2022-08-15T14:46:38-05:00 2021-09-30 366055558 GRANT THORNTON LLP 1415 VANTAGE PARK DRIVE SUITE 500 CHARLOTTE NC 28203 990 2020-10-01 581450888 ANC HEALTHCARE INC ANCH 8475831618 425 W NEW ENGLAND AVE SUITE 300 WINTER PARK FL 32789 NEIL LURIA CEO 8475831618 2022-08-12 1 NEIL LURIA XXX-XX-XXXX MICHELE N MELCHIOR P00488037 7046323500 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z NEIL LURIA 425 W NEW ENGLAND AVE SUITE 300 WINTER PARK FL 32789 9242557 0 X N/A X 1981 NC SEE FORM 990, PART III, LINE 1. X 7 7 1 7 -204090 0 0 0 10703057 6939534 1407639 64275 4331431 1788792 16442127 8792601 653495811 185009964 0 0 0 0 0 0 0 14328765 5594413 667824576 190604377 -651382449 -181811776 342432322 120132251 77669007 36652934 264763315 83479317 THE ORGANIZATION'S MISSION IS TO OPERATE AN INTEGRATED HEALTH DELIVERY SYSTEM FOR THE BENEFIT OF THE RESIDENTS OF WESTERN NORTH CAROLINA. THE ORGANIZATION'S OPERATIONS CEASED DUE TO SALE OF A SUBSTANTIAL PORTION OF ITS ASSETS ON 2/1/19. 0 0 186014812 185009964 0 THE ENTITY SOLD THE OPERATING FACILITIES OF THE HEALTH SYSTEM AND A SUBSTANTIAL PORTION OF THE ASSETS, INCLUDING THOSE OF ITS SUBSIDIARIES, IN A PRIOR YEAR. THE ORGANIZATION CONTINUES TO MAINTAIN OVERSITE OF ITS SUBSIDIARIES DURING THE PROCESS OF LIQUIDATION AND EVENTUAL TERMINATION. CURRENT ACTIVITY INCLUDES WINDING DOWN THE REMAINING AFFAIRS OF THE HEALTH SYSTEM, INCLUDING COLLECTION AND SETTLEMENT OF OUTSTANDING RECEIVABLES AND LIABILITIES, AND DISTRIBUTION OF ASSETS. THE ENTITY IS IN THE PROCESS OF WINDING DOWN FOR EVENTUAL TERMINATION. 186014812 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 0 0 1 X 7 0 1 1 1 1 1 0 0 0 0 0 0 0 0 0 X 7 7 0 1 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 1 1 1 CA X ANC HEALTHCARE INC 8475831618 425 W NEW ENGLAND AVENUE WINTER PARK FL 32789 X X RONALD A PAULUS MD FORMER SYSTEM PRES & CEO 0.00 0.00 X 3516005 0 0 JOHN W GARRETT MD CHAIR 2.00 2.00 X X 0 0 0 THOMAS MAHER VICE CHAIR 2.00 2.25 X X 0 0 0 LAVOY SPOONER JR DIRECTOR 1.00 0.00 X 0 0 0 SUZANNE S DEFERIE DIRECTOR 1.00 0.00 X 0 0 0 DR CHRISTOPHER FLANDERS DIRECTOR 1.00 0.00 X 0 0 0 JEFFREY RANKIN DIRECTOR 1.00 0.00 X 0 0 0 DAVID WORLEY DIRECTOR 1.00 0.00 X 0 0 0 NEIL LURIA CEO/CHIEF WIND-DOWN OFFICE 10.00 2.00 X 0 0 0 MATTHEW RUBIN CFO/SECRETARY 10.00 2.00 X 0 0 0 GREGORY HAGOOD CHIEF TRANSITION OFFICER 2.00 0.00 X 0 0 0 MEG FINNEGAN VP HR 2.00 0.00 X 0 0 0 KIRA ABRAMOVS VP FINANCE 20.00 0.00 X 0 0 0 PAUL HOGAN VP TREAS. & ACCT 5.00 0.00 X 0 0 0 3516005 0 0 1 1 1 0 SOLIC CAPITAL ADVISORS LLC 425 W NEW ENGLAND AVE WINTER PARK FL 32789 WIND DOWN CONSULTING 925000 FAEGRE DRINKER BIDDLE & REATH LLP ONE LOGAN SQUARE PHILADELPHIA PA 19103 LEGAL 843019 KPMG LLP 620 S TYRON ST SUITE 1000 CHARLOTTE NC 28203 FINANCIAL AUDIT FEES 554223 WILLIS TOWERS WATSON 93245 NETWORK PLACE CHICAGO IL 60673 INSURANCE CONSULTING 523423 GIBBINS ADVISORS 1900 CHURCH STREET NASHVILLE TN 37203 OVERSIGHT CONSULTING 333899 10 MEDICARE/MEDICAID ADJUSTMENTS 900099 