ST LUKES PHYSICIAN NETWORK INC: Form 990, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- ST LUKES PHYSICIAN NETWORK INC (EIN 26-3082073)
- Tax period
- 2020-10-01 to 2021-09-30
- Filed
- 2022-08-14
- IRS object ID
- 202242269349300304
- Schema version
- 2020v4.2
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-08-14T11:30:17-05:00 | ReturnTs |
| Tax Period End | 2021-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 410746749 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLIFTONLARSONALLEN LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 227 WEST TRADE STREET SUITE 800 | AddressLine1Txt |
| City | CHARLOTTE | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 28202 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2020-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 263082073 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ST LUKE'S PHYSICIAN NETWORK INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | STLU | BusinessNameControlTxt |
| Phone | 8288943311 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 101 HOSPITAL DRIVE | AddressLine1Txt |
| City | COLUMBUS | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 28722 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ELIZABETH PRESNELL | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 8288943311 | PhoneNum |
| Signature | 2022-08-12 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | ELIZABETH | PersonFirstNm |
| Person Last | PRESNELL | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | JOHN NORMAN | PreparerPersonNm |
| PTIN | P01506766 | PTIN |
| Phone | 7049985200 | PhoneNum |
| Preparation | 2022-08-12 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 2 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2020 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | ELIZABETH PRESNELL | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 101 HOSPITAL DRIVE | AddressLine1Txt |
| City | COLUMBUS | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 28722 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $5,825,100 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | N/A | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2008 | FormationYr |
| Legal Domicile State | NC | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE QUALITY, PATIENT-FOCUSED HEALTHCARE TO POLK COUNTY AND SURROUNDING COUNTIES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 2 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 2 | VotingMembersIndependentCnt |
| Total Employee | 9 | TotalEmployeeCnt |
| Total Volunteers | 2 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $527,100 | PYContributionsGrantsAmt |
| CY Contributions Grants | $126,585 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $4,898,464 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $5,695,778 | CYProgramServiceRevenueAmt |
| PY Investment Income | $0 | PYInvestmentIncomeAmt |
| CY Investment Income | $0 | CYInvestmentIncomeAmt |
| PY Other Revenue | $5,230 | PYOtherRevenueAmt |
| CY Other Revenue | $2,737 | CYOtherRevenueAmt |
| PY Total Revenue | $5,430,794 | PYTotalRevenueAmt |
| CY Total Revenue | $5,825,100 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $74,424 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $6,132,401 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $6,385,504 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $1,775,140 | PYOtherExpensesAmt |
| CY Other Expenses | $2,068,345 | CYOtherExpensesAmt |
| PY Total Expenses | $7,981,965 | PYTotalExpensesAmt |
| CY Total Expenses | $8,453,849 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$2,551,171 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$2,628,749 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $1,108,723 | TotalAssetsBOYAmt |
| Total Assets EOY | $1,663,323 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $18,713,689 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $21,897,038 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$17,604,966 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$20,233,715 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO PROMOTE COMMUNITY HEALTH THROUGH THE PROVISION OF HEALTH CARE SERVICES TO THE RESIDENTS OF POLK COUNTY, NC AND SURROUNDING COUNTIES, AS WELL AS TO PROMOTE, IMPROVE, AND ENHANCE THE QUALITY OF HEALTH CARE SERVICES IN POLK COUNTY, NC AND SURROUNDING COUNTIES. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $8,289,077 | ExpenseAmt |
