2013-11-15T16:36:22-06:00 2012-12-31 990 2012-01-01 440545297 ST LUKES HOSPITAL OF KANSAS CITY STLU 8169322000 4401 WORNALL ROAD KANSAS CITY MO 64111 AMY NACHTIGAL 8169322000 2013-11-15 2012 2016-03-07 17:11:31Z JULIE QUIRIN 4401 WORNALL ROAD KANSAS CITY MO 64111 876203254 0 X WWW.SAINTLUKESHEALTHSYSTEM.ORG X 1882 MO TERTIARY CARE TEACHING HOSPITAL 32 24 4618 479 -369295 -369295 11591006 14123934 505697698 561306984 27909485 10738540 8627862 8692952 553826051 594862410 17001865 21774981 0 0 241767137 268639721 0 0 182315 255281889 299984226 514050891 590398928 39775160 4463482 1120069946 1145530905 376608671 391137424 743461275 754393481 X SAINT LUKE'S HOSPITAL IS A NOT-FOR-PROFIT TERTIARY REFERRAL CENTER COMMITTED TO THE HIGHEST LEVELS OF EXCELLENCE IN PROVIDING HEALTH SERVICES TO ALL PATIENTS IN A CARING ENVIRONMENT. WE ARE DEDICATED TO MEDICAL RESEARCH AND EDUCATION. AS A MEMBER OF THE SAINT LUKE'S HEATLH SYSTEM WE ARE COMMITTED TO ENHANCING THE PHYSICAL, MENTAL AND SPIRITUAL HEALTH OF THE COMMUNITIES WE SERVE. 1 0 528274803 21774981 569612092 HOSPITAL CARE:ALL PROGRAM SERVICE EXPENSES WERE INCURRED IN FURTHERANCE OF OUR MISSION, WHICH IS TO ENSURE THE HIGHEST LEVELS OF EXCELLENCE IN PROVIDING HEALTH CARE SERVICES TO ALL PATIENTS IN A CARING ENVIRONMENT. IN 2012, THERE WERE 107,133 PATIENT DAYS AND 4,409 NEWBORN DAYS. SAINT LUKE'S HOSPITAL IS A FULL-SERVICE HEALTH CARE FACILITY FEATURING AWARD-WINNING HEART SURGERY, NATIONALLY RECOGNIZED TRANSPLANT PROGRAMS, A STATE-OF-THE-ART WOMEN'S HEALTH CENTER, TRAUMA SERVICES AND MORE.THE HOSPITAL HAS 578 ACTIVE PHYSICIANS AND CONTINUES TO ADVANCE TREATMENT OPTIONS THROUGH LANDMARK RESEARCH STUDIES.RESEARCH, EDUCATION, AND TEACHING:IN ADDITION TO THE SUBSTANTIAL AMOUNT OF FREE CARE PROVIDED, SAINT LUKE'S HOSPITAL HAS MADE A MAJOR COMMITMENT TO MEDICAL AND NURSING EDUCATION. THIS INCLUDES THE SIGNIFICANT FUNDING REQUIREMENTS TO MAINTAIN AN ACCREDITED TEACHING AFFILIATION AND PROVIDE FOR THE TRAINING OF 120 RESIDENTS IN 25 MEDICAL SPECIALTIES OR SUB-SPECIALTIES. SAINT LUKE'S HOSPITAL ALSO PROVIDES TRAINING PROGRAMS FOR RADIATION THERAPY, MEDICAL IMAGING, CHAPLAINS, PATIENT CARE TECHNICIANS AND PHLEBOTOMY. SAINT LUKE'S HOSPITAL IS ALSO ACCREDITED TO OFFER CONTINUING MEDICAL EDUCATION PROGRAMS FOR PRACTICING PHYSICIANS. SAINT LUKE'S HOSPITAL IS ALSO CONCERNED ABOUT THE LONG-TERM WELFARE OF THE COMMUNITY AND MAKES AN ADDITIONAL INVESTMENT IN THE FUTURE OF HEALTH CARE THROUGH RESEARCH ACTIVITIES. 528274803 1 1 0 1 0 0 0 0 0 1 1 1 0 1 1 0 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 0 1 0 0 0 0 1 1 1 1 0 0 1 X 49 0 1 4618 1 1 1 0 0 0 0 0 0 0 0 0 X 32 24 1 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 0 X THE ORGANIZATION 8169322000 4401 WORNALL ROAD KANSAS CITY MO 64111 X THOMAS W WAGSTAFF 2.00 X X 0 0 0 DAVID W GIBSON 2.00 X X 0 0 0 JOHN R PHILLIPS 2.00 X X 0 0 0 MARSHALL H DEAN JR 2.00 X X 0 0 0 WILLIAM J ALIBER 2.00 X 0 0 0 THOMAS T CROUCH 2.00 X 0 27240 0 GREGORY M BENTZ 2.00 X 0 0 0 CINDY COWHERD 2.00 X 0 0 0 MARK BERNHARDT MD 2.00 X 0 0 0 BUSH C HELZBERG 2.00 X 0 0 0 JOHN HELZBERG MD 40.00 X 548714 0 25730 ELLEN J HOCKADAY 2.00 X 0 0 0 CHARLES D HORNER 2.00 X 0 0 0 DANIEL P BOLEN 2.00 X 0 0 0 THOMAS L BROWN 2.00 X 0 0 0 J GRANT BURCHAM 2.00 X 0 0 0 PETER S HOLT