Attach to Form 990 or Form 990-EZ.
Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
| (i)Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 9 above (see instructions)) | (iv) Is the organization listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
| Total | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any unusual grants.) .... | ||||||
| 2 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf....... | ||||||
| 3 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | ||||||
| 4 | Total. Add lines 1 through 3 | ||||||
| 5 | The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f).. | ||||||
| 6 | Public support. Subtract line 5 from line 4. | ||||||
Calendar year
(or fiscal year beginning in) ![]() |
(a) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | ||||||
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | ||||||
| 9 | Net income from unrelated business activities, whether or not the business is regularly carried on.. | ||||||
| 10 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.).. | ||||||
| 11 | Total support. Add lines 7 through 10. | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | ||||||
| 2 | Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose...... | ||||||
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513... | ||||||
| 4 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf... | ||||||
| 5 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | ||||||
| 6 | Total. Add lines 1 through 5. | ||||||
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons... | ||||||
| b | Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year. | ||||||
| c | Add lines 7a and 7b.. | ||||||
| 8 | Public support. (Subtract line 7c from line 6.) | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | ||||||
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | ||||||
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | ||||||
| 11 | Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on. | ||||||
| 12 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) .. | ||||||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | ||||||
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
||||
| 1 | Net short-term capital gain | 1 | ||||
| 2 | Recoveries of prior-year distributions | 2 | ||||
| 3 | Other gross income (see instructions) | 3 | ||||
| 4 | Add lines 1 through 3 | 4 | ||||
| 5 | Depreciation and depletion | 5 | ||||
| 6 | Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) | 6 | ||||
| 7 | Other expenses (see instructions) | 7 | ||||
| 8 | Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) | 8 | ||||
| Section B - Minimum Asset Amount | (A) Prior Year |
(B) Current Year (optional) |
||||
| 1 | Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): | 1 | ||||
| a | Average monthly value of securities | 1a | ||||
| b | Average monthly cash balances | 1b | ||||
| c | Fair market value of other non-exempt-use assets | 1c | ||||
| d | Total (add lines 1a, 1b, and 1c) | 1d | ||||
| e |
Discount claimed for blockage or other factors (explain in detail in Part VI): |
|||||
| 2 | Acquisition indebtedness applicable to non-exempt use assets | 2 | ||||
| 3 | Subtract line 2 from line 1d | 3 | ||||
| 4 | Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions). | 4 | ||||
| 5 | Net value of non-exempt-use assets (subtract line 4 from line 3) | 5 | ||||
| 6 | Multiply line 5 by .035 | 6 | ||||
| 7 | Recoveries of prior-year distributions | 7 | ||||
| 8 | Minimum Asset Amount (add line 7 to line 6) | 8 | ||||
| Section C - Distributable Amount | Current Year | |||||
| 1 | Adjusted net income for prior year (from Section A, line 8, Column A) | 1 | ||||
| 2 | Enter 85% of line 1 | 2 | ||||
| 3 | Minimum asset amount for prior year (from Section B, line 8, Column A) | 3 | ||||
| 4 | Enter greater of line 2 or line 3 | 4 | ||||
| 5 | Income tax imposed in prior year | 5 | ||||
| 6 | Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) | 6 | ||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | ||
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
||
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | ||
| 4 Amounts paid to acquire exempt-use assets | ||
| 5 Qualified set-aside amounts (prior IRS approval required) | ||
| 6 Other distributions (describe in Part VI). See instructions | ||
| 7Total annual distributions. Add lines 1 through 6. | ||
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
||
| 9 Distributable amount for 2015 from Section C, line 6 | ||
| 10 Line 8 amount divided by Line 9 amount | ||
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2015 |
(iii) Distributable Amount for 2015 |
|
|---|---|---|---|---|
|
1
Distributable amount for 2015 from Section C, line 6 |
||||
|
2
Underdistributions, if any, for years prior to 2015 (reasonable cause required--see instructions) |
||||
| 3 Excess distributions carryover, if any, to 2015: | ||||
| a | ||||
| b | ||||
| c | ||||
| d From 2013....... | ||||
| e From 2014....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2015 distributable amount | ||||
|
i
Carryover from 2010 not applied (see instructions) |
||||
| j Remainder. Subtract lines 3g, 3h, and 3i from 3f. | ||||
| 4Distributions for 2015 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2015 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from 4. | ||||
|
5
Remaining underdistributions for years prior to 2015, if any. Subtract lines 3g and 4a from line 2 (if amount greater than zero, see instructions) |
||||
|
6
Remaining underdistributions for 2015. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions) |
||||
|
7 Excess distributions carryover to 2016. Add lines 3j and 4c. |
||||
| 8 Breakdown of line 7: | ||||
| a | ||||
| b | ||||
| c Excess from 2013....... | ||||
| d From 2014....... | ||||
| e From 2015....... | ||||
| Facts And Circumstances Test |
|---|
| Return Reference | Explanation |
|---|
| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.
