CAROMONT HEALTH INC: Form 990, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- CAROMONT HEALTH INC (EIN 58-1636959)
- Tax period
- 2020-07-01 to 2021-06-30
- Filed
- 2022-05-02
- IRS object ID
- 202211229349300836
- Schema version
- 2020v4.2
- 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
- Form 990
- Schedule A
- Schedule C
- Schedule D
- Schedule F
- Schedule I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-05-02T13:39:45-05:00 | ReturnTs |
| Tax Period End | 2021-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 560747981 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DIXON HUGHES GOODMAN LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 500 RIDGEFIELD COURT | AddressLine1Txt |
| City | ASHEVILLE | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 28806 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2020-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 581636959 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CAROMONT HEALTH | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | CARO | BusinessNameControlTxt |
| Phone | 7048342000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2525 COURT DRIVE PO BOX 1747 | AddressLine1Txt |
| City | GASTONIA | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 280531747 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DAVID O'CONNOR | PersonNm |
| Person Title | EVP, CFO | PersonTitleTxt |
| Phone | 7048342000 | PhoneNum |
| Signature | 2022-05-02 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | DAVID | PersonFirstNm |
| Person Last | OCONNOR | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | AMY BIBBY | PreparerPersonNm |
| PTIN | P00445891 | PTIN |
| Phone | 8282542254 | PhoneNum |
| Preparation | 2022-05-02 | PreparationDt |
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 | 2020 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | DAVID O'CONNOR | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2525 COURT DRIVE PO BOX 1747 | AddressLine1Txt |
| City | GASTONIA | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 280531747 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $53,008,631 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.CAROMONT.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1984 | FormationYr |
| Legal Domicile State | NC | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE COMPASSIONATE, EXCEPTIONAL AND HIGHLY RELIABLE CARE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 14 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 16 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $2,137,924 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $2,386,051 | CYProgramServiceRevenueAmt |
| PY Investment Income | $22,002,212 | PYInvestmentIncomeAmt |
| CY Investment Income | $50,621,553 | CYInvestmentIncomeAmt |
| PY Other Revenue | $23,112 | PYOtherRevenueAmt |
| CY Other Revenue | $1,027 | CYOtherRevenueAmt |
| PY Total Revenue | $24,163,248 | PYTotalRevenueAmt |
| CY Total Revenue | $53,008,631 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $515,164 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $825,472 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $825,210 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $916,059 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $2,429,440 | PYOtherExpensesAmt |
| CY Other Expenses | $1,570,171 | CYOtherExpensesAmt |
| PY Total Expenses | $3,769,814 | PYTotalExpensesAmt |
| CY Total Expenses | $3,311,702 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $20,393,434 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $49,696,929 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $769,770,199 | TotalAssetsBOYAmt |
| Total Assets EOY | $956,040,256 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $7,435,039 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $8,857,103 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $762,335,160 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $947,183,153 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO PROVIDE COMPASSIONATE, EXCEPTIONAL AND HIGHLY RELIABLE CARE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $2,095,050 | ExpenseAmt |
