABLENESS OPINION. THE CONSULTANT REVIEWS THE SYSTEM'S EXECUTIVE COMPENSATION PHILOSOPHY AND ANALYZES MARKET COMPETITIVENESS (IN TOTAL AND BY EACH COMPENSATION AND BENEFIT ELEMENT) FOR THE EXECUTIVES USING APPROPRIATE COMPARABILITY DATA. COMPENSATION COMMITTEE ACTIONS ARE CONTEMPORANEOUSLY DOCUMENTED. THE PROCESS SATISFIES THE REBUTTABLE PRESUMPTION PROCEDURE. COMPENSATION FOR OFFICERS NOT REVIEWED BY THE COMPENSATION COMMITTEE IS SET/APPROVED ANNUALLY BY SAINT LUKE'S HEALTH SYSTEM EXECUTIVE MANAGEMENT BASED ON MARKET COMPENSATION DATA. PART II DON SIPES AND CHUCK ROBB DID NOT RECEIVE COMPENSATION FOR DUTIES AS A DIRECTOR OR OFFICER OF THE FILING ORGANIZATION BUT RECEIVED COMPENSATION FROM RELATED ORGANIZATIONS FOR SERVICES RENDERED TO THE RELATED ORGANIZATIONS. JANET BUCKMAN RECEIVED COMPENSATION FOR SERVICES RENDERED TO THE FILING AND RELATED ORGANIZATIONS. AARON HUFFSTUTTER HIGHLY COMPENSATED EMPLOYEE BUYOUT OF NON-COMPETE X 75000 58895 0 0 1 58895 0 FORM 990, PART VI, SECTION A, LINE 2 DANETTE RARDON, BONITA PRICE, AND DWIGHT GRIFFIN HAVE A BUSINESS RELATIONSHIP. DON SIPES AND CHARLES ROBB HAVE A BUSINESS RELATIONSHIP BECAUSE THEY ARE DIRECTORS, OFFICERS, AND/OR EMPLOYEES OF THE SAME AFFILIATED TAX-EXEMPT ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 4 THE ORGANIZATION AMENDED AND UPDATED SELECTED PROVISIONS OF ITS ARTICLES AND BYLAWS AT THE END OF 2014. THE CHANGES FORMALIZED ADDITIONAL RESERVE POWERS FOR THE SOLE MEMBER, UPDATED BOARD MEMBER QUALIFICATIONS TO BE CONSISTENT WITH SYSTEM STANDARDS, CLARIFIED OBLIGATIONS TO CARRY OUT POLICIES AND ORDERS OF THE SOLE MEMBER, UPDATED AND ALIGNED CEO AUTHORITY AND DUTIES, CLARIFIED MEDICAL STAFF RESPONSIBILITIES TO THE BOARD AS TO PATIENT CARE PROVIDED WITHIN THE HOSPITAL, AND STANDARDIZED CERTAIN PROVISIONS ACROSS SYSTEM HOSPITALS WITH THE GOAL OF BETTER FACILITATING OPERATIONS AS AN ALIGNED AND INTEGRATED HEALTH SYSTEM. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE CORPORATE MEMBER IS SAINT LUKE'S HEALTH SYSTEM, A 501(C)(3) ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A THE GOVERNING BODY IS ELECTED BY THE SOLE CORPORATE MEMBER. FORM 990, PART VI, SECTION A, LINE 7B THE SOLE MEMBER HAS SPECIFIED RESERVE POWERS OVER MAJOR DECISIONS SUCH AS AMENDMENTS TO ARTICLES AND BYLAWS, APPOINTMENT & REMOVAL OF DIRECTORS AND THE CEO, DEBT, BUDGETS, CAPITAL EXPENDITURES, POLICIES APPLICABLE TO THE ORGANIZATION, AND STRATEGIC OPERATING DECISIONS. AS PART OF AN INTEGRATED HEALTH SYSTEM, THE SOLE MEMBER ALSO PROVIDES VARIOUS MANAGEMENT AND SUPPORT FUNCTIONS TO THE ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 11 THE 990 IS