2011-11-14T14:36:15-06:00 2010-12-31 990 2010-01-01 480543792 CUSHING MEMORIAL HOSPITAL CORPORATION CUSH 9136841100 711 MARSHALL LEAVENWORTH KS 66048 RONALD BAKER 9136841100 2011-11-14 2010 2016-02-24 21:20:13Z RON BAKER 711 MARSHALL LEAVENWORTH KS 66048 29025414 0 X WWW.SAINTLUKESHEALTHSYSTEM.ORG X 1930 KS FAITH-BASED, NOT-FOR-PROFIT COMMUNITY HOSPITAL 8 6 398 162 18326 -2949 49035 74347 26206823 28886841 16612 61677 1271 678 26273741 29023543 951132 1260788 0 0 14844121 15768111 0 0 0 14733097 17403598 30528350 34432497 -4254609 -5408954 15525767 17700950 16498891 24064234 -973124 -6363284 X CUSHING 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 THE SAINT LUKE'S HEALTH SYSTEM, WE ARE DEDICATED TO ENHANCING THE PHYSICAL, MENTAL AND SPIRITUAL HEALTH OF THE COMMUNITIES WE SERVE. 0 0 29926058 1260788 28868496 AS A VOLUNTARY, NONPROFIT ORGANIZATION, CUSHING MEMORIAL HOSPITAL CORPORATION IS COMMITTED TO SERVING ALL WHO SEEK OUR SERVICES REGARDLESS OF THEIR SOCIOECONOMIC STATUS. THE HOSPITAL PARTICIPATES IN THE MEDICAID, TRICARE, AND MEDICARE PROGRAMS AND HAS CHARITY CARE POLICIES FOR ASSISTING PEOPLE WITHOUT ADEQUATE MEANS TO PAY FOR THEIR CARE. 29926058 1 1 0 1 0 0 0 0 1 1 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 1 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 1 0 0 398 1 1 1 0 0 0 0 0 0 0 0 0 X 8 6 1 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 0 0 X THE ORGANIZATION 9136841100 711 MARSHALL LEAVENWORTH KS 66048 X JULIE ANDERSON 1.00 X 0 0 0 MICHAEL CROW 1.00 X X 0 0 0 CAROL MEYER 1.00 X X 0 207352 34702 STEVEN RANZENBERGER 1.00 X 0 0 0 RITA SWANN 1.00 X X 0 0 0 JOHN PETERSON 1.00 X 0 0 0 DON SIPES 1.00 X X 0 256614 52488 VICTORIA WELLS 1.00 X 0 0 0 RON BAKER 40.00 X 186388 0 49380 IDA BEYING 40.00 X 109712 0 6887 SALLY BORDER 40.00 X 105853 0 24404 ADELE DUCHARME 40.00 X 0 0 0 ROBERT KATZENBERGER 40.00 X 116504 0 22429 DALE DALENBERG 40.00 X 285644 0 24228 CHUCK ROBB X 0 0 0 JUDITH SCOTT 40.00 X 0 0 0 SHELBY FRIGON 40.00 X 0 0 0 804101 463966 214518 5 0 1 0 EMERGENCY MEDICAL SERVICES KS LLC 920 MAIN STREET SUITE 300 KANSAS CITY MO 64105 EMERGENCY ROOM PHYSICIANS 1373762 P1 GROUP INC 16210 W 108TH ST LENEXA KS 66219 MAINTENANCE SERVICES 612116 J E DUNN CONSTRUCTION CO INC 1001 LOCUST KANSAS CITY MO 64106 CONSTRUCTION 495448 ANESTHESIA SERVICES PA 2205 S 4TH ST LEAVENWORTH KS 66048 PHYSICIAN SERVICES 399996 NURSEFINDERS 524 E LAMAR BLVD SUITE 300 ARLINGTON TX 76011 TEMPORARY HELP SERVICES 309538 11 120 21365 52862 74347 NET PATIENT REVENUE 622110 28106483 28106483 RENTAL REVENUE 531120 384836 384836 OTHER PROGRAM SERVICES 622110 209331 209331 REGIONAL LAB 541380 186191 167865 18326 28886841 61696 61696 678 678 1852 1871 -19 -19 -19 29023543 28868496 18326 62374 1254138 1254138 6650 6650 482624 