4A (Expenses $ 226935964 including grants of $ 24229816) (Revenue $ 244841935)
SAINT LUKE'S SOUTH HOSPITAL (SLS) IS A FAITH-BASED, NOT-FOR-PROFIT, COMMUNITY HOSPITAL CURRENTLY LICENSED TO OPERATE 203 BEDS AND IS DEDICATED TO PROVIDING BOTH SERVICES AND LEADERSHIP IN CARING FOR ITS COMMUNITY. ALL PROGRAM SERVICE EXPENSES WERE INCURRED IN FURTHERANCE OF OUR MISSION, WHICH IS TO ENSURE THE HIGHEST LEVELS OF EXCELLENCE IN PROVIDING HEALTH RELATED SERVICES TO OUR PATIENTS IN A CARING ENVIRONMENT AND ENHANCING THE PHYSICAL, MENTAL AND SPIRITUAL HEALTH OF THE COMMUNITIES WE SERVE. IN 2021, THERE WERE 37,700 PATIENT DAYS INCLUDING 840 NEWBORN DAYS. IN ADDITION, THE HOSPITAL PROVIDED 55,000 EMERGENCY ROOM VISITS AND 75,200 OUTPATIENT VISITS AND OUTPATIENT SURGERIES. EMERGENCY SERVICES ARE PROVIDED 24 HOURS A DAY, 7 DAYS A WEEK AND ARE STAFFED BY BOARD-CERTIFIED EMERGENCY PHYSICIANS. THE HOSPITAL PARTICIPATES IN THE MEDICAID AND MEDICARE PROGRAMS AND HAS FINANCIAL ASSISTANCE POLICIES FOR PEOPLE WITHOUT ADEQUATE MEANS TO PAY FOR THEIR CARE. The hospital collaborated with other Saint Luke's Health System entities, the Missouri and Kansas Hospital Associations, and Mid-America Regional council to implement initiatives for establishing COVID testing sites, vaccine distribution, expanding virtual visits, and post-discharge follow-up for COVID-19 patients in addition to expanding coverage for the increase in hospitalized patients. The health system realigned its care and services to continue to treat and care for COVID-19 patients while protecting its employees.

Schedule H, Part V, Section B, Line 5 Facility , 1
Facility , 1 - SAINT LUKES SOUTH HOSPITAL. Input from persons representing the broad interests of the community was taken into account through key informant interviews (16 interviews) and community meetings (85 participants). Stakeholders included: individuals with special knowledge of or expertise in public health; local public health departments; hospital staff and providers; representatives of social service organizations; and leaders, representatives, and members of medically underserved, low-income, and minority populations. Individuals from the following organizations were interviewed: Boys & Girls Club of Greater Kansas City, Crittenton Children's Center, Harvesters - The Community Food Network, Johnson County Department of Health and Environment, Saint Luke's Health System, Saint Luke's Hospital of Kansas City, Saint Luke's Physician Group, Saint Luke's South Hospital, Samuel U. Rodgers Health Center, and United Community Services of Johnson County.

