Form990
Click to see attachment
Department of the Treasury
Internal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except black lung benefit trust or private foundation)

MediumBullet The organization may have to use a copy of this return to satisfy state reporting requirements.
OMB No. 1545-0047
2012
Open to Public Inspection
A For the 2012 calendar year, or tax year beginning 01-01-2012 , 2012, and ending 12-31-2012
BCheck if applicable:
CName of organization
ST LUKES COMMUNITY HEALTH SERVICES
 
Doing Business As
St Luke's The woodlands Hospital
 
Number and street (or P.O. box if mail is not delivered to street address)
6624 FANNIN
Suite 1100
Room/suite
City or town, state or country, and ZIP + 4
HOUSTON, TX77030
D Employer identification number

76-0536234
E Telephone number

G Gross receipts $ 170,772,894
F Name and address of principal officer:
DAVID j FINE
6624 FANNIN street suite 1100
HOUSTON,TX77030
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.SLEH.COM
H(a)
Is this a group return for
affiliates?
H(b)
Are all affiliates included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:
 
L Year of formation: 1997
M State of legal domicile: TX
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: ST. LUKE'S THE WOODLANDS HOSPITAL, SERVING ALL GOD'S CHILDREN AS THE HEALTH MINISTRY OF THE EPISCOPAL DIOCESE OF TEXAS, SEEKS TO RAISE THE QUALITY OF LIFE BY ENHANCING COMMUNITY HEALTH THROUGH SUPERIOR SERVICE
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 10
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 9
5 Total number of individuals employed in calendar year 2011 (Part V, line 2a) ...... 5 1,052
6 Total number of volunteers (estimate if necessary) ............. 6 317
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 973,383
b Net unrelated business taxable income from Form 990-T, line 34 ......... 7b 525,747
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 100,000 0
9 Program service revenue (Part VIII, line 2g) ......... 159,809,122 172,075,517
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... -2,848,069 -2,830,827
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 386,955 691,122
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 157,448,008 169,935,812
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 487,166 1,799,372
14 Benefits paid to or for members (Part IX, column (A), line 4)..... 0 0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 53,315,240 58,443,031
16a Professional fundraising fees (Part IX, column (A), line 11e)..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 90,340,384 96,261,169
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 144,142,790 156,503,572
19 Revenue less expenses. Subtract line 18 from line 12....... 13,305,218 13,432,240
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 169,198,889 179,556,380
21 Total liabilities (Part X, line 26)............. 169,413,610 166,338,861
22 Net assets or fund balances. Subtract line 21 from line 20..... -214,721 13,217,519
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title
Paid Preparer Use Only
Print/Type preparer's name
 
Preparer's signature
Date
PTIN
Firm's name MediumBullet

Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ............
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y
Form 990 (2012)
Form 990 (2012)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response to any question in this Part III ...............
1
Briefly describe the organization’s mission: ST. LUKE'S THE WOODLANDS HOSPITAL, SERVING ALL GOD'S CHILDREN AS THE HEALTH MINISTRY OF THE EPISCOPAL DIOCESE OF TEXAS, SEEKS TO RAISE THE QUALITY OF LIFE BY ENHANCING COMMUNITY HEALTH THROUGH THE DELIVERY OF SUPERIOR VALUE HEALTH SERVICES. IN PARTNERSHIP WITH OUR MEDICAL STAFF, WE ARE DEDICATED TO EXCELLENCE AND COMPASSION IN CARING FOR THE WHOLE PERSON - MIND, BODY, AND SPIRIT. WE ARE ALSO COMMITTED TO THE GROWTH AND DEVELOPMENT OF OUR EMPLOYEES, AND TO SECURING THE HEALTH OF FUTURE GENERATIONS BY CREATING, APPLYING, AND DISSEMINATING HEALTH KNOWLEDGE THROUGH EDUCATION AND RESEARCH.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? ......................
If “Yes,” describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program services? ............................
If “Yes,” describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 124,866,110 including grants of $ 1,799,372 ) (Revenue $ 171,549,476 )
STATS Admissions 11,920 Emergency Room Visits 37,967 Surgeries 4,975 Births 1,804 Outpatient Visits 62,285 U.S. News & World Report named SLWH as one of the Top 10 hospitals in the Houston Metro Area with special recognition for its high-performing Neurology & Neurosurgery and Orthopedic services. In October, SLWH was awarded the Texas Mother-Friendly Worksite designation for its commitment to improving the health of newborns and infants. The new St. Luke's Performance Medicine facility, an outpatient department of SLWH, celebrated its multi-million dollar expansion and renovation with a ribbon-cutting ceremony in October. The 7,000-square-foot facility, formerly known as Tektonic Athletic Development and Rehabilitation, specializes in sports medicine, physical rehabilitation, sports performance assessment and training. The center also features a Human Performance Lab that offers one of only a few Bod Pods in Greater Houston. The Bod Pod provides highly accurate body composition analysis due to its unique air-displacement technology. The Lab also utilizes VO2 Max with EKG equipment to measure an athlete's ability to consume and use oxygen effectively. The center also offers personal wellness programs, concussion management, work rehab and a cardiac and pulmonary rehabilitation program. SLWH received the American Heart Association's Mission: Lifeline Bronze Quality Achievement Award for the Hospital's commitment and success in implementing a higher standard of care for heart attack and STEMI patients. In October, SLWH opened the Wound Care Clinic in the campus' Medical Arts Center (MAC) III building. The clinic is the only outpatient hospital-based wound care clinic in the South Montgomery County and North Harris County area; and the only one of its kind in the area to offer the technologically advanced hyperbaric oxygen therapy chamber treatment. SLWH expanded its Neuroscience Center with the addition of Interventional Neuroradiology. This accredited medical sub-specialty uses minimally invasive image-based technologies and procedures to diagnose and treat disorders of the head, neck and spine. SLWH received the UnitedHealth Premium Specialty Center designation in recognition of quality care for Cardiac Surgery, Interventional Cardiac Care and Electrophysiology. The Hospital met extensive quality and outcomes criteria based on nationally recognized medical standards and expert advice. SLWH received the 2012 "Best Practices Award" from Comprehensive Pharmacy Services (CPS)-marking the third time the hospital has garnered this recognition. The award for the Southwest Region was granted for a score of 95 percent or higher on CPS' annual operational audit. The Texas Health Care Quality Improvement Awards committee awarded SLWH its Silver Award, which acknowledges hospitals for improving care related to acute myocardial infarction (heart attack), heart failure, pneumonia and surgical care and excellence in healthcare quality through improved performance on national quality measures. SLWH's Sleep Center program received a five-year accreditation from the American Academy of Sleep Medicine (AASM). In May, SLWH treated its 100th patient with the Gamma Knife technology. SLWH acquired the Gamma Knife `in 2011 and remains the first and only hospital in North Harris and Montgomery counties to offer the technology. SLWH provides an outreach clinic for advanced cirrhosis therapies and pre-screening for potential liver transplant with Texas Medical Center physicians. The clinic, staffed by the liver transplant physicians from St. Luke's Cooley Transplant Center, in affiliation with the Baylor College of Medicine, serves patients with end-stage liver disease, complications of cirrhosis and benign and hepatobiliary disorders. Honored as a "2012 Hometown Hero" by Interfaith of The Woodlands, SLWH was recognized for its outstanding support provided to the community in nonprofit donations, volunteerism, community education and sponsorships. SLWH hosted its second annual Medical Mentorship Program, which is dedicated to providing high school upperclassmen and college students the opportunity to experience a physician's day-to-day responsibilities. The Pediatric Department received a makeover in the "Sunshine Closet," which houses toys and equipment for patients and guests of the Pediatric Unit. The new organization system, valued at more than $4,000, was donated by The Container Store in The Woodlands as a collaborative effort with the Junior League of North Harris and South Montgomery Counties. SLWH and SLLH volunteers were honored in April at the annual Auxiliary Awards Luncheon that recognized the more than 28,000 service hours donated by volunteers at both hospitals in 2011, valued at $610,362. Expansion In June, SLWH opened the West Tower's fourth floor. The new patient care area added 30 single-room beds to the existing 154 patient rooms, increasing the hospital's bed capacity by nearly 20 percent. SLWH continues construction of the West Tower's fifth and sixth floors, potentially opening an additional 60 patient beds by 2014. patient care area added 30 single-room beds to the existing 154 patient rooms, increasing the hospital's bed capacity by nearly 20 percent. SLWH continues construction of the West Tower's fifth and sixth floors, potentially opening an additional 60 patient beds by 2014.
4b (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4c (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4d Other program services (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet124,866,110
Form 990 (2012)
Form 990 (2012)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If “Yes,” complete Schedule AClick to see attachment........................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors (see instructions)? ...
2
 
No
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If “Yes,” complete Schedule C, Part I..........
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If “Yes,” complete Schedule C, Part II........
4
 
No
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If “Yes,” complete Schedule C,
Part III............................
5
 
 
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If “Yes,” complete Schedule D, Part IClick to see attachment........................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If “Yes,” complete Schedule D, Part IIClick to see attachment...
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If “Yes,” complete Schedule D, Part III Click to see attachment....................
8
 
No
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If “Yes,” complete Schedule D, Part IVClick to see attachment..............
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi-endowments? If “Yes,” complete Schedule D, Part VClick to see attachment......
10
Yes
 
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10?
If “Yes,” complete Schedule D, Part VI.Click to see attachment...................
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VIIClick to see attachment.......
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VIIIClick to see attachment.......
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part IXClick to see attachment............
11d
 
No
e
Did the organization report an amount for other liabilities in Part X, line 25? If “Yes,” complete Schedule D, Part XClick to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If “Yes,” complete Schedule D, Part XClick to see attachment.........................
11f
Yes
 
12a
Did the organization obtain separate, independent audited financial statements for the tax year?
If “Yes,” complete Schedule D, Parts XI and XII Click to see attachment.................
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If “Yes,” and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If “Yes,” complete Schedule E....
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States?.....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If “Yes,” complete Schedule F, Parts I and IV.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or assistance to any organization or entity located outside the United States? If “Yes,” complete Schedule F, Parts II and IV
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or assistance to individuals located outside the United States? If “Yes,” complete Schedule F, Parts III and IV...
16
 
