ST LUKES HOSPITAL FOUNDATION INC: Form 990, tax year 2011
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- Organization
- ST LUKES HOSPITAL FOUNDATION INC (EIN 56-1757097)
- Tax period
- 2011-10-01 to 2012-09-30
- Filed
- 2013-05-10
- IRS object ID
- 201311309349300121
- Schema version
- 2011v1.5
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-05-10T05:59:20-05:00 | Timestamp |
| Tax Period End Date | 2012-09-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 560747981 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DIXON HUGHES GOODMAN LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 500 RIDGEFIELD COURT | AddressLine1 |
| City | ASHEVILLE | City |
| State | NC | State |
| ZIP Code | 28806 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-10-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 561757097 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ST LUKE'S FOUNDATION INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | STLU | NameControl |
| Phone | 8288943311 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 101 HOSPITAL DRIVE | AddressLine1 |
| City | COLUMBUS | City |
| State | NC | State |
| ZIP Code | 28722 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | CHRISTINE MARTIN | Name |
| Title | CFO | Title |
| Phone | 8288943311 | Phone |
| Date Signed | 2013-05-10 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | AMY BIBBY | Name |
| PTIN | P00445891 | PTIN |
| Phone | 8282542254 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-25 16:41:14Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | CHRISTINE MARTIN | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 101 HOSPITAL DRIVE | AddressLine1 |
| City | COLUMBUS | City |
| State | NC | State |
| ZIP Code | 28722 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 995251 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | N/A | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1928 | YearFormation |
| State Legal Domicile | NC | StateLegalDomicile |
| Activity Or Mission Description | ST. LUKE'S FOUNDATION RAISES FUNDS TO HELP SUPPORT ST. LUKE'S HOSPITAL | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 17 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 17 | NbrIndependentVotingMembers |
| Total Nbr Employees | 3 | TotalNbrEmployees |
| Total Nbr Volunteers | 0 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 278599 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 913522 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 0 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 0 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 58473 | InvestmentIncomePriorYear |
| Investment Income Current Year | 75754 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | -6067 | OtherRevenuePriorYear |
| Other Revenue Current Year | -4541 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 331005 | TotalRevenuePriorYear |
| Total Revenue Current Year | 984735 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 87249 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 35679 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 42749 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 10191 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 19914 | OtherExpensePriorYear |
| Other Expenses Current Year | 72509 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 142842 | TotalExpensesPriorYear |
| Total Expenses Current Year | 115258 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 188163 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 869477 | RevenuesLessExpensesCY |
| Total Assets BOY | 3252900 | TotalAssetsBOY |
| Total Assets EOY | 4423001 | TotalAssetsEOY |
| Total Liabilities BOY | 137938 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 178827 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 3114962 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 4244174 | NetAssetsOrFundBalancesEOY |
| Mission Description | 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. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 86626 | Expense |
| Revenue | 0 | Revenue |
| Description | 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 CONTRIBUTEAT 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. | Description |
| Total Program Service Expense | 86626 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 0 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 1 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 0 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 0 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 3 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 17 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 17 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 0 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| Other Website | X | OtherWebsite |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHRISTINE MARTIN | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 8288940892 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 101 HOSPITAL DRIVE | AddressLine1 |
| City | COLUMBUS | City |
| State | NC | State |
| ZIP Code | 28722 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (18 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation |
|---|---|---|---|---|---|---|
| JUDY LAIR | ||||||
| CHAIRMAN | 1.00 | X | X | 0 | 0 | 0 |
| PAUL SUTHERLAND | ||||||
| VICE CHAIR/TREASURER | 1.00 | X | X | 0 | 0 | 0 |
| PATTY HOLL | ||||||
| SECRETARY | 1.00 | X | X | 0 | 0 | 0 |
| FRED FOY | ||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | |
| JAY GEDDINGS | ||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | |
| PETRA HARRELSON | ||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | |
| DON HOFMANN | ||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | |
| BILL JONES | ||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | |
| BETH LAUGHRIDGE | ||||||
