4A (Expenses $ 873124807 including grants of $ 97187602) (Revenue $ 1003264721)
HOSPITAL CARE: ALL PROGRAM SERVICE EXPENSES WERE INCURRED IN FURTHERANCE OF OUR MISSION, WHICH IS TO ENSURE THE HIGHEST LEVELS OF EXCELLENCE IN PROVIDING HEALTH CARE SERVICES TO ALL PATIENTS IN A CARING ENVIRONMENT. SAINT LUKE'S HOSPITAL IS A FULL-SERVICE HEALTH CARE FACILITY FEATURING AWARD-WINNING HEART SURGERY, NATIONALLY RECOGNIZED TRANSPLANT PROGRAMS, A STATE-OF-THE-ART WOMEN'S HEALTH CENTER, TRAUMA SERVICES, ADOLESCENT AND FAMILY MENTAL HEALTH TREATMENT SERVICES, AND MORE. THE HOSPITAL PARTICIPATES IN THE MEDICAID AND MEDICARE PROGRAMS AND HAS A FINANCIAL ASSISTANCE POLICY FOR ASSISTING PEOPLE WITHOUT ADEQUATE MEANS TO PAY FOR THEIR CARE. THE HOSPITAL HAS OVER 500 ACTIVE PHYSICIANS AND CONTINUES TO ADVANCE TREATMENT OPTIONS THROUGH LANDMARK RESEARCH STUDIES. RESEARCH, EDUCATION, AND TEACHING: IN ADDITION TO THE SUBSTANTIAL AMOUNT OF FREE CARE PROVIDED, SAINT LUKE'S HOSPITAL HAS MADE A MAJOR COMMITMENT TO MEDICAL AND NURSING EDUCATION. THIS INCLUDES THE SIGNIFICANT FUNDING REQUIREMENTS TO MAINTAIN AN ACCREDITED TEACHING AFFILIATION AND PROVIDE FOR THE TRAINING OF RESIDENTS IN VARIOUS MEDICAL SPECIALTIES OR SUB-SPECIALTIES. SAINT LUKE'S HOSPITAL ALSO PROVIDES TRAINING PROGRAMS FOR MEDICAL IMAGING, CHAPLAINS, PATIENT CARE TECHNICIANS AND PHLEBOTOMY. SAINT LUKE'S HOSPITAL IS ALSO ACCREDITED TO OFFER CONTINUING MEDICAL EDUCATION PROGRAMS FOR PRACTICING PHYSICIANS. SAINT LUKE'S HOSPITAL IS CONCERNED ABOUT THE LONG-TERM WELFARE OF THE COMMUNITY AND MAKES AN ADDITIONAL INVESTMENT IN THE FUTURE OF HEALTH CARE THROUGH RESEARCH ACTIVITIES. 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 - ST LUKE'S HOSPITAL OF KANSAS CITY. Primary data were gathered through key stakeholder interviews and online meetings. Six community meetings were conducted: one in each county and one focused on the Kansas City region. Another meeting was held with Saint Luke's Hospital of Kansas City (""SLH"")staff members. Interviews were conducted by phone and meetings were conducted by online video conferences. Twenty-six (26) interviews were conducted with 28 stakeholders participating to learn about community health issues in the SLH community. Participants included individuals representing public health departments, social service organizations, community health centers, and similar organizations. Questions focused first on identifying and discussing health issues in the community before theCOVID-19 pandemic began. Interviews then focused on the pandemic's impacts and on what has been learned about the community's health given those impacts. Stakeholders also were asked to describe the types of initiatives, programs, and investments that should be implemented to address the community's health issues and to be better prepared for future risks. Eighty-five (85) stakeholders participated in the six community meetings. These individuals represented organizations such as local health departments, non-profit organizations, local businesses, health care providers, local policymakers, and school systems. Seventy-nine (79) Saint Luke's Health System staff participated in the internal meetings. Individuals from administration, nursing, case management, social services, emergency departments, and other similar departments participated. Each meeting began with a presentation that discussed the goals and status of the CHNA process and the purpose of the community meetings. Then, secondary data were presented, along with a summary of the most unfavorable community health indicators. Meeting participants then were asked to discuss whether the identified, unfavorable indicators accurately identified the most significant community health issues and were encouraged to add issues that they believed were significant. After discussing the needs identified through secondary data and adding others to the list, participants in each meeting were asked through an online survey process to identify ""three to five"" they consider to be most significant."