MD 2.00 30.00 X 57507 137583 0 DAVID T HUNT 2.00 X 0 0 0 JAMES T LACY 2.00 X 0 0 0 CANDICE MCDOWELL 2.00 X 0 0 0 CHARLES M NEWELL 2.00 X 0 0 0 ROBERT N SAWYER 2.00 X 0 0 0 RICHARD G NORDEN 2.00 X 0 0 0 RICHARD F OWEN 2.00 X 0 0 0 JAMES P PACE 2.00 X 0 0 0 BRUCE PENDLETON 2.00 X 0 0 0 ALISON SCHOLES MD 2.00 X 0 0 0 DAVID POWELL 2.00 X 0 0 0 STANLEY SHAFFER MD 2.00 X 0 0 0 THOMAS L WAGSTAFF 2.00 X 0 0 0 MINA STEEN 2.00 X 0 0 0 MICHAEL THOMAS 2.00 X 0 0 0 H GUYON TOWNSEND III 2.00 X 0 0 0 THOMAS R WILLARD 2.00 X 0 0 0 DEBORAH WILLIAMS 2.00 X 0 0 0 JEFFREY A WATERS MD 2.00 X 0 0 0 MICHAEL L WEAVER MD 2.00 X 0 89986 9278 RT REV MARTIN FIELD 2.00 X X 0 0 0 JULIE QUIRIN 50.00 X 603264 0 111954 DEBBIE WHITE 50.00 X 290774 0 66202 JANI JOHNSON 50.00 50.00 X 258240 75964 61664 CHARLES ROBB 2.00 50.00 X 0 764459 269164 DORIS ROGERS 50.00 X 151680 0 44338 KEVIN THORPE 50.00 X 277175 0 59478 JOHN YEAST MD 50.00 X 404415 0 32275 AMY NACHTIGAL 50.00 X 338318 0 49751 BRADLEY SIMMONS 50.00 X 159530 0 10107 MELINDA ESTES 2.00 50.00 X 0 1246676 234135 ANGELA LOCKE 50.00 X 115842 0 16375 DANIEL MARGOLIN MD 40.00 X 654319 0 31976 PAUL CHESIS MD 40.00 X 747752 0 4414 SCOTT RAVIS MD 40.00 X 821781 0 11530 HENRY MOLLMAN 40.00 X 798176 0 25175 JEFFREY KUNIN 40.00 X 698481 0 34145 6925968 2341908 1097691 237 0 1 0 JE DUNN CONSTRUCTION COMPANY PO BOX 801150 KANSAS CITY MO 64180 CONSTRUCTION & CONSTR MANAGEMENT 26997834 UNIVERSITY OF MISSOURI - KANSAS CITY PO BOX 805111 KANSAS CITY MO 64180 MEDICAL RESIDENT SERVICES 8289867 P1 GROUP 16210 W 108TH ST LENEXA KS 66219 FACILITIES MANAGEMENT 7404712 HEART SURGEONS OF KANSAS CITY 4320 WORNALL ROAD KANSAS CITY MO 64111 MEDICAL SERVICES 3811123 WESTPORT ANESTHESIA SERVICES INC PO BOX 10370 KANSAS CITY MO 64171 MEDICAL SERVICES 3762822 67 2417461 776274 10930199 14123934 NET PATIENT REVENUE 622110 530335833 530335833 REGIONAL LAB SERVICES 621500 10496374 10496374 PHYSICIAN SERVICES 621110 3523930 3523930 HOST HOSPITAL REVENUE 622110 2949711 2949711 EHR/MEANINGFUL USE 622110 2284341 2284341 11716795 11716795 561306984 2415668 -369295 2784963 344 344 387844 0 387844 387844 387844 289628476 34896 281226235 114609 8402241 -79713 8322528 8322528 EQUITY IN KCOI 622110 5248605 5248605 EQUITY IN AFFILIATES 900099 3056503 3056503 8305108 594862410 569612092 -369295 11495679 X 21774981 21774981 3611278 574443 3036835 215405835 204941825 10291132 172878 9189641 8610728 578913 25750074 23881492 1859688 8894 14682893 13750142 932751 2091714 2091714 131587 131587 770437 770437 59252609 52649708 6602901 23275 18768 4507 11537570 9758114 1778913 543 2374229 376476 1997753 16628690 14947237 1681453 334908 253832 81076 562131 516038 46093 12180229 11398064 782165 31225223 29559115 1666108 5876311 4783330 1092981 OTHER MEDICAL SUPPLIES 98742992 98712839 30153 SHARED SERVICES 39393780 13146912 26246868 PATIENT RELATED BAD DBT 15886277 15886277 SWAP RELATED COSTS 2109055 1972855 136200 863209 761627 101582 590398928 528274803 61941810 182315 16673830 33435326 8662048 3067182 74259377 84709125 1230161 940161 9896316 11567747 7946383 6906912 771962822 291192889 456347927 480769933 144867877 77136157 217256704 266080554 42656943 33763978 7274977 8131804 132997403 139022026 1120069946 1145530905 49894439 57868930 1938217 969109 294182369 299751585 30593646 32547800 376608671 391137424 X 616717251 619378107 91009056 99213590 35734968 35801784 743461275 754393481 1120069946 1145530905 X 4463482 22592385 -16123661 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 52120 0 0 0 52120 0 EXPLANATION OF LOBBYING ACTIVITIES: PART II-B, LINE 1: LINE F-PORTION OF DUES PAID TO HOSPITAL, MEDICAL, & CIVIC ASSOCIATIONS USED TOWARD LOBBYING ACTIVITIES. 