2018-11-14T15:58:52-06:00 2017-12-31 BKD LLP 200 E Main St Suite 700 Fort Wayne IN 46802 990 2017-01-01 341292849 ST LUKE'S HOSPITAL FOUNDATION % LAURA MURPHY STLU 4198935900 5901 MONCLOVA ROAD MAUMEE OH 43537 DANIEL L WAKEMAN PRESIDENT 4198935900 2018-11-15 true Aaron D Hershberger P00961884 2604604000 2018-11-15 68.38.119.134 35027420183185000008 2018-11-14 P C32BFEAB8C27A52315DF5F02F320116B11D77C77 8193C6E21FDC853689B017ED35849D8705607233 2017 2019-02-21 02:37:17Z DANIEL L WAKEMAN 5901 MONCLOVA ROAD MAUMEE OH 43537 26749539 false X WWW.STLUKESHOSPITAL.COM X 1979 OH ST. LUKE'S HOSPITAL FDN, THROUGH ITS SUPPORT OF ST. LUKE'S HOSPITAL, CONTRIBUTES TO THE PROVISION OF HEALTH CARE AND ENHANCING THE QUALITY OF LIFE FOR PEOPLE IN OUR COMMUNITY. 16 15 0 20 0 0 2142476 651234 0 0 1568390 1581258 -6881 -5944 3703985 2226548 231149 846038 0 0 119555 185700 0 0 139492 52399 175080 403103 1206818 3300882 1019730 23927980 26513477 86759 97427 23841221 26416050 ST. LUKE'S HOSPITAL FOUNDATION IS DEDICATED TO SECURING RESOURCES TO SUPPORT THE HEALING AND CHARITABLE MISSION OF ST. LUKE'S HOSPITAL FOR THE COMMUNITIES IT SERVES. false false 846038 846038 ST. LUKE'S HOSPITAL FOUNDATION, THROUGH ITS SUPPORT OF ST. LUKE'S HOSPITAL, CONTRIBUTES TO THE PROVISION OF HEALTH CARE AND ENHANCING THE QUALITY OF LIFE FOR PEOPLE IN OUR COMMUNITY. N/A N/A 846038 true true false false false false false false false false true false false true true false false true false false false false false false true false false true true true false false false false false false false false false false false false true true true true false false true 0 0 0 false false false false false true true false false false false X 16 15 true false false false true true true true true false false true true true true true true false false false OH X LAURA MURPHY 4198978408 5901 MONCLOVA RD MAUMEE OH 43537 BLACK CHRISTINE L TRUSTEE 1.0 0.0 X 0 0 0 BURKE HAL D TRUSTEE 1.0 0.0 X 0 0 0 CARROLL WILLIAM ST LUKE'S HOSPITAL CHAIRPERSON 1.0 2.0 X 0 0 0 CHOKA BRYON TRUSTEE 1.0 0.0 X 0 0 0 COOPER MICHELE G TRUSTEE 1.0 0.0 X 0 0 0 COYLE-STAMOS MEGAN M CHAIRPERSON 1.0 0.0 X 0 0 0 EMERY JEAN M TRUSTEE 1.0 0.0 X 0 0 0 JINDAL MD VALENTINA TRUSTEE 1.0 0.0 X 0 0 0 LAWLESS CHRISTINA L TRUSTEE 1.0 0.0 X 0 0 0 LONSBROUGH KATHERINE TRUSTEE 1.0 0.0 X 0 0 0 RAMBO GLENN L TRUSTEE 1.0 0.0 X 0 0 0 REED DAVID A TRUSTEE 1.0 0.0 X 0 0 0 SEYMOUR DALE J TRUSTEE 1.0 2.0 X 0 0 0 WAKEMAN DANIEL PRESIDENT/CEO, EX-OFFICIO 1.0 43.0 X X 0 449328 43757 