EAST CAROLINA HEALTH: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- EAST CAROLINA HEALTH (EIN 56-0989789)
- Tax period
- 2016-10-01 to 2017-09-30
- Filed
- 2018-06-22
- IRS object ID
- 201801739349300140
- Schema version
- 2016v3.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2018-06-22T14:44:36-05:00 | ReturnTs |
| Tax Period End | 2017-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 560747981 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DIXON HUGHES GOODMAN LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 500 RIDGEFIELD COURT | AddressLine1Txt |
| City | ASHEVILLE | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 28806 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2016-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 560989789 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HALIFAX REGIONAL MEDICAL CENTER INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | HALI | BusinessNameControlTxt |
| Phone | 2525358011 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 250 SMITH CHURCH ROAD | AddressLine1Txt |
| City | ROANOKE RAPIDS | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 27870 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | SHERRY JENSEN | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 2525358011 | PhoneNum |
| Signature | 2018-06-22 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Amy Bibby | PreparerPersonNm |
| PTIN | P00445891 | PTIN |
| Phone | 8282542254 | PhoneNum |
| Preparation | 2018-06-06 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | WILL MAHONE | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 250 SMITH CHURCH ROAD | AddressLine1Txt |
| City | ROANOKE RAPIDS | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 27870 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $105,258,487 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.halifaxmedicalcenter.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1972 | FormationYr |
| Legal Domicile State | NC | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE MEDICAL SERVICES TO THE RESIDENTS OF HALIFAX COUNTY AND SURROUNDING COUNTIES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 15 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 13 | VotingMembersIndependentCnt |
| Total Employee | 953 | TotalEmployeeCnt |
| Total Volunteers | 62 | TotalVolunteersCnt |
| Total Gross UBI | $748,904 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | -$313,527 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $1,007,257 | PYContributionsGrantsAmt |
| CY Contributions Grants | $574,602 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $106,482,433 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $103,894,758 | CYProgramServiceRevenueAmt |
| PY Investment Income | $378,817 | PYInvestmentIncomeAmt |
| CY Investment Income | $324,166 | CYInvestmentIncomeAmt |
| PY Other Revenue | $19,385 | PYOtherRevenueAmt |
| CY Other Revenue | $46,453 | CYOtherRevenueAmt |
| PY Total Revenue | $107,887,892 | PYTotalRevenueAmt |
| CY Total Revenue | $104,839,979 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $42,512,423 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $41,947,327 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $55,961,361 | PYOtherExpensesAmt |
| CY Other Expenses | $58,424,782 | CYOtherExpensesAmt |
| PY Total Expenses | $98,473,784 | PYTotalExpensesAmt |
| CY Total Expenses | $100,372,109 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $9,414,108 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $4,467,870 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $93,448,891 | TotalAssetsBOYAmt |
| Total Assets EOY | $98,761,838 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $42,360,559 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $47,493,119 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $51,088,332 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $51,268,719 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | PLACING PATIENTS FIRST BY PROVIDING EXCELLENT AND COMPASSIONATE HEALTHCARE SERVICES. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $93,773,089 | ExpenseAmt |
| Revenue | $103,970,673 | RevenueAmt |
