ASHE MEMORIAL HOSPITAL INC: Form 990, tax year 2018
View the entire original 990 at ProPublica ↗
- Organization
- ASHE MEMORIAL HOSPITAL INC (EIN 56-0603900)
- Tax period
- 2018-01-01 to 2018-12-31
- Filed
- 2019-11-05
- IRS object ID
- 201923099349301607
- Schema version
- 2018v3.1
- 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 I
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2019-11-05T10:37:22-06:00 | ReturnTs |
| Tax Period End | 2018-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 410746749 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLIFTONLARSONALLEN LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 227 WEST TRADE STREET SUITE 800 | AddressLine1Txt |
| City | CHARLOTTE | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 28202 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2018-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 560603900 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ASHE MEMORIAL HOSPITAL INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | ASHE | BusinessNameControlTxt |
| Phone | 3368467101 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 HOSPITAL AVENUE | AddressLine1Txt |
| City | JEFFERSON | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 28640 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | CHARLES WRIGHT | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 3368467101 | PhoneNum |
| Signature | 2019-11-04 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | JOHN NORMAN | PreparerPersonNm |
| PTIN | P01506766 | PTIN |
| Phone | 7049985200 | PhoneNum |
| Preparation | 2019-11-04 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 67.137.57.251 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2019-11-04 | IPDt |
| IP Tm | 16:58:55 | IPTm |
| IP Timezone | ES | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 356E76376044E692544D6A37DDF1E0572DA6BBCB | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | B78854EE20A5AAAEA57700933C1E697C4E2B71FA | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2018 | TaxYr |
| Build TS | 2020-03-31 21:24:44Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | LAURA LAMBETH | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 HOSPITAL AVE | AddressLine1Txt |
| City | JEFFERSON | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 28640 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $35,886,021 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.ASHEMEMORIAL.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1939 | FormationYr |
| Legal Domicile State | NC | LegalDomicileStateCd |
| Activity Or Mission | ACUTE HOSPITAL CARE SERVICES PROVIDED TO THE RESIDENTS OF ASHE COUNTY, NC AND SURROUNDING AREAS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 14 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 14 | VotingMembersIndependentCnt |
| Total Employee | 402 | TotalEmployeeCnt |
| Total Volunteers | 33 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $1,044,314 | PYContributionsGrantsAmt |
| CY Contributions Grants | $895,977 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $34,597,538 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $34,734,805 | CYProgramServiceRevenueAmt |
| PY Investment Income | $32,388 | PYInvestmentIncomeAmt |
| CY Investment Income | $50,502 | CYInvestmentIncomeAmt |
| PY Other Revenue | $194,404 | PYOtherRevenueAmt |
| CY Other Revenue | $204,737 | CYOtherRevenueAmt |
| PY Total Revenue | $35,868,644 | PYTotalRevenueAmt |
| CY Total Revenue | $35,886,021 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $800,335 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $771,510 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $17,184,427 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $17,731,579 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $241,006 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $17,504,644 | PYOtherExpensesAmt |
| CY Other Expenses | $17,237,810 | CYOtherExpensesAmt |
| PY Total Expenses | $35,489,406 | PYTotalExpensesAmt |
| CY Total Expenses | $35,740,899 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $379,238 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $145,122 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $17,298,384 | TotalAssetsBOYAmt |
| Total Assets EOY | $16,536,417 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $6,525,156 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $5,747,932 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $10,773,228 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $10,788,485 | NetAssetsOrFundBalancesEOYAmt |
| Mission | THE HOSPITAL'S MISSION STATEMENT IS TO MEET THE NEEDS OF THE COMMUNITY BY DELIVERING PATIENT-CENTERED, HIGH QUALITY HEALTH CARE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $33,293,516 | ExpenseAmt |