Schedule H, Part V, Section B, Line 11 Facility , 1
Facility , 1 - SAINT LUKES SOUTH HOSPITAL. The hospital's CHNA identified the following significant health needs in the three-county community assessed by SLS: * Access to care To address this need, SLS will implement the following initiatives: 1. Support SLHS initiatives to expand access for Medicaid recipients to Convenient Care Clinics. 2. Support initiatives to provide access to the SLHS Financial Assistance Policy at Convenient Care Clinics. 3. Support SLHS initiatives to expand access to Telehealth services for residents of Jackson, Wyandotte, and Johnson counties. 4. Continue providing taxicab and Uber/Lyft vouchers for low-income patients who need transportation post-discharge. 5. Continue providing Telehealth services for victims of domestic violence at the Safehome Shelter. 6. Support SLHS advocacy efforts to expand Medicaid eligibility in Kansas. 7. Evaluate opportunity to develop and implement a community education program regarding Medicaid enrollment. 8. Identify and enroll Medicaid-eligible individuals during hospital episodes of care (use Humanarc). 9. Continue providing case management for high-utilizer and vulnerable patients with referrals to health care and social services. 10. Continue providing access to the SLS Medication Assistance Access Program for patients who are underinsured and/or uninsured. 11. Continue providing Allied Health Professions training programs which contribute to the supply of health professionals across the region. 12. Support SLHS and SLPG initiatives to recruit new mental health professionals, including psychiatrists and social workers that represent under-represented racial and ethnic cohorts. 13. Evaluate the opportunity to expand behavioral health services for SLS employees and their families. 14. Continue participating in SLHS (and Saint Luke's Physician Group) initiatives to recruit other providers that represent under-represented racial and ethnic cohorts. 15. Continue collaborations between SLS and Federally Qualified Health Centers that serve Johnson County. 16. Continue providing on-site access to a MedSafe box where community members can appropriately dispose of unused prescription medications. 17. Continue supporting the PATH Fund at Saint Luke's Rehabilitation Institute which provides Durable Medical Equipment (DME) and limited outpatient therapy for uninsured and Medicaid patients. 18. Continue supporting the Compassionate Care Fund that supports access to medications and health care services for those adversely impacted by health disparities and social determinants of health. * Needs of growing senior population To address this need, SLS will implement the following initiatives: 1. Implement (as an early adopter) the Saint Luke's At Home program which provides medical care to homebound patients aged 65 years and older. 2. Continue providing outreach services and health screenings for low-income and disabled seniors living in identified buildings and communities. 3. Continue providing free out-bound transportation for seniors. 4. Continue providing free community health education programs/seminars on topics about aging, grandparenting, and managing chronic diseases. 5. Continue helping patients apply for Medicare, Medicaid, and insurance benefits to support needed medical and home-based services. 6. Continue providing psychosocial evaluations/screenings to patients who present certain risk factors for mental health issues. 7. Expand the Meds to Beds program, which provides patients with access to medications prior to discharge. * Poverty and social determinants of health To address this need, SLS will implement the following initiatives: 1. Participate in SLHS Anchor Institution strategies to be included in the SLHS Destination 2025 Strategic Plan: a. Expand hiring programs that build pipelines for people of color and local hiring and workforce development programs. b. Hold on-site (and participate in off-site) job fairs. 2. Expand programs to interest (and begin to train) high-school aged students in the health professions. 3. Continue offering the Saint Luke's Community Resource Hub to expand patient, employee, and community awareness of available health and social services. 4. Continue screening all patients for social determinants of health issues. a. Document needs in EPIC based on Health Leads screening toolkit. b. Place consults in Care Progression for interventions. c. Refer patients to information available on the Saint Luke's Community Resource Hub. 5. Identify a strategy to address food insecurity. 6. Implement a base wage of $15 per hour for SLHS employees. * Unhealthy behaviors To address this need, SLS will implement the following initiatives: 1. Continue providing inpatient assessments for tobacco and alcohol and make referrals to resources for patients who are in need of services. 2. Continue providing support groups for patients with chronic diseases (e.g., diabetes, cancer, heart disease, obesity/overweight, and others) that focus on managing conditions and prevention. 3. Continue providing stroke-related community health education and virtual support groups. 4. Continue expanding and exploring partnerships with local and statewide advocacy coalitions and initiatives to promote healthy eating and food security. 5. Continue partnerships with local and state governments on healthy trails and sidewalk initiatives and expand its Walk with Ease program. 6. Continue providing the virtual weight management program. 7. Explore the opportunity to collaborate with school and community centers to provide education seminars on the appropriate use of alcohol and the risks associated with abuse. 8. Explore the opportunity to participate in ad campaigns (community health education) to promote safe drinking (partnership with law enforcement and hospital partners and local public health departments). 9. Advocate for Tobacco 21 to be implemented on a state-wide basis and for initiatives focused on reducing vaping. No hospital organization can address all of the health needs present in its community. SLS is committed to serving the community by adhering to its mission, using its skills and capabilities, and remaining a strong organization so that it can continue to provide a wide range of community benefits. SLS does not intend to address two of the seven significant community health needs identified through its 2020 CHNA, as follows: 1) COVID-19 pandemic and effects. SLS recognizes the significant challenges of the COVID-19 pandemic and its effects. SLS addresses the needs of COVID-19 patients by providing access to care. The hospital also supports community-focused SLHS initiatives in the Kansas City region. 2) Mental and behavioral health. While the hospital's 2020 CHNA identified Mental and Behavioral health as a significant community health need, SLS does not provide psychiatric or behavioral health care and thus does not have the expertise or dedicated resources to address this need. The committee charged with developing the 2021-2023 SLS Implementation Strategy identified five other needs as higher priorities.