Information about Schedule O (Form 990 or 990-EZ) and its instructions is at| Return Reference | Explanation |
|---|---|
| CORE FORM, PART III, STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS | ST. LUKE'S HOSPITAL ANDERSON CAMPUS ("SL-ANDERSON") IS A JOINT COMMISSION-ACCREDITED, NOT-FOR-PROFIT, 108-LICENSED BED ACUTE CARE HOSPITAL LOCATED AND PROVIDING CARE PRIMARILY TO RESIDENTS OF NORTHAMPTON AND MONROE COUNTIES IN PENNSYLVANIA AND WARREN COUNTY IN NEW JERSEY. IN FY '16, SL-ANDERSON PROVIDED CARE FOR 250,000 PEOPLE ANNUALLY AND 22,000 PATIENT ENCOUNTERS WERE MEDICAID AND 5,300 PATIENT ENCOUNTERS WERE SELF-PAY. SL-ANDERSON IS RECOGNIZED BY THE IRS AS AN INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION. PURSUANT TO ITS CHARITABLE PURPOSES, SL-ANDERSON PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN OR ABILITY TO PAY. MOREOVER, SL-ANDERSON OPERATES CONSISTENTLY WITH THE FOLLOWING CRITERIA OUTLINES IN THE IRS REVENUE RULING 69-545: 1) SL-ANDERSON PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS REGARDLESS OF ABILITY TO PAY, INCLUDING CHARITY CARE, SELF-PAY, MEDICARE AND MEDICAID PATIENTS; 2) SL-ANDERSON OPERATES AN ACTIVE EMERGENCY ROOM FOR ALL PERSONS; WHICH IS OPEN 24 HOURS A DAY, 7 DAYS A WEEK, 365 DAYS PER YEAR; 3) SL-ANDERSON MAINTAINS AN OPEN MEDICAL STAFF, WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS; 4) CONTROL OF SL-ANDERSON RESTS WITH ITS BOARD OF DIRECTORS AND THE BOARD OF DIRECTORS OF ST. LUKE'S HEALTH NETWORK, INC., D.B.A. ST. LUKE'S UNIVERSITY HEALTH NETWORK. BOTH BOARDS COMPRISE A MAJORITY OF INDEPENDENT CIVIC LEADERS AND OTHER PROMINENT MEMBERS OF THE COMMUNITY, AS WELL AS PHYSICIANS ON THE HOSPITAL/NETWORK MEDICAL STAFF; AND 5) SURPLUS FUNDS ARE USED TO IMPROVE THE QUALITY OF PATIENT CARE, EXPAND AND RENOVATE FACILITIES AND ADVANCE MEDICAL CARE; PROGRAMS AND ACTIVITIES. THE OPERATIONS OF SL-ANDERSON, AS SHOWN THROUGH THE FACTORS OUTLINED ABOVE AND OTHER INFORMATION CONTAINED HEREIN, CLEARLY DEMONSTRATE THAT THE USE AND CONTROL OF SL-ANDERSON IS FOR THE BENEFIT OF THE PUBLIC AND THAT NO PART OF THE INCOME OR NET EARNINGS OF THE ORGANIZATION INURES TO THE BENEFIT OF ANY PRIVATE INDIVIDUAL NOR IS ANY PRIVATE INTEREST BEING SERVED OTHER THAN INCIDENTALLY. SL-ANDERSON OPENED ON NOVEMBER 7, 2011 AND WAS THE FIRST NEW, NON-REPLACEMENT HOSPITAL IN PENNSYLVANIA IN MORE THAN FOUR DECADES. SL-ANDERSON IS LOCATED ON A 500-ACRE SITE OWNED BY ST. LUKE'S UNIVERSITY HEALTH NETWORK. IN ADDITION TO SL-ANDERSON, THE FIRST PHASE OF SITE DEVELOPMENT INCLUDES AN OUTPATIENT CANCER CENTER AND A MEDICAL OFFICE BUILDING. THE MEDICAL OFFICE BUILDING PROVIDES IMAGING, PHYSICAL THERAPY, LABORATORY AND OTHER OUTPATIENT TESTING, HEALTH AND FITNESS CENTER AND OFFICES FOR A WIDE RANGE OF PHYSICIAN SPECIALISTS, INCLUDING A NEWLY EXPANDED HEART AND VASCULAR CENTER. AT THE MEDICAL OFFICE BUILDING WE OFFER SUPPORT CLASSES FOR MEMBERS OF THE COMMUNITY. THE