No
17
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If “Yes,” complete Schedule G, Part I (see instructions)....
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If “Yes,” complete Schedule G, Part II............
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If “Yes,” complete Schedule G, Part III...................
19
 
No
20a
Did the organization operate one or more hospital facilities? If “Yes,” complete Schedule H.... Click to see attachment
20a
Yes
 
b
If “Yes” to line 20a, did the organization attach a copy of its audited financial statements to this return? Click to see list of attachments
20b
Yes
 
Form 990 (2012)
Form 990 (2012)
Page 4
Part IV
Checklist of Required Schedules (continued)
21
Did the organization report more than $5,000 of grants and other assistance to any government or organization in the United States on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II... Click to see attachment
21
Yes
 
22
Did the organization report more than $5,000 of grants and other assistance to individuals in the United States on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........ Click to see attachment
22
Yes
 
23
Did the organization answer “Yes” to Part VII, Section A, line 3, 4, or 5 about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If “Yes,” complete Schedule J....................... Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 25................
24a
 
No
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
 
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds?......................
24c
 
 
d
Did the organization act as an “on behalf of” issuer for bonds outstanding at any time during the year?...
24d
 
 
25a
Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If “Yes,” complete Schedule L, Part I........
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If “Yes,” complete Schedule L, Part I...................
25b
 
No
26
Was a loan to or by a current or former officer, director, trustee, key employee, highest compensated employee, or disqualified person outstanding as of the end of the organization’s tax year? If “Yes,” complete Schedule L,
Part II..........................
26
 
No
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons? If “Yes,” complete Schedule L, Part III.........
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If “Yes,” complete Schedule L, Part IV ..........................
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If “Yes,”
complete Schedule L, Part IV.....................
28b
 
No
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or direct or indirect owner? If “Yes,” complete Schedule L, Part IV...
28c
 
No
29
Did the organization receive more than $25,000 in non-cash contributions? If “Yes,” complete Schedule M..
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If “Yes,” complete Schedule M.............
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If “Yes,” complete Schedule N,
Part I...........................
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If “Yes,” complete Schedule N, Part II......................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If “Yes,” complete Schedule R, Part I........ Click to see attachment
33
 
No
34
Was the organization related to any tax-exempt or taxable entity? If “Yes,” complete Schedule R, Part II, III, or IV, and Part V, line 1........................ Click to see attachment
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
Yes
 
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If “Yes,” complete Schedule R, Part V, line 2... Click to see attachment
35b
 
No
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If “Yes,” complete Schedule R, Part V, line 2............. Click to see attachment
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If “Yes,” complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2012)
Form 990 (2012)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response to any question in this Part V ...............
Yes
No
1a
Enter the number reported in Box 3 of Form 1096 Enter -0- if not applicable ..
1a
0
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable .
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................
2a
1,052
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No,” provide an explanation in Schedule O.....
3b
Yes
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)?..........................
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts.
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If “Yes,” to line 5a or 5b, did the organization file Form 8886-T? ............
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions?...
6a
 
No
b
If “Yes,” did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?........................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?....................
7a
 
No
b
If “Yes,” did the organization notify the donor of the value of the goods or services provided?.....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?...........................
7c
 
No
d
If “Yes,” indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?............................
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?............................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?..........................
7h
 
 
8
Sponsoring organizations maintaining donor advised funds and section 509(a)(3) supporting organizations. Did the supporting organization, or a donor advised fund maintained by a sponsoring organization, have excess business holdings at any time during the year?............
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the organization make any taxable distributions under section 4966?..........
9a
 
 
b
Did the organization make a distribution to a donor, donor advisor, or related person?.......
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ..........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If “Yes,” enter the amount of tax-exempt interest received or accrued during the year. ....................
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note. See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans ....
13b
 
c
Enter the amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If “No,” provide an explanation in Schedule O..
14b
 
 
Form 990 (2012)
Form 990 (2012)
Page 6
Part VI
Governance, Management, and Disclosure For each “Yes” response to lines 2 through 7b below, and for a “No” response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response to any question in this Part VI ...............
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year .....................
1a
10
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent ...................
1b
9
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
 
No
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? ...........................
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
Yes
 
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
Yes
 
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .........................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If “Yes,” provide the names and addresses in Schedule O.......
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If “Yes,” did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
 
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If “No,” go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If “Yes,” describe in Schedule O how this was done.......................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line 15a or 15b, describe the process in Schedule O (see instructions).
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
 
No
b
If “Yes,” did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
 
 
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
18
Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how), the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, physical address, and telephone number of the person who possesses the books and records of the organization:
MediumBulletSTEPHEN PICKETT6624 FANNIN STREET SUITE 1100HOUSTONTX77030 (832) 355-2042
Form 990 (2012)
Form 990 (2012)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response to any question in this Part VII ...............
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the
organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
(A)
Name and Title 		(B)
Average hours per week (list any hours for related organizations below dotted line) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(1) DAVID J FINE........................................................................
treasurer SECRETARY & director
 6.0
.......................49.0 		X   X       0 1,671,626 451,822
(2) MICHAEL RICHMOND........................................................................
CHAIRMAN & director
 2.0
.......................7.0 		X   X       0 0 0
(3) RALPH MCINGVALE........................................................................
VICE CHAIRMAN & Director
 2.0
.......................0.0 		X   X       0 0 0
(4) CHARLES HANKINS md........................................................................
DIRECTOR
 2.0
.......................0.0 		X           0 0 0
(5) STEPHEN PICKETT........................................................................
asst. secretary
 2.0
.......................53.0 		X   X       0 969,319 161,085
(6) JEFY M MATHEW md........................................................................
DIRECTOR EX OFFICIO
 2.0
.......................1.0 		X           0 32,400 0
(7) THE REVEREND GARY H JONES........................................................................
DIRECTOR
 2.0
.......................0.0 		X           0 0 0
(8) chester jones........................................................................
director
 2.0
.......................18.0 		X           0 0 0
(9) gary whitlock........................................................................
director
 2.0
.......................0.0 		X           0 0 0
(10) brad beers........................................................................
director
 2.0
.......................2.0 		X           0 0 0
(11) gerald glenn........................................................................
director
 2.0
.......................0.0 		X           0 0 0
(12) gerry sevick........................................................................
director
 2.0
.......................0.0 		X           0 0 0
(13) ann snyder........................................................................
director
 2.0
.......................0.0 		X           0 0 0
(14) MARGI NEMETH........................................................................
DIRECTOR EX OFfICIO
 2.0
.......................0.0 		X           0 0 0
(15) DEBRA F SUKIN........................................................................
SR V P AND CEO WOODLANDS
 53.0
.......................2.0 		    X       419,146 0 126,834
(16) Brian e Doyle........................................................................
Assistant Treasurer
 2.0
.......................53.0 		    X       0 159,564 30,057
(17) Margaret A REITER........................................................................
VP AND CNO SLTWH
 55.0
.......................0.0 		      X     216,207 0 27,530
Form 990 (2012)
Form 990 (2012)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and Title 		(B)
Average hours per week (list any hours for related organizations below dotted line) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(18) Mary Sue Lipham........................................................................
AVP & cfo
 55.0
.......................0.0 		      X     194,698 0 32,694
(19) margaret smith........................................................................
avp operations sltwh
 55.0
.......................0.0 		      X     172,474 0 20,170
(20) TANA ELLIOTT........................................................................
supervisor emergency dept
 55.0
.......................0.0 		        X   122,151 0 22,724
(21) robyn s james........................................................................
director tektonic
 55.0
.......................0.0 		        X   122,763 0 12,276
(22) mary b mcnutt........................................................................
staff nurse
 55.0
.......................0.0 		        X   129,997 0 13,941
(23) bo su........................................................................
staff nurse
 55.0
.......................0.0 		        X   124,493 0 6,508
(24) fatima d naca........................................................................
staff nurse
 55.0
.......................0.0 		        X   118,260 0 20,746












1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 1,620,189 2,832,909 926,387
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organizationMediumBullet22
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If “Yes,” complete Schedule J for such individual ..............
3
 