WASHBURN SYLVIA TRUSTEE 1.0 0.0 X 0 0 0 HARRIS CONSTANCE AUXILIARY PRESIDENT/EX-OFFICIO 1.0 0.0 X 0 0 0 RILEY KEVIN CHIEF FINANCIAL OFFICER 1.0 43.0 X 0 85722 8290 BURMEISTER KEITH VP CHIEF RELATIONS OFFICER 1.0 43.0 X 0 225486 15058 BURMEISTER KERRY ADMINISTRATIVE DIRECTOR FINANC 1.0 43.0 X 0 162281 38114 KIM JEFF V.P. CHIEF INFORMATION OFFICER 1.0 43.0 X 0 174508 23942 MORRISSEY MARTIN V.P. GENERAL COUNSEL 1.0 43.0 X 0 266106 40184 SESSLER CONNIE ADMINISTRATIVE DIRECTOR HR/SUP 1.0 43.0 X 0 158277 38768 PACK KELLE PRESIDENT, FOUNDATION 40.0 0.0 X 0 101120 22580 0 1622828 230693 0 false true false 0 6451 52067 348245 244471 651234 0 660578 660578 0 0 5890 4907 983 0 983 983 25412802 24492122 920680 920680 920680 19035 52067 25962 -6927 -6927 0 0 0 0 0 0 0 2226548 1575314 826770 826770 19268 19268 0 0 0 0 139293 68944 70349 16437 8136 8301 18257 9036 9221 11713 5739 5974 0 0 0 0 0 102327 102327 4369 59 4310 37731 235 37496 1790 1790 11388 11388 0 0 575 575 0 0 0 0 0 0 BAD DEBT EXPENSE 3367 3367 INTERCOMPANY SERVICES 1687 1687 FOUNDATION ACTIVITIES 3841 3841 DUES & SUBSCRIPTIONS 1933 1933 6072 6072 1206818 846038 221288 139492 123320 119181 2141514 1700239 38016 47122 0 0 0 0 0 0 0 0 0 0 0 0 960000 960000 960000 19143162 22036548 0 0 0 0 0 0 1521968 1650387 23927980 26513477 5131 11115 0 0 0 0 0 0 0 0 0 0 0 0 0 0 81628 86312 86759 97427 X 21264278 23789459 1111130 1028439 1465813 1598152 23841221 26416050 23927980 26513477 1019730 1555099 X false true X true false X X 1 ST LUKE'S HOSPITAL 344428232 3 true 826770 0 1 826770 true false false false false false false false false false false false false false false false PART IV, SECTION C, LINE 1: ST. LUKES HOSPITAL FOUNDATION IS AN OHIO NOT-FOR-PROFIT CORPORATION THAT OPERATES TO BENEFIT AND CARRY OUT THE PURPOSES OF ST. LUKES HOSPITAL (SLH) OR ANY OTHER SUCCESSOR INSTITUTION. SLH IS AN OHIO NOT-FOR-PROFIT CORPORATION DESCRIBED IN CODE SECTION 501 (C)(3) THAT IS NOT A PRIVATE FOUNDATION BECAUSE IT IS DESCRIBED IN CODE SECTION 501 (A)(1). ST. LUKE'S HOLDING COMPANY, INC. (SLHC) IS THE SOLE MEMBER OF ST. LUKES HOSPITAL FOUNDATION AND IS THE PARENT OF AN INTEGRATED HEALTH CARE DELIVERY NETWORK MADE UP OF AN AFFILIATED GROUP OF EXEMPT ORGANIZATIONS WHICH INCLUDE A HOSPITAL, HEALTH CARE PROVIDERS, SPECIALIZED HEALTH SERVICES, AN ENTITY PROVIDING SUPPORT SERVICES AND A FOUNDATION. SLHC PROVIDES OVERALL DIRECTION, MANAGEMENT AND CONTROL TO ITS FIRST-TIER SUBSIDIARIES, AND INDIRECTLY THROUGH ITS FIRST-TIER SUBSIDIARIES, TO