| Revenue | $5,695,778 | RevenueAmt |
| Desc | ST. LUKE'S PHYSICIAN NETWORK (SLPN) PROVIDES HEALTH CARE SERVICES TO CITIZENS OF POLK COUNTY, NC, AND SURROUNDING COUNTIES, THROUGH VARIOUS CLINICS ACROSS A WIDE VARIETY OF MEDICAL SPECIALTIES. SLPN PROVIDES HEALTH CARE SERVICES TO CITIZENS OF POLK COUNTY, NC AND SURROUNDING COUNTIES, THROUGH A TOTAL OF FOUR CLINICS. THE FOUR CLINICS ARE COMPRISED OF TWO RURAL HEALTH CLINIC'S (SALUDA FAMILY MEDICINE AND FOOTHILLS FAMILY MEDICINE AND GENERAL SURGERY) ALONG WITH ROSENBERG BONE AND JOINT AND ST. LUKE'S UROLOGY CLINIC. FOR FY 2021, THE CLINICS HAD A COMBINED TOTAL OF 25,191 VISITS. | Desc |
| Total Program Service Expenses | $8,289,077 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 9 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 2 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 2 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | 0 | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ELIZABETH PRESNELL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 8288940954 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 101 HOSPITAL DRIVE | AddressLine1Txt |
| City | COLUMBUS | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 28722 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | Yes (X) | NoListedPersonsCompensatedInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (7 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| TOMMY MELTON | ||||||||
| CHAIR | 1.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| LINDA GREENSFELDER PHD | ||||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| BRIAN ROSENBURG MD | ||||||||
| PHYSICIAN | 45.00 | $1,566,285 | $0 | $60,991 | Yes (X) | |||
| JEFFREY VIAR DO | ||||||||
| PHYSICIAN | 45.00 | $238,146 | $0 | $44,446 | Yes (X) | |||
| GERHARDT WINKEL MD | ||||||||
| PHYSICIAN | 45.00 | $414,624 | $0 | $67,435 | Yes (X) | |||
| WILLIAM SAVAGE DO | ||||||||
| PHYSICIAN | 45.00 | $336,417 | $0 | $59,578 | Yes (X) | |||
| THOMAS DASHIELL JR MD | ||||||||
| PHYSICIAN | 45.00 | $327,797 | $0 | $39,332 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,883,269 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $271,782 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 4 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp
Contractor Name ContractorName
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ATRIUM HEALTH | BusinessNameLine1Txt |
Contractor Address ContractorAddress
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 32861 | AddressLine1Txt |
| City | CHARLOTTE | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 28232 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Services | MANAGEMENT AND BILLING SERVICES | ServicesDesc |
| Compensation | $575,871 | CompensationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 1 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $126,585 | GovernmentGrantsAmt |
| Total Contributions | $126,585 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT REVENUE | 621110 | $5,495,092 | $5,495,092 |
| OTHER OPERATING | 621110 | $200,686 | $200,686 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $5,695,778 | TotalProgramServiceRevenueAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $2,737 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $2,737 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,737 | TotalRevenueColumnAmt |
| Exclusion | $2,737 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $5,825,100 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $5,695,778 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $2,737 | ExclusionAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,936,482 | TotalAmt |
| Program Services | $5,818,004 | ProgramServicesAmt |
| Management And General | $118,478 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $29,514 | TotalAmt |
| Program Services | $28,925 | ProgramServicesAmt |
| Management And General | $589 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $310,560 | TotalAmt |
| Program Services | $304,362 | ProgramServicesAmt |
| Management And General | $6,198 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $108,948 | TotalAmt |
| Program Services | $106,773 | ProgramServicesAmt |
| Management And General | $2,175 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $119,329 | TotalAmt |
| Program Services | $81,997 | ProgramServicesAmt |
| Management And General | $37,332 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,370 | TotalAmt |
