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BLUE RIDGE HEALTHCARE SYSTEMS INC: Form 990, tax year 2021

View the entire original 990 at ProPublica ↗

Organization
BLUE RIDGE HEALTHCARE SYSTEMS INC (EIN 56-2150313)
Tax period
2021-01-01 to 2021-12-31
Filed
2022-11-03
IRS object ID
202243079349301809
Schema version
2021v4.2
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

FieldValueIRS element (for citing)
Return2022-11-03T10:25:26-05:00ReturnTs
Tax Period End2021-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN410746749PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1CLIFTONLARSONALLEN LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1227 WEST TRADE STREET SUITE 800AddressLine1Txt
CityCHARLOTTECityNm
State AbbreviationNCStateAbbreviationCd
ZIP28202ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2021-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN562150313EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1BLUE RIDGE HEALTHCARE SYSTEM INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlBLUEBusinessNameControlTxt
Phone8285805000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line12201 SOUTH STERLING STREETAddressLine1Txt
CityMORGANTONCityNm
State AbbreviationNCStateAbbreviationCd
ZIP28655ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonPATRICIA A MOLLPersonNm
Person TitleCHIEF FINANCIAL OFFICERPersonTitleTxt
Phone8285805000PhoneNum
Signature2022-11-02SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstPATRICIAPersonFirstNm
Person LastMOLLPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonJOHN NORMANPreparerPersonNm
PTINP01506766PTIN
Phone7049985200PhoneNum
Preparation2022-11-02PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer3TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2021TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1BLUE RIDGE HEALTHCAREBusinessNameLine1Txt
FieldValueIRS element (for citing)
Principal OfficerKATHY BAILEYPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line12201 SOUTH STERLING STREETAddressLine1Txt
CityMORGANTONCityNm
State AbbreviationNCStateAbbreviationCd
ZIP28655ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$7,568,628GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.BLUERIDGEHEALTH.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1999FormationYr
Legal Domicile StateNCLegalDomicileStateCd
Activity Or MissionTO ENHANCE THE DELIVERY OF HEALTH CARE SERVICES WITHIN THE SERVICE AREA.ActivityOrMissionDesc
Voting Members Governing Body9VotingMembersGoverningBodyCnt
Voting Members Independent9VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$7,611,166PYProgramServiceRevenueAmt
CY Program Service Revenue$7,568,628CYProgramServiceRevenueAmt
PY Investment Income$0PYInvestmentIncomeAmt
CY Investment Income$0CYInvestmentIncomeAmt
PY Other Revenue$0PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$7,611,166PYTotalRevenueAmt
CY Total Revenue$7,568,628CYTotalRevenueAmt
PY Grants And Similar Paid$13,200PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$0PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$0CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$8,177,946PYOtherExpensesAmt
CY Other Expenses$8,077,735CYOtherExpensesAmt
PY Total Expenses$8,191,146PYTotalExpensesAmt
CY Total Expenses$8,077,735CYTotalExpensesAmt
PY Revenues Less Expenses-$579,980PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$509,107CYRevenuesLessExpensesAmt
Total Assets BOY$117,161,124TotalAssetsBOYAmt
Total Assets EOY$118,344,901TotalAssetsEOYAmt
Total Liabilities BOY$121,285,906TotalLiabilitiesBOYAmt
Total Liabilities EOY$122,978,790TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY-$4,124,782NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY-$4,633,889NetAssetsOrFundBalancesEOYAmt
