2019-11-05T10:37:22-06:00 2018-12-31 410746749 CLIFTONLARSONALLEN LLP 227 WEST TRADE STREET SUITE 800 CHARLOTTE NC 28202 990 2018-01-01 560603900 ASHE MEMORIAL HOSPITAL INC ASHE 3368467101 200 HOSPITAL AVENUE JEFFERSON NC 28640 CHARLES WRIGHT CFO 3368467101 2019-11-04 1 JOHN NORMAN P01506766 7049985200 2019-11-04 67.137.57.251 2019-11-04 16:58:55 ES P 356E76376044E692544D6A37DDF1E0572DA6BBCB B78854EE20A5AAAEA57700933C1E697C4E2B71FA 2018 2020-03-31 21:24:44Z LAURA LAMBETH 200 HOSPITAL AVE JEFFERSON NC 28640 35886021 0 X WWW.ASHEMEMORIAL.ORG X 1939 NC ACUTE HOSPITAL CARE SERVICES PROVIDED TO THE RESIDENTS OF ASHE COUNTY, NC AND SURROUNDING AREAS. 14 14 402 33 0 0 1044314 895977 34597538 34734805 32388 50502 194404 204737 35868644 35886021 800335 771510 0 0 17184427 17731579 0 0 241006 17504644 17237810 35489406 35740899 379238 145122 17298384 16536417 6525156 5747932 10773228 10788485 THE HOSPITAL'S MISSION STATEMENT IS TO MEET THE NEEDS OF THE COMMUNITY BY DELIVERING PATIENT-CENTERED, HIGH QUALITY HEALTH CARE. 0 0 33293516 771510 34735134 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. 33293516 1 1 0 1 0 0 0 0 0 0 1 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 1 1 0 1 1 0 0 0 0 0 1 0 0 0 0 0 0 1 1 1 0 0 0 1 40 0 1 402 1 0 0 0 0 0 0 0 0 0 0 0 0 X 14 14 0 1 0 0 1 1 1 1 1 0 0 0 1 1 1 1 1 1 1 0 X CHARLES WRIGHT CFO 3368460798 200 HOSPITAL AVENUE JEFFERSON NC 28640 X TOM EFFORD PRESIDENT 1.00 X X 0 0 0 HOBART DAVIS VICE PRESIDENT 1.00 X X 0 0 0 DONNIE JOHNSON VICE PRESIDENT 1.00 X X 0 0 0 JAN CADDELL TREASURER 1.00 X X 0 0 0 JANE LONON SECRETARY 1.00 X X 0 0 0 WALTER E DAVIS MD BOARD MEMBER 1.00 X 0 0 0 DENNIS E HOUCK BOARD MEMBER 1.00 X 0 0 0 EDWARD J MILLER MD BOARD MEMBER 1.00 X 0 0 0 STEPHEN SHOEMAKER BOARD MEMBER 1.00 X 0 0 0 DR CHARLES JONES BOARD MEMBER 1.00 X 0 0 0 SUE HAMPTON BOARD MEMBER 1.00 X 0 0 0 BRETT T SUMMEY DDS BOARD MEMBER 1.00 X 0 0 0 JAMES G GAMBILL JR BOARD MEMBER 1.00 X 0 0 0 GREG BOWER RPH BOARD MEMBER 1.00 X 0 0 0 HORACE THOMPSON BOARD MEMBER 1.00 X 0 0 0 OWEN D OKSANEN PHYSICIAN 40.00 X 402684 0 0 MELINDA WONSICK PHYSICIAN 40.00 X 401135 0 0 TYLER CALLAHAN PHYSICIAN 40.00 X 270885 0 0 RONALD W BENFIELD MD PHYSICIAN 40.00 X 458931 0 0 BRIAN SACHS MD PHYSICIAN 40.00 X 318323 0 0 1851958 0 0 5 0 1 0 JEFFERSON EMERGENCY SERVICES PO BOX 740666 ATLANTA GA 30328 ED PROVIDERS 951311 NOVANT HEALTH 2085 FRONTIS PLAZA WINSTON SALEM NC 27103 MANAGEMENT COMPANY 911136 RESTORE RESPIRATORY CARE INC 200 GALLERIA PARKWAY SUITE 1800 ATLANTA GA 30339 RESPIRATORY THERAPY 893030 MORRISON MANAGEMENT SPECIALISTS INC A1 5801 PEACHTREE DUNWOODY R ATLANTA GA 30342 FOOD SERVICE 751499 CROTHALL HEALTHCARE A1516 1500 LIBERTY RIDGE DRIVE SUITE 210 WAYNE PA 19087 HOUSEKEEPING SERVICES 379210 12 257129 625227 13621 895977 PATIENT SERVICE REVENUE 623000 34260350 34260350 PHARMACY 446110 331037 331037 OTHER OPERATING REVENUE 623000 143418 143418 34734805 50502 50502 204408 0 204408 204408 204408 MISCELLANEOUS 900099 329 329 329 35886021 34735134 0 254910 771510 771510 1851958 1796400 55558 13141314 12747074 