CALDWELL MEMORIAL HOSPITAL INC: Form 990, tax year 2018
View the entire original 990 at ProPublica ↗
- Organization
- CALDWELL MEMORIAL HOSPITAL INC (EIN 56-0554202)
- Tax period
- 2018-07-01 to 2019-06-30
- Filed
- 2020-05-04
- IRS object ID
- 202011259349300011
- Schema version
- 2018v3.3
- 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 J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2020-05-04T11:41:53-05:00 | ReturnTs |
| Tax Period End | 2019-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BDO USA LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 421 Fayetteville Street Suite 300 | AddressLine1Txt |
| City | Raleigh | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 27601 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2018-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 560554202 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Caldwell Memorial Hospital | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % MICHAEL BUNCH | InCareOfNm |
| Business Name Control | CALD | BusinessNameControlTxt |
| Phone | 8287575100 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 321 Mulberry Street SW | AddressLine1Txt |
| City | Lenoir | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 28645 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MICHAEL BUNCH | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 8287575100 | PhoneNum |
| Signature | 2020-04-27 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | SANDRA L FEINSMITH | PreparerPersonNm |
| PTIN | P01064157 | PTIN |
| Phone | 9192781936 | PhoneNum |
| Preparation | 2020-05-04 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 38.132.154.29 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Federal Original Submission Id | 69472520201255000005 | FederalOriginalSubmissionId |
| Federal Original Submission Id | 2020-05-04 | FederalOriginalSubmissionIdDt |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | EF2991C9A21BE3EFA88C6B14E99CCE4945012704 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | F1629F6A3F74945AEE6FE2E323340EE9C36B3F52 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2018 | TaxYr |
| Build TS | 2020-11-06 18:47:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Laura J Easton | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 321 Mulberry Street SW | AddressLine1Txt |
| City | Lenoir | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 28645 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $154,045,029 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.caldwellmemorial.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1945 | FormationYr |
| Legal Domicile State | NC | LegalDomicileStateCd |
| Activity Or Mission | To provide safe, effective, compassionate care and to promote healthy lifestyles to our community. | ActivityOrMissionDesc |
| Voting Members Governing Body | 15 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 12 | VotingMembersIndependentCnt |
| Total Employee | 1015 | TotalEmployeeCnt |
| Total Volunteers | 148 | TotalVolunteersCnt |
| Total Gross UBI | $830,758 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | -$571,349 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $10,056,048 | PYContributionsGrantsAmt |
| CY Contributions Grants | $15,872,415 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $120,364,435 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $136,176,010 | CYProgramServiceRevenueAmt |
| PY Investment Income | $268,004 | PYInvestmentIncomeAmt |
| CY Investment Income | $1,107,109 | CYInvestmentIncomeAmt |
| PY Other Revenue | $914,869 | PYOtherRevenueAmt |
| CY Other Revenue | $889,495 | CYOtherRevenueAmt |
| PY Total Revenue | $131,603,356 | PYTotalRevenueAmt |
| CY Total Revenue | $154,045,029 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $62,054,927 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $68,105,030 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $59,701,984 | PYOtherExpensesAmt |
| CY Other Expenses | $74,247,037 | CYOtherExpensesAmt |
| PY Total Expenses | $121,756,911 | PYTotalExpensesAmt |
| CY Total Expenses | $142,352,067 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $9,846,445 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $11,692,962 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $86,425,728 | TotalAssetsBOYAmt |
| Total Assets EOY | $97,819,298 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $28,952,397 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $28,653,005 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $57,473,331 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $69,166,293 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | To provide safe, effective, compassionate care and to promote healthy lifestyles to our community. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $121,118,538 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $135,860,292 | RevenueAmt |
| Desc | SINCE OPENING IN 1951, CALDWELL MEMORIAL HOSPITAL HAS CONTINUED TO GROW AND CHANGE IN ORDER TO BETTER MEET THE NEEDS OF OUR COMMUNITY. THE MISSION OF CALDWELL MEMORIAL HOSPITAL IS TO PROVIDE SAFE, EFFECTIVE, COMPASSIONATE CARE AND TO PROMOTE HEALTHY LIFESTYLES TO OUR COMMUNITY. ANCHORED BY A 110-BED ACUTE CARE FACILITY, CALDWELL MEMORIAL HOSPITALS SERVICES INCLUDE A VAST ARRAY OF MEDICAL AND SURGICAL SERVICES. AMONG SERVICES OFFERED, BUT BY NO MEANS A COMPLETE LIST, ARE CAROTID ARTERY STENTING; CARDIOVASCULAR AND ENDOVASCULAR CARE; RADIATION ONCOLOGY; COMPUTER-ASSISTED ORTHOPEDIC SURGERY; NEUROLOGY AND MEMORY CARE; PAIN MANAGEMENT; A FULLY STAFFED 24-HOUR EMERGENCY DEPARTMENT; CALDWELL PHYSICIANS CLINICS CONVENIENTLY LOCATED COUNTY-WIDE; DIAGNOSTIC SERVICES; OUTPATIENT SURGERY; PLUS URGENT CARE; AND THE QUEST 4 LIFE WELLNESS CENTER. MULTIPLE EDUCATIONAL AND COUNSELING PROGRAMS ARE AVAILABLE FOR A WIDE ARRAY OF HEALTHCARE NEEDS INCLUDING CANCER, DIABETES, NUTRITION, JOINT CARE, PRE-NATAL CLASSES AND PARENTING SKILLS. CALDWELL PHYSICIANS IS A DIVISION OF CALDWELL MEMORIAL HOSPITAL. WITH PRACTICES IN COMMUNITIES COUNTYWIDE, CALDWELL PHYSICIANS PROVIDES THE PRIMARY AND SPECIALTY HEALTHCARE, DIAGNOSTICS AND TREATMENTS THAT OUR COMMUNITY NEEDS IN CONVENIENT LOCATIONS NEAR THEIR HOMES. CALDWELL PHYSICIANS INCLUDES: ANDERSON MEDICAL PARK, ANDERSON PLUS URGENT CARE, BLOWING ROCK MEDICAL, BLOWING ROCK PLUS URGENT CARE, LAUREL PARK WOMENS HEALTH - LENOIR, LAUREL PARK WOMENS HEALTH - GRANITE FALLS, MULBERRY PEDIATRICS, ROBBINS MEDICAL PARK, ROBBINS PULMONOLOGY, ROBBINS EAR, NOSE, THROAT AND ALLERGY, ROBBINS PLUS URGENT CARE, ROBBINS CARDIOLOGY, ROBBINS SURGICAL, SOUTHFORK MEDICAL PARK, RIVERCREST MEDICAL PARK, RIVERCREST PLUS URGENT CARE, THE FALLS PEDIATRICS, WESTPOINTE MEDICAL PRACTICE, CALDWELL UROLOGY ASSOCIATES, CALDWELL FOOT & ANKLE, AND THE FALLS PEDIATRICS PLUS URGENT CARE. | Desc |
