2020-08-14T14:20:28-05:00 2019-09-30 560747981 DIXON HUGHES GOODMAN LLP 500 RIDGEFIELD COURT ASHEVILLE NC 28806 990 2018-10-01 561458024 PISGAH HEALTH FOUNDATION PISG 8284353772 153 W JORDAN ST BREVARD NC 28712 LEX GREEN CPA PRESIDENT 8284353772 2020-08-14 1 AMY BIBBY P00445891 8282542254 2020-08-14 99.47.28.203 2020-08-14 14:20:00 ED P 48FB394F9AA065459641371F168D9F2AFFFBB473 48FB394F9AA065459641371F168D9F2AFFFBB473 2018 2020-11-06 18:47:13Z X LEX GREEN CPA 153 W JORDAN ST BREVARD NC 28712 5915720 0 X WWW.PISGAHHEALTHFOUNDATION.ORG X 1985 NC RECEIVE AND ADMINISTER CHARITABLE CONTRIBUTIONS. 7 7 0 25 0 0 928607 5501760 18351 0 436418 407843 0 6117 1383376 5915720 1795985 2093719 0 0 329262 481580 0 0 138048 168224 528317 2293471 3103616 -910095 2812104 11940646 13790907 1998874 1256586 9941772 12534321 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 2375169 2093719 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 2375169 1 1 0 0 0 0 0 0 1 1 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 7 7 0 0 1 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X X SHARON STEELE CPA 8287716720 890 HENDERSONVILLE ROAD SUITE 300 ASHEVILLE NC 28803 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 ART FISHER BOARD MEMBER 2.00 X 0 0 0 JIM WRIGHT MD BOARD MEMBER 2.00 X 0 0 0 JIM TYSON MD BOARD MEMBER 2.00 X 0 0 0 LEX GREEN CPA PRESIDENT 50.00 X 0 151523 17381 0 151523 17381 0 0 1 0 0 5374758 127002 4635 5501760 218169 218169 189674 0 189674 189674 189674 OTHER INCOME 900099 6117 6117 6117 5915720 0 0 413960 2093719 2093719 151522 121218 30304 252330 201864 50466 77728 62182 15546 24542 24542 2600 2600 291876 281450 8341 2085 10856 8685 2171 125160 100128 25032 32022 25618 6404 10740 8592 2148 1665 1332 333 5845 5845 5215 5215 MISCELLANEOUS 17796 14237 3559 3103616 2375169 590399 138048 202 199 511256 114765 14517 97487 3577 492700 69313 289256 423387 13151492 11125415 11940646 13790907 227586 1028980 1998874 20 1998874 1256586 X 7913090 10114968 59427 450098 1969255 1969255 9941772 12534321 11940646 13790907 2812104 -224369 4814 0 X 0 0 0 X X 1 TRANSYLVANIA COMMUNITY HOSPITAL INC 560562293 3 1 2058537 0 1 2058537 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 PART IV; SECTION A; LINE 1 TRANSYLVANIA COMMUNITY HOSPITAL, INC. IS LISTED AS A SUPPORTED ORGANIZATION BY NAME. OTHER SUPPORTED ORGANIZATIONS ARE REFERENCED BY THE TERM "AFFILIATED ENTITIES AND DEFINED AS OTHER LEGAL ENTITIES THAT MAY FROM TIME TO TIME BE FORMED BY THE SYSTEM. SINCE THE PURPOSE STATES THAT THE FOUNDATION SHALL OPERATE EXCLUSIVELY FOR CHARITABLE AND EDUCATIONAL PURPOSES REFERENCED BY THE INTERNAL REVENUE CODE, THEN THE OTHER LEGAL ENTITIES WOULD ONLY INCLUDE THOSE TYPES OF ORGANIZATIONS FORMED BY THE SYSTEM. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 9759625 11397454 1553227 9506909 51906 13151491 9108938 432658 218029 9759625 11223306 5888 1179744 3300000 9108938 13359332 167981 810108 3114115 11223306 15391986 11515 -431923 1612246 13359332 0.72500 0.27500 0 0 221000 221000 206721 22973 183748 3534 -3534 40495 40495 0 24484 2311 22173 423387 DUE TO AFFILIATE 20 20 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 TRANSYLVANIA COMMUNITY HOSPITAL INC 260 HOSPITAL DRIVE BREVARD NC 28712 560562293 501(C)(3) 2058537 SUPPORT OF HOSPITAL PROGRAMS/CAPITAL NEEDS WNC BRIDGE FOUNDATION PO BOX 1315 ASHEVILLE NC 28704 562110357 501(C)(3) 25000 SUPPPORT OF HOSPITALITY HOUSE FOR FAMILIES OF HOSPITAL PATIENTS MEALS ON WHEELS 431 E MAIN ST BREVARD NC 28712 561224960 501(C)(3) 5547 SUPPORT OF FOOD DISTRIBUTION PROGRAM 3 PART I, LINE 2: TRANSYLVANIA COMMUNITY HOSPITAL IS THE PRIMARY RECIPIENT OF GRANTS FROM THE FOUNDATION, AND ALL PAYMENTS ARE DIRECTLY RELATED TO PROJECTS AUTHORIZED BY THE BOARD OF THAT ORGANIZATION. GRANTS PROVIDED TO ORGANIZATIONS OTHER THAN THE HOSPITAL OR A RELATED ORGANIZATION ARE REQUIRED TO SUBMIT A REPORT ONE YEAR FOLLOWING THE GRANT DETAILING THE USE OF THE FUNDS. X X X X 0 0 0 0 0 0 0 0 0 LEX GREEN CPA PRESIDENT 0 130088 0 21435 0 0 0 0 0 17381 0 168904 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 A, LINE 4 THE ORGANIZATION HAS AMENDED ITS BYLAWS TO BECOME AN INDEPENDENT PUBLIC CHARITY. THE ORGANIZATION FORMALLY WAS AFFILIATED WITH A 501(C)(3) TAX EXEMPT HOSPITAL THAT HAD THE POWER TO APPOINT ITS BOARD MEMBERS AND APPROVE ITS BYLAWS. THE ORGANIZATION IS NOW A SELF GOVERNING ORGANIZATION ESTABLISHED TO PROMOTE HEALTH AND COMMUNITY SUPPORT. 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 PISGAH HEALTH HOLDINGS LLC 153 W JORDAN STREET BREVARD NC 28712 HOLDING COMPANY NC 0 0 PISGAH HEALTH FOUNDATION INC MISSION HEALTH SYSTEM INC 400 RIDGEFIELD COURT SUITE 100 ASHEVILLE NC 28806 581450888 SUPPORTING ORGANIZATION NC 501(C)(3) LINE 12B, II N/A 0 MISSION MEDICAL ASSOCIATES INC 400 RIDGEFIELD COURT SUITE 100 ASHEVILLE NC 28806 263627231 EMPLOYED PHYSICIAN GROUP NC 501(C)(3) LINE 11 MISSION HEALTH SYSTEM INC 0 THE MCDOWELL HOSPITAL INC 430 RANKIN DRIVE MARION NC 28742 560623938 COMMUNITY HOSPITAL NC 501(C)(3) LINE 3 MISSION HEALTH SYSTEM INC 0 MISSION HEALTH SYSTEM FOUNDATION INC 400 RIDGEFIELD COURT SUITE 100 ASHEVILLE NC 28806 561881331 FOUNDATION NC 501(C)(3) LINE 7 MISSION HEALTH SYSTEM INC 0 BLUE RIDGE REGIONAL HOSPITAL INC P O BOX 9 SPRUCE PINE NC 28777 561025032 COMMUNITY HOSPITAL NC 501(C)(3) LINE 3 MISSION HEALTH SYSTEM INC 0 BLUE RIDGE REGIONAL HOSPITAL FOUNDATION INC PO BOX 247 SPRUCE PINE NC 28777 582172660 HOSPITAL FOUNDATION NC 501(C)(3) LINE 12B, II BLUE RIDGE REGIONAL HOSPITAL INC 0 TRANSYLVANIA COMMUNITY HOSPITAL INC 260 HOSPITAL DRIVE BREVARD NC 28712 560562293 COMMUNITY HOSPITAL NC 501(C)(3) LINE 3 MISSION HEALTH SYSTEM INC 0 ANGEL MEDICAL CENTER INC PO BOX 1209 FRANKLIN NC 28744 566000064 COMMUNITY HOSPITAL NC 501(C)(3) LINE 3 MISSION HEALTH SYSTEM INC 0 HIGHLANDS CASHIERS HEALTH FOUNDATION INC PO BOX 742 HIGHLANDS NC 28741 561165833 HOSPITAL FOUNDATION NC 501(C)(3) LINE 12B, II HIGHLANDS-CASHIERS HOSPITAL INC 0 TRANSYLVANIA PHYSICIAN SERVICES INC 260 HOSPITAL DRIVE BREVARD NC 28712 561920816 PHYSICIAN SERVICES NC 501(C)(3) LINE 3 