TY 2019 Form 990

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W-2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(1) WAKEMAN DANIEL...................................................................... PRESIDENT/CEO, EX-OFFICIO	41.0 ................. 3.0	X	X			398,763	0	69,201
(2) KIM JEFF...................................................................... VP CHIEF INFORMATION OFFICER	41.0 ................. 3.0			X		269,281	0	90,130
(3) MATTISON MD LALAIN...................................................................... TRUSTEE	1.0 ................. 40.0	X				0	260,358	81,312
(4) MORRISSEY MARTIN...................................................................... VP GENERAL COUNSEL	41.0 ................. 3.0			X		255,208	0	72,332
(5) RILEY KEVIN...................................................................... CHIEF FINANCIAL OFFICER	41.0 ................. 3.0			X		271,510	0	37,223
(6) BURMEISTER KEITH...................................................................... VP CHIEF RELATIONS OFFICER	41.0 ................. 3.0			X		218,691	0	64,695
(7) STOUT JOHN LEFT 111...................................................................... VP BUSINESS PERFORMANCE DEV	41.0 ................. 3.0			X		210,494	0	62,182
(8) TROSIN JILL...................................................................... VP PATIENT CARE/CNO	40.0 ................. 0.0			X		221,574	0	50,969
(9) SESSLER CONNIE...................................................................... VP HR/SUPPORT SERVICES	41.0 ................. 3.0			X		178,596	0	54,580
(10) O'LEARY WENDY...................................................................... ADMIN DIRECTOR SOFTWARE APP	40.0 ................. 0.0				X	148,483	0	46,322
(11) BURMEISTER KERRY...................................................................... ADMIN DIRECTOR FINANCE	41.0 ................. 3.0			X		152,607	0	37,444
(12) THOMPSON DAN...................................................................... ADMIN DIRECTOR TECHNOLOGY	40.0 ................. 0.0				X	146,992	0	42,523
(13) ONYSYK ANTHONY...................................................................... CLINICAL PHARMACIST	40.0 ................. 0.0				X	123,838	0	40,275
(14) ST MARY JUDY...................................................................... PHARMACIST, MANAGER	40.0 ................. 0.0				X	135,085	0	28,343
(15) GRABARCZYK JENNIFER...................................................................... CHIEF CLINICAL PHARMACIST	40.0 ................. 0.0				X	127,946	0	32,740
(16) BAZELEY MD STEPHEN...................................................................... VP MEDICAL AFFAIRS	40.0 ................. 1.0		X			103,295	0	36,029
(17) MATTISON MD TIMOTH...................................................................... TRUSTEE	1.0 ................. 1.0	X				15,000	20,429	11,539

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W-2/1099-MISC)
(18) RETTIG MD ADAM........................................................................ TRUSTEE	1.0 .......................0.0	X		45,000
(19) ARQUETTE MARY........................................................................ TRUSTEE	1.0 .......................0.0	X		0
(20) BAUERLE STEPHEN M........................................................................ TRUSTEE	1.0 .......................0.0	X		0
(21) BLACK CHRISTINE L........................................................................ FDN CHAIRPERSON/EX-OFFICIO	1.0 .......................1.0	X		0
(22) CARROLL WILLIAM J........................................................................ CHAIRPERSON	1.0 .......................2.0	X	X	0
(23) DEPOMPEI SPHR CCP A........................................................................ TRUSTEE	1.0 .......................1.0	X		0
(24) GOLIGOSKI TIMOTHY L........................................................................ TRUSTEE	1.0 .......................1.0	X		0
(25) HOUSTON MD THOMAS........................................................................ VICE CHAIRPERSON	1.0 .......................1.0	X	X	0
(26) MACHIN BARBARA E........................................................................ SECRETARY	1.0 .......................1.0	X	X	0
(27) MCWEENY PHILIP........................................................................ TRUSTEE	1.0 .......................0.0	X		0
(28) SMITH CYNTHIA B........................................................................ TRUSTEE	1.0 .......................1.0	X		0
(29) TORRES MD SESINAND........................................................................ TRUSTEE	1.0 .......................0.0	X		0
(30) WAUGH DIANA FAITH........................................................................ TRUSTEE	1.0 .......................0.0	X		0
(31) CARR RICHARD........................................................................ TRUSTEE	1.0 .......................0.0	X		0
(32) STEINBAUGH MARY ANNE........................................................................ AUXILIARY PRESIDENT/EX-OFFICIO	1.0 .......................0.0	X		0
(33) WINEMAN-KRIEGER SHEIL........................................................................ AUXILIARY PRESIDENT/EX-OFFICIO	1.0 .......................0.0	X		0

(A) Name and business address	(B) Description of services	(C) Compensation
SOUTHWEST ANESTHESIA SERVICES, 1715 INDIAN WOOD CIRCLE SUITE 100 MAUMEE,OH43537	ANESTHESIA SERVICES	3,338,034
NAVIGANT CYMETRIX CORPORATION, 4511 PAYSPHERE CIRCLE CHICAGO,IL60674	BILLING SERVICES	3,224,519
TRIMEDX INC, 5451 LAKEVIEW PKWY SOUTH DR INDIANAPOLIS,IN46268	BIOMED SERVICES	3,045,044
LABORATORY CORPORATION OF AMERICA, PO BOX 12140 BURLINGTON,NC27216	REFERRED LAB TESTING	2,003,697
TOLEDO CLINIC INC, 4235 SECOR RD TOLEDO,OH43623	SURGERY ON CALL	1,725,895
2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization 60

- TIN:

SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
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Attach to Form 990 or Form 990-EZ.
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Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public
Inspection

Name of the organization

ST LUKE'S HOSPITAL

Employer identification number

34-4428232

Part I

Reason for Public Charity Status (All organizations must complete this part.) See instructions.

The organization is not a private foundation because it is: (For lines 1 through 12, check only one box.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990 or 990-EZ).)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An agricultural research organization described in 170(b)(1)(A)(ix) operated in conjunction with a land-grant college or university or a non-land grant college of agriculture. See instructions. Enter the name, city, and state of the college or university:

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box in lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations ...............................

Provide the following information about the supported organization(s).

(i) Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i) Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


Total

For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2019

Page 2

Part II

Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization failed to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..
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.

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(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

Gross receipts from related activities, etc. (see instructions) ..................

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here........................................ right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2019 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2018 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2019. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2018. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2019. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2018. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow

Schedule A (Form 990 or 990-EZ) 2019

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(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.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(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.)..

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization,
check this box and stop here............................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2019 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2018 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2019 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2018 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2019. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3% support tests—2018. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions .... right arrow

Schedule A (Form 990 or 990-EZ) 2019

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked 12a of Part I, complete Sections A and B. If you checked 12b of Part I, complete Sections A and C. If you checked 12c of Part I, complete Sections A, D, and E. If you checked 12d of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.

Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.

Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.

Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 12a or 12b in Part I, answer (b) and (c) below.

Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.

Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).

Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.

Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ).

Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.

Did one or more disqualified persons (as defined in line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined in line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.

10a

Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.

10a

Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).

10b

Schedule A (Form 990 or 990-EZ) 2019

Page 5

Part IV

Supporting Organizations (continued)

Yes

Has the organization accepted a gift or contribution from any of the following persons?

A person who directly or indirectly controls, either alone or together with persons described in (b) and (c) below, the governing body of a supported organization?

11a

A family member of a person described in (a) above?

11b

A 35% controlled entity of a person described in (a) or (b) above? If “Yes” to a, b, or c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.

Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.

Section C. Type II Supporting Organizations

Yes

Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).

Section D. All Type III Supporting Organizations

Yes

Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?

Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).

By reason of the relationship described in (2), did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer (a) and (b) below.

Yes

Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.

Did the activities described in (a) constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.

Parent of Supported Organizations. Answer (a) and (b) below.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? Provide details in Part VI.

Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.

Schedule A (Form 990 or 990-EZ) 2019

Page 6

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970 (explain in Part VI). See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	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

Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990 or 990-EZ) 2019

Page 7

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations(continued)

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 2019 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-2019	(iii) Distributable Amount for 2019
1 Distributable amount for 2019 from Section C, line 6
2 Underdistributions, if any, for years prior to 2019 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2019:
a From 2014.......
b From 2015.......
c From 2016.......
d From 2017.......
e From 2018.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2019 distributable amount
i Carryover from 2014 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.
4Distributions for 2019 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2019 distributable amount
c Remainder. Subtract lines 4a and 4b from 4.
5 Remaining underdistributions for years prior to 2019, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions.
6 Remaining underdistributions for 2019. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions.
7 Excess distributions carryover to 2020. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2015.....
b Excess from 2016.....
c Excess from 2017.....
d Excess from 2018.....
e Excess from 2019.....

Schedule A (Form 990 or 990-EZ) (2019)

Schedule A (Form 990 or 990-EZ) 2019

Page 8

Part VI

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Return Reference	Explanation

Schedule A (Form 990 or 990-EZ) 2019

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990, 990-EZ,
or 990-PF)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2019

Name of the organization

ST LUKE'S HOSPITAL

Employer identification number

34-4428232

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

Check if your organization is covered by the General Rule or a Special Rule.
Note: Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.

General Rule

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or other property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules

For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 exclusively for religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and III.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Don't complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year ......... Arrow Bullet

Caution: An organization that isn't covered by the General Rule and/or the Special Rules doesn't file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its Form 990-EZ
or on its Form 990PF, Part I, line 2, to certify that it doesn't meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).

For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.

Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2019)

Schedule B (Form 990, 990-EZ, or 990-PF) (2019) Page 2

Name of organization ST LUKE'S HOSPITAL

Part I Contributors	Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	,	$ RESTRICTED	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

Page 3

Name of organization ST LUKE'S HOSPITAL		Employer identification number 34-4428232

Part II	Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

Page 4


Name of organization ST LUKE'S HOSPITAL			Employer identification number 34-4428232
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527

SchCMd Bullet

Complete if the organization is described below. SchCMd Bullet

Attach to Form 990 or Form 990-EZ.
SchCMd Bullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public
Inspection

If the organization answered "Yes" on Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet

Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet

Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet

Section 527 organizations: Complete Part I-A only.
If the organization answered "Yes" on Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet

Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet

Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered "Yes" on Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet

Section 501(c)(4), (5), or (6) organizations: Complete Part III.

Name of the organization

ST LUKE'S HOSPITAL

Employer identification number

34-4428232

Part I-A

Complete if the organization is exempt under section 501(c) or is a section 527 organization.

Provide a description of the organization’s direct and indirect political campaign activities in Part IV (see instructions for definition of “political campaign activities")

Political campaign activity expenditures (see instructions) .................................................................... SchCMd Bullet

Volunteer hours for political campaign activities (see instructions) ..................................................................

Part I-B

Complete if the organization is exempt under section 501(c)(3).

Enter the amount of any excise tax incurred by the organization under section 4955 ................................ SchCMd Bullet

Enter the amount of any excise tax incurred by organization managers under section 4955 ....................... SchCMd Bullet

If the organization incurred a section 4955 tax, did it file Form 4720 for this year? .........................................

Yes No

Was a correction made? ......................................................................................................................

Yes No

If "Yes," describe in Part IV.

Part I-C

Complete if the organization is exempt under section 501(c), except section 501(c)(3).

Enter the amount directly expended by the filing organization for section 527 exempt function activities ..... SchCMd Bullet

Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ............................................................................................................................ SchCMd Bullet

Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b........... SchCMd Bullet

Did the filing organization file Form 1120-POL for this year? ...................................................................

Yes No

Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.

(a) Name	(b) Address	(c) EIN	(d) Amount paid from filing organization's funds. If none, enter -0-.	(e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.
1
2
3
4
5
6

For Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ.

Cat. No. 50084S

Schedule C (Form 990 or 990-EZ) 2019

Page 2

Part II-A

Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).

A Check SchCMd Bullet

if the filing organization belongs to an affiliated group (and list in Part IV each affiliated group member's name, address, EIN, expenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet

if the filing organization checked box A and "limited control" provisions apply.

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(b) Affiliated group totals
1a	Total lobbying expenditures to influence public opinion (grass roots lobbying) ......................
b	Total lobbying expenditures to influence a legislative body (direct lobbying) ........................
c	Total lobbying expenditures (add lines 1a and 1b) ............................................................
d	Other exempt purpose expenditures ...............................................................................
e	Total exempt purpose expenditures (add lines 1c and 1d) ..................................................
f	Lobbying nontaxable amount. Enter the amount from the following table in both columns.
	If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
	Not over $500,00020% of the amount on line 1e.
	Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
	Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
	Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
	Over $17,000,000$1,000,000.

g	Grassroots nontaxable amount (enter 25% of line 1f) .................................................
h	Subtract line 1g from line 1a. If zero or less, enter -0-. ................................................
i	Subtract line 1f from line 1c. If zero or less, enter -0-. ................................................
j	If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting section 4911 tax for this year? ...................................................................................................................	Yes No

4-Year Averaging Period Under Section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2016	(b) 2017	(c) 2018	(d) 2019	(e) Total

2a	Lobbying nontaxable amount

b	Lobbying ceiling amount (150% of line 2a, column(e))

c	Total lobbying expenditures

d	Grassroots nontaxable amount

e	Grassroots ceiling amount (150% of line 2d, column (e))

f	Grassroots lobbying expenditures

Schedule C (Form 990 or 990-EZ) 2019

Page 3

Part II-B

Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).

For each "Yes" response on lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.

(a)

Yes|No

(b)

Amount

During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:

Volunteers? ...........................................................................................................

Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........

Media advertisements? ...................................................................................................

Mailings to members, legislators, or the public? .............................................................................

Publications, or published or broadcast statements? ...........................................................

Grants to other organizations for lobbying purposes? ..........................................................

Direct contact with legislators, their staffs, government officials, or a legislative body? .......................

Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................

Other activities? ...................................................................................................................

Yes

3,332

Total. Add lines 1c through 1i ....................................................................................................

3,332

Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....

If "Yes," enter the amount of any tax incurred under section 4912 ...........................................

If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................

If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? ........................

Part III-A

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).

Yes

Were substantially all (90% or more) dues received nondeductible by members? ...............................................

Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................

Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................

Part III-B

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."

Dues, assessments and similar amounts from members ......................................................................

Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).

Current year .............................................................................................................................

Carryover from last year ............................................................................................................

Total ...........................................................................................................................................

Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .

If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ......................................................................................................................

Taxable amount of lobbying and political expenditures (see instructions) .........................................

Part IV

Supplemental Information

Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.

Return Reference	Explanation
PART II-B, LINE 1	ST. LUKES HOSPITAL PAYS DUES TO THE OHIO HOSPITAL ASSOCIATION - A PORTION OF WHICH IS ALLOCABLE TO LOBBYING BY THE ASSOCIATION.

Schedule C (Form 990 or 990EZ) 2019

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet

Attach to Form 990.
SchDMd Bullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

ST LUKE'S HOSPITAL

Employer identification number

34-4428232

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .........
2	Aggregate value of contributions to (during year)
3	Aggregate value of grants from (during year)
4	Aggregate value at end of year ........

Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds are the organization’s property, subject to the organization’s exclusive legal control? ............

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................

Yes No

Part II

Conservation Easements.
Complete if the organization answered "Yes" on Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.


a	Total number of conservation easements ......................	2a
b	Total acreage restricted by conservation easements ....................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 7/25/06, and not on a historic structure listed in the National Register ...	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................

Yes No

In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.

If the organization elected, as permitted under FASB ASC 958, not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under FASB ASC 958, to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:

(i)

Revenue included on Form 990, Part VIII, line 1 ......................... SchDMd Bullet

(ii)

Assets included in Form 990, Part X ............................... SchDMd Bullet

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under FASB ASC 958 relating to these items:

Revenue included on Form 990, Part VIII, line 1 .......................... SchDMd Bullet

Assets included in Form 990, Part X ............................... SchDMd Bullet

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 52283D

Schedule D (Form 990) 2019

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No


b	If "Yes," explain the arrangement in Part XIII and complete the following table:		Amount
c	Beginning balance .............................	1c
d	Additions during the year ............................	1d
e	Distributions during the year ..........................	1e
f	Ending balance ................................	1f

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...

Yes No

If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ....

Part V

Endowment Funds.
Complete if the organization answered "Yes" on Form 990, Part IV, line 10.

		(a) Current year	(b) Prior year	(c) Two years back	(d) Three years back	(e) Four years back

1a	Beginning of year balance ....
b	Contributions ...
c	Net investment earnings, gains, and losses
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...
f	Administrative expenses ....
g	End of year balance ......

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

Term endowment SchDMd Bullet

The percentages on lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) Unrelated organizations .................

3a(i)

(ii) Related organizations .................

3a(ii)

If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........

Describe in Part XIII the intended uses of the organization's endowment funds.