FOLLOWING CLASSES ARE OFFERED CONSISTENTLY: - ST. LUKE'S HOSPICE - GRIEF AND LOSS - LIVING WELL WITH DIABETES CLASS - WESCOE FOUNDATION FOR PULMONARY FIBROSIS SUPPORT GROUP - ST. LUKE'S BARIATRIC PEP RALLY - HEALTHY AGING SERIES - BETTER BREATHERS SUPPORT GROUP - LA LECHE LEAGUE OVER THE PAST THREE YEARS, SL-ANDERSON BEGAN EXPANSION OF FREEMANSBURG AVENUE, THE PRIMARY ACCESS TO THE HOSPITAL CAMPUS, AT A TOTAL COST OF $35 MILLION WHEN THE PROJECT IS COMPLETED. SL-ANDERSON IS SERVICE ORIENTED WITH A GOAL TO REDUCE PATIENT AND FAMILY STRESS AND ANXIETY AND TO PROVIDE A CALM AND REASSURING ENVIRONMENT BY MEETING, AND OFTEN EXCEEDING, THEIR PERSONAL NEEDS. SOFTER LIGHTING IS USED IN THE HALLWAYS AND THE DCOR IS DONE IN RELAXING EARTH TONES, AVAILABLE AMENITIES INCLUDE: FLAT SCREEN TELEVISIONS, FREE WIFI SERVICE, DAILY NEWSPAPER DELIVERY, IPADS TO CONNECT TO THE INTERNET, A RECLINER AND COMFORTABLE SOFA BED IN EVERY ROOM AND AN AFTERNOON TEA SERVICE. SL-ANDERSON ALSO FOCUSES ON MAKING ITS SERVICES EASY TO ACCESS. FOR EXAMPLE, MRI APPOINTMENTS ARE AVAILABLE ON SATURDAYS AND SUNDAY AND ALL-DIGITAL MAMMOGRAPHY IS OFFERED AT 6:30 AM TO ACCOMMODATE WORKING WOMEN. ST. LUKE'S UNIVERSITY HEALTH NETWORK PARTNERED WITH THE RODALE INSTITUTE TO DEVELOP AN ORGANIC FARM LOCATED ON THE ANDERSON CAMPUS. THE FARM IS USED TO PROVIDE LOCALLY GROWN ORGANIC PRODUCE IN NETWORK CAFETERIAS AND WILL BE SERVED TO PATIENTS, EMPLOYEES, AND VISITORS. WORKING WITH THE RODALE INSTITUTE TO DEVELOP THE ST. LUKE'S RODALE INSTITUTE ORGANIC FARM ALLOWS ST. LUKE'S TO CONTINUE PROVIDING PATIENTS WITH A HOLISTIC HEALTHCARE EXPERIENCE THAT CREATES A POSITIVE ATMOSPHERE FOR HEALTH AND HEALING. BY PROVIDING PATIENTS, VISITORS, AND STAFF MEMBERS WITH LOCAL GROWN ORGANIC PRODUCE, ST. LUKE'S DEMONSTRATES A COMMITMENT TO THE ENVIRONMENT AND PROMOTING THE HEALTH AND WELL-BEING OF OUR PATIENTS AND THE COMMUNITY. EXCESS PRODUCE IS SOLD TO STAFF MEMBERS AND THE COMMUNITY ALLOWING THESE INDIVIDUALS TO MAKE HEALTHY EATING CHOICES IN THEIR OWN HOMES, CONTRIBUTING TO HEALTHIER LIFESTYLES. IN FY16 THE ORGANIC FARM INCREASED THE NUMBER OF VARIETIES OF PRODUCE TO 100 UP FROM 30 VARIETIES THE YEAR PRIOR. THE ST. LUKES RODALE INSTITUTE ORGANIC FARM HAS DOUBLED ITS ACREAGE TO NOW SPAN 11.5 ACRES. THE COST OF THE FARM IN FY16 WAS $140,000. IN SUMMER OF 2017 SL-ANDERSON WILL OPEN A NEW SPECIALTY PAVILION THAT WILL HOUSE AN AMBULATORY SURGERY CENTER WITH ADDITIONAL OPERATING ROOMS AND PRACTICES THAT FOCUS ON SPECIALTY SERVICES, SUCH AS GASTROENTEROLOGY, UROLOGY AND WOMENS HEALTH. THIS BUILDING IS A 25 MILLION DOLLAR INVESTMENT IN THE FUTURE OF HEALTHCARE WHICH WILL SERVICE THE GREATER LEHIGH VALLEY COMMUNITY. SL-ANDERSON SPECIALTY SERVICES INCLUDE: - CARDIAC CATHETERIZATION - CARDIOLOGY - EMERGENCY SERVICES - ENDOCRINOLOGY - ENDOSCOPIES - GYNECOLOGY - INFUSION SERVICES - LITHOTRIPSY - NEUROLOGY/NEUROSURGERY - ONCOLOGY/HEMATOLOGY - ORTHOPEDICS, JOINT