| Total Program Service Expenses | $121,118,538 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (true) | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | Yes (true) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (true) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | false | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 63 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 1015 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (true) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (true) | Form990TFiledInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 15 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 12 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MICHAEL BUNCH | PersonNm |
| Phone | 8287575100 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 321 MULBERRY STREET SW | AddressLine1Txt |
| City | Lenoir | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 28645 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (28 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|---|
| Michael Chamberlain | ||||||||||
| Director | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||||
| Jerry Church | ||||||||||
| Director | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||||
| Richard Coffey | ||||||||||
| Director/Chairman | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | Yes (X) | |||
| Chris Ellington | ||||||||||
| Director | 2.0 | 58.0 | Yes (X) | $0 | $1,148,254 | $173,340 | ||||
| Joseph Gibbons | ||||||||||
| Director | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||||
| William Howard III | ||||||||||
| Director | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||||
| Doug Johnson | ||||||||||
| Director | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||||
| Bill Johnson | ||||||||||
| Director | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||||
| Jeffrey Keverline MD | ||||||||||
| Director/Vice Chairman | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | Yes (X) | |||
| Diana McClinton MD | ||||||||||
| Director | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||||
| Gary Park | ||||||||||
| Director | 2.0 | 58.0 | Yes (X) | $0 | $2,623,154 | $553,104 | ||||
| Richard Pearce MD | ||||||||||
| Director | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||||
| David Smith | ||||||||||
| Director | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||||
| Alan Stiles | ||||||||||
| Director | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||||
| Crystal Thomas | ||||||||||
| Director | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||||
| Boyd Wilson | ||||||||||
| Director/Secretary & Treasurer | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | Yes (X) | |||
| John Powell MD | ||||||||||
| Director | 2.0 | 0.0 | Yes (X) | $271,365 | $0 | $36,846 | ||||
| Laura Easton | ||||||||||
| Director/President & CEO | 60.0 | 0.0 | Yes (X) | $370,472 | $0 | $41,875 | Yes (X) | |||
| Rebecca Smith | ||||||||||
| COO & CNO | 60.0 | 0.0 | $267,931 | $0 | $20,946 | Yes (X) | ||||
| Michael Bunch | ||||||||||
| CFO | 60.0 | 0.0 | $74,275 | $0 | $3,601 | Yes (X) | ||||
| David Lowery MD | ||||||||||
| CMO | 60.0 | 0.0 | $378,942 | $0 | $38,877 | Yes (X) | ||||
| Donita Damron | ||||||||||
| VP Physician Services | 60.0 | 0.0 | $179,842 | $0 | $22,622 | Yes (X) | ||||
| Randal Bast | ||||||||||
| Medical Practice Physician | 60.0 | 0.0 | $657,243 | $0 | $28,946 | Yes (X) | ||||
| Philip Jenkins | ||||||||||
| Medical Practice Physician | 60.0 | 0.0 | $458,598 | $0 | $25,375 | Yes (X) | ||||
| Thomas Young | ||||||||||
| Medical Practice Physician | 60.0 | 0.0 | $426,410 | $0 | $31,729 | Yes (X) | ||||
| Robert Dacus | ||||||||||
| Medical Practice Physician | 60.0 | 0.0 | $418,434 | $0 | $33,625 | Yes (X) | ||||
| John Edmunds | ||||||||||
| Medical Practice Physician | 60.0 | 0.0 | $410,943 | $0 | $27,780 | Yes (X) | ||||
| Shawn Hartley | ||||||||||
| Former Officer | 0.0 | 0.0 | $101,302 | $0 | $0 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $4,015,757 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $3,771,408 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $1,038,666 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 88 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (true) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| DLP Cardiac Partners LLC | |||||
| 3700 Arco Cop Office Suite 450 | CHARLOTTE | NC | 27273 | Cath Lab | $707,637 |
| Staffency LLC | |||||
| 221 W College Avenue Floor 2 | APPLETON | WI | 54911 | HEALTHCARE STAFFING | $428,935 |
| Horizon CSA LLC | |||||
| 265 Pit Road | MOORESVILLE | NC | 28115 | Medical Equipment | $389,904 |
| Hayes Locums LLC | |||||
| 6700 N Andrews Avenue 600 | FORT LAUDERDALE | FL | 33309 | Healthcare Staffing | $289,993 |
| James R Vannoy Sons Construction | |||||
| 1608 US Hwy 221 North | JEFFERSON | NC | 28640 | Construction | $287,797 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 9 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $14,410,240 | RelatedOrganizationsAmt |
| All Other Contributions | $1,462,175 | AllOtherContributionsAmt |
| Total Contributions | $15,872,415 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt | ExclusionExclusionAmt |
|---|---|---|---|---|---|
| PATIENT SERVICES | 621500 | $133,551,598 | $133,551,598 | ||
| QUEST4LIFE WELLNESS CENTER REVENUE | 713990 | $830,758 | $830,758 | ||
| OTHER PROGRAM SERVICES REVENUE | 900099 | $2,018,181 | $1,625,861 | $392,320 | |
| JOINT VENTURE INCOME | 541900 | -$334,186 | -$334,186 | ||
