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GASTON MEMORIAL HOSPITAL INC: Form 990, tax year 2021

View the entire original 990 at ProPublica ↗

Organization
GASTON MEMORIAL HOSPITAL INC (EIN 56-0619359)
Tax period
2021-07-01 to 2022-06-30
Filed
2023-05-08
IRS object ID
202301289349301125
Schema version
2021v4.2
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2023-05-08T09:36:37-05:00ReturnTs
Tax Period End2022-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN440160260PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1FORVIS LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1500 RIDGEFIELD COURTAddressLine1Txt
CityASHEVILLECityNm
State AbbreviationNCStateAbbreviationCd
ZIP28806ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2021-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN560619359EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1GASTON MEMORIAL HOSPITAL INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlGASTBusinessNameControlTxt
Phone7048342000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line12525 COURT DRIVEAddressLine1Txt
CityGASTONIACityNm
State AbbreviationNCStateAbbreviationCd
ZIP28054ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonDAVID O'CONNORPersonNm
Person TitleEVP, CFOPersonTitleTxt
Phone7048342000PhoneNum
Signature2023-05-08SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstDAVIDPersonFirstNm
Person LastOCONNORPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonAMY BIBBYPreparerPersonNm
PTINP00445891PTIN
Phone8282542254PhoneNum
Preparation2023-05-08PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer3TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2021TaxYr
Build TS2023-04-26 12:10:37ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1CAROMONT REGIONAL MEDICAL CTRBusinessNameLine1Txt
FieldValueIRS element (for citing)
Principal OfficerDAVID O'CONNORPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line12525 COURT DRIVEAddressLine1Txt
CityGASTONIACityNm
State AbbreviationNCStateAbbreviationCd
ZIP28054ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$689,404,813GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.CAROMONT.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1945FormationYr
Legal Domicile StateNCLegalDomicileStateCd
Activity Or MissionTO PROVIDE COMPASSIONATE, EXCEPTIONAL AND HIGHLY RELIABLE CARE.ActivityOrMissionDesc
Voting Members Governing Body14VotingMembersGoverningBodyCnt
Voting Members Independent9VotingMembersIndependentCnt
Total Employee3967TotalEmployeeCnt
Total Volunteers81TotalVolunteersCnt
Total Gross UBI$97,333TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$46,086NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$3,244,094PYContributionsGrantsAmt
CY Contributions Grants$451,028CYContributionsGrantsAmt
PY Program Service Revenue$628,441,590PYProgramServiceRevenueAmt
CY Program Service Revenue$682,507,664CYProgramServiceRevenueAmt
PY Investment Income$19,583,338PYInvestmentIncomeAmt
CY Investment Income$2,772,379CYInvestmentIncomeAmt
PY Other Revenue$13,793,421PYOtherRevenueAmt
CY Other Revenue$3,673,742CYOtherRevenueAmt
PY Total Revenue$665,062,443PYTotalRevenueAmt
CY Total Revenue$689,404,813CYTotalRevenueAmt
PY Grants And Similar Paid$1,427,796PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$1,497,469CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$242,581,957PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$270,037,481CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$319,849,996PYOtherExpensesAmt
CY Other Expenses$360,398,787CYOtherExpensesAmt
PY Total Expenses$563,859,749PYTotalExpensesAmt
CY Total Expenses$631,933,737CYTotalExpensesAmt
PY Revenues Less Expenses$101,202,694PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$57,471,076CYRevenuesLessExpensesAmt
Total Assets BOY$627,844,903TotalAssetsBOYAmt
Total Assets EOY$730,850,666TotalAssetsEOYAmt
Total Liabilities BOY$494,526,058TotalLiabilitiesBOYAmt
Total Liabilities EOY$506,717,452TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$133,318,845NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$224,133,214NetAssetsOrFundBalancesEOYAmt
MissionTO PROVIDE COMPASSIONATE, EXCEPTIONAL AND HIGHLY RELIABLE CARE.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$597,157,248ExpenseAmt
Grant$1,497,469GrantAmt
Revenue$682,410,331RevenueAmt
DescCAROMONT HEALTH'S PHILOSOPHY OF CARE IS FOUNDED IN THREE DISTINCT WAYS. IT IS A HEALTH SYSTEM THAT INVESTS IN THE FUTURE OF HEALTHCARE FROM RESEARCH TO EDUCATION. IT IS AN ACTIVE COMMUNITY PARTNER, SUPPORTING AND DRIVING PROGRAMS THAT ENCOURAGE HEALTHIER LIFESTYLES. IT IS ALSO A DYNAMIC ORGANIZATION FOCUSED ON CONTINUOUS DAILY IMPROVEMENT, ADVANCED MEDICINE AND THE DELIVERY OF COMPASSIONATE, EXCEPTIONAL AND HIGHLY RELIABLE CARE. THE FISCAL YEAR ENDING JUNE 30, 2022 SAW CAROMONT HEALTH LIVING ITS VISION TO BE OUR COMMUNITY'S MOST TRUSTED HEALTHCAREPARTNER. THE COMPLETE 2022 COMMUNITY BENEFIT REPORT CAN BE FOUND AT WWW.CAROMONTHEALTH.ORG.Desc
Total Program Service Expenses$597,157,248TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi EndowmentsYes (1)DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt BondsYes (1)TaxExemptBondsInd
Invest Tax Exempt Bonds0InvestTaxExemptBondsInd
Escrow Account0EscrowAccountInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam MemYes (1)BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document329IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee3967EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (1)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (1)Form990TFiledInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtYes (1)SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members14GoverningBodyVotingMembersCnt
Independent Voting Member9IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldNCStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1THE ORGANIZATIONBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone7048342000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line12525 COURT DRIVEAddressLine1Txt
CityGASTONIACityNm
State AbbreviationNCStateAbbreviationCd
ZIP28054ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (30 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
MR DAVID PAYSEUR
CHAIR1.001.00Yes (X)Yes (X)$0$0$0
MR JEFFREY CASH
VICE CHAIR0.001.00Yes (X)Yes (X)$0$0$0
REV PEARL BURRIS-FLOYD
SECRETARY1.001.00Yes (X)Yes (X)$0$106,553$0
MR BARRY POMEROY
TREASURER1.001.00Yes (X)Yes (X)$0$0$0
DRJAY HENDLER
CHIEF-OF-STAFF (BEGIN 1/1/22)1.0040.00Yes (X)$0$468,258$29,004
DR HEALTH HIGH
CHIEF-OF-STAFF ELECT (BEGIN 1/1/22)1.0040.00Yes (X)$0$621,849$39,368
DR MICHEAL GASLIN
CHIEF-OF-STAFF (THROUGH 12/31/21)1.001.00Yes (X)$27,500$0$0
DR ERIC EMERSON
PAST-CHIEF-OF-STAFF (NON-VOTING) THROUGH 12/31/211.001.00Yes (X)$21,333$0$0
MR BOB HOVIS
(COMMISSIONER LIASON)1.002.00Yes (X)$0$19,872$0
MR JOSEPH DAVIS JR
DIRECTOR1.001.00Yes (X)$0$0$0
MR WILLIAM ANTHONY
DIRECTOR1.001.00Yes (X)$0$0$0
MS ANNETTE CARTER
DIRECTOR1.001.00Yes (X)$0$0$0
MS JANIE PEAK
DIRECTOR1.001.00Yes (X)$0$0$0
MR FRANK STEWART
DIRECTOR1.001.00Yes (X)$0$0$0
MR DONNIE LOFTIS
DIRECTOR (THROUGH 11/10/21)1.001.00Yes (X)$0$0$0
MR TIMOTHY EFIRD
DIRECTOR1.001.00Yes (X)$0$0$0
REVBENJAMIN HINTON
DIRECTOR (BEGIN 1/1/22)1.001.00Yes (X)$0$0$0
MR JASON AUSTELL
DIRECTOR (BEGIN 2/28/22)1.001.00Yes (X)$0$0$0
MR TIMOTHY CONNER
DIRECTOR (THROUGH 12/31/21)1.001.00Yes (X)$0$0$0
MR K CHRISTOPHER PEEK
CEO45.0010.00Yes (X)$1,491,823$0$253,847
MR DAVID O'CONNOR
EVP/CFO/ASST. TREASURER45.0010.00Yes (X)$816,772$0$147,842
MS LEIGH HICKMAN
VP/CLO/ASST. SEC45.0010.00Yes (X)$440,881$0$82,961
MR DANNY WHARTON
VP CLINICAL SERVICES THROUGH 12/21-EVP CHIEF OPERA45.0010.00$393,303$0$65,431Yes (X)
MS KATHLEEN BESSON
EVP/CHIEF OPERATING OFFICER THROUGH 12/21-SPECIAL45.0010.00$1,055,121$0$68,898Yes (X)
DR TODD DAVIS
EVP CHIEF PHYSICIAN EXECUTIVE45.0010.00$880,099$0$157,314Yes (X)
DR GEORGE ADCOCK III
VP MEDICAL AFFAIRS40.0010.00$536,521$0$98,134Yes (X)
MR RICHARD BLACKBURN
VP SUPPORT SERVICES40.0010.00$444,245$0$61,407Yes (X)
MS ROBIN LANG
VP CHIEF INFORMATION OFFICER40.0010.00$490,417$0$86,494Yes (X)
MR FRANK MURPHY
VP STRATEGY BUSINESS DEVELOPMENT40.0010.00$463,540$0$79,963Yes (X)
MS ASHLEY LONG
VP CHIEF NURSING OFFICER40.0010.00$302,573$0$61,513Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$7,364,128TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$1,216,532TotReportableCompRltdOrgAmt
Total Other Compensation$1,232,176TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K362IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
THE ROBINS AND MORTON GROUP
400 SHADES CREEK PARKWAYBIRMINGHAMAL352465870CONSTRUCTION MANAGEMENT$61,944,735
CROSS COUNTRY STAFFING
PO BOX 404682ATLANTAGA303844682TEMPORARY STAFFING$34,214,416
MCMILLAN PAZDAN SMITH LLC
PO BOX 537044ATLANTAGA303539450CONSTRUCTION MANAGEMENT$6,708,566
EDIFICE INC
PO BOX 36349CHARLOTTENC28236CONSTRUCTION MANAGEMENT$4,424,386
EPIC SYSTEMS CORPORATION
PO BOX 88314MILWAUKEEWI532880314SOFTWARE SYSTEMS$2,504,880
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K52CntrctRcvdGreaterThan100KCnt
Related Organizations$442,763RelatedOrganizationsAmt
All Other Contributions$8,265AllOtherContributionsAmt
Total Contributions$451,028TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmt
PATIENT SERVICE REVENUE621500$680,909,967$680,909,967
ANCILLARY REVENUE621500$1,597,697$1,500,364$97,333
FieldValueIRS element (for citing)
Total Program Service Revenue$682,507,664TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$588,932TotalRevenueColumnAmt
Exclusion$588,932ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Other$2,183,447OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Other$0OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Other$2,183,447OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,183,447TotalRevenueColumnAmt
Exclusion$2,183,447ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmt
CAFETERIA & VENDING INCOME900099$1,821,375$1,821,375
MISCELLANEOUS REVENUE900099$1,670,946$1,670,946
PHARMACY REVENUE621500$119,779$119,779

