Civic Intelligence

St Luke'S Hospital

990 • Fiscal year 2013 • EIN 34-4428232

Jan 01, 2013 to Dec 31, 2013 • Filed on Nov 13, 2014

5901 Monclova Road43537

(419) 893-5911

Siviq Scores

Precomputed percentiles for this filing year versus similar nonprofits in the same peer cohort.

Liabilities / Assets

44th percentile

0.28x

Higher debt load relative to assets than 44% of similar nonprofits.

2013 filings • 501(c)3 • $100M-$250M nonprofits • Source year 2013

Liabilities / Revenue

39th percentile

0.38x

Higher debt load relative to revenue than 39% of similar nonprofits.

2013 filings • 501(c)3 • $100M-$250M nonprofits • Source year 2013

Net Margin

35th percentile

0.8%

Higher net margin than 35% of similar nonprofits.

2013 filings • 501(c)3 • $100M-$250M nonprofits • Source year 2013

Top Officer Pay

69th percentile

$804,935

Higher top officer pay than 69% of similar nonprofits.

Top officer pay equals 0.5% of source-year revenue.

2013 filings • 501(c)3 • $100M-$250M nonprofits • Source year 2013

Asset Growth

54th percentile

6.4%

Faster asset growth than 54% of similar nonprofits.

2013 filings • 501(c)3 • $100M-$250M nonprofits • Annualized from 2012 to 2013

Revenue Growth

Score unavailable

No value available

No earlier valid filing was available within the previous three public years.

Source year 2013

Assets

Up

$229,104,194

Up $13,881,281 (+6.4%) from 2012

Net Assets

Up

$164,205,573

Up $40,135,326 (+32%) from 2012

Liabilities

Down

$64,898,621

Down $26,254,045 (-29%) from 2012

Revenue

$172,521,637

No earlier filing loaded for comparison.

Expenses

Up

$171,094,686

Up $4,911,081 (+3.0%) from 2012

Net Income

$1,426,951

No earlier filing loaded for comparison.

Historical Trend

Balance Sheet Trend

The highlighted filing sits inside the broader history for assets, liabilities, and net assets.

$300M$200M$100M$0Assets 2010: $193,605,170Liabilities 2010: $68,409,979Net Assets 2010: $125,195,1912010Assets 2011: $200,475,684Liabilities 2011: $88,736,420Net Assets 2011: $111,739,2642011Assets 2012: $215,222,913Liabilities 2012: $91,152,666Net Assets 2012: $124,070,2472012Assets 2013: $229,104,194Liabilities 2013: $64,898,621Net Assets 2013: $164,205,5732013Assets 2014: $229,716,100Liabilities 2014: $99,689,744Net Assets 2014: $130,026,3562014Assets 2015: $236,749,746Liabilities 2015: $115,509,267Net Assets 2015: $121,240,4792015Assets 2016: $252,524,429Liabilities 2016: $119,803,862Net Assets 2016: $132,720,5672016Assets 2017: $279,470,426Liabilities 2017: $157,958,127Net Assets 2017: $121,512,2992017Assets 2018: $250,481,476Liabilities 2018: $170,418,940Net Assets 2018: $80,062,5362018Assets 2019: $235,122,404Liabilities 2019: $179,315,110Net Assets 2019: $55,807,2942019Assets 2021: $213,857,056Liabilities 2021: $164,961,487Net Assets 2021: $48,895,5692021Assets 2022: $199,430,419Liabilities 2022: $187,888,238Net Assets 2022: $11,542,1812022

Highlighted filing

2013

Assets$229,104,194
Liabilities$64,898,621
Net Assets$164,205,573

Operations Trend

Revenue, expenses, and net income across loaded years, with this filing highlighted.