Part VI

Land, Buildings, and Equipment.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(a) Cost or other basis (investment)	(b) Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value

1a	Land .....	820,000	6,135,278		6,955,278
b	Buildings ....		73,681,332	9,592,916	64,088,416
c	Leasehold improvements		689,575	184,714	504,861
d	Equipment ....		47,065,233	27,216,400	19,848,833
e	Other .....		39,153,363	12,151,738	27,001,625
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..					118,399,013

Schedule D (Form 990) 2019

Page 3

Part VII

InvestmentsOther Securities.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)	(b) Book value	(c) Method of valuation: Cost or end-of-year market value
(1) Financial derivatives.........
(2) Closely-held equity interests........
(3)Other
(B)
(C)
(D)
(E)
(F)
(G)
(H)
(I)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

InvestmentsProgram Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

(a) Description of investment	(b) Book value	(c) Method of valuation: Cost or end-of-year market value

(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value
(1)INTEREST IN FOUNDATION				23,491,115
(2)DUE FROM AFFILIATES				22,750,375
(3)EST THIRD PARTY SETTLEMENT REC				2,943
(4)OTHER RECEIVABLES				366,567
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				46,611,000

Part X

Other Liabilities.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability	(b) Book value
(1) Federal income taxes	0
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	71,589,243
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII

Schedule D (Form 990) 2019

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......		1
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d .....................		2e
3	Subtract line 2e from line 1..................		3
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIII.) ...........	4b
c	Add lines 4a and 4b....................		4c
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......		5

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........		1
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities .........	2a
b	Prior year adjustments ............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d....................		2e
3	Subtract line 2e from line 1...................		3
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIII.) ............	4b
c	Add lines 4a and 4b.....................		4c
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......		5

Part XIII

Supplemental Information

Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b; Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Return Reference

Explanation

Schedule D, Part X, Line 2

ST. LUKES HOSPITAL IS INCLUDED IN THE CONSOLIDATED AUDITED STATEMENTS OF ST. LUKES HOLDING COMPANY, INC. (SLHC) AND IS INCORPORATED UNDER THE LAWS OF THE STATE OF OHIO. SLHC AND ITS WHOLLY OWNED SUBSIDIARIES, ST. LUKES HOSPITAL, ST. LUKES HOSPITAL FOUNDATION AND CARE ENTERPRISES, INC. ARE NONPROFIT CORPORATIONS AND ARE EXEMPT FROM STATE AND LOCAL TAXES. THE IRS HAS DETERMINED THAT SLHC, ST. LUKES HOSPITAL, ST. LUKES HOSPITAL FOUNDATION, CARE ENTERPRISES, INC. AND WELLCARE PHYSICIANS GROUP, LLC ARE EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. ACCORDINGLY, NO TAX PROVISION IS REFLECTED IN SLHCS CONSOLIDATED FINANCIAL STATEMENTS. CARE HOLDINGS, INC. AND PHYSICIANS ADVANTAGE MSO, INC., WHOLLY OWNED SUBSIDIARIES OF SLHC, ARE TAXABLE CORPORATIONS. INCOME TAX PROVISIONS FOR THESE ENTITIES ARE NOT MATERIAL TO SLHCS AUDITED FINANCIAL STATEMENTS.

Schedule D (Form 990) 2019

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

Complete if the organization answered "Yes" on Form 990, Part IV, question 20.
MediumBullet

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990EZ for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

ST LUKE'S HOSPITAL

Employer identification number

34-4428232

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .

Yes

If "Yes," was it a written policy? ......................

Yes

If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.

Applied uniformly to all hospital facilities Applied uniformly to most hospital facilities Generally tailored to individual hospital facilities

Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.

Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?

If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:

Yes

100% 150% 200% Other %

Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate

which of the following was the family income limit for eligibility for discounted care: . . . . . . . .

Yes

200% 250% 300% 350% 400% Other %

If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.

Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

Yes

Did the organization budget amounts for free or discounted care provided under its financial assistance policy during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

Yes

If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .

If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .

Did the organization prepare a community benefit report during the tax year? . . . . . . . . .

Yes

If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .

Yes

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) . . .	2,682,326	2,025,526	656,800	0.300 %
b	Medicaid (from Worksheet 3, column a) . . . . .	21,683,719	10,205,310	11,478,409	5.210 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .	8,502,824	6,376,444	2,126,380	0.970 %
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	32,868,869	18,607,280	14,261,589	6.480 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	73,083		73,083	0.030 %
f	Health professions education (from Worksheet 5) . . .	3,203,309	359,244	2,844,065	1.290 %
g	Subsidized health services (from Worksheet 6) . . . .	1,798,629	73,174	1,725,455	0.780 %
h	Research (from Worksheet 7) .
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	71,880		71,880	0.030 %
j	Total. Other Benefits . .	5,146,901	432,418	4,714,483	2.130 %
k	Total. Add lines 7d and 7j .	38,015,770	19,039,698	18,976,072	8.610 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2019

Schedule H (Form 990) 2019

Page

Part II

Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.

		(c) Total community building expense	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development
3	Community support
4	Environmental improvements	53,203	53,203	0.020 %
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy
8	Workforce development
9	Other
10	Total	53,203	53,203	0.020 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with Healthcare Financial Management Association Statement No. 15? ..........................

Yes

Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......

6,581,754

Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......

1,250,533

Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.

Section B. Medicare

Enter total revenue received from Medicare (including DSH and IME).....

51,413,283

Enter Medicare allowable costs of care relating to payments on line 5.....

51,834,304

Subtract line 6 from line 5. This is the surplus (or shortfall)........

-421,021

Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Did the organization have a written debt collection policy during the tax year? ..........

Yes

If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

Yes

Part IV

Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(d) Officers, directors, trustees, or key employees' profit % or stock ownership %	(e) Physicians' profit % or stock ownership %
1ST LUKE'S PHYSICIAN	PHYSICIAN HOSPITAL ORG	50 %	1.33 %	48.67 %
2HOSPITAL ORG INC
3ST LUKE'S HOSPITAL	PAIN MANAGEMENT SERVICES	51 %	0 %	49 %
4PAIN MANAGEMENT LLC
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2019

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest—see instructions)How many hospital facilities did the organization operate during the tax year?1Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)
1	ST LUKE'S HOSPITAL 5901 MONCLOVA ROAD MAUMEE,OH43537 WWW.STLUKESHOSPITAL.COM 1224	X	X	X	X

Schedule H (Form 990) 2019

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)

	ST LUKE'S HOSPITAL
Name of hospital facility or letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................

Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C...............

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12......................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The significant health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 19

In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................

Yes

6 a

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C..................................

Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................

Did the hospital facility make its CHNA report widely available to the public?..............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): WWW.STLUKESHOSPITAL.COM

Other website (list url):

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 20

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

Yes

If "Yes" (list url): WWW.STLUKESHOSPITAL.COM

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.

12a

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?...............................

12a

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2019

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	ST LUKE'S HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 200.%
and FPG family income limit for eligibility for discounted care of 400.%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

Yes

If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

WWW.STLUKESHOSPITAL.COM

The FAP application form was widely available on a website (list url):

WWW.STLUKESHOSPITAL.COM

A plain language summary of the FAP was widely available on a website (list url):
WWW.STLUKESHOSPITAL.COM

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Individuals were notified about the FAP by being offered a paper copy of the plain language summary of the FAP, by
receiving a conspicuous written notice about the FAP on their billing statements, and via conspicuous public displays or
other measures reasonably calculated to attract patients' attention

Notified members of the community who are most likely to require financial assistance about availability of the FAP

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2019

Page 6

Part VFacility Information (continued)

Billing and Collections

	ST LUKE'S HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?..................................

Yes

Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs (if not, describe in Section C)

Made a reasonable effort to orally notify individuals about the FAP and FAP application process (if not, describe in
Section C)

Processed incomplete and complete FAP applications (if not, describe in Section C)

Made presumptive eligibility determinations (if not, describe in Section C)

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?..................

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Section C)

Other (describe in Section C)

Schedule H (Form 990) 2019

Page 7

Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)

	ST LUKE'S HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicaid, either alone or in combination with
Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month
period

The hospital facility used a prospective Medicare or Medicaid method

During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ...............................

If "Yes," explain in Section C.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ...........................

If "Yes," explain in Section C.

Schedule H (Form 990) 2019

Page 8

Part V

Facility Information (continued)

Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference	Explanation
PART V, SECTION B, LINE 5	ST. LUKE'S HOSPITAL TOOK INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY THE HOSPITAL FACILITY, THROUGH THE HOSPITAL COUNCIL OF NORTHWEST OHIO, INCLUDING THOSE WITH SPECIAL KNOWLEDGE OR EXPERTISE IN PUBLIC HEALTH. THESE PERSONS INCLUDED STAFF OF THE TOLEDO-LUCAS COUNTY HEALTH DEPARTMENT, MENTAL HEALTH RECOVERY AND SERVICES BOARD OF LUCAS COUNTY, AND LOCAL HOSPITAL STAFF INVOLVED IN COMMUNITY HEALTH PROGRAMMING. THE HOSPITAL FACILITY CONSULTED WITH THESE PERSONS THROUGH MEETINGS AND ALSO VIA EMAIL CORRESPONDENCE. ADDITIONALLY, THE HOSPITAL CONSULTED WITH OTHER ORGANIZATIONS AND OTHER GROUPS IN CONDUCTING ITS MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). THESE CONSULTING INDIVIDUALS REPRESENTED THE FOLLOWING ORGANIZATIONS: - UNIVERSITY OF TOLEDO - YMCA LIVE WELL TOLEDO - TOLEDO PUBLIC SCHOOL NURSES - MERCY HEALTH PARTNERS - LUCAS COUNTY EDUCATIONAL SERVICE CENTER - TOLEDO LUCAS COUNTY FAMILY COUNCIL - HELP ME GROW, LUCAS COUNTY FAMILY COUNCIL - NORTHWEST OHIO CONGREGATIONAL NURSE ASSOCIATION - FAMILY & CHILDREN FIRST COUNCIL - MENTAL HEALTH RECOVERY AND SERVICES BOARD OF LUCAS COUNTY - LUCAS COUNTY TOBACCO COALITION - TOLEDO COMMUNITY FOUNDATION - AMERICAN CANCER SOCIETY - PROMEDICA HEALTH SYSTEM - YWCA - OHIO DEPARTMENT OF HEALTH - HOME VISITING & TRAINING COORDINATOR, LUCAS COUNTY - GRACE COMMUNITY CENTER - JUVENILE COURT, LUCAS COUNTY - JOB & FAMILY SERVICES, LUCAS COUNTY - HOSPITAL COUNCIL OF NORTHWEST OHIO - TOLEDO-LUCAS COUNTY CARENET - UNITED WAY OF GREATER TOLEDO - EXCHANGE CLUB - TOLEDO PUBLIC SCHOOLS BOARD OF EDUCATION - BOWLING GREEN STATE UNIVERSITY PART V, SECTION B, LINE 11: ACTIONS TAKEN DISCLOSURE ST. LUKE'S HOSPITAL (ST. LUKE'S) WILL SPECIFICALLY IMPLEMENT PROGRAMS TO ADDRESS THE FOLLOWING HEALTH NEEDS, LISTED IN ORDER OF PRIORITY: - CARDIOVASCULAR HEALTH - STROKE - CANCER PROGRAMS/SCREENINGS SKIN, ORAL, AND/OR BREAST - AGE/GERIATRIC-RELATED INITIATIVES NUTRITION, DEMENTIA, AND/OR FALL PREVENTION - TOBACCO USE, PREVENTION, AND TREATMENT - DIABETES ACTIONS TAKEN DURING 2019 TO ADDRESS THE ABOVE IDENTIFIED NEEDS ARE INCLUDED BELOW: HEALTH NEED IDENTIFIED: CARDIOVASCULAR HEALTH - STROKE STRATEGY #1 PROVIDE ONGOING EDUCATION FOR EMERGENCY DEPARTMENT PHYSICIANS AND NURSES, INTENSIVE CARE CENTER NURSES, AND HOSPITALISTS TO IMPROVE DOOR-TO-NEEDLE TIME WHICH IN TURN WILL IMPROVE PATIENT OUTCOMES. ACTIONS TAKEN IN 2019: ALL NEW ST. LUKES EMERGENCY DEPARTMENT (E.D.) AND INTENSIVE CARE CENTER (ICC) R.N.S WERE REQUIRED TO COMPLETE 3 HOURS OF ONE-ON-ONE EDUCATION WITH THE ST. LUKES STROKE COORDINATOR REGARDING NEURO INTERVENTION PROTOCOLS AND E.D./ICC STROKE ALERT PROTOCOLS, RESPECTIVELY. E.D. STROKE ALERT TRAINING SESSIONS HELD IN 2019: JANUARY 14, JANUARY 17, FEBRUARY 15, FEBRUARY 21, FEBRUARY 22, MARCH 1, JUNE 19, JULY 17, JULY 19, AUGUST 2, AUGUST 6, AUGUST 13, SEPTEMBER 9, NOVEMBER 13, AND DECEMBER 11. ICC STROKE ALERT TRAINING HELD IN 2019: APRIL 18, APRIL 25, MAY 2, MAY 9, AUGUST 27, SEPTEMBER 27, AND NOVEMBER 9. THE ST. LUKES STROKE COORDINATOR PRESENTED AT THE PROMEDICA TOLEDO HOSPITAL NURSING STROKE CONFERENCE ON JUNE 14, 2019. CONTENT INCLUDED THE FOLLOWING EDUCATION: BASIC STROKE, ALTEPLASE, NEURO INTERVENTION (THROMBECTOMY), NEURO ASSESSMENT SKILLS, AND INPATIENT STROKE ALERT PATIENT SCENARIOS WITH DISCUSSION. APPROXIMATELY 60 R.N.S ATTENDED. ST. LUKES E.D. PHYSICIAN EDUCATION WEBINARS (JANUARY 31, FEBRUARY 26, APRIL 17, AUGUST 15, OCTOBER 29, AND NOVEMBER 7) WERE CONDUCTED UTILIZING CT/CTA/CTP RAPID IMAGING AND ACTUAL CASE STUDIES TO IMPROVE KNOWLEDGE, CONFIDENCE, AND EFFICIENCY IN EMERGENT TRIAGE OF ACUTE STROKE PATIENTS. A 4-HOUR MANDATORY NEURO INTERVENTION STROKE EDUCATION PROGRAM WAS PROVIDED TO ALL ST. LUKES ICC, CARDIOVASCULAR ICU (CVU), E.D., AND INTERVENTIONAL RADIOLOGY (I.R.) R.N.S ON JULY 10, 2019. A STROKE PRESENTATION WAS PROVIDED TO THE ST. LUKES FAMILY MEDICINE RESIDENTS AND FACULTY ON AUGUST 22, 2019 BY THE ST. LUKES STROKE COORDINATOR. THE FOLLOWING EDUCATIONAL OPPORTUNITIES WERE PROVIDED FOR ALL ST. LUKES E.D. PHYSICIANS, HOSPITALIST PHYSICIANS, AND ICC/CVU/E.D./I.R. R.N.S IN 2019: - NEURO INTERVENTION CASE DEBRIEFINGS WERE HELD ON MAY 2, 2019 WITH 25 ATTENDEES. - 2019 EDUCATION PROGRAMS ON CLEVIPREX (CLEVIDIPINE) CONTINUOUS I.V. INFUSION USED IN MANAGING BLOOD PRESSURE IN ACUTE ISCHEMIC STROKE PATIENTS WERE HELD ON JANUARY 24, APRIL 17, AND MAY 20. - AN ACUTE ISCHEMIC STROKE EDUCATION PROGRAM, REGARDING ALTEPLASE ADMINISTRATION CRITERIA, WAS HELD ON MAY 30, 2019 WITH 15 ATTENDEES. - AN ACUTE ISCHEMIC STROKE EDUCATION PROGRAM, FOCUSING ON ALTEPLASE AND EVALUATING FOR DISABILITY AND WHAT IS CONSIDERED A MEASURABLE DEFICIT, WAS HELD ON JUNE 11, 2019 WITH 20 ATTENDEES. - A PROGRAM, STROKE: KNOWLEDGE IS POWER WAS PRESENTED ON AUGUST 9, 2019 AND AUGUST 28, 2019 TO R.N.S FOR 1 HOUR OF CEUS.
STRATEGY #2 - CONDUCT MULTIPLE BLOOD PRESSURE SCREENINGS AT ST. LUKES	HOSPITAL AND/OR AT SERVICE AREA SENIOR CENTERS/VENUES. ACTIONS TAKEN IN 2019: ST. LUKES AT MAUMEE SENIOR CENTER, BLOOD PRESSURE TRACKING & RESULTS FOR 2019: DATE TOTAL NORMAL PREHYPERTENSIVE HIGH STAGE 1 HIGH STAGE 2 1/10/2019 11 5 2 1 3 1/31/2019 8 3 3 0 2 2/14/2019 16 5 7 2 2 2/28/2019 8 4 3 0 1 3/14/2019 12 3 6 2 1 3/28/2019 11 7 2 1 1 4/4/2019 11 4 3 1 3 4/25/2019 15 4 5 1 5 6/6/2019 8 5 1 0 2 6/20/2019 10 3 4 2 1 7/11/2019 11 6 3 1 1 7/25/2019 6 2 3 1 0 8/8/2019 15 7 6 1 1 8/22/2019 12 5 5 2 0 9/5/2019 8 1 4 2 1 9/19/2019 6 1 4 1 0 10/3/2019 10 5 1 3 1 10/17/2019 13 5 3 2 3 10/31/2019 8 4 3 1 0 11/7/2019 6 1 3 2 0 11/21/2019 6 1 2 0 3 12/5/2019 10 3 4 2 1 12/19/2019 10 2 5 3 0 OTHER ST. LUKES BLOOD PRESSURE EVENTS IN 2019: DATE/EVENT TOTAL NORMAL PREHYPERTENSIVE HIGH STAGE 1 HIGH STAGE 2 2/1/2019 - WEAR RED FOR WOMEN 74 27 19 15 13 6/8/2019 - RUN FOR RORY 7 3 4 0 0 TOLEDO ZOO SUMMER DAYS: 6/17/2019 25 10 6 6 3 7/15/2019 24 14 2 5 3 8/12/2019 23 7 4 5 7 8/10/2019 - MAUMEE AREA RIVER RIDE 19 11 3 1 4 ST. LUKES EMPLOYEE FLU SHOT CLINICS: 10/1/2019 32 21 2 4 5 10/3/2019 28 8 10 8 2 10/4/2019 7 5 0 1 1 10/8/2019 13 5 2 4 2 10/9/2019 10 5 3 0 2 10/11/2019 6 2 2 2 0 10/16/2019 12 3 4 2 3 10/22/2019 12 8 1 1 2 11/12/2019 - MAUMEE CHAMBER OF COMMERCE EXPO 11 4 1 5 1 12/10/2019 - ST. LUKES SENIOR HOLIDAY LUNCH 46 8 8 14 16
STRATEGY #3 EDUCATE THE COMMUNITY ABOUT STROKE RECOGNITION AND EARLY	ACTION MINIMIZING BRAIN DAMAGE. WHEN INDICATED, COLLABORATE WITH LOCAL EMS PROVIDERS TO EDUCATE THE COMMUNITY. ACTIONS TAKEN IN 2019: ST. LUKES STROKE COORDINATOR PRESENTED STROKE: KNOWLEDGE IS POWER ON JANUARY 17, 2019 AT WATERFORD LEVIS COMMONS, IN PERRYSBURG, OHIO. THERE WERE 45 ATTENDEES. AT ST. LUKES GO RED FOR WOMEN ON FEBRUARY 1, 2019, A STROKE BOOTH WAS PRESENTED/AVAILABLE TO APPROXIMATELY 220+ WOMEN. DR. KAMALA TAMIRISA PRESENTED ON AFIB AND TREATMENT, AND DR. SYED ZAIDI PRESENTED A PATIENTS JOURNEY THROUGH STROKE. IN ADDITION, CARDIOCHEKS, BLOOD PRESSURE CHECKS, AND CAROTID ARTERY SCREENINGS WERE OFFERED TO ATTENDEES. ST. LUKES STAFFED THE ST. LUKES COMMUNITY HEALTH FAIR STROKE AWARENESS BOOTH ON APRIL 11, 2019. THERE WERE APPROXIMATELY 100 COMMUNITY MEMBERS PRESENT. A ST. LUKES ASK AN EXPERT PROGRAM WAS HELD ON APRIL 16, 2019 AT THE MAUMEE BRANCH LIBRARY. BRAIN ATTACKS AND HOW TO RECOGNIZE THEM WAS PRESENTED TO APPROXIMATELY 10 COMMUNITY MEMBERS. THE ST. LUKES STROKE IN TIME EVENT/EDUCATION DINNER WAS HELD ON MAY 16, 2019 FOR STROKE SURVIVORS, STAFF, AND COMMUNITY. THERE WERE APPROXIMATELY 120 ATTENDEES. ST. LUKES STAFFED THE AHA HEART WALK IN DOWNTOWN TOLEDO ON MAY 18, 2019. THERE WERE 118 COMMUNITY MEMBERS WHO RECEIVED GIFT BAGS WITH A VARIETY OF STROKE EDUCATIONAL MATERIALS, SUCH AS RECOGNIZING SIGNS/SYMPTOMS, RISK FACTORS, IMPORTANCE OF CALLING 911, AND ACUTE STROKE TREATMENTS AND MEDICATIONS. ST. LUKES STAFFED THE 2019 RUN FOR RORY WALK/RUN ON JUNE 8, 2019. HANDS-ONLY CPR DEMONSTRATIONS WERE SHOWN TO 25 COMMUNITY MEMBERS. ST. LUKES STROKE COORDINATOR ALSO PROVIDED A STROKE BOOTH WITH EDUCATION ON SIGNS, SYMPTOMS, RISK FACTORS, AND IMPORTANCE OF CALLING 911. ST. LUKES STAFF PROVIDED HANDS-ONLY CPR DEMONSTRATIONS TO 15 COMMUNITY MEMBERS ON JUNE 11, 2019 AT THE CONNECTING KIDS TO MEALS HOLLAND BRANCH LIBRARY MEAL SITE. THE ST. LUKES STROKE COORDINATOR PRESENTED STROKE: KNOWLEDGE IS POWER ON JULY 11, 2019 TO ST. LUKES PROSTATE CANCER SUPPORT GROUP. THERE WERE 13 ATTENDEES. THE ST. LUKES STROKE COORDINATOR PRESENTED STROKE: KNOWLEDGE IS POWER ON JUNE 12, 2019 AT THE LAKES OF MONCLOVA. THERE WERE 35 ATTENDEES. ST. LUKES STAFF PROVIDED HANDS-ONLY CPR DEMONSTRATIONS TO 15 COMMUNITY MEMBERS ON JULY 15, 2019 AT THE TOLEDO ZOO SUMMER DAYS. ST. LUKES PROVIDED HANDS-ONLY CPR DEMONSTRATIONS TO 6 COMMUNITY MEMBERS ON JULY 29, 2019 AT THE CONNECTING KIDS TO MEALS HOLLAND BRANCH LIBRARY MEAL SITE. ST. LUKES PROVIDED HANDS-ONLY CPR DEMONSTRATIONS TO APPROXIMATELY 50 COMMUNITY MEMBERS AT THE 2019 PERRYSBURG SUMMER FRIDAY NIGHT EVENTS. ST. LUKES HOSTED AN ASK AN EXPERT PROGRAM ON OCTOBER 1, 2019 AT THE MAUMEE BRANCH LIBRARY, PRESENTED BY BEVERLY MALCZEWSKI, RN, REGARDING HANDS-ONLY CPR. APPROXIMATELY 10 COMMUNITY MEMBERS WERE IN ATTENDANCE. ST. LUKES STAFFED THE LUCAS COUNTY HEALTH FAIR STROKE AWARENESS BOOTH ON OCTOBER 3, 2019. THERE WERE APPROXIMATELY 150 ATTENDEES. ST. LUKES STAFFED THE JEEP HEALTH FAIR STROKE AWARENESS BOOTH ON OCTOBER 10, 2019. THERE WERE APPROXIMATELY 25 ATTENDEES. THE ST. LUKES STROKE COORDINATOR PARTICIPATED IN THE MAKING OF A ST. LUKES HOSPITAL TELEVISION COMMERCIAL ON OCTOBER 16, 2019. PART OF THE COMMERCIAL CONTENT FOCUSED ON ST. LUKES HOSPITALS HIGHER LEVEL OF STROKE TREATMENT AND CAPABILITIES THAT ST. LUKES IS ABLE TO PROVIDE TO ALL THE SURROUNDING COUNTIES. IT WAS DUE TO AIR IN JANUARY 2020. THE ST. LUKES STROKE COORDINATOR PARTICIPATED IN A LIVE RADIO INTERVIEW ON 97.7 FM ON OCTOBER 23, 2019, IN ORDER TO PROVIDE COMMUNITY EDUCATION ON BE FAST, VARIOUS TYPES OF STROKES, RISK FACTORS, CALLING 911, ACUTE TREATMENTS AVAILABLE TO STROKE PATIENTS WHO ARRIVE SHORTLY AFTER STROKE SYMPTOMS ARE DISCOVERED, AND THE IMPORTANCE OF TIME IS BRAIN. THE ST. LUKES STROKE COORDINATOR PROVIDED A STROKE BOOTH AT THE MANOR OF PERRYSBURG COMMUNITY HEALTH FAIR ON NOVEMBER 14, 2019. THE EDUCATION FOCUSED ON SIGNS, SYMPTOMS, RISK FACTORS, IMPORTANCE OF CALLING 911, AND ACUTE STROKE TREATMENTS AND MEDICATIONS. THERE WERE 45 COMMUNITY ATTENDEES WHO RECEIVED GIFT BAGS WITH A VARIETY OF STROKE EDUCATIONAL MATERIALS. ST. LUKES STAFFED THE SENIOR SERVICE HOLIDAY LUNCH STROKE AWARENESS BOOTH ON DECEMBER 10, 2019. THERE WERE APPROXIMATELY 160 ATTENDEES. 58 CAROTID SCREENS WERE CONDUCTED ON ATTENDEES. 57 WERE NORMAL. ONE WAS CATEGORIZED AS POSITIVE. EMS STROKE EDUCATION: - FEBRUARY 25, 2019: ROSSFORD EMS STROKE PRESENTATION WITH 1 HOUR CEU PROVIDED. THERE WERE 10 EMS ATTENDEES. - APRIL 10, 2019: ST. LUKES EMS STROKE PRESENTATION TO AREA EMS PERSONNEL WITH 2 HOURS OF CEUS PROVIDED. THERE WERE APPROXIMATELY 25 ATTENDEES. - SEPTEMBER 21, 2019: MIDDLETON TOWNSHIP EMS STROKE PRESENTATION WITH 1 HOUR OF CEUS PROVIDED. THERE WERE 7 EMS ATTENDEES. ST. LUKES HOSPITAL FAMLY MEDICINE RESIDENCY STAFFED/PARTICIPATED IN THE FOLLOWING STROKE EDUCATION EVENTS: STROKE RISKS IN OLDER ADULTS BY: JP GALLAGHER, D.O. THERE WERE APPROXIMATELY 15 COMMUNITY MEMBERS AT EACH EVENT. 5/1/2019 KINGSTON ASSISTED LIVING 5/8/2019 THE WATERFORD AT LEVIS COMMONS 5/15/2019 WOOD COUNTY SENIOR CENTER 5/22/2019 PERRYSBURG COMMONS 5/29/2019 MAUMEE SENIOR CENTER HEALTH NEED IDENTIFIED: SKIN, ORAL, AND/OR BREAST/LUNG CANCER STRATEGY #1 CONDUCT A FREE SKIN CANCER SCREENING OR ORAL CANCER SCREENING IN ST. LUKES SERVICE AREA. ACTIONS TAKEN IN 2019: ST. LUKES HOSPITAL, ALONG WITH DERMATOLOGY ASSOCIATES, CONDUCTED SKIN CANCER SCREENINGS FOR 22 COMMUNITY MEMBERS ON AUGUST 3, 2019. 11 OF THE COMMUNITY MEMBERS WERE REFERRED FOR TREATMENT. STRATEGY #2 - CONDUCT A PUBLIC EDUCATIONAL SESSION REGARDING CANCER PREVENTION/TREATMENT IN ST. LUKES SERVICE AREA. ACTIONS TAKEN IN 2019: ST. LUKES HOSPITAL HOSTED A MONTHLY PROSTATE CANCER EDUCATION AND SUPPORT GROUP ON THE SECOND THURSDAY OF EACH MONTH. ON AVERAGE, THERE WERE 2025 ATTENDEES/PARTICIPANTS PER MEETING. ST. LUKES HOSTED AN ASK AN EXPERT SESSION ON FEBRUARY 12, 2019 AT THE MAUMEE BRANCH LIBRARY PRESENTED BY ST. LUKES HOSPITALS CLINICAL DIETITIAN TEAM ABOUT KETO, PALEO, AND VEGAN DIETS (AND CANCER PREVENTION). APPROXIMATELY 10 COMMUNITY MEMBERS WERE IN ATTENDANCE. ST. LUKES HOSTED A LUNCH-N-LEARN PROGRAM ON MARCH 12, 2019 WITH SPEAKER DR. ASISH MUKHERJEE, COLON-RECTAL SURGEON, ENTITLED, COLON HEALTH, COLON CANCER, COLITIS, AND DIVERTICULAR DISEASE. APPROXIMATELY 60 COMMUNITY MEMBERS WERE IN ATTENDANCE. ST. LUKES HOSPITAL CONDUCTED 251 CT LOW DOSE LUNG SCREENINGS (TO HELP DETECT LUNG CANCER) FOR PATIENTS/COMMUNITY MEMBERS IN 2019. HEALTH NEED IDENTIFIED: AGE/GERIATRIC-RELATED INITIATIVES NUTRITION, DEMENTIA, AND/OR FALL PREVENTION STRATEGY #1 CONTINUE TO IMPLEMENT THE AGE/GERIATRIC-RELATED NUTRITION, MEMORY, AND/OR FALL PREVENTION/BALANCE EDUCATION ACTIONS. ACTIONS TAKEN IN 2019: ST. LUKES HOSTED AN ASK AN EXPERT SESSION ON FEBRUARY 12, 2019 AT THE MAUMEE BRANCH LIBRARY PRESENTED BY ST. LUKES HOSPITALS CLINICAL DIETITIAN TEAM ABOUT KETO, PALEO, AND VEGAN DIETS. APPROXIMATELY 10 COMMUNITY MEMBERS WERE IN ATTENDANCE. APPROXIMATELY 100 PEOPLE ATTENDED THE ST. LUKES SENIOR SERVICE/COMMUNITY HEALTH FAIR ON APRIL 11, 2019. NUTRITION, MEMORY, AND/OR FALL PREVENTION EDUCATIONAL MATERIALS WERE DISTRIBUTED AT THIS EVENT. ST. LUKES HOSTED A LUNCH-N-LEARN PROGRAM ON JUNE 11, 2019 WITH SPEAKER DIANA WAUGH ABOUT MEMORY AND DEMENTIA. APPROXIMATELY 80 COMMUNITY MEMBERS WERE IN ATTENDANCE. ST. LUKES HOSTED AN ASK AN EXPERT PROGRAM ON JUNE 25, 2019 AT THE MAUMEE BRANCH LIBRARY PRESENTED BY ST. LUKES EMERGENCY DEPARTMENT REGARDING SUMMERTIME HEALTH AND SAFETY. APPROXIMATELY 10 COMMUNITY MEMBERS WERE IN ATTENDANCE. ST. LUKES HOSPITAL COLLECTED HEALTHY SNACKS AND DRINKS AT THE JULY 18, 2019 MAUMEE 5K RACE AND DONATED MANY OF THE ITEMS TO THE MAUMEE SENIOR CENTER. ST. LUKES HOSTED AN ASK AN EXPERT PROGRAM ON AUGUST 27, 2019 AT THE MAUMEE BRANCH LIBRARY PRESENTED BY DR. JAMES LYIONS ON SAFETY, ACCIDENT PREVENTION AND FALL RISK. APPROXIMATELY 15 COMMUNITY MEMBERS WERE IN ATTENDANCE. AT THE SEPTEMBER 6, 2019 MAUMEE SENIOR CENTER HEALTH FAIR, 51 COMMUNITY MEMBERS HAD DEXA SCREENS PERFORMED BY ST. LUKES STAFF. 24 WERE FOUND TO HAVE OSTEOPENIA AND 3 WERE FOUND TO HAVE OSTEOPOROSIS. AT THE OCTOBER 3, 2019 LUCAS COUNTY EMPLOYEE HEALTH FAIR, 100 COMMUNITY MEMBERS HAD DEXA SCREENS PERFORMED BY ST. LUKES STAFF. 17 WERE FOUND TO HAVE OSTEOPENIA AND 1 WAS FOUND TO HAVE OSTEOPOROSIS. AT THE OCTOBER 20, 2019 ISLAMIC CENTER OF GREATER TOLEDO HEALTH FAIR, 23 FLU SHOTS WERE ADMINISTERED TO COMMUNITY MEMBERS BY ST. LUKES STAFF. AT THE NOVEMBER 14, 2019 MANOR AT PERRYSBURG HEALTH FAIR, 7 COMMUNITY MEMBERS HAD DEXA SCREENS PERFORMED BY ST. LUKES STAFF. ALL RESULTS WERE FOUND TO BE NORMAL. ST. LUKES HOSPITAL SPONSORED A MEMORY MATTERS SYMPOSIUM WITH SPEAKER DR. BETH NOLAN ABOUT UNDERSTANDING, LOVING, AND LIVING WITH MEMORY LOSS ON NOVEMBER 20, 2019. APPROXIMATELY 75 COMMUNITY MEMBERS WERE EDUCATED/ATTENDED. ST. LUKES HOSTED AN ASK AN EXPERT PROGRAM ON DECEMBER 2, 2019 AT THE MAUMEE BRANCH LIBRARY PRESENTED BY DIANA SPIESS, A CERTIFIED HEALTH AND WELLNESS COACH, ABOUT HOLIDAY AND F
STROKE RISKS IN OLDER ADULTS BY: JP GALLAGHER, DO. THERE WERE	APPROXIMATELY 15 COMMUNITY MEMBERS AT EACH EVENT. 5/1/2019 KINGSTON ASSISTED LIVING 5/8/2019 THE WATERFORD AT LEVIS COMMONS 5/15/2019 WOOD COUNTY SENIOR CENTER 5/22/2019 PERRYSBURG COMMONS 5/29/2019 MAUMEE SENIOR CENTER REDUCING THE RISK OF FALLS BY: TONY PFEIFFER, MSW, LISW-S. THERE WERE APPROXIMATELY 15 COMMUNITY MEMBERS AT EACH EVENT. 6/5/2019 KINGSTON ASSISTED LIVING 6/12/2019 THE WATERFORD AT LEVIS COMMONS 6/19/2019 WOOD COUNTY SENIOR CENTER 6/26/2019 PERRYSBURG COMMONS HEAT AND SUMMER PRECAUTIONS BY: EMMANUEL JEAN-LOUIS, MD. THERE WERE APPROXIMATELY 15 COMMUNITY MEMBERS AT EACH EVENT. 7/3/2019 KINGSTON ASSISTED LIVING 7/10/2019 THE WATERFORD AT LEVIS COMMONS 7/17/2019 WOOD COUNTY SENIOR CENTER 7/24/2019 PERRYSBURG COMMONS 7/31/2019 MAUMEE SENIOR CENTER MANAGING HYPERTENSION BY: PETER NGUYEN, MD. THERE WERE APPROXIMATELY 15 COMMUNITY MEMBERS AT EACH EVENT. 8/7/2019 KINGSTON ASSISTED LIVING 8/14/2019 THE WATERFORD AT LEVIS COMMONS 8/21/2019 WOOD COUNTY SENIOR CENTER 8/28/2019 PERRYSBURG COMMONS ORAL HEALTH CARE AND AGING BY: AMY FUNG, MD. THERE WERE APPROXIMATELY 15 COMMUNITY MEMBERS AT EACH EVENT. 9/4/2019 KINGSTON ASSISTED LIVING 9/11/2019 THE WATERFORD AT LEVIS COMMONS 9/18/2019 WOOD COUNTY SENIOR CENTER 9/25/2019 PERRYSBURG COMMONS SLEEP DISTURBANCES BY: MICHELE YOUNG, MD. THERE WERE APPROXIMATELY 15 COMMUNITY MEMBERS AT EACH EVENT. 10/2/2019 KINGSTON ASSISTED LIVING 10/9/2019 THE WATERFORD AT LEVIS COMMONS 10/16/2019 WOOD COUNTY SENIOR CENTER 10/23/2019 PERRYSBURG COMMONS 10/30/2019 MAUMEE SENIOR CENTER SENSORY CHANGES AND AGING BY: MICHELE YOUNG, MD. THERE WERE APPROXIMATELY 15 COMMUNITY MEMBERS AT EACH EVENT. 11/6/2019 KINGSTON ASSISTED LIVING 11/13/2019 THE WATERFORD AT LEVIS COMMONS 11/20/2019 WOOD COUNTY SENIOR CENTER 11/27/2019 PERRYSBURG COMMONS DEPRESSION AND ANXIETY BY: EMMANUEL JEAN-LOUIS, MD. THERE WERE APPROXIMATELY 15 COMMUNITY MEMBERS AT EACH EVENT. 12/7/2019 KINGSTON ASSISTED LIVING 12/11/2019 THE WATERFORD AT LEVIS COMMONS 12/18/2019 WOOD COUNTY SENIOR CENTER HEALTH NEED IDENTIFIED: TOBACCO USE, PREVENTION, AND TREATMENT STRATEGY #1 - CONDUCT PEAK FLOW/PULMONARY FUNCTION SCREENINGS AT A ST. LUKE'S HOSPITAL-SPONSORED SENIOR EVENT(S). ACTIONS TAKEN IN 2019: 31 PULMONARY FUNCTION SCREENS AND EDUCATION WERE PROVIDED AT THE APRIL 11, 2019 ST. LUKES COMMUNITY/SENIOR SERVICE EVENT. APPROXIMATELY 160 COMMUNITY MEMBERS ATTENDED THIS EVENT. PULMONARY FUNCTION SCREENS WERE CONDUCTED BY ST. LUKES STAFF AT THE ISLAMIC CENTER HEALTH FAIR HELD IN OCTOBER 24, 2019, AND AT THE LOCAL 50 PLUMBER AND PIPEFITTERS HEALTH FAIR ON DECEMBER 7, 2019. OVER 50 PULMONARY FUNCTION SCREENS WERE PERFORMED AT THESE COMMUNITY EVENTS. STRATEGY #2 - CONTINUE ST. LUKE'S HOSPITAL PULMONARY REHAB PROGRAM. ACTIONS TAKEN IN 2019: ST. LUKES PULMONARY REHAB PROGRAM CONTINUED TO OFFER A SUPERVISED EXERCISE PROGRAM FOR PULMONARY REHAB OUTPATIENTS, AND ST. LUKES CONDUCTED A MONTHLY TOBACCO EDUCATION COMPONENT FACILITATED BY ST. LUKES CERTIFIED TOBACCO TREATMENT SPECIALISTS. STRATEGY #3 - SPONSOR/CONDUCT A ST. LUKE'S FREE PULMONARY SUPPORT GROUP AMONG ST. LUKE'S PATIENTS AND COMMUNITY MEMBERS. ACTIONS TAKEN IN 2019: ST. LUKES HOSPITAL CONTINUED TO OFFER A MONTHLY SUPPORT GROUP FOR COMMUNITY MEMBERS NEEDING ASSISTANCE IN MAINTAINING A SMOKE-FREE LIFESTYLE. THERE WAS NO CHARGE FOR THIS PROGRAM. ON AVERAGE, 1520 COMMUNITY MEMBERS PARTICIPATED PER MONTH. STRATEGY #4 - PROVIDE TOBACCO CESSATION EDUCATION TO SELF-IDENTIFIED INPATIENTS. ACTIONS TAKEN IN 2019: EVERY ST. LUKES INPATIENT, WHO HAD BEEN IDENTIFIED AS A TOBACCO USER, WAS SEEN BY A ST. LUKES TOBACCO TREATMENT SPECIALIST FOR THE PURPOSE OF RECOMMENDING TOBACCO CESSATION MEDICATIONS AND COUNSELING. PATIENTS WHO WERE INTERESTED IN QUITTING RECEIVED FREE TELEPHONE AND/OR INDIVIDUAL FOLLOW-UP. IN 2019, OVER 1,000 PATIENTS WERE COUNSELED BY ST. LUKES PULMONARY REHAB STAFF. PRINTED EDUCATIONAL MATERIALS WERE ROUTINELY GIVEN TO ALL IDENTIFIED TOBACCO USERS AND WERE AVAILABLE TO VISITORS THROUGHOUT ST. LUKES HOSPITAL. STRATEGY #5 PROVIDE TOBACCO CESSATION EDUCATION TO INDIVIDUALS AND GROUPS ON AN OUTPATIENT BASIS. ACTIONS TAKEN IN 2019: A QUARTERLY 6-WEEK CESSATION PROGRAM WAS OFFERED FOR COMMUNITY MEMBERS WHO PREFERRED QUITTING WITH A GROUP. IN ADDITION, ST. LUKES PROVIDED INDIVIDUAL COUNSELING APPOINTMENTS. TELEPHONIC COUNSELING WAS ALSO OFFERED AND WAS POPULAR WITH PATIENTS OUTSIDE OF THE ST. LUKES SERVICE AREA, OR WITH THOSE WHO HAD CHALLENGES WITH TRANSPORTATION. SOME ST. LUKES PATIENTS RECEIVED FINANCIAL ASSISTANCE WITH THEIR TOBACCO CESSATION MEDICATIONS. ST. LUKES ALSO PARTICIPATED WITH THE LUCAS COUNTY HEALTH DEPARTMENT IN PROVIDING TOBACCO CESSATION EDUCATION AND TREATMENT SERVICES TO UNINSURED AND UNDERINSURED LUCAS COUNTY RESIDENTS. STRATEGY #6 PROVIDE FREE ALTERNATIVE-TO-SUSPENSION SERVICES, AND TOBACCO EDUCATION SERVICES TO LOCAL/AREA SCHOOLS. ACTIONS TAKEN IN 2019: ST. LUKES HOSPITAL CONTINUED TO OFFER FREE INTERVENTION AND CESSATION SERVICES TO 28 SCHOOLS, WITHIN 18 DIFFERENT SCHOOL DISTRICTS IN THE GREATER TOLEDO AREA. IN 2019, ST. LUKES EXPERIENCED AN INCREASE IN SCHOOL PARTICIPATION FOR BOTH THE ST. LUKES ALTERNATIVE-TO-SUSPENSION PROGRAM AND CESSATION SERVICES. WITH VAPING AND E-CIGARETTE USE ON THE RISE IN SCHOOLS, ST. LUKES INCREASED ITS EDUCATION/TREATMENT SERVICES TO ACCOMMODATE THESE INCREASED COMMUNITY AND SCHOOL NEEDS. THE ST. LUKES CERTIFIED TOBACCO TREATMENT SPECIALIST SPOKE TO MANY SCHOOLS/STUDENTS, BUSINESSES, HOSPITALS AND COMMUNITY ORGANIZATIONS REGARDING THE EMERGING USE OF NICOTINE, E-CIGARETTES AND VAPING IN 2019. SHE WAS A KEYNOTE SPEAKER AT A VAPING COMMUNITY EVENT, HELD ON SEPTEMBER 26, 2019 AT ST. LUKES HOSPITAL. 106 COMMUNITY MEMBERS ATTENDED THE EVENT. A VAPING FORUM WAS HELD WITH 19 AREA SCHOOL SUPERINTENDENTS AND ADMINISTRATORS, FROM EIGHT DIFFERENT LOCAL SCHOOL SYSTEMS, AT ST. LUKES HOSPITAL ON OCTOBER 23, 2019. VARIOUS STRATEGIES ON HOW TO ADDRESS THE EMERGING VAPING AMONG STUDENTS WAS ADDRESSED. ADDITIONALLY, IN NOVEMBER 2019, THE ST. LUKES TOBACCO TREATMENT SPECIALIST WAS HIGHLIGHTED ON A WTOL (CHANNEL 11) NEWS SEGMENT REGARDING THE EMERGENCE OF VAPING AND ELECTRONIC CIGARETTES. ST. LUKES ALSO CONTINUED ITS SUPPORT AND PARTNERSHIP WITH THE TOLEDO-LUCAS COUNTY HEALTH DEPARTMENTS TOBACCO USE PREVENTION AND CESSATION PROGRAM IN 2019. ST. LUKES DEVELOPED TWO YOU-TUBE VIDEOS WITH THE ST. LUKES TOBACCO TREATMENT SPECIALIST THAT WERE USED FOR RAISING COMMUNITY AWARENESS AND PREVENTION. THEY WERE ENTITLED, QUITTING NICOTINE WERE HERE TO HELP YOU SUCCEED AND HELPING TEENS QUIT NICOTINE. THE ST. LUKES EMPLOYEE/COMMUNITY ASSISTANCE COORDINATOR SERVED SURROUNDING SCHOOL DISTRICTS IN ASSISTING STUDENTS WITH SUBSTANCE ABUSE RELATED ISSUES INCLUDING VAPING WITH THE DRUG THC. HE MET WITH 73 STUDENTS IN THE 2019 2020 SCHOOL YEAR TO PROVIDE EDUCATION, INTERVENTION AND REFERRAL SERVICES. THIS IS A 135% INCREASE OVER THE PREVIOUS YEAR, WITH VAPING BEING THE PRIMARY REASON FOR BEING SEEN. HEALTH NEED IDENTIFIED: DIABETES STRATEGY #1 - CONDUCT BLOOD GLUCOSE (SUGAR) SCREENINGS AT ST. LUKE'S SPONSORED SENIOR/COMMUNITY EVENTS. (CARDIOCHEKS ARE A SCREENING TEST FOR GLUCOSE AND/OR CHOLESTEROL.) ACTIONS TAKEN IN 2019: DATE: EVENT NUMBER OF CARDIOCHEKS 1/31/2019 Maumee Senior Center 6 2/14/2019 Maumee Senior Center 10 3/14/2019 Maumee Senior Center 5 4/11/2019 St. Lukes Community Health Fair 37 6/06/2019 Maumee Senior Center 1 6/20/2019 Maumee Senior Center 5 8/22/2019 Maumee Senior Center 7 9/6/2019 Maumee Senior Center 32 9/19/2019 Maumee Senior Center 8 10/17/2019 Maumee Senior Center 10 11/7/2019 Maumee Senior Center 3 12/5/2019 Maumee Senior Center 6 12/10/2019 Senior Service Holiday Lunch 33 12/11/2019 Holiday Hoopla (Caregiver Lunch) 26 STRATEGY #2 CONTINUE TO PROVIDE INDIVIDUAL AND GROUP PATIENT EDUCATION AT THE ST. LUKES DIABETES CARE CENTER. ACTIONS TAKEN IN 2019: ST. LUKES HELD INDIVIDUAL SESSIONS FOR DIABETES SELF-MANAGEMENT EDUCATION (DSME) IN 2019. ST. LUKES HAD 444 REFERRALS FOR DSME AND SCHEDULED SESSIONS WITH 400 OF THE PATIENTS. 170 WERE NEW PATIENTS. INDIVIDUAL AND GROUP PATIENT EDUCATION SESSIONS CONTINUED TO BE HELD AT THE ST. LUKES DIABETES CARE CENTER. THE ST. LUKES DIABETES EDUCATOR TREATED 47 COMMUNITY MEMBERS FOR MEDICAL NUTRITION THERAPY (MNT), FOR THE YEAR 2019. APPROXIMATELY 220+ PEOPLE ATTENDED THE WEAR RED FOR WOMEN EVENT ON FEBRUARY 1, 2019 IN THE ST. LUKES AUDITORIUM. DIABETES EDUCATION WAS AVAILABLE TO THOSE WHO STOPPED AT THE VENDOR TABLE. A DIABETES ADVISORY GROUP MEETING WAS HELD ON FEBRUARY 19, 2020 IN THE ST. LUKES DIABETES CARE CENTER CLASSROOM. THE ST. LUKES DIABETES EDUCATOR PRODUCED TWO YOU-TUBE EDUCATIONAL VIDEOS IN 2019. THESES VIDEOS WERE REVIEWED BY 1,294 COMMUNITY MEMBERS. STRATEGY #3 - CONDUCT DIABETES EDUCATIONAL SESSIONS AT ST. LUKES SENIOR EVENTS AND/OR SERVICE AREA SENIOR CENTERS. ACTIONS TAKEN IN 2019: ST. LUKES HELD A DIABETES CLASS ON THE SECOND MONDAY OF EVERY MONTH IN THE ST. LUKES CARDIAC REHAB AREA. A TOTAL OF 27 PEOPLE WERE IN
PART V, SECTION B, LINE 16J	THE FINANCIAL ASSISTANCE POLICY (FAP) WAS WIDELY AVAILABLE AT THE FOLLOWING URL: WWW.STLUKESHOSPITAL.COM PART V, SECTION B, LINE 20B A PATIENT FINANCIAL ADVOCATE (PFA) IS AVAILABLE AT THE HOSPITAL TO ASSIST EACH PATIENT WHO HAS BEEN ADMITTED TO THE HOSPITAL FACILITY AND TO NOTIFY THE INDIVIDUAL OF THE FINANCIAL ASSISTANCE POLICY.