394240 1806591 1752392 54199 931716 903764 27952 250000 250000 66641 66641 45497 45497 2269251 1876610 392641 47218 9443 37303 472 6312969 5902625 378779 31565 359269 39519 319750 626958 626958 60281 49430 10851 110370 110370 1165267 1165267 251683 251683 BAD DEBT EXPENSE 5050103 5050103 MISCELLANEOUS 557591 175656 172966 208969 RECRUITMENT 64712 64712 35740899 33293516 2206377 241006 2570666 3110053 1008361 858361 3414474 3265731 910067 922773 182736 144331 34761886 27169681 8444893 7592205 522505 535415 244682 107548 17298384 16536417 3245546 3043891 180666 89275 3098944 2614766 6525156 5747932 X 10229256 10388107 543972 400378 10773228 10788485 17298384 16536417 X 145122 -1474 -128391 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 5381 5381 0 PART II-B, LINE 1: 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. 212253 212253 18287222 12199030 6088192 109022 52694 56328 14837873 13812726 1025147 1315516 1105231 210285 7592205 X PART X, LINE 2: 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. 1 1 X 1 X 1 X 1 1 0 1 1 300020 300020 0.00980 3388682 3042615 346067 0.01130 709917 895831 0 0.00000 4398619 3938446 646087 0.02110 4398619 3938446 646087 0.02110 1 2016806 1169748 14746324 16500752 -1754428 X 1 0 1 1 ASHE MEMORIAL HOSPITAL 200 HOSPITAL AVENUE JEFFERSON NC 28640 X X X X CRITICAL ACCESS HOSPITAL ASHE MEMORIAL HOSPITAL INC 1 0 0 1 X X X X X X X X X 17 1 1 1 1 X WWW.ASHEMEMORIAL.ORG X 1 17 1 WWW.ASHEMEMORIAL.ORG 0 1 X 150.000000000000 250.000000000000 X X X X X X 1 1 X X X 1 X WWW.ASHEMEMORIAL.ORG X WWW.ASHEMEMORIAL.ORG X WWW.ASHEMEMORIAL.ORG X X X X X X 1 0 X X X 1 X 0 0 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. 3 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 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. 1 FINANCIAL ASSISTANCE 267 771510 PART I, LINE 2: FINANCIAL ASSISTANCE IS TRACKED THROUGH THE HOSPITAL'S FAP WHICH IS DESCRIBED IN SCHEDULE H. X X X X 0 0 0 0 0 0 0 0 0 OWEN D OKSANEN PHYSICIAN 402684 0 0 0 0 0 0 0 0 0 402684 0 0 0 MELINDA WONSICK PHYSICIAN 401135 0 0 0 0 0 0 0 0 0 401135 0 0 0 TYLER CALLAHAN PHYSICIAN 270885 0 0 0 0 0 0 0 0 0 270885 0 0 0 RONALD W BENFIELD MD PHYSICIAN 458931 0 0 0 0 0 0 0 0 0 458931 0 0 0 BRIAN SACHS MD PHYSICIAN 318323 0 0 0 0 0 0 0 0 0 318323 0 0 0 PART I, LINE 3 COMPENSATION FOR THE CEO IS PROVIDED BY AN UNRELATED ORGANIZATION. PLEASE SEE THE RESPONSE TO FORM 990, PART VI, LINE 15A FOR MORE DETAILS. DR CHARLES JONES BOARD MEMBER 397045 CALL PAY7, RENTAL OFFICE SPACE, AND LEASED ROOM 0 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. AMH ASHE WOMEN'S CENTER LLC 420 E 2ND STREET WEST JEFFERSON NC 28694 451482188 PHYSICIANS PRACTICE NC 396909 ASHE MEMORIAL HOSPITAL ASHE FINANCIAL SERVICES LLC 200 HOSPITAL AVENUE JEFFERSON NC 28640 810919041 HEALTHCARE NC 296815 67208 ASHE MEMORIAL HOSPITAL ASHE MEMORIAL HOSPITAL FOUNDATION INC 200 HOSPITAL AVE JEFFERSON NC 28640 582078244 FUNDRAISING NC 501(C)(3) 11A ASHE MEMORIAL HOSPITAL 0 0 0 1 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 ASHE MEMORIAL HOSPITAL FOUNDATION C 257129