$300M$200M$100M$0-$100MExpenses 2010: $165,493,9262010Expenses 2011: $175,229,1832011Expenses 2012: $166,183,6052012Revenue 2013: $172,521,637Expenses 2013: $171,094,686Net Income 2013: $1,426,9512013Revenue 2014: $181,089,973Expenses 2014: $162,052,300Net Income 2014: $19,037,6732014Revenue 2015: $194,600,256Expenses 2015: $174,214,221Net Income 2015: $20,386,0352015Revenue 2016: $188,863,678Expenses 2016: $179,979,537Net Income 2016: $8,884,1412016Revenue 2017: $177,439,386Expenses 2017: $188,993,239Net Income 2017: -$11,553,8532017Revenue 2018: $179,758,699Expenses 2018: $206,710,706Net Income 2018: -$26,952,0072018Revenue 2019: $194,301,693Expenses 2019: $220,305,635Net Income 2019: -$26,003,9422019Revenue 2021: $231,520,498Expenses 2021: $219,249,667Net Income 2021: $12,270,8312021Revenue 2022: $171,843,780Expenses 2022: $211,627,425Net Income 2022: -$39,783,6452022

Highlighted filing

2013

Revenue$172,521,637
Expenses$171,094,686
Net Income$1,426,951
Jump To
Filing Snapshot
Filing Period
Jan 1, 2013 to Dec 31, 2013
Signed
Nov 13, 2014
Return Version
2013v3.0
Gross Receipts
$202,013,719
Mission and Program Overview

Mission

St. Luke's hospital, together with its medical staff, is committed to providing quality, cost-effective healthcare services in an atmosphere of care and compassion, through the use of technologically advanced medical and surgical services, while fostering the wellness of those it serves.

Balance Sheet Detail
LineBeginningEndChange
Assets
Land, Buildings, and Equipment, Net$95,572,265$95,172,846▼ $399,419
Investments in Publicly Traded Securities$60,867,382$71,730,035▲ $10,862,653
Accounts Receivable$21,303,961$23,547,170▲ $2,243,209
Other Notes and Loans Receivable, Net$3,361,982$3,321,328▼ $40,654
Cash and Non-Interest-Bearing Accounts$3,568,820$3,096,089▼ $472,731
Investments Other Securities$2,867,406$2,888,573▲ $21,167
Inventories for Sale or Use$1,649,240$1,919,357▲ $270,117
Prepaid Expenses and Deferred Charges$603,974$388,463▼ $215,511
Intangible Assets$104,590$104,590→ $0
Total Assets$215,222,913$229,104,194▲ $13,881,281
Other Assets Total$25,323,293$26,935,743▲ $1,612,450
Liabilities
Other Liabilities$75,727,399$51,357,570▼ $24,369,829
Accounts Payable and Accrued Expenses$15,425,267$13,541,051▼ $1,884,216
Total Liabilities$91,152,666$64,898,621▼ $26,254,045
Net Assets / Fund Balance
Unrestricted Net Assets$106,510,106$143,946,117▲ $37,436,011
Temporarily Rstr Net Assets$17,560,141$20,259,456▲ $2,699,315
Permanently Rstr Net Assets-$0-
Total Net Assets Fund Balance$124,070,247$164,205,573▲ $40,135,326
Total Liabilities and Net Assets / Fund Balance$215,222,913$229,104,194▲ $13,881,281

Asset Categories

AssetBook ValueDepreciationBasis
Buildings$60,745,459$9,919,022$70,664,481
Equipment$18,537,873$15,636,239$34,174,112
Other Land Buildings$10,059,693$1,481,760$11,541,453
Land$5,363,660-$4,368,660
Leasehold Improvements$466,161$59,838$525,999
Other Assets Org$20,252,008--
Compensation and Service Providers

Employees

NameTitleFull / Part TimeBaseOtherTotal
David ChenPharmacy ManagerFT$119,267$21,081$140,348
Khaled El-sayedCardio Surgical Assistant IiFT$115,741$24,154$139,895
Jennifer GrabarczykChief Clinical PharmacistFT$117,165$14,115$131,280
Jeffery SteerCardio Surgical Assistant IiFT$114,322$15,708$130,030
Kelly McgrainStaff PharmacistFT$114,131$7,450$121,581
Rajendra R Kattar MdDirector-$15,000$763,502$15,000
Robert C Friess DoDirector-$7,500-$7,500
Lalaine E Mattison MdDirector-$720-$720

Board Members and Trustees

Highest Paid Contractors

ContractorServicesLocationCompensation
Southwest Anesthesia ServAnesthesia Services-$2,669,656
University Of ToledoPhysician Services-$2,295,489
Spieker CoGeneral Construction-$2,272,772
Ohio Hospital AssociationTemporary Agency Staffing-$1,389,989
University Of Toledo PhysiciansPhysician Services-$1,137,147
Revenue and Support