10636673 226226 1193355 1298083 10758171 13861202 184270 258844 3667643 10636673 12913296 446175 1409156 907425 13861202 11473500 410455 1636652 607311 12913296 17822493 384178 -1606263 5126908 11473500 0.74560 0.25440 1 0 395175 6089798 6484973 453048733 102033089 351015644 7830559 5687387 2143172 266081582 176993630 89087952 38516975 6478783 32038192 480769933 PASSIVE BOND MARKET INDEX SL COMMON TRUST 63144913 F SELECTINVEST MULTISTRATEGY LTD 1331559 F FINANCIAL SQUARE TRUST PRIME-COMMERCE BANK 3776015 F PATHEON USA FUND VII LP 5686360 F CASH-AGENCY ACCOUNTS 309516 F SSGA RUSSELL 1000 INDEX 53313280 F SIGULER GUFF DISTRESSED OPPORTUNITIES 7590135 F 1607 CAPITAL EQUITY FUND 17301562 F AETHER REAL ASSETS 1940056 F CASH-MONEY MARKET 17443038 F SSGA 1-3 YEAR US CREDIT INDEX 61796627 F SIGULER GUFF BRIC OPPORTUNITIES FUND 1381852 F SIGULER GUFF DISTRESSED OPPORTUNITIES FUND IV 2718659 F MAGNITUDE INTERNATIONAL CLASS A SERIES 08/11 14127447 F PRISMA SPECTRUM FUND LTD 12902103 F PANTHEON USA FUND VII LP 572411 F CROWN GLOBAL SECONDARIES 320021 F DOVER STREET VIII CAYMAN FUND LP 425000 F 266080554 INVESTMENT IN AFFILIATES 6754398 RECEIVABLES FROM AFFILIATES 3663284 INVESTMENT IN HOSPITAL LINEN SERVICE 485000 OTHER ASSETS 703748 INTEREST IN ASSETS OF FOUNDATION - SFAS 136 124257202 FIN 45 PHYSICIAN GUARANTEE ASSETS 3158394 139022026 RESERVE FOR SELF INSURED RISKS 10661960 OTHER CURRENT LIABILITIES 3199262 OTHER NONCURRENT LIABILITIES 10777202 PAYABLES TO AFFILIATES 4750982 FIN 45 PHYSICIAN GUARANTEE LIABILITY 3158394 32547800 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: SAINT LUKE'S HOSPITAL'S ENDOWMENT FUNDS ARE PRIMARILY INTENDED TO COVER HOSPITAL EXPENSES FOR PATIENTS WHO ARE UNINSURED/UNDERINSURED AND CANNOT AFFORD TREATMENT, GENERAL OPERATIONS OF THE HOSPITAL AND CAPITAL EXPENDITURES FOR EQUIPMENT. THE ASSETS HELD AT THE UNRELATED ORGANIZATION REPRESENTS THE ORGANIZATION'S SHARE OF NET ASSETS AT SAINT LUKE'S HOSPITAL FOUNDATION PER SFAS 136. SUCH ASSETS ARE REPORTED IN PART X, LINE 15. PART XI, XII, AND XIII - THE ORGANIZATION'S FINANCIAL STATEMENTS ARE INCLUDED IN THE CONSOLIDATED AUDIT OF SAINT LUKE'S HEALTH SYSTEM. 1 1 X 1 X 133.000000000000 1 X 1 1 1 0 0 15332398 921284 14411114 0.02430 85718613 75109985 10608628 0.01790 101051011 76031269 25019742 0.04220 830938 20733 810205 0.00140 21184628 4401703 16782925 0.02830 1497331 823107 674224 0.00110 4467211 4467211 0.00750 152380 152380 0.00030 28132488 5245543 22886945 0.03860 129183499 81276812 47906687 0.08080 7311 7311 0.00000 1562 1562 0.00000 8873 8873 0 16811759 163713114 191352790 -27639676 X 1 1 1 KANSAS CITY ORTHOPAEDIC INSTITUTE LLC ORTHOPAEDIC SERVICES 0.40000 0.45830 2 HEALTH OUTCOMES SCIENCES LLC RESEARCH 0.01090 0.50050 3 SAINT LUKE'S - GI DIAGNOSTICS LLC GASTROENTEROLOGY SERVICES 0.51000 0.49000 2 1 ST LUKES HOSPITAL OF KANSAS CITY