Schedule H, Part V, Section B, Line 11 Facility , 1
"Facility , 1 - ST LUKE'S HOSPITAL OF KANSAS CITY. THE COMMUNITY HEALTH NEEDS ASSESSMENT IDENTIFIED FIVE PRIORITY HEALTH NEEDS: ACCESS TO CARE To address this need, SLH will implement the following initiatives: 1. Support SLHS initiatives to expand access for Medicaid recipients to Convenient Care Clinics. 2. Support SLHS initiatives to extend the Financial Assistance Policy to Convenient Care Clinics. 3. Support SLHS strategy to expand availability of Telehealth services across the Kansas City region. 4. Continue providing Telehealth services to victims of domestic violence at the Safehome Shelter. 5. Support SLHS advocacy efforts to assure successful implementation of Medicaid expansion in Missouri in advance of July 1, 2021. 6. Support SLHS advocacy efforts to expand Medicaid eligibility in Kansas. 7. Evaluate opportunity to provide community education regarding Medicaid enrollment. 8. Help community residents enroll in Medicaid 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 education and training for the community and for health care through Advanced Comprehensive Stroke community education, Fifth grade stroke education program, advanced stroke life support and other community based health education & support groups. 11. Continue the hospital's Medication Assistance Access Program for patients who are underinsured and/or uninsured. 12. Continue providing taxicab and Uber/Lyft vouchers for low-income patients who need transportation post-discharge. 13. Continue providing Graduate Medical Education (GME) and Allied Health Professions training programs which contribute to the supply of health professionals across the region. 14. Continue operating the SLH Internal Medicine Clinic as a health professions training site that enhances access to care for Medicaid, Medicare, and other patients. 15. Continue active efforts to recruit mental health professionals, including psychiatrists and social workers. 16. Continue offering Care Connection Team services that connect under-resourced patients to social and medical services post-discharge. 17. Continue participation in SLHS (and Saint Luke's Physician Group) initiatives to recruit providers that represent under-represented racial and ethnic cohorts. 18. Continue collaborations with Kansas City-area Federally Qualified Health Centers, including the Care Coordination collaboration between SLHS and KC Care Health Center that places a 0.5 FTE Community Health Worker in the Emergency Department. COVID-19 PANDEMIC To address this need, SLH will implement the following initiatives: 1. Work with the Missouri Hospital Association and the Kansas Hospital Association on COVID-19 vaccination distribution plans. 2. Continue operating COVID-19 testing at SLH and expanding testing at community sites. 3. Continue conducting post-discharge follow-up with COVID-19 patients (care coordinator contacts SLPG patients; non-SLPG patients are contacted by a care coordinator or social worker on days 1, 3, 7, and 10). 4. Participate in Mid-America Regional Council (MARC) COVID-19 initiatives. 5. Continue developing and utilizing the ""COVID-19 Care-Companion Platform."" 6. Continue providing COVID-19 information on the Saint Luke's Community Resource Hub. MATERNAL AND CHILD HEALTH To address this need, SLH will undertake the following program initiatives: 1. Continue operating the SLH OBGYN Clinic as a health professions training site that enhances access to care for Medicaid, Medicare, and other patients 2. Continue supporting members of the SLH Medical Staff as they participate in regional, state-wide, and national quality-related and community health improvement activities. 3. Continue providing Missouri Show-Me 5 evidence-based maternity care practices shown to support breastfeeding initiation and duration; seek formal designation (certification) for the program in 2021. 4. Continue implementing a Centering Pregnancy Program (a care model that provides pregnancy and birth education in a group setting) once group meetings (suspended due to the pandemic) can be resumed. 5. Continue providing maternal and child health patients with access to Social Workers and with referrals to wrap-around services (mental health, nutrition, other). 6. Develop a collaborative strategy for enhancing access to prenatal care for Black and other mothers and for addressing above average teen pregnancy rates. 