2024-05-13T10:06:14-05:00 2023-06-30 470617373 COMMONSPIRIT HEALTH 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 990 2022-07-01 760458535 BAYLOR ST LUKE'S MEDICAL GROUP BAYL 8323555575 6624 FANNIN ST 1100 HOUSTON TX 77030 LINDA KULHANEK CFO 8323555575 2024-05-13 1 LINDA KULHANEK 999009999 0 HEATHER ADKINS P01725376 3032989100 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z T DOUGLAS LAWSON 6624 FANNIN ST 1100 HOUSTON TX 77030 106860008 0 X STLUKESHEALTH.ORG/BAYLOR-ST-LUKES-MEDICAL-GROUP X 1996 TX TO NURTURE THE HEALING MINISTRY OF THE ROMAN CATHOLIC CHURCH BY BRINGING IT NEW LIFE, ENERGY, AND VIABILITY IN THE TWENTY-FIRST CENTURY. FIDELITY TO THE GOSPEL URGES US TO EMPHASIZE HUMAN DIGNITY AND SOCIAL JUSTICE AS IT MOVES TOWARD THE CREATION OF HEALTHIER COMMUNITIES. 6 0 686 0 0 0 942625 984423 102281147 104475738 1746 10610 4921558 1389237 108147076 106860008 17800 15300 0 0 36560405 36053257 0 0 0 156836914 154598109 193415119 190666666 -85268043 -83806658 62734485 51080546 457911585 530204584 -395177100 -479124038 AS AN AFFILIATE OF COMMONSPIRIT HEALTH, WE MAKE THE HEALING PRESENCE OF GOD KNOWN IN OUR WORLD BY IMPROVING THE HEALTH OF THE PEOPLE WE SERVE, ESPECIALLY THOSE WHO ARE VULNERABLE, WHILE WE ADVANCE SOCIAL JUSTICE FOR ALL. 0 0 175159036 15300 104475738 BAYLOR ST. LUKE'S MEDICAL GROUP ("BSLMG") SERVES TO PROMOTE HEALTH CARE SERVICES AND HIGH QUALITY HEALTH CARE TO HOUSTON AND SURROUNDING COMMUNITIES BY PROVIDING HOSPITAL BASED AND COMMUNITY BASED CLINICS AS WELL AS OTHER HOSPITAL BASED PHYSICIAN SERVICES. BSLMG EMPLOYED 313 PHYSICIANS IN THE AREAS OF ANESTHESIOLOGY, HEMATOLOGY, ONCOLOGY, AND INTERNAL MEDICINE. APPROXIMATELY 929,069 PATIENT ENCOUNTERS WITH BSLMG PHYSICIANS TOOK PLACE DURING THE PERIOD ENDED JUNE 30, 2023. 175159036 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 X 0 0 686 1 0 0 0 0 0 0 0 0 0 0 0 0 X 6 0 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 1 0 X LINDA KULHANEK 8323552885 6624 FANNIN STREET STE 2505 HOUSTON TX 77030 T DOUGLAS LAWSON PHD CEO OF CHI ST. LUKE'S HEALTH SYSTEM 1.00 49.00 X 0 2252440 209833 JOHN FLYNN MD CHAIR/SYS SVP PHYSICIAN ENTERPRISE 50.00 0.00 X X 0 819036 27592 LINDA KULHANEK CFO OF CHI ST. LUKE'S HEALTH SYSTEM 1.00 49.00 X 0 540498 33078 MARGARET ROPER DIV VP PHYSICIAN ENTERPRISE (TERMED 5/12/23) 50.00 0.00 X 374242 0 36873 ROBERT BRANSTETTER TREASURER/VP FINANCE 50.00 0.00 X 325588 0 37597 DANIEL WATSON VP OPERATIONS (TERMED 4/5/23) 50.00 0.00 X 247379 0 49357 SYED SULTAN DIRECTOR IMAGING OPERATIONS 50.00 0.00 X 210734 0 48141 ORDIA HALLER DIRECTOR ACCOUNTING 0.00 50.00 