| Grant | $771,510 | GrantAmt |
| Revenue | $34,735,134 | RevenueAmt |
| Desc | ASHE MEMORIAL PROVIDES INPATIENT, OUTPATIENT, AND EMERGENCY CARE SERVICES FOR RESIDENTS OF ASHE COUNTY AND THE SURROUNDING AREAS. THE HOSPITAL PROVIDED A SIGNIFICANT AMOUNT OF COMMUNITY BENEFIT AND OUTREACH TO THE COUNTY AND SURROUNDING AREAS. BENEFIT AND OUTREACH PROGRAMS ARE PROVIDED IN CONJUNCTION WITH THE ASHE COUNTY HEALTH COUNCIL AND INDEPENDENTLY THROUGH VARIOUS DEPARTMENTS AND SERVICES. | Desc |
| Total Program Service Expenses | $33,293,516 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | Yes (1) | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | Yes (1) | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | Yes (1) | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | 0 | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 40 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 402 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 14 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 14 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (1) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | 0 | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHARLES WRIGHT CFO | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3368460798 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 HOSPITAL AVENUE | AddressLine1Txt |
| City | JEFFERSON | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 28640 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | Yes (X) | NoListedPersonsCompensatedInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (20 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| TOM EFFORD | |||||||
| PRESIDENT | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| HOBART DAVIS | |||||||
| VICE PRESIDENT | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| DONNIE JOHNSON | |||||||
| VICE PRESIDENT | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| JAN CADDELL | |||||||
| TREASURER | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| JANE LONON | |||||||
| SECRETARY | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| WALTER E DAVIS MD | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| DENNIS E HOUCK | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| EDWARD J MILLER MD | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| STEPHEN SHOEMAKER | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| DR CHARLES JONES | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| SUE HAMPTON | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| BRETT T SUMMEY DDS | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| JAMES G GAMBILL JR | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| GREG BOWER RPH | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| HORACE THOMPSON | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| OWEN D OKSANEN | |||||||
| PHYSICIAN | 40.00 | $402,684 | $0 | $0 | Yes (X) | ||
| MELINDA WONSICK | |||||||
| PHYSICIAN | 40.00 | $401,135 | $0 | $0 | Yes (X) | ||
| TYLER CALLAHAN | |||||||
| PHYSICIAN | 40.00 | $270,885 | $0 | $0 | Yes (X) | ||
| RONALD W BENFIELD MD | |||||||
| PHYSICIAN | 40.00 | $458,931 | $0 | $0 | Yes (X) | ||
| BRIAN SACHS MD | |||||||
| PHYSICIAN | 40.00 | $318,323 | $0 | $0 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,851,958 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $0 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 5 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| JEFFERSON EMERGENCY SERVICES | |||||
| PO BOX 740666 | ATLANTA | GA | 30328 | ED PROVIDERS | $951,311 |
| NOVANT HEALTH | |||||
| 2085 FRONTIS PLAZA | WINSTON SALEM | NC | 27103 | MANAGEMENT COMPANY | $911,136 |
| RESTORE RESPIRATORY CARE INC | |||||
| 200 GALLERIA PARKWAY SUITE 1800 | ATLANTA | GA | 30339 | RESPIRATORY THERAPY | $893,030 |
| MORRISON MANAGEMENT SPECIALISTS INC A1 | |||||
| 5801 PEACHTREE DUNWOODY R | ATLANTA | GA | 30342 | FOOD SERVICE | $751,499 |
| CROTHALL HEALTHCARE A1516 | |||||
| 1500 LIBERTY RIDGE DRIVE SUITE 210 | WAYNE | PA | 19087 | HOUSEKEEPING SERVICES | $379,210 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 12 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $257,129 | RelatedOrganizationsAmt |
| Government Grants | $625,227 | GovernmentGrantsAmt |
| All Other Contributions | $13,621 | AllOtherContributionsAmt |
| Total Contributions | $895,977 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT SERVICE REVENUE | 623000 | $34,260,350 | $34,260,350 |
| PHARMACY | 446110 | $331,037 | $331,037 |
| OTHER OPERATING REVENUE | 623000 | $143,418 | $143,418 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $34,734,805 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $50,502 | TotalRevenueColumnAmt |