7. Expand Crittenton's partnership with Sesame Street in Communities to include SLH mothers and babies. 8. Continue involving Rose Brooks Center social worker(s) in maternal and child health community health programs. MENTAL AND BEHAVIORAL HEALTH To address this need, SLH will implement the following initiatives: 1. Continue operating a variety of Crittenton on-site clinical programs (subsidized health services) including inpatient hospitalization, residential treatment, adolescent substance use, and outpatient clinic. 2. Continue providing Crittenton In-Home services. 3. Seek additional funding via state contracts and grants to expand intensive in-home therapeutic and case management services for children and families experiencing mental/behavioral health and other trauma-related concerns. 4. Implement a virtual (and eventually in-person) intensive outpatient program for children and families struggling with anxiety and depression. 5. Expand the nationally-recognized Crittenton Trauma Smart program which is designed to help children heal from complex or repetitive trauma. 6. Evaluate the ability to offer virtual suicide risk assessments to schools within the Greater Kansas City Region. 7. Continue providing Foster Care case management and Adoption programs. 8. Continue working with the Saint Luke's College of Nursing/Rockhurst to develop classes to train and certify Behavioral Health Technicians (BHTs). 9. Provide Crisis Intervention Training for law enforcement on how to work with children with mental illness and trauma. 10. Continue to utilize Sesame Street in Communities materials and resources to help children and families understand racism, trauma, homelessness, foster care, and other topics that impact health and wellness, social-emotional skills, and school readiness. 11. Evaluate the opportunity to expand behavioral health services for SLHS employees and their families. 12. Provide trauma-informed mental health training and support to law enforcement through Crisis Intervention Team and other initiatives. 13. Continue operating the SLH Behavioral Assessment Center, which operates 24/7 for any patient experiencing a behavioral health crisis including patients who present in the Emergency Department. 14. Continue providing Social Workers in the SLH Emergency Department, so patients can be referred for placement or other needed services. 15. SLH's social workers will continue assisting Medical Education Internal Medicine (Primary Care) and OB/GYN clinics and Emergency Room Department patients who require additional mental health support and social determinants of health support. 16. Continue collaborating with the Kansas City Assessment and Triage Center to provide community mental health, drug, alcohol, and medical detoxification services. 17. Seek funding to provide trauma-informed education to middle and high schools in Center School District. POVERTY AND SOCIAL DETERMINANTS OF HEALTH To address this need, SLH will implement the following initiatives: 1. Participate in SLHS Anchor Institution strategies to be included in the SLHS Destination 2025 Strategic Plan. 2. Implement a base wage of $15 per hour for SLHS employees. 3. Expand programs to interest (and begin to train) high-school aged students in the health professions. 4. Expand the Bluford Leadership Program, an internship opportunity for minority students with college and university health care degrees. 5. Continue offering the Saint Luke's Community Resource Hub to expand patient, employee, and community awareness of available health and social services. 6. Continue screening all patients for social determinants of health issues. 7. Identify a strategy to address food insecurity. 8. Continue providing post-discharge transportation and housing for homeless patients over the age of 18 and in need of services through the Bodhi Housing Program. SLH does not intend to address two of the eight significant community health needs identified through its 2020 CHNA, Needs of Growing Senior Population and Unhealthy Behaviors. SLH already offers a wide array of acute and continuing care services for this growing senior population and anticipates continuing to meet its health care needs. For Unhealthy Behaviors, the committee charged with developing this implementation strategy identified six other needs as higher priorities for the 2021-2023 SLH implementation strategy."

