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Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," on Form 990, Part IV, line 21 or 22.
Graphic Arrow Attach to Form 990.
Graphic Arrow Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2021
Open to Public
Inspection
Name of the organization
Saint Lukes Health System Inc
 
Employer identification number
43-1747502
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient
that received more than $5,000. Part II can be duplicated if additional space is needed.
(a) Name and address of organization
or government		 (b) EIN (c) IRC section
(if applicable)		 (d) Amount of cash grant (e) Amount of non-cash
assistance		 (f) Method of valuation
(book, FMV, appraisal,
other)		 (g) Description of
noncash assistance		 (h) Purpose of grant
or assistance
(1) AIDS SERVICE FOUNDATION OF GREATER KANSAS CITY
PO Box 32192
Kansas City,MO64171 		43-1613911 501(c)(3) 17,500       COMMUNITY SUPPORT
(2) BOYS AND GIRLS CLUBS OF GREATER KANSAS CITY
4001 Blue Parkway
Suite 102
Kansas City,MO64130 		43-6072065 501(c)(3) 50,000       COMMUNITY SUPPORT
(3) NORTHLAND HEALTH ALLIANCE
PO Box 14414
Parkville,MO64152 		83-2056703 501(c)(3) 14,000       COMMUNITY SUPPORT
(4) MARCH OF DIMES
4400 College Blvd
Suite 180
Overland Park,KS66211 		13-1846366 501(c)(3) 10,000       COMMUNITY SUPPORT
(5) AMERICAN HEART ASSOCIATION
13851 W 63rd Street 346
Shawnee,KS66216 		13-5613797 501(c)(3) 10,000       COMMUNITY SUPPORT
(6) JEWISH FAMILY SERVICES
5801 W 115th St
Suite 104
Overland Park,KS66211 		43-6049281 501(c)(3) 12,500       COMMUNITY SUPPORT
(7) KC CARE HEALTH CENTER
3515 Broadway
Kansas City,MO64111 		43-0967292 501(c)(3) 10,000       COMMUNITY SUPPORT
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Graphic Arrow
7
3
Enter total number of other organizations listed in the line 1 table ........................ . Graphic Arrow
0
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2021

Schedule I (Form 990) 2021
Page 2
Part III
Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.
(a) Type of grant or assistance (b) Number of
recipients		 (c) Amount of
cash grant		 (d) Amount of
noncash assistance		 (e) Method of valuation (book,
FMV, appraisal, other)		 (f) Description of noncash assistance
(1)
(2)
(3)
(4)
(5)
(6)
(7)
Part IV
Supplemental Information. Provide the information required in Part I, line 2; Part III, column (b); and any other additional information.
Return Reference Explanation
Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds. GRANTS ARE PROVIDED TO QUALIFIED CHARITIES FOR GENERAL OPERATIONS AND TO BE USED IN FULFILLING THE EXEMPT PURPOSE OF THE GRANTEE CHARITABLE ORGANIZATION. SUCH GRANTS FURTHER OR SUPPORT A CHARITABLE PURPOSE OF SAINT LUKE'S HEALTH SYSTEM.
Schedule I (Form 990) 2021



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