ST LUKES HOSPITAL INC: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- ST LUKES HOSPITAL INC (EIN 56-0554222)
- Tax period
- 2015-10-01 to 2016-09-30
- Filed
- 2017-05-15
- IRS object ID
- 201731359349300113
- Schema version
- 2015v3.0
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-05-15T05:52:45-05:00 | ReturnTs |
| Tax Period End | 2016-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 560747981 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DIXON HUGHES GOODMAN LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 500 RIDGEFIELD COURT | AddressLine1Txt |
| City | ASHEVILLE | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 28806 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 560554222 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ST LUKE'S HOSPITAL 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 | 2017-05-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | AMY BIBBY | PreparerPersonNm |
| PTIN | P00445891 | PTIN |
| Phone | 8282542254 | PhoneNum |
| Preparation | 2017-05-08 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | 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 | $38,132,549 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.SAINTLUKESHOSPITAL.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1928 | FormationYr |
| Legal Domicile State | NC | LegalDomicileStateCd |
| Activity Or Mission | THE HOSPITAL PROVIDES INPATIENT, OUTPATIENT, AND EMERGENCY SERVICES TO ITS PATIENTS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 14 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 12 | VotingMembersIndependentCnt |
| Total Employee | 323 | TotalEmployeeCnt |
| Total Volunteers | 76 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $576,039 | PYContributionsGrantsAmt |
| CY Contributions Grants | $389,675 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $35,195,045 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $37,330,235 | CYProgramServiceRevenueAmt |
| PY Investment Income | $232,853 | PYInvestmentIncomeAmt |
| CY Investment Income | $246,417 | CYInvestmentIncomeAmt |
| PY Other Revenue | $148,904 | PYOtherRevenueAmt |
| CY Other Revenue | $157,597 | CYOtherRevenueAmt |
| PY Total Revenue | $36,152,841 | PYTotalRevenueAmt |
| CY Total Revenue | $38,123,924 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | 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 | $13,663,001 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $13,773,134 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $18,454,128 | PYOtherExpensesAmt |
| CY Other Expenses | $20,480,617 | CYOtherExpensesAmt |
| PY Total Expenses | $32,117,129 | PYTotalExpensesAmt |
| CY Total Expenses | $34,253,751 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $4,035,712 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $3,870,173 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $35,389,462 | TotalAssetsBOYAmt |
| Total Assets EOY | $40,239,331 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $8,613,394 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $9,208,716 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $26,776,068 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $31,030,615 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO PROVIDE THE HIGHEST QUALITY FOCUSED HEALTHCARE SERVICES TO THE RESIDENTS OF POLK COUNTY AND SURROUNDING COMMUNITIES IN A SAFE, ETHICAL, COST EFFECTIVE MANNER. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $29,161,436 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $37,375,908 | RevenueAmt |
| Desc | ST. LUKE'S HOSPITAL IS COMMITTED TO OPERATE A HEALTH SYSTEM THAT PROVIDES HOSPITAL, ACUTE AND EMERGENCY CARE AND ADVANCED SERVICES SUCH AS ADVANCED REHABILITATIVE SERVICES, RADIOLOGY SERVICES, LAB SERVICES, PAIN MANAGEMENT SERVICES, THERAPY, INTENSIVE OUTPATIENT PSYCHOTHERAPY, AND GERIATRIC-PSYCHIATRIC CARE FOR ADULTS 55+ WHO SUFFER FROM DEPRESSION, DEMENTIA, ALZHEIMER'S AND OTHER MENTAL HEALTH DISORDERS, FOR THE BENEFIT OF THE RESIDENTS OF POLK COUNTY AND SURROUNDING COMMUNITIES. COMMITMENT TO THIS MISSION REQUIRES BOTH AN "INVESTMENT IN AND A "PARTNERSHIP WITH" THE COMMUNITY WHICH ST. LUKE'S HOSPITAL SERVES. SEE SCHEDULE O FOR CONTINUATION:DURING FY 2016, THE ORGANIZATION HAD APPROXIMATELY 21,000 VISITS. ST. LUKE'S HOSPITAL DEFINES AND MEASURES THIS "INVESTMENT IN AND A "PARTNERSHIP WITH" THE COMMUNITY USING THE FOLLOWING CATEGORIES OF COMMUNITY BENEFIT: COMMUNITY BENEFIT PROGRAMS - INCLUDES THE UNREIMBURSED COST OF VARIOUS EDUCATION PROGRAMS, NON-BILLED MEDICAL SERVICES, IN-KIND DONATIONS AND OTHER SERVICES THAT MEET A STRONG COMMUNITY NEED, BUT DO NOT PAY FOR THEMSELVES. EXAMPLES OF THESE COMMUNITY BENEFIT PROGRAMS INCLUDE PERIODIC HEALTHTALK PROGRAMS TO PROVIDE EDUCATION AND UPDATED INFORMATION ON PARTICULAR AND TIMELY HEALTH TOPICS; VARIOUS HEALTH AND CANCER SCREENINGS FOR PEOPLE WHO ARE UNDERINSURED AND UNINSURED; AND FIRST AID AND HAND HYGIENE STATIONS