Schedule H (Form 990) 2019

Page 9

Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, from largest to smallest) How many non-hospital health care facilities did the organization operate during the tax year?21
Name and address		Type of Facility (describe)
1	REGENCY CT RADIOLOGY SERVICES 300 REGENCY COURT SUITE 105 TOLEDO,OH43623	RADIOLOGY
2	FALLEN TIMBERS RADIOLOGY 5757 MONCLOVA RD SUITE 31 MAUMEE,OH43537	RADIOLOGY
3	SLH OUTPAITENT SURGERY - SURGICARE 5959 MONCLOVA RD MAUMEE,OH43537	OUTPATIENT SURGERY
4	FALLEN TIMBERS LAB 5757 MONCLOVA RD MAUMEE,OH43537	LAB
5	WATERVILLE SATELLITE LAB 900 WATERVILLE-MONCLOVA RD SUITE WATERVILLE,OH43566	LAB
6	ST LUKE'S DIABETES CARE CENTER 5871 MONCLOVA RD MAUMEE,OH43537	WOUND/DIABETES CARE
7	PERRYSBURG RADIOLOGY SERVICES 1103 VILLAGE SQUARE DR SUITE 200 PERRYSBURG,OH43551	RADIOLOGY
8	PERRYSBURG SATELLITE LAB 1103 VILLAGE SQUARE DR SUITE 201 PERRYSBURG,OH43551	LAB
9	WATERVILLE REHAB 900 WATERVILLE-MONCLOVA RD SUITE WATERVILLE,OH43566	PHYSICAL THERAPY
10	SWANTON REHAB 1 TURTLE CREEK CIRCLE SWANTON,OH43558	PHYSICAL THERAPY
11	VESTIBULAR CLINIC 6005 MONCLOVA RD SUITE 360 MAUMEE,OH43537	VESTIBULAR CLINIC
12	MAUMEE VALLEY IMAGING 6005 MONCLOVA RD MAUMEE,OH43537	RADIOLOGY
13	TOBACCO TREATMENT CENTER 5757 MONCLOVA RD MAUMEE,OH43537	TOBACCO TREATMENT
14	RIVER ROAD SATELLITE LAB 28442 E RIVER RD SUITE 101 PERRYSBURG,OH43551	LAB
15	PERRYSBURG REHAB 1103 VILLAGE SQUARE DR PERRYSBURG,OH43551	PHYSICAL THERAPY
16	PAIN CENTER 5759 MONCLOVA RD MAUMEE,OH43537	PAIN CENTER
17	ANTI COAGULATION CLINIC 6005 MONCLOVA RD MAUMEE,OH43537	ANTI-COAGULATION SERVICES
18	ST LUKE'S FAMILY MEDICINE RESIDENCY 7045 LIGHTHOUSE WAY PERRYSBURG,OH43551	RESIDENCY PROGRAM
19	FAMILY MEDICINE CLINIC SATELLITE LAB 7045 LIGHTHOUSE WAY PERRYSBURG,OH43551	LAB
20	MAUMEE VALLEY SATELLITE LAB 6005 MONCLOVA RD SUITE 210 MAUMEE,OH43537	LAB
21	MAUMEE VALLEY REHAB 6005 MONCLOVA RD SUITE 225 MAUMEE,OH43537	REHAB

Schedule H (Form 990) 2019

Page 10

Part VI

Supplemental Information

Provide the following information.

