2013-11-14T16:54:25-06:00 2012-12-31 990 2012-01-01 431707306 ST LUKES OF TRENTON STLU 6603595621 191 IOWA BLVD TRENTON MO 64683 GARY JORDAN 6603595621 2013-11-14 2012 2016-02-24 21:20:13Z WRIGHT MEMORIAL HOSPITAL GARY JORDAN 191 IOWA BLVD TRENTON MO 64683 26690050 0 X WWW.SAINTLUKESHEALTHSYSTEM.ORG X 1995 MO CRITICAL ACCESS HOSPITAL 10 8 246 15 0 0 124410 45965 24181781 26627633 319611 16452 0 0 24625802 26690050 3064 62911 0 0 12619701 12415607 0 0 0 13491757 14815801 26114522 27294319 -1488720 -604269 13173385 13123165 5659423 6269015 7513962 6854150 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 22553261 62911 26627633 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 CHARITY CARE POLICIES FOR ASSISTING PEOPLE WITHOUT ADEQUATE MEANS TO PAY FOR THEIR CARE. THE HOSPITAL ENCOURAGES MANY 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 REGARDING ELDERLY ABUSE/NEGLECT AND SPECIALIZED PEDIATRIC CARE. IN ADDITION, THE HOSPITAL PROVIDED CLINICS, SCREENINGS, SUPPORT GROUPS, SOCIAL WORKS SERVICES AND PARTICIPATED IN CHARITABLE EVENTS AND SPONSORSHIPS. 22553261 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 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 0 1 0 0 0 1 21 0 1 246 1 0 0 0 0 0 0 0 0 0 0 X 10 8 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X THE ORGANIZATION 6603595621 191 IOWA BLVD TRENTON MO 64683 X DON SIPES 2.00 50.00 X X 0 339041 55262 WENDELL LENHART 2.00 X X 0 0 0 BEV HOOKER 2.00 X X 0 0 0 CHARLES ROBB 2.00 50.00 X X 0 764459 269164 SCOTT WILSON 2.00 X 0 0 0 BONITA PRICE 2.00 X X 0 0 0 MACK WOODARD 2.00 X 0 0 0 DANETTE RARDON 2.00 X 0 0 0 TOM WITTEN 2.00 X 0 0 0 DWIGHT GRIFFIN 2.00 X 0 0 0 ELAINA HEAD 40.00 X 48456 0 18149 GARY JORDAN 40.00 X 185352 0 39553 BARBARA BALL 40.00 X 117699 0 11805 JANET BUCKMAN 20.00 20.00 X 0 176061 15699 RON BREMER 10.00 X 0 109125 0 HESAMODIN BORHANI 40.00 X 289066 0 37728 PAMELA RALLS 40.00 X 189042 0 10207 GEORGE GARCIA 40.00 X 239624 0 28626 JERRY KEUHN 40.00 X 243428 0 22186 DONALD MARTIN 40.00 X 113873 0 13422 LESLIE REED 0.00 X 107018 0 0 1533558 1388686 521801 10 1 1 0 DOCS WHO CARE 1337 SOUTH FOUNTAIN DRIVE OLATHE KS 66061 EMERGENCY DEPT PHYSICIANS 992630 HAVE A NICE DAY ANESTHESIA ASSOCIATES L 2106 WOODCREST DR CHILLICOTHE MO 64601 ANESTHESIA SERVICES 570000 PREMIER SPECIALTY NETWORK LLC 1835 E REPUBLIC ROAD SPRINGFIELD MO 65804 PHYSICIAN SERVICES 261431 SHARED MEDICAL SERVICES INC PO BOX 330 COTTAGE GROVE WI 53527 MRI PATIENT SERVICES 191205 4 16589 29376 45965 NET PATIENT REVENUE 622110 26138018 26138018 EHR MEANINGFUL USE FDS 622110 369250 369250 OTHER PROGRAM REVENUE 622110 120365 120365 26627633 16452 16452 26690050 26627633 0 16452 X 62911 62911 479342 479342 9187873 8241128 946745 186460 158954 27506 1864998 1589877 275121 696934 594124 102810 16019 16019 155266 155266 4249606 3818751 430855 6283 6283 891443 798021 93422 194414 194414 3140755 2761379 379376 26116 20503 5613 114376 83920 30456 945277 519355 425922 257722 156978 100744 MEDICAL SUPPLIES 1924605 1917882 6723 BAD DEBTS 1475440 1475440 SHARED SERVICES - SLHS 1357332 321803 1035529 OTHER EXPENSES 61147 32235 28912 27294319 22553261 4741058 0 15220 13479 2911708 2338276 3076336 3116867 308597 341424 552388 463723 5807469 1529832 4453379 4277637 1855757 2571759 13173385 13123165 