RANDOLPH HOSPITAL INC: Form 990, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- RANDOLPH HOSPITAL INC (EIN 56-0530234)
- Tax period
- 2020-10-01 to 2021-09-30
- Filed
- 2022-08-15
- IRS object ID
- 202232279349303593
- 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 ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-08-15T15:07:24-05:00 | ReturnTs |
| Tax Period End | 2021-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 410746749 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLIFTONLARSONALLEN LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 227 WEST TRADE STREET SUITE 800 | AddressLine1Txt |
| City | CHARLOTTE | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 28202 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2020-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 560530234 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RANDOLPH HOSPITAL INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | RAND | BusinessNameControlTxt |
| Phone | 3366255151 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 364 WHITE OAK STREET | AddressLine1Txt |
| City | ASHEBORO | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 27203 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | LORETTA LONG | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 3366255151 | PhoneNum |
| Signature | 2022-08-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | LORETTA | PersonFirstNm |
| Person Last | LONG | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | JOHN NORMAN | PreparerPersonNm |
| PTIN | P01506766 | PTIN |
| Phone | 7049985200 | PhoneNum |
| Preparation | 2022-08-15 | 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
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RANDOLPH HEALTH | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | ANGELA P ORTH | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 364 WHITE OAK STREET | AddressLine1Txt |
| City | ASHEBORO | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 27203 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $81,442,252 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.RANDOLPHHEALTH.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1928 | FormationYr |
| Legal Domicile State | NC | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE QUALITY HEALTH CARE AND TO PROMOTE HEALTH AND WELLNESS. | ActivityOrMissionDesc |
| Contract Termination | Yes (X) | ContractTerminationInd |
| Voting Members Governing Body | 10 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 974 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $4,208,010 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $112,515,268 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $81,442,252 | CYProgramServiceRevenueAmt |
| PY Investment Income | $98,899 | PYInvestmentIncomeAmt |
| CY Investment Income | $0 | CYInvestmentIncomeAmt |
| PY Other Revenue | $24,100 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $116,846,277 | PYTotalRevenueAmt |
| CY Total Revenue | $81,442,252 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $2,769,268 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $47,180,821 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $41,827,321 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $61,713,149 | PYOtherExpensesAmt |
| CY Other Expenses | $41,156,350 | CYOtherExpensesAmt |
| PY Total Expenses | $111,663,238 | PYTotalExpensesAmt |
| CY Total Expenses | $82,983,671 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $5,183,039 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$1,541,419 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $118,605,955 | TotalAssetsBOYAmt |
| Total Assets EOY | $0 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $68,138,216 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $0 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $50,467,739 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $0 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | RANDOLPH HOSPITAL'S MISSION IS TO PROVIDE QUALITY HEALTH CARE AND TO FOSTER HEALTH AND WELLNESS IN OUR COMMUNITIES. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | Yes (1) | SignificantChangeInd |
| Expense | $71,460,954 | ExpenseAmt |
| Revenue | $81,442,252 | RevenueAmt |
| Desc | RANDOLPH HOSPITAL, A NOT-FOR-PROFIT, 145-BED COMMUNITY HOSPITAL WAS ESTABLISHED IN 1928 WITH THE APPROVAL OF A COOPERATIVE PLAN WITH THE DUKE ENDOWMENT AT A JOINT MEETING OF THE ASHEBORO ROTARY CLUB, THE KIWANIS CLUB, THE CHAMBER OF COMMERCE, THE TOWN COUNCIL AND INTERESTED CITIZENS. THE PLAN CALLED FOR THE BUILDING OF A 40-BED HOSPITAL. | Desc |
| Total Program Service Expenses | $71,460,954 | 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 | 0 | 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 | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | 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 | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| 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 | Yes (1) | 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 | 128 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 974 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| 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 |
| 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 | 10 | 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 | Yes (1) | 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 | Yes (1) | LocalChaptersInd |
| Policies Reference Chapters | Yes (1) | PoliciesReferenceChaptersInd |
| 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 | 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 | LORETTA LONG CFO | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3366298810 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 364 WHITE OAK STREET | AddressLine1Txt |
| City | ASHEBORO | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 27203 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (21 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| MICHAEL MILLER | ||||||||
| SECRETARY | 0.50 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| ELBERT LASSITER JR | ||||||||
| VICE CHAIR | 0.50 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| GLENN MAC PUGH | ||||||||
| CHAIRMAN | 0.50 | Yes (X) | Yes (X) | $0 | $0 | $0 | 2.50 | |
| LINDA BROWN | ||||||||
| BOARD MEMBER | 0.50 | Yes (X) | $0 | $0 | $0 | |||
| DAVID BRYANT | ||||||||
| BOARD MEMBER | 0.50 | Yes (X) | $0 | $0 | $0 | |||
| DR CRANFORD KNOTT | ||||||||
| BOARD MEMBER | 0.50 | Yes (X) | $0 | $0 | $0 | |||
| THOMAS LAWRENCE MD | ||||||||
| BOARD MEMBER | 0.50 | Yes (X) | $0 | $0 | $0 | |||
| T REYNOLDS LISK | ||||||||
| BOARD MEMBER | 0.50 | Yes (X) | $0 | $0 | $0 | |||
| CHRIS RICHARDSON MD | ||||||||
| BOARD MEMBER | 0.50 | Yes (X) | $0 | $0 | $0 | |||
| ROBERT SHACKLEFORD JR PHD | ||||||||
| BOARD MEMBER | 0.50 | Yes (X) | $0 | $0 | $0 | |||
| BARBARA WOLFE | ||||||||
| VP | 40.00 | Yes (X) | $178,543 | $0 | $7,791 | 5.00 | ||
| ROBERT CLAUSER | ||||||||
| VP | 40.00 | Yes (X) | $205,409 | $0 | $15,877 | 5.00 | ||
| ANGELA ORTH CONE | ||||||||
| VP | 40.00 | Yes (X) | $0 | $0 | $0 | 5.00 | ||
| TREMONTEO CRAWFORD | ||||||||
| VP | 40.00 | Yes (X) | $196,238 | $0 | $7,791 | 5.00 | ||
| LORETTA LONG | ||||||||
| VP | 40.00 | Yes (X) | $156,239 | $0 | $12,722 | 5.00 | ||
| DR CHARES WEST JR | ||||||||
| VP | 40.00 | Yes (X) | $321,763 | $0 | $13,814 | 5.00 | ||
| LISA HAMPTON | ||||||||
| DIRECTOR | 40.00 | $152,861 | $0 | $7,791 | Yes (X) | |||
| ANGELA BURGESS | ||||||||
| CIO | 40.00 | $152,657 | $0 | $7,791 | Yes (X) | |||
| CHRISTOPHER PARRISH | ||||||||
| DIRECTOR | 40.00 | $121,280 | $0 | $15,877 | Yes (X) | |||
| MARK MOORE | ||||||||
| DIRECTOR | 40.00 | $117,829 | $0 | $15,877 | Yes (X) | |||
| MEGAN GODWIN | ||||||||
| PHARMACIST | 40.00 | $120,721 | $0 | $9,568 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,723,540 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $114,899 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 10 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | 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 |
|---|---|---|---|---|---|
| CONE HEALTH | |||||
| 1200 NORTH ELM STREET | GREENSBORO | NC | 27401 | HOSPITALIST,LAB,PHARM,MGT FEE | $4,507,927 |
| ANKURA CONSULTING GROUP | |||||
| 1220 19TH STREET NW STE 700 | WASHINGTON | DC | 20036 | CONSULTING | $2,228,210 |
| NELSON MULLINS RILEY SCARBOROUGH A07081 | |||||
| 1320 MAIN STREET 17TH FLOOR | COLUMBIA | SC | 29211 | LEGAL SERVICES | $2,150,310 |
| TRIMEDX INC | |||||
| 5451 LAKEVIEW PKWY S DR | INDIANAPOLIS | GA | 303536922 | REPAIRS AND MAINTENACE | $1,226,103 |
| HOULIHAN LOKEY CAPITAL INC | |||||
| 111 S WACKER DR 37TH FL | CHICAGO | IL | 60606 | CONSULTING | $1,104,708 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 38 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT SERVICE REVENU | 621400 | $68,465,528 | $68,465,528 |
| MRI OF ASHEBORO LLC | 621400 | $743,066 | $743,066 |
| CANCER CENTER REVENUE | 621400 | $541,579 | $541,579 |
| JOINT VENTURE | 621400 | $116,167 | $116,167 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $11,575,912 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $11,575,912 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $81,442,252 | TotalProgramServiceRevenueAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $81,442,252 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $81,442,252 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $31,629,540 | TotalAmt |
| Program Services | $30,048,063 | ProgramServicesAmt |
| Management And General | $1,581,477 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,118,967 | TotalAmt |
| Program Services | $8,601,122 | ProgramServicesAmt |
| Management And General | $1,517,845 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $78,814 | TotalAmt |
| Program Services | $66,992 | ProgramServicesAmt |
| Management And General | $11,822 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,557,441 | TotalAmt |
| Program Services | $2,358,586 | ProgramServicesAmt |
| Management And General | $1,198,855 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,245,147 | TotalAmt |
| Program Services | $8,913,278 | ProgramServicesAmt |
| Management And General | $1,331,869 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $95,897 | TotalAmt |
| Program Services | $90,784 | ProgramServicesAmt |
| Management And General | $5,113 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $194,525 | TotalAmt |
| Program Services | $194,525 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,008,746 | TotalAmt |
| Program Services | $3,008,746 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $395,143 | TotalAmt |
| Program Services | $395,143 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (2 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MISCELLANEOUS | $23,502,962 | $17,627,226 | $5,875,736 |
| PROFESSIONAL FEES | $156,489 | $156,489 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $82,983,671 | TotalAmt |
| Program Services | $71,460,954 | ProgramServicesAmt |
| Management And General | $11,522,717 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,230,096 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,162,508 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,218,063 | BOYAmt |
| EOY | $0 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $930,794 | BOYAmt |
| EOY | $0 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $0 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $0 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $39,850,073 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,994,013 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,365,494 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $31,854,914 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $118,605,955 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,377,852 | BOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,500,673 | BOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $30,259,691 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $68,138,216 | BOYAmt |
| EOY | $0 | 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 | $45,647,049 | BOYAmt |
| EOY | $0 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,820,690 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $50,467,739 | BOYAmt |
| EOY | $0 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $118,605,955 | BOYAmt |
| EOY | $0 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$1,541,419 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$3,432,033 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$45,494,287 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | 0 | FSAuditedInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Total Lobbying Expenditures | $0 | TotalLobbyingExpendituresAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | A PORTION OF THE DUES PAID TO THE NORTH CAROLINA HOSPITAL ASSOCIATION AND THE AMERICAN HOSPITAL ASSOCIATION WERE ATTRIBUTABLE TO LOBBYING ACTIVITIES CARRIED OUT BY THOSE ORGANIZATIONS ON BEHALF OF THEIR MEMBERS. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | 0 | FinancialAssistanceBudgetInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,340,126 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $5,340,126 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06440 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $13,786,145 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $11,675,208 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,110,937 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02540 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $19,126,271 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $11,675,208 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $7,451,063 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08980 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $66,105 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $66,105 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00080 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $22,597 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $22,597 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $88,702 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $88,702 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00110 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $19,214,973 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $11,675,208 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $7,539,765 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.09090 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $4,473,475 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $3,802,454 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $36,125,264 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $49,399,936 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$13,274,672 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp
Entity Name EntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 1 RANDOLPH NEWCO LLC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Primary Activities | MEDICAL EQUIPMENT RENTAL | PrimaryActivitiesTxt |
| Org Profit Or Ownership | 0.83030 | OrgProfitOrOwnershipPct |
| Physicians Profit Or Ownership | 0.16970 | PhysiciansProfitOrOwnershipPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RANDOLPH HOSPITAL INCORPORATED | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 364 WHITE OAK STREET | AddressLine1Txt |
| City | ASHEBORO | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 27203 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.RANDOLPHHEALTH.ORG | WebsiteAddressTxt |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RANDOLPH HOSPITAL INCORPORATED | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 18 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (1) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | SEE PART VI | OwnWebsiteURLTxt |
| Other Website | Yes (X) | OtherWebsiteInd |
| Other Website URL | SEE PART VI | OtherWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Rpt Available Thru Other Method | Yes (X) | RptAvailableThruOtherMethodInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 18 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | SEE PART VI | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 300.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Income Level Criteria | Yes (X) | IncomeLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Residency Criteria | Yes (X) | ResidencyCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | WWW.RANDOLPHHOSPITAL.ORG | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | WWW.RANDOLPHHOSPITAL.ORG | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | WWW.RANDOLPHHOSPITAL.ORG | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Other Actions Taken | Yes (X) | OtherActionsTakenInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| RANDOLPH HOSPITAL INCORPORATED | PART V, SECTION B, LINE 5: IN THE FALL OF 2018, RANDOLPH COUNTY PUBLIC HEALTH JOINED WITH RANDOLPH HEALTH, TO ESTABLISH THE ASSESSMENT FRAMEWORK AND A TIMELINE FOR DATA COLLECTION AND ANALYSIS, PRIORITIZATION OF HEALTH CONCERNS AND DEVELOPMENT OF COMMUNITY HEALTH IMPROVEMENT PLANS (CHIP). DATA COLLECTION AND ANALYSIS TOOK PLACE FROM SEPTEMBER 2018 - SEPTEMBER 2019. PRIMARY DATA WAS COLLECTED FROM THE COMMUNITY IN TWO DIFFERENT WAYS: DISTRIBUTION OF PAPER SURVEYS AND AN INTERNET SURVEY.WITH TECHNOLOGY CONTINUING TO ADVANCE, MORE OF AN EMPHASIS WAS PLACED ON ON-LINE SURVEYS ALTHOUGH, PAPER SURVEYS WERE STILL AN IMPORTANT TOOL. IN ADDITION TO ON-LINE SURVEYS, PAPER SURVEYS WERE DISTRIBUTED TO AGENCIES AND ORGANIZATIONS WITHIN THE COUNTY USING THE CONVENIENCE SAMPLE METHOD. ALL SURVEYS DISTRIBUTED WERE IN BOTH ENGLISH AND SPANISH. OF THE 1,500 TOTAL DISTRIBUTED SURVEYS, 927 WERE RETURNED FOR A RESPONSE RATE OF 62%. AN INTERNET SURVEY WAS DEVELOPED USING SURVEY MONKEY. THE INTERNET SURVEY WAS ACCESSIBLE THROUGH THE RANDOLPH COUNTY GOVERNMENT WEBSITE AS WELL AS THE RANDOLPH HEALTH WEBSITE. IN AN EFFORT TO PROMOTE THE INTERNET SURVEY, PRESS RELEASES RAN IN ALL AREA NEWSPAPERS, AS WELL AS PROMOTED VIA SOCIAL MEDIA.TO ENSURE A SOLID REPRESENTATION FROM KEY SECTORS, THE SURVEY WAS SENT TO RANDOLPH COUNTY GOVERNMENT DEPARTMENT HEADS AND DIRECTORS FROM VARIOUS AGENCIES OR REPRESENTATIVES WITHIN THE COUNTY. THE MAJOR SOURCE FOR SECONDARY DATA IN THE 2019 RANDOLPH COUNTY COMMUNITY HEALTH ASSESSMENT INCLUDED:- NORTH CAROLINA STATE CENTER FOR HEALTH STATISTICS- NORTH CAROLINA DEPARTMENT OF HEALTH & HUMAN SERVICES- CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC)- CECIL G. SHEPS CENTER FOR HEALTH SERVICES RESEARCH- US CENSUS DEPARTMENTAS APPLICABLE, RANDOLPH COUNTY STATISTICS HAVE BEEN COMPARED WITH STATE STATISTICS AS WELL AS FOUR PEER COUNTIES. THESE PEER COUNTIES WERE IDENTIFIED BASED UPON AGE, RACE AND POVERTY CHARACTERISTICS AND ARE SELECTED FROM A GROUP OF COUNTIES WITHIN THE SAME POPULATION RANGE AS THE SUBJECT COUNTY.FOR RANDOLPH COUNTY, THE FOLLOWING FOUR PEER COUNTIES WERE IDENTIFIED: CRAVEN, DAVIDSON, HARNETT AND JOHNSTON. THEREFORE, IN ADDITION TO NORTH CAROLINA STATISTICS, THESE FOUR COUNTIES WERE USED FOR COMPARISON THROUGHOUT THE ASSESSMENT PROCESS. |
| RANDOLPH HOSPITAL INCORPORATED | PART V, SECTION B, LINE 6B: RANDOLPH COUNTY HEALTH DEPARTMENT |
| RANDOLPH HOSPITAL INCORPORATED | PART V, SECTION B, LINE 7D: BOTH RANDOLPH COUNTY AND RANDOLPH HOSPITAL WEBSITES HAVE POSTED THE COMMUNITY HEALTH NEEDS ASSESSMENT AND EXECUTIVE SUMMARY. THE ASSESSMENT IS ALSO IN ALL SEVEN RANDOLPH COUNTY LIBRARIES. TWENTY-FIVE DATA BOOKS AND 150 EXECUTIVE SUMMARIES WILL BE ORDERED AND PRINTED FOR DISTRIBUTION THROUGHOUT THE COMMUNITY. |
| RANDOLPH HOSPITAL INCORPORATED | PART V, SECTION B, LINE 11: IN AUGUST 2019, ADVISORY COMMITTEE MEMBERS MET TO IDENTIFY LEADING COMMUNITY HEALTH CONCERNS IN RANDOLPH COUNTY. DURING THE MEETING, MEMBERS REVIEWED HEALTH CONCERNS IDENTIFIED THROUGH SURVEYS AS WELL AS THE INFORMATION GATHERED THROUGH SECONDARY RESEARCH. THROUGH NOMINAL GROUP TECHNIQUE THE COMMITTEE SELECTED 15 COMMUNITY HEALTH CONCERNS SOME OF WHICH INCLUDE: OBESITY, MENTAL HEALTH, SUBSTANCE ABUSE, ACCESS TO CARE, TOBACCO, SEXUALLY TRANSMITTED DISEASES, CHRONIC DISEASE MANAGEMENT AND INJURY PREVENTION. AFTER MUCH DISCUSSION, THE COMMITTEE AGREED TO FOCUS ON THREE PRIORITY HEALTH CONCERNS:1. FOCUS AREA: EARLY AND MIDDLE CHILDHOOD A. INCREASE THE PROPORTION OF CHILDREN WHO ARE READY FOR SCHOOL IN ALL FIVE DOMAINS OF HEALTHY DEVELOPMENT: PHYSICAL DEVELOPMENT, SOCIAL-EMOTIONAL DEVELOPMENT, APPROACHES TO LEARNING, LANGUAGE AND COGNITIVE DEVELOPMENT B. INCREASE THE PROPORTION OF PARENTS WHO READ TO THEIR YOUNG CHILD2. FOCUS AREA: HEALTH-RELATED QUALITY OF LIFE AND WELL-BEING A. INCREASE THE PROPORTION OF ADULTS WHO SELF-REPORT GOOD OR BETTER PHYSICAL AND MENTAL HEALTH 3. FOCUS AREA: MENTAL HEALTH A. DECREASE THE AVERAGE NUMBER OF POOR MENTAL HEALTH DAYS AMONG ADULTS B. REDUCE THE RATE OF MENTAL HEALTH-RELATED VISITS TO THE EMERGENCY DEPARTMENT BY THE EXPANSION OF BEHAVIORAL HEALTH SERVICES WITHIN THE PRIMARY CARE SETTINGIT IS IMPORTANT TO NOTE THAT ALTHOUGH THE ADVISORY COMMITTEE IDENTIFIED FIFTEEN HEALTH ISSUES, THE DECISION WAS MADE TO LIMIT THE FOCUS TO MAKE A LARGER IMPACT ON THE TOP THREE AREAS THAT HAD THE OPPORTUNITY TO IMPROVE THE OVERALL HEALTH OF THE COMMUNITY. THE IDENTIFIED PRIORITY AREAS ARE ALSO IN LINE WITH THE AREAS IDENTIFIED DURING THE RANDOLPH COUNTY STRATEGIC PLANNING PROCESS. THE ENTIRE COUNTY IS NOW ALIGNED WITH FOCUSING ON THE SAME HEALTH PRIORITY AREAS--CREATING, A COORDINATED AND UNITED COUNTY-WIDE EFFORT TO ADDRESS THE HEALTH OF OUR COMMUNITY. |
| RANDOLPH HOSPITAL INCORPORATED | PART V, SECTION B, LINE 20E: THE HOSPITAL ESTABLISHES DURING PRE-REGISTRATION WHETHER A PATIENT IS COVERED BY INSURANCE. IF THE PATIENT IS NOT COVERED BY INSURANCE, THE HOSPITAL MAKES THE PATIENT AWARE OF THE FINANCIAL ASSISTANCE POLICY. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 25 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (25 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - RH STAYWELL SENIOR CARE | ||||
| 809 CURRY DRIVE | ASHEBORO | NC | 27205 | PACE CENTER |
| 2 - RHMG ATHLETIC TRAINING | ||||
| 600 W SALISBURY ST STE A | ASHEBORO | NC | 27203 | ATHLETIC TRAINING |
| 3 - RH CANCER CENTER | ||||
| 364 WHITE OAK ST | ASHEBORO | NC | 27203 | CANCER TREATMENT |
| 4 - RHMG CHC BETTERCARE | ||||
| 600 W SALISBURY ST STE B | ASHEBORO | NC | 27203 | CORPORATE HEALTH & WELLNESS |
| 5 - RHMG DEEP RIVER P T -ASHEBORO | ||||
| 600 W SALISBURY ST STE A | ASHEBORO | NC | 27203 | PHYSICAL THERAPY |
| 6 - RHMG DEEP RIVER P T -RAMSEUR | ||||
| 701 LIBERTY ST | RAMSEUR | NC | 27316 | PHYSICAL THERAPY |
| 7 - RHMG DEEP RIVER P T -RANDLEMAN | ||||
| 148 POINTE SOUTH DRIVE | RANDLEMAN | NC | 27317 | PHYSICAL THERAPY |
| 8 - RH DIABETES CENTER | ||||
| 208-D FOUST ST | ASHEBORO | NC | 27203 | DIABETES TREATMENT |
| 9 - RHMG EAR NOSE & THROAT | ||||
| 124 N PARK ST | ASHEBORO | NC | 27203 | EAR NOSE AND THROAT |
| 10 - RHMG ENDOSCOPY CENTER | ||||
| 700 SUNSET AVE | ASHEBORO | NC | 27203 | ENDOSCOPY |
| 11 - RHMG FAMILY PRACTICE - LIBERTY | ||||
| 504 N GREENSBORO | LIBERTY | NC | 27298 | FAMILY MEDICINE |
| 12 - RHMG FAMILY PRACTICE - RANDLEMAN | ||||
| 670 W ACADEMY ST | RANDLEMAN | NC | 27317 | FAMILY MEDICINE |
| 13 - RHMG FAMILY PRACTICE - SEAGROVE | ||||
| 514 N BROAD ST | SEAGROVE | NC | 27341 | FAMILY MEDICINE |
| 14 - RHMG FAMILY PRACTICE & WELLNESS | ||||
| 132-C W MILLER ST | ASHEBORO | NC | 27203 | FAMILY MEDICINE |
| 15 - RHMG FITNESS CENTER | ||||
| 600 W SALISBURY ST STE A | ASHEBORO | NC | 27203 | FITNESS CENTER |
| 16 - RHMG GASTROENTEROLOGY | ||||
| 700 SUNSET AVE | ASHEBORO | NC | 27203 | GASTROENTEROLOGY |
| 17 - RHHOME HEALTH | ||||
| 341 N FAYETTEVILLE ST | ASHEBORO | NC | 27203 | HOME HEALTH |
| 18 - RHMG INTERNAL MEDICINE | ||||
| 237-A N FAYETTEVILLE ST | ASHEBORO | NC | 27203 | INTERNAL MEDICINE |
| 19 - RH MRI CENTER | ||||
| 237 N FAYETTEVILLE ST STE B | ASHEBORO | NC | 27203 | MRI |
| 20 - RHMG ORTHOPEDICS & SPORTS MEDICINE | ||||
| 503 N FAYETTEVILLE ST | ASHEBORO | NC | 27203 | ORTHOPEDICS/SPORTS MEDICINE |
| 21 - RHMGPEDIATRICS | ||||
| 713 S FAYETTEVILLE ST | ASHEBORO | NC | 27203 | PEDIATRICS |
| 22 - RHMG P T & SPORTS MEDICINE | ||||
| 503 N FAYETTEVILLE ST | ASHEBORO | NC | 27203 | PHYSICAL THERAPY |
| 23 - RH SURGERY CENTER | ||||
| 724 THOMAS ST | ASHEBORO | NC | 27203 | SURGICAL CENTER |
| 24 - RHMG UROLOGY | ||||
| 132-C W MILLER ST | ASHEBORO | NC | 27203 | UROLOGY |
| 25 - RH WOUND CARE & HYPERBARIC CENTER | ||||
| 212 FOUST ST | ASHEBORO | NC | 27203 | WOUND CARE |
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 6A: | NORTH CAROLINA HOSPITAL ASSOCIATION |
| PART I, LN 7 COL(F): | UNINSURED PATIENTS NOT QUALIFYING FOR FINANCIAL ASSISTANCE OR STATE, FEDERAL, AND /OR GRANT FUND PROGRAMS ARE RESPONSIBLE FOR A DISCOUNTED PAYMENT AMOUNT IN ACCORDANCE WITH IRS SECTION 501(R). PAYMENT PLANS ARE OFFERED THROUGH RANDOLPH HOSPITAL WITH NO INCURRED INTEREST CHARGES. THE PATIENT FINANCIAL SERVICES DEPARTMENT OF RANDOLPH HOSPITAL PROVIDES A MONTHLY STATEMENT, MAKES TELEPHONE CONTACT, AND/OR SENDS COLLECTION LETTERS. UNCOLLECTED DELIQUENT ACCOUNTS MAY BE REFERRED TO AN EXTERNAL COLLECTION AGENCY OR ATTORNEY FOR CONTINUED COLLECTION. ALL INTERNAL AND EXTERNAL COLLECTIONS PROCESSES COMPLY WITH THE FAIR DEBT COLLECTION PRACTICES ACT (FDCPA). |
| PART III, LINE 2: | THE ORGANIZATION APPLIED THE COST-TO CHARGE RATIO TO ITS BAD DEBT CHARGES TO ARRIVE AT THE COST OF BAD DEBT REPORTED ON PART III, LINE 2. |
| PART III, LINE 3: | THE ORGANIZATION ESTIMATES FROM HISTORICAL PERSPECTIVE AND EXPERIENCE THAT APPROXIMATELY 85% OF BAD DEBT EXPENSE MAY BE ATTRIBUTABLE TO COMMUNITY BENEFIT. |
| PART III, LINE 4: | THE ORGANIZATION'S FINANCIAL STATEMENTS DO NOT INCLUDE A FOOTNOTE ON BAD DEBT. BAD DEBT EXPENSE WAS OBTAINED FROM AUDITED FINANCIAL STATEMENTS. |
| PART III, LINE 8: | THE HOSPITAL TRADITIONALLY INCURS A SHORTFALL IN PROVIDING MEDICARE SERVICES AND CONSIDERS THE ENTIRE SHORTFALL AS A COMMUNITY BENEFIT. MEDICARE DOES NOT REIMBURSE THE HOSPITAL ENOUGH TO COVER ITS COSTS ASSOCIATED WITH PROVIDING MEDICARE SERVICES, YET THE HOSPITAL CONTINUES TO FULFILL ITS MISSION OF PROVIDING SERVICES TO ITS COMMUNITY REGARDLESS OF THE REIMBURSEMENT LEVELS. AS SUCH, THE HOSPITAL BELIEVES THAT IT IS APPROPRIATE TO REPORT THIS SHORTFALL AS PART OF ITS COMMUNITY BENEFIT. THE BAD DEBT INCLUDED AS UNCOMPENSATED CARE REPRESENTS THE COST OF PROVIDING THOSE SERVICES, CALCULATED USING THE COST TO CHARGE RATIO OF THE CHARGES RECORDED IN THE FINANCIAL STATEMENTS AS BAD DEBT. |
| PART III, LINE 9B: | RANDOLPH HOSPITAL IS COMMITTED TO ASSISTING PATIENTS THAT DO NOT HAVE THE FINANCIAL RESOURCES TO PAY FOR THEIR HEALTH CARE SERVICES. THE HOSPITAL MAKES AVAILABLE FINANCIAL COUNSELING TO DETERMINE THE APPROPRIATE DISPOSITION OF THE PATIENT ACCOUNT. A MEDICAL ASSISTANCE COUNSELOR REVIEWS ACCOUNTS FOR POSSIBLE FINANCIAL ASSISTANCE FROM STATE, FEDERAL, AND/OR ENDOWMENT FUNDS PROGRAMS. RANDOLPH HOSPITAL PROVIDES CHARITY TO PATIENTS WHO MEET CRITERIA AS OUTLINED IN THE FINANCIAL ASSISTANCE POLICY. ANY PATIENT/GUARANTOR WHO REFUSES TO COMPLETE THE APPLICATION WILL BE CONSIDERED AS HAVING THE ABILITY TO PAY HIS ACCOUNT AND HANDLED ACCORDINGLY. |
| PART VI, LINE 2: | THE HOSPITAL WORKS WITH THE RANDOLPH COUNTY HEALTH DEPARTMENT ON AN ONGOING BASIS TO ASSESS THE HEALTH CARE NEEDS OF THE COMMUNITY IT SERVES. ADDITIONAL ASSISTANCE IS PROVIDED BY COMMUNITY INSTITUTIONS, BUSINESSES, AGENCIES AND INDIVIDUALS WITH AN INTEREST IN IMPROVING THE HEALTH STATUS OF RANDOLPH COUNTY RESIDENTS. |
| PART VI, LINE 3: | THE HOSPITAL HAS A DEDICATED PATIENT FINANCIAL TEAM THAT TAKES A PROACTIVE APPROACH TO COUNSELING AND EDUCATING PATIENTS ON THE HEALTHCARE BILLING PROCESS AND CREATING CUSTOMIZED PAYMENT OPTIONS TO HELP ALLEVIATE INITIAL FINANCIAL BURDENS. IF IT APPEARS THAT A PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE, OUR TEAM WILL HELP THE PATIENT DETERMINE WHICH ROUTE IS MOST APPROPRIATE FOR THEIR SITUATION. THE HOSPITAL ASSESSES AT THE TIME OF REGISTRATION AND DURING INTERVIEWS WITH FINANCIAL COUNSELORS WHETHER A PATIENT MIGHT QUALIFY FOR FINANCIAL ASSISTANCE AND PROVIDES LITERATURE TO THE PATIENT AT THAT TIME. THE HOSPITAL ALSO WIDELY COMMUNICATES THE AVAILABILITY OF THE FINANCIAL ASSISTANCE POLICY ON ITS WEBSITE, BILLING STATEMENTS, AND SIGNS POSTED CONSPICUOUSLY THROUGH OUT ITS FACILITIES. |
| PART VI, LINE 4: | THE US CENSUS BUREAU REPORTED AN ESTIMATED POPULATION OF APPROXIMATELY 143,149 IN RANDOLPH COUNTY FOR THE YEAR 2017. THIS WAS AN INCREASE OF ALMOST 1% FROM THE YEAR 2010 WHEN THE POPULATION WAS REPORTED TO BE APPROXIMATELY 141,752. THE ESTIMATED POPULATION IN NORTH CAROLINA IN 2017 WAS 10,052,564 WHICH WAS AN INCREASE OF 5.4% FROM 2010.SIMILAR TO NORTH CAROLINA AS A WHOLE, THE POPULATION OF RANDOLPH COUNTY IS DIVIDED ALMOST EQUALLY BETWEEN MALES (49.3%-RC, 48.7%-NC) AND FEMALES (50.7%-RC, 51.3%-NC). RESIDENTS OF RANDOLPH COUNTY ARE PREDOMINATELY WHITE (84.9%), FOLLOWED BY HISPANIC (11.1%) AND BLACK (6.3%). THE HISPANIC POPULATION IN RANDOLPH COUNTY (11.1%) IS HIGHER WHEN COMPARED TO NORTH CAROLINA (9.1%) AS A WHOLE. THE BLACK POPULATION IN RANDOLPH COUNTY (6.3%) IS LOWER WHEN COMPARED TO NORTH CAROLINA (21.5%).FROM AN ECONOMIC STANDPOINT, PERSONAL INCOME PER CAPITA FOR RANDOLPH COUNTY WAS AT $36,339 IN 2017, BELOW THE AVERAGE PER CAPITA INCOME FOR ALL RESIDENTS OF NORTH CAROLINA. THE PERCENTAGE OF MEDICAID ELIGIBLE PATIENTS IN RANDOLPH COUNTY IN 2017 IS 25.2%, EXCEEDING THE AVERAGE LEVEL IN NORTH CAROLINA. UNEMPLOYMENT RATES FOR RANDOLPH COUNTY IN 2018 IS APPROXIMATELY 3.7% OF THE WORKFORCE, SLIGHTLY ABOVE THE NORTH CAROLINA RATE OF 3.6%. |
| PART VI, LINE 7, REPORTS FILED WITH STATES | NC |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| 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 (7 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DR CHARES WEST JR | ||||||||||||||
| VP | $294,179 | $0 | $0 | $0 | $27,584 | $0 | $0 | $0 | $13,814 | $0 | $335,577 | $0 | $0 | $0 |
| ROBERT CLAUSER | ||||||||||||||
| VP | $196,381 | $0 | $0 | $0 | $9,028 | $0 | $0 | $0 | $15,877 | $0 | $221,286 | $0 | $0 | $0 |
| TREMONTEO CRAWFORD | ||||||||||||||
| VP | $181,103 | $0 | $0 | $0 | $15,135 | $0 | $0 | $0 | $7,791 | $0 | $204,029 | $0 | $0 | $0 |
| BARBARA WOLFE | ||||||||||||||
| VP | $152,140 | $0 | $0 | $0 | $26,403 | $0 | $0 | $0 | $7,791 | $0 | $186,334 | $0 | $0 | $0 |
| LORETTA LONG | ||||||||||||||
| VP | $149,520 | $0 | $0 | $0 | $6,719 | $0 | $0 | $0 | $12,722 | $0 | $168,961 | $0 | $0 | $0 |
| LISA HAMPTON | ||||||||||||||
| DIRECTOR | $126,447 | $0 | $0 | $0 | $26,414 | $0 | $0 | $0 | $7,791 | $0 | $160,652 | $0 | $0 | $0 |
| ANGELA BURGESS | ||||||||||||||
| CIO | $146,010 | $0 | $0 | $0 | $6,647 | $0 | $0 | $0 | $7,791 | $0 | $160,448 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 4B | FormAndLineReferenceDesc |
| Explanation | CERTAIN MEMBERS OF THE SENIOR MANAGEMENT TEAM PARTICIPATE IN THE RANDOLPH HOSPITAL, INC. DEFERRED COMPENSATION PLAN. UNDER THIS PLAN, AN ANNUAL CONTRIBUTION IS MADE INTO A TRUST FOR EACH PARTICIPANT BASED ON A PERCENTAGE (10% OR 15%) OF THEIR SALARY. EACH PARTICIPANT DIRECTS THE INVESTMENT OF HIS/HER ACCOUNT BALANCE. DURING 2018, ROBERT CLAUSER, ANGELA ORTH, AND BARBARA WOLFE RECEIVED PAYOUTS FROM THE PLAN OF $58,682, $37,247, AND $48,101, RESPECTIVELY. | ExplanationTxt |
Schedule N IRS990ScheduleN
Liquidation Of Assets Table LiquidationOfAssetsTableGrp
Liquidation Of Assets Detail LiquidationOfAssetsDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Assets Distri Or Expnss Paid | REAL AND PERSONAL HOSPITAL PROPERTY PURCHASED AS PART OF A BANKRUPTCY PROCEEDING | AssetsDistriOrExpnssPaidDesc |
| Distribution | 2021-07-01 | DistributionDt |
| Fair Market Value Of Asset | $6,996,683 | FairMarketValueOfAssetAmt |
| Method Of FMV Determination | BANKRUPTCY AUCTION | MethodOfFMVDeterminationTxt |
| EIN | 854354835 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | AMERICAN HEALTHCARE SYSTEMS LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 505 N BRAND BLVD STE 1110 | AddressLine1Txt |
| City | GLENDALE | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 91203 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRC Section | C CORP/LLC | IRCSectionTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Director Of Successor | 0 | DirectorOfSuccessorInd |
| Employee Of Successor | Yes (1) | EmployeeOfSuccessorInd |
| Owner Of Successor | 0 | OwnerOfSuccessorInd |
| Receive Compensation | 0 | ReceiveCompensationInd |
| Assets Distributed | 0 | AssetsDistributedInd |
| Required To Notify AG | Yes (1) | RequiredToNotifyAGInd |
| Attorney General Notified | Yes (1) | AttorneyGeneralNotifiedInd |
| Liabilities Paid | Yes (1) | LiabilitiesPaidInd |
| Bonds Outstanding | 0 | BondsOutstandingInd |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 2E: | PERSON(S) INVOLVED: ALL OFFICERS AND KEY EMPLOYEES OF RANDOLPH HOSPITAL |
| PART I, LINE 2E: | EXPLANATION OF INVOLVEMENT: AS A CONDITION TO THE PURCHASE AGREEMENT PURSUANT TO THE BANKRUPTCY PROCEEDING, THE PURCHASER MADE AN OFFER OF EMPLOYMENT TO ALL EMPLOYEES OF RANDOLPH HOSPITAL. |
| PART I, LINE 3: | UNABLE TO PARTNER WITH A SUITABLE TAX-EXEMPT PARTNER, THE ORGANIZATION WAS FORCED TO DECLARE BANKRUPTCY. THE ORGANIZATION SOLD ITS ASSETS TO AMERICAN HEALTHCARE SYSTEMS, A FOR-PROFIT ENTITY, AS DECIDED BY THE UNITED STATES BANKRUPTCY COURT MIDDLE DISTRICT OF NORTH CAROLINA GREENSBORO DIVISION IN BANKRUPTCY CASE NO. 20-10247. AS A RESULT, THE TAX-EXEMPT STATUS OF THE ORGANIZATION HAS TERMINATED. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART III, LINE 3 | UNABLE TO PARTNER WITH A SUITABLE TAX-EXEMPT PARTNER, THE ORGANIZATION WAS FORCED TO DECLARE BANKRUPTCY. THE ORGANIZATION SOLD ITS ASSETS TO AMERICAN HEALTHCARE SYSTEMS, A FOR-PROFIT ENTITY, AS DECIDED BY THE UNITED STATES BANKRUPTCY COURT MIDDLE DISTRICT OF NORTH CAROLINA GREENSBORO DIVISION IN BANKRUPTCY CASE NO. 20-10247. AS A RESULT, THE TAX-EXEMPT STATUS OF THE ORGANIZATION HAS TERMINATED. |
| FORM 990, PART VI, SECTION A, LINE 1 | THERE STANDS AN EXECUTIVE COMMITTEE CONSISTING OF THE CHAIRMAN, VICE CHAIRMAN, CHAIRMAN-ELECT, SECRETARY, CHAIRMAN OF THE FINANCE, AUDIT, INVESTMENT AND RETIREMENT COMMITTEE, AND UP TO TWO OTHER DIRECTORS AS DESIGNATED BY THE CHAIRMAN. THE COMMITTEE HAS AND MAY EXERCISE THE AUTHORITY OF THE BOARD IN THE MANAGEMENT OF THE ORGANIZATION, TO THE EXTENT PERMITTED BY LAW, DURING THE INTERVALS BETWEEN MEETINGS OF THE BOARD. |
| FORM 990, PART VI, SECTION A, LINE 6 | THE CORPORATION SHALL HAVE ONE CLASS OF MEMBERS CONSISTING OF AT LEAST 23 MEMBERS AND NEVER CONSISTING OF MORE THAN 30 MEMBERS. FOUR MEMBERS SHALL BE EX OFFICIO, AS INDICATED BELOW. THE REMAINDER SHALL BE ELECTED AS PROVIDED IN DETAIL IN THE BYLAWS. THE PRINCIPAL CRITERION FOR SELECTION OF CORPORATE MEMBERS SHALL BE THE PERSON'S QUALIFICATIONS TO EVENTUALLY SERVE AS A DIRECTOR OF RANDOLPH HOSPITAL, AS SET FORTH IN THE BYLAWS. AS CANDIDATES BECOME AVAILABLE, THE MEMBERS MAY EXPAND OR CONTRACT THEIR NUMBER, WITHIN THE LIMITS STATED ABOVE, IN ORDER TO PROVIDE AN ADEQUATE POOL OF MEMBERS WHO ARE QUALIFIED TO SERVE AS DIRECTORS. IN ADDITION TO THE ELECTED MEMBERS, THE MAYOR OF ASHEBORO, NORTH CAROLINA, THE CHAIRMAN OF THE BOARD OF COMMISSIONERS OF RANDOLPH COUNTY, NORTH CAROLINA, THE RANDOLPH COUNTY SUPERINTENDENT OF SCHOOLS, CITY OF ASHEBORO SUPERINTENDENT OF SCHOOLS, AND THE COUNTY HEALTH OFFICER OF RANDOLPH COUNTY, NORTH CAROLINA, SHALL BE EX OFFICIO MEMBERS OF THE CORPORATION. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE DIRECTORS SHALL BE ELECTED BY THE MEMBERS AT THE ANNUAL MEETING OF THE CORPORATE MEMBERS FROM NOMINATIONS RECEIVED BOTH FROM THE GOVERNANCE COMMITTEE AND FROM THE FLOOR AT THE ANNUAL MEETING. IF ANY DIRECTORS SHALL SERVE ONE-YEAR TERMS, AND SHALL CONTINUE TO SERVE UNTIL THEIR SUCCESSORS ARE ELECTED. DIRECTORS MAY BE RE-ELECTED. ANY DIRECTOR MAY BE REMOVED FROM OFFICE AT ANY TIME, WITH OR WITHOUT CAUSE, BY A MAJORITY VOTE OF THE MEMBERS OF THE CORPORATION. |
| FORM 990, PART VI, SECTION A, LINE 7B | CHANGES TO THE BYLAWS, SALE OR MERGER OF THE HOSPITAL MUST BE APPROVED BY THE MEMBERS. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE 990 IS REVIEWED AT THE FAIR (FINANCE, AUDIT, INVESTMENT AND RETIREMENT) COMMITTEE PRIOR TO FILING WITH THE IRS. ALL OF THE BOARD MEMBERS ARE INVITED TO ATTEND. ANYONE NOT AT THE MEETING IS GIVEN A COPY OF THE 990 AND IS INVITED TO ASK QUESTIONS. |
| FORM 990, PART VI, SECTION B, LINE 12C | RANDOLPH HOSPITAL HAS A PART TIME CORPORATE COMPLIANCE OFFICER CHARGED WITH EDUCATING THE BOARD, OFFICERS, AND OTHER EMPLOYEES ON THE CONFLICT OF INTEREST POLICY. ALL NEW EMPLOYEES ARE GIVEN INFORMATION UPON ORIENTATION, AND ALL CURRENT EMPLOYEES ARE REQUIRED TO TAKE ANNUAL EDUCATION ON COMPLIANCE WITH THE POLICY. THERE IS A CORPORATE COMPLIANCE MEETING TO UPDATE KEY INDIVIDUALS ON NEW ISSUES AND NEW INFORMATION REGARDING CORPORATE COMPLIANCE. THE MEMBERS OF THE BOARD OF DIRECTORS ARE REQUIRED ANNUALLY TO READ, SIGN, AND REMIT A COPY OF THE POLICY TO THE BOARD CHAIR. ALL BOARD MEMBERS ARE AWARE OF THE POLICY AND IN CASE OF ANY CONFLICT OF INTEREST, THEY WILL RECUSE THEMSELVES. |
| FORM 990, PART VI, SECTION B, LINE 15 | RANDOLPH HOSPITAL USES COMPETITIVE MARKET SURVEYS, FROM SUCH ORGANIZATIONS AS NCHHRA AND VASHHRA, TO DETERMINE APPROPRIATE COMPENSATION LEVELS FOR EXECUTIVES THAT ARE COMMENSURATE WITH ORGANIZATIONS OF SIMILAR SIZE AND STRUCTURE. PERIODICALLY, AN EXTERNAL FIRM IS USED TO EVALUATE COMPENSATION. A COMPENSATION COMMITTEE OF THE BOARD HAS FINAL DETERMINATION OF COMPENSATION LEVELS FOR TOP EXECUTIVES. |
| FORM 990, PART VI, SECTION C, LINE 19 | PHOTOCOPIES OF THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST AT THE ORGANIZATION'S ADMINISTRATIVE OFFICE. |
| FORM 990, PART XI, LINE 9: | TERMINATION OF EXEMPT STATUS -45,494,287. |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|
| MRI OF ASHEBORO LLC | |||||||
| 237 N FAYETTEVILLE STREET B | ASHEBORO | NC | 27203 | 472225445 | IMAGING SERVICES | NC | RANDOLPH HOSPITAL INC |
| PIEDMONT INTEGRATED HEALTH LLC | |||||||
| 364 WHITE OAK STREET | ASHEBORO | NC | 27203 | 472221211 | CLINICALLY INTEGRATED NETWORK | NC | RANDOLPH HOSPITAL INC |
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (4 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 |
|---|---|---|---|---|---|---|---|---|---|---|
| RANDOLPH SPECIALTY GROUP | ||||||||||
| 364 WHITE OAK STREET | ASHEBORO | NC | 27203 | 113827203 | HEALTHCARE | NC | 501(C)(3) | LINE 10 | RANDOLPH HOSPITAL INC | Yes (1) |
| RANDOLPH CANCER CENTER | ||||||||||
| 373 N FAYETTEVILLE STREET | ASHEBORO | NC | 27203 | 562181482 | HEALTHCARE | NC | 501(C)(3) | LINE 12A, I | RANDOLPH HOSPITAL INC | Yes (1) |
| RANDOLPH HOSPITAL COMMUNITY HEALTH FOUNDATION | ||||||||||
| 364 WHITE OAK STREET | ASHEBORO | NC | 27203 | 582240755 | SUPPORT ORGANIZATION | NC | 501(C)(3) | LINE 12A, I | RANDOLPH HOSPITAL INC | Yes (1) |
| STAYWELL SENIOR CARE | ||||||||||
| PO BOX 1048 | ASHEBORO | NC | 27204 | 461289922 | HEALTHCARE | NC | 501(C)(3) | LINE 12A, I | RANDOLPH HOSPITAL INC | Yes (1) |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RANDOLPH NEWCO LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 364 WHITE OAK STREET | AddressLine1Txt |
| City | ASHEBORO | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 27203 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 471905523 | EIN |
| Primary Activities | MEDICAL EQUIPMENT RENTAL | PrimaryActivitiesTxt |
| Legal Domicile State | NC | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RANDOLPH HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Predominant Income Type | UNRELATED | PredominantIncomeTypeTxt |
| Disproportionate Allocations | 0 | DisproportionateAllocationsInd |
| General Or Managing Partner | 0 | GeneralOrManagingPartnerInd |
| 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 | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | Yes (1) | 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 | Yes (1) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | 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 (7 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| RANDOLPH SPECIALTY GROUP | ||
| K | $70,290 | CASH |
| RANDOLPH SPECIALTY GROUP | ||
| O | $2,380,218 | CASH |
| RANDOLPH SPECIALTY GROUP | ||
| Q | $739,984 | CASH |
| RANDOLPH CANCER CENTER | ||
| J | $186,750 | CASH |
| STAYWELL SENIOR CARE | ||
| L | $395,700 | CASH |
| STAYWELL SENIOR CARE | ||
| O | $188,886 | CASH |
| STAYWELL SENIOR CARE | ||
| Q | $562,230 | CASH |