ALL AFFILIATED SECOND TIER SUBSIDIARIES OF EACH FIRST-TIER SUBSIDIARIES. THE ACTIVITIES OF SLHC SUPPORT THE EXEMPT PURPOSES OF THE AFFILIATED ORGANIZATIONS IN THE SLHC NETWORK AND ENHANCE AND IMPROVE THE DELIVERY OF EFFECTIVE HEALTH CARE SERVICES TO THE COMMUNITIES SERVED BY THE SLHC NETWORK. CONTROL AND MANAGEMENT EFFECTIVELY IS VESTED IN THE SAME PERSONS THAT CONTROL AND MANAGE ALL SUBSIDIARY ORGANIZATIONS THROUGH RESERVED POWERS. SLHC HAS RESERVED POWERS IN EACH SUBSIDIARYS CODE OF REGULATIONS OR BYLAWS ALONG WITH THE RIGHT TO APPROVE CERTAIN ACTIONS OF EACH SUBSIDIARYS BOARD OF TRUSTEES. THE FIRST-TIER SUBSIDIARIES HAVE IN TURN RESERVED SIMILAR POWERS OVER THE SECOND-TIER SUBSIDIARIES TO INTEGRATE OVERALL DIRECTION, MANAGEMENT AND CONTROL. ST. LUKES HOSPITAL FOUNDATION QUALIFIES AS A TYPE II SUPPORTING ORGANIZATION BECAUSE IT IS SUPERVISED AND CONTROLLED IN CONNECTION WITH ALL ORGANIZATIONS THAT ARE EXEMPT AFFILIATED MEMBERS OF SLHC. COMMON SUPERVISION AND CONTROL ARE SHARED THROUGH THE STRUCTURAL RELATIONSHIP OF SLHC. THERE HAS ALSO BEEN A HISTORIC AND CONTINUING RELATIONSHIP BETWEEN ST. LUKES HOSPITAL FOUNDATION AND ST. LUKES HOSPITAL AND A SUBSTANTIAL IDENTITY OF INTERESTS BETWEEN THE ORGANIZATIONS AS A RESULT OF THIS RELATIONSHIP SUPPORTING COMMON CONTROL CONSISTENT WITH TYPE II SUPPORTING ORGANIZATION CLASSIFICATION. ST. LUKES HOSPITAL FOUNDATION HAS MAINTAINED, AND WILL CONTINUE TO MAINTAIN, A SIGNIFICANT INVOLVEMENT IN EACH SUPPORTED ORGANIZATIONS OPERATIONS. 960000 960000 960000 DUE FROM AFFILIATES 42843 OTHER RECEIVABLES 5824 CASH VALUE OF LIFE INSURANCE 3568 FUNDED PERPETUITIES 1598152 1650387 0 DUE TO AFFILIATES 86312 86312 SCHEDULE D, PART X, LINE 2 ST. LUKE'S HOSPITAL FOUNDATION IS INCLUDED IN THE CONSOLIDATED AUDITED STATEMENTS OF ST LUKE'S HOLDING COMPANY, INC (SLHC) AND IS INCORPORATED UNDER THE LAWS OF THE STATE OF OHIO. SLHC AND ITS WHOLLY OWNED SUBSIDIARIES, ST LUKE'S HOSPITAL, ST. LUKE'S HOSPITAL FOUNDATION AND CARE ENTERPRISES, INC. ARE NONPROFIT CORPORATIONS AND ARE EXEMPT FROM STATE AND LOCAL TAXES. THE IRS HAS DETERMINED THAT SLHC, ST LUKE'S HOSPITAL, ST. LUKE'S HOSPITAL FOUNDATION, CARE ENTERPRISES, INC. AND WELLCARE PHYSICIANS GROUP, LLC TO BE EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501 (C)(3) OF THE INTERNAL REVENUE CODE. ACCORDINGLY, NO TAX PROVISION IS REFLECTED IN SLHC'S CONSOLIDATED FINANCIAL STATEMENTS. CARE HOLDINGS, INC. AND PHYSICIANS ADVANTAGE MSO, INC. WHOLLY OWNED SUBSIDIARIES OF SLHC, ARE TAXABLE