4401 WORNALL ROAD KANSAS CITY MO 64111

X X X X X 2 KANSAS CITY ORTHOPAEDIC INSTITUTELLC

3651 COLLEGE BLVD LEAWOOD KS 66211

X X ORTHOPAEDIC SPECIALTY SERVICES ST LUKE'S HOSPITAL OF KANSAS CITY 1 1 1 133.000000000000 1 400.000000000000 1 X X X 1 1 X X X 1 0 1 X 0 0 KANSAS CITY ORTHOPAEDIC INSTITUTE LLC 2 1 1 200.000000000000 1 400.000000000000 1 X X X X X X X 1 0 1 0 0 X X 0 0 6 SAINT LUKE'S PHYSICIAN SPECIALISTSLLC

4320 WORNALL ROAD KANSAS CITY MO 64111

PHYSICIAN CLINICS SAINT LUKE'S - GI DIAGNOSTICS LLC

4321 WASHINGTON SUITE 5700 KANSAS CITY MO 64111

GI SERVICES INFUSION CENTER

4321 WASHINGTON KANSAS CITY MO 64111

INFUSION CENTER INFUSION CENTER

100 NE SAINT LUKES BLVD LEES SUMMIT MO 64086

INFUSION CENTER INFUSION CENTER

12300 METCALF OVERLAND PARK KS 66213

INFUSION CENTER CHILDREN'S SPOT

4333 PENNSYLVANIA KANSAS CITY MO 64111

SPECIAL NEEDS CHILDREN THERAPY PART I, LINE 7: COST OF CHARITY CARE AND UNREIMBURSED HEALTH SERVICES WERE CALCULATED USING THE APPROPRIATE COST TO CHARGE RATIO FROM THE HOSPITAL'S COST REPORT. THIS RATIO CALCULATION IS PERFORMED SEPARATELY FOR HOSPITAL FACILITY REVENUES AND PHYSICIAN PROFESSIONAL REVENUE. PART I, LINE 7G: SUBSIDIZED HEALTH SERVICES INCLUDES $674,224 IN UNREIMBURSED COSTS FOR COMMUNITY SERVICE PHYSICIAN CLINICS. PART I, L7 COL(F): TOTAL EXPENSE FROM ALL REPORTABLE HOSPITAL FACILITIES OF $609,378,368 LESS BAD DEBT EXPENSE OF $16,808,759 EQUALS TOTAL EXPENSE OF $592,569,609 FOR PURPOSES OF CALCULATING LINE 7, COLUMN (F), PART III, LINE 4: FINANCIAL STATEMENT FOOTNOTE REGARDING BAD DEBT EXPENSE: THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS, CONSIDERING BUSINESS AND GENERAL ECONOMIC CONDITIONS IN ITS SERVICE AREA, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE (INCLUDING COPAYMENT AND DEDUCTIBLE AMOUNTS FROM PATIENTS), THE SYSTEM ANALYZED CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AND A PROVISION FOR BAD DEBTS. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS, THE SYSTEM RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. ACCOUNTS ARE WRITTEN OFF WHEN ALL REASONABLE INTERNAL AND EXTERNAL COLLECTION EFFORTS HAVE BEEN PERFORMED. THESE ADJUSTMENTS ARE ACCRUED ON AN ESTIMATED BASIS AND ARE ADJUSTED AS NEEDED IN FUTURE PERIODS. ACCOUNTS RECEIVABLE ARE CHARGED TO THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS WHEY THEY ARE DEEMED UNCOLLECTIBLE.BAD DEBT IS REPORTED CONSISTENT WITH THE FINANCIAL STATEMENTS. PART III, LINE 8: MEDICARE ALLOWABLE COSTS WERE CALCULATED USING A COST-TO-CHARGE RATIO DIRECTLY FROM THE MEDICARE COST REPORT. SHORTFALLS ARISE FROM PAYMENTS THAT ARE LESS THAN WHAT IT COSTS TO PROVIDE THE CARE AND SERVICES. WE ACCEPT ALL MEDICARE PATIENTS KNOWING THE COST OF PROVIDING THE CARE MAY EXCEED THE FUNDS WE RECEIVE FROM MEDICARE FOR THE SERVICE. OUR SHORTFALL IS CONSIDERED TO BE COMMUNITY BENEFIT. MEDICARE SHORTFALLS MUST BE ABSORBED BY THE HOSPITAL IN ORDER TO CONTINUE TREATING THE ELDERLY IN OUR COMMUNITY. ADDITIONALLY, IT IS IMPLIED IN INTERNAL REVENUE SERVICE REVENUE RULING 69-545 THAT TREATING MEDICARE PATIENTS IS A COMMUNITY BENEFIT. REVENUE RULING 69-545, WHICH ESTABLISHED THE COMMUNITY BENEFIT STANDARD FOR TAX-EXEMPT HOSPITALS, INDICATES THAT PARTICIPATION IN PUBLICLY-FINANCED PROGRAMS, SUCH AS MEDICARE, IS EVIDENCE