MissionBLUE RIDGE HEALTHCARE SYSTEM, INC. OPERATES BLUE RIDGE MEDICAL GROUP AND BLUE RIDGE HEALTHCARE HOSPITALS, INC. AND THEIR RELATED ENTITIES AS AN INTEGRATED HEALTH CARE DELIVERY SYSTEM TO ENHANCE THE DELIVERY OF HEALTH CARE SERVICES WITHIN THE SERVICE AREA.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$3,756,665ExpenseAmt
Revenue$7,568,628RevenueAmt
DescBLUE RIDGE HEALTHCARE SYSTEM'S EXEMPT PURPOSE IS TO OPERATE AN INTEGRATED HEALTH CARE DELIVERY SYSTEM. DURING THE COURSE OF 2021, BLUE RIDGE HEALTHCARE SYSTEM OVERSAW 5,943 ADMISSIONS, 171,518 ED/OUTPATIENTS VISITS, AND 9,219 SURGERIES, RESULTING IN 32,293 DAYS OF CARE IN THE GENERAL HOSPITAL.Desc
Total Program Service Expenses$3,756,665TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi Endowments0DonorRstrOrQuasiEndowmentsInd
Report Land Building Equipment0ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other Liabilities0ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt BondsYes (1)TaxExemptBondsInd
Invest Tax Exempt Bonds0InvestTaxExemptBondsInd
Escrow Account0EscrowAccountInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control Ent0TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document152IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee0EmployeeCnt
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members9GoverningBodyVotingMembersCnt
Independent Voting Member9IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesYes (1)DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1PATRICIA MOLLBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone8285805003PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line12201 SOUTH STERLING STREETAddressLine1Txt
CityMORGANTONCityNm
State AbbreviationNCStateAbbreviationCd
ZIP28655ZIPCd
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (11 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt
J MICHAEL BRIDGES
CHAIRMAN1.00Yes (X)Yes (X)$0$0$0
M H MCCRARY
VICE-CHAIRMAN1.00Yes (X)Yes (X)$0$0$0
SHERROD SALSBURY
SECRETARY1.00Yes (X)Yes (X)$0$0$0
JEFF CARSWELL
TREASURER1.00Yes (X)Yes (X)$0$0$0
JOHN BRANSTROM
BOARD MEMBER1.00Yes (X)$0$0$0
ALAN GRIFFIN
BOARD MEMBER1.00Yes (X)$0$0$0
SUSAN HAIRE
BOARD MEMBER1.00Yes (X)$0$0$0
FELICIA SIMMONS
BOARD MEMBER1.00Yes (X)$0$0$0
ALAN VANNOPPEN
BOARD MEMBER1.00Yes (X)$0$0$0
PATRICIA MOLL
CFO1.00Yes (X)$0$231,542$27,26850.00
KATHY BAILEY
PRESIDENT & CEO1.00Yes (X)$0$307,396$7,05050.00
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$538,938TotReportableCompRltdOrgAmt
Total Other Compensation$34,318TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
ATRIUM HEALTH
1000 BLYTHE BOULEVARDCHARLOTTENC28203MANAGEMENT SERVICES$9,508,143
CHRISTOPHER KEVIN PRITCHARD
PO BOX 3041MORGANTONNC28680MINOR CONSTRUCTION & MAINTENANCE SERVICE$494,937
JPS SERVICES
1985 TATE BLVD SEHICKORYNC28602CLEANING SERVICES$390,778
CARSWELL'S LANDSCAPING AND LAWNCARE
PO BOX 1873MORGANTONNC28680LANDSCAPING/LAWN MAINTENANCE SERVICES$279,488
COPE SERVICES LLC
PO BOX 55MORGANTONNC28680MINOR CONSTRUCTION & MAINTENANCE SERVICE$242,277
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K5CntrctRcvdGreaterThan100KCnt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescINTER-FACILITY REVENUEDesc
Business541610BusinessCd
Total Revenue Column$7,471,787TotalRevenueColumnAmt
Related Or Exempt Func Income$7,471,787RelatedOrExemptFuncIncomeAmt

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$96,841TotalRevenueColumnAmt
Related Or Exempt Func Income$96,841RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$7,568,628TotalProgramServiceRevenueAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$7,568,628TotalRevenueColumnAmt
Related Or Exempt Func Income$7,568,628RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$4,314,308TotalAmt
Management And General$4,314,308ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$2,333TotalAmt
Management And General$2,333ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$485TotalAmt
Program Services$485ProgramServicesAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$3,688,425TotalAmt
Program Services$3,688,425ProgramServicesAmt