CORPORATIONS. INCOME TAX PROVISIONS FOR THESE ENTITIES ARE NOT MATERIAL TO SLHC'S AUDITED FINANCIAL STATEMENTS. GOLF OUTING 71102 52067 19035 784 8052 17126 0 71102 52067 19035 784 8052 17126 25962 -6927 true ST LUKE'S HOSPITAL 5901 MONCLOVA RD MAUMEE OH 43537 344428232 501(C)(3) 826770 OPERATING/CAPITAL GRANT 1 SCHOLARSHIPS 16 19268 SCHEDULE I, PART I, LINE 2 AS AN AFFILIATE OF ST. LUKE'S HOLDING COMPANY, INC. (SLHC) CORPORATE POLICIES EXIST TO ENSURE THAT THE APPROVAL, DISTRIBUTION AND MANAGEMENT OF GRANT FUNDS IS CONSISTENT WITH THE AGREED UPON CONSTRAINTS OF THE GRANT/CONTRACT. REQUESTS FOR GRANT FUNDING ARE SUBMITTED AND APPROVED BASED ON GENERALLY ACCEPTED ACCOUNTING PRINCIPLES AND FEDERAL AND STATE REGULATIONS GOVERNING THE USE OF GRANT FUNDS TO ENSURE THAT THEY MEET THE REQUIREMENTS OF THE RESPECTIVE GRANT/CONTRACT. GRANT FILES ARE MAINTAINED BY THE ST. LUKE'S HOSPITAL FOUNDATION DEPARTMENT WHICH IS RESPONSIBLE TO PREPARE/SUBMIT FISCAL REPORTS AS REQUIRED BY THE FUNDING AGENCY. false false false false false false false false false WAKEMAN DANIEL PRESIDENT/CEO, EX-OFFICIO 0 395044 0 50000 0 4284 0 24258 0 19499 0 493085 BURMEISTER KEITH VP CHIEF RELATIONS OFFICER 0 218690 0 5000 0 1796 0 13543 0 1515 0 240544 BURMEISTER KERRY ADMINISTRATIVE DIRECTOR FINANC 0 153683 0 5000 0 3598 0 22682 0 15432 0 200395 KIM JEFF V.P. CHIEF INFORMATION OFFICER 0 146663 0 0 0 27845 0 7422 0 16520 0 198450 MORRISSEY MARTIN V.P. GENERAL COUNSEL 0 258784 0 5000 0 2322 0 16035 0 24149 0 306290 SESSLER CONNIE ADMINISTRATIVE DIRECTOR HR/SUP 0 148355 0 5000 0 4922 0 24280 0 14488 0 197045 PART I, LINE 3: ST. LUKE'S HOSPITAL, A RELATED TAX-EXEMPT ORGANIZATION OF ST. LUKE'S HOSPITAL FOUNDATION, USES THE FOLLOWING TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S TOP MANAGEMENT OFFICIALS: INDEPENDENT COMPENSATION CONSULTANT COMPENSATION SURVEY OR STUDY APPROVAL BY THE EXECUTIVE COMMITTEE OF THE BOARD. FORM 990, PART VI, SECTION A, LINE 1B: DANIEL L. WAKEMAN IS A COMPENSATED EMPLOYEE OF A RELATED ORGANIZATION, AND AS SUCH, IS CONSIDERED A NON-INDEPENDENT BOARD MEMBER. FORM 990, PART VI, SECTION A, LINE 2: KEITH BURMEISTER AND KERRY BURMEISTER HAVE A FAMILY RELATIONSHIP. FORM 990, PART VI, SECTION A, LINE 6: ST. LUKE'S HOLDING COMPANY, INC. IS THE SOLE MEMBER OF ST. LUKE'S HOSPITAL FOUNDATION. FORM 990, PART VI, SECTION A, LINE 7A: ST. LUKE'S HOLDING COMPANY, INC. (SLHC) IS THE PARENT CORPORATION AND SOLE MEMBER OF ST. LUKE'S HOSPITAL FOUNDATION. AS THE MEMBER, SLHC HAS THE