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$61,642TotalRevenueColumnAmt
Exclusion$61,642ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$3,673,742OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$689,404,813TotalRevenueColumnAmt
Related Or Exempt Func Income$682,410,331RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$97,333UnrelatedBusinessRevenueAmt
Exclusion$6,446,121ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$1,497,320TotalAmt
Program Services$1,497,320ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$149TotalAmt
Program Services$149ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$5,077,999TotalAmt
Management And General$5,077,999ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$219,230,142TotalAmt
Program Services$201,278,118ProgramServicesAmt
Management And General$17,952,024ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total-$3,452,589TotalAmt
Program Services-$3,098,107ProgramServicesAmt
Management And General-$354,482ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$34,521,081TotalAmt
Program Services$30,976,754ProgramServicesAmt
Management And General$3,544,327ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$14,660,848TotalAmt
Program Services$13,155,599ProgramServicesAmt
Management And General$1,505,249ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$1,033,485TotalAmt
Program Services$1,033,485ProgramServicesAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$41,197TotalAmt
Management And General$41,197ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$201,595TotalAmt
Management And General$201,595ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$993TotalAmt
Management And General$993ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$13TotalAmt
Management And General$13ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$107,077,647TotalAmt
Program Services$104,023,092ProgramServicesAmt
Management And General$3,054,555ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$2,001,972TotalAmt
Program Services$439,168ProgramServicesAmt
Management And General$1,562,804ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$5,796,200TotalAmt
Program Services$4,139,844ProgramServicesAmt
Management And General$1,656,356ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$2,525,594TotalAmt
Program Services$2,525,594ProgramServicesAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$7,474,885TotalAmt
Program Services$7,474,885ProgramServicesAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$113,083TotalAmt
Program Services$76,644ProgramServicesAmt
Management And General$36,439ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$287,624TotalAmt
Program Services$181,820ProgramServicesAmt
Management And General$105,804ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$7,528,190TotalAmt
Program Services$7,528,190ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$35,094,543TotalAmt
Program Services$35,094,543ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$2,220,854TotalAmt
Program Services$2,220,854ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES$116,408,018$116,408,018
UBI TAX-$5,272-$5,272
BAD DEBT$61,721,221$61,721,221
MEDICAID ASSESSMENT FEE$5,747,676$5,747,676

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$5,129,269TotalAmt
Program Services$4,732,381ProgramServicesAmt
Management And General$396,888ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$631,933,737TotalAmt
Program Services$597,157,248ProgramServicesAmt
Management And General$34,776,489ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$38,205BOYAmt
EOY$1EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$56,140,383BOYAmt
EOY$64,795,343EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$9,993,724BOYAmt
EOY$11,497,614EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$12,114,663BOYAmt
EOY$7,185,216EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$900,382,467LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$438,530,669LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$279,527,827BOYAmt
EOY$461,851,798EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$116,334,886BOYAmt
EOY$72,361,185EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$153,695,215BOYAmt
EOY$113,159,509EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$627,844,903BOYAmt
EOY$730,850,666EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$98,682,391BOYAmt
EOY$145,635,796EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$276,469,534BOYAmt
EOY$263,486,757EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$119,374,133BOYAmt
EOY$97,594,899EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$494,526,058BOYAmt
EOY$506,717,452EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$55,033,113BOYAmt
EOY$127,925,123EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$78,285,732BOYAmt
EOY$96,208,091EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$133,318,845BOYAmt
EOY$224,133,214EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$627,844,903BOYAmt
EOY$730,850,666EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$57,471,076ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$1,720NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$33,345,013OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
VolunteersYes (1)VolunteersInd
Paid Staff Or ManagementYes (1)PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other Organizations0GrantsOtherOrganizationsInd
Direct Contact LegislatorsYes (1)DirectContactLegislatorsInd
Direct Contact Legislators$169,320DirectContactLegislatorsAmt
Rallies Demonstrations0RalliesDemonstrationsInd
Other ActivitiesYes (1)OtherActivitiesInd
Other Activities$35,990OtherActivitiesAmt
Total Lobbying Expenditures$205,310TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART II-B, LINE 1:FormAndLineReferenceDesc
ExplanationANNUAL DUES WERE PAID TO THE NORTH CAROLINA HOSPITAL ASSOCIATION AND THE AMERICAN HOSPITAL ASSOCIATION, OF WHICH $35,990 WAS DETERMINED TO BE EXPENDITURES USED IN LOBBYING ACTIVITIES BY THESE ORGANIZATIONS. THE ORGANIZATION HAD AN ADDITIONAL $169,320 IN LOBBYING COSTS FOR FISCAL YEAR 2022. LOBBYING REGISTRATION IS IN THE NAME OF CAROMONT HEALTH, INC. LOBBYING EXPENDITURES ARE REPORTED ON THE GASTON MEMORIAL HOSPITAL, INC FORM 990.ExplanationTxt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$12,061BeginningYearBalanceAmt
End Year Balance$12,061EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$10,190BeginningYearBalanceAmt
Investment Earnings Or Losses$1,941InvestmentEarningsOrLossesAmt
Other Expenditures$70OtherExpendituresAmt
End Year Balance$12,061EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$10,310BeginningYearBalanceAmt
Investment Earnings Or Losses$228InvestmentEarningsOrLossesAmt
Other Expenditures$348OtherExpendituresAmt
End Year Balance$10,190EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$10,049BeginningYearBalanceAmt
Investment Earnings Or Losses$655InvestmentEarningsOrLossesAmt
Other Expenditures$394OtherExpendituresAmt
End Year Balance$10,310EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$9,841BeginningYearBalanceAmt
Investment Earnings Or Losses$703InvestmentEarningsOrLossesAmt
Other Expenditures$495OtherExpendituresAmt
End Year Balance$10,049EndYearBalanceAmt
FieldValueIRS element (for citing)
Endowments Held Unrelated Org0EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org0EndowmentsHeldRelatedOrgInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$7,555,850OtherCostOrOtherBasisAmt
Book Value$7,555,850BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$350,525,749OtherCostOrOtherBasisAmt
Depreciation$218,516,285DepreciationAmt
Book Value$132,009,464BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$9,899,957OtherCostOrOtherBasisAmt
Depreciation$9,139,531DepreciationAmt
Book Value$760,426BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$283,062,139OtherCostOrOtherBasisAmt
Depreciation$205,159,567DepreciationAmt
Book Value$77,902,572BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$249,338,772OtherCostOrOtherBasisAmt
Depreciation$5,715,286DepreciationAmt
Book Value$243,623,486BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$461,851,798TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (4 entries)

DescDescBook ValueBookValueAmt
NET PENSION ASSET/DEFERRAL$96,693,945
DEFERRED FINANCING COSTS$826,175
OTHER RECEIVABLES$5,629,408
DEFERRED CHARGE-INTEREST RATE SWAP$10,009,981
FieldValueIRS element (for citing)
Total Book Value Other Assets$113,159,509TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)