No
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If “Yes,” complete Schedule J for such individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If “Yes,” complete Schedule J for such person ........
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address 		(B)
Description of services 		(C)
Compensation
Robins Morton, 400 Shades Creek ParkwayBIRMINGHAMAL35209 construction service 9,050,912
Siemens Medical Solutions USA, 51 Valley Stream parkwayMALVERNPA19355 construction service 2,850,000
spawglass, 13800 West RoadHOUSTONTX77041 construction service 892,368
Kirksey Architecture, 6909 portwest driveHOUSTONTX77024 architectural srvs 687,347
GE Healthcare, PO Box 843553DALLASTX752843553 consulting services 354,312
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet12
Form 990 (2012)
Form 990 (2012)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response to any question in this Part VIII ..............
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512, 513, or 514
Contributions, Gifts, Grants and Other Similar Amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c  
d Related organizations...1d  
e Government grants (contributions)1e  
f All other contributions, gifts, grants, and
similar amounts not included above1f 		 
g Noncash contributions included in lines
1a-1f:$ 		 
h Total. Add lines 1a-1f.......MediumBullet 0
Program Service Revenue Business Code
2a NET PATIENT REVENUE 900099 171,623,046 171,330,646 292,400  
b HEALTH EDUCATION/WOMEN'S SERVICES/REHAB/SCREENINGS 900099 108,004 58,215 49,789  
c INSTITUTIONAL REVENUE 900099 344,467 110,826 233,641  
d
e
f All other program service revenue .        
g Total. Add lines 2a–2f........MediumBullet 172,075,517
Other Revenue 3 Investment income (including dividends, interest, and other similar amounts).......MediumBullet -2,830,827     -2,830,827
4 Income from investment of tax-exempt bond proceeds..MediumBullet 0      
5 Royalties...........MediumBullet 0      
(i) Real (ii) Personal
6a Gross rents 32,003 1,067,679
b Less: rental expenses   670,126
c Rental income or (loss) 32,003 397,553
d Net rental income or (loss).......MediumBullet 429,556   397,553 32,003
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory    
b Less: cost or other basis and sales expenses    
c Gain or (loss)    
d Net gain or (loss)..........MediumBullet 0      
8a Gross income from fundraising events (not including
$  
of contributions reported on line 1c). See Part IV, line 18 ..
a  
b Less: direct expenses ...b  
c Net income or (loss) from fundraising events..MediumBullet 0    
9a Gross income from gaming activities.
See Part IV, line 19 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from gaming activities...MediumBullet 0      
10a Gross sales of inventory, less
returns and allowances .
a 330,205
b Less: cost of goods sold ..b 166,956
c Net income or (loss) from sales of inventory..MediumBullet 163,250     163,250
Miscellaneous Revenue Business Code
11a MEDICAL RECORDS 900099 78,436     78,436
b MISCELLANEOUS 900099 19,880     19,880
c            
d All other revenue ....        
e Total. Add lines 11a–11d ...... MediumBullet 98,316
12 Total revenue. See Instructions......MediumBullet 169,935,812 171,499,687 973,383 -2,537,258
Form 990 (2012)
Form 990 (2012)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).Check if Schedule O contains a response to any question in this Part IX ...............
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII. 		(A)
Total expenses 		(B)
Program service expenses 		(C)
Management and general expenses 		(D)
Fundraising expenses
1 Grants and other assistance to governments and organizations in the United States. See Part IV, line 21 1,608,320 1,608,320
2 Grants and other assistance to individuals in the United States. See Part IV, line 22 191,052 191,052
3 Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16 0  
4 Benefits paid to or for members 0  
5 Compensation of current officers, directors, trustees, and key employees .... 1,002,525 0 1,002,525 0
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .... 0      
7 Other salaries and wages 46,774,826 43,307,314 3,467,512  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 2,297,025 2,058,826 238,199  
9 Other employee benefits ....... 4,943,187 4,511,803 431,384  
10 Payroll taxes ........... 3,425,468 3,131,432 294,036  
11 Fees for services (non-employees):        
a Management ...... 484,616 474,397 10,219  
b Legal ......... 6,314   6,314  
c Accounting ........... 0      
d Lobbying ........... 0      
e Professional fundraising services. See Part IV, line 17 0  
f Investment management fees ...... 1,238   1,238  
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) ........ 5,103,960 3,451,769 1,652,191  
12 Advertising and promotion .... 131,446 48,813 82,633  
13 Office expenses ....... 1,663,549 1,355,402 308,147  
14 Information technology ...... 163,636 22,369 141,267  
15 Royalties .. 0      
16 Occupancy ........... 3,267,482 584,078 2,683,404  
17 Travel ............ 51,119 28,642 22,477  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ...... 0      
19 Conferences, conventions, and meetings .... 0      
20 Interest ........... 344,336 344,336    
21 Payments to affiliates ....... 0      
22 Depreciation, depletion, and amortization ..... 8,810,203 4,643,134 4,167,069  
23 Insurance .............. 6,045,185   6,045,185  
24 Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a MEDICAL SUPPLIES 30,458,158 30,458,158    
b BAD DEBT 18,429,117 18,429,117    
c EQUIPMENT AND FACILITY MAINTEN 3,501,174 2,373,296 1,127,878  
d OTHER OUTSIDE SERVICES 14,566,339 7,099,165 7,467,174  
e All other expenses 3,233,297 744,687 2,488,610  
25 Total functional expenses. Add lines 1 through 24e 156,503,572 124,866,110 31,637,462 0
26 Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2012)
Form 990 (2012)
Page 11
Part X Balance Sheet Check if Schedule O contains a response to any question in this Part X ...............
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash—non-interest-bearing ............. 8,592,333 1 7,128,727
2 Savings and temporary cash investments ......... 0 2 0
3 Pledges and grants receivable, net ........... 0 3 0
4 Accounts receivable, net ............. 18,548,074 4 17,540,936
5 Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L ..................
0 5 0
6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
0 6 0
7 Notes and loans receivable, net ............. 0 7 0
8 Inventories for sale or use .............. 1,881,307 8 2,303,664
9 Prepaid expenses and deferred charges .......... 159,176 9 1,570,518
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 220,133,620
b Less: accumulated depreciation ..... 10b 69,417,509 139,283,252 10c 150,716,111
11 Investments—publicly traded securities .......... 0 11 0
12 Investments—other securities. See Part IV, line 11 ..... 0 12 0
13 Investments—program-related. See Part IV, line 11 ..... 0 13 0
14 Intangible assets ............... 59,038 14 52,226
15 Other assets. See Part IV, line 11 ........... 675,709 15 244,198
16 Total assets. Add lines 1 through 15 (must equal line 34)...... 169,198,889 16 179,556,380
Liabilities 17 Accounts payable and accrued expenses ......... 9,527,500 17 15,205,356
18 Grants payable ................. 0 18 0
19 Deferred revenue ................ 40,679 19 40,679
20 Tax-exempt bond liabilities ............. 0 20 0
21 Escrow or custodial account liability. Complete Part IV of Schedule D.. 0 21 0
22 Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
persons. Complete Part II of Schedule L.......... 0 22 0
23 Secured mortgages and notes payable to unrelated third parties .. 0 23 0
24 Unsecured notes and loans payable to unrelated third parties .... 0 24 0
25 Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D.................... 159,845,431 25 151,092,826
26 Total liabilities. Add lines 17 through 25......... 169,413,610 26 166,338,861
Net Assets or Fund Balance Organizations that follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets .............. -214,721 27 13,217,519
28 Temporarily restricted net assets ........... 0 28 0
29 Permanently restricted net assets ........... 0 29 0
Organizations that do not follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 30 through 34.
30 Capital stock or trust principal, or current funds ........   30  
31 Paid-in or capital surplus, or land, building or equipment fund .....   31  
32 Retained earnings, endowment, accumulated income, or other funds   32  
33 Total net assets or fund balances ........... -214,721 33 13,217,519
34 Total liabilities and net assets/fund balances ........ 169,198,889 34 179,556,380
Form 990 (2012)
Form 990 (2012)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response to any question in this Part XI ...............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
169,935,812
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
156,503,572
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
13,432,240
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
-214,721
5
Net unrealized gains (losses) on investments ...............
5
 
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
 
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
 
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33, column (B))
10
13,217,519
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response to any question in this Part XII ..............
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?
2a
 
No
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If “Yes,” to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133?
3a
 
No
b
If “Yes,” did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits
3b
 
 
Form 990 (2012)
Form 990, Special Condition Description:
Special Condition Description
Additional Data


Software ID:  
Software Version:  
SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service
Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.
right arrow Attach to Form 990 or Form 990-EZ. right arrow See separate instructions.
OMB No. 1545-0047
2012
Open to Public
Inspection
Name of the organization
ST LUKES COMMUNITY HEALTH SERVICES
 
Employer identification number

76-0536234
Part I
Reason for Public Charity Status (All organizations must complete this part.) See instructions.
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
f
g
(i) A person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the supported organization? ................
11g(i)
 
 
(ii) A family member of a person described in (i) above? ......................
11g(ii)
 
 
(iii) A 35% controlled entity of a person described in (i) or (ii) above? ................
11g(iii)
 
 
h
Provide the following information about the supported organization(s).
(i) Name of supported organization (ii) EIN (iii) Type of organization (described on lines 1- 9 above or IRC section (see instructions)) (iv) Is the organization in col. (i) listed in your governing document? (v) Did you notify the organization in col. (i) of your support? (vi) Is the organization in col. (i) organized in the U.S.? (vii) Amount of monetary support
Yes No Yes No Yes No
Total                  

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2012
Schedule A (Form 990 or 990-EZ) 2012
Page 2
Part II
Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year (or fiscal year beginning in) right arrow (a) 2008 (b) 2009 (c) 2010 (d) 2011 (e) 2012 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....            
2 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......            
3 The value of services or facilities furnished by a governmental unit to the organization without charge..            
4 Total. Add lines 1 through 3            
5 The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..            
6 Public support. Subtract line 5 from line 4.            
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (a) 2008 (b) 2009 (c) 2010 (d) 2011 (e) 2012 (f) Total
7 Amounts from line 4..            
8 Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...            
9 Net income from unrelated business activities, whether or not the business is regularly carried on..            
10 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)..            
11 Total support (Add lines 7 through 10).            
12
12
 
13
First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization, check this box and stop here........................................right arrow
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
18
Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow
Schedule A (Form 990 or 990-EZ) 2012
Schedule A (Form 990 or 990-EZ) 2012
Page 3
Part III
Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year (or fiscal year beginning in) right arrow (a) 2008 (b) 2009 (c) 2010 (d) 2011 (e) 2012 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .            
2 Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......            
3 Gross receipts from activities that are not an unrelated trade or business under section 513..            
4 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...            
5 The value of services or facilities furnished by a governmental unit to the organization without charge..            
6 Total. Add lines 1 through 5.            
7a Amounts included on lines 1, 2, and 3 received from disqualified persons...            
b Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.            
c Add lines 7a and 7b..            
8 Public support (Subtract line 7c from line 6.)            
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (a) 2008 (b) 2009 (c) 2010 (d) 2011 (e) 2012 (f) Total
9 Amounts from line 6...            
10a Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
b Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.            
c Add lines 10a and 10b.            
11 Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.            
12 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.) ..            
13 Total support. (Add lines 9, 10c, 11, and 12.)..            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2012
Schedule A (Form 990 or 990-EZ) 2012
Page 4
Part IV
Supplemental Information. Complete this part to provide the explanations required by Part II, line 10; Part II, line 17a or 17b; and Part III, line 12. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
 
Explanation
 
 
 
 
Schedule A (Form 990 or 990-EZ) 2012

Additional Data


Software ID:  
Software Version:  
SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b
SchDMd Bullet Attach to Form 990. SchDMd Bullet See separate instructions.
OMB No. 1545-0047
2012
Open to Public Inspection
Name of the organization
ST LUKES COMMUNITY HEALTH SERVICES
 
