2011-11-14T14:37:25-06:00 2010-12-31 990 2010-01-01 742849611 SAINT LUKES HOSPITAL OF GARNETT INC SAIN 7854483131 421 SOUTH MAPLE BOX 309 GARNETT KS 66032 VICKI MILLS 7854483131 2011-11-14 2010 2016-03-07 17:11:31Z ANDERSON COUNTY HOSPITAL DENNIS HACHENBERG 421 S MAPLE GARNETT KS 66032 15336600 0 X WWW.SAINTLUKESHEALTHSYSTEM.ORG X 1997 KS CRITICAL ACCESS HOSPITAL 7 4 243 150 0 0 131277 156039 14907948 15175518 17137 5043 0 0 15056362 15336600 4653 24877 0 0 8073145 8199953 0 0 0 6581155 7103690 14658953 15328520 397409 8080 2306513 2413651 1740485 1870793 566028 542858 X ANDERSON COUNTY 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 12665945 24877 15175518 ANDERSON COUNTY HOSPITAL HAS BEEN DESIGNATED BY THE STATE OF KANSAS AND MEDICARE AS A CRITICAL ACCESS HOSPITAL.ALL PROGRAM SERVICE EXPENSES WERE INCURRED IN FURTHERANCE OF OUR MISSION, WHICH IS TO ENSURE HIGH QUALITY HEALTHCARE IN A CARING ENVIRONMENT FOR THE COMMUNITIES WE SERVE. IN 2010, THERE WERE 11,895 PATIENT DAYS, 13,605 RURAL HEALTH CLINIC VISITS, 3074 EMERGENCY ROOM VISITS, 20,485 OUTPATIENT VISITS AND 1039 AMBULANCE CALLS. WE PROVIDED UN-INSURED OR INDIGENT AREA CHILDREN WITH 546 VACCINATIONS.AS A VOLUNTARY, NONPROFIT, RURAL CRITICAL ACCESS HOSPITAL, SAINT LUKE'S HOSPITAL OF GARNETT IS COMMITTED TO SERVING ALL WHO SEEK OUR SERVICES REGARDLESS OF THEIR SOCIOECONOMIC STATUS. THOUGH WE HAVE PROVIDED SUCH CARE THROUGHOUT OUR 59-YEAR HISTORY, OUR COMMITMENT TO THOSE WITHOUT ADEQUATE MEANS TO PAY FOR THEIR CARE HAS GROWN SIGNIFICANTLY IN RECENT YEARS. 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 ALSO PROVIDES HEALTH RELATED ACTIVITIES AND SERVICES IN SUPPORT OF THE COMMUNITY INCLUDING PROVIDING AN ANNUAL HEATH FAIR, AN ANNUAL BREAST CANCER AWARENESS CAMPAIGN AND CLINIC AND COMMUNITY WIDE HEALTH, WEIGHT, FIRST AID AND CPR CLASSES. IN ADDITION, WE PROVIDE A HEALTH CAREERS CLASS AT THE HIGH SCHOOL AND ARE A WORK STUDY SITE FOR HIGH SCHOOL STUDENTS INTERESTED IN HEALTH RELATED CAREERS. 12665945 1 1 0 1 0 0 0 0 0 1 0 0 1 1 0 1 1 0 0 0 0 0 0 0 0 1 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 7 0 1 243 1 0 0 0 0 0 0 0 0 0 0 X 7 4 1 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 0 0 X THE ORGANIZATION 7854483131 421 SOUTH MAPLE BOX 309 GARNETT KS 66032 X WILLIAM BARNES 1.00 X X 0 0 0 CAROL ASKINS-BELLER 1.00 X X 0 0 0 MACKENZIE PETERSON MD 40.00 X 153470 0 28844 DON SIPES 1.00 X X 0 256614 52488 EUGENE HIGHBERGER 1.00 X 0 0 0 CAROL MEYER 1.00 X X 0 207352 34702 DAVID LYBARGER 1.00 X 0 0 0 DENNIS HACHENBERG 40.00 X 157738 0 49582 VICKI MILLS 40.00 X 133533 0 18470 MARGO WILLIAMS 40.00 X 88732 0 13171 WENDY BELCHER 40.00 X 111316 0 30796 644789 463966 228053 4 0 1 0 DOCS WHO CARE 1337 S FOUNTAIN DR OLATHE KS 66061 ER & URGENT CARE COVERAGE 1038246 BOWES ANESTHESIA 9622 PERRY LANE OVERLAND PARK KS 66212 CRNA SERVICES 172723 CPSI 6600 WALL STREET MOBILE AL 36685 COMPUTER SERVICES 172238 BLUE VALLEY IMAGING 10222 MONROVIA LENEXA KS 66215 IMAGING SERVICES 109530 4 156039 156039 NET PATIENT REVENUE 622110 14467067 14467067 AMBULANCE CONTRACT 621910 555000 555000 MEDICAL CLINIC RENT 531120 85910 85910 CAFETERIA 622110 54375 54375 OTHER PROGRAM REVENUE 622110 13166 13166 15175518 5043 5043 15336600 15175518 0 5043 24877 24877 643542 182314 461228 5802560 5222904 579656 164292 137763 26529 1079652 905315 174337 509907 427570 82337 9106 9106 92136 92136 2487326 2273550 213776 35916 6621 29295 1791921 1652386 139535 98379 98379 759710 537343 222367 23676 20577 3099 86039 47717 38322 7599 7599 2479 2479 278168 252837 25331 BAD DEBT 804435 804435 SHARED SERVICES-SLHS 600000 157381 442619 OTHER 26800 9876 16924 15328520 12665945 2662575 0 403 303533 305599 52113 53779 1314228 1333227 166439 198744 119175 198749 219114 214154 7439 4960 343586 318190 2306513 2413651 903424 1017993 837061 852800 1740485 1870793 X 566028 542858 566028 542858 2306513 2413651 X 8080 -31250 X 0 1 1 X 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 3070 0 0 0 3070 0 EXPLANATION OF OTHER LOBBYING ACTIVITIES: PART II-B, LINE 1I: LINE F - PORTION OF DUES PAID TO VARIOUS HOSPITAL AND RELATED MEDICAL ASSOCIATIONS USED TOWARD LOBBYING ACTIVITIES. 4096 4096 0 5954 5436 518 209064 204622 4442 4960 OTHER RECEIVABLES 27840 DUE FROM AFFILIATES 18151 ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS 272199 318190 DUE TO COUNTY BOARD OF TRUSTEES 387334 DUE TO SLHS AFFILIATED ENTITIES 465466 852800 15336600 15328520 8080 -31250 -31250 -23170 15332638 0 15332638 3962 3962 15336600 15328522 2 2 15328520 0 15328520 PART XI, LINE 8 - OTHER ADJUSTMENTS: PENSION LIABILITY TRANSFER TO SYSTEM -27,286. RISK RENTENTION GROUP SUBSCRIBER SAVINGS DIVIDEND -3,965. ROUNDING 1. PART XII, LINE 4B - OTHER ADJUSTMENTS: RISK RETENTION GROUP SUBSCRIBER SAVINGS ACCOUNT DIVIDEND 3,965. ROUNDING -3. PART XIII, LINE 2D - OTHER ADJUSTMENTS: ROUNDING 2. PART X - THE ORGANIZATION HAD NO FIN 48 LIABILITY. 1 1 X 1 X 133.000000000000 1 X 1 1 0 0 128101 128101 0.00880 1892207 1978267 -86060 0.00000 2020308 1978267 42041 0.00290 110532 1020 109512 0.00750 22979 22979 0.00160 1603259 1458190 145069 0.01000 56984 56984 0.00390 1793754 1459210 334544 0.02300 3814062 3437477 376585 0.02590 14811 14811 0.00100 2806 2806 0.00020 14427 14427 0.00100 140101 140101 0.00960 172145 172145 0.01180 0 625850 7083982 7303857 -219875 X 1 1 1 1 SAINT LUKE'S HOSPITAL OF GARNETT