| Exclusion | $50,502 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $204,408 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $204,408 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $204,408 | TotalRevenueColumnAmt |
| Exclusion | $204,408 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MISCELLANEOUS | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $329 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $329 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $329 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $35,886,021 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $34,735,134 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $254,910 | ExclusionAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $771,510 | TotalAmt |
| Program Services | $771,510 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,851,958 | TotalAmt |
| Program Services | $1,796,400 | ProgramServicesAmt |
| Management And General | $55,558 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,141,314 | TotalAmt |
| Program Services | $12,747,074 | ProgramServicesAmt |
| Management And General | $394,240 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,806,591 | TotalAmt |
| Program Services | $1,752,392 | ProgramServicesAmt |
| Management And General | $54,199 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $931,716 | TotalAmt |
| Program Services | $903,764 | ProgramServicesAmt |
| Management And General | $27,952 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $250,000 | TotalAmt |
| Management And General | $250,000 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $66,641 | TotalAmt |
| Management And General | $66,641 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $45,497 | TotalAmt |
| Management And General | $45,497 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,269,251 | TotalAmt |
| Program Services | $1,876,610 | ProgramServicesAmt |
| Management And General | $392,641 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $47,218 | TotalAmt |
| Program Services | $9,443 | ProgramServicesAmt |
| Management And General | $37,303 | ManagementAndGeneralAmt |
| Fundraising | $472 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,312,969 | TotalAmt |
| Program Services | $5,902,625 | ProgramServicesAmt |
| Management And General | $378,779 | ManagementAndGeneralAmt |
| Fundraising | $31,565 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $359,269 | TotalAmt |
| Program Services | $39,519 | ProgramServicesAmt |
| Management And General | $319,750 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $626,958 | TotalAmt |
| Program Services | $626,958 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $60,281 | TotalAmt |
| Program Services | $49,430 | ProgramServicesAmt |
| Management And General | $10,851 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $110,370 | TotalAmt |
| Program Services | $110,370 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,165,267 | TotalAmt |
| Program Services | $1,165,267 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $251,683 | TotalAmt |
| Program Services | $251,683 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| BAD DEBT EXPENSE | $5,050,103 | $5,050,103 | ||
| MISCELLANEOUS | $557,591 | $175,656 | $172,966 | $208,969 |
| RECRUITMENT | $64,712 | $64,712 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $35,740,899 | TotalAmt |
| Program Services | $33,293,516 | ProgramServicesAmt |
| Management And General | $2,206,377 | ManagementAndGeneralAmt |
| Fundraising | $241,006 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,570,666 | BOYAmt |
| EOY | $3,110,053 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,008,361 | BOYAmt |
| EOY | $858,361 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,414,474 | BOYAmt |
| EOY | $3,265,731 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $910,067 | BOYAmt |
| EOY | $922,773 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $182,736 | BOYAmt |
| EOY | $144,331 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $34,761,886 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $27,169,681 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,444,893 | BOYAmt |
| EOY | $7,592,205 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $522,505 | BOYAmt |
| EOY | $535,415 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $244,682 | BOYAmt |
| EOY | $107,548 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,298,384 | BOYAmt |
| EOY | $16,536,417 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,245,546 | BOYAmt |
| EOY | $3,043,891 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $180,666 | BOYAmt |
| EOY | $89,275 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,098,944 | BOYAmt |
| EOY | $2,614,766 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,525,156 | BOYAmt |
| EOY | $5,747,932 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,229,256 | BOYAmt |
