2023-02-14T20:42:11-06:00 2021-12-31 410746749 CLIFTONLARSONALLEN LLP 227 WEST TRADE STREET SUITE 800 CHARLOTTE NC 28202 990 2021-01-01 560603900 ASHE MEMORIAL HOSPITAL INC ASHE 3368467101 200 HOSPITAL AVENUE JEFFERSON NC 28640 CHARLES WRIGHT CFO 3368467101 2023-02-14 1 CHARLES WRIGHT 999009999 JOHN NORMAN P01506766 7049985200 2023-02-13 3 AAL1 IAL1 2021 2023-03-07 01:45:13Z BRIAN YATES 200 HOSPITAL AVENUE JEFFERSON NC 28640 45501677 0 X WWW.ASHEMEMORIAL.ORG X 1939 NC ACUTE HOSPITAL CARE SERVICES PROVIDED TO THE RESIDENTS OF ASHE COUNTY, NC AND SURROUNDING AREAS. 13 13 427 16 0 0 1753520 5491976 34923819 39779911 55196 39483 173858 190307 36906393 45501677 707382 375211 0 0 16151738 16375274 0 0 186970 19590885 23234567 36450005 39985052 456388 5516625 26395324 27570450 16159590 11816293 10235734 15754157 THE HOSPITAL'S MISSION STATEMENT IS TO MEET THE NEEDS OF THE COMMUNITY BY DELIVERING PATIENT-CENTERED, HIGH QUALITY HEALTH CARE. 0 0 37030201 375211 39786041 ASHE MEMORIAL PROVIDES INPATIENT, OUTPATIENT, AND EMERGENCY CARE SERVICES FOR RESIDENTS OF ASHE COUNTY AND THE SURROUNDING AREAS. THE HOSPITAL PROVIDED A SIGNIFICANT AMOUNT OF COMMUNITY BENEFIT AND OUTREACH TO THE COUNTY AND SURROUNDING AREAS. BENEFIT AND OUTREACH PROGRAMS ARE PROVIDED IN CONJUNCTION WITH THE ASHE COUNTY HEALTH COUNCIL AND INDEPENDENTLY THROUGH VARIOUS DEPARTMENTS AND SERVICES. 37030201 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 1 0 0 0 0 0 0 1 1 1 0 0 0 1 40 0 1 427 1 0 0 0 0 0 0 0 0 0 0 0 0 X 13 13 0 1 0 0 1 1 1 1 1 0 0 0 1 1 1 1 1 1 1 0 X ASHE MEMORIAL HOSPITAL ACCOUNTING DEPARTMENT 3368467101 200 HOSPITAL AVENUE JEFFERSON NC 28640 X JANE LONON CHAIRPERSON 1.00 X X 0 0 0 KYLE HALL SECRETARY 1.00 X X 0 0 0 MARTIN LITTLE 1ST VICE CHAIR 1.00 X X 0 0 0 KAREN POWELL 2ND VICE CHAIR 1.00 X X 0 0 0 CHARLES JONES MD BOARD MEMBER 1.00 X 0 0 0 CB JONES BOARD MEMBER 1.00 X 0 0 0 GREG BOWER RPH BOARD MEMBER 1.00 X 0 0 0 JIM GAMBILL BOARD MEMBER 1.00 X 0 0 0 DAVID PRICE BOARD MEMBER 1.00 X 0 0 0 WILL VANNOY BOARD MEMBER 1.00 X 0 0 0 SUE HAMPTON BOARD MEMBER 1.00 X 0 0 0 EDWARD MILLER MD BOARD MEMBER 1.00 X 0 0 0 STEPHEN SHOEMAKER BOARD MEMBER 1.00 X 0 0 0 HORACE THOMPSON BOARD MEMBER 1.00 X 0 0 0 WALTER DAVIS MD BOARD MEMBER 1.00 X 0 0 0 ELSA COX EDD BOARD MEMBER 1.00 X 0 0 0 BRIAN YATES CHIEF EXECUTIVE OFFICER 40.00 X 0 0 0 BRIAN SACHS MD PHYSICIAN 40.00 X 388018 0 0 TARA BLALOCK BURGHER PHYSICIAN 40.00 X 329177 0 0 RONALD W BENFIELD