FURP.ORG / PUBLIC DATA EXPLORER

ST LUKES HOSPITAL FOUNDATION INC: Form 990, tax year 2015

View the entire original 990 at ProPublica ↗

Organization
ST LUKES HOSPITAL FOUNDATION INC (EIN 56-1757097)
Tax period
2015-10-01 to 2016-09-30
Filed
2017-05-15
IRS object ID
201701359349300210
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 ReturnHeader

FieldValueIRS element (for citing)
Return2017-05-15T05:52:45-05:00ReturnTs
Tax Period End2016-09-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN560747981PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1DIXON HUGHES GOODMAN LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1500 RIDGEFIELD COURTAddressLine1Txt
CityASHEVILLECityNm
State AbbreviationNCStateAbbreviationCd
ZIP28806ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2015-10-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN561757097EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1ST LUKE'S FOUNDATION INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlSTLUBusinessNameControlTxt
Phone8288943311PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1101 HOSPITAL DRIVEAddressLine1Txt
CityCOLUMBUSCityNm
State AbbreviationNCStateAbbreviationCd
ZIP28722ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonELIZABETH PRESNELLPersonNm
Person TitleCFOPersonTitleTxt
Phone8288943311PhoneNum
Signature2017-05-15SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonAMY BIBBYPreparerPersonNm
PTINP00445891PTIN
Phone8282542254PhoneNum
Preparation2017-05-15PreparationDt
FieldValueIRS element (for citing)
Tax2015TaxYr
Build TS2021-01-29 14:40:06ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerELIZABETH PRESNELLPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1101 HOSPITAL DRIVEAddressLine1Txt
CityCOLUMBUSCityNm
State AbbreviationNCStateAbbreviationCd
ZIP28722ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$316,235GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressN/AWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1928FormationYr
Legal Domicile StateNCLegalDomicileStateCd
Activity Or MissionST. LUKE'S FOUNDATION RAISES FUNDS TO HELP SUPPORT ST. LUKE'S HOSPITALActivityOrMissionDesc
Voting Members Governing Body17VotingMembersGoverningBodyCnt
Voting Members Independent17VotingMembersIndependentCnt
Total Employee2TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$625,367PYContributionsGrantsAmt
CY Contributions Grants$211,585CYContributionsGrantsAmt
PY Program Service Revenue$0PYProgramServiceRevenueAmt
CY Program Service Revenue$0CYProgramServiceRevenueAmt
PY Investment Income$90,702PYInvestmentIncomeAmt
CY Investment Income$72,246CYInvestmentIncomeAmt
PY Other Revenue$0PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$716,069PYTotalRevenueAmt
CY Total Revenue$283,831CYTotalRevenueAmt
PY Grants And Similar Paid$126,309PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$37,158CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$49,796PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$109,139CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$18,237CYTotalFundraisingExpenseAmt
PY Other Expenses$54,034PYOtherExpensesAmt
CY Other Expenses$58,835CYOtherExpensesAmt
PY Total Expenses$230,139PYTotalExpensesAmt
CY Total Expenses$205,132CYTotalExpensesAmt
PY Revenues Less Expenses$485,930PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$78,699CYRevenuesLessExpensesAmt
Total Assets BOY$3,981,635TotalAssetsBOYAmt
Total Assets EOY$4,504,981TotalAssetsEOYAmt
Total Liabilities BOY$394,777TotalLiabilitiesBOYAmt
Total Liabilities EOY$504,328TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$3,586,858NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$4,000,653NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionST. LUKE'S FOUNDATION RAISES FUNDS TO HELP SUPPORT ST. LUKE'S HOSPITAL, WHOSE PURPOSE IS TO PROVIDE HEALTHCARE IN A VARIETY OF FORMATS TO RESIDENTS OF COLUMBUS, NC AND THE SURROUNDING AREA.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$158,363ExpenseAmt
Grant$37,158GrantAmt
DescST. LUKE'S HOSPITAL FOUNDATION RAISES FUNDS TO SUPPORT PROJECTS WHICH WILL ENHANCE THE DELIVERY OF THE BEST POSSIBLE HEALTH CARE TO THE PEOPLE OF ST. LUKE'S HOSPITAL SERVICE AREA. TO ACCOMPLISH THIS END, THE FOUNDATION MAINTAINS AND SOLICITS MEMBERSHIPS: -THE PALMER & JERVEY SOCIETY ARE DONORS WHO CONTRIBUTE AT LEAST $1,000 UP TO $4,999-THE SOCIETY OF 1972 ARE DONORS WHO CONTRIBUTE AT LEAST $5,000 UP TO $9,999-THE SOCIETY OF 1928 ARE DONORS WHO CONTRIBUTE AT LEAST $10,000 ST. LUKE'S HOSPITAL FOUNDATION INVITES THE COMMUNITY TO SUPPORT THE HOSPITAL THROUGH CONTRIBUTIONS TO THE FOUNDATION, AND HOSTS SEVERAL FUNDRAISING EVENTS THROUGHOUT THE YEAR, INCLUDING A HUNTER DERBY IN CONJUNCTION WITH THE BLUE RIDGE HUNTER JUMPER ASSOCIATION, AND THE ACHE AROUND THE LAKE, AN 8K FUNDRAISING WALK/RUN AROUND LAKE LANIER.Desc