| Desc | 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 ACCOMPLISHMENTS- Implemented year three of management service agreement with Adept Health (Novant) providing consulting services for quality, discharge planning, physician leadership, revenue cycle, clinical documentation, physician practice management, practice information systems, facility and engineering services. Annual savings from purchasing and service discounts were $1,173,659 and $673,659 net of fee.- Halifax Regional extended its management services agreement with Adept Health for 10 years with performance measures.- Recruited 3 new physicians and providers for Emergency Services.- Recruited a new Manager, Erin White, as Director for Therapy Services.- Performed assessment and implemented recommendations to reduce Hospital Acquired Infections or Conditions (HACs).- Implemented Length of Stay reduction program with Adept Health to decrease average length of stay by 0.5 days.- Purchased and installed a new Urology table.- Expanded Halifax Works to provide Urgent Care Services for not only occupational health clients but all patients. Added on site imaging services.- Dr. Holder began skin-to-skin contact in recovery area for C-Section patients. This increases bonding of mother, father, and baby in the recovery area.- Implemented second year of 2 year grant from Kate B Reynolds Trust to develop a Diabetes Resource Center for low income, uninsured and underinsured minority communities in our service area.- Reduced overall all payer readmission rates and identified high risk patients for follow up home visit within 3 days of discharge.- Marketing of Woodside was expanded by Lisa Turner, Nurse Manager of Woodside Behavioral Health Unit, with visits to Martin County, Tarboro, Scotland Neck, Henderson, and Oxford hospitals to offer our services. A second provider began working with Dr Ijaz, Scott Morelli, PA- Received an unqualified financial and operational audit for FY2016 with no audit adjustments.- Employee fundraising campaigns raised $14, 023 for the United Way to support the important services of the United Way.- Implemented Vincari software to assist surgeons with electronic documentation.- The Respiratory Care Team members recertified for Advanced Cardiac Life Support (ACLS) and Neonatal Resuscitation Program (NRP) and performed the first bronchoscopy since 2015 with Dr Duggan.- Successfully implemented new ShoreTel enterprise phone system at a cost of $460,000.- Implemented PolicyStat software to house all enterprise wide policies for effective online access and use.- Implemented ICNET Pharmacy system software as clinical surveillance system for infection prevention. - Planned and implemented the Birthing Center Breastfeeding Support Group for patients.- Gwen Davis RN encouraged and trained Drs Tiwari, Vallani, Bhagwandass, Dorsey, Rajan, Wier, Ketoff and Martin to enter their own computerized order entry.- Met all 2017 Meaningful Use goals for Hi Tech stimulus funds of $459,000.- Workplace Violence Committee led by Barbara Moore RN continued to identify strategies to improve workplace safety. With a significant grant from the Halifax Regional Foundation, $45,000 of safety facility improvements are being implemented in the Emergency Services area.- Reorganized Quality and Risk Management for concurrent quality reviews.- One of our nurses was recognized as a Great 100 Nurses in North Carolina for 2017. Amy Joseph, our OB Services Nurse Manager has been recognized this year.- Reaccredited in Laboratory for Clinical Laboratory Improvement Amendments (CLIA) through 2019 and installed new chemistry and immunoassay analyzers providing additional tests.- Installed three new patient educational channels called the GetWell Network.- Completed implementation of Antibiotic Stewardship Program to monitor antibiotic usage, educate staff and make formulary recommendations to Pharmacy and Therapeutics Committee.- Began reporting clinical data to LeapFrog Quality Rating Service after achieving a hospital patient safety score of "B".- Reassigned Patient Safety to the Risk Management staff and developed a "Good Catch" program to reward staff who report quality opportunities to improve.- Patients are pleased to be able to pay and communicate online for their bills with PatientCo software. Over 43% or 4300 patient services payments were made online.- Implemented a new weight loss program in conjunction with Halifax Works to serve employees and those of area businesses.- Implemented conversion from computed radiology (CR) to digital radiology (DR) for all radiology equipment. This received Board of Directors' approval for $1,129,558.- Renovated all 7 bathrooms in Radiology and replaced all flooring for improved appearance.- Continued to implement plan for replacement of emergency electrical generators and boilers. This received Board of Directors' approval for $5,184,500.- Achieved American College of Radiology (ACR) reaccreditations for all areas certified by the ACR ie CT, Nuclear Medicine, MRI, Mammography, and Ultrasound services.- Wound Care Service earned Center of Distinction award from Healogics by achieving a wound healing rate of 93%.- Medical Staff completely rewrote the Medical staff Bylaws and Rules and Regulations for Medical Staff using draft of Novant Health Medical Staff Bylaws.- Began reviewing new USP 800 Standards for two Pharmacy hoods with Novant Health facility staff. One hood is to assure safety for staff with dangerous chemotherapy and antibiotic drugs and the other hood is to assure sanitary conditions for other compounding. These new standards may require renovation costs exceeding $400,000 in FY18.