MD PHYSICIAN 40.00 X 306315 0 0 MELINDA WONSICK PHYSICIAN 40.00 X 266135 0 0 THEODORE FLINT GRAY III PHYSICIAN 40.00 X 186539 0 0 1476184 0 0 13 0 1 0 JEFFERSON EMERGENCY SERVICES PO BOX 740666 ATLANTA GA 30328 ED PROVIDERS 1027523 JLD ENTERPRISES 2104 TALMAGE DRIVE LELAND NC 28451 CONSTRUCTION COMPANY 413187 MEDSTREAM ANESTHESIA PO BOX 63467 CHARLOTTE NC 282633467 HEALTHCARE SOLUTIONS COMPANY 397387 RESTORE RESPIRATORY CARE INC 200 GALLERIA PARKWAY SUITE 1800 ATLANTA GA 30339 RESPIRATORY THERAPY 378932 MEDICAL SOLUTIONS LLCC PO BOX 310737 DES MOINES IA 503310737 TRAVEL NURSING AGENCY 297828 10 5305322 186654 5491976 PATIENT SERVICE REVENUE 623000 39330331 39330331 PHARMACY 446110 274119 274119 175461 175461 39779911 39483 39483 184177 0 184177 184177 184177 OTHER INCOME 623000 6130 6130 6130 45501677 39786041 0 223660 X 372335 372335 2876 2876 13397827 12995892 401935 114702 111261 3441 1886639 1830039 56600 976106 946822 29284 300000 300000 60032 60032 39150 39150 5794515 4791909 1002606 62745 12548 49570 627 7138549 6674542 428314 35693 305185 33570 271615 468624 468624 3558 2918 640 56642 56642 1260117 1260117 319801 319801 BAD DEBT EXPENSE 4984182 4984182 CHEMOTHERAPY DRUGS 2013478 2013478 OTHER 401978 126634 124694 150650 RECRUITMENT 26011 26011 39985052 37030201 2767881 186970 11295407 9826820 827611 827611 3508856 5482886 938790 1283546 213413 250235 38675150 29386995 6695778 9288155 561604 577452 2353865 33745 26395324 27570450 2585579 2905200 4806593 4312714 6167418 4123219 2600000 0 0 475160 16159590 11816293 X 9933271 15502879 302463 251278 10235734 15754157 26395324 27570450 5516625 1798 0 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 212253 212253 18618573 13707883 4910690 421274 95315 325959 18093273 14311064 3782209 1329777 1272733 57044 9288155 DUE FROM AMH 475160 475160 X PART X, LINE 2: THE HOSPITAL IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND ARE EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. AWC AND AFS ARE SINGLE MEMBER LIMITED LIABILITY COMPANIES AND ARE CONSIDERED DISREGARDED ENTITIES FOR INCOME TAX PURPOSES. THE ORGANIZATION FOLLOWS THE INCOME TAX STANDARD REGARDING THE RECOGNITION AND MEASUREMENT OF UNCERTAIN TAX POSITIONS, WHICH CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN AN ENTITY'S CONSOLIDATED FINANCIAL STATEMENTS AND PRESCRIBES A RECOGNITION THRESHOLD AND MEASUREMENT PRINCIPLE FOR THE CONSOLIDATED FINANCIAL STATEMENTS RECOGNITION AND MEASUREMENT OF TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN ON A TAX RETURN THAT ARE NOT CERTAIN TO BE REALIZED. THE ORGANIZATION HAS DETERMINED THAT IT DOES NOT HAVE ANY MATERIAL UNCERTAIN TAX POSITIONS AS OF DECEMBER 31, 2020 AND 2019. 