Employer identification number

76-0536234
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .........    
2 Aggregate contributions to (during year) ...    
3 Aggregate grants from (during year) .....    
4 Aggregate value at end of year ........    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................
Part II
Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ....................... 2a  
b Total acreage restricted by conservation easements .................. 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 8/17/06, and not on a historic structure listed in the National Register .................... 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................
6
Staff and volunteer hours devoted to monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .......................................
9
In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:
(i)
Revenues included in Form 990, Part VIII, line 1 ........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ..............................SchDMd Bullet $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958) relating to these items:
a
Revenues included in Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 52283D
Schedule D (Form 990) 2012

Schedule D (Form 990) 2012
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b
If "Yes," explain the arrangement in Part XIII and complete the following table:
Amount
c Beginning balance ................................. 1c  
d Additions during the year .............................. 1d  
e Distributions during the year ............................. 1e  
f Ending balance ................................... 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21? .....................
b
If “Yes,” explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ........
Part V
Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.
(a)Current year (b)Prior year b (c)Two years back (d)Three years back (e)Four years back
1a Beginning of year balance ....          
b Contributions ........          
c Net investment earnings, gains, and losses          
d Grants or scholarships .....          
e Other expenditures for facilities
and programs ........ 		         
f Administrative expenses ....          
g End of year balance ......          
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet  
b
Permanent endowment SchDMd Bullet  
c
Temporarily restricted endowment SchDMd Bullet  
The percentages in lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations ........................
3a(i)
 
No
(ii) related organizations ........................
3a(ii)
Yes
 
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
Yes
 
4
Describe in Part XIII the intended uses of the organization's endowment funds.
Part VI
Land, Buildings, and Equipment. See Form 990, Part X, line 10.
Description of property (a) Cost or other basis (investment) (b)Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .................   11,787,902 11,787,902
b Buildings ................   136,691,358 18,417,932 118,273,426
c Leasehold improvements ............   2,090,668 1,696,704 393,964
d Equipment ................   66,204,493 49,302,873 16,901,620
e Other .................   3,359,199   3,359,199
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......SchDMdBullet 150,716,111
Schedule D (Form 990) 2012

Schedule D (Form 990) 2012
Page 3
Part VII
Investments—Other Securities. See Form 990, Part X, line 12.
(a) Description of security or category
(including name of security)		 (b)Book value (c) Method of valuation:
Cost or end-of-year market value
(1)Financial derivatives    
(2)Closely-held equity interests    
Other








Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet  
Part VIII
Investments—Program Related. See Form 990, Part X, line 13.
(a) Description of investment type (b) Book value (c) Method of valuation:
Cost or end-of-year market value








Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)Small Bullet  
Part IX
Other Assets. See Form 990, Part X, line 15.
(a) Description (b) Book value








Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet  
Part X
Other Liabilities. See Form 990, Part X, line 25.
1.(a) Description of liability (b) Book value
Federal income taxes 0
INTERCOMPANY PAYABLES 110,288,030
MEDICARE/MEDICAID RESERVES 1,289,938
CONSTRUCTION PAYABLE RETAINER 3,085,397
EQUIPMENT LEASE PAYABLE 3,742,460
OTHER LONG TERM LIABILITIES (L 32,687,001




Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 151,092,826
2. Fin 48 (ASC 740) Footnote. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII .....................................................
Schedule D (Form 990) 2012

Schedule D (Form 990) 2012
Page 4
Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return
1 Total revenue, gains, and other support per audited financial statements ....... 1  
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains on investments .......... 2a  
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIII.) ............ 2d  
e Add lines 2a through 2d ..................... 2e  
3 Subtract line 2e from line 1..................... 3  
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b . 4a  
b Other (Describe in Part XIII.) ........... 4b  
c Add lines 4a and 4b....................... 4c  
5 Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ...... 5  
Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
1 Total expenses and losses per audited financial statements ........... 1  
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities .......... 2a  
b Prior year adjustments .............. 2b  
c Other losses ................ 2c  
d Other (Describe in Part XIII.) ............ 2d  
e Add lines 2a through 2d...................... 2e  
3 Subtract line 2e from line 1..................... 3  
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b .. 4a  
b Other (Describe in Part XIII.) ............ 4b  
c Add lines 4a and 4b....................... 4c  
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ...... 5  
Part XIII
Supplemental Information
Complete this part to provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.
Identifier Return Reference Explanation
FORM 990, SCHEDULE D, PART V, QUESTION 4 Part V: endowment funds st. luke's community health services does not have an endowment fund. However, st. luke's episcopal hospital and St. Luke's Foundation, related organizations, do hold endowment funds.
FORM 990, SCHEDULE D, PART X Part XIV: Supplemental information provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under fin 48. ASC Topic 740 prescribes a recognition threshold and measurement attribute for financial statement recognition and measurement of a tax position taken or expected to be taken in a tax return. there were no uncertain tax positions recorded in the consolidated financial statements at december 31, 2012 or 2011.
Schedule D (Form 990) 2012

Additional Data


Software ID:  
Software Version:  




SCHEDULE H (Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, question 20.
MediumBullet Attach to Form 990. MediumBullet See separate instructions.
OMB No. 1545-0047
2012
Open to Public Inspection
Name of the organization
ST LUKES COMMUNITY HEALTH SERVICES
 
Employer identification number

76-0536234
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a ...
1a
Yes
 
b
If "Yes," was it a written policy? .......................
1b
Yes
 
2
If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.
3
Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.
a
Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?
If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:
3a
Yes
 
%
b
Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate
which of the following was the family income limit for eligibility for discounted care: .........
3b
Yes
 
%
c
If the organization used factors other than FPG in determining eligibility, describe in Part VI the income based criteria for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.
4
Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? ..............

4

Yes

 
5a
Did the organization budget amounts for free or discounted care provided under its financial assistance policy during the tax year? ............................

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? ......
5b
 
No
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? ..............
5c
 
 
6a
Did the organization prepare a community benefit report during the tax year? ..........
6a
Yes
 
b
If "Yes," did the organization make it available to the public? ..............
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance and
Means-Tested
Government Programs
 (a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Financial Assistance at cost
(from Worksheet 1) .. 		    3,804,662   3,804,662 2.760 %
b Medicaid (from Worksheet 3,
column a) .... 		    11,134,231 8,667,155 2,467,076 1.790 %
c Costs of other means-tested
government programs (from
Worksheet 3, column b) . 		           
d Total Financial Assistance
and Means-Tested
Government Programs . 		    14,938,893 8,667,155 6,271,738 4.550 %
Other Benefits
            
e Community health
improvement services and
community benefit operations
(from Worksheet 4) ..
f Health professions education
(from Worksheet 5) .. 		           
g Subsidized health services
(from Worksheet 6) .. 		           
h Research (from Worksheet 7)            
i Cash and in-kind
contributions for community
benefit (from Worksheet 8) 		           
j Total. Other Benefits ..            
k Total. Add lines 7d and 7j .     14,938,893 8,667,155 6,271,738 4.550 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2012
Schedule H (Form 990) 2012
Page
Part II
Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue 		(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing            
2 Economic development            
3 Community support 15   6,263   6,263  
4 Environmental improvements            
5 Leadership development and training for community members 2   901   901  
6 Coalition building            
7 Community health improvement advocacy 34 5,500 10,855   10,855  
8 Workforce development            
9 Other 7   2,499   2,499  
10 Total 58 5,500 20,518   20,518  
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
18,429,117
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......
3
 
4
Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
36,007,920
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
40,311,321
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-4,303,401
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI.......................

9b

Yes

 
Part IV
Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)
(a) Name of entity (b) Description of primary
activity of entity 		(c) Organization's
profit % or stock
ownership % 		(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership % 		(e) Physicians'
profit % or stock
ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2012
Schedule H (Form 990) 2012
Page
Part VFacility Information
Section A. Hospital Facilities
(list in order of size from largest to smallest—see instructions)
How many hospital facilities did the organization operate during the tax year?1
Name, address, and primary website address 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital Research Facility ER-24Hours ER-Other Other (Describe) Facility reporting group
1 ST LUKES THE WOODLANDS HOSPITAL
17200 ST LUKES WAY
THE WOODLANDS,TX77384 		X X         X      
Schedule H (Form 990) 2012
Schedule H (Form 990) 2012
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
St Luke's The Woodlands Hospital
Name of hospital facility or facility reporting group  
For single facility filers only: line Number of Hospital Facility (from Schedule H, Part V, Section A) 1
Yes No
Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)
1 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 9.................... 1   No
If “Yes,” indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
2 Indicate the tax year the hospital facility last conducted a CHNA: 20  
3 In conducting its most recent CHNA, did the hospital facility take into account input from representatives of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If “Yes,” describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................... 3    
4 Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI................................ 4    
5 Did the hospital facility make its CHNA report widely available to the public? ............. 5    
If “Yes,” indicate how the CHNA report was made widely available (check all that apply):
a
b
c
6 If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply to date):
a
b
c
d
e
f
g
h
i
7 Did the hospital facility address all of the needs identified in its most recently conducted CHNA? If “No,” explain in Part VI which needs it has not addressed and the reasons why it has not addressed such needs ........ 7    
8a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)? ........................... 8a    
b If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ...... 8b    
c If "Yes" to line 8b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2012
Schedule H (Form 990) 2012
Page
Part VFacility Information (continued)