PREPARED JOINTLY BY ACCOUNTING STAFF OF THE ENTITY AND SAINT LUKE'S HEALTH SYSTEM TAX STAFF AND REVIEWED BY THE FILING ORGANIZATION'S CEO. THE 990 DRAFT WAS MADE AVAILABLE TO THE AUDIT COMMITTEE OF THE SYSTEM BOARD OF DIRECTORS FOR REVIEW. THE 990 WAS PROVIDED TO THE ORGANIZATION'S BOARD MEMBERS FOR VIEWING BEFORE FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C SAINT LUKE'S HEALTH SYSTEM AND ITS AFFILIATES, INCLUDING THE FILING ORGANIZATION, HAVE COMPREHENSIVE WRITTEN CONFLICT OF INTEREST POLICIES APPLICABLE TO ALL DIRECTORS, OFFICERS, AND EMPLOYEES. ANY ACTUAL, POSSIBLE OR PERCEIVED CONFLICT OF INTEREST IS EXPECTED TO BE HANDLED THROUGH FULL AND TIMELY DISCLOSURE OF ANY SUCH INTEREST, TOGETHER WITH ABSENCE OF PERSUASION IN ANY DISCUSSION AND IN ANY VOTE WHEREIN THE INTEREST IS INVOLVED. DISCLOSURE IS TO BE MADE WHEN THE INTEREST ARISES, AT ANY TIME THE INTEREST BECOMES A MATTER OF GOVERNING BOARD ACTION, AND THEN ANNUALLY THROUGH COMPLETION OF A CONFLICT OF INTEREST QUESTIONNAIRE. THE SYSTEM VICE PRESIDENT OF INTERNAL AUDIT REVIEWS COMPLETED QUESTIONNAIRES AND INVESTIGATES POSSIBLE CONFLICTS OF INTEREST. A REPORT IS PROVIDED TO THE AUDIT COMMITTEE OF THE SYSTEM BOARD OF DIRECTORS AND ANY IDENTIFIED CONFLICT OF INTEREST IS REPORTED TO THE APPLICABLE ENTITY. FORM 990, PART VI, SECTION B, LINE 15 ANNUALLY, THE SAINT LUKE'S HEALTH SYSTEM BOARD OF DIRECTORS' COMPENSATION COMMITTEE REVIEWS, DISCUSSES, SETS AND APPROVES COMPENSATION FOR THE ORGANIZATION'S TOP MANAGEMENT EXECUTIVE AND CFO. INDEPENDENT, EXTERNAL DIRECTORS SERVE ON THE COMPENSATION COMMITTEE. AN INDEPENDENT COMPENSATION CONSULTING FIRM ANNUALLY PROVIDES A WRITTEN REPORT AND REASONABLENESS OPINION. THE CONSULTANT REVIEWS THE SYSTEM'S EXECUTIVE COMPENSATION PHILOSOPHY AND ANALYZES MARKET COMPETITIVENESS (IN TOTAL AND BY EACH COMPENSATION AND BENEFIT ELEMENT) FOR THE EXECUTIVES USING APPROPRIATE COMPARABILITY DATA. COMPENSATION COMMITTEE ACTIONS ARE CONTEMPORANEOUSLY DOCUMENTED. THE PROCESS SATISFIES THE REBUTTABLE PRESUMPTION PROCEDURE. COMPENSATION FOR OFFICERS NOT REVIEWED BY THE COMPENSATION COMMITTEE IS SET/APPROVED ANNUALLY BY SAINT LUKE'S HEALTH SYSTEM EXECUTIVE MANAGEMENT BASED ON MARKET COMPENSATION DATA. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S ARTICLES OF INCORPORATION AND AMENDMENTS THERETO ARE MADE AVAILABLE TO THE PUBLIC THROUGH THE MO SECRETARY OF STATE. THE ORGANIZATION'S FINANCIAL STATEMENTS ARE ATTACHED TO THIS RETURN. THE ORGANIZATION'S OTHER GOVERNING DOCUMENTS AND CONFLICTS OF INTEREST POLICY ARE NOT MADE AVAILABLE TO THE PUBLIC. FORM 990, PART VII, COLUMN E DON SIPES AND CHUCK ROBB DID NOT RECEIVE