| EOY | $10,388,107 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $543,972 | BOYAmt |
| EOY | $400,378 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,773,228 | BOYAmt |
| EOY | $10,788,485 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,298,384 | BOYAmt |
| EOY | $16,536,417 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $145,122 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$1,474 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$128,391 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | 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 (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | 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) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $5,381 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $5,381 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION IS A MEMBER OF THE NORTH CAROLINA HOSPITAL ASSOCIATION AND THE AMERICAN HOSPITAL ASSOCIATION. A PORTION OF THE MEMBERSHIP DUES PAID TO THESE ORGANIZATIONS IS ALLOCATED TO LOBBYING EXPENDITURES ON BEHALF OF ITS MEMBERSHIP BODY. THE AMOUNT LISTED ABOVE IS AN ESTIMATE OF THE AMOUNT OF DUES ATTRIBUTABLE TO LOBBYING FOR THE 12 MONTH PERIOD ENDING DECEMBER 31, 2018. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $212,253 | OtherCostOrOtherBasisAmt |
| Book Value | $212,253 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $18,287,222 | OtherCostOrOtherBasisAmt |
| Depreciation | $12,199,030 | DepreciationAmt |
| Book Value | $6,088,192 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $109,022 | OtherCostOrOtherBasisAmt |
| Depreciation | $52,694 | DepreciationAmt |
| Book Value | $56,328 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $14,837,873 | OtherCostOrOtherBasisAmt |
| Depreciation | $13,812,726 | DepreciationAmt |
| Book Value | $1,025,147 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,315,516 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,105,231 | DepreciationAmt |
| Book Value | $210,285 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $7,592,205 | TotalBookValueLandBuildingsAmt |
| 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 IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND ARE EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. AWC AND AFS ARE SINGLE MEMBER LIMITED LIABILITY COMPANIES AND ARE CONSIDERED DISREGARDED ENTITIES FOR INCOME TAX PURPOSES. THE ORGANIZATION FOLLOWS THE INCOME TAX STANDARD REGARDING THE RECOGNITION AND MEASUREMENT OF UNCERTAIN TAX POSITIONS, WHICH CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN AN ENTITY'S CONSOLIDATED FINANCIAL STATEMENTS AND PRESCRIBES A RECOGNITION THRESHOLD AND MEASUREMENT PRINCIPLE FOR THE CONSOLIDATED FINANCIAL STATEMENTS RECOGNITION AND MEASUREMENT OF TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN ON A TAX RETURN THAT ARE NOT CERTAIN TO BE REALIZED. THE ORGANIZATION HAS DETERMINED THAT IT DOES NOT HAVE ANY MATERIAL UNCERTAIN TAX POSITIONS AS OF DECEMBER 31, 2018 AND 2017. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent150 | Yes (X) | Percent150Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent250 | Yes (X) | Percent250Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $300,020 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $300,020 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00980 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,388,682 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,042,615 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $346,067 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01130 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $709,917 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $895,831 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,398,619 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,938,446 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $646,087 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02110 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,398,619 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,938,446 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $646,087 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02110 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $2,016,806 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $1,169,748 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $14,746,324 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $16,500,752 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$1,754,428 | 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 (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | 0 | FinancialAssistancePrvsnInd |
| 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 | ASHE MEMORIAL HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 HOSPITAL AVENUE | AddressLine1Txt |