Revenue Composition

Contributions and Grants
$10,412,864
Program Service Revenue
$155,377,352
Investment Income
$2,245,477
Other Revenue
$4,485,944
All Other Contributions
$35,304
Change in Net Assets
$1,426,951
Expenses and Functional Allocation

Major Expense Lines

Line ItemAmount
Salaries, Compensation, and Employee Benefits$86,789,225
Other Expenses$82,978,468
Grants and Similar Amounts Paid$1,326,993
Professional Fundraising Fees$0
Total Fundraising Expense$0

Functional Expense Allocation

Line ItemProgramManagementFundraisingTotal
Other Salaries and Wages$58,847,407$12,503,117-$71,350,524
Fees for Services Other$17,355,756$1,837,898-$19,193,654
Depreciation Depletion$8,057,765$895,307-$8,953,072
Other Employee Benefits$6,867,427$1,507,484-$8,374,911
All Other Expenses$4,878,509$272,689-$5,151,198
Payroll Taxes$4,035,692$884,942-$4,920,634
Occupancy$3,206,471$356,275-$3,562,746
Other Expenses$2,216,647$7,216-$2,216,647
Information Technology$1,971,613$219,068-$2,190,681
Pension Plan Contributions$1,738,348$381,588-$2,119,936
Office Expenses$1,057,911$457,352-$1,515,263
Insurance$1,197,327$133,036-$1,330,363
Grants to Domestic Orgs$1,282,746--$1,282,746
Advertising$377,508$203,274-$580,782
Fees for Services Legal-$415,323-$415,323
Fees for Service Investment Mgmnt Fees-$223,664-$223,664
Travel$50,108$168,680-$218,788
Fees for Services Accounting-$138,083-$138,083
Interest$80,407$8,934-$89,341
Grants to Domestic Individuals$44,247--$44,247
Current Officers, Directors, Trustees, and Key Employees$720$22,500-$23,220
Fees for Services Lobbying-$8,342-$8,342
Total Functional Expenses$150,449,914$20,644,772$0$171,094,686
International Activity

Grant and Assistance Recipients

RecipientLocationCategoryPurposeAmount
34-1899439-501(c)(3)Operating Support$1,000,000
34-1292849-501(c)(3)Operating Support$278,806
Fundraising, Events, and Gaming
Fundraising activities
No
Gaming activities
No
Professional fundraiser used
No

Fundraising and Gaming Totals

Line ItemAmount
Professional Fundraising Fees$0
Political and Lobbying Activity
Political campaign activity
No
Lobbying activity
Yes
Subject to proxy tax
No
Insider Transactions and Loans

Interested-Person Transactions

Interested PartyRelationshipDescriptionShared RevenueAmount
-See Part VSee Part VNo$2,669,656
-See Part VSee Part VNo$110,875
Debt and Bond Financing

Other Reported Liabilities

LiabilityAmount
Pension Liability$22,803,129
Estimated Third Party Settlements Payable$15,834,958
Due to Affiliates$10,333,891
Intercompany Debt to the Toledo Hospital$1,817,334
Malpractice Tail Liability$464,709
Asbestos Remediation$103,549
Governance and Compliance

Governance Checklist

Compiled or reviewed by an accountant
No
Annual disclosure for covered persons
Yes
Audit committee
Yes
Backup withholding compliance
Yes
Business relationship with family members
No
Business relationship with organization members
No
Material changes to governing documents
No
Compensation from other sources disclosed
No
CEO compensation reviewed
No
Other officer compensation reviewed
No
Conflict-of-interest policy
Yes
Audited financial statements prepared
Yes
Key decisions subject to board approval
Yes
Management duties delegated
No

Governance Explanations

Form 990, Part VI, Section A, Line 6

As an ohio non-profit organization, this corporation has a corporate member.