X 0 155090 23743 ANGELA LINDER DIRECTOR PHYSICIAN PRACTICE 50.00 0.00 X 152653 0 18408 MONICA MARTINEZ DIRECTOR PHYSICIAN PRACTICE (TERMED 7/20/22) 50.00 0.00 X 152613 0 16229 BRET ADAMS SECRETARY (TERMED 6/30/23) 50.00 0.00 X 85213 0 15411 PETER BIGLER MD VICE CHAIR 50.00 0.00 X X 0 0 0 MITESH PATEL MD BOARD MEMBER 50.00 0.00 X 0 0 0 DIXIE MCCLENDON-COKER MD BOARD MEMBER 50.00 0.00 X 0 0 0 NAGAKRISHNAL NACHIMUTHU MD BOARD MEMBER 50.00 0.00 X 0 0 0 YONG CHOI MD BOARD MEMBER 50.00 0.00 X 0 0 0 1548422 3767064 516262 20 1 1 0 HEART INSTITUTE OF EAST TEXAS 310 GASLIGHT BLVD LUFKIN TX 75904 PHYSICIAN SERVICES 17783341 BAYLOR COLLEGE OF MEDICINE 1 BAYLOR PLAZA HOUSTON TX 77030 PHYSICIAN SERVICES 5924313 RAMASWAMY RAVIKUMAR MD 6300 W PARKER RD MOB 2 STE 322 PLANO TX 75093 PHYSICIAN SERVICES 1167058 MICHAEL H HUBER MD PA 1111 W FRANK AVE STE 100 LUFKIN TX 75904 PHYSICIAN SERVICES 524407 SEAN M MORAN MD PA 1111 W FRANK AVE STE 100 LUFKIN TX 75904 PHYSICIAN SERVICES 478740 7 974423 10000 984423 PATIENT SERVICES 900099 102600562 102600562 0 0 MEDICAL SERVICES 621300 1852244 1852244 0 0 MEDICARE REIMBURSEMENT 900099 22932 22932 0 0 104475738 645 645 704292 0 704292 704292 704292 9965 0 9965 9965 9965 EMPLOYEE RETENTION CRE 900099 573233 0 0 573233 CLINICALLY INTERGRATED 900099 111712 0 0 111712 684945 106860008 104475738 0 1399847 X 15300 15300 482246 424376 57870 26901256 23673106 3228150 1470968 1294452 176516 5198600 4574768 623832 2000187 1760165 240022 7606 6693 913 5380344 4304275 1076069 113320455 105347996 7972459 77308 71896 5412 2090883 1944521 146362 4523291 4206661 316630 13693501 12734956 958545 327070 304175 22895 15785 14680 1105 4129509 3840443 289066 4919628 4575254 344374 87020 80929 6091 MEDICAL SUPPLIES 5530183 5530183 0 0 REPAIRS AND MAINTENANCE 276101 256774 19327 0 RECRUITMENT AND RELOCAT 75138 69878 5260 0 OTHER TAXES 51000 40800 10200 93287 86755 6532 190666666 175159036 15507630 0 6568 1 2275304 3265757 0 9985272 8019520 0 0 78870 78870 0 693951 140277 37127713 26230926 14432351 10896787 0 0 0 295166 0 34967003 28679334 62734485 51080546 28812588 16065080 0 0 0 0 0 0 0 429098997 514139504 457911585 530204584 X -395177100 -479124038 0 -395177100 -479124038 62734485 51080546 X -83806658 -140280 X 0 1 X 1 0 X SCHEDULE A, PART I, LINE 3C - SCHEDULE H NOT REQUIRED BAYLOR ST. LUKE'S MEDICAL GROUP IS RECOGNIZED AS A HOSPITAL BY THE INTERNAL REVENUE SERVICE UNDER IRC SECTION 170(B)(1)(A)(III). HOWEVER, BAYLOR ST. LUKE'S MEDICAL GROUP DOES NOT CURRENTLY OPERATE ANY LICENSED HOSPITAL FACILITIES; THEREFORE, NO SCHEDULE H IS REQUIRED. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 5200024 3833410 1366614 15540263 9962930 5577333 16171489 12434586 3736903 215937 215937 10896787 RIGHT OF USE OPERATING LEASE ASSET 28666496 OTHER CURRENT ASSETS 12838 28679334 INTERCOMPANY PAYABLES 480508789 LT PORTION OF OPERATING LEASE LIABILITY 27288712 CURRENT PORTION OF OPERATING LEASE LIABILITY 5507798 UNCLAIMED PROPERTY 60722 OTHER LIABILITIES 36458 PHYSICIAN RECRUIT AND GUARANTEE PAYABLE-ST 737025 514139504 X PART X, LINE 2: BAYLOR ST. LUKE'S MEDICAL GROUP'S FINANCIAL INFORMATION IS INCLUDED IN COMMONSPIRIT HEALTH'S CONSOLIDATED AUDITED FINANCIAL STATEMENTS, WHICH INCLUDES THE FOLLOWING DISCLOSURE: COMMONSPIRIT REVIEWS ITS TAX POSITIONS QUARTERLY AND HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. 1 THE HEART INSTITUTE OF EAST TEXAS 310 GASLIGHT BLVD LUFKIN TX 75904 751893084 15300 0 GENERAL SUPPORT 0 1 PART I, LINE 2: THE ORGANIZATION GRANTS FUNDS TO OTHER ORGANIZATIONS AND REQUIRES ALL GRANT RECIPIENTS TO MEASURE THEIR SUCCESS IN ATTAINING PROGRAM GOALS. 1 1 0 0 0 0 0 0 0 T DOUGLAS LAWSON PHD CEO OF CHI ST. LUKE'S HEALTH SYSTEM 0 1063853 0 998886 0 189701 0 187354 0 22479 0 2462273 0 165402 JOHN FLYNN MD CHAIR/SYS SVP PHYSICIAN ENTERPRISE 0 636709 0 150000 0 32327 0 0 0 27592 0 846628 0 0 LINDA KULHANEK CFO OF CHI ST. LUKE'S HEALTH SYSTEM 0 464144 0 72292 0 4062 0 18502 0 14576 0 573576 0 0 MARGARET ROPER DIV VP PHYSICIAN ENTERPRISE (TERMED 321966 0 50604 0 1672 0 16703 0 20170 0 411115 0 0 0 ROBERT BRANSTETTER TREASURER/VP FINANCE 291152 0 26163 0 8273 0 16779 0 20818 0 363185 0 0 0 DANIEL WATSON VP OPERATIONS (TERMED 4/5/23) 226279 0 20594 0 506 0 17112 0 32245 0 296736 0 0 0 SYED SULTAN DIRECTOR IMAGING OPERATIONS 195706 0 14173 0 855 0 13800 0 34341 0 258875 0 0 0 ORDIA HALLER DIRECTOR ACCOUNTING 0 140437 0 12831 0 1822 0 10320 0 13423 0 178833 0 0 ANGELA LINDER DIRECTOR PHYSICIAN PRACTICE 143807 0 8160 0 686 0 7758 0 10650 0 171061 0 0 0 MONICA MARTINEZ DIRECTOR PHYSICIAN PRACTICE (TERMED 87903 0 9082 0 55628 0 7152 0 9077 0 168842 0 0 0 PART I, LINE 3 DURING THE CALENDAR YEAR 2022, COMPENSATION FOR THE TOP MANAGEMENT OFFICIAL WAS ESTABLISHED AND PAID BY COMMONSPIRIT HEALTH, A RELATED ORGANIZATION. COMMONSPIRIT HEALTH USED THE FOLLOWING TO ESTABLISH THE TOP MANAGEMENT OFFICIAL'S COMPENSATION: (1) COMPENSATION COMMITTEE; (2) INDEPENDENT COMPENSATION CONSULTANT; (3) COMPENSATION SURVEY OR STUDY; (4) APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. PART I, LINE 4A: CERTAIN REPORTABLE INDIVIDUALS ARE COVERED BY AN EXECUTIVE SEVERANCE POLICY THAT PROVIDES MARKET-STANDARD