Other Expenses OtherExpensesGrp (2 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmt
SUPPLIES$54,013$54,013
INTERCOMPANY$3,408$3,408

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$14,763TotalAmt
Program Services$10,334ProgramServicesAmt
Management And General$4,429ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$8,077,735TotalAmt
Program Services$3,756,665ProgramServicesAmt
Management And General$4,321,070ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$182,371BOYAmt
EOY$3,229,214EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$14,167BOYAmt
EOY$16,783EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$116,964,586BOYAmt
EOY$115,098,904EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$117,161,124BOYAmt
EOY$118,344,901EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$2,958,521BOYAmt
EOY$7,245,784EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$118,327,385BOYAmt
EOY$115,733,006EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$121,285,906BOYAmt
EOY$122,978,790EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY-$4,124,782BOYAmt
EOY-$4,633,889EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY-$4,124,782BOYAmt
EOY-$4,633,889EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$117,161,124BOYAmt
EOY$118,344,901EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$509,107ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3Yes (X)SupportingOrganization509a3Ind
Supporting Org Type2Yes (X)SupportingOrgType2Ind
IRS Written DeterminationYes (X)IRSWrittenDeterminationInd
Supported Organizations1SupportedOrganizationsCnt

Supported Org Information SupportedOrgInformationGrp

Supported Organization Name SupportedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1BLUE RIDGE HEALTHCARE HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
EIN560529976EIN
Organization Type3OrganizationTypeCd
Governing Document ListedYes (1)GoverningDocumentListedInd
Support$93,290SupportAmt
Other Support$0OtherSupportAmt
FieldValueIRS element (for citing)
Supported Organizations Total1SupportedOrganizationsTotalCnt
Support Sum$93,290SupportSumAmt
Other Support Sum$0OtherSupportSumAmt

Form990 Sch A Supporting Org Form990SchASupportingOrgGrp

FieldValueIRS element (for citing)
Listed By Name Governing DocYes (1)ListedByNameGoverningDocInd
Suprt Org No IRS Determination0SuprtOrgNoIRSDeterminationInd
Supported Org Section C4560SupportedOrgSectionC456Ind
Supported Org Not Organized US0SupportedOrgNotOrganizedUSInd
Organization Change Suprt Org0OrganizationChangeSuprtOrgInd
Support Non Supported Org0SupportNonSupportedOrgInd
Payment Substantial Contribtr0PaymentSubstantialContribtrInd
Loan Disqualified Person0LoanDisqualifiedPersonInd
Controlled Disqualified Prsn0ControlledDisqualifiedPrsnInd
Disqualified Prsn Controll Int0DisqualifiedPrsnControllIntInd
Disqualified Prsn Ownr Int0DisqualifiedPrsnOwnrIntInd
Excess Business Holdings Rules0ExcessBusinessHoldingsRulesInd
Contribution Controller0ContributionControllerInd
Contribution Family0ContributionFamilyInd
Contribution35 Controlled0Contribution35ControlledInd
FieldValueIRS element (for citing)
Majority Dir Trst Supported OrgYes (1)MajorityDirTrstSupportedOrgInd

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Total Book Value Land Buildings$0TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (2 entries)