482624 12735452 11580531 1154921 329224 288433 40791 1298398 1113036 185362 922413 808126 114287 100987 100987 34082 34082 564 564 5014576 4435589 578987 48120 3972 44148 4869748 4675465 194283 102927 13161 89766 620673 584901 35772 42360 27149 15211 30182 24582 5600 646070 561514 84556 1088239 998768 89471 277591 266913 10678 BAD DEBT 2178554 2178554 SHARED SERVICES-SLHS 1800000 584741 1215259 SWAP RELATED COSTS 215133 194674 20459 RE TAXES & LICENSES 159913 159854 59 EICU EXPENSES 113534 113534 60345 51773 8572 34432497 29926058 4506439 0 830 866 2006248 2982969 3466839 3133421 1000 2000 498008 582845 220830 327768 21699867 12272721 8484334 9427146 69504 105221 747517 870275 30657 268439 15525767 17700950 2043592 1994995 14455299 22069239 16498891 24064234 X -1049639 -6452411 52157 64769 24358 24358 -973124 -6363284 15525767 17700950 X -5408954 18794 X 0 1 1 X 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 4201 0 0 0 4201 0 EXPLANATION OF OTHER LOBBYING ACTIVITIES: PART II-B, LINE 1I: LINE F: PORTION OF DUES PAID TO THE KANSAS HOSPITAL ASSOCIATION USED FOR LOBBYING ACTIVITIES. 76514 21606 307 1000 8300 89127 74358 3277 1121 76514 74358 74358 0.72670 0.27330 0 0 20000 407583 427583 11261533 5624708 5636825 8836920 5965170 2871750 1173831 682843 490988 9427146 PAYABLE TO AFFILIATES 14118325 OTHER NONCURRENT LIABILITIES 53838 RESERVE FOR SELF INSURED RISKS 603000 ESTIMATED THIRD PARTY PAYOR SETTLEMENTS 688027 CAPITAL LEASES 286049 LONG TERM DEBT TO ST LUKES HEALTH SYSTEM 6320000 22069239 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 AND CAPITAL EQUIPMENT PURCHASES FOR THE HOSPITAL. 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 125.000000000000 1 X 1 1 0 0 1452028 986003 466025 0.01440 3867980 3474480 393500 0.01220 3905736 2662091 1243645 0.03860 9225744 7122574 2103170 0.06520 87188 87188 0.00270 97893 97893 0.00300 355 355 0.00000 20248 20248 0.00060 205684 205684 0.00630 9431428 7122574 2308854 0.07150 2736 2736 0.00010 1945 1945 0.00010 4681 4681 0.00020 0 708030 7575049 9738385 -2163336 X 1 1 1 1 CUSHING MEMORIAL HOSPITAL CORPORATION

711 MARSHALL LEAVENWORTH KS 66048

X X X NOT REQUIRED 1 PART I, LINE 7: COST OF CHARITY CARE AND UNREIMBURSED HEALTH SERVICES WERE CALCULATED USING THE APPROPRITE COST TO CHARGE RATIO FROM THE ORGANIZATION'S COST REPORT. PART I, L7 COL(F): OUR TOTAL EXPENSE FROM FORM 990, PART IX, LINE 25, COLUMN (A) WAS $34,432,497. THE BAD DEBT EXPENSE INCLUDED IN THIS AMOUNT WAS $2,178,554. THIS LEFT US WITH A TOTAL EXPENSE OF $32,253,943 FOR PURPOSES OF CACLULATING LINE 7, COLUMN (F). PART II: CUSHING MEMORIAL HOSPITAL SPONSORS OR PARTICIPATES IN MANY COMMUNITY BUILDING ACTIVITIES WHICH PROMOTE THE HEALTH OF OUR COMMUNITY. ACTIVE PARTICIPATION IN MANY COMMUNITY ORGANIZATIONS