2014-08-06T12:31:00-05:00 2013-09-30 560747981 DIXON HUGHES GOODMAN LLP 500 RIDGEFIELD COURT ASHEVILLE NC 28806 990 2012-10-01 561757097 ST LUKE'S FOUNDATION INC STLU 8288943311 101 HOSPITAL DRIVE COLUMBUS NC 28722 CHRISTINE MARTIN 8288943311 2014-08-06 1 AMY BIBBY P00445891 8282542254 2012 2015-11-30 17:44:51Z CHRISTINE MARTIN 101 HOSPITAL DRIVE COLUMBUS NC 28722 576564 0 X N/A X 1928 NC ST. LUKE'S FOUNDATION RAISES FUNDS TO HELP SUPPORT ST. LUKE'S HOSPITAL 17 17 3 0 0 0 913522 485548 0 0 75754 74927 -4541 11444 984735 571919 0 1652105 0 0 42749 44419 0 0 10518 72509 89510 115258 1786034 869477 -1214115 4423001 3601770 178827 243300 4244174 3358470 ST. 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. 0 0 1753398 1652105 0 ST. 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 TO ITS PALMER JERVEY SOCIETY OF DONORS WHO CONTRIBUTE AT LEAST $1,000 IN A CALENDAR YEAR, INVITES THE COMMUNITY TO SUPPORT THE HOSPITAL THROUGH CONTRIBUTIONS TO THE FOUNDATION, AND HOSTS SEVERAL FUNDRAISING EVENTS THROUGHOUT THE YEAR INCLUDING A MOTHER'S DAY MINI PRIX IN CONJUNCTION WITH THE BLUE RIDGE HUNTER JUMPER ASSOCIATION AND THE ACHE AROUND THE LAKE, AN 8K FUNDRAISING WALK/RUN AROUND LAKE LANIER AND A TEAHOUSE BRUNCH. 1753398 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 3 1 0 0 0 0 0 0 0 0 0 0 X 17 17 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 X CHRISTINE MARTIN 8288940954 101 HOSPITAL DRIVE COLUMBUS NC 28722 JUDY LAIR 1.00 X X 0 0 0 PAUL SUTHERLAND 1.00 X X 0 0 0 PATTY HOLL 1.00 X X 0 0 0 FRED FOY 1.00 X 0 0 0 JAY GEDDINGS 1.00 X 0 0 0 PETRA HARRELSON 1.00 X 0 0 0 DON HOFFMANN 1.00 X 0 0 0 BILL JONES 1.00 X 0 0 0 BETH LAUGHRIDGE 1.00 X 0 0 0 LOUISE RADFORD 1.00 X 0 0 0 FRED BAISDEN 1.00 X 0 0 0 JEAN SHUMWAY 1.00 X 0 0 0 STACEY STAFFORD 1.00 X 0 0 0 JOYCE MOFFATT 1.00 X 0 0 0 NED DICK 1.00 X 0 0 0 CATHY TAYLOR 1.00 X 0 0 0 NANCY MCKINSTRY 1.00 X 0 0 0 LARRY WASSONG 1.00 X 0 0 0 MESHELLE COLVIN 40.00 X 28227 28226 6655 28227 28226 6655 0 0 0 0 0 20950 6100 458498 485548 74927 74927 7595 20950 4645 2950 2950 RECOVERY OF BAD DEBT 900099 8494 8494 8494 571919 0 0 86371 1652105 1652105 31555 10519 10518 10518 5461 5461 7403 7403 11600 11600 3945 3945 11400 11400 6905 6905 2413 2413 375 375 MISCELLANEOUS 52872 52872 1786034 1753398 22118 10518 175032 165672 1512005 476077 296227 182876 2439737 2777145 4423001 3601770 330 1448 178497 241852 178827 243300 X 3416315 2603835 632029 511482 195830 243153 4244174 3358470 4423001 3601770 X -1214115 234305 94647 -541 X 0 1 X 1 0 X 313124 943746 287169 293671 493143 2330853 313124 943746 287169 293671 493143 2330853 690666 1640187 39579 39902 58473 75754 74927 288635 8494 8494 2627982 41120 0.62410 0.75730 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 DUE TO RELATED PARTIES 241852 241852 X 527230 234305 4645 238950 288280 283639 283639 571919 130080 4645 4645 125435 1660599 1660599 1786034 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: INCOME TAXES- THE HOSPITAL, ST. LUKE'S FOUNDATION, INC., COMMUNITY HEALTH CONNECTIONS, INC., AND ST. LUKE'S PHYSICIAN NETWORK, INC. 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, 2013. FISCAL YEARS ENDING ON OR AFTER SEPTEMBER 30, 2010 REMAIN SUBJECT TO EXAMINATION BY FEDERAL AND STATE TAX AUTHORITIES. PART XI, LINE 2D - OTHER ADJUSTMENTS: SPECIAL EVENT EXPENSE 4,645. PART XI, LINE 4B - OTHER ADJUSTMENTS: RECOVERY OF BAD DEBT 8,494. CHANGE IN RESTRICTED NET ASSETS 275,145. PART XII, LINE 2D - OTHER ADJUSTMENTS: SPECIAL EVENT EXPENSE 4,645. PART XII, LINE 4B - OTHER ADJUSTMENTS: RECOVERY OF BAD DEBT 8,494. GRANTS FROM THE FOUNDATION 1,652,105. ACHE AROUND THE LAKE 20850 17925 2925 3000 MINI PRIX 7695 3025 4670 1645 28545 20950 7595 4645 4645 2950 1 ST LUKE'S HOSPITAL INC 101 HOSPITAL DRIVE COLUMBUS NC 28722 560554222 501(C)(3) 1652105 TO ASSIST THE HOSPITAL 1 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: THE ST. LUKE'S FOUNDATION IS A SUPPORTING ORGANIZATION OF THE ST. LUKE'S HOSPITAL. ALL GRANTS MADE WERE USED TO SUPPORT THE ACTIVITIES AND PROGRAMS OF ST. LUKE'S HOSPITAL. FORM 990, PART VI, SECTION A, LINE 1 THE 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 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. 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 15A A 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 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. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 9: ADJUSTMENT ON PLEDGE RECEIVABLES 1,082. ADJUSTMENT ON OPERATIONS -1,623. 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 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 ST LUKE'S HEALTHCARE INC 0 ST LUKE'S HOSPITAL INC 101 HOSPITAL DRIVE COLUMBUS NC 28722 560554222 PROVIDE HEALTH CARE SERVICES TO THE CITIZENS OF POLK COUNTY, NC NC 501(C)(3) LINE 3 ST LUKE'S HEALTHCARE INC 0 ST LUKE'S PROFESSIONAL BUILDING INC 101 HOSPITAL DRIVE COLUMBUS NC 28722 561423404 RENTAL REAL ESTATE NC N/A C 0 0 1 1 0 0 0 0 0 0 1 0 1 0 0 1 0 0 1 1