1 1 X 1 X 1 X 1 1 0 1 1 61202 61202 0.00170 3115951 1501835 1614116 0.04610 3177153 1501835 1675318 0.04780 3177153 1501835 1675318 0.04780 1 1686886 506066 8617761 8444080 173681 X 1 0 1 1 ASHE MEMORIAL HOSPITAL 200 HOSPITAL AVENUE JEFFERSON NC 28640 X X X X CRITICAL ACCESS HOSPITAL ASHE MEMORIAL HOSPITAL INC 1 0 0 1 X X X X X X X X X 20 1 1 1 1 X WWW.ASHEMEMORIAL.ORG X 1 20 1 WWW.ASHEMEMORIAL.ORG 0 1 X 150.000000000000 250.000000000000 X X X X X X 1 1 X X X 1 X WWW.ASHEMEMORIAL.ORG X WWW.ASHEMEMORIAL.ORG X WWW.ASHEMEMORIAL.ORG X X X X X X 1 0 X X 1 X 0 0 ASHE MEMORIAL HOSPITAL INC. PART V, SECTION B, LINE 5: LIKE MOST ACTIVITIES IN 2020, THE PROCESS THAT WOULD TYPICALLY BE USED TO COMPLETE THE FIRST PHASE OF THE CHA WAS SIGNIFICANTLY IMPACTED BY THE SARS-COV-2 ("COVID-19") PANDEMIC. IN PREVIOUS YEARS, MUCH OF THE DATA GATHERED FROM THE COMMUNITY WOULD HAVE COME FROM A HEALTH OPINION SURVEY. BECAUSE OF THE RESTRICTIONS ON THE ABILITY TO CONDUCT THE SURVEY THROUGH MEANS THAT WOULD HAVE REQUIRED FACE-TO-FACE CONTACT, WE WERE NOT ABLE TO USE THE SURVEY AS A TOOL TO HELP ASSESS THE NEEDS OF THE COMMUNITY. INSTEAD, THE FIRST PHASE OF THE CHA PROCESS RELIED ON THE COLLECTION AND ANALYSIS OF COMMUNITY INPUT THROUGH VIDEOCONFERENCE AND TELEPHONE INTERVIEWS WITH COMMUNITY STAKEHOLDERS AND LEADERS IDENTIFIED BY THE HOSPITAL AND IN CONJUNCTION WITH APPHEALTHCARE, AS WELL AS THE REVIEW OF COMMUNITY SECONDARY DATA. IN OCTOBER 2020, KEY EXECUTIVES OF THE HOSPITAL MET VIA TELEPHONE WITH KEY MEMBERS OF APPHEALTHCARE TO DISCUSS THE PROCESS FOR COMPLETING THE CHA FOR 2020. DURING THOSE MEETINGS, THE HOSPITAL AND APPHEALTHCARE DETERMINED THAT, DUE TO THE INABILITY TO CONDUCT SURVEYS OUT IN THE COMMUNITY, COUPLED WITH THE STRAIN ON LOCAL RESOURCES IN 2020, THE BEST OPTION FOR GATHERING INFORMATION FROM THE COMMUNITY WAS TO CONDUCT INTERVIEWS VIA VIDEOCONFERENCE OR TELEPHONE WITH COMMUNITY STAKEHOLDERS AND LEADERS THAT WORK DIRECTLY WITH RESIDENTS OF THE COMMUNITY AND, IN PARTICULAR, THOSE THAT MIGHT BE DISADVANTAGED BECAUSE OF CERTAIN SOCIOECONOMIC FACTORS IN THE COMMUNITY. INTERVIEWS OF COMMUNITY STAKEHOLDERS AND LEADERS TOOK PLACE IN OCTOBER AND NOVEMBER OF 2020. INTERVIEWEES REPRESENTED