INCLUDE LEAVENWORTH COUNTY DEVELOPMENT CORPORATION, CHAMBER OF COMMERCE, FORT LEAVENWORTH COMMUNITY RELATIONS AND PARTNERS, LEADERSHIP LEAVENWORTH LANSING CLASS, VOLUNTEER WORK WITH HARVESTERS TO FEED CHILDREN IN NEED AND MANY MORE. WE 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.THE RATIO OF PATIENT CARE COST TO CHARGES (FROM MEDICARE COST REPORT) IS APPLIED TO THE BAD DEBT EXPENSE FROM OUR FINANCIAL STATEMENTS TO CALCULATE COST OF BAD DEBT ON LINE 2. DISCOUNTS AND ALLOWANCES ARE ACCOUNTED FOR SEPARATELY FROM BAD DEBT EXPENSE. 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. THROUGHOUT THE YEAR, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON ITS REVIEW OF ACCOUNTS RECEIVABLE PAYOR COMPOSITION AND AGING, TAKING INTO CONSIDERATION RECENT WRITE-OFF EXPERIENCE BY PAYOR CATEGORY, PAYOR AGREEMENT RATE CHANGES, AND OTHER FACTORS. THE RESULTS OF THESE EVALUATIONS ARE THEN USED TO MAKE ANY MODIFICATIONS TO THE PROVISION FOR BAD DEBTS TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE RECEIVABLES. AFTER AMOUNTS DUE FROM THIRD PARTY PAYORS ARE SATISFIED, THE SYSTEM FOLLOWS ESTABLISHED GUIDELINES FOR PLACING CERTAIN PAST-DUE PATIENT BALANCES WITH EXTERNAL COLLECTION AGENCIES. 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. 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. 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 ASSESSMENT CONSISTS OF ONGOING MEETINGS WITH FORT LEAVENWORTH, U.S. PENITENTIARY, AND LANSING STATE CORRECTIONAL FACILITY OFFICIALS. THROUGH FEEDBACK FROM THESE MEETINGS, COMMUNITY NEEDS ARE COMMUNICATED TO THE HOSPITAL AND CONSIDERED. PART VI, LINE 3: THE HOSPITAL FOLLOWS THE SAINT LUKE'S HEALTH SYSTEM POLICIES FOR THE 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 PERTAINING TO POSSIBLE NEED IN PAYING THEIR BILL, 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 IN-PATIENT AS WELL AS 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 HUMAN ARC, AN ELIGIBILITY ENROLLMENT SERVICE COMPANY THAT SCREENS ALL UNINSURED PATIENTS WITH A BALANCE OVER $2,000, ANY PATIENT IDENTIFIED BY A SOCIAL WORKER AS WELL AS ON ALL PATIENTS THAT REQUEST ASSISTANCE IN APPLYING FOR POSSIBLE MEDICAID OR OTHER GOVERNMENT COVERAGE. PART VI, LINE 4: CUSHING MEMORIAL HOSPITAL IS LOCATED IN LEAVENWORTH COUNTY, KANSAS, JUST OUTSIDE OF THE KANSAS CITY METROPOLITAN AREA. WE GENERALLY DESCRIBE OUR COMMUNITY AS A 31 ZIP CODE SERVICE AREA. PART VI, LINE 6: THE BOARD OF DIRECTORS CONSISTS OF MEDICAL PROFESSIONALS, BUSINESS PROFESSIONALS AND ACTIVE COMMUNITY MEMBERS NEARLY ALL OF WHOM RESIDE OR PRACTICE IN THE COMMUNITY. THE BOARD IS INVOLVED IN THE PLANNING AND COMMUNITY ASSESSMENT PROCESSES. THE MEDICAL STAFF IS OPEN FOR NEARLY ALL SPECIALTIES AND PRIVILEGES ARE AVAILABLE TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY.CUSHING MEMORIAL HOSPITAL DONATES EMERGENCY, LABORATORY, AND RADIOLOGY SERVICES TO PATIENTS OF SAINT VINCENT'S CLINIC, WHICH PROVIDES PRIMARY HEATH CARE SERVICES TO THE UNINSURED POOR OF LEAVENWORTH COUNTY.THE HOSPITAL ALSO PROVIDES SCHOLARSHIPS TO LOCAL STUDENTS INTERESTED IN PURSUING A DEGREE IN HEALTH CARE. IN ADDITION, MANY HOURS ARE DONATED BY STAFF IN ON-THE-JOB EDUCATION OF STUDENTS IN LOCAL COLLEGE HEALTH CARE CURRICULUM. PART VI, LINE 7: 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 SAINT LUKES MEDICAL GROUP (501C3 AFFILIATE) 6750 ANTIOCH ROAD STE 210 SHAWNEE MISSION KS 66204 431598353 501(C)(3) 1241306 OPERATING FUNDS 1 SCHOLARSHIPS TO STUDENTS IN HEALTHCARE FIELD 10 6650 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 0 0 0 0 0 0 0 0 0 CAROL MEYER 0 186000 0 50 0 21302 0 32428 0 2274 0 242054 0 8944 DON SIPES 0 221426 0 50 0 35138 0 32699 0 19789 0 309102 0 18033 RON BAKER 183599 0 50 0 2739 0 24665 0 24715 0 235768 0 0 0 DALE DALENBERG 284489 0 50 0 1105 0 2195 0 22033 0 309872 0 0 0 SUPPLEMENTAL INFORMATION PART III DON SIPES AND CAROL MEYER 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. FORM 990, PART VI, SECTION A, LINE 2 DON SIPES AND CAROL MEYER 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. 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. 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 PRIOR TO FILING. THE 990 WAS MADE AVAILABLE 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 COMPLIANCE OFFICER 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 15A 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. 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 TOTAL COMPENSATION PHILOSOPHY AND ANALYZES MARKET COMPETITIVENESS (IN TOTAL AND BY EACH COMPENSATION 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 SURVEYS AND COMPARABILITY DATA PROVIDED BY AN INDEPENDENT COMPENSATION CONSULTING FIRM. 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 CAROL MEYER 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. THESE INDIVIDUALS WORKED 40 HOURS OR MORE PER WEEK FOR ALL RELATED ORGANIZATIONS. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED GAINS ON INVESTMENTS: 33,749. PENSION LIABILITY TRANSFER TO SLHS -3,550. RRG SAA DIVIDEND -17,411. MEDICAL STAFF ACCOUNT - OPENING BALANCE 6,006. TOTAL TO FORM 990, PART XI, LINE 5: 18,794. CUSHING HOSPITAL PHYSICIAN SERVICES LLC 711 MARSHALL LEAVENWORTH KS 66048 261440016 PHYSICIAN SERVICES-BILLING KS SAINT LUKES HEALTH SYSTEM 10920 ELM AVENUE 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 HWY SMITHVILLE MO 64089 440545393 HEALTH CARE MO 501(C)(3) 170B1AIII SAINT LUKES HEALTH SYSTEM INC 0 SAINT LUKES SOUTH HOSPITAL INC 12300 METCALF AVE OVERLAND PARK KS 66213 481203262 HEALTH CARE KS 501(C)(3) 170B1AIII SAINT LUKES HEALTH SYSTEM INC 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 INC 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 INC 0 CRITTENTON 10918 ELM AVENUE KANSAS CITY MO 64134 440545808 HEALTH CARE MO 501(C)(3) 170B1AIII ST LUKES HOSPITAL OF KANSAS CITY 0 SAINT LUKES HEALTH SYSTEM HOME CARE AND HOSPICE 3100 BROADWAY SUITE 1000 KANSAS CITY MO 64111 431127200 HEALTH CARE MO 501(C)(3) 170B1AIII SAINT LUKES HEALTH SYSTEM INC 0 SAINT LUKES HOSPITAL OF TRENTON 191 IOWA BLVD TRENTON MO 64683 431707306 HEALTH CARE MO 501(C)(3) 170B1AIII SAINT LUKES HEALTH SYSTEM INC 0 SAINT LUKES HOSPITAL OF GARNETT 421 SOUTH MAPLE GARNETT KS 66032 742849611 HEALTH CARE KS 501(C)(3) 170B1AIII SAINT LUKES HEALTH SYSTEM INC 0 CABOT WESTSIDE HEALTH CENTER 2121 SUMMIT KANSAS CITY MO 64108 440546280 HEALTH CARE MO 501(C)(3) 170B1AVI SAINT LUKES HEALTH SYSTEM INC 0 MIDWEST EAR INSTITUTE INC 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 STREET CHILLICOTHE MO 64601 431735565 HEALTH CARE MO 501(C)(3) 170B1AIII SAINT LUKES HEALTH SYSTEM INC 0 SAINT LUKES CANCER INSTITUTE LLC 4323 WORNALL RD PEET 1 KANSAS CITY MO 64111 431933950 HEALTH CARE MO 501(C)(3) 170B1AIII SAINT LUKES HEALTH SYSTEM INC 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 INC 0 MEDICAL PLAZA IMAGING ASSOCIATES 4401 WORNALL ROAD KANSAS CITY MO 64111 431609584 HEALTH CARE MO 501(C)(3) 170B1AIII SAINT LUKES HEALTH SYSTEM INC 0 SAINT LUKES COLLEGE OF HEALTH SCIENCES 8320 WARD PARKWAY STE 300 KANSAS CITY MO 64114 272716128 POST-SECONDARY NURSING EDUCATION MO 501(C)(3) 170B1AII ST LUKES HOSPITAL OF KANSAS CITY 0 SLCC INC 4330 WORNALL ROAD STE 2000 KANSAS CITY MO 64111 271994652 HEALTH CARE KS APPLYING FOR 501(C)( APPLYING FOR 170B1AI SAINT LUKES HEALTH SYSTEM INC 0 MEDICAL PLAZA PARTNERS LP 4320 WORNALL ROAD SUITE 410 KANSAS CITY MO 64111 431357824 OWN AND OPERATE MEDICAL OFFICE BUILDING MO N/A MEDICAL PARK ASSOCIATES A LP 601 SOUTH 169 HWY SMITHVILLE MO 64089 431311049 OWN AND 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 ADVOCATES LLC 10918 ELM AVENUE KANSAS CITY MO 64134 202739036 FOSTER CARE MO N/A SAINT LUKES CARDIOLOGY SERVICES LLC 10920 ELM AVENUE 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 ST LUKES HEALTH VENTURES INC 4320 WORNALL ROAD SUITE 410 KANSAS CITY MO 64111 431278476 ACCOUNTING MO N/A C MEDICAL PLAZA MANAGEMENT INC 4320 WORNALL ROAD SUITE 410 KANSAS CITY MO 64111 431352317 MEDICAL OFFICE BUILDING MANAGEMENT MO N/A C VENTURE FINANCIAL SERVICES INC 9500 E 63RD STE 202 KANSAS CITY MO 64133 431605740 COLLECTIONS MO N/A C SPELMAN DEVELOPMENT CORPORATION 601 SOUTH 169 HWY SMITHVILLE MO 64089 431296007 HEALTH CARE MO N/A C 0 1 0 0 1 0 0 0 0 0 0 0 1 1 1 1 1 1 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.