2022-11-15T04:32:52-06:00 2021-12-31 440160260 FORVIS LLP 500 RIDGEFIELD COURT ASHEVILLE NC 28806 990 2021-01-01 561458024 PISGAH HEALTH FOUNDATION PISG 8284353772 153 W JORDAN ST BREVARD NC 28712 CATHLEEN BLANCHARD CHAIR 8284353772 2022-11-15 1 CATHLEEN BLANCHARD 999009999 AMY BIBBY P00445891 8282542254 2022-11-15 3 AAL1 IAL1 2021 2022-09-23 18:48:47Z CATHLEEN BLANCHARD 153 W JORDAN ST BREVARD NC 28712 6136671 0 X WWW.PISGAHHEALTHFOUNDATION.ORG X 1985 NC RECEIVE AND ADMINISTER CHARITABLE CONTRIBUTIONS. 9 9 7 200 0 0 5296554 5499366 0 0 554385 628599 0 8706 5850939 6136671 5134143 809411 0 0 416289 406265 0 0 178291 1338823 1485195 6889255 2700871 -1038316 3435800 13771281 16755144 2107538 1259016 11663743 15496128 PISGAH HEALTH FOUNDATION'S MISSION IS TO PURPOSEFULLY, CREATIVELY, AND COLLABORATIVELY ENHANCE THE HEALTH AND WELL-BEING OF OUR COMMUNITIES BY ADDRESSING LOCAL HEALTH AND WELLNESS INEQUITIES THROUGH STRATEGIC AND MEANINGFUL PARTNERSHIPS. 0 0 1809411 809411 OUR ORGANIZATION BEGAN AWARDING MODERATE LEVEL GRANTS TO PERTINENT NON-PROFIT ORGANIZATIONS DESIGNED TO IMPROVE THE SOCIAL DETERMINANTS OF HEALTH IN WESTERN NORTH CAROLINA. WE ALSO LAUNCHED A COMMUNITY- BASED HEALTH AND WELLNESS PROGRAM IN TRANSYLVANIA COUNTY. OUR ACCOMPLISHMENTS AND NOTEWORTHY NEWS DEVELOPMENTS CAN BE FOUND AT OUR WEBSITE: PISGAHHEALTHFOUNDATION.ORG 1809411 1 1 0 0 0 0 0 0 1 1 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 7 0 1 7 1 0 0 0 0 0 0 0 0 0 0 0 0 X 9 9 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X X THE ORGANIZATION 8284353780 153 W JORDAN STREET BREVARD NC 28712 CATHLEEN BLANCHARD BOARD CHAIR 2.00 X X 0 0 0 DAVID NEUMANN ESQ BOARD TREASURER 2.00 X X 0 0 0 JAMIE RAMSEY MD BOARD SECRETARY 2.00 X X 0 0 0 JEREMY PURCELL BOARD VICE-CHAIR 2.00 X X 0 0 0 JIM WRIGHT MD BOARD MEMBER 1.00 X 0 0 0 ART FISHER BOARD MEMBER 1.00 X 0 0 0 JIM TYSON MD BOARD MEMBER 1.00 X 0 0 0 WILLIAM MILLS BOARD MEMBER 1.00 X 0 0 0 JUAN MASCARO BOARD MEMBER 1.00 X 0 0 0 LEX GREEN CPA PRESIDENT 50.00 X 150000 0 33584 150000 0 33584 1 0 1 0 SHARECARE INC 255 E PACES FERRY ROAD NE ATLANTA GA 30305 ADMINISTRATION OF WELLNESS PROGRAM 1000000 ED BURDETTE CONSTRUCTION 123 E MAIN STREET UNIT 103 BREVARD NC 28712 RENOVATION 124025 2 5499366 5499366 136134 136134 8706 0 8706 8706 8706 492465 0 492465 492465 492465 6136671 0 0 637305 X 785411 785411 24000 24000 150000 120000 30000 171893 137514 34379 56127 44902 11225 28245 22596 5649 118010 94408 23602 72275 57820 14455 1051926 1000000 41541 10385 59619 47695 11924 18927 15142 3785 34947 27958 6989 38550 30840 7710 2642 2114 528 7200 5760 1440 MISCELLANEOUS 81099 64879 16220 2700871 1809411 713169 178291 202 45644 988711 329919 160765 131766 1285 1290 3565 24723 641744 85204 423696 556540 12193057 15665262 13771281 16755144 35637 236073 2071901 1022943 2107538 1259016 X 8931486 12478312 2732257 3017816 11663743 15496128 13771281 16755144 X 3435800 124681 271904 X X 0 1 X 