THAT A HOSPITAL MEETS THE COMMUNITY BENEFIT STANDARD. PART III, LINE 9B: IF A PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE THE ACCOUNT IS ADJUSTED ACCORDINGLY. ANY REMAINING BALANCE WOULD BE COLLECTED UNDER THE DEBT COLLECTION POLICY. OUR COLLECTION POLICIES ARE THE SAME FOR ALL PATIENTS. ALTHOUGH WE ARE NOT LEGALLY BOUND BY THE FAIR DEBT COLLECTION PRACTICES ACT, THE PRINCIPLES ADDRESSED ARE GENERALLY FOLLOWED. ST LUKE'S HOSPITAL OF KANSAS CITY PART V, SECTION B, LINE 14G: THE HOSPITAL FOLLOWS THE SAINT LUKE'S HEALTH SYSTEM POLICIES FOR FINANCIAL ASSISTANCE. 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 NOTIFYING PATIENTS THAT THE HOSPITAL HAS FINANCIAL ASSISTANCE FOR WHICH THEY MAY QUALIFY, 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 WITH A BALANCE OVER $2,000, ANY PATIENTS IDENTIFIED BY OUR SOCIAL WORKER TEAMS, AND ALL PATIENTS THAT REQUEST ASSISTANCE IN APPLYING FOR MEDICAID OR OTHER GOVERNMENT COVERAGE. KANSAS CITY ORTHOPAEDIC INSTITUTE, LLC PART V, SECTION B, LINE 20D: KCOI PROVIDES ELECTIVE SERVICES. DISCOUNTS FOR FAP ELIGIBLE PATIENTS ARE APPLIED TO CHARGES AND/OR PATIENT'S RESPONSIBLE PORTION AFTER INSURANCE PAYMENTS AND ADJUSTMENTS. PART VI, LINE 2: THE HOSPITAL ASSESSES COMMUNITY NEEDS ON AN ANNUAL BASIS IN NUMEROUS WAYS, INCLUDING THROUGH ITS COMPREHENSIVE, DATA DRIVEN, ANNUAL STRATEGIC PLANNING PROCESS. THE HOSPITAL OBTAINS HIDI MARKET DATA AND OTHER OUTPATIENT MARKET DATA THROUGH ITS ANNUAL ENVIRONMENTAL ASSESSMENT PROCESS. WITH THIS DATA, THE HOSPITAL IDENTIFIES SERVICES RECEIVED BY THE RESIDENTS OF OUR COMMUNITY (DEFINED BY OUR PRIMARY AND SECONDARY SERVICE AREAS). ANY PREDOMINANT SERVICES NOT CURRENTLY OFFERED BY THE HOSPITAL ARE CONSIDERED AT THIS TIME.ANOTHER ELEMENT OF THE COMMUNITY NEEDS ASSESSMENT INVOLVES ANNUALLY UPDATING ITS MEDICAL STAFF DEVELOPMENT PLAN. AS A TERTIARY AND QUATERNARY HEALTHCARE PROVIDER, IT IS CRITICAL THAT THE HOSPITAL ENSURES IT HAS APPROPRIATE MEDICAL STAFF LEVELS IN A VARIETY OF MEDICAL SPECIALTIES AND SUBSPECIALTIES TO SERVE THE PATIENTS IN OUR COMMUNITY. THE HOSPITAL PARTNERS WITH ITS MEDICAL STAFF IN THIS ENDEAVOR.ANOTHER ASPECT OF THE HOSPITAL'S COMMUNITY NEEDS ASSESSMENT IS AN ANALYSIS OF WORKFORCE PLANNING TO ENSURE ADEQUATE CLINICAL AND OTHER PROFESSIONAL STAFF TO PROVIDE NEEDED HEALTHCARE SERVICES THROUGHOUT THE COMMUNITY. THE HOSPITAL IS ACTIVELY ENGAGED IN A VARIETY OF FORMAL EDUCATION ACTIVITIES. PART VI, LINE 3: SEE RESPONSE TO SCHEDULE H, PART V, LINE 13G. PART VI, LINE 4: THE HOSPITAL IS A LOCATED IN THE URBAN CORE OF KANSAS CITY, MISSOURI. IT IS A MAJOR TEACHING AND RESEARCH FACILITY, AND PROVIDES TERTIARY AND QUATERNARY LEVEL PATIENT CARE SERVICES TO THE METROPOLITAN KANSAS CITY AREA, AND SERVES AS A MAJOR REFERRAL HOSPITAL FOR THE SURROUNDING 67 COUNTY AREA. MAJOR PATIENT SERVICE LINES INCLUDE CARDIOVASCULAR SERVICES, BRAIN AND STROKE SERVICES, WOMEN'S AND CHILDREN'S SERVICES, AND CANCER CARE SERVICES. APPROXIMATELY 20% OF THE OVERALL PATIENT VOLUME THAT THE HOSPITAL SERVES COMES FROM OUTSIDE THE METROPOLITAN KANSAS CITY AREA. PART VI, LINE 5: THE BOARD OF DIRECTORS IS MADE UP OF MEDICAL AND BUSINESS PROFESSIONALS, ALMOST ALL OF WHOM RESIDE IN THE HOSPITAL'S PRIMARY SERVICE AREA. THEY ARE INVOLVED IN THE COMMUNITY NEEDS ASSESSMENT