| City | JEFFERSON | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 28640 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Other | CRITICAL ACCESS HOSPITAL | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ASHE MEMORIAL HOSPITAL INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | 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 (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (1) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (1) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | WWW.ASHEMEMORIAL.ORG | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 17 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | WWW.ASHEMEMORIAL.ORG | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 150.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 250.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Income Level Criteria | Yes (X) | IncomeLevelCriteriaInd |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Residency Criteria | Yes (X) | ResidencyCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | WWW.ASHEMEMORIAL.ORG | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | WWW.ASHEMEMORIAL.ORG | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | WWW.ASHEMEMORIAL.ORG | 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 (1) | FAPActionsOnNonpaymentInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicare | Yes (X) | LookBackMedicareInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| ASHE MEMORIAL HOSPITAL INC. | PART V, SECTION B, LINE 5: DEVELOPMENT OF THE COMMUNITY HEALTH OPINION SURVEY TOOL WAS GUIDED BY CDC DEMOGRAPHIC DATA COLLECTION STANDARDS, NACCHO GUIDELINES FOR CONDUCTING A COMMUNITY HEALTH ASSESSMENT, BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM, YOUTH RISK BEHAVIOR SURVEY, WNC HEALTHY IMPACT INITIATIVE, AND THE 2014 ASHE COUNTY COMMUNITY HEALTH OPINION SURVEY. SEVERAL KEY COMMUNITY PARTNERS PROVIDED INPUT ON SURVEY QUESTIONS, SUCH AS ASHE MEMORIAL HOSPITAL, HIGH COUNTRY AREA AGENCY ON AGING, AND WESTERN YOUTH NETWORK. APPALACHIAN DISTRICT BOARD OF HEALTH MEMBERS PROVIDED INPUT ABOUT THE SURVEY QUESTIONS AND DISTRIBUTION POINTS. THE INJURY AND VIOLENCE PREVENTION BRANCH OF THE DIVISION OF PUBLIC HEALTH ALSO PROVIDED GUIDANCE ON QUESTION DEVELOPMENT. THE COMMUNITY HEALTH OPINION SURVEY WAS CONDUCTED FROM JULY 17 - AUGUST 18, 2017. THE OPINION SURVEY WAS PROMOTED AND DISTRIBUTED IN THE FOLLOWING WAYS: - DISTRIBUTED ELECTRONICALLY BY WEBSITE POSTING, SOCIAL MEDIA AND EMAIL LISTSERVS TO VARIOUS AREA EMPLOYERS - PROMOTED THROUGH A PRESS RELEASE AND RADIO SEGMENT ON WKSK - DISTRIBUTED AS TRADITIONAL HARD COPIES IN VARIOUS COMMUNITY LOCATIONS, INCLUDING BUT NOT LIMITED TO: APPHEALTHCARE CLINIC AND WIC OFFICE ASHE COUNTY CHAMBER OF COMMERCE ASHE COUNTY FARMERS MARKET ASHE COUNTY PARKS & RECREATION ASHE COUNTY TRANSPORTATION AUTHORITY ASHE COUNTY EMS ASHE COUNTY FIRE DEPARTMENT ASHE PUBLIC LIBRARY ASHE FAMILY LITERACY CENTER ASHE OUTREACH MINISTRIES ASHE MEMORIAL HOSPITAL ASHE PARTNERSHIP FOR CHILDREN ASHE SAFETY DAY ASHE SHARING CENTER HEALTH FAIR DAYMARK RECOVERY SERVICES MOUNTAIN FAMILY CARE CENTER MOUNT JEFFERSON FAMILY MEDICINE RIVERVIEW COMMUNITY CENTER ST. FRANCIS CHURCH SUMMIT SUPPORT SERVICES |
| ASHE MEMORIAL HOSPITAL INC. | PART V, SECTION B, LINE 6A: ALLEGHANY MEMORIAL HOSPITALAPPALACHIAN REGIONAL HEALTHCARE SYSTEMS |
| ASHE MEMORIAL HOSPITAL INC. | PART V, SECTION B, LINE 6B: APPALACHIAN DISTRICT HEALTH DEPARTMENT |
| ASHE MEMORIAL HOSPITAL INC. | PART V, SECTION B, LINE 11: THE HOSPITAL, IN CONJUNCTION WITH THE ASHE HEALTH ALLIANCE, IDENTIFIED THE FOLLOWING PRIORITIES:1. MENTAL/BEHAVIORAL HEALTH2. SUBSTANCE USE AND MISUSE PREVENTION3. PHYSICAL ACTIVITY AND NUTRITIONTHE HOSPITAL IS WORKING WITH OTHER STAKEHOLDERS THAT PARTICIPATED IN THE CHNA TO ADDRESS THE ABOVE HEALTH PRIORITIES IN A COLLABORATIVE MANNER, BRINGING THE RESOURCES OF ALL STAKEHOLDERS TO ADDRESS THE NEEDS THROUGH THE PLANNING AND IMPLEMENTATION OF EVIDENCE-BASED INTERVENTIONS. ALL STAKEHOLDERS ARE MAPPING THE ASSETS AVAILABLE SO THAT THE COMMUNITY COLLABORATORS ALREADY ENGAGED IN RELATED WORK CAN PARTICIPATE IN IDENTIFYING ASSETS THAT SUPPORT HEALTH AND POTENTIAL GAPS THAT MAY EXIST. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 3 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - MOUNTAIN FAMILY CARE CENTER | ||||
| 200 HOSPITAL AVENUE | JEFFERSON | NC | 28640 | RURAL HEALTH CLINIC |
| 2 - AMH ASHE WOMEN'S CENTER | ||||
| 420 E 2ND STREET | WEST JEFFERSON | NC | 28694 | PHYSICIANS OFFICES |
| 3 - MOUNT JEFFERSON FAMILY MEDICINE | ||||
| 200 HOSPITAL AVENUE | JEFFERSON | NC | 28640 | FAMILY MEDICINE |
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 6A: | NCHA |