- Recruited 10 new volunteers for a total of 62 volunteers who provided 7725.5 volunteer hours for our patients. The Auxiliary donated $29,824 to Halifax Regional for items requested by hospital departments. Leah and Elle, our Pet Therapy team, continue to visit the hospital. The volunteer program funded two $300 scholarships to area high schools and one $2000 scholarship for nursing students. They donated $1000 to the Halifax Regional Foundation. New Volunteer areas: Outpatient Registration and Risk Management. Volunteers continue to staff blood drives at the hospital.- Applied and received the following financial grants in FY2017:Kate B Reynolds Get Fit Stay Fit Grant $108,250Halifax Regional Foundation Annual Contribution 30,476Halifax Regional Auxiliary Annual Contribution 29,824Access East-Medicare Community Based Care Transitions Program 68,964Susan G Komen Grant 50,000Kate B Reynolds Diabetes Grant 93,500 Total $381,014 | Desc |
| Total Program Service Expenses | $93,773,089 | 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 | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | 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 | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| 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 | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (1) | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | Yes (1) | 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 | 144 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 953 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| 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 |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 15 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 13 | 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 | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | 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 | Yes (1) | 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 | Yes (1) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | Yes (1) | WrittenPolicyOrProcedureInd |
| States Where Copy Of Return Is Fld | NC | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SHERRY JENSEN | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 2525358005 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 250 SMITH CHURCH ROAD | AddressLine1Txt |
| City | ROANOKE RAPIDS | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 27870 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (23 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| Tom Lynch | |||||||||
| Chairman | 1.00 | 1.00 | Yes (X) | Yes (X) | $1,800 | $0 | $0 | ||
| Fannie Greene | |||||||||
| Vice Chairwoman | 1.00 | 1.00 | Yes (X) | Yes (X) | $1,200 | $0 | $0 | ||
| Drewery Beale | |||||||||
| Treasurer | 1.00 | 1.00 | Yes (X) | $1,500 | $0 | $0 | |||
| Dr Natarajan Rajan | |||||||||
| Secretary | 1.00 | 1.00 | Yes (X) | $1,150 | $0 | $0 | |||
| Bob Patterson | |||||||||
| Past Chairman | 1.00 | 1.00 | Yes (X) | $1,350 | $0 | $0 | |||
| Dr Joey Thomas | |||||||||
| Chief of Staff | 1.00 | 1.00 | Yes (X) | $7,452 | $0 | $0 | |||
| Dr Sandeep Tiwari | |||||||||
| Past Chief of Staff | 1.00 | 1.00 | Yes (X) | $1,800 | $0 | $0 | |||
| William Mahone | |||||||||
| President/CEO | 40.00 | 1.50 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| Hugh Bazemore | |||||||||
| Board Member | 1.00 | 1.00 | Yes (X) | $950 | $0 | $0 | |||
| James Pierce | |||||||||
| Board Member | 1.00 | 1.00 | Yes (X) | $650 | $0 | $0 | |||
| Johnny Draper | |||||||||
| Board Member | 1.00 | 1.00 | Yes (X) | $500 | $0 | $0 | |||
| Vernon Bryant | |||||||||
| Board Member | 1.00 | 1.00 | Yes (X) | Yes (X) | $800 | $0 | $0 | ||
| Evelyn Dawson | |||||||||
| Board Member | 1.00 | Yes (X) | $450 | $0 | $0 | ||||
| Rev Randy Martin | |||||||||
| Board Member | 1.00 | Yes (X) | $550 | $0 | $0 | ||||
| Sherry Jensen | |||||||||
| VP of Finance/CFO | 40.00 | 1.50 | Yes (X) | $279,598 | $0 | $15,487 | |||
| William Hodge | |||||||||
| Board Member | 1.00 | 1.00 | Yes (X) | $1,400 | $0 | $0 | |||
| Karen Daniels | |||||||||
| VP/CNO | 40.00 | 1.00 | $205,170 | $0 | $7,779 | Yes (X) | |||
| Bruce Robistow | |||||||||
| VP | 40.00 | 0.50 | $171,749 | $0 | $15,008 | Yes (X) | |||
| Steven Hill | |||||||||
| CRNA | 40.00 | $228,954 | $0 | $15,582 | Yes (X) | ||||
| Kenneth Hartz | |||||||||
| CRNA | 40.00 | $219,355 | $0 | $18,760 | Yes (X) | ||||
| Steven Ulsas | |||||||||
| CRNA | 40.00 | $203,389 | $0 | $1,476 | Yes (X) | ||||
| Elizabeth Crawley | |||||||||
| CRNA | 40.00 | $194,975 | $0 | $13,027 | Yes (X) | ||||
| Claude Dietrich | |||||||||
| CRNA | 40.00 | $173,571 | $0 | $18,675 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,698,313 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $105,794 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 30 | 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 |
