Attach to Form 990 or 990-EZ.
Information about Schedule O (Form 990 or 990-EZ) and its instructions is at| Return Reference | Explanation |
|---|---|
| Form 990, Part III, Line 3 Significant changes in program services | BY RESOLUTION OF THE ORGANIZATION'S GOVERNING BODY, SL AUGUSTA CORPORATION WAS MERGED WITH AND INTO ST. LUKE'S PROPERTIES CORPORATION, EFFECTIVE 7/1/16. ACCORDINGLY, THE INFORMATION CONTAINED IN THIS FORM 990 REPRESENTS THE ORGANIZATION'S WIND-UP PERIOD. PLEASE REFER TO FORM 990, SCHEDULE N FOR ADDITIONAL INFORMATION. |
| Form 990, Part V, Line 1a FORM 1096 REPORTING | ST. LUKE'S HEALTH SYSTEM CORPORATION REMITS ALL VENDORS PAYMENTS AND ISSUES FORM 1099 ON BEHALF OF ITS RELATED ORGANIZATIONS. INDIVIDUAL ENTITIES OF ST. LUKE'S HEALTH SYSTEM CORPORATION DO NOT FILE FORMS 1096 FOR THIS REASON. |
| Form 990, Part V, Line 2a FORM W-3 AND W-2 REPORTING | THE EMPLOYEES OF ST. LUKE'S AUGUSTA CORPORATION ARE PAID BY A COMMON PAYMASTER, ST. LUKE'S HEALTH SYSTEM CORPORATION, (76-0536232). THEREFORE, NO FORM W-3 OR 941'S WERE FILED BY ST. LUKE'S AUGUSTA CORPORATION AS ALL PAYROLL INFORMATION RELATED TO THESE EMPLOYEES WAS INCLUDED IN THE FORM W-3 AND 941S FILED BY ST. LUKE'S HEALTH SYSTEM CORPORATION. |
| Form 990, Part VI, Line 14 WRITTEN DOCUMENT RETENTION AND DESTRUCTION POLICY | ST LUKE'S HEALTH SYSTEM CORPORATION AND RELATED ENTITIES HAVE A WRITTEN GENERAL POLICY RELATED TO DOCUMENT RETENTION AND DESTRUCTION. DOCUMENTS AND RECORDS ARE RETAINED FOR VARIOUS FEDERAL, STATE OR OTHER JURISDICTION STATUTES FOR MEDICAL OR FINANCIAL REVIEW ON A DEPARTMENT BY-DEPARTMENT BASIS. |
| Form 990, Part VI, Line 3 Delegation of management duties | CHI ST. LUKE'S HEALTH CONTRACTED WITH FTI, LLC TO PROVIDE MANAGEMENT SERVICES IN THE CAPACITY OF INTERIM CHIEF FINANCIAL OFFICER FOR THE ENTIRE SYSTEM. JENNY BARNETT-SARPALIUS SERVED IN THIS ROLE FOR THE PERIOD JULY 1, 2015 THROUGH DECEMBER 28, 2015. EFFECTIVE DECEMBER 28, 2015, SHE BECAME AN OFFICIAL EMPLOYEE AND CHIEF FINANCIAL OFFICER OF THE SYSTEM. FTI, LLC PAID Jenny Barnett-Sarpalius $159,231 IN REPORTABLE COMPENSATION DURING 2015. |
| Form 990, Part VI, Line 6 Classes of members or stockholders | According to the bylaws of SL Augusta Corporation, the entity's sole member is St. Luke's Properties Corporation, a Texas nonprofit organization. |
| Form 990, Part VI, Line 7a Members or stockholders electing members of governing body | THE BOARD OF DIRECTORS SHALL CONSIST OF NOT LESS THAN FOUR ELECTED MEMBERS, ALL OF SUCH MEMBERS TO BE ELECTED BY ST. LUKE'S PROPERTIES CORPORATION PURSUANT TO THE ACTION AND RESOLUTIONS ADOPTED BY THE BOARD OF DIRECTORS OF ST. LUKE'S PROPERTIES CORPORATION. |
| Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders | THE BOARD OF DIRECTORS SHALL HAVE FULL POWER AND AUTHORITY TO MANAGE THE BUSINESS, OPERATIONS, AND AFFAIRS OF THE CORPORATION IN ACCORDANCE WITH THE BYLAWS WHICH THE BOARD OF DIRECTORS SHALL ADOPT. |
| Form 990, Part VI, Line 11b Review of form 990 by governing body | THE RETURN WAS MADE AVAILABLE TO THE OFFICERS AND DIRECTORS BEFORE FILING. |
| Form 990, Part VI, Line 12c Conflict of interest policy | Catholic Health Initiatives ("CHI") has a Conflicts of Interest ("COI") policy in place to maintain the integrity of all of its activities. The policy applies to CHI Board of Stewardship Trustees and members of its committees; all board and board committee members of CHI Entities; all CHI employees; all CHI physicians (both employed and non-employed) and all physician administrators and leaders; advanced practice clinicians (both employed and non-employed); and all CHI research personnel (both employed and non-employed). Disclosure, review and management of perceived, potential or actual conflicts of interest are accomplished through a defined COI disclosure process. Each person has a general ongoing obligation to promptly and fully report to his/her direct manager, supervisor, medical staff office, board or board committee chair any situation or circumstance that may create a conflict of interest. The person must report the actual or potential conflict as soon as she/he becomes aware of it. In any situation where the person may be in doubt, a full disclosure should be made to permit an impartial and objective determination. In addition to the general ongoing obligation, there are initial