2023-08-14T11:35:25-05:00 2022-09-30 440160260 FORVIS LLP 500 RIDGEFIELD COURT ASHEVILLE NC 28806 990 2021-10-01 561255030 MOUNTAIN VISTA HEALTH PARK INC MOUN 9108592181 PO BOX 1547 DENTON NC 27239 CINDY MONTGOMERY ADMINISTRATOR 9108592181 2023-08-14 1 CINDY MONTGOMERY 999009999 AMY BIBBY P00445891 8282542254 2023-08-11 3 AAL1 IAL1 2021 2023-04-26 12:10:37Z SCOTT MORRIS PO BOX 1547 DENTON NC 27239 9856452 0 X WWW.MTVISTAHEALTH.COM X 1971 NC TO PROVIDE QUALITY LONG-TERM NURSING CARE FOR RESIDENTS. 9 9 201 23 0 0 1344585 1007136 9704065 8449326 231521 356669 44998 43321 11325169 9856452 0 0 0 0 4898093 5451818 0 0 0 2515412 2430255 7413505 7882073 3911664 1974379 11798809 12351718 810103 756435 10988706 11595283 TO PROVIDE QUALITY LONG-TERM SKILLED NURSING CARE AND ASSISTED LIVING SERVICES TO THE SOUTH DAVIDSON COUNTY COMMUNITY. 0 0 7176006 8449326 MOUNTAIN VISTA HEALTH PARK, INC. IS A CORPORATION WHICH PROVIDES LONG-TERM NURSING CARE AND ADULT-CARE HOME SERVICES. THE FACILITY HAS 60 NURSING AND 60 ADULT-CARE BEDS. WE OFFER SERVICES TO THE PUBLIC WITHOUT REGARD TO RELIGION OR ETHNICITY. 7176006 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 6 0 1 201 1 0 0 0 0 0 0 0 0 0 0 0 0 X 9 9 0 0 0 0 1 1 0 1 1 0 0 1 0 1 1 1 1 0 X SCOTT MORRIS 9108592181 PO BOX 1547 DENTON NC 27239 X SCOTT MORRIS PRESIDENT 0.25 X X 0 0 0 IRA MATNEY VICE PRESIDENT 0.25 X X 0 0 0 RONNIE HARRISON TREASURER 0.25 X X 0 0 0 ANNETTE YARBORO ASSISTANT TREASURER 0.25 X X 0 0 0 LORA GRIFFIN SECRETARY 0.25 X 0 0 0 JEFF GALLIMORE BOARD MEMBER 0.25 X 0 0 0 STEVE HARRIS BOARD MEMBER 0.25 X 0 0 0 LISA MATNEY BOARD MEMBER 0.25 X 0 0 0 TINA LANIER BOARD MEMBER 0.25 X 0 0 0 0 0 0 0 0 0 0 LEGACY HEALTHCARE SERVICES PO BOX 743715 ATLANTA GA 30384 PHYSICAL, SPEECH, AND OCCUPATIONAL THERA 404478 FORVIS LLP 500 RIDGEFIELD COURT ASHEVILLE NC 20086 FINANCIAL AND IT SERVICES 142571 YADKIN VALLEY HEALTHCARE 17955 NC-109 DENTON NC 27239 MEDICAL SERVICES 131519 3 994361 12775 1007136 MEDICARE/MEDICAID 623000 5274354 5274354 SELF-PAY 623000 2034238 2034238 THIRD-PARTY 623000 1009441 1009441 PROVIDER RELIEF FUNDI 900099 131293 131293 8449326 261581 261581 1000 0 1000 1000 1000 11391 83697 0 0 11391 83697 95088 95088 MISCELLANEOUS INCOME 623000 42321 42321 42321 9856452 8449326 0 399990 4523215 4250258 272957 41250 38051 3199 545022 495930 49092 342331 316320 26011 27084 27084 49241 49241 61664 61664 3223 3223 459253 308311 150942 154725 154725 7311 3729 3582 3244 2514 730 225613 225613 26691 21054 5637 CONTRACT SERVICES 554671 440302 114369 FOOD 306509 306509 MEDICAID ASSESSMENT 245693 245693 MEDICAL SUPPLIES 241759 241759 63574 63574 7882073 7176006 706067 0 2898742 2979521 667854 650471 17023 24455 26896 70745 6345692 3951623 2250098 2394069 5804365 6156903 133831 75554 11798809 12351718 546558 682460 131293 0 132252 73975 810103 756435 X 10988706 11595283 10988706 11595283 11798809 12351718 1974379 -1369060 1258 0 X X 0 0 0 X 54086 66111 1344585 1138429 2603211 6628693 7104478 7213460 9704065 8318033 38968729 6628693 7158564 7279571 11048650 9456462 41571940 0 0 0 41571940 127322 78179 107130 98085 262581 673297 127322 78179 107130 98085 262581 673297 6756015 7236743 7386701 11146735 9719043 42245237 0.98410 0.98660 0.01590 0.01340 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 1001 1001 0 PART II-B, LINE 1: A PORTION OF THE DUES PAID TO THE NORTH CAROLINA HEALTH CARE FACILITIES ASSOCIATION BY THE ORGANIZATION WERE ATTRIBUTABLE TO LOBBYING ACTIVITIES. 19358 19358 4954888 2828248 2126640 301092 266114 34978 972672 784142 188530 97682 73119 24563 2394069 PATIENTS' LIABILITY 73975 73975 LORA GRIFFIN BOARD MEMBER 131519 OWNER OF YADKIN VALLEY HEALTHCARE PHARMACY 0 FORM 990, PART VI, SECTION A, LINE 6 THREE MEMBERS OF THE BOARD SERVE ON THE NOMINATING COMMITTEE. FORM 990, PART VI, SECTION A, LINE 7A THREE MEMBERS OF THE BOARD SERVE ON THE NOMINATING COMMITTEE. THESE NOMINATIONS ARE ACTED ON BY THE FULL BOARD. FORM 990, PART VI, SECTION B, LINE 11B THE PRESIDENT AND THE MANAGEMENT COMPANY REVIEW AND APPROVE THE 990 PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 15 DIRECTORS RECEIVE NO COMPENSATION. KEY EMPLOYEE COMPENSATION IS REVIEWED BY THE MANAGEMENT COMPANY AND THE ADMINISTRATOR ANNUALLY. COMPENSATION RATES FOR KEY EMPLOYEES ARE COMMENSURATE WITH SIMILAR POSITIONS AS COMPARED WITH INDUSTRY DATA. FORM 990, PART VI, SECTION C, LINE 19 FINANCIAL STATEMENTS ARE PUBLIC RECORD THROUGH THE DEPARTMENT OF HUMAN SERVICES.