Form 990, Part VI, Section A, Line 7A

Promedica health system, inc. (phs) is the parent corporation and sole member of st. Luke's hospital or is the sole member of the sole member of st. Luke's hospital. As the member, phs 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 business unit is granted certain powers with respect to such business unit's operations, as the member, promedica health system, inc. Retains approval rights with respect to certain corporate actions such as (i) adoption of the business unit's strategic plans and financial plans, (ii) expenditures for non-budgeted items in excess of certain dollar limits set from time to time by the member, (iii) expenditures for items which are included in the business unit's annual budgets but which exceed the budgeted amount by an amount in excess of certain dollar limits set from time to time by the member, (iv) incurrence, assumption or guarantee of any indebtedness, (v) 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 the member and (vi) any merger, consolidation, reorganization, dissolution or liquidation.

Form 990, Part VI, Section B, Line 11

Under the guidance of promedica health system, inc.'s (phs) tax consultants, form 990s are prepared by the respective accounting department of each affiliate and reviewed by the affiliate's finance leadership. After affiliate's finance leadership approval, copies of the form 990 for phs and their subsidiaries are provided to the respective company's board of trustees and are reviewed and signed by the respective company's president prior to filing with the internal revenue service.

Form 990, Part VI, Section B, Line 12C

Promedica health system, inc. And affiliates (phs) have standards of conduct that apply to all phs 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 v.p., audit & compliance/chief compliance officer (cco). Summarized information is forwarded for review to the chief financial officer, general counsel, business unit presidents and the president and chief executive officer (president/ceo), based upon their respective knowledge of the board members. The purpose of this review is to both inform management of the disclosed conflicts and to allow them to identify to the v.p., audit & compliance, any potential undisclosed conflicts. The audit & compliance department 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. The results of the audit are reported directly to the chair of the audit & compliance committee with a copy to the president/ceo. The report includes a summary of the audit procedures performed, any significant concerns identified and their resolution. Any unresolved conflicts are addressed by the audit committee with recommendations to the full board as needed. 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 member's 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 annually (or immediately if new conflicts of interest arise), all salaried employees are required to complete and submit an electronic employee certification questionnaire within 30 days of notification. The human resources department ensures that all questionnaires, which are stored electronically, are completed and provides notification to the v.p., audit & compliance of the number of annual employee certification questionnaires sent and received, copies of any questionnaires containing disclosures that warrant further review by the audit & compliance department, and a list of all new employees hired during the previous 12 months. Identified conflicts are initially reviewed by the v.p., audit & compliance and if necessary discussed with the business unit president in which the employee works, and general counsel. If the conflict is considered a significant exposure risk for phs, a recommendation will be prepared for final approval of the phs president/ceo. Results of the employee process audit are included in the above report to the chair of the audit & compliance committee. Failure to complete the certification questionnaire, or the completion of a false or incomplete certification questionnaire, 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 employee's certification questionnaire or his/her actions or circumstances shall be grounds for sanction up to and including termination of employment.

Form 990, Part VI, Section B, Line 15

St. Luke's hospital's top management official and other officers are compensated by promedica health system, inc. (phs), a related tax-exempt organization. Compensation determinations of st. Luke's hospital's top management official and other officers are made by a compensation committee of phs. 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 promedica health system compensation committee every october. Salary adjustments are determined at the december meeting of the compensation committee. The compensation committee approves other forms of compensation based upon the prior year performance at the january meeting each year.

Form 990, Part VI, Section C, Line 19

Promedica health system, inc. And subsidiaries provide any document open to public inspection upon request.

FORM 990, PART VI, SECTION B, LINE 16B:

Joint venture operating agreements involving promedica health system, inc. And subsidiaries (phs) include provisions to protect phs's 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. Phs continually ensures that its tax exempt status is protected by actively participating in the governance of all phs joint ventures.

Filing and Contact Details

Filer

EIN
34-4428232
Phone
4198935911

Signing Officer

Name
Daniel L Wakeman
Title
President
Phone
4198935911
Signed
2014-11-13
Discuss with paid preparer
Yes

Organization Details

Principal Officer
Daniel L Wakeman
Formed
1906
Legal Domicile
Oh
Voting Board Members
26
Independent Board Members
18
Employees
1,585
Volunteers
309

Preparer

Preparer
Samantha Bokori
Phone
3174648600
Supplemental Narrative

Additional Explanations

Form 990, Part IX, Line 11G

Physician services: program service expenses 8,433,020. Management and general expenses 166,268. Fundraising expenses 0. Total expenses 8,599,288. General purchased services: program service expenses 8,922,736. Management and general expenses 1,671,630. Fundraising expenses 0. Total expenses 10,594,366.

