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.
Attach to Form 990 or Form 990-EZ. See separate instructions. Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
St Luke's Regional Medical Center
Employer identification number
82-0161600
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
By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons other than foundation managers and other than one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2).
f
If the organization received a written determination from the IRS that it is a Type I, Type II, or Type III supporting organization, check this box
..................................................
g
Since August 17, 2006, has the organization accepted any gift or contribution from any of the following persons?
(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) 2013
Schedule A (Form 990 or 990-EZ) 2013
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)
(a) 2009
(b) 2010
(c) 2011
(d) 2012
(e) 2013
(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)
(a) 2009
(b) 2010
(c) 2011
(d) 2012
(e) 2013
(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
Gross receipts from related activities, etc. (see instructions)
..................
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.................................................
Section C. Computation of Public Support Percentage
14
Public support percentage for 2013 (line 6, column (f) divided by line 11, column (f))
.........
14
15
Public support percentage for 2012 Schedule A, Part II, line 14
...............
15
16a
33 1/3% support test—2013.
If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization
.......................
b
33 1/3% support test—2012.
If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization
.....................
17a
10%-facts-and-circumstances test—2013.
If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part IV how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization
.....................................................
b
10%-facts-and-circumstances test—2012.
If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part IV how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization
................................................
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
.....................................................
Schedule A (Form 990 or 990-EZ) 2013
Schedule A (Form 990 or 990-EZ) 2013
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)
(a) 2009
(b) 2010
(c) 2011
(d) 2012
(e) 2013
(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)
(a) 2009
(b) 2010
(c) 2011
(d) 2012
(e) 2013
(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
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.............................................
Section C. Computation of Public Support Percentage
15
Public support percentage for 2013 (line 8, column (f) divided by line 13, column (f))
.........
15
16
Public support percentage from 2012 Schedule A, Part III, line 15
...............
16
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2013 (line 10c, column (f) divided by line 13, column (f))
......
17
18
Investment income percentage from 2012 Schedule A, Part III, line 17
.............
18
19a
33 1/3% support tests—2013.
If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
........
b
33 1/3% support tests—2012.
If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
.....
20
Private foundation.
If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions
.....
Schedule A (Form 990 or 990-EZ) 2013
Schedule A (Form 990 or 990-EZ) 2013
Page 4
Part IV
Supplemental Information.
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) 2013
Additional Data
Software ID:
Software Version:
-
TIN:
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.
Attach to Form 990 or 990-EZ.
Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
St Luke's Regional Medical Center
Employer identification number
82-0161600
Return Reference
Explanation
Form 990 Part I, LIne 1F
On April 1,2014,Chris Roth was appointed Chief Operating Officer of St. Luke's Health System,Ltd. As a result of this change, Kathy Moore was appointed Chief Executive Officer for St. Luke's Regional Medical Center,Ltd.,Mountain States Tumor Institute,Inc., and St. Luke's Health Foundation,Ltd. In addition,effective April 1,2014,the Board of Directors for St. Luke's Regional Medical Center, Ltd.,became the fiduciary board for St. Luke's McCall,Ltd. With this change,Kathy Moore also became Chief Executive Officer over St. Luke's McCall,Ltd. It should be noted,however,that with this change in governance St. Luke's Health System,Ltd. is still the sole member of St. Luke's McCall,Ltd.
Form 990 Part III-Statement of Program Accomplishments
Please note that the program expense amounts reported in Statement III-Statement of Program Accomplishments,do not include an allocation of certain administrative and functional support costs. These costs are classified as Management and General within Part IX-Statement of Functional Expenses.
Form 990, Part VI, Section A, line 4
Effective April 1,2014,the overall governance structure for the St. Luke's Health System was reorganized into two governing regions, with St. Luke's Health System,Ltd. having overall fiduciary oversight over these regions. The reorganization is described as follows: (1) St. Luke's Western Region,consisting of the following legal entities: --St. Luke's Regional Medical Center,Ltd.(SLRMC) --Mountain States Tumor Institute,Inc.(MSTI) --St. Luke's McCall,Ltd.(SLM) (2) St. Luke's Eastern Region,consisting of the following legal entities: --St. Luke's Magic Valley Regional Medical Center,Ltd.(SLMV) --St. Luke's Wood River Medical Center,Ltd.(SLWR) As a result of these changes,the governing boards for SLRMC and SLMV also serve as the fiduciary boards over the other legal entities within their respective regions. The bylaws of all these organizations have been changed accordingly and are described in the explanations for line 7b within Part VI of this return. It should be noted that community boards for SLM and SLWR have been chartered by their fiduciary boards,with each chairperson of these boards also serving as a member on the chartering fiduciary board. Having these additional local boards will insure that the communities have involvement with the operations of their respective hospital organizations,as well as to make sure the overall health needs of their communities are addressed. It should be noted,however,that the overall legal entity structure and sole member relationships are unchanged,as described in Form 990, Schedule R.