AT VARIOUS COMMUNITY EVENTS AND FESTIVALS. OUR GENEROUS IN-KIND CONTRIBUTIONS TO NUMEROUS POLK COUNTY SOCIAL SERVICES AND CIVIC ENTITIES INCLUDE VOLUNTEER LEADERSHIP ROLES WITH POLK FIT, FRESH, AND FRIENDLY, POLK WELLNESS CENTER, HIGHWOODS APARTMENTS FOR LOW INCOME FAMILIES, MENTAL HEALTH TASK FORCE FOR COMMUNITY HEALTH, THERMAL BELT OUTREACH HEALTH CARE COMMITTEE AND THE POLK COUNTY VISIONING COMMISSION, TO NAME A FEW. CIVIC PARTICIPATION INCLUDES TRYON KIWANIS CLUB, FOOTHILLS CHAMBER OF COMMERCE, TRYON ROTARY CLUB AND THE BLUE RIDGE HUNTER JUMPER ASSOCIATION, AMONG OTHERS. ST. LUKE'S HOSPITAL, OUR MEDICAL STAFF AND OUR EMPLOYEES CONTRIBUTE GENEROUSLY TO THE HEALTH, EDUCATION AMD WELL-BEING OF ALL AGES AND CIRCUMSTANCES IN POLK COUNTY. | Desc |
| Total Program Service Expenses | $29,161,436 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | 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 |
| Temp Or Permanent Endowments | Yes (1) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | 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 | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| 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 With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| 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 | 20 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 323 | 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 |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 14 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 12 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (1) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | 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 | Yes (1) | 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 |
| States Where Copy Of Return Is Fld | NC | StatesWhereCopyOfReturnIsFldCd |
| 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 |
Form990 Part VII Section A Form990PartVIISectionAGrp (21 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| CLARK BENSON | ||||||||
| CHAIR | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| JEAN SHUMWAY | ||||||||
| VICE CHAIR | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| MARION MCMILLAN | ||||||||
| TREASURER | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| DR WARREN CARSON | ||||||||
| SECRETARY | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| MICHAEL BAUGHMAN | ||||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| LAURA ELLINGTON | ||||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| LARY WASSON | ||||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| DR LINDA GREENSFELDER | ||||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| DON HOFMANN | ||||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| JAMES HOLLEMAN MD | ||||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $261,794 | $44,794 | 45.00 | ||
| SANDRA MCCORMACK MD | ||||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| TOMMY MELTON | ||||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| BRIAN ROSENBERG MD | ||||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $1,124,100 | $68,740 | 45.00 | ||
| PAUL SUTHERLAND | ||||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| ELIZABETH PRESNELL | ||||||||
| CFO | 40.00 | Yes (X) | $133,877 | $0 | $37,931 | |||
| KEN SHULL | ||||||||
| CEO (THROUGH 8/16) | 45.00 | Yes (X) | $255,404 | $0 | $52,528 | |||
| JAMES BROSS | ||||||||
| CEO (BEGAN 8/16) | 45.00 | Yes (X) | $0 | $0 | $0 | |||
| CATHY MOORE | ||||||||
| CNO | 40.00 | Yes (X) | $128,000 | $0 | $10,516 | |||
| DR BELYNDA VESER | ||||||||
| PHYSICIAN | 40.00 | $157,503 | $0 | $39,233 | Yes (X) | |||
| LYNN CROCKER | ||||||||
| PHARMACY DIRECTOR | 40.00 | $113,081 | $0 | $42,255 | Yes (X) | |||
| KEVIN REYNOLDS | ||||||||
| PHARMACIST | 40.00 | $115,099 | $0 | $32,239 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $902,964 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,385,894 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $328,236 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 6 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (4 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| CAROLINAS HEALTHCARE SYSTEM | |||||
| PO BOX 32861 | CHARLOTTE | NC | 28232 | MANAGEMENT CONTRACT | $1,681,089 |
| VMAX ASSOCIATION PA | |||||
| 72 ALPINE WAY | ASHEVILLE | NC | 28805 | ANESTHESIA SERVICES | $770,898 |
| RIVERSIDE EMERGENCY | |||||
| PO BOX 674579 | DETROIT | MI | 48267 | PHYSICIAN SERVICES | $578,790 |
| EMCARE PHYSICIAN SERVICES INC | |||||
| 7032 COLLECTIN CENTER DRIVE | CHICAGO | IL | 60693 | PHYSICIAN SERVICES | $316,660 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 4 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $37,158 | RelatedOrganizationsAmt |
| All Other Contributions | $352,517 | AllOtherContributionsAmt |
| Total Contributions | $389,675 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT SERVICE REVENUE | 621990 | $37,282,451 | $37,282,451 |