FORM 990, PART XI, LINE 9:

Pension/post-retirement expense adjustment 28,984,896. Beneficial interest in foundation 2,699,023.

FORM 990, PART IV, LINE 24A:

St. Luke's hospital is a health facility that is a subsidiary of promedica health system, inc. (phs). St. Luke's hospital holds an intercompany note payable to the toledo hospital, which is also a subsidiary of phs. The note payable represents st. Luke's hospital's portion of tax-exempt bonds issued by promedica healthcare obligated group.

FORM 990, PART III, LINE 4:

Promedica health system, inc. - program service accomplishments established in 1986, promedica health system, inc. (promedica) is a mission-based, locally owned, not-for-profit healthcare organization highly focused on achieving core values. Headquartered in toledo, ohio, promedica serves 27 counties in northwest ohio and southeast michigan and is one of the region's leading healthcare providers. Our stewardship of resources has enabled us to wisely invest in cutting-edge technology, innovative programs and family-centered facilities that help to ensure patients and area residents have equal access to high-quality, safe care in the most appropriate setting, regardless of a patient's ability to pay. Based on needs that we have assessed within the communities we serve, promedica launched new services and programs in 2013 to help meet the growing demands of local consumers across all spectrums of life, including those individuals who are often the most vulnerable when it comes to health care: the elderly, poor and underserved. Promedica's mission is to improve the health and well-being of those we serve. This is reflected in our four core values, including: compassion - we treat our patients and each other with respect, integrity and dignity; innovation - we continually search to find a better way forward; teamwork - we partner with others because we are better together than apart; and excellence - we strive to be the best in all we do. Promedica and its affiliates comprise 320 sites, more than 1,800 physicians and approximately 15,000 employees and volunteers. During 2013, promedica discharged 69,357 inpatients and served more than 1,394,807 outpatients, while handling 269,606 emergency visits system-wide. Among the region's largest employers, promedica plays a significant role in economic development and stability in our region. During 2013, for every one dollar of revenue, another 33 cents was created in our service-area economy, with a total economic output of $3.01 billion. We also create a direct economic impact with our revenue, payroll and employment. Additionally, spending on services and materials with vendors in our region creates an indirect economic benefit. Additionally, our physicians, leadership team members and employees individually contribute personal resources to the community in numerous ways - such as through tutoring elementary students in reading, providing monthly health lectures at local senior centers, generously contributing to community fundraising campaigns such as united way, participating in medical missions, serving on local not-for-profit boards, and donating nonperishable goods to numerous local food pantries and churches - underscoring a key benefit of promedica being locally owned and operated. Promedica's member and affiliate hospitals include: the toledo hospital; toledo children's hospital (operating as part of the toledo hospital); flower hospital; fostoria hospital association; defiance hospital, inc.; bay park community hospital; herrick memorial hospital, inc.; emma l. Bixby medical center; promedica wildwood orthopaedic and spine hospital (a division of the toledo hospital); and st. Luke's hospital. In 2013, promedica also provided integrated services, comprised of: - promedica continuing care services corporation, providing rehabilitation, hospice, home care, ambulatory and senior services, community health, medical transportation services, and care coordination. - promedica physician group (promedica physicians), with more than 550 healthcare providers, including primary care, obstetrics and specialty physicians, as well as advanced practice providers; they help promedica to broaden the care we offer area residents, including in smaller, outlying communities. - promedica insurance corporation, the largest health maintenance organization physically located in northwest ohio. In 2013, paramount advantage began providing medicaid coverage in all of ohio's 88 counties. To support these e