| PART I, LN 7 COL(F): | THE ORGANIZATION RECOGNIZES PATIENT SERVICE REVENUE ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY PAYOR COVERAGE ON THE BASIS OF CONTRACTUAL RATES FOR THE SERVICES RENDERED. FOR UNINSURED PATIENTS THAT DO NOT QUALIFY FOR CHARITY CARE, THE ORGANIZATION RECOGNIZES REVENUE ON THE BASIS OF ITS STANDARD RATES FOR SERVICES PROVIDED (OR ON THE BASIS OF DISCOUNTED RATES, IF NEGOTIATED OR PROVIDED BY POLICY). ON THE BASIS OF HISTORICAL EXPERIENCE, A SIGNIFICANT PORTION OF THE ORGANIZATION'S UNINSURED PATIENTS WILL BE UNABLE OR UNWILLING TO PAY FOR THE SERVICES PROVIDED. THUS, THE ORGANIZATION RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS RELATED TO UNINSURED PATIENTS IN THE PERIOD THE SERVICES ARE PROVIDED. |
| PART III, LINE 2: | THE ORGANIZATION APPLIED THE COST-TO-CHARGE RATIO TO ITS BAD DEBT GROSS CHARGES TO DETERMINE THE AMOUNT REPORTED AS BAD DEBT EXPENSE IN SCHEDULE H. |
| PART III, LINE 3: | THE ORGANIZATION ISOLATED BAD DEBT CHARGES ATTRIBUTABLE TO UNINSURED PATIENTS AND MULTIPLIED THOSE CHARGES BY ITS COST-TO-CHARGE RATIO TO ESTIMATE THE ORGANIZATIONS' BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBILE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. |
| PART III, LINE 9B: | THE WRITTEN POLICY DOES NOT SPECIFICALLY ADDRESS THIS ISSUE BUT WE NORMALLY PROVIDE THE CHARITY CARE DISCOUNT PRIOR TO SENDING TO BAD DEBT IF THE PATIENT QUALIFIES FOR CHARITY IN PART BUT FAILS TO PAY THEIR PORTION DUE. |
| PART VI, LINE 2: | THE HOSPITAL CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT IN CONJUNCTION WITH THE APPALACHIAN DISTRICT BOARD OF HEALTH AND THE ASHE HEALTH ALLIANCE. AT THE JANUARY 2017 MEETING, THE APPALACHIAN DISTRICT BOARD OF HEALTH ADOPTED A TIMELINE FOR COMPLETING THE COMMUNITY HEALTH ASSESSMENT (CHA). A CHA PLANNING COMMITTEE COMPRISED OF MULTI-DISCIPLINARY STAKEHOLDERS AND COMMUNITY LEADERS FROM ALLEGHANY, ASHE AND WATAUGA COUNTIES MET IN JUNE 2017 TO GUIDE IMPLEMENTATION OF THE CHA TIMELINE AND ENSURE THE PROCESS ENGAGED THE COMMUNITY IN AN INCLUSIVE AND RESPECTFUL MANNER. THE FIRST PHASE OF THE CHA PROCESS INCLUDED THE COLLECTION AND ANALYSIS OF COMMUNITY INPUT THROUGH AN OPINION SURVEY AND COMMUNITY SECONDARY DATA REVIEW. DEVELOPMENT OF THE COMMUNITY HEALTH OPINION SURVEY TOOL WAS GUIDED BY CDC DEMOGRAPHIC DATA COLLECTION STANDARDS, NACCHO GUIDELINES FOR CONDUCTING A COMMUNITY HEALTH ASSESSMENT, BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM, YOUTH RISK BEHAVIOR SURVEY, WNC HEALTHY IMPACT INITIATIVE, AND THE 2014 ASHE COUNTY COMMUNITY HEALTH OPINION SURVEY. SEVERAL KEY COMMUNITY PARTNERS PROVIDED INPUT ON SURVEY QUESTIONS, SUCH AS ASHE MEMORIAL HOSPITAL, HIGH COUNTRY AREA AGENCY ON AGING, AND WESTERN YOUTH NETWORK. APPALACHIAN DISTRICT BOARD OF HEALTH MEMBERS PROVIDED INPUT ABOUT THE SURVEY QUESTIONS AND DISTRIBUTION POINTS. THE INJURY AND VIOLENCE PREVENTION BRANCH OF THE DIVISION OF PUBLIC HEALTH ALSO PROVIDED GUIDANCE ON QUESTION DEVELOPMENT. THE COMMUNITY HEALTH OPINION SURVEY WAS CONDUCTED FROM JULY 17 - AUGUST 18, 2017. THE SURVEY WAS AVAILABLE AND PROMOTED ONLINE AND IN PAPER FORM IN ENGLISH AND IN SPANISH. RESPONDENTS OF THE COMMUNITY HEALTH OPINION SURVEY INCLUDE 729 ASHE COUNTY RESIDENTS. THE SURVEY SAMPLE INCREASED BY 149 PERCENT SINCE THE LAST OPINION SURVEY WAS CONDUCTED IN 2014. APPHEALTHCARE STAFF PLANNED AND MONITORED SURVEY DISTRIBUTION TO TRACK WHETHER THE SURVEY SAMPLE WAS REPRESENTATIVE OF COUNTY DEMOGRAPHICS. OPINION SURVEY RESPONDENTS WERE DISPROPORTIONATELY COMPRISED OF FEMALES AND INDIVIDUALS WITH HIGHER EDUCATION DEGREES. THE OPINION SURVEY LACKED PROPORTIONAL RESPONSES FROM MEN, INDIVIDUALS AGES 65 OR OLDER, AND INDIVIDUALS WITH A HOUSEHOLD INCOME LESS THAN $20,000. MANY SURVEY RESPONDENTS CHOSE NOT TO ANSWER THE DEMOGRAPHIC QUESTIONS IN THE SURVEY. |
| PART VI, LINE 3: | PATIENTS AND/OR GUARANTORS ARE EVALUATED FOR CHARITY CARE APPROVAL PRIOR TO SERVICES BEING RENDERED, AT THE TIME OF SERVICE, OR AS SOON AS PRACTICAL AFTER SERVICE HAS BEEN PROVIDED TO THE PATIENT. AMH POSTS NOTICES REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE TO LOW-INCOME UNINSURED PATIENTS. THESE NOTICES ARE POSTED IN VISIBLE LOCATIONS THROUGHOUT THE HOSPITAL SUCH AS ADMITTING/REGISTRATION, FINANCIAL COUNSELING OFFICE, AND OTHER OUTPATIENT AND/OR EMERGENCY SETTINGS. NOTICES OR BROCHURES ARE ALSO PROVIDED TO UNINSURED PATIENTS AT TIME OF REGISTRATION AND INCLUDE BRIEF INSTRUCTIONS ON HOW TO APPLY FOR FINANCIAL ASSISTANCE OR A DISCOUNTED PAYMENT AND A CONTACT TELEPHONE NUMBER THAT A PATIENT OR FAMILY MEMBER CAN CALL TO OBTAIN MORE INFORMATION. INFORMATION REGARDING FINANCIAL ASSISTANCE IS INCLUDED WITH THE PATIENT'S BILLS AND STATEMENTS. BUSINESS CARDS NOTIFYING PATIENTS OF FINANCIAL ASSISTANCE PROGRAMS AND WHERE TO TELEPHONE FOR ASSISTANCE ARE LOCATED THROUGHOUT THE HOSPITAL.OUR CHARITY POLICY AND CHARITY APPLICATION IS AVAILABLE ON THE HOSPITAL'S WEBSITE. INFORMATION REGARDING CHARITY APPLICATION IS PROVIDED IN ENGLISH AND IN SPANISH. AMH ALSO SHARES ITS CHARITY CARE POLICIES WITH APPROPRIATE COMMUNITY HEALTH AND HUMAN SERVICES AGENCIES AND OTHERORGANIZATIONS THAT ASSIST SUCH PATIENTS. |