|---|---|---|---|---|---|
| Novant Health | |||||
| 2085 Frontis Plaza | Winston Salem | NC | 27103 | Management | $2,071,897 |
| TherexDBA Rehabcare | |||||
| PO Box 502096 | St Louis | MO | 631502096 | PT/ST/OT Services | $1,082,350 |
| Sodexo | |||||
| PO Box 360170 | Pittsburgh | PA | 631502096 | Dietary Services | $896,892 |
| O C Mitchell | |||||
| 1411 South Miami Blvd | Durham | NC | 27703 | Contractor | $514,672 |
| Diversified Clinical Services | |||||
| 28525 Network Place | Chicago | IL | 606731285 | Wound Care Services | $424,005 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 40 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $58,325 | RelatedOrganizationsAmt |
| All Other Contributions | $516,277 | AllOtherContributionsAmt |
| Total Contributions | $574,602 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| NET PATIENT SERVICE REV | 541380 | $103,123,292 | $102,377,810 | $745,482 |
| OTHER PATIENT SERVICES | 900099 | $575,509 | $575,509 | |
| PURCHASE DISCOUNTS | 541900 | $161,145 | $161,145 | |
| PHARMACY | 446110 | $34,812 | $34,812 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $103,894,758 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $678,249 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | $3,422 | UnrelatedBusinessRevenueAmt |
| Exclusion | $674,827 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $76,361 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $64,425 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $11,936 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $11,936 | TotalRevenueColumnAmt |
| Exclusion | $11,936 | ExclusionAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $333,153 | SecuritiesAmt |
| Other | $20,930 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -$333,153 | SecuritiesAmt |
| Other | -$20,930 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$354,083 | TotalRevenueColumnAmt |
| Exclusion | -$354,083 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| MISCELLANEOUS INCOME | 900099 | $17,813 | $17,813 |
| FOOD/VENDING REVENUE | 900099 | $16,704 | $16,704 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $34,517 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $104,839,979 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $103,149,276 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $748,904 | UnrelatedBusinessRevenueAmt |
| Exclusion | $367,197 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $703,697 | TotalAmt |
| Program Services | $340,713 | ProgramServicesAmt |
| Management And General | $362,984 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $33,074,453 | TotalAmt |
| Program Services | $30,334,049 | ProgramServicesAmt |
| Management And General | $2,740,404 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,374,279 | TotalAmt |
| Program Services | $1,236,103 | ProgramServicesAmt |
| Management And General | $138,176 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,373,494 | TotalAmt |
| Program Services | $3,933,762 | ProgramServicesAmt |
| Management And General | $439,732 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,421,404 | TotalAmt |
| Program Services | $2,177,945 | ProgramServicesAmt |
| Management And General | $243,459 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $500,001 | TotalAmt |
| Management And General | $500,001 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $95,204 | TotalAmt |
| Management And General | $95,204 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $191,310 | TotalAmt |
| Management And General | $191,310 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $94,544 | TotalAmt |
| Program Services | $94,544 | ProgramServicesAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,864,309 | TotalAmt |
| Program Services | $14,147,620 | ProgramServicesAmt |
| Management And General | $716,689 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $348,719 | TotalAmt |
| Program Services | $348,719 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,973,419 | TotalAmt |
| Program Services | $2,194,685 | ProgramServicesAmt |
| Management And General | $778,734 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,504,614 | TotalAmt |
| Program Services | $1,476,861 | ProgramServicesAmt |
| Management And General | $27,753 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,004,382 | TotalAmt |
| Program Services | $1,004,382 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $188,143 | TotalAmt |
| Program Services | $162,897 | ProgramServicesAmt |
| Management And General | $25,246 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $572,614 | TotalAmt |
| Program Services | $572,614 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,210,451 | TotalAmt |
| Program Services | $4,210,451 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $914,903 | TotalAmt |