| OTHER REVENUE | 900099 | $109,659 | $109,659 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $136,176,010 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $254,048 | TotalRevenueColumnAmt |
| Exclusion | $254,048 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $812,893 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $812,893 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $812,893 | TotalRevenueColumnAmt |
| Exclusion | $812,893 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $853,061 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $853,061 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $853,061 | TotalRevenueColumnAmt |
| Exclusion | $853,061 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $0 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $0 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gaming Gross Income | $0 | GamingGrossIncomeAmt |
| Gaming Direct Expenses | $0 | GamingDirectExpensesAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $0 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $0 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| GAIN/LOSS ON FA DISPOSAL | 900099 | $76,752 | $76,752 |
| OTHER REVENUE | 900099 | -$150 | -$150 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $76,602 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $154,045,029 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $135,029,534 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $830,758 | UnrelatedBusinessRevenueAmt |
| Exclusion | $2,312,322 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,824,921 | TotalAmt |
| Management And General | $1,824,921 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $54,756,523 | TotalAmt |
| Program Services | $45,447,913 | ProgramServicesAmt |
| Management And General | $9,308,610 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,017,586 | TotalAmt |
| Program Services | $847,730 | ProgramServicesAmt |
| Management And General | $169,856 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,058,067 | TotalAmt |
| Program Services | $6,439,869 | ProgramServicesAmt |
| Management And General | $618,198 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,447,933 | TotalAmt |
| Program Services | $3,145,938 | ProgramServicesAmt |
| Management And General | $301,995 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,614,654 | TotalAmt |
| Management And General | $1,614,654 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $23,442 | TotalAmt |
| Management And General | $23,442 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,942 | TotalAmt |
| Management And General | $15,942 | ManagementAndGeneralAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,324,969 | TotalAmt |
| Program Services | $5,419,542 | ProgramServicesAmt |
| Management And General | $2,905,427 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $262,877 | TotalAmt |
| Management And General | $262,877 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $897,436 | TotalAmt |
| Program Services | $897,436 | ProgramServicesAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $491,231 | TotalAmt |
| Program Services | $491,231 | ProgramServicesAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,608,110 | TotalAmt |
| Program Services | $4,608,110 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $587,783 | TotalAmt |
| Program Services | $352,668 | ProgramServicesAmt |
| Management And General | $235,115 | ManagementAndGeneralAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,369 | TotalAmt |
| Management And General | $5,369 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $90,421 | TotalAmt |
| Program Services | $90,421 | ProgramServicesAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,156,502 | TotalAmt |
| Program Services | $6,156,502 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $758,483 | TotalAmt |
| Program Services | $758,483 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| PATIENT CARE CUPPLIES & SERVIC | $19,072,682 | $19,072,682 | |
| BAD DEBT EXPENSE | $15,290,818 | $15,290,818 | |
| MINOR EQUIPMENT AND R&M | $1,165,368 | $1,130,407 | $34,961 |
| HOME OFFICE ALLOCATION | $12,819,000 | $8,973,301 | $3,845,699 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,061,950 | TotalAmt |
| Program Services | $1,995,487 | ProgramServicesAmt |
| Management And General | $66,463 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $142,352,067 | TotalAmt |
| Program Services | $121,118,538 | ProgramServicesAmt |
| Management And General | $21,233,529 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $758,086 | BOYAmt |
| EOY | $10,959,818 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,008,376 | BOYAmt |
| EOY | $15,572,996 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,554,741 | BOYAmt |
| EOY | $4,026,377 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,770,034 | BOYAmt |
| EOY | $1,846,651 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $147,044,064 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $91,031,700 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $51,283,011 | BOYAmt |
| EOY | $56,012,364 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,853,865 | BOYAmt |
| EOY | $1,578,594 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,888,065 | BOYAmt |
| EOY | $7,051,223 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,736,825 | BOYAmt |
| EOY | $771,275 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,572,725 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $86,425,728 | BOYAmt |
| EOY | $97,819,298 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,032,945 | BOYAmt |
| EOY | $24,325,859 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,883,011 | BOYAmt |
| EOY | $1,401,725 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,036,441 | BOYAmt |
| EOY | $2,925,421 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $28,952,397 | BOYAmt |
| EOY | $28,653,005 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $57,473,331 | BOYAmt |
| EOY | $69,166,293 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $57,473,331 | BOYAmt |
| EOY | $69,166,293 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $86,425,728 | BOYAmt |