COMPENSATION, RANGING FROM PAYMENTS OF 9 MONTHS TO 2 YEARS OF BASE COMPENSATION, DEPENDING ON THE EXECUTIVE'S POSITION, IN THE EVENT OF A POSITION ELIMINATION OR OTHER INVOLUNTARY TERMINATION, IN ACCORDANCE WITH THE GUIDELINES OF THE POLICY. CERTAIN REPORTABLE INDIVIDUALS ARE COVERED BY A NON-EXECUTIVE SEVERANCE POLICY THAT PROVIDES MARKET-STANDARD COMPENSATION, RANGING FROM PAYMENTS OF 2 WEEKS TO 52 WEEKS OF BASE COMPENSATION, DEPENDING ON THE EMPLOYEE'S POSITION AND TENURE, IN THE EVENT OF A POSITION ELIMINATION OR OTHER INVOLUNTARY TERMINATION, IN ACCORDANCE WITH THE GUIDELINES OF THE POLICY. THE FOLLOWING REPORTABLE INDIVIDUALS RECEIVED SEVERANCE PAYMENTS DURING THE 2022 CALENDAR YEAR, AND THESE SEVERANCE PAYMENTS WERE INCLUDED IN THE INDIVIDUALS' W-2 INCOME AND REPORTABLE COMPENSATION ON PART VII AND SCHEDULE J, PART II, COLUMN (B)(III): MONICA MARTINEZ, $55,538. PART I, LINE 4B: DURING THE 2022 CALENDAR YEAR, COMMONSPIRIT HEALTH ("COMMONSPIRIT") MAINTAINED A SUPPLEMENTAL NON-QUALIFIED DEFERRED COMPENSATION PLAN FOR DIVISION CEOS/PRESIDENTS AND OTHER DESIGNATED COMMONSPIRIT EXECUTIVES AT THE LEVEL OF SENIOR VICE PRESIDENT AND ABOVE. DURING 2022 THE FOLLOWING DISTRIBUTIONS WERE MADE BY COMMONSPIRIT FROM THE DEFERRED COMPENSATION PLAN: T. DOUGLAS LAWSON, $174,690. DUE TO THE "SUPER" VESTING RULES UNDER COMMONSPIRIT'S DEFERRED COMPENSATION PLAN, PARTICIPANTS WHO HAVE MET CERTAIN REQUIREMENTS SUCH AS INVOLUNTARY TERMINATION WITHOUT CAUSE, AGE, AGE AND YEARS OF SERVICE, OR MORE THAN 5 YEARS OF PLAN PARTICIPATION ARE ELIGIBLE TO RECEIVE THEIR 2022 CONTRIBUTIONS IN CASH. THESE CASH PAYOUTS ARE INCLUDED IN THE PARTICIPANT'S REPORTABLE COMPENSATION IN COLUMN (III) OTHER REPORTABLE COMPENSATION ON SCHEDULE J PART II. PART II: BAYLOR ST. LUKE'S MEDICAL GROUP FOLLOWS COMMONSPIRIT'S EXECUTIVE COMPENSATION PHILOSOPHY. COMMONSPIRIT'S EXECUTIVE COMPENSATION PHILOSOPHY IS DESIGNED TO ASSIST COMMONSPIRIT IN ATTRACTING AND RETAINING THE CALIBER OF EXECUTIVES REQUIRED TO ENABLE COMMONSPIRIT TO FULFILL ITS MISSION OF PROVIDING HIGH QUALITY HEALTHCARE FOR ALL PERSONS REGARDLESS OF THEIR ABILITY TO PAY FOR SERVICES, IMPROVING THE QUALITY OF LIFE IN THE COMMUNITIES COMMONSPIRIT SERVES, PROMOTING PATIENT AND EMPLOYEE SATISFACTION, AND ENSURING FINANCIAL STABILITY. A SUBSTANTIAL PORTION OF EXECUTIVE COMPENSATION IS PERFORMANCE BASED AND IS LINKED TO ORGANIZATIONAL GOALS APPROVED IN ADVANCE BY THE HUMAN RESOURCES AND COMPENSATION COMMITTEE. THESE GOALS INCLUDE ATTAINMENT OF ANNUAL AND LONG-TERM FINANCIAL PERFORMANCE, CERTAIN HEALTHCARE QUALITY STANDARDS AND COMMONSPIRIT'S