2024-11-15T01:09:19-06:00 2023-12-31 990 2023-01-01 842727303 AHSNF INC AHSN 7043654202 PO BOX 32861 CHARLOTTE NC 282322861 RODNEY BALL VP, SECRETARY & TREASURER 7043654202 2024-11-14 0 2023 2024-10-15 13:58:12Z KEN D HAYNES PO BOX 32861 CHARLOTTE NC 282322861 34974215 0 X N/A X 2019 NC TO PROMOTE HEALTHCARE AND PUBLIC HEALTH BY OPERATING ONE OR MORE NURSING HOMES (INCLUDING SKILLED NURSING FACILITIES), HOSPITALS, AND/OR HEALTHCARE FACILITIES TO FACILITATE THE CHARITABLE AND GOVERNMENTAL PURPOSES AND ACTIVITIES OF SUCH FACILITIES THAT ARE, OR MAY BECOME AFFILIATED WITH, THE ORGANIZATION FROM TIME TO TIME. 3 0 0 0 0 0 200 0 31252497 34974215 0 -15 0 0 31252697 34974200 2730 0 0 0 30448909 33920963 0 0 0 29734022 28324598 60185661 62245561 -28932964 -27271361 32707040 32188140 56916274 83668735 -24209234 -51480595 X TO PROMOTE HEALTHCARE AND PUBLIC HEALTH BY OPERATING ONE OR MORE NURSING HOMES (INCLUDING SKILLED NURSING FACILITIES), HOSPITALS, AND/OR HEALTHCARE FACILITIES TO FACILITATE THE CHARITABLE AND GOVERNMENTAL PURPOSES AND ACTIVITIES OF SUCH FACILITIES THAT ARE OR MAY BECOME AFFILIATED WITH THE ORGANIZATION FROM TIME TO TIME. 0 0 59496846 0 34974215 THE ORGANIZATION OWNS AND OPERATES SKILLED NURSING FACILITIES THAT PROVIDE SHORT-TERM NURSING AND REHABILITATION SERVICES, LONG-TERM CARE SERVICES, AND END OF LIFE CARE TO PATIENTS IN CHARLOTTE, NC AND ITS SURROUNDING COMMUNITIES.DURING CALENDAR YEAR 2023, THE ORGANIZATION PROVIDED SKILLED NURSING SERVICES THAT INCLUDED 772 ADMISSIONS AND 129,028 PATIENT DAYS AT FIVE LOCATIONS IN THE CHARLOTTE, NC METRO AREA, INCLUDING: HUNTERSVILLE OAKS, SARDIS OAKS, CLEVELAND PINES, STANLY MANOR, AND JESSE HELMS NURSING CENTER. 59496846 1 0 0 0 0 0 0 0 1 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 3 0 0 1 0 0 0 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 X RODNEY BALL 7045125219 PO BOX 32861 CHARLOTTE NC 282322861 ANTHONY C DEFURIO DIRECTOR, SECR, TREAS (TO 8/14/23) 1.00 39.00 X X 0 5112458 426937 KEN D HAYNES DIRECTOR, PRESIDENT 1.00 39.00 X X 0 2993827 440667 SCOTT C RISSMILLER MD DIRECTOR 1.00 39.00 X 0 2339677 356821 COLLIN LANE FORMER OFFICER (8/1/21) 0.00 40.00 X 0 795651 92674 RODNEY BALL DIRECTOR, VP, SECR, TREAS 2.00 38.00 X X 0 714396 79879 JENNIFER SULLIVAN TOP MGMT OFFICIAL 1.00 39.00 X 0 634032 52922 ROSE COOK FORMER OFFICER (10/1/20) 0.00 40.00 X 0 463835 64140 MIKE STOLZENBACH VP, FACILITIES, CONT CARE 15.00 35.00 X 0 376423 65010 0 13430299 1579050 0 1 1 0 SODEXO MAGIC LLC P O BOX 360170 PITTSBURGH PA 15251 DIETARY SERVICES 3428659 PRO DIVERSITY PARTNERS LLC 420 LEXINGTON AVE STE 2903 NEW YORK NY 10170 RECRUITING SERVICES 3364638 HEALTHPRO HERITAGE LLC PO BOX 69268 BALTIMORE MD 21264 THERAPY SERVICES 1121879 MORRISON MANAGEMENT SPECIALISTS INC PO BOX 102289 ATLANTA GA 30368 DIETARY SERVICES 842357 ARAMARK HEALTHCARE SUPPORT SERVICES LLC P O BOX 978839 DALLAS TX 75397 ENVIRONMENTAL SERVICES 492893 5 PATIENT SERVICE REVENUE 621110 34918273 34918273 DIETARY REVENUE 722513 55942 55942 34974215 15 -15 -15 -15 34974200 34974215 0 -15 X 27100275 27041901 58374 