| EOY | $97,819,298 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $11,692,962 | ReconcilationRevenueExpnssAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | 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 (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | 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) |
|---|---|---|
| Total Grassroots Lobbying | TotalGrassrootsLobbyingGrp | |
| Total Direct Lobbying | TotalDirectLobbyingGrp | |
| Total Lobbying Expend | TotalLobbyingExpendGrp | |
| Other Exempt Purpose Expend | OtherExemptPurposeExpendGrp | |
| Total Exempt Purpose Expend | TotalExemptPurposeExpendGrp | |
| Lobbying Nontaxable Amount | LobbyingNontaxableAmountGrp | |
| Grassroots Nontaxable | GrassrootsNontaxableGrp | |
| Tot Lbbyng Grassroot Mns Non Tx | TotLbbyngGrassrootMnsNonTxGrp | |
| Tot Lbby Expend Mns Lbbyng Non Tx | TotLbbyExpendMnsLbbyngNonTxGrp | |
| Volunteers | false | VolunteersInd |
| Paid Staff Or Management | false | PaidStaffOrManagementInd |
| Media Advertisements | false | MediaAdvertisementsInd |
| Mailings Members | false | MailingsMembersInd |
| Publications Or Broadcast | false | PublicationsOrBroadcastInd |
| Grants Other Organizations | false | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | false | DirectContactLegislatorsInd |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Other Activities | Yes (true) | OtherActivitiesInd |
| Other Activities | $15,942 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $15,942 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | false | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1, LOBBYING ACTIVITIES | FormAndLineReferenceDesc |
| Explanation | Annual dues were paid to the American Hospital Association and North Carolina Hospital Association. A percentage, determined by the organizations, was estimated to be expenditures used in lobbying activities by these organizations. | ExplanationTxt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp | |
| CY Minus3 Yr Endwmt Fund | CYMinus3YrEndwmtFundGrp | |
| CY Minus4 Yr Endwmt Fund | CYMinus4YrEndwmtFundGrp |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $0 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $2,754,303 | OtherCostOrOtherBasisAmt |
| Book Value | $2,754,303 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $73,882,050 | OtherCostOrOtherBasisAmt |
| Depreciation | $37,188,230 | DepreciationAmt |
| Book Value | $36,693,820 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Leasehold Improvements | LeaseholdImprovementsGrp |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $63,745,453 | OtherCostOrOtherBasisAmt |
| Depreciation | $52,444,560 | DepreciationAmt |
| Book Value | $11,300,893 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $6,662,258 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,398,910 | DepreciationAmt |
| Book Value | $5,263,348 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $56,012,364 | TotalBookValueLandBuildingsAmt |
| Financial Derivatives | FinancialDerivativesGrp | |
| Closely Held Equity Interests | CloselyHeldEquityInterestsGrp |
Other Securities OtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | OTHER ASSETS | Desc |
| Book Value | $7,051,223 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $7,051,223 | TotalBookValueSecuritiesAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| THIRD PARTY | $1,346,827 |
| DEFERRED FEE PLAN LIABILITY | $1,578,594 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $2,925,421 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2 | FormAndLineReferenceDesc |
| Explanation | THE HOSPITAL AND FOUNDATION ARE NONPROFIT CORPORATIONS AND HAVE BEEN RECOGNIZED AS TAX-EXEMPT, PURSUANT TO SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. NO PROVISION FOR INCOME TAXES HAS BEEN MADE IN THE ACCOMPANYING COMBINED FINANCIAL STATEMENTS. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 250. | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | false | FPGReferenceDiscountedCareInd |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | false | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (true) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (true) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $6,209,643 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $6,209,643 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04360 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $19,703,259 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $19,050,293 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $652,966 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00460 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $25,912,902 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $19,050,293 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $6,862,609 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04820 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $166,467 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $166,467 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00120 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $166,467 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $166,467 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00120 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $26,079,369 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $19,050,293 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $7,029,076 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04940 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $15,290,818 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $10,103,617 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $49,609,234 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $62,409,290 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$12,800,056 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp (4 entries)
| Primary ActivitiesPrimaryActivitiesTxt | Org Profit Or OwnershipOrgProfitOrOwnershipPct | Physicians Profit Or OwnershipPhysiciansProfitOrOwnershipPct |
|---|---|---|
| AMERICAN HOME PATIEN | ||
| HEALTHCARE | 0.25 | 0.75 |
| GUARDIAN HEALTHCARE | ||
| HEALTHCARE | 0.5 | 0.5 |