RIGHT TO (A) NOMINATE AND ELECT A MINORITY OF THE MEMBERS AND REMOVE THE MEMBERS OF THE BOARD OF TRUSTEES OF ST. LUKE'S HOSPITAL FOUNDATION, AND (B) APPROVE THE NOMINEES TO FILL ANY VACANCIES ON THE BOARD OF TRUSTEES, A MAJORITY OF WHOM ARE NOMINATED BY ST. LUKE'S HOSPITAL FOUNDATION. FORM 990, PART VI, SECTION A, LINE 7B: WHILE THE BOARD OF TRUSTEES OF EACH CORPORATION IS GRANTED CERTAIN POWERS WITH RESPECT TO THEIR OPERATIONS, AS THE SOLE MEMBER, ST. LUKE'S HOLDING COMPANY, INC. (SLHC) RETAINS APPROVAL RIGHTS WITH RESPECT TO CERTAIN CORPORATE ACTIONS SUCH AS (1) ADOPTION OF THE CORPORATION'S STRATEGIC PLANS AND FINANCIAL PLANS, (2) EXPENDITURES FOR NON-BUDGETED ITEMS IN EXCESS OF CERTAIN DOLLAR LIMITS SET FROM TIME TO TIME BY SLHC, (3) EXPENDITURES FOR ITEMS WHICH ARE INCLUDED IN THE CORPORATION'S ANNUAL BUDGETS BUT WHICH EXCEED THE BUDGETED AMOUNT BY AN AMOUNT IN EXCESS OF CERTAIN DOLLAR LIMITS SET FROM TIME TO TIME BY SLHC, (4) INCURRENCE, ASSUMPTION OR GUARANTEE OF ANY INDEBTEDNESS, (5) SALE, LEASE OR OTHER DISPOSITION OF REAL PROPERTY OR ASSETS WITH A VALUE IN EXCESS OF CERTAIN DOLLAR LIMITS SET FROM TIME TO TIME BY SLHC AND (6) ANY MERGER, CONSOLIDATION, REORGANIZATION, DISSOLUTION OR LIQUIDATION. FORM 990, PART VI, SECTION B, LINE 11B: UNDER THE GUIDANCE OF ST. LUKE'S HOLDING COMPANY, INC. (SLHC) TAX CONSULTANTS, FORM 990'S ARE PREPARED BY THE RESPECTIVE ACCOUNTING DEPARTMENT OF EACH SLHC SUBSIDIARY AND REVIEWED BY THE RESPECTIVE SUBSIDIARY'S FINANCE LEADERSHIP ALONG WITH AN INDEPENDENT ACCOUNTING FIRM. AFTER SUBSIDIARY'S FINANCE LEADERSHIP APPROVAL, COPIES OF THE FORM 990 FOR SLHC AND THEIR SUBSIDIARIES ARE PROVIDED TO THE RESPECTIVE COMPANY'S BOARD OF TRUSTEES AND REVIEWED AND SIGNED BY THE RESPECTIVE COMPANY'S PRESIDENT PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C: ST LUKE'S HOLDING COMPANY, INC. AND SUBSIDIARIES (SLHC) HAVE STANDARDS OF ETHICAL BUSINESS PRACTICE THAT APPLY TO ALL SLHC BOARD MEMBERS AND EMPLOYEES. BOARD MEMBERS AND EMPLOYEES ARE EXPECTED TO CERTIFY THEIR COMPLIANCE WITH THE APPLICABLE STANDARDS PRIOR TO ELECTION/APPOINTMENT OR PRIOR TO BEGINNING EMPLOYMENT. BOARD MEMBERS ANNUALLY (OR IMMEDIATELY IF NEW POTENTIAL CONFLICTS OF INTEREST ARISE), ALL BOARD MEMBERS ARE REQUIRED TO COMPLETE AND RETURN THE BOARD MEMBER CERTIFICATION STATEMENT WITHIN 30 DAYS OF DISSEMINATION. BOARD MEMBER CERTIFICATION STATEMENTS ARE COMPILED AND REVIEWED BY THE ST. LUKE'S ADMINISTRATION OFFICE. SUMMARIZED INFORMATION IS FORWARDED FOR REVIEW