AHSNF INC: Form 990, tax year 2022
View the entire original 990 at ProPublica ↗
- Organization
- AHSNF INC (EIN 84-2727303)
- Tax period
- 2022-01-01 to 2022-12-31
- Filed
- 2023-11-14
- IRS object ID
- 202313189349305591
- Schema version
- 2022v5.0
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2023-11-14T10:48:48-06:00 | ReturnTs |
| Tax Period End | 2022-12-31 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2022-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 842727303 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | AHSNF INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | AHSN | BusinessNameControlTxt |
| Phone | 7043654202 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 32861 | AddressLine1Txt |
| City | CHARLOTTE | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 282322861 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | RODNEY BALL | PersonNm |
| Person Title | VP, SECRETARY & TREASURER | PersonTitleTxt |
| Phone | 7043654202 | PhoneNum |
| Signature | 2023-11-14 | SignatureDt |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | RODNEY | PersonFirstNm |
| Person Last | BALL | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | 0 | IRSResponsiblePrtyInfoCurrInd |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 2 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2022 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | KEN D HAYNES | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 32861 | AddressLine1Txt |
| City | CHARLOTTE | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 282322861 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $31,252,697 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | N/A | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2019 | FormationYr |
| Legal Domicile State | NC | LegalDomicileStateCd |
| Activity Or Mission | TO PROMOTE HEALTHCARE AND PUBLIC HEALTH BY OPERATING ONE OR MORE NURSING HOMES (INCLUDING SKILLED NURSING FACILITIES), HOSPITALS, AND/OR HEALTHCARE FACILITIES TO FACILITATE THE CHARITABLE AND GOVERNMENTAL PURPOSES AND ACTIVITIES OF SUCH FACILITIES THAT ARE, OR MAY BECOME AFFILIATED WITH, THE ORGANIZATION FROM TIME TO TIME. | ActivityOrMissionDesc |
| Voting Members Governing Body | 3 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 0 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $979 | PYContributionsGrantsAmt |
| CY Contributions Grants | $200 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $37,410,859 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $31,252,497 | CYProgramServiceRevenueAmt |
| PY Investment Income | $4 | PYInvestmentIncomeAmt |
| CY Investment Income | $0 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $37,411,842 | PYTotalRevenueAmt |
| CY Total Revenue | $31,252,697 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $720 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $2,730 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $33,121,708 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $30,448,909 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $25,202,756 | PYOtherExpensesAmt |
| CY Other Expenses | $29,734,022 | CYOtherExpensesAmt |
| PY Total Expenses | $58,325,184 | PYTotalExpensesAmt |
| CY Total Expenses | $60,185,661 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$20,913,342 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$28,932,964 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $34,390,165 | TotalAssetsBOYAmt |
| Total Assets EOY | $32,707,040 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $29,666,435 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $56,916,274 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $4,723,730 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$24,209,234 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO PROMOTE HEALTHCARE AND PUBLIC HEALTH BY OPERATING ONE OR MORE NURSING HOMES (INCLUDING SKILLED NURSING FACILITIES), HOSPITALS, AND/OR HEALTHCARE FACILITIES TO FACILITATE THE CHARITABLE AND GOVERNMENTAL PURPOSES AND ACTIVITIES OF SUCH FACILITIES THAT ARE OR MAY BECOME AFFILIATED WITH THE ORGANIZATION FROM TIME TO TIME. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $55,312,093 | ExpenseAmt |