1	Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2	Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3	Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4	Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5	Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6	Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7	State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.

Form and Line Reference	Explanation
PART I, LINE 7	ST. LUKE'S HOSPITAL CALCULATED THE COST OF FINANCIAL ASSISTANCE AND MEANS-TESTED GOVERNMENT PROGRAMS, USING THE COST-TO-CHARGE RATIO DERIVED FROM SCHEDULE H, WORKSHEET 2, RATIO OF PATIENT CARE COST-TO CHARGES. OTHER BENEFITS AMOUNTS REPORTED ON LINE 7 WERE CALCULATED USING COSTS CHARGED DIRECTLY TO THE INDIVIDUAL PROGRAMS VIA THE FINANCIAL ACCOUNTING SYSTEM. AN INDIRECT COST ALLOCATION FACTOR FOR SHARED SERVICES IS ALSO CALCULATED AND INCLUDED IN APPLICABLE PROGRAMS LISTED IN OTHER BENEFITS.
PART II	ST. LUKE'S HOSPITAL PROMOTED THE HEALTH OF ITS COMMUNITY BY ENGAGING IN ACTIVITIES THAT PROMOTE COMMUNITY BUILDING.
PART III, SECTION A, LINE 2	ST. LUKE'S HOSPITAL'S ANALYSIS AND ASSESSMENT OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND RELATED BAD DEBT EXPENSE USES A RECEIPTS LOOK-BACK METHOD UTILIZING HISTORICAL PAYMENT DATA ON ACCOUNTS, INCLUDING CONTRACTUAL ADJUSTMENTS FOR PAYER DISCOUNTS, AS WELL AS PATIENT PAYMENTS, SUCH AS COPAYS AND DEDUCTIBLES, TO ESTABLISH ANTICIPATED COLLECTABILITY RATES FOR ACCOUNTS RECEIVABLE WITHIN EACH PAYER CATEGORY.
PART III, SECTION A, LINE 3	ST. LUKE'S HOSPITAL ESTIMATED THE POSSIBLE AMOUNT OF FINANCIAL ASSISTANCE WITHIN BAD DEBT EXPENSE BASED ON HISTORICAL PERCENTAGES.
PART III, SECTION A, LINE 4	PROVISION FOR BAD DEBTS AND ALLOWANCE FOR ESTIMATED UNCOLLECTIBLE ACCOUNTS ARE DISCUSSED ON PAGE 9 OF THE ATTACHED ST. LUKE'S HOLDING COMPANY AND SUBSIDIARIES CONSOLIDATED FINANCIAL STATEMENTS.
PART III SECTION B LINE 8	MEDICARE SHORTFALL, WHICH IS THE EXCESS OF COSTS TO TREAT MEDICARE PATIENTS OVER THE REIMBURSEMENT RECEIVED FROM THE FEDERAL GOVERNMENT, SHOULD BE TREATED AS COMMUNITY BENEFIT FOR THE FOLLOWING REASONS: - THE MEDICARE SHORTFALL REPRESENTS THE RELIEF OF A FINANCIAL BURDEN THAT WOULD OTHERWISE BE BORNE BY A GOVERNMENT PROGRAM. - THE MEDICARE SHORTFALL REPRESENTS A SOCIETAL BENEFIT INSOFAR AS MANY OF THE PROGRAMS AND SERVICES WOULD NOT BE PROVIDED TO THE COMMUNITY, IF THE DECISION TO PROVIDE SUCH SERVICES WAS MADE ON A FINANCIAL BASIS. - MEDICARE IS A SOCIETAL BENEFIT, PROVIDED BY THE FEDERAL GOVERNMENT, FOR THOSE WHO WOULD OTHERWISE BE UNINSURED AFTER AGING OUT OF TRADITIONAL MEANS OF HEALTH INSURANCE, SUCH AS INSURANCE PROVIDED BY AN EMPLOYER. - MEDICARE IS NOT A TRUE MARKET PAYER, AS COMPARED TO COMMERCIAL PAYERS, WHEREBY REIMBURSEMENT RATES CAN BE NEGOTIATED AND ADJUSTED IN ORDER TO REDUCE INCURRED LOSSES. ST. LUKE'S HOSPITAL USED THE MEDICARE ALLOWABLE COSTS PER ITS 2019 AS-FILED MEDICARE COST REPORTS, LESS ANY ADJUSTMENTS FOR SUBSIDIZED HEALTH SERVICES AND HEALTH PROFESSIONS EDUCATION, IF APPLICABLE. ALLOWABLE COSTS ARE CALCULATED BY ALLOCATING TOTAL FACILITY COSTS TO REVENUE GENERATING UNITS WITHIN THE HOSPITAL. THE MEDICARE COST REPORT DOES NOT REFLECT ALL OF THE COSTS ASSOCIATED WITH MEDICARE PROGRAMS.
PART III SECTION C LINE 9B	FINANCIAL ASSISTANCE DISCOUNTS ARE GRANTED FOR MEDICALLY NECESSARY SERVICES WHEN IT IS DETERMINED THAT THE PATIENT AND FAMILY INCOME MEETS THE CRITERIA ESTABLISHED. PATIENTS WHO HAVE INSURANCE COVERAGE OR WHO ARE ENTITLED TO GOVERNMENTAL ASSISTANCE ARE IDENTIFIED IN ORDER FOR REIMBURSEMENT TO BE OBTAINED. ALL PATIENTS WITH SELF-PAY BALANCES AFTER INSURANCE MAY OBTAIN FINANCIAL ASSISTANCE ADJUSTMENTS IF THEY PROVIDE APPROPRIATE DOCUMENTATION THAT THEY SATISFY THE INCOME GUIDELINES. VERIFICATION OF FINANCIAL ASSISTANCE IS PURSUED THROUGHOUT THE INTERNAL COLLECTION PROCESS UNTIL ALL OPTIONS HAVE BEEN EXHAUSTED. ALL PATIENTS THAT HAVE A SELF-PAY BALANCE, INCLUDING PATIENTS THAT MAY QUALIFY FOR CHARITY CARE OR FINANCIAL ASSISTANCE, RECEIVE BILLING STATEMENTS AND PAYMENT REMINDERS. THESE STATEMENTS INFORM ALL PATIENTS OF THE OPPORTUNITY TO SEEK A FINANCIAL ASSISTANCE ADJUSTMENT FOR MEDICALLY NECESSARY SERVICES, THE ELIGIBILITY CRITERIA, AND THE METHOD TO APPLY. IF A FINANCIAL ASSISTANCE APPLICATION HAS NOT BEEN COMPLETED AND/OR REQUESTED INCOME VERIFICATION HAS NOT BEEN RECEIVED FROM A PATIENT WHO COULD POTENTIALLY QUALIFY, THE PATIENT WILL CONTINUE TO RECEIVE BILLING STATEMENTS THROUGH THE NORMAL COLLECTION PROCESS. IF A PATIENT DOES NOT HAVE INSURANCE, A PRESUMPTIVE CHARITY DETERMINATION (WHICH USES PUBLICLY AVAILABLE DATA SUCH AS DEMOGRAPHIC INFORMATION, CREDIT HISTORY, ETC.) MAY BE MADE TO ASSIST WITH QUALIFYING FOR FINANCIAL ASSISTANCE. ONCE IT HAS BEEN DETERMINED THAT A PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE, AN ADJUSTMENT IS PROCESSED. THE PATIENT ACCOUNT ANALYST WILL DETERMINE PATIENT ELIGIBILITY AND CALCULATE THE ADJUSTMENT BASED ON POLICY GUIDELINES. AN ADJUSTMENT FORM IS PREPARED AND APPROVED PER POLICY. UNINSURED PATIENTS MAY BE REQUIRED TO COMPLETE AN APPLICATION AND PROVIDE REQUIRED DOCUMENTATION, INCLUDING ANY DOCUMENTATION REQUIRED TO DETERMINE ELIGIBILITY. UNINSURED PATIENTS ARE NOTIFIED IN WRITING WHETHER OR NOT THEY QUALIFY FOR ANY FINANCIAL ASSISTANCE ADJUSTMENT FOR WHICH THEY HAVE SUBMITTED AN APPLICATION, AND OF ANY REMAINING BALANCE OWED. THE ADJUSTMENT IS THEN APPLIED TO THE PATIENT'S ACCOUNT. PATIENTS MAY BE OFFERED PAYMENT PLANS WHEN APPROPRIATE BASED ON DOCUMENTED FINANCIAL NEED AND CIRCUMSTANCES. LONGER PAYMENT PLANS MAY BE OFFERED ON AN EXCEPTION BASIS FOR CASES WITH UNUSUALLY HIGH BALANCES OR SPECIAL CIRCUMSTANCES DEMONSTRATING AN INABILITY TO PAY. ONCE THE INTERNAL COLLECTION PROCESS HAS BEEN COMPLETED, PATIENT ACCOUNTS MAY BE REFERRED TO AN EXTERNAL COLLECTION AGENCY IF THE PATIENT HAS NOT CONTACTED US REGARDING THEIR DESIRE TO APPLY FOR FINANCIAL ASSISTANCE, SENT IN A FINANCIAL ASSISTANCE APPLICATION, RESPONDED TO REQUESTS FOR ADDITIONAL INFORMATION, OR WE ARE UNABLE TO MAKE A PRESUMPTIVE CHARITY DETERMINATION. IT IS THE EXPECTATION OF THE EXTERNAL COLLECTION AGENCY AS THEY WORK ACCOUNTS TO OFFER FINANCIAL ASSISTANCE WHEN APPLICABLE. THROUGHOUT THE COLLECTION PROCESS, THE COLLECTION AGENCY WILL INFORM UNINSURED PATIENTS OF THE CRITERIA TO OBTAIN FINANCIAL ASSISTANCE ADJUSTMENTS BASED ON FAMILY INCOME AND FAMILY SIZE AND WILL FORWARD APPLICATIONS FOR PATIENTS WHO SUBMIT THE REQUIRED DOCUMENTATION TO THE CENTRAL BUSINESS OFFICE FOR PROCESSING.
PART VI, LINE 2	ST. LUKES HOSPITAL HAS ACTIVELY PARTICIPATED IN THE LUCAS COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) SINCE ITS EARLY BEGINNINGS. THROUGH THE COURSE OF A PRIMARY MARKET RESEARCH SURVEY (WHICH IS CONSISTENT WITH THE BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM [BRFSS] QUESTIONNAIRE DEVELOPED BY THE CENTERS FOR DISEASE CONTROL AND PREVENTION) AND PUBLISHED HEALTH AND DEMOGRAPHIC DATA, A CHNA IS COMPLETED EVERY THREE YEARS. A MULTI-DISCIPLINARY, COMPREHENSIVE GROUP OF STAKEHOLDERS (INCLUDING A ST. LUKES HOSPITAL REPRESENTATIVE) FROM LUCAS COUNTY DISCUSS, DEBATE AND RANK FINDINGS FROM THE CHNA. ST. LUKES HOSPITAL, THEN REVIEWS THE CHNA RESULTS, LUCAS COUNTY FINDINGS REPORT, AND COUNTY LEADING CAUSES OF DEATH (THE LEADING CAUSES OF DEATH IN LUCAS COUNTY, 2013 - 2015 WERE HEART DISEASE, CANCER, CHRONIC LOWER RESPIRATORY DISEASES, STROKE, AND ACCIDENTS/ UNINTENTIONAL INJURIES) TO DEVELOP ITS OWN CHNA REPORT AND IMPLEMENTATION PLAN FOR ITS PRIMARY SERVICE AREA, MOST OF WHICH IS LOCATED IN LUCAS COUNTY.
PART VI, LINE 3	THE OPPORTUNITY FOR FINANCIAL ASSISTANCE ADJUSTMENTS IS COMMUNICATED TO PATIENTS AT ST. LUKES HOSPITAL THROUGH THE FOLLOWING METHODS: A. ADMITTING LOCATIONS WILL HAVE FINANCIAL ASSISTANCE FORMS AVAILABLE FOR SELF-PAY PATIENTS TO COMPLETE WHEN REGISTERED AS UNINSURED. AT ADMITTING, UNINSURED PATIENTS ARE INFORMED OF THE OPPORTUNITY TO SEEK FINANCIAL ASSISTANCE. B. A PATIENT FINANCIAL ADVOCATE IS AVAILABLE AT THE HOSPITAL TO ASSIST UNINSURED PATIENTS IN COMPLETING THE FORMS. THE PATIENT FINANCIAL ADVOCATE ATTEMPTS TO MEET WITH IN-HOUSE PATIENTS TO ASSESS ELIGIBILITY AND TO ASSIST WITH APPLICATION FOR GOVERNMENT ASSISTANCE PROGRAMS, TO EXPLAIN PATIENT LIABILITY FOR CHARGES, TO PROVIDE AN ESTIMATE OF CHARGES WHEN FEASIBLE, TO EXPLAIN THE OPPORTUNITY FOR FINANCIAL ASSISTANCE, INCLUDING THE CRITERIA AND THE METHOD FOR APPLYING, AND TO EXPLAIN PAYMENT OPTIONS. C. A MESSAGE IS SENT ALONG WITH THE PATIENT BILLING STATEMENTS TO NOTIFY THE UNINSURED PATIENT THAT FINANCIAL ASSISTANCE IS AVAILABLE, TO EXPLAIN THE ELIGIBILITY CRITERIA, AND TO DESCRIBE THE METHOD TO APPLY. D. A SUMMARY OF THE POLICY FOR UNINSURED PATIENTS IS INCLUDED IN THE STATEMENTS OF UNINSURED PATIENT, AVAILABLE VIA THE ST. LUKES HOSPITAL WEB SITE, AVAILABLE AT HOSPITAL REGISTRATION LOCATIONS, OR BY CALLING THE ST. LUKES HOSPITAL CUSTOMER SERVICE DEPARTMENT. BUSINESS OFFICE PERSONNEL ALSO NOTIFY UNINSURED PATIENTS OF THE FINANCIAL ADJUSTMENT POLICY THROUGH THE CUSTOMER SERVICE AND COLLECTION DEPARTMENTS.
PART VI, LINE 4	ST. LUKES HOSPITAL IS LOCATED IN MAUMEE, OHIO, WHICH IS IN THE SOUTHWEST PORTION OF LUCAS COUNTY. AS OF THE 2010 CENSUS, THERE WERE 441,815 PEOPLE, 180,267 HOUSEHOLDS, AND 111,016 FAMILIES RESIDING IN LUCAS COUNTY. THE RACIAL MAKEUP OF THE COUNTY WAS 74.0% WHITE, 19.0% BLACK OR AFRICAN AMERICAN, 1.5% ASIAN, 0.3% AMERICAN INDIAN, 2.0% FROM OTHER RACES, AND 3.1% FROM TWO OR MORE RACES. THE MEDIAN HOUSEHOLD INCOME AND PER CAPITA INCOME IN THE COUNTY WERE $46,806 AND $23,981, RESPECTIVELY. APPROXIMATELY, 14% OF FAMILIES AND 18% OF THE POPULATION WERE BELOW THE POVERTY LINE. BESIDES LUCAS COUNTY, ST. LUKES ALSO DRAWS A CONSIDERABLE NUMBER OF PATIENTS FROM WOOD COUNTY AND FULTON COUNTY.
PART VI, LINE 5	ST. LUKES HOSPITAL HAS AN OPEN MEDICAL STAFF, AND AS OF DECEMBER 31, 2019, HAD 475 ACTIVE OR ASSOCIATE MEMBERS. ST. LUKES HOSPITAL HAS 12 BOARD MEMBERS WHO ARE VOLUNTEERS AND NOT COMPENSATED FOR THEIR SERVICE TO OUR HOSPITAL. ST. LUKES HOSPITAL OPERATES SEVERAL SERVICES EITHER FREE OR AT LOW COST FOR THE BENEFIT OF THE COMMUNITY SUCH AS OUR COURTESY VAN SERVICE, WHICH TRANSPORTS PATIENTS TO OUR HOSPITAL CAMPUS AND BACK TO THEIR HOME FOR FREE AND OUR TOBACCO TREATMENT CENTER WHICH PROVIDES EDUCATION OR SERVICES AT NO OR LOW COST.
PART VI, LINE 6	St. Lukes Holding Company, Inc. is an Ohio not-for-profit corporation which serves as a holding company for several corporations. The St. Lukes Holding Company, Inc. provides its subsidiaries and other affiliated entities various types of health care services including management, long-range planning and community health services. St. Lukes Holding Company, Inc. is the parent of the following subsidiaries: St. Lukes Hospital an Ohio not-for-profit corporation operates a general, acute care facility offering inpatient and outpatient healthcare services primarily to residents in the southwestern part of Lucas County, northern Wood County and eastern Fulton County in Ohio. St. Lukes Hospital Foundation an Ohio not-for-profit corporation supports the activities and purposes of the Hospital. Care Enterprises, Inc. an Ohio not-for-profit corporation operates and manages medical office buildings. Care Enterprises, Inc. includes a 70 percent ownership in Waterville Medical Center, LLC. WellCare Physicians Group, LLC employs physicians and other medical professionals providing primary and specialty healthcare services to its patients. Care Holdings, Inc. engages in the business of the ownership, development and management of real estate. Physicians Advantage MSO, Inc. provides management services to WellCare Physicians Group, LLC and other independent physicians on a fee-for-service basis. PART VI, LINE 7 STATE FILING OF COMMUNITY BENEFIT REPORT: OHIO

Schedule H (Form 990) 2019

Additional Data

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Schedule I
(Form 990)

Department of the Treasury
Internal Revenue Service

Grants and Other Assistance to Organizations,
Governments and Individuals in the United States

Complete if the organization answered "Yes," on Form 990, Part IV, line 21 or 22.
lBullet

Attach to Form 990.
lBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2019

Open to Public
Inspection

Name of the organization
ST LUKE'S HOSPITAL

Employer identification number
34-4428232

Part I

General Information on Grants and Assistance

Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................