6118598 6118598 JOINT VENTURE INCOME 900099 768320 768320 DRUG PROGRAM REIMBURSEMENT 900099 52616 52616 6939534 56255 -204090 260345 457976 449956 8020 8020 8020 340B LIABILITY ADJUSTMENTS 900099 836706 836706 MEDICARE AND SETTLEMENT PAYMENTS 900099 717384 717384 TAX REFUNDS 900099 181355 181355 53347 53347 1788792 8792601 8546971 -204090 449720 185009964 185009964 700000 700000 1549792 1549792 456580 456580 2020 2020 13435 13435 23975 23975 1014774 1014774 INCOME AND OTHER TAXES 969624 969624 FMR EE TRUE UP EXPENSES 484017 14521 469496 PRE-CLOSE INVOICES 217966 217966 MEDICAL SETTLEMENTS 20703 20703 141527 141527 190604377 186014812 4589565 0 0 0 329285913 110435286 41292 51832 399311 323375 0 0 0 0 3583078 0 0 0 2554198 2040365 0 0 0 0 4476444 5415019 181392 0 1910694 1866374 0 0 342432322 120132251 1007890 462868 30000000 0 46661117 36190066 77669007 36652934 X 260087393 78073006 4675922 5406311 264763315 83479317 342432322 120132251 X -181811776 786592 -258814 X 0 1 X 1 0 X X 2 MISSION HOSPITAL INC 560532141 3 1 0 0 MISSION HEALTH SYSTEM FOUNDATION INC 561881331 7 1 0 0 2 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 VARIOUS SETTLEMENTS 35434343 OTHER LIABILITIES 731207 DUE TO HCA 24516 36190066 X PART X, LINE 2: ANC APPLIES THE PROVISIONS OF FINANCIAL ACCOUNTING STANDARDS BOARD (FASB) ACCOUNTING STANDARDS CODIFICATION (ASC) TOPIC 740, INCOME TAXES, IN ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES. ASC TOPIC 740 PROVIDES GUIDANCE ON WHEN TAX POSITIONS ARE RECOGNIZED IN AN ENTITY'S FINANCIAL STATEMENTS AND HOW THE VALUES OF THESE POSITIONS ARE DETERMINED. THERE IS CURRENTLY NO SIGNIFICANT IMPACT ON ANC'S CONSOLIDATED FINANCIAL STATEMENTS AS A RESULT OF THE APPLICATION OF ASC TOPIC 740. 1 PISGAH HEALTH FOUNDATION PO BOX 2440 BREVARD NC 28217 561458024 501(C)(3) 5000000 GENERAL PURPOSE WNC BRIDGE FOUNDATION 2123 HENDERSONVILLE ROAD ARDEN NC 28704 562110357 501(C)(3) 5000000 GENERAL PURPOSE GATEWAY WELLNESS FOUNDATION 135 S MAIN ST MARION NC 28752 463395393 501(C)(3) 5000000 GENERAL PURPOSE AMY WELLNESS FOUNDATION PO BOX 15729 ASHEVILLE NC 28813 582172660 501(C)(3) 5000000 GENERAL PURPOSE HIGHLANDS CASHIERS HEALTH FOUNDATION PO BOX 742 HIGHLANDS NC 28741 561165833 501(C)(3) 5000000 GENERAL PURPOSE NANTAHALA HEALTH FOUNDATION 1547 HIGHLANDS RD FRANKLIN NC 28734 832682447 501(C)(3) 5000000 GENERAL PURPOSE DOGWOOD HEALTH TRUST 890 HENDERSONVILLE RD ASHEVILLE NC 28803 830590696 501(C)(3) 155009964 GENERAL PURPOSE 7 0 PART I, LINE 2: THE NET PROCEEDS AND MONETIZATION FROM THE SALE OF THE ORGANIZATION'S ASSETS ARE DISTRIBUTED TO AREA NON-PROFITS THAT SUPPORT ACTIVITIES WHICH BENEFIT THE WESTERN NORTH CAROLINA COMMUNITY IN THE AREAS OF HEALTH AND EDUCATION. THE MAJORITY OF FUNDS CONTINUE TO BE DISTRIBUTED TO DOGWOOD HEALTH TRUST (DHT), A PRIVATE, NONPROFIT FOUNDATION. DHT'S MISSION IS TO DRAMATICALLY IMPROVE THE HEALTH AND WELL-BEING OF ALL PEOPLE AND COMMUNITIES IN WESTERN NORTH CAROLINA. X X X X 1 0 0 0 0 0 0 0 0 RONALD A PAULUS MD FORMER SYSTEM PRES & CEO 0 0 0 0 3516005 0 0 0 0 0 3516005 0 0 0 PART I, LINE 4A THE COMPENSATION REPORTED ON THIS FORM 990 REFLECTS A SEVERANCE PAYMENT PAID TO THE FORMER SYSTEM PRESIDENT & CEO PAID IN CALENDAR YEAR 2020. CASH 2021-04-21 5000000 CASH VALUE 561458024 PISGAH HEALTH FOUNDATION PO BOX 2440 BREVARD NC 28217 501(C)(3) CASH 2021-04-21 5000000 CASH VALUE 562110357 WNC BRIDGE FOUNDATION 2123 HENDERSONVILLE ROAD ARDEN NC 28704 501(C)(3) CASH 2021-04-21 5000000 CASH VALUE 463395393 GATEWAY WELLNESS FOUNDATION 135 S MAIN ST MARION NC 28752 501(C)(3) CASH 2021-04-21 5000000 CASH VALUE 582172660 AMY WELLNESS FOUNDATION PO BOX 15729 ASHEVILLE NC 28813 501(C)(3) CASH 2021-04-21 5000000 CASH VALUE 561165833 HIGHLANDS CASHIERS HEALTH FOUNDATION PO BOX 742 HIGHLANDS NC 28741 501(C)(3) CASH 2021-04-21 5000000 CASH VALUE 832682447 NANTAHALA HEALTH FOUNDATION 1547 HIGHLANDS RD FRANKLIN NC 28734 501(C)(3) CASH 2021-01-20 155009964 CASH VALUE 830590696 DOGWOOD HEALTH TRUST 890 HENDERSONVILLE RD ASHEVILLE NC 28803 501(C)(3) 0 0 0 0 FORM 990, PART V, LINE 15: 4960 EXCISE TAX THE ORGANIZATION IS NOT SUBJECT TO THE 4960 EXCISE TAX FOR THE CURRENT YEAR. THE COMPENSATION REPORTED ON THIS FORM 990 WAS INCLUDED IN THE ANALYSIS FOR 4960 REMUNERATION IN A PRIOR YEAR, AND THE TAX WAS CALCULATED AND REMITTED AT THAT TIME. FORM 990, PART VI, SECTION A, LINE 3 THE ORGANIZATION IS IN PROCESS OF WINDING DOWN THE AFFAIRS OF THE HEALTH SYSTEM AND AS SUCH THE BOARD HAS ENGAGED AN UNRELATED THIRD PARTY (ACTING UNDER THE BOARD'S SUPERVSION) TO CARRY OUT THE FUNCTIONS OF MANAGEMENT DURING THIS TIME. ALL CURRENT OFFICERS LISTED IN PART VII ARE EMPLOYEES OF THE INDEPENDENT CONTRACTOR. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS REVIEWED BY AN INDEPENDENT ACCOUNTING FIRM. A FINAL COPY OF THE FORM 990 WAS PROVIDED TO THE BOARD OF DIRECTORS THE WEEK AFTER FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION'S CONFLICT OF INTEREST EXPECTATION IS STATED AT THE BEGINNING OF EACH BOARD MEETING. EDUCATION ABOUT THE RESPONSIBILITIES OF A BOARD MEMBER INCLUDING CONFLICTS OF INTEREST IS PROVIDED DURING ORIENTATION FOR NEW BOARD MEMBERS. BOARD MEETINGS BEGIN WITH A COMMENT SUMMARIZING THE CONFLICT OF INTEREST EXPECTATION, THE DUTY TO DISCLOSE CONFLICTS, AND THE DUTY TO RECUSE IF A CONFLICT IS PRESENT. IF A CONFLICT OF INTEREST IS IDENTIFIED, THE INTERESTED PERSON DOES NOT PARTICIPATE IN ANY DECISION RELATING TO THE ISSUE. A CONFLICT OF INTEREST IS A PARTICULAR RELATIONSHIP OR ARRANGEMENT THAT WOULD REASONABLY BE EXPECTED TO EXERT AN INFLUENCE ON THE INDIVIDUAL'S JUDGMENT AND PRECLUDE THE INDIVIDUAL FROM BEING AN INDEPENDENT DIRECTOR OR BEING INDEPENDENT WITH RESPECT TO THE ISSUE UNDER CONSIDERATION. IN ADDITION TO BOARD MEMBERS, THE ORGANIZATION'S CONFLICT OF INTEREST EXPECTATION APPLIES TO THE ORGANIZATION'S OFFICERS AND DIRECTORS, AS WELL AS IMMEDIATE FAMILY MEMBERS OF SUCH INTERESTED PERSONS AND ENTITIES IN WHICH INTERESTED PERSONS HAVE A MATERIAL FINANCIAL INTEREST. THE ORGANIZATION EXPECTS THAT ALL INTERESTED PERSONS DISCLOSE ANY AND ALL CONFLICTS OF INTEREST IN ACCORDANCE WITH THE IRS GUIDELINES FOR TAX-EXEMPT ENTITIES AS WELL AS ANY OTHER APPLICABLE STATE OR FEDERAL LAW. INTERNAL AND EXTERNAL AUDITORS OR OUTSIDE COUNSEL WILL PERIODICALLY REVIEW AND ADVISE TO DETERMINE WHETHER THE ORGANIZATION IS IN COMPLIANCE WITH THE EXPECTATION AND APPLICABLE LAW. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION REFLECTED IN THIS FORM 990 IS FOR CALENDAR YEAR 2020 AND WAS PAID TO THE FORMER SYSTEM PRESIDENT & CEO. ANC HEALTHCARE HAD NO OTHER EMPLOYEES AND THEREFORE 15B IS NOT APPLICABLE FOR THE YEAR 2020. THE FOLLOWING REFLECTS THE POLICIES AND PROCESSES THAT WERE IN PLACE AND THAT WERE RELEVANT TO THE COMPENSATION REFLECTED IN THIS FORM 990. THE ORGANIZATION DRAWS WAGE COMPARISON DATA FROM OUTSIDE EXECUTIVE COMPENSATION CONSULTANTS TO ENSURE COMPENSATION LEVELS ARE AT FAIR MARKET VALUE. THE HUMAN RESOURCES AND COMPENSATION COMMITTEE OF THE RELATED ORGANIZATION (COMMITTEE) REVIEWS THIS DATA AND RECOMMENDS TO THE BOARD OF THE RELATED ORGANIZATION ANY REVISIONS TO THE OVERALL PHILOSOPHY AND POLICY TO GUIDE THE DETERMINATION OF COMPENSATION AND BENEFIT PACKAGES FOR EXECUTIVES WHICH INCLUDES THE CEO, THE CFO, AND PRESIDENT AS WELL AS ALL OTHER EXECUTIVES, WHICH WOULD INCLUDE ALL KEY EMPLOYEES. THE COMMITTEE KEEPS AND DISTRIBUTES MINUTES OF ALL ITS MEETINGS TO ITS MEMBERS. ITEMS OF A SENSITIVE NATURE ARE REFERENCED IN THE MINUTES WITH DETAILED, SUPPORTING DOCUMENTATION RETAINED ON FILE. THE COMMITTEE ALSO DISCLOSES ANY POTENTIAL CONFLICTS OF INTEREST SITUATIONS TO THE COMMITTEE CHAIRMAN THAT MAY AFFECT THEIR INDEPENDENT DIRECTORS' STATUS AS SOON AS THEY ARISE, AND MAINTAINS COMPLETE DOCUMENTATION OF ALL MATTERS DISCUSSED BY THE COMMITTEE. THE COMMITTEE OBTAINS EDUCATION AND TRAINING TO EXERCISE ALL RESPONSIBILITIES EFFECTIVELY AND KEEPS ABREAST OF SIGNIFICANT DEVELOPMENTS IN EXECUTIVE COMPENSATION PRACTICES AND REGULATIONS, AND ENSURES THAT ALL ASPECTS OF MISSION HEALTH SYSTEM AND HOSPITAL EXECUTIVE COMPENSATION ADHERE TO ALL RELEVANT REGULATORY REQUIREMENTS, AND REVIEWS THE COMMITTEE CHARTER ANNUALLY REVISING AS APPROPRIATE AND CONDUCTS AN ANNUAL EVALUATION OF THE COMMITTEE'S PERFORMANCE. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S ARTICLES OF INCORPORATION ARE AVAILABLE TO THE PUBLIC THROUGH THE NORTH CAROLINA SECRETARY OF STATE WEBSITE. CONFLICT OF INTEREST POLICY AND BY-LAWS ARE AVAILABLE UPON REQUEST. FORM 990, PART VII THE COMPENSATION REPORTED ON THIS FORM 990 REFLECTS A SEVERANCE PAYMENT PAID TO THE FORMER SYSTEM PRESIDENT & CEO PAID IN CALENDAR YEAR 2020. FORM 990, PART XI, LINE 9: SUBSIDIARY ACTIVITY NOT ON THE 990 48,188. CHANGE IN INVESTMENT VALUE -440,172. RECEIVABLES ADJUSTMENT 133,170. ANC IMAGING SERVICES LLC 425 W NEW ENGLAND AVE NO 300 WINTER PARK FL 32789 465181350 MDEI. 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