disclosure obligations. The board, board committee members, and new employees are required to make disclosures at the time of their initial hiring/appointment. All non-employed, credentialed or contracted physicians are required to make disclosures at the time of their credentialing and during any subsequent reappointment or recredentialing. All researchers are required to make disclosures upon consideration of affiliation with a research sponsor. In addition to the general ongoing and initial disclosure obligations, there is an annual disclosure obligation. All corporate officers, board and board committee members, employees at the level of manager and above, researchers, supply chain employees, employed physicians, physician administrators and leaders, and employed advanced practice clinicians must complete a new conflict of interest disclosure annually. Disclosures of perceived, potential or actual conflicts involving financial interests are forwarded to the Conflicts of Interest Review Committee ("C-CIRC") or Legal Services Group for review depending on the position of the person involved. The C-CIRC reviews COI questionnaires containing disclosures of perceived or possible conflicts for employees at a level of manager or above, supply chain employees, researchers and physicians, physician administrators and leaders, and advanced practice clinicians (both employed and non-employed). In the determination of a conflict, a COI management plan will be developed for that person. With respect to those audiences for which the C-CIRC has review responsibility, the C-CIRC will facilitate development of any such conflict of interest management plan in collaboration with local CRP staff. A designated CHI Entity staff will be responsible for monitoring the COI management plan and for documenting monitoring activities. At its sole discretion, a CHI Entity may reject a Person's request to enter into the relationship in question, or require the relationship be sufficiently altered to avoid a potential COI. If the C-CIRC determines that there is a potential or actual conflict of interest that does not currently have appropriate controls to address the conflict of interest, it may recommend that the disclosing person be allowed to participate in the activity or transaction subject to restrictions as outlined in the COI management plan. If a Person does not agree with a determination made by the C-CIRC, its interpretation of the Policy or Addenda, or seeks an exemption or exception, the following steps should be followed. The Employee disputing the review decision, interpretation of the Policy, or seeking exemption or exception must present the matter to the Employee's immediate direct manager or supervisor for review and determination. If the Employee and the manager do not agree with the review decision, interpretation of the Policy, or seek exemption or exception, the manager shall consult with the manager's Vice President (or higher if the manager is a Vice President) to reach a determination. If the matter remains unresolved, it shall be referred to the CHI Vice President of Human Resources and the CHI Corporate Responsibility Officer. If they are unable to reach agreement, the matter shall be referred to the CHI General Counsel, whose decision shall be final. Reviews and determinations involving board and board committee members and corporate officers will be the responsibility of the board, board executive committee, or board chair, with guidance from the Legal Services Group (LSG). Annual COI disclosures of all trustee and corporate officers will be reviewed by the CHI Senior Vice President, Legal Services, and General Counsel or his or her designee who will report potential conflicts to the applicable Board Chair. The Board Chair or designee shall make such further investigation of any conflict of interest disclosures as he or she may deem appropriate. If the conflict involves the Board Chair, the Vice Chair will assume the Chair's role. Based on review and evaluation of the relevant facts and circumstances, the Board Chair will make an initial determination as to whether a conflict of interest exists and whether, pursuant to the COI Policy, review and approval or other action by the Board is required. A written record of the Board Chair's determination, including relevant