AND MUSCLE DISORDERS - PAIN MANAGEMENT - PERINATAL SERVICES - PULMONARY CRITICAL CARE - RADIATION ONCOLOGY - RADIOLOGY (ADVANCED, INTERVENTIONAL) - RENAL DIALYSIS - SPORTS MEDICINE, PHYSICAL AND OCCUPATIONAL THERAPY, REHAB - SURGERY (GENERAL, SPECIALTY AND LAPAROSCOPIC) - UROLOGY - UROGYNECOLOGY - VASCULAR SERVICES - WOMEN'S IMAGING CENTER MISSION ======= THE MISSION OF SL-ANDERSON IS TO PROVIDE COMPASSIONATE, EXCELLENT QUALITY AND COST-EFFECTIVE HEALTHCARE TO RESIDENTS OF THE COMMUNITIES SERVED REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN OR ABILITY TO PAY. SL-ANDERSON HAS AN UNWAVERING COMMITMENT TO EXCELLENCE AS WE CARE FOR THE SICK AND INJURED; EDUCATE PHYSICIANS, NURSES AND OTHER HEALTHCARE PROVIDERS; AND IMPROVE ACCESS TO CARE IN THE COMMUNITIES WE SERVE, REGARDLESS OF A PATIENT'S ABILITY TO PAY FOR THEIR CARE. |
| CORE FORM, PART III, STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS | COMMUNITY OUTREACH ================== IN KEEPING WITH ITS COMMITMENT TO THE COMMUNITIES IT SERVES. SL-ANDERSON ANNUALLY REACHES MORE THAN 12,500 PEOPLE THROUGH ITS COMMUNITY OUTREACH ENDEAVORS. THE HOSPITAL OFFERS A VARIETY OF FREE SCREENINGS/SERVICES FOR COMMUNITY-RUN EVENTS THROUGHOUT THE YEAR. COMMUNITY OUTREACH, INCLUDES, BUT IS NOT LIMITED TO THESE PROGRAMS OUTLINED BELOW. ST. LUKES UNIVERSITY HEALTH NETWORK PARTNERS WITH LOCAL SCHOOLS AND COMMUNITIES TO IMPROVE THE HEALTH OF STUDENTS THROUGH OUR ADOPT A SCHOOL PROGRAM. THE ST. LUKE'S ADOPT A SCHOOL PROGRAM SUPPORTS THE COMMUNITY HEALTH NEEDS ASSESSMENT PRIORITY AREAS THAT ARE IDENTIFIED AT EACH CAMPUS BY COLLECTING AND ANALYZING DATA AND COMMUNITY INPUT. BASED ON THE IDENTIFIED NEEDS AND PRIORITIES, EACH CAMPUS DEVELOPS PARTNERS, PLANS AND PROGRAMS TO IMPROVE THE HEALTH OF THOSE IN THE COMMUNITIES. IN JANUARY, 2014, ST. LUKES ANDERSON CAMPUS ADOPTED THE BANGOR AREA SCHOOL DISTRICT AND CONTRACTED WITH A COMMUNITY HEALTH LIAISON MANAGER TO OVERSEE THE VARIOUS PROGRAMS AND INITIATIVES AND TO BUILD EFFECTIVE PARTNERSHIPS TO IMPROVE THE HEALTH OUTCOMES. 2,000 OF THE 2,979 BANGOR AREA SCHOOL DISTRICT STUDENTS WERE REACHED DIRECTLY THROUGH OUTREACH AND THE ENTIRE SCHOOL DISTRICT WAS REACHED INDIRECTLY THROUGH THE ADOPT A SCHOOL PROGRAM IN FY16. OUR INITIATIVES ARE CONTINUALLY ASSESSED AND EVALUATED IN ORDER TO PROVIDE MEASURABLE AND EFFECTIVE HEALTH OUTCOMES. ST. LUKES EVIDENCE BASED PROGRAMS/SERVICES INCLUDE: 1) MOBILE YOUTH HEALTH SERVICES (CONNECTING STUDENTS TO MEDICAL, DENTAL & VISION VANS, INSURANCE, PHYSICAL & BEHAVIORAL HEALTH ASSESSMENTS AND SERVICES) 2) HEALTHY LIVING INITIATIVES (TAIL ON THE TRAIL, LIVE YOUR LIFE, SCHOOL GARDENS, NUTRITION AND HEALTH EDUCATION PROGRAMS) 3) LITERACY PROGRAMS (DR. SEUSS DAY, READING ROCKS AND LITTLE FREE LIBRARIES) 4) YOUTH DEVELOPMENT (LEADER IN ME AND CAREER MENTORING) ADOPT A SCHOOL SUPPORT TO BANGOR AREA SCHOOL DISTRICT ----------------------------------------------------- THE