| LAUREL PARK MOB | ||
| MEDICAL OFFICE BUILDING | 0.149 | 0.851 |
| PRIME SURGICAL SUITE | ||
| AMBULATORY SURGERY CENTER | 0.57 | 0.43 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CALDWELL MEMORIAL HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 321 MULBERRY STREET SW | AddressLine1Txt |
| City | Lenoir | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 28645 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| State License | H0061 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Other | DISPROPORTIONATE SHARE HOSPITAL | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CALDWELL MEMORIAL HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 17 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | false | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (true) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | See Part V | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 17 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | See Part V | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 250. | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 0. | FPGFamilyIncmLmtDscntCarePct |
| Explained Basis | false | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | SEE PART V | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | SEE PART V | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | SEE PART V | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | 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 |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, SECTION B, LINE 5 | CALDWELL MEMORIAL HOSPITAL (CMH) DEPLOYED A SURVEY TO LOCAL EXPERT ADVISORS TO GAIN INPUT ON LOCAL HEALTH NEEDS AND THE NEEDS OF PRIORITY POPULATIONS. LOCAL EXPERT ADVISORS WERE LOCAL INDIVIDUALS SELECTED ACCORDING TO CRITERIA REQUIRED BY THE FEDERAL GUIDELINES AND REGULATIONS AND THE HOSPITALS DESIRE TO REPRESENT THE REGIONS GEOGRAPHICALLY AND ETHNICALLY DIVERSE POPULATION. CMH RECEIVED INPUT FROM 19 LOCAL EXPERT ADVISORS REPRESENTING THE BROAD INTEREST OF THE COMMUNITY SERVED. IN ADDITION TO SURVEYING THE LOCAL EXPERT ADVISORS, CMH SOLICITED WRITTEN COMMENTS FROM THE COMMUNITY ABOUT ITS 2017 CHNA. |
| part v, section b, line 6b | quorum health resources |
| PART V, SECTION B, LINE 7a | https://www.caldwellmemorial.org/about-us/-community-health-needs- assessment/ |
| Part V, SECTION B, LINE 10a | https://www.caldwellmemorial.org/about-us/-community-health-needs- assessment/ |
| PART V, SECTION B, LINE 11 | THE HOSPITAL HAS IDENTIFIED THE FOLLOWING AREAS AS REPRESENTING THE SIGNIFICANT HEALTH NEEDS FOR CALDWELL COUNTY: 1. MENTAL HEALTH AND SUBSTANCE ABUSE 2. CHRONIC DISEASE 3. OBESITY 4. CANCER 5. HEART DISEASE THE HOSPITAL HAS DEVELOPED IMPLEMENTATION STRATEGIES FOR THREE OF THE FIVE NEEDS (MENTAL HEALTH & SUBSTANCE ABUSE, CHRONIC DISEASE, AND CANCER; OBESITY AND HEART DISEASE ARE ADDRESSED WITHIN CHRONIC DISEASE) INCLUDING ACTIVITIES TO CONTINUE/PURSUE, COMMUNITY PARTNERS TO WORK ALONGSIDE, AND LEADING AND LAGGING INDICATORS TO TRACK. THE HOSPITAL ALSO IDENTIFIED FOURTEEN OTHER HEALTH NEEDS DURING ITS CHNA PROCESS, BUT DUE TO RESOURCE CONSTRAINTS, DID NOT DEVELOP STRATEGIES TO ADDRESS THOSE ADDITIONAL HEALTH NEEDS. THE HOSPITAL INTENDS TO ADdRESS THE SIGNIFICANT HEALTH NEEDS IDENTIFIED ABOVE IN THE FOLLOWING WAY: MENTAL HEALTH AND SUBSTANCE ABUSE THE HOSPITAL INTENDS TO ADD AN IN-HOUSE PSYCHIATRIC UNIT THAT WILL RECRUIT PSYCHIATRISTS, COUNSELORS, SOCIAL WORKERS, AND MENTAL HEALTH TECHNICIANS TO MANAGE THE SERVICES AND IMPROVE ACCESS TO MENTAL HEALTH CARE. THE UNIT WILL ALSO INCLUDE AN OUTPATIENT PSYCHIATRIC CLINIC. THE HOSPITAL EXPECTS TO COLLABORATE WITH THE UNC HEALTH SYSTEM TO LEARN FROM OTHER FACILITIES AND IMPLEMENT THE BEST PROGRAM POSSIBLE. THE HOSPITAL WILL ALSO PILOT A PROGRAM WITH ONE PRIMARY CARE PHYSICIAN TO OFFER TELEMEDICINE PSYCHIATRIC SERVICES IN PARTNERSHIP WITH UNC. IF THE PILOT IS SUCCESSFUL, CMH WILL CONSIDER EXPANDING THE PROGRAM TO OTHER PROVIDERS. THE HOSPITAL WILL ALSO CONTINUE DISCUSSING OPTIONS FOR THE USE OF TELEPSYCHIATRY IN THE EMERGENCY DEPARTMENT. THE HOSPITAL WILL DEVELOP A SYSTEM-WIDE PROTOCOL FOR THE USE OF NARCAN IN EMERGENCY DEPARTMENT. CHRONIC DISEASE (ALSO INCLUDES OBESITY AND HEART DISEASE) THE HOSPITAL PLANS TO TAKE THE FOLLOWING STEPS TO ADDRESS THIS NEED: - WORKING TO HAVE ALL PRACTICES CERTIFIED AS PATIENT-CENTERED MEDICAL HOMES - BRINGING IN INTENSIVIST CARE MANAGER - ADDING OUTPATIENT NUTRITION AND DIABETES SERVICES TO ADDITIONAL PRIMARY CARE PRACTICES - ENHANCING MAMMOGRAPHY SERVICES BY ADDING 3D MAMMOGRAPHY CANCER THE HOSPITAL PLANS TO TAKE THE FOLLOWING STEPS TO ADDRESS THIS NEED: - ENHANCING MAMMOGRAPHY SERVICES BY ADDING 3D MAMMOGRAPHY |
| PART V, LINE 16A, FAP WEBSITE | HTTP://CALDWELLMEMORIAL.ORG/FINANCIAL-ASSISTANCE-POLICY/ |
| PART V, LINE 16B, FAP APPLICATION WEBSITE | HTTP://CALDWELLMEMORIAL.ORG/FINANCIAL-ASSISTANCE-POLICY/ |
| PART V, LINE 16C, FAP PLAIN LANGUAGE SUMMARY WEBSITE | HTTP://CALDWELLMEMORIAL.ORG/FINANCIAL-ASSISTANCE-POLICY/ |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 9 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (9 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| COMMUNITY PHARMACY | ||||
| 321 MULBERRY STREET SW | LENOIR | NC | 28645 | RETAIL/EMPLOYEE PHARMACY |
| QUEST 4 LIFE WELLNESS CENTER | ||||
| 1031 MORGANTON BLVD | LENOIR | NC | 28645 | WELLNESS CENTER |
| CALDWELL PHYSICIANS NETWORK | ||||
| 321 MULBERRY STREET SW | LENOIR | NC | 28645 | PHYSICIAN PRACTICE |
| CALDWELL MEMORIAL SLEEP CENTER | ||||
| 270 PINE MOUNTAIN ROAD | HUDSON | NC | 28638 | SLEEP CENTER |
| THE CENTER FOR WOUND MANAGEMENT | ||||
| 401 MULBERRY STREET | LENOIR | NC | 28645 | WOUND CARE CENTER |
| GEORGE M HANCOCK SURGERY CENTER | ||||
| 1031 MORGANTON BLVD | LENOIR | NC | 28645 | OP SURGERY CENTER |
| CENTER FOR DIABETES HEALTH | ||||
| 1031 MORGANTON BLVD | LENOIR | NC | 28645 | DIABETES EDUCATION AND SUPPORT |
| PAIN MANAGEMENT CENTER | ||||
| 1031 MORGANTON BLVD | LENOIR | NC | 28645 | PAIN MANAGEMENT |
| LAUREL PARK BREAST CENTER | ||||
| COLLEGE AVENUE | LENOIR | NC | 28645 | BREAST HEALTH |