- Promedica Sponsored A School-based Food Drive Challenge as Part of Its

Come to the table initiative. Schools raised more than 17,000 pounds of non-perishable food items for community food programs across promedica's service area. - promedica's summer youth employment program partnered 70 central-city teens ages 16 19 with mentors in departments such as human resources, radiology, dietary, and information technology to learn skills including customer service, punctuality and being accountable to others. - promedica system grants submitted an application for $24 million over three years to the cms health care innovation awards, round 2. The proposed population health model integrates evidence-based clinical programs and community services including education and outreach, wellness and prevention, social support services, case and disease management, home care coordination and telemedicine, clinical pharmacy - medication adherence, and care navigation as means for improving community health and well-being. - promedica further enhanced its relationship with cleveland clinic in 2013, signing a memorandum of understanding to develop a health system affiliation that will allow the two organizations to create a clinically aligned network focused on providing high-quality, cost-effective and technologically advanced clinical services. - promedica continued its initiative to fight obesity by introducing a pilot program for children and adolescents with a body mass index (bmi) that classifies them as obese. Families meet quarterly over a 12-month period with a dietitian in a physician's office or outpatient clinic to receive nutrition counseling and ask questions. Each child's bmi and responses to a health questionnaire will be compared before, during and after the 12-month period to determine the program's effectiveness. - coordinated through our advocacy department, promedica continued to provide health and nutrition education to elementary school children in grades 1 - 6. The healthy kids conversation map(r) program is designed to empower students and their parents/guardians to make healthy choices about food and exercise. - promedica physicians expanded care to better cover local and rural communities, adding 88 new primary care physicians and specialists in 2013. - promedica participated in dozens of community health fairs that included approximately 8,000 free public screenings for high blood pressure, high cholesterol, body mass index and bone density. - as part of its hunger-free initiative, promedica established a food reclamation program in partnership with hollywood casino (rossford, ohio), as well as the toledo and flower hospitals, providing more than 70,000 pounds of repackaged, un-served food to community feeding sites. - promedica cancer institute's community outreach included screenings for skin and prostate cancers, the fourth annual survivor celebration for cancer survivors, friends and caregivers, and sponsorship of the annual susan g. Komen race(r) for the cure in support of breast cancer research. - through its advocacy fund, promedica continued to support local community organizations that provide assistance to those in need with basic necessities that directly impact individuals' health and well-being. This support amounted to grants totaling nearly $400,000 in 2013. - promedica began construction of the 55,000 square foot mary ellen falzone diabetes center. Opening in 2014, the facility is named for a young girl who died from juvenile diabetes before her family even knew she had the disease. Located on the campus of the toledo hospital, it will bring diabetes programs, services and physicians together in one convenient location to serve all community members working to manage their diabetes. - flower hospital began renovations to add private patient rooms for inpatients and expand its psychiatric care unit. - promedica continuing care services corporation, in partnership with paramount insurance, began offering telehealth monitoring services to eligible home-care patients to reduce

Further, Promedica Continues to Be A Leading Participant in the Lucas

County carenet initiative - a collaborative effort among promedica, mercy health partners, the university of toledo medical center, the city of toledo, and others. Carenet was created to provide free or lower-cost health care for low-income lucas county residents. Established in 2003, carenet bridges the gap between adults without health insurance and needed healthcare services. While some individuals may qualify for governmental insurance programs such as medicaid, others do not; it is for these individuals that carenet was established. Additionally during 2013, promedica provided $54,110,000 of community benefit through the cost - not reimbursed by the government - for treating medicaid patients. Promedica's total cost - not reimbursed by the government - for treating medicare patients during 2013 was $93,196,000 and is not reflected in the community benefit amount of $129,920,000 noted above. Indeed, promedica goes beyond industry standards in meeting the goal of providing care to everyone, regardless of their ability to pay. We provide hospital care free-of-charge to all families without insurance with incomes at or below 200% of the federal poverty level. In addition to free care for those families under this federal poverty level, promedica hospitals provide significant discounts to families with incomes of up to 400% of the federal poverty level. In many situations, other funding sources are secured and accommodations made. Promedica's policies are posted and available in writing in all promedica facilities. Also, financial advocates are available to help patients by explaining our free care and discount programs, and to assist with the paperwork necessary to qualify for government funding. Patient bills provide clear explanations, qualifications and reminders of these programs. In summary, promedica demonstrates its mission and core values by providing high-quality health care to all patients, regardless of their race, creed, sex, 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.