ORGANIZATIONS THAT WORK WITH ASHE COUNTY RESIDENTS TO ADDRESS ONGOING HEALTH AND SOCIOECONOMIC CONCERNS INCLUDING: - SAFE HOME FOR EVERYONE PARTNERSHIP OF ASHE- NC COOPERATIVE EXTENSION - DAYMARK RECOVERY SERVICES- ASHE CHAMBER OF COMMERCE- WESTERN YOUTH NETWORK- ASHE COUNTY SCHOOLS - PARTNERSHIP OF ASHE - ASHE MEMORIAL HOSPITAL ASHE MEMORIAL HOSPITAL INC. PART V, SECTION B, LINE 6A: ALLEGHANY MEMORIAL HOSPITALAPPALACHIAN REGIONAL HEALTHCARE SYSTEMS ASHE MEMORIAL HOSPITAL INC. PART V, SECTION B, LINE 6B: APPALACHIAN DISTRICT HEALTH DEPARTMENT ASHE MEMORIAL HOSPITAL INC. PART V, SECTION B, LINE 11: THE HOSPITAL, IN CONJUNCTION WITH THE ASHE HEALTH ALLIANCE, IDENTIFIED THE FOLLOWING PRIORITIES:1. MENTAL/BEHAVIORAL HEALTH2. SUBSTANCE USE AND MISUSE PREVENTION3. PHYSICAL ACTIVITY AND NUTRITIONTHE HOSPITAL IS WORKING WITH OTHER STAKEHOLDERS THAT PARTICIPATED IN THE CHNA TO ADDRESS THE ABOVE HEALTH PRIORITIES IN A COLLABORATIVE MANNER, BRINGING THE RESOURCES OF ALL STAKEHOLDERS TO ADDRESS THE NEEDS THROUGH THE PLANNING AND IMPLEMENTATION OF EVIDENCE-BASED INTERVENTIONS. ALL STAKEHOLDERS ARE MAPPING THE ASSETS AVAILABLE SO THAT THE COMMUNITY COLLABORATORS ALREADY ENGAGED IN RELATED WORK CAN PARTICIPATE IN IDENTIFYING ASSETS THAT SUPPORT HEALTH AND POTENTIAL GAPS THAT MAY EXIST. 3 1 - MOUNTAIN FAMILY CARE CENTER 200 HOSPITAL AVENUE JEFFERSON NC 28640 RURAL HEALTH CLINIC 2 - AMH ASHE WOMEN'S CENTER 420 E 2ND STREET WEST JEFFERSON NC 28694 PHYSICIANS OFFICES 3 - MOUNT JEFFERSON FAMILY MEDICINE 200 HOSPITAL AVENUE JEFFERSON NC 28640 FAMILY MEDICINE PART I, LINE 6A: NCHA PART I, LN 7 COL(F): THE ORGANIZATION RECOGNIZES PATIENT SERVICE REVENUE ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY PAYOR COVERAGE ON THE BASIS OF CONTRACTUAL RATES FOR THE SERVICES RENDERED. FOR UNINSURED PATIENTS THAT DO NOT QUALIFY FOR CHARITY CARE, THE ORGANIZATION RECOGNIZES REVENUE ON THE BASIS OF ITS STANDARD RATES FOR SERVICES PROVIDED (OR ON THE BASIS OF DISCOUNTED RATES, IF NEGOTIATED OR PROVIDED BY POLICY). ON THE BASIS OF HISTORICAL EXPERIENCE, A SIGNIFICANT PORTION OF THE ORGANIZATION'S UNINSURED PATIENTS WILL BE UNABLE OR UNWILLING TO PAY FOR THE SERVICES PROVIDED. THUS, THE ORGANIZATION RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS RELATED TO UNINSURED PATIENTS IN THE PERIOD THE SERVICES ARE PROVIDED. PART III, LINE 2: THE ORGANIZATION APPLIED THE COST-TO-CHARGE RATIO TO ITS BAD DEBT GROSS CHARGES TO DETERMINE THE