Form 990, Part VI, Section A, line 6
St. Luke's Health System,Ltd. is the sole member of St. Luke's Regional Medical Center,Ltd.
Form 990, Part VI, Section A, line 7a
St. Luke's Health System,Ltd.(Member)and St. Luke's Regional Medical Center,Ltd.(Corporation)cooperatively select and employ the CEO of the Corporation. St. Luke's Health System, Ltd.,is the sole member of the Corporation.
Form 990, Part VI, Section A, line 7b
St. Luke's Health System,Ltd.(Member)maintains approval and implementation authority over St. Luke's Regional Medical Center,Ltd.(Corporation). Actions requiring approval authority may be initiated by either the Corporation or its Member,but must be approved by both the Corporation (by action of its Board of Directors) and the Member. Actions requiring approval authority of the Member include: (a) Amendment to the Articles of Incorporation; (b) Amendment to the Bylaws of the Corporation; (c) Appointment of members of the Corporation's Board of Directors,other than ex officio directors; (d) Removal of an individual from the Corporation's Board of Directors if and when removal is requested by the Corporation's Board of Directors, which request may only be made if the Director is failing to meet the reasonable expectations for service on the Corporation's Board of Directors that are established by the Member and are uniform for the Corporation and for all of the other hospitals for which the Member then serves as the sole corporate member. (e) Approval of operating and capital budgets of the Corporation,and deviations to an approved budget over the amounts established from time to time by the Member;and (f) Approval of the strategic/tactical plans and goals and objectives of the Corporation. Implementation Authority means those actions which the Member may take without the approval or recommendation of the Corporation. This authority will not be utilized until there has been appropriate communication between the Member and the Corporation's Board of Directors and its Chief Executive Officer. Actions requiring implementation authority include: (a) Changes to the Statements of mission,philosophy,and values of the Corporation; (b) Removal of an individual from the Corporation's Board of Directors if and when the Member determines in good faith that the Director is failing to meet the Approved Board of Member Expectations. This authority to remove Directors shall not be used merely because there is a difference in business judgment between the Director and the Corporation or the Member,and shall never be used to remove one or more Directors from the Corporation's Board of Directors in order to change a decision made by the Corporation's Board of Directors; (c) Employment and termination of the Chief Executive Officer of the Corporation; (d) Appointment of the auditor for the Corporation and the coordination of the Corporation's annual audit; (e) Sales,lease,exchange,mortgage,pledge,creation of a security interest in or other disposition of real property of the Corporation if such property has a fair market value in excess of a limit set from time to time by the Member that is not otherwise contained in an Approved Budget; (f) Sale,merger,consolidation,change of membership,sale of all or substantially all of the assets of the corporation,or closure of any facility operated by the Corporation; (g) The dissolution of the Corporation; (h) Incurrence of debt by or for the Corporation in accordance with requirements established from time to time by the Member and that is not otherwise contained in an Approved Budget;and (i) Authority to establish policies to promote and develop an integrated, cohesive health care delivery system across all corporations for which the Member serves as the corporate member.
Form 990, Part VI, Section B, line 11
The Form 990(Form)is reviewed by an independent public accounting firm based on audited financial statements and with the assistance of the organization's finance and accounting staff. The final draft of the Form is made available to the Finance Committee of the Board of Directors. The Board receives the final version of the Form prior to filing.
Form 990, Part VI, Section B, line 12c
The organization annually reviews the conflict of interest policy with each board member and also with new board members. Persons covered under the policy include officers,directors,senior executives,non-director members of Board committees and others as identified by a senior executive. At all levels the board is responsible for assessing,reviewing,and resolving any conflicts of interest that have been disclosed by a covered person,or a conflict of interest disclosed by a covered person with respect to a covered person other than himself/herself. Where a conflict exists,the affected parties must recuse themselves from participating in any discussion related to the conflict.