5188608 5112616 75992 1632080 1608177 23903 16222 15974 248 11371982 11198093 173889 3751 3694 57 227847 200853 26994 3389082 2987567 401515 46091 40630 5461 86827 76540 10287 949281 648359 300922 3356601 2534447 822154 108221 108221 INTERCOMPANY EXPENSE 5112571 4506869 605702 OTHER SUPPLIES 2052940 1809723 243217 MEDICAL SUPPLIES 1474814 1474814 DIETARY SUPPLIES 128368 128368 62245561 59496846 2748715 0 2288304 2916359 750 750 107107 11348 68830982 39571299 30310879 29259683 32707040 32188140 763155 1242445 56153119 82426290 56916274 83668735 X 0 0 0 0 -24209234 -51480595 -24209234 -51480595 32707040 32188140 -27271361 0 X 0 1 X 1 0 X 1 128969 128969 0 4262058 4262058 57614578 39571299 18043279 6103987 6103987 850359 850359 29259683 INTERCOMPANY PAYABLE 82342394 RESERVES 83896 82426290 X PART IV, LINE 1B: THE FILING ORGANIZATION MANAGES SNF PATIENT TRUST ACCOUNTS FOR PATIENTS AT ALL OF ITS NURSING FACILITIES. THE FUNDS BELONG TO THE PATIENTS AND ARE ONLY SPENT ON BEHALF OF THE PATIENTS IN ACCORDANCE WITH NC STATE GUIDELINES. PART X, LINE 2: THE ORGANIZATION HAS EVALUATED UNCERTAIN TAX POSITIONS FOR ITS CALENDAR YEARS ENDED DECEMBER 31, 2023 AND 2022, INCLUDING A QUANTIFICATION OF TAX RISK IN AREAS SUCH AS UNRELATED BUSINESS TAXABLE INCOME AND THE TAXATION OF ITS JOINT VENTURES. THIS EVALUATION DID NOT HAVE A MATERIAL EFFECT ON THE ORGANIZATION'S FINANCIAL STATEMENTS FOR CALENDAR YEARS ENDED DECEMBER 31, 2023 AND 2022. 0 1 0 0 0 0 0 0 0 ANTHONY C DEFURIO DIRECTOR, SECR, TREAS (TO 8/14/23) 0 1560281 0 1371375 0 2180802 0 410490 0 16447 0 5539395 0 1506640 KEN D HAYNES DIRECTOR, PRESIDENT 0 1553910 0 1200600 0 239317 0 401550 0 39117 0 3434494 0 160246 SCOTT C RISSMILLER MD DIRECTOR 0 1192635 0 1019475 0 127567 0 328253 0 28568 0 2696498 0 0 COLLIN LANE FORMER OFFICER (8/1/21) 0 530324 0 220054 0 45273 0 57862 0 34812 0 888325 0 34104 RODNEY BALL DIRECTOR, VP, SECR, TREAS 0 458513 0 188983 0 66900 0 50134 0 29745 0 794275 0 33777 JENNIFER SULLIVAN TOP MGMT OFFICIAL 0 423432 0 188183 0 22417 0 42140 0 10782 0 686954 0 10492 ROSE COOK FORMER OFFICER (10/1/20) 0 287821 0 124492 0 51522 0 36097 0 28043 0 527975 0 14894 MIKE STOLZENBACH VP, FACILITIES, CONT CARE 0 260373 0 113215 0 2835 0 28646 0 36364 0 441433 0 0 PART I, LINE 4B CERTAIN DIRECTORS, OFFICERS, AND KEY EMPLOYEES OF THE FILING ORGANIZATION PARTICIPATED IN AND/OR RECEIVED PAYMENTS FROM A NON-QUALIFIED DEFERRED COMPENSATION PLAN (RESTORATION OR SERP) AND/OR RECEIVED PAYMENTS FOR SEVERANCE. THE DETERMINATION OF THE PAYMENT AMOUNT FROM NON-QUALIFIED DEFERRED COMPENSATION PLANS FOLLOWED THE EMPLOYMENT ORGANIZATION'S COMPENSATION PROCEDURES. THE FOLLOWING DIRECTORS, OFFICERS, AND KEY EMPLOYEES RECEIVED PAYMENTS FROM THE FILING ORGANIZATION OR A RELATED ORGANIZATION FOR SEVERANCE AND/OR NON-QUALIFIED DEFERRED COMPENSATION PLANS DURING THE CURRENT TAX YEAR: SEVERANCE PAYMENTS: ANTHONY C. DEFURIO 333,519 NON-QUALIFIED DEFERRED COMPENSATION PAYMENTS: ANTHONY C. DEFURIO 1,506,640 KEN HAYNES 160,246 COLLIN LANE 34,104 RODNEY BALL 33,777 ROSE COOK 14,894 JENNIFER SULLIVAN 10,492 