DescDescBook ValueBookValueAmt
BOND PROCEEDS HELD BY TRUSTEE$59,101,590
INTERCOMPANY/OTHER RECEIVABLES$55,997,314
FieldValueIRS element (for citing)
Total Book Value Other Assets$115,098,904TotalBookValueOtherAssetsAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART X, LINE 2:FormAndLineReferenceDesc
ExplanationTHE FILING ORGANIZATION IS A TAX-EXEMPT ORGANIZATION AS DEFINED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE FILING ORGANIZATION'S INCOME TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL AND STATE AUTHORITIES. THE FILING ORGANIZATION IS NOT AWARE OF ANY ACTIVITIES THAT WOULD JEOPARDIZE ITS TAX-EXEMPT STATUS. THE FILING ORGANIZATION IS NOT AWARE OF ANY ACTIVITIES THAT ARE SUBJECT TO TAX ON UNRELATED BUSINESS INCOME OR EXCISE OR OTHER TAXES. THE FILING ORGANIZATION ADOPTED THE INCOME TAX STANDARD FOR UNCERTAIN TAX POSITIONS. THIS STANDARD CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN AN ORGANIZATION'S FINANCIAL STATEMENTS IN ACCORDANCE WITH THE INCOME TAX STANDARD. THIS STANDARD PRESCRIBES RECOGNITION AND MEASUREMENT OF TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN ON A TAX RETURN THAT ARE NOT CERTAIN TO BE REALIZED. THIS STANDARD HAD NO IMPACT ON THE FILING ORGANIZATION'S FINANCIAL STATEMENTS FOR THE YEARS ENDED DECEMBER 31, 2021 OR DECEMBER 31, 2020.ExplanationTxt

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records Maintained0GrantRecordsMaintainedInd

Recipient Table RecipientTable

Recipient Business Name RecipientBusinessName

FieldValueIRS element (for citing)
Business Name Line1BLUE RIDGE HEALTHCARE HOSPITALSBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line12201 SOUTH STERLING STAddressLine1Txt
CityMORGANTONCityNm
State AbbreviationNCStateAbbreviationCd
ZIP28655ZIPCd
FieldValueIRS element (for citing)
Recipient EIN560529976RecipientEIN
IRC Section501(C)(3)IRCSectionDesc
Cash Grant$9,000CashGrantAmt
Non Cash Assistance$0NonCashAssistanceAmt
Purpose Of GrantGUILD GRANT/SPONSORSHIPSPurposeOfGrantTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Club Dues Or FeesYes (X)ClubDuesOrFeesInd
Written Policy Ref T And E ExpnssYes (1)WrittenPolicyRefTAndEExpnssInd
Substantiation RequiredYes (1)SubstantiationRequiredInd
Compensation CommitteeYes (X)CompensationCommitteeInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (1)SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgYes (1)CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsYes (1)CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (2 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
KATHY BAILEY
PRESIDENT & CEO$0$305,344$0$0$0$2,052$0$2,052$0$4,998$0$314,446$0$0
PATRICIA MOLL
CFO$0$203,974$0$20,000$0$7,568$0$9,211$0$18,057$0$258,810$0$0

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 1AALL BENEFITS PROVIDED TO OFFICERS FACILITATE BUSINESS RELATIONSHIPS. BRHC PAID THE CLUB DUES FOR KATHY BAILEY AND A RELATED ORGANIZATION INCLUDED THE AMOUNT OF DUES PAID IN HER TAXABLE INCOME.
PART I, LINE 3IN 2021, THE ORGANIZATION TERMINATED THE MANAGEMENT SERVICES CONTRACT WITH ATRIUM HEALTH (FORMERLY CAROLINAS HEALTHCARE SYSTEM) AND ENTERED INTO A MANAGEMENT SERVICES CONTRACT WITH UNC HEALTH. UNCHECKED ITEMS WERE CONDUCTED BY BOTH ATRIUM HEALTH AND BLUE RIDGE HEALTHCARE HOSPITALS AS PART OF THE AGREEMENTS IN PLACE AT THE TIME OF EMPLOYMENT. THE ORGANIZATION COMPENSATION COMMITTEE REVIEWS AND APPROVES THE COMPENSATION PACKAGE.
PART I, LINE 4BDURING THE YEAR, THE FOLLOWING INDIVIDUAL LISTED IN PART VII AND SCHEDULE J PARTICIPATED IN A SECTION 457(F) PLAN: PATRICIA MOLL $7,568
PART I, LINE 6BONUSES ARE PAID IF THE ORGANIZATION'S RESULTS MEET CERTAIN PERFORMANCE INDICATORS.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1PUBLIC FINANCE AUTHORITYBusinessNameLine1Txt
FieldValueIRS element (for citing)
Bond Issuer EIN562150313BondIssuerEIN
CUSIP74444KBK9CUSIPNum
Bond Issued2020-07-23BondIssuedDt
PurposeTO REFUND THE REFUNDED BONDSPurposeDesc
Defeased0DefeasedInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Pool Financing0PoolFinancingInd