COMMITMENT TO SERVING THE POOR AND DISENFRANCHISED IN THE COMMUNITIES IT SERVES. TOTAL COMPENSATION, WHICH INCLUDES BASE SALARY, ANNUAL, AND LONG-TERM INCENTIVE COMPENSATION, IS ESTABLISHED TO APPROXIMATE THE PREVAILING MARKET CONDITIONS FOR EXECUTIVES OF COMPANIES OF SIMILAR SIZE, REVENUES AND COMPLEXITY. PAYMENTS PURSUANT TO A LONG-TERM FINANCIAL PERFORMANCE GOAL WERE PAID IN CALENDAR YEAR 2022. FORM 990, PART V, LINE 1C: PAYMENTS TO VENDORS FOR ENTITIES THAT ARE PART OF COMMONSPIRIT HEALTH ARE MADE BY COMMONSPIRIT HEALTH. THEREFORE, NO FORMS 1099 ARE ISSUED BY BAYLOR ST. LUKE'S MEDICAL GROUP. COMMONSPIRIT HEALTH FILES THE FORMS 1099 AND COMPLIES WITH THE BACKUP WITHHOLDING RULES FOR REPORTABLE PAYMENTS TO VENDORS AND GAME WINNINGS. THE FORMS 1099 ISSUED ON BEHALF OF BAYLOR ST. LUKE'S MEDICAL GROUP ARE REPORTED TO THE IRS. FORM 990, PART VI, SECTION A, LINE 6 ACCORDING TO THE BYLAWS OF BAYLOR ST. LUKE'S MEDICAL GROUP, THE ENTITY'S SOLE MEMBER IS BAYLOR ST. LUKE'S HEALTH VENTURES, A TEXAS NONPROFIT CORPORATION. FORM 990, PART VI, SECTION A, LINE 7A ACCORDING TO THE ORGANIZATION'S BYLAWS, ALL DIRECTORS SHALL BE ELECTED BY THE SOLE MEMBER, BAYLOR ST. LUKE'S HEALTH VENTURES. FORM 990, PART VI, SECTION A, LINE 7B ACCORDING TO SEC. 5.4.1 OF THE BY-LAWS, THE CORPORATE MEMBER SHALL HAVE THE RIGHT TO APPROVE ANY OF THE ACTIONS SET FORTH BELOW: - ANY CHANGE IN THE MISSION OR PHILOSOPHY OF THE CORPORATION; - ANY AMENDMENT TO THE CERTIFICATE OF FORMATION; - THE REMOVAL, WITH OR WITHOUT CAUSE, OF ANY MEMBER OF THE BOARD OF DIRECTORS OF THE CORPORATION; - SUBJECT TO CONSULTATION WITH THE BOARD, THE INCURRENCE OF DEBT, INCLUDING WITHOUT LIMITATION, BORROWINGS, GUARANTEES, LOANS, ENCUMBRANCES, OPERATING LEASES, AND CAPITAL LEASES, IN EXCESS OF THRESHOLDS AND WITHIN THE LIMITS ESTABLISHED FROM TIME TO TIME BY THE CORPORATE MEMBER; - ANY JOINT VENTURE TO WHICH THE CORPORATION IS A PARTY; - THE CREATION OF A NEW CORPORATION, PARTNERSHIP OR LIMITED LIABILITY COMPANY BY THE CORPORATION; - ANY MERGER OR CONSOLIDATION TO WHICH THE CORPORATION IS A PARTY; - THE SALE OR DISPOSITION OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION; - THE ADOPTION OF LONG RANGE AND STRATEGIC PLANS; - SUBJECT TO CONSULTATION WITH THE BOARD, THE ADOPTION OF OPERATING AND CAPITAL BUDGETS AND AMENDMENTS THERETO; AND - SUBJECT TO CONSULTATION WITH THE BOARD, ANY VARIATIONS FROM PREVIOUSLY APPROVED OPERATING AND/OR CAPITAL BUDGETS, IN EXCESS OF THRESHOLDS ESTABLISHED BY THE CORPORATE MEMBER. FORM 990, PART VI, SECTION B, LINE 11B THE RETURN WAS MADE AVAILABLE TO THE OFFICERS AND DIRECTORS BEFORE FILING. SUBSEQUENT TO THE RETURN BEING PROVIDED TO THE BOARD, THE TAX DEPARTMENT FILES THE RETURN WITH THE APPROPRIATE FEDERAL AND STATE AGENCIES, MAKING ANY NON-SUBSTANTIVE CHANGES NECESSARY TO EFFECT E-FILING. ANY SUCH CHANGES ARE NOT RE-SUBMITTED TO THE BOARD. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION HAS A CONFLICTS OF INTEREST ("COI") POLICY (THE "POLICY") IN PLACE TO PROTECT THE INTERESTS OF COMMONSPIRIT HEALTH ("COMMONSPIRIT") IN CIRCUMSTANCES THAT MAY RESULT IN A CONFLICT BETWEEN PERSONAL INTERESTS OF A PERSON AND THE INTERESTS OF THE ORGANIZATION AND THOSE IT SERVES. COMMONSPIRIT'S COI POLICY APPLIES TO COMMONSPIRIT, ITS DIRECT AFFILIATES AND SUBSIDIARIES AND ANY RELATED ENTITY THE GOVERNING DOCUMENTS OF WHICH REQUIRE THE ENTITY TO COMPLY WITH COMMONSPIRIT POLICY (COLLECTIVELY THE "SYSTEM ENTITIES"). THE FOLLOWING PERSONS ARE REQUIRED TO DISCLOSE ACTUAL OR POTENTIAL CONFLICTS OF INTEREST AT LEAST ANNUALLY (VIA A FORMAL SYSTEM-ADMINISTERED SURVEY) IF THE PERSON'S AFFILIATION WITH COMMONSPIRIT CONTINUES: - MEMBERS OF CORPORATE AND COMMUNITY BOARDS OF SYSTEM ENTITIES - MEMBERS OF COMMITTEES OF CORPORATE AND COMMUNITY BOARDS OF SYSTEM ENTITIES - MEMBERS OF THE EXECUTIVE LEADERSHIP TEAM ("ELT") OF COMMONSPIRIT - CORPORATE OFFICERS OF SYSTEM ENTITIES - KEY EMPLOYEES AND HIGHEST COMPENSATED EMPLOYEES AS SPECIFIED BY THE INTERNAL REVENUE SERVICE FOR FORM 990 PURPOSES WHO ARE NOT OTHERWISE INCLUDED IN THE CATEGORIES ABOVE - EMPLOYEES OF SYSTEM ENTITIES AT THE VICE PRESIDENT LEVEL AND ABOVE - ALL INDIVIDUALS ENGAGED IN RESEARCH AT INSTITUTIONS OWNED OR OPERATED BY A SYSTEM ENTITY - SELECT EMPLOYEES AS DETERMINED FROM TIME TO TIME BY LEADERSHIP DISCLOSURE, REVIEW, AND MANAGEMENT OF PERCEIVED, POTENTIAL, OR ACTUAL CONFLICTS OF INTEREST ARE ACCOMPLISHED THROUGH A DEFINED COI DISCLOSURE REVIEW PROCESS. EACH PERSON IS REQUIRED TO PROMPTLY AND FULLY DISCLOSE ANY SITUATION OR CIRCUMSTANCE THAT MAY CREATE A CONFLICT OF INTEREST AS SOON AS SHE/HE BECOMES AWARE OF IT. IN ADDITION, AT THE INCEPTION OF AN INDIVIDUAL'S RELATIONSHIP WITH COMMONSPIRIT (E.G. HIRING, BOARD APPOINTMENT), AND FOR CERTAIN POSITIONS, ANNUALLY THEREAFTER, WRITTEN CONFLICT OF INTEREST DISCLOSURE FORMS MUST BE COMPLETED. A FAILURE TO DISCLOSE MAY RESULT IN DISCIPLINARY OR CORRECTIVE ACTIONS. REPORTED POTENTIAL OR ACTUAL CONFLICTS OF INTEREST ARE INITIALLY REVIEWED BY LEGAL, CORPORATE RESPONSIBILITY OR RESEARCH INTEGRITY STAFF. IF NECESSARY, A CONFLICT OF INTEREST MANAGEMENT PLAN IS DEVELOPED, WHICH PLAN SHALL BE SUBJECT TO ACCEPTANCE BY THE APPROPRIATE DIRECT MANAGER, SUPERVISOR, MEDICAL STAFF OFFICE, BOARD OR BOARD COMMITTEE (FOR BOARD, BOARD COMMITTEE, ELT OR CORPORATE OFFICER CONFLICTS), OR OTHER APPROPRIATE INDIVIDUAL OR BODY. ONCE ACCEPTED, THE CONFLICT OF INTEREST MANAGEMENT PLAN IS COMMUNICATED TO THE PERSON WITH THE ACTUAL OR POTENTIAL CONFLICT AND THE INDIVIDUAL MUST CONDUCT THEMSELVES IN CONFORMITY WITH THE PLAN. IN THE EVENT THAT A TRANSACTIONAL CONFLICT INTEREST ARISES IN CONNECTION WITH A SYSTEM ENTITY BOARD MEETING, THE CONFLICTED INDIVIDUAL MUST DISCLOSE THAT CONFLICT PRIOR TO OR AT THE BEGINNING OF THE MEETING IN WHICH THE MATTER IS TO BE CONSIDERED. THE CONFLICTED INDIVIDUAL IS EXCLUDED FROM VOTING ON THE TRANSACTION AND IS PROHIBITED FROM USING PERSONAL INFLUENCE WITH RESPECT TO THE MATTER, BUT IS NOT PROHIBITED FROM PROVIDING INPUT IF REQUESTED TO DO SO. FORM 990, PART VI, SECTION B, LINE 15B FOR LEADERSHIP POSITIONS WITH SUBSTANTIAL INFLUENCE (NOT INCLUDING THE PRESIDENT/CEO, WHO IS PAID BY A RELATED ORGANIZATION), COMPENSATION IS REVIEWED BY AN INDEPENDENT GROUP USING COMPARABILITY DATA AND RECOMMENDATIONS ARE PRESENTED TO THE ORGANIZATION'S EXECUTIVE COMMITTEE FOR APPROVAL OF BASE PAY INCREASES AND INCENTIVE ACHIEVEMENT. THE DOCUMENTATION OF THE DELIBERATIONS INCLUDES (A) THE TERMS OF THE AGREEMENT APPROVED AND THE DATE APPROVED; (B) THE MEMBERS OF THE COMMITTEE WHO WERE PRESENT DURING DISCUSSION OF THE APPROVED AGREEMENT AND THOSE WHO VOTED ON IT; AND (C) THE COMPARABILITY DATA OBTAINED AND RELIED UPON BY THE COMMITTEE AND HOW THE DATA WAS OBTAINED. COMPENSATION FOR OTHER OFFICERS (INCLUDING THE PRESIDENT/CEO) AND KEY EMPLOYEES OF THE ORGANIZATION IS ESTABLISHED BY COMMONSPIRIT HEALTH COMPENSATION USING EXTERNAL COMPENSATION SURVEYS OR STUDIES CONTAINING COMPARABLE DATA FOR SIMILARLY SITUATED ORGANIZATIONS, BOTH TAXABLE AND TAX EXEMPT FOR SIMILAR JOB RESPONSIBILITIES. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S FINANCIAL STATEMENTS, CONFLICT OF INTEREST POLICY AND GOVERNING DOCUMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. THE ORGANIZATION'S FINANCIAL STATEMENTS ARE INCLUDED IN COMMONSPIRIT HEALTH'S CONSOLIDATED AUDITED FINANCIAL STATEMENTS THAT ARE AVAILABLE AT WWW.COMMONSPIRIT.ORG. FORM 990, PART VI, LINE 14: WRITTEN DOCUMENT RETENTION AND DESTRUCTION POLICY: ST. LUKE'S 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 IX, LINE 11G OTHER FEES FOR SERVICES: PROGRAM SERVICE EXPENSES 86,473,307. MANAGEMENT AND GENERAL EXPENSES 6,551,784. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 93,025,091. CONTRACT SERVICES: PROGRAM SERVICE EXPENSES 501,784. MANAGEMENT AND GENERAL EXPENSES 37,769. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 539,553. CONTRACT LABOR: PROGRAM SERVICE EXPENSES 733,257. MANAGEMENT AND GENERAL EXPENSES 55,191. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 788,448. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 17,639,648. MANAGEMENT AND GENERAL EXPENSES 1,327,715. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 18,967,363. FORM 990, PART XI, LINE 9: TRANSFER TO RELATED EXEMPT ORGANIZATION, ST. LUKE'S HEALTH SYSTEM CORP -140,280. ALEGENT CREIGHTON CLINIC 12809 W DODGE RD OMAHA NE 68154 470765154 HOSPITAL NE 501(C)(3) LINE 3 ACH 0 ALEGENT CREIGHTON HEALTH 12809 W DODGE RD OMAHA NE 68154 470757164 HOSPITAL NE 501(C)(3) LINE 3 CHI NEBRASKA 0 ALEGENT HEALTH - BERGAN MERCY HEALTH SYSTEM 7500 MERCY RD OMAHA NE 68124 470484764 HOSPITAL NE 501(C)(3) LINE 3 CHI NEBRASKA 0 ALEGENT HEALTH - COMM MEM HOSPITAL OF MO VALLEY IA 631 N 8TH ST MISSOURI VALLEY IA 51555 420776568 HOSPITAL IA 501(C)(3) LINE 3 CHI NEBRASKA 0 ALEGENT HEALTH - IMMANUEL MEDICAL CENTER 6901 N 72ND ST OMAHA NE 68122 470376615 HOSPITAL NE 501(C)(3) LINE 3 CHI NEBRASKA 0 ALEGENT HEALTH - MEMORIAL HOSPITAL SCHUYLER 104 W 17TH ST SCHUYLER NE 68661 470399853 HOSPITAL NE 501(C)(3) LINE 3 CHI NEBRASKA 0 ALEGENT HEALTH - MERCY HOSPITAL CORNING IOWA PO BOX 368 CORNING IA 50841 420782518 HOSPITAL IA 501(C)(3) LINE 3 CHI NEBRASKA 0 ALVERNA APARTMENTS 300 SE 8TH AVE LITTLE FALLS MN 56345 411351177 LTERM CARE MN 501(C)(3) LINE 10 CSH 0 APPLETREE COURT 601 OAK ST BRECKENRIDGE MN 56520 411850500 SENIOR LIVING MN 501(C)(3) LINE 10 SFH 0 ARROYO GRANDE COMMUNITY HOSPITAL FOUNDATION 345 S HALCYON RD ARROYO GRANDE CA 93420 203256066 FUNDRAISING FOUNDATION CA 501(C)(3) LINE 12A, I DH 0 BAKERSFIELD MEMORIAL HOSPITAL 420 34TH STREET BAKERSFIELD CA 93301 951802779 HOSPITAL CA 501(C)(3) LINE 3 DCC 0 BARROW NEUROLOGICAL FOUNDATION 350 WEST THOMAS ROAD PHOENIX AZ 85013 860174371 FUNDRAISING FOUNDATION AZ 501(C)(3) LINE 7 DH 0 BAYLOR ST LUKE'S HEALTH VENTURES 17200 ST LUKES WAY STE 170 THE WOODLANDS TX 77384 274499340 PHYSICIANS TX 501(C)(3) LINE 12A, I SLHS 0 BAYLOR ST LUKE'S MEDICAL GROUP 6624 FANNIN ST STE 1100 HOUSTON TX 77030 760458535 PHYSICIANS TX 501(C)(3) LINE 3 BSLHV 0 BORNEMANN HEALTHCARE CORPORATION 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 232187242 INACTIVE PA 501(C)(3) LINE 12A, I CSH 0 BRAZOSPORT HEALTH FOUNDATION INC 100 MEDICAL DRIVE LAKE JACKSON TX 77566 760080110 FUNDRAISING FOUNDATION TX 501(C)(3) LINE 12A, I TCHB 0 BRAZOSPORT REGIONAL 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