Form 990, Part VI, Section B, line 15
Executive compensation is set by St. Luke's boards of directors and is reviewed annually. Compensation levels are based on an independent analysis of comparable pay packages offered at similar institutions across the country, with the goal of placing executives in the 50th percentile of those surveyed. These surveys are usually done every two years,with the most recent compensation survey completed during calendar year 2014. St. Luke's Health System is committed to providing the highest quality medical care to all people regardless of their ability to pay. To keep that commitment,St. Luke's puts a great deal of time and effort into recruiting and retaining the top physicians in a variety of medical fields. Our relationships with physicians range from having privileges at the hospital to full employment. For those physicians who choose to be employed,St. Luke's must offer competitive pay and benefits. Physician compensation is based on a range of criteria and can be influenced by a number of variables including: -Community need for medical specialty -Experience -Productivity -Geography -National surveys adjusted for local conditions -Willingness to serve regardless of patients' ability to pay -Duration of relationship and contractual terms -Performance on quality metrics To ensure physician compensation and benefits remain within industry standards and legal requirements for not-for-profit institutions, St. Luke's has a Physician Arrangements policy that specifies circumstances requiring a third-party valuation and also periodically uses third-party consulting firms to review St. Luke's physician compensation arrangements. Given the growing national shortage of physicians,recruiting and retaining physicians is more critical than ever to guarantee that people seeking care at St. Luke's will continue to have access to the physicians and specialists they need regardless of their insurance status or insurance provider.
Form 990, Part VI, Section C, line 19
The organization's governing documents,conflict of interest policy,and financial statements are not available to the public. Form 990,which contains financial information,is available for public inspection.
Form 990 Part VII Section A
The total hours worked and compensation reported for Kathy Moore,Chris Roth,Jeff Taylor,Christine Neuhoff,and Gary Fletcher,represent services rendered to the following organizations within the St. Luke's Health System: Kathy Moore: St. Luke's Regional Medical Center,Ltd. Mountain States Tumor Institure,Inc. St. Luke's Health Foundation,Ltd. St. Luke's McCall,Ltd. St. Luke's Clinic Coordinate Care,Ltd. Chris Roth: St. Luke's Health System,Ltd. St. Luke's Regional Medical Center,Ltd. Mountain States Tumor Institute,Inc. St. Luke's Health Foundation,Ltd. Jeff Taylor: St. Luke's Health System,Ltd. St. Luke's Regional Medical Center,Ltd. Mountain States Tumor Institute,Inc. St. Luke's McCall,Ltd. St. Luke's Magic Valley Regional Medical Center,Ltd. St. Luke's Wood River Medical Center,Ltd. St. Luke's Clinic Coordinated Care,Ltd. Christine Neuhoff: St. Luke's Health System,Ltd. St. Luke's Regional Medical Center,Ltd. Mountain States Tumor Institute,Inc. St. Luke's McCall,Ltd. St. Luke's Magic Valley Regional Medical Center,Ltd. St. Luke's Wood River Medical Center,Ltd. St. Luke's Clinic Coordinated Care,Ltd. Gary Fletcher: St. Luke's Health System,Ltd. St. Luke's Clinic Coordinated Care,Ltd. In addition,Catherine Reynolds,M.D. is a member of Syringa Family Medicine,P.A.,(Syringa)a physician practice that has a professional service agreement with St. Luke's Regional Medical Center,Ltd.(SLRMC). Dr. Reynolds works at least 40 hours per week on behalf of this practice for SLRMC. During CY'13,SLRMC paid Syringa $180,919 for services rendered to St. Luke's patients. Also,it should be noted that the hours reported for the directors (employed by St. Luke's)officers,key employees,and highest-paid employees are based on a minimum 40 hour work week. However,due to the demands of their roles within the St. Luke's Health System,the hours worked by these individuals often exceed the minimum required 40 hours.
Form 990, Part IX, line 11g
Temporary Services: Program service expenses 4,548,136. Management and general expenses 2,138,414. Fundraising expenses 0. Total expenses 6,686,550.
Form 990, Part XI, line 9:
Change in Minimum Liability-Defined Benefit Plan 9,918,218.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.