| Program Services | $692,900 | ProgramServicesAmt |
| Management And General | $222,003 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| BAD DEBT EXPENSE | $15,167,058 | $15,167,058 | |
| MEDICAL SUPPLIES | $9,436,751 | $9,436,635 | $116 |
| DRUG EXPENSE | $3,180,834 | $3,180,834 | |
| MISCELLANEOUS EXPENSES | $2,556,173 | $2,508,362 | $47,811 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $621,353 | TotalAmt |
| Program Services | $551,955 | ProgramServicesAmt |
| Management And General | $69,398 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $100,372,109 | TotalAmt |
| Program Services | $93,773,089 | ProgramServicesAmt |
| Management And General | $6,599,020 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,279,542 | BOYAmt |
| EOY | $25,345,379 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $216,682 | BOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,333,749 | BOYAmt |
| EOY | $9,646,155 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,483,479 | BOYAmt |
| EOY | $1,575,397 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $856,148 | BOYAmt |
| EOY | $1,561,198 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $85,889,504 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $57,570,532 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $28,426,814 | BOYAmt |
| EOY | $28,318,972 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,373,954 | BOYAmt |
| EOY | $12,401,434 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $491,983 | BOYAmt |
| EOY | $830,648 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,986,540 | BOYAmt |
| EOY | $19,082,655 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $93,448,891 | BOYAmt |
| EOY | $98,761,838 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,403,011 | BOYAmt |
| EOY | $23,799,874 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,715,000 | BOYAmt |
| EOY | $13,128,358 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,129,603 | BOYAmt |
| EOY | $6,579,200 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,112,945 | BOYAmt |
| EOY | $3,985,687 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $42,360,559 | BOYAmt |
| EOY | $47,493,119 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $50,809,056 | BOYAmt |
| EOY | $51,065,358 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $279,276 | BOYAmt |
| EOY | $203,361 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $51,088,332 | BOYAmt |
| EOY | $51,268,719 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $93,448,891 | BOYAmt |
| EOY | $98,761,838 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $4,467,870 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$239,089 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$4,048,394 | 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 | $10,000 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $10,000 | 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 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. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $867,707 | OtherCostOrOtherBasisAmt |
| Book Value | $867,707 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $27,005,070 | OtherCostOrOtherBasisAmt |
| Depreciation | $18,410,444 | DepreciationAmt |
| Book Value | $8,594,626 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $16,807,037 | OtherCostOrOtherBasisAmt |
| Depreciation | $11,458,034 | DepreciationAmt |
| Book Value | $5,349,003 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $38,633,339 | OtherCostOrOtherBasisAmt |
| Depreciation | $26,337,904 | DepreciationAmt |
| Book Value | $12,295,435 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,576,351 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,364,150 | DepreciationAmt |
| Book Value | $1,212,201 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $28,318,972 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (2 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| OTHER RECEIVABLES | $821,646 |
| DUE FROM ROANOKE VALLEY HEALTH SERVICES, INC. | $18,261,009 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $19,082,655 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | THIRD PARTY PAYOR SETTLEMENT | Desc |
| Amt | $3,985,687 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $3,985,687 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $85,362,909 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | -$239,089 | NetUnrealizedGainsInvstAmt |
| Other Revenue | $64,425 | OtherRevenueAmt |
| Revenue Not Reported | -$174,664 | RevenueNotReportedAmt |
| Revenue Subtotal | $85,537,573 | RevenueSubtotalAmt |
| Investment Expenses Not Incld | $94,544 | InvestmentExpensesNotIncldAmt |
| Other Revenues Not Included | $19,207,862 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $19,302,406 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $104,839,979 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $85,182,522 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $64,425 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $64,425 | ExpensesNotReportedAmt |