DescDescAmtAmt
ESTIMATED 3RD PARTY SETTLEMENTS$67,480,425
INTEREST RATE SWAP LIABILITY$10,009,981
PENSION DEFERRED INFLOW$20,104,493
FieldValueIRS element (for citing)
Total Liability$97,594,899TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$664,030,167TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst-$1,720NetUnrealizedGainsInvstAmt
Other Revenue$3,983,494OtherRevenueAmt
Revenue Not Reported$3,981,774RevenueNotReportedAmt
Revenue Subtotal$660,048,393RevenueSubtotalAmt
Investment Expenses Not Incld$13InvestmentExpensesNotIncldAmt
Other Revenues Not Included$29,356,407OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$29,356,420RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$689,404,813TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$574,196,009TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included$3,983,506OtherExpensesIncludedAmt
Expenses Not Reported$3,983,506ExpensesNotReportedAmt
Expenses Subtotal$570,212,503ExpensesSubtotalAmt
Investment Expenses Not Incld2$13InvestmentExpensesNotIncld2Amt
Other Expenses Not Included$61,721,221OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$61,721,234ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$631,933,737TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART V, LINE 4:THE ORGANIZATION'S ENDOWMENT FUNDS ARE USED FOR ONCOLOGY MEDICATIONS FOR INDIGENT PATIENTS.
PART X, LINE 2:THE SYSTEM IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE SYSTEM HAS DETERMINED THAT IT DOES NOT HAVE ANY UNRECOGNIZED TAX BENEFITS OR OBLIGATIONS AS OF JUNE 30, 2022 AND 2021.
PART XI, LINE 2D - OTHER ADJUSTMENTS:EXPENSES IN REVENUES 9,765. PROVIDER RELIEF FUNDS 3,973,729.
PART XI, LINE 4B - OTHER ADJUSTMENTS:BAD DEBT 61,721,221. INTERCOMPANY TRANSFER FROM AFFILIATE -32,364,814.
PART XII, LINE 2D - OTHER ADJUSTMENTS:EXPENSES IN REVENUES 9,777. PROVIDER RELIEF FUNDS 3,973,729.
PART XII, LINE 4B - OTHER ADJUSTMENTS:BAD DEBT 61,721,221. AUXILIARY SCHOLARSHIPS

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd
Percent200Yes (X)Percent200Ind
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd
Percent200 DYes (X)Percent200DInd
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed Budget0ExpensesExceedBudgetInd
Annual Community Bnft ReportYes (1)AnnualCommunityBnftReportInd
Report Publically AvailableYes (1)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$12,159,846TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$12,159,846NetCommunityBenefitExpnsAmt
Total Expense0.02130TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$74,092,822TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$74,208,372DirectOffsettingRevenueAmt
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$86,252,668TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$74,208,372DirectOffsettingRevenueAmt
Net Community Benefit Expns$12,159,846NetCommunityBenefitExpnsAmt
Total Expense0.02130TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$2,385,709TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$570DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,385,139NetCommunityBenefitExpnsAmt
Total Expense0.00420TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$2,124,739TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$219,827DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,904,912NetCommunityBenefitExpnsAmt
Total Expense0.00330TotalExpensePct

Research ResearchGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$535,042TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$136,014DirectOffsettingRevenueAmt
Net Community Benefit Expns$399,028NetCommunityBenefitExpnsAmt
Total Expense0.00070TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,287,712TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,287,712NetCommunityBenefitExpnsAmt
Total Expense0.00230TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$6,333,202TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$356,411DirectOffsettingRevenueAmt
Net Community Benefit Expns$5,976,791NetCommunityBenefitExpnsAmt
Total Expense0.01050TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$92,585,870TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$74,564,783DirectOffsettingRevenueAmt
Net Community Benefit Expns$18,136,637NetCommunityBenefitExpnsAmt
Total Expense0.03180TotalExpensePct

Workforce Development WorkforceDevelopmentGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$3,885,916TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$3,885,916NetCommunityBenefitExpnsAmt
Total Expense0.00680TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$3,885,916TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$3,885,916NetCommunityBenefitExpnsAmt
Total Expense0.00680TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense$61,721,221BadDebtExpenseAmt
Bad Debt Expense Attributable$3,400,000BadDebtExpenseAttributableAmt
Reimbursed By Medicare$104,898,373ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$118,436,540CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$13,538,167MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (1)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1CAROMONT REGIONAL MEDICAL CENTERBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line12525 COURT DRIVEAddressLine1Txt
CityGASTONIACityNm
State AbbreviationNCStateAbbreviationCd
ZIP28054ZIPCd
FieldValueIRS element (for citing)
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd
Other3 DIAGNOSTIC IMAGING CENTERS AND 6 OP SERIVCE CENTEROtherDesc

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1CAROMONT REGIONAL MEDICAL CENTERBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY0TaxExemptHospitalCYOrPYInd
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
CHNA Conducted21CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts0CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsYes (1)CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLWWW.CAROMONTHEALTH.ORGOwnWebsiteURLTxt
Other WebsiteYes (X)OtherWebsiteInd
Other Website URLWWW.GASTONGOV.COM/DEPARTMENTS/HEALTH-AND-HUMAN-SERVICESOtherWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Rpt Available Thru Other MethodYes (X)RptAvailableThruOtherMethodInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt21ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (1)StrategyPostedWebsiteInd
Strategy Website URLHTTPS://WWW.CAROMONTHEALTH.ORG/DOCUMENTS/FY21_PRESENTATION_CHNA-(1).PDFStrategyWebsiteURLTxt
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care200.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care200.000000000000FPGFamilyIncmLmtDscntCarePct
Income Level CriteriaYes (X)IncomeLevelCriteriaInd
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Other MethodYes (X)OtherMethodInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLSEE DISCLOSUREFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLSEE DISCLOSUREFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLSEE DISCLOSUREFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
FAP TranslatedYes (X)FAPTranslatedInd
Other PublicityYes (X)OtherPublicityInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection Activities0CollectionActivitiesInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Other Actions TakenYes (X)OtherActionsTakenInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Look Back Medicare PrivateYes (X)LookBackMedicarePrivateInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
CAROMONT REGIONAL MEDICAL CENTERPART V, SECTION B, LINE 5: GASTON COUNTY COMMUNITY HEALTH ASSESSMENT WAS CONDUCTED BY THE FOLLOWING PARTNERS: THE GASTON COUNTY DEPARTMENT OF HEALTH AND HUMAN SERVICES, GASTON TOGETHER, UNITED WAY OF GASTON COUNTY, CAROMONT HEALTH, AND STAKEHOLDER ORGANIZATIONS. THE ASSESSMENT INCLUDES THE COLLECTION AND ANALYSIS OF EXISTING STATISTICAL DATA, QUALITY OF LIFE SURVEY DATA COLLECTED DIRECTLY FROM RESIDENTS AND INPUT FROM COMMUNITY FOCUS GROUPS.
CAROMONT REGIONAL MEDICAL CENTERPART V, SECTION B, LINE 6B: THE HOSPITAL CONDUCTED THEIR CHNA WITH THE FOLLOWING ORGANIZATIONS: GASTON COUNTY DEPARTMENT OF HEALTH AND HUMAN SERVICES, CAROMONT HEALTH, GASTON TOGETHER, THE UNITED WAY OF GASTON COUNTY AND REPRESENTATIVES OF OTHER STAKEHOLDER ORGANIZATIONS.
CAROMONT REGIONAL MEDICAL CENTERPART V, SECTION B, LINE 7D: PARTNERING AGENCIES PRESENTED THE CHNA AT WORKSHOPS, MEETINGS AND ON AGENCY WEBSITES TO ENCOURAGE COMMUNITY STAKEHOLDERS TO USE THEM TO ENHANCE THE WELLBEING OF GASTON COUNTY AND ITS RESIDENTS.
CAROMONT REGIONAL MEDICAL CENTERPART V, SECTION B, LINE 11: CAROMONT HEALTH PRIORITIES (2019-2021) ARE TO PROACTIVELY MANAGE MENTAL HEALTH ISSUES IN PRIMARY CARE OFFICES THROUGH THE HIRE OF MORE LCSWS, ENHANCE OPIOID AND PRESCRIPTION DRUG ABUSE INTERVENTION AND MANAGEMENT PROTOCOLS AND TO IMPROVE ACCESS TO AFFORDABLE HEALTH FOOD IN LOW INCOME COMMUNITIES THROUGH WORK WITH LOCAL STAKEHOLDERS. THE IMPLEMENTATION PLAN AND PRIORITIES FOR THE MOST RECENT CHNA WERE SET IN NOVEMBER 2022.
CAROMONT REGIONAL MEDICAL CENTERPART V, SECTION B, LINE 13B: REGARDLESS OF INCOME, ASSETS ARE ALSO USED TO DETERMINE IF A PATIENT QUALIFIES FOR CHARITY. BELOW IS THE VERBIAGE FROM THIS POLICY: EXEMPT ASSETSTHE PRIMARY RESIDENCE ON UP TO ONE ACRE OF LAND, ONE AUTOMOBILE FOR EACH WORKING AGED ADULT, AND OTHER ASSETS, INCLUDING BUT NOT LIMITED TO, RETIREMENT FUNDS, INVESTMENTS AND OTHER FINANCIAL ASSETS, CASH VALUE OF LIFE INSURANCE POLICIES, AND EQUITY IN PROPERTY OR REAL ASSETS, TOTALING UP TO $25,000 ARE ALSO EXEMPT FROM CONSIDERATION AS ASSETS IN DETERMINING CHARITY CARE ELIGIBILITY. ANNUAL INCOME FROM PROPERTY OF REAL ASSETS WILL BE DEDUCTED FROM THE AMOUNT OF EQUITY IN THE ASSET WHEN CALCULATING THE EXEMPTION.
CAROMONT REGIONAL MEDICAL CENTERPART V, SECTION B, LINE 15E: CAROMONT HEALTH HAS A TEAM DEDICATED TO EDUCATING AND/OR ASSISTING PATIENTS WITH OTHER STATE OR GOVERNMENT AGENCIES THAT MAY BE A SOURCE OF ASSISTANCE.
CAROMONT REGIONAL MEDICAL CENTERPART V, SECTION B, LINE 16J: PLAIN LANGUAGE BROCHURES ARE DISTRIBUTED AT REGISTRATION SITES. FINANCIAL COUNSELORS PROACTIVELY COMMUNICATE VERBALLY OR IN WRITING PRIOR TO SERVICE FOR SCHEDULED VISITS AND IN-HOUSE, AND/OR AFTER SERVICE TO THOSE MOST LIKELY TO REQUIRE FINANCIAL ASSISTANCE. VERBIAGE IS ALSO ON THE PATIENT BILLING STATEMENT. SPANISH INSTRUCTIONS ON WEBSITE AND IN PERSON INTERPRETER STAFF AVAILABLE TO ASSIST.
CAROMONT REGIONAL MEDICAL CENTERPART V, SECTION B, LINE 18E: COLLECTION ACTIONS ARE TAKEN AFTER REASONABLE EFFORTS HAVE BEEN MADE TO DETERMINE PATIENT'S ELIGIBILITY FOR ASSISTANCE.
CAROMONT REGIONAL MEDICAL CENTERPART V, SECTION B, LINE 20E: PLAIN LANGUAGE BROCHURES AT REGISTRATION SITES. PROACTIVELY COMMUNICATING VERBIALLY AND/OR IN WRITING TO SCHEDULED PATIENTS PRIOR TO SERVICE. COMMUNICATING IN-HOUSE, DURING SERVICE, OR AFTER SERVICE TO THOSE MOST LIKELY TO QUALIFY FOR ASSISTANCE.
PART V, SECTION B, LINE 16ATHE PLAIN LANGUAGE SUMMARY AND CHARITY CARE APPLICATION CAN BE FOUND USING THE LINKS BELOW:PLAIN LANGUAGE SUMMARY: HTTP://WWW.CAROMONTHEALTH.ORG/DOCUMENTS/REGISTRATION_CHARITYCAREPOLICYCHARITY CARE APPLICATION: HTTP://WWW.CAROMONTHEALTH.ORG/DOCUMENTS/CHARITY-CARE-APPLICATION-ENGLISH