AMOUNT REPORTED AS BAD DEBT EXPENSE IN SCHEDULE H. PART III, LINE 3: THE ORGANIZATION DOES NOT SPECIFICALLY TRACK BAD DEBT CHARGES THAT COULD BE ATTRIBUTABLE TO PATIENTS THAT COULD OTHERWISE QUALIFY UNDER ITS FINANCIAL ASSISTANCE PLAN. HISTORICALLY, THE ORGANIZATION ESTIMATES THAT APPROXIMATELY 30% OF BAD DEBT CHARGES WOULD LIKELY QUALIFY FOR FINACIAL ASSISTANCE. PART III, LINE 9B: THE WRITTEN POLICY DOES NOT SPECIFICALLY ADDRESS THIS ISSUE BUT WE NORMALLY PROVIDE THE CHARITY CARE DISCOUNT PRIOR TO SENDING TO BAD DEBT IF THE PATIENT QUALIFIES FOR CHARITY IN PART BUT FAILS TO PAY THEIR PORTION DUE. PART VI, LINE 2: THE HOSPITAL CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT IN CONJUNCTION WITH THE APPHEALTHCARE (APPALACHIAN DISTRICT HEALTH DEPARTMENT), OTHER HEALTH SERVICE PROVIDERS, AND OTHER COMMUNITY STAKEHOLDERS TO MONITOR HOW WELL WE, AS A COMMUNITY ARE MEETINGOUR MISSION TO PREVENT, PROMOTE AND PROTECT THE PUBLIC'S HEALTH. THE FIRST PHASE OF THIS PROCESS INCLUDED THE COLLECTION AND ANALYSIS OF COMMUNITY INPUT THROUGH ONE ON ONE INTERVIEWS WITH MULTI-DISCIPLINARY COMMUNITY STAKEHOLDERS AND LEADERS THAT SERVE AND REPRESENT ALL RESIDENTS OF ASHE COUNTY, BUT ESPECIALLY THOSE THAT MAY BE DISADVANTAGED. ADDITIONALLY, THE PROCESS INCLUDED THE ACCUMULATION OF THE MOST CURRENT AND AVAILABLE SECONDARY DATA ABOUT THE COMMUNITY THAT THE HOSPITAL SERVES. THIS PHASE WAS COMPLETED IN DECEMBER 2020. THE CHNA REPORT COMPRISES THE RESULTS OF THIS FIRST PHASE OF THE PROCESS. THE SECOND PHASE WILL BE CONDUCTED BETWEEN JANUARY-MAY, 2021 THROUGH THE DEVELOPMENT OF COMMUNITY HEALTH ACTION PLANS. PART VI, LINE 3: PATIENTS AND/OR GUARANTORS ARE EVALUATED FOR CHARITY CARE APPROVAL PRIOR TO SERVICES BEING RENDERED, AT THE TIME OF SERVICE, OR AS SOON AS PRACTICAL AFTER SERVICE HAS BEEN PROVIDED TO THE PATIENT. AMH POSTS NOTICES REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE TO LOW-INCOME UNINSURED PATIENTS. THESE NOTICES ARE POSTED IN VISIBLE LOCATIONS THROUGHOUT THE HOSPITAL SUCH AS ADMITTING/REGISTRATION, FINANCIAL COUNSELING OFFICE, AND OTHER OUTPATIENT AND/OR EMERGENCY SETTINGS. NOTICES OR BROCHURES ARE ALSO PROVIDED TO UNINSURED PATIENTS AT TIME OF REGISTRATION AND INCLUDE BRIEF INSTRUCTIONS ON HOW TO APPLY FOR FINANCIAL ASSISTANCE OR A DISCOUNTED PAYMENT AND A CONTACT TELEPHONE NUMBER THAT A PATIENT OR FAMILY MEMBER CAN CALL TO OBTAIN MORE INFORMATION. INFORMATION REGARDING FINANCIAL ASSISTANCE IS INCLUDED