FORM 990, PART VI, SECTION A, LINE 3 THE ORGANIZATION DELEGATED CONTROL OVER MANAGEMENT DUTIES TO THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY (CMHA), AS DESCRIBED IN AN INTEGRATION AGREEMENT ENTERED INTO BETWEEN THE ORGANIZATION AND CMHA, EFFECTIVE FEBRUARY 1, 2020. PER THE INTEGRATION AGREEMENT, THE ORGANIZATION ENGAGED CMHA TO MANAGE AND OVERSEE THE DAY-TO-DAY ACTIVITIES AND OPERATIONS OF THE ORGANIZATION, WHICH INVOLVE CMHA PROVIDING ADMINISTRATIVE SERVICES, RESOURCES, PERSONNEL, AND STAFF. CMHA PROVIDES THESE SERVICES AND STAFF TO THE ORGANIZATION AT COST. DIRECTORS, OFFICERS, AND KEY EMPLOYEES OF THE ORGANIZATION ARE ALSO OFFICERS AND/OR EMPLOYEES OF CMHA. SEE FORM 990, PART VII FOR ALL COMPENSATION RECEIVED BY DIRECTORS, OFFICERS, AND KEY EMPLOYEES FROM CMHA, A RELATED ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A THE DIRECTORS OF THE FILING ORGANIZATION ARE APPOINTED BY THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY. FORM 990, PART VI, SECTION A, LINE 7B THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY MAY REMOVE A DIRECTOR AT ANY TIME WITH OR WITHOUT CAUSE. THE CORPORATION'S ARTICLES OF INCORPORATION MAY BE AMENDED OR RESTATED FROM TIME TO TIME BY THE BOARD OF DIRECTORS, SUBJECT TO APPROVAL BY THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY. THE CORPORATION'S BYLAWS MAY BE AMENDED OR REPEALED, AND NEW BYLAWS MAY BE ADOPTED, BY THE BOARD, EXCEPT AS OTHERWISE PROVIDED IN THE CORPORATION'S ARTICLES OF INCORPORATION OR BY LAW. ANY AMENDMENT TO THE PROVISIONS PERTAINING TO BOARD APPOINTMENT RIGHTS IS SUBJECT TO APPROVAL BY THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY. FORM 990, PART VI, SECTION B, LINE 11B THE FILING ORGANIZATION'S BOARD OF DIRECTORS RECEIVES A COPY OF THE FORM 990 WITH SUFFICIENT TIME TO PERMIT REVIEW, COMMENT, AND QUESTIONS PRIOR TO ITS FILING. IF MODIFICATIONS ARE REQUIRED FOLLOWING SUCH REVIEW AND COMMENT, THE REVISED FORM 990 IS REDISTRIBUTED TO ALL DIRECTORS PRIOR TO ITS FILING WITH THE IRS, ALONG WITH A REPORT NOTING THE MODIFICATIONS. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST (COI) POLICY PROTECTS THE INTERESTS OF THE ORGANIZATION WHEN IT IS CONTEMPLATING ENTERING INTO A TRANSACTION OR ARRANGEMENT THAT MIGHT BENEFIT THE PRIVATE INTERESTS OF AN OFFICER OR DIRECTOR OF THE ORGANIZATION, OR MIGHT RESULT IN A POSSIBLE EXCESS BENEFIT TRANSACTION, AND IS INTENDED TO SUPPLEMENT BUT NOT REPLACE ANY FEDERAL/STATE LAWS GOVERNING CONFLICT OF INTEREST THAT ARE APPLICABLE TO THE ORGANIZATION. THE CONFLICT OF INTEREST POLICY APPLIES TO "INTERESTED PERSONS", WHICH ARE DEFINED AS MEMBERS OF THE ORGANIZATION'S BOARD OF DIRECTORS, MEMBERS OF A COMMITTEE WITH DELEGATED POWERS FROM THE ORGANIZATION'S BOARD OF DIRECTORS, OR PRINCIPAL OFFICERS OF THE ORGANIZATION IF ANY SUCH PERSONS HAVE A DIRECT OR INDIRECT FINANCIAL INTEREST. AN INTERESTED PERSON MUST DISCLOSE THE EXISTENCE OF THE FINANCIAL INTEREST, AND BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS, TO THE ORGANIZATION'S BOARD OF DIRECTORS OR ITS APPLICABLE COMMITTEE THAT IS CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT. IN THE EVENT THE ORGANIZATION'S BOARD OF DIRECTORS OR ITS APPLICABLE COMMITTEE DETERMINES THAT A CONFLICT OF INTEREST EXISTS, THE INTERESTED PERSON MAY PRESENT RELEVANT INFORMATION ABOUT THE PROPOSED TRANSACTION OR ARRANGEMENT TO THE ORGANIZATION'S BOARD OF DIRECTORS OR ITS APPLICABLE COMMITTEE, BUT AFTER SUCH PRESENTATION THE INTERESTED PERSON SHALL LEAVE THE MEETING WHILE THE REMAINING MEMBERS OF THE ORGANIZATION'S BOARD OF DIRECTORS OR ITS APPLICABLE COMMITTEE DISCUSS AND VOTE UPON THE PROPOSED TRANSACTION OR ARRANGEMENT. THE CHAIRPERSON OF THE ORGANIZATION'S BOARD OF DIRECTORS OR ITS APPLICABLE COMMITTEE SHALL, IF APPROPRIATE, APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT. AFTER EXERCISING DUE DILIGENCE, THE DISINTERESTED MEMBERS OR APPLICABLE COMMITTEE SHALL DETERMINE WHETHER THE ORGANIZATION CAN WITH REASONABLE EFFORTS OBTAIN A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT FROM A PERSON OR ENTITY THAT WOULD NOT PRESENT A CONFLICT OF INTEREST. IF A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT IS NOT REASONABLY POSSIBLE UNDER CIRCUMSTANCES NOT PRODUCING A CONFLICT OF INTEREST, THE DISINTERESTED MEMBERS OR APPLICABLE COMMITTEE SHALL DETERMINE BY A MAJORITY VOTE WHETHER THE PROPOSED TRANSACTION OR ARRANGEMENT IS IN THE ORGANIZATION'S BEST INTEREST, FOR ITS OWN BENEFIT, AND FAIR AND REASONABLE AND, IN ACCORDANCE WITH SUCH DETERMINATION, SHALL DETERMINE WHETHER TO APPROVE THE PROPOSED TRANSACTION OR ARRANGEMENT. IF THE ORGANIZATION'S BOARD OF DIRECTORS OR ITS APPLICABLE COMMITTEE HAS REASONABLE CAUSE TO BELIEVE THAT AN INTERESTED PERSON HAS FAILED TO DISCLOSE AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, IT SHALL INFORM THE INTERESTED PERSON OF THE BASIS FOR SUCH BELIEF AND AFFORD THE INTERESTED PERSON AN OPPORTUNITY TO EXPLAIN THE ALLEGED FAILURE TO DISCLOSE. IF, AFTER HEARING THE INTERESTED PERSON'S RESPONSE AND MAKING FURTHER INVESTIGATION AS WARRANTED BY THE CIRCUMSTANCES, THE ORGANIZATION'S BOARD OF DIRECTORS OR ITS APPLICABLE COMMITTEE DETERMINES THAT THE INTERESTED PERSON HAS FAILED TO DISCLOSE AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, IT SHALL TAKE APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTION. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION PAYS NO COMPENSATION TO OFFICERS, DIRECTORS AND KEY EMPLOYEES. ALL COMPENSATION PAID TO OFFICERS, DIRECTORS AND KEY EMPLOYEES WAS PAID BY A RELATED ORGANIZATION, THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY (CMHA). THE COMPENSATION, BENEFITS, AND EQUITY COMMITTEE (THE "COMMITTEE") OF THE ADVOCATE HEALTH, INC. BOARD OF DIRECTORS HAS AUTHORITY AS CMHA DELEGATES TO IT, FOR THE REVIEW AND APPROVAL OF SENIOR EXECUTIVE COMPENSATION, INCLUDING SENIOR EXECUTIVE INCENTIVE PLANS. NO MEMBER OF THE COMMITTEE IS AN EMPLOYEE OF THE FILING ORGANIZATION. THE COMMITTEE RELIES UPON AN EXTERNAL, INDEPENDENT COMPENSATION CONSULTANT EXPERIENCED IN HEALTHCARE TO PROVIDE THE COMMITTEE WITH COMPENSATION COMPARABILITY DATA FOR NEW EXECUTIVE POSITION APPOINTMENTS AND FOR