Financial Assistance Policy Yes No
9 Did the hospital facility have in place during the tax year a written financial assistance policy that:
Explained eligibility criteria for financial assistance, and whether such assistance includes free or discounted care? 9 Yes  
10 Used federal poverty guidelines (FPG) to determine eligibility for providing free care?........... 10 Yes  
If "Yes," indicate the FPG family income limit for eligibility for free care: 200.%
If "No," explain in Part VI the criteria the hospital facility used.
11 Used FPG to determine eligibility for providing discounted care?................. 11 Yes  
If “Yes,” indicate the FPG family income limit for eligibility for discounted care: 400.%
If "No," explain in Part VI the criteria the hospital facility used.
12 Explained the basis for calculating amounts charged to patients?................. 12 Yes  
If “Yes,” indicate the factors used in determining such amounts (check all that apply):
a
b
c
d
e
f
g
h
13 Explained the method for applying for financial assistance?................... 13 Yes  
14 Included measures to publicize the policy within the community served by the hospital facility?....... 14 Yes  
If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
a
b
c
d
e
f
g
Billing and Collections
15 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained actions the hospital facility may take upon non-payment?....... 15 Yes  
16 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP:
a
b
c
d
e
17 Did the hospital facility or an authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP?.......... 17   No
If “Yes,” check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
Schedule H (Form 990) 2012
Schedule H (Form 990) 2012
Page
Part VFacility Information (continued)

18 Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):
a
b
c
d
e
Policy Relating to Emergency Medical Care
Yes No
19 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.......... 19 Yes  
If “No,” indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)
20 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
21 During the tax year, did the hospital facility charge any FAP-eligible individuals to whom the hospital facility provided emergency or other medically necessary services, more than the amounts generally billed to individuals who had insurance covering such care? ............................ 21   No
If “Yes,” explain in Part VI.
22 During the tax year, did the hospital facility charge any FAP-eligible individuals an amount equal to the gross charge for any service provided to that individual? ......................... 22   No
If “Yes,” explain in Part VI.
Schedule H (Form 990) 2012
Schedule H (Form 990) 2012
Page
Part VFacility Information (continued)

Section C. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, from largest to smallest)
How many non-hospital health care facilities did the organization operate during the tax year?3
Name and address Type of Facility (describe)
1 St Luke's Sleep Disorders Lab
17350 St Lukes Way Suite 460
The Woodlands,TX77384 		Sleep Clinic
2 St Luke's Performance Medicine
17350 St Lukes Way
The Woodlands,TX77384 		Outpatient Sports Rehab formerly Tektonic Athletic Development & Rehab
3 SLWH Wound Care Clinic
17450 St Lukes Way
The Woodlands,TX77384 		outpatient hospital based wound care clinic
4
5
6
7
8
9
10
Schedule H (Form 990) 2012
Schedule H (Form 990) 2012
Page
Part VI
Supplemental Information
Complete this part to provide the following information.
1 Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II; Part III, lines 4, 8, and 9b; Part V, Section A; and Part V, Section B, lines 1j, 3, 4, 5c, 6i, 7, 10, 11, 12h, 14g, 16e, 17e, 18e, 19c, 19d, 20d, 21, and 22.
2 Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any needs assessments reported in Part V, Section B.
3 Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4 Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5 Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6 Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7 State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
8 Facility reporting group(s). If applicable, for each hospital facility in a facility reporting group provide the descriptions required for Part V, Section B, lines 1j, 3, 4, 5c, 6i, 7, 10, 11, 12h, 14g, 16e, 17e, 18e, 19c, 19d, 20d, 21, and 22.
Identifier ReturnReference Explanation
charity care Schedule H, Part I, Line 7 The cost to charge ratio method was utilized to determine financial assistance at cost; however, St. Luke's internal cost accounting system was used to determine unreimbursed Medicaid costs. Total expenses per Form 990, Part IX, line 25(a) were reduced by bad debt expense in the amount of $18,429,117 to determine the percentage in schedule H, Part I, line 7(f). If the percentage reported in part i, line 7, financial assistance and certain other community benefits at cost, were to be calculated on a system-wide basis, the combined percentage for all of the hospital facilities of the st. luke's episcopal health system would be approximately 5.51%. St. Luke's Community Health Services d/b/a St. Luke's The Woodlands Hospital received supplemental medicaid payments of $930,014 during 2012. These payments were included in the direct offsetting revenue amounts found in Schedule H, Part I, line 7b column d. These supplemental medicaid payments resulted in a reduction in net community benefit expense and percentages found in columns(e)and (f). If all direct offsetting revenue found in column (d) was not subtracted from total community benefit expense, the percentage in column (f) would be 10.82%.
FOOTNOTE FOR BAD DEBT EXPENSE SCHEDULE H, PART III, SECTION A, LINE 4 The consolidated St. Luke's Episcopal Health System's audited financial statements for 2012 address accounts receivable allowance methodology on pages 15-16. The full audited financial statements for the St. Luke's Episcopal Health System are attached to this filing.
RATIONALE FOR INCLUDING BAD DEBTS AS COMMUNITY BENEFIT SCHEDULE H, PART III, SECTION A, LINE 4 Although St. Lukes Community Health Services d/b/a St. Luke's The Woodlands Hospital strives to identify eligible candidates for patient assistance and/or charity care, there are circumstances in which the candidate does not assist in the determination process, and patient assistance/charity care guidelines cannot be met, therefore the accounts become a bad debt expense for the hospital records. It is difficult to accurately determine how many of these accounts would have met the patient assistance/charity care guidelines had the candidate cooperated with the application process.
RATIONALE FOR INCLUDING MEDICARE SHORTFALL AS COMMUNITY BENEFIT SCHEDULE h, pART iii, SECTION B, LINE 8 St. Luke's COMMUNITY HEALTH SERVICES D/B/A ST. LUKE'S THE wOODLANDS Hospital has reported all revenue and allowable costs that were included in the Medicare Cost Report for 2012 on Part III, Section B lines 5 & 6. St. Luke's COMMUNITY HEALTH SERVICES D/B/A ST. LUKE'S THE wOODLANDS Hospital has adopted the community benefit and charity care policies of the St. Luke's Episcopal Health System, which require it to provide care to all patients who present themselves for care. Medicare patients receive the same high quality care as patients that have other forms of payment. As Medicare reimbursements do not fully cover the cost of the healthcare provided, St. Luke's COMMUNITY HEALTH SERVICES D/B/A ST. LUKE'S THE wOODLANDS Hospital considers the shortfall amount as an additional community benefit to the elderly members of the community it serves, and the community enjoys high quality healthcare from St. Luke's COMMUNITY HEALTH SERVICES D/B/A ST. LUKE'S THE wOODLANDS Hospital for all its citizens, regardless of method of payment.
COLLECTION POLICY SCHEDULE H, PART iii, LINE 9B St. Luke's COMMUNITY HEALTH SERVICES D/B/A ST. LUKE'S THE wOODLANDS Hospital has adopted the debt collection policy of the St. Luke's Episcopal Health System ("System"). The System's policy states that St. Luke's COMMUNITY HEALTH SERVICES D/B/A ST. LUKE'S THE wOODLANDS Hospital will not pursue collection practices against patients who have qualified for charity care or other financial assistance once the account has received the charity adjustment. For those patients who have qualified for partial assistance, an adjustment is posted to the charity allowance and the remaining balance may be pursued as directed by our collection policy. In certain cases, a patient's qualification for charity care or financial assistance may not be readily determined; however, if after collection practices have begun it later becomes known that a person qualifies, the collection efforts will immediately cease for the charity care patient or be pursued at the lower partially adjusted amount.
Measures to publicize financial assistance policy Part V, Line 14g St. Luke's community Health Services d/b/a St. Luke's The Woodlands Hospital provides financial counseling and Medicaid screening for its uninsured patients. If an uninsured patient is admitted to a facility, the patient/guarantor is visited by a representative/ counselor who will first screen for Medicaid eligibility. If patient does not qualify for governmental assistance, the counselor attempts to complete a financial assistance information form (charity form) by assisting with the accumulation of appropriate information and sometimes necessary documents. The documents are then forwarded for evaluation and qualification for financial assistance.
Needs Assessment SCHEDULE H, PART VI, LINE 2 and Part II St. Luke's Community Health Services d/b/a St. Luke's The Woodlands Hospital meets the needs of the community through its education, outreach programs and services in the communities it serves. St. Luke's Community Health Services d/b/a St. Luke's The Woodlands Hospital sponsors a variety of programs identified through community needs assessments, including health and wellness fairs, educational lecture series, economic outlook conferences, and local chapter fundraisers for national causes.
Patient education of eligibility for Assistance SCHEDULE H, PART VI, LINE 3 As a part of its mission, St. Luke's Episcopal Health System provides care to patients without financial means to pay for hospital services. Charity care will be provided to all patients who present themselves for care at St. Luke's COMMUNITY HEALTH SERVICES D/B/A ST. LUKE'S THE wOODLANDS Hospital or related entities without regard to race, creed, color, or national origin and who are classified as financially or medically indigent. St. Luke's will provide partial or full financial assistance for medically necessary care in accordance with Texas law and hospital eligibility guidelines to patients who require hospital care or medical services and cannot afford such care or services because of limitations in their health insurance or personal finances. St. Luke's works collaboratively with our third party eligibility vendors to ensure all self pay patients are screened for the appropriate governmental assistance prior to qualifying them for charity. Once the vendor screens a patient and determines he/she does not qualify for any third party funding, the patient is verbally educated and additional screening takes place by a St. Luke's employee to determine if the patient is eligible for charity service prior to discharge. Patients that have been discharged prior to charity screening, such as emergency room patients, receive a written notification of possible eligibility services. If the patient is determined not to be eligible for government assistance, he/she may notify the hospital that they seek charity assistance. The appropriate charity form is sent to the patient/guarantor for completion and then returned to the hospital for evaluation and qualification. Once determination of eligibility is made, the patient is sent a notice informing him/her if they qualify for FULL, partial, or NO CHARITY CARE SERVICES.
community information SCHEDULE H, PART VI, LINE 4 St. Luke's COMMUNITY HEALTH SERVICES D/B/A ST. LUKE'S THE wOODLANDS Hospital defines the community it serves broadly to include Montgomery County, north Harris County, and the greater Houston area. The Woodlands and south Montgomery County have experienced 83% population growth since 2000. St. Luke's Community Health Services d/b/a St. Luke's The Woodlands Hospital WAS BUILT TO SERVE THE GROWING NEEDS OF THE WOODLANDS AREA, MONTGOMERY COUNTY, AND NORTHERN REGIONS OF HARRIS COUNTY NEAR HOUSTON, TEXAS WITH THE SAME HIGH QUALITY MEDICAL CARE THAT IS PROVIDED BY THE ST. LUKE'S Episcopal HOSPITAL IN THE TEXAS MEDICAL CENTER.
Promotion of community health SCHEDULE H, PART VI, LINE 5 and Part II St. Luke's Community Health Services d/b/a St. Luke's The Woodlands Hospital addresses various community concerns, including health improvement, education, and access to health care. St. Luke's Community Health Services d/b/a St. Luke's The Woodlands Hospital directs leadership time and talent to serve on community collaboration boards and health advocacy programs to promote the health of the community the Hospital serves. St. Luke's Community Health Services d/b/a St. Luke's The Woodlands Hospital works with neighborhood resources (e.g. schools, businesses, community organizations) to promote health, wellness, and disease prevention. During 2012, St. Luke's Community Health Services d/b/a St. Luke's The Woodlands Hospital participated in community health fairs with various corporations along with the provision of first aid support for charity events held in The Woodlands area. St. Luke's Community Health Services d/b/a St. Luke's The Woodlands Hospital also provided community education events to highlight health concerns such as cardiology and heart problems, pediatric care, neuroscience innovations, stroke care, breast cancer, and brain awareness.
Affiliated Health Care system SCHEDULE H, PART VI, LINE 6 St. Luke's Community Health Services d/b/a St. Luke's The Woodlands Hospital("SLWH"), AS AN INTEGRAL PART OF THE ST. LUKE'S EPISCOPAL HEALTH SYSTEM IN HOUSTON, TX, CONTRIBUTES TO ENHANCING COMMUNITY HEALTH BY DELIVERING SUPERIOR VALUE IN HIGH-QUALITY, COST-EFFECTIVE ACUTE CARE. IN COLLABORATION WITH ITS MEDICAL STAFF, SLWH IS DEDICATED TO EXCELLENCE AND COMPASSION IN CARING FOR THE WHOLE PERSON - BODY, MIND AND SPIRIT. SLWH ALSO IS COMMITTED TO THE GROWTH AND DEVELOPMENT OF ITS EMPLOYEES AND TO SECURING THE HEALTH OF FUTURE GENERATIONS BY CREATING, APPLYING, AND DISSEMINATING HEALTH KNOWLEDGE THROUGH EDUCATION and research.
State Community Benefit Report schedule H, Part i, line 6a and Part VI, line 7 COMMUNITY BENEFIT REPORTS FOR ST. LUKE'S EPISCOPAL HEALTH SYSTEM, INCLUDING ST. LUKE'S COMMUNITY HEALTH SERVICES D/B/A ST. LUKE'S THE WOODLANDS HOSPITAL, ARE PREPARED FOR THE STATE OF TEXAS AND ARE AVAILABLE TO THE PUBLIC UPON REQUEST.
Schedule H (Form 990) 2012
Additional Data