1305681 1631441 4353742 4637574 5659423 6269015 X 7258010 6671183 255952 182967 7513962 6854150 13173385 13123165 X -604269 -55543 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 11536 0 0 0 11536 0 EXPLANATION OF LOBBYING ACTIVITIES: 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 35579 11099 3700 42978 32828 8817 6066 35579 1 0 4336182 991117 3345065 1471287 538715 932572 4277637 INTEREST IN NET ASSETS OF WMH FOUNDATION - SFAS 136 182967 DUE FROM AFFILIATES 28228 ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS 2360564 2571759 DUE TO CHARITABLE TRUST 1370359 DUE TO AFFILIATES 3117215 ESTIMATED THIRD-PARTY PAYOR SETTLEMENT 150000 4637574 X 25200491 264 264 25200227 1489823 1489823 26690050 25757322 0 25757322 1536997 1536997 27294319 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: 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 SHARE OF NET ASSETS AT WRIGHT MEMORIAL HOSPITAL FOUNDATION. SUCH ASSETS ARE REPORTED IN PART X, LINE 15. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: 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, 2012, 2011, 2010, AND 2009, REMAIN SUBJECT TO EXAMINATION FOR BOTH FEDERAL AND STATE PURPOSES. PART XI, LINE 2D - OTHER ADJUSTMENTS: RELEASE OF RESTRICTED CONTRIBUTIONS-RECORDED AS BOOK REVENUE WHEN RELEASED 264. PART XI, LINE 4B - OTHER ADJUSTMENTS: RISK RETENTION GROUP SUBSCRIBER SAVINGS ACCOUNT DIVIDEND 9,174. RESTRICTED CONTRIBUTIONS RECEIVED IN 2012 RECOGNIZED AS REVENUE FOR TAX 5,210. BAD DEBT NET WITH REVENUE FOR BOOKS; INCLUDED IN EXPENSES FOR TAX 1,475,440. ROUNDING -1. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT NET WITH REVENUE FOR BOOKS; INCLUDED IN EXPENSES FOR TAX 1,475,440. ROUNDING GRANT TO WMH FOUNDATION TO TRANSFER HOME CARE & HOSPICE BALANCE 61,557. 1 1 X 1 X 133.000000000000 1 X 1 1 0 0 239141 239141 0.00930 4658890 3693832 965058 0.03740 4898031 3693832 1204199 0.04670 30385 19630 10755 0.00040 28678 28678 0.00110 7645722 4697007 2948715 0.11420 2011 2011 0.00010 7706796 4716637 2990159 0.11580 12604827 8410469 4194358 0.16250 0 1475440 12129030 12168915 -39885 X 1 1 1 1 WRIGHT MEMORIAL HOSPITAL

191 IOWA BLVD TRENTON MO 64683

X X X X ST LUKES OF TRENTON 1 1 1 133.000000000000 1 200.000000000000 1 X X X 1 1 X X X 1 0 1 X 0 0 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, L7 COL(F): TOTAL EXPENSE FROM FORM 990, PART IX, LINE 25, COLUMN (A) OF $27,232,762 LESS BAD DEBT EXPENSE OF $1,475,440 EQUALS TOTAL EXPENSE OF $25,757,322 FOR PURPOSES OF CALCULATING LINE 7, COLUMN (F). PART II: 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: ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE HOSPITAL ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE HOSPITAL ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYOR HAS NOT YET PAID, OR FOR PAYORS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY). FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH A THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE HOSPITAL 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. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS.BAD DEBT IS REPORTED 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. ST LUKES OF TRENTON PART V, SECTION B, LINE 14G: THE HOSPITAL FOLLOWS THE SAINT LUKE'S HEALTH SYSTEM POLICIES FOR UNINSURED. 