STRATEGY STUDIO / NONPROFIT PEOPLE SEARCH

ST LUKE'S HOSPITAL FOUNDATION: Form 990, tax year 2015

View the entire original 990 at ProPublica ↗

Organization
ST LUKE'S HOSPITAL FOUNDATION (EIN 34-1292849)
Tax period
2015-01-01 to 2015-12-31
Filed
2016-11-12
IRS object ID
201643179349300104
Schema version
2015v2.1
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

FieldValueIRS element (for citing)
Return2016-11-12T00:24:23-06:00ReturnTs
Tax Period End2015-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN861065772PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1DELOITTE TAX LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1111 MONUMENT CIRCLE STE 4200AddressLine1Txt
CityINDIANAPOLISCityNm
State AbbreviationINStateAbbreviationCd
ZIP462045108ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2015-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN341292849EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1ST LUKE'S HOSPITAL FOUNDATIONBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlSTLUBusinessNameControlTxt
Phone4198935911PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line15901 MONCLOVA ROADAddressLine1Txt
CityMAUMEECityNm
State AbbreviationOHStateAbbreviationCd
ZIP43537ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonDANIEL L WAKEMANPersonNm
Person TitlePRESIDENTPersonTitleTxt
Phone4198935911PhoneNum
Signature2016-11-11SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonSHAWNA M JIMENEZPreparerPersonNm
PTINP01222873PTIN
Phone3174648600PhoneNum
FieldValueIRS element (for citing)
Tax2015TaxYr
Build TS2017-02-10 21:41:12ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerDANIEL L WAKEMANPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line15901 MONCLOVA ROADAddressLine1Txt
CityMAUMEECityNm
State AbbreviationOHStateAbbreviationCd
ZIP43537ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$18,132,002GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.PROMEDICA.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1979FormationYr
Legal Domicile StateOHLegalDomicileStateCd
Activity Or MissionTO SUPPORT ST. LUKE'S HOSPITAL PROJECTS / PROGRAMS THAT IMPROVE PATIENT CARE OR SUPPORT THE COMMUNITY.ActivityOrMissionDesc
Voting Members Governing Body16VotingMembersGoverningBodyCnt
Voting Members Independent12VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers27TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$542,318PYContributionsGrantsAmt
CY Contributions Grants$484,293CYContributionsGrantsAmt
PY Program Service Revenue$0PYProgramServiceRevenueAmt
CY Program Service Revenue$0CYProgramServiceRevenueAmt
PY Investment Income$1,081,449PYInvestmentIncomeAmt
CY Investment Income$976,413CYInvestmentIncomeAmt
PY Other Revenue-$8,948PYOtherRevenueAmt
CY Other Revenue-$6,704CYOtherRevenueAmt
PY Total Revenue$1,614,819PYTotalRevenueAmt
CY Total Revenue$1,454,002CYTotalRevenueAmt
PY Grants And Similar Paid$269,620PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$284,335CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$141,344PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$103,227CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$76,390CYTotalFundraisingExpenseAmt
PY Other Expenses$144,147PYOtherExpensesAmt
CY Other Expenses$94,669CYOtherExpensesAmt
PY Total Expenses$555,111PYTotalExpensesAmt
CY Total Expenses$482,231CYTotalExpensesAmt
PY Revenues Less Expenses$1,059,708PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$971,771CYRevenuesLessExpensesAmt
Total Assets BOY$21,234,588TotalAssetsBOYAmt
Total Assets EOY$21,140,924TotalAssetsEOYAmt
Total Liabilities BOY$35,980TotalLiabilitiesBOYAmt
Total Liabilities EOY$5,076,564TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$21,198,608NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$16,064,360NetAssetsOrFundBalancesEOYAmt
MissionTHE 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.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$284,335ExpenseAmt
Grant$284,335GrantAmt
DescST. 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.Desc
Total Program Service Expenses$284,335TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising ActivitiesYes (1)FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To IndividualsYes (1)GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded EntityYes (1)DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (1)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee0EmployeeCnt
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo ContributionsYes (1)QuidProQuoContributionsInd
Quid Pro Quo Contri DisclYes (1)QuidProQuoContriDisclInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members16GoverningBodyVotingMembersCnt
Independent Voting Member12IndependentVotingMemberCnt
Family Or Business RlnYes (1)FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEO0CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldOHStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1RICH POTTERBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone4198918506PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line15901 MONCLOVA ROADAddressLine1Txt
CityMAUMEECityNm
State AbbreviationOHStateAbbreviationCd
ZIP43537ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (23 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndKey EmployeeKeyEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
BARBARA J DENNIS
EX OFFICIO1.000.00Yes (X)$0$0$0
CHRISTINA L LAWLESS
TRUSTEE1.000.00Yes (X)$0$0$0
CHRISTINE C BLACK
TRUSTEE1.000.00Yes (X)$0$0$0
DALE J SEYMOUR
TRUSTEE1.002.00Yes (X)$0$0$0
DANIEL L WAKEMAN
PRESIDENT, EX OFFICIO1.0041.00Yes (X)$0$388,535$99,700Yes (X)
DAVID A REED
TRUSTEE1.000.00Yes (X)$0$0$0
GARY M CATES
EX OFFICIO1.0041.00Yes (X)$0$354,496$73,638
GLENN L RAMBO
TRUSTEE1.000.00Yes (X)$0$0$0
HAL D BURKE
TRUSTEE1.000.00Yes (X)$0$0$0
JEAN M EMERY
TRUSTEE1.000.00Yes (X)$0$0$0
JOHN BACHEY
EX OFFICIO1.001.00Yes (X)$0$0$0
KATHLEEN R TAMLYN BSN RN
TRUSTEE1.000.00Yes (X)$0$0$0
KEVIN C WEBB PHD
EX OFFICIO1.0052.00Yes (X)$0$658,740$115,301
MEGAN COYLE-STAMOS
CHAIRPERSON1.001.00Yes (X)$0$0$0Yes (X)
MICHELE G COOPER
TRUSTEE1.000.00Yes (X)$0$0$0
PHILIP MCWEENY
TRUSTEE1.000.00Yes (X)$0$0$0
TIMOTHY L LANGHORST
TRUSTEE1.0040.00Yes (X)$0$153,553$15,659
VALENTINA JINDAL MD
TRUSTEE1.000.00Yes (X)$0$0$0
ALAN M SATTLER
TREASURER0.5051.50$0$588,758$120,076Yes (X)
JEFFREY C KUHN
SECRETARY0.5051.50$0$592,348$112,234Yes (X)
MARTIN DANSACK
VP ACCOUNTING & TAXATION, PHS0.5041.00$0$193,478$37,066Yes (X)
KATHLEEN S HANLEY
FORMER OFFICER0.0041.00$0$696,193$166,986Yes (X)
LORI A JOHNSTON
FORMER KEY EMPLOYEE0.0041.50$0$404,352$110,260Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$4,030,453TotReportableCompRltdOrgAmt
Total Other Compensation$850,920TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (1)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt
Federated Campaigns$5,740FederatedCampaignsAmt
Fundraising$24,894FundraisingAmt
Related Organizations$274,205RelatedOrganizationsAmt
All Other Contributions$179,454AllOtherContributionsAmt
Total Contributions$484,293TotalContributionsAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$371,880TotalRevenueColumnAmt
Exclusion$371,880ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$5,510RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$4,772RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$738RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$738TotalRevenueColumnAmt
Exclusion$738ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$17,252,813SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$16,648,280SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$604,533SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$604,533TotalRevenueColumnAmt
Exclusion$604,533ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$17,506FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event$24,894ContriRptFundraisingEventAmt
Fundraising Direct Expenses$24,948FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column-$7,442TotalRevenueColumnAmt
Exclusion-$7,442ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,454,002TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$969,709ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$256,384TotalAmt
Program Services$256,384ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$27,951TotalAmt
Program Services$27,951ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$80,454TotalAmt
Management And General$26,707ManagementAndGeneralAmt
Fundraising$53,747FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$4,664TotalAmt
Management And General$1,547ManagementAndGeneralAmt
Fundraising$3,117FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$15,568TotalAmt
Management And General$3,099ManagementAndGeneralAmt
Fundraising$12,469FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$2,541TotalAmt
Management And General$2,541ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$151TotalAmt
Management And General$151ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$591TotalAmt
Management And General$591ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$56,782TotalAmt
Management And General$56,782ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$8,794TotalAmt
Management And General$5,637ManagementAndGeneralAmt
Fundraising$3,157FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$1,395TotalAmt
Management And General$1,395ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$1,118TotalAmt
Management And General$515ManagementAndGeneralAmt
Fundraising$603FundraisingAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$15,579TotalAmt
Management And General$15,579ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$343TotalAmt
Management And General$343ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$584TotalAmt
Management And General$584ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$5,958TotalAmt
Management And General$5,958ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$77TotalAmt
Management And General$77ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp

FieldValueIRS element (for citing)
DescBAD DEBT EXPENSEDesc
Total$1,226TotalAmt
Fundraising$1,226FundraisingAmt

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$2,071TotalAmt
Fundraising$2,071FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$482,231TotalAmt
Program Services$284,335ProgramServicesAmt
Management And General$121,506ManagementAndGeneralAmt
Fundraising$76,390FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$106,444BOYAmt
EOY$117,571EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$1,325,063BOYAmt
EOY$1,702,420EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$58,044BOYAmt
EOY$37,647EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$480,000LandBldgEquipCostOrOtherBssAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$480,000BOYAmt
EOY$480,000EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$19,258,603BOYAmt
EOY$18,795,979EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$6,434BOYAmt
EOY$7,307EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$21,234,588BOYAmt
EOY$21,140,924EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$20,329BOYAmt
EOY$17,282EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$15,651BOYAmt
EOY$5,059,282EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$35,980BOYAmt
EOY$5,076,564EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$19,993,449BOYAmt
EOY$14,833,222EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$1,205,159BOYAmt
EOY$1,231,138EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$21,198,608BOYAmt
EOY$16,064,360EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$21,234,588BOYAmt
EOY$21,140,924EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$971,771ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$1,106,019NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$5,000,000OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3Yes (X)SupportingOrganization509a3Ind
Supporting Org Type2Yes (X)SupportingOrgType2Ind
Supported Organizations1SupportedOrganizationsCnt

Supported Org Information SupportedOrgInformationGrp

Supported Organization Name SupportedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1ST LUKE'S HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
EIN344428232EIN
Organization Type3OrganizationTypeCd
Governing Document ListedYes (1)GoverningDocumentListedInd
Support$256,277SupportAmt
Other Support$0OtherSupportAmt
FieldValueIRS element (for citing)
Supported Organizations Total1SupportedOrganizationsTotalCnt
Support Sum$256,277SupportSumAmt
Other Support Sum$0OtherSupportSumAmt

Form990 Sch A Supporting Org Form990SchASupportingOrgGrp

FieldValueIRS element (for citing)
Listed By Name Governing DocYes (1)ListedByNameGoverningDocInd
Suprt Org No IRS Determination0SuprtOrgNoIRSDeterminationInd
Supported Org Section C4560SupportedOrgSectionC456Ind
Supported Org Not Organized US0SupportedOrgNotOrganizedUSInd
Organization Change Suprt Org0OrganizationChangeSuprtOrgInd
Support Non Supported Org0SupportNonSupportedOrgInd
Payment Substantial Contribtr0PaymentSubstantialContribtrInd
Loan Disqualified Person0LoanDisqualifiedPersonInd
Controlled Disqualified Prsn0ControlledDisqualifiedPrsnInd
Disqualified Prsn Controll Int0DisqualifiedPrsnControllIntInd
Disqualified Prsn Ownr Int0DisqualifiedPrsnOwnrIntInd
Excess Business Holdings Rules0ExcessBusinessHoldingsRulesInd
Contribution Controller0ContributionControllerInd
Contribution Family0ContributionFamilyInd
Contribution35 Controlled0Contribution35ControlledInd
FieldValueIRS element (for citing)
Majority Dir Trst Supported Org0MajorityDirTrstSupportedOrgInd