Yes No

Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.

Part II

Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient

that received more than $5,000. Part II can be duplicated if additional space is needed.

(a) Name and address of organization or government	(b) EIN	(c) IRC section (if applicable)	(d) Amount of cash grant	(h) Purpose of grant or assistance
(1) AMERICAN HEART ASSOCIATION 5455 NORTH HIGH STREET COLUMBUS,OH43214	13-5613797	501(C)(3)	10,000	CHARITABLE DONATION
(2) THE TOLEDO ZOOLOGICAL SOCIETY 2700 BROADWAY TOLEDO,OH43609	34-4440256	501(C)(3)	30,000	CHARITABLE DONATION
(3) TOLEDO CLASSIC INC 4405 DORR STREET TOLEDO,OH43607	34-1499072	501(C)(3)	7,500	CHARITABLE DONATION
(4) HOSPITAL COUNCIL OF NORTHWEST OHIO 3231 CENTRAL PARK WEST STE 200 TOLEDO,OH43617	34-1116795	501(C)(3)	11,000	CHARITABLE DONATION
(5) FALLEN TIMBERS BATTLEFIELD PRESERVATION PO BOX 758 MAUMEE,OH43537	34-1804550	501(C)(3)	7,500	CHARITABLE DONATION
(6) MARCH OF DIMES INC 1550 CRYSTAL DRIVE STE 1300 ARLINGTON,VA22202	13-1846366	501(C)(3)	22,500	CHARITABLE DONATION
(7) LPGA TOURNAMENT PROPERTIES ONE LLC 100 INTERNATIONAL GOLF DRIVE DAYTONA BEACH,FL32124	27-1317091		22,000	SPONSORSHIP
(8) WELLCARE PHYSICIANS GROUP LLC 5901 MONCLOVA ROAD MAUMEE,OH43537	61-1528443	501(C)(3)	10,436,326	OPERATING SUPPORT
(9) ST LUKE'S HOSPITAL FOUNDATION 5901 MONCLOVA ROAD MAUMEE,OH43537	31-1292849	501(C)(3)	372,923	OPERATING SUPPORT

Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image

Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50055P

Schedule I (Form 990) 2019

Page 2

Part III

Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.

(a) Type of grant or assistance	(b) Number of recipients	(c) Amount of cash grant	(d) Amount of noncash assistance	(e) Method of valuation (book, FMV, appraisal, other)	(f) Description of noncash assistance

(1) DIRECT CASH ASSISTANCE	19	31,108	FMV
(1)
(2)
(3)
(4)
(5)
(6)
(7)

Part IV

Supplemental Information. Provide the information required in Part I, line 2; Part III, column (b); and any other additional information.

Return Reference	Explanation
SCHEDULE I, PART I, LINE 2	AS AN AFFILIATE OF ST. LUKE'S HOLDING COMPANY, INC. (SLHC), FINANCE, WITH THE APPROVAL AND OVERSIGHT OF THE FINANCE COMMITTEE, ENSURES THAT FUNDS ARE DISTRIBUTED APPROPRIATELY ACCORDING TO SLHC'S STRATEGIC BUSINESS PLAN AND CONSISTENT WITH FINANCE POLICIES AND PROCEDURES.

Schedule I (Form 990) 2019

Additional Data

Software ID:
Software Version:

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet

Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
SchJMediumBullet

Attach to Form 990.
SchJMediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

ST LUKE'S HOSPITAL

Employer identification number

34-4428232

Part I

Questions Regarding Compensation

Yes

Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes on Line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain .........

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked on Line 1a? ..

Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

During the year, did any person listed on Form 990, Part VII, Section A, line 1a, with respect to the filing organization or a related organization:

Receive a severance payment or change-of-control payment? .............

Yes

Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........

Participate in, or receive payment from, an equity-based compensation arrangement? .........

If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.

Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:

The organization? ....................

Any related organization? .......................

If "Yes," on line 5a or 5b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:

The organization? ..................

Any related organization? ......................

If "Yes," on line 6a or 6b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Were any amounts reported on Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III ..........................

If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50053T

Schedule J (Form 990) 2019

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.

For each individual whose compensation must be reported on Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.

(A) Name and Title		(B) Breakdown of W-2 and/or 1099-MISC compensation			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation in column (B) reported as deferred on prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1MATTISON MD LALAINE E TRUSTEE	(i) (ii)	------------- 234,377	------------- 25,000	------------- 981	------------- 60,937	------------- 20,375	------------- 341,670	------------- 0
2WAKEMAN DANIEL PRESIDENT/CEO, EX-OFFICIO	(i) (ii)	394,479 -------------	0 -------------	4,284 -------------	46,471 -------------	22,730 -------------	467,964 -------------	0 -------------
3BURMEISTER KEITH VP CHIEF RELATIONS OFFICER	(i) (ii)	215,959 -------------	0 -------------	2,732 -------------	43,591 -------------	21,104 -------------	283,386 -------------	0 -------------
4BURMEISTER KERRY ADMIN DIRECTOR FINANCE	(i) (ii)	151,912 -------------	0 -------------	695 -------------	17,924 -------------	19,520 -------------	190,051 -------------	0 -------------
5KIM JEFF VP CHIEF INFORMATION OFFICER	(i) (ii)	268,039 -------------	0 -------------	1,242 -------------	58,915 -------------	31,215 -------------	359,411 -------------	0 -------------
6MORRISSEY MARTIN VP GENERAL COUNSEL	(i) (ii)	252,886 -------------	0 -------------	2,322 -------------	42,419 -------------	29,913 -------------	327,540 -------------	0 -------------
7RILEY KEVIN CHIEF FINANCIAL OFFICER	(i) (ii)	270,268 -------------	0 -------------	1,242 -------------	8,250 -------------	28,973 -------------	308,733 -------------	0 -------------
8SESSLER CONNIE VP HR/SUPPORT SERVICES	(i) (ii)	176,336 -------------	0 -------------	2,260 -------------	44,686 -------------	9,894 -------------	233,176 -------------	0 -------------
9TROSIN JILL VP PATIENT CARE/CNO	(i) (ii)	218,163 -------------	0 -------------	3,411 -------------	40,785 -------------	10,184 -------------	272,543 -------------	0 -------------
10STOUT JOHN LEFT 1119 VP BUSINESS PERFORMANCE DEV	(i) (ii)	193,304 -------------	0 -------------	17,190 -------------	54,560 -------------	7,622 -------------	272,676 -------------	0 -------------
11THOMPSON DAN ADMIN DIRECTOR TECHNOLOGY	(i) (ii)	146,895 -------------	0 -------------	97 -------------	19,652 -------------	22,871 -------------	189,515 -------------	0 -------------
12O'LEARY WENDY ADMIN DIRECTOR SOFTWARE APP	(i) (ii)	148,362 -------------	0 -------------	121 -------------	29,714 -------------	16,608 -------------	194,805 -------------	0 -------------
13ST MARY JUDY PHARMACIST, MANAGER	(i) (ii)	134,931 -------------	0 -------------	154 -------------	27,538 -------------	805 -------------	163,428 -------------	0 -------------
14ONYSYK ANTHONY CLINICAL PHARMACIST	(i) (ii)	123,766 -------------	0 -------------	72 -------------	25,396 -------------	14,879 -------------	164,113 -------------	0 -------------
15GRABARCZYK JENNIFER CHIEF CLINICAL PHARMACIST	(i) (ii)	127,802 -------------	0 -------------	144 -------------	16,369 -------------	16,371 -------------	160,686 -------------	0 -------------

Schedule J (Form 990) 2019

Page 3

Part III

Supplemental Information

Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.

Return Reference

Explanation

SCHEDULE J, PART I, LINE 3

ST. LUKES HOSPITAL USES THE FOLLOWING TO ESTABLISH THE COMPENSATION OF THE ORGANIZATIONS TOP MANAGEMENT OFFICIALS: - INDEPENDENT COMPENSATION CONSULTANT - COMPENSATION SURVEY OR STUDY - APPROVAL BY THE EXECUTIVE COMMITTEE OF THE BOARD SCHEDULE J, PART I, LINE 4A JOHN STOUT RECEIVED $14,846 OF SEVERANCE PAYMENTS DURING 2019. SEVERANCE IS FOR 1040 HOURS THAT BEGAN IN NOVEMBER 2019 AND ENDS IN MAY 2020.

Schedule J (Form 990) 2019

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.
MediumBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2019