| Expenses Subtotal | $85,118,097 | ExpensesSubtotalAmt |
| Investment Expenses Not Incld2 | $94,544 | InvestmentExpensesNotIncld2Amt |
| Other Expenses Not Included | $15,159,468 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $15,254,012 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $100,372,109 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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, 2017. |
| Part XI, Line 2d - Other Adjustments: | RENTAL EXPENSES NET W/ REVENUES 64,425. |
| Part XI, Line 4b - Other Adjustments: | TRANSFER OF EQUITY 3,600,000. BAD DEBT EXPENSE IN REVENUE 15,159,468. CHANGE IN VALUE OF DEFINED PENSION PLAN 448,394. LOSS ON EXTINGUISHMENT OF DEBT |
| Part XII, Line 2d - Other Adjustments: | RENTAL EXPENSES NET W/ REVENUES 64,425. |
| Part XII, Line 4b - Other Adjustments: | BAD DEBT EXPENSE IN REVENUE 15,159,468. |
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 |
| Percent200 | Yes (X) | Percent200Ind |
| 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 | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| 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 | $3,391,184 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $3,391,184 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03980 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $15,485,639 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $12,874,860 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,610,779 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03060 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $82,627 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $39,664 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $42,963 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00050 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $18,959,450 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $12,914,524 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $6,044,926 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07090 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $473,498 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $426 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $473,072 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00560 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,650 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,650 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $476,148 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $426 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $475,722 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00560 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $19,435,598 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $12,914,950 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $6,520,648 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07650 | TotalExpensePct |
Economic Development EconomicDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,194 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,194 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Coalition Building CoalitionBuildingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $3,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,194 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $4,194 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $15,159,469 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $452,467 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $34,818,690 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $33,347,074 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $1,471,616 | 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 | Yes (1) | 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 | HALIFAX REGIONAL MEDICAL CENTER | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 250 SMITH CHURCH ROAD | AddressLine1Txt |
| City | ROANOKE RAPIDS | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 27870 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Other | DISPROPORTIONATE SHARE HOSPITAL | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HALIFAX REGIONAL MEDICAL CENTER | 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 | 15 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | 0 | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | www.halifaxmedicalcenter.org | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 15 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | www.halifaxmedicalcenter.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 | 200.000000000000 | 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 |