COMPENSATION REVIEWS FOR EXISTING EXECUTIVES. THE CONSULTANT, WHICH IS RETAINED DIRECTLY BY THE COMMITTEE, PROVIDES THIRD-PARTY INFORMATION AND EVALUATES THE COMPETITIVENESS AND REASONABLENESS OF EXECUTIVE COMPENSATION AND BENEFITS PROGRAMS IN RELATION TO MARKET PRACTICES FOR SIMILARLY SITUATED HEALTHCARE ORGANIZATIONS. THE COMMITTEE MAKES ITS DECISIONS WITH RESPECT TO EXECUTIVE COMPENSATION IN ACCORDANCE WITH CMHA AND THE FILING ORGANIZATION'S POLICIES, IRS REGULATIONS, AND STANDARD CORPORATE GOVERNANCE PRACTICES. SUCH POLICIES INCLUDE ADHERENCE TO EXECUTIVE COMPENSATION PHILOSOPHY AND REVIEW PROCESSES; PROCESSES ENSURING COMMITTEE MEMBER AND COMPENSATION CONSULTANT INDEPENDENCE; USE OF VALID MARKET COMPARISONS OF DATA FROM HEALTHCARE ORGANIZATIONS OF SIMILAR SIZE, STRUCTURE, AND COMPLEXITY AND ESTABLISHMENT OF THE REBUTTABLE PRESUMPTION OF REASONABLENESS, PER IRS GUIDELINES. MINUTES OF THE DELIBERATIONS OF THE COMMITTEE ARE MAINTAINED IN THE ADVOCATE HEALTH, INC. LEGAL DEPARTMENT. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S ARTICLES OF INCORPORATION ARE AVAILABLE TO THE PUBLIC ON REQUEST AND ARE AVAILABLE ON THE WEBSITE OF THE NORTH CAROLINA SECRETARY OF STATE. THE ORGANIZATION'S BYLAWS ARE NOT PUBLISHED, BUT PROVISIONS FROM THE BYLAWS ARE INCLUDED AS NECESSARY IN THE ORGANIZATION'S POLICIES, AND ARE ATTACHED TO THE FORM 1023 FILED FOR THE ORGANIZATION WITH THE IRS, WHICH IS PUBLICLY AVAILABLE. THE CONFLICT OF INTEREST POLICY IS AVAILABLE TO THE PUBLIC ON REQUEST. THE ORGANIZATION'S FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC BY INCLUDING THEM AS PART OF THE ANNUAL INFORMATION STATEMENT OF THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY (CMHA) FILED ON THE MSRB WEBSITE (EMMA). FORM 990, PART IX, LINE 11G OTHER PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 11,198,093. MANAGEMENT AND GENERAL EXPENSES 173,889. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 11,371,982. AH GEORGIA INC PO BOX 32861 CHARLOTTE NC 282322861 831707383 HEALTHCARE MANAGEMENT NC 501(C)(3) LINE 10 CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY 0 ATRIUM HEALTH EMPLOYEE ASSISTANCE INC PO BOX 32861 CHARLOTTE NC 282322861 850548753 EMERGENCY ASSISTANCE NC 501(C)(3) LINE 7 CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY 0 1717 GARDEN TERRACE LLC PO BOX 32861 CHARLOTTE NC 282322861 260897680 REAL ESTATE NC NC POLITICAL SUBDIVI CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY 0 3021 NESBITT LLC PO BOX 32861 CHARLOTTE NC 282322861 853018530 REAL ESTATE DE NC POLITICAL SUBDIVI CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY 0 ABC PARKWAY LLC PO BOX 32861 CHARLOTTE NC 282322861 REAL ESTATE NC NC POLITICAL SUBDIVI CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY 0 ATRIUM HEALTH HUNTERSVILLE ASC LLC PO BOX 32861 CHARLOTTE NC 282322861 863426328 HEALTHCARE NC NC POLITICAL SUBDIVI CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY 0 AV INSURANCE LLC PO BOX 32861 CHARLOTTE NC 282322861 205608253 INSURANCE NC NC POLITICAL SUBDIVI 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