Open to Public
Inspection

Name of the organization

ST LUKE'S HOSPITAL

Employer identification number

34-4428232

Return Reference	Explanation
FORM 990, PART III, PROGRAM SERVICE ACCOMPLISHMENTS	ST. LUKES HOSPITAL (ST. LUKES), A MISSION-BASED, LOCALLY OWNED, NONPROFIT HEALTHCARE ORGANIZATION HIGHLY FOCUSED ON ACHIEVING CORE VALUES. HEADQUARTERED IN MAUMEE, OHIO, ST. LUKES SERVES THE SOUTHWEST PORTION OF LUCAS COUNTY AND PORTIONS OF WOOD AND FULTON COUNTIES. OUR STEWARDSHIP OF RESOURCES HAS ENABLED US TO WISELY INVEST IN PATIENT-CENTERED CARE, ADVANCED TECHNOLOGY, INNOVATIVE PROGRAMS, AND FAMILY-ORIENTED FACILITIES THAT HELP TO ENSURE PATIENTS AND AREA RESIDENTS HAVE EQUAL ACCESS TO HIGH-QUALITY, SAFE CARE IN THE MOST APPROPRIATE SETTING, REGARDLESS OF PATIENTS ABILITY TO PAY. A 300 BED FACILITY IN MAUMEE, OHIO, ST LUKES PROVIDES EXTENSIVE HEALTHCARE SERVICES SUCH AS EMERGENCY MEDICINE; SURGICAL SERVICES; OUTPATIENT PHYSICAL, OCCUPATIONAL, PULMONARY AND CARDIAC REHABILITATION; CRITICAL CARE; CARDIOLOGY; RESPIRATORY; LABOR AND DELIVERY; AND A FULL RANGE OF LABORATORY AND RADIOLOGY SERVICES. ST. LUKES CAMPUS IS HOME TO THE PROMEDICA MAUMEE CANCER CENTER FOR OUTPATIENT CANCER CARE, AS WELL AS A SLEEP DISORDERS CLINIC, A PAIN CLINIC, A FAMILY BIRTHING CENTER, A DIABETES CARE CENTER, AND TOBACCO TREATMENT CENTER. IN 2019, ST. LUKES ALSO HAD CHEST PAIN ACCREDITATION FROM THE SOCIETY OF CARDIOVASCULAR PATIENT CARE, PRIMARY STROKE CENTER CERTIFICATION, AND THE LABORATORY WAS CERTIFIED BY THE COLLEGE OF AMERICAN PATHOLOGISTS. ST. LUKES SERVED 9,493 INPATIENTS AND 188,008 OUTPATIENTS IN 2019. FURTHER, 31,831 INDIVIDUALS SOUGHT EMERGENCY CARE AT ST. LUKES. THE HOSPITAL CONTRIBUTED $18,976,072 IN COMMUNITY BENEFIT THROUGH COMMUNITY BENEFIT EXPENDITURES, FINANCIAL ASSISTANCE AND GOVERNMENT SPONSORED, MEANS-TESTED HEALTHCARE. THROUGH COMMUNITY HEALTH IMPROVEMENT SERVICES, HEALTH PROFESSIONALS EDUCATION, SUBSIDIZED HEALTH SERVICES, CASH AND IN-KIND CONTRIBUTIONS, AND OTHER COMMUNITY BENEFIT OPERATIONS, ST. LUKES CONTRIBUTED $4,714,483 TO THE COMMUNITY DURING 2019. INCLUDED IN THIS FIGURE ARE PROGRAMS AND EVENTS SUCH AS: - PARTICIPATION IN AMERICAN MEDICINE CHEST CHALLENGES, A MEDICATION DROP OFF EVENT, WHERE COMMUNITY MEMBERS DROP OFF EXPIRED AND UNUSED MEDICATIONS TO SAFELY DISPOSE OF DRUGS THAT POTENTIALLY MAY BE ABUSED. - DIABETES EDUCATION PROGRAMS OFFERED WEEKLY, AS WELL AS MONTHLY SUPPORT GROUPS FOR INDIVIDUALS RECENTLY DIAGNOSED WITH DIABETES. - SPONSORSHIP OF THE AMERICAN HEART ASSOCIATIONS GO RED FOR WOMEN EVENT IN SUPPORT OF WOMENS HEART HEALTH, AS WELL AS STRONG PARTICIPATION IN THE HEART WALK IN SUPPORT OF OVERALL HEART HEALTH. - SCREENING EVENTS FOR SKIN, CANCER AND INTRODUCTION OF LOW-DOSE CT SCAN FOR LUNG CANCER DETECTION. - TOBACCO CESSATION PROGRAMS AND SUPPORT GROUPS FOR COMMUNITY MEMBERS. - A COURTESY VAN PROVIDED TO PATIENTS NEEDING TRANSPORTATION TO AND FROM THE HOSPITAL FOR APPOINTMENTS AND TESTING. - SENIOR SERVICE EDUCATION PROGRAMS COVERING TOPICS SUCH AS EXERCISE FOR SENIORS, HEALTHY CHOICES FOR EATING OUT, AND BREAST HEALTH. ST. LUKES PROVIDED A SIGNIFICANT AMOUNT OF FINANCIAL ASSISTANCE TO THE COMMUNITY DURING 2019 OF WHICH $656,800 REPRESENTED UNCOMPENSATED AMOUNTS FOR TREATMENT TO THOSE PATIENTS WHO DID NOT HAVE THE FINANCIAL RESOURCES TO PAY FOR HOSPITAL SERVICES. FINANCIAL ASSISTANCE REPRESENTS THE COST TO PROVIDE SERVICE AND DOES NOT INCLUDE THE COSTS FOR ACCOUNTS WRITTEN OFF TO BAD DEBT FOR PATIENTS WHO DID NOT PAY THEIR BILLS. ST. LUKES COST OF BAD DEBT FOR 2019 WAS $1,714,415. THIS AMOUNT IS NOT INCLUDED IN THE $18,976,072 NOTED ABOVE. FURTHER, ST. LUKES PROVIDED $11,478,409 OF COMMUNITY BENEFIT THROUGH COSTS NOT REIMBURSED BY THE GOVERNMENT FOR TREATING MEDICAID AND OTHER MEANS TESTED PATIENTS. ALSO, IN 2019, THE TOTAL COSTS NOT REIMBURSED BY THE GOVERNMENT FOR TREATING MEDICARE PATIENTS WAS $6,946,593 AND IS NOT INCLUDED IN THE COMMUNITY BENEFIT AMOUNT OF $18,976,072 NOTED ABOVE. DURING 2019, ST LUKES EXPENDED $47,669,087 IN NET PAYROLL, PROVIDING 1,425 JOBS IN NORTHWEST OHIO. A TOTAL OF $3,026,726 WAS WITHHELD FROM HOSPITAL EMPLOYEES IN STATE AND LOCAL TAXES. IN SUMMARY, ST. LUKES DEMONSTRATES ITS MISSION AND CORE VALUES BY PROVIDING HIGH-QUALITY HEALTH CARE TO ALL PATIENTS, REGARDLESS OF THEIR RACE, CREED, GENDER, NATIONAL ORIGIN, DISABILITY, OR AGE. AND WE RECOGNIZE THAT NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PURCHASE ESSENTIAL MEDICAL CARE. THEREFORE, WE PROVIDE THESE HEALTHCARE SERVICES, RECRUIT AND TRAIN HEALTHCARE PROFESSIONALS TO SERVE THE BROADER COMMUNITY; PROVIDE APPROPRIATE FINANCIAL ASSISTANCE; OFFER SERVICES AND CONTRIBUTIONS TO OTHER NONPROFIT ORGANIZATIONS THAT ALLOW THEM TO PROVIDE KEY SERVICES TO THEIR CONSTITUENTS; AND PRESENT FREE EDUCATIONAL CLASSES, HEALTH FAIRS AND OTHER ACTIVITIES TO OUR LOCAL COMMUNITY TO HELP ENSURE ALL MEMBERS HAVE EQUAL ACCESS TO CARE. COMMUNITY BENEFIT DEFINITIONS ST. LUKES PREPARES ITS COMMUNITY BENEFIT REPORTS USING REPORTING GUIDELINES PUBLISHED BY THE CATHOLIC HEALTH ASSOCIATION OF THE UNITED STATES AND CONSISTENT WITH FORM 990, SCHEDULE H, HOSPITALS, REPORTING. COMMUNITY BENEFITS ARE PROGRAMS AND ACTIVITIES THAT PROVIDE TREATMENT AND/OR PROMOTE HEALTH AND HEALING AS A RESPONSE TO IDENTIFIED COMMUNITY NEEDS. COMMUNITY BENEFITS REPORTED BY ST. LUKES RESPOND TO IDENTIFIED COMMUNITY NEEDS AND MEET AT LEAST ONE OF THE FOLLOWING CRITERIA: - IMPROVE ACCESS TO HEALTHCARE SERVICE - ENHANCE THE HEALTH OF THE COMMUNITY - ADVANCE HEALTHCARE KNOWLEDGE - RELIEVE OR REDUCE THE BURDEN OF GOVERNMENT OR OTHER COMMUNITY EFFORTS FINANCIAL ASSISTANCE CONSISTENT WITH ITS MISSION, ST. LUKES PROVIDES A SIGNIFICANT AMOUNT OF FINANCIAL ASSISTANCE TO PATIENTS WITH LIMITED OR NO ABILITY TO PAY THEIR BILL. ST. LUKES PROVIDES FREE CARE TO THOSE UNINSURED PATIENTS WITH INCOMES UP TO 200% OF THE FEDERAL POVERTY LEVEL. SIGNIFICANT DISCOUNTS ARE ALSO PROVIDED ON A SLIDING SCALE TO UNINSURED PATIENTS UP TO 400% OF THE POVERTY LEVEL. FINANCIAL ASSISTANCE IS REPORTED IN THE FORM OF COST TO PROVIDE SERVICES AND HAS BEEN REDUCED TO REFLECT REIMBURSEMENT RECEIVED FROM STATE PROGRAMS DESIGNED TO RELIEVE THE BURDEN OF PROVIDING FINANCIAL ASSISTANCE. THE COST OF FINANCIAL ASSISTANCE DOES NOT INCLUDE THE COSTS FOR ACCOUNTS THAT ARE WRITTEN OFF TO BAD DEBT FOR PATIENTS THAT DO NOT PAY THEIR BILL. GOVERNMENT SPONSORED HEALTH CARE GOVERNMENT-SPONSORED HEALTH CARE INCLUDE SERVICES THAT ARE REIMBURSED OR PARTIALLY REIMBURSED THROUGH FEDERAL, STATE AND LOCAL MEANS-TESTED PROGRAMS SUCH AS MEDICAID. ST. LUKES INCLUDES THE UNPAID COSTS OF THESE PUBLIC PROGRAMS TO THE EXTENT THAT PAYMENTS RECEIVED ARE LESS THAN THE COSTS OF PROVIDING SERVICES. THE UNPAID COSTS OF TREATING MEDICARE PATIENTS IS REPORTED SEPARATELY AND IS NOT INCLUDED IN ST. LUKES COMMUNITY BENEFIT REPORT. ADDITIONALLY, THE COST OF FINANCIAL ASSISTANCE HAS BEEN ELIMINATED FROM ANY ACCOUNTS REPORTED IN THIS CATEGORY. COMMUNITY HEALTH IMPROVEMENT SERVICES AND COMMUNITY BENEFIT OPERATIONS COMMUNITY HEALTH IMPROVEMENT SERVICES INCLUDES ACTIVITIES CARRIED OUT FOR THE EXPRESS PURPOSE OF IMPROVING COMMUNITY HEALTH. THESE ACTIVITIES DO NOT GENERATE INPATIENT OR OUTPATIENT BILLS AS THEY EXTEND BEYOND PATIENT CARE ACTIVITIES AND ARE SUBSIDIZED BY ST. LUKES. COMMUNITY BENEFIT OPERATIONS INCLUDE COSTS ASSOCIATED WITH DEDICATED STAFF, COMMUNITY HEALTH NEED AND/OR ASSESSMENT, AND OTHER COSTS ASSOCIATED WITH COMMUNITY BENEFIT PLANNING AND ADMINISTRATION. HEALTH PROFESSIONS EDUCATION HEALTH PROFESSIONS EDUCATION INCLUDE COSTS FOR ALL EDUCATIONAL PROGRAMS ST. LUKES IS INVOLVED WITH, THE PROVISION OF A CLINICAL SETTING FOR TRAINING FOR HEALTHCARE STUDENTS OUTSIDE THE ORGANIZATION, AND FUNDING FOR HEALTHCARE EDUCATION. SUBSIDIZED HEALTH SERVICES SUBSIDIZED HEALTH SERVICES ARE SERVICES PROVIDED TO THE COMMUNITY DESPITE A FINANCIAL LOSS. THESE SERVICES GENERATE A BILL FOR REIMBURSEMENT AND INCLUDE CLINICAL PATIENT CARE SERVICES THAT ARE PROVIDED BECAUSE THEY ARE NEEDED IN THE COMMUNITY AND OTHER PROVIDERS ARE UNWILLING, OR UNABLE, TO PROVIDE THE SERVICES, OR THE SERVICES OTHERWISE WOULD NOT BE AVAILABLE TO MEET COMMUNITY NEEDS. CASH AND IN-KIND CONTRIBUTIONS CASH AND IN-KIND CONTRIBUTIONS INCLUDE FUNDS AND IN-KIND SERVICES DONATED TO COMMUNITY ORGANIZATIONS AND THE COMMUNITY AT LARGE. IN-KIND SERVICES INCLUDE HOURS DONATED BY STAFF FOR COMMUNITY NEEDS WHILE ON WORK TIME; AS WELL AS DONATIONS OF FOOD, EQUIPMENT, AND SUPPLIES.
FORM 990, PART VI, SECTION A, LINE 1B	LALAINE E. MATTISON, MD., TIMOTHY J. MATTISON, MD., ADAM RETTIG, MD., AND DANIEL WAKEMAN ARE COMPENSATED BY THE ORGANIZATION OR A RELATED ENTITY AND THEREFORE ARE NON-INDEPENDENT TRUSTEES. FORM 990, PART VI, SECTION A, LINE 2 LALAINE E. MATTISON, MD AND TIMOTHY J. MATTISON, MD HAVE A FAMILY RELATIONSHIP. KEITH BURMEISTER AND KERRY BURMEISTER HAVE A FAMILY RELATIONSHIP. FORM 990, PART VI, SECTION A, LINE 6 ST. LUKE'S HOLDING COMPANY IS THE SOLE MEMBER OF ST. LUKE'S HOSPITAL.
FORM 990, PART VI, SECTION A, LINE 7A	ST. LUKE'S HOLDING COMPANY, INC. (SLHC) IS THE PARENT CORPORATION AND SOLE MEMBER OF ST. LUKE'S HOSPITAL. AS THE MEMBER, SLHC HAS THE RIGHT TO (A) NOMINATE AND ELECT A MINORITY OF THE MEMBERS AND REMOVE THE MEMBERS OF THE BOARD OF TRUSTEES OF ST. LUKE'S HOSPITAL AND (B) APPROVE THE NOMINEES TO FILL ANY VACANCIES ON THE BOARD OF TRUSTEES, A MAJORITY OF WHOM ARE NOMINATED BY ST. LUKE'S HOSPITAL.
FORM 990, PART VI, SECTION A, LINE 7B	WHILE THE BOARD OF TRUSTEES OF EACH CORPORATION IS GRANTED CERTAIN POWERS WITH RESPECT TO THEIR OPERATIONS, AS THE SOLE MEMBER, ST. LUKE'S HOLDING COMPANY, INC. (SLHC) RETAINS APPROVAL RIGHTS WITH RESPECT TO CERTAIN CORPORATE ACTIONS SUCH AS (1) ADOPTION OF THE CORPORATION'S STRATEGIC PLANS AND FINANCIAL PLANS, (2) EXPENDITURES FOR NON-BUDGETED ITEMS IN EXCESS OF CERTAIN DOLLAR LIMITS SET FROM TIME TO TIME BY SLHC, (3) EXPENDITURES FOR ITEMS WHICH ARE INCLUDED IN THE CORPORATION'S ANNUAL BUDGETS BUT WHICH EXCEED THE BUDGETED AMOUNT BY AN AMOUNT IN EXCESS OF CERTAIN DOLLAR LIMITS SET FROM TIME TO TIME BY SLHC, (4) INCURRENCE, ASSUMPTION OR GUARANTEE OF ANY INDEBTEDNESS, (5) SALE, LEASE OR OTHER DISPOSITION OF REAL PROPERTY OR ASSETS WITH A VALUE IN EXCESS OF CERTAIN DOLLAR LIMITS SET FROM TIME TO TIME BY SLHC AND (6) ANY MERGER, CONSOLIDATION, REORGANIZATION, DISSOLUTION OR LIQUIDATION.
FORM 990, PART VI, SECTION B, LINE 11B	UNDER THE GUIDANCE OF ST. LUKE'S HOLDING COMPANY, INC.'S (SLHC) TAX CONSULTANTS, FORM 990'S ARE PREPARED BY THE RESPECTIVE ACCOUNTING DEPARTMENT OF EACH SLHC SUBSIDIARY AND REVIEWED BY THE RESPECTIVE SUBSIDIARY'S FINANCE LEADERSHIP ALONG WITH AN INDEPENDENT ACCOUNTING FIRM. AFTER SUBSIDIARY'S FINANCE LEADERSHIP APPROVAL, COPIES OF THE FORM 990 FOR SLHC AND THEIR SUBSIDIARIES ARE PROVIDED TO THE RESPECTIVE COMPANY'S BOARD OF TRUSTEES AND REVIEWED AND SIGNED BY THE RESPECTIVE COMPANY'S PRESIDENT OR AUTHORIZED SIGNER PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C ST LUKES HOLDING COMPANY, INC. AND SUBSIDIARIES (SLHC) HAVE STANDARDS OF ETHICAL BUSINESS PRACTICE THAT APPLY TO ALL SLHC BOARD MEMBERS AND EMPLOYEES. BOARD MEMBERS AND EMPLOYEES ARE EXPECTED TO CERTIFY THEIR COMPLIANCE WITH THE APPLICABLE STANDARDS PRIOR TO ELECTION/APPOINTMENT OR PRIOR TO BEGINNING EMPLOYMENT. BOARD MEMBERS ANNUALLY (OR IMMEDIATELY IF NEW POTENTIAL CONFLICTS OF INTEREST ARISE), ALL BOARD MEMBERS ARE REQUIRED TO COMPLETE AND RETURN THE BOARD MEMBER CERTIFICATION STATEMENT WITHIN 30 DAYS OF DISSEMINATION. BOARD MEMBER CERTIFICATION STATEMENTS ARE COMPILED AND REVIEWED BY THE ST. LUKES ADMINISTRATION OFFICE. SUMMARIZED INFORMATION IS FORWARDED FOR REVIEW TO THE CHIEF FINANCIAL OFFICER, LEGAL COUNSEL, ST. LUKES PRESIDENT AND THE VICE PRESIDENT OF MEDICAL AFFAIRS. THE PURPOSE OF THIS REVIEW IS TO BOTH INFORM MANAGEMENT OF THE DISCLOSED CONFLICTS AND TO BRING ANY POTENTIAL UNDISCLOSED CONFLICTS TO THE ATTENTION OF THE ST. LUKES ADMINISTRATION OFFICE. THE ST. LUKES ADMINISTRATION OFFICE THEN CONDUCTS AN AUDIT OF ALL BOARD MEMBER CERTIFICATION STATEMENTS (ALONG WITH ANY RELATIONSHIPS NOTED THROUGH THE ABOVE REVIEW) TO IDENTIFY ANY POSITIONAL CONFLICTS OF INTEREST AND TO TEST MATERIAL TRANSACTIONS WITH BOARD MEMBERS/THEIR AFFILIATES FOR FAIR MARKET VALUE. SIGNIFICANT POTENTIAL CONFLICTS OF INTEREST ARE REVIEWED WITH GENERAL COUNSEL FOR RECOMMENDATIONS TO THE COMPLIANCE COMMITTEE FOR CORRECTIVE ACTION. THE ST. LUKES ADMINISTRATION OFFICE FORWARDS THE COMPLIANCE OFFICER A REPORT OF BOARD MEMBERS WHO HAVE SIGNED AND RETURNED THE ANNUAL BOARD MEMBER CERTIFICATION STATEMENT, SIGNIFICANT POTENTIAL CONFLICTS DISCLOSED AND THE RESOLUTION OF SUCH CONFLICTS. THE COMPLIANCE OFFICER ISSUES A REPORT TO THE COMPLIANCE COMMITTEE OF THESE FINDINGS. FAILURE TO FILE THE CERTIFICATION STATEMENT, OR THE FILING OF A FALSE OR INCOMPLETE CERTIFICATION STATEMENT, OR FAILURE TO DISCLOSE IMMEDIATELY ANY NEW CONFLICTS OF INTEREST THAT MAY ARISE, OR FAILURE TO COOPERATE WITHOUT CONDITION, HONESTLY AND COMPLETELY WITH ANY INVESTIGATION OR REVIEW OF THE BOARD MEMBERS CERTIFICATION STATEMENT OR HIS/HER ACTIONS OR CIRCUMSTANCES SHALL BE GROUNDS FOR SANCTION BY THE BOARD OF TRUSTEES UP TO AND INCLUDING REMOVAL FROM THE BOARD/COMMITTEE/COUNCIL. EMPLOYEES, EXCLUDING EMPLOYED PHYSICIANS ALL NEW EMPLOYEES, EXCLUDING EMPLOYED PHYSICIANS, ARE PROVIDED A PAPER COPY OF THE EMPLOYEE STANDARDS OF ETHICAL BUSINESS AND THE EMPLOYEE CERTIFICATION STATEMENT WHICH THE NEW EMPLOYEE IS REQUIRED TO COMPLETE PRIOR TO BEGINNING EMPLOYMENT. ANNUALLY (OR IMMEDIATELY IF NEW POTENTIAL CONFLICTS OF INTEREST ARISE), ALL SALARIED EMPLOYEES AND SPECIFICALLY IDENTIFIED HOURLY EMPLOYEES, EXCLUDING EMPLOYED PHYSICIANS, ARE REQUIRED TO COMPLETE AND SUBMIT AN ELECTRONIC EMPLOYEE CERTIFICATION STATEMENT BY AN ESTABLISHED DEADLINE THAT IS COMMUNICATED TO THE EMPLOYEE. THE HUMAN RESOURCES DEPARTMENT ENSURES THAT ALL STATEMENTS, WHICH ARE STORED ELECTRONICALLY, ARE COMPLETED AND PROVIDES NOTIFICATION TO THE COMPLIANCE OFFICER OF THE NUMBER OF ANNUAL EMPLOYEE CERTIFICATION STATEMENTS SENT AND COMPLETED AND COPIES OF ANY STATEMENTS CONTAINING DISCLOSURES THAT WARRANT FURTHER REVIEW. THE HUMAN RESOURCE ADMINISRATIVE DIRECTOR REPORTS IDENTIFIED CONFLICTS TO THE COMPLIANCE COMMITTEE. IF THE CONFLICT IS CONSIDERED A SIGNIFICANT EXPOSURE RISK FOR SLHC, A RECOMMENDATION WILL BE PREPARED BY THE COMPLIANCE COMMITTEE FOR FINAL APPROVAL BY THE ST. LUKES PRESIDENT. FAILURE TO COMPLETE THE CERTIFICATION STATEMENT, OR THE COMPLETION OF A FALSE OR INCOMPLETE CERTIFICATION STATEMENT, OR FAILURE TO DISCLOSE IMMEDIATELY ANY NEW CONFLICTS OF INTEREST THAT MAY ARISE, OR FAILURE TO COOPERATE WITHOUT CONDITION, HONESTLY AND COMPLETELY WITH ANY INVESTIGATION OR REVIEW OF THE EMPLOYEES CERTIFICATION STATEMENT OR HIS/HER ACTIONS OR CIRCUMSTANCES SHALL BE GROUNDS FOR SANCTION UP TO AND INCLUDING TERMINATION OF EMPLOYMENT. EMPLOYED PHYSICIANS ALL NEW EMPLOYED PHYSICIANS ARE PROVIDED EITHER AN ELECTRONIC OR PAPER COPY OF THE EMPLOYED PHYSICIAN STANDARD OF CONDUCT AND THE PHYSICIAN CERTIFICATION STATEMENT WHICH THE NEW PHYSICIAN IS REQUIRED TO COMPLETE PRIOR TO BEGINNING EMPLOYMENT. ANNUALLY (OR IMMEDIATELY IF NEW POTENTIAL CONFLICTS OF INTEREST ARISE), ALL EMPLOYED PHYSICIANS ARE REQUIRED TO COMPLETE AND SUBMIT AN ELECTRONIC PHYSICIAN CERTIFICATION STATEMENT BY THE ESTABLISHED AND COMMUNICATED DEADLINE. THE HUMAN RESOURCE ADMINISTRATIVE DIRECTOR ENSURES THAT ALL CERTIFICATION STATEMENTS, WHICH ARE STORED ELECTRONICALLY, ARE REVIEWED. IDENTIFIED CONFLICTS ARE REPORTED TO THE COMPLIANCE COMMITTEE. IF THE CONFLICT IS CONSIDERED A SIGNIFICANT EXPOSURE RISK FOR SLHC, A RECOMMENDATION WILL BE PREPARED BY THE COMPLIANCE COMMITTEE FOR FINAL APPROVAL BY THE ADMINISTRATOR WITH PRIMARY RESPONSIBILITY FOR THE PHYSICIANS EMPLOYMENT AGREEMENT AND/OR THE BOARD OF TRUSTEES. THE HUMAN RESOURCES DEPARTMENT FORWARDS THE COMPLIANCE OFFICER A REPORT OF THE NUMBER OF ANNUAL PHYSICIAN CERTIFICATION STATEMENTS SENT AND COMPLETED AND COPIES OF ANY STATEMENTS CONTAINING DISCLOSURES THAT WARRANT FURTHER REVIEW. THE COMPLIANCE OFFICER ISSUES AN ANNUAL REPORT TO THE COMPLIANCE COMMITTEE OF THESE FINDINGS. ANY ITEMS THAT MEET CRITERIA FOR PUBLIC DISCLOSURE WILL BE COMMUNICATED TO THE APPROPRIATE PHYSICIAN BY THE ASSIGNED ADMINISTRATOR. THE ADMINISTATOR WILL PROVIDE THE PHYSICIAN-INDUSTRY RELATIONSHIP DISCLOSURES TO THE APPLICABLE SLHC MARKETING COMMUNICATIONS REPRESENTATIVE. THE PUBLIC DISCLOSURE WILL BE POSTED ON THE ST. LUKES HOSPITAL WEBSITE (STLUKESHOSPITAL.COM) BY THE SLHC MARKETING COMMUNICATIONS REPRESENTATIVE. FAILURE TO FILE THE CERTIFICATION STATEMENT, OR THE FILING OF A FALSE OR INCOMPLETE CERTIFICATION STATEMENT, OR FAILURE TO DISCLOSE IMMEDIATELY ANY NEW CONFLICTS OF INTEREST THAT MAY ARISE, OR FAILURE TO COOPERATE WITHOUT CONDITION, HONESTLY AND COMPLETELY WITH ANY INVESTIGATION OR REVIEW OF THE PHYSICIANS CERTIFICATION STATEMENT OR HIS/HER ACTIONS OR CIRCUMSTANCES SHALL BE GROUNDS FOR SANCTION BY THE VICE PRESIDENT OF MEDICAL AFFAIRS OR BOARD OF TRUSTEES UP TO AND INCLUDING TERMINATION OF THE PHYSICIANS ASSOCIATION/CONTRACT WITH SLHC.
FORM 990, PART VI, SECTION B, LINE 15A & 15B	EACH YEAR INDEPENDENT CONSULTANTS CONDUCT AN ANNUAL SURVEY AND RECOMMEND EXECUTIVE PAYROLL BASE SALARY RANGES BASED UPON THE MARKET. THE DATA IS REVIEWED AND APPROVED BY THE ST. LUKE'S HOSPITAL EXECUTIVE COMMITTEE OF THE BOARD EVERY NOVEMBER. SALARY ADJUSTMENTS ARE DETERMINED AT THE NOVEMBER MEETING OF THE EXECUTIVE COMMITTEE OF THE BOARD. THE EXECUTIVE COMMITTEE OF THE BOARD APPROVES OTHER FORMS OF COMPENSATION BASED UPON THE PRIOR YEAR PERFORMANCE AT THE FEBRUARY MEETING EACH YEAR.
FORM 990, PART VI, SECTION B, LINE 16A & 16B	JOINT VENTURE OPERATING AGREEMENTS INVOLVING ST. LUKES HOLDING COMPANY, INC. (SLHC) OR ITS SUBSIDIARIES INCLUDE PROVISIONS TO PROTECT SLHCS TAX EXEMPT STATUS. EACH AGREEMENT CONTAINS SPECIFIC LANGUAGE RELATED TO THE PROVISION OF HEALTH CARE SERVICES WITH FOCUS ON COMMUNITY HEALTH BENEFIT AND MUST FOLLOW A FORMAL REVIEW PROCESS PRIOR TO CONTRACT EXECUTION. SLHC CONTINUALLY ENSURES THAT ITS TAX-EXEMPT STATUS IS PROTECTED BY ACTIVELY PARTICIPATING IN THE GOVERNANCE OF ALL SLHC JOINT VENTURES.
FORM 990, PART VI, SECTION C, LINE 19	ST. LUKE'S HOLDING COMPANY, INC. AND SUBSIDIARIES PROVIDE ANY DOCUMENT OPEN TO PUBLIC INSPECTION UPON REQUEST.
FORM 990, PART IX, LINE 11G	GENERAL $ 3,543,147 CONTR NPHYS 771,335 CONTR PHYS 9,317,745 BILLING SERVICES 3,332,584 CONSULTANTS 1,307,324 LITHOTRIPTOR 178,768 SERVICE CONTRACTS 5,174,663 LAUNDRY 531,088 FOOD SVC MGT 531,150 TEMP AGENCY 1,540,888 REFERRED TESTING 2,805,904 OTHER 142,212
FORM 990, PART XI, LINE 9	PENSION/POST-RETIREMENT EXPENSE ADJUSTMENT $(4,608,879) BENEFICIAL INTEREST IN FOUNDATION 3,149,511 TOTAL (1,459,368)