| Program Services | $7,370 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $346,522 | TotalAmt |
| Program Services | $346,522 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,252 | TotalAmt |
| Program Services | $4,252 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $32,650 | TotalAmt |
| Program Services | $32,650 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $172,800 | TotalAmt |
| Program Services | $172,800 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (2 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| MEDICAL SUPPLIES | $1,135,393 | $1,135,393 |
| BAD DEBT EXPENSE | $250,029 | $250,029 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,453,849 | TotalAmt |
| Program Services | $8,289,077 | ProgramServicesAmt |
| Management And General | $164,772 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $104,330 | BOYAmt |
| EOY | $116,972 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $965,578 | BOYAmt |
| EOY | $1,538,021 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,205 | BOYAmt |
| EOY | $19,370 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $302,230 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $313,270 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,610 | BOYAmt |
| EOY | -$11,040 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,108,723 | BOYAmt |
| EOY | $1,663,323 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $181,585 | BOYAmt |
| EOY | $218,339 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,532,104 | BOYAmt |
| EOY | $21,678,699 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,713,689 | BOYAmt |
| EOY | $21,897,038 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$17,604,966 | BOYAmt |
| EOY | -$20,233,715 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$17,604,966 | BOYAmt |
| EOY | -$20,233,715 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,108,723 | BOYAmt |
| EOY | $1,663,323 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$2,628,749 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $15,448 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,287 | DepreciationAmt |
| Book Value | $14,161 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $286,782 | OtherCostOrOtherBasisAmt |
| Depreciation | $311,983 | DepreciationAmt |
| Book Value | -$25,201 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | -$11,040 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS | $198,480 |
| ADVANCED MEDICARE AND MEDICAID PAYMENTS | $166,381 |
| DUE TO RELATED PARTIES | $21,313,838 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $21,678,699 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE HOSPITAL, THE FOUNDATION, AND SLPN ARE EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. ACCORDINGLY, NO PROVISION FOR INCOME TAXES HAS BEEN RECORDED IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. THE PROFESSIONAL BUILDING IS A FOR-PROFIT CORPORATION SUBJECT TO FEDERAL AND STATE INCOME TAXES. THE HOSPITAL AND THE AFFILIATES HAVE DETERMINED THAT THEY DO NOT HAVE ANY MATERIAL UNRECOGNIZED TAX BENEFITS OR OBLIGATOINS AS OF SEPTEMBER 30, 2020. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (5 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| BRIAN ROSENBURG MD | ||||||||||||||
| PHYSICIAN | $1,095,036 | $0 | $446,077 | $0 | $25,172 | $0 | $37,190 | $0 | $23,801 | $0 | $1,627,276 | $0 | $0 | $0 |
| GERHARDT WINKEL MD | ||||||||||||||
| PHYSICIAN | $393,383 | $0 | $0 | $0 | $21,241 | $0 | $35,608 | $0 | $31,827 | $0 | $482,059 | $0 | $0 | $0 |
| WILLIAM SAVAGE DO | ||||||||||||||
| PHYSICIAN | $334,846 | $0 | $474 | $0 | $1,097 | $0 | $26,833 | $0 | $32,745 | $0 | $395,995 | $0 | $0 | $0 |
| THOMAS DASHIELL JR MD | ||||||||||||||
| PHYSICIAN | $288,811 | $0 | $108 | $0 | $38,878 | $0 | $36,846 | $0 | $2,486 | $0 | $367,129 | $0 | $0 | $0 |
| JEFFREY VIAR DO | ||||||||||||||
| PHYSICIAN | $179,734 | $0 | $57,416 | $0 | $996 | $0 | $18,512 | $0 | $25,934 | $0 | $282,592 | $0 | $0 | $0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | THE SOLE MEMBER OF THE ORGANIZATION IS ST. LUKE'S HEALTH CARE, INC., A SECTION 501(C)(3) NORTH CAROLINA ORGANIZATION. |
| FORM 990, PART VI, SECTION A, LINE 7A | ST. LUKE'S PHYSICIAN NETWORK'S BOARD IS APPOINTED BY THE BOARD OF DIRECTORS OF ST. LUKE'S HEALTH CARE, INC. (THE SOLE MEMBER OF ST. LUKE'S PHYSICIAN NETWORK). |