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Retired$1,890,000RetiredAmt
Total Proceeds$119,374,723TotalProceedsAmt
Issuance Costs From Proceeds$1,249,232IssuanceCostsFromProceedsAmt
Capital Expenditures$55,001,603CapitalExpendituresAmt
Unspent$63,590,000UnspentAmt
Refunding Tax Exempt BondsYes (1)RefundingTaxExemptBondsInd
Refunding Taxable Bonds0RefundingTaxableBondsInd
Final Allocation Made0FinalAllocationMadeInd
Adequate Books And Rec MaintYes (1)AdequateBooksAndRecMaintInd

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Owning Bond Financed Property0OwningBondFinancedPropertyInd
Any Lease Arrangements0AnyLeaseArrangementsInd
Mgmt Contract Bond Fincd Prop0MgmtContractBondFincdPropInd
Any Research Agreements0AnyResearchAgreementsInd
Bond Iss Meet Prvt Sec Pymt Test0BondIssMeetPrvtSecPymtTestInd
Change In Use Bond Financed Prop0ChangeInUseBondFinancedPropInd
Procs Nonqualified Bond RemdtdYes (1)ProcsNonqualifiedBondRemdtdInd

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Form8038 T Filed0Form8038TFiledInd
Rebate Not Due YetYes (1)RebateNotDueYetInd
Exception To Rebate0ExceptionToRebateInd
No Rebate Due0NoRebateDueInd
Variable Rate Issue0VariableRateIssueInd
Hedge Identified In Bks And Rec0HedgeIdentifiedInBksAndRecInd
Gross Proceeds Invested In GIC0GrossProceedsInvestedInGICInd
Gross Proceeds Invested0GrossProceedsInvestedInd
Written Proc To Monitor ReqsYes (1)WrittenProcToMonitorReqsInd