| 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.halifaxmedicalcenter.org | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | www.halifaxmedicalcenter.org | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | http://www.halifaxmedicalcenter.org/charity.html | 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 |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Other Actions Taken | Yes (X) | OtherActionsTakenInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | Yes (1) | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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 from October 2014 to January 2015. Surveys were distributed across the counties in an effort to include the opinions of a diverse population. The final analysis included 810 surveys from Halifax and 335 from Northampton Co. State of Our County Listening Sessions were also held in seven communities in Halifax County from April 16 to May 20, 2015. The results were summarized and presented to each of these communities from October 1 to October 20, 2015. |
| 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. |
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 7: | THE ORGANIZATION USED WORKSHEET 2 OF THE 2014 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 $14,043,783 WHICH HAS BEEN REMOVED FOR PURPOSES OF THE CALCULATION OF CHARITY CARE PERCENTAGE FOR PART I, LINE 7, COLUMN (F). |
| PART I, LINE 7(E) | THE COMMUNITY HEALTH IMPROVEMENTS SERVICES ON PART I, LINE 7(E) INCLUDE THE FOLLOWING:PATIENT EDUCATION $121,387LIBRARY FOR PATIENT EDUCATION $ 5,903CASE MANAGMENT HEART FAILURE $168,777THE COMMUNITY BENEFIT OPERATIONS SERVICES ON PART I, LINE 7(E) INCLUDE THE FOLLOWING:GRANT WRITING $ 56,000 |
| 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 2017 are 51,310 Halifax; 19,862 Northampton; and 19,883 Warren. Persons age 65 and older July 2017 are 19.6% Halifax; 24.1% Northampton; and 22.9% Warren. People living in poverty are 27% Halifax; 22.4% Northampton; and 26.4% Warren. The population under age 65 living with a disability are 15.8% Halifax; 17.6% Northampton; and 16.6% Warren. Persons without health insurance are 13.7% Halifax; 12.0% Northampton; and 16.6% 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: | THE ORGANIZATION IS NOT PART OF AN AFFILIATED HEALTH CARE SYSTEM. |
| Part VI, Line 7, Reports Filed With States | NC |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| 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 (8 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Sherry Jensen | ||||||||||||||
| VP of Finance/CFO | $231,366 | $0 | $48,232 | $0 | $0 | $0 | $1,639 | $0 | $13,848 | $0 | $295,085 | $0 | $0 | $0 |
| Karen Daniels | ||||||||||||||
| VP/CNO | $180,284 | $0 | $24,886 | $0 | $0 | $0 | $856 | $0 | $6,923 | $0 | $212,949 | $0 | $0 | $0 |
| Bruce Robistow | ||||||||||||||
| VP | $149,723 | $0 | $22,026 | $0 | $0 | $0 | $1,160 | $0 | $13,848 | $0 | $186,757 | $0 | $0 | $0 |
| Steven Hill | ||||||||||||||
| CRNA | $227,454 | $0 | $1,500 | $0 | $0 | $0 | $1,734 | $0 | $13,848 | $0 | $244,536 | $0 | $0 | $0 |
| Kenneth Hartz | ||||||||||||||
| CRNA | $219,055 | $0 | $300 | $0 | $0 | $0 | $1,429 | $0 | $17,331 | $0 | $238,115 | $0 | $0 | $0 |
| Steven Ulsas | ||||||||||||||
| CRNA | $203,144 | $0 | $245 | $0 | $0 | $0 | $1,476 | $0 | $0 | $0 | $204,865 | $0 | $0 | $0 |
| Elizabeth Crawley | ||||||||||||||
| CRNA | $194,725 | $0 | $250 | $0 | $0 | $0 | $1,258 | $0 | $11,769 | $0 | $208,002 | $0 | $0 | $0 |
| Claude Dietrich | ||||||||||||||
| CRNA | $173,321 | $0 | $250 | $0 | $0 | $0 | $1,344 | $0 | $17,331 | $0 | $192,246 | $0 | $0 | $0 |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (2 entries)
| Bond ReferenceBondReferenceCd | Bond Issuer EINBondIssuerEIN | CUSIPCUSIPNum | Bond IssuedBondIssuedDt | Issue PriceIssuePriceAmt | PurposePurposeDesc | DefeasedDefeasedInd | On Behalf Of IssuerOnBehalfOfIssuerInd | Pool FinancingPoolFinancingInd |
|---|---|---|---|---|---|---|---|---|
| NORTH CAROLINA MEDICAL CARE COMMISSION | ||||||||
| A | 521309402 | NONEAVAIL | 2011-07-28 | $6,500,000 | CAPITAL ACQUISITION | 0 | 0 | 0 |
| NORTH CAROLINA MEDICAL CARE COMMISSION | ||||||||
| B | 521309402 | NONEAVAIL | 2016-09-27 | $8,845,000 | REFUNDING BONDS | 0 | 0 | 0 |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)
| Bond ReferenceBondReferenceCd | RetiredRetiredAmt | Total ProceedsTotalProceedsAmt | Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt | Capital ExpendituresCapitalExpendituresAmt | Substantial CompletionSubstantialCompletionYr | Current RefundingCurrentRefundingInd | Advance RefundingAdvanceRefundingInd | Final Allocation MadeFinalAllocationMadeInd | Adequate Books And Rec MaintAdequateBooksAndRecMaintInd | Other Spent ProceedsOtherSpentProceedsAmt |
|---|---|---|---|---|---|---|---|---|---|---|
| A | $870,000 | $6,502,377 | $130,000 | $6,372,043 | 2013 | 0 | 0 | Yes (1) | Yes (1) | |
| B | $1,131,250 | $8,845,135 | $145,064 | 0 | 0 | Yes (1) | Yes (1) | $8,699,936 |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (2 entries)