| Grant | $2,730 | GrantAmt |
| Revenue | $31,252,497 | RevenueAmt |
| Desc | THE ORGANIZATION OWNS AND OPERATES SKILLED NURSING FACILITIES THAT PROVIDE SHORT-TERM NURSING AND REHABILITATION SERVICES, LONG-TERM CARE SERVICES, AND END OF LIFE CARE TO PATIENTS IN CHARLOTTE, NC AND ITS SURROUNDING COMMUNITIES.DURING CALENDAR YEAR 2022, THE ORGANIZATION PROVIDED SKILLED NURSING SERVICES THAT INCLUDED 712 ADMISSIONS AND 112,671 PATIENT DAYS AT FIVE LOCATIONS IN THE CHARLOTTE, NC METRO AREA, INCLUDING: HUNTERSVILLE OAKS, SARDIS OAKS, CLEVELAND PINES, STANLY MANOR, AND JESSE HELMS NURSING CENTER. | Desc |
| Total Program Service Expenses | $55,312,093 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | Yes (1) | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 0 | EmployeeCnt |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 3 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 0 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (1) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RODNEY BALL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7045125219 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 32861 | AddressLine1Txt |
| City | CHARLOTTE | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 282322861 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (9 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|
| ANTHONY C DEFURIO | |||||||||
| DIRECTOR, SECR, TREAS | 1.00 | 39.00 | Yes (X) | Yes (X) | $0 | $3,313,582 | $483,931 | ||
| KEN D HAYNES | |||||||||
| DIRECTOR, PRESIDENT | 1.00 | 39.00 | Yes (X) | Yes (X) | $0 | $2,965,556 | $439,717 | ||
| SCOTT C RISSMILLER MD | |||||||||
| DIRECTOR | 1.00 | 39.00 | Yes (X) | $0 | $2,602,279 | $375,100 | |||
| RODNEY BALL | |||||||||
| TOP FINANCIAL OFFICIAL | 2.00 | 38.00 | Yes (X) | $0 | $770,635 | $86,460 | |||
| JENNIFER SULLIVAN | |||||||||
| TOP MGMT OFFICIAL | 1.00 | 39.00 | Yes (X) | $0 | $513,403 | $48,356 | |||
| MIKE STOLZENBACH | |||||||||
| VP, FACILITIES, CONT CARE | 15.00 | 35.00 | $0 | $403,883 | $64,674 | Yes (X) | |||
| SCHAREE LEE | |||||||||
| EXEC DIR - CONT CARE (TO 10/7/22) | 40.00 | 0.00 | $0 | $184,111 | $24,542 | Yes (X) | |||
| COLLIN LANE | |||||||||
| FORMER OFFICER (8/1/21) | 0.00 | 40.00 | $0 | $779,264 | $88,852 | Yes (X) | |||
| ROSE COOK | |||||||||
| FORMER OFFICER (10/1/20) | 0.00 | 40.00 | $0 | $501,915 | $61,570 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $12,034,628 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $1,673,202 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| PRO DIVERSITY PARTNERS LLC | |||||
| 420 LEXINGTON AVE STE 2903 | NEW YORK | NY | 10170 | RECRUITING SERVICES | $4,059,099 |
| SODEXO MAGIC LLC | |||||
| P O BOX 360170 | PITTSBURGH | PA | 15251 | DIETARY SERVICES | $3,057,149 |
| HEALTHPRO HERITAGE LLC | |||||
| PO BOX 69268 | BALTIMORE | MD | 21264 | THERAPY SERVICES | $2,170,107 |
| MORRISON MANAGEMENT SPECIALISTS INC | |||||
| PO BOX 102289 | ATLANTA | GA | 30368 | DIETARY SERVICES | $797,307 |
| ARAMARK HEALTHCARE SUPPORT SERVICES LLC | |||||
| P O BOX 978839 | DALLAS | TX | 75397 | ENVIRONMENTAL SERVICES | $591,408 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $200 | AllOtherContributionsAmt |
| Total Contributions | $200 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT SERVICE REVENUE | 621110 | $31,214,066 | $31,214,066 |
| DIETARY REVENUE | 722513 | $38,431 | $38,431 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $31,252,497 | TotalProgramServiceRevenueAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $31,252,697 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $31,252,497 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,730 | TotalAmt |
| Program Services | $2,730 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,872,032 | TotalAmt |
| Program Services | $1,758,758 | ProgramServicesAmt |
| Management And General | $113,274 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,366,354 | TotalAmt |
| Program Services | $21,126,274 | ProgramServicesAmt |
| Management And General | $1,240,080 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,846,005 | TotalAmt |
| Program Services | $4,575,427 | ProgramServicesAmt |
| Management And General | $270,578 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,364,518 | TotalAmt |