| Grant | $825,472 | GrantAmt |
| Revenue | $2,386,051 | RevenueAmt |
| Desc | CAROMONT 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, 2021 SAW CAROMONT HEALTH LIVING ITS VISION TO BE OUR COMMUNITY'S MOST TRUSTED HEALTHCARE PARTNER. THE COMPLETE 2021 COMMUNITY BENEFIT REPORT CAN BE FOUND AT WWW.CAROMONTHEALTH.ORG. | Desc |
| Total Program Service Expenses | $2,095,050 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | 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 | 0 | 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 | Yes (1) | 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 | Yes (1) | 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 | Yes (1) | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | 0 | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 2 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 16 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | Yes (1) | ForeignFinancialAccountInd |
| Foreign Country | CJ | ForeignCountryCd |
| 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 | 14 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | 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 | 0 | 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 | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | Yes (1) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | Yes (1) | WrittenPolicyOrProcedureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE ORGANIZATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7048342000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2525 COURT DRIVE | AddressLine1Txt |
| City | GASTONIA | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 28054 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (21 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 |
|---|---|---|---|---|---|---|---|
| MR DAVID PAYSEUR | |||||||
| CHAIR | 1.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| MR JEFFREY CASH | |||||||
| VICE CHAIR | 1.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| DR ANDREW LIGHT | |||||||
| SECRETARY THROUGH 12/31/2020 | 1.00 | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| MR BARRY M POMEROY | |||||||
| TREASURER | 1.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| MR DONNIE LOFTIS | |||||||
| DIRECTOR | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | |
| MR JOSEPH B DAVIS JR | |||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |
| MS JANIE PEAK | |||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |
| MR WILLIAM ANTHONY | |||||||
| DIRECTOR | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | |
| DR CHARLES MEAKIN III | |||||||
| DIRECTOR | 1.00 | 3.00 | Yes (X) | $0 | $0 | $0 | |
| MS PEARL BURRIS FLOYD | |||||||
| DIRECTOR THROUGH 12/31/2020/SECRETARY STARTING ON | 1.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| MS ANNETTE CARTER | |||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |
| MR TIMOTHY D CONNER | |||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |
| MR FRANK STEWART | |||||||
| DIRECTOR | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | |
| MR TIMOTHY EFIRD | |||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |
| MR BOB HOVIS | |||||||
| (COMMISSIONER LIASON) | 1.00 | 2.00 | Yes (X) | $0 | $20,244 | $0 | |
| DR MICHEAL GASLIN | |||||||
| CHIEF-OF-STAFF | 1.00 | 1.00 | Yes (X) | $0 | $30,000 | $0 | |
| DR JAY HENDLER | |||||||
| CHIEF-OF-STAFF ELECT | 1.00 | 40.00 | Yes (X) | $0 | $467,871 | $30,742 | |
| DR ERIC T EMERSON | |||||||
| PAST-CHIEF-OF-STAFF (NON-VOTING) | 1.00 | 1.00 | Yes (X) | $0 | $20,000 | $0 | |
| MR K CHRISTOPHER PEEK | |||||||
| CEO | 6.00 | 49.00 | Yes (X) | $0 | $1,162,438 | $225,233 | |
| MR DAVID M O'CONNOR | |||||||
| EVP/ASST. TREASURER | 6.00 | 49.00 | Yes (X) | $0 | $728,075 | $136,607 | |
| MR LEIGH K HICKMAN | |||||||
| CLO/ASST. SEC. | 6.00 | 49.00 | Yes (X) | $0 | $366,970 | $75,277 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $2,795,598 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $467,859 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp
Contractor Name ContractorName
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WEATHERBY LOCUMS INC | BusinessNameLine1Txt |
Contractor Address ContractorAddress
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 972633 | AddressLine1Txt |
| City | DALLAS | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 753972633 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Services | TEMPORARY STAFFING | ServicesDesc |
| Compensation | $177,488 | CompensationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 1 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| LOSS ON INV. IN STLC | 900099 | $1,163,604 | $1,163,604 |
| PATIENT SERVICE REVENUE | 621110 | $1,144,506 | $1,144,506 |
| GAIN ON INV. IN MRISC | 900099 | $77,941 | $77,941 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $2,386,051 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $13,351,221 | TotalRevenueColumnAmt |
| Exclusion | $13,351,221 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $37,270,332 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $37,270,332 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $37,270,332 | TotalRevenueColumnAmt |
| Exclusion | $37,270,332 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | SETTLEMENT REVENUE | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $1,027 | TotalRevenueColumnAmt |
| Exclusion | $1,027 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $1,027 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $53,008,631 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $2,386,051 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $50,622,580 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $825,472 | TotalAmt |
| Program Services | $825,472 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $681,778 | TotalAmt |
| Program Services | $681,778 | ProgramServicesAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $54,482 | TotalAmt |
| Program Services | $54,482 | ProgramServicesAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $55,645 | TotalAmt |
| Program Services | $55,645 | ProgramServicesAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $124,154 | TotalAmt |
| Program Services | $124,154 | ProgramServicesAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,182,497 | TotalAmt |
| Management And General | $1,182,497 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $109,936 | TotalAmt |
| Program Services | $75,781 | ProgramServicesAmt |
| Management And General | $34,155 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,933 | TotalAmt |
| Program Services | $13,933 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $92,018 | TotalAmt |
| Program Services | $92,018 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,264 | TotalAmt |
| Program Services | $1,264 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $68,580 | TotalAmt |
| Program Services | $68,580 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,418 | TotalAmt |
| Program Services | $12,418 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (2 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| MEDICAL SUPPLIES | $86,467 | $86,467 |
| MISCELLANEOUS | $3,058 | $3,058 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,311,702 | TotalAmt |
| Program Services | $2,095,050 | ProgramServicesAmt |
| Management And General | $1,216,652 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | -$2 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $58,860,745 | BOYAmt |
| EOY | $31,482,782 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $76,285 | BOYAmt |
| EOY | $97,675 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,699,793 | BOYAmt |
| EOY | $129,116 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,650 | BOYAmt |
| EOY | $13,577 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$20,550 | BOYAmt |
| EOY | $26,077 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $4,457,463 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $756,976 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,769,068 | BOYAmt |
| EOY | $3,700,487 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $700,283,643 | BOYAmt |