PROCESS, IN FUNDRAISING, AND IN GENERAL STEWARDSHIP. MEDICAL STAFF PRIVILEGES ARE OFFERED TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY.THE HOSPITAL UTILIZES SURPLUS FUNDS TO MAINTAIN ACCESS TO PATIENT SERVICES AND TO EXPAND ACCESS POINTS OF CARE TO PATIENTS THROUGHOUT THE COMMUNITY INCLUDING, BUT NOT LIMITED TO, THE FOLLOWING: 1) COMMUNITY SERVICE OUTPATIENT CLINICS THAT PROVIDE SUBSIDIZED CARE TO LOW INCOME PATIENTS; 2) DIABETES EDUCATION PROGRAMS AND PARENT EDUCATION AND PRENATAL EDUCATION; 3) PSYCHIATRIC SERVICES; AND 4) FORMAL RESEARCH ACTIVITIES. PART VI, LINE 6: THE HOSPITAL IS AFFILIATED WITH SAINT LUKE'S HEALTH SYSTEM, WHICH CONSISTS OF 11 AREA HOSPITALS AND SEVERAL PRIMARY AND SPECIALTY CARE PRACTICES, AND PROVIDES A RANGE OF INPATIENT, OUTPATIENT, AND HOME CARE SERVICES. FOUNDED AS A FAITH-BASED, NOT-FOR-PROFIT ORGANIZATION, OUR MISSION INCLUDES A COMMITMENT TO THE HIGHEST LEVELS OF EXCELLENCE IN HEALTH CARE AND THE ADVANCEMENT OF MEDICAL RESEARCH AND EDUCATION. THE HEALTH SYSTEM IS AN ALIGNED ORGANIZATION IN WHICH THE PHYSICIANS AND HOSPITALS ASSUME RESPONSIBILITY FOR ENHANCING THE PHYSICAL, MENTAL, AND SPIRITUAL HEALTH OF PEOPLE IN THE METROPOLITAN KANSAS CITY AREA AND THE SURROUNDING REGION. 1 SLCC INC (501C3 AFFILIATE) 4330 WORNALL ROAD STE 2000 KANSAS CITY MO 64111 271994652 501(C)(3) 11762543 CAPITAL FUNDS TRANSFER SAINT LUKE'S MEDICAL GROUP (501C3 AFFILIATE) 6750 ANTIOCH RD STE 210 SHAWNEE MISSION KS 64086 431598353 501(C)(3) 4625690 CAPITAL FUNDS TRANSFER SLNC INC (501C3 AFFILIATE) 4401 WORNALL ROAD KANSAS CITY MO 64111 451470888 501(C)(3) 1497738 CAPITAL FUNDS TRANSFER EPISCOPAL COMMUNITY SERVICES 750 PASEO BLVD KANSAS CITY MO 64106 431525298 501(C)(3) 20000 CHARITABLE DONATION TO BENEFIT COMMUNITY SAINT LUKE'S COLLEGE OF HEALTH SCIENCES (501C3 AFFILIATE) 624 WESTPORT RD KANSAS CITY MO 64111 272716128 501(C)(3) 3775000 CAPITAL FUNDS TRANSFER MEDICAL PLAZA IMAGING ASSOCIATES (501C3 AFFILIATE) 4401 WORNALL ROAD KANSAS CITY MO 64111 431609584 501(C)(3) 34533 CAPITAL FUNDS TRANSFER 6 0 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: GRANTS ARE PROVIDED TO QUALIFIED 501(C)(3) CHARITIES. ALL DONEE INFORMATION IS KEPT AS PART OF THE ORGANIZATION'S BOOKS AND RECORDS. X 1 1 X 1 1 0 0 0 0 0 1 0 JOHN HELZBERG MD 544934 0 0 0 3780 0 5000 0 20730 0 574444 0 0 0 PETER S HOLT MD 57507 137583 0 0 0 0 0 0 0 0 57507 137583 0 0 JULIE QUIRIN 412875 0 129394 0 60995 0 102075 0 9879 0 715218 0 43680 0 DEBBIE WHITE 229076 0 60568 0 1130 0 52560 0 13642 0 356976 0 0 0 JANI JOHNSON 167230 74996 68327 0 22683 968 28706 8444 18411 6103 305357 90511 18400 0 CHARLES ROBB 0 479101 0 170587 0 114771 0 242514 0 26650 0 1033623 0 91874 DORIS ROGERS 139164 0 0 0 12516 0 23651 0 20687 0 196018 0 10064 0 KEVIN THORPE 203404 0 51034 0 22737 0 37405 0 22073 0 336653 0 16170 0 JOHN YEAST MD 346932 0 52731 0 4752 0 12500 0 19775 0 436690 0 0 0 AMY NACHTIGAL 250000 0 64895 0 23423 0 47550 0 2201 0 388069 0 19720 0 BRADLEY SIMMONS 135056 0 24000 0 474 0 1831 0 8276 0 169637 0 0 0 MELINDA ESTES 0 1194934 0 0 0 51742 0 205000 0 29135 0 1480811 0 0 DANIEL MARGOLIN MD 337346 0 314936 0 2037 0 11250 0 20726 0 686295 0 0 0 PAUL CHESIS MD 47699 0 0 0 700053 0 969 0 3445 0 752166 0 0 0 SCOTT RAVIS MD 490077 0 329726 0 1978 0 6250 0 5280 0 833311 