Software ID:  
Software Version:  
Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," to Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990
OMB No. 1545-0047
2012
Open to Public
Inspection
Name of the organization
ST LUKES COMMUNITY HEALTH SERVICES
 
Employer identification number
76-0536234
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ....................................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Governments and Organizations in the United States. Complete if the organization answered "Yes" to
Form 990, Part IV, line 21, for any recipient that received more than $5,000. Part II can be duplicated if additional space is needed.
(a) Name and address of organization
or government		 (b) EIN (c) IRC Code section
if applicable		 (d) Amount of cash grant (e) Amount of non-cash
assistance		 (f) Method of valuation
(book, FMV, appraisal,
other)		 (g) Description of
non-cash assistance		 (h) Purpose of grant
or assistance
(1) SOUTH MONTGOMERY COUNTY CHAMBER OF COMMERCE
1400 WOODLOCH FOREST DRIVE
SUITE 300
THE WOODLANDS,TX77380 		74-2053667 501(C)(6) 8,000       SPONSORSHIP - 2012 CHAIRMANS BALL.
(2) INTERFAITH OF THE WOODLANDS
4242 INTERFAITH WAY
THE WOODLANDS,TX77381 		74-1804123 501(c)(3) 10,000       ADDITIONAL SUPPORT FOR THE WOODLANDS 2011 CELEBRATION OF EXCELLENCE GALA HONORING THE HOMETOWN HEROES.
(3) AMERICAN HEART ASSOCIATION
10060 BUFFALO SPEEDWAY
HOUSTON,TX77054 		13-5613797 501(C)(3) 8,000       SPONSOR HEART WALK 2012 - FOR THE FIGHT AGAINST CARDIOVASCULAR DISEASE
(4) Service Organization of Houston
2950 50th Street
Lubbock,TX79413 		32-0318004 501(c)(3) 1,041,228       to support healthcare services in underserved areas
(5) harris county clinical services Inc
2801 Via Fortuna Ste 500
austin,TX787467573 		43-2110434 501(c)(3) 507,592       to support clinical healthcare in Harris County














2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................ Bullet Image
4
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
1
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2012

Schedule I (Form 990) 2012
Page 2
Part III
Grants and Other Assistance to Individuals in the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.
(a)Type of grant or assistance (b)Number of
recipients		 (c)Amount of
cash grant		 (d)Amount of
non-cash assistance		 (e)Method of valuation (book,
FMV, appraisal, other)		 (f)Description of non-cash assistance
(1) individual indigent healthcare 50 191,052      












Part IV
Supplemental Information.
Complete this part to provide the information required in Part I, line 2, Part III, column (b), and any other additional information.
Identifier Return Reference Explanation
FORM 990, SCHEDULE I, PART I, QUESTION 2 FORM 990, SCHEDULE I, PART IV, SUPPLEMENTAL INFORMATION Organizations seeking grants ARE MONITORED TO ENSURE THAT THEY HAVE federal tax exempt STATUS AND THAT GRANT fUNDS ARE FOR REASONABLE PURPOSES. Individuals seeking funds for medical services provided by outside medical groups are screened for eligibility using the charity care guidelines of the hospital.
Schedule I (Form 990) 2012


Additional Data


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Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet Complete if the organization answered "Yes" to Form 990,
Part IV, question 23.
SchJMediumBullet Attach to Form 990. SchJMediumBullet See separate instructions.
OMB No. 1545-0047
2012
Open to Public Inspection
Name of the organization
ST LUKES COMMUNITY HEALTH SERVICES
 
Employer identification number

76-0536234
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain....
1b
 
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all officers,
directors, trustees, and the CEO/Executive Director, regarding the items checked in line 1a? .......
2
 
 
3
Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.
4
During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? ................
4a
 
No
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? .........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3) and 501(c)(4) organizations only must complete lines 5-9.
5
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ...........................
5a
 
No
b
Any related organization? .........................
5b
 
No
If "Yes," to line 5a or 5b, describe in Part III.
6
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization? ...........................
6a
 
No
b
Any related organization? .........................
6b
 
No
If "Yes," to line 6a or 6b, describe in Part III.
7
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
 
No
8
Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................
8
 
No
9
If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2012

Schedule J (Form 990) 2012
Page 2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.
For each individual whose compensation must be reported in Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.
(A) Name and Title (B) Breakdown of W-2 and/or 1099-MISC compensation (C) Retirement and other deferred compensation (D) Nontaxable
benefits		 (E) Total of columns
(B)(i)-(D) 		(F) Compensation
reported as deferred
in prior Form 990
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
(1)DAVID J FINEtreasurer SECRETARY & director (i)
(ii)		 0
1,039,788 		0
578,872 		0
52,966 		0
427,164 		0
24,658 		0
2,123,448 		0
0
(2)STEPHEN PICKETTasst. secretary (i)
(ii)		 0
641,595 		0
315,068 		0
12,656 		0
153,005 		0
8,080 		0
1,130,404 		0
0
(3)DEBRA F SUKINSR V P AND CEO WOODLANDS (i)
(ii)		 309,623
0 		100,815
0 		8,708
0 		110,176
0 		16,658
0 		545,980
0 		0
0
(4)Margaret A REITERVP AND CNO SLTWH (i)
(ii)		 191,803
0 		24,404
0 		0
0 		17,935
0 		9,595
0 		243,737
0 		0
0
(5)Mary Sue LiphamAVP & cfo (i)
(ii)		 170,361
0 		24,337
0 		0
0 		16,530
0 		16,164
0 		227,392
0 		0
0
(6)Brian e DoyleAssistant Treasurer (i)
(ii)		 0
144,598 		0
14,966 		0
0 		0
17,278 		0
12,779 		0
189,621 		0
0
(7)margaret smithavp operations sltwh (i)
(ii)		 156,472
0 		16,002
0 		0
0 		12,109
0 		8,061
0 		192,644
0 		0
0
Schedule J (Form 990) 2012

Schedule J (Form 990) 2012
Page 3
Part III
Supplemental Information
Complete this part to provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II.
Also complete this part for any additional information.
Identifier Return Reference Explanation
PART I, QUESTIONS REGARDING COMPENSATION, QUESTION 3 compensation of the ceo/executive director St. Luke's Community Health Services d/b/a St. Luke's The Woodlands Hospital does not provide compensation to its chief executive officer. St. Luke's Episcopal Health System, a related exempt organization, provides compensation to this officer and relies upon an organized compensation committee, compensation studys, and an independent compensation consultant to establish proper compensation levels. Executive compensation is approved by the compensation committee and becomes part of a written employment contract for that executive.
Part I, Questions Regarding Compensation, line 4b SUPPLEMeNTAL NONQUALIFIED RETIREMENT PLAN THE INDIVIDUALS LISTED BELOW PARTICIPATED IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN WITH THE FOLLOWING AMOUNTS CREDITED TO THEIR ACCOUNTS: DAVID J FINE $406,203.00 STEPHEN PICKETT $133,430.00 Debra f Sukin $ 88,002.92
Schedule J (Form 990) 2012

Additional Data


Software ID:  
Software Version:  
SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
OMB No. 1545-0047
2012
Open to Public
Inspection
Name of the organization
ST LUKES COMMUNITY HEALTH SERVICES
 