| OTHER PATIENT SERVICES | 621990 | $44,639 | $44,639 |
| PHYSICAL THERAPY FEES | 900099 | $3,145 | $3,145 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $37,330,235 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $255,042 | TotalRevenueColumnAmt |
| Exclusion | $255,042 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $45,673 | 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 | $45,673 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $45,673 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $45,673 | RelatedOrExemptFuncIncomeAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $8,625 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -$8,625 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$8,625 | TotalRevenueColumnAmt |
| Exclusion | -$8,625 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| CAFETERIA/MEALS | 900099 | $57,984 | $57,984 |
| PURCHASE DISCOUNTS | 900099 | $52,058 | $52,058 |
| VENDING | 900099 | $1,882 | $1,882 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $111,924 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $38,123,924 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $37,375,908 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $358,341 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $493,755 | TotalAmt |
| Management And General | $493,755 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,344,495 | TotalAmt |
| Program Services | $8,383,876 | ProgramServicesAmt |
| Management And General | $960,619 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,191,484 | TotalAmt |
| Program Services | $2,719,692 | ProgramServicesAmt |
| Management And General | $471,792 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $743,400 | TotalAmt |
| Program Services | $633,504 | ProgramServicesAmt |
| Management And General | $109,896 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $36,719 | TotalAmt |
| Management And General | $36,719 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,125 | TotalAmt |
| Management And General | $3,125 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,730,968 | TotalAmt |
| Program Services | $4,261,329 | ProgramServicesAmt |
| Management And General | $2,469,639 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $406 | TotalAmt |
| Management And General | $406 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $886,192 | TotalAmt |
| Program Services | $500,973 | ProgramServicesAmt |
| Management And General | $385,219 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,313,546 | TotalAmt |
| Program Services | $1,176,937 | ProgramServicesAmt |
| Management And General | $136,609 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $54,270 | TotalAmt |
| Program Services | $29,734 | ProgramServicesAmt |
| Management And General | $24,536 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $156,087 | TotalAmt |
| Program Services | $156,087 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $936,601 | TotalAmt |
| Program Services | $936,601 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $147,339 | TotalAmt |
| Program Services | $147,339 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (2 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| MEDICAL SUPPLIES | $5,592,462 | $5,592,462 |
| BAD DEBT EXPENSE | $4,622,902 | $4,622,902 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $34,253,751 | TotalAmt |
| Program Services | $29,161,436 | ProgramServicesAmt |
| Management And General | $5,092,315 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,053,551 | BOYAmt |
| EOY | $7,313,891 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,607,779 | BOYAmt |
| EOY | $3,608,590 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $628,983 | BOYAmt |
| EOY | $703,055 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $224,428 | BOYAmt |
| EOY | $245,691 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $28,358,747 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $17,429,341 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,069,432 | BOYAmt |
| EOY | $10,929,406 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,594,981 | BOYAmt |
| EOY | $8,218,804 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $546,110 | BOYAmt |
| EOY | $548,346 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,664,198 | BOYAmt |
| EOY | $8,671,548 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $35,389,462 | BOYAmt |
| EOY | $40,239,331 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,152,342 | BOYAmt |
| EOY | $3,528,899 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,320,351 | BOYAmt |
| EOY | $3,122,323 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,140,701 | BOYAmt |
| EOY | $2,557,494 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,613,394 | BOYAmt |
| EOY | $9,208,716 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,748,381 | BOYAmt |
| EOY | $29,974,083 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $922,805 | BOYAmt |