TO THE CHIEF FINANCIAL OFFICER, LEGAL COUNSEL, ST. LUKE'S PRESIDENT AND THE VICE PRESIDENT OF MEDICAL AFFAIRS. THE PURPOSE OF THIS REVIEW IS TO BOTH INFORM MANAGEMENT OF THE DISCLOSED CONFLICTS AND TO BRING ANY POTENTIAL UNDISCLOSED CONFLICTS TO THE ATTENTION OF THE ST. LUKE'S ADMINISTRATION OFFICE. THE ST. LUKE'S ADMINISTRATION OFFICE THEN CONDUCTS AN AUDIT OF ALL BOARD MEMBER CERTIFICATION STATEMENTS (ALONG WITH ANY RELATIONSHIPS NOTED THROUGH THE ABOVE REVIEW) TO IDENTIFY ANY POSITIONAL CONFLICTS OF INTEREST AND TO TEST MATERIAL TRANSACTIONS WITH BOARD MEMBERS/THEIR AFFILIATES FOR FAIR MARKET VALUE. SIGNIFICANT POTENTIAL CONFLICTS OF INTEREST ARE REVIEWED WITH GENERAL COUNSEL FOR RECOMMENDATIONS TO THE COMPLIANCE COMMITTEE FOR CORRECTIVE ACTION. LUKE'S ADMINISTRATION OFFICE FORWARDS THE COMPLIANCE OFFICER A REPORT OF BOARD MEMBERS WHO HAVE SIGNED AND RETURNED THE ANNUAL BOARD MEMBER CERTIFICATION STATEMENT, SIGNIFICANT POTENTIAL CONFLICTS DISCLOSED AND THE RESOLUTION OF SUCH CONFLICTS. THE COMPLIANCE OFFICER ISSUES A REPORT TO THE COMPLIANCE COMMITTEE OF THESE FINDINGS. THE CERTIFICATION STATEMENT, OR THE FILING OF A FALSE OR INCOMPLETE CERTIFICATION STATEMENT, OR FAILURE TO DISCLOSE IMMEDIATELY ANY NEW CONFLICTS OF INTEREST THAT MAY ARISE, OR FAILURE TO COOPERATE WITHOUT CONDITION, HONESTLY AND COMPLETELY WITH ANY INVESTIGATION OR REVIEW OF THE BOARD MEMBER'S CERTIFICATION STATEMENT OR HIS/HER ACTIONS OR CIRCUMSTANCES SHALL BE GROUNDS FOR SANCTION BY THE BOARD OF TRUSTEES UP TO AND INCLUDING REMOVAL FROM THE BOARD/COMMITTEE/COUNCIL. EMPLOYEES, EXCLUDING EXMPLOYED PHYSICIANS ALL NEW EMPLOYEES, EXCLUDING EMPLOYED PHYSICIANS, ARE PROVIDED A PAPER COPY OF THE EMPLOYEE STANDARDS OF ETHICAL BUSINESS AND THE EMPLOYEE CERTIFICATION STATEMENT WHICH THE NEW EMPLOYEE IS REQUIRED TO COMPLETE PRIOR TO BEGINNING EMPLOYMENT. ANNUALLY (OR IMMEDIATELY IF NEW POTENTIAL CONFLICTS OF INTEREST ARISE), ALL SALARIED EMPLOYEES AND SPECIFICALLY IDENTIFIED HOURLY EMPLOYEES, EXCLUDING EMPLOYED PHYSICIANS, ARE REQUIRED TO COMPLETE AND SUBMIT AN ELECTRONIC EMPLOYEE CERTIFICATION STATEMENT BY AN ESTABLISHED DEADLINE THAT IS COMMUNICATED TO THE EMPLOYEE. THE HUMAN RESOURCES DEPARTMENT ENSURES THAT ALL STATEMENTS, WHICH ARE STORED ELECTRONICALLY, ARE COMPLETED AND PROVIDES NOTIFICATION TO THE COMPLIANCE OFFICER OF THE NUMBER OF ANNUAL EMPLOYEE CERTIFICATION STATEMENTS SENT AND COMPLETED AND COPIES OF ANY STATEMENTS CONTAINING DISCLOSURES THAT WARRANT FURTHER REVIEW. THE HUMAN RESOURCE