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3C | CALDWELL PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS FINANCIAL ASSISTANCE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. BECAUSE CALDWELL DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS FINANCIAL ASSISTANCE, THEY ARE NOT REPORTED AS NET PATIENT SERVICE REVENUE. THE CRITERIA FOR FINANCIAL ASSISTANCE, WHILE NOT ALL INCLUSIVE, CONSIDERS THE PATIENTS INCOME, THEIR FINANCIAL STATUS INCLUDING THE EXTENT OF FINANCIAL OBLIGATIONS FOR HEALTH CARE SERVICES, AND ANY OTHER PERTINENT FACTORS DEEMED APPROPRIATE BY CALDWELL IN ASSESSING THE PATIENTS ABILITY TO PAY FOR THEIR SERVICES. |
| PART I, LINE 7 | WORKSHEET FROM SCHEDULE H INSTRUCTIONS IS USED TO COMPUTE A COST-TO-CHARGE RATIO TO CALCULATE FINANCIAL ASSISTANCE AND UNREIMBURSED MEDICAID AT COST. |
| PART I, LN 7 COL(F) | UNCOLLECTIBLE ACCOUNTS - THE HOSPITAL HAS PROVIDED SERVICES TO PERSONS WHO HAVE NOT PAID FOR SUCH SERVICES EITHER BECAUSE THEY HAVE BEEN UNWILLING OR UNABLE TO PAY. EFFORTS ARE MADE BY THE HOSPITAL TO DETERMINE IF A PATIENT MEETS FINANCIAL ASSISTANCE POLICY GUIDELINES THAT ARE ESTABLISHED BY THE HOSPITAL. IF THESE GUIDELINES ARE MET AND CAN BE VERIFIED, THEN SUCH AMOUNTS ARE INCLUDED IN FINANCIAL ASSISTANCE. UNTIL SUCH TIME, SUCH AMOUNTS ARE COMBINED IN THE PROVISION FOR UNCOLLECTIBLE ACCOUNTS BECAUSE THEY HAVE NOT BEEN VERIFIED OR DOCUMENTED AS FINANCIAL ASSISTANCE DUE TO LACK OF SUPPORTING FINANCIAL INFORMATION. IN SOME CASES, PATIENTS WHO WOULD (OR COULD) QUALIFY FOR FINANCIAL ASSISTANCE ARE UNWILLING OR UNABLE TO PRODUCE THE NECESSARY INFORMATION TO SUBSTANTIATE THEIR QUALIFICATION. THUS, THE PROVISION FOR UNCOLLECTIBLE ACCOUNTS INCLUDE AMOUNTS THAT WOULD OTHErWISE QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE HOSPITAL'S GUIDELINES. THE ESTIMATED COST OF UNREIMBURSED SERVICES ATTRIBUTABLE TO THE PROVISION FOR UNCOLLECTIBLE ACCOUNTS - EFFECTIVELY "FREE" SERVICES PROVIDED TO PATIENTS - HAS BEEN DETERMINED BY APPLYING A COST TO CHARGE RATIO TO THE AMOUNT OF THE PROVISION FOR UNCOLLECTIBLE ACCOUNTS. |
| PART III, LINE 2 | THE COST FOR BAD DEBT EXPENSES WAS CALCULATED BY APPLYING THE COST-TO-CHARGE RATIO FOR THE YEAR TO THE GROSS BAD DEBT CHARGES FOR THE YEAR. |
| PART III, LINE 3 | THE ESTIMATE FOR BAD DEBT EXPENSES ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE FINANCIAL ASSISTANCE POLICY WAS CALCULATED BY APPLYING THE COST-TO-CHARGE RATIO FOR THE YEAR TO THE GROSS BAD DEBT CHARGES ATTRIBUTABLE TO UNINSURED PATIENTS DURING THE YEAR. |
| PART III, LINE 4 | Net patient service revenue is reported at the estimated net realizable amounts from patients, third-party payors, and others for services rendered, including estimated retroactive adjustments due to future audits, reviews, and investigations. Retroactive adjustments are accrued on an estimated basis in the period the related services are rendered, and such amounts are adjusted in future periods as adjustments become known or as years are no longer subject to such audits, reviews, and investigations. |
| PART III, Line 9b | THE HOSPITAL DOES NOT SUBJECT ANY PATIENTS TO A COLLECTION AGENCY WHO HAS QUALIFIED FOR FINANCIAL ASSISTANCE GUIDELINES. |
| PART VI, LINE 2 | FEDERAL REGULATIONS SURROUNDING CHNA REQUIRE LOCAL INPUT FROM REPRESENTATIVES OF PARTICULAR DEMOGRAPHIC SECTORS. FOR THIS REASON, THE HOSPITAL DEVELOPED A STANDARD PROCESS OF GATHERING COMMUNITY INPUT. IN ADDITION TO GATHERING DATA FROM THE ABOVE SOURCES: - WE DEPLOYED A CHNA "ROUND 1" SURVEY TO OUR LOCAL EXPERT ADVISORS TO GAIN INPUT ON LOCAL HEALTH NEEDS AND THE NEEDS OF PRIORITY POPULATIONS. LOCAL EXPERT ADVISORS WERE LOCAL INDIVIDUALS SELECTED ACCORDING TO CRITERIA REQUIRED BY THE FEDERAL GUIDELINES AND REGULATIONS AND THE HOSPITAL'S DESIRE TO REPRESENT THE REGION'S GEOGRAPHICALLY AND ETHNICALLY DIVERSE POPULATION. WE RECEIVED COMMUNITY INPUT FROM 19 LOCAL EXPERT ADVISORS. SURVEY RESPONSES STARTED JUNE 2, 2017, AND ENDED WITH THE LAST RESPONSE ON JUNE 12, 2017. - INFORMATION ANALYSIS AUGMENTED BY LOCAL OPINIONS SHOWED HOW CALDWELL COUNTY RELATES TO ITS PEERS IN TERMS OF PRIMARY AND CHRONIC NEEDS AND OTHER ISSUES OF UNINSURED PERSONS, LOW-INCOME PERSONS, AND MINORITY GROUPS. RESPONDENTS COMMENTED ON WHETHER THEY BELIEVE CERTAIN POPULATION GROUPS ("PRIORITY POPULATIONS") NEED HELP TO IMPROVE THEIR CONDITION, AND IF SO, WHO NEEDS TO DO WHAT TO IMPROVE THE CONDITIONS OF THESE GROUPS. WHEN THE ANALYSIS WAS COMPLETE, WE PUT THE INFORMATION AND SUMMARY CONCLUSIONS BEFORE OUR LOCAL EXPERT ADVISORS WHO WERE ASKED TO AGREE OR DISAGREE WITH THE SUMMARY CONCLUSIONS. THEY WERE FREE TO AUGMENT POTENTIAL CONCLUSIONS WITH ADDITIONAL COMMENTS OF NEED. CONSULTATION WITH LOCAL EXPERTS OCCURRED AGAIN VIA AN INTERNET-BASED SURVEY (EXPLAINED BELOW) BEGINNING JUNE 22, 2017, AND ENDING JUNE 30, 2017. HAVING TAKEN STEPS TO IDENTIFY POTENTIAL COMMUNITY NEEDS, THE LOCAL EXPERTS THEN PARTICIPATED IN A STRUCTURED COMMUNICATION TECHNIQUE CALLED A "WISDOM OF CROWDS" METHOD. THE PREMISE OF THIS APPROACH RELIES ON A PANEL OF EXPERTS WITH THE ASSUMPTION THAT THE COLLECTIVE WISDOM OF PARTICIPANTS IS SUPERIOR TO THE OPINION OF ANY ONE INDIVIDUAL, REGARDLESS OF THEIR PROFESSIONAL CREDENTIALS. IN THE CALDWELL MEMORIAL HOSPITAL PROCESS, EACH LOCAL EXPERT HAD THE OPPORTUNITY TO INTRODUCE NEEDS PREVIOUSLY UNIDENTIFIED AND TO CHALLENGE CONCLUSIONS DEVELOPED FROM THE DATA ANALYSIS. WHILE THERE WERE A FEW OPINIONS OF THE DATA CONCLUSIONS NOT BEING COMPLETELY ACCURATE, MOST OF THE COMMENTS AGREED WITH OUR FINDINGS. WE DEVELOPED A LIST OF ALL NEEDS IDENTIFIED BY ANY OF THE ANALYZED DATA. THE LOCAL EXPERTS THEN ALLOCATED 100 POINTS AMONG THE LIST OF HEALTH NEEDS, INCLUDING THE OPPORTUNITY TO LIST ADDITIONAL NEEDS THAT WERE NOT IDENTIFIED FROM THE DATA. WE DIVIDED THE RANKED NEEDS INTO TWO GROUPS: "SIGNIFICANT"OTHER IDENTIFIED NEEDS." THE SIGNIFICANT NEEDS WERE PRIORITIZED BASED ON TOTAL POINTS CAST BY THE LOCAL EXPERTS IN DESCENDING ORDER, FURTHER RANKED BY THE NUMBER OF LOCAL EXPERTS CASTING ANY POINTS FOR THE NEED. BY OUR DEFINITION, A SIGNIFICANT NEED HAD TO INCLUDE ALL RANK ORDERED NEEDS UNTIL AT LEAST FIFTY PERCENT (50%) OF ALL POINTS WERE INCLUDED AND TO THE EXTENT POSSIBLE, REPRESENTED POINTS ALLOCATED BY A MAJORITY OF VOTING LOCAL EXPERTS. THE DETERMINATION OF THE BREAK POINT -- "SIGNIFICANT" AS OPPOSED TO "OTHER" -- WAS A QUALITATIVE INTERPRETATION BY THE CALDWELL MEMORIAL HOSPITAL EXECUTIVE TEAM WHERE A REASONABLE BREAK POINT IN RANK ORDER OCCURRED. |
