2021-11-09T13:34:19-06:00 2020-12-31 410746749 CLIFTONLARSONALLEN LLP 227 WEST TRADE STREET SUITE 800 CHARLOTTE NC 28202 990 2020-01-01 562150313 BLUE RIDGE HEALTHCARE SYSTEM INC BLUE 8285805000 2201 SOUTH STERLING STREET MORGANTON NC 28655 PATRICIA A MOLL CHIEF FINANCIAL OFFICER 8285805000 2021-11-03 1 PATRICIA MOLL 999009999 JOHN NORMAN P01506766 7049985200 2021-11-03 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z BLUE RIDGE HEALTHCARE KATHY BAILEY 2201 SOUTH STERLING STREET MORGANTON NC 28655 7611166 0 X WWW.BLUERIDGEHEALTH.ORG X 1999 NC TO ENHANCE THE DELIVERY OF HEALTH CARE SERVICES WITHIN THE SERVICE AREA. 13 12 0 0 0 0 0 0 6845725 7611166 0 0 66 0 6845791 7611166 20890 13200 0 0 0 0 0 0 0 7386226 8177946 7407116 8191146 -561325 -579980 69568806 117161124 73113608 121285906 -3544802 -4124782 BLUE 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. 0 0 3352353 13200 7611166 BLUE RIDGE HEALTHCARE SYSTEM'S EXEMPT PURPOSE IS TO OPERATE AN INTEGRATED HEALTH CARE DELIVERY SYSTEM. DURING THE COURSE OF 2020, BLUE RIDGE HEALTHCARE SYSTEM OVERSAW 5,588 ADMISSIONS, 151,917 ED/OUTPATIENTS VISITS, AND 8,379 SURGERIES, RESULTING IN 27,507 DAYS OF CARE IN THE GENERAL HOSPITAL. 3352353 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 100 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 13 12 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X PATRICIA MOLL 8285805003 2201 SOUTH STERLING STREET MORGANTON NC 28655 X CLAY RICHARDSON MD MEMBER AT LARGE 1.00 50.00 X X 0 200016 51708 J MICHAEL BRIDGES CHAIRMAN 1.00 X X 0 0 0 M H MCCRARY VICE-CHAIRMAN 1.00 X X 0 0 0 SHERROD SALSBURY SECRETARY 1.00 X X 0 0 0 JEFF CARSWELL TREASURER 1.00 X X 0 0 0 JOHN BRANSTROM BOARD MEMBER 1.00 X 0 0 0 ALAN GRIFFIN BOARD MEMBER 1.00 X 0 0 0 ALLEN VANNOPPEN BOARD MEMBER 1.00 X 0 0 0 BRIAN GWYN BOARD MEMBER 1.00 X 0 0 0 FRIEDA CLARK BOARD MEMBER 1.00 X 0 0 0 SUSAN HAIRE BOARD MEMBER 1.00 X 0 0 0 FELICIA SIMMONS BOARD MEMBER 1.00 X 0 0 0 JENNIFER BRADY MD BOARD MEMBER 1.00 X 0 0 0 KATHY BAILEY PRESIDENT & CEO 1.00 50.00 X 0 0 0 ROBERT G FRITTS SENIOR VP OF FINANCE/CFO 1.00 50.00 X 0 0 0 PATRICIA MOLL INTERIM CFO 1.00 50.00 X 0 35762 2047 0 235778 53755 0 0 1 0 ATRIUM HEALTH 1000 BLYTHE BOULEVARD CHARLOTTE NC 28203 MANAGEMENT SERVICES 7834481 CHRISTOPHER KEVIN PRITCHARD PO BOX 3041 MORGANTON NC 28680 MINOR CONSTRUCTION & MAINTENANCE SERVICE 351509 JPS SERVICES 1985 TATE BLVD SE HICKORY NC 28602 CLEANING SERVICES 315498 CARSWELL'S LANDSCAPING AND LAWNCARE PO BOX 1873 MORGANTON NC 28680 LANDSCAPING/LAWN MAINTENANCE SERVICES 288955 COPE SERVICES LLC PO BOX 55 MORGANTON NC 28680 MINOR CONSTRUCTION & MAINTENANCE SERVICE 261116 17 INTER-FACILITY REVENUE 541610 7548848 7548848 62318 62318 7611166 7611166 7611166 0 0 13200 13200 4031054 4031054 807739 807739 2926171 2926171 352020 352020 SUPPLIES 31226 31226 INTERCOMPANY 26827 26827 MISC EXPENSES 2909 2909 8191146 3352353 4838793 0 1139794 182371 18914 14167 68410098 116964586 69568806 117161124 7096155 2958521 66017453 118327385 73113608 121285906 X -3544802 -4124782 -3544802 -4124782 69568806 117161124 -579980 0 X X 0 1 X 1 0 X X X 1 BLUE RIDGE HEALTHCARE HOSPITAL 560529976 3 1 24459 0 1 24459 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 BOND PROCEEDS HELD BY TRUSTEE 58948329 INTERCOMPANY/OTHER RECEIVABLES 58016257 116964586 X PART X, LINE 2: THE 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, 2020 OR DECEMBER 31, 2019. 