| Bond ReferenceBondReferenceCd | Owning Bond Financed PropertyOwningBondFinancedPropertyInd | Any Lease ArrangementsAnyLeaseArrangementsInd | Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd | Any Research AgreementsAnyResearchAgreementsInd | Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd | Change In Use Bond Financed PropChangeInUseBondFinancedPropInd | Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd |
|---|---|---|---|---|---|---|---|
| A | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| B | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (2 entries)
| Bond ReferenceBondReferenceCd | Form8038 T FiledForm8038TFiledInd | Rebate Not Due YetRebateNotDueYetInd | Exception To RebateExceptionToRebateInd | No Rebate DueNoRebateDueInd | Variable Rate IssueVariableRateIssueInd | Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd | Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd | Gross Proceeds InvestedGrossProceedsInvestedInd | Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd |
|---|---|---|---|---|---|---|---|---|---|
| A | 0 | Yes (1) | Yes (1) | 0 | Yes (1) | 0 | 0 | 0 | 0 |
| B | 0 | 0 | 0 | 0 | Yes (1) | 0 | 0 | 0 | 0 |
Procedures Corrective Action ProceduresCorrectiveActionGrp (2 entries)
| Bond ReferenceBondReferenceCd | Procedures Corrective ActionProceduresCorrectiveActionInd |
|---|---|
| A | 0 |
| B | 0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II, LINE 3: TOTAL PROCEEDS | FormAndLineReferenceDesc |
| Explanation | TOTAL PROCEEDS ON LINE 3 INCLUDE INVESTMENT EARNINGS TO DATE OF $ 2,488. | ExplanationTxt |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LYNCH'S OFFICE SUPPLY | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | BOARD MEMBER, TOM LYNCH, OWNS THE COMPANY | RelationshipDescriptionTxt |
| Transaction | $170,715 | TransactionAmt |
| Transaction | PURCHASES OF OFFICE SUPPLIES | TransactionDesc |
| Sharing Of Revenues | 0 | SharingOfRevenuesInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section A, line 3 | DURING MARCH OF 2014 THE HOSPITAL SYSTEM ENTERED INTO A MANAGEMENT SERVICES AGREEMENT WITH NOVANT HEALTH INC. THAT CONTINUES THROUGH FEBRUARY 2017. 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 HRMC PROVIDES REIMBURSEMENT FOR THOSE COSTS. DURING THE YEAR, NOVANT PAID COMPENSATION OF $486,665 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 3,233,523. Management and general expenses 55,974. Fundraising expenses 0. Total expenses 3,289,497. MAINTENANCE CONTRACTS: Program service expenses 1,904,639. Management and general expenses 1,683. Fundraising expenses 0. Total expenses 1,906,322. CONTRACT SERVICES: Program service expenses 2,742,538. Management and general expenses 530,950. Fundraising expenses 0. Total expenses 3,273,488. SUPPORT FEES: Program service expenses 23,404. Management and general expenses 0. Fundraising expenses 0. Total expenses 23,404. NURSING SERVICES: Program service expenses 1,462,738. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,462,738. PHYSICIAN FEES: Program service expenses 4,763,564. Management and general expenses 0. Fundraising expenses 0. Total expenses 4,763,564. OTHER PROFESSIONAL FEES: Program service expenses 17,214. Management and general expenses 0. Fundraising expenses 0. Total expenses 17,214. CONSULTING FEES: Program service expenses 0. Management and general expenses 128,082. Fundraising expenses 0. Total expenses 128,082. |
| Form 990, Part XI, line 9: | CHANGE IN VALUE OF DEFINED PENSION PLAN -448,394. TRANSFER OF EQUITY -3,600,000. |
| FORM 990, PART XII, LINE 2C: | THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HALIFAX REGIONAL MEDICAL CENTER CRNA BILLING LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 250 SMITH CHURCH ROAD | AddressLine1Txt |
| City | rOANOKE RAPIDS | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 27870 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 461929125 | EIN |
| Primary Activities | BILLING SUPPORT | PrimaryActivitiesTxt |
| Legal Domicile State | NC | LegalDomicileStateCd |
| Total Income | $1,861,903 | TotalIncomeAmt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HALIFAX REGIONAL MEDICAL CENTER INC | BusinessNameLine1Txt |
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| 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 | Yes (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 | Yes (1) |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | 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 | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (4 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| ROANOKE VALLEY HEALTH SERVICES | ||
| B | $3,600,000 | CASH |
| HALIFAX REGIONAL MEDICAL CENTER FOUNDATION | ||
| C | $58,325 | CASH |
| ROANOKE VALLEY HEALTH SERVICES | ||
| R | $11,412,082 | CASH |
| ROANOKE VALLEY HEALTH SERVICES | ||
| S | $6,566,572 | CASH |