ADMINISRATIVE DIRECTOR REPORTS IDENTIFIED CONFLICTS TO THE COMPLIANCE COMMITTEE. IF THE CONFLICT IS CONSIDERED A SIGNIFICANT EXPOSURE RISK FOR SLHC, A RECOMMENDATION WILL BE PREPARED BY THE COMPLIANCE COMMITTEE FOR FINAL APPROVAL BY THE ST. LUKES PRESIDENT. FAILURE TO COMPLETE THE CERTIFICATION STATEMENT, OR THE COMPLETION OF A FALSE OR INCOMPLETE CERTIFICATION STATEMENT, OR FAILURE TO DISCLOSE IMMEDIATELY ANY NEW CONFLICTS OF INTEREST THAT MAY ARISE, OR FAILURE TO COOPERATE WITHOUT CONDITION, HONESTLY AND COMPLETELY WITH ANY INVESTIGATION OR REVIEW OF THE EMPLOYEES CERTIFICATION STATEMENT OR HIS/HER ACTIONS OR CIRCUMSTANCES SHALL BE GROUNDS FOR SANCTION UP TO AND INCLUDING TERMINATION OF EMPLOYMENT. EMPLOYED PHYSICIANS ALL NEW EMPLOYED PHYSICIANS ARE PROVIDED EITHER AN ELECTRONIC OR PAPER COPY OF THE EMPLOYED PHYSICIAN STANDARD OF CONDUCT AND THE PHYSICIAN CERTIFICATION STATEMENT WHICH THE NEW PHYSICIAN IS REQUIRED TO COMPLETE PRIOR TO BEGINNING EMPLOYMENT. ANNUALLY (OR IMMEDIATELY IF NEW POTENTIAL CONFLICTS OF INTEREST ARISE), ALL EMPLOYED PHYSICIANS ARE REQUIRED TO COMPLETE AND SUBMIT AN ELECTRONIC PHYSICIAN CERTIFICATION STATEMENT BY THE ESTABLISHED AND COMMUNICATED DEADLINE. THE HUMAN RESOURCE ADMINISTRATIVE DIRECTOR ENSURES THAT ALL CERTIFICATION STATEMENTS, WHICH ARE STORED ELECTRONICALLY, ARE REVIEWED. IDENTIFIED CONFLICTS ARE REPORTED TO THE COMPLIANCE COMMITTEE. IF THE CONFLICT IS CONSIDERED A SIGNIFICANT EXPOSURE RISK FOR SLHC, A RECOMMENDATION WILL BE PREPARED BY THE COMPLIANCE COMMITTEE FOR FINAL APPROVAL BY THE ADMINISTRATOR WITH PRIMARY RESPONSIBILITY FOR THE PHYSICIANS EMPLOYMENT AGREEMENT AND/OR THE BOARD OF TRUSTEES. THE HUMAN RESOURCES DEPARTMENT FORWARDS THE COMPLIANCE OFFICER A REPORT OF THE NUMBER OF ANNUAL PHYSICIAN CERTIFICATION STATEMENTS SENT AND COMPLETED AND COPIES OF ANY STATEMENTS CONTAINING DISCLOSURES THAT WARRANT FURTHER REVIEW. THE COMPLIANCE OFFICER ISSUES AN ANNUAL REPORT TO THE COMPLIANCE COMMITTEE OF THESE FINDINGS. ANY ITEMS THAT MEET CRITERIA FOR PUBLIC DISCLOSURE WILL BE COMMUNICATED TO THE APPROPRIATE PHYSICIAN BY THE ASSIGNED ADMINISTRATOR. THE ADMINISTATOR WILL PROVIDE THE PHYSICIAN-INDUSTRY RELATIONSHIP DISCLOSURES TO THE APPLICABLE SLHC MARKETING COMMUNICATIONS REPRESENTATIVE. THE PUBLIC DISCLOSURE WILL BE POSTED ON THE ST. LUKES HOSPITAL WEBSITE (STLUKESHOSPITAL.COM) BY THE SLHC MARKETING COMMUNICATIONS REPRESENTATIVE. FAILURE TO FILE THE CERTIFICATION STATEMENT, OR THE FILING OF A FALSE OR INCOMPLETE CERTIFICATION