Form990 Schedule A Part VI Form990ScheduleAPartVIGrp

FieldValueIRS element (for citing)
Form And Line ReferencePART IV, SECTION C, LINE 1:FormAndLineReferenceDesc
ExplanationST. LUKE'S HOSPITAL FOUNDATION IS AN OHIO NOT-FOR-PROFIT CORPORATION THAT OPERATES TO BENEFIT AND CARRY OUT THE PURPOSES OF ST. LUKE'S HOSPITAL, OR ANY SUCCESSOR INSTITUTION. ST. LUKE'S HOSPITAL 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 509(A)(1). BOTH ST. LUKE'S HOSPITAL FOUNDATION AND ST. LUKE'S HOSPITAL ARE MEMBERS OF THE PROMEDICA HEALTH SYSTEM, INC. NETWORK PURSUANT TO THE TERMS OF A JOINDER AGREEMENT DATED MAY 25, 2010. PROMEDICA HEALTH SYSTEM, INC. (34-1517671), IS THE MEMBER OF ST. LUKE'S HOSPITAL FOUNDATION AND ST. LUKE'S HOSPITAL AND IS THE PARENT OF AN INTEGRATED HEALTH CARE DELIVERY NETWORK MADE UP OF AN AFFILIATED GROUP OF EXEMPT ORGANIZATIONS WHICH INCLUDES HOSPITALS, HEALTH CARE PROVIDERS, CONTINUING CARE SERVICES, SPECIALIZED HEALTH SERVICES, ENTITIES PROVIDING SUPPORT SERVICES, AND FOUNDATIONS. PROMEDICA HEALTH SYSTEM, INC. (PHS) PROVIDES OVERALL DIRECTION, MANAGEMENT AND CONTROL TO ITS FIRST TIER SUBSIDIARIES, INCLUDING ST. LUKE'S HOSPITAL FOUNDATION AND ST. LUKE'S HOSPITAL, AND INDIRECTLY THROUGH ITS FIRST TIER SUBSIDIARIES, TO ALL AFFILIATED SECOND TIER SUBSIDIARIES OF EACH FIRST TIER SUBSIDIARY. THE ACTIVITIES OF PHS SUPPORT THE EXEMPT PURPOSES OF THE AFFILIATED ORGANIZATIONS IN THE PHS NETWORK AND ENHANCE AND IMPROVE THE DELIVERY OF EFFECTIVE HEALTH CARE SERVICES TO THE COMMUNITIES SERVED BY THE PHS NETWORK. CONTROL AND MANAGEMENT EFFECTIVELY IS VESTED IN THE SAME PERSONS THAT CONTROL AND MANAGE ALL SUBSIDIARY ORGANIZATIONS THROUGH RESERVED POWERS. PHS HAS RESERVED POWERS IN EACH SUBSIDIARY'S CODE OF REGULATIONS OR BYLAWS ALONG WITH THE RIGHT TO APPROVE CERTAIN ACTIONS OF EACH SUBSIDIARY'S 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. LUKE'S 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 PHS. COMMON SUPERVISION AND CONTROL ARE SHARED THROUGH THE STRUCTURAL RELATIONSHIP OF PHS. THERE HAS ALSO BEEN A HISTORIC AND CONTINUING RELATIONSHIP BETWEEN ST. LUKE'S HOSPITAL FOUNDATION AND ST. LUKE'S 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. LUKE'S HOSPITAL FOUNDATION HAS MAINTAINED, AND WILL CONTINUE TO MAINTAIN, A SIGNIFICANT INVOLVEMENT IN EACH SUPPORTED ORGANIZATION'S OPERATIONS.ExplanationTxt

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$480,000InvestmentCostOrOtherBasisAmt
Book Value$480,000BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$480,000TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
DUE TO AFFILIATES$59,282
INTERCOMPANY NOTE PAYABLE TO PROMEDICA HEALTH SYSTEM, INC.$5,000,000
FieldValueIRS element (for citing)
Total Liability$5,059,282TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART X, LINE 2:FormAndLineReferenceDesc
ExplanationST. LUKE'S HOSPITAL FOUNDATION IS INCLUDED IN THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF PROMEDICA HEALTH SYSTEM, INC. AND SUBSIDIARIES (PHS). THE FOLLOWING REFLECTS PHS'S LIABILITY FOR UNCERTAIN TAX POSITIONS UNDER ASC 740. EXCEPT AS NOTED BELOW, PHS DID NOT HAVE ANY MATERIAL UNCERTAIN TAX POSITIONS AT DECEMBER 31, 2015 AND 2014. FOR THE YEARS ENDED DECEMBER 31, 2015 AND 2014, A TAXABLE SUBSIDIARY OF PHS RECOGNIZED A LIABILITY FOR UNCERTAIN TAX POSITIONS OF $0 AND $9,027,000, RESPECTIVELY. ST. LUKE'S HOSPITAL FOUNDATION DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS AT DECEMBER 31, 2015 AND 2014.ExplanationTxt

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Event1GOLF OUTINGEvent1Nm
Gross Receipts Event1$42,400GrossReceiptsEvent1Amt
Charitable Contri Event1$24,894CharitableContriEvent1Amt
Gross Revenue Event1$17,506GrossRevenueEvent1Amt
Cash Prizes Event1$1,015CashPrizesEvent1Amt
Non Cash Prizes Event1$1,314NonCashPrizesEvent1Amt
Food And Beverage Event1$8,219FoodAndBeverageEvent1Amt
Other Direct Expenses Event1$14,400OtherDirectExpensesEvent1Amt
Gross Receipts Total$42,400GrossReceiptsTotalAmt
Charitable Contributions Tot$24,894CharitableContributionsTotAmt
Gross Revenue Total Events$17,506GrossRevenueTotalEventsAmt
Cash Prizes Total Events$1,015CashPrizesTotalEventsAmt
Non Cash Prizes Total Events$1,314NonCashPrizesTotalEventsAmt
Food And Beverage Total Events$8,219FoodAndBeverageTotalEventsAmt
Oth Direct Expnss Total Events$14,400OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events$24,948DirectExpenseSummaryEventsAmt
Net Income Summary-$7,442NetIncomeSummaryAmt

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Recipient Table RecipientTable

Recipient Business Name RecipientBusinessName

FieldValueIRS element (for citing)
Business Name Line1ST LUKE'S HOSPITALBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line15901 MONCLOVA RDAddressLine1Txt
CityMAUMEECityNm
State AbbreviationOHStateAbbreviationCd
ZIP43537ZIPCd
FieldValueIRS element (for citing)
Recipient EIN344428232RecipientEIN
IRC Section501(C)(3)IRCSectionDesc
Cash Grant$256,277CashGrantAmt
Purpose Of GrantOPERATING/CAPITAL GRANTPurposeOfGrantTxt
FieldValueIRS element (for citing)
Total501c3 Org1Total501c3OrgCnt
Total Other Org0TotalOtherOrgCnt

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp

FieldValueIRS element (for citing)
Grant TypeSCHOLARSHIPSGrantTypeTxt
Recipient18RecipientCnt
Cash Grant$27,951CashGrantAmt
Non Cash Assistance$0NonCashAssistanceAmt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 2:FormAndLineReferenceDesc
ExplanationAS AN AFFILIATE OF PROMEDICA HEALTH SYSTEM, INC. (PHS) 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 AND RESEARCH FILES ARE MAINTAINED BY THE (PHS) SYSTEM GRANTS DEPARTMENT AND THE CORPORATE RESEARCH ADMINISTRATION DEPARTMENT WHICH ARE RESPONSIBLE TO PREPARE/SUBMIT FISCAL REPORTS AS REQUIRED BY THE FUNDING AGENCY. SYSTEM GRANTS DEPARTMENT FACILITATES A SINGLE AUDIT OF FEDERAL AWARDS IN ACCORDANCE WITH THE REQUIREMENTS OF OFFICE OF MANAGEMENT AND BUDGET CIRCULAR A-133.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (1)SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
DANIEL L WAKEMAN
PRESIDENT, EX OFFICIO$0$283,314$0$100,690$0$4,531$0$83,371$0$16,329$0$488,235$0$10,755
GARY M CATES
EX OFFICIO$0$246,893$0$86,307$0$21,296$0$54,923$0$18,715$0$428,134$0$0
KEVIN C WEBB PHD
EX OFFICIO$0$446,920$0$200,389$0$11,431$0$101,135$0$14,166$0$774,041$0$0
TIMOTHY L LANGHORST
TRUSTEE$0$118,131$0$31,789$0$3,633$0$8,638$0$7,021$0$169,212$0$0
ALAN M SATTLER
TREASURER$0$405,315$0$154,161$0$29,282$0$97,575$0$22,501$0$708,834$0$0
JEFFREY C KUHN
SECRETARY$0$396,043$0$169,512$0$26,793$0$100,167$0$12,067$0$704,582$0$0
MARTIN DANSACK
VP ACCOUNTING & TAXATION, PHS$0$150,887$0$35,168$0$7,423$0$18,893$0$18,173$0$230,544$0$0
KATHLEEN S HANLEY
FORMER OFFICER$0$456,423$0$197,040$0$42,730$0$149,277$0$17,709$0$863,179$0$0
LORI A JOHNSTON
FORMER KEY EMPLOYEE$0$292,887$0$91,600$0$19,865$0$89,618$0$20,642$0$514,612$0$0