| EOY | $951,650 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $104,882 | BOYAmt |
| EOY | $104,882 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $26,776,068 | BOYAmt |
| EOY | $31,030,615 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $35,389,462 | BOYAmt |
| EOY | $40,239,331 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $3,870,173 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $384,374 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| 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 C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $2,220 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $2,220 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | THE HOSPITAL PAID DUES TO AHA AND NCHA, AMOUNTS ALLOCATED FOR LOBBYING ARE ESTIMATED AT: $828 FOR NCHA AND $1,392 FOR THE FISCAL YEAR ENDING SEPTEMBER 30, 2016. | ExplanationTxt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $4,228,974 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $426,783 | InvestmentEarningsOrLossesAmt |
| Administrative Expenses | $65,041 | AdministrativeExpensesAmt |
| End Year Balance | $4,590,716 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $3,694,903 | BeginningYearBalanceAmt |
| Contributions | $637,814 | ContributionsAmt |
| Investment Earnings Or Losses | -$103,743 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $4,228,974 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $3,348,197 | BeginningYearBalanceAmt |
| Contributions | $32,351 | ContributionsAmt |
| Investment Earnings Or Losses | $314,355 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $3,694,903 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $2,971,426 | BeginningYearBalanceAmt |
| Contributions | $47,323 | ContributionsAmt |
| Investment Earnings Or Losses | $329,448 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $3,348,197 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $2,546,063 | BeginningYearBalanceAmt |
| Contributions | $40,350 | ContributionsAmt |
| Investment Earnings Or Losses | $385,013 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $2,971,426 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.82830 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.07580 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.09590 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | Yes (1) | EndowmentsHeldRelatedOrgInd |
| Related Org List Sch R | Yes (1) | RelatedOrgListSchRInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $59,433 | OtherCostOrOtherBasisAmt |
| Book Value | $59,433 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $13,953,651 | OtherCostOrOtherBasisAmt |
| Depreciation | $7,822,886 | DepreciationAmt |
| Book Value | $6,130,765 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $442,032 | OtherCostOrOtherBasisAmt |
| Depreciation | $395,482 | DepreciationAmt |
| Book Value | $46,550 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $13,015,792 | OtherCostOrOtherBasisAmt |
| Depreciation | $9,210,973 | DepreciationAmt |
| Book Value | $3,804,819 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $887,839 | OtherCostOrOtherBasisAmt |
| Book Value | $887,839 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $10,929,406 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (2 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| INTERCOMPANY NOTES RECEIVABLE | $8,656,747 |
| ESTIMATED THIRD PARTY SETTLEMENTS | $14,801 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $8,671,548 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| THIRD PARTY PAYABLE | $2,523,950 |
| CEDRIC SEAMAN CHARITABLE TRUST | $33,544 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $2,557,494 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $33,882,271 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $384,374 | NetUnrealizedGainsInvstAmt |
| Revenue Not Reported | $384,374 | RevenueNotReportedAmt |
| Revenue Subtotal | $33,497,897 | RevenueSubtotalAmt |
| Investment Expenses Not Incld | $3,125 | InvestmentExpensesNotIncldAmt |
| Other Revenues Not Included | $4,622,902 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $4,626,027 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $38,123,924 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $29,627,724 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $29,627,724 | ExpensesSubtotalAmt |
| Investment Expenses Not Incld2 | $3,125 | InvestmentExpensesNotIncld2Amt |
| Other Expenses Not Included | $4,622,902 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $4,626,027 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $34,253,751 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, LINE 4: | THE ORGANIZATION'S ENDOWMENT FUNDS ARE ORGANIZED TO PROVIDE FUNDS FOR GENERAL PURPOSES. |