| PART VI, LINE 4: | ASHE COUNTY, NORTH CAROLINA IS LOCATED IN THE NORTHWESTERN CORNER OF NORTH CAROLINA. THE COUNTY BORDERS WATAUGA, WILKES AND ALLEGHANY COUNTIES, IN ADDITION TO TENNESSEE AND VIRGINA. ASHE COUNTY SITS IN THE BLUE RIDGE MOUNTAINS WITH A LARGE VARIETY OF OUTDOOR RECREATION AND CULTURAL ATTRACTIONS. THE TWO LARGEST TOWNSHIPS ARE WEST JEFFERSON AND JEFFERSON, BOTH LOCATED IN THE CENTRAL AREAS OF THE COUNTY. ASHE COUNTY IS HOME TO FIVE MOUNTAINS THAT EACH RISE ABOVE 5,000 FEET. THE COUNTY IS HOME TO MOUNT JEFFERSON, WITH A PEAK THAT TOWERS MORE THAN 1,600 FEET ABOVE THE TOWNS OF JEFFERSON AND WEST JEFFERSON.THE POPULATION OF ASHE COUNTY IS 26,992 WITH AN EVEN DISTRIBUTION OF MALES AND FEMALES. ACCORDING TO THE 2016 ESTIMATE, ASHE COUNTY'S POPULATION DECREASED BY 1.1 PERCENT FROM 2010 TO 2016, COMPARED TO A POPULATION INCREASE OF 6.4 PERCENT FOR THE STATE OF NORTH CAROLINA. THE POPULATION HAS PLATEAUED SINCE 2010 AND IS EXPECTED TO SLOWLY DECREASE OVER THE NEXT TEN YEARS.THE AVERAGE ASHE COUNTY RESIDENT IS 47 YEARS OLD, ALMOST 1.5 YEARS OLDER THAN THE AVERAGE RESIDENT THREE YEARS AGO. THE MEDIAN AGE IS 49 YEARS FOR MACON COUNTY AND 38.3 YEARS FOR NORTH CAROLINA OVERALL. APPROXIMATELY 19 PERCENT OF INDIVIDUALS IN ASHE COUNTY ARE LESS THAN 18 YEARS OLD, COMPARABLE TO THAT OF MACON COUNTY. THE MAJORITY OF RESIDENTS IN ASHE COUNTY (92.3 PERCENT) IDENTIFY AS WHITE, NONHISPANIC COMPARED TO 68.5 PERCENT OF PEOPLE ACROSS NORTH CAROLINA. THE PERCENTAGE OF AFRICAN AMERICAN, NONHISPANIC RESIDENTS IN ASHE COUNTY IS MUCH LOWER AT 1.1 PERCENT THAN NORTH CAROLINA (21.5 PERCENT). THE PERCENT OF HISPANIC OR LATINO RESIDENTS IN ASHE COUNTY REMAINS AT 5 PERCENT, COMPARED TO 8.9 PERCENT IN NORTH CAROLINA, 3.4 PERCENT IN WATAUGA COUNTY, AND 9.6 PERCENT IN ALLEGHANY COUNTY. APPROXIMATELY 1.1 PERCENT OF THE POPULATION IDENTIFIES AS 2 OR MORE RACES. APPROXIMATELY 1,382 ASHE COUNTY RESIDENTS ARE HISPANIC OR LATINO. AMONG THOSE, 81.9 PERCENT ARE MEXICAN, 0.1 PERCENT ARE PUERTO RICAN, 0.7 PERCENT ARE CUBAN, AND 0.1 PERCENT ARE FROM SOME OTHER COUNTRY OF ORIGIN. ASIAN RESIDENTS REPRESENT LESS THAN 1 PERCENT OF THE POPULATION; OF THOSE, 34 PERCENT ARE FILIPINO, 19 PERCENT ARE ASIAN INDIAN, AND 47 PERCENT ARE OF A DIFFERENT ASIAN DECENT. THE NUMBER OF ASIAN RESIDENTS IN ASHE COUNTY HAS INCREASED SLIGHTLY SINCE THE 2014 CHA.NATIONWIDE, SOME GROUPS OF PEOPLE EXPERIENCE HEALTH DISPARITIES, WHICH ARE PREVENTABLE DIFFERENCES IN HEALTH OUTCOMES THAT ARE CREATED BY SOCIAL, ECONOMIC, AND ENVIRONMENTAL CONDITIONS. THESE CONDITIONS LEAD TO BEHAVIORS SUCH AS SMOKING,POOR NUTRITION, AND LACK OF EXERCISE, WHICH AFFECT OUR HEALTH. HEALTH DISPARITIES ARE INEQUITABLE AND ARE DIRECTLY RELATED TO THE HISTORICAL AND CURRENT UNEQUAL DISTRIBUTION OF SOCIAL, POLITICAL, ECONOMIC, AND ENVIRONMENTAL RESOURCES. WHILE RACIAL AND ETHNIC MINORITY POPULATIONS IN ASHE COUNTY STILL COMPRISE A SMALL PERCENTAGE OF THE OVERALL POPULATION, IT IS IMPORTANT TO PAY CLOSE ATTENTION TO DIFFERENCES IN HEALTH OUTCOMES FOR THESE POPULATIONS. HEALTH DISPARITIES AMONG POPULATIONS ARE NOTED THROUGHOUT THIS REPORT BY HEALTH TOPIC. THE NORTH CAROLINA CENTER FOR STATE HEALTH STATISTICS NOTES THAT RACE OR ETHNICITY DOES NOT CAUSE A PARTICULAR HEALTH PROBLEM OR STATUS. IT IS LIKELY THAT FACTORS SUCH AS INCOME, EDUCATION, ACCESS TO HEALTH CARE, STRESS AND RACISM ARE AMONG THE MAJOR CAUSES OF THE POORER HEALTH OF MINORITIES ON MANY HEALTH MEASURES COMPARED TO WHITES. FEW SOURCES OF HEALTH DATA RECORD THESE TYPES OF HEALTH INFORMATION, ALTHOUGH MOST DATA SOURCES HAVE INFORMATION ON RACE OR ETHNICITY. SHOWING DATA BY RACE CAN IDENTIFY SPECIFIC AREAS OF DISPARITIES AND CAN HELP TARGET RESOURCES AND INTERVENTIONS TO POPULATIONS MOST IN NEED. REFER TO THE SECTION ON SOCIAL DETERMINANTS OF HEALTH FOR MORE INFORMATION ON THE FACTORS THAT ARE LIKELY TO CAUSE HEALTH DISPARITIES AMONG DIFFERENT RACIAL AND ETHNIC GROUPS. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Type | FINANCIAL ASSISTANCE | GrantTypeTxt |
| Recipient | 267 | RecipientCnt |
| Cash Grant | $771,510 | CashGrantAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | FINANCIAL ASSISTANCE IS TRACKED THROUGH THE HOSPITAL'S FAP WHICH IS DESCRIBED IN SCHEDULE H. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (5 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| OWEN D OKSANEN | ||||||||||||||
| PHYSICIAN | $402,684 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $402,684 | $0 | $0 | $0 |
| MELINDA WONSICK | ||||||||||||||