| Program Services | $1,288,330 | ProgramServicesAmt |
| Management And General | $76,188 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,424 | TotalAmt |
| Program Services | $17,764 | ProgramServicesAmt |
| Management And General | $1,660 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,148,767 | TotalAmt |
| Program Services | $12,939,908 | ProgramServicesAmt |
| Management And General | $1,208,859 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,188 | TotalAmt |
| Program Services | $14,805 | ProgramServicesAmt |
| Management And General | $1,383 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $154,450 | TotalAmt |
| Program Services | $138,074 | ProgramServicesAmt |
| Management And General | $16,376 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,247,761 | TotalAmt |
| Program Services | $2,903,419 | ProgramServicesAmt |
| Management And General | $344,342 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,221 | TotalAmt |
| Program Services | $21,653 | ProgramServicesAmt |
| Management And General | $2,568 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $88,417 | TotalAmt |
| Program Services | $79,043 | ProgramServicesAmt |
| Management And General | $9,374 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $774,440 | TotalAmt |
| Program Services | $532,129 | ProgramServicesAmt |
| Management And General | $242,311 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,387,807 | TotalAmt |
| Program Services | $2,525,166 | ProgramServicesAmt |
| Management And General | $862,641 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $125,755 | TotalAmt |
| Program Services | $125,755 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| INTERCOMPANY EXPENSE | $4,468,784 | $3,994,983 | $473,801 |
| MEDICAL SUPPLIES | $3,022,283 | $3,022,283 | |
| DIETARY SUPPLIES | $160,151 | $160,151 | |
| OTHER SUPPLIES | $95,574 | $85,441 | $10,133 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $60,185,661 | TotalAmt |
| Program Services | $55,312,093 | ProgramServicesAmt |
| Management And General | $4,873,568 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,610 | BOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,801,618 | BOYAmt |
| EOY | $2,288,304 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $750 | BOYAmt |
| EOY | $750 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $34,304 | BOYAmt |
| EOY | $107,107 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $68,483,585 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $38,172,706 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $32,551,883 | BOYAmt |
| EOY | $30,310,879 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $34,390,165 | BOYAmt |
| EOY | $32,707,040 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $623,592 | BOYAmt |
| EOY | $763,155 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $29,042,843 | BOYAmt |
| EOY | $56,153,119 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $29,666,435 | BOYAmt |
| EOY | $56,916,274 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Org Does Not Follow FASB117 | Yes (X) | OrgDoesNotFollowFASB117Ind |
Cap Stk Tr Prin Current Funds CapStkTrPrinCurrentFundsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Pd In Cap Srpls Land Bldg Eqp Fund PdInCapSrplsLandBldgEqpFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,723,730 | BOYAmt |
| EOY | -$24,209,234 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,723,730 | BOYAmt |
| EOY | -$24,209,234 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $34,390,165 | BOYAmt |
| EOY | $32,707,040 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$28,932,964 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agent Trustee Etc | Yes (1) | AgentTrusteeEtcInd |
| Beginning Balance | $162,052 | BeginningBalanceAmt |
| Additions During Year | $1,190,939 | AdditionsDuringYearAmt |
| Distributions During Year | $1,224,022 | DistributionsDuringYearAmt |
| Ending Balance | $128,969 | EndingBalanceAmt |
| Incl Escrow Custodial Acct Liab | 0 | InclEscrowCustodialAcctLiabInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,180,921 | OtherCostOrOtherBasisAmt |