| EOY | $913,500,393 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,651,016 | BOYAmt |
| EOY | $4,778,183 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,439,549 | BOYAmt |
| EOY | $2,311,968 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $769,770,199 | BOYAmt |
| EOY | $956,040,256 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,435,039 | BOYAmt |
| EOY | $8,857,103 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,435,039 | BOYAmt |
| EOY | $8,857,103 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $762,335,160 | BOYAmt |
| EOY | $947,183,153 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $762,335,160 | BOYAmt |
| EOY | $947,183,153 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $769,770,199 | BOYAmt |
| EOY | $956,040,256 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $49,696,929 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $94,062,015 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $41,089,049 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| 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) |
|---|---|---|
| Supporting Organization509a3 | Yes (X) | SupportingOrganization509a3Ind |
| Supporting Org Type2 | Yes (X) | SupportingOrgType2Ind |
| Supported Organizations | 5 | SupportedOrganizationsCnt |
Supported Org Information SupportedOrgInformationGrp (5 entries)
| EINEIN | Organization TypeOrganizationTypeCd | Governing Document ListedGoverningDocumentListedInd | SupportSupportAmt | Other SupportOtherSupportAmt |
|---|---|---|---|---|
| GASTON MEMORIAL HOSPITAL INC | ||||
| 560619359 | 3 | Yes (1) | $0 | $0 |
| GASTON MEMORIAL HOSPITAL FOUNDATION INC | ||||
| 561479699 | 10 | Yes (1) | $825,472 | $0 |
| CAROMONT HEALTH SERVICES INC | ||||
| 561455630 | 3 | Yes (1) | $0 | $0 |
| CAROMONT MEDICAL GROUP INC | ||||
| 561479712 | 10 | Yes (1) | $0 | $0 |
| HOSPICE OF GASTON COUNTY INC | ||||
| 581341530 | 7 | Yes (1) | $0 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supported Organizations Total | 5 | SupportedOrganizationsTotalCnt |
| Support Sum | $825,472 | SupportSumAmt |
| Other Support Sum | $0 | OtherSupportSumAmt |
Form990 Sch A Supporting Org Form990SchASupportingOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Listed By Name Governing Doc | Yes (1) | ListedByNameGoverningDocInd |
| Suprt Org No IRS Determination | 0 | SuprtOrgNoIRSDeterminationInd |
| Supported Org Section C456 | 0 | SupportedOrgSectionC456Ind |
| Supported Org Not Organized US | 0 | SupportedOrgNotOrganizedUSInd |
| Organization Change Suprt Org | 0 | OrganizationChangeSuprtOrgInd |
| Support Non Supported Org | 0 | SupportNonSupportedOrgInd |
| Payment Substantial Contribtr | 0 | PaymentSubstantialContribtrInd |
| Loan Disqualified Person | 0 | LoanDisqualifiedPersonInd |
| Controlled Disqualified Prsn | 0 | ControlledDisqualifiedPrsnInd |
| Disqualified Prsn Controll Int | 0 | DisqualifiedPrsnControllIntInd |
| Disqualified Prsn Ownr Int | 0 | DisqualifiedPrsnOwnrIntInd |
| Excess Business Holdings Rules | 0 | ExcessBusinessHoldingsRulesInd |
| Contribution Controller | 0 | ContributionControllerInd |
| Contribution Family | 0 | ContributionFamilyInd |
| Contribution35 Controlled | 0 | Contribution35ControlledInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Majority Dir Trst Supported Org | 0 | MajorityDirTrstSupportedOrgInd |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART IV, SECTION A, LINE 1: | THE ORGANIZATION SPECIFICALLY LISTS CAROMONT REGIONAL MEDICAL CENTER AS THE PRIMARY SUPPORTED ORGANIZATION IN THE GOVERNING DOCUMENTS. THE OTHER SUPPORTED ORGANIZATIONS ARE NOT LISTED BY NAME. HOWEVER, THESE ORGANIZATIONS ARE PART OF THE HEALTH SYSTEM WHICH IS SUPPORTED BY CAROMONT HEALTH. |
| PART IV, SECTION C, LINE 1: | THE PRIMARY SUPPORTED ORGANIZATION, CAROMONT REGIONAL MEDICAL CENTER, SHARES THE SAME BOARD AS CAROMONT HEALTH. CAROMONT HEALTH DEMONSTRATES CONTROL OVER THE OTHER SUPPORTED ORGANIZATIONS BY ITS ABILITY TO ELECT THE BOARDS OF EACH OF THESE ORGANIZATIONS AND ALL SUPPORTED ORGANIZATIONS MUST HAVE THE SAME PRESIDENT AND CEO AS THE SUPPORTING ORGANIZATION. THE 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. |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | Yes (1) | VolunteersInd |
| Paid Staff Or Management | Yes (1) | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | Yes (1) | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Total Lobbying Expenditures | $0 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | 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
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,536,779 | OtherCostOrOtherBasisAmt |
| Book Value | $3,536,779 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $339,940 | OtherCostOrOtherBasisAmt |
| Depreciation | $276,985 | DepreciationAmt |
| Book Value | $62,955 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $580,744 | OtherCostOrOtherBasisAmt |
| Depreciation | $479,991 | DepreciationAmt |
| Book Value | $100,753 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $3,700,487 | TotalBookValueLandBuildingsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $186,156,862 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $94,062,015 | NetUnrealizedGainsInvstAmt |
| Other Revenue | $41,089,049 | OtherRevenueAmt |
| Revenue Not Reported | $135,151,064 | RevenueNotReportedAmt |
| Revenue Subtotal | $51,005,798 | RevenueSubtotalAmt |
| Investment Expenses Not Incld | $1,182,497 | InvestmentExpensesNotIncldAmt |
| Other Revenues Not Included | $820,336 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $2,002,833 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $53,008,631 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $1,308,869 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $1,308,869 | ExpensesSubtotalAmt |
| Investment Expenses Not Incld2 | $1,182,497 | InvestmentExpensesNotIncld2Amt |
| Other Expenses Not Included | $820,336 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $2,002,833 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $3,311,702 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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, 2021 AND 2020. |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | INTERCOMPANY TRANSFERS 41,089,049. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | CONTRIBUTION EXPENSE INCLUDED IN REVENUE 825,472. BAD DEBT EXPENSE INCLUDED IN REVENUE -5,136. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | CONTRIBUTION EXPENSE INCLUDED IN REVENUE 825,472. BAD DEBT EXPENSE INCLUDED IN REVENUE -5,136. |
Schedule F IRS990ScheduleF
Account Activities Outside US AccountActivitiesOutsideUSGrp (2 entries)
| RegionRegionTxt | OfficesOfficesCnt | EmployeeEmployeeCnt | Type Of Activities ConductedTypeOfActivitiesConductedTxt | Specific Services ProvidedSpecificServicesProvidedTxt | Region Total ExpendituresRegionTotalExpendituresAmt |
|---|---|---|---|---|---|
| CENTRAL AMERICA AND THE CARIBBEAN - ANTIGUA & BARBUDA, ARUBA, BAHAMAS, | 0 | 0 | INVESTMENTS | STOCK IN CAROMONT INSURANCE SERVICES, LTD. | $550,000 |
| CENTRAL AMERICA AND THE CARIBBEAN - ANTIGUA & BARBUDA, ARUBA, BAHAMAS, | 0 | 0 | INVESTMENTS | SELF INSURANCE PREMIUMS | $2,616,996 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Subtotal Offices | 0 | SubtotalOfficesCnt |
| Subtotal Employees | 0 | SubtotalEmployeesCnt |
| Continuation Total Office | 0 | ContinuationTotalOfficeCnt |
| Continuation Total Employee | 0 | ContinuationTotalEmployeeCnt |
| Total Office | 0 | TotalOfficeCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Subtotal Spent | $3,166,996 | SubtotalSpentAmt |
| Continuation Spent | $0 | ContinuationSpentAmt |
| Total Spent | $3,166,996 | TotalSpentAmt |
| Transfer To Foreign Corp | Yes (1) | TransferToForeignCorpInd |
| Interest In Foreign Trust | 0 | InterestInForeignTrustInd |
| Foreign Corp Ownership | Yes (1) | ForeignCorpOwnershipInd |
| Passive Foreign Investmest Co | 0 | PassiveForeignInvestmestCoInd |
| Foreign Partnership | 0 | ForeignPartnershipInd |
| Boycott Countries | 0 | BoycottCountriesInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART III ACCOUNTING METHOD: | FormAndLineReferenceDesc |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GASTON MEMORIAL HOSPITAL FOUNDATION | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2525 COURT DRIVE | AddressLine1Txt |