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2019

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: ST. LUKE'S HOSPITAL IS COMMITTED TO PROVIDING QUALITY, COST-EFFECTIVE HEALTHCARE SERVICES THROUGH THE USE OF ADVANCED SERVICES WHILE FOSTERING WELLNESS.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	16
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	12
5	Total number of individuals employed in calendar year 2019 (Part V, line 2a) ......	5	1,756
6	Total number of volunteers (estimate if necessary) .............	6	208
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	0
b	Net unrelated business taxable income from Form 990-T, line 39 .........	7b

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	5,517,799	582,703
9	Program service revenue (Part VIII, line 2g) .........	170,648,008	187,578,166
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	2,270,451	3,597,417
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	1,322,441	2,543,407
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	179,758,699	194,301,693
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	9,140,691	10,898,699
14	Benefits paid to or for members (Part IX, column (A), line 4).....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	86,010,243	91,130,880
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	111,559,772	118,276,056
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	206,710,706	220,305,635
19	Revenue less expenses. Subtract line 18 from line 12.......	-26,952,007	-26,003,942
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	250,481,476	235,122,404
21	Total liabilities (Part X, line 26).............	170,418,940	179,315,110
22	Net assets or fund balances. Subtract line 21 from line 20.....	80,062,536	55,807,294

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 171,191,493 including grants of $ 10,898,699 ) (Revenue $ 187,696,991 )
	ST. LUKE'S HOSPITAL IS AN ACUTE CARE FACILITY PROVIDING INPATIENT AND OUTPATIENT HEALTH CARE SERVICES TO THE GENERAL PUBLIC. SEE SCHEDULE O.

4b	(Code: ) (Expenses $ 14,261,589 including grants of $ ) (Revenue $ )
	CONSISTENT WITH OUR MISSION, ST. LUKE'S HOSPITAL PROVIDES A SIGNIFICANT AMOUNT OF FINANCIAL ASSISTANCE TO PATIENTS WITH LIMITED OR NO ABILITY TO PAY. SEE SCHEDULE O.

4c	(Code: ) (Expenses $ 5,146,901 including grants of $ ) (Revenue $ 432,418 )
	CONSISTENT WITH OUR MISSION, ST. LUKE'S HOSPITAL PROVIDES A SIGNIFICANT AMOUNT OF COMMUNITY BENEFIT INCLUDING COMMUNITY HEALTH IMPROVEMENT SERVICES, SUBSIDIZED HEALTH SERVICES, HEALTH PROFESSIONS EDUCATION, AND CASH AND IN-KIND CONTRIBUTIONS. SEE SCHEDULE O.

4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses190,599,983

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	3,022,363	280,787	857,839

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d	582,703
e	Government grants (contributions)		1e

f	All other contributions, gifts, grants, and similar amounts not included above		1f	0

g	Noncash contributions included in lines 1a - 1f:$		1g	0

h Total. Add lines 1a-1f.......		582,703

		Business Code
2a	NET PATIENT SERVICES	622110	187,578,166	187,578,166
b
c
d
e
f	All other program service revenue.
g	Total. Add lines 2a–2f .....		187,578,166

3 Investment income (including dividends, interest, and othersimilar amounts) ......			1,945,518			1,945,518
4 Income from investment of tax-exempt bond proceeds			0
5 Royalties...........			0
		(ii) Personal	(i) Real
6a	Gross rents		26,823	6a
b	Less: rental expenses			6b
c	Rental income or (loss)	0	26,823	6c
d	Net rental income or (loss).......			26,823			26,823
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory	89,200	24,718,708	7a
b	Less: cost or other basis and sales expenses	48,182	23,107,827	7b
c	Gain or (loss)	41,018	1,610,881	7c
d	Net gain or (loss).........			1,651,899			1,651,899
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
			8a	0
b	Less: direct expenses ...		8b	0
c	Net income or (loss) from fundraising events..			0
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a	0
b	Less: direct expenses ...		9b	0
c	Net income or (loss) from gaming activities..			0
10a	Gross sales of inventory, less returns and allowances ..
			10a	0
b	Less: cost of goods sold ..		10b	0
c	Net income or (loss) from sales of inventory..			0
Business Code			Miscellaneous Revenue
11a	GAIN ON SETTLEMENT		900099	1,218,467			1,218,467
b	CAFETERIA		722514	746,874			746,874
c	MED STAFF/AUXILIARY/GIFT SHOP		900099	414,220	414,220
d	All other revenue ....			137,023	137,023
e	Total. Add lines 11a–11d ......			2,516,584
12	Total revenue. See instructions.....			194,301,693	188,129,409		5,589,581

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	10,867,591	10,867,591
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........	31,108	31,108
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............	0
4	Benefits paid to or for members .......	0
5	Compensation of current officers, directors, trustees, and key employees ...........	2,914,804	60,000	2,854,804
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........	0
7	Other salaries and wages........	70,621,847	60,000,424	10,621,423
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	2,524,071	2,144,451	379,620
9	Other employee benefits .......	9,861,641	8,378,450	1,483,191
10	Payroll taxes ...........	5,208,517	4,501,448	707,069
11	Fees for services (non-employees):
a	Management ......	0
b	Legal .........	477,954		477,954
c	Accounting ...........	85,040		85,040
d	Lobbying ...........	3,332		3,332
e	Professional fundraising services. See Part IV, line 17	0
f	Investment management fees ......	176,835		176,835
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	29,176,808	21,301,844	7,874,964
12	Advertising and promotion ....	952,197	617,986	334,211
13	Office expenses .......	1,975,320	1,580,219	395,101
14	Information technology ......	8,041,256	7,237,130	804,126
15	Royalties ..	0
16	Occupancy ...........	3,770,874	3,457,515	313,359
17	Travel ............	177,407	113,346	64,061
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .	0
19	Conferences, conventions, and meetings ....	0
20	Interest ...........	2,356,703	2,120,978	235,725
21	Payments to affiliates .......	0
22	Depreciation, depletion, and amortization ..	17,086,228	15,377,605	1,708,623
23	Insurance ...	503,512	503,512
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	MEDICAL SUPPLIES	36,316,451	36,316,451
b	DRUGS	8,646,069	8,646,069
c	LICENSES & FEES	3,568,227	3,381,107	187,120
d	EQUIPMENT RENTAL	2,066,685	1,885,573	181,112
e	All other expenses	2,895,158	2,077,176	817,982
25	Total functional expenses. Add lines 1 through 24e	220,305,635	190,599,983	29,705,652	0
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			3,753,764	1	4,150,984
2	Savings and temporary cash investments .........			0	2	0
3	Pledges and grants receivable, net ......			0	3	0
4	Accounts receivable, net .............			31,655,573	4	29,326,788
5	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
				0	5	0
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
				0	6	0
7	Notes and loans receivable, net ...........			0	7	0
8	Inventories for sale or use ............			1,469,181	8	1,390,865
9	Prepaid expenses and deferred charges ......			4,643,964	9	2,594,424
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	167,544,781
b	Less: accumulated depreciation	10b	49,145,768	130,877,269	10c	118,399,013
11	Investments—publicly traded securities .			36,564,014	11	30,978,183
12	Investments—other securities. See Part IV, line 11 .....			595,461	12	508,137
13	Investments—program-related. See Part IV, line 11 ..			0	13	0
14	Intangible assets ...............			0	14	1,163,010
15	Other assets. See Part IV, line 11 ...........			40,922,250	15	46,611,000
16	Total assets. Add lines 1 through 15 (must equal line 33)...			250,481,476	16	235,122,404

17	Accounts payable and accrued expenses .....	43,084,113	17	43,432,817
18	Grants payable ...	0	18	0
19	Deferred revenue .........	0	19	0
20	Tax-exempt bond liabilities .........	0	20	0
21	Escrow or custodial account liability. Complete Part IV of Schedule D	0	21	0
22	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
		0	22	0
23	Secured mortgages and notes payable to unrelated third parties ..	64,419,307	23	64,293,050
24	Unsecured notes and loans payable to unrelated third parties ..	0	24	0
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D	62,915,520	25	71,589,243
26	Total liabilities. Add lines 17 through 25..	170,418,940	26	179,315,110

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	59,720,932	27	32,316,179
28	Net assets with donor restrictions ...........	20,341,604	28	23,491,115
	Organizations that do not follow FASB ASC 958, check here and complete lines 29 through 33.
29	Capital stock or trust principal, or current funds .....		29
30	Paid-in or capital surplus, or land, building or equipment fund ...		30
31	Retained earnings, endowment, accumulated income, or other funds		31
32	Total net assets or fund balances ...........	80,062,536	32	55,807,294
33	Total liabilities and net assets/fund balances ........	250,481,476	33	235,122,404

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(f) Direct controlling entity
(1) COBRA VENTURES LLC 5901 MONCLOVA RD MAUMEE,OH43537 20-4671613	LAND LEASING	OH	ST LUKE HF
(2) WELLCARE PHYSICIANS GROUP LLC 5901 MONCLOVA RD MAUMEE,OH43537 61-1528443	EMPLOYS PHYS	OH	ST LUKE HC

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1)CARE ENTERPRISES INC 5901 MONCLOVA RD MAUMEE,OH43537 34-1366709	FAC LEASING	OH	501(C)(3)	12B	ST LUKE HC		No
(2)ST LUKE'S HOSPITAL FOUNDATION 5901 MONCLOVA RD MAUMEE,OH43537 34-1292849	FOUNDATION	OH	501(C)(3)	12B	ST LUKE HC		No
(3)ST LUKE'S HOLDING COMPANY INC 5901 MONCLOVA RD MAUMEE,OH43537 81-2599592	PARENT CO	OH	501(C)(3)	12B	NA		No

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Predominant income(related, unrelated, excluded from tax under sections 512-514)	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity		(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No
(1) WATERVILLE MEDICAL CENTER LLC 5901 MONCLOVA RD MAUMEE,OH43537 32-0160784	FAC LEASING	OH	CARE ENT INC	N/A
(2) ST LUKE'S HOSPITAL PAIN MANAGEMENT LLC 5901 MONCLOVA RD MAUMEE,OH43537 83-3639701	PAIN MANAGEMENT	OH	ST LUKES HOSP	RELATED	342,132	597,334		No			No	51.000 %

(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(e) Are all partners section 501(c)(3) organizations?		(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No