STATEMENT, OR FAILURE TO DISCLOSE IMMEDIATELY ANY NEW CONFLICTS OF INTEREST THAT MAY ARISE, OR FAILURE TO COOPERATE WITHOUT CONDITION, HONESTLY AND COMPLETELY WITH ANY INVESTIGATION OR REVIEW OF THE PHYSICIANS CERTIFICATION STATEMENT OR HIS/HER ACTIONS OR CIRCUMSTANCES SHALL BE GROUNDS FOR SANCTION BY THE VICE PRESIDENT OF MEDICAL AFFAIRS OR BOARD OF TRUSTEES UP TO AND INCLUDING TERMINATION OF THE PHYSICIANS ASSOCIATION/CONTRACT WITH SLHC. FORM 990, PART VI, SECTION B, LINE 15: ST. LUKE'S HOSPITAL FOUNDATION'S TOP MANAGEMENT OFFICIAL AND OTHER OFFICERS ARE COMPENSATED BY ST. LUKE'S HOSPITAL (SLH), A RELATED TAX EXEMPT ORGANIZATION. COMPENSATION DETERMINATIONS OF ST. LUKE'S HOSPITAL FOUNDATION'S TOP MANAGEMENT OFFICIAL AND OTHER OFFICERS ARE MADE BY AN EXECUTIVE COMMITTEE OF THE BOARD OF SLH. EACH YEAR INDEPENDENT CONSULTANTS CONDUCT AN ANNUAL SURVEY AND RECOMMEND EXECUTIVE PAYROLL BASE SALARY RANGES BASED UPON THE MARKET. THE DATA IS REVIEWED AND APPROVED BY THE SLH EXECUTIVE COMMITTEE OF THE BOARD EVERY NOVEMBER. SALARY ADJUSTMENTS ARE DETERMINED AT THE NOVEMBER MEETING OF THE EXECUTIVE COMMITTEE OF THE BOARD. THE EXECUTIVE COMMITTEE OF THE BOARD APPROVES OTHER FORMS OF COMPENSATION BASED UPON THE PRIOR YEAR PERFORMANCE AT THE FEBRUARY MEETING EACH YEAR. FORM 990, PART VI, SECTION C, LINE 19: ST. LUKE'S HOLDING COMPANY, INC. AND SUBSIDIARIES PROVIDE ANY DOCUMENT OPEN TO PUBLIC INSPECTION UPON REQUEST. COBRA VENTURES LLC 5901 MONCLOVA RD MAUMEE OH 43537 204671613 LAND LEASING OH 5890 743472 ST LUKE HF WELLCARE PHYSICIANS LLC 5904 MONCLOVA RD MAUMEE OH 43537 611528443 EMPLOYS PHYS OH ST LUKE HC CARE ENTERPRISES INC 5901 MONCLOVA RD MAUMEE OH 43537 341366709 FAC LEASING OH 501(C)(3) 12B ST LUKE HC false ST LUKE'S HOSPITAL 5901 MONCLOVA RD MAUMEE OH 43537 344428232 HOSPITAL OH 501(C)(3) 3 ST LUKE HC false ST LUKE'S HOLDING COMPANY INC 5901 MONCLOVA RD MAUMEE OH 43537 812599592 PARENT CO OH 501(C)(3) 12B NA false WATERVILLE MEDICAL CENTER LLC 5901 MONCLOVA RD MAUMEE OH 43537 320160784 FAC LEASING OH CARE ENTERPRISE N/A false false OHIO CARE AMBULATORY SURGICAL 5959 MONCLOVA RD MAUMEE OH 43537 344428232 SURGICAL CTR OH ST LUKE HOSPITA N/A false false CARE HOLDINGS 5901 MONCLOVA RD MAUMEE OH 43537 341796790 HOLDING CO OH ST LUKE HC C CORP false PHYSICIAN ADVANTAGE MSO 5901 MONCLOVA RD MAUMEE OH 43537 061811760 PHY MGMT SVCS OH ST LUKE HC C CORP false false true true false false false false false false false false false false false true true false false false