| PART X, LINE 2: | THE HOSPITAL, THE FOUNDATION, INC., 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 OBLIGATIONS AS OF SEPTEMBER 30, 2016. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | PROVISION FOR UNCOLLECTIBLE ACCOUNTS 4,622,902. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | PROVISION FOR UNCOLLECTIBLE ACCOUNTS 4,622,902. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $340,274 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $340,274 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01150 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,014,016 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,343,154 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $670,862 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02260 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,354,290 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,343,154 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,011,136 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03410 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $6,090 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $6,090 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $173,128 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $173,128 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00580 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,025,238 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,619,903 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $405,335 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01370 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,564 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $4,564 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,209,020 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,619,903 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $589,117 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01990 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,563,310 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,963,057 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,600,253 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05400 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReportedInd |
| Bad Debt Expense | $4,622,902 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $1,392,317 | BadDebtExpenseAttributableAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ST LUKE'S HOSPITAL | BusinessNameLine1Txt |
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) |
|---|---|---|
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ST LUKE'S HOSPITAL INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| CHNA Conducted | 15 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (1) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | SEE PART V SUPPLEMENTAL INFORMATION | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Rpt Available Thru Other Method | Yes (X) | RptAvailableThruOtherMethodInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 12 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | HTTP://WWW.SAINTLUKESHOSPITAL.COM/DOCS/CHIP.PDF | StrategyWebsiteURLTxt |
| Strategy Attached | 0 | StrategyAttachedInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 300.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Income Level Criteria | Yes (X) | IncomeLevelCriteriaInd |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | HTTP://WWW.SAINTLUKESHOSPITAL.COM/GETPAGE.PHP?NAME=FINANCIAL-ASSISTANCE&SUB | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | HTTP://WWW.SAINTLUKESHOSPITAL.COM/GETPAGE.PHP?NAME=FINANCIAL-ASSISTANCE&SUB | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | HTTP://WWW.SAINTLUKESHOSPITAL.COM/GETPAGE.PHP?NAME=FINANCIAL-ASSISTANCE&SUB | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| FAP Notice Displayed | Yes (X) | FAPNoticeDisplayedInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified Before Discharge | Yes (X) | FAPNotifiedBeforeDischargeInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Other Method Used | Yes (X) | OtherMethodUsedInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| ST. LUKE'S HOSPITAL, INC. | PART V, SECTION B, LINE 5: MARKETING/PUBLIC RELATIONS DIRECTOR REPRESENTED ST. LUKE'S HOSPITAL WITH WNC HEALTHY IMPACT FOR COLLABORATING/GENERATING/ANALYZING DEMOGRAPHIC AND HEALTH DATA. THE DIRECTOR ALSO SERVES ON BOARD OF POLK COUNTY'S LOCAL HEALTH COALITION, POLK FIT, FRESH, FRIENDLY. WE COLLABORATED WITH RUTHERFORD-POLK-MCDOWELL HEALTH DISTRICT TO ORGANIZE A COMMUNITY HEALTH FORUM AND DEVELOPED CHIP FROM THOSE RESULTS. |
| ST. LUKE'S HOSPITAL, INC. | PART V, SECTION B, LINE 6A: THE HOSPITAL MADE THE CHNA AVAILABLE TO THE LOCAL NEWS MEDIA/NEWSLETTERS. |
| ST. LUKE'S HOSPITAL, INC. | PART V, SECTION B, LINE 6B: WESTERN HEALTH NETWORK COALITION |
| ST. LUKE'S HOSPITAL, INC. | PART V, SECTION B, LINE 7D: HTTP://WWW.SAINTLUKESHOSPITAL.COM/DOCS/HEALTH_ASSESSMENT_POLK_COUNTY_9-6-13.PDF |