| Book Value | $4,180,921 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $57,029,004 | OtherCostOrOtherBasisAmt |
| Depreciation | $38,172,706 | DepreciationAmt |
| Book Value | $18,856,298 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $7,033,461 | OtherCostOrOtherBasisAmt |
| Book Value | $7,033,461 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $240,199 | OtherCostOrOtherBasisAmt |
| Book Value | $240,199 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $30,310,879 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | INTERCOMPANY PAYABLE | Desc |
| Amt | $56,153,119 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $56,153,119 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART IV, LINE 1B: | THE FILING ORGANIZATION MANAGES SNF PATIENT TRUST ACCOUNTS FOR ALL OF ITS NURSING FACILITIES' PATIENTS. THE FUNDS BELONG TO THE PATIENTS AND ARE ONLY SPENT ON BEHALF OF THE PATIENTS IN ACCORDANCE WITH NC STATE GUIDELINES. |
| PART X, LINE 2: | THE ORGANIZATION HAS EVALUATED UNCERTAIN TAX POSITIONS FOR ITS CALENDAR YEARS ENDED DECEMBER 31, 2022 AND DECEMBER 31, 2021, INCLUDING A QUANTIFICATION OF TAX RISK IN AREAS SUCH AS UNRELATED BUSINESS TAXABLE INCOME AND THE TAXATION OF ITS JOINT VENTURES. THIS EVALUATION DID NOT HAVE A MATERIAL EFFECT ON THE ORGANIZATION'S FINANCIAL STATEMENTS FOR THE CALENDAR YEARS ENDED DECEMBER 31, 2022 AND DECEMBER 31, 2021. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ANTHONY C DEFURIO | ||||||||||||||
| DIRECTOR, SECR, TREAS | $0 | $1,530,455 | $0 | $1,590,000 | $0 | $193,127 | $0 | $455,288 | $0 | $28,643 | $0 | $3,797,513 | $0 | $145,447 |
| KEN D HAYNES | ||||||||||||||
| DIRECTOR, PRESIDENT | $0 | $1,330,997 | $0 | $1,392,000 | $0 | $242,559 | $0 | $401,250 | $0 | $38,467 | $0 | $3,405,273 | $0 | $203,562 |
| SCOTT C RISSMILLER MD | ||||||||||||||
| DIRECTOR | $0 | $1,130,814 | $0 | $1,432,000 | $0 | $39,465 | $0 | $346,988 | $0 | $28,112 | $0 | $2,977,379 | $0 | $0 |
| COLLIN LANE | ||||||||||||||
| FORMER OFFICER (8/1/21) | $0 | $478,521 | $0 | $270,716 | $0 | $30,027 | $0 | $56,979 | $0 | $31,873 | $0 | $868,116 | $0 | $27,637 |
| RODNEY BALL | ||||||||||||||
| TOP FINANCIAL OFFICIAL | $0 | $408,795 | $0 | $338,829 | $0 | $23,011 | $0 | $56,652 | $0 | $29,808 | $0 | $857,095 | $0 | $20,140 |
| ROSE COOK | ||||||||||||||
| FORMER OFFICER (10/1/20) | $0 | $281,597 | $0 | $176,009 | $0 | $44,309 | $0 | $39,032 | $0 | $22,538 | $0 | $563,485 | $0 | $11,161 |
| JENNIFER SULLIVAN | ||||||||||||||
| TOP MGMT OFFICIAL | $0 | $392,967 | $0 | $96,659 | $0 | $23,777 | $0 | $34,209 | $0 | $14,147 | $0 | $561,759 | $0 | $0 |
| MIKE STOLZENBACH | ||||||||||||||
| VP, FACILITIES, CONT CARE | $0 | $251,706 | $0 | $149,595 | $0 | $2,582 | $0 | $28,715 | $0 | $35,959 | $0 | $468,557 | $0 | $0 |
| SCHAREE LEE | ||||||||||||||
| EXEC DIR - CONT CARE (TO 10/7/22) | $0 | $124,307 | $0 | $35,544 | $0 | $24,260 | $0 | $7,580 | $0 | $16,962 | $0 | $208,653 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 4B | FormAndLineReferenceDesc |
| Explanation | CERTAIN DIRECTORS, OFFICERS, AND KEY EMPLOYEES OF THE FILING ORGANIZATION PARTICIPATED IN AND/OR RECEIVED PAYMENTS FROM A SUPPLEMENTAL NON-QUALIFIED DEFERRED COMPENSATION PLAN ( SERP) OF THEIR EMPLOYER, A RELATED ORGANIZATION. THE DETERMINATION OF THE PAYMENT AMOUNT FROM NON-QUALIFIED DEFERRED COMPENSATION PLANS FOLLOWED THE EMPLOYMENT ORGANIZATION'S COMPENSATION PROCEDURES. THE FOLLOWING DIRECTORS, OFFICERS, AND KEY EMPLOYEES RECEIVED PAYMENTS FROM NON-QUALIFIED DEFERRED COMPENSATION PLANS DURING THE CURRENT TAX YEAR: ANTHONY DEFURIO $145,447 KEN HAYNES $203,562 COLLIN LANE $27,731 RODNEY BALL $20,209 ROSE COOK $11,199 | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 3 | THE ORGANIZATION DELEGATED CONTROL OVER MANAGEMENT DUTIES TO THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY ("CMHA"), AS DESCRIBED IN AN INTEGRATION AGREEMENT ENTERED INTO BETWEEN THE ORGANIZATION AND CMHA, EFFECTIVE FEBRUARY 1, 2020. PER THE INTEGRATION AGREEMENT, THE ORGANIZATION ENGAGED CMHA TO MANAGE AND OVERSEE THE DAY-TO-DAY ACTIVITIES AND OPERATIONS OF THE ORGANIZATION, WHICH INVOLVE CMHA PROVIDING ADMINISTRATIVE SERVICES, RESOURCES, PERSONNEL, AND STAFF. CMHA PROVIDES THESE SERVICES AND STAFF TO THE ORGANIZATION AT COST. DIRECTORS, OFFICERS, AND KEY EMPLOYEES OF THE ORGANIZATION ARE ALSO OFFICERS AND/OR EMPLOYEES OF CMHA. SEE FORM 990, PART VII FOR ALL COMPENSATION RECEIVED BY DIRECTORS, OFFICERS, AND KEY EMPLOYEES FROM CMHA, A RELATED ORGANIZATION. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE DIRECTORS OF THE FILING ORGANIZATION ARE APPOINTED BY THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY MAY REMOVE A DIRECTOR AT ANY TIME WITH OR WITHOUT CAUSE. THE CORPORATION'S ARTICLES OF INCORPORATION MAY BE AMENDED OR RESTATED FROM TIME TO TIME BY THE BOARD OF DIRECTORS, SUBJECT TO APPROVAL BY THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY. THE CORPORATION'S BYLAWS MAY BE AMENDED OR REPEALED, AND NEW BYLAWS MAY BE ADOPTED, BY THE BOARD, EXCEPT AS OTHERWISE PROVIDED IN THE CORPORATION'S ARTICLES OF INCORPORATION OR BY LAW. ANY AMENDMENT TO THE PROVISIONS PERTAINING TO BOARD APPOINTMENT RIGHTS IS SUBJECT TO APPROVAL BY THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE FILING ORGANIZATION'S BOARD OF DIRECTORS RECEIVES A COPY OF THE FORM 990 WITH SUFFICIENT TIME TO PERMIT REVIEW, COMMENT, AND QUESTIONS PRIOR TO ITS FILING. IF MODIFICATIONS ARE REQUIRED FOLLOWING SUCH REVIEW AND COMMENT, THE REVISED FORM 990 IS REDISTRIBUTED TO ALL DIRECTORS PRIOR TO ITS FILING WITH THE IRS, ALONG WITH A REPORT NOTING THE MODIFICATIONS. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE CONFLICT OF INTEREST ("COI") POLICY PROTECTS THE INTERESTS OF THE ORGANIZATION WHEN IT IS CONTEMPLATING ENTERING INTO A TRANSACTION OR ARRANGEMENT THAT MIGHT BENEFIT THE PRIVATE INTERESTS OF AN OFFICER OR DIRECTOR OF THE ORGANIZATION, OR MIGHT RESULT IN A POSSIBLE EXCESS BENEFIT TRANSACTION, AND IS INTENDED TO SUPPLEMENT BUT NOT REPLACE ANY FEDERAL/STATE LAWS GOVERNING CONFLICT OF INTEREST THAT ARE APPLICABLE TO THE ORGANIZATION. THE CONFLICT OF INTEREST POLICY APPLIES TO "INTERESTED PERSONS", WHICH ARE DEFINED AS MEMBERS OF THE ORGANIZATION'S BOARD OF DIRECTORS, MEMBERS OF A COMMITTEE WITH DELEGATED POWERS FROM THE ORGANIZATION'S BOARD OF DIRECTORS, OR PRINCIPAL OFFICERS OF THE ORGANIZATION IF ANY SUCH PERSONS HAVE A DIRECT OR INDIRECT FINANCIAL INTEREST. AN INTERESTED PERSON MUST DISCLOSE THE EXISTENCE OF THE FINANCIAL INTEREST, AND BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS, TO THE ORGANIZATION'S BOARD OF DIRECTORS OR ITS APPLICABLE COMMITTEE THAT IS CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT. IN THE EVENT THE ORGANIZATION'S BOARD OF DIRECTORS OR ITS APPLICABLE COMMITTEE DETERMINES THAT A CONFLICT OF INTEREST EXISTS, THE INTERESTED PERSON MAY PRESENT RELEVANT INFORMATION ABOUT THE PROPOSED TRANSACTION OR ARRANGEMENT TO THE ORGANIZATION'S BOARD OF DIRECTORS OR ITS APPLICABLE COMMITTEE, BUT AFTER SUCH PRESENTATION THE INTERESTED PERSON SHALL LEAVE THE MEETING WHILE THE REMAINING MEMBERS OF THE ORGANIZATION'S BOARD OF DIRECTORS OR ITS APPLICABLE COMMITTEE DISCUSS AND VOTE UPON THE PROPOSED TRANSACTION OR ARRANGEMENT. THE CHAIRPERSON OF THE ORGANIZATION'S BOARD OF DIRECTORS OR ITS APPLICABLE COMMITTEE SHALL, IF APPROPRIATE, APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT. AFTER EXERCISING DUE DILIGENCE, THE DISINTERESTED MEMBERS OR APPLICABLE COMMITTEE SHALL DETERMINE WHETHER THE ORGANIZATION CAN WITH REASONABLE EFFORTS OBTAIN A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT FROM A PERSON OR ENTITY THAT WOULD NOT PRESENT A CONFLICT OF INTEREST. IF A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT IS NOT REASONABLY POSSIBLE UNDER CIRCUMSTANCES NOT PRODUCING A CONFLICT OF INTEREST, THE DISINTERESTED MEMBERS OR APPLICABLE COMMITTEE SHALL DETERMINE BY A MAJORITY VOTE WHETHER THE PROPOSED TRANSACTION OR ARRANGEMENT IS IN THE ORGANIZATION'S BEST INTEREST, FOR ITS OWN BENEFIT, AND FAIR AND REASONABLE AND, IN ACCORDANCE WITH SUCH DETERMINATION, SHALL DETERMINE WHETHER TO APPROVE THE PROPOSED TRANSACTION OR ARRANGEMENT. IF THE ORGANIZATION'S BOARD OF DIRECTORS OR ITS APPLICABLE COMMITTEE HAS REASONABLE CAUSE TO BELIEVE THAT AN INTERESTED PERSON HAS FAILED TO DISCLOSE AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, IT SHALL INFORM THE INTERESTED PERSON OF THE BASIS FOR SUCH BELIEF AND AFFORD THE INTERESTED PERSON AN OPPORTUNITY TO EXPLAIN THE ALLEGED FAILURE TO DISCLOSE. IF, AFTER HEARING THE INTERESTED PERSON'S RESPONSE AND MAKING FURTHER INVESTIGATION AS WARRANTED BY THE CIRCUMSTANCES, THE ORGANIZATION'S BOARD OF DIRECTORS OR ITS APPLICABLE COMMITTEE DETERMINES THAT THE INTERESTED PERSON HAS FAILED TO DISCLOSE AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, IT SHALL TAKE APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTION. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE ORGANIZATION PAYS NO COMPENSATION TO OFFICERS, DIRECTORS AND KEY EMPLOYEES. ALL COMPENSATION PAID TO OFFICERS, DIRECTORS AND KEY EMPLOYEES WAS PAID BY A RELATED ORGANIZATION, THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY ("CMHA"). THE DIVERSITY, INCLUSION, & COMPENSATION COMMITTEE (THE "COMMITTEE") OF THE ATRIUM HEALTH, INC. BOARD OF DIRECTORS HAS AUTHORITY AS CMHA DELEGATES TO IT, FOR THE REVIEW AND APPROVAL OF SENIOR EXECUTIVE COMPENSATION, INCLUDING SENIOR EXECUTIVE INCENTIVE PLANS. NO MEMBER OF THE COMMITTEE IS AN EMPLOYEE OF THE FILING ORGANIZATION. THE COMMITTEE RELIES UPON AN EXTERNAL, INDEPENDENT COMPENSATION CONSULTANT EXPERIENCED IN HEALTHCARE TO PROVIDE THE COMMITTEE WITH COMPENSATION COMPARABILITY DATA FOR NEW EXECUTIVE POSITION APPOINTMENTS AND FOR COMPENSATION REVIEWS FOR EXISTING EXECUTIVES. THE CONSULTANT, WHICH IS RETAINED DIRECTLY BY THE COMMITTEE, PROVIDES THIRD-PARTY INFORMATION AND EVALUATES THE COMPETITIVENESS AND REASONABLENESS OF EXECUTIVE COMPENSATION AND BENEFITS PROGRAMS IN RELATION TO MARKET PRACTICES FOR SIMILARLY SITUATED HEALTHCARE ORGANIZATIONS. THE COMMITTEE MAKES ITS DECISIONS WITH RESPECT TO EXECUTIVE COMPENSATION IN ACCORDANCE WITH CMHA AND THE FILING ORGANIZATION'S POLICIES, IRS REGULATIONS, AND STANDARD CORPORATE GOVERNANCE PRACTICES. SUCH POLICIES INCLUDE ADHERENCE TO EXECUTIVE COMPENSATION PHILOSOPHY AND REVIEW PROCESSES; PROCESSES ENSURING COMMITTEE MEMBER AND COMPENSATION CONSULTANT INDEPENDENCE; USE OF VALID MARKET COMPARISONS OF DATA FROM HEALTHCARE ORGANIZATIONS OF SIMILAR SIZE, STRUCTURE, AND COMPLEXITY AND ESTABLISHMENT OF THE REBUTTABLE PRESUMPTION OF REASONABLENESS, PER IRS GUIDELINES. MINUTES OF THE DELIBERATIONS OF THE COMMITTEE ARE MAINTAINED IN THE ATRIUM HEALTH, INC. LEGAL DEPARTMENT. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION'S ARTICLES OF INCORPORATION ARE AVAILABLE TO THE PUBLIC ON REQUEST AND ARE AVAILABLE ON THE WEBSITE OF THE NORTH CAROLINA SECRETARY OF STATE. THE ORGANIZATION'S BYLAWS ARE NOT PUBLISHED, BUT PROVISIONS FROM THE BYLAWS ARE INCLUDED AS NECESSARY IN THE ORGANIZATION'S POLICIES, AND ARE ATTACHED TO THE FORM 1023 FILED FOR THE ORGANIZATION WITH THE IRS, WHICH IS PUBLICLY AVAILABLE. THE CONFLICT OF INTEREST POLICY IS AVAILABLE TO THE PUBLIC ON REQUEST. THE ORGANIZATION'S FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC BY INCLUDING THEM AS PART OF THE ANNUAL INFORMATION STATEMENT OF THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY ("CMHA") FILED ON THE MSRB WEBSITE (EMMA). |
| FORM 990, PART IX, LINE 11G | OTHER PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 12,939,908. MANAGEMENT AND GENERAL EXPENSES 1,208,859. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 14,148,767. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (41 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| AH GEORGIA INC | ||||||||||
| PO BOX 32861 | CHARLOTTE | NC | 282322861 | 831707383 | HEALTHCARE MANAGEMENT | NC | 501(C)(3) | LINE 10 | CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY | 0 |
| ATRIUM HEALTH EMPLOYEE ASSISTANCE INC | ||||||||||
| PO BOX 32861 | CHARLOTTE | NC | 282322861 | 850548753 | EMERGENCY ASSISTANCE | NC | 501(C)(3) | LINE 7 | CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY | 0 |
| 1717 GARDEN TERRACE LLC | ||||||||||
| PO BOX 32861 | CHARLOTTE | NC | 282322861 | 260897680 | REAL ESTATE | NC | NC POLITICAL SUBDIVI | CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY | 0 | |
| 3021 NESBITT LLC | ||||||||||
| PO BOX 32861 | CHARLOTTE | NC | 282322861 | 853018530 | REAL ESTATE | NC | NC POLITICAL SUBDIVI | CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY | 0 | |
| ABC PARKWAY LLC | ||||||||||
| PO BOX 32861 | CHARLOTTE | NC | 282322861 | REAL ESTATE | NC | NC POLITICAL SUBDIVI | CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY | 0 | ||
| ATRIUM HEALTH HUNTERSVILLE ASC LLC | ||||||||||
| PO BOX 32861 | CHARLOTTE | NC | 282322861 | 863426328 | HEALTHCARE | NC | NC POLITICAL SUBDIVI | CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY | 0 | |
| AV INSURANCE LLC | ||||||||||
| PO BOX 32861 | CHARLOTTE | NC | 282322861 | 205608253 | INSURANCE | NC | NC POLITICAL SUBDIVI | CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY | 0 | |
| CAROLINAS HEALTHCARE INFORMATION EXCHANGE LLC | ||||||||||
| PO BOX 32861 | CHARLOTTE | NC | 282322861 | 352437316 | HEALTHCARE MANAGEMENT | NC | NC POLITICAL SUBDIVI | CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY | 0 | |
| CAROLINAS MEDICAL CENTER AT HOME LLC | ||||||||||
| PO BOX 32861 | CHARLOTTE | NC | 282322861 | 261451047 | HEALTHCARE | NC | NC POLITICAL SUBDIVI | CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY | 0 | |
| CAROLINAS SHARED SERVICES LLC | ||||||||||
| PO BOX 32861 | CHARLOTTE | NC | 282322861 | 341988710 | HEALTHCARE MANAGEMENT | NC | NC POLITICAL SUBDIVI | CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY | 0 | |
| CHS FUND STRATEGIES MANAGEMENT LLC | ||||||||||
| PO BOX 32861 | CHARLOTTE | NC | 282322861 | 810849277 | INVESTMENT MANAGEMENT | NC | NC POLITICAL SUBDIVI | CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY | 0 | |
| CLEVELAND AMBULATORY SERVICES LLC | ||||||||||
| PO BOX 32861 | CHARLOTTE | NC | 282322861 | 561909421 | HEALTHCARE | NC | NC POLITICAL SUBDIVI | CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY | 0 | |
| EAST BOULEVARD 1601 LLC | ||||||||||
| PO BOX 32861 | CHARLOTTE | NC | 282322861 | 261098896 | REAL ESTATE | NC | NC POLITICAL SUBDIVI | CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY | 0 | |
| EAST BOULEVARD 1615 LLC | ||||||||||
| PO BOX 32861 | CHARLOTTE | NC | 282322861 | REAL ESTATE | NC | NC POLITICAL SUBDIVI | CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY | 0 | ||
| GATEWAY HOLDINGS - INDEPENDENCE LLC | ||||||||||
| PO BOX 32861 | CHARLOTTE | NC | 282322861 | REAL ESTATE | NC | NC POLITICAL SUBDIVI | CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY | 0 | ||
| LOOKOUT NC PROPERTIES LLC | ||||||||||
| PO BOX 32861 | CHARLOTTE | NC | 282322861 | 852992379 | REAL ESTATE | NC | NC POLITICAL SUBDIVI | CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY | 0 | |
| PINEVILLE LTACH REHAB HOSPITAL LLC | ||||||||||
| PO BOX 32861 | CHARLOTTE | NC | 282322861 | 371663995 | HEALTHCARE | NC | NC POLITICAL SUBDIVI | CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY | 0 | |
| UNION HEALTH SERVICES LLC | ||||||||||
| PO BOX 32861 | CHARLOTTE | NC | 282322861 | 300597871 | HEALTHCARE | NC | NC POLITICAL SUBDIVI | CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY | 0 | |
| UNION MEDICAL OFFICE BUILDING LLC | ||||||||||
| PO BOX 32861 | CHARLOTTE | NC | 282322861 | REAL ESTATE | NC | NC POLITICAL SUBDIVI | CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY | 0 | ||
| UNION MEDICAL SERVICES LLC | ||||||||||
| PO BOX 32861 | CHARLOTTE | NC | 282322861 | 203013475 | HEALTHCARE | NC | NC POLITICAL SUBDIVI | CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY | 0 | |
| WEST STANLY IMAGING LLC | ||||||||||
| PO BOX 32861 | CHARLOTTE | NC | 282322861 | 262414332 | HEALTHCARE | NC | NC POLITICAL SUBDIVI | CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY | 0 | |
| CAROLINAS AMBULATORY SURGERY INC | ||||||||||
| PO BOX 32861 | CHARLOTTE | NC | 282322861 | 812714217 | HEALTHCARE | NC | NC POLITICAL SUBDIVI | CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY | 0 | |
| CAROLINAS COLLEGE OF HEALTH SCIENCES | ||||||||||
| PO BOX 32861 | CHARLOTTE | NC | 282322861 | EDUCATION | NC | NC POLITICAL SUBDIVI | CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY | 0 | ||
| CHS PHARMACY SERVICES INC | ||||||||||
| PO BOX 32861 | CHARLOTTE | NC | 282322861 | 473367492 | HEALTHCARE | NC | NC POLITICAL SUBDIVI | CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY | 0 | |
| MERCY EQUIPMENT CORPORATION | ||||||||||
| PO BOX 32861 | CHARLOTTE | NC | 282322861 | 561660616 | HEALTHCARE | NC | NC POLITICAL SUBDIVI | CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY | 0 | |