0 0 0 HENRY MOLLMAN 770346 0 22286 0 5544 0 5000 0 20175 0 823351 0 0 0 JEFFREY KUNIN 695430 0 0 0 3051 0 11250 0 22895 0 732626 0 0 0 PART I, LINE 1A BRAD SIMMONS RECEIVED A TEMPORARY HOUSING ALLOWANCE IN CONNECTION WITH HIS RELOCATION IN 2012. THE AMOUNT IS INCLUDED IN HIS TAXABLE COMPENSATION. PART I, LINES 4A-B 457(F) PLAN PARTICIPANT AND AMOUNT INCLUDED IN COLUMN C FOR THE PLAN: CHARLES ROBB - $125,043 MELINDA ESTES - $200,000 JULIE QUIRIN - $30,375 SEVERANCE PAYMENT AMOUNT INCLUDED IN COLUMN B(III): PAUL CHESIS - $699,920 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. THIS INCENTIVE COMPENSATION IS EVALUATED AS PART OF THE REVIEW OF MARKET COMPETITIVE DATA AND REASONABLENESS OF OVERALL COMPENSATION AND BENEFITS. SUPPLEMENTAL INFORMATION PART III CHARLES ROBB AND MELINDA ESTES 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. JOHN HELZBERG DID NOT RECEIVE COMPENSATION FOR DUTIES AS A DIRECTOR OF THE ORGANIZATION BUT RECEIVED COMPENSATION FOR SERVICES RENDERED AS AN EMPLOYEE OF THE ORGANIZATION. COMPENSATION FOR JANI JOHNSON FROM RELATED ORGANIZATIONS IS FOR SERVICES PROVIDED AS AN EMPLOYEE OF A RELATED ORG AFTER HER TERM ENDED AS OFFICER FOR THE ORGANIZATION IN SEPTEMBER 2012. DIXON DIVELY MARK BERNHARDT IS >5% MEMBER & OFFICER OF DIXON DIVELY. 801384 MEDICAL SERVICES 0 WAGSTAFF & CARTMELL THOMAS L. & THOMAS W. WAGSTAFF, FAMILY MEMBERS, ARE >5% PARTNERS 706990 LEGAL SERVICES 0 METRO EMERGENCY PHYSICIANS LLC ALISON SCHOLES IS >5% MEMBER OF METRO EMERGENCY PHYSICIANS, LLC 765736 MEDICAL SERVICES 0 HAROLD MORRIS MD FAMILY MEMBER OF MELINDA ESTES, OFFICER. 30758 HAROLD MORRIS IS A PHYSICIAN EMPLOYED BY ST LUKES HOSPITAL OF KANSAS CITY 0 KATHERINE RINAS FAMILY MEMBER OF DEBRA WHITE, OFFICER. 25278 KATHERINE RINAS IS EMPLOYED BY ST LUKES HOSPITAL OF KANSAS CITY 0 NEW PROGRAM SERVICES FORM 990, PART III, LINE 2 EFFECTIVE NOVEMBER 1, 2012, SAINT LUKE'S CANCER INSTITUTE (SLCI), AN AFFILIATED 501(C)(3) ORGANIZATION, MERGED INTO THE FILING ORGANIZATION. SERVICES PREVIOUSLY PROVIDED BY SLCI ARE NOW OFFERED THROUGH THE FILING ORGANIZATION. THIS INCLUDES COMPREHENSIVE CANCER SERVICES THAT INCLUDE PREVENTION, EARLY DETECTION, DIAGNOSIS, TREATEMENT, RESEARCH, EDUCATION AND SUPPORTIVE CARE. NUMBER REPORTED IN BOX 3 OF FORM 1096 FORM 990, PART V, LINE 1A ST LUKES HOSPITAL OF KANSAS CITY (SLH) IS PART OF SAINT LUKE'S HEALTH SYSTEM, AN INTEGRATED HEALTH SYSTEM. THE MAJORITY OF SLH VENDORS ARE PAID THROUGH A CENTRALIZED PAYMENT SYSTEM WITH 1099S ISSUED BY THE CENTRALIZED SERVICE ENTITY FORM 990, PART VI, SECTION A, LINE 2 THOMAS L WAGSTAFF AND THOMAS W WAGSTAFF - FAMILY AND BUSINESS RELATIONSHIP. ELLEN HOCKADY AND GRANT BURCHAM - FAMILY RELATIONSHIP. JOHN R PHILIPS AND CHARLES D HORNER - BUSINESS RELATIONSHIP. CHARLES ROBB, MELINDA ESTES, AND MICHAEL WEAVER 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 3 AS PART OF AN INTEGRATED HEALTH SYSTEM, THE ORGANIZATION ROUTINELY DELEGATED VARIOUS MANAGEMENT AND SUPPORT FUNCTIONS TO RELATED ENTITIES INCLUDING SAINT LUKES HEALTH SYSTEM INC. FORM 990, PART VI, SECTION B, LINE 11 THE 990 IS PREPARED JOINTLY BY ACCOUNTING STAFF OF THE ENTITY AND SAINT LUKE'S HEALTH SYSTEM (SYSTEM) TAX STAFF. THE RETURN IS REVIEWED BY THE ENTITY'S CFO BEFORE FILING. THE 990 DRAFT WAS ALSO PRESENTED TO