1 0 X 376081 501760 132237 327882 499366 1837326 376081 501760 132237 327882 499366 1837326 580335 1256991 209057 218169 55876 199040 136134 818276 6117 6117 2661719 18351 0.47220 0.75490 X SCHEDULE A, PART VI, LIST OF UNUSUAL GRANTS: DESCRIPTION: UNEXPECTED PROCEEDS FROM HOSPITAL SALE GRANTED TO FOUNDATION DATE: 12/31/20 AMOUNT: 5000000. DESCRIPTION: UNEXPECTED PROCEEDS FROM HOSPITAL SALE GRANTED TO FOUNDATION DATE: 09/30/19 AMOUNT: 5000000. DESCRIPTION: UNEXPECTED ESTATE GRANT DATE: 09/30/18 AMOUNT: 85295. DESCRIPTION: UNEXPECTED ESTATE GRANT DATE: 09/30/17 AMOUNT: 552526. DESCRIPTION: UNEXPECTED PROCEEDS FROM HOSPITAL SALE GRANTED TO FOUNDATION DATE: 12/31/21 AMOUNT: 5000000. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 12193057 5000000 9712 1537507 15665262 13093673 621357 1487061 34912 12193057 13151491 3630 116327 177775 13093673 9759625 11397454 1553227 9506909 51906 13151491 9108938 432658 218029 9759625 0.81400 0.18600 0 0 221000 221000 206721 33818 172903 89998 51386 38612 124025 124025 556540 X 6261352 124681 124681 6136671 0 6136671 2428967 0 2428967 271904 271904 2700871 PART X, LINE 2: THE ORGANIZATION IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE; ACCORDINGLY, THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS DO NOT REFLECT A PROVISION OR LIABILITY FOR FEDERAL AND STATE INCOME TAXES. THE ORGANIZATION HAS DETERMINED THAT IT DOES NOT HAVE ANY MATERIAL UNRECOGNIZED TAX BENEFITS OR OBLIGATIONS AS OF DECEMBER 31, 2021. PART XII, LINE 4B - OTHER ADJUSTMENTS: OTHER CHANGES DUE TO GRANT REFUNDS PART V, LINE 4 THE FOUNDATION'S ENDOWMENT CONSISTS OF SEVEN INDIVIDUAL FUNDS ESTABLISHED FOR A VARIETY OF PURPOSES. ITS ENDOWMENT INCLUDES BOTH DONOR-RESTRICTED ENDOWMENT FUNDS AND FUNDS DESIGNATED BY THE BOARD OF TRUSTEES TO FUNCTION AS ENDOWMENTS. AS REQUIRED BY GAAP, NET ASSETS ASSOCIATED WITH ENDOWMENT FUNDS, INCLUDING FUNDS DESIGNATED BY THE BOARD OF TRUSTEES TO FUNCTION AS ENDOWMENTS, ARE CLASSIFIED AND REPORTED BASED ON THE EXISTENCE OR ABSENCE OF DONOR-IMPOSED RESTRICTIONS. 1 ABCCM ASHEVILLE BUNCOMBE COMMUNITY CHRISTIAN MINISTRY INC 20 20TH STREET ASHEVILLE NC 28806 560945001 10000 0 FOOD RESOURCE ANCHOR BAPTIST CHURCH & MINISTRIES 3232 HENDERSONVILLE HWY PISGAH FOREST NC 28768 561419926 10000 0 FOOD RESOURCE BEACON OF HOPE SERVICES PO BOX 877 MARSHALL NC 28753 562241353 10000 0 FOOD RESOURCE BLUE RIDGE ORGANIZING PROJECT INC PO BOX 8821 ASHEVILLE NC 28801 823030537 10000 0 FOOD RESOURCE BOYS & GIRLS CLUB TRANSYLVANIA COUNTY 11 GALLIMORE RD BREVARD NC 28712 562142829 15000 0 COVID NEEDS THE BREAD OF LIFE 238 S CALDWELL ST BREVARD NC 28712 562053857 10000 0 FOOD RESOURCE BREVARD MUSIC CENTER PO BOX 312 BREVARD NC 28712 560729350 19680 0 COVID NEEDS CALVARY BAPTIST CHURCH 133 OSBORNE RD BREVARD NC 28712 560930840 15000 0 FOOD RESOURCE CAMPLIFY HENDERSON COUNTY YOUNG LEADERS PO BOX 751 HENDERSONVILLE NC 28793 260770191 10000 0 COVID NEEDS CHILDREN FIRST COMMUNITIES