| PHYSICIAN | $401,135 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $401,135 | $0 | $0 | $0 |
| TYLER CALLAHAN | ||||||||||||||
| PHYSICIAN | $270,885 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $270,885 | $0 | $0 | $0 |
| RONALD W BENFIELD MD | ||||||||||||||
| PHYSICIAN | $458,931 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $458,931 | $0 | $0 | $0 |
| BRIAN SACHS MD | ||||||||||||||
| PHYSICIAN | $318,323 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $318,323 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 3 | FormAndLineReferenceDesc |
| Explanation | COMPENSATION FOR THE CEO IS PROVIDED BY AN UNRELATED ORGANIZATION. PLEASE SEE THE RESPONSE TO FORM 990, PART VI, LINE 15A FOR MORE DETAILS. | ExplanationTxt |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DR CHARLES JONES | PersonNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | BOARD MEMBER | RelationshipDescriptionTxt |
| Transaction | $397,045 | TransactionAmt |
| Transaction | CALL PAY7, RENTAL OFFICE SPACE, AND LEASED ROOM | TransactionDesc |
| Sharing Of Revenues | 0 | SharingOfRevenuesInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 3 | SEE NOTE FOR PART VI, LINE 15. |
| FORM 990, PART VI, SECTION A, LINE 6 | THE HOSPITAL IS ORGANIZED AS A STOCK CORPORATION, AND SHARES OF STOCK ARE SOLD TO MEMBERS OF THE COMMUNITY AND ARE FREELY TRANSFERABLE, BUT HAVE NO CAPITAL VALUE. SHAREHOLDERS DO NOT RECEIVE DIVIDENDS. |
| FORM 990, PART VI, SECTION A, LINE 7A | TRUSTEES SHALL BE ELECTED BY THE SHAREHOLDERS OF THE CORPORATION AT THE ANNUAL MEETING OF THE MEMBERSHIP. EACH SELECTED TRUSTEE SHALL HOLD OFFICE FOR A TERM OF THREE YEARS AND UNTIL HIS SUCCESSOR IS ELECTED AND QUALIFIED. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE ORGANIZATION CANNOT SELL REAL PROPERTY WITHOUT APPROVAL BY THE SHAREHOLDERS. PLEASE SEE THE RESPONSE TO LINE 6 ABOVE. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE RETURN WAS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM WITH THE ASSISTANCE AND OVERSIGHT OF MANAGEMENT. THE BOARD IS INFORMED OF THE FILING OF THE RETURN AND THE 990 IS MADE AVAILABLE TO THEM FOR REVIEW AFTER THE RETURN IS FILED. |
| FORM 990, PART VI, SECTION B, LINE 12C | ALL VOTING MEMBERS ARE REQUIRED TO REVIEW AND SIGN A CONFLICT OF INTEREST SURVEY AND RETURN TO THE BOARD CHAIRMAN. THE SURVEY INCLUDES A DISCLOSURE STATEMENT AND A REVIEW OF THE POLICY. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE HOSPITAL HAS BEEN MANAGED BY HCA AND/OR QUORUM HEALTH RESOURCES, LLC (QHR) SINCE 1982. THE CONTRACT EXPIRED IN AUGUST 2013 AND WAS NOT RENEWED BY THE BOARD OF TRUSTEES. SUBSEQUENTLY, THE BOARD OF TRUSTEES OF THE HOSPITAL CONTRACTED WITH NOVANT HEALTH SHARED SERVICES WITH THE EFFECTIVE DATE OF AUGUST 2013. NOVANT WAS TO EMPLOY THE CEO. AS THE EMPLOYER OF THE CEO, NOVANT SETS COMPENSATION UTILIZING THE APPROPRIATE COMPARABILITY DATA TO ESTABLISH FAIR MARKET VALUE COMPENSATION. |
| FORM 990, PART VI, SECTION C, LINE 19 | PHOTOCOPIES OF THE FORM 990 ARE AVAILABLE UPON REQUEST AT THE ORGANIZATION'S ADMINISTRATIVE OFFICE. PLEASE CONTACT THE ADMINISTRATIVE OFFICE FOR FURTHER DETAILS. SEE FORM 990, PART VI, LINE 20. |
| FORM 990, PART XI, LINE 9: | TEMPORARILY RESTRICTED CONTRIBUTIONS 312,242. CONTRIBUTIONS RELEASED FOR OPERATIONS -440,633. |
| FORM 990, PART XII, LINE 2C | NO CHANGE FROM PRIOR YEAR. |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | End Of Year AssetsEndOfYearAssetsAmt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Total IncomeTotalIncomeAmt |
|---|---|---|---|---|---|---|---|---|---|
| AMH ASHE WOMEN'S CENTER LLC | |||||||||
| 420 E 2ND STREET | WEST JEFFERSON | NC | 28694 | 451482188 | PHYSICIANS PRACTICE | NC | $396,909 | ASHE MEMORIAL HOSPITAL | |
| ASHE FINANCIAL SERVICES LLC | |||||||||
| 200 HOSPITAL AVENUE | JEFFERSON | NC | 28640 | 810919041 | HEALTHCARE | NC | $67,208 | ASHE MEMORIAL HOSPITAL | $296,815 |
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ASHE MEMORIAL HOSPITAL FOUNDATION INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 HOSPITAL AVE | AddressLine1Txt |
| City | JEFFERSON | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 28640 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 582078244 | EIN |
| Primary Activities | FUNDRAISING | PrimaryActivitiesTxt |
| Legal Domicile State | NC | LegalDomicileStateCd |
| Exempt Code Section | 501(C)(3) | ExemptCodeSectionTxt |
| Public Charity Status | 11A | PublicCharityStatusTxt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ASHE MEMORIAL HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Organization | 0 | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ASHE MEMORIAL HOSPITAL FOUNDATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | C | TransactionTypeTxt |
| Involved | $257,129 | InvolvedAmt |