ST. LUKE'S HOSPITAL - PROGRAM SERVICE ACCOMPLISHMENTS

St. Luke's hospital (d/b/a promedica st. Luke's hospital) is a member of promedica health system, inc. (promedica), a mission-based, locally owned, nonprofit healthcare organization highly focused on achieving core values. Headquartered in toledo, ohio, promedica serves 27 counties in northwest ohio and southeast michigan, and is one of the region's leading healthcare providers. 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, promedica st. Luke's hospital (slh) has 1,307 employees who provide extensive healthcare services such as emergency medicine; surgical services; outpatient physical, occupational and cardiac rehabilitation; critical care; cardiology; labor and delivery; and a full range of laboratory and radiology services. Slh's campus also is home to the ohio hearing and balance institute and the northwest ohio oncology center for outpatient cancer care, as well as a sleep disorders clinic and tobacco treatment center. In 2013, slh also received chest pain center accreditation from the society of cardiovascular patient care. Slh served 11,129 inpatients and 230,892 outpatients in 2013. Further, 40,427 individuals sought emergency care at slh. The hospital contributed $10,248,000 in community benefit through community benefit expenditures, financial assistance and government-sponsored, means-tested health care. Through community health improvement services, health professions education, subsidized health services, cash and in-kind contributions, community building activities, and other community benefit operations, slh contributed $6,049,000 to the community during 2013. Included in this figure are programs and events such as: - participation in the american medicine chest challenge, 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 support groups for individuals recently diagnosed with diabetes. - sponsorship of the american heart association's wear red event in support of women's heart health, as well as strong participation in the heart walk in support of overall heart health. - health screenings for blood pressure, blood sugar and cholesterol at local fairs and community events, as well as first aid coverage for special events. - screenings for skin, breast and prostate cancer. - tobacco cessation programs and support groups for community members wishing to quit smoking and tobacco use. - 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 heart disease, osteoporosis, hearing loss, and stroke prevention. Slh provided a significant amount of financial assistance to the community during 2013, of which $2,092,000 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 do not pay their bills. Slh's cost of bad debt for 2013 was $4,316,000. This amount is not included in the community benefit amount of $10,248,000 noted above. Further, slh provided $2,107,000 of community benefit through costs - not reimbursed by the government - for treating medicaid patients. Also in 2013, the total costs - not reimbursed by the government - for treating medicare patients was $10,200,000 and is not included in the community benefit amount of $10,248,000 noted above. During 2013, slh expended $44,523,000 in net payroll, providing 1,

Community Benefit Definitions

Promedica health system, inc. And its subsidiaries (the system) 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 the system respond to an identified community need and meet at least one of the following criteria: - improve access to healthcare service. - enhance the health of the community. - advance medical or healthcare knowledge. - relieve or reduce the burden of government or other community efforts. Financial assistance consistent with its mission, the system provides a significant amount of financial assistance to patients with limited or no ability to pay their bill. Promedica hospitals provide 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 federal 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. The system 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 the system's community benefit report. Additionally, the cost of financial assistance has been eliminated from any amounts reported in this category. Community health improvement services & community benefit operations community health improvement services include 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 the system. 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 internships and residency education, the provision of a clinical setting for undergraduate/vocational training for students outside the organization, and funding for education that is linked to community services and health improvement. 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 patient demand. Research research activities include clinical and community health research, as well as studies on healthcare delivery. The amount reported for the system is reduced by any external subsidies, such as grants. Cash and in-kind contributions cash and in-kind contributions include funds and in-kind services donated to community organizations and/or the community at large. In-kind services include hours donated by staff to the community while on work time; as well as donation of food, equipment and supplies.

Financial Statement Notes

PART X, LINE 2:

St. Luke's hospital is included in the consolidated audited financial statements of promedica health system, inc. And subsidiaries (phs). The following reflects phs's liability for uncertain tax positions under asc 740. Except as noted below, phs did not have any material uncertain tax positions at december 31, 2013 and 2012. For the years ended december 31, 2013 and 2012, a taxable subsidiary of phs recognized a liability for uncertain tax positions of $1,059,000 and $1,552,000, respectively. The subsidiary recognized a credit for interest and penalties within the income tax expense line in the consolidated statements of operations related to unrecognized tax benefits of $20,000 and $117,000 as of december 31, 2013 and 2012, respectively. St. Luke's hospital does not have any uncertain tax positions at december 31, 2013 and 2012.

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