FOLLOWING IS A SUMMARY OF SL-ANDERSON ADOPT A SCHOOL SUPPORT TO BANGOR AREA SCHOOL DISTRICT FROM JULY 2015-JUNE 2016: TOTAL FUNDS CONTRIBUTED WERE $46,540. EDUCATION: ST. LUKE'S MEDICAL STUDENTS (3/14/16) PROVIDED INTERACTIVE HEALTH EDUCATION AT DEFRANCO ELEMENTARY SCHOOL. LITERACY: SL-ANDERSON PROVIDED DR. SEUSS DAY LITERACY PROMOTIONS (3/4/16) AT WASHINGTON ELEMENTARY SCHOOL. VISION VAN: ST. LUKES VISION VAN VISITED BANGOR AREA SCHOOL DISTRICT ONCE IN FY 2016. THE ST. LUKES VISION VAN PROVIDED VISION TESTING AND GLASSES TO STUDENTS WHO DO NOT HAVE VISION INSURANCE OR WHO HAVE BARRIERS IN OBTAINING VISION CARE. THIS SERVICE IS PROVIDED AT NO COST TO THE STUDENT. DENTAL VAN: ST. LUKES DENTAL VAN VISITED BANGOR AREA SCHOOL DISTRICT TWELVE TIMES IN FY 2016. THE ST. LUKES DENTAL VAN PROVIDED ACCESS TO DENTAL CARE FOR CHILDREN AGED 3-18 WITH NO DENTAL INSURANCE OR WHO HAVE GATEWAY/AMERIHEALTH CARITAS INSURANCES, AND THEY HAVE NOT SEEN A DENTIST FOR AT LEAST SIX MONTHS. MOBILE YOUTH MEDICAL VAN: ST. LUKES MEDICAL VAN VISITED BANGOR AREA SCHOOL DISTRICT SIX TIMES IN FY 2016. BEHAVIORAL HEALTH CONSULTANT ON MOBILE VAN FUNDED BY UNITED WAY FOR THE BANGOR MIDDLE SCHOOL AND THE ANDERSON CAMPUS FOR THE HIGH SCHOOL. HEALTHY LIVING: ST. LUKES SPONSORED THE KELLYN FOUNDATION NUTRITION AND GARDEN EDUCATION PROGRAMS THROUGHOUT THE YEAR PLUS ORGANIC VEGETABLE GARDENS. THEY ALSO PROMOTED THE ST. LUKES RODALE ORGANIC INSTITUTE FARM COMMUNITY PROGRAMS WITH THE CHILDRENS HOME OF EASTON. ANDERSON CAMPUS COMMUNITY HEALTH LIAISON MANAGER TO MANAGE PROGRAMS, INITIATIVES AND OUTREACH. |
| CORE FORM, PART III; QUESTION 4D | EXPENSES INCURRED IN PROVIDING VARIOUS OTHER MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN OR ABILITY TO PAY. PLEASE REFER TO THE ORGANIZATION'S COMMUNITY BENEFIT STATEMENT INCLUDED IN SCHEDULE O. |
| CORE FORM, PART V; QUESTION 1A & CORE FORM, PART VII; SECTION B | THE ORGANIZATION IS AN AFFILIATE WITHIN ST. LUKE'S UNIVERSITY HEALTH NETWORK ("NETWORK"); A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY NETWORK. THE ORGANIZATION'S FORM 990 REFLECTS NO TOP FIVE INDEPENDENT CONTRACTORS FOR SERVICES AND REPORTS THAT NO FORMS 1099 WERE FILED WITH THE INTERNAL REVENUE SERVICE ("IRS"). ST. LUKE'S HOSPITAL OF BETHLEHEM, PENNSYLVANIA, A RELATED INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION PAYS ALL OUTSTANDING ACCOUNTS PAYABLE INVOICES ON BEHALF OF THIS ORGANIZATION. IN CONJUNCTION WITH THIS SERVICE, ST. LUKE'S HOSPITAL OF BETHLEHEM, PENNSYLVANIA ALSO PREPARES AND ISSUES FORMS 1099 TO THESE VENDORS RECEIVING PAYMENTS WHERE APPLICABLE AND FILES THESE FORMS 1099 WITH THE IRS. ST. LUKE'S HOSPITAL OF BETHLEHEM, PENNSYLVANIA ALLOCATES THESE PAYMENTS TO THE ORGANIZATION VIA AN INTERCOMPANY ACCOUNT. |
| CORE FORM, PART VI, SECTION A; QUESTIONS 6 & 7 | ST. LUKE'S HEALTH NETWORK, INC. IS THE SOLE MEMBER OF THIS ORGANIZATION. ST. LUKE'S HEALTH NETWORK, INC. HAS THE RIGHT TO ELECT THE MEMBERS OF THIS ORGANIZATION'S BOARD OF DIRECTORS AND HAS CERTAIN RESERVED POWERS AS DEFINED IN THIS ORGANIZATION'S BYLAWS. |