| ST. LUKE'S HOSPITAL, INC. | PART V, SECTION B, LINE 11: IN REVIEWING DATA AND COMMUNITY CONCERNS, WE SELECTED SEVERAL HEALTH CONCERNS THAT WE HAVE THE CAPABILITY/RESOURCES TO AFFECT. A VARIETY OF DATA AND INFORMATION WAS COLLECTED FOR THE CHNA. THE PROCESS INCLUDED REVIEW AND ANALYSIS OF:1) SECONDARY, QUANTITATIVE STATISTICAL DATA;2) PRIMARY, QUALITATIVE COMMUNITY FEEDBACK;3) CURRENT COMMUNITY HEALTH RESOURCES AND ST. LUKE'S SPECIFIC ASSETS. TO SELECT PRIORITIES AND RELATED STRATEGIES THAT WE HAD CAPACITY TO IMPROVE, THE FOLLOWING CRITERIA WERE CONSIDERED:- DATA AND COMMUNITY INDICATES AN IMPORTANT NEED IN THE COMMUNITY- ST. LUKE'S HOSPITAL AND PARTNER-PROVIDERS HAVE CAPACITY TO MAKE AN IMPACT- ADDRESSING A SELECTED ISSUE HOLDS POTENTIAL TO AFFECT OTHER HEALTH CONDITIONS- STRATEGIES ALIGN WITH ST. LUKE'S CAPACITY AND MISSION |
| ST. LUKE'S HOSPITAL, INC. | PART V, SECTION B, LINE 22D: THEY USE THE AVERAGE AMOUNTS BILLED FOR INSURANCE COMPANIES AND MEDICARE AS THE MAXIMUM DISCOUNT AMOUNT GIVEN TO COMMERCIAL/MANAGED CARE PAYORS. |
| PART V, SECTION B, LINE 7A: | HTTP://WWW.RPMHD.ORG/IMAGES/FORMS/1000/1120/CHA/2016/RPM1120.001.2016-P.PDF |
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 7: | THE ORGANIZATION UTILIZED THE IRS WORKSHEETS TO DETERMINE THE COST TO CHARGE RATIO |
| PART I, LINE 7G: | OPERATION OF EMERGENCY DEPARTMENT AT A LOSS FOR THE BENEFIT OF THE COMMUNITY |
| PART I, LN 7 COL(F): | THE TOTAL EXPENSE ON FORM 990 PART XI, LN 25 CONTAINS A BAD DEBT EXPENSE OF 4,622,902 THAT HAS BEEN REMOVED FOR THE CALCULATION OF CHARITY CARE PERCENTAGE. |
| PART II, COMMUNITY BUILDING ACTIVITIES: | *COMMUNITY BENEFIT PROGRAMS-INCLUDES THE UNREIMBURSED COST OF VARIOUS EDUCATION PROGRAMS, NON-BILLED MEDICAL SERVICES, IN-KIND DONATIONS AND OTHER SERVICES THAT MEET A STRONG COMMUNITY NEED, BUT DO NOT PAY FOR THEMSELVES. EXAMPLES OF THESE COMMUNITY BENEFIT PROGRAMS INCLUDE PERIODIC HEALTHTALK PROGRAMS TO PROVIDE EDUCATION AND UPDATED INFORMATION ON PARTICULAR AND TIMELY HEALTH TOPICS; VARIOUS HEALTH AND CANCER SCREENINGS FOR THE COMMUNITY, SCHOOLS, CHURCHES; AND FIRST AID AND HAND HYGIENE STATIONS AT VARIOUS COMMUNITY EVENTS AND FESTIVALS.OUR GENEROUS IN-KIND CONTRIBUTIONS TO NUMEROUS POLK COUNTY SOCIAL SERVICES AND CIVIC ENTITIES INCLUDE VOLUNTEER LEADERSHIP ROLES WITH POLK FIT, FRESH, FRIENDLY, POLK COUNTY WELLNESS COALITION, POLK WELLNESS CENTER, HIGHWOODS APARTMENTS FOR LOW INCOME FAMILIES, THERMAL BELT OUTREACH HEALTH CARE COMMITTEE AND THE POLK COUNTY VISIONING COMMISSION, TO NAME A FEW. CIVIC PARTICIPATION INCLUDES TRYON KIWANIS CLUB, FOOTHILLS CHAMBER OF COMMERCE, TRYON ROTARY CLUB AND THE BLUE RIDGE HUNTER JUMPER ASSOCIATION, AMONG OTHERS. |
| PART III, LINE 4: | THE PATIENT FINANCIAL ADVISOR REVIEWED THE FINANCIAL ASSISTANCE SPREADSHEETS FOR THE 2015 TAX PERIOD AND TOOK INTO ACCOUNT ALL ACCOUNTS THAT LEFT PATIENT RESPONSIBILITY. THE ACCOUNTS WERE THEN REVIEWED TO SEE IF THE PATIENT PAID OR IF THE ACCOUNTS CYCLED TO BAD DEBT.THE ORGANIZATION HAS ESTIMATED THAT A PORTION OF ITS BAD DEBTS COULD HAVE POTENTIALLY QUALIFIED FOR FINANCIAL ASSISTANCE UNDER ITS FINANCIAL ASSISTANCE POLICY. THE ORGANIZATION ESTIMATES APPROXIMATELY 33% OF ITS BAD DEBT REPRESENTS CHARITY CARE. |
| PART III, LINE 8: | AN INTERNAL COST-TO-CHARGE RATIO WAS USED TO COMPUTE MEDICARE ALLOCABLE COSTS OF CARE ON PART III, LN 6 AND IS USED IN THE ORGANIZATIONS COST REPORT. |
| PART III, LINE 9B: | THE ORGANIZATION APPLIES THE SAME PROCEDURE TO ALL ACCOUNTS WHICH PROVIDE FOR THE MAILING OF TWO STATEMENTS, TWO LETTERS, AND TWO PHONE CALLS PRIOR TO MOVING THE ACCOUNT TO THE COLLECTION PROCESS. |
| PART VI, LINE 2: | EVERY FOUR YEARS THE STATE OF NORTH CAROLINA REQUIRES EVERY LOCAL HEALTH DEPARTMENT AND NORTH CAROLINA HEALTHY CAROLINIANS PARTNERSHIPS TO CONDUCT A COMMUNITY HEALTH ASSESSMENT. A COMMUNITY HEALTH ASSESSMENT IS A PROCESS THAT ALLOWS THE MEMBERS OF THE COMMUNITY AND STAKEHOLDERS TO GAIN A BETTER UNDERSTANDING OF THE COUNTY'S HEALTH NEEDS AND CONCERNS.FOR SEVERAL YEARS, ST. LUKE'S HOSPITAL HAS COLLABORATED WITH WNC HEALTHY IMPACT FOR A COMPREHENSIVE COMMUNITY HEALTH ASSESSMENT (CHA). USING AVAILABLE DATA AND A CROSS-SECTION OF COUNTY RESIDENTS, WE SURVEY MEMBERS OF THE COMMUNITY REGARDING THEIR PERCEIVED HEALTHCARE NEEDS AND DISPARITIES. WE UTILIZE NC DATA AND HOST A HEALTH FORUM EVERY THREE YEARS DURING WHICH WE PRESENT THE SURVEY FINDINGS TO THE COMMUNITY. THE CHA IS PRESENTED DURING A PUBLIC MEETING, PRESENTED TO OUR BOARD OF COMMISSIONERS, INCLUDED ON WEBSITES AND PUBLISHED IN AREA NEWS MEDIA. THE HEALTH FORUM HELPS TO BRING PEOPLE WITH DIVERSE BACKGROUNDS AND DEMOGRAPHICS TO THE TABLE TO REACH CONSENSUS ON POLK COUNTY'S TOP HEALTHCARE NEEDS TO BE ADDRESSED AND WORK TOGETHER TO CREATE SOLUTIONS. FROM THE DATA, PUBLIC MEETING AND THE HOSPITAL'S STRATEGIC PLAN, WE CREATED A COMMUNITY HEALTH IMPROVEMENT PLAN IN CONJUNCTION WITH OUR LOCAL HEALTH DEPARTMENT. |