TRANSYLVANIA COMMUNITY HOSPITAL INC 0 ANGEL MEDICAL CENTER AUXILIARY INC PO BOX 1209 FRANKLIN NC 28744 562133719 SUPPORTING ORGANIZATION NC 501(C)(3) LINE 12B, II ANGEL MEDICAL CENTER INC 0 MCDOWELL HEALTHCARE FOUNDATION INC 430 RANKIN DRIVE MARION NC 28752 463395393 FOUNDATION NC 501(C)(3) LINE 7 THE MCDOWELL HOSPITAL INC 0 HIGHLANDS-CASHIERS HOSPITAL INC PO BOX 190 HIGHLANDS NC 28741 560509400 COMMUNITY HOSPITAL NC 501(C)(3) LINE 3 MISSION HEALTH SYSTEM INC 0 HIGHLANDS-CASHIERS PHYSICIAN SERVICES INC PO BOX 742 HIGHLANDS NC 28741 452422428 PHYSICIAN SERVICES NC 501(C)(3) LINE 12B, II HIGHLANDS-CASHIERS HOSPITAL INC 0 COMMUNITY CAREPARTNERS INC PO BOX 5779 ASHEVILLE NC 28813 562005198 LONG TERM REHABILITATION NC 501(C)(3) LINE 11 MISSION HEALTH SYSTEM INC 0 MISSION HOSPITAL INC 400 RIDGEFIELD COURT SUITE 100 ASHEVILLE NC 28806 560532141 ACUTE CARE HOSPITAL NC 501(C)(3) LINE 3 MISSION HEALTH SYSTEM INC 0 ASHEVILLE IMAGING LLP 534 BILTMORE AVENUE ASHEVILLE NC 28801 561907201 MEDICAL IMAGING SERVICES NC N/A ASHEVILLE MRI PO BOX 2959 ASHEVILLE NC 28802 561665863 MEDICAL IMAGING SERVICES NC MISSION HOSPITAL INC RELATED 0 1 0.50000 BLUE RIDGE DME LLC 125 HOSPITAL DRIVE SPRUCE PINE NC 28777 263570174 HOME MEDICAL EQUIPMENT AND SUPPLIES SALES NC N/A BLUE RIDGE-TKC LLC 5935 CARNEGIE BLVD CHARLOTTE NC 28209 471382912 REAL ESTATE RENTAL NC N/A HEALTHCARE III LIMITED PARTNERSHIP 260 HOSPITAL DRIVE BREVARD NC 28712 561599596 RENTAL NC N/A HEALTHCARE LIMITED LIABILITY COMPANY VII 260 HOSPITAL DRIVE BREVARD NC 28712 200343455 RENTAL NC N/A IMAGING REALTY LLP 534 BILTMORE AVENUE ASHEVILLE NC 28801 561907203 MEDICAL BUILDING NC N/A MSJHS AND CCP JOINT DEVELOPMENT COMPANY LLC 428 BILTMORE AVENUE ASHEVILLE NC 28801 562250464 LONG TERM ACUTE CARE HOSPITAL NC N/A SPRUCE PINE HEALTHCARE LLC 5935 CARNEGIE BLVD CHARLOTTE NC 28209 471390107 REAL ESTATE NC N/A TRANSYLVANIA HEALTHCARE II LIMITED PARTNERSHIP 2 MEDICAL PARK DRIVE BREVARD NC 28712 200333230 RENTAL NC N/A WNC STONE CENTER 509 BILTMORE AVENUE ASHEVILLE NC 28801 272152974 LITHOTRIPTER RENTAL NC N/A WESTERN NC HEALTHCARE INNOVATORS LLC 5935 CARNEGIE BLVD CHARLOTTE NC 28209 800787882 REAL ESTATE RENTAL NC N/A WESTERN REGIONAL RADIATION THERAPY CENTER 68 HOSPITAL DRIVE SYLVA NC 28779 561849395 RADIATION THERAPY NC N/A WNC STONE CENTER 509 BILTMORE AVENUE ASHEVILLE NC 28801 272152974 LITHOTRIPTER RENTAL NC MISSION HOSPITAL INC RELATED 0 1 0.33330 DOGWOOD INSURANCE COMPANY LTD THEGRANDPAVILIONCOMMERCIALCENTREPOB GRAND CAYMAN CJ CAPTIVE INSURANCE ENTITY CJ N/A C 0 TRANSYLVANIA SERVICES INC 260 HOSPITAL DRIVE BREVARD NC 28712 561448199 REAL ESTATE NC N/A C 0 MISSION HEALTH PARTNERS INC 509 BILTMORE AVENUE ASHEVILLE NC 28801 465566095 CLINICALLY INTEGRATED NETWORK NC N/A C 0 HEALTHY STATE INC 509 BILTMORE AVENUE ASHEVILLE NC 28801 812108613 ADMINISTRATIVE NC N/A C 0 AVENU HEALTH INC 509 BILTMORE AVENUE ASHEVILLE NC 28801 823337055 HEALTHCARE NC N/A C 0 POOLED INCOME FUND (1) NC N/A T 0 CHARITABLE REMAINDER TRUST (1) NC N/A T 0 0 1 1 0 0 0 0 0 0 0 0 1 0 1 1 0 0 1 1