| CORE FORM, PART VI, SECTION B; QUESTION 11B | THE ORGANIZATION IS AN AFFILIATE WITHIN ST. LUKE'S UNIVERSITY HEALTH NETWORK ("NETWORK"); A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY NETWORK. ST. LUKE'S HEALTH NETWORK, INC. IS THE TAX-EXEMPT PARENT ENTITY OF THE NETWORK. THE ORGANIZATION'S FEDERAL FORM 990 WAS PROVIDED TO EACH VOTING MEMBER OF THE ORGANIZATION'S GOVERNING BODY (ITS BOARD OF DIRECTORS) PRIOR TO THE FILING WITH THE INTERNAL REVENUE SERVICE ("IRS"). IN ADDITION, THE ST. LUKE'S UNIVERSITY HEALTH NETWORK FINANCE COMMITTEE WAS UPDATED AS TO THIS ORGANIZATION'S CURRENT YEAR FORM 990 PRIOR TO FILING. ST. LUKE'S HEALTH NETWORK, INC. BOARD OF DIRECTORS HAS DELEGATED TO THE FINANCE COMMITTEE THE RESPONSIBILITY TO OVERSEE AND COORDINATE THE FEDERAL FORM 990 PREPARATION AND FILING PROCESS FOR THE TAX-EXEMPT AFFILIATES OF THE NETWORK. AS PART OF THE ORGANIZATION'S FEDERAL FORM 990 TAX RETURN PREPARATION PROCESS THE ORGANIZATION HIRED A PROFESSIONAL CERTIFIED PUBLIC ACCOUNTING ("CPA") FIRM WITH EXPERIENCE AND EXPERTISE IN BOTH HEALTHCARE AND NOT-FOR-PROFIT TAX RETURN PREPARATION TO PREPARE THE FEDERAL FORM 990. THE CPA FIRM'S TAX PROFESSIONALS WORKED CLOSELY WITH THE NETWORK'S FINANCE PERSONNEL, INCLUDING ITS SENIOR VICE PRESIDENT OF FINANCE, VICE PRESIDENT OF FINANCE, DIRECTOR OF ACCOUNTING AND VARIOUS OTHER NETWORK INDIVIDUALS ("INTERNAL WORKING GROUP") TO OBTAIN THE INFORMATION NEEDED IN ORDER TO PREPARE A COMPLETE AND ACCURATE TAX RETURN. THE CPA FIRM PREPARED A DRAFT FEDERAL FORM 990 AND FURNISHED IT TO THE NETWORK'S INTERNAL WORKING GROUP FOR THEIR REVIEW. THE NETWORK'S INTERNAL WORKING GROUP REVIEWED THE DRAFT FEDERAL FORM 990 AND DISCUSSED QUESTIONS AND COMMENTS WITH THE CPA FIRM. REVISIONS WERE MADE TO THE DRAFT FEDERAL FORM 990 WHERE NECESSARY AND A FINAL DRAFT WAS FURNISHED BY THE CPA FIRM TO THE NETWORK'S INTERNAL WORKING GROUP FOR FINAL REVIEW AND APPROVAL PRIOR TO PRESENTATION OF THE FEDERAL FORM 990 TO THE MEMBERS OF THE ST. LUKE'S HEALTH NETWORK, INC. FINANCE COMMITTEE. THEREAFTER, THE FINAL FEDERAL FORM 990 WAS PROVIDED TO EACH VOTING MEMBER OF THE ORGANIZATION'S GOVERNING BODY PRIOR TO FILING WITH THE IRS. |
| CORE FORM, PART VI, SECTION B; QUESTION 12 | THE ORGANIZATION IS AN AFFILIATE WITHIN ST. LUKE'S UNIVERSITY HEALTH NETWORK ("NETWORK"); A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY NETWORK. ST. LUKE'S HEALTH NETWORK, INC. IS THE TAX-EXEMPT PARENT ENTITY OF THE NETWORK. THE NETWORK HAS A WRITTEN CONFLICT OF INTEREST POLICY AND REGULARLY MONITORS AND ENFORCES COMPLIANCE WITH THAT POLICY. THE POLICY REQUIRES THAT A CONFLICT OF INTEREST DISCLOSURE FORM CONSISTENT WITH BEST GOVERNANCE PRACTICES AND INTERNAL REVENUE SERVICE GUIDELINES BE CIRCULATED TO OFFICERS, DIRECTORS, BOARD COMMITTEE MEMBERS AND