Procedures Corrective Action ProceduresCorrectiveActionGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Procedures Corrective ActionYes (1)ProceduresCorrectiveActionInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART II, COLUMN A, LINE 3FormAndLineReferenceDesc
ExplanationPROCEEDS INCLUDE AN ORIGINAL ISSUE PREMIUM OF $13,300,835, LESS AN UNDERWRITER'S DISCOUNT OF $466,112.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (7 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 3IN 2021, THE ORGANIZATION TERMINATED THE MANAGEMENT SERVICES CONTRACT WITH ATRIUM HEALTH AND ENTERED INTO A MANAGEMENT SERVICES CONTRACT WITH UNC HEALTH. THE TERMS OF THE CONTRACT CALL FOR THE ORGANIZATION TO PAY UNC HEALTH AN ANNUAL MANAGEMENT FEE BASED UPON THE ORGANIZATION'S NET OPERATING REVENUES.
FORM 990, PART VI, SECTION B, LINE 11BTHE CHIEF FINANCIAL OFFICER, THE BOARD AND THE EXECUTIVE COMMITTEE WILL REVIEW THE PREPARED FORM 990 BEFORE IT IS FILED WITH THE IRS. A DRAFT OF FORM 990 WAS POSTED FOR ACCESS BY THE GOVERNING BODY BEFORE IT WAS FILED WITH THE IRS.
FORM 990, PART VI, SECTION B, LINE 12CCORPORATE COUNSEL, WHO REVIEWS ALL ANNUAL CONFLICT OF INTEREST DISCLOSURES, IS PRESENT AT EVERY BOARD MEETING TO ENSURE THAT ANY POTENTIAL CONFLICTS ARE APPROPRIATELY HANDLED BY MEMBERS ABSTAINING FROM VOTES AS APPROPRIATE.
FORM 990, PART VI, SECTION B, LINE 15SUCH A PROCESS WAS PERFORMED FOR DETERMINING THE COMPENSATION OF THE ORGANIZATION'S PRESIDENT/CEO AND CFO DURING 2021.
FORM 990, PART VI, SECTION C, LINE 19BY-LAWS ARE AVAILABLE UPON REQUEST THROUGH CORPORATE COUNSEL. ARTICLES OF INCORPORATION ARE FILED WITH NC STATE AND ARE AVAILABLE ON THEIR WEBSITE. FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST.
PART VIIDESCRIPTION OF HOURS -- FOR RELATED ORGANIZATIONS, OFFICERS AND KEY EMPLOYEES LISTED ON PART VII WORK AN AVERAGE OF 40 TO 50 HOURS PER WEEK. THEIR TIME IS SHARED BETWEEN THE FILING ORGANIZATION AND OTHER RELATED ENTITIES LISTED ON SCHEDULE R.
FORM 990, PART XII, LINE 2CNO CHANGES FOR APPROVING AUDITED FINANCIAL STATEMENTS OR SELECTION OF INDEPENDENT ACCOUNTANTS HAVE OCCURRED FROM THE PRIOR YEAR.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (7 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtDirect Controlling NADirectControllingNACdControlled OrganizationControlledOrganizationInd
BLUE RIDGE HEALTHCARE HOSPITALS INC
2201 SOUTH STERLING STREETMORGANTONNC28655560529976HEALTHCARENC501(C)(3)LINE 3N/A0
VALDESE NURSING HOME INC
95 LOCUST STREETCONNELLY SPRINGSNC28612581978560HEALTHCARENC501(C)(3)LINE 10N/A0
GRACE NURSING CENTER INC
109 FOOTHILLS DRIVEMORGANTONNC28655561838369HEALTHCARENC501(C)(3)LINE 10N/A0
GRACE LIFECARE INC
500 LENOIR ROADMORGANTONNC28655561722754HEALTHCARENC501(C)(3)LINE 10N/A0
GRACE PROPERTIES INC
500 LENOIR ROADMORGANTONNC28655561727514HEALTHCARENC501(C)(3)LINE 12A, IN/A0
BLUE RIDGE FOUNDATION INC
2201 SOUTH STERLING STREETMORGANTONNC28655582063920HEALTHCARENC501(C)(3)LINE 7N/A0
BLUE RIDGE HEALTHCARE MEDICAL GROUP INC
2201 SOUTH STERLING STREETMORGANTONNC28655020777195HEALTHCARENC501(C)(3)LINE 10N/A0

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1GRACE HEALTH VENTURES INCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line12201 SOUTH STERLING STREETAddressLine1Txt
CityMORGANTONCityNm
State AbbreviationNCStateAbbreviationCd
ZIP28655ZIPCd
FieldValueIRS element (for citing)
EIN561581317EIN
Primary ActivitiesRELATEDPrimaryActivitiesTxt
Legal Domicile StateNCLegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1BLUE RIDGE HEALTHCARE SYSTEMBusinessNameLine1Txt
FieldValueIRS element (for citing)
Entity TypeCEntityTypeTxt
Ownership1.00000OwnershipPct
Controlled OrganizationYes (1)ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsYes (1)ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (1)TransferToOtherOrgInd
Transfer From Other OrgYes (1)TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (3 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
BLUE RIDGE HEALTHCARE HOSPITALS INC
A$3,797,481FMV
BLUE RIDGE HEALTHCARE HOSPITALS INC
Q$3,592,124ACTUAL COST
GRACE LIFECARE INC
Q$136,716ACTUAL COST