Employer identification number

76-0536234
Identifier Return Reference Explanation
FORM 990, PART IV, QUESTION 12a & 12b CHECK LIST OF REQUIRED SCHEDULES; FINANCIAL STATEMENT AND REPORTING did the organization obtain separate, independent audited financial statements for the tax year? was the organization included in consolidated, independent audited financial statements for the tax year? ST. LUKE'S EPISCOPAL HEALTH SYSTEM CORPORATION AND ITS RELATED ENTITIES WERE AUDITED AS A CONSOLIDATED GROUP IN ACCORDANCE WITH GAAP. THUS, THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS DO NOT PROVIDE AN ENTITY BY ENTITY REPORTING FOR CALENDAR YEAR 2012.
FORM 990, PART V, QUESTIONS 1 AND 2a STATEMENT REGARDING OTHER IRS FILINGS AND TAX COMPLIANCE ENTER THE NUMBER REPORTED IN BOX 3 OF FORM 1096, ANNUAL SUMMARY AND TRANSMITTAL OF U.S. INFORMATION RETURNS. ST. LUKE'S EPISCOPAL HEALTH SYSTEM CORPORATION REMITS ALL VENDORS PAYMENTS AND ISSUES FORM 1099 ON BEHALF OF ITS RELATED ORGANIZATIONS. individual entities of st. luke's episcopal health system corporation do not file forms 1096 for this reason. ENTER THE NUMBER OF EMPLOYEES REPORTED ON FORM W-3, TRANSMITTAL OF WAGE AND TAX STATEMENTS, FILED FOR THE CALENDAR YEAR ENDING WITH OR WITHIN THE YEAR COVERED BY THIS RETURN. THE EMPLOYEES OF ST. LUKE'S COMMUNITY HEALTH SERVICES ARE PAID BY A COMMON PAYMASTER, ST. LUKE'S EPISCOPAL HEALTH SYSTEM CORPORATION, (76-0536232). THEREFORE, NO FORM W-3 OR 941S WERE FILED BY ST. LUKE'S COMMUNITY HEALTH SERVICES AS ALL PAYROLL INFORMATION RElaTED TO THESE EMPLOYEES WAS INCLUDED IN THE FORM W-3 AND 941S FILED BY ST. LUKE'S EPISCOPAL HEALTH SYSTEM CORPORATION.
FORM 990, PART VI, SECTION A, QUESTIONS 6, 7a AND 7b SECTION A: GOVERNING BODY AND MANAGEMENT Did THE ORGANIZATION HAVE MEMBERS OR STOCKHOLDERS? THE SOLE MEMBER OF ST. LUKE'S COMMUNITY HEALTH SERVICES SHALL BE ST. LUKE'S EPISCOPAL HEALTH SYSTEM CORPORATION. Did THE ORGANIZATION HAVE MEMBERS, STOCKHOLDERS, OR OTHER PERSONS who had the power to elect or appoint ONE OR MORE MEMBERS OF THE GOVERNING BODY? THE MANAGEMENT OF THE AFFAIRS OF THE CORPORATION SHALL BE VESTED IN A BOARD OF DIRECTORS. THE BOARD OF DIRECTORS SHALL CONSIST OF MEMBERS ELECTED BY THE ST. LUKE'S EPISCOPAL HEALTH SYSTEM CORPORATION UPON NOMINATION OF THE BISHOP OF THE DIOCESE OF TEXAS AS THE CHAIRMAN OF THE BOARD OF DIRECTORS OF ST. LUKE'S EPISCOPAL HEALTH SYSTEM CORPORATION. ARE ANY governance DECISIONS OF THE organization reserved to (or SUBJECT TO APPROVAL BY) MEMBERS, STOCKHOLDERS, OR PERSONS other than the governing body? THE BOARD OF DIRECTORS SHALL HAVE FULL POWER AND AUTHORITY TO MANAGE THE BUSINESS, OPERATIONS AND AFFAIRS OF THE CORPORATION IN ACCORDANCE WITH (a) THE BYLAWS WHICH THE BOARD OF DIRECTORS SHALL ADOPT, (b) THE GOALS OF ST. LUKE'S EPISCOPAL HEALTH SYSTEM CORPORATION AND (c) THE CANONS OF THE PROTESTANT EPISCOPAL CHURCH IN THE DIOCESE OF TEXAS AS FROM TIME TO TIME IN FORCE.
FORM 990, PART VI, SECTION b, QUESTION 11 & 11a SECTION b: policies has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? Describe in Schedule O the process, if any, used by the organization to review this Form 990. The St. Luke's Community Health Services FORM 990 WAS PREPARED BY THE TAX DEPARTMENT OF ITS PARENT, ST. LUKE'S EPISCOPAL HEALTH SYSTEM (SLEHS), UTILIZING INFORMATION PROVIDED BY THE REPORTING ENTITY'S MANAGEMENT, OFFICERS, AND DIRECTORS. COLLABORATIVE REVIEW OF THE RETURN BY THE ORGANIZATION'S EXTERNAL ADVISORS, EXECUTIVE MANAGEMENT AND THE SLEHS TAX DIRECTOR WAS CONDUCTED, and the return was made available to the officers and directors before filing.
FORM 990, PART VI, SECTION B, QUESTION 12c SECTION B: POLICIES Did THE ORGANIZATION REGULARLY AND CONSISTENTLY MONITOR AND ENFORCE COMPLIANCE WITH THE WRITTEN CONFLICT OF INTEREST POLICY? PRIMARY MONITORING OF CONFLICT OF INTEREST IS DONE THROUGH ANNUAL POLLING OF OFFICERS, DIRECTORS, AND KEY EMPLOYEES FOR POTENTIAL CONFLICTS. CONFLICT OF INTEREST SUBMISSIONS ARE REVIEWED BY THE CORPORATE COMPLIANCE OFFICER AND SENIOR COUNSEL WHO BRING ACTIONABLE ITEMS TO THE BOARD. IF THE INSTITUTION DETERMINES THAT A SIGNIFICANT POSSIBLILITY EXISTS THAT THERE IS A CONFLICT OF INTEREST, THE INDIVIDUALS INVOLVED WILL BE REQUIRED TO REFRAIN FROM MAKING A DECISION OR TAKING ANY ACTION UNTIL THE MATTER CAN BE FULLY INVESTIGATED AND A DECISON MADE AS TO WHETHER A CONFLICT EXISTS. IF A CONFLICT IS CONFIRMED, A PLAN FOR ALLEVIATION OR MANAGING THE CONFLICT IS IMPLEMENTED. INDIVIDUALS WITH POTENTIAL CONFLICTS MAY BE ASKED TO RECUSE AND ABSENT THEMSELVES FROM MEETINGS IN WHICH AN ALLEGED CONFLICT IS DISCUSSED IF SO DOING WOULD BETTER ASSURE THE INTEGRITY OF THE PROCESS.
FORM 990, PART VI, SECTION B, QUESTION 14 SECTION B: POLICIES Did THE ORGANIZATION HAVE A WRITTEN DOCUMENT RETENTION AND DESTRUCTION POLICY? st. luke's episcopal health system corporation and related entities have a written general policy related to document retention and destruction. DOCUMENTS AND RECORDS ARE RETAINED FOR VARIOUS FEDERAL, STATE OR OTHER JURISDICTION STATUTES FOR MEDICAL OR FINANCIAL REVIEW ON A DEPARTMENT BY DEPARTMENT BASIS.
FORM 990, PART VI, SECTION B, QUESTION 15 SECTION B: POLICIES DID THE PROCESS FOR DETERMINING COMPENSATION OF THE FOLLOWING PERSONS INCLUDE A REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA, AND CONTEMPORANEOUS SUBSTANTITATION OF THE DELIBERATION AND DECISION FOR: a) THE ORGANIZATIONS CEO, EXECUTIVE DIRECTOR, OR TOP MANAGEMENT OFFICIAL? b) OTHER OFFICERS OR KEY EMPLOYEES OF THE ORGANIZATION? DESCRIBE THE PROCESS IN SCHEDULE O. THE ORGANIZATION'S COMPENSATION COMMITTEE MEETS AS NEEDED, BUT AT LEAST ONE TIME PER YEAR. THIS COMMITTEE CONSISTS OF THREE OUTSIDE DIRECTORS. ITS FUNCTION IS TO MAKE RECOMMENDATIONS/DECISIONS ON SALARY AND BENEFITS FOR KEY EXECUTIVES. VARIOUS DATA IS UTILIZED IN DECISION-MAKING INCLUDING COMPENSATION CONSULTANTS, MANAGEMENT'S LEVEL OF ACHIEVMENT OF STIPULATED PERFORMANCE TARGETS, EXTERNAL SURVEYS, AND LOCAL MARKET CONDITIONS. PERMANENT MINUTES ARE PREPARED AND REVIEWED BY COMPENSATION COMMITTEE MEMBERS PRIOR TO THEIR RATIFICATION. THESE MINUTES ARE SUFFICIENTLY DETAILED TO PROVIDE SUBSTANTIATION OF THE DECISIONS MADE BY THE COMMITTEE WITH REGARD TO EACH KEY EXECUTIVE'S COMPENSATION AND BENEFITS. A REPORT IS MADE TO THE FULL BOARD BY THE COMPENSATION COMMITTEE CHAIR AT WHICH TIME RATIFICATION OF COMMITTEE ACTION IS VOTED BY THE BOARD.
FORM 990, PART VI, SECTION C, QUESTION 19 Section c: disclosure DESCRIBE IN SCHEDULE O WHETHER (AND IF SO, HOW) THE ORGANIZATION MAde IT GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. ST. LUKE'S EPISCOPAL HEALTH SYSTEM CORPORATION AND ITS RELATED ENTITIES HAVE NOT CREATED A GENERAL POLICY PROVIDING FOR THE DISCLOSURE OF CERTAIN DOCUMENTS. in practice, these documents have been made available to the public upon written request only. .
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2012

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SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" to Form 990, Part IV, line 33, 34, 35, 36, or 37.
MediumBulletAttach to Form 990. MediumBullet See separate instructions.