facts and circumstances, will be made. The Board Chair shall then make an appropriate report to the Executive Committee of the Board concerning such review, evaluation and determination. If a difference of opinion exists between the Board Chair and another Trustee as to whether the facts and circumstances of a given situation constitute a conflict of interest or whether Board review and approval or other action is required within the COI Policy, the matter shall be submitted to the Board's Executive Committee, which shall make a final determination as to the matter presented. Such determination, including relevant facts and circumstances, will be reflected in the Executive Committee minutes and will be reported to the Board. When any conflict of interest is considered by the board, the trustee or corporate officer, as appropriate, must disclose all of the material facts to the Board. The trustee shall not vote and the trustee or corporate officer shall not use his or her personal influence on the matter. The trustee or corporate officer shall be excused from the meeting during discussion and vote on the conflict of interest. In reviewing such transactions between CHI or CHI Entities and vendors or other contractors who are, or are affiliated with, Trustees or Corporate Officers, the Board will act as it would in reviewing transactions with unrelated third parties. The transaction is not be approved unless the Board determines that the transaction is fair to CHI or the CHI Entity. The Board must approve the transaction by a majority of the Trustees on the Board, without counting the vote of any individual who has an interest in the transaction. All determinations of conflicts of interest are reported as required by law, regulations, and CHI policy. |
| Form 990, Part VI, Line 19 Required documents available to the public | The organization's financial statements, conflict of interest policy and governing documents are available to the public upon request. The organization's financial statements are included in Catholic Health Initiatives' consolidated audited financial statements that are available at www.catholichealthinitiatives.org or at www.DACBOND.org. |
| Form 990, Part XI, Line 9 Other changes in net assets or fund balances | EQUITY TRANSFER - SEE SCHEDULE N - -2384891; |
| FORM 990, PART VI, LINE 15A PROCESS FOR DETERMINING COMPENSATION - TOP MANAGEMENT OFFICIAL | THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL'S COMPENSATION IS PAID BY CATHOLIC HEALTH INITIATIVES (CHI), A RELATED ORGANIZATION. CHI HAS A DEFINED COMPENSATION PHILOSOPHY. BOTH THE EXECUTIVE AND NON-EXECUTIVE COMPENSATION STRUCTURES AND RANGES ARE REVIEWED ANNUALLY IN COMPARISON TO MARKET DATA. CHI USES THE KORN FERRY HAY GROUP AS THE INDEPENDENT THIRD PARTY TO ASSESS EXECUTIVE COMPENSATION PROGRAMS AND TO ENSURE THE REASONABLENESS OF ACTUAL SALARIES AND TOTAL COMPENSATION PACKAGES. COMPENSATION OF THE SENIOR MOST EXECUTIVES IS REVIEWED ANNUALLY. THE KORN FERRY HAY GROUP REVIEWS BOTH CASH AND TOTAL COMPENSATION FOR OVERALL REASONABLENESS, FOR ADHERENCE TO CHI'S COMPENSATION PHILOSOPHY, AND FOR COMPARABILITY TO THE NOT-FOR-PROFIT HEALTHCARE MARKET. THIS INDEPENDENT REVIEW IS DELIVERED BY KORN FERRY HAY GROUP TO THE HR COMMITTEE OF THE CHI BOARD OF STEWARDSHIP TRUSTEES ANNUALLY AT THEIR SEPTEMBER MEETING AND MINUTES ARE SHARED WITH THE FULL BOARD AT THE DECEMBER MEETING. THE LAST REVIEW WAS SEPTEMBER 13, 2016. IN ADDITION, KORN FERRY HAY GROUP COMPLETED A COMPREHENSIVE REVIEW OF ALL POSITIONS AT THE LEVEL OF VICE PRESIDENT AND ABOVE IN THE FALL OF 2014 TO DETERMINE AND VALIDATE APPROPRIATE COMPENSATION LEVELS. THESE LEVELS HAVE BEEN REVIEWED ANNUALLY SINCE AND REVISED BASED ON MARKET DATA, WHERE APPLICABLE. |
| FORM 990, PART VI, LINE 15B Process for Determining Compensation - Officers/Key Employees | During the tax year ended 6/30/2016, no officers, directors or trustees received compensation from the organization. Any executive compensation paid to officers, directors or trustees by related organizations was set by the related organization's compensation committee utilizing both an independent consultant and comparability studies to determine compensation. Therefore, these questions are more appropriately answered as "N/A" |
| Software ID: | 15000238 |
| Software Version: | 2015v3.0 |