SENIOR MANAGERS ANNUALLY. THE NETWORK'S COMPLIANCE DEPARTMENT, INCLUDING ITS CORPORATE COMPLIANCE OFFICER AND SENIOR VICE PRESIDENT/GENERAL COUNSEL, ASSUME RESPONSIBILITY FOR THE COMPLETION OF THE CONFLICT OF INTEREST QUESTIONNAIRES AND ENFORCEMENT WITH THE POLICY. IF A DIRECTOR DISCLOSES AN INTEREST THAT COULD GIVE RISE TO A CONFLICT, THE DIRECTOR'S POTENTIAL CONFLICT MAY BE DISCLOSED TO THE ORGANIZATION'S GOVERNING BODY, WHICH EVALUATES THE CONFLICT AND ITS POTENTIAL IMPACT ON THE DIRECTOR'S PARTICIPATION ON THE BOARD. AFTER CONSULTATION AND DISCUSSION THE BOARD OF DIRECTORS MAY TAKE ACTION, IF APPROPRIATE AND NECESSARY, TO ADDRESS ANY SUCH CONFLICT IN A MANNER CONSISTENT WITH THE NETWORK'S CONFLICT OF INTEREST POLICY. |
| CORE FORM, PART VI, SECTION B; QUESTION 15 | THE ORGANIZATION IS AN AFFILIATE WITHIN ST. LUKE'S UNIVERSITY HEALTH NETWORK ("NETWORK"); A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY NETWORK. ST. LUKE'S HEALTH NETWORK, INC. IS THE TAX-EXEMPT PARENT ENTITY OF THE NETWORK. COMPENSATION REVIEW EXECUTIVE COMPENSATION FOR THE NETWORK CONSISTS OF FIXED SALARY, AT-RISK COMPENSATION AND OTHER DEFERRED COMPENSATION ARRANGEMENTS. TOTAL COMPENSATION FOR NETWORK EXECUTIVES IS APPROVED ANNUALLY BY THE NETWORK'S BOARD OF DIRECTORS. THE RECOMMENDED COMPENSATION IS ESTABLISHED THROUGH A MULTI-FACETED APPROACH INCLUDING USE OF AN INDEPENDENT CONSULTANT ENGAGED ON AN ONGOING BASIS BY THE BOARD OF DIRECTORS AND WHO WORKS DIRECTLY WITH THE EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD. ALSO INCLUDED IS THE REVIEW OF FORMS 990 AND COMPENSATION SURVEYS OF OTHER COMPARABLE HEALTHCARE ORGANIZATIONS. PLEASE REFER TO THE SCHEDULE J, PART III RESPONSE TO SCHEDULE J, PART I, QUESTION 3 FOR ADDITIONAL INFORMATION. |
| CORE FORM, PART VI, SECTION C; QUESTION 19 | THE ORGANIZATION'S FILED CERTIFICATE OF INCORPORATION AND ANY AMENDMENTS CAN BE OBTAINED AND REVIEWED THROUGH THE COMMONWEALTH OF PENNSYLVANIA. |
| CORE FORM, PART VII AND SCHEDULE J | CORE FORM, PART VII AND SCHEDULE J REFLECT CERTAIN BOARD MEMBERS AND OFFICERS RECEIVING COMPENSATION AND BENEFITS FROM RELATED ORGANIZATIONS. PLEASE NOTE THIS REMUNERATION WAS FOR SERVICES RENDERED AS FULL-TIME EMPLOYEES OF THIS ORGANIZATION OR A RELATED ORGANIZATION AND NOT FOR SERVICES RENDERED AS A VOTING MEMBER OR OFFICER OF THIS ORGANIZATION'S BOARD OF DIRECTORS. PLEASE NOTE THIS ORGANIZATION'S FORM 990 REFLECTS NO COMPENSATED INDIVIDUALS FROM THIS ENTITY. ST. LUKE'S HOSPITAL OF BETHLEHEM, PENNSYLVANIA, A RELATED INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION EMPLOYS THESE INDIVIDUALS. ST. LUKE'S HOSPITAL OF BETHLEHEM, PENNSYLVANIA ISSUES FORMS W-2 TO INDIVIDUALS WHO PROVIDE SERVICES AT ST. LUKES HOSPITAL ANDERSON CAMPUS, AND FILES THE APPLICABLE FORMS WITH THE INTERNAL REVENUE SERVICE. ST. LUKE'S HOSPITAL OF BETHLEHEM, PENNSYLVANIA ALLOCATES THESE PAYMENTS TO THIS ORGANIZATION VIA AN INTERCOMPANY ACCOUNT. |