Total Program Service Expenses$158,363TotalProgramServiceExpensesAmt
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 Equipment0ReportLandBuildingEquipmentInd
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 Individuals0GrantsToIndividualsInd
Schedule J Required0ScheduleJRequiredInd
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 Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee2EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
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 Members17GoverningBodyVotingMembersCnt
Independent Voting Member17IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
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 CEOYes (1)CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1ELIZABETH PRESNELLBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone8288940954PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1101 HOSPITAL DRIVEAddressLine1Txt
CityCOLUMBUSCityNm
State AbbreviationNCStateAbbreviationCd
ZIP28722ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (21 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
PAUL SUTHERLAND
CHAIRMAN1.00Yes (X)Yes (X)$0$0$0
DON HOFMANN
VICE CHAIR1.00Yes (X)Yes (X)$0$0$0
JEAN SHUMWAY
SECRETARY1.00Yes (X)Yes (X)$0$0$0
LARRY WASSONG
TREASURER1.00Yes (X)Yes (X)$0$0$0
FRED BAISDEN
TRUSTEE1.00Yes (X)$0$0$0
CLARK BENSON
TRUSTEE1.00Yes (X)$0$0$0
SHERRY DASHIELL
TRUSTEE1.00Yes (X)$0$0$0
JAY GEDDINGS
TRUSTEE1.00Yes (X)$0$0$0
PETRA HARRELSON
TRUSTEE1.00Yes (X)$0$0$0
BETH LAUGHRIDGE
TRUSTEE1.00Yes (X)$0$0$0
CRAIG GERMANO
TRUSTEE1.00Yes (X)$0$0$0
JOYCE MOFFATT
TRUSTEE1.00Yes (X)$0$0$0
PATTY HOLL
TRUSTEE1.00Yes (X)$0$0$0
ARLENE KOLKER
TRUSTEE1.00Yes (X)$0$0$0
SUZANNE METCALF
TRUSTEE1.00Yes (X)$0$0$0
RANAE WALDMAN
TRUSTEE1.00Yes (X)$0$0$0
RACHEL RAMSEY
TRUSTEE1.00Yes (X)$0$0$0
ANDREW MORRIS
TRUSTEE1.00Yes (X)$0$0$0
ROGER NEWMAN
TRUSTEE1.00Yes (X)$0$0$0
ROBERTA RATTERREE
TRUSTEE1.00Yes (X)$0$0$0
MESHELLE COLVIN
EXECUTIVE DIRECTOR40.00Yes (X)$28,046$28,045$9,452
FieldValueIRS element (for citing)
Total Reportable Comp From Org$28,046TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$28,045TotReportableCompRltdOrgAmt
Total Other Compensation$9,452TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K0TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt
All Other Contributions$211,585AllOtherContributionsAmt
Total Contributions$211,585TotalContributionsAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$91,048TotalRevenueColumnAmt
Exclusion$91,048ExclusionAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$18,802SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities-$18,802SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$18,802TotalRevenueColumnAmt
Exclusion-$18,802ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$13,602FundraisingGrossIncomeAmt
Fundraising Direct Expenses$13,602FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$283,831TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$72,246ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$37,158TotalAmt
Program Services$37,158ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$32,772TotalAmt
Program Services$10,924ProgramServicesAmt
Management And General$10,924ManagementAndGeneralAmt
Fundraising$10,924FundraisingAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$50,226TotalAmt
Program Services$50,226ProgramServicesAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$26,141TotalAmt
Program Services$19,260ProgramServicesAmt
Management And General$3,441ManagementAndGeneralAmt
Fundraising$3,440FundraisingAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$14,167TotalAmt
Management And General$14,167ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$1,537TotalAmt
Program Services$1,537ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$3,430TotalAmt
Program Services$3,430ProgramServicesAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$9,129TotalAmt
Program Services$9,129ProgramServicesAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$1,329TotalAmt
Program Services$1,329ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$343TotalAmt
Program Services$343ProgramServicesAmt

Other Expenses OtherExpensesGrp (2 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtFundraisingFundraisingAmt
MISCELLANEOUS$18,949$15,076$3,873
ALLOWANCE FOR UNCOLLECT$9,951$9,951

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$205,132TotalAmt
Program Services$158,363ProgramServicesAmt
Management And General$28,532ManagementAndGeneralAmt
Fundraising$18,237FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$56,247BOYAmt
EOY$234,124EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$218,389BOYAmt
EOY$218,827EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$22,020BOYAmt
EOY$6,386EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$3,684,979BOYAmt
EOY$4,045,644EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$3,981,635BOYAmt
EOY$4,504,981EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$2,533BOYAmt
EOY$2,982EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$392,244BOYAmt
EOY$501,346EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$394,777BOYAmt
EOY$504,328EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$3,242,516BOYAmt
EOY$3,677,558EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$101,189BOYAmt
EOY$79,942EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$243,153BOYAmt
EOY$243,153EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$3,586,858BOYAmt
EOY$4,000,653EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$3,981,635BOYAmt
EOY$4,504,981EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$78,699ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$335,096NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
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)
Public Organization170Yes (X)PublicOrganization170Ind

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$293,671CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$493,143CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$231,532CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$630,670CurrentTaxYearMinus1YearAmt
Current Tax Year$225,187CurrentTaxYearAmt
Total$1,874,203TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$293,671CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$493,143CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$231,532CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$630,670CurrentTaxYearMinus1YearAmt
Current Tax Year$225,187CurrentTaxYearAmt
Total$1,874,203TotalAmt
FieldValueIRS element (for citing)
Substantial Contributors Tot$748,744SubstantialContributorsTotAmt
Public Support Total170$1,125,459PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$75,754CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$74,927CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$60,240CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$92,058CurrentTaxYearMinus1YearAmt
Current Tax Year$91,048CurrentTaxYearAmt
Total$394,027TotalAmt

Other Income170 OtherIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus3 Years$8,494CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$6,413CurrentTaxYearMinus2YearsAmt
Total$14,907TotalAmt
FieldValueIRS element (for citing)
Total Support$2,283,137TotalSupportAmt
Gross Receipts Rltd Activities$41,120GrossReceiptsRltdActivitiesAmt
Public Support CY1700.49290PublicSupportCY170Pct
Public Support PY1700.30510PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170Yes (X)ThirtyThrPctSuprtTestsCY170Ind

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

FieldValueIRS element (for citing)
Total Book Value Land Buildings$0TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescDUE TO RELATED PARTIESDesc
Amt$501,346Amt
FieldValueIRS element (for citing)
Total Liability$501,346TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART X, LINE 2:FormAndLineReferenceDesc
ExplanationTHE 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.ExplanationTxt

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Event1ACHE AROUND THE LAKE/HUNTER DERBYEvent1Nm
Gross Receipts Event1$13,602GrossReceiptsEvent1Amt
Gross Revenue Event1$13,602GrossRevenueEvent1Amt
Non Cash Prizes Event1$680NonCashPrizesEvent1Amt
Food And Beverage Event1$1,450FoodAndBeverageEvent1Amt
Entertainment Event1$400EntertainmentEvent1Amt
Other Direct Expenses Event1$11,072OtherDirectExpensesEvent1Amt
Gross Receipts Total$13,602GrossReceiptsTotalAmt
Gross Revenue Total Events$13,602GrossRevenueTotalEventsAmt
Non Cash Prizes Total Events$680NonCashPrizesTotalEventsAmt
Food And Beverage Total Events$1,450FoodAndBeverageTotalEventsAmt
Entertainment Total Events$400EntertainmentTotalEventsAmt
Oth Direct Expnss Total Events$11,072OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events$13,602DirectExpenseSummaryEventsAmt
Net Income Summary$0NetIncomeSummaryAmt

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 HOSPITAL INCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1101 HOSPITAL DRIVEAddressLine1Txt
CityCOLUMBUSCityNm
State AbbreviationNCStateAbbreviationCd
ZIP28722ZIPCd
FieldValueIRS element (for citing)
Recipient EIN560554222RecipientEIN
IRC Section501(C)(3)IRCSectionDesc
Cash Grant$37,158CashGrantAmt
Purpose Of GrantTO ASSIST THE HOSPITALPurposeOfGrantTxt
FieldValueIRS element (for citing)
Total501c3 Org1Total501c3OrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 2:FormAndLineReferenceDesc
ExplanationTHE ST. LUKE'S FOUNDATION IS A RELATED ORGANIZATION OF THE ST. LUKE'S HOSPITAL, WHOSE PURPOSES IS TO MAKE MONETARY SUPPORT TO THE HOSPITAL. ALL GRANTS MADE WERE USED TO SUPPORT THE ACTIVITIES AND PROGRAMS OF ST. LUKE'S HOSPITAL.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (7 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 1THE EXECUTIVE COMMITTEE SHALL BE COMPOSED OF THE OFFICERS OF THE CORPORATION, THE PRESIDENT OF ST. LUKE'S HEALTHCARE, THE CHAIRMAN OF THE BOARD OF DIRECTORS OF ST. LUKE'S HEALTHCARE, THE CHAIRMEN OF THE STANDING COMMITTEES OF THE FOUNDATION AND THE EXECUTIVE DIRECTOR (WITHOUT VOTE). THE CHAIRMAN OF THE BOARD OF TRUSTEES SHALL BE THE CHAIRMAN OF THE EXECUTIVE COMMITTEE. THE VICE-CHAIRMAN OF THE BOARD SHALL BE THE VICE CHAIRMAN OF THE EXECUTIVE COMMITTEE. 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. MEETINGS OF THE EXECUTIVE COMMITTEE SHALL BE HELD AT THE CALL OF THE CHAIRMAN OR UPON DELEGATION OF THE CHAIRMAN TO THE VICE-CHAIRMAN. THE EXECUTIVE COMMITTEE SHALL NOT TAKE ANY ACTION THAT CONFLICTS WITH POLICIES OF THE BOARD AND SHALL SUBMIT ITS MINUTES AND RECORDS TO THE NEXT MEETING OF THE BOARD OF TRUSTEES FOR ITS REVIEW. FIVE (5) MEMBERS OF THE EXECUTIVE COMMITTEE SHALL CONSTITUTE A QUORUM AT ANY MEETING OF THE EXECUTIVE COMMITTEE. ANY MOTION OR RESOLUTION MAY BE CARRIED BY A MAJORITY OF THOSE IN ATTENDANCE, PROVIDED, HOWEVER, THAT NO MOTION OR RESOLUTION AT ANY MEETING OF THE EXECUTIVE COMMITTEE SHALL BE CARRIED UNLESS IT RECEIVES THE AFFIRMATIVE VOTE OF AT LEAST (5) MEMBERS OF THE EXECUTIVE COMMITTEE ATTENDING THE MEETING.
FORM 990, PART VI, SECTION B, LINE 11THE 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.
FORM 990, PART VI, SECTION B, LINE 12COFFICERS, 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 15AA MARKET BASED PAY SCALE WAS USED TO DETERMINE THE COMPENSATION PACKAGE FOR THE DIRECTOR OF THE FOUNDATION. THE COMPENSATION IS ALSO BASED ON QUALIFICATIONS AND YEARS OF EXPERIENCE.
FORM 990, PART VI, SECTION C, LINE 18RECENT 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 19PHOTOCOPIES 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 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/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtDirect Controlling NADirectControllingNACdControlled OrganizationControlledOrganizationIndBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Txt
ST LUKE'S HEALTH CARE INC
101 HOSPITAL DRIVECOLUMBUSNC28722561423318CONTROLLING ENTITYNC501(C)(3)PFN/A0
ST LUKE'S PHYSICIAN NETWORK INC
101 HOSPITAL DRIVECOLUMBUSNC28722263082073PROVIDE HEALTH CARE SERVICES TO THE CITIZENS OF POLK COUNTY, NCNC501(C)(3)LINE 30ST LUKE'S HEALTHCARE INC
ST LUKE'S HOSPITAL INC
101 HOSPITAL DRIVECOLUMBUSNC28722560554222PROVIDE HEALTH CARE SERVICES TO THE CITIZENS OF POLK COUNTY, NCNC501(C)(3)LINE 30ST LUKE'S HEALTHCARE INC

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1ST LUKE'S PROFESSIONAL BUILDING INCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1101 HOSPITAL DRIVEAddressLine1Txt
CityCOLUMBUSCityNm
State AbbreviationNCStateAbbreviationCd
ZIP28722ZIPCd
FieldValueIRS element (for citing)
EIN561423404EIN
Primary ActivitiesRENTAL REAL ESTATEPrimaryActivitiesTxt
Legal Domicile StateNCLegalDomicileStateCd
Direct Controlling NAN/ADirectControllingNACd
Entity TypeCEntityTypeTxt
Controlled Organization0ControlledOrganizationInd
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 Org0LoansOrGuaranteesFromOthOrgInd
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 OrgYes (1)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd