2019-05-30T08:24:43-05:00 2018-09-30 560747981 DIXON HUGHES GOODMAN LLP 500 RIDGEFIELD COURT ASHEVILLE NC 28806 990 2017-10-01 560989789 HALIFAX REGIONAL MEDICAL CENTER INC HALI 2525358011 250 SMITH CHURCH ROAD ROANOKE RAPIDS NC 27870 SHERRY JENSEN VP OF FINANCE/CFO 2525358011 2019-05-30 1 AMY BIBBY P00445891 8282542254 2019-05-23 24.241.144.70 2019-05-30 07:59:55 ED P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 3C4A73C7F70BFF54BAAC11A85090BDFB39FC8B01 2017 2019-02-21 02:37:17Z WILL MAHONE 250 SMITH CHURCH ROAD ROANOKE RAPIDS NC 27870 110782362 0 X WWW.HALIFAXREGIONAL.ORG X 1972 NC TO PROVIDE MEDICAL SERVICES TO THE RESIDENTS OF HALIFAX COUNTY AND SURROUNDING COUNTIES. 15 11 959 60 966447 -162909 574602 197545 103894758 109770592 324166 427364 46453 49385 104839979 110444886 0 0 0 0 41947327 43754228 0 0 0 58424782 60934007 100372109 104688235 4467870 5756651 98761838 96800365 47493119 42714018 51268719 54086347 X PLACING PATIENTS FIRST BY PROVIDING EXCELLENT AND COMPASSIONATE HEALTHCARE SERVICES. 0 0 97228506 108809236 PROVIDING QUALITY HEALTHCARE IS ONLY PART OF THE HOSPITAL'S CONTRIBUTION TO THE COMMUNITY. WITH OVER 1,000 EMPLOYEES, HALIFAX REGIONAL IS ONE OF THE REGION'S LARGEST EMPLOYERS. MANY OF THE APPROXIMATELY 60 PHYSICIANS ON THE HOSPITAL STAFF HIRE THEIR OWN EMPLOYEES AS WELL AND INVEST IN DEVELOPING THEIR PRACTICES, EXTENDING ECONOMIC IMPACT. THE MEDICAL CENTER PURCHASES MILLIONS OF DOLLARS OF GOODS AND SERVICES FROM THE REGION.PLEASE SEE SCHEDULE O FOR A CONTINUATION OF THE PROGRAM SERVICE ACCOMPLISHMENTS1. REACCREDITED OF 3-YEAR SURVEY BY THE JOINT COMMISSION.2. RECRUITED A NEW MANAGER, KEITH STEBBINS, AS DIRECTOR OF PLANT OPERATIONS.3. LEADERSHIP OF ROANOKE VALLEY COMMUNITY HEALTH INITIATIVE WAS MEASURED BY IMPROVEMENT IN WISCONSIN COUNTY HEALTH RANKING FOR HALIFAX COUNTY AND NORTHAMPTON COUNTIES IN RANKING OF 100 NORTH CAROLINA COUNTIES BY 2% FROM 2017.4. IMPLEMENTED ECU BEHAVIORAL HEALTH TELEPSYCHIATRY SERVICE FOR EMERGENCY PATIENTS' ASSESSMENT AND TREATMENT.5. IMPLEMENTED NEW STATE-BASED ONLINE PROCESS FOR RECEIVING NEW REFERRALS OF BEHAVIORAL HEALTH PATIENTS TO OUR INPATIENT SERVICES. 6. THE GASTROINTESTINAL PROCEDURAL LAB BEGAN COMPUTERIZED DOCUMENTATION ON MEDITECH FEBRUARY 14TH.7. RECEIVED AN UNQUALIFIED FINANCIAL AND OPERATIONAL AUDIT FOR FY2017 WITH NO AUDIT ADJUSTMENTS FOR THE 12TH YEAR IN A ROW.8. EMPLOYEE FUNDRAISING CAMPAIGNS RAISED $16,000 FOR THE UNITED WAY TO SUPPORT THE IMPORTANT SERVICES OF THE UNITED WAY.9. MULTIDISCIPLINARY TEAM DEFINED AND IMPLEMENTED A PREPARE FOR DISCHARGE (PFD) ORDER THAT PROVIDES FOCUS ON NEXT DAY DISCHARGE PLANNING. THIS CAN SIGNIFICANTLY IMPROVE DISCHARGE PLANNING PROCESSES AND REDUCE LENGTH OF STAY FOR ALL PATIENTS.10. INCREASED THE NUMBER OF POST-DISCHARGE HOME VISITS 53% (885 VISITS) BY TRANSITIONAL CARE NURSES TO MANAGE CARE FOR PATIENTS AND REDUCE RE-ADMISSIONS.11. COMPLETED ACTION PLAN FOR FULL RISK ASSESSMENT OF THE BIRTHING CENTER.12. HALIFAX REGIONAL NURSE RECOGNIZED AS A GREAT 100 NURSES IN NORTH CAROLINA FOR 2017. TONYA HASTY, RN IN OUR CATH LAB HAS BEEN RECOGNIZED THIS YEAR.13. FULL IMPLEMENTATION OF SCANNING AND ARCHIVING SYSTEM IN HEALTH INFORMATION MANAGEMENT FOR ELECTRONIC MEDICAL RECORD.14. IMPLEMENTATION OF PAIN ASSESSMENT AND MANAGEMENT COMMITTEE BY PHARMACY LEADERSHIP TO EDUCATE THE RISK, AND DECREASE PRESCRIBING, OF OPIOIDS.15. REASSESSED AND CREATED NEW PLAN FOR REPLACEMENT OF EMERGENCY ELECTRICAL GENERATORS WITH BOILERS TO FOLLOW.16. ACHIEVED AMERICAN COLLEGE OF RADIOLOGY (ACR) RE-ACCREDITATIONS FOR ALL AREAS CERTIFIED BY THE ACR I.E. CT, NUCLEAR MEDICINE, MRI, MAMMOGRAPHY AND ULTRASOUND SERVICES.17. IMPLEMENTED NEW USP 800 STANDARDS WITH RENOVATION OF NEW PHARMACY CLEAN ROOM TO MIX, OR COMPOUND, DRUGS FOR PATIENTS.18. WORKED WITH THE NEW PRESIDENT OF HALIFAX COMMUNITY COLLEGE, DR. MICHAEL ELAM, TO COMPLETELY REDESIGN NURSE TRAINING PROGRAMS. THIS IS TO EFFECTIVELY TRAIN A FULL CLASS OF NEW NURSES FROM OUR AREA AND TO IMPLEMENT A TRANSITIONAL PROGRAM THAT TRAINS LICENSED PRACTICAL NURSES OR LPNS TO BECOME RNS. DISCUSSIONS ALSO INCLUDE A CAN TO RN PROGRAM AND A NURSE RESIDENCY TO PROVIDE NEW GRADUATES SUPPORT AND STABILITY AS THEY BEGIN THEIR PRACTICE.19. APPLIED AND RECEIVED THE FOLLOWING FINANCIAL GRANTS IN FY 2018:GRANTING AGENCY & AMOUNT IN TOTAL:KATE B. REYNOLDS GET FIT STAY FIT GRANT (AUGUST 2018) -- $123,250HALIFAX REGIONAL FOUNDATION ANNUAL CONTRIBUTION (MAY 2018) -- $56,223HALIFAX REGIONAL VOLUNTEERS ANNUAL CONTRIBUTION (APRIL 2018) -- $21,314SUSAN G. KOMEN GRANT (DEC. 2017 & MAY 2018) -- $50,000 97228506 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 1 1 0 0 0 0 1 1 1 0 0 0 1 145 0 1 959 1 1 1 0 0 0 0 0 0 0 0 0 X 15 11 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 NC X SHERRY JENSEN 2525358005 250 SMITH CHURCH ROAD ROANOKE RAPIDS NC 27870 FANNIE GREENE CHAIRWOMAN 1.00 X X 1434 0 0 DR NATARAJAN RAJAN VICE CHAIRMAN 1.00 X X 22000 0 0 DREWERY BEALE TREASURER 1.00 X X 1500 0 0 EVELYN DAWSON SECRETARY 1.00 X X 575 0 0 DR JOEY THOMAS CHIEF OF STAFF 1.00 X 10964 0 0 BOB PATTERSON BOARD MEMBER 1.00 X 1800 0 0 VERNON BRYANT BOARD MEMBER 1.00 X 600 0 0 HUGH BAZEMORE BOARD MEMBER 1.00 X 1100 0 0 JOHNNY DRAPER BOARD MEMBER 1.00 X 750 0 0 JAMES PIERCE BOARD MEMBER 1.00 X 650 0 0 WILLIAM HODGE BOARD MEMBER 1.00 X 1150 0 0 REV RANDY MARTIN BOARD MEMBER 1.00 X 600 0 0 WILLIAM MAHONE PRESIDENT/CEO 40.00 X X 0 0 0 TOM LYNCH PAST CHAIRMAN 1.00 X 2100 0 0 DR SANDEEP TIWARI PAST CHIEF OF STAFF 1.00 X 500 0 0 SHERRY JENSEN VP OF FINANCE/CFO 40.00 X 240589 0 58004 KAREN DANIELS VP/CNO 40.00 X 184192 0 50001 BRUCE ROBISTOW VP 40.00 X 154502 0 40004 JASON HARRELL VP OF OPERATIONS/CNO 40.00 X 0 0 0 STEVEN HILL CRNA 40.00 X 221264 0 38011 KENNETH HARTZ CRNA 40.00 X 215716 0 44030 CLAUDE DIETTRICH CRNA 40.00 X 208781 0 37090 STEVEN ULSAS CRNA 40.00 X 208171 0 24000 ELIZABETH CRAWLEY CRNA 40.00 X 197888 0 31602 1676826 0 322742 46 0 1 0 NOVANT HEALTH 2085 FRONTIS PLAZA WINSTON SALEM NC 27103 MANAGEMENT 1839636 SODEXO PO BOX 360170 PITTSBURGH PA 631502096 DIETARY SERVICES 1666588 THEREX INC DBA REHABCARE PO BOX 502096 ST LOUIS MO 631502096 PT/ST/OT SERVICES 1088294 MEDICAL SOLUTIONS 1010 N 102ND ST SUITE 300 OMAHA NE 68114 CONTRACT NURSING 970749 NORTHERN EMERGENCY SPECIALISTS PC 1070 E 5TH STREET ROANOKE RAPIDS NC 27870 EMERGENCY PHYSICIAN 402412 37 104606 92939 197545 NET PATIENT SERVICE REV 541380 109545026 108583670 961356 PURCHASE DISCOUNTS 541900 132175 132175 OTHER PATIENT SERVICES 900099 47477 47477 PHARMACY 446110 45914 45914 109770592 702584 5091 697493 62080 62256 -176 -176 -176 266825 8395 -266825 -8395 -275220 -275220 FOOD/VENDING REVENUE 900099 33016 33016 MISCELLANEOUS INCOME 900099 16545 16545 49561 110444886 108809236 966447 471658 X 557642 264103 293539 33793136 30939733 2853403 1457796 1324244 133552 5502555 4998455 504100 2443099 2219282 223817 750000 750000 192388 192388 181720 181720 83938 83938 15713231 14653030 1060201 255773 255773 3119415 2375961 743454 1412580 1388913 23667 1029597 1029597 144149 110114 34035 628947 628947 4145252 4145252 552350 333356 218994 BAD DEBT EXPENSE 16954245 16954245 MEDICAL SUPPLIES 9467243 9465893 1350 DRUG EXPENSE 3007089 3007089 MISCELLANEOUS EXPENSES 2736520 2668380 68140 559570 466139 93431 104688235 97228506 7459729 0 25345379 23110440 9646155 10079078 1575397 1612688 1561198 1054771 88482157 60301177 28318972 28180980 12401434 12237007 830648 1139454 19082655 19385947 98761838 96800365 23799874 23179045 13128358 11875911 6579200 5840000 3985687 1819062 47493119 42714018 X 51065358 53959066 203361 127281 51268719 54086347 98761838 96800365 X 5756651 -188869 -2750154 X X 0 1 X 1 0 X 0 0 0 0 0 0 0 0 1 10000 10000 0 PART II-B, LINE 1: THE ORGANIZATION IS A MEMBER OF THE AMERICAN HOSPITAL ASSOCIATION AND THE NORTH CAROLINA HOSPITAL ASSOCIATION. A PORTION OF DUES PAID TO THE ORGANIZATION IS ALLOCATED TO LOBBYING EFFORTS ON BEHALF OF THE MEMBERSHIP BODY. THE APPROXIMATE PORTION OF DUES PAID TO THESE ORGANIZATIONS FOR THE YEAR THAT CONSTITUED LOBBYING WAS $10,000. 867707 867707 27005070 18924981 8080089 17180885 12040255 5140630 39841884 27920939 11920945 3586611 1415002 2171609 28180980 OTHER RECEIVABLES 319748 DUE FROM ROANOKE VALLEY HEALTH SERVICES, INC. 19066199 19385947 THIRD PARTY PAYOR SETTLEMENT 1819062 1819062 X 90529936 -188869 62256 -126613 90656549 83938 19704399 19788337 110444886 87712308 62256 62256 87650052 83938 16954245 17038183 104688235 PART X, LINE 2: THE MEDICAL CENTER IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE; ACCORDINGLY, THE ACCOMPANYING COMBINED FINANCIAL STATEMENTS DO NOT REFLECT A PROVISION OR LIABILITY FOR FEDERAL AND STATE INCOME TAXES. THE MEDICAL CENTER HAS DETERMINED THAT IT DOES NOT HAVE ANY MATERIAL UNRECOGNIZED TAX BENEFITS OR OBLIGATIONS AS OF SEPTEMBER 30, 2018. PART XI, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES NET W/ REVENUES 62,256. PART XI, LINE 4B - OTHER ADJUSTMENTS: TRANSFER OF EQUITY 3,600,000. BAD DEBT EXPENSE IN REVENUE 16,954,245. CHANGE IN VALUE OF DEFINED PENSION PLAN -849,846. LOSS ON EXTINGUISHMENT OF DEBT PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES NET W/ REVENUES 62,256. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE IN REVENUE 16,954,245. 1 1 X 1 X 1 X 1 1 1 0 1 1 3419544 3419544 0.03900 13304141 11119932 2184209 0.02490 16723685 11119932 5603753 0.06390 744223 84945 659278 0.00750 56485 56485 0.00060 800708 84945 715763 0.00810 17524393 11204877 6319516 0.07200 1 16954245 506400 43457378 44492036 -1034658 X 1 1 1 1 HALIFAX REGIONAL MEDICAL CENTER 250 SMITH CHURCH ROAD ROANOKE RAPIDS NC 27870 X X X DISPROPORTIONATE SHARE HOSPITAL HALIFAX REGIONAL MEDICAL CENTER 1 0 0 1 X X X X X X X X X 16 1 0 0 1 X WWW.HALIFAXREGIONAL.ORG X 1 16 1 WWW.HALIFAXMEDICALCENTER.ORG 0 1 X 200.000000000000 250.000000000000 X X X X X 1 1 X X X 1 X WWW.HALIFAXREGIONAL.ORG X WWW.HALIFAXREGIONAL.ORG X WWW.HALIFAXREGIONAL.ORG X X X X X 1 X 0 X X X X 1 X 0 1 HALIFAX REGIONAL MEDICAL CENTER PART V, SECTION B, LINE 5: PRIMARY DATA WAS OBTAINED FROM COMMUNITY-WIDE HEALTH SURVEYS CONDUCTED BY HALIFAX AND NORTHAMPTON COUNTY HEALTH DEPARTMENTS. SURVEYS WERE DISTRIBUTED ACROSS THE COUNTIES IN AN EFFORT TO INCLUDE THE OPINIONS OF A DIVERSE POPULATION. HALIFAX REGIONAL MEDICAL CENTER PART V, SECTION B, LINE 11: THE TOP PRIORITY ADDRESSED IN THIS CHNA WAS IDENTIFIED AS OVERWEIGHT/OBESITY. THE OBJECTIVES TO ADDRESSING THIS NEED INCLUDE: INCREASE AWARENESS OF THE OBESITY EPIDEMIC AND PROMOTE HEALTHY LIFESTYLES, BECOME A LEADING PARTNER WITH THE ROANOKE VALLEY COMMUNITY HEALTH INITIATIVE, AND CREATE A COMMUNITY RESOURCE DIRECTORY OF AVAILABLE RESOURCES TO HELP LEAD A HEALTHY LIFESTYLE. THE OTHER RISK FACTORS THAT WERE IDENTIFIED INCLUDE: DIET, PHYSICAL INACTIVITY, HIGH BLOOD CHOLESTEROL/HYPERTENSION, SUBSTANCE ABUSE, AND STRESS. THESE OTHER RISK FACTORS ARE BEING ADDRESSED BY OTHER AGENCIES IN THE AREA. ALSO, ADDRESSING THIS TOP PRIORITY OF OBESITY WILL ALSO HELP WITH THE OTHER FACTORS IDENTIFIED. HALIFAX REGIONAL MEDICAL CENTER PART V, SECTION B, LINE 16J: ON THE BACK OF THE BILLING STATEMENT, THE ORGANIZATION LISTS THE CHARITY POLICY AND PROVIDES THE PATIENT WITH A FINANCIAL COUNSELOR TO DISCUSS THEIR ABILITY TO PAY THE INVOICE/RECEIVE CHARITY CARE. HALIFAX REGIONAL MEDICAL CENTER PART V, SECTION B, LINE 20E: SIGNAGE IS PLACED IN VARIOUS PLACES IN THE HOSPITAL INCLUDING ADMISSIONS AND EMERGENCY DEPT. PART I, LINE 7: THE ORGANIZATION USED WORKSHEET 2 OF THE 2017 SCHEDULE H INSTRUCTIONS TO COMPUTE CHARITY CARE, UNREIMBURSED MEDICAID, AND SUBSIDIZED HEALTH SERVICES AT COST FOR PURPOSES OF PART I, LINE 7. PART I, LN 7 COL(F): THE TOTAL EXPENSE LISTED ON FORM 990, PART XI, LINE 25 CONTAINS BAD DEBT EXPENSE OF $16,954,245 WHICH HAS BEEN REMOVED FOR PURPOSES OF THE CALCULATION OF CHARITY CARE PERCENTAGE FOR PART I, LINE 7, COLUMN (F). PART II, COMMUNITY BUILDING ACTIVITIES: HOSPITAL EMPLOYEES ROUTINELY DEVOTE THEIR TIME TO SERVICE ON THE CITY COUNCIL AND THE LOCAL CHAMBER OF COMMERCE TO PROMOTE COMMUNITY ECONOMIC DEVELOPMENT. THE HOSPITAL SPONSORS NUMEROUS EDUCATIONAL PROGRAMS INCLUDING DIABETES AND CHILDHOOD OBESITY PROJECTS. OUR WEBSITE OFFERS HEALTHY LIFE STYLE TIPS AND TOOLS TO IMPROVE HEALTHY LIVING AS WELL AS SENDS OUT EMAILS FOR THIS PROMOTION. WE PROMOTE FAMILY FEST TO ENCOURAGE EXERCISE AND HEALTHY EATING FOR THE CHILDREN OF OUR COMMUNITY. PART III, LINE 4: THERE IS NOT A FOOTNOTE IN THE ORGANIZATION'S FINANCIAL STATEMENTS TO DISCUSS THE BAD DEBT EXPENSE.TOTAL BAD DEBT CONSISTS OF TOTAL CHARGES WRITTEN OFF TO BAD DEBT LESS ANY RECOVERIES AND PASS-THROUGH AMOUNTS FROM MEDICARE. IN OUR COMMUNITY, THE POPULATIONS OF PEOPLE WHO LIVE BELOW THE POVERTY LEVEL IS ABOUT 27%. PEOPLE WITHOUT HEALTH INSURANCE IS 13.7% IN THE AREA. BASED ON OUR PAST EXPERIENCE WITH CHARITY CARE AND BAD DEBT, ABOUT 10% OF THE PEOPLE THAT ARE CURRENTLY IN BAD DEBT WOULD QUALIFY FOR FINANCIAL ASSISTANCE. PART III, LINE 8: APPROXIMATELY 50% OF THE HOSPITAL'S TOTAL CHARGES ARE FROM MEDICARE. APPROXIMATELY 18% OF THE POPULATION OF HALIFAX COUNTY IS AGE 65 AND OVER. THE HOSPITAL HAS A RESPONSIBILITY TO THE COMMUNITY TO PROVIDE QUALITY CARE, AND A SHORTFALL WHEN APPLICABLE FOR OUR MEDICARE COST OF CARE SHOULD BE CONSIDERED A COMMUNITY BENEFIT. PART III, LINE 9B: HALIFAX REGIONAL MEDICAL CENTER WORKS TO QUALIFY PATIENTS FOR FINANCIAL ASSISTANCE BEFORE ASSIGNING UNPAID ACCOUNTS TO OUTSIDE COLLECTION AGENCIES. THE HOSPITAL HAS PURCHASED SOFTWARE SERIVCES TO MAKE IT EASIER TO QUALIFY PATIENTS FOR CHARITY CARE. WE ALSO WORK WITH VANGUARD SERVICES TO HELP PATIENTS QUALIFY FOR MEDICAID AND OTHER INSURANCES. HRMC STRIVES TO HELP PATIENTS QUALIFY FOR APPROPRIATE FINANCIAL ASSISTANCE BEFORE SENDING ACCOUNTS TO BAD DEBT COLLECTION AGENCIES.WHEN A PATIENT IS DETERMINED TO QUALIFY FOR FINANCIAL ASSISTANCE, NO COLLECTION EFFORTS ARE MADE FOR THE PATIENT'S ACCOUNTS. PART VI, LINE 2: THE HOSPITAL IS PART OF THE ROANOKE VALLEY COMMUNITY HEALTH INITIATIVE (RV-CHI).THIS TEAM IS COMPRISED OF REPRESENTATIVES FROM THE HALIFAX AND NORTHAMPTON COUNTY HEALTH DEPARTMENTS, AREA SCHOOLS, RURAL HEALTH GROUP CLINIC, OUR COMMUNITY HOSPITAL, CO-OP EXTENSION OFFICE, AND HALIFAX REGIONAL. THIS GROUP MEETS QUARTERLY TO DISCUSS COMMUNITY HEALTH ISSUES AND HOW THEY ARE BEING ADDRESSED BY THESE COMMUNITY ORGANIZATIONS. THE RV-CHI ALSO HAS A COORDINATING GROUP THAT MEETS MONTHLY. OUR EDUCATION DIRECTOR ATTENDS THIS MONTHLY MEETING AS WELL. ALSO, OUR BOARD IS COMPRISED OF LOCAL COMMUNITY LEADERS WHO BRING ISSUES TO THE BOARD AND SENIOR MANAGEMENT. PART VI, LINE 3: OUR FINANCIAL ASSISTANCE POLICY IS ON OUR WEBSITE, AND SIGNAGE IS POSTED THROUGHOUT THE HOSPITAL TO INFORM PATIENTS ABOUT OUR POLICY. THE PROCESS AND PHONE NUMBERS TO CALL ARE ALSO NOTED ON OUR PATIENT STATEMENTS. WE HAVE STAFF FROM OUR COLLECTIONS DEPARTMENT AVAILABLE TO DISCUSS THE PROCESS WITH PATIENTS. THE COLLECTIONS DEPT APPLIES THE POLICY AS APPROPRIATE WHEN ASSISTING PATIENTS IN QUALIFYING FOR CHARITY CARE OR COLLECTING PAYMENTS FROM OUR PATIENTS. WE ALSO USE SOFTWARE TO HELP DETERMINE IF PATIENTS QUALIFY FOR CHARITY CARE. THIS MAKES IT EASIER FOR PATIENTS TO QUALIFY WITHOUT HAVING TO PRESENT A LOT OF PAPERWORK. PART VI, LINE 4: OUR PRIMARY SERVICE AREA CONSISTS OF HALIFAX, NORTHAMPTON, AND WARREN COUNTIES. THE PERCENTAGE OF THE HOSPITAL PATIENTS WITH MEDICARE AND MEDICAID IS 71% OF OUR TOTAL REVENUE. THE TOTAL POPULATION ESTIMATES JULY 2018 ARE 50,574 HALIFAX; 19,676 NORTHAMPTON; AND 19,807 WARREN. PERSONS AGE 65 AND OLDER JULY 2018 ARE 20.1% HALIFAX; 25.2% NORTHAMPTON; AND 24.7% WARREN. PEOPLE LIVING IN POVERTY ARE 28.1% HALIFAX; 24.3% NORTHAMPTON; AND 20.9% WARREN. THE POPULATION UNDER AGE 65 LIVING WITH A DISABILITY ARE 15% HALIFAX; 16.4% NORTHAMPTON; AND 14.1% WARREN. PERSONS WITHOUT HEALTH INSURANCE ARE 13.5% HALIFAX; 11.59% NORTHAMPTON; AND 16.4% WARREN. PART VI, LINE 5: HALIFAX REGIONAL MEDICAL CENTER WORKS CLOSELY WITH THE AREA COUNTY HEALTH DEPARTMENTS TO DO COMMUNITY HEALTH ASSESSMENTS AND DETERMINE HEALTH NEEDS IN THE AREA. HRMC ALSO WORKS CLOSELY WITH THE RURAL HEALTH GROUP AND HAS IMPLEMENTED A CASE MANAGEMENT PROGRAM FOR HEART FAILURE PATIENTS. HRMC PROVIDES COMMUNITY HEALTH INFORMATION, EDUCATION, AND EXERCISE THROUGH OUR HEALTHLINKS IN THE LOCAL MALL. ON THE HRMC WEBSITE, THERE IS A LINK TO SIGN UP FOR FREE HEALTH-ED EMAILS THAT CONTAIN FREE TIPS FOR A HEALTHY LIFESTYLE AND NOTICES ABOUT HEALTHY ACTIVITIES AND EDUCATION.A MAJORITY OF THE ORGANIZATION'S GOVERNING BODY IS COMPRISED OF PERSONS WHO RESIDE IN THE ORGANIZATION'S PRIMARY SERVICE AREA AND WHO ARE NEITHER EMPLOYEES NOR INDEPENDENT CONTRACTORS OF THE ORGANIZATION NOR FAMILY MEMBERS THEREOF. THE ORGANIZATION EXTENDS MEDICAL STAFF PRIVILEDGES TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY FOR MANY OF ITS DEPARTMENTS.ANY SURPLUS OF FUNDS IS REINVESTED INTO THE HOSPITAL BY PURCHASE NEW EQUIPMENT AND REPLACE EXISTING EQUIPMENT, UPDATE THE BUILDING STRUCTURE, AND IMPROVE OPERATIONS. WE ALSO USE FUNDS TO IMPROVE QUALITY OF CARE AND PROVIDE EDUCATIONAL OPPORTUNITIES FOR STAFF MEMBERS. PART VI, LINE 6: HALIFAX REGIONAL IS UNDER A MANAGEMENT CONTRACT WITH NOVANT HEALTH. PART VI, LINE 7, REPORTS FILED WITH STATES NC X X X X 0 0 0 0 0 0 0 0 0 SHERRY JENSEN VP OF FINANCE/CFO 235555 0 5034 0 0 0 42000 0 16004 0 298593 0 0 0 KAREN DANIELS VP/CNO 181607 0 2585 0 0 0 42000 0 8001 0 234193 0 0 0 BRUCE ROBISTOW VP 152217 0 2285 0 0 0 24000 0 16004 0 194506 0 0 0 STEVEN HILL CRNA 220764 0 500 0 0 0 22007 0 16004 0 259275 0 0 0 KENNETH HARTZ CRNA 215716 0 0 0 0 0 24000 0 20030 0 259746 0 0 0 CLAUDE DIETTRICH CRNA 208781 0 0 0 0 0 23488 0 13602 0 245871 0 0 0 STEVEN ULSAS CRNA 208171 0 0 0 0 0 24000 0 0 0 232171 0 0 0 ELIZABETH CRAWLEY CRNA 197888 0 0 0 0 0 18000 0 13602 0 229490 0 0 0 A NORTH CAROLINA MEDICAL CARE COMMISSION 521309402 NONEAVAIL 2011-07-28 6500000 CAPITAL ACQUISITION 0 0 0 B NORTH CAROLINA MEDICAL CARE COMMISSION 521309402 NONEAVAIL 2016-09-27 8845000 REFUNDING BONDS 0 0 0 A 1110000 6502377 130000 6372043 2013 0 0 1 1 B 2168333 8845135 145064 8699936 0 0 1 1 A 0 0 0 0 0 0 0 B 0 0 0 0 0 0 0 A 0 1 1 0 1 0 0 0 0 B 0 0 0 0 1 0 0 0 0 A 0 B 0 PART II, LINE 3: TOTAL PROCEEDS TOTAL PROCEEDS ON LINE 3 INCLUDE INVESTMENT EARNINGS TO DATE OF $ 2,488. LYNCH'S OFFICE SUPPLY BOARD MEMBER, TOM LYNCH, OWNS THE COMPANY 143614 PURCHASES OF OFFICE SUPPLIES 0 AUDREY HARDY RELATIVE OF BOARD MEMBER 89763 COMPENSATION FOR SERVICES 0 BETTY ANDERSON RELATIVE OF BOARD MEMBER 25673 COMPENSATION FOR SERVICES 0 PAULA ELIAS RELATIVE OF BOARD MEMBER 16838 COMPENSATION FOR SERVICES 0 FORM 990, PART VI, SECTION A, LINE 3 THE HOSPITAL SYSTEM HAD A MANAGEMENT SERVICES AGREEMENT WITH NOVANT HEALTH INC. THE BOARD OF HRMC CONTINUES TO OVERSEE THE OPERATIONS OF THE HEALTHCARE FACILITY AND RELATED EXEMPT ACTIVITIES. HRMC RECEIVES MANAGEMENT SERVICES AS WELL AS EXPENSE SAVINGS FOR AN ANNUAL MANAGEMENT FEE. NOVANT PROVIDES HRMC WITH A CEO AND COO AND HRMC PROVIDES REIMBURSEMENT FOR THOSE COSTS. DURING THE 2017 CALENDAR YEAR YEAR, NOVANT PAID COMPENSATION OF $427,508 TO THE ORGANIZATION'S CEO. FORM 990, PART VI, SECTION B, LINE 11B THE RETURN WAS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM WITH ASSISTANCE AND INFORMATION PROVIDED BY MANAGEMENT. THE HOSPITAL PROVIDED EVERY VOTING BOARD MEMBER A COPY OF THE DRAFT 990 PRIOR TO A SCHEDULED MEETING. DETAILS OF THE RETURN WERE DISCUSSED WITH MANAGEMENT AND THE FINANCE COMMITTEE OF THE BOARD, WHO THEN DELIVERED A REPORT TO THE FULL BOARD PRIOR TO FILING THE RETURN WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C (BYLAWS, ARTICLE 2, SECTION 3) "ANY DUALITY OF INTEREST OR POSSIBLE CONFLICT OF INTEREST ON THE PART OF ANY GOVERNING BOARD MEMBER SHALL BE DISCLOSED TO THE OTHER MEMBERS OF THE BOARD OF DIRECTORS AND MADE A MATTER OF RECORD THROUGH AN ANNUAL PROCEDURE AND ALSO WHEN THE INTEREST BECOMES A MATTER OF BOARD ACTION. ANY GOVERNING BOARD MEMBER HAVING A DUALITY OF INTEREST OR POSSIBLE CONFLICT OF INTEREST ON ANY MATTER SHALL NOT VOTE OR USE PERSONAL INFLUENCE ON THAT MATTER, AND SHALL NOT BE COUNTED IN DETERMINING THE QUORUM FOR THE MEETING, EVEN WHERE PERMITTED BY LAW. THE MINUTES OF THE MEETING SHALL REFLECT THAT A DISCLOSURE WAS MADE, THE ABSTENTION FROM VOTING, AND THE QUORUM SITUATION. ANY EXISTING OR APPARENT CONFLICT OF INTEREST WILL BE REFERRED TO THE EXECUTIVE COMMITTEE OF THE BOARD FOR RESOLUTION." THE CONFLICT OF INTEREST POLICY IS REVIEWED ANNUALLY. BOARD MEMBERS AND HOSPITAL MANAGEMENT PERSONNEL ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST QUESTIONNAIRE EACH YEAR. FORM 990, PART VI, SECTION B, LINE 15 AN OUTSIDE CONSULTANT IS USED TO DETERMINE THE APPROPRIATE COMPENSATION BASED ON COMPARABLE POSITIONS AND BENCHMARKS. THE CONSULTANT EVALUATES THE SALARIES FOR THE VPS. THE CEO APPROVES THE VP SALARIES. NOVANT DETERMINES THE COMPENSATION FOR THE CEO. FORM 990, PART VI, SECTION C, LINE 18 PHOTOCOPIES OF THE FORM 990 ARE AVAILABLE UPON REQUEST AT THE ORGANIZATION'S ADMINISTRATIVE OFFICE. FORM 990, PART VI, SECTION C, LINE 19 PHOTOCOPIES OF THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON WRITTEN REQUEST AT THE ORGANIZATION'S ADMINISTRATIVE OFFICE. FORM 990, PART IX, LINE 11G PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 3,222,389. MANAGEMENT AND GENERAL EXPENSES 21,711. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,244,100. MAINTENANCE CONTRACTS: PROGRAM SERVICE EXPENSES 1,962,842. MANAGEMENT AND GENERAL EXPENSES 2,627. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,965,469. CONTRACT SERVICES: PROGRAM SERVICE EXPENSES 2,860,336. MANAGEMENT AND GENERAL EXPENSES 869,922. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,730,258. SUPPORT FEES: PROGRAM SERVICE EXPENSES 37,736. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 37,736. NURSING SERVICES: PROGRAM SERVICE EXPENSES 1,540,020. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,540,020. PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 5,007,315. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,007,315. OTHER PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 22,392. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 22,392. CONSULTING FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 165,941. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 165,941. FORM 990, PART XI, LINE 9: CHANGE IN VALUE OF DEFINED PENSION PLAN 849,846. TRANSFER OF EQUITY -3,600,000. FORM 990, PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. HALIFAX REGIONAL MEDICAL CENTER CRNA BILLING LLC 250 SMITH CHURCH ROAD ROANOKE RAPIDS NC 27870 461929125 BILLING SUPPORT NC 1912063 HALIFAX REGIONAL MEDICAL CENTER INC HALIFAX REGIONAL MEDICAL CENTER FOUNDATION INC 250 SMITH CHURCH ROAD ROANOKE RAPIDS NC 27870 561698825 FUNDRAISING FOR ASSOCIATED CHARITABLE ORGANIZATION NC 501(C)(3) LINE 7 HALIFAX REGIONAL MEDICAL CENTER INC 1 ROANOKE VALLEY HEALTH SERVICES INC 250 SMITH CHURCH ROAD ROANOKE RAPIDS NC 27870 561925492 HEALTHCARE NC 501(C)(3) LINE 3 HALIFAX REGIONAL MEDICAL CENTER INC 1 0 1 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 ROANOKE VALLEY HEALTH SERVICES B 3600000 CASH HALIFAX REGIONAL MEDICAL CENTER FOUNDATION C 56223 CASH ROANOKE VALLEY HEALTH SERVICES R 11274354 CASH ROANOKE VALLEY HEALTH SERVICES S 6869164 CASH HALIFAX REGIONAL MEDICAL CENTER FOUNDATION M 56223 CASH