2011-05-13T09:59:04-05:00 2010-09-30 DIXON HUGHES GOODMAN LLP 500 Ridgefield Court Asheville NC 28806 990 2009-10-01 561757097 ST LUKE'S FOUNDATION INC STLU 8288943311 101 HOSPITAL DRIVE COLUMBUS NC 28722 CHRISTINE MARTIN 8288943311 2011-05-13 1 Amy Bibby 8282542254 2009 2016-02-24 21:20:13Z CHRISTINE MARTIN 101 HOSPITAL DRIVE COLUMBUS NC 28722 983652 0 X N/A X 1928 NC ST. LUKE'S FOUNDATION RAISES FUNDS TO HELP SUPPORT ST. LUKE'S HOSPITAL 20 20 1 20 0 0 313124 943748 0 39579 39902 33066 -28775 385769 954875 0 0 37642 36432 0 0 20890 19056 58532 55488 327237 899387 2007727 3069949 66923 102784 1940804 2967165 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 46583 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. 46583 1 1 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 1 1 0 0 0 0 0 0 0 0 0 20 20 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 X X CHRISTINE MARTIN 8288940892 101 HOSPITAL DRIVE COLUMBUS NC 28722 Hertha Flack 1.00 X 0 0 0 Jerry Johnson 1.00 X X 0 0 0 Judy Lair 1.00 X X 0 0 0 Marion McMillian 1.00 X 0 0 0 Norm Powers 1.00 X X 0 0 0 Phyllis Eifert 1.00 X 0 0 0 Tom Harris 1.00 X 0 0 0 Woody Woodham 1.00 X 0 0 0 CAROL MEESKE 1.00 X 0 0 0 BOB REEVES 1.00 X 0 0 0 RACHEL RAMSEY 1.00 X 0 0 0 CLARK BENSON 1.00 X 0 0 0 MARY ANN CLAUD 1.00 X X 0 0 0 BOB DICK 1.00 X 0 0 0 TOMMY MELTON 1.00 X 0 0 0 KEITH COLLINS 1.00 X 0 0 0 LILLIE BROWN 1.00 X 0 0 0 DIANNE ARBOUR 1.00 X 0 0 0 DAVE TRUITT 1.00 X 0 0 0 MARK WOODBRIDGE 1.00 X 0 0 0 CAROL JACKSON 40.00 X 59910 0 4791 59910 0 4791 0 0 0 0 0 54876 888872 943748 37173 37173 2731 2 2729 2729 2729 0 54876 28775 -28775 -28775 954875 0 0 11127 30360 30360 6072 6072 10 10 8895 8895 5527 5527 2370 2370 383 383 801 801 MISCELLANEOUS 1070 1070 55488 46583 8905 0 218493 1123319 1789234 1946630 2007727 3069949 658 2455 66265 100329 66923 102784 X 1940804 2967165 1940804 2967165 2007727 3069949 X 0 1 1 X 0 X 244064 306328 236980 313124 943746 2044242 244064 306328 236980 313124 943746 2044242 107426 1936816 36241 37686 42520 39579 39902 195928 2240170 123038 0.86460 0.70860 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 DUE TO RELATED PARTIES 100329 100329 954875 55488 899387 126975 126975 1026362 1110625 126975 126975 983650 -28775 -28775 954875 84263 28775 28775 55488 0 55488 Part XII, Line 4b - Other Adjustments: SPECIAL EVENT EXPENSES: -28775. Part XIII, Line 2d - Other Adjustments: SPECIAL EVENT EXPENSES: 28775. ACHE AROUND THE LAKE 22626 22626 480 2253 8267 SPRING FLING 32250 32250 4200 6000 300 7275 54876 54876 480 4200 8253 300 15542 28775 -28775 Form 990, Part VI, Section B, line 11 THE FINANCE COMMITTEE HAD A MEETING ON 04/27/11 TO COMPLETE A COMPREHENSIVE REVIEW OF THE FORM 990. THE ORGANIZATION HELD A FULL BOARD MEETING ON 04/28/11, 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 ON 04/28/11. 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. ST LUKE'S HEALTH CARE INC 101 HOSPITAL DRIVE COLUMBUS NC 28722 561423318 CONTROLLING ENTITY NC 501(c)(3) PF 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 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 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 PROFESSIONAL BUILDING INC 101 HOSPITAL DRIVE COLUMBUS NC 28722 561423404 RENTAL REAL ESTATE NC N/A C 0 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1