421 S MAPLE GARNETT KS 66032

X X X NOT REQUIRED 1 2 ANDERSON COUNTY LONG TERM CARE UNIT

421 S MAPLE GARNETT KS 66032

LONG TERM CARE NURSING FACILITY ANDERSON COUNTY HOSPITAL FAMILY CARE CTR

436 W 4TH GARNETT KS 66032

RURAL HEALTH CLINIC PART I, LINE 3C: THE HOSPITAL USES THE FEDERAL POVERTY GUIDELINES TO DETERMINE ELIGIBILITY.IN ADDITION, MEDICAL INDIGENCY MAY BE DETERMINED ON AN INDIVIDUAL BASIS FOR INCOME ABOVE THE FEDERAL POVERTY LEVEL WHEN A SINGLE ILLNESS OR INJURY CAUSES HARDSHIP. PART I, LINE 6A: ANDERSON COUNTY HOSPITAL PREPARES AN ANNUAL COMMUNITY BENEFIT REPORT WHICH IS SHARED WITH IT'S COMMUNITY ADVISORY GROUPS, EMPLOYER ADVISORY GROUPS, FOUNDATION AND COUNTY BOARDS AND OTHER CONSTITUENCIES. PART I, LINE 7: COST OF CHARITY CARE AND UNREIMBURSED HEALTH SERVICES WERE CALCULATED USING THE APPROPRITE COST TO CHARGE RATIO FROM THE HOSPITAL'S COST REPORT PART I, LINE 7G: SUBSIDIZED HEALTH SERVICES FOR EMERGENCY DEPARTMENT. PART I, L7 COL(F): OUR TOTAL EXPENSE FROM FORM 990, PART IX, LINE 25, COLUMN (A) WAS $15,328,520. THE BAD DEBT EXPENSE INCLUDED IN THIS AMOUNT WAS $804,435. THIS LEFT US WITH A TOTAL EXPENSE OF $14,524,085 FOR PURPOSES OF CACLULATING LINE 7, COLUMN (F). PART II: ANDERSON COUNTY HOSPITAL'S COMMUNITY BUILDING ACTIVITIES COVER A WIDE RANGE. THE HOSPITAL TAKES THE LEAD IN MANY COMMUNITY ENDEAVORS. WE PROVIDE MEETING SPACE, REFRESHMENTS AND SPEAKERS FOR MANY COMMUNITY PROJECTS AND OTHER CHARITABLE ORGANIZATIONS. WE PROVIDE THE SPOKE AROUND WHICH MOST OF THE COALITION BUILDING IN OUR COMMUNITY, BRINGING TOGETHER OTHER HEALTH AND SOCIAL SERVICES ORGANIZATIONS TO PLAN FOR THE BENEFIT OF THE COMMUNITY. WE PROVIDE OVER $140,101 IN FUNDS FOR WORKFORCE DEVELOPMENT IN THE COMMUNITY INCLUDING EMT, NURSE AID AND MEDICATION AID CLASSES THAT ARE OPEN TO THE COMMUNITY. WE PARTICIPATE IN THE GRADE AND HIGHSCHOOL BY OFFERING HEALTH RELATED CLASSES TO ALL AGE GROUPS. WE OFFER HEALTH CAREER ASSISTANCE AND CLASSES TO THE HIGH SCHOOL AND PARTICIPATE IN THE HIGH SCHOOL WORK STUDY PROGRAM WHICH OFFERS STUDENTS AN OPPORTUNITY TO SHADOW IN THE HEALTH CARE WORK ENVIRONMENT. 