| PART VI, LINE 3 | CALDWELL MEMORIAL HOSPITAL (CMH) PROVIDES NEEDED HEALTHCARE SERVICES TO ANYONE REGARDLESS OF THAT PERSON'S ABILITY TO PAY. CMH'S FINANCIAL ASSISTANCE POLICY IS DESIGNED TO ASSIST PATIENTS WHO ARE FINANCIALLY UNABLE TO PAY FOR HEALTHCARE SERVICES. a link to the POLICY CAN BE FOUND ON THE CMH PUBLIC website. CMH DISPLAYS INFORMATION REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE IN ITS EMERGENCY ROOM, REGISTRATION AREAS IN THE HOSPITAL AND CLINICS, and FINANCIAL COUNSELOR OFFICES. A LINK IS ALSO PROVIDED ON THE HOSPITAL'S WEBSITE TO THE AVAILABILITY OF FINANCIAL ASSISTANCE AND ITS FINANCIAL ASSISTANCE POLICY, ALONG WITH AN ON-LINE APPLICATION. INPATIENT CASE MANAGERS ALSO PROVIDE INFORMATION TO THE PATIENTS REGARDING AVAILABLE PROGRAMS AND THE ORGANIZation's FINANCIAL POLICY. CONSULTATION WITH FINANCIAL COUNSELORS IS ALSO AVAILABLE TO ALL PATIENTS AS NEEDED. |
| PART VI, LINE 4 | THE PRIMARY SERVICE AREA FOR CALDWELL MEMORIAL HOSPITAL IS CALDWELL COUNTY WITH A LIMITED NUMBER OF PAtients FROM THE SURROUNDING COUNTIES OF BURKE, WATAUGA, AND CATAWBA. CALDWELL COUNTY IS IN THE NW SECTION OF NC IN THE FOOTHILLS OF THE BLUE RIDGE MOUNTAINS AND IS BOUNDED ON THE NW BY WATAUGA COUNTY, ON THE NE BY WILKES COUNTY, ON THE EAST BY ALEXANDER COUNTY, ON THE SOUTH BY CATAWBA AND BURKE COUNTIES, AND ON THE WEST BY BURKE AND AVERY COUNTIES. TODAY THERE ARE NINE INCORPORATED MUNICIPALITIES IN THE COUNTY: LENOIR, HUDSON, GRANITE FALLS, CEDAR ROCK, CAJAHS MOUNTAIN, GAMEWELL, SAWMILLS, AND PARTS OF BLOWING ROCK AND RHODHISS. POPULATION IS JUST OVER 81,000. MEDIAN INCOME IS $40,735. POPULATION MAKEUP IS 87.4% WHITE, 5.3% HISPANIC, 4.8% BLACK OR AFRICAN AMERICAN AND 2.4% OTHER. MEDIAN AGE IS 44.1 YEARS. 49.4%% ARE MALES AND 50.6% FEMALES. |
| PART VI, LINE 5 | CALDWELL MEMORIAL HOSPITAL PROVIDES FINANCIAL SUPPORT TO 2 COMMUNITY AGENCIES: THE HELPING HANDS CLINIC (PROVIDING CARE TO THE UNINSURED) AND THE SATIE AND JE BROYHILL CALDWELL SENIOR CENTER (FOCUS ON THE LIVES AND ADVOCACY OF SENIORS). OTHER COMMUNITY INVOLVEMENT INCLUDES BUT NOT LIMITED TO: ANNUAL PROSTATE SCREENING, HEALTH FAIRS, SUPPORT AND INVOLVEMENT IN THE CALDWELL COMMUNITY GARDEN WHICH HELPS FOSTER COMMUNITY GARDENING, REPRESENTATION BY ORGANIZATION REPRESENTATIVES ON LOCAL HEALTH CARE RELATED BOARDS (BOARD OF HEALTH, HOSPICE, AND CHILD PROTECTION TEAM.) CALDWELL MEMORIAL HEALTHWORKS WHICH IS OCCUPATIONAL, INDUSTRIAL AND WORKER'S COMP MEDICINE DESIGNED TO ASSIST EMPLOYERS TOWARD IMPROVING QUALITY OF HEALTHCARE. |
| PART VI, LINE 6 | CALDWELL MEMORIAL HOSPITAL IS PART OF THE UNC HEALTH CARE SYSTEM. UNC HEALTH CARE IS A NOT-FOR-PROFIT INTEGRATED HEALTH CARE SYSTEM OWNED BY THE STATE OF NORTH CAROLINA AND BASED IN CHAPEL HILL. ORIGINALLY ESTABLISHED NOV. 1, 1998, UNC HEALTH CARE CURRENTLY COMPRISES UNC HOSPITALS AND ITS PROVIDER NETWORK, THE CLINICAL PROGRAMS OF THE UNC SCHOOL OF MEDICINE, AND TEN AFFILIATE HOSPITALS AND HOSPITAL SYSTEMS ACROSS THE STATE. COLLECTIVELY, THIS GROUP OF HEALTH CARE PROVIDERS WORKS TOGETHER TO MAKE SURE THAT ALL OF THE COMMUNITIES SERVED RECEIVED THE HIGHEST QUALITY OF CARE. |
| Part VI, Line 7, List of States Receiving Community Benefit Report | nc |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantiation Required | Yes (true) | SubstantiationRequiredInd |
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | Yes (true) | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | Yes (true) | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (13 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Chris Ellington | ||||||||||||||
| Director | $0 | $684,185 | $0 | $231,196 | $0 | $232,873 | $0 | $152,107 | $0 | $21,233 | $0 | $1,321,594 | $0 | $180,594 |
| Gary Park | ||||||||||||||
| Director | $0 | $526,087 | $0 | $507,300 | $0 | $1,589,767 | $0 | $532,111 | $0 | $20,993 | $0 | $3,176,258 | $0 | $1,461,911 |
| John Powell MD | ||||||||||||||
| Director | $222,548 | $0 | $48,458 | $0 | $359 | $0 | $11,471 | $0 | $25,375 | $0 | $308,211 | $0 | $0 | $0 |
| Laura Easton | ||||||||||||||
| Director/President & CEO | $310,871 | $0 | $39,928 | $0 | $19,673 | $0 | $16,500 | $0 | $25,375 | $0 | $412,347 | $0 | $0 | $0 |
| Rebecca Smith | ||||||||||||||
| COO & CNO | $215,261 | $0 | $27,385 | $0 | $25,285 | $0 | $13,015 | $0 | $7,931 | $0 | $288,877 | $0 | $0 | $0 |
| David Lowery MD | ||||||||||||||
| CMO | $316,652 | $0 | $54,701 | $0 | $7,589 | $0 | $13,502 | $0 | $25,375 | $0 | $417,819 | $0 | $0 | $0 |
| Donita Damron | ||||||||||||||
| VP Physician Services | $159,111 | $0 | $20,595 | $0 | $136 | $0 | $5,967 | $0 | $16,655 | $0 | $202,464 | $0 | $0 | $0 |
| Randal Bast | ||||||||||||||
| Medical Practice Physician | $653,680 | $0 | $3,069 | $0 | $494 | $0 | $3,571 | $0 | $25,375 | $0 | $686,189 | $0 | $0 | $0 |
| Philip Jenkins | ||||||||||||||
| Medical Practice Physician | $458,287 | $0 | $0 | $0 | $311 | $0 | $0 | $0 | $25,375 | $0 | $483,973 | $0 | $0 | $0 |
| Thomas Young | ||||||||||||||
| Medical Practice Physician | $416,071 | $0 | $10,146 | $0 | $193 | $0 | $6,354 | $0 | $25,375 | $0 | $458,139 | $0 | $0 | $0 |
| Robert Dacus | ||||||||||||||
| Medical Practice Physician | $396,829 | $0 | $21,111 | $0 | $494 | $0 | $8,250 | $0 | $25,375 | $0 | $452,059 | $0 | $0 | $0 |
| John Edmunds | ||||||||||||||
| Medical Practice Physician | $398,586 | $0 | $10,895 | $0 | $1,462 | $0 | $11,125 | $0 | $16,655 | $0 | $438,723 | $0 | $0 | $0 |
| Shawn Hartley | ||||||||||||||
| Former Officer | $99,155 | $0 | $0 | $0 | $2,147 | $0 | $0 | $0 | $0 | $0 | $101,302 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 4B | DURING THE CALENDAR YEAR 2018, THE FOLLOWING INDIVIDUALS RECEIVED DISTRIBUTIONS FROM A NON-QUALIFIED SUPPLEMENTAL RETIREMENT PLAN (457(F)): CHRIS ELLINGTON (DIRECTOR) $180,594 GARY PARK RECEIVED DISTRIBUTION OF $1,461,911. LAURA EASTON (CEO) HAS A SECURED BENEFIT PLAN WHICH IS INCLUDED IN THE STUDY COMPLETED BY THE INDEPENDENT COMPENSATION CONSULTANT; THE LOAN UNDER THIS ARRANGEMENT IS RECORDED ON THE FINANCIAL STATEMENTS AND FULLY SECURED BY LIFE INSURANCE ON THE LIFE OF THE CEO. |