IN SCHOOLS PO BOX 16695 ASHEVILLE NC 28816 591721943 10000 0 FOOD RESOURCE COMMUNITY HOUSING COALITION OF MADISON COUNTY PO BOX 1166 MARSHALL NC 28753 113660564 30000 0 HOME REPAIR ELIADA HOMES INC PO BOX 16708 ASHEVILLE NC 28816 560611587 20220 0 BLDG REPAIR FOOD CONNECTION INC PO BOX 8324 ASHEVILLE NC 28814 814190128 9984 0 FOOD RESOURCE FOOD FOR FAIRVIEW INCORPORATED PO BOX 2077 FAIRVIEW NC 28730 582539200 6000 0 FOOD RESOURCE FOSTERING HOPES INC PO BOX 2870 ASHEVILLE NC 28802 853394119 25000 0 MARKETING HAYWOOD COUNTY MEALS ON WHEELS 157 PARAGON PARKWAY CLYDE NC 28721 566001524 9360 0 FOOD RESOURCE HAYWOOD STREET CONGREGATION 297 HAYWOOD ST ASHEVILLE NC 28801 455301549 18100 0 FOOD RESOURCE HENDERSON COUNTY COUNCIL ON AGING (DBA COUNCIL ON AGING FOR HENDERSON COUNT 105 KING CREEK BLVD HENDERSONVILLE NC 28792 560936674 19000 0 FOOD RESOURCE HENDERSON COUNTY HABITAT FOR HUMANITY 1111 KEITH ST HENDERSONVILLE NC 28792 561642263 20000 0 HOME REPAIR HENDERSONVILLE RESCUE MISSION PO BOX 1512 HENDERSONVILLE NC 28793 581480173 10000 0 FOOD RESOURCE INTERFAITH ASSISTANCE MINISTRY PO BOX 2562 HENDERSONVILLE NC 28793 581556963 10000 0 FOOD RESOURCE LEICESTER BAPTIST CHURCH PO BOX 331 LEICESTER NC 28748 561647913 6000 0 FOOD RESOURCE LORD S HARVEST FOR THE HUNGRY INC 911 BAILEY STREET MARS HILL NC 28754 471662400 10000 0 FOOD RESOURCE LOVING FOOD RESOURCES INC PO BOX 25142 ASHEVILLE NC 28813 561823591 10000 0 FOOD RESOURCE MAGGIE VALLEY UMC PO BOX 112 MAGGIE VALLEY NC 28751 561809410 10000 0 FOOD RESOURCE MANNA FOOD BANK INC 627 SWANNANOA RIVER ASHEVILLE NC 28805 581514800 14167 0 FOOD RESOURCE MEALS ON WHEELS OF ASHEVILLE AND BUNCOMBE COUNTY INC 146 VICTORIA ROAD ASHEVILLE NC 28801 561115597 10000 0 FOOD RESOURCE MEALS ON WHEELS OF BREVARD INC PO BOX 485 BREVARD NC 28712 561224960 10000 0 FOOD RESOURCE MEMORYCARE 100 FAR HORIZONS LN ASHEVILLE NC 28803 562178294 40000 0 COVID NEEDS MILLS RIVER LIFE ENRICHMENT CENTER 137 OLD TURNPIKE ROAD MILLS RIVER NC 28759 834700354 10000 0 FOOD RESOURCE MONTMORENCI UMC INC 89 OLD CANDLER TOWN RD CANDLER NC 28715 853425927 8000 0 FOOD RESOURCE MOUNTAIN PROJECTS INC 2177 ASHEVILLE RD WAYNESVILLE NC 28786 560849092 40000 0 HOME REPAIR MOUNTAIN ROOTS INC PO BOX 248 CEDAR MTN NC 28718 270898040 6000 0 SCHOLARSHIPS MY FATHER'S STOREHOUSE DBA THE STOREHOUSE PO BOX 6146 HENDERSONVILLE NC 28739 010787966 10000 0 FOOD RESOURCE ONLY HOPE WNC INC 416 ALLEN RD E FLAT ROCK NC 28726 453751833 10000 0 FOOD RESOURCE PIGEON MULTICULTURAL DEVELOPMENT CENTER PO BOX 1494 WAYNESVILLE NC 28786 320131282 7000 0 FOOD RESOURCE RISE & SHINENEIGHBORS IN MINISTRY PO BOX 1036 BREVARD NC 28732 562032133 13450 0 SCHOLARSHIPS SHARING HOUSETRANSYLVANIA CHRISTIAN MINISTRY INC PO BOX 958 BREVARD NC 28712 561292875 10000 0 FOOD RESOURCE SMART START OF TRANSYLVANIA COUNTY PO BOX 1676 BREVARD NC 28712 311489864 10000 0 HOME REPAIR STEP WESTERN NORTH CAROLINA 319 FOREST LAKE RD BREVARD NC 28712 