COMPENSATION FOR DUTIES AS A DIRECTOR OR OFFICER OF THE FILING ORGANIZATION BUT RECEIVED COMPENSATION FROM RELATED ORGANIZATIONS FOR SERVICES RENDERED TO THE RELATED ORGANIZATIONS. JANET BUCKMAN RECEIVED COMPENSATION FOR SERVICES RENDERED TO THE FILING AND RELATED ORGANIZATIONS. FORM 990, PART IX, LINE 11G PURCHASED SERVICES & OTHER: PROGRAM SERVICE EXPENSES 2,234,945. MANAGEMENT AND GENERAL EXPENSES 229,402. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,464,347. REPAIRS & MAINTENANCE: PROGRAM SERVICE EXPENSES 121,098. MANAGEMENT AND GENERAL EXPENSES 20,440. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 141,538. PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 1,996,686. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,996,686. FORM 990, PART XI, LINE 9: ROUNDING -2. PENSION SETTLEMENT/LIABILITY TRANSFER TO SLHS -84,758. CHANGE IN NET ASSETS AT WMH FOUNDATION - SFAS 136 -25,192. RRG SSA DIVIDEND ALLOCATION -28,285. SAINT LUKES HEALTH SYSTEM 901 E 104TH ST KANSAS CITY MO 64131 431747502 HEALTH SYSTEM KS 501(C)(3) 509(A)(3) - TYPE 1 0 ST LUKES HOSPITAL OF KANSAS CITY 4401 WORNALL ROAD KANSAS CITY MO 64111 440545297 HEALTH CARE MO 501(C)(3) 170B1AIII SAINT LUKES HEALTH SYSTEM 0 SAINT LUKES NORTHLAND HOSPITAL CORPORATION 601 SOUTH 169 HIGHWAY SMITHVILLE MO 64089 440565393 HEALTH CARE MO 501(C)(3) 170B1AIII SAINT LUKES HEALTH SYSTEM 0 SAINT LUKES SOUTH HOSPITAL INC 12300 METCALF AVENUE OVERLAND PARK KS 66213 481203262 HEALTH CARE KS 501(C)(3) 170B1AIII SAINT LUKES HEALTH SYSTEM 0 SAINT LUKES EAST HOSPITAL 100 NE SAINT LUKES BLVD LEES SUMMIT MO 64086 562488077 HEALTH CARE MO 501(C)(3) 170B1AIII SAINT LUKES HEALTH SYSTEM 0 SAINT LUKES MEDICAL GROUP 901 E 104TH ST KANSAS CITY MO 64131 431598353 HEALTH CARE MO 501(C)(3) 170B1AIII SAINT LUKES HEALTH SYSTEM 0 CRITTENTON 10918 ELM AVE KANSAS CITY MO 64134 440545808 HEALTH CARE MO 501(C)(3) 170B1AIII ST LUKES HOSPITAL OF KANSAS CITY 0 SAINT LUKES HEALTH SYSTEM HOMECARE AND HOSPICE 3100 BROADWAY SUITE 1000 KANSAS CITY MO 64111 431127200 HEALTH CARE MO 501(C)(3) 170B1AIII SAINT LUKES HEALTH SYSTEM 0 SAINT LUKES HOSPITAL OF GARNETT 421 SOUTH MAPLE GARNETT KS 66032 742849611 HEALTH CARE KS 501(C)(3) 170B1AVI SAINT LUKES HEALTH SYSTEM 0 CABOT WESTSIDE HEALTH CENTER 901 E 104TH ST KANSAS CITY MO 64131 440546280 HEALTH CARE MO 501(C)(3) 170B1AIII SAINT LUKES HEALTH SYSTEM 0 MIDWEST EAR INSTITUTEINC 4320 WORNALL ROAD STE 420 KANSAS CITY MO 64111 480905027 HEALTH CARE KS 501(C)(3) 170B1AIII ST LUKES HOSPITAL OF KANSAS CITY 0 SAINT LUKES HOSPITAL OF CHILLICOTHE 2799 N WASHINGTON CHILLICOTHE MO 64601 431735565 HEALTH CARE MO 501(C)(3) 170B1AIII