WITH THE PATIENT'S BILLS AND STATEMENTS. BUSINESS CARDS NOTIFYING PATIENTS OF FINANCIAL ASSISTANCE PROGRAMS AND WHERE TO TELEPHONE FOR ASSISTANCE ARE LOCATED THROUGHOUT THE HOSPITAL.OUR CHARITY POLICY AND CHARITY APPLICATION IS AVAILABLE ON THE HOSPITAL'S WEBSITE. INFORMATION REGARDING CHARITY APPLICATION IS PROVIDED IN ENGLISH AND IN SPANISH. AMH ALSO SHARES ITS CHARITY CARE POLICIES WITH APPROPRIATE COMMUNITY HEALTH AND HUMAN SERVICES AGENCIES AND OTHERORGANIZATIONS THAT ASSIST SUCH PATIENTS. PART VI, LINE 4: ASHE COUNTY, NORTH CAROLINA IS LOCATED IN THE NORTHWESTERN CORNER OF NORTH CAROLINA. THE COUNTY BORDERS WATAUGA, WILKES AND ALLEGHANY COUNTIES, IN ADDITION TO TENNESSEE AND VIRGINA. ASHE COUNTY SITS IN THE BLUE RIDGE MOUNTAINS WITH A LARGE VARIETY OF OUTDOOR RECREATION AND CULTURAL ATTRACTIONS. THE TWO LARGEST TOWNSHIPS ARE WEST JEFFERSON AND JEFFERSON, BOTH LOCATED IN THE CENTRAL AREAS OF THE COUNTY. ASHE COUNTY IS HOME TO FIVE MOUNTAINS THAT EACH RISE ABOVE 5,000 FEET. THE COUNTY IS HOME TO MOUNT JEFFERSON, WITH A PEAK THAT TOWERS MORE THAN 1,600 FEET ABOVE THE TOWNS OF JEFFERSON AND WEST JEFFERSON.THE POPULATION OF ASHE COUNTY IS 26,786 WITH AN EVEN DISTRIBUTION OF MALES AND FEMALES. ACCORDING TO THE 2019 ESTIMATE, ASHE COUNTY'S POPULATION DECREASED BY 1.8 PERCENT FROM 2010 TO 2019, COMPARED TO A POPULATION INCREASE OF 9.9 PERCENT FOR THE STATE OF NORTH CAROLINA. THE POPULATION HAS PLATEAUED SINCE 2010 AND IS EXPECTED TO SLOWLY DECREASE OVER THE NEXT TEN YEARS.THE AVERAGE ASHE COUNTY RESIDENT IS 48 YEARS OLD, SLIGHTLY MORE THAN ONE YEAR OLDER THAN THE AVERAGE RESIDENT THREE YEARS AGO. THE MEDIAN AGE IS 38.6 YEARS FOR NORTH CAROLINA OVERALL. THE MAJORITY OF RESIDENTS IN ASHE COUNTY (95.1 PERCENT) IDENTIFY AS WHITE, NON-HISPANIC COMPARED TO 68.9 PERCENT OF PEOPLE ACROSS NORTH CAROLINA. THE PERCENTAGE OF AFRICAN AMERICAN, NON-HISPANIC RESIDENTS IN ASHE COUNTY IS MUCH LOWER AT 1.1 PERCENT THAN NORTH CAROLINA (21.5 PERCENT). THE PERCENT OF HISPANIC OR LATINO RESIDENTS IN ASHE COUNTY REMAINS AT 5 PERCENT, COMPARED TO 9.2 PERCENT IN NORTH CAROLINA. APPROXIMATELY 1.5 PERCENT OF THE POPULATION IDENTIFIES AS 2 OR MORE RACES.APPROXIMATELY 1,336 ASHE COUNTY RESIDENTS ARE HISPANIC OR LATINO. AMONG THOSE, 78.7 PERCENT ARE MEXICAN, 7.2 PERCENT ARE PUERTO RICAN, 8.1 PERCENT ARE CUBAN, AND 6.0 PERCENT ARE FROM SOME OTHER COUNTRY OF ORIGIN. ASIAN RESIDENTS REPRESENT LESS THAN 1 PERCENT OF THE POPULATION; OF THOSE, 45 