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 COST TO CHARGES METHODOLOGY IS APPLIED TO TOTAL BAD DEBT EXPENSE TO CALCULATE THE COST OF BAD DEBT. FINANCIAL STATEMENT FOOTNOTE REGARDING BAD DEBT EXPENSE: THE HOSPITAL PROVIDES FOR ACCOUNTS RECEIVABLE THAT COULD BECOME UNCOLLECTIBLE IN THE FUTURE BY ESTABLISHING AN ALLOWANCE TO REDUCE THE CARRYING VALUE OF SUCH RECEIVABLES TO THEIR ESTIMATED NET REALIZABLE VALUE. THE HOSPITAL ESTIMATES THIS ALLOWANCE BASED ON THE AGING OF ITS ACCOUNTS RECEIVABLE AND ITS HISTORICAL COLLECTION EXPERIENCE FOR EACH TYPE OF PAYOR. PART III, LINE 8: MEDICARE ALLOWABLE COSTS WERE CALCULATED USING A COST-TO-CHARGE RATIO FROM MEDICARE COST REPORT.ANDERSON COUNTY HOSPITAL IS A CRITICAL ACCESS HOSPITAL IN A FEDERALLY DESIGNATED LOW INCOME HPSA, LOCATED IN THE SECOND LOWEST INCOME COUNTY IN THE STATE OF KANSAS. THE AVERAGE AGE OF OUR INPATIENT POPULATION IS 74 AND THE AVERAGE AGE OF OUR OUTPATIENT POPULATION IS 62. MEDICARE SHORTFALLS MUST BE ABSORBED BY THE HOSPITAL IN ORDER TO CONTINUE TREATING THE ELDERLY IN OUR COMMUNITY. WE PROVIDE SERVICES TO THE MOST NEEDY CONSTITUENCIES IN OUR AREA. THESE INCLUDE BOTH MEDICAID AND MEDICARE POPULATIONS. THE LOSS ON MEDICARE SHOULD BE TREATED AS COMMUNITY BENEFIT.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. IN ADDITION, ONCE EVERY 3 YEARS, A COMMUNITY HEALTH SURVEY WHICH IS DELIVERED TO OVER 4000 HOMES IN THE SERVICE AREA. DETAILED INFORMATION ON HEALTH AND SOCIAL CONCERNS IN THE COMMUNITY AS WELL AS OTHER HEALTH RELATED INFORMATION IS GARNERED FROM THE SURVEYS. THE HOSPITAL ALSO HAS A NUMBER OF COMMUNITY ADVISORY BOARDS REPRESENTING DIFFERENT CONSTITUENCIES THAT MEET AT LEAST ANNUALLY TO ASSIST US IN PLANNING FOR THE HEALTH CARE NEEDS OF THE COMMUNITY. WE PARTICIPATE MONTHLY IN THE COMMUNITY WIDE HEALTH COALITION MADE UP OF OTHER HEALTH PROVIDERS WITHIN OUR AREA. FROM TIME TO TIME WE HAVE COMMUNITY FOCUS GROUPS TO ASSIST US IN UNDERSTANDING THE HEALTHCARE NEEDS IN OUR COMMUNITY. PART VI, LINE 3: ANDERSON COUNTY HOSPITAL INFORMS AND EDUCATES PATIENTS AND PERSONS WHO MAY BE BILLED FOR PATIENT CARE ABOUT THE ELIGIBILITY FOR ASSISTANCE BY POSTING SIGNS THROUGHOUT THE FACILITY AND ON HOSPITAL SPECIFIC LITERATURE GIVEN OUT TO EACH PATIENT WHO SEEKS SERVICES AS WELL AS ON OUR PATIENT STATEMENTS. WE COORDINATE IDENTIFICATION OF NEED WITH OUR PHYSICIAN OFFICE AND WITH OTHER ENTITIES WITHIN OUR HEALTH SYSTEM. WE HAVE A FINANCIAL AND SOCIAL SERVICE COUNSELORS WHO WORKS WITH FAMILIES AND INDIVIDUALS IN NEED. SINCE ANDERSON COUNTY IS A LOW-INCOME HPSA WE UNDERSTAND THAT A LARGE PART OF OUR POPULATION