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 3PROMEDICA HEALTH SYSTEM, INC., A RELATED TAX-EXEMPT ORGANIZATION OF ST. LUKE'S HOSPITAL FOUNDATION, USES THE FOLLOWING TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - COMPENSATION SURVEY OR STUDY - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE
PART I, LINE 4BELIGIBLE EMPLOYEES PARTICIPATE IN VARIOUS NONQUALIFIED DEFERRED COMPENSATION PLANS ORGANIZED UNDER CODE SECTION 457(F). THE EXACT PURPOSE OF EACH PLAN VARIES, BUT THEY INCLUDE: COMPENSATION LIMITATION MAKE-UP PLANS, VOLUNTARY DEFERRAL PLANS, DEFERRAL OF A PORTION OF INCENTIVE BONUS TYPE PLANS, ETC. ANY AMOUNT ULTIMATELY PAID UNDER THE PROGRAM TO THE EMPLOYEE IS REPORTED AS COMPENSATION ON FORM 990, SCHEDULE J, PART II, COLUMN B IN THE YEAR PAID. SUPPLEMENTAL NONQUALIFIED PLAN PAYMENTS WERE MADE DURING THE YEAR TO THE FOLLOWING LISTED PERSONS IN PART VII: DANIEL L. WAKEMAN $10,791

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 2GARY M. CATES AND MICHELE G. COOPER HAVE A BUSINESS RELATIONSHIP.
FORM 990, PART VI, SECTION A, LINE 6AS AN OHIO NON-PROFIT ORGANIZATION, THIS CORPORATION HAS A CORPORATE MEMBER.
FORM 990, PART VI, SECTION A, LINE 7APROMEDICA HEALTH SYSTEM, INC. (PHS) IS THE PARENT CORPORATION AND SOLE MEMBER OF ST. LUKE'S HOSPITAL FOUNDATION OR IS THE SOLE MEMBER OF THE SOLE MEMBER OF ST. LUKE'S HOSPITAL FOUNDATION. AS THE MEMBER, PHS 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 7BWHILE THE BOARD OF TRUSTEES OF EACH BUSINESS UNIT IS GRANTED CERTAIN POWERS WITH RESPECT TO SUCH BUSINESS UNIT'S OPERATIONS, AS THE MEMBER, PROMEDICA HEALTH SYSTEM, INC. RETAINS APPROVAL RIGHTS WITH RESPECT TO CERTAIN CORPORATE ACTIONS SUCH AS (I) ADOPTION OF THE BUSINESS UNIT'S STRATEGIC PLANS AND FINANCIAL PLANS, (II) EXPENDITURES FOR NON-BUDGETED ITEMS IN EXCESS OF CERTAIN DOLLAR LIMITS SET FROM TIME TO TIME BY THE MEMBER, (III) EXPENDITURES FOR ITEMS WHICH ARE INCLUDED IN THE BUSINESS UNIT'S ANNUAL BUDGETS BUT WHICH EXCEED THE BUDGETED AMOUNT BY AN AMOUNT IN EXCESS OF CERTAIN DOLLAR LIMITS SET FROM TIME TO TIME BY THE MEMBER, (IV) INCURRENCE, ASSUMPTION OR GUARANTEE OF ANY INDEBTEDNESS, (V) 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 THE MEMBER AND (VI) ANY MERGER, CONSOLIDATION, REORGANIZATION, DISSOLUTION OR LIQUIDATION.
FORM 990, PART VI, SECTION B, LINE 11UNDER THE GUIDANCE OF PROMEDICA HEALTH SYSTEM, INC.'S (PHS) TAX CONSULTANTS, FORM 990S ARE PREPARED BY THE RESPECTIVE ACCOUNTING DEPARTMENT OF EACH AFFILIATE AND REVIEWED BY THE AFFILIATE'S FINANCE LEADERSHIP. AFTER AFFILIATE'S FINANCE LEADERSHIP APPROVAL, COPIES OF THE FORM 990 FOR PHS AND THEIR SUBSIDIARIES ARE PROVIDED TO THE RESPECTIVE COMPANY'S BOARD OF TRUSTEES AND ARE REVIEWED AND SIGNED BY THE RESPECTIVE COMPANY'S PRESIDENT PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE.
FORM 990, PART VI, SECTION B, LINE 12CPROMEDICA HEALTH SYSTEM, INC. AND AFFILIATES (PHS) HAVE STANDARDS OF CONDUCT THAT APPLY TO ALL PHS 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 V.P., AUDIT & COMPLIANCE/CHIEF COMPLIANCE OFFICER (CCO). SUMMARIZED INFORMATION IS FORWARDED FOR REVIEW TO THE CHIEF FINANCIAL OFFICER, GENERAL COUNSEL, BUSINESS UNIT PRESIDENTS AND THE PRESIDENT AND CHIEF EXECUTIVE OFFICER (PRESIDENT/CEO), BASED UPON THEIR RESPECTIVE KNOWLEDGE OF THE BOARD MEMBERS. THE PURPOSE OF THIS REVIEW IS TO BOTH INFORM MANAGEMENT OF THE DISCLOSED CONFLICTS AND TO ALLOW THEM TO IDENTIFY TO THE V.P., AUDIT & COMPLIANCE, ANY POTENTIAL UNDISCLOSED CONFLICTS. THE AUDIT & COMPLIANCE DEPARTMENT 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. THE RESULTS OF THE AUDIT ARE REPORTED DIRECTLY TO THE CHAIR OF THE AUDIT & COMPLIANCE COMMITTEE WITH A COPY TO THE PRESIDENT/CEO. THE REPORT INCLUDES A SUMMARY OF THE AUDIT PROCEDURES PERFORMED, ANY SIGNIFICANT CONCERNS IDENTIFIED AND THEIR RESOLUTION. ANY UNRESOLVED CONFLICTS ARE ADDRESSED BY THE AUDIT COMMITTEE WITH RECOMMENDATIONS TO THE FULL BOARD AS NEEDED. 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 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 EMPLOYED PHYSICIANS ANNUALLY (OR IMMEDIATELY IF NEW 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 QUESTIONNAIRE BY AN ESTABLISHED DEADLINE THAT IS COMMUNICATED TO THE EMPLOYEE. THE HUMAN RESOURCES DEPARTMENT ENSURES THAT ALL QUESTIONNAIRES, WHICH ARE STORED ELECTRONICALLY, ARE COMPLETED AND PROVIDES NOTIFICATION TO THE V.P., AUDIT & COMPLIANCE OF THE NUMBER OF ANNUAL EMPLOYEE CERTIFICATION QUESTIONNAIRES SENT AND RECEIVED AND COPIES OF ANY QUESTIONNAIRES CONTAINING DISCLOSURES THAT WARRANT FURTHER REVIEW BY THE AUDIT & COMPLIANCE DEPARTMENT. ALL NEW EMPLOYEES, EXCLUDING EMPLOYED PHYSICIANS, ARE PROVIDED EITHER AN ELECTRONIC OR PAPER COPY OF THE EMPLOYEE STANDARD OF CONDUCT AND THE EMPLOYEE CERTIFICATION STATEMENT WHICH THE NEW EMPLOYEE IS REQUIRED TO COMPLETE PRIOR TO BEGINNING EMPLOYMENT. THE AUDIT & COMPLIANCE DEPARTMENT HAS ACCESS TO A REPORT THAT IDENTIFIES ALL NEW HIRES. A SAMPLE OF EMPLOYEES IS IDENTIFIED AND AN AUDIT IS CONDUCTED TO ENSURE THAT REQUIRED DOCUMENTATION IS ON FILE. IDENTIFIED CONFLICTS ARE INITIALLY REVIEWED BY THE V.P., AUDIT & COMPLIANCE AND IF NECESSARY DISCUSSED WITH THE BUSINESS UNIT PRESIDENT IN WHICH THE EMPLOYEE WORKS, AND GENERAL COUNSEL. IF THE CONFLICT IS CONSIDERED A SIGNIFICANT EXPOSURE RISK FOR PHS, A RECOMMENDATION WILL BE PREPARED FOR FINAL APPROVAL OF THE PHS PRESIDENT/CEO. RESULTS OF THE EMPLOYEE PROCESS AUDIT ARE INCLUDED IN THE ABOVE REPORT TO THE CHAIR OF THE AUDIT & COMPLIANCE COMMITTEE. FAILURE TO COMPLETE THE CERTIFICATION QUESTIONNAIRE, OR THE COMPLETION OF A FALSE OR INCOMPLETE CERTIFICATION QUESTIONNAIRE, 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 EMPLOYEE'S CERTIFICATION QUESTIONNAIRE OR HIS/HER ACTIONS OR CIRCUMSTANCES SHALL BE GROUNDS FOR SANCTION UP TO AND INCLUDING TERMINATION OF EMPLOYMENT. EMPLOYED PHYSICIANS ANNUALLY (OR IMMEDIATELY IF NEW CONFLICTS OF INTEREST ARISE), ALL EMPLOYED PHYSICIANS ARE REQUIRED TO COMPLETE AND SUBMIT AN ELECTRONIC PHYSICIAN CERTIFICATION QUESTIONNAIRE BY THE ESTABLISHED AND COMMUNICATED DEADLINE. THE OFFICE OF THE PRESIDENT/CHIEF MEDICAL OFFICER AND THE CHIEF OPERATING OFFICER FOR PROMEDICA PHYSICIAN GROUP (PPG) ENSURES THAT ALL QUESTIONNAIRES, WHICH ARE STORED ELECTRONICALLY, ARE COMPLETED AND REVIEWED AND ENSURES NOTIFICATION IS PROVIDED TO THE V.P., AUDIT & COMPLIANCE OF THE NUMBER OF ANNUAL PHYSICIAN CERTIFICATION QUESTIONNAIRES SENT AND RECEIVED AND ALSO ENSURES COPIES OF ANY QUESTIONNAIRES CONTAINING DISCLOSURES THAT WARRANT FURTHER REVIEW BY THE AUDIT & COMPLIANCE DEPARTMENT ARE FORWARDED ACCORDINGLY. 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. IDENTIFIED CONFLICTS ARE INITIALLY REVIEWED BY THE PPG PRESIDENT/CHIEF MEDICAL OFFICER, CHIEF OPERATING OFFICER OR THEIR DESIGNEE, AND IF APPROPRIATE, ARE SUBSEQUENTLY REPORTED TO THE OFFICE OF THE V.P., AUDIT & COMPLIANCE. IF THE CONFLICT IS CONSIDERED A SIGNIFICANT EXPOSURE RISK FOR PHS, A RECOMMENDATION WILL BE PREPARED FOR FINAL APPROVAL BY THE PHS PRESIDENT/CHIEF EXECUTIVE OFFICER. RESULTS OF THE EMPLOYED PHYSICIAN AUDIT ARE INCLUDED IN THE ABOVE REPORT TO THE CHAIR OF THE AUDIT & COMPLIANCE COMMITTEE. ANY ITEMS THAT MEET CRITERIA FOR PUBLIC DISCLOSURE WILL BE COMMUNICATED TO THE APPROPRIATE PHYSICIAN BY THE PPG PRESIDENT/CHIEF MEDICAL OFFICER OR DESIGNEE IN ADVANCE OF THE POSTING. THE PPG PRESIDENT/CHIEF MEDICAL OFFICER OR DESIGNEE WILL PROVIDE THE PHYSICIAN-INDUSTRY RELATIONSHIP DISCLOSURES TO THE APPLICABLE PHS MARKETING/COMMUNICATIONS REPRESENTATIVE. THE PUBLIC DISCLOSURE WILL BE POSTED ON THE PPG PHYSICIAN WEBSITE (I.E., WWW.PPGDOCS.ORG) DATABASE BY THE PHS MARKETING/COMMUNICATIONS REPRESENTATIVE.
FORM 990, PART VI, SECTION B, LINE 15ST. LUKE'S HOSPITAL FOUNDATION'S TOP MANAGEMENT OFFICIAL AND OTHER OFFICERS ARE COMPENSATED BY PROMEDICA HEALTH SYSTEM, INC. (PHS), A RELATED TAX-EXEMPT ORGANIZATION. COMPENSATION DETERMINATIONS OF ST. LUKE'S HOSPITAL FOUNDATION'S TOP MANAGEMENT OFFICIAL AND OTHER OFFICERS ARE MADE BY A COMPENSATION COMMITTEE OF PHS. 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 PROMEDICA HEALTH SYSTEM COMPENSATION COMMITTEE EVERY OCTOBER. SALARY ADJUSTMENTS ARE DETERMINED AT THE DECEMBER MEETING OF THE COMPENSATION COMMITTEE. THE COMPENSATION COMMITTEE APPROVES OTHER FORMS OF COMPENSATION BASED UPON THE PRIOR YEAR PERFORMANCE AT THE JANUARY MEETING EACH YEAR.
FORM 990, PART VI, SECTION C, LINE 19PROMEDICA HEALTH SYSTEM, INC. AND SUBSIDIARIES PROVIDE ANY DOCUMENT OPEN TO PUBLIC INSPECTION UPON REQUEST.
FORM 990, PART XI, LINE 9:REVERSAL OF CONTRIBUTIONS -5,000,000.

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp (25 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdTotal IncomeTotalIncomeAmtEnd Of Year AssetsEndOfYearAssetsAmtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Txt
COBRA VENTURES LLC
5901 MONCLOVA RDMAUMEEOH43537204671613LAND LEASINGOH$5,510$94,354ST LUKE'S HOSPITAL FOUNDATION
MIDWEST CARDIOVASCULAR CONSULTANTS LLC
5855 MONROE STSYLVANIAOH43560611448753EMPLOYS PHYSICIANSOH$0$535,504PROMEDICA PHYSICIAN GROUP
PROMEDICA CENTRAL PHYSICIANS LLC
5855 MONROE STSYLVANIAOH43560341881137EMPLOYS PHYSICIANSOH$231,170,716$291,204,025PROMEDICA PHYSICIAN GROUP
PROMEDICA EAST PHYSICIANS LLC
5855 MONROE STSYLVANIAOH43560341881145EMPLOYS PHYSICIANSOH$7,735,386-$1,576,704PROMEDICA PHYSICIAN GROUP
PROMEDICA WEST PHYSICIANS LLC
5855 MONROE STSYLVANIAOH43560341893773EMPLOYS PHYSICIANSOH$15,982,568-$8,068,901PROMEDICA PHYSICIAN GROUP
PROMEDICA NORTHWEST OHIO CARDIOLOGY CONSULTANTS LLC
5855 MONROE STSYLVANIAOH43560263888045EMPLOYS PHYSICIANSOH$30,141,070-$56,519,329PROMEDICA PHYSICIAN GROUP
PROMEDICA CARDIOTHORACIC PHYSICIANS LLC
5855 MONROE STSYLVANIAOH43560270978204EMPLOYS PHYSICIANSOH$5,936,506-$9,670,745PROMEDICA PHYSICIAN GROUP
WELLCARE PHYSICIANS LLC
5901 MONCLOVA RDMAUMEEOH43537611528443EMPLOYS PHYSICIANSOH$16,368,856$8,878,730PROMEDICA PHYSICIAN GROUP
THE PHARMACY COUNTER LLC
5855 MONROE STSYLVANIAOH43560271325141MEDICAL EQUIPMENT & PHARMACYOH$60,641,144$17,065,865PROMEDICA PHYSICIAN GROUP
WOLF CREEK ASSOCIATES LLC
901 KIMOLE LNADRIANMI49221383164818FACILITY LEASINGMI$131,432$1,308,580EMMA L BIXBY MEDICAL CENTER
PROMEDICA MONROE CARDIOLOGY PLLC
5855 MONROE STSYLVANIAOH43560272920342EMPLOYS PHYSICIANSMI$2,425,382-$3,059,070PROMEDICA PHYSICIAN GROUP
ERIE WEST HOSPICE & PALLIATIVE CARE LLC
5855 MONROE STSYLVANIAOH43560205752995PROVIDES HOSPICE CAREOH$4,709,330$7,039,875PROMEDICA PHYSICIANS AND CONTINUUM SERVICES
PROMEDICA ANESTHESIA CONSULTANTS LLC
5855 MONROE STSYLVANIAOH43560453251737EMPLOYS PHYSICIANSOH$30,303,052-$44,305,935PROMEDICA PHYSICIAN GROUP
PROMEDICA PHYSICIANS MANAGEMENT SERVICES LLC
5855 MONROE STSYLVANIAOH43560453230331PRACTICE MANAGEMENTOH$0-$2,356,472PROMEDICA PHYSICIAN GROUP
PROMEDICA SURGICAL SERVICES LLC
5855 MONROE STSYLVANIAOH43560EMPLOYS PHYSICIANSOH$0$0PROMEDICA PHYSICIAN GROUP
MISSION POINTE GOLF COURSE LLC
2142 NORTH COVETOLEDOOH43606GOLF COURSEOH$0$391,382PROMEDICA FOUNDATION
PROMEDICA INNOVATIONS LLC
1801 RICHARDS RDTOLEDOOH43607INVESTMENT COMPANYOH$0$0PROMEDICA HEALTH SYSTEM INC
PROMEDICA GENITO-URINARY SURGEONS LLC
5855 MONROE STSYLVANIAOH43560461120436EMPLOYS PHYSICIANSOH$11,558,436-$14,936,580PROMEDICA PHYSICIAN GROUP
PROMEDICA MONROE PHYSICIANS PLLC
5855 MONROE STSYLVANIAOH43560461111822EMPLOYS PHYSICIANSMI$27,275-$757,452PROMEDICA PHYSICIAN GROUP
PROMEDICA MULTI-SPECIALTY PHYSICIANS LLC
5855 MONROE STSYLVANIAOH43560454976786EMPLOYS PHYSICIANSOH$0$159,481PROMEDICA PHYSICIAN GROUP
PROMEDICA HOSPITALISTS LLC
5855 MONROE STSYLVANIAOH43560EMPLOYS PHYSICIANSOH$0$0PROMEDICA PHYSICIAN GROUP
PROMEDICA HOSPITALISTS PLLC
5855 MONROE STSYLVANIAOH43560EMPLOYS PHYSICIANSMI$0$0PROMEDICA PHYSICIAN GROUP
MEMORIAL ANESTHESIA LTD
715 SOUTH TAFT AVEFREMONTOH43420205763680EMPLOYS PHYSICIANSOH$0$0PROMEDICA PHYSICIAN GROUP
MEMORIAL PROFESSIONAL SERVICES LTD
715 SOUTH TAFT AVEFREMONTOH43420273763993EMPLOYS PHYSICIANSOH$10,132,691-$381,185PROMEDICA PHYSICIAN GROUP
PHS VENTURES LLC
1801 RICHARDS RDTOLEDOOH43607341880473HEALTH CARE MANAGEMENT SERVICESDE$0$0PROMEDICA HEALTH SYSTEM INC

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (29 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationIndDirect Controlling NADirectControllingNACd
BAY PARK COMMUNITY HOSPITAL
2801 BAY PARK DROREGONOH43616341883132HOSPITALOH501(C)(3)3PROMEDICA HEALTH SYSTEM INCYes (1)
CARE ENTERPRISES INC
5901 MONCLOVA RDMAUMEEOH43537341366709FACILITY LEASINGOH501(C)(3)11B, IIPROMEDICA HEALTH SYSTEM INCYes (1)
DEFIANCE HOSPITAL AUXILIARY
1200 RALSTONDEFIANCEOH43512510173779HOSPITAL / FOUNDATION SUPPORTOH501(C)(3)11D, III-ODEFIANCE HOSPITAL INCYes (1)
DEFIANCE HOSPITAL INC
1200 RALSTONDEFIANCEOH43512344446484HOSPITALOH501(C)(3)3PROMEDICA HEALTH SYSTEM INCYes (1)
EMMA L BIXBY MEDICAL CENTER
818 RIVERSIDE AVEADRIANMI49221382796005HOSPITALMI501(C)(3)3PROMEDICA HEALTH SYSTEM INCYes (1)
EMMA L BIXBY MEDICAL CENTER AUXILIARY
818 RIVERSIDE AVEADRIANMI49221382149602HOSPITAL / FOUNDATION SUPPORTMI501(C)(3)11B, IIEMMA L BIXBY MEDICAL CENTERYes (1)
FLOWER HOSPITAL
5200 HARROUN RDSYLVANIAOH43560344428794HOSPITALOH501(C)(3)3PROMEDICA HEALTH SYSTEM INCYes (1)
FOSTORIA HOSPITAL ASSOCIATION
501 VAN BUREN STREETFOSTORIAOH44830340898745HOSPITALOH501(C)(3)3PROMEDICA HEALTH SYSTEM INCYes (1)
FOSTORIA HOSPITAL AUXILIARY
PO BOX 907FOSTORIAOH44830346517634HOSPITAL / FOUNDATION SUPPORTOH501(C)(3)11A, IFOSTORIA HOSPITAL ASSOCIATIONYes (1)
HERRICK MEDICAL CENTER AUXILIARY
500 E POTTAWATAMIE STTECUMSEHMI49286383076105HOSPITAL / FOUNDATION SUPPORTMI501(C)(3)11B, IIHERRICK MEMORIAL HOSPITAL INCYes (1)
HERRICK MEMORIAL HOSPITAL INC
500 E POTTAWATAMIE STTECUMSEHMI49286383049015HOSPITALMI501(C)(3)3PROMEDICA HEALTH SYSTEM INCYes (1)
LENAWEE LONG TERM CARE
700 LAKESHIRE TRADRIANMI49221382879330LONG TERM CAREMI501(C)(3)9EMMA L BIXBY MEDICAL CENTERYes (1)
PROMEDICA CONTINUING CARE SERVICES CORP
5855 MONROE STSYLVANIAOH43560344492440LONG TERM AND HOME HEALTH CAREOH501(C)(3)9PROMEDICA PHYSICIANS AND CONTINUUM SERVICESYes (1)
PROMEDICA COURIER SERVICES INC
3170 W CENTRAL AVETOLEDOOH43606260324790COURIER SERVICEOH501(C)(3)11B, IIPROMEDICA PHYSICIANS AND CONTINUUM SERVICESYes (1)
PROMEDICA HEALTH SYSTEM INC
1801 RICHARDS RDTOLEDOOH43607341517671PARENT COMPANY OF HEALTH SYSTEMOH501(C)(3)11B, II0N/A
PROMEDICA INDEMNITY CORP
ONE CHURCH ST 5TH FLOORBURLINGTONVT05401341931936PROFESSIONAL & GENERAL LIABILITYVT501(C)(3)11B, IIPROMEDICA HEALTH SYSTEM INCYes (1)
PROMEDICA PHYSICIANS AND CONTINUUM SERVICES
5855 MONROE STSYLVANIAOH43560341880767PHYSICIAN MANAGEMENT SERVICESOH501(C)(3)11B, IIPROMEDICA HEALTH SYSTEM INCYes (1)
PROMEDICA PHYSICIAN GROUP
5855 MONROE STSYLVANIAOH43560341899439PHYSICIAN HEALTH CARE SERVICESOH501(C)(3)9PROMEDICA PHYSICIANS AND CONTINUUM SERVICESYes (1)
ST LUKE'S HOSPITAL
5901 MONCLOVA RDMAUMEEOH43537344428232HOSPITALOH501(C)(3)3PROMEDICA HEALTH SYSTEM INCYes (1)
PROMEDICA FOUNDATION
2142 N COVE BLVDTOLEDOOH43606341517672FOUNDATIONOH501(C)(3)11B, IIPROMEDICA HEALTH SYSTEM INCYes (1)
THE TOLEDO HOSPITAL
2142 N COVE BLVDTOLEDOOH43606344428256HOSPITALOH501(C)(3)3PROMEDICA HEALTH SYSTEM INCYes (1)
TOLEDO DISTRICT NURSE ASSOCIATION
1946 N 13TH STREETTOLEDOOH43624344427949SKILLED HOME CAREOH501(C)(3)9PROMEDICA PHYSICIANS AND CONTINUUM SERVICESYes (1)
VISITING NURSE HOSPICE AND HEALTH CARE
5855 MONROE STSYLVANIAOH43560341831624HOSPICE HOME CAREOH501(C)(3)9PROMEDICA PHYSICIANS AND CONTINUUM SERVICESYes (1)
KAITLYN'S COTTAGE INC
1260 RALSTON AVEDEFIANCEOH43512454781053RESPITE CAREOH501(C)(3)9DEFIANCE HOSPITAL INCYes (1)
MEMORIAL HOSPITAL
715 SOUTH TAFT AVEFREMONTOH43420344430849HOSPITALOH501(C)(3)3PROMEDICA HEALTH SYSTEM INCYes (1)
MONROE CANCER CENTER
800 STEWART RDMONROEMI48162271302183CANCER CENTERMI501(C)(3)9MERCY MEMORIAL HOSPITAL CORPORATIONYes (1)
MONROE COMMUNITY HEALTH SERVICES
718 N MACOMBMONROEMI48162382934134LONG TERM CAREMI501(C)(3)9MERCY MEMORIAL HOSPITAL CORPORATIONYes (1)
MERCY MEMORIAL HOSPITAL CORPORATION
718 N MACOMBMONROEMI48162381984289HOSPITALMI501(C)(3)3PROMEDICA HEALTH SYSTEM INCYes (1)
PARAMOUNT ADVANTAGE
1901 INDIAN WOOD CIRMAUMEEOH43537203376102HEALTH INSURANCEOH501(C)(3)9PROMEDICA INSURANCE CORP INC AND SUBSIDIARIESYes (1)