PERCENT ARE FILIPINO, 36 PERCENT ARE VIETNAMESE, AND 19 PERCENT ARE OF A DIFFERENT ASIAN DESCENT. THE NUMBER OF ASIAN RESIDENTS IN ASHE COUNTY HAS INCREASED SLIGHTLY SINCE THE 2017 CHA.NATIONWIDE, SOME GROUPS OF PEOPLE EXPERIENCE HEALTH DISPARITIES, WHICH ARE PREVENTABLE DIFFERENCES IN HEALTH OUTCOMES THAT ARE CREATED BY SOCIAL, ECONOMIC, AND ENVIRONMENTAL CONDITIONS. THESE CONDITIONS LEAD TO BEHAVIORS SUCH AS SMOKING,POOR NUTRITION, AND LACK OF EXERCISE, WHICH AFFECT OUR HEALTH. HEALTH DISPARITIES ARE INEQUITABLE AND ARE DIRECTLY RELATED TO THE HISTORICAL AND CURRENT UNEQUAL DISTRIBUTION OF SOCIAL, POLITICAL, ECONOMIC, AND ENVIRONMENTAL RESOURCES. WHILE RACIAL AND ETHNIC MINORITY POPULATIONS IN ASHE COUNTY STILL COMPRISE A SMALL PERCENTAGE OF THE OVERALL POPULATION, IT IS IMPORTANT TO PAY CLOSE ATTENTION TO DIFFERENCES IN HEALTH OUTCOMES FOR THESE POPULATIONS. HEALTH DISPARITIES AMONG POPULATIONS ARE NOTED THROUGHOUT THIS REPORT BY HEALTH TOPIC. THE NORTH CAROLINA CENTER FOR STATE HEALTH STATISTICS NOTES THAT RACE OR ETHNICITY DOES NOT CAUSE A PARTICULAR HEALTH PROBLEM OR STATUS. IT IS LIKELY THAT FACTORS SUCH AS INCOME, EDUCATION, ACCESS TO HEALTH CARE, STRESS AND RACISM ARE AMONG THE MAJOR CAUSES OF THE POORER HEALTH OF MINORITIES ON MANY HEALTH MEASURES COMPARED TO WHITES. FEW SOURCES OF HEALTH DATA RECORD THESE TYPES OF HEALTH INFORMATION, ALTHOUGH MOST DATA SOURCES HAVE INFORMATION ON RACE OR ETHNICITY. SHOWING DATA BY RACE CAN IDENTIFY SPECIFIC AREAS OF DISPARITIES AND CAN HELP TARGET RESOURCES AND INTERVENTIONS TO POPULATIONS MOST IN NEED. REFER TO THE SECTION ON SOCIAL DETERMINANTS OF HEALTH FOR MORE INFORMATION ON THE FACTORS THAT ARE LIKELY TO CAUSE HEALTH DISPARITIES AMONG DIFFERENT RACIAL AND ETHNIC GROUPS. 1 ASHE MEMORIAL HOSPITAL FOUNDATION 200 HOSPITAL AVE JEFFERSON NC 28640 582078244 501(C)(3) 372335 0 GENERAL SUPPORT 1 PART I, LINE 2: FINANCIAL ASSISTANCE IS TRACKED THROUGH THE HOSPITAL'S FAP WHICH IS DESCRIBED IN SCHEDULE H. X X X X 0 0 0 0 0 0 0 0 0 BRIAN SACHS MD PHYSICIAN 388018 0 0 0 0 0 0 0 0 0 388018 0 0 0 TARA BLALOCK BURGHER PHYSICIAN 329177 0 0 0 0 0 0 0 0 0 329177 0 0 0 RONALD W BENFIELD MD PHYSICIAN 306315 0 0 0 0 0 0 0 0 0 306315 0 0 0 MELINDA WONSICK PHYSICIAN 266135 0 0 0 0 0 0 0 0 0 266135 0 0 0 THEODORE FLINT GRAY III PHYSICIAN 186539 0 0 0 0 0 0 0 0 0 186539 0 0 0 PART I, LINE 3 COMPENSATION FOR THE CEO IS PROVIDED BY AN UNRELATED ORGANIZATION. PLEASE SEE THE RESPONSE TO