0 BLUE RIDGE HEALTHCARE HOSPITALS 2201 SOUTH STERLING ST MORGANTON NC 28655 560529976 501(C)(3) 13200 GUILD GRANT/SPONSORSHIPS 1 X 1 1 X X 0 0 0 0 0 1 1 0 0 CLAY RICHARDSON MD MEMBER AT LARGE 0 181001 0 19015 0 0 0 8415 0 43293 0 251724 0 0 PART I, LINE 1A ALL 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 3 UNCHECKED ITEMS ARE CONDUCTED BY ATRIUM HEALTH (FORMERLY CAROLINAS HEALTHCARE SYSTEM) AS PART OF THE MANAGEMENT AGREEMENT. THE ORGANIZATION COMPENSATION COMMITTEE REVIEWS AND APPROVES. PART I, LINE 6 BONUSES ARE PAID IF THE ORGANIZATION'S RESULTS MEET CERTAIN PERFORMANCE INDICATORS. PART II COMPENSATION FOR KATHY BAILEY AND ROBERT FRITTS IS PAID BY ATRIUM HEALTH THROUGH A MANAGEMENT SERVICE CONTRACT. A PUBLIC FINANCE AUTHORITY 562150313 74444KBK9 2020-07-23 TO REFUND THE REFUNDED BONDS 0 0 0 A 119374723 1249232 55001603 63590000 1 0 0 1 A 0 0 0 0 0 0 1 A 0 1 0 0 0 0 0 0 1 A 1 PART II, COLUMN A, LINE 3 PROCEEDS INCLUDE AN ORIGINAL ISSUE PREMIUM OF $13,300,835, LESS AN UNDERWRITER'S DISCOUNT OF $466,112. FORM 990, PART VI, SECTION A, LINE 3 IN 1999, THE ORGANIZATION ENTERED INTO A MANAGEMENT SERVICES CONTRACT WITH ATRIUM HEALTH. THE TERMS OF THE CONTRACT CALL FOR THE ORGANIZATION TO PAY ATRIUM HEALTH AN ANNUAL MANAGEMENT FEE BASED UPON THE ORGANIZATION'S NET OPERATING REVENUES. IN ADDITION, ATRIUM HEALTH IS REQUIRED TO FURNISH THE ORGANIZATION WITH A CHIEF EXECUTIVE OFFICER AND CHIEF FINANCIAL OFFICER. THE ORGANIZATION REIMBURSES ATRIUM HEALTH FOR THE SALARY AND BENEFITS COST OF THESE INDIVIDUALS. FORM 990, PART VI, SECTION B, LINE 11B THE 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 12C CORPORATE 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 15 SUCH A PROCESS WAS PERFORMED FOR DETERMINING THE COMPENSATION OF THE ORGANIZATION'S PRESIDENT/CEO AND CFO DURING 2020. FORM 990, PART VI, SECTION C, LINE 19 BY-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 VII DESCRIPTION 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 2C NO CHANGES FOR APPROVING AUDITED FINANCIAL STATEMENTS OR SELECTION OF INDEPENDENT ACCOUNTANTS HAVE OCCURRED FROM THE PRIOR YEAR. BLUE RIDGE HEALTHCARE HOSPITALS INC 2201 SOUTH STERLING STREET MORGANTON NC 28655 560529976 HEALTHCARE NC 501(C)(3) LINE 3 N/A 0 VALDESE NURSING HOME INC 95 LOCUST STREET CONNELLY SPRINGS NC 28612 581978560 HEALTHCARE NC 501(C)(3) LINE 10 N/A 0 GRACE NURSING CENTER INC 109 FOOTHILLS DRIVE MORGANTON NC 28655 561838369 HEALTHCARE NC 501(C)(3) LINE 10 N/A 0 GRACE LIFECARE INC 500 LENOIR ROAD MORGANTON NC 28655 561722754 HEALTHCARE NC 501(C)(3) LINE 10 N/A 0 GRACE PROPERTIES INC 500 LENOIR ROAD MORGANTON NC 28655 561727514 HEALTHCARE NC 501(C)(3) LINE 12A, I N/A 0 BLUE RIDGE FOUNDATION INC 2201 SOUTH STERLING STREET MORGANTON NC 28655 582063920 HEALTHCARE NC 501(C)(3) LINE 7 N/A 0 BLUE RIDGE HEALTHCARE MEDICAL GROUP INC 2201 SOUTH STERLING STREET MORGANTON NC 28655 020777195 HEALTHCARE NC 501(C)(3) LINE 10 N/A 0 GRACE HEALTH VENTURES INC 2201 SOUTH STERLING STREET MORGANTON NC 28655 561581317 RELATED NC BLUE RIDGE HEALTHCARE SYSTEM C 1.00000 1 1 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 1 1 BLUE RIDGE HEALTHCARE HOSPITALS INC A 2951899 FMV BLUE RIDGE HEALTHCARE HOSPITALS INC Q 3959324 ACTUAL COST BLUE RIDGE HEALTHCARE MEDICAL GROUP INC Q 120863 ACTUAL COST GRACE LIFECARE INC Q 167794 ACTUAL COST GRACE NURSING CENTER INC Q 11612 ACTUAL COST VALDESE NURSING HOME INC Q 11064 ACTUAL COST