| PART VI, LINE 3: | ST. LUKE'S HOSPITAL ADVISES ALL UNDERINSURED/UNINSURED PATIENTS THRU VERBAL OR WRITTEN NOTIFICATION OF ASSISTANCE OFFERED BY OUR PATIENT FINANCIAL COUNSELOR TO ASSESS ANY POSSIBLE THIRD PARTY ASSISTANCE THROUGH FEDERAL, STATE, LOCAL GOVERNMENT PROGRAMS OR FINANCIAL ASSISTANCE. ALL PATIENT INFORMATION PACKETS GIVEN TO INPATIENT AND OUTPATIENT PATIENTS INCLUDE AN INFORMATION SHEET WITH DETAILED DIRECTIONS ON FINANCIAL ASSISTANCE PROCESSES AND HOW TO CONTACT THE SLH FINANCIAL COUNSELOR. THE INFORMATION INCLUDES DETAILED DESCRIPTIONS OF THE PAPERWORK REQUIRED AND APPROPRIATE TIMEFRAMES TO COMPLETE FULL APPLICATIONS. ALL STATEMENTS DIRECT PATIENTS TO CONTACT CUSTOMER SERVICE FOR FINANCIAL ASSISTANCE OPTIONS. THE ED REGISTRATION EMPLOYEE ASKS UNINSURED PATIENTS TO COMPLETE A FLOW SHEET WHICH IS GIVEN TO THE PATIENT FINANCIAL COUNSELOR TO REVIEW FOR THIRD PARTY PROGRAMS OR FINANCIAL ASSISTANCE. INFORMATION IS ALSO AVAILABLE ON THE HOSPITAL'S WEBSITE. |
| PART VI, LINE 4: | ST. LUKE'S HOSPITAL IS A FEDERALLY DESIGNATED CRITICAL ACCESS HOSPITAL THAT PROVIDES A WIDE RANGE OF ACUTE CARE SERVICES, 24/7 EMERGENCY CARE, GERIATRIC-PSYCHIATRIC INPATIENT AND INTENSIVE OUTPATIENT CARE, ADVANCED ORTHOPEDIC AND REHAB SERVICES, AND GENERAL SURGERY. THE 35-BED HOSPITAL IS LOCATED IN WESTERN NORTH CAROLINA AT THE FOOT OF THE BLUE RIDGE MOUNTAINS RIGHT AT THE NC/SC STATE LINE. THE PRIVATE, NOT-FOR-PROFIT COMMUNITY HOSPITAL PROVIDES PRIMARY AND ACUTE HEALTHCARE SERVICES TO POLK COUNTY AND UPSTATE SOUTH CAROLINA. ST. LUKE'S IS SITUATED 40 MILES SOUTHEAST OF ASHEVILLE, NC, AND 25 MILES NORTH OF SPARTANBURG, SC. POLK COUNTY IS A WELL-KNOWN AFFLUENT RETIREMENT COMMUNITY, WITH SEVERAL INDEPENDENT AND ASSISTED LIVING COMMUNITIES THAT ALSO PROVIDE NURSING HOME CARE, REHAB, PERSONAL CARE AND TRAVEL, LEISURE AND ENTERTAINMENT OPPORTUNITIES. ACCORDING TO ISOTHERMAL PLANNING AND DEVELOPMENT COMMISSION, THE STATE DATA CENTER PROJECTS THAT ALMOST 38 PERCENT OF THE REGION'S POPULATION WILL BE AGED 50 OR OLDER IN 2015. THIS TREND IS EVEN MORE PRONOUNCED IN POLK COUNTY--WHICH HAS BECOME A MAJOR RETIREMENT DESTINATION--WHERE THE PERCENTAGE OF THE POPULATION AGED 50 AND OLDER IS PROJECTED TO GROW TO 46.5 PERCENT BY 2015.THE REGION HAS PROVEN TO BE AN ATTRACTIVE DESTINATION FOR RETIREES. THIS IS PARTICULARLY TRUE FOR POLK COUNTY AND RUTHERFORD COUNTY (ESPECIALLY AROUND LAKE LURE). RETIREE ATTRACTION HAS BROUGHT NEW SOURCES OF WEALTH, DEMAND FOR HOUSING, AND POTENTIAL ENTREPRENEURS TO THE REGION. WHILE THERE ARE A NUMBER OF SMALL INDUSTRIAL PLANTS IN THE AREA, INCLUDING MILLIKEN AND TIMKEN, THE INDUSTRIAL BASE IS LIMITED. ST. LUKE'S HOSPITAL IS CURRENTLY THE LARGEST PRIVATE EMPLOYER IN POLK COUNTY AVERAGING 250 EMPLOYEES. THE POLK COUNTY SCHOOL SYSTEM IS THE COUNTY'S LARGEST WITH MORE THAN 300 FULL-TIME EMPLOYEES.CURRENTLY, ST. LUKE'S SERVICE AREA ENCOMPASSES ALL OF POLK COUNTY (POPULATION-19,461). - PRIMARY SERVICE AREA --COLUMBUS AND TRYON (POP. 12,965)- SECONDARY SERVICE AREA-NORTH --SALUDA AND MILL SPRING (POP. 6,496)- SECONDARY SERVICE AREA-SOUTH -- LANDRUM AND CAMPOBELLO, SC, (POP. 17,780)ST. LUKE'S TOTAL SERVICE AREA POPULATION IS 37,241, OF WHICH 55 PERCENT ARE COVERED BY MEDICARE, 26 PERCENT AS PRIVATE PAY, AND 19 PERCENT DESCRIBED AS MEDICAID/SELF-PAY.RESIDENTS 65 AND OLDER COMPRISE 23.4 PERCENT OF THE POPULATION IN POLK COUNTY. THE LARGEST POPULATION GROUPS ARE THE 35-54 AND 55-74 YEAR OLDS, MAKING UP 26 PERCENT AND 24 PERCENT RESPECTIVELY. MEDIAN HOUSEHOLD INCOME IS $38,184, AND THE PERCENT OF POVERTY FOR POLK COUNTY IS 11.2 PERCENT, BELOW NC AND US RATES. |
| PART VI, LINE 5: | ST. LUKE'S HOSPITAL IS THE ONLY HOSPITAL IN OUR PRIMARY SERVICE AREA. WE ARE THE SAFETY-NET FOR OUR CITIZENS, WITH 24/7 EMERGENCY SERVICES FOR PHYSICAL INJURIES AND ILLNESSES AS WELL AS MENTAL HEALTH PATIENTS. IN FISCAL YEAR 2015, ST. LUKE'S PROVIDED $4.1 MILLION IN COMMUNITY CARE. WE ARE INVOLVED IN SERVICE TO OUR COMMUNITY THROUGH SPECIAL EVENTS, HEALTH FAIRS AND SCREENINGS, AND OUTREACH EDUCATION.IN THE EVENT OF SURPLUS FUNDS THE ORGANIZATION USES THE MAJORITY OF THESE AMOUNTS TO INVEST IN EDUCATION AND TRAINING OF CLINICAL AND NON CLINICAL STAFF, TUITION ASSISTANCE, WEBINARS, NURSING EDUCATION GRANTS, AND REINVESTMENT IN CAPITAL PROJECTS SUCH AS TECHNOLOGY WHICH WILL ENHANCE AND IMPROVE QUALITY OF CARE. |
| PART VI, LINE 7, REPORTS FILED WITH STATES | NC |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| 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 (6 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JAMES HOLLEMAN MD | ||||||||||||||
| TRUSTEE | $0 | $222,799 | $0 | $38,995 | $0 | $0 | $0 | $29,783 | $0 | $15,011 | $0 | $306,588 | $0 | $0 |
| BRIAN ROSENBERG MD | ||||||||||||||
| TRUSTEE | $0 | $716,698 | $0 | $405,389 | $0 | $2,013 | $0 | $50,176 | $0 | $18,564 | $0 | $1,192,840 | $0 | $0 |
| ELIZABETH PRESNELL | ||||||||||||||
| CFO | $121,606 | $0 | $2,000 | $0 | $10,271 | $0 | $10,061 | $0 | $27,870 | $0 | $171,808 | $0 | $0 | $0 |
| KEN SHULL | ||||||||||||||
| CEO (THROUGH 8/16) | $204,342 | $0 | $43,281 | $0 | $7,781 | $0 | $30,548 | $0 | $21,980 | $0 | $307,932 | $0 | $0 | $0 |