| CAROLINAS HEALTH NETWORK INC | ||||||||||
| PO BOX 32861 | CHARLOTTE | NC | 282322861 | 561899343 | HEALTHCARE MANAGEMENT | NC | NC POLITICAL SUBDIVI | CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY | 0 | |
| 1025 KINGS DRIVE TENANT LLC | ||||||||||
| PO BOX 32861 | CHARLOTTE | NC | 282322861 | REAL ESTATE | NC | NC POLITICAL SUBDIVI | CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY | 0 | ||
| ABBOT RIDGE LLC | ||||||||||
| PO BOX 32861 | CHARLOTTE | NC | 282322861 | 861766226 | REAL ESTATE | NC | NC POLITICAL SUBDIVI | CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY | 0 | |
| DRE1LLC | ||||||||||
| PO BOX 32861 | CHARLOTTE | NC | 282322861 | REAL ESTATE | NC | NC POLITICAL SUBDIVI | CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY | 0 | ||
| LB ACQUISITIONS LLC | ||||||||||
| PO BOX 32861 | CHARLOTTE | NC | 282322861 | 301251297 | REAL ESTATE | NC | NC POLITICAL SUBDIVI | CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY | 0 | |
| ROCKY ROAD 1 LLC | ||||||||||
| PO BOX 32861 | CHARLOTTE | NC | 282322861 | 861257491 | REAL ESTATE | NC | NC POLITICAL SUBDIVI | CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY | 0 | |
| RM1 PROPERTIES LLC | ||||||||||
| PO BOX 32861 | CHARLOTTE | NC | 282322861 | 853038041 | REAL ESTATE | NC | NC POLITICAL SUBDIVI | CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY | 0 | |
| RR ASSEMBLAGE LLC | ||||||||||
| PO BOX 32861 | CHARLOTTE | NC | 282322861 | 853897459 | REAL ESTATE | NC | NC POLITICAL SUBDIVI | CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY | 0 | |
| THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY | ||||||||||
| PO BOX 32861 | CHARLOTTE | NC | 282322861 | 560529945 | HEALTHCARE | NC | NC POLITICAL SUBDIVI | 0 | ||
| ATRIUM HEALTH INC | ||||||||||
| PO BOX 32861 | CHARLOTTE | NC | 282322861 | 843647453 | HEALTHCARE | NC | 501(C)(3) | LINE 10 | CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY | 0 |
| 1057 EAST LLC | ||||||||||
| PO BOX 32861 | CHARLOTTE | NC | 282322861 | REAL ESTATE | NC | NC POLITICAL SUBDIVI | CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY | 0 | ||
| SUNRISE PROPERTIES LLC | ||||||||||
| PO BOX 32861 | CHARLOTTE | NC | 282322861 | 372043234 | REAL ESTATE | NC | NC POLITICAL SUBDIVI | CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY | 0 | |
| IRCAD NORTH AMERICA INC | ||||||||||
| PO BOX 32861 | CHARLOTTE | NC | 282322861 | 932040912 | HEALTHCARE DEVELOPMENT | NC | NC POLITICAL SUBDIVI | CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY | 0 | |
| THE PEARL INNOVATION DISTRICT MANAGEMENT CO | ||||||||||
| PO BOX 32861 | CHARLOTTE | NC | 282322861 | 882000136 | HEALTHCARE DEVELOPMENT | NC | 501(C)(3) | LINE 7 | CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY | 0 |
| ATRIUM HEALTH FOUNDATION | ||||||||||
| PO BOX 32861 | CHARLOTTE | NC | 282322861 | 566060481 | FUNDRAISING | NC | 501(C)(3) | LINE 7 | CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY | 0 |
| ADVOCATE HEALTH INC | ||||||||||
| 1000 BLYTHE BLVD | CHARLOTTE | NC | 28203 | 884157429 | HEALTHCARE | NC | 501(C)(3) | LINE 12B, II | 0 | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd |
|---|---|---|---|---|---|---|---|---|---|
| CAROLINAS IMAGING SERVICES LLC | |||||||||
| 700 E MOREHEAD STREET STE 300 | CHARLOTTE | NC | 28202 | 912185756 | HEALTHCARE | NC | N/A | 0 | 0 |
| ENDOSCOPY CENTER - MONROE LLC | |||||||||
| 11301 CARMEL COMMONS BLVD STE 302 | CHARLOTTE | NC | 28226 | 260731594 | HEALTHCARE | NC | N/A | 0 | 0 |
| ENDOSCOPY CENTER HOLDINGS LLC | |||||||||
| 11301 CARMEL COMMONS BLVD STE 302 | CHARLOTTE | NC | 28226 | 260316896 | HEALTHCARE MANAGEMENT | NC | N/A | 0 | 0 |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ALLIANCE MEDICAL INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 32861 | AddressLine1Txt |
| City | CHARLOTTE | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 282322861 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 561682606 | EIN |
| Primary Activities | HEALTHCARE | PrimaryActivitiesTxt |
| Legal Domicile State | NC | LegalDomicileStateCd |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Entity Type | C | EntityTypeTxt |
| Controlled Organization | 0 | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |