2016-11-11T15:28:54-06:00 2015-12-31 410746749 CLIFTONLARSONALLEN LLP 227 WEST TRADE STREET SUITE 800 CHARLOTTE NC 28202 990 2015-01-01 582078244 ASHE MEMORIAL HOSPITAL FOUNDATION INC ASHE 3368467101 200 HOSPITAL AVENUE JEFFERSON NC 28640 CHARLES WRIGHT CFO 3368467101 2016-11-11 1 JOHN NORMAN P01506766 7049985200 2016-11-11 2015 2017-02-10 21:41:12Z LAURA LAMBETH 200 HOSPITAL AVENUE JEFFERSON NC 28640 365279 0 X N/A X 1993 NC PROMOTION OF ASHE MEMORIAL HOSPITAL ACTIVITIES. 22 22 0 0 0 0 27565 327546 0 0 22979 11872 0 -4731 50544 334687 52970 714417 0 0 0 0 0 0 0 0 32130 52970 746547 -2426 -411860 1437740 585253 586593 173003 851147 412250 ASHE MEMORIAL HOSPITAL FOUNDATION'S MISSION IS TO PROMOTE ALL ACTIVITIES OF ASHE MEMORIAL HOPITAL. 0 0 746547 714417 THE FOUNDATION SUPPORTS ASHE MEMORIAL HOSPITAL AND ITS ACTIVITIES. DURING THE SHORT PERIOD ENDING DECEMBER 31, 2014, THE FOUNDATION GAVE $52,970 TO THE HOSPITAL TO SUPPORT THE HEALTHCARE NEEDS IN THE COMMUNITY. 746547 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 0 0 X 22 22 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 0 0 0 0 0 X X CHARLES WRIGHT 3368460798 200 HOSPITAL AVENUE JEFFERSON NC 28640 X MARTIN LITTLE PRESIDENT 1.00 0.00 X X 0 0 0 DONNIE JOHNSON VICE-PRESIDENT 1.00 0.00 X X 0 0 0 KAREN POWELL TREASURER 1.00 0.00 X X 0 0 0 JEFF DOLLAR SECRETARY 1.00 0.00 X X 0 0 0 VITA BLEVINS BOARD MEMBER 1.00 0.00 X 0 0 0 PAT COOPER BOARD MEMBER 1.00 0.00 X 0 0 0 JOHN JOHNSTON BOARD MEMBER 1.00 0.00 X 0 0 0 KEVIN KURTZ MD BOARD MEMBER 1.00 0.00 X 0 0 0 JANE LONON BOARD MEMBER 1.00 0.00 X 0 0 0 PHIL MCMILLAN BOARD MEMBER 1.00 0.00 X 0 0 0 KATRINA MILLER BOARD MEMBER 1.00 0.00 X 0 0 0 DON PHILLIPS BOARD MEMBER 1.00 0.00 X 0 0 0 PAT PHILLIPS BOARD MEMBER 1.00 0.00 X 0 0 0 TIMOTHY RECTOR DDS BOARD MEMBER 1.00 0.00 X 0 0 0 KAY SEXTON BOARD MEMBER 1.00 0.00 X 0 0 0 GREG SEXTON BOARD MEMBER 1.00 0.00 X 0 0 0 JOHN SHEPHERD BOARD MEMBER 1.00 0.00 X 0 0 0 MICHAEL VANNOY BOARD MEMBER 1.00 0.00 X 0 0 0 SHANE VANNOY BOARD MEMBER 1.00 0.00 X 0 0 0 GREG WARMUTH BOARD MEMBER 1.00 0.00 X 0 0 0 JOE THORE DIRECTOR 5.00 0.00 X 0 0 0 0 0 0 0 0 0 0 0 35377 292169 327546 3168 3168 8704 0 8704 8704 8704 25861 35377 30592 -4731 -4731 334687 0 0 7141 714417 714417 MISCELLANEOUS 32130 32130 746547 746547 0 0 605872 283435 16839 2855 815029 298963 1437740 585253 586593 173003 586593 173003 X 834308 409395 16839 2855 851147 412250 1437740 585253 X -411860 -27037 X X 0 1 X 1 0 X X 1 ASHE MEMORIAL HOSPITAL INC 560603900 3 1 1163984 0 1 1163984 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 DUE TO ASHE MEMORIAL HOSPITAL 173003 173003 X PART X, LINE 2: THE HOSPITAL AND FOUNDATION ARE NOT-FOR-PROFIT CORPORATIONS AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND ARE EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. FISCAL YEARS ENDING ON OR AFTER SEPTEMBER 30, 2011 REMAIN SUBJECT TO EXAMINATION BY FEDERAL AND STATE TAX AUTHORITIES. THE ORGANIZATION FOLLOWS THE INCOME TAX STANDARD REGARDING THE RECOGNITION AND MEASUREMENT OF UNCERTAIN TAX POSITIONS, WHICH CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN AN ENTITY'S FINANCIAL STATEMENTS AND PRESCRIBES A RECOGNITION THRESHOLD AND MEASUREMENT PRINCIPLES FOR THE FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN ON A TAX RETURN THAT ARE NOT CERTAIN TO BE REALIZED. THE ORGANIZATION HAS DETERMINED THAT IT DOES NOT HAVE ANY MATERIAL UNCERTAIN TAX POSITIONS AS OF DECEMBER 31, 2015. 0 ASHE MEMORIAL HOSPITAL INC 200 HOSPITAL AVENUE JEFFERSON NC 28640 560603900 501(C)(3) 714417 GENERAL OPERATIONAL SUPPORT 1 PART I, LINE 2: ASHE MEMORIAL HOSPITAL FOUNDATION IS A SUPPORTING ORGANIZATION FOR ASHE MEMORIAL HOSPITAL. ALL ASSISTANCE IS GIVEN FOR GENERAL OPERATIONAL SUPPORT OF THE HOSPITAL ACTIVITIES. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 WAS REVIEWED BY TOP MANAGEMENT OF THE FOUNDATION AND ASHE MEMORIAL HOSPITAL (THE SUPPORTED ORGANIZATION). FORM 990, PART VI, SECTION B, LINE 12C EACH BOARD MEMBER ANNUALLY RECEIVES A COPY OF THE CONFLICT OF INTEREST POLICY AND SIGNS A STATEMENT THAT THE POLICY HAS BEEN REVIEWED, AND DISCLOSES ANY CONFLICTS OF INTEREST. AT THAT TIME EACH BOARD MEMBER IS RESPONSIBLE FOR RECUSING THEMSELVES FROM A PARTICULAR VOTE IF A CONFLICT ARISES. FORM 990, PART VI, SECTION C, LINE 18 PHOTOCOPIES OF THE ORGANIZATION'S FORM 1023 AND FORM 990 ARE AVAILABLE UPON REQUEST. THE FORM 990 CAN ALSO BE ACCESSED THROUGH GUIDESTAR.ORG, A NON-PROFIT WEBSITE. 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 REQUEST. FORM 990, PART XI, LINE 9: CHANGE IN UNREALIZED LOSSES ON INVESTMENTS -27,037. FORM 990, PART XII, LINE 2C NO CHANGE FROM PRIOR YEAR. ASHE MEMORIAL HOSPITAL INC 200 HOSPITAL AVENUE JEFFERSON NC 28640 560603900 PROVIDES INPATIENT, OUTPATIENT, AND EMERGENCY CARE SERVICES NC 501(C)(3) LINE 3 N/A 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0