OMB No. 1545-0047
2012
Open to Public Inspection
Name of the organization
ST LUKES COMMUNITY HEALTH SERVICES
 
Employer identification number

76-0536234
Part I
Identification of Disregarded Entities (Complete if the organization answered "Yes" to Form 990, Part IV, line 33.)
(a)
Name, address, and EIN (if applicable) of disregarded entity


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Total income


 		(e)
End-of-year assets


 		(f)
Direct controlling
entity










Part II
Identification of Related Tax-Exempt Organizations (Complete if the organization answered "Yes" to Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.)
(a)
Name, address, and EIN of related organization


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Exempt Code section


 		(e)
Public charity status
(if section 501(c)(3))

 		(f)
Direct controlling
entity

 		(g)
Section 512(b)(13) controlled entity?
Yes No
(1) ST LUKES EPISCOPAL HEALTH SYSTEM CORP

6624 FANNIN

HOUSTON,TX77030
76-0536232 		PARENT CORP TX 501(c)(3) 11a EPIS DIOCESE
 
 
No
(2) ST LUKES EPISCOPAL HOSPITAL

6720 BERTNER

HOUSTON,TX77030
74-1161938 		HOSPITAL TX 501(c)(3) 3 SYSTEM CORP
 
 
No
(3) ST LUKES EPISCOPAL HEALTH SYSTEM FOUNDA

PO BOX 20269

HOUSTON,TX77225
76-0127715 		invest mgmt TX 501(c)(3) 11a SYSTEM CORP
 
 
No
(4) ST LUKES EPISCOPAL PROPERTIES CORP

6624 FANNIN

HOUSTON,TX77030
76-0531716 		prop mgmt TX 501(c)(3) 11a SYSTEM CORP
 
 
No
(5) ST LUKES MEDICAL TOWER CORPORATION

6624 FANNIN

HOUSTON,TX77030
76-0531713 		med offices TX 501(c)(3) 11a properties
 
 
No
(6) ST LUKES EPISCOPAL HEALTH CHARITIES

6624 FANNIN

HOUSTON,TX77030
76-0531710 		grant support TX 501(c)(3) 11a SYSTEM CORP
 
 
No
(7) GREATER HOUSTON HEALTH NETWORK

6624 FANNIN

HOUSTON,TX77030
76-0458535 		CLINIC TX 501(c)(3) 3 sleh
 
 
No
(8) SL AUGUSTA CORPORATION

6624 FANNIN

HOUSTON,TX77030
76-0226623 		title holding TX 501(c)(2) N/A properties
 
 
No
(9) ST LUKES COMMUNITY DEVELOPMENT CORP

6624 fannin st ste 2505

HOUSTON,TX77030
26-0274448 		mgmt support TX 501(c)(3) 11a SYSTEM CORP
 
 
No
(10) ST LUKES COMMUNITY DEV CORP SUGAR LAND

6624 fannin st ste 2505

HOUSTON,TX77030
26-1947374 		HOSPITAL TX 501(c)(3) 3 System Corp
 
 
No
(11) ST LUKES COMMUNITY DEV CORP THE WOODLAND

6624 fannin st ste 2505

HOUSTON,TX77030
26-0335902 		HOSPITAL TX 501(c)(3) 3 SL CDC
 
 
No
(12) ST LUKES COMMUNITY DEV CORP THE VINTAGE

6624 fannin st ste 2505

HOUSTON,TX77030
26-3734606 		HOSPITAL TX 501(c)(3) 3 SL CDC
 
 
No
(13) Woodlands Doctor Group

17200 st Lukes way

the woodlands,TX77384
27-4499340 		clinic TX pending 9 SL CHS
 
Yes
 
(14) St Luke's Community Dev Corp - PMC

6624 fannin st ste 2505

houston,TX77030
27-3733278 		hospital TX pending 3 SL CDC
 
 
No
(15) Sugar land doctor group

6624 fannin st ste 1100

houston,TX77030
45-4270163 		clinic TX pending 9 SL CDC - SL
 
 
No
(16) St Luke's Foundation

1213 hermann drive ste 855

houston,TX77004
45-3811485 		grants TX pending 7 system corp
 
 
No
(17) st Luke's Sugar Land Properties Corpora

6624 fannin st ste 2505

houston,TX77030
45-4120549 		prop mgmt TX pending 11a sl cdc -sl
 
 
No
(18) St Luke's Anesthesiology Associates

6624 fannin ste 1100

houston,TX77030
46-1517163 		specialists TX pending 9 SLEH
 
 
No
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2012
Schedule R (Form 990) 2012
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership (Complete if the organization answered "Yes" to Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.)
(a)
Name, address, and EIN of
related organization



 		(b)
Primary activity




 		(c)
Legal
domicile
(state or foreign
country)


 		(d)
Direct controlling
entity



 		(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(f)
Share of total income




 		(g)
Share of end-of-year
assets



 		(h)
Disproprtionate allocations?




 		(i)
Code V—UBI
amount in box 20 of
Schedule K-1
(Form 1065)
 		(j)
General or
managing
partner?



 		(k)
Percentage
ownership
Yes No Yes No
(1) ST LUKES LAKESIDE HOSPITAL LLC

6624 fannin suite 2505
HOUSTON,TX77030
30-0427437 		HOSPITAL TX na
  		          0      
(2) ST LUKES HOSPITAL AT THE VINTAGE LLC

6624 fannin suite 2505
HOUSTON,TX77030
26-3734616 		HOSPITAL TX na
  		          0      
(3) PMC Hospital LLC

6624 fannin suite 2505
houston,TX77030
27-3280598 		hospital TX na
  		          0      
(4) HC SL vintage I LLC

18000 West Sarah Land Ste 250
brookfield,WI53045
27-0453767 		property hold WI na
  		          0      






Part IV
Identification of Related Organizations Taxable as a Corporation or Trust (Complete if the organization answered "Yes" to Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.)
(a)
Name, address, and EIN of
related organization
 		(b)
Primary activity
 		(c)
Legal
domicile
(state or foreign
country)
 		(d)
Direct controlling
entity
 		(e)
Type of entity
(C corp, S corp,
or trust) 		(f)
Share of total income
 		(g)
Share of end-of-year
assets
 		(h)
Percentage
ownership
 		(i)
Section 512(b)(13) controlled entity?
Yes No
(1) ST LUKES MEDICAL ARTS CENTER I CONDO ASS

6624 FANNIN
HOUSTON,TX77030
30-0355518 		CONDOMINIUM A TX NA
  		c         No
(2) ST LUKES MEDICAL TWR CONDO ASSOCIATION

6624 FANNIN
HOUSTON,TX77030
76-0298751 		CONDOMINIUM A TX NA
  		c         No
(3) ST LUKES 6620 MAIN CONDO ASSOCIATION

6624 FANNIN
HOUSTON,TX77030
30-0355517 		CONDOMINIUM A TX NA
  		c         No
(4) THE THI AT SLEH DAC BLDG CONDO ASSOC

6624 FANNIN
HOUSTON,TX77030
90-0064009 		CONDOMINIUM A TX NA
  		c         No
(5) SLEHS HOLDINGS INC AND SUBSIDIARIES

6624 FANNIN
HOUSTON,TX77030
76-0637138 		HOLDING COMPA TX na
  		c         No
(6) ST LUKES EPISCOPAL HOSP PHYSICIAN HOSP O

6720 BERTNER
HOUSTON,TX77030
76-0377932 		PHO TX NA
  		c         No
(7) ALL SAINTS INSURANCE COMPANY SPC LTD

PO BOX 69 GT
Georgetown,GRAND CAYMANKy-1102
CJ
SELF INSURANC CJ NA
  		N/A         No
Schedule R (Form 990) 2012
Schedule R (Form 990) 2012
Page 3
Part V
Transactions With Related Organizations (Complete if the organization answered "Yes" to Form 990, Part IV, line 34, 35b, or 36.)
Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest (ii) annuities (iii) royalties or (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .
1a
 
No
b Gift, grant, or capital contribution to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
 
No
c Gift, grant, or capital contribution from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
 
No
d Loans or loan guarantees to or for related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
Yes
 
e Loans or loan guarantees by related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
 
No
f Dividends from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
 
 
g Sale of assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1g
 
No
h Purchase of assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1h
 
No
i Exchange of assets with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1j
 
No
k Lease of facilities, equipment, or other assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1k
 
No
l Performance of services or membership or fundraising solicitations for related organization(s) . . . . . . . . . . . . . . . . . . . .
1l
Yes
 
m Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .
1m
 
No
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .
1n
 
No
o Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
 
No
p Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
Yes
 
q Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
Yes
 
r Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
 
 
s Other transfer of cash or property from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1s
 
 
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of other organization 		(b)
Transaction
type (a-s) 		(c)
Amount involved 		(d)
Method of determining amount involved





Schedule R (Form 990) 2012
Schedule R (Form 990) 2012
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership (Complete if the organization answered "Yes" to Form 990, Part IV, line 37.)
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity 		(b)
Primary activity 		(c)
Legal domicile
(state or foreign
country) 		(d)
Predominant income (related, unrelated, excluded from tax under section 512-514)

(e)
Are all partners
section
501(c)(3)
organizations? 		(f)
Share of total income




 		(g)
Share of
end-of-year
assets 		(h)
Disproprtionate allocations? 		(i)
Code V—UBI
amount in box 20
of Schedule K-1
(Form 1065) 		(j)
General or
managing
partner? 		(k)
Percentage
ownership
Yes No Yes No Yes No






























Schedule R (Form 990) 2012
Schedule R (Form 990) 2012
Page 5
Part VII
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule R (see instructions).
Identifier Return Reference Explanation
form 990, Schedule R Part V, Transactions with related organizations St. Luke's Episcopal Health System Corporation remits all vendor payments on behalf of its related organizations, including St. Luke's Community Health services D/b/a/ St. Luke's the Woodlands Hospital. st. Luke's episcopal health system corporation also provides administrative and financial services as well as cash management on behalf of its related organizations, including St. Luke's Community Health services D/b/a/ St. Luke's the Woodlands Hospital and is reimbursed for expenses incurred.

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