FORM 990, PART VI, LINE 15A FOR MORE DETAILS. DR CHARLES JONES BOARD MEMBER CALL PAY, RENTAL OFFICE SPACE, AND LEASED ROOM 0 FORM 990, PART VI, SECTION A, LINE 3 SEE NOTE FOR PART VI, LINE 15. FORM 990, PART VI, SECTION A, LINE 6 THE HOSPITAL IS ORGANIZED AS A STOCK CORPORATION, AND SHARES OF STOCK ARE SOLD TO MEMBERS OF THE COMMUNITY AND ARE FREELY TRANSFERABLE, BUT HAVE NO CAPITAL VALUE. SHAREHOLDERS DO NOT RECEIVE DIVIDENDS. FORM 990, PART VI, SECTION A, LINE 7A TRUSTEES SHALL BE ELECTED BY THE SHAREHOLDERS OF THE CORPORATION AT THE ANNUAL MEETING OF THE MEMBERSHIP. EACH SELECTED TRUSTEE SHALL HOLD OFFICE FOR A TERM OF THREE YEARS AND UNTIL HIS SUCCESSOR IS ELECTED AND QUALIFIED. FORM 990, PART VI, SECTION A, LINE 7B THE ORGANIZATION CANNOT SELL REAL PROPERTY WITHOUT APPROVAL BY THE SHAREHOLDERS. PLEASE SEE THE RESPONSE TO LINE 6 ABOVE. FORM 990, PART VI, SECTION B, LINE 11B THE RETURN WAS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM WITH THE ASSISTANCE AND OVERSIGHT OF MANAGEMENT. THE BOARD IS INFORMED OF THE FILING OF THE RETURN AND THE 990 IS MADE AVAILABLE TO THEM FOR REVIEW AFTER THE RETURN IS FILED. FORM 990, PART VI, SECTION B, LINE 12C ALL VOTING MEMBERS ARE REQUIRED TO REVIEW AND SIGN A CONFLICT OF INTEREST SURVEY AND RETURN TO THE BOARD CHAIRMAN. THE SURVEY INCLUDES A DISCLOSURE STATEMENT AND A REVIEW OF THE POLICY. FORM 990, PART VI, SECTION B, LINE 15 NOVANT AND A BOARD COMMITTEE DETERMINE THE COMPENSATION PROVIDED TO THE NOVANT EMPLOYED CEO. NONE OF THE OFFICERS OF THE CORPORATION ARE COMPENSATED. FORM 990, PART VI, SECTION C, LINE 19 PHOTOCOPIES OF THE FORM 990 ARE AVAILABLE UPON REQUEST AT THE ORGANIZATION'S ADMINISTRATIVE OFFICE. PLEASE CONTACT THE ADMINISTRATIVE OFFICE FOR FURTHER DETAILS. SEE FORM 990, PART VI, LINE 20. FORM 990, PART IX, LINE 11G OTHER FEES: PROGRAM SERVICE EXPENSES 4,791,909. MANAGEMENT AND GENERAL EXPENSES 1,002,606. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,794,515. AMH ASHE WOMEN'S CENTER LLC 420 E 2ND STREET WEST JEFFERSON NC 28694 451482188 PHYSICIANS PRACTICE NC ASHE MEMORIAL HOSPITAL ASHE FINANCIAL SERVICES LLC 200 HOSPITAL AVENUE JEFFERSON NC 28640 810919041 HEALTHCARE NC ASHE MEMORIAL HOSPITAL ASHE MEMORIAL HOSPITAL FOUNDATION INC 200 HOSPITAL AVE JEFFERSON NC 28640 582078244 FUNDRAISING NC 501(C)(3) LINE 12A, I ASHE MEMORIAL HOSPITAL 0 0 1 1 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 ASHE MEMORIAL HOSPITAL FOUNDATION B 372335 CASH