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (12 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtPredominant Income TypePredominantIncomeTypeTxtShare Of Total IncomeShareOfTotalIncomeAmtShare Of EOY AssetsShareOfEOYAssetsAmtDisproportionate AllocationsDisproportionateAllocationsIndGeneral Or Managing PartnerGeneralOrManagingPartnerIndOwnershipOwnershipPct
BIXBY MEDICAL OFFICE LIMITED PARTNERSHIP
818 RIVERSIDE AVEADRIANMI49221382972398FACILITY LEASINGMIEMMA L BIXBY MEDICAL CENTERRELATED$36,791$1,173,7760Yes (1)0.64600
REYNOLDS RD SURGICAL CENTER LLC
2865 N REYNOLDS RDTOLEDOOH43615311569454FREESTANDING AMBULATORY SURGICAL CENTEROHTHE TOLEDO HOSPITALRELATED$726,688$2,333,126000.65040
WATERVILLE MEDICAL CENTER LLC
5901 MONCLOVA RDMAUMEEOH43537320160784FACILITY LEASINGOHCARE ENTERPRISES INCRELATED$32,184$753,658000.70000
NORTHWEST OHIO DEDICATED BREAST MRI LLC
5901 MONCLOVA RDMAUMEEOH43537260679898MEDICAL DIAGNOSTICSOHTHE TOLEDO HOSPITALRELATED$211,264$449,126000.50000
WEST CENTRAL SURGICAL CENTER LLC
7055 W CENTRALTOLEDOOH43617200088459AMBULATORY SURGICAL CENTEROHTHE TOLEDO HOSPITALRELATED$298,291$2,912,4570Yes (1)0.50000
OHIO CARE AMBULATORY SURGICAL CENTER LLC
5959 MONCLOVA RDMAUMEEOH43537341863472AMBULATORY SURGICAL CENTEROHST LUKE'S HOSPITALRELATED$73,215$1,293,530000.54680
LENAWEE PHYSICIAN HOSPITAL ORGANIZATION LLC
818 RIVERSIDE AVEADRIANMI49221383605511PHYSICIAN MANAGEMENT SERVICESMIEMMA L BIXBY MEDICAL CENTERRELATED-$23,464$253,4700Yes (1)0.50000
PROMEDICA SURGICAL SERVICES CO-MANAGEMENT CO LLC
5901 MONCLOVA RDMAUMEEOH43537461989695PHYSICIAN MANAGEMENT SERVICESOHPROMEDICA HEALTH SYSTEM INCRELATED$743,257$816,423000.51920
EAST-WEST HOLDINGS LTD
715 SOUTH TAFT AVEFREMONTOH43420204066818REAL ESTATEOHMEMORIAL HOSPITALRELATED$6,016$306,259000.50000
SURGICAL INSTITUTE OF MONROE LLC
1051 S TELEGRAPH RDMONROEMI48161270843485AMBULATORY SURGICAL CENTERMIPROMEDICA PHYSICIANS AND CONTINUUM SERVICESRELATED$4,044$3,684,750000.54000
PROMEDICA MASTER TENANT LLC
1801 RICHARDS RDTOLEDOOH43607475288490REAL ESTATEOHPROMEDICA MANAGER MEMBER LLCRELATED$103,3280Yes (1)0.01000
PROMEDICA DOWNTOWN CAMPUS LANDLORD LLC
1801 RICHARDS RDTOLEDOOH43607473163945REAL ESTATEOHPROMEDICA MANAGER MEMBER LLCRELATED$22,771,2160Yes (1)0.90000

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (12 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtOwnershipOwnershipPctControlled OrganizationControlledOrganizationIndShare Of Total IncomeShareOfTotalIncomeAmtShare Of EOY AssetsShareOfEOYAssetsAmt
CARE HOLDINGS
5901 MONCLOVA RDMAUMEEOH43537341796790HOLDING COMPANYOHPROMEDICA HEALTH SYSTEM INCC1.00000Yes (1)
HERRICK MEMORIAL DEVELOPMENT CORP
500 E POTTAWATAMIE TRADRIANMI49221383146907FACILITY LEASINGMIEMMA L BIXBY MEDICAL CENTERC1.00000Yes (1)$906$964,439
LHA PHYSICIAN SERVICES CORPORATION
818 RIVERSIDE AVEADRIANMI49221611451576PHYSICIAN BILLINGMIEMMA L BIXBY MEDICAL CENTERC1.00000Yes (1)-$44,391
PHYSICIANS ADVANTAGE MSO
5901 MONCLOVA RDMAUMEEOH43537061811760PHYSICIAN MANAGEMENT SERVICESOHPROMEDICA HEALTH SYSTEM INCC1.00000Yes (1)
PROMEDICA CENTRAL CORPORATION OF MICHIGAN
5855 MONROE STSYLVANIAOH43560383322278PHYSICIAN HEALTH CARE SERVICESOHPROMEDICA PHYSICIAN GROUPC1.00000Yes (1)-$1,047,084$3,582,068
PROMEDICA INSURANCE CORP INC AND SUBSIDIARIES
1901 INDIAN WOOD CIRMAUMEEOH43537341570675HEALTH CARE INSURANCEOHPROMEDICA HEALTH SYSTEM INCC1.00000Yes (1)$76,588,676$344,035,035
PROMEDICA NORTH PHYSICIAN CORPORATION
5855 MONROE STSYLVANIAOH43560383482148PHYSICIAN HEALTH CARE SERVICESOHPROMEDICA PHYSICIAN GROUPC1.00000Yes (1)$203,340
PROMEDICA RETAIL GROUP INC
3890 MONROE STTOLEDOOH43606341159928FLORISTOHPROMEDICA PHYSICIANS AND CONTINUUM SERVICESC1.00000Yes (1)$485$1,016,984
HERRICK MEMORIAL OFFICE PLAZA CONDOMINIUM ASSOCIATION
818 RIVERSIDE AVEADRIANMI49221383639616FACILITY MANAGEMENTMIHERRICK MEMORIAL DEVELOPMENT CORPC0.71800Yes (1)$45$55,879
PROMEDICA HEALTH NETWORK INC
1801 RICHARDS RDTOLEDOOH43607474006496PHYSICIAN MANAGEMENT SERVICESOHPROMEDICA HEALTH SYSTEM INCC1.00000Yes (1)
MONROE HEALTH VENTURES
718 N MACOMBMONROEMI48164382704426PHARMACYMIMERCY MEMORIAL HOSPITAL CORPORATIONC1.00000Yes (1)
PROMEDICA MANAGER MEMBER LLC
1801 RICHARDS RDTOLEDOOH43607475168737REAL ESTATEOHPROMEDICA HEALTH SYSTEM INCC1.00000Yes (1)$9,536,974
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (1)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgYes (1)LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (4 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
ST LUKE'S HOSPITAL
B$256,277FMV
ST LUKE'S HOSPITAL
C$237,705FMV
PROMEDICA HEALTH SYSTEM INC
E$5,000,000FMV
PROMEDICA HEALTH SYSTEM INC
P$58,720FMV