| TRUSTEE | 40.00 | X | 0 | 0 | 0 | |
| LOUISE RADFORD | ||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | |
| RACHEL RAMSEY | ||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | |
| JEAN SHUMWAY | ||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | |
| STACEY STAFFORD | ||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | |
| JOYCE MOFFATT | ||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | |
| KEITH COLLINS | ||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | |
| CATHY TAYLOR | ||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | |
| PAUL ZIMMERMAN | ||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | |
| MESHELLE COLVIN | ||||||
| EXECUTIVE DIRECTOR | 40.00 | X | 27496 | 27495 | 6153 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 27496 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 27495 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 6153 | TotalOtherCompensation |
| Number Individuals GT100 K | 0 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 0 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
| Number Of Contractors GT100 K | 0 | NumberOfContractorsGT100K |
| Fundraising Events | 35145 | FundraisingEvents |
| Related Organizations | 16100 | RelatedOrganizations |
| All Other Contributions | 862277 | AllOtherContributions |
| Total Contributions | 913522 | TotalContributions |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 75754 | TotalRevenueColumn |
| Exclusion | $75,754 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Fundraising Events | 5975 | GrossIncomeFundraisingEvents |
| Cntrbtns Rprtd Fundraising Events | 35145 | CntrbtnsRprtdFundraisingEvents |
| Fundraising Direct Expenses | 10516 | FundraisingDirectExpenses |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -4541 | TotalRevenueColumn |
| Exclusion | -$4,541 | ExclusionAmount |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 984735 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $71,213 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 30573 | Total |
| Program Services | 10191 | ProgramServices |
| Management And General | 10191 | ManagementAndGeneral |
| Fundraising | 10191 | Fundraising |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5051 | Total |
| Program Services | 5051 | ProgramServices |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7125 | Total |
| Program Services | 7125 | ProgramServices |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8250 | Total |
| Management And General | 8250 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 306 | Total |
| Program Services | 306 | ProgramServices |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3396 | Total |
| Program Services | 3396 | ProgramServices |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 995 | Total |
| Program Services | 995 | ProgramServices |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3297 | Total |
| Program Services | 3297 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 387 | Total |
| Program Services | 387 | ProgramServices |
Other Expenses OtherExpenses (2 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices |
|---|---|---|
| MISCELLANEOUS | 34234 | 34234 |
| BAD DEBT | 21644 | 21644 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 115258 | Total |
| Program Services | 86626 | ProgramServices |
| Management And General | 18441 | ManagementAndGeneral |
| Fundraising | 10191 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 598615 | BOY |
| EOY | 175032 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 586972 | BOY |
| EOY | 1512005 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 296227 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2067313 | BOY |
| EOY | 2439737 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3252900 | BOY |
| EOY | 4423001 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2577 | BOY |
| EOY | 330 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 135361 | BOY |
| EOY | 178497 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 137938 | BOY |
| EOY | 178827 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3114962 | BOY |
| EOY | 3416315 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 632029 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 195830 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3114962 | BOY |
| EOY | 4244174 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3252900 | BOY |
| EOY | 4423001 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 869477 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 259735 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org170b1 Avi | X | PubliclySupportedOrg170b1Avi |
Gifts Grants Contrib Received170 GiftsGrantsContribReceived170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 236980 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 313124 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 943746 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 287169 | CurrentTaxYearMinus1Year |
| Current Tax Year | 293671 | CurrentTaxYear |
| Total | 2074690 | Total |
Total170 Total170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 236980 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 313124 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 943746 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 287169 | CurrentTaxYearMinus1Year |
| Current Tax Year | 293671 | CurrentTaxYear |
| Total | 2074690 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Amounts Subst Contributors Total | 309496 | AmountsSubstContributorsTotal |
| Public Support Total170 | 1765194 | PublicSupportTotal170 |
Gross Investment Income170 GrossInvestmentIncome170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 42520 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 39579 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 39902 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 58473 | CurrentTaxYearMinus1Year |