Schedule H, Part I, Line 7 OTHER COMMUNITY BENEFITS
OUR HOSPITAL SPONSORS OR PROVIDES MANY COMMUNITY BUILDING ACTIVITIES WHICH PROMOTE THE HEALTH OF OUR COMMUNITY. THE HOSPITAL PARTICIPATES IN EDUCATIONAL OFFERINGS FOR THE COMMUNITY. THE HOSPITAL PROVIDES FINANCIAL SUPPORT TO THE HEALTH PARTNERSHIP CLINIC OF JOHNSON COUNTY WHICH PROVIDES SERVICES TO MEDICAID PATIENTS AND FREE MEDICAL AND DENTAL CARE TO LOW INCOME UNINSURED PATIENTS. THE HOSPITAL PARTICIPATES WITH WY-JO CARE PROVIDING CHARITY CARE FOR LOW-INCOME, UNINSURED RESIDENTS OF JOHNSON AND WYANDOTTE COUNTIES. THE HOSPITAL SUPPORTS MULTIPLE COMMUNITY EVENTS TO BENEFIT VARIOUS COMMUNITY ORGANIZATIONS. IN ADDITION, THE HOSPITAL PARTICIPATES IN CAREER SHADOWING, IS INVOLVED IN THE CENTER FOR ADVANCED PROFESSIONAL STUDIES (CAPS PROGRAM) FOR HIGH SCHOOL STUDENTS, AND PROVIDES STAFF FOR VARIOUS PRESENTATIONS AND EDUCATION OPPORTUNITIES FOR OUR COMMUNITY. WE ENCOURAGE OUR EMPLOYEES TO SERVE ON COMMUNITY BOARDS AND VOLUNTEER FOR ACTIVITIES THAT PROMOTE HEALTH IN THE COMMUNITY.

Schedule H, Part I, Line 7g Subsidized Health Services
COST OF CHARITY CARE AND UNREIMBURSED HEALTH SERVICES WAS CALCULATED USING THE APPROPRIATE COST TO CHARGE RATIO FROM THE ORGANIZATION'S MEDICARE COST REPORT.

Schedule H, Part I, Line 7 Bad Debt Expense excluded from financial assistance calculation
22558159

Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount
FINANCIAL STATEMENT FOOTNOTE REGARDING BAD DEBT EXPENSE: Performance obligations are identified based on the nature of the services provided. Revenue associated with performance obligations satisfied over time is recognized based on actual charges incurred in relation to total expected (or actual) charges. Performance obligations satisfied over time relate to patients receiving inpatient acute care services. The System measures the performance obligation from admission into the hospital to the point when there are no further services required for the patient, which is generally the time of discharge. For outpatient services, the performance obligation is satisfied as the patient simultaneously receives and consumes the benefits provided as the services are performed. In the case of these outpatient services, recognition of the obligation over time yields the same result as recognizing the obligation at a point in time. Management believes this method provides a faithful depiction of the transfer of services over the term of performance obligations based on the inputs needed to satisfy the obligations. As the System's performance obligations relate to contracts with a duration of less than one year, the System has applied the optional exemption provided in the guidance and, therefore, is not required to disclose the aggregate amount of the transaction price allocated to performance obligations that are unsatisfied or partially unsatisfied at the end of the reporting period. The unsatisfied or partially unsatisfied performance obligations referred to above are primarily related to inpatient acute care services at the end of the reporting period. The performance obligations for these contracts are generally completed when the patients are discharged, which generally occurs within days or weeks of the end of the reporting period. The System uses a portfolio approach to account for categories of patient contracts as a collective group rather than recognizing revenue on an individual contract basis. The portfolios consist of major payor classes for inpatient revenue and major payor classes and types of services provided for outpatient revenue. Based on the historical collection trends and other analyzes, the System believes that revenue recognized by utilizing the portfolio approach approximates the revenue that would have been recognized if an individual contract approach were used. The System determines the transaction price, which involves significant estimates and judgment, based on standard charges for goods and services provided, reduced by explicit and implicit price concessions, including contractual adjustments provided to third-party payors, discounts provided to uninsured and underinsured patients in accordance with policy and/or implicit price concessions based on the historical collection experience of patient accounts. The System determines the transaction price associated with services provided to patients who have third-party payor coverage based on reimbursement terms per contractual agreements, discount policies and historical experience. For uninsured patients who do not qualify for charity care, the System determines the transaction price associated with services on the basis of charges, reduced by implicit price concessions. Implicit price concessions included in the estimate of the transaction price are based on historical collection experience for applicable patient portfolios. Patients who meet the System's criteria for charity care are provided care without charge; such amounts are not reported as revenue. Subsequent changes to the estimate of the transaction price are generally recorded as adjustments to patient service revenue in the period of the change. PATIENT RELATED BAD DEBT IS REPORTED CONSISTENT WITH THE FINANCIAL STATEMENTS.

Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote
SEE FOOTNOTE PROVIDED ABOVE IN THE EXPLANATION FOR PART III, LINE 2

Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance
THE DEBT COLLECTION POLICY AND PROCEDURES PROHIBIT ANY COLLECTION EFFORTS FOR THE PORTION OF THE PATIENT ACCOUNT BALANCE THAT QUALIFIES FOR FINANCIAL ASSISTANCE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. FOR ANY REMAINING BALANCES DUE, THE SAME COLLECTION POLICY AND PROCEDURES ARE APPLIED EQUALLY TO ALL PATIENT TYPES. ALTHOUGH WE ARE NOT LEGALLY BOUND BY THE FAIR DEBT COLLECTION PRACTICES ACT, THE PRINCIPLES ADDRESSED ARE GENERALLY FOLLOWED.

Schedule H, Part V, Section B, Line 16a FAP website
- SAINT LUKE'S SOUTH HOSPITAL: Line 16a URL: www.saintlukeskc.org/financial-assistance;

Schedule H, Part V, Section B, Line 16b FAP Application website
- SAINT LUKE'S SOUTH HOSPITAL: Line 16b URL: www.saintlukeskc.org/financial-assistance;

Schedule H, Part V, Section B, Line 16c FAP plain language summary website
- SAINT LUKE'S SOUTH HOSPITAL: Line 16c URL: www.saintlukeskc.org/financial-assistance;

Schedule H, Part VI, Line 4 Community information
SAINT LUKE'S SOUTH IS LOCATED IN SUBURBAN JOHNSON COUNTY, KANSAS WHICH IS PART OF THE LARGER KANSAS CITY METROPOLITAN AREA. THE HOSPITAL'S PRIMARY SERVICE AREA HAS HISTORICALLY BEEN HIGHLY POPULATED WITH COLLEGE EDUCATED, INSURED INDIVIDUALS.

Schedule H, Part VI, Line 5 Promotion of community health
THE BOARD OF DIRECTORS IS MADE UP OF MEDICAL AND BUSINESS PROFESSIONALS, ALL OF WHOM RESIDE IN THE HOSPITAL'S PRIMARY SERVICE AREA. MEDICAL STAFF PRIVILEGES ARE OFFERED TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY.

Schedule H, Part VI, Line 6 Affiliated health care system
THE HOSPITAL IS AFFILIATED WITH SAINT LUKE'S HEALTH SYSTEM, WHICH CONSIST OF 16 AREA HOSPITAL FACILITIES, AND SEVERAL PRIMARY AND SPECIALTY CARE PRACTICES, AND PROVIDES A RANGE OF INPATIENT, OUTPATIENT, AND HOME CARE SERVICES. FOUNDED AS A FAITH-BASED, NOT-FOR-PROFIT ORGANIZATION, OUR MISSION INCLUDES A COMMITMENT TO THE HIGHEST LEVELS OF EXCELLENCE IN HEALTH CARE AND THE ADVANCEMENT OF MEDICAL RESEARCH AND EDUCATION. THE HEALTH SYSTEM IS AN ALIGNED ORGANIZATION IN WHICH THE PHYSICIANS AND HOSPITALS ASSUME RESPONSIBILITY FOR ENHANCING THE PHYSICAL, MENTAL AND SPIRITUAL HEALTH OF PEOPLE IN THE METROPOLITAN KANSAS CITY AREA AND THE SURROUNDING REGION.

Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs
MEDICARE ALLOWABLE COSTS WERE CALCULATED USING A COST-TO-CHARGE RATIO DIRECTLY FROM THE MEDICARE COST REPORT. SHORTFALLS ARISE FROM PAYMENTS THAT ARE LESS THAN WHAT IT COSTS TO PROVIDE THE CARE AND SERVICES. WE ACCEPT ALL MEDICARE PATIENTS KNOWING THE COST OF PROVIDING THE CARE MAY EXCEED THE FUNDS WE RECEIVE FROM MEDICARE FOR THE SERVICE. OUR SHORTFALL IS CONSIDERED TO BE COMMUNITY BENEFIT. MEDICARE SHORTFALLS MUST BE ABSORBED BY THE HOSPITAL IN ORDER TO CONTINUE TREATING THE ELDERLY IN OUR COMMUNITY. ADDITIONALLY, IT IS IMPLIED IN INTERNAL REVENUE SERVICE REVENUE RULING 69-545 THAT TREATING MEDICARE PATIENTS IS A COMMUNITY BENEFIT. REVENUE RULING 69-545, WHICH ESTABLISHED THE COMMUNITY BENEFIT STANDARD FOR TAX-EXEMPT HOSPITALS, INDICATES THAT PARTICIPATION IN PUBLICLY-FINANCED PROGRAMS, SUCH AS MEDICARE, IS EVIDENCE THAT A HOSPITAL MEETS THE COMMUNITY BENEFIT STANDARD.

Schedule H, Part VI, Line 2 Needs assessment
AN EFFORT TO UNDERSTAND AND CREATE A HEALTHIER COMMUNITY REQUIRES COLLABORATION AND INPUT FROM MANY COMMUNITY STAKEHOLDERS. THROUGH DATA RESEARCH AND KEY CONVERSATIONS IN THE KANSAS CITY COMMUNITY, THIS CHNA PULLS TOGETHER COMMUNITY FINDINGS AND ADDRESSES TOP HEALTH PRIORITIES TO HELP IMPROVE COMMUNITY HEALTH OVER THE NEXT THREE YEARS. SAINT LUKE'S HOSPITAL ALSO ASSESSES COMMUNITY NEEDS ON AN ANNUAL BASIS IN NUMEROUS WAYS, INCLUDING THROUGH ITS COMPREHENSIVE, DATA DRIVEN, AND ANNUAL STRATEGIC PLANNING PROCESS. THE HOSPITAL OBTAINS HIDI MARKET DATA AND OTHER OUTPATIENT MARKET DATA THROUGH ITS ANNUAL ENVIRONMENTAL ASSESSMENT PROCESS. WITH THIS DATA, THE HOSPITAL IDENTIFIES SERVICES RECEIVED BY THE RESIDENTS OF OUR COMMUNITY (DEFINED BY OUR PRIMARY AND SECONDARY SERVICE AREAS). ANY PREDOMINANT SERVICES NOT CURRENTLY OFFERED BY THE HOSPITAL ARE CONSIDERED DURING STRATEGIC PLANNING. ANOTHER ELEMENT OF THE COMMUNITY NEEDS ASSESSMENT INVOLVES ANNUALLY UPDATING SAINT LUKE'S HOSPITAL'S MEDICAL STAFF DEVELOPMENT PLAN. AS A TERTIARY AND QUATERNARY HEALTHCARE PROVIDER, IT IS CRITICAL THAT THE HOSPITAL ENSURES IT HAS APPROPRIATE MEDICAL STAFF LEVELS IN A VARIETY OF MEDICAL SPECIALTIES AND SUBSPECIALTIES TO SERVE THE PATIENTS IN OUR COMMUNITY. THE HOSPITAL PARTNERS WITH ITS MEDICAL STAFF IN THIS ENDEAVOR. ANOTHER ASPECT OF THE HOSPITAL'S COMMUNITY NEEDS ASSESSMENT IS AN ANALYSIS OF WORKFORCE PLANNING TO ENSURE ADEQUATE CLINICAL AND OTHER PROFESSIONAL STAFF TO PROVIDE NEEDED HEALTHCARE SERVICES THROUGHOUT THE COMMUNITY. THE HOSPITAL AND RELATED HEALTH SYSTEM ARE ACTIVELY ENGAGED IN A VARIETY OF FORMAL HEALTH PROFESSIONALS EDUCATION PROGRAMS.

Schedule H, Part VI, Line 3 Patient education of eligibility for assistance
THE HOSPITAL FOLLOWS THE SAINT LUKE'S HEALTH SYSTEM POLICIES FOR FINANCIAL ASSISTANCE, PATIENT BILLING AND COLLECTION. IN ADDITION TO THESE POLICIES, THE HOSPITAL PROVIDES EDUCATION ON FINANCIAL ASSISTANCE ELIGIBILITY TO PATIENTS AND PERSONS WHO MAY BE BILLED FOR SERVICES THROUGH MANY SOURCES INCLUDING THE SLHS WEBSITE, INFORMATION ON BILLING STATEMENTS, INFORMATION UPON CHECK-IN LOCATED IN THE ADMITTING PATIENT PACKETS, ON OUR B-131 RELEASE TO TREAT FORMS SIGNED BY ALL PATIENTS REQUESTING SERVICES, VISITS WITH INPATIENTS BY SOCIAL WORKER TEAMS, AND FOLLOW-UP CALLS TO PATIENTS AFTER DISCHARGE. FINANCIAL ASSISTANCE APPLICATIONS OR MEDICAID APPLICATIONS ARE REQUESTED ON ALL UNINSURED INPATIENTS PRIOR TO DISCHARGE. THE HOSPITAL ALSO CONTRACTS WITH ELIGIBILITY ENROLLMENT COMPANIES TO SCREEN ALL UNINSURED PATIENTS, ANY PATIENTS IDENTIFIED BY OUR SOCIAL WORKER OR CASE MANAGEMENT TEAMS, AND ALL PATIENTS THAT REQUEST ASSISTANCE IN APPLYING FOR MEDICAID OR OTHER GOVERNMENT COVERAGE. THE ELIGIBILITY ENROLLMENT SERVICE ALSO PROVIDES PATIENTS WITH INFORMATION ON FINANCIAL ASSISTANCE.