| PART I, LINE 6 | Senior management has an incentive program which is partially earned based on profit margin and days cash on hand. The earned incentive is reviewed by the HR Committee of the Board and approved annually. Employed Physicians are paid on a productivity basis based on RVU's generated in their practice operations and these are tied to MGMA benchmarks. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 1: | THE EXECUTIVE/FINANCE COMMITTEE SHALL HAVE THE POWER TO TRANSACT ALL REGULAR BUSINESS OF THE HOSPITAL DURING THE PERIOD BETWEEN THE MEETINGS OF THE BOARD OF DIRECTORS, SUBJECT TO ANY PRIOR LIMITATION IMPOSED BY THE BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION A, LINE 6: | THE UNIVERSITY OF NORTH CAROLINA HEALTH CARE SYSTEM IS A MEMBER. |
| FORM 990, PART VI, SECTION A, LINE 7A: | THE UNIVERSITY OF NORTH CAROLINA HEALTH CARE SYSTEM IS A MEMBER AND THEY HAVE THE POWER TO APPOINT BOARD MEMBERS AND APPROVE GOVERNANCE DECISIONS. |
| FORM 990, PART VI, SECTION A, LINE 7B: | THE UNIVERSITY OF NORTH CAROLINA HEALTH CARE SYSTEM AS A MEMBER HAS APPROVAL RIGHTS TO ALL GOVERNANCE DECISIONS. |
| FORM 990, PART VI, SECTION B, LINE 11B: | THE FORM 990 WAS PREPARED BY AN INDEPENDENT ACCOUNTANT WITH ASSISTANCE AND OVERSIGHT BY MANAGEMENT. THE FULL BOARD RECEIVED A COPY OF THE FORM 990 FOR THEIR REVIEW AND FOR ANY QUESTIONS. THE FULL BOARD VOTED FOR A FINAL APPROVAL OF THE FORM 990. |
| FORM 990, PART VI, SECTION B, LINE 12C: | THE AUDIT AND COMPLIANCE COMMITTEE OF THE BOARD ANNUALLY REVIEWS THE CONFLICT OF INTEREST STATEMENTS. MINUTES OF BOARD MEETINGS REFLECT ANY DECLARED CONFLICT OF INTEREST. |
| FORM 990, PART VI, SECTION B, LINE 15: | THE ORGANIZATION COMPLETES THE REBUTTABLE PRESUMPTION OF REASONABLENESS AS DESCRIBED IN TREASURY REGULATION 4958(6)(C) FOR EACH OFFICER AND KEY EMPLOYEE. THIS PROCESS IS PERFORMED BY AN OUTSIDE INDEPENDENT COMPENSATION SPECIALIST. THE CONSULTANT'S FINDINGS ARE PRESENTED TO THE HR COMMITTEE OF THE BOARD AND ARE ULTIMATELY APPROVED BY THE FULL BOARD. |
| FORM 990, PART VI, SECTION C, LINE 18: | PHOTOCOPIES OF THE FORM 990 ARE AVAILABLE UPON REQUEST AT THE ORGANIZATIONS ADMINISTRATIVE OFFICE. IN ADDITION, RECENT FILINGS OF THE FORM 990 ARE AVAILABLE ON GUIDESTAR.ORG. |
| FORM 990, PART VI, SECTION C, LINE 19: | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, FINANCIAL STATEMENTS, AND CONFLICT OF INTEREST POLICY AVAILABLE UPON REQUEST. PLEASE USE THE ORGANIZATIONS "CONTACT US" LINK ON ITS WEBSITE FOR REQUESTS. |
| FORM 990, PART VII, LINE 1B AVERAGE HOURS PER WEEK | BOARD MEMBERS AND OFFICERS CONTRIBUTE THEIR TIME AND SERVICES UPON REQUEST AND ON AN AS-NEEDED BASIS, WHICH, THROUGHOUT THE YEAR, MAY DIFFER FROM THE AVERAGE NUMBER OF HOURS PER WEEK REPORTED ON PART VII, LINE 1B. |
| FORM 990, PART XII, LINE 2C: | NO CHANGE FROM PRIOR YEAR. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (12 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| UNC ROCKINGHAM HEALTH CARE INC | ||||||||||
| 117 E KINGS HWY | EDEN | NC | 27288 | 823745228 | HEALTHCARE | NC | 501(C)(3) | LINE 3 | UNC HEALTH C | false |
| UNC HEALTH CARE SYSTEM | ||||||||||
| 101 MANNING DRIVE | Chapel Hill | NC | 27514 | 562206970 | HEALTHCARE | NC | SECTION 115 | UNC HEALTH C | false | |
| UNC HOSPITALS | ||||||||||
| 211 FRIDAY CENTER DR SUITE 2029 | CHAPEL HILL | NC | 27517 | 561118388 | HEALTHCARE | NC | SECTION 115 | UNC HEALTH C | false | |
| THE REX HEALTHCARE FOUNDATION INC | ||||||||||
| 4420 LAKE BOONE TRAIL | RALEIGH | NC | 27607 | 566052117 | support rex h | NC | 501(C)(3) | LINE 12B ii | UNC HEALTH C | false |
| CALDWELL MEMORIAL HOSPITAL FOUNDATION | ||||||||||
| PO BOX 1890 | LENOIR | NC | 28645 | 581935514 | SUPPORT OF CA | NC | 501(C)(3) | LINE 7 | CALDWELL MEM | Yes (true) |
| CHATHAM HOSPITAL INC | ||||||||||
| PO BOX 649 | SILER CITY | NC | 27344 | 560611546 | HEALTHCARE | NC | 501(C)(3) | LINE 3 | UNC HEALTH C | false |
| HIGH POINT REGIONAL HEALTH | ||||||||||
| 601 N ELM STREET | HIGH POINT | NC | 27261 | 560532309 | HEALTHCARE | NC | 501(C)(3) | LINE 3 | UNC HEALTH C | false |
| PIEDMONT TRIAD HEALTH SERVICES | ||||||||||
| 101 MANNING DR MED WING E 2ND FLO | CHAPEL HILL | NC | 27514 | 561497163 | HEALTHCARE | NC | 501(C)(3) | LINE 12B II | UNC HEALTH C | false |
| HIGH POINT REGIONAL HEALTH SYSTEM FOUNDA | ||||||||||
| 601 N ELM STREET | HIGH POINT | NC | 27261 | 272854711 | support high | NC | 501(C)(3) | LINE 12A, I | UNC HEALTH C | false |
| REX HEALTHCARE INC | ||||||||||
| 4420 LAKE BOONE TRAIL | RALEIGH | NC | 27607 | 561509129 | HEALTHCARE | NC | 501(C)(3) | LINE 12A, I | UNC HEALTH C | false |
| REX HOSPITAL INC | ||||||||||
| 4420 LAKE BOONE TRAIL | RALEIGH | NC | 27607 | 561509260 | HEALTHCARE | NC | 501(C)(3) | LINE 3 | UNC HEALTH C | false |
| UNC PHYSICIANS NETWORK | ||||||||||
| 1600 PERIMETER PARK DR STE 225 | MORRISVILLE | NC | 27560 | 271081647 | HEALTHCARE | NC | 501(C)(3) | LINE 10 | UNC HEALTH C | false |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | UNC PHYSICIANS NETWORK GROUP PRACTICES | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1600 PERIMETER PARK DRIVE Ste 225 | AddressLine1Txt |
| City | MORRISVILLE | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 27560 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 461416986 | EIN |
| Primary Activities | HEALTHCARE | PrimaryActivitiesTxt |
| Legal Domicile State | NC | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NA | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Entity Type | C CORP | EntityTypeTxt |
| Share Of Total Income | $0 | ShareOfTotalIncomeAmt |
| Share Of EOY Assets | $0 | ShareOfEOYAssetsAmt |
| Ownership | 0.00000 | OwnershipPct |
| Controlled Organization | false | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (true) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | false | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Caldwell Memorial Hospital Foundation | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | C | TransactionTypeTxt |
| Involved | $1,319,468 | InvolvedAmt |
| Method Of Amount Determination | CASH | MethodOfAmountDeterminationTxt |