Schedule H, Part V, Section B, Line 5 Facility , 1
Facility , 1 - KANSAS CITY ORTHOPAEDIC INSTITUTE, LLC:. A wide range of primary and secondary data was used to identify the top three health priorities in KCOI's community. Priorities were identified based on recurrent themes from interviews conducted with key contributors, alignment with national and local priorities and the ability of KCOI to address the health need. Hospital leaders and community stakeholders were engaged to better understand the needs of the community. Secondary quantitative data was analyzed from multiple community and hospital sources to better understand the impact of each of the identified needs. Secondary data was collected through multiple community resources. The most current data available was compiled and analyzed for key population health indicators. Secondary Data Sources: * Centers for Disease Control and Prevention * City Data * County Health Rankings * Healthy Kansans 2020 * Healthy People 2020 * Johnson County Government Data * Kansas Department of Health and Environment * Kansas Health Matters * Medicare's Hospital Compare * National Institute of Mental Health * Truven Health Analytics * U.S. Census Bureau

Schedule H, Part V, Section B, Line 11 Facility , 1
Facility , 1 - KANSAS CITY ORTHOPAEDIC INSTITUTE, LLC. Kansas City Orthopaedic Institute (KCOI) and Saint Luke's Health System (SLHS) leadership reviewed the significant needs identified via interviews, input received from community representatives and local and national data and considered how KCOI can address each. In addition, KCOI and SLHS leadership determined which of the top priority health issues to pursue in a more strategic and targeted approach over the next three years. The following represent the three resulting prioritized needs. Priority 1: Behavioral Health Care KCOI is committed to providing services to support behavioral health in Johnson County. KCOI will provide the following services in addressing behavioral health as a priority need: - KCOI physicians can help identify those patients who show signs of broken bones caused by domestic violence or abuse. Staff members at KCOI follow a robust policy put into place to ensure any patient indicating a need for advocacy, protection or shelter will be referred to the appropriate resources. - KCOI will continue to provide education on this topic to staff members. KCOI will continue to refer patients to SAFEHOME should the need be assessed. SAFEHOME is a local organization dedicated to providing shelter, advocacy, counseling and education to domestic violence victims within the community. Priority 2: Improve Access to Care KCOI will work to expand access to comprehensive, quality health care services for low-income individuals. KCOI will implement the following strategies in addressing access to care as a priority need: - KCOI has in place Charity Care and Financial Assistance protocols and will make those processes readily available for those who qualify in order to increase access - KCOI will advocate on key health policy issues at the state and national level, including Medicaid reform, access to care, and health care financing for the low-income population. - Aid a number of Wy/Jo Care cases per year that KCOI supports through provision of care and services. - Continue to provide access to care through the urgent care clinic with extended appointment hours. - KCOI will host the local chapter of the National Association for Orthopaedic Nurses' medical Education program for mid-level clinicians that provide access to care for allpatients. Priority 3: Increase Access to Physical Activity and Nutrition KCOI will work to improve the access to physical activity and healthy nutrition in Johnson County. kCOI will provide the following services dedicated to nutrition and physical activity: - Continue strategies for optimizing patients for surgery such as incorporating nutrition and physical activity themes in preoperative education to patients. - Provide resources and education for primary service area regarding physical activity. THERE ARE NO NEEDS IDENTIFIED IN THE CHNA THAT ARE NOT BEING ADDRESSED.

Schedule H, Part V, Section B, Line 13 Facility , 1
Facility , 1 - KANSAS CITY ORTHOPAEDIC INSTITUTE, LLC:. THE HOSPITAL PROVIDES ELECTIVE SERVICES. FINANCIAL ASSISTANCE ELIGIBILITY IS BASED ON THE FEDERAL POVERTY GUIDELINE AND OTHER FINANCIAL RESOURCES. IN ALL CASES, THE PATIENT'S AND RESPONSIBLE PARTY'S OVERALL FINANCIAL POSITION AND HOUSEHOLD SIZE AND INCOME ARE CONSIDERED WHEN DETERMINING FINANCIAL ASSISTANCE. FPL% GUIDELINES ARE APPLIED AS FOLLOWS: HOSPITAL SERVICES - UNSCHEDULED PATIENTS: 133% OR LESS FPL, 100% CHARITY 0% PATIENT RESPONSIBILITY HOSPITAL SERVICES - SCHEDULED PATIENTS: 133% OR LESS FPL, 75% CHARITY 25% PATIENT RESPONSIBILITY