842308494 20000 0 HOME REPAIR THE HOPE CENTER OF ASHEVILLE 552 RIDGE RD HENDERSONVILLE NC 28792 824305125 16100 0 COVID NEEDS THE HOUSING ASSISTANCE CORPORATION 214 NORTH KING ST HENDERSONVILLE NC 28792 581831757 50000 0 HOME REPAIR THE SALUDA POPUP PANTRY PO BOX 428 SALUDA NC 28773 854044389 10000 0 FOOD RESOURCE THE SALVATION ARMY ASHEVILLEBUNCOMBE 209 HAYWOOD ST ASHEVILLE NC 28801 580660607 10000 0 FOOD RESOURCE TRACTOR FOOD AND FARMS PO BOX 1507 BURNSVILLE NC 28714 455100047 10000 0 FOOD RESOURCE TRANSYLVANIA COUNTY SCHOOLS-CHILD NUTRITION SERVICES 225 ROSENWALD LANE BREVARD NC 28712 561646825 10000 0 FOOD RESOURCE TRANSYLVANIA FARMERS MARKET PO BOX 204 BREVARD NC 28712 462390369 10000 0 FOOD RESOURCE TRUE RIDGE 110 EDNEY ST UNIT A HENDERSONVILLE NC 28792 821094679 10000 0 FOOD RESOURCE TRYON SEVENTH-DAY ADVENTIST CHURCH 2820 LYNN ROAD TRYON NC 28782 561395046 10000 0 FOOD RESOURCE WNC RESCUE MISSION PO BOX 1512 HENDERSONVILLE NC 28793 561249407 10000 0 FOOD RESOURCE BOUNTIFUL CITIES PO BOX 898 ASHEVILLE NC 28802 050587434 10000 0 FOOD RESOURCE EBLEN CHARITIES 50 WESTGATE PKWY ASHEVILLE NC 28806 561758077 10000 0 FOOD RESOURCE GOD'S WAY FELLOWSHIP PO BOX 330 BALSAM GROVE NC 28708 043774691 10000 0 FOOD RESOURCE THE COMMUNITY KITCHEN INC PO BOX 513 CANTON NC 28716 510605733 10000 0 FOOD RESOURCE 54 0 SCHOLARSHIPS 24000 PART I, LINE 2: APPLICANTS MUST APPLY FOR FUNDING FOR SPECIFIC NEEDS. IN THE EVENT THAT FUNDS ARE NOT SPENT APPROPRIATELY, THE FOUNDATION WILL FACTOR THIS INTO FUTURE AWARD DECISIONS. X X X X 0 0 0 0 0 0 0 0 0 LEX GREEN CPA PRESIDENT 150000 0 0 0 0 0 0 0 33584 0 183584 0 0 0 PART I, LINE 3 EXECUTIVE COMMITTEE REVIEW OF INDUSTRYWIDE AVERAGE CEO AND KEY EMPLOYEE SALARIES. PERFORMANCE REVIEW. FORMALLY VOTED AND APPROVED DECISIONS ON COMPENSATION. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM. A FINAL COPY OF THE FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C EACH BOARD MEETING BEGINS WITH A REMINDER ABOUT OUR CONFICT OF INTEREST POLICY AND CONFLICTS ARE DECLARED BEFORE AND DURING ALL MEETINGS. EACH BOARD MEMBER IS EXPECTED TO REVIEW THE CONFLICT OF INTEREST POLICY ANNUALLY. FORM 990, PART VI, SECTION B, LINE 15 EXECUTIVE COMMITTEE REVIEW OF INDUSTRY-WIDE AVERAGE CEO AND KEY EMPLOYEE SALARIES. PERFORMANCE REVIEW. FORMALLY VOTED AND APPROVED DECISIONS ON COMPENSATION. FORM 990, PART VI, SECTION C, LINE 19 WWW.GUIDESTAR.ORG FORM 990, PART IX, LINE 11G CONTRACT SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 41,541. FUNDRAISING EXPENSES 10,385. TOTAL EXPENSES 51,926. BLUE ZONE - COMMUNITY HEALTH PROJECT: PROGRAM SERVICE EXPENSES 1,000,000. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,000,000. FORM 990, PART XI, LINE 9: OTHER CHANGE DUE TO GRANT REFUNDS 271,904. FORM 990, PART XII, LINE 2C THIS HAS NOT CHANGED FROM THE PRIOR YEAR. PISGAH HEALTH HOLDINGS LLC 153 W JORDAN STREET BREVARD NC 28712 HOLDING COMPANY NC 0 0 PISGAH HEALTH FOUNDATION INC