SAINT LUKES HEALTH SYSTEM 0 SAINT LUKES CUSHING HOSPITAL 711 MARSHALL LEAVENWORTH KS 66048 480543792 HEALTH CARE KS 501(C)(3) 170B1AIII SAINT LUKES HEALTH SYSTEM 0 SAINT LUKES CARE 901 E 104TH ST KANSAS CITY MO 64131 260185090 HEALTH CARE MO 501(C)(3) 509(A)(3) - TYPE 1 SAINT LUKES HEALTH SYSTEM 0 MEDICAL PLAZA IMAGING ASSOCIATES LLC 4401 WORNALL ROAD KANSAS CITY MO 64111 431609584 HEALTH CARE MO 501(C)(3) 170B1AIII SAINT LUKES HEALTH SYSTEM 0 SAINT LUKES COLLEGE OF HEALTH SCIENCES 624 WESTPORT ROAD KANSAS CITY MO 64111 272716128 POST-SECONDARY NURSING EDUCATION MO 501(C)(3) 170B1AII ST LUKES HOSPITAL OF KANSAS CITY 0 SLCC INC 4330 WORNALL RD STE 2000 KANSAS CITY MO 64111 271994652 HEALTH CARE KS 501(C)(3) 170B1AIII SAINT LUKES HEALTH SYSTEM 0 SLNC INC 901 E 104TH ST KANSAS CITY MO 64131 451470888 HEALTH CARE KS 501(C)(3) 170B1AIII SAINT LUKES HEALTH SYSTEM 0 ADVANCED UROLOGIC ASSOCIATES INC 901 E 104TH ST KANSAS CITY MO 64131 454725529 HEALTH CARE MO 501(C)(3) 170B1AIII SAINT LUKES HEALTH SYSTEM 0 MEDICAL PLAZA PARTNERS LP 4320 WORNALL ROAD SUITE 714 KANSAS CITY MO 64111 431357824 OWN & OPERATE MEDICAL OFFICE BUILDING MO N/A SAINT LUKES SURGICENTER-LEES SUMMIT LLC 11221 ROE AVE SUITE 230 OVERLAND PARK KS 66211 470853481 HEALTH CARE MO N/A SAINT LUKES SOUTH SURGERY CENTER LLC 11221 ROE AVE SUITE 230 OVERLAND PARK KS 66211 201721929 HEALTH CARE KS N/A SAINT LUKES - GI DIAGNOSTICS LLC 4321 WASHINGTON STE 5700 KANSAS CITY MO 64111 274142549 HEALTH CARE MO N/A SAINT LUKES HEALTH SYSTEM RISK RETENTION GROUP 901 E 104TH ST KANSAS CITY MO 64131 371471890 INSURANCE SC N/A C 0 ST LUKES HEALTH VENTURESINC 901 E 104TH ST KANSAS CITY MO 64131 431278476 ACCOUNTING MO N/A C 0 MEDICAL PLAZA MANAGEMENT INC 4320 WORNALL ROAD SUITE 714 KANSAS CITY MO 64111 431352317 MEDICAL OFFICE BUILDING MANAGEMENT MO N/A C 0 VENTURE FINANCIAL SERVICES INC 9500 E 63RD ST STE 202 KANSAS CITY MO 64133 431605740 COLLECTIONS MO N/A C 0 SAINT LUKES HEALTH SYSTEM INSURANCE LTD 113 SOUTH CHURCH STREET GEORGETOWN CJ INSURANCE CJ N/A C 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 1 1 1 0 0 SCHEDULE R, PART V, ITEM 1, TRANSACTIONS WITH RELATED ORGANIZATIONS SAINT LUKE'S HEALTH SYSTEM (SYSTEM) AND ITS AFFILIATED ENTITIES OPERATE AS A HIGHLY INTEGRATED HEALTH CARE DELIVERY SYSTEM. THE SYSTEM MANAGES AND OPERATES RELATED HOSPITALS AND THEIR AFFILIATES AS A COMMON MISSION ORIENTED HEALTH CARE SYSTEM IN ORDER TO BETTER SERVE THE HEALTH-RELATED NEEDS OF GREATER KANSAS CITY AND SURROUNDING AREAS. AS A RESULT, THERE ARE NUMEROUS INTERCOMPANY INTERACTIONS INCLUDING CENTRALIZED SUPPORT SERVICES AND SHARING OF RESOURCES AND COSTS.