THE AUDIT COMMITTEE OF THE SYSTEM BOARD OF DIRECTORS FOR REVIEW. THE 990 WAS PROVIDED TO THE ORGANIZATION'S BOARD MEMBERS 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 FURTHER INVESTIGATES POSSIBLE CONFLICTS OF INTEREST. A REPORT IS PROVIDED TO THE AUDIT COMMITTEE OF THE SYSTEM BOARD OF DIRECTORS AND ANY IDENTIFIED CONFLICT OF INTEREST IS REPORTED TO THE APPLICABLE ENTITY. FORM 990, PART VI, SECTION B, LINE 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 EXECUTIVES AND OFFICERS. 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 PHILOSPHY 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. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE NOT PUBLICLY AVAILABLE. FORM 990, PART VII, COLUMN E DIRECTORS ARE NOT COMPENSATED FOR SERVING AS A DIRECTOR OR BOARD OFFICER. CHARLES ROBB, MELINDA ESTES, AND MICHAEL WEAVER 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. JOHN HELZBERG DID NOT RECEIVE COMPENSATION FOR DUTIES AS A DIRECTOR OF THE ORGANIZATION BUT RECEIVED COMPENSATION FOR SERVICES RENDERED AS AN EMPLOYEE OF THE ORGANIZATION. COMPENSATION FOR JANI JOHNSON FROM RELATED ORGANIZATIONS IS FOR SERVICES PROVIDED AS AN EMPLOYEE OF A RELATED ORG AFTER HER TERM ENDED AS OFFICER FOR THE ORGANIZATION IN SEPTEMBER 2012. PETER HOLT DID NOT RECEIVE COMPENSATION FOR DUTIES AS A DIRECTOR OF THE ORGANIZATION BUT RECEIVED COMPENSATION FOR SERVICES PROVIDED TO THE ORGANIZATION. COMPENSATION FOR ANGELA LOCKE IS FOR SERVICES PROVIDED TO THE ORGANIZATION FOR THE ENTIRE CALENDAR YEAR AND INCLUDES COMPENSATION FOR SERVICES PRIOR TO BECOMING AN OFFICER IN SEPTEMBER 2012. OTHER FEES FORM 990, PART IX, LINE 11G OTHER FEES: PROGRAM SERVICE EXPENSES 52,649,708. MANAGEMENT AND GENERAL EXPENSES 6,602,901. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 59,252,609. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 9: PENSION LIABILITY TRANSFER -895,350. RRG DIVIDEND -117,552. TRANSFER FROM RESTRICTED ACCTS NOT RECORDED IN OPERATING ACCTS -534,491. CHANGE IN THE INTEREST IN ASSETS OF FOUNDATION - SFAS 136 8,149,852. TRANSFER TO SLHS - BOND PROCEEDS -11,046,525. ROUNDING -4. NET ASSET TRANSFER - SLCI MERGER -11,679,591. JOINT VENTURES FORM 990, PART VI, LINE 16B DURING 2012, THE ORGANIZATION PARTICIPATED IN A JOINT VENTURE ESTABLISHED SEVERAL YEARS AGO. THE ORGANIZATION'S PROCEDURES INCLUDE OVERSIGHT AND REVIEW OF ANY JOINT VENTURES TO ENSURE EXEMPT STATUS IS PROTECTED. THE ORGANIZATION HAS MAJORITY CONTROL AND/OR OPERATING AGREEMENT REQUIREMENTS FOR THE VENTURE TO OPERATE IN A MANNER CONSISTENT WITH THE ORGANIZATION'S EXEMPT MISSION AND FOR THE VENTURE TO NOT ENGAGE IN POLITICAL CANDIDATE CAMPAIGN ACTIVITY OR OTHER ACTIVITIES THAT WOULD JEOPARDIZE THE ORGANIZATION'S EXEMPTION. INVESTMENT INCOME FORM 990, PART VIII, LINE 3 INVESTMENT INCOME INCLUDES $117,552 OF SUBSCRIBER SAVINGS ACCOUNT ALLOCATION FROM RELATED RISK RETENTION GROUP. TAX EXEMPT BOND LIABILITIES FORM 990, PART X, BALANCE SHEET, LINE 20 THE AMOUNT REPORTED AS TAX-EXEMPT BONDS IS THE PORTION OF SAINT LUKE'S HEALTH SYSTEM BONDS ALLOCATED TO ST LUKES HOSPITAL OF KANSAS CITY. REQUIRED INFORMATION FOR THE BONDS, INCLUDING SCHEDULE K, IS REPORTED IN THE SAINT LUKE'S HEALTH SYSTEM (EIN: 43-1747502) IRS FORM 990. 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