| CORE FORM, PART VII, SECTION A, COLUMN B | THE ORGANIZATION IS AN AFFILIATE WITHIN ST. LUKE'S UNIVERSITY HEALTH NETWORK ("NETWORK"); A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY NETWORK. THE NETWORK INCLUDES BOTH FOR-PROFIT AND NOT FOR-PROFIT ORGANIZATIONS. CERTAIN BOARD OF DIRECTOR MEMBERS AND OFFICERS LISTED ON CORE FORM, PART VII AND SCHEDULE J OF THIS FORM 990 MAY HOLD SIMILAR POSITIONS WITH BOTH THIS ORGANIZATION AND OTHER AFFILIATES WITHIN THE NETWORK. THE HOURS SHOWN ON THIS FORM 990 FOR BOARD MEMBERS WHO RECEIVE NO COMPENSATION FOR SERVICES RENDERED IN A NON-BOARD CAPACITY, REPRESENTS THE ESTIMATED HOURS DEVOTED PER WEEK FOR THIS ORGANIZATION. TO THE EXTENT THESE INDIVIDUALS SERVE AS A MEMBER OF THE BOARD OF DIRECTORS OF OTHER RELATED ORGANIZATIONS WITHIN THE NETWORK, THEIR RESPECTIVE HOURS PER WEEK PER ORGANIZATION ARE APPROXIMATELY THE SAME AS REFLECTED ON CORE FORM, PART VII OF THIS FORM 990. THE HOURS REFLECTED ON CORE FORM, PART VII OF THIS FORM 990, FOR BOARD MEMBERS WHO RECEIVE COMPENSATION FOR SERVICES RENDERED IN A NON-BOARD CAPACITY, PAID OFFICERS, REFLECT TOTAL HOURS WORKED PER WEEK ON BEHALF OF THE NETWORK; NOT SOLELY THIS ORGANIZATION. |
| CORE FORM, PART XI; QUESTION 9 | OTHER CHANGES IN NET ASSETS OR FUND BALANCES INCLUDE: - NET ASSETS RELEASED FROM RESTRICTIONS USED FOR PURCHASES OF PROPERTY AND EQUIPMENT - $460,569; - PLEDGES RECEIVED (TEMPORARILY RESTRICTED) -($122,528); - NET ASSETS RELEASED FROM RESTRICTIONS USED FOR PROPERTY AND EQUIPMENT (TEMPORARILY RESTRICTED) - ($89,709); - NET ASSETS RELEASED FROM RESTRICTIONS FOR OPERATIONS - TEMPORARILY RESTRICTED; ($12,000); and - ALLOWANCE FOR PLEDGES WRITTEN OFF AND ACTUAL WRITE-OFFS - TEMPORARILY RESTRICTED; $2,835. |
| CORE FORM, PART XII; QUESTION 2 | THE ORGANIZATION IS AN AFFILIATE WITHIN ST. LUKE'S UNIVERSITY HEALTH NETWORK ("NETWORK)"); A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY NETWORK. ST. LUKE'S HEALTH NETWORK, INC. IS THE TAX-EXEMPT PARENT ENTITY OF THE NETWORK. AN INDEPENDENT CPA FIRM AUDITED THE CONSOLIDATED FINANCIAL STATEMENTS OF THE NETWORK AND ITS CONTROLLED AFFILIATES FOR THE YEARS ENDED JUNE 30, 2016 AND JUNE 30, 2015; RESPECTIVELY, AND ISSUED A CONSOLIDATED FINANCIAL STATEMENT WITH CONSOLIDATING SCHEDULES BY ENTITY. AN UNQUALIFIED OPINION WAS ISSUED EACH YEAR BY THE INDEPENDENT CPA FIRM. THE NETWORK'S FINANCE COMMITTEE ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF THE NETWORK'S CONSOLIDATED FINANCIAL STATEMENTS AND THE SELECTION OF AN INDEPENDENT AUDITOR. |
| CORE FORM, PART XII; QUESTION 3 | THE ORGANIZATION IS AN AFFILIATE WITHIN ST. LUKE'S UNIVERSITY HEALTH NETWORK ("NETWORK"); A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY NETWORK. THE NETWORK'S FINANCE COMMITTEE ENGAGED AN INDEPENDENT ACCOUNTING FIRM TO PREPARE AND ISSUE A NETWORK WIDE CONSOLIDATED AUDIT UNDER THE SINGLE AUDIT ACT AND OMB CIRCULAR A-133. |
| Software ID: | |
| Software Version: |