NEEDS ASSISTANCE. PART VI, LINE 4: ANDERSON COUNTY HOSPITAL IS A CRITICAL ACCESS HOSPITAL, LOCATED IN GARNETT, A RURAL COMMUNITY SOUTHWEST OF KANSAS CITY AT THE CONFLUENCE OF HWY 59 AND 169. THE SERVICE AREA ENCOMPASSES ALL OF ANDERSON COUNTY AND PORTIONS OF FRANKLIN, LINN, COFFEY AND ALLEN COUNTIES. THE CURRENT COUNTY POPULATION IS 8700 AND THE EXTENDED SERVICE AREA POPULATION IS 12,000 PEOPLE. THE GARNETT AREA IS MAINLY A FARMING COMMUNITY. THE COUNTY IS FEDERALLY DESIGNATED AS A LOW-INCOME HPSA. 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 X PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: GRANTS ARE PROVIDED TO QUALIFYING ORGANIZATIONS. ALL DONEE INFORMATION IS KEPT AS PART OF THE ORGANIZATION'S BOOKS AND RECORDS. 0 0 0 0 0 0 0 1 0 MACKENZIE PETERSON MD 92199 0 61050 0 221 0 6339 0 22505 0 182314 0 0 0 DON SIPES 0 221426 0 50 0 35138 0 32699 0 19789 0 309102 0 18033 CAROL MEYER 0 186000 0 50 0 21302 0 32428 0 2274 0 242054 0 8944 DENNIS HACHENBERG 148787 0 0 0 8951 0 30247 0 19335 0 207320 0 0 0 VICKI MILLS 109184 0 0 0 24349 0 8307 0 10163 0 152003 0 5147 0 PART I, LINE 7 EMPLOYED PHYSICIANS ARE ELIGIBLE FOR BONUSES BASED ON PRODUCTIVITY AND OTHER PERFORMANCE MEASURES. 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 BEFORE 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: PENSION LIABILITY TRANSFER TO SYSTEM -27,286. RISK RENTENTION GROUP SUBSCRIBER SAVINGS DIVIDEND -3,965. ROUNDING 1. TOTAL TO FORM 990, PART XI, LINE 5: -31,250. SAINT LUKES HEALTH SYSTEM INC 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 LUKE'S NORTHLAND HOSPITAL CORPORATION 601 S 169 HWY SMITHVILLE MO 64089 440545393 HEALTH CARE MO 501(C)(3) 170B1AIII SAINT LUKE'S HEALTH SYSTEM 0 SAINT LUKE'S SOUTH HOSPITAL INC 12300 METCALF AVENUE OVERLAND PARK KS 66213 481203262 HEALTH CARE KS 501(C)(3) 170B1AIII SAINT LUKE'S HEALTH SYSTEM 0 SAINT LUKE'S EAST HOSPITAL 100 NE SAINT LUKES BLVD LEES SUMMIT MO 64086 562488077 HEALTH CARE MO 501(C)(3) 170B1AIII SAINT LUKE'S HEALTH SYSTEM 0 SAINT LUKE'S CARE 10920 ELM AVENUE KANSAS CITY MO 64134 260185090 HEALTH CARE MO 501(C)(3) 509(A)(3) - TYPE 1 SAINT LUKE'S HEALTH SYSTEM 0 SAINT LUKE'S HEALTH SYSTEM HOME CARE AND HOSPICE 3100 BROADWAY SUITE 1000 KANSAS CITY MO 64111 431127200 HEALTH CARE MO 501(C)(3) 170B1AIII SAINT LUKE'S HEALTH SYSTEM 0 SAINT LUKE'S CANCER INSTITUTE LLC 4323 WORNALL ROAD PEET 1 KANSAS CITY MO 64111 431933950 HEALTH CARE MO 501(C)(3) 170B1AIII SAINT LUKE'S HEALTH SYSTEM 0 CUSHING MEMORIAL HOSPITAL CORPORATION 711 MARSHALL LEAVENWORTH KS 66048 480543792 HEALTH CARE KS 501(C)(3) 170B1AIII SAINT LUKE'S HEALTH SYSTEM 0 SAINT LUKE'S MEDICAL GROUP 6750 ANTIOCH SUITE 210 SHAWNEE MISSION KS 66204 431598353 HEALTH CARE MO 501(C)(3) 170B1AIII SAINT LUKE'S HEALTH SYSTEM 0 SAINT LUKE'S HOSPITAL OF CHILLICOTHE 100 CENTRAL STREET CHILLICOTHE MO 64601 431735565 HEALTH CARE MO 501(C)(3) 170B1AIII SAINT LUKE'S HEALTH SYSTEM 0 SAINT LUKE'S HOSPITAL OF TRENTON 191 IOWA BLVD TRENTON MO 64683 431707306 HEALTH CARE MO 501(C)(3) 170B1AIII SAINT LUKE'S HEALTH SYSTEM 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 CRITTENTON 10918 ELM AVENUE KANSAS CITY MO 64134 440545808 HEALTH CARE MO 501(C)(3) 170B1AIII ST LUKES HOSPITAL OF KANSAS CITY 0 CABOT WESTSIDE HEALTH CENTER 2121 SUMMIT KANSAS CITY MO 64108 440546280 HEALTH CARE MO 501(C)(3) 170B1AVI SAINT LUKE'S HEALTH SYSTEM 0 MEDICAL PLAZA IMAGING ASSOCIATES LLC 4401 WORNALL ROAD KANSAS CITY MO 64111 431609584 HEALTH CARE MO 501C3 170B1AIII SAINT LUKE'S HEALTH SYSTEM 0 SAINT LUKE'S COLLEGE OF HEALTH SCIENCES 8320 WARD PARKWAY SUITE 300 KANSAS CITY MO 64114 272716128 POST-SECONDARY NURSING EDUCATION MO 501C3 170B1AII SAINT LUKE'S HOSPITAL 0 SLCC INC 4330 WORNALL ROAD SUITE 2000 KANSAS CITY MO 64111 271994652 HEALTH CARE KS APPLYING FOR 501C3 APPLYING FOR 170B1AI SAINT LUKE'S HEALTH SYSTEM 0 MEDICAL PLAZA PARTNERS LP 4320 WORNALL RD 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 LUKE'S SURGICENTER-LEE'S SUMMIT LLC 11221 ROE AVE SUITE 230 OVERLAND PARK KS 66211 470853481 HEALTH CARE MO N/A SAINT LUKE'S 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 LUKE'S CARDIOLOGY SERVICES LLC 10920 ELM AVENUE KANSAS CITY MO 64134 263726426 HEALTH CARE MO N/A SAINT LUKE'S-GI DIAGNOSTICS LLC 4321 WASHINGTON SUITE 5700 KANSAS CITY MO 64111 274142549 HEALTH CARE MO N/A SAINT LUKE'S HEALTH SYSTEM RISK RETENTION GROUP 10920 ELM AVENUE KANSAS CITY MO 64134 371471890 INSURANCE SC N/A ST LUKE'S HEALTH VENTURES INC 4320 WORNALL ROAD SUITE 410 KANSAS CITY MO 64111 431278476 ACCOUNTING MO N/A MEDICAL PLAZA MANAGEMENT INC 4320 WORNALL ROAD SUITE 410 KANSAS CITY MO 64111 431352317 MEDICAL OFFICE BUILDING MANAGEMENT MO N/A VENTURE FINANCIAL SERVICES INC 9500 E 63RD ST STE 202 KANSAS CITY MO 64133 431605740 COLLECTIONS MO N/A SPELMAN DEVELOPMENT CORPORATION 601 SOUTH 169 HIGHWAY SMITHVILLE MO 64089 431296007 HEALTH CARE MO N/A 0 0 0 0 0 0 0 0 1 0 0 1 0 1 1 1 1 0 TRANSACTIONS WITH RELATED ORGANIZATIONS SCHEDULE R, PART V, LINE 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.