| Current Tax Year | 75754 | CurrentTaxYear |
| Total | 256228 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | 2330918 | TotalSupport |
| Gross Receipts From Admissions Etc | 41120 | GrossReceiptsFromAdmissionsEtc |
| Public Support Pertcentage170 | 0.75730 | PublicSupportPertcentage170 |
| Public Support Pertcent Prior Year | 0.84260 | PublicSupportPertcentPriorYear |
| Thirty Three Percnt Tests CY170 | X | ThirtyThreePercntTestsCY170 |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 0 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | DUE TO RELATED PARTIES | Description |
| Amount | $178,497 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 178497 | TotalOfAmounts |
| Total Revenue | 984735 | TotalRevenue |
| Total Expenses | 115258 | TotalExpenses |
| Excess Or Deficit For Year | 869477 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | 259735 | NetUnrealizedGLOnInvestments |
| Total Adjustments | 259735 | TotalAdjustments |
| Excess Or Deficit Per FS | 1129212 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 670280 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | 259735 | NetUnrealizedGainsInvestments |
| Revenue Not Rptd F990 | 259735 | RevenueNotRptdF990 |
| Revenue Subtotal | 410545 | RevenueSubtotal |
| Other Revenues Not Included | 574190 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 574190 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 984735 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 125774 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | 10516 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 10516 | ExpensesNotRptdF990 |
| Expenses Subtotal | 115258 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 115258 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (4 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | PART X: | 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 DON NOT HAVE ANY MATERIAL UNRECOGNIZED TAX BENEFITS OR OBLIGATIONS AS OF SEPTEMBER 30, 2012. FISCAL YEARS ENDING ON OR AFTER SEPTEMBER 30, 2009 REMAIN SUBJECT TO EXAMINATION BY FEDERAL AND STATE TAX AUTHORITIES. |
| PART XI, LINE 8 - OTHER ADJUSTMENTS: | CHANGE IN RESTICTED NET ASSETS | |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | SPECIAL EVENT EXPENSES -10,516. RESTRICTED CONTRIBUTIONS 584,706. | |
| PART XIII, LINE 2D - OTHER ADJUSTMENTS: | SPECIAL EVENT EXPENSES 10,516. |
Schedule G IRS990ScheduleG
Events Information EventsInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | ACHE AROUND THE LAKE | NameOfEvent1 |
| Gross Receipts Event1 | 38710 | GrossReceiptsEvent1 |
| Charitable Contributions Event1 | 33962 | CharitableContributionsEvent1 |
| Gross Revenue Event1 | 4748 | GrossRevenueEvent1 |
| Non Cash Prizes Event1 | 950 | NonCashPrizesEvent1 |
| Other Direct Expenses Event1 | 8073 | OtherDirectExpensesEvent1 |
| Name Of Event2 | MINI PRIX | NameOfEvent2 |
| Gross Receipts Event2 | 2410 | GrossReceiptsEvent2 |
| Charitable Contributions Event2 | 1183 | CharitableContributionsEvent2 |
| Gross Revenue Event2 | 1227 | GrossRevenueEvent2 |
| Other Direct Expenses Event2 | 1493 | OtherDirectExpensesEvent2 |
| Gross Receipts Total | 41120 | GrossReceiptsTotal |
| Charitable Contributions Total | 35145 | CharitableContributionsTotal |
| Gross Revenue Total Events | 5975 | GrossRevenueTotalEvents |
| Non Cash Prizes Total Events | 950 | NonCashPrizesTotalEvents |
| Other Direct Expenses Total Events | 9566 | OtherDirectExpensesTotalEvents |
| Direct Expense Summary Events | 10516 | DirectExpenseSummaryEvents |
| Net Income Summary | -4541 | NetIncomeSummary |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (6 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| 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. | |
| FORM 990, PART XI, LINE 5: | NET UNREALIZED GAINS ON INVESTMENTS: 259,735. CHANGE IN RESTICTED NET ASSETS TOTAL TO FORM 990, PART XI, LINE 5: 259,735. | CHANGES IN NET ASSETS OR FUND BALANCES: |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (4 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Direct Controlling Entity NADirectControllingEntityNA | Controlled OrgControlledOrg | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| ST LUKE'S HEALTH CARE INC | |||||||||||
| 101 HOSPITAL DRIVE | COLUMBUS | NC | 28722 | 561423318 | CONTROLLING ENTITY | NC | 501(C)(3) | PF | N/A | 0 | |
| COMMUNITY HEALTH CONNECTIONS | |||||||||||
| 101 HOSPITAL DRIVE | COLUMBUS | NC | 28722 | 561722387 | TO PROVIDE HOME BASED MEDICAL TREATMENT IN AND AROUND COLUMBUS, NC | NC | 501(C)(3) | LINE 9 | 0 | ST LUKE'S HEALTHCARE INC | |
| ST LUKE'S PHYSICIAN NETWORK INC | |||||||||||
| 101 HOSPITAL DRIVE | COLUMBUS | NC | 28722 | 263082073 | PROVIDE HEALTH CARE SERVICES TO THE CITIZENS OF POLK COUNTY, NC | NC | 501(C)(3) | LINE 3 | 0 | ST LUKE'S HEALTHCARE INC | |
| 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 | 0 | ST LUKE'S HEALTHCARE INC | |
Form990 Schedule R Part IV Form990ScheduleRPartIV
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ST LUKE'S PROFESSIONAL BUILDING INC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 101 HOSPITAL DRIVE | AddressLine1 |
| City | COLUMBUS | City |
| State | NC | State |
| ZIP Code | 28722 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 561423404 | EIN |
| Primary Activity | RENTAL REAL ESTATE | PrimaryActivity |
| Legal Domicile State | NC | LegalDomicileState |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |
| Type Of Entity | C | TypeOfEntity |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 1 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 1 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 1 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 1 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 1 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 1 | OtherTransferFromOtherOrg |