| FORM 990, PART VI, SECTION A, LINE 7B | ST. LUKE'S HEALTH CARE, THE SOLE MEMBER OF ST. LUKE'S PHYSICIAN NETWORK, HAS THE FOLLOWING POWERS: 1. TO MERGE, CONSOLIDATE, OR SELL SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION; 2. TO ACQUIRE OR CREATE ANOTHER CORPORATION; 3. TO APPROVE ALL AMENDMENTS TO THE ARTICLES OF INCORPORATIN AND BYLAWS OF THE CORPORATION; 4. TO GRANT PERMISSION TO DISSOLVE THIS CORPORATION; AND 5. TO APPOINT THE MEMBERS OF THE CORPORATION'S BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION B, LINE 11B | A COPY OF THE FORM 990 WILL BE MADE AVAILABLE TO EACH VOTING BOARD MEMBER FOR REVIEW PRIOR TO A REQUEST FOR A VOTE. AFTER THE BOARD MEMBERS HAVE HAD AN OPPORTUNITY TO REVIEW AND ALL QUESTIONS HAVE BEEN ANSWERED SATISFACTORILY, THE BOARD WILL BE ASKED TO VOTE TO APPROVE FOR SUBMISSION. |
| FORM 990, PART VI, SECTION B, LINE 12C | OFFICERS, DIRECTORS, AND KEY EMPLOYEES ARE REQUIRED TO SIGN A CONFLLICT OF INTEREST STATEMENT UPON HIRE OR APPOINTMENT. ANY DIRECTOR, OFFICER, COMMITTEE MEMBER OR EMPLOYEE DEPARTMENT HEAD HAVING A CONFLICT OF INTEREST IN A CONTRACT OR THE TRANSACTION PRESENTED TO THE BOARD OR A BOARD COMMITTEE FOR AUTHORIZATION, APPROVAL, OR RATIFICATION SHALL MAKE A PROMPT, FULL AND FRANK DISCLOSURE OF HIS/HER INTEREST TO THE BOARD OR BOARD COMMITTEE PRIOR TO ITS ACTING ON SUCH CONTRACT OR TRANSACTION. SUCH DISCLOSURE SHALL INCLUDE ANY RELEVANT AND MATERIAL FACTS, KNOWN TO SUCH PERSON, ABOUT THE CONTRACT OR TRANSACTION THAT MIGHT REASONABLY BE CONSTRUED TO BE ADVERSE TO THE CORPORATION'S INTEREST. A DIRECTOR, COMMITTEE MEMBER, OFFICER OF THE BOARD OR CORPORATION OR EMPLOYEE DEPARTMENT HEAD WHO HAS A DIRECT OR INDIRECT INTEREST IN ANY TRANSACTION PRESENTED TO THIS BOARD OR A BOARD COMMITTEE SHALL DISCLOSE HIS OR HER INTEREST AND SHALL ABSENT HIMSELF OR HERSELF FROM ALL DISCUSSION OF AND ANY VOTE UPON SUCH MATTER. A CONFLICT OF INTEREST TRANSACTION MUST BE AUTHORIZED, APPROVED OR RATIFIED BY THE AFFIRMATIVE VOTE OF A MAJORITY OF THE DIRECTORS OR COMMITTEE MEMBERS WHO HAVE NO DIRECT OR INDIRECT INTEREST IN THE TRANSACTION AND TO WHOM THE MATERIAL FACTS OF THE TRANSACTION AND OF ANY PERSON'S INTEREST IN THE TRANSACTION WERE DISCLOSED OR KNOWN. IF A MAJORITY OF THE MEMBERS WHO HAVE NO DIRECT OR INDIRECT INTEREST IN THE TRANSACTION VOTE TO AUTHORIZE, APPROVE OR RATIFY THE TRANSACTION, A QUORUM IS PRESENT FOR THE PURPOSE OF TAKING SUCH ACTION. |
| FORM 990, PART VI, SECTION B, LINE 15 | COMPENSATION FOR KEY TEAMMATES GOES THROUGH A REVIEW PROCESS. FOR PROVIDERS, FMV AND LOCAL MARKET CONDITIONS ARE TAKEN INTO CONSIDERATION TO DETERMINE THE APPROPRIATE COMPENSATION. ATRIUM HEALTH HAS AN APPROVED COMPENSATION COMMITTEE THAT RETAINS INDEPENDENT EXPERTS TO DESIGN COMPLETE COMPENSATION PACKAGES. THE COMPENSATION COMMITTEE REVIEWS COMPARABILITY DATA, REVIEWS EXECUTIVE OFFICERS' PERFORMANCE AND RECOMMENDATIONS FOR SENIOR OFFICERS. EXECUTIVE COMPENSATION IS APPROVED AND AN OFFICIAL REPORT IS GIVEN TO THE BOARD ALONG WITH DOCUMENTATION IN THE MINUTES OF MEETINGS. |
| FORM 990, PART VI, SECTION C, LINE 18 | RECENT FILINGS OF THE FORM 990 ARE AVAILABLE UPON REQUEST AT THE ORGANIZATION'S ADMINISTRATIVE OFFICE. IN ADDITION, RECENT FILINGS OF THE FORM 990 ARE AVAILABE ONLINE AT GUIDESTAR.ORG. |
| FORM 990, PART VI, SECTION C, LINE 19 | PHOTOCOPIES OF THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON WRITTEN REQUEST AT THE ORGANIZATION'S ADMINISTRATIVE OFFICE. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|
| ST LUKE'S HEALTH CARE INC | ||||||||||
| 101 HOSPITAL DR | COLUMBUS | NC | 28722 | 561423318 | CONTROLLING ENTITY | NC | 501(C)(3) | PF | 0 | |
| ST LUKE'S FOUNDATION INC | ||||||||||
| 101 HOSPITAL DR | COLUMBUS | NC | 28722 | 561757097 | FUNDRAISING FOR ST. LUKE'S HOSPITAL | NC | 501(C)(3) | LINE 7 | 0 | ST LUKE'S HEALTH CARE INC |
| ST LUKE'S HOSPITAL INC | ||||||||||
| 101 HOSPITAL DR | COLUMBUS | NC | 28722 | 560554222 | HEALTH CARE SERVICES FOR POLK COUNTY, NC RESIDENTS | NC | 501(C)(3) | LINE 3 | 0 | ST LUKE'S HEALTH CARE INC |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ST LUKE'S PROFESSIONAL BUILDING INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 101 HOSPITAL DR | AddressLine1Txt |
| City | COLUMBUS | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 28722 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 561423404 | EIN |
| Primary Activities | RENTAL REAL ESTATE | PrimaryActivitiesTxt |
| Legal Domicile State | NC | LegalDomicileStateCd |
| Entity Type | C | EntityTypeTxt |
| Controlled Organization | 0 | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |