GASTON MEMORIAL HOSPITAL INC: Form 990, tax year 2020

View the entire original 990 at ProPublica ↗

Organization: GASTON MEMORIAL HOSPITAL INC (EIN 56-0619359)
Tax period: 2020-07-01 to 2021-06-30
Filed: 2022-10-19
IRS object ID: 202242929349301109
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 B
Schedule C
Schedule D
Schedule H
Schedule I
Schedule J
Schedule K
Schedule L
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2022-10-19T09:25:36-05:00	ReturnTs
Tax Period End	2021-06-30	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	440160260	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	FORVIS 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	560619359	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	GASTON MEMORIAL HOSPITAL INC	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	GAST	BusinessNameControlTxt
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

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	DAVID O'CONNOR	PersonNm
Person Title	EVP, CFO	PersonTitleTxt
Phone	7048342000	PhoneNum
Signature	2022-10-19	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	2022-03-24	PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

Field	Value	IRS element (for citing)
Trusted Customer	3	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)
Amended Return	Yes (X)	AmendedReturnInd

Doing Business As Name DoingBusinessAsName

Field	Value	IRS element (for citing)
Business Name Line1	CAROMONT REGIONAL MEDICAL CTR	BusinessNameLine1Txt

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	AddressLine1Txt
City	GASTONIA	CityNm
State Abbreviation	NC	StateAbbreviationCd
ZIP	28054	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$665,062,849	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	1945	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	3900	TotalEmployeeCnt
Total Volunteers	0	TotalVolunteersCnt
Total Gross UBI	$103,276	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$33,182	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$642,684	PYContributionsGrantsAmt
CY Contributions Grants	$3,244,094	CYContributionsGrantsAmt
PY Program Service Revenue	$569,291,318	PYProgramServiceRevenueAmt
CY Program Service Revenue	$628,441,590	CYProgramServiceRevenueAmt
PY Investment Income	$109,185	PYInvestmentIncomeAmt
CY Investment Income	$19,583,338	CYInvestmentIncomeAmt
PY Other Revenue	$13,455,701	PYOtherRevenueAmt
CY Other Revenue	$13,793,421	CYOtherRevenueAmt
PY Total Revenue	$583,498,888	PYTotalRevenueAmt
CY Total Revenue	$665,062,443	CYTotalRevenueAmt
PY Grants And Similar Paid	$1,172,657	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$1,427,796	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$226,010,355	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$242,581,957	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$299,315,037	PYOtherExpensesAmt
CY Other Expenses	$319,849,996	CYOtherExpensesAmt
PY Total Expenses	$526,498,049	PYTotalExpensesAmt
CY Total Expenses	$563,859,749	CYTotalExpensesAmt
PY Revenues Less Expenses	$57,000,839	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$101,202,694	CYRevenuesLessExpensesAmt
Total Assets BOY	$442,215,147	TotalAssetsBOYAmt
Total Assets EOY	$627,844,903	TotalAssetsEOYAmt
Total Liabilities BOY	$337,638,253	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$494,526,058	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$104,576,894	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$133,318,845	NetAssetsOrFundBalancesEOYAmt
Mission	TO PROVIDE COMPASSIONATE, EXCEPTIONAL AND HIGHLY RELIABLE CARE.	MissionDesc
Significant New Program Srvc	0	SignificantNewProgramSrvcInd
Significant Change	0	SignificantChangeInd
Expense	$522,777,177	ExpenseAmt
Grant	$1,427,796	GrantAmt
Revenue	$628,338,314	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	$522,777,177	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (1)	DescribedInSection501c3Ind
Schedule B Required	Yes (1)	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	Yes (1)	DonorRstrOrQuasiEndowmentsInd
Report Land Building Equipment	Yes (1)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	0	ReportInvestmentsOtherSecInd
Report Program Related Invst	0	ReportProgramRelatedInvstInd
Report Other Assets	Yes (1)	ReportOtherAssetsInd
Report Other Liabilities	Yes (1)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	Yes (1)	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	0	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (1)	ConsolidatedAuditFinclStmtInd
School Operating	0	SchoolOperatingInd
Foreign Office	0	ForeignOfficeInd
Foreign Activities	0	ForeignActivitiesInd
More Than5000 K To Org	0	MoreThan5000KToOrgInd
More Than5000 K To Individuals	0	MoreThan5000KToIndividualsInd
Professional Fundraising	0	ProfessionalFundraisingInd
Fundraising Activities	0	FundraisingActivitiesInd
Gaming Activities	0	GamingActivitiesInd
Operate Hospital	Yes (1)	OperateHospitalInd
Audited Financial Stmt Att	Yes (1)	AuditedFinancialStmtAttInd
Grants To Organizations	Yes (1)	GrantsToOrganizationsInd
Grants To Individuals	Yes (1)	GrantsToIndividualsInd
Schedule J Required	Yes (1)	ScheduleJRequiredInd
Tax Exempt Bonds	Yes (1)	TaxExemptBondsInd
Invest Tax Exempt Bonds	0	InvestTaxExemptBondsInd
Escrow Account	0	EscrowAccountInd
On Behalf Of Issuer	0	OnBehalfOfIssuerInd
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	Yes (1)	BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent	0	BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri	0	DeductibleNonCashContriInd
Deductible Art Contribution	0	DeductibleArtContributionInd
Terminate Operations	0	TerminateOperationsInd
Partial Liquidation	0	PartialLiquidationInd
Disregarded Entity	0	DisregardedEntityInd
Related Entity	Yes (1)	RelatedEntityInd
Related Organization Ctrl Ent	0	RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	0	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	0	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (1)	ScheduleORequiredInd
IRP Document	306	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (1)	BackupWthldComplianceInd
Employee	3900	EmployeeCnt
Employment Tax Returns Filed	Yes (1)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	Yes (1)	UnrelatedBusIncmOverLimitInd
Form990 T Filed	Yes (1)	Form990TFiledInd
Foreign Financial Account	0	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTransInd
Taxable Party Notification	0	TaxablePartyNotificationInd
Nondeductible Contributions	0	NondeductibleContributionsInd
Quid Pro Quo Contributions	0	QuidProQuoContributionsInd
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	0	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	0	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	0	IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt	0	SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc	0	SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	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	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	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	0	InvestmentInJointVentureInd
States Where Copy Of Return Is Fld	NC	StatesWhereCopyOfReturnIsFldCd
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 (28 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Key EmployeeKeyEmployeeInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd
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
MS PEARL BURRIS FLOYD
DIRECTOR THROUGH 12/31/2020/SECRETARY STARTING ON	1.00	1.00	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
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 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 JANIE PEAK
DIRECTOR	1.00	2.00	Yes (X)		$0	$0	$0
MR TIMOTHY EFIRD
DIRECTOR	1.00	2.00	Yes (X)		$0	$0	$0
MR BOB HOVIS
(COMMISSIONER LIASON)	1.00	2.00	Yes (X)		$0	$20,244	$0
DR ERIC T EMERSON
PAST-CHIEF-OF-STAFF (NON-VOTING)	1.00	1.00	Yes (X)		$20,000	$0	$0
DR MICHEAL GASLIN
CHIEF-OF-STAFF	1.00	1.00	Yes (X)		$30,000	$0	$0
DR JAY HENDLER
CHIEF-OF-STAFF ELECT	1.00	40.00	Yes (X)		$0	$467,871	$30,742
MR K CHRISTOPHER PEEK
CEO	45.00	10.00		Yes (X)	$1,162,438	$0	$225,233
MR DAVID M O'CONNOR
EVP/ASST. TREASURER	45.00	10.00		Yes (X)	$728,075	$0	$136,607
MS LEIGH K HICKMAN
CLO/ASST. SEC.	45.00	10.00		Yes (X)	$366,970	$0	$75,277
MS KATHLEEN K BESSON
EVP/COO	45.00	10.00			$696,031	$0	$161,199	Yes (X)
DR TODD R DAVIS
EVP CHIEF MEDICAL OFFICER	45.00	10.00			$701,554	$0	$130,860	Yes (X)
DR GEORGE E ADCOCK III
VP MEDICAL AFFAIRS	40.00	10.00			$502,974	$0	$88,685		Yes (X)
MR RICHARD C BLACKBURN
VP SUPPORT SERVICES	40.00	10.00			$402,686	$0	$82,633		Yes (X)
MR SCOTT E WELLS
VP PATIENT CARE SERVICES	40.00	10.00			$321,736	$0	$10,618		Yes (X)
MS ROBIN L LANG
VP INFORMATION SERVICES	40.00	10.00			$389,201	$0	$80,133		Yes (X)
MR FRANK D MURPHY
VP STRATEGY BUSINESS DEVELOPMENT	40.00	10.00			$365,888	$0	$72,851		Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$5,687,553	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$488,115	TotReportableCompRltdOrgAmt
Total Other Compensation	$1,094,838	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	242	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
CROSS COUNTRY STAFFING
PO BOX 404682	ATLANTA	GA	303844682	TEMPORARY STAFFING	$11,153,092
MCMILLAN PAZDAN SMITH LLC
PO BOX 537044	ATLANTA	GA	303539450	CONSTRUCTION MANAGEMENT	$6,210,010
TRIMEDX INC
5451 LAKEVIEW PKWY S DR	INDIANANPOLIS	IN	46268	HEATHCARE TECHNOLOGY/CYBERSECURITY	$3,277,235
THE ROBINS AND MORTON GROUP
400 SHADES CREEK PARKWAY	BIRMINGHAM	AL	352465870	CONSTRUCTION MANAGEMENT	$3,239,187
EPIC SYSTEMS CORPORATION
PO BOX 88314	MILWAUKEE	WI	532880314	SOFTWARE SYSTEMS	$2,589,240

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	56	CntrctRcvdGreaterThan100KCnt
Related Organizations	$3,244,094	RelatedOrganizationsAmt
Total Contributions	$3,244,094	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt
PATIENT SERVICE REVENUE	621500	$626,224,402	$626,224,402
ANCILLARY REVENUE	621500	$2,217,188	$2,113,912	$103,276

Field	Value	IRS element (for citing)
Total Program Service Revenue	$628,441,590	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$181,009	TotalRevenueColumnAmt
Exclusion	$181,009	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Other	$19,402,329	OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Other	$0	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Other	$19,402,329	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$19,402,329	TotalRevenueColumnAmt
Exclusion	$19,402,329	ExclusionAmt

Field	Value	IRS element (for citing)
Gross Sales Of Inventory	$47,003	GrossSalesOfInventoryAmt
Cost Of Goods Sold	$406	CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$46,597	TotalRevenueColumnAmt
Exclusion	$46,597	ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	ExclusionExclusionAmt
ECONOMIC IMPACT STIMULUS PAYMENT	900099	$10,350,995	$10,350,995
MISCELLANEOUS REVENUE	900099	$1,586,201	$1,586,201
CAFETERIA & VENDING INCOME	722210	$1,570,318	$1,570,318

Miscellaneous Revenue MiscellaneousRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$239,310	TotalRevenueColumnAmt
Exclusion	$239,310	ExclusionAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$13,746,824	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$665,062,443	TotalRevenueColumnAmt
Related Or Exempt Func Income	$628,338,314	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$103,276	UnrelatedBusinessRevenueAmt
Exclusion	$33,376,759	ExclusionAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part IX	Yes (X)	InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$1,335,088	TotalAmt
Program Services	$1,335,088	ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

Field	Value	IRS element (for citing)
Total	$92,708	TotalAmt
Program Services	$92,708	ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$3,655,068	TotalAmt
Management And General	$3,655,068	ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$194,511,461	TotalAmt
Program Services	$173,808,608	ProgramServicesAmt
Management And General	$20,702,853	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$592,497	TotalAmt
Program Services	$519,669	ProgramServicesAmt
Management And General	$72,828	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$30,867,829	TotalAmt
Program Services	$27,073,666	ProgramServicesAmt
Management And General	$3,794,163	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$12,955,102	TotalAmt
Program Services	$11,362,707	ProgramServicesAmt
Management And General	$1,592,395	ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$256,926	TotalAmt
Management And General	$256,926	ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$804,866	TotalAmt
Management And General	$804,866	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$179,000	TotalAmt
Management And General	$179,000	ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$1,156	TotalAmt
Management And General	$1,156	ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$12	TotalAmt
Management And General	$12	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$71,961,059	TotalAmt
Program Services	$65,861,918	ProgramServicesAmt
Management And General	$6,099,141	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$1,708,555	TotalAmt
Program Services	$158,080	ProgramServicesAmt
Management And General	$1,550,475	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$4,136,490	TotalAmt
Program Services	$2,555,235	ProgramServicesAmt
Management And General	$1,581,255	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$2,819,414	TotalAmt
Program Services	$2,819,414	ProgramServicesAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$11,535,035	TotalAmt
Program Services	$11,535,035	ProgramServicesAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$107,400	TotalAmt
Program Services	$74,418	ProgramServicesAmt
Management And General	$32,982	ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$211,333	TotalAmt
Program Services	$113,050	ProgramServicesAmt
Management And General	$98,283	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$6,443,860	TotalAmt
Program Services	$6,443,860	ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$31,994,625	TotalAmt
Program Services	$31,994,625	ProgramServicesAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$2,450,564	TotalAmt
Program Services	$2,450,564	ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES	$109,027,839	$109,027,839
UBI TAX	$81,468		$81,468
BAD DEBT	$63,882,663	$63,882,663
MEDICAID ASSESSMENT FEE	$6,321,658	$6,321,658

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$5,926,073	TotalAmt
Program Services	$5,346,372	ProgramServicesAmt
Management And General	$579,701	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$563,859,749	TotalAmt
Program Services	$522,777,177	ProgramServicesAmt
Management And General	$41,082,572	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$101,676	BOYAmt
EOY	$38,205	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$52,785,755	BOYAmt
EOY	$56,140,383	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$9,919,291	BOYAmt
EOY	$9,993,724	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$9,162,934	BOYAmt
EOY	$12,114,663	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$675,146,069	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$395,618,242	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$241,523,277	BOYAmt
EOY	$279,527,827	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$71,979	BOYAmt
EOY	$116,334,886	EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	$7,313,661	BOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$121,336,574	BOYAmt
EOY	$153,695,215	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$442,215,147	BOYAmt
EOY	$627,844,903	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$63,226,340	BOYAmt
EOY	$98,682,391	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$157,789,480	BOYAmt
EOY	$276,469,534	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$116,622,433	BOYAmt
EOY	$119,374,133	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$337,638,253	BOYAmt
EOY	$494,526,058	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	$49,902,739	BOYAmt
EOY	$55,033,113	EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$54,674,155	BOYAmt
EOY	$78,285,732	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$104,576,894	BOYAmt
EOY	$133,318,845	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$442,215,147	BOYAmt
EOY	$627,844,903	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$101,202,694	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	$1,298	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	-$72,462,041	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)
Hospital	Yes (X)	HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor US Address ContributorUSAddress

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Total Contributions	RESTRICTED	TotalContributionsAmt

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
Direct Contact Legislators	$123,649	DirectContactLegislatorsAmt
Rallies Demonstrations	0	RalliesDemonstrationsInd
Other Activities	Yes (1)	OtherActivitiesInd
Other Activities	$35,985	OtherActivitiesAmt
Total Lobbying Expenditures	$159,634	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	ANNUAL DUES WERE PAID TO THE NORTH CAROLINA HOSPITAL ASSOCIATION AND THE AMERICAN HOSPITAL ASSOCIATION, OF WHICH $35,985 WAS DETERMINED TO BE EXPENDITURES USED IN LOBBYING ACTIVITIES BY THESE ORGANIZATIONS. THE ORGANIZATION HAD AN ADDITIONAL $123,649 IN LOBBYING COSTS FOR FISCAL YEAR 2021. 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

CY Endwmt Fund CYEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$10,190	BeginningYearBalanceAmt
Investment Earnings Or Losses	$1,941	InvestmentEarningsOrLossesAmt
Other Expenditures	$70	OtherExpendituresAmt
End Year Balance	$12,061	EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$10,310	BeginningYearBalanceAmt
Investment Earnings Or Losses	$228	InvestmentEarningsOrLossesAmt
Other Expenditures	$348	OtherExpendituresAmt
End Year Balance	$10,190	EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$10,049	BeginningYearBalanceAmt
Investment Earnings Or Losses	$655	InvestmentEarningsOrLossesAmt
Other Expenditures	$394	OtherExpendituresAmt
End Year Balance	$10,310	EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$9,841	BeginningYearBalanceAmt
Investment Earnings Or Losses	$703	InvestmentEarningsOrLossesAmt
Other Expenditures	$495	OtherExpendituresAmt
End Year Balance	$10,049	EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$9,521	BeginningYearBalanceAmt
Investment Earnings Or Losses	$1,013	InvestmentEarningsOrLossesAmt
Other Expenditures	$693	OtherExpendituresAmt
End Year Balance	$9,841	EndYearBalanceAmt

Field	Value	IRS element (for citing)
Prmnnt Endowment Balance EOY	1.00000	PrmnntEndowmentBalanceEOYPct
Endowments Held Unrelated Org	0	EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org	0	EndowmentsHeldRelatedOrgInd

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$7,555,850	OtherCostOrOtherBasisAmt
Book Value	$7,555,850	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$334,139,725	OtherCostOrOtherBasisAmt
Depreciation	$195,058,323	DepreciationAmt
Book Value	$139,081,402	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$9,746,642	OtherCostOrOtherBasisAmt
Depreciation	$8,845,848	DepreciationAmt
Book Value	$900,794	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$262,065,532	OtherCostOrOtherBasisAmt
Depreciation	$186,579,806	DepreciationAmt
Book Value	$75,485,726	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$61,638,320	OtherCostOrOtherBasisAmt
Depreciation	$5,134,265	DepreciationAmt
Book Value	$56,504,055	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$279,527,827	TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (7 entries)

DescDesc	Book ValueBookValueAmt
NET PENSION ASSET/DEFERRAL	$79,072,086
DEFERRED FINANCING COSTS	$950,063
OTHER RECEIVABLES	$4,325,548
457B PLAN ASSETS	$18,906,458
DEFERRED CHARGE-INTEREST RATE SWAP	$20,993,528
457F PLAN ASSETS	$2,692,535
PREPAID COUNTY LEASE	$26,754,997

Field	Value	IRS element (for citing)
Total Book Value Other Assets	$153,695,215	TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (5 entries)

DescDesc	AmtAmt
457B PLAN LIABILITY	$18,906,458
ESTIMATED 3RD PARTY SETTLEMENTS	$63,162,903
INTEREST RATE SWAP LIABILITY	$20,993,528
457F PLAN LIABILITY	$2,692,535
PENSION DEFERRED INFLOW	$13,618,709

Field	Value	IRS element (for citing)
Total Liability	$119,374,133	TotalLiabilityAmt
Footnote Text	Yes (X)	FootnoteTextInd
Total Rev Etc Audited Fincl Stmt	$528,685,425	TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst	$1,298	NetUnrealizedGainsInvstAmt
Revenue Not Reported	$1,298	RevenueNotReportedAmt
Revenue Subtotal	$528,684,127	RevenueSubtotalAmt
Investment Expenses Not Incld	$12	InvestmentExpensesNotIncldAmt
Other Revenues Not Included	$136,378,304	OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt	$136,378,316	RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990	$665,062,443	TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt	$499,884,574	TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported	$0	ExpensesNotReportedAmt
Expenses Subtotal	$499,884,574	ExpensesSubtotalAmt
Investment Expenses Not Incld2	$12	InvestmentExpensesNotIncld2Amt
Other Expenses Not Included	$63,975,163	OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt	$63,975,175	ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990	$563,859,749	TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART V, LINE 4:	THE ORGANIZATION'S ENDOWMENT FUNDS ARE USED FOR ONCOLOGY MEDICATIONS FOR INDIGENT PATIENTS.
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 4B - OTHER ADJUSTMENTS:	BAD DEBT 63,882,663. INTERCOMPANY TRANSFER FROM AFFILIATE 72,449,044. CHANGE IN VALUE OF INTEREST RATE SWAP AUXILIARY REVENUES 46,597.
PART XII, LINE 4B - OTHER ADJUSTMENTS:	BAD DEBT 63,882,663. AUXILIARY SCHOLARSHIPS 92,500.

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
Percent200 D	Yes (X)	Percent200DInd
Free Care Medically Indigent	Yes (1)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (1)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	0	ExpensesExceedBudgetInd
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	$12,133,777	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$12,133,777	NetCommunityBenefitExpnsAmt
Total Expense	0.02430	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$74,148,766	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$67,762,108	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$6,386,658	NetCommunityBenefitExpnsAmt
Total Expense	0.01280	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$86,282,543	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$67,762,108	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$18,520,435	NetCommunityBenefitExpnsAmt
Total Expense	0.03710	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$2,279,002	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$4,140	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$2,274,862	NetCommunityBenefitExpnsAmt
Total Expense	0.00450	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$2,347,134	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$193,187	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$2,153,947	NetCommunityBenefitExpnsAmt
Total Expense	0.00430	TotalExpensePct

Research ResearchGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$433,279	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$225,464	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$207,815	NetCommunityBenefitExpnsAmt
Total Expense	0.00040	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$1,340,616	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$1,340,616	NetCommunityBenefitExpnsAmt
Total Expense	0.00270	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$6,400,031	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$422,791	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$5,977,240	NetCommunityBenefitExpnsAmt
Total Expense	0.01190	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$92,682,574	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$68,184,899	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$24,497,675	NetCommunityBenefitExpnsAmt
Total Expense	0.04900	TotalExpensePct

Workforce Development WorkforceDevelopmentGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$3,179,039	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$3,179,039	NetCommunityBenefitExpnsAmt
Total Expense	0.00640	TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$3,179,039	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$3,179,039	NetCommunityBenefitExpnsAmt
Total Expense	0.00640	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense	$63,882,663	BadDebtExpenseAmt
Bad Debt Expense Attributable	$3,989,890	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$105,947,648	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$105,244,986	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	$702,662	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

Field	Value	IRS element (for citing)
Other	Yes (X)	OtherInd

Field	Value	IRS element (for citing)
Written Debt Collection Policy	Yes (1)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (1)	FinancialAssistancePrvsnInd
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	CAROMONT REGIONAL MEDICAL CENTER	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)
Licensed Hospital	Yes (X)	LicensedHospitalInd
General Medical And Surgical	Yes (X)	GeneralMedicalAndSurgicalInd
Emergency Room24 Hrs	Yes (X)	EmergencyRoom24HrsInd
Other	3 DIAGNOSTIC IMAGING CENTERS AND 6 OP SERIVCE CENTER	OtherDesc

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	CAROMONT REGIONAL MEDICAL CENTER	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
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	WWW.CAROMONTHEALTH.ORG	OwnWebsiteURLTxt
Other Website	Yes (X)	OtherWebsiteInd
Other Website URL	WWW.GASTONGOV.COM/DEPARTMENTS/HEALTH-AND-HUMAN-SERVICES	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	HTTP://WWW.CAROMONTHEALTH.ORG/DOCUMENTS/FOR-HEALTHCARE-PROFESSIONALS/GASTON	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	200.000000000000	FPGFamilyIncmLmtDscntCarePct
Income Level Criteria	Yes (X)	IncomeLevelCriteriaInd
Asset Level Criteria	Yes (X)	AssetLevelCriteriaInd
Medical Indigency Criteria	Yes (X)	MedicalIndigencyCriteriaInd
Insurance Status Criteria	Yes (X)	InsuranceStatusCriteriaInd
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
Other Method	Yes (X)	OtherMethodInd
Includes Publicity Measures	Yes (1)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	SEE DISCLOSURE	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	SEE DISCLOSURE	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	SEE DISCLOSURE	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
FAP Translated	Yes (X)	FAPTranslatedInd
Other Publicity	Yes (X)	OtherPublicityInd
FAP Actions On Nonpayment	Yes (1)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	0	CollectionActivitiesInd
Provided Written Notice	Yes (X)	ProvidedWrittenNoticeInd
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 (10 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
CAROMONT REGIONAL MEDICAL CENTER	PART V, SECTION B, LINE 5: GASTON COUNTY COMMUNITY HEALTH ASSESSMENT WAS CONDUCTED BY THE FOLLOWING PARTNERS: THE GASTON COUNTY DEPARTMENT OF HEALTH AND HUMAN SERVICES, GASTON TOGETHER, UNITED WAY OF GASTON COUNTY, CAROMONT HEALTH, AND STAKEHOLDER ORGANIZATIONS. THE ASSESSMENT INCLUDES THE COLLECTION AND ANALYSIS OF EXISTING STATISTICAL DATA, QUALITY OF LIFE SURVEY DATA COLLECTED DIRECTLY FROM RESIDENTS AND INPUT FROM COMMUNITY FOCUS GROUPS.
CAROMONT REGIONAL MEDICAL CENTER	PART V, SECTION B, LINE 6B: THE HOSPITAL CONDUCTED THEIR CHNA WITH THE FOLLOWING ORGANIZATIONS: GASTON COUNTY DEPARTMENT OF HEALTH AND HUMAN SERVICES, CAROMONT HEALTH, GASTON TOGETHER, THE UNITED WAY OF GASTON COUNTY AND REPRESENTATIVES OF OTHER STAKEHOLDER ORGANIZATIONS.
CAROMONT REGIONAL MEDICAL CENTER	PART V, SECTION B, LINE 7D: PARTNERING AGENCIES PRESENTED THE CHNA AT WORKSHOPS, MEETINGS AND ON AGENCY WEBSITES TO ENCOURAGE COMMUNITY STAKEHOLDERS TO USE THEM TO ENHANCE THE WELLBEING OF GASTON COUNTY AND ITS RESIDENTS.
CAROMONT REGIONAL MEDICAL CENTER	PART V, SECTION B, LINE 11: CAROMONT HEALTH PRIORITIES (2019-2021) ARE TO PROACTIVELY MANAGE MENTAL HEALTH ISSUES IN PRIMARY CARE OFFICES THROUGH THE HIRE OF MORE LCSWS, ENHANCE OPIOID AND PRESCRIPTION DRUG ABUSE INTERVENTION AND MANAGEMENT PROTOCOLS AND TO IMPROVE ACCESS TO AFFORDABLE HEALTH FOOD IN LOW INCOME COMMUNITIES THROUGH WORK WITH LOCAL STAKEHOLDERS.
CAROMONT REGIONAL MEDICAL CENTER	PART V, SECTION B, LINE 13B: REGARDLESS OF INCOME, ASSETS ARE ALSO USED TO DETERMINE IF A PATIENT QUALIFIES FOR CHARITY. BELOW IS THE VERBIAGE FROM THIS POLICY: EXEMPT ASSETSTHE PRIMARY RESIDENCE ON UP TO ONE ACRE OF LAND, ONE AUTOMOBILE FOR EACH WORKING AGED ADULT, AND OTHER ASSETS, INCLUDING BUT NOT LIMITED TO, RETIREMENT FUNDS, INVESTMENTS AND OTHER FINANCIAL ASSETS, CASH VALUE OF LIFE INSURANCE POLICIES, AND EQUITY IN PROPERTY OR REAL ASSETS, TOTALING UP TO $25,000 ARE ALSO EXEMPT FROM CONSIDERATION AS ASSETS IN DETERMINING CHARITY CARE ELIGIBILITY. ANNUAL INCOME FROM PROPERTY OF REAL ASSETS WILL BE DEDUCTED FROM THE AMOUNT OF EQUITY IN THE ASSET WHEN CALCULATING THE EXEMPTION.
CAROMONT REGIONAL MEDICAL CENTER	PART V, SECTION B, LINE 15E: CAROMONT HEALTH HAS A TEAM DEDICATED TO EDUCATING AND/OR ASSISTING PATIENTS WITH OTHER STATE OR GOVERNMENT AGENCIES THAT MAY BE A SOURCE OF ASSISTANCE.
CAROMONT REGIONAL MEDICAL CENTER	PART V, SECTION B, LINE 16J: PLAIN LANGUAGE BROCHURES ARE DISTRIBUTED AT REGISTRATION SITES. FINANCIAL COUNSELORS PROACTIVELY COMMUNICATE VERBALLY OR IN WRITING PRIOR TO SERVICE FOR SCHEDULED VISITS AND IN-HOUSE, AND/OR AFTER SERVICE TO THOSE MOST LIKELY TO REQUIRE FINANCIAL ASSISTANCE. VERBIAGE IS ALSO ON THE PATIENT BILLING STATEMENT. SPANISH INSTRUCTIONS ON WEBSITE AND IN PERSON INTERPRETER STAFF AVAILABLE TO ASSIST.
CAROMONT REGIONAL MEDICAL CENTER	PART V, SECTION B, LINE 18E: COLLECTION ACTIONS ARE TAKEN AFTER REASONABLE EFFORTS HAVE BEEN MADE TO DETERMINE PATIENT'S ELIGIBILITY FOR ASSISTANCE.
CAROMONT REGIONAL MEDICAL CENTER	PART V, SECTION B, LINE 20E: PLAIN LANGUAGE BROCHURES AT REGISTRATION SITES. PROACTIVELY COMMUNICATING VERBIALLY AND/OR IN WRITING TO SCHEDULED PATIENTS PRIOR TO SERVICE. COMMUNICATING IN-HOUSE, DURING SERVICE, OR AFTER SERVICE TO THOSE MOST LIKELY TO QUALIFY FOR ASSISTANCE.
PART V, SECTION B, LINE 16A	THE PLAIN LANGUAGE SUMMARY AND CHARITY CARE APPLICATION CAN BE FOUND USING THE LINKS BELOW:PLAIN LANGUAGE SUMMARY: HTTP://WWW.CAROMONTHEALTH.ORG/DOCUMENTS/REGISTRATION_CHARITYCAREPOLICYCHARITY CARE APPLICATION: HTTP://WWW.CAROMONTHEALTH.ORG/DOCUMENTS/CHARITY-CARE-APPLICATION-ENGLISH

Supplemental Information Detail SupplementalInformationDetail (16 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART I, LINE 3C:	FREE CARE IS PROVIDED TO PATIENTS WITH A FPG OF 200% OR LESS. ALL OTHER PATIENTS RECEIVE AN INSURANCE DISCOUNT BASED ON THEIR INDIVIDUAL INSURANCE PLAN AGREEMENT OR AN UNINSURED DISCOUNT FOR SELF PAY PATIENTS. UNINSURED DISCOUNTS ARE COMPARABLE TO OUR INSURANCE DISCOUNTS.REGARDLESS OF INCOME, ASSETS ARE ALSO USED TO DETERMINE IF A PATIENT QUALIFIES FOR CHARITY. BELOW IS THE VERBIAGE FROM THIS POLICY:EXEMPT ASSETSTHE PRIMARY RESIDENCE ON UP TO ONE ACRE OF LAND, ONE AUTOMOBILE FOR EACH WORKING AGED ADULT, AND OTHER ASSETS UP TO $25,000 INCLUDING BUT NOT LIMITED TO, RETIREMENT FUNDS, INVESTMENTS AND OTHER FINANCIAL ASSETS, CASH VALUE OF LIFE INSURANCE POLICIES, AND EQUITY IN PROPERTY OR REAL ASSETS ARE ALSO EXEMPT FROM CONSIDERATION AS ASSETS IN DETERMINING CHARITY CARE ELIGIBILITY. ANNUAL INCOME FROM PROPERTY OF REAL ASSETS WILL BE DEDUCTED FROM THE AMOUNT OF EQUITY IN THE ASSET WHEN CALCULATING THE EXEMPTION.PART 1, LINE 6A:COMMUNITY BENEFIT REPORT: THE ORGANIZATION'S COMMUNITY BENEFIT REPORT MADE AVAILABLE TO THE PUBLIC CONTAINS COMMUNITY BENEFITS FOR ALL RELATED ORGANIZATIONS TO THE HOSPITAL.
PART I, LINE 7:	THE COSTING METHODOLOGY USED IS A COST ACCOUNTING SYSTEM. ALL PATIENT SEGMENTS ARE INCLUDED. THIS SYSTEM ASSIGNS DIRECT COSTS TO SUPPLIES, PROCEDURES, ROUTINE AND SPECIALTY ROOM RATES BASED ON THE DEPARTMENT OF ORIGINATION. FIXED COSTS ARE ALLOCATED BASED ON STATISTICAL BASIS. THESE COSTS ARE THEN AGGREGATED AT THE PATIENT LEVEL AND TABULATED BY PAYOR TYPE. NO COST TO CHARGE RATIOS WERE USED IN THE CALCULATIONS.
PART I, LN 7 COL(F):	63,882,663 BAD DEBT EXPENSE REMOVED FROM TOTAL EXPENSES PRIOR TO CALCULATING PERCENT OF TOTAL EXPENSE.
PART I, LINE 7H:	CAROMONT HEALTH IS INVOLVED IN APPROXIMATELY 40 RESEARCH STUDIES, APPROXIMATELY 55% OF WHICH ARE CLINICAL TRIALS COOPERATIVE GROUP PROGRAM STUDIES SPONSORED BY THE NATIONAL CANCER INSTITUTE (NCI). CAROMONT HEALTH ALSO PARTICIPATES IN DRUG AND DEVICE STUDIES SPONSORED BY VARIOUS PHARMACEUTICAL, BIOTECHNOLOGY, AND DEVICE COMPANIES, AS WELL AS UNFUNDED ONCOLOGY, NURSING AND PHARMACY RESEARCH STUDIES.
PART II, COMMUNITY BUILDING ACTIVITIES:	WORKFORCE DEVELOPMENT - CAROMONT HEALTH'S RECRUITMENT OF PHYSICIANS, ADVANCED CARE PRACTITIONERS, NURSING AND CLINICAL STAFF, AND BUSINESS AND SUPPORT STAFF EXTENDS INTO THE FIVE COUNTIES THE SYSTEM SERVES AND IS DRIVEN BY THE CHANGING POPULATION OF THE REGION AND THE SPECIFIC HEALTH NEEDS OF PATIENTS. THE SYSTEM'S GOAL IS TO BE PRO-ACTIVE AND ANTICIPATORY SO THAT THE HEALTH CARE NEEDS OF THE COMMUNITY ARE MET IN A QUALITY-DRIVEN AND CONVENIENT MANNER. ADDITIONALLY, CAROMONT HEALTH OFFERS A FULL PROGRAM FOCUSED ON JOB COMPETENCY TRAINING AND PROFESSIONAL DEVELOPMENT OPPORTUNITIES FOR EMPLOYEES AT ALL LEVELS OF THE ORGANIZATION AND ROBUST EDUCATION PARTNERSHIPS WITH PUBLIC SCHOOLS, CAREER TECH PROGRAMS, AND COLLEGES AND UNIVERSITIES TO DEVELOP CAREER PATHWAYS FOR STUDENTS.
PART III, LINE 2:	CHARGES FOR SERVICES PROVIDED IN THE EMERGENCY DEPARTMENT ARE EVALUATED FOR CHARITY BASED ON MEANS TESTING. CHARGES FOR SERVICES PROVIDED ELSEWHERE IN THE HOSPITAL ARE EVALUATED FOR CHARITY BASED ON MEANS TESTING AND/OR APPLICATIONS FILED BY THE PATIENTS. IF NO MEANS TESTING IS DONE AND NO APPLICATION IS FILED, THE UNPAID AMOUNT IS WRITTEN-OFF TO BAD DEBT. THE % OF PATIENTS QUALIFYING FOR CHARITY IN THE EMERGENCY DEPARTMENT WAS APPLIED TO THE REMAINDER OF THE HOSPITAL TO DETERMINE THE % OF BAD DEBT PATIENTS WHO COULD HAVE BEEN CHARITY.
PART III, LINE 2:	CHARGES WRITTEN OFF TO BAD DEBT WERE TABULATED AT THE PATIENT LEVEL AND ARE REPORTED AT THE AMOUNT CHARGED TO PATIENTS. ACCOUNTS ARE RESERVED AS BAD DEBT BASED ON AN ACCOUNTS RECEIVABLE AGING METHODOLOGY. WHEN ACCOUNTS ARE SENT TO A COLLECTION AGENCY, THEY ARE WRITTEN OFF THE ACCOUNTS RECEIVABLE SYSTEM. ANY SUBSEQUENT COLLECTIONS ON THE ACCOUNTS ARE POSTED AS RECOVERIES AND REDUCE THE EXPENSE. ALL UNINSURED PATIENTS RECEIVE A DISCOUNT ON THEIR BILL, WHICH IS RECORDED AS A CONTRACTUAL ADJUSTMENT. THE AMOUNT OF THE UNINSURED DISCOUNTS ARE EXCLUDED FROM BAD DEBT EXPENSE. PART III, LINE 3: CHARGES FOR SERVICES PROVIDED IN THE EMERGENCY DEPARTMENT ARE EVALUATED FOR CHARITY BASED ON MEANS TESTING. CHARGES FOR SERVICES PROVIDED ELSEWHERE IN THE HOSPITAL ARE EVALUATED FOR CHARITY BASED ON MEANS TESTING AND/OR APPLICATIONS FILED BY THE PATIENTS. IF NO MEANS TESTING IS DONE AND NO APPLICATION IS FILED, THE UNPAID AMOUNT IS WRITTEN-OFF TO BAD DEBT. THE % OF PATIENTS QUALIFYING FOR CHARITY IN THE EMERGENCY DEPARTMENT WAS APPLIED TO THE REMAINDER OF THE HOSPITAL TO DETERMINE THE % OF BAD DEBT PATIENTS WHO COULD HAVE BEEN CHARITY. PART III, LINE 4: THE ORGANIZATION'S FINANCIAL STATEMENTS DO NOT CONTAIN A FOOTNOTE ON BAD DEBT EXPENSE. BAD DEBT EXPENSE IS REPORTED AS A DEDUCTION FROM PATIENT REVENUE.
PART III, LINE 1:	THE ORGANIZATION COMPLIES WITH THE REPORTING REQUIREMENTS OF GASB. STATEMENT NO. 15 IS NOT APPLICABLE.
PART III, LINE 8:	THE MEDICARE COST REPORT STANDARD COSTING METHODOLOGY WAS FOLLOWED WHEN FILING THE COST REPORT. THIS IS A STEP DOWN METHODOLOGY THAT APPLIES THE AVERAGE PATIENT COST TO MEDICARE PATIENTS. THE COST REPORT DOES NOT ALLOW HOSPITALS TO REPORT ALL OPERATING COSTS. BECAUSE OF THESE TWO ISSUES, THE MEDICARE COST REPORT METHODOLOGY UNDERSTATES THE TRUE COST OF TREATING MEDICARE PATIENTS.
PART III, LINE 9B:	THE POLICY CONTAINS PROVISIONS ON THE COLLECTION PRACTICES TO BE FOLLOWED FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR CHARITY CARE OR FINANCIAL ASSISTANCE. BELOW IS VERBIAGE FROM THE CHARITY POLICY:CAROMONT REGIONAL MEDICAL CENTER OFFERS MEDICAL SERVICES FREE OF CHARGE THROUGH THE CHARITY CARE PROGRAM. DETERMINATION OF CHARITY CARE WILL BE BASED ON THE PATIENT'S INCOME, FAMILY SIZE, AND ASSETS. POTENTIAL ELIGIBILITY EXISTS ONLY AFTER THE REIMBURSEMENT EFFORTS FROM ALL OTHER THIRD PARTY RESOURCES, FEDERAL, STATE, AND LOCAL ASSISTANCE PROGRAMS HAVE BEEN EXHAUSTED.
PART VI, LINE 2:	EVERY 3 YEARS, CAROMONT HEALTH ESTABLISHES COMMUNITY PRIORITIES THROUGH A NUMBER OF MECHANISMS:1. LEADERSHIP OPINIONS ARE SOUGHT TO HELP IDENTIFY NEEDED SERVICES IN THE COMMUNITY VIA PARTNERSHIPS WITH THE GASTON COUNTY DEPARTMENT OF HEALTH & HUMAN SERVICES, LOCAL NON-PROFIT ORGANIZATIONS FOCUSED ON HEALTH IMPROVEMENT IN OUR COMMUNITIES AND OTHER HEALTH-FOCUSED ENTITIES. CAROMONT HEALTH ALSO WORKS WITH COMMUNITY AGENCIES TO CONDUCT COMMUNITY NEEDS ASSESSMENTS AND QUALITY OF LIFE SURVEYS EVERY THREE YEARS. 2. PATIENT SATISFACTION DATA IS ANALYZED TO DETERMINE WHERE AND/OR HOW SERVICES NEED TO BE IMPROVED.3. SERVICE AREA DATA (VITAL STATISTICS, DEMOGRAPHICS AND UTILIZATION) ARE ANALYZED FOR TRENDS. THIS INFORMATION IS COORDINATED WITH PUBLIC HEALTH DATA TO DETERMINE VOIDS AND SERVICE AREA HEALTH PROBLEMS.4. FINDINGS FROM COMMUNITY SURVEYS/REPORTS PUBLISHED BY OTHER ORGANIZATIONS (UNITED WAY, CHAMBER OF COMMERCE, PARTNERSHIP FOR CHILDREN, GASTON COUNTY GOVERNMENT, ETC.) ARE GATHERED AND REVIEWED FOR PERTINENCE TO COMMUNITY HEALTH PROBLEMS.5. BOARD MEMBERS, SENIOR LEADERS AND DEPARTMENT DIRECTORS ARE INVOLVED IN NUMEROUS ORGANIZATIONS IN THE COMMUNITY. THROUGH THIS NETWORK OF RELATIONSHIPS, INFORMATION ABOUT THE COMMUNITY AND THE NEEDS OF AREA RESIDENTS AND ORGANIZATIONS IS USED IN THE DEVELOPMENT OF PROGRAMS AND SERVICES AVAILABLE THOUGH CAROMONT HEALTH.
PART VI, LINE 3:	THE ORGANIZATION INFORMS AND EDUCATES THE PATIENTS ABOUT THEIR ELIGIBILITY FOR ASSISTANCE IN SEVERAL WAYS. A CHARITY AND FINANCIAL SUMMARY IS ON OUR WEBSITE, AND BROCHURES ARE DISTRIBUTED IN THE EMERGENCY ROOM AND ALL OTHER REGISTRATION SITES. SPECIFICALLY TRAINED STAFF (FINANCIAL COUNSELORS AND BENEFIT ELIGIBILITY SPECIALISTS) PROACTIVELY MAKE CONTACT WITH PATIENTS PRIOR TO, AT TIME OF SERVICE, AND/OR AFTER DISCHARGE TO DISCUSS ELIGIBILITY FOR MEDICAID AND OTHER INSURANCE BENEFITS AND OFFER ASSISTANCE WITH THE APPLICATIONS. THE COMMUNICATION IS ATTEMPTED AS SOON AS POSSIBLE. WRITTEN COMMUNICATION IS MADE PRIOR TO COLLECTION AGENCY PLACEMENT.
PART VI, LINE 4:	GASTON COUNTY, COVERING 355.9 SQUARE MILES IN THE SOUTHERN PORTION OF THE PIEDMONT REGION OF NORTH CAROLINA, IS THE ORGANIZATION'S PRIMARY MARKET. LINCOLN, CLEVELAND AND YORK COUNTY, AS WELL AS PARTS OF WESTERN MECKLENBURG COUNTY, MAKE UP THE HEALTH SYSTEM'S SECONDARY MARKET. ACCORDING TO THE U.S. CENSUS BUREAU, GASTON COUNTY HAD AN ESTIMATED POPULATION OF 224,529, A MEDIAN HOUSEHOLD INCOME OF $52,835 AND 11.6% OF PERSONS IN POVERTY. RACE AND ETHNIC DEMOGRAPHICS STATE THAT 77.6% OF THE POPULATION IDENTIFY THEMSELVES AS WHITE, 17.9% AS BLACK OR AFRICAN AMERICAN, 7.6% AS HISPANIC, 2.2% AS TWO OR MORE RACES, AND 1.6% AS ASIAN.
PART VI, LINE 5:	COMMUNITY HEALTHCOMMUNITY HEALTH INITIATIVES ARE FOCUSED ON DISEASE PREVENTION AND MANAGEMENT OF CHRONIC ILLNESS. THAT INCLUDES WORKING WITH EMPLOYERS ON INNOVATIVE PROGRAMS AND COLLABORATING WITH HEALTH CARE NEIGHBORS, MANAGING ILLNESS WITHIN THE HEALTH SYSTEM'S WORKFORCE AND INTENSE FOCUS ON SUCCESSFUL CARE COORDINATION FOR PATIENTS WITH CHRONIC DISEASE. ADDITIONALLY, CAROMONT PROVIDES NEARLY $1 MILLION ANNUALLY IN SPONSORSHIP AND GRANT SUPPORT FOR LOCAL NON-PROFITS, COMMUNITY PROGRAMS AND SERVICES, AND OTHER COMMUNITY INITIATIVES AIMED AT IMPROVING THE HEALTH OF THE COMMUNITY. ACTING AS A TRUSTED HEALTHCARE PARTNERS, CAROMONT HEALTH SEEKS TO PROVIDE CARE AND SUPPORT TO ALL MEMBERS OF THE COMMUNITY.
PART VI, LINE 6:	ESTABLISHED IN 1946, CAROMONT REGIONAL MEDICAL CENTER IS A 435-BED, NOT-FOR-PROFIT ACUTE CARE FACILITY OFFERING COMPREHENSIVE INPATIENT HOSPITAL SERVICES. CAROMONT REGIONAL MEDICAL CENTER IS THE ANCHOR OF CAROMONT HEALTH, A HEALTH CARE SYSTEM WITH FIVE AFFILIATE COMPANIES INCLUDING A NETWORK OF 55 PRIMARY AND SPECIALTY PHYSICIAN OFFICES.CAROMONT REGIONAL MEDICAL CENTER HAS 3 DIAGNOSTIC IMAGING CENTERS, A SAME-DAY SURGERY CENTER, AND 1 OFF-SITE EMERGENCY DEPARTMENT. CAROMONT HEALTH ALSO HAS A FREE-STANDING ENDOSCOPY CENTER, 1 AMBULATORY SURGERY CENTER, AND 1 OCCUPATIONAL MEDICINE CLINIC.
PART VI, LINE 7, REPORTS FILED WITH STATES	NC

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Grant Records Maintained	Yes (1)	GrantRecordsMaintainedInd

Recipient Table RecipientTable (23 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Recipient EINRecipientEIN	IRC SectionIRCSectionDesc	Cash GrantCashGrantAmt	Purpose Of GrantPurposeOfGrantTxt
GASTON COUNTY LEASE
128 WEST MAIN AVE	GASTONIA	NC	28052	566000300	GOVERNMENTAL	$477,684	COMMUNITY ASSISTANCE
KINTEGRA HEALTH
991 WEST HUDSON BLVD	GASTONIA	NC	28052	581958398	501(C)(3)	$223,754	COMMUNITY ASSISTANCE
GASTON COUNTY SCHOOLS
PO BOX 1397	GASTONIA	NC	280531397	566001032	GOVERNMENTAL	$175,550	COMMUNITY ASSISTANCE
HEALTHNET GASTON
200 EAST FRANKLIN BLVD	GASTONIA	NC	28052	561913112	501(C)(3)	$75,000	COMMUNITY ASSISTANCE
GASTON TOGETHER
P O BOX 817	GASTONIA	NC	28053	562048064	501(C)(3)	$22,000	COMMUNITY ASSISTANCE
GASTON BUSINESS ASSOC
PO BOX 7	GASTONIA	NC	28052		501(C)(3)	$17,000	COMMUNITY ASSISTANCE
BOYS AND GIRLS CLUB OF GREATER GASTON
PO BOX 23	GASTONIA	NC	28053	561419498	501(C)(3)	$12,500	COMMUNITY ASSISTANCE
THE CATHERINE PHARR CARSTARPHEN
PO BOX 1939	MCADENVILLE	NC	28101	560623961	501(C)(3)	$12,500	COMMUNITY ASSISTANCE
CITY OF BELMONT
PO BOX 431	BELMONT	NC	28012	560856848	GOVERNMENTAL	$10,000	COMMUNITY ASSISTANCE
GASTON COMMUNITY FOUNDATION
1201 EAST GARRISON BLVD	GASTONIA	NC	28053	581340834	501(C)(3)	$10,000	COMMUNITY ASSISTANCE
MEDASSIST OF MECKLENBURG
4428 TAGGART CREEK RD SUITE 101	CHARLOTTE	NC	282085400	562018957	501(C)(3)	$10,000	COMMUNITY ASSISTANCE
UNITED WAY OF GASTON COUNTY
200 EAST FRANKLIN BLVD	GASTONIA	NC	28052	560653356	501(C)(3)	$10,000	COMMUNITY ASSISTANCE
GIRLS ON THE RUN INTERNATIONAL INC
801 EAST MOREHEAD ST SUITE 201	CHARLOTTE	NC	28202	474179257	501(C)(3)	$7,500	COMMUNITY ASSISTANCE
GASTON COUNTY FAMILY YMCA
201 SOUTH CLAY STREET	GASTONIA	NC	28052	560655420	501(C)(3)	$6,500	COMMUNITY ASSISTANCE
CITY OF LOWELL
101 WEST FIRST ST	LOWELL	NC	28098		GOVERNMENTAL	$6,000	COMMUNITY ASSISTANCE
DANIEL STOWE BORANICAL GARDENS
6500 S NEW HOPE RD	BELMONT	NC	280128788	208362933	501(C)(3)	$5,100	COMMUNITY ASSISTANCE
CAROLINA THREAD TRAIL
4530 PARK RD SUITE 420	CHARLOTTE	NC	28209	261528527	501(C)(3)	$5,000	COMMUNITY ASSISTANCE
CITY OF GASTONIA
PO BOX 1748	GASTONIA	NC	28053	566000227	GOVERNMENTAL	$5,000	COMMUNITY ASSISTANCE
DOWNTOWN BELMONT DEVELOPMENT ASSOCIATION
PO BOX 431	BELMONT	NC	28012	474333734	501(C)(3)	$5,000	COMMUNITY ASSISTANCE
GASTON COUNTY EDUCATION FOUNDATION
PO BOX 1397	GASTONIA	NC	28053	561764830	501(C)(3)	$5,000	COMMUNITY ASSISTANCE
HEART SOCIETY OF GASTON COUNTY
1201 EAST GARRISON BLVD	GASTONIA	NC	28054	561330921	501(C)(3)	$5,000	COMMUNITY ASSISTANCE
HOLY ANGELS INC
660 WILKINSON BLVD	BELMONT	NC	28012	561762654	501(C)(3)	$5,000	COMMUNITY ASSISTANCE
CITY OF BESSEMER CITY
125 EAST VIRGINA AVE	BESSEMER CITY	NC	28016	566001177	GOVERNMENTAL	$5,000	COMMUNITY ASSISTANCE

Field	Value	IRS element (for citing)
Total501c3 Org	23	Total501c3OrgCnt
Total Other Org	0	TotalOtherOrgCnt

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp (2 entries)

Grant TypeGrantTypeTxt	RecipientRecipientCnt	Cash GrantCashGrantAmt
ONCOLOGY PHARMACY FUND	4	$208
SCHOLARSHIPS	32	$92,500

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART I, LINE 2:	OTHER ORGANIZATIONS THAT RECEIVE GRANT FUNDS MAY BE REQUIRED TO SUBMIT MONTHLY REPORTS THAT ARE MONITORED BY MANAGEMENT AND/OR THE BOARD OF DIRECTORS. ALL GRANTS DECISIONS ARE DOCUMENTED.
SCHEDULE I, PART III	THE PURPOSE OF THE GERTRUDE CLINTON HEALTH CAREERS SCHOLARSHIP IS TO ENCOURAGE MEDICAL AND HEALTH-RELATED PROFESSIONALS IN THE FIELD OF HUMAN SERVICES TO PRACTICE THEIR SPECIALTIES AT CAROMONT REGIONAL MEDICAL CENTER OR IN GASTON COUNTY.

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Travel For Companions	Yes (X)	TravelForCompanionsInd
Club Dues Or Fees	Yes (X)	ClubDuesOrFeesInd
Written Policy Ref T And E Expnss	Yes (1)	WrittenPolicyRefTAndEExpnssInd
Substantiation Required	0	SubstantiationRequiredInd
Compensation Committee	Yes (X)	CompensationCommitteeInd
Independent Consultant	Yes (X)	IndependentConsultantInd
Written Employment Contract	Yes (X)	WrittenEmploymentContractInd
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	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 (11 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	$776,638	$0	$272,457	$0	$113,343	$0	$203,933	$0	$21,300	$0	$1,387,671	$0	$89,251	$0
MR DAVID M O'CONNOR
EVP/ASST. TREASURER	$495,147	$0	$138,597	$0	$94,331	$0	$115,312	$0	$21,295	$0	$864,682	$0	$78,443	$0
MS KATHLEEN K BESSON
EVP/COO	$481,122	$0	$135,437	$0	$79,472	$0	$139,907	$0	$21,292	$0	$857,230	$0	$72,127	$0
DR TODD R DAVIS
EVP CHIEF MEDICAL OFFICER	$477,347	$0	$134,394	$0	$89,813	$0	$109,569	$0	$21,291	$0	$832,414	$0	$72,973	$0
DR GEORGE E ADCOCK III
VP MEDICAL AFFAIRS	$329,538	$0	$155,589	$0	$17,847	$0	$67,462	$0	$21,223	$0	$591,659	$0	$0	$0
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 RICHARD C BLACKBURN
VP SUPPORT SERVICES	$280,190	$0	$76,866	$0	$45,630	$0	$69,828	$0	$12,805	$0	$485,319	$0	$0	$0
MS ROBIN L LANG
VP INFORMATION SERVICES	$302,887	$0	$81,622	$0	$4,692	$0	$69,556	$0	$10,577	$0	$469,334	$0	$3,548	$0
MS LEIGH K HICKMAN
CLO/ASST. SEC.	$303,156	$0	$63,025	$0	$789	$0	$60,798	$0	$14,479	$0	$442,247	$0	$0	$0
MR FRANK D MURPHY
VP STRATEGY BUSINESS DEVELOPMENT	$283,686	$0	$80,954	$0	$1,248	$0	$59,648	$0	$13,203	$0	$438,739	$0	$0	$0
MR SCOTT E WELLS
VP PATIENT CARE SERVICES	$101,821	$0	$69,492	$0	$150,423	$0	$5,542	$0	$5,076	$0	$332,354	$0	$116,636	$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART I, LINE 1A	THE ORGANIZATION HAS A POLICY TO ADDRESS WHEN SPOUSAL TRAVEL IS PERMITTED AND PAYS CLUB DUES FOR THE PRESIDENT/CEO FOR BUSINESS PURPOSES AS PART OF THE EMPLOYMENT CONTRACT.
PART I, LINE 4B	THE FOLLOWING INDIVIDUALS RECEIVED DEFERRED COMPENSATION ALLOCATIONS FROM THE FILING ORGANIZATION FROM A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP): DAVID O'CONNOR - $ 95,362 KATHLEEN K. BESSON - 93,188 TODD DAVIS, MD - 92,469 K. CHRISTOPHER PEEK - 188,258 DR. G.E. WARD ADCOCK III- 51,109 ROBIN LANG- 45,819 FRANK D. MURPHY - 43,973 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 PHYSICIANS NET RESULTS FROM OPERATIONS AS CALCULATED BASED SOLELY ON HIS/HER NET CHARGES LESS HIS/HER ALLOCABLE SHARE OF CLINIC OVERHEAD COSTS.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (3 entries)

Bond ReferenceBondReferenceCd	Bond Issuer EINBondIssuerEIN	Bond IssuedBondIssuedDt	Issue PriceIssuePriceAmt	PurposePurposeDesc	DefeasedDefeasedInd	On Behalf Of IssuerOnBehalfOfIssuerInd	Pool FinancingPoolFinancingInd
NORTH CAROLINA MEDICAL CARE COMMISSION
A	521309402	2003-01-23	$120,000,000	SEE PART VI	0	0	0
NORTH CAROLINA MEDICAL CARE COMMISSION
B	521309402	2019-11-19	$41,460,000	SEE PART VI	0	0	0
NORTH CAROLINA MEDICAL CARE COMMISSION
C	521309402	2021-02-10	$129,092,857	SEE PART VI	0	0	0

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (3 entries)

Bond ReferenceBondReferenceCd	RetiredRetiredAmt	Total ProceedsTotalProceedsAmt	Capitalized InterestCapitalizedInterestAmt	Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt	Credit EnhancementCreditEnhancementAmt	Capital ExpendituresCapitalExpendituresAmt	Other Spent ProceedsOtherSpentProceedsAmt	Substantial CompletionSubstantialCompletionYr	Refunding Taxable BondsRefundingTaxableBondsInd	Final Allocation MadeFinalAllocationMadeInd	Adequate Books And Rec MaintAdequateBooksAndRecMaintInd
A	$8,300,000	$123,594,002	$5,150,936	$1,256,069	$3,386,000	$91,583,288	$22,217,709	2005	Yes (1)	Yes (1)	Yes (1)
B	$1,885,000	$41,460,000							Yes (1)	Yes (1)	Yes (1)
C		$129,128,872		$1,064,190		$11,741,861		2023	0	0	0

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (3 entries)

Bond ReferenceBondReferenceCd	Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd	Engage Bond Counsel ContractsEngageBondCounselContractsInd	Any Research AgreementsAnyResearchAgreementsInd	Engage Bond Counsel ResearchEngageBondCounselResearchInd	Private Bus Use By OthersPrivateBusUseByOthersPct	Total Private Business UseTotalPrivateBusinessUsePct	Change In Use Bond Financed PropChangeInUseBondFinancedPropInd	Change In Use Bond Financed PropChangeInUseBondFinancedPropPct	Remedial Action TakenRemedialActionTakenInd	Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd
A	Yes (1)	Yes (1)	Yes (1)	Yes (1)	0.00150	0.00150	Yes (1)	0.00110	0	Yes (1)
B	0		0				0			Yes (1)
C	0		0				0			Yes (1)

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (3 entries)

Bond ReferenceBondReferenceCd	Form8038 T FiledForm8038TFiledInd	Rebate Not Due YetRebateNotDueYetInd	Exception To RebateExceptionToRebateInd	No Rebate DueNoRebateDueInd	Variable Rate IssueVariableRateIssueInd	Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd	Business Name Line2HedgeProviderName/BusinessNameLine2Txt	Term Of HedgeTermOfHedgePct	Superintegrated HedgeSuperintegratedHedgeInd	Hedge TerminatedHedgeTerminatedInd	Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd	Gross Proceeds InvestedGrossProceedsInvestedInd	Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd
MERRILL LYNCH
A	0	0	0	Yes (1)	Yes (1)	Yes (1)	CAPITAL SERVICES	31.600000000000	Yes (1)	0	0	0	Yes (1)
(no name)
B	0	0	0	0	Yes (1)	0					0	0	Yes (1)
(no name)
C	0	0	0	0	Yes (1)	0					0	0	Yes (1)

Procedures Corrective Action ProceduresCorrectiveActionGrp (2 entries)

Bond ReferenceBondReferenceCd	Procedures Corrective ActionProceduresCorrectiveActionInd
A	Yes (1)
B	0

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
DATE REBATE COMPUTATION PERFORMED	ISSUER NAME: NORTH CAROLINA MEDICAL CARE COMMISSION DATE THE REBATE COMPUTATION WAS PERFORMED: 12/05/2017
SCHEDULE K SUPPLENTAL INFORMATION	THREE 501(C)(3) ORGANIZATIONS WITHIN THE PARENT-SUBSIDIARY CONTROLLED GROUP BENEFIT FROM THE BONDS AS FOLLOWS: GASTON MEMORIAL HOSPITAL, INC. (56-0619359) CAROMONT HEALTH, INC. (58-1636959) CAROMONT HEALTH SERVICES, INC. (56-1455630) CAROMONT REGIONAL MEDICAL CENTER HOLDS THE LIABILITY FOR THE BONDS, PER AUDITED FINANCIAL STATEMENTS.
SCHEDULE K, PART I, COLUMN (F); DESCRIPTION OF PURPOSE:	ISSUE A - THE SYSTEM USED THE PROCEEDS FROM THESE BONDS FOR VARIOUS CAPITAL IMPROVEMENTS, INCLUDING, BUT NOT LIMITED TO, A NEW WOMEN'S CENTER AND PARKING DECK, RENOVATIONS TO EXISTING FACILITIES, AND EQUIPMENT. IN ADDITION, PROCEEDS WERE USED TO REFUND IN ADVANCE OF THEIR MATURITIES $17,000,000 IN PRINCIPAL AMOUNT OF THE SERIES 1998 HOSPITAL REVENUE BONDS. ISSUE B - ON NOVEMBER 19, 2019 THE BANK EXCHANGED THE 2018 TAXABLE BONDS FOR FIXED RATE TAX-EXEMPT BONDS (THE "2019 TAX-EXEMPT BONDS") ISSUED BY THE NCMCC. THIS EXCHANGE OF THE SERIES 2018 BONDS FOR THE SERIES 2019 TAX-EXEMPT BONDS CONSTITUTES A CURRENT REFUNDING OF THE SERIES 2018 BONDS AND PROVIDES CAROMONT WITH INCREMENTAL INTEREST COST SAVINGS. ISSUE C - ON JANUARY 21, 2021, THE NORTH CAROLINA MEDICAL CARE COMMISSION ISSUED $105,260,000 OF SERIES 2021A AND SERIES 2021B HOSPITAL REVENUE BONDS ("SERIES 2021 BONDS"). THE $40,950,000 SERIES 2021A BONDS ARE TAX-EXEMPT FIXED RATE BONDS THAT MATURE FEBRUARY 1, 2036 AND THE $64,310,000 SERIES 2021B BONDS ARE TAX-EXEMPT PUT BONDS THAT MATURE FEBRUARY 1, 2051. THE INTEREST RATE FOR THE NEW BONDS IS 5%. THE PROCEEDS WILL BE USED BY THE SYSTEM FOR VARIOUS CAPITAL IMPROVEMENTS, INCLUDING, BUT NOT LIMITED TO, A NEW FOUR-STORY, APPROXIMATELY 140,000 SQUARE FOOT CRITICAL CARE TOWER ON THE HOSPITAL CAMPUS AND TO PAY THE FEES AND EXPENSES INCURRED IN CONNECTION WITH THE SALE AND ISSUANCE OF THE BONDS.
SCHEDULE K, PART II, LINE 3 COLUMN (A):	LINE 3 COLUMN (A) INCLUDES THE TOTAL INVESTMENT EARNINGS ON BOND PROCEEDS IN THE AMOUNT OF $ 3,594,002.
SCHEDULE K, PART II, LINE 11; OTHER SPENT PROCEEDS:	OTHER SPENT PROCEEDS INCLUDE DEPOSITS MADE INTO A REFUNDING ESCROW ACCOUNT ALONG WITH INTEREST EARNED ON THE ACCOUNT, BOTH OF WHICH WERE SUBSEQUENTLY USED TO PAY PRINCIPLE AND INTEREST ON THE REFUNDED BONDS. SEE THE RESPONSE FOR PART I, COLUMN (F) FOR DETAILS.

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

Field	Value	IRS element (for citing)
Person	GENA POMEROY	PersonNm

Field	Value	IRS element (for citing)
Relationship Description	FAMILY RELATIONSHIP WITH BOARD MEMBER	RelationshipDescriptionTxt
Transaction	$41,575	TransactionAmt
Transaction	COMPENSATION FOR EMPLOYEE SERVICES	TransactionDesc
Sharing Of Revenues	0	SharingOfRevenuesInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 6	THE SOLE MEMBER OF THE CORPORATION IS CAROMONT HEALTH, INC., A NORTH CAROLINA NOT-FOR-PROFIT CORPORATION.
FORM 990, PART VI, SECTION A, LINE 7A	THE BOARD OF DIRECTORS CONSISTS OF FOURTEEN (14) MEMBERS, ALL OF WHOM ARE THE MEMBERS OF THE BOARD OF DIRECTORS OF CAROMONT HEALTH, INC., AND ALL OF WHOM ARE APPOINTED BY THE BOARD OF DIRECTORS OF CAROMONT HEALTH.
FORM 990, PART VI, SECTION A, LINE 7B	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.
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 RESPONSIBILITY 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 RESPONSIBILITY 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 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 IX, LINE 11G	HOSPITALIST FEES: PROGRAM SERVICE EXPENSES 7,689,122. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,689,122. PHYSICIAN LEADERSHIP FEES: PROGRAM SERVICE EXPENSES 253,210. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 253,210. INTEGRATION & PERFORMANCE IMPROVEMENT FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 548,259. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 548,259. CONTRACT SERVICES: PROGRAM SERVICE EXPENSES 38,784,317. MANAGEMENT AND GENERAL EXPENSES 2,993,245. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 41,777,562. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 11,595,343. MANAGEMENT AND GENERAL EXPENSES 679,371. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 12,274,714. PROFESSIONAL SERVICES: PROGRAM SERVICE EXPENSES 5,989,835. MANAGEMENT AND GENERAL EXPENSES 155,459. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,145,294. CTS BIOMED: PROGRAM SERVICE EXPENSES 1,318,631. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,318,631. CONSULTING FEES: PROGRAM SERVICE EXPENSES 216,520. MANAGEMENT AND GENERAL EXPENSES 562,291. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 778,811. LICENSE FEES: PROGRAM SERVICE EXPENSES 14,940. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 14,940. TAX EXEMPT BOND FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 1,160,516. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,160,516.
FORM 990, PART XI, LINE 9:	INTERCOMPANY TRANSFER FROM AFFILIATE -72,449,044. AUXILIARY NET ASSET ADJUSTMENT -12,997.
PART XII, LINE 2C	THE PROCESS HAS NOT CHANGED FROM LAST YEAR.
FORM 990 AMENDED RETURN	THE FORM 990 HAS BEEN AMENDED TO AMEND SCHEDULE I PART II LINES 1 AND 2, TO REMOVE AN ORGANIZATION ERRONEOUSLY LISTED AS A GRANT RECIPIENT.
FORM 990, PART V AND PART VII	COMMON PAYMASTER: THE FILING ORGANIZATION USES A RELATED ORGANIZATION FOR ITS PAYROLL FUNCTION. 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 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	Direct Controlling NADirectControllingNACd	Controlled OrganizationControlledOrganizationInd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt
CAROMONT HEALTH INC
2525 COURT DRIVE	GASTONIA	NC	28054	581636959	MEDICAL SERVICES	NC	501(C)(3)	LINE 12C, III-FI	N/A	0
CAROMONT HEALTH SERVICES INC
2526 COURT DRIVE	GASTONIA	NC	28054	561455630	OUTPATIENT SERVICES	NC	501(C)(3)	LINE 3		0	CAROMONT HEALTH INC
GASTON MEMORIAL HOSPITAL FOUNDATION INC
2527 COURT DRIVE	GASTONIA	NC	28054	561479699	FOUNDATION	NC	501(C)(3)	LINE 11		0	CAROMONT HEALTH INC
CAROMONT MEDICAL GROUP INC
2528 COURT DRIVE	GASTONIA	NC	28054	561479712	MEDICAL GROUP	NC	501(C)(3)	LINE 11		0	CAROMONT HEALTH INC
HOSPICE OF GASTON COUNTY INC
2529 COURT DRIVE	GASTONIA	NC	28054	581341530	HOSPICE CARE	NC	501(C)(3)	LINE 7		0	CAROMONT HEALTH INC
GASTON COUNTY
PO BOX 1578	GASTONIA	NC	280531578	566000300	GOVERNMENT ADMINISTRATION	NC			N/A	0

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	0	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	0	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	Yes (1)	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	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	Yes (1)	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	Yes (1)	SharingOfFacilitiesInd
Paid Employees Sharing	Yes (1)	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	Yes (1)	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	Yes (1)	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	Yes (1)	TransferToOtherOrgInd
Transfer From Other Org	Yes (1)	TransferFromOtherOrgInd