| City | GASTONIA | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 28053 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 561479699 | RecipientEIN |
| IRC Section | 501(C)(3) | IRCSectionDesc |
| Cash Grant | $825,472 | CashGrantAmt |
| Valuation Method Used | FMV | ValuationMethodUsedDesc |
| Purpose Of Grant | OPERATIONS OF THE GRANTMAKING ORGANIZATION | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | PROVIDED FUNDS TO THE FOUNDATION TO ASSIST IN THE GRANT MAKING AND BENEVOLENCE INITIATIVES OPERATED BY THE FOUNDATION. ALL GRANTS DECISIONS ARE DOCUMENTED. | ExplanationTxt |
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 | Yes (1) | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | Yes (1) | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (4 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MR K CHRISTOPHER PEEK | ||||||||||||||
| CEO | $0 | $776,638 | $0 | $272,457 | $0 | $113,343 | $0 | $203,933 | $0 | $21,300 | $0 | $1,387,671 | $0 | $89,251 |
| MR DAVID M O'CONNOR | ||||||||||||||
| EVP/ASST. TREASURER | $0 | $495,147 | $0 | $138,597 | $0 | $94,331 | $0 | $115,312 | $0 | $21,295 | $0 | $864,682 | $0 | $78,443 |
| DR JAY HENDLER | ||||||||||||||
| CHIEF-OF-STAFF ELECT | $0 | $426,547 | $0 | $37,375 | $0 | $3,949 | $0 | $14,250 | $0 | $16,492 | $0 | $498,613 | $0 | $0 |
| MR LEIGH K HICKMAN | ||||||||||||||
| CLO/ASST. SEC. | $0 | $303,156 | $0 | $63,025 | $0 | $789 | $0 | $60,798 | $0 | $14,479 | $0 | $442,247 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3 | COMPENSATION PAID TO CEO OF CAROMONT HEALTH, INC. WAS PAID BY CAROMONT REGIONAL MEDICAL CENTER, A RELATED ORGANIZATION. CAROMONT REGIONAL MEDICAL CENTER UTILIZED THE FOLLOWING METHODS TO DETERMINE APPROPRIATE COMPENSATION FOR THE CEO THAT HAD INFLUENCE OVER THE ORGANIZATION'S ACTIVITIES: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - WRITTEN EMPLOYMENT CONTRACTS - COMPENSATION SURVEY OR STUDY - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE |
| PART I, LINE 4B | THE FOLLOWING INDIVIDUALS RECEIVED DEFERRED COMPENSATION ALLOCATIONS BY RELATED ORGANIZATION CAROMONT REGIONAL MEDICAL CENTER FROM A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP): DAVID O'CONNOR - $ 95,362 K. CHISTOPHER PEEK - 188,258 LEIGH K. HICKMAN - 47,249 |
| PART I, LINE 6 | EXECUTIVE 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 PHYSICIAN'S NET RESULTS FROM OPERATIONS AS CALCULATED BASED SOLELY ON HIS/HER NET CHARGES LESS HIS/HER ALLOCABLE SHARE OF CLINIC OVERHEAD COSTS. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 7A | THE BOARD OF DIRECTORS CONSISTS OF FOURTEEN (14) MEMBERS, EIGHT (8) MEMBERS OF WHOM WILL BE APPOINTED BY THE BOARD OF COUNTY COMMISSIONERS, ONE OF WHICH SHALL BE A GASTON COUNTY COMMISSIONER, FIVE (5) MEMBERS OF WHOM WILL BE APPOINTED BY THE EXISTING BOARD OF DIRECTORS OF THE ORGANIZATION, AND ONE (1) MEMBER WHO WILL BE THE CHIEF OF STAFF OF CAROMONT REGIONAL MEDICAL CENTER. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE 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 12C | MEMBERS 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 AUDIT AND COMPLIANCE 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 AUDIT AND COMPLIANCE OFFICER. QUESTIONNAIRES SUBMITTED BY DIRECTORS ARE REVIEWED ANNUALLY BY THE NOMINATING COMMITTEE OF THE BOARD. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE 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 THE 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 18 | THE ORGANIZATION'S FORM 990 IS MADE AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART VI, SECTION C, LINE 19 | AT 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 XI, LINE 9: | TRANSFERS TO RELATED ORGANIZATIONS 41,089,049. |
| PART XII, LINE 2C | THIS PROCESS HAS NOT CHANGED FROM PRIOR YEARS. |