Supplemental Information Detail SupplementalInformationDetail (17 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 3C:FREE CARE IS PROVIDED TO PATIENTS WITH A FPG OF 200% OR LESS. ALL OTHER PATIENTS RECEIVE AN INSURANCE DISCOUNT BASED ON THEIR INDIVIDUAL INSURANCE PLAN AGREEMENT OR AN UNINSURED DISCOUNT FOR SELF PAY PATIENTS. UNINSURED DISCOUNTS ARE COMPARABLE TO OUR INSURANCE DISCOUNTS.REGARDLESS OF INCOME, ASSETS ARE ALSO USED TO DETERMINE IF A PATIENT QUALIFIES FOR CHARITY. BELOW IS THE VERBIAGE FROM THIS POLICY:EXEMPT ASSETSTHE PRIMARY RESIDENCE ON UP TO ONE ACRE OF LAND, ONE AUTOMOBILE FOR EACH WORKING AGED ADULT, AND OTHER ASSETS UP TO $25,000 INCLUDING BUT NOT LIMITED TO, RETIREMENT FUNDS, INVESTMENTS AND OTHER FINANCIAL ASSETS, CASH VALUE OF LIFE INSURANCE POLICIES, AND EQUITY IN PROPERTY OR REAL ASSETS ARE ALSO EXEMPT FROM CONSIDERATION AS ASSETS IN DETERMINING CHARITY CARE ELIGIBILITY. ANNUAL INCOME FROM PROPERTY OF REAL ASSETS WILL BE DEDUCTED FROM THE AMOUNT OF EQUITY IN THE ASSET WHEN CALCULATING THE EXEMPTION.PART 1, LINE 6A:COMMUNITY BENEFIT REPORT: THE ORGANIZATION'S COMMUNITY BENEFIT REPORT MADE AVAILABLE TO THE PUBLIC CONTAINS COMMUNITY BENEFITS FOR ALL RELATED ORGANIZATIONS TO THE HOSPITAL.
PART I, LINE 7:THE COSTING METHODOLOGY USED IS A COST ACCOUNTING SYSTEM. ALL PATIENT SEGMENTS ARE INCLUDED. THIS SYSTEM ASSIGNS DIRECT COSTS TO SUPPLIES, PROCEDURES, ROUTINE AND SPECIALTY ROOM RATES BASED ON THE DEPARTMENT OF ORIGINATION. FIXED COSTS ARE ALLOCATED BASED ON STATISTICAL BASIS. THESE COSTS ARE THEN AGGREGATED AT THE PATIENT LEVEL AND TABULATED BY PAYOR TYPE. THE RATIO OF COST TO CHARGE METHOD IS NOT MATERIALLY USED IN THE COST ACCOUNTING SYSTEM.
PART I, LN 7 COL(F):61,721,221 BAD DEBT EXPENSE REMOVED FROM TOTAL EXPENSES PRIOR TO CALCULATING PERCENT OF TOTAL EXPENSE.
PART I, LINE 7H:CAROMONT HEALTH IS INVOLVED IN APPROXIMATELY 40 RESEARCH STUDIES, APPROXIMATELY 55% OF WHICH ARE CLINICAL TRIALS COOPERATIVE GROUP PROGRAM STUDIES SPONSORED BY THE NATIONAL CANCER INSTITUTE (NCI). CAROMONT HEALTH ALSO PARTICIPATES IN DRUG AND DEVICE STUDIES SPONSORED BY VARIOUS PHARMACEUTICAL, BIOTECHNOLOGY, AND DEVICE COMPANIES, AS WELL AS UNFUNDED ONCOLOGY, NURSING AND PHARMACY RESEARCH STUDIES.
PART II, COMMUNITY BUILDING ACTIVITIES:CAROMONT HEALTH'S RECRUITMENT OF PHYSICIANS, ADVANCED CARE PRACTITIONERS, NURSING AND CLINICAL STAFF, AND BUSINESS AND SUPPORT STAFF EXTENDS INTO THE FIVE COUNTIES THE SYSTEM SERVES AND IS DRIVEN BY THE CHANGING POPULATION OF THE REGION AND THE SPECIFIC HEALTH NEEDS OF PATIENTS. THE SYSTEM'S GOAL IS TO BE PRO-ACTIVE AND ANTICIPATORY SO THAT THE HEALTH CARE NEEDS OF THE COMMUNITY ARE MET IN A QUALITY-DRIVEN AND CONVENIENT MANNER. ADDITIONALLY, CAROMONT HEALTH OFFERS A FULL PROGRAM FOCUSED ON JOB COMPETENCY TRAINING AND PROFESSIONAL DEVELOPMENT OPPORTUNITIES FOR EMPLOYEES AT ALL LEVELS OF THE ORGANIZATION AND ROBUST EDUCATION PARTNERSHIPS WITH PUBLIC SCHOOLS, CAREER TECH PROGRAMS, AND COLLEGES AND UNIVERSITIES TO DEVELOP CAREER PATHWAYS FOR STUDENTS.
PART III, LINE 2:CHARGES FOR SERVICES PROVIDED IN THE EMERGENCY DEPARTMENT ARE EVALUATED FOR CHARITY BASED ON MEANS TESTING. CHARGES FOR SERVICES PROVIDED ELSEWHERE IN THE HOSPITAL ARE EVALUATED FOR CHARITY BASED ON MEANS TESTING AND/OR APPLICATIONS FILED BY THE PATIENTS. IF NO MEANS TESTING IS DONE AND NO APPLICATION IS FILED, THE UNPAID AMOUNT IS WRITTEN-OFF TO BAD DEBT. THE % OF PATIENTS QUALIFYING FOR CHARITY IN THE EMERGENCY DEPARTMENT WAS APPLIED TO THE REMAINDER OF THE HOSPITAL TO DETERMINE THE % OF BAD DEBT PATIENTS WHO COULD HAVE BEEN CHARITY.
PART III, LINE 3:EXCLUDED ALL EMERGENCY ROOM PATIENT ACCOUNTS THAT ARE SCREENED BY OUR REAL TIME TRANSUNION SOFTWARE, ALL OTHER ACCOUNTS THAT HAD A CHARITY PENDING INDICATOR TO SHOW CHARITY WAS CONSIDERED, AND ALL OTHER ACCOUNTS WITH A NOTE IN THE ACCOUNT HISTORY THAT CHARITY WAS CONSIDERED. AFTER EXCLUSIONS THERE REMAINED $6,795,698 THAT WENT TO BAD DEBT AND WE ESTIMATED 50% COULD POSSIBLY HAVE BEEN CHARITY IF ALL REQUIREMENTS WERE MET BY THE PATIENT.
PART III, LINE 2:CHARGES WRITTEN OFF TO BAD DEBT WERE TABULATED AT THE PATIENT LEVEL AND ARE REPORTED AT THE AMOUNT CHARGED TO PATIENTS. ACCOUNTS ARE RESERVED AS BAD DEBT BASED ON AN ACCOUNTS RECEIVABLE AGING METHODOLOGY. WHEN ACCOUNTS ARE SENT TO A COLLECTION AGENCY, THEY ARE WRITTEN OFF THE ACCOUNTS RECEIVABLE SYSTEM. ANY SUBSEQUENT COLLECTIONS ON THE ACCOUNTS ARE POSTED AS RECOVERIES AND REDUCE THE EXPENSE. ALL UNINSURED PATIENTS RECEIVE A DISCOUNT ON THEIR BILL, WHICH IS RECORDED AS A CONTRACTUAL ADJUSTMENT. THE AMOUNT OF THE UNINSURED DISCOUNTS ARE EXCLUDED FROM BAD DEBT EXPENSE. PART III, LINE 3: CHARGES FOR SERVICES PROVIDED IN THE EMERGENCY DEPARTMENT ARE EVALUATED FOR CHARITY BASED ON MEANS TESTING. CHARGES FOR SERVICES PROVIDED ELSEWHERE IN THE HOSPITAL ARE EVALUATED FOR CHARITY BASED ON MEANS TESTING AND/OR APPLICATIONS FILED BY THE PATIENTS. IF NO MEANS TESTING IS DONE AND NO APPLICATION IS FILED, THE UNPAID AMOUNT IS WRITTEN-OFF TO BAD DEBT. THE % OF PATIENTS QUALIFYING FOR CHARITY IN THE EMERGENCY DEPARTMENT WAS APPLIED TO THE REMAINDER OF THE HOSPITAL TO DETERMINE THE % OF BAD DEBT PATIENTS WHO COULD HAVE BEEN CHARITY. PART III, LINE 4: THE ORGANIZATION'S FINANCIAL STATEMENTS DO NOT CONTAIN A FOOTNOTE ON BAD DEBT EXPENSE. BAD DEBT EXPENSE IS REPORTED AS A DEDUCTION FROM PATIENT REVENUE.
PART III, LINE 1:THE ORGANIZATION COMPLIES WITH THE REPORTING REQUIREMENTS OF GASB. STATEMENT NO. 15 IS NOT APPLICABLE.
PART III, LINE 8:THE MEDICARE COST REPORT STANDARD COSTING METHODOLOGY WAS FOLLOWED WHEN FILING THE COST REPORT. THIS IS A STEP DOWN METHODOLOGY THAT APPLIES THE AVERAGE PATIENT COST TO MEDICARE PATIENTS. THE COST REPORT DOES NOT ALLOW HOSPITALS TO REPORT ALL OPERATING COSTS. BECAUSE OF THESE TWO ISSUES, THE MEDICARE COST REPORT METHODOLOGY UNDERSTATES THE TRUE COST OF TREATING MEDICARE PATIENTS. WE HAVE USED COSTING METHOD TO DETERMINE TOTAL COSTS RELATED TO THE MEDICARE PROGRAM AND ALL OF THE SHORTFALL SHOULD BE CONSIDERED COMMUNITY BEFEFIT AS THIS REPRESENTS THE TRUE COST OF ADMINSTERING THE PROGRAM
PART III, LINE 9B:THE POLICY CONTAINS PROVISIONS ON THE COLLECTION PRACTICES TO BE FOLLOWED FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR CHARITY CARE OR FINANCIAL ASSISTANCE. BELOW IS VERBIAGE FROM THE CHARITY POLICY:CAROMONT REGIONAL MEDICAL CENTER OFFERS MEDICAL SERVICES FREE OF CHARGE THROUGH THE CHARITY CARE PROGRAM. DETERMINATION OF CHARITY CARE WILL BE BASED ON THE PATIENT'S INCOME, FAMILY SIZE, AND ASSETS. POTENTIAL ELIGIBILITY EXISTS ONLY AFTER THE REIMBURSEMENT EFFORTS FROM ALL OTHER THIRD PARTY RESOURCES, FEDERAL, STATE, AND LOCAL ASSISTANCE PROGRAMS HAVE BEEN EXHAUSTED.
PART VI, LINE 2:EVERY 3 YEARS, CAROMONT HEALTH ESTABLISHES COMMUNITY PRIORITIES THROUGH A NUMBER OF MECHANISMS:1. LEADERSHIP OPINIONS ARE SOUGHT TO HELP IDENTIFY NEEDED SERVICES IN THE COMMUNITY VIA PARTNERSHIPS WITH THE GASTON COUNTY DEPARTMENT OF HEALTH & HUMAN SERVICES, LOCAL NON-PROFIT ORGANIZATIONS FOCUSED ON HEALTH IMPROVEMENT IN OUR COMMUNITIES AND OTHER HEALTH-FOCUSED ENTITIES. CAROMONT HEALTH ALSO WORKS WITH COMMUNITY AGENCIES TO CONDUCT COMMUNITY NEEDS ASSESSMENTS AND QUALITY OF LIFE SURVEYS EVERY TWO TO THREE YEARS. 2. PATIENT SATISFACTION DATA, HEALTH TRENDS, AND CARE OUTCOMES ARE ANALYZED TO DETERMINE WHERE AND/OR HOW SERVICES SHOULD TO BE EXPANDED OR IMPROVED.3. SERVICE AREA DATA (VITAL STATISTICS, DEMOGRAPHICS AND UTILIZATION) ARE ANALYZED FOR GROWTH AND HEALTH TRENDS. THIS INFORMATION IS COORDINATED WITH PUBLIC HEALTH DATA TO DETERMINE OPPORTUNITIES AND VOIDS IN HEALTHCARE SERVICE.4. FINDINGS FROM COMMUNITY SURVEYS/REPORTS PUBLISHED BY OTHER ORGANIZATIONS (DEPARTMENT OF HEALTH AND HUMAN SERVICES, GASTON COUNTY GOVERNMENT, ECONOMIC IMPACT AND DEVELOPMENT GROUPS, ETC.) ARE GATHERED AND REVIEWED FOR PERTINENCE TO COMMUNITY HEALTH PROBLEMS.5. BOARD MEMBERS, SENIOR LEADERS AND SYSTEM MANAGEMENT ARE INVOLVED IN NUMEROUS ORGANIZATIONS IN THE COMMUNITY. THROUGH THIS NETWORK OF RELATIONSHIPS, INFORMATION ABOUT THE COMMUNITY AND THE NEEDS OF AREA RESIDENTS AND ORGANIZATIONS IS USED IN THE DEVELOPMENT OF PROGRAMS AND SERVICES AVAILABLE THROUGH CAROMONT HEALTH.
PART VI, LINE 3:THE ORGANIZATION INFORMS AND EDUCATES THE PATIENTS ABOUT THEIR ELIGIBILITY FOR ASSISTANCE IN SEVERAL WAYS. A CHARITY AND FINANCIAL SUMMARY IS ON OUR WEBSITE. BROCHURES ARE DISTRIBUTED IN THE EMERGENCY ROOM AND ALL OTHER REGISTRATION SITES. SPECIFICALLY TRAINED STAFF (FINANCIAL COUNSELORS AND BENEFIT ELIGIBILITY SPECIALISTS) PROACTIVELY MAKE CONTACT WITH PATIENTS PRIOR TO, AT TIME OF SERVICE, AND/OR AFTER DISCHARGE TO DISCUSS ELIGIBILITY FOR MEDICAID, OTHER INSURANCE/PROGRAM BENEFITS, OR CHARITY CARE, AND TO OFFER ASSISTANCE WITH THE APPLICATIONS. THE COMMUNICATION IS ATTEMPTED AS SOON AS POSSIBLE. WRITTEN COMMUNICATION IS MADE PRIOR TO COLLECTION AGENCY PLACEMENT.
PART VI, LINE 4:GASTON COUNTY, COVERING 355.9 SQUARE MILES IN THE SOUTHERN PORTION OF THE PIEDMONT REGION OF NORTH CAROLINA, IS THE ORGANIZATION'S PRIMARY MARKET. LINCOLN, CLEVELAND AND PARTS OF WESTERN MECKLENBURG COUNTY, AS WELL AS YORK COUNTY, SOUTH CAROLINA, MAKE UP THE HEALTH SYSTEM'S SECONDARY MARKET. ACCORDING TO THE U.S. CENSUS BUREAU, GASTON COUNTY HAD AN ESTIMATED POPULATION OF 230,856, A MEDIAN HOUSEHOLD INCOME OF $53,474 AND 11.6% OF PERSONS IN POVERTY. RACE AND ETHNIC DEMOGRAPHICS STATE THAT 76.0% OF THE POPULATION IDENTIFY THEMSELVES AS WHITE, 19.1% AS BLACK OR AFRICAN AMERICAN, 8.3% AS HISPANIC, 2.4% AS TWO OR MORE RACES, AND 1.7% AS ASIAN.
PART VI, LINE 5:COMMUNITY HEALTH INITIATIVES ARE FOCUSED ON DISEASE PREVENTION AND MANAGEMENT OF CHRONIC ILLNESS. THAT INCLUDES WORKING WITH EMPLOYERS ON INNOVATIVE PROGRAMS AND COLLABORATING WITH HEALTH CARE NEIGHBORS, MANAGING ILLNESS WITHIN THE HEALTH SYSTEM'S WORKFORCE AND INTENSE FOCUS ON SUCCESSFUL CARE COORDINATION FOR PATIENTS WITH CHRONIC DISEASE. ADDITIONALLY, CAROMONT PROVIDES NEARLY $1 MILLION ANNUALLY IN SPONSORSHIP AND GRANT SUPPORT FOR LOCAL NON-PROFITS, COMMUNITY PROGRAMS AND SERVICES, AND OTHER COMMUNITY INITIATIVES AIMED AT IMPROVING THE HEALTH OF THE COMMUNITY. ACTING AS A TRUSTED HEALTHCARE PARTNERS, CAROMONT HEALTH SEEKS TO PROVIDE CARE AND SUPPORT TO ALL MEMBERS OF THE COMMUNITY.
PART VI, LINE 6:ESTABLISHED IN 1946, CAROMONT REGIONAL MEDICAL CENTER IS A 435-BED, NOT-FOR-PROFIT ACUTE CARE FACILITY OFFERING COMPREHENSIVE INPATIENT HOSPITAL SERVICES. CAROMONT REGIONAL MEDICAL CENTER IS THE ANCHOR OF CAROMONT HEALTH, A HEALTH CARE SYSTEM WITH FIVE AFFILIATE COMPANIES INCLUDING A NETWORK OF MORE THAN 55 PRIMARY AND SPECIALTY PHYSICIAN OFFICES.
PART VI, LINE 7, REPORTS FILED WITH STATESNC

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Recipient Table RecipientTable (14 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtNon Cash AssistanceNonCashAssistanceAmtPurpose Of GrantPurposeOfGrantTxt
KINTEGRA HEALTH
991 WEST HUDSON BLVDGASTONIANC28052581958398501(C)(3)$176,226$0COMMUNITY ASSISTANCE
GASTON COUNTY SCHOOLS
PO BOX 1397GASTONIANC280531397566001032GOVERNMENTAL$76,000$0COMMUNITY ASSISTANCE
HEALTHNET GASTON
200 EAST FRANKLIN BLVDGASTONIANC28052561913112501(C)(3)$75,000$0COMMUNITY ASSISTANCE
GASTON TOGETHER
P O BOX 817GASTONIANC28053562048064501(C)(3)$32,000$0COMMUNITY ASSISTANCE
MONTCROSS AREA CHAMBER OF COMMERCE
PO BOX 368BELMONTNC28012560710166501(C)(6)$19,460$0COMMUNITY ASSISTANCE
HEART SOCIETY OF GASTON COUNTY INC (E-PA
1201 EAST GARRISON BLVDGASTONIANC28054561330921501(C)(3)$15,000$0COMMUNITY ASSISTANCE
CANCER SERVICES OF GASTON COUNTY INC
306 SOUTH COLUMBIA STGASTONIANC28054561164253501(C)(3)$13,883$0COMMUNITY ASSISTANCE
GASTON COUNTY FAMILY YMCA
201 SOUTH CLAY STREETGASTONIANC28052560655420501(C)(3)$11,000$0COMMUNITY ASSISTANCE
UNITED WAY
P O BOX 2597GASTONIANC28052560653356501(C)(3)$10,480$0COMMUNITY ASSISTANCE
BOYS AND GIRLS CLUB OF GREATER GASTON
PO BOX 23GASTONIANC28053561419498501(C)(3)$10,000$0COMMUNITY ASSISTANCE
CITY OF MOUNT HOLLY
PO BOX 406MOUNT HOLLYNC28120566001295GOVERNMENTAL$10,000$0COMMUNITY ASSISTANCE
GASTON COMMUNITY FOUNDATION
1201 E GARRISON BLVDGASTONIANC28053581340834501(C)(3)$110,000$0COMMUNITY ASSISTANCE
MEDASSIST OF MECKLENBURG
4428 TAGGART CREEK RD SUITE 101CHARLOTTENC282085400562018957501(C)(3)$7,500$0COMMUNITY ASSISTANCE
CITY OF BESSEMER CITY
125 EAST VIRGINA AVEBESSEMER CITYNC28016566001177GOVERNMENTAL$7,000$0COMMUNITY ASSISTANCE
FieldValueIRS element (for citing)
Total501c3 Org17Total501c3OrgCnt
Total Other Org2TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 2:OTHER ORGANIZATIONS THAT RECEIVE GRANT FUNDS MAY BE REQUIRED TO SUBMIT MONTHLY REPORTS THAT ARE MONITORED BY MANAGEMENT AND/OR THE BOARD OF DIRECTORS. ALL GRANTS DECISIONS ARE DOCUMENTED.
SCHEDULE I, PART IIITHE PURPOSE OF THE GERTRUDE CLINTON HEALTH CAREERS SCHOLARSHIP IS TO ENCOURAGE MEDICAL AND HEALTH-RELATED PROFESSIONALS IN THE FIELD OF HUMAN SERVICES TO PRACTICE THEIR SPECIALTIES AT CAROMONT REGIONAL MEDICAL CENTER OR IN GASTON COUNTY.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Travel For CompanionsYes (X)TravelForCompanionsInd
Club Dues Or FeesYes (X)ClubDuesOrFeesInd
Written Policy Ref T And E ExpnssYes (1)WrittenPolicyRefTAndEExpnssInd
Substantiation Required0SubstantiationRequiredInd
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
Written Employment ContractYes (X)WrittenEmploymentContractInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (1)SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgYes (1)CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsYes (1)CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (13 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
MR K CHRISTOPHER PEEK
CEO$904,884$0$369,925$0$217,014$0$231,203$0$22,644$0$1,745,670$0$147,084$0
MS KATHLEEN BESSON
EVP/CHIEF OPERATING OFFICER THROUGH$530,924$0$155,162$0$369,035$0$51,558$0$17,340$0$1,124,019$0$255,765$0
DR TODD DAVIS
EVP CHIEF PHYSICIAN EXECUTIVE$591,753$0$176,834$0$111,512$0$134,670$0$22,644$0$1,037,413$0$79,352$0
MR DAVID O'CONNOR
EVP/CFO/ASST. TREASURER$544,529$0$158,779$0$113,464$0$125,198$0$22,644$0$964,614$0$81,550$0
DR HEALTH HIGH
CHIEF-OF-STAFF ELECT (BEGIN 1/1/22)$0$372,030$0$248,563$0$1,256$0$16,985$0$22,383$0$661,217$0$0
DR GEORGE ADCOCK III
VP MEDICAL AFFAIRS$362,787$0$124,690$0$49,044$0$75,539$0$22,595$0$634,655$0$32,337$0
MS ROBIN LANG
VP CHIEF INFORMATION OFFICER$336,982$0$96,634$0$56,801$0$75,500$0$10,994$0$576,911$0$38,287$0
MR FRANK MURPHY
VP STRATEGY BUSINESS DEVELOPMENT$322,626$0$92,740$0$48,174$0$65,984$0$13,979$0$543,503$0$32,738$0
MS LEIGH HICKMAN
VP/CLO/ASST. SEC$340,398$0$99,649$0$834$0$67,628$0$15,333$0$523,842$0$0$0
MR RICHARD BLACKBURN
VP SUPPORT SERVICES$306,220$0$88,061$0$49,964$0$47,607$0$13,800$0$505,652$0$0$0
DRJAY HENDLER
CHIEF-OF-STAFF (BEGIN 1/1/22)$0$426,953$0$37,356$0$3,949$0$15,295$0$13,709$0$497,262$0$0
MR DANNY WHARTON
VP CLINICAL SERVICES THROUGH 12/21-E$266,637$0$77,860$0$48,806$0$54,502$0$10,929$0$458,734$0$31,734$0
MS ASHLEY LONG
VP CHIEF NURSING OFFICER$235,912$0$66,435$0$226$0$50,275$0$11,238$0$364,086$0$0$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 1ATHE ORGANIZATION HAS A POLICY TO ADDRESS WHEN SPOUSAL TRAVEL IS PERMITTED AND PAYS CLUB DUES FOR THE PRESIDENT/CEO FOR BUSINESS PURPOSES AS PART OF THE EMPLOYMENT CONTRACT.
PART I, LINE 4BTHE FOLLOWING INDIVIDUALS RECEIVED DEFERRED COMPENSATION ALLOCATIONS FROM THE FILING ORGANIZATION FROM A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP): DAVID O'CONNOR - $ 104,898 TODD DAVIS, MD - 114,370 K. CHRISTOPHER PEEK - 215,253 GEORGE ADCOCK III - 56,219 ROBIN LANG - 50,402 FRANK D. MURPHY - 50,034 ASHLEY LONG - 35,963 LEIGH HICKMAN - 51,975 DANNY WHARTON - 40,610
PART I, LINE 6EXECUTIVE INCENTIVE COMPENSATION PLAN FOR ALL KEY EMPLOYEES BASED ON THE ACHIEVEMENT OF ANNUAL BUSINESS OBJECTIVES WHICH INCLUDE A FINANCIAL GOAL ATTRIBUTABLE TO OPERATING MARGIN. MANAGER INCENTIVE PLAN BASED ON CONSOLIDATED CORPORATE AND INDIVIDUAL PERFORMANCE GOALS. CERTAIN CAROMONT MEDICAL GROUP, INC. PHYSICIAN'S COMPENSATION PACKAGES ARE BASED ON THE INDIVIDUAL PHYSICIANS NET RESULTS FROM OPERATIONS AS CALCULATED BASED SOLELY ON HIS/HER NET CHARGES LESS HIS/HER ALLOCABLE SHARE OF CLINIC OVERHEAD COSTS.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (3 entries)

Bond ReferenceBondReferenceCdBond Issuer EINBondIssuerEINBond IssuedBondIssuedDtIssue PriceIssuePriceAmtPurposePurposeDescDefeasedDefeasedIndOn Behalf Of IssuerOnBehalfOfIssuerIndPool FinancingPoolFinancingInd
NORTH CAROLINA MEDICAL CARE COMMISSION
A5213094022003-01-23$120,000,000SEE PART VI000
NORTH CAROLINA MEDICAL CARE COMMISSION
B5213094022019-11-19$41,460,000SEE PART VI000
NORTH CAROLINA MEDICAL CARE COMMISSION
C5213094022021-02-10$129,092,857SEE PART VI000

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (3 entries)

Bond ReferenceBondReferenceCdRetiredRetiredAmtTotal ProceedsTotalProceedsAmtCapitalized InterestCapitalizedInterestAmtIssuance Costs From ProceedsIssuanceCostsFromProceedsAmtCredit EnhancementCreditEnhancementAmtCapital ExpendituresCapitalExpendituresAmtOther Spent ProceedsOtherSpentProceedsAmtSubstantial CompletionSubstantialCompletionYrRefunding Tax Exempt BondsRefundingTaxExemptBondsIndRefunding Taxable BondsRefundingTaxableBondsIndFinal Allocation MadeFinalAllocationMadeIndAdequate Books And Rec MaintAdequateBooksAndRecMaintIndUnspentUnspentAmt
A$15,100,000$123,594,002$5,150,936$1,256,069$3,386,000$91,583,288$22,217,70920050Yes (1)Yes (1)Yes (1)
B$3,810,000$41,460,0000Yes (1)Yes (1)Yes (1)
C$345,000$129,343,611$1,064,190$56,041,94720230000$72,237,474

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (3 entries)

Bond ReferenceBondReferenceCdOwning Bond Financed PropertyOwningBondFinancedPropertyIndAny Lease ArrangementsAnyLeaseArrangementsIndMgmt Contract Bond Fincd PropMgmtContractBondFincdPropIndEngage Bond Counsel ContractsEngageBondCounselContractsIndAny Research AgreementsAnyResearchAgreementsIndEngage Bond Counsel ResearchEngageBondCounselResearchIndPrivate Bus Use By OthersPrivateBusUseByOthersPctTotal Private Business UseTotalPrivateBusinessUsePctBond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestIndChange In Use Bond Financed PropChangeInUseBondFinancedPropIndChange In Use Bond Financed PropChangeInUseBondFinancedPropPctRemedial Action TakenRemedialActionTakenIndProcs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd
A00Yes (1)Yes (1)Yes (1)Yes (1)0.001400.001400Yes (1)0.001100Yes (1)
B00000.000800.0008000Yes (1)
C00000.000000.0000000Yes (1)

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (3 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledIndRebate Not Due YetRebateNotDueYetIndException To RebateExceptionToRebateIndNo Rebate DueNoRebateDueIndVariable Rate IssueVariableRateIssueIndHedge Identified In Bks And RecHedgeIdentifiedInBksAndRecIndBusiness Name Line2HedgeProviderName/BusinessNameLine2TxtTerm Of HedgeTermOfHedgePctSuperintegrated HedgeSuperintegratedHedgeIndHedge TerminatedHedgeTerminatedIndGross Proceeds Invested In GICGrossProceedsInvestedInGICIndGross Proceeds InvestedGrossProceedsInvestedIndWritten Proc To Monitor ReqsWrittenProcToMonitorReqsInd
MERRILL LYNCH
A000Yes (1)Yes (1)Yes (1)CAPITAL SERVICES31.600000000000Yes (1)000Yes (1)
(no name)
B0000Yes (1)000Yes (1)
(no name)
C0000Yes (1)000Yes (1)

Procedures Corrective Action ProceduresCorrectiveActionGrp (3 entries)

Bond ReferenceBondReferenceCdProcedures Corrective ActionProceduresCorrectiveActionInd
AYes (1)
B0
C0

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
DATE REBATE COMPUTATION PERFORMEDISSUER NAME: NORTH CAROLINA MEDICAL CARE COMMISSION DATE THE REBATE COMPUTATION WAS PERFORMED: 12/05/2017
SCHEDULE K SUPPLENTAL INFORMATIONTHREE 501(C)(3) ORGANIZATIONS WITHIN THE PARENT-SUBSIDIARY CONTROLLED GROUP BENEFIT FROM THE BONDS AS FOLLOWS: GASTON MEMORIAL HOSPITAL, INC. (56-0619359) CAROMONT HEALTH, INC. (58-1636959) CAROMONT HEALTH SERVICES, INC. (56-1455630) CAROMONT REGIONAL MEDICAL CENTER HOLDS THE LIABILITY FOR THE BONDS, PER AUDITED FINANCIAL STATEMENTS.
SCHEDULE K, PART I, COLUMN (F); DESCRIPTION OF PURPOSE:ISSUE A - THE SYSTEM USED THE PROCEEDS FROM THESE BONDS FOR VARIOUS CAPITAL IMPROVEMENTS, INCLUDING, BUT NOT LIMITED TO, A NEW WOMEN'S CENTER AND PARKING DECK, RENOVATIONS TO EXISTING FACILITIES, AND EQUIPMENT. IN ADDITION, PROCEEDS WERE USED TO REFUND IN ADVANCE OF THEIR MATURITIES $17,000,000 IN PRINCIPAL AMOUNT OF THE SERIES 1998 HOSPITAL REVENUE BONDS. ISSUE B - ON NOVEMBER 19, 2019 THE BANK EXCHANGED THE 2018 TAXABLE BONDS FOR FIXED RATE TAX-EXEMPT BONDS (THE "2019 TAX-EXEMPT BONDS") ISSUED BY THE NCMCC. THIS EXCHANGE OF THE SERIES 2018 BONDS FOR THE SERIES 2019 TAX-EXEMPT BONDS CONSTITUTES A CURRENT REFUNDING OF THE SERIES 2018 BONDS AND PROVIDES CAROMONT WITH INCREMENTAL INTEREST COST SAVINGS. ISSUE C - ON JANUARY 21, 2021, THE NORTH CAROLINA MEDICAL CARE COMMISSION ISSUED $105,260,000 OF SERIES 2021A AND SERIES 2021B HOSPITAL REVENUE BONDS ("SERIES 2021 BONDS"). THE $40,950,000 SERIES 2021A BONDS ARE TAX-EXEMPT FIXED RATE BONDS THAT MATURE FEBRUARY 1, 2036 AND THE $64,310,000 SERIES 2021B BONDS ARE TAX-EXEMPT PUT BONDS THAT MATURE FEBRUARY 1, 2051. THE INTEREST RATE FOR THE NEW BONDS IS 5%. THE PROCEEDS WILL BE USED BY THE SYSTEM FOR VARIOUS CAPITAL IMPROVEMENTS, INCLUDING, BUT NOT LIMITED TO, A NEW FOUR-STORY, APPROXIMATELY 140,000 SQUARE FOOT CRITICAL CARE TOWER ON THE HOSPITAL CAMPUS AND TO PAY THE FEES AND EXPENSES INCURRED IN CONNECTION WITH THE SALE AND ISSUANCE OF THE BONDS.
SCHEDULE K, PART II, LINE 3 COLUMN (A):LINE 3 COLUMN (A) INCLUDES THE TOTAL INVESTMENT EARNINGS ON BOND PROCEEDS IN THE AMOUNT OF $ 3,594,002.
SCHEDULE K, PART II, LINE 3 COLUMN (C):LINE 3 COLUMN (C) INCLUDES THE TOTAL INVESTMENT EARNINGS ON BOND PROCEEDS IN THE AMOUNT OF $ 250,754.
SCHEDULE K, PART II, LINE 11; OTHER SPENT PROCEEDS:OTHER SPENT PROCEEDS INCLUDE DEPOSITS MADE INTO A REFUNDING ESCROW ACCOUNT ALONG WITH INTEREST EARNED ON THE ACCOUNT, BOTH OF WHICH WERE SUBSEQUENTLY USED TO PAY PRINCIPLE AND INTEREST ON THE REFUNDED BONDS. SEE THE RESPONSE FOR PART I, COLUMN (F) FOR DETAILS.

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

FieldValueIRS element (for citing)
PersonGENA POMEROYPersonNm
FieldValueIRS element (for citing)
Relationship DescriptionFAMILY RELATIONSHIP WITH BOARD MEMBERRelationshipDescriptionTxt
Transaction$91,281TransactionAmt
TransactionCOMPENSATION FOR EMPLOYEE SERVICESTransactionDesc
Sharing Of Revenues0SharingOfRevenuesInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (12 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 6THE SOLE MEMBER OF THE CORPORATION IS CAROMONT HEALTH, INC., A NORTH CAROLINA NOT-FOR-PROFIT CORPORATION.
FORM 990, PART VI, SECTION A, LINE 7ATHE BOARD OF DIRECTORS CONSISTS OF FOURTEEN (14) MEMBERS, ALL OF WHOM ARE THE MEMBERS OF THE BOARD OF DIRECTORS OF CAROMONT HEALTH, INC., AND ALL OF WHOM ARE APPOINTED BY THE BOARD OF DIRECTORS OF CAROMONT HEALTH.
FORM 990, PART VI, SECTION A, LINE 7BTHE FOLLOWING POWERS OF THE CORPORATION SHALL BE RESERVED TO CAROMONT HEALTH, INC., THE PARENT CORPORATION AND HOLDING COMPANY OF THE CORPORATION: (A) FINANCIAL POWERS, INCLUDING THE POWER TO APPROVE AN OPERATING BUDGET FOR THE CORPORATION, POWER TO APPROVE COMPENSATION PLANS, AND POWER TO ASSUME DEBT ON BEHALF OF THE CORPORATION; (B) GOVERNING POWERS, INCLUDING THE POWER TO APPROVE ALL CHANGES TO THE GOVERNING DOCUMENTS OF THE CORPORATION AND POWER TO APPROVE THE MISSION, VISION AND VALUES OF THE CORPORATION; AND (C) STRATEGIC POWERS, INCLUDING THE POWER TO APPROVE ALL CERTIFICATE OF NEED APPLICATIONS WHICH THE CORPORATION MAY FILE IN ANY STATE, AND THE POWER TO APPROVE ALL SALE OR LEASE TRANSACTIONS OF THE CORPORATION.
FORM 990, PART VI, SECTION B, LINE 11BTHE ORGANIZATION'S FORM 990 WAS REVIEWED BY THE AUDIT FINANCE INVESTMENT COMMITTEE OF THE BOARD OF DIRECTORS OF CAROMONT HEALTH PRIOR TO PRESENTATION TO THE FULL BOARD BEFORE THE FORM WAS FILED WITH THE IRS.
FORM 990, PART VI, SECTION B, LINE 12CMEMBERS OF THE BOARD OF DIRECTORS, MEMBERS OF SENIOR LEADERSHIP, ANY PHYSICIAN HOLDING A LEADERSHIP OR ADMINISTRATIVE POSITION WITHIN THE ORGANIZATION, DIRECTORS, RESEARCH STUDY PERSONNEL, MANAGERS AND ALL STAFF MEMBERS OF THE PURCHASING AND MARKETING DEPARTMENTS AND ANY OTHER DEPARTMENT DEEMED TO HAVE MATERIAL DECISION MAKING RESPONSIBILITIES ON BEHALF OF CAROMONT HEALTH SHALL FULLY AND TRUTHFULLY COMPLETE A QUESTIONNAIRE CONCERNING POTENTIAL AND ACTUAL CONFLICTS OF INTEREST ANNUALLY. SUCH QUESTIONNAIRE SHALL IDENTIFY THE INDIVIDUAL'S OBLIGATION TO IMMEDIATELY MAKE THE CORPORATE RESPONSIBILITY OFFICER AWARE IN WRITING OF ANY POTENTIAL OR ACTUAL CONFLICTS OF INTEREST AS THEY MAY ARISE AND CONTAIN SAID INDIVIDUAL'S AGREEMENT TO ABIDE BY ALL TERMS AND CONDITIONS OF THIS POLICY AS A CONDITION OF RETAINING THEIR POSITION. SUCH QUESTIONNAIRES ARE REVIEWED ANNUALLY BY THE CHIEF LEGAL OFFICER AND THE CORPORATE RESPONSIBILITY OFFICER. QUESTIONNAIRES SUBMITTED BY DIRECTORS ARE REVIEWED ANNUALLY BY THE NOMINATING COMMITTEE OF THE BOARD.
FORM 990, PART VI, SECTION B, LINE 15THE CEO, CFO, COO, CMO AND CHIEF LEGAL OFFICER ARE COMPENSATED FOR THEIR SERVICES BY CAROMONT REGIONAL MEDICAL CENTER, A SUBSIDIARY OF CAROMONT HEALTH, INC. THE COMPENSATION OF ALL CAROMONT EXECUTIVES FOR EACH YEAR IS ESTABLISHED BY THE COMPENSATION COMMITTEE OF THE CAROMONT HEALTH BOARD OF DIRECTORS, BASED ON GUIDANCE AND OPINIONS PROVIDED BY AN INDEPENDENT, THIRD-PARTY COMPENSATION CONSULTANT. PURSUANT TO THE COMMITTEE CHARTER FOR THE COMPENSATION COMMITTEE OF THE BOARD, THE BOARD OF DIRECTORS APPROVES THE EXECUTIVE COMPENSATION PHILOSOPHY, WHICH ESTABLISHES THE PARAMETERS FOR ALL EXECUTIVE COMPENSATION DECISIONS. THE BOARD OF DIRECTORS DELEGATES ALL COMPENSATION DECISIONS FOR ALL EXECUTIVES TO THE COMPENSATION COMMITTEE, PROVIDED SUCH DECISIONS ARE CONSISTENT WITH THE COMPENSATION PHILOSOPHY. BOARD APPROVAL MUST BE OBTAINED WHEN COMPENSATION DECISIONS DEVIATE FROM THE COMPENSATION PHILOSOPHY. A MAJORITY OF BOARD MEMBERS WHO SERVE ON THE COMPENSATION COMMITTEE ARE INDEPENDENT AND ALL ARE FREE FROM ANY CONFLICT OF INTEREST. ANY COMPENSATION COMMITTEE MEMBER WHO DEVELOPS A CONFLICT OF INTEREST DURING HIS/HER TERM WITH RESPECT TO THE DISCUSSION OF ANY EXECUTIVE'S COMPENSATION DOES NOT PARTICIPATE IN THE DISCUSSION OR DECISION-MAKING BY THE REMAINING MEMBERS OF THE COMPENSATION COMMITTEE. THE COMPENSATION COMMITTEE RETAINS JURISDICTION OVER THE TOTAL COMPENSATION PACKAGE FOR EXECUTIVES AND REVIEWS EXECUTIVE BENEFITS AND PERQUISITES AS WELL AS TOTAL CASH COMPENSATION. COMPENSATION FOR THE CEO IS ESTABLISHED THROUGH A PROCESS OF PERFORMANCE EVALUATION, COMPARISON WITH COMPARABLE MARKET DATA AND DETERMINATION BY THE COMPENSATION COMMITTEE OF ACCEPTABLE SALARY RANGE AND PERCENTILE RANKING. ALL COMPENSATION DECISIONS FOR THE CEO ARE APPROVED BY THE COMPENSATION COMMITTEE, AS LONG AS THE COMPENSATION DECISIONS ARE CONSISTENT WITH THE EXECUTIVE COMPENSATION PHILOSOPHY. THE PROCESS FOR DETERMINING COMPENSATION FOR EXECUTIVE MANAGEMENT UTILIZES COMPENSATION SURVEYS AND STUDIES. FULL COLLECTED COMPENSATION INFORMATION AND ANY COMPENSATION OPINIONS PROVIDED DURING THESE PROCESSES WILL BE KEPT WITH THE COMPENSATION COMMITTEE OR BOARD MINUTES, AS APPLICABLE.
FORM 990, PART VI, SECTION C, LINE 18THE ORGANIZATION'S FORM 990 IS MADE AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART VI, SECTION C, LINE 19AT THIS TIME, THE ORGANIZATION'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT MADE AVAILABLE TO THE PUBLIC. THE ENTIRE ORGANIZATION'S COMBINED FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON REQUEST.
FORM 990, PART IX, LINE 11GHOSPITALIST FEES: PROGRAM SERVICE EXPENSES 9,986,714. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 9,986,714. PHYSICIAN LEADERSHIP FEES: PROGRAM SERVICE EXPENSES 400,126. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 400,126. INTEGRATION & PERFORMANCE IMPROVEMENT FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 546,660. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 546,660. CONTRACT SERVICES: PROGRAM SERVICE EXPENSES 77,700,594. MANAGEMENT AND GENERAL EXPENSES 1,612,408. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 79,313,002. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 7,053,709. MANAGEMENT AND GENERAL EXPENSES 490,991. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,544,700. PROFESSIONAL SERVICES: PROGRAM SERVICE EXPENSES 7,509,175. MANAGEMENT AND GENERAL EXPENSES 45,491. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,554,666. CTS BIOMED: PROGRAM SERVICE EXPENSES 1,197,950. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,197,950. CONSULTING FEES: PROGRAM SERVICE EXPENSES 109,202. MANAGEMENT AND GENERAL EXPENSES 282,050. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 391,252. LICENSE FEES: PROGRAM SERVICE EXPENSES 65,622. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 65,622. TAX EXEMPT BOND FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 76,955. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 76,955.
FORM 990, PART XI, LINE 9:INTERCOMPANY TRANSFER FROM AFFILIATE 32,364,814. AUXILIARY NET ASSET ADJUSTMENT -47,302. NET CONTRIBUTION EARNINGS AND RECLASS 1,027,501.
PART XII, LINE 2CTHE PROCESS HAS NOT CHANGED FROM LAST YEAR.
FORM 990, PART V AND PART VIICOMMON PAYMASTER: THE FILING ORGANIZATION USES A RELATED ORGANIZATION FOR ITS PAYROLL FUNCTION. ALL W-2S ARE FILED BY THE COMMON PAYMASTER. HOWEVER, AMOUNTS PAID BY THE COMMON PAYMASTER ARE TREATED AS IF PAID DIRECTLY BY THE ORGANIZATION FOR WHICH SERVICES ARE PERFORMED.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (6 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtDirect Controlling NADirectControllingNACdControlled OrganizationControlledOrganizationIndBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Txt
CAROMONT HEALTH INC
2525 COURT DRIVEGASTONIANC28054581636959MEDICAL SERVICESNC501(C)(3)LINE 12C, III-FIN/A0
CAROMONT HEALTH SERVICES INC
2526 COURT DRIVEGASTONIANC28054561455630OUTPATIENT SERVICESNC501(C)(3)LINE 30CAROMONT HEALTH INC
GASTON MEMORIAL HOSPITAL FOUNDATION INC
2527 COURT DRIVEGASTONIANC28054561479699FOUNDATIONNC501(C)(3)LINE 110CAROMONT HEALTH INC
CAROMONT MEDICAL GROUP INC
2528 COURT DRIVEGASTONIANC28054561479712MEDICAL GROUPNC501(C)(3)LINE 110CAROMONT HEALTH INC
HOSPICE OF GASTON COUNTY INC
2529 COURT DRIVEGASTONIANC28054581341530HOSPICE CARENC501(C)(3)LINE 70CAROMONT HEALTH INC
GASTON COUNTY
PO BOX 1578GASTONIANC280531578566000300GOVERNMENT ADMINISTRATIONNCN/A0
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth OrgYes (1)RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (1)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (1)PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (1)TransferToOtherOrgInd
Transfer From Other OrgYes (1)TransferFromOtherOrgInd