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, AND VISITS BY SOCIAL WORKER TEAMS WHEN AN INPATIENT AS WELL AS FOLLOW UP CALLS AFTER DISCHARGE. FINANCIAL ASSISTANCE OR MEDICAID APPLICATIONS ARE REQUESTED ON ALL UNINSURED PATIENTS PRIOR TO DISCHARGE.THE HOSPITAL ALSO CONTRACTS WITH ELIGIBILITY ENROLLMENT SERVICE COMPANIES TO SCREEN ALL UNINSURED PATIENTS, ANY PATIENT IDENTIFIED BY A SOCIAL WORKER OR CASE MANAGER AS WELL AS ALL PATIENTS THAT REQUEST ASSISTANCE IN APPLYING FOR MEDICAID OR OTHER GOVERNMENT COVERAGE. 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 MEETS WITH STAFF, VOLUNTEERS, PATIENTS, BOARD MEMBERS AND PHYSICIANS. THE FEEDBACK PROVIDED BY THESE GROUPS IS COMMUNICATED TO HOSPITAL MANAGEMENT AND CONSIDERED WHEN DETERMINING THE NEEDS OF THE COMMUNITY. THE HOSPITAL ALSO WORKS WITH THE PATIENT ADVOCATE AND MARKETING DEPARTMENTS TO DETERMINE FEEDBACK RECEIVED FROM THECOMMUNITY REGARDING ITS NEEDS. THIS FEEDBACK IS ALSO COMMUNICATED TO HOSPITAL MANAGEMENT AND EVALUATED DURING THE ANNUAL BUDGET AND STRATEGIC PLANNING PROCESS. PART VI, LINE 3: SEE RESPONSE TO SCHEDULE H, PART V, LINE 13G. 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 HAS HISTORICALLY BEEN CONSIDERED 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 AND 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 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. 0 WRIGHT MEMORIAL HOSPITAL FOUNDATION 191 IOWA BLVD TRENTON MO 64683 562548994 501(C)(3) 62911 HOME CARE & HOSPICE SUPPORT 1 1 1 0 0 0 0 0 1 0 DON SIPES 0 235195 0 66841 0 37005 0 37870 0 17392 0 394303 0 17999 CHARLES ROBB 0 479101 0 170587 0 114771 0 242514 0 26650 0 1033623 0 91874 GARY JORDAN 184246 0 0 0 1106 0 19001 0 20552 0 224905 0 0 0 JANET BUCKMAN 0 154780 0 20447 0 834 0 7131 0 8568 0 191760 0 0 HESAMODIN BORHANI 266808 0 19750 0 2508 0 15000 0 22728 0 326794 0 0 0 PAMELA RALLS 181336 0 5887 0 1819 0 3779 0 6428 0 199249 0 0 0 GEORGE GARCIA 161201 0 77223 0 1200 0 12954 0 15672 0 268250 0 0 0 JERRY KEUHN 239939 0 0 0 3489 0 9710 0 12476 0 265614 0 0 0 LESLIE REED 106553 0 0 0 465 0 0 0 0 0 107018 0 0 0 PART I, LINES 4A-B 457(F) PLAN PARTICIPANT AND AMOUNT INCLUDED IN COLUMN C FOR THE PLAN: CHARLES ROBB - $125,043 SEVERANCE/SALARY CONTINUATION PAYMENTS PAID BY THE FILING ORGANIZATION: LES REED - $95,105 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 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. 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 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, DEBT, BUDGETS, CAPITAL EXPENDITURES 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 PRESENTED 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 OR THE SYSTEM VICE PRESIDENT OF HUMAN RESOURCES 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 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 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE NOT PUBLICLY AVAILABLE. 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. RON BREMER RECEIVED COMPENSATION FOR SERVICES RENDERED TO THE FILING ORGANIZATION AND OTHER RELATED ORGANIZATIONS. OTHER FEES FORM 990, PART IX, LINE 11G PURCHASED SERVICES & OTHER: PROGRAM SERVICE EXPENSES 1,670,278. MANAGEMENT AND GENERAL EXPENSES 408,911. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,079,189. REPAIRS & MAINTENANCE: PROGRAM SERVICE EXPENSES 370,589. MANAGEMENT AND GENERAL EXPENSES 21,944. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 392,533. PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 1,777,884. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,777,884. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 9: RISK RETENTION GROUP SSA DIVIDEND -9,174. PENSION LIABILITY TRANSFER TO SLHS -29,996. CHANGE IN NET ASSETS AT WMH FOUNDATION - SFAS 136 -16,375. ROUNDING 2. INVESTMENT INCOME FORM 990, PART VIII, LINE 3 INVESTMENT INCOME INCLUDES $9,174 OF SUBSCRIBER SAVINGS ACCOUNT ALLOCATION FROM RELATED RISK RETENTION GROUP. SAINT LUKES HEALTH SYSTEM 10920 ELM AVE KANSAS CITY MO 64134 431747502 HEALTH SYSTEM KS 501(C)(3) 509(A)(3) - TYPE 1 ST LUKES HOSPITAL OF KANSAS CITY 0 ST LUKES HOSPITAL OF KANSAS CITY 4401 WORNALL ROAD KANSAS CITY MO 64111 440545297 HEALTH CARE MO 501(C)(3) 170B1AIII 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 SAINTLUKES BLVD LEES SUMMIT MO 64086 562488077 HEALTH CARE MO 501(C)(3) 170B1AIII SAINT LUKES HEALTH SYSTEM 0 SAINT LUKES MEDICAL GROUP 6750 ANTIOCH SUITE 210 SHAWNEE MISSION KS 66204 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 2121 SUMMIT KANSAS CITY MO 64108 440546280 HEALTH CARE MO 501(C)(3) 170B1AIII SAINT LUKES HEALTH SYSTEM 0 MIDWEST EAR INSTITUTEINC 4200 PENNSYLVANIA SUITE 100 KANSAS CITY MO 64111 480905027 HEALTH CARE KS 501(C)(3) 170B1AIII ST LUKES HOSPITAL OF KANSAS CITY 0 SAINT LUKES HOSPITAL OF CHILLICOTHE 100 CENTRAL ST CHILLICOTHE MO 64601 431735565 HEALTH CARE MO 501(C)(3) 170B1AIII SAINT LUKES HEALTH SYSTEM 0 CUSHING MEMORIAL HOSPITAL CORPORATION 711 MARSHALL LEAVENWORTH KS 66048 480543792 HEALTH CARE KS 501(C)(3) 170B1AIII SAINT LUKES HEALTH SYSTEM 0 SAINT LUKES CANCER INSTITUTELLC 4323 WORNALL ROAD PEET 1 KANSAS CITY MO 64111 431933950 HEALTH CARE MO 501(C)(3) 170B1AIII SAINT LUKES HEALTH SYSTEM 0 SAINT LUKES CARE 10920 ELM AVENUE KANSAS CITY MO 64134 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 4401 WORNALL ROAD KANSAS CITY MO 64111 451470888 HEALTH CARE KS APPLIED FOR 501(C)(3 170B1AIII SAINT LUKES HEALTH SYSTEM 0 MEDICAL PLAZA PARTNERS LP 4320 WORNALL ROAD SUITE 410 KANSAS CITY MO 64111 431357824 OWN & OPERATE MEDICAL OFFICE BUILDING MO N/A MEDICAL PARK ASSOCIATES A LP 601 SOUTH 169 HIGHWAY SMITHVILLE MO 64089 431311049 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 FAMILY ADVOCATESLLC 10918 ELM AVENUE KANSAS CITY MO 64134 202739036 FOSTER CARE MO N/A SAINT LUKES CARDIOLOGY SERVICES LLC 10920 ELM AVE KANSAS CITY MO 64134 263726426 HEALTH CARE MO 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 10920 ELM AVENUE KANSAS CITY MO 64134 371471890 INSURANCE SC N/A C 0 ST LUKES HEALTH VENTURESINC 4320 WORNALL ROAD SUITE 410 KANSAS CITY MO 64111 431278476 ACCOUNTING MO N/A C 0 MEDICAL PLAZA MANAGEMENT INC 4320 WORNALL ROAD SUITE 410 KANSAS CITY MO 64111 431352317 MEDICAL OFFICE BUILDING MANAGEMENT MO N/A C 0 SPELMAN DEVELOPMENT CORPORATION 601 SOUTH 169 HIGHWAY SMITHVILLE MO 64089 431296007 HEALTH CARE 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 0 0 0 0 0 0 0 0 0 0 0 1 1 0 1 1 1 0 0 TRANSACTIONS WITH RELATED ORGANIZATIONS SCHEDULE R, PART V, ITEM 1 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.