| FORM 990, PART V AND PART VII | CAROMONT HEALTH IS A COMMON PAYMASTER AS DEFINED IN REGULATIONS SECTION 31.3121(S)-(1)(B) FOR SEVERAL ORGANIZATIONS. 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 Disregarded Entities IdDisregardedEntitiesGrp (4 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Total IncomeTotalIncomeAmt | End Of Year AssetsEndOfYearAssetsAmt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|
| CAROMONT OCCUPATIONAL MEDICINE LLC | |||||||||
| 2525 COURT DRIVE | GASTONIA | NC | 28054 | 510522690 | OCCUPATIONAL MEDICINE | NC | $1,149,642 | $305,210 | CAROMONT HEALTH INC |
| CAROMONT AMBULATORY SERVICES LLC | |||||||||
| 2525 COURT DRIVE | GASTONIA | NC | 28054 | 510522692 | AMBULATORY SERVICES | NC | $0 | $0 | CAROMONT HEALTH INC |
| CAROMONT COMMUNITY IMAGING LLC | |||||||||
| 2525 COURT DRIVE | GASTONIA | NC | 28054 | 562255954 | IMAGING SERVICES | NC | $0 | $0 | CAROMONT HEALTH INC |
| CHI CONTINUUM LLC | |||||||||
| 2525 COURT DRIVE | GASTONIA | NC | 28054 | 463056575 | ACCOUNTABLE CARE ORGANIZATION | NC | $0 | $0 | CAROMONT HEALTH INC |
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (6 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 | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| CAROMONT HEALTH SERVICES INC | |||||||||||
| 2526 COURT DRIVE | GASTONIA | NC | 28054 | 561455630 | OUTPATIENT SERVICES | NC | 501(C)(3) | LINE 3 | CAROMONT HEALTH INC | Yes (1) | |
| GASTON MEMORIAL HOSPITAL FOUNDATION INC | |||||||||||
| 2527 COURT DRIVE | GASTONIA | NC | 28054 | 561479699 | FOUNDATION | NC | 501(C)(3) | LINE 11 | CAROMONT HEALTH INC | Yes (1) | |
| CAROMONT MEDICAL GROUP INC | |||||||||||
| 2528 COURT DRIVE | GASTONIA | NC | 28054 | 561479712 | MEDICAL GROUP | NC | 501(C)(3) | LINE 11 | CAROMONT HEALTH INC | Yes (1) | |
| HOSPICE OF GASTON COUNTY INC | |||||||||||
| 2529 COURT DRIVE | GASTONIA | NC | 28054 | 581341530 | HOSPICE CARE | NC | 501(C)(3) | LINE 7 | CAROMONT HEALTH INC | Yes (1) | |
| GASTON MEMORIAL HOSPITAL INC | |||||||||||
| 2530 COURT DRIVE | GASTONIA | NC | 28054 | 560619359 | HOSPITAL | NC | 501(C)(3) | LINE 3 | CAROMONT HEALTH INC | Yes (1) | |
| GASTON COUNTY | |||||||||||
| PO BOX 1578 | GASTONIA | NC | 280531578 | 566000300 | GOVERNMENT ADMINISTRATION | NC | 0 | N/A | |||
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MRI SPECIALISTS OF THE CAROLINAS LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2525 COURT DRIVE | AddressLine1Txt |
| City | GASTONIA | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 28054 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 263318787 | EIN |
| Primary Activities | MEDICAL SERVICES | PrimaryActivitiesTxt |
| Legal Domicile State | NC | LegalDomicileStateCd |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Disproportionate Allocations | 0 | DisproportionateAllocationsInd |
| General Or Managing Partner | 0 | GeneralOrManagingPartnerInd |
| Ownership | 0.50000 | OwnershipPct |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CAROMONT INSURANCE SERVICES LTD | BusinessNameLine1Txt |
Foreign Address ForeignAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 69 | AddressLine1Txt |
| City | GRAND CAYMAN | CityNm |
| Country | CJ | CountryCd |
| Foreign Postal | KY1-1102 | ForeignPostalCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Primary Activities | INSURANCE CAPTIVE | PrimaryActivitiesTxt |
| Legal Domicile Foreign Country | CJ | LegalDomicileForeignCountryCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CAROMONT HEALTH INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Entity Type | C | EntityTypeTxt |
| Share Of Total Income | $2,650,013 | ShareOfTotalIncomeAmt |
| Share Of EOY Assets | $9,874,195 | ShareOfEOYAssetsAmt |
| Ownership | 1.00000 | OwnershipPct |
| Controlled Organization | Yes (1) | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | 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 | 0 | 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 | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (4 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| GASTON MEMORIAL HOSPITAL INC | ||
| S | $72,449,044 | CASH |
| GASTON MEMORIAL HOSPITAL FOUNDATION | ||
| B | CASH | |
| CAROMONT HEALTH SERVICES | ||
| S | $1,790,336 | CASH |
| CAROMONT MEDICAL GROUP | ||
| R | $36,287,334 | CASH |