Schedule H, Part V, Section B, Line 13 Facility , 1
Facility , 1 - KANSAS CITY ORTHOPAEDIC INSTITUTE, LLC:. THE HOSPITAL PROVIDES ELECTIVE SERVICES. FINANCIAL ASSISTANCE ELIGIBILITY IS BASED ON THE FEDERAL POVERTY GUIDELINE AND OTHER FINANCIAL RESOURCES. IN ALL CASES, THE PATIENT'S AND RESPONSIBLE PARTY'S OVERALL FINANCIAL POSITION AND HOUSEHOLD SIZE AND INCOME ARE CONSIDERED WHEN DETERMINING FINANCIAL ASSISTANCE. FPL% GUIDELINES ARE APPLIED AS FOLLOWS: HOSPITAL SERVICES - UNSCHEDULED PATIENTS: 133% OR LESS FPL, 100% CHARITY 0% PATIENT RESPONSIBILITY HOSPITAL SERVICES - SCHEDULED PATIENTS: 133% OR LESS FPL, 75% CHARITY 25% PATIENT RESPONSIBILITY.

Schedule H, Part V, Section B, Line 20 Facility , 1
Facility , 1 - KANSAS CITY ORTHOPAEDIC INSTITUTE, LLC:. THERE WAS NO EXTRAORDINARY COLLECTION ACTIVITY IN 2021.

Schedule H, Part I, Line 3c ASSISTANCE ELIGIBILITY
THE HOSPITAL USES THE FEDERAL POVERTY GUIDELINES TO DETERMINE ELIGIBILITY. IN ADDITION, MEDICAL INDIGENCY MAY BE DETERMINED ON AN INDIVIDUAL BASIS FOR INCOME ABOVE THE FEDERAL POVERTY LEVEL WHEN A SINGLE ILLNESS OR INJURY CAUSES HARDSHIP.

Schedule H, Part I, Line 7g Subsidized Health Services
SUBSIDIZED HEALTH SERVICES AE FOR THE TRANSPLANT SERVICES.

Schedule H, Part I, Line 7 Bad Debt Expense excluded from financial assistance calculation
21664680

Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance
COST OF CHARITY CARE AND UNREIMBURSED HEALTH SERVICES ARE CALCULATED USING THE APPOPRIATE COST TO CHARGE RATIO FORM THE HOSPITAL'S COST REPORT.

Schedule H, Part II Community Building Activities
THE ORGANIZATION WORKS WITH SEVERAL COMMUNITY ORGANIZATIONS THAT ARE DEDICATED TO THE IMPROVEMENT OF LIFE IN THE COMMUNITY. THIS INCLUDES SUPPORT OF STAFF/WORKFORCE DEVELOPMENT IN THE COMMUNITY AND PARTICIPATING IN COALITIONS TO IMPROVE COMMUNITY HEALTH, EDUCATION AND PATIENT SUPPORT.

Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount
PATIENT RELATED BAD DEBT IS REPORTED CONSISTENT WITH THE FINANCIAL STATEMENTS.

Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote
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.

Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance
IF A PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE THE ACCOUNT IS ADJUSTED ACCORDINGLY. ANY REMAINING BALANCE WOULD BE COLLECTED UNDER THE DEBT COLLECTION POLICY. OUR COLLECTION POLICIES ARE THE SAME FOR ALL PATIENTS. ALTHOUGH WE ARE NOT LEGALLY BOUND BY THE FAIR DEBT COLLECTION PRACTICES ACT, THE PRINCIPLES ADDRESSED ARE GENERALLY FOLLOWED.

Schedule H, Part V, Section B, Line 16a FAP website
- ST LUKES HOSPITAL OF KANSAS CITY: Line 16a URL: WWW.SAINTLUKESKC.ORG/FINANCIAL-ASSISTANCE; - KANSAS CITY ORTHOPAEDIC INSTITUTE, LLC: Line 16a URL: www.saintlukeskc.org/financial-assistance;

Schedule H, Part V, Section B, Line 16b FAP Application website
- ST LUKES HOSPITAL OF KANSAS CITY: Line 16b URL: WWW.SAINTLUKESKC.ORG/FINANCIAL-ASSISTANCE; - KANSAS CITY ORTHOPAEDIC INSTITUTE, LLC: Line 16b URL: www.saintlukeskc.org/financial-assistance;

Schedule H, Part V, Section B, Line 16c FAP plain language summary website
- ST LUKES HOSPITAL OF KANSAS CITY: Line 16c URL: WWW.SAINTLUKESKC.ORG/FINANCIAL-ASSISTANCE; - KANSAS CITY ORTHOPAEDIC INSTITUTE, LLC: Line 16c URL: www.saintlukeskc.org/financial-assistance;

Schedule H, Part VI, Line 5 Promotion of community health
THE BOARD OF DIRECTORS IS MADE UP OF MEDICAL AND BUSINESS PROFESSIONALS, ALMOST ALL OF WHOM RESIDE IN THE HOSPITAL'S PRIMARY SERVICE AREA. THEY ARE INVOLVED IN THE COMMUNITY NEEDS ASSESSMENT PROCESS AND IN GENERAL STEWARDSHIP. MEDICAL STAFF PRIVILEGES ARE OFFERED TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY. THE HOSPITAL UTILIZES SURPLUS FUNDS TO MAINTAIN ACCESS TO PATIENT SERVICES AND TO EXPAND ACCESS POINTS OF CARE TO PATIENTS THROUGHOUT THE COMMUNITY. SEE HOW THE HOSPITAL IS ADDRESSING THE ACCESS TO CARE NEED IN SCH H, PART V, LINE 11 DETAIL.

Schedule H, Part VI, Line 6 Affiliated health care system
SAINT LUKE'S HOSPITAL IS AFFILIATED WITH SAINT LUKE'S HEALTH SYSTEM, WHICH CONSISTS OF 16 AREA HOSPITAL FACILITIES AND MULTIPLE 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 HOSPITALS 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. For this community health assessment, Saint Luke's Hospital of Kansas City collaborated with the following Saint Luke's hospitals: Saint Luke's South Hospital, Saint uke's East Hospital, and Saint Luke's North Hospital. These facilities collaborated through gathering and assessing secondary data together, conducting community meetings and key stakeholder interviews, relying on shared methodologies, report formats, and staff to manage the CHNA process.

Schedule H, Part VI, Line 3 Patient education of eligibility for assistance
SAINT LUKE'S HOSPITAL FOLLOWS THE SAINT LUKE'S HEALTH SYSTEM POLICIES FOR FINANCIAL ASSISTANCE, PATIENT BILLING AND COLLECTION. IN ADDITION TO THESE POLICIES, SAINT LUKE'S HOSPITAL PROVIDES EDUCATION ON FINANCIAL ASSISTANCE ELIGIBILITY TO PATIENTS AND PERSONS WHO MAY BE BILLED FOR SERVICES THROUGH MANY SOURCES INCLUDING THE SLHS WEB SITE, 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. SAINT LUKE'S 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.

Schedule H, Part VI, Line 4 Community information
SAINT LUKE'S HOSPITAL IS LOCATED IN THE URBAN CORE OF KANSAS CITY, MISSOURI. IT IS A MAJOR TEACHING AND RESEARCH FACILITY, AND PROVIDES TERTIARY AND QUATERNARY LEVEL PATIENT CARE SERVICES TO THE METROPOLITAN KANSAS CITY AREA, AND SERVES AS A MAJOR REFERRAL HOSPITAL FOR THE SURROUNDING COUNTIES. FOR purposes of THE CHNA, The community was defined by considering the geographic origins of the hospital's discharges and Emergency room visits in calendar year 2019. On that basis, SLH's community was defined as a five-county area that includes Jackson County, Missouri; Johnson County, Kansas; Clay County, Missouri; Platte County, Missouri; and Wyandotte County, Kansas. The community accounted for 72 percent of the hospital's 2019 inpatient volumes and 90 percent of its emergency room visits.