| DR BELYNDA VESER | ||||||||||||||
| PHYSICIAN | $157,503 | $0 | $0 | $0 | $0 | $0 | $16,801 | $0 | $22,432 | $0 | $196,736 | $0 | $0 | $0 |
| LYNN CROCKER | ||||||||||||||
| PHARMACY DIRECTOR | $113,081 | $0 | $0 | $0 | $0 | $0 | $24,000 | $0 | $18,255 | $0 | $155,336 | $0 | $0 | $0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 1 | THE EXECUTIVE COMMITTEE SHALL BE COMPOSED OF THE CHAIRMAN OF THE BOARD WHO SHALL ACT AS CHAIRMAN OF THE COMMITTEE, THE VICE-CHAIRMAN, THE SECRETARY, THE TREASURER AND THE CHIEF OF THE MEDICAL STAFF. WHEN THE BOARD IS NOT IN SESSION, THE EXECUTIVE COMMITTEE SHALL HAVE THE POWER AND AUTHORITY OF THE BOARD TO TRANSACT ALL REGULAR BUSINESS OF THE CORPORATION, SUBJECT TO ANY PRIOR LIMITATIONS IMPOSED BY THE BOARD OR BY STATUTE. THE EXECUTIVE COMMITTEE SHALL NOT TAKE ANY ACTION THAT CONFLICTS WITH ESTABLISHED POLICIES OF THE BOARD AND IT SHALL DEFER, WHEN POSSIBLE, ALL MATTERS OF MAJOR IMPORTANCE TO THE BOARD. |
| FORM 990, PART VI, SECTION A, LINE 3 | EFFECTIVE JULY 1, 2008, THE HOSPITAL AND AFFILIATES ENTERED INTO A TEN-YEAR MANAGEMENT SERVICES AGREEMENT (THE MSA) WITH THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY WHICH DOES BUSINESS AS CAROLINAS HEALTHCARE SYSTEM (CHS) TO MANAGE THE HOSPITAL AND AFFILIATES ON A DAY-TO-DAY BASIS. THE TERMS OF THE MSA CALL FOR THE HOSPITAL AND AFFILIATES TO PAY CHS AN ANNUAL MANAGEMENT FEE. IN ADDITION, CHS IS REQUIRED TO FURNISH THE HOSPITAL AND AFFILIATES A CHIEF EXECUTIVE OFFICER, CHIEF FINANCIAL OFFICER, AND A CHIEF NURSING OFFICER. THE HOSPITAL AND AFFILIATES REIMBURSE CHS THE SALARY AND BENEFITS COST OF THESE INDIVIDUALS. THE ORGANIZATION IS UTILIZING PART VII AND SCHEDULE J OF THE FORM 990 TO REPORT THE COMPENSATION PAID TO THE CEO AND ASSISTANT VICE PRESIDENT OF FINANCEE BY THE MANAGEMENT FOR SERVICES PROVIDED TO THE FILING ORGANIZATION. THE COMPENSATION HAS BEEN REPORTED IN THE FILING ORGANIZATION'S COMPENSATION COLUMNS. |
| FORM 990, PART VI, SECTION B, LINE 11 | THE FINANCE COMMITTEE HAD A MEETING TO COMPLETE A COMPREHENSIVE REVIEW OF THE FORM 990. THE ORGANIZATION HELD A FULL BOARD MEETING, WHERE THE FINANCE COMMITTEE PRESENTED THE FORM 990 TO THE ENTIRE BOARD. A COPY OF THE FORM 990 WAS MADE AVAILABLE TO EACH VOTING BOARD MEMBER FOR REVIEW PRIOR TO THE MEETING. ADDITIONALLY, EACH MEMBER RECEIVED A COPY OF THE 990 AT THE BOARD MEETING. AFTER A QUESTION & ANSWER PERIOD, THE VOTING BOARD VOTED TO APPROVE THE FORM 990 AS PRESENTED. THE ORGANIZATION'S BOARD OF DIRECTORS APPROVES THE 990 ANNUALLY PRIOR TO SUBMISSION. |
| FORM 990, PART VI, SECTION B, LINE 12C | OFFICERS, DIRECTORS OR TRUSTEES, AND KEY EMPLOYEES ARE REQUIRED TO SIGN A CONFLICT OF INTEREST STATEMENT UPON HIRE OR APPOINTMENT. THE CONFLICTS OF INTEREST STATEMENT IS SIGNED ANNUALLY. THE CONFLICT OF INTEREST POLICY IS EXPLAINED DURING NEW EMPLOYEE ORIENTATION AND ALTHOUGH ALL EMPLOYEES ARE NOT TO SIGN THE STATEMENT THE EMPLOYEES ARE ENCOURAGED TO REPORT CONFLICT OF INTEREST ISSUES. |
| FORM 990, PART VI, SECTION B, LINE 15 | CAROLINAS HEALTHCARE SYSTEM 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 AVAILABLE ONLINE AT WWW.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. |
| FORM 990, PART IX, LINE 11G | CONTRACT LABOR: PROGRAM SERVICE EXPENSES 779,222. MANAGEMENT AND GENERAL EXPENSES 892,667. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,671,889. OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 1,904,609. MANAGEMENT AND GENERAL EXPENSES 1,576,972. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,481,581. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 1,577,498. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,577,498. |
| FORM 990, PART XII, LINE 2C: | THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. |
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 | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| ST LUKE'S HEALTH CARE INC | |||||||||||
| 101 HOSPITAL DRIVE | COLUMBUS | NC | 28722 | 561423318 | CONTROLLING ENTITY | NC | 501(C)(3) | PF | N/A | 0 | |
| ST LUKE'S FOUNDATION INC | |||||||||||
| 101 HOSPITAL DRIVE | COLUMBUS | NC | 28722 | 561757097 | RAISES FUNDS TO HELP SUPPORT ST. LUKE'S HOSPITAL | NC | 501(C)(3) | LINE 7 | 0 | ST LUKE'S HEALTHCARE INC | |
| ST LUKE'S PHYSICIAN NETWORK INC | |||||||||||
| 101 HOSPITAL DRIVE | COLUMBUS | NC | 28722 | 263082073 | PROVIDE HEALTH CARE SERVICES TO THE CITIZENS OF POLK COUNTY, NC | NC | 501(C)(3) | LINE 3 | 0 | ST LUKE'S HEALTHCARE 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 DRIVE | 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 |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Entity Type | C | EntityTypeTxt |
| Controlled Organization | 0 | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | Yes (1) | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | 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 | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |