STRATEGY STUDIO / NONPROFIT PEOPLE SEARCH

CAROMONT MEDICAL GROUP INC: Form 990, tax year 2013

View the entire original 990 at ProPublica ↗

Organization
CAROMONT MEDICAL GROUP INC (EIN 56-1479712)
Tax period
2013-07-01 to 2014-06-30
Filed
2015-05-01
IRS object ID
201501219349300515
Schema version
2013v4.0
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 ReturnHeader

FieldValueIRS element (for citing)
Return2015-05-01T09:36:37-05:00ReturnTs
Tax Period End2014-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN560747981PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1DIXON HUGHES GOODMAN LLPBusinessNameLine1

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1500 RIDGEFIELD COURTAddressLine1
CityASHEVILLECity
StateNCState
ZIP Code28806ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2013-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN561479712EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1CAROMONT MEDICAL GROUP INCBusinessNameLine1
FieldValueIRS element (for citing)
Business Name ControlCAROBusinessNameControlTxt
Phone7048342000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line12525 COURT DRIVE PO BOX 1747AddressLine1
CityGASTONIACity
StateNCState
ZIP Code280531747ZIPCode

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonDAVID O'CONNORPersonNm
Person TitleEVP, CFOPersonTitleTxt
Phone7048342000PhoneNum
Signature2015-03-26SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonAMY BIBBYPreparerPersonNm
PTINP00445891PTIN
Phone8282542254PhoneNum
FieldValueIRS element (for citing)
Tax2013TaxYr
Build TS2016-03-07 17:11:31ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerDAVID O'CONNORPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line12525 COURT DRIVE PO BOX 1747AddressLine1
CityGASTONIACity
StateNCState
ZIP Code280531747ZIPCode
FieldValueIRS element (for citing)
Gross Receipts$111,075,217GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.CAROMONT.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1985FormationYr
Legal Domicile StateNCLegalDomicileStateCd
Activity Or MissionTO PROVIDE EXCEPTIONAL HEALTH CARE TO THE COMMUNITIES WE SERVE.ActivityOrMissionDesc
Voting Members Governing Body3VotingMembersGoverningBodyCnt
Voting Members Independent3VotingMembersIndependentCnt
Total Employee834TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$25,293PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$87,106,169PYProgramServiceRevenueAmt
CY Program Service Revenue$92,461,244CYProgramServiceRevenueAmt
PY Investment Income$3,323,993PYInvestmentIncomeAmt
CY Investment Income$3,718,649CYInvestmentIncomeAmt
PY Other Revenue$2,333,958PYOtherRevenueAmt
CY Other Revenue$3,068,263CYOtherRevenueAmt
PY Total Revenue$92,789,413PYTotalRevenueAmt
CY Total Revenue$99,248,156CYTotalRevenueAmt
PY Grants And Similar Paid$4,800PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$79,985,121PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$79,780,100CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$25,464,613PYOtherExpensesAmt
CY Other Expenses$31,993,979CYOtherExpensesAmt
PY Total Expenses$105,454,534PYTotalExpensesAmt
CY Total Expenses$111,774,079CYTotalExpensesAmt
PY Revenues Less Expenses-$12,665,121PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$12,525,923CYRevenuesLessExpensesAmt
Total Assets BOY$72,766,218TotalAssetsBOYAmt
Total Assets EOY$65,089,441TotalAssetsEOYAmt
Total Liabilities BOY$8,224,707TotalLiabilitiesBOYAmt
Total Liabilities EOY$10,029,156TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$64,541,511NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$55,060,285NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTO PROVIDE EXCEPTIONAL HEALTH CARE TO THE COMMUNITIES WE SERVE.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$106,418,644ExpenseAmt
Revenue$92,461,244RevenueAmt
DescSEE SCHEDULE O.CAROMONT MEDICAL GROUP OWNS AND OPERATES A NETWORK OF OVER 40 PRIMARY CARE AND SPECIALTY PHYSICIAN PRACTICES AND THREE URGENT CARE CENTERS. IT EMPLOYS OVER 170 PHYSICIANS AND OVER 60 ADVANCED PRACTITIONERS IN TWENTY-THREE DIFFERENT SPECIALTIES. IN FISCAL YEAR 2014, THE MEDICAL GROUP PROVIDED OVER 490,000 PATIENT VISITS. CAROMONT MEDICAL GROUP IS COMMITTED TO PROVIDING HIGH QUALITY CARE TO ITS PATIENTS. 100% OF ITS PRIMARY CARE PRACTICES HAVE BEEN RECOGNIZED AS A LEVEL 3 PATIENT-CENTERED MEDICAL HOME. THIS HIGHEST LEVEL OF RECOGNITION AVAILABLE TO PRIMARY CARE PRACTICES BY THE NATIONAL CENTER FOR QUALITY ASSURANCE (NCQA) IDENTIFIES PRACTICES THAT EMPHASIZE CARE COORDINATION AND COMMUNICATION TO IMPROVE QUALITY OUTCOMES FOR THEIR PATIENTS. IN ADDITION, OVER HALF OF THE SPECIALTY PHYSICIAN PRACTICES HAVE BEEN RECOGNIZED AS A LEVEL 3 PHYSICIAN PRACTICE CONNECTIONS. THIS HIGHEST LEVEL OF RECOGNITION AVAILABLE TO SPECIALTY PRACTICES BY THE NCQA IDENTIFIES PRACTICES THAT USE SYSTEMATIC PROCESSES AND INFORMATION TECHNOLOGY TO IMPROVE THE QUALITY OF PATIENT CARE. CAROMONT MEDICAL GROUP IS ACTIVE IN ITS COMMUNITIES IN A NUMBER OF WAYS. THE PRACTICES MAKE MONETARY AND IN-KIND CONTRIBUTIONS TO COMMUNITY NON-PROFIT ORGANIZATIONS, PHYSICIANS AND STAFF VOLUNTEER AT COMMUNITY EVENTS AND HEALTH FAIRS, AND LEADERS SERVE ON COMMUNITY BOARDS. CAROMONT MEDICAL GROUP ALSO INVESTS IN THE FUTURE OF HEALTH CARE BY OFFERING OPPORTUNITIES TO ADVANCE THE EDUCATION OF LOCAL HEALTH CARE STUDENTS THROUGH PRECEPTORSHIP PROGRAMS FOR COLLEGE STUDENTS, JOB SHADOWING PROGRAMS FOR HIGH SCHOOL STUDENTS, AND MENTORSHIP PROGRAMS.Desc
Total Program Service Expenses$106,418,644TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other Liabilities0ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded EntityYes (1)DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
Info In Schedule O Part VYes (X)InfoInScheduleOPartVInd
IRP Document167IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee834EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members3GoverningBodyVotingMembersCnt
Independent Voting Member3IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1DAVID O'CONNORBusinessNameLine1
FieldValueIRS element (for citing)
Phone7048342000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line12525 COURT DRIVEAddressLine1
CityGASTONIACity
StateNCState
ZIP Code28054ZIPCode

Form990 Part VII Section A Form990PartVIISectionAGrp (14 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
SHEILA REILLY PHD
CHAIRMAN 20131.001.00Yes (X)Yes (X)$0$0$0
MR SPURGEON MACKIE
CHAIRMAN 20141.001.00Yes (X)Yes (X)$0$0$0
MR DONNIE LOFTIS
DIRECTOR 20131.001.00Yes (X)$0$0$0
MS SUSIE BROWN
DIRECTOR1.001.00Yes (X)$0$0$0
DR ROBERT CROUCH
DIRECTOR1.001.00Yes (X)$0$0$0
DOUG LUCKETT
CEO/PRESIDENT1.0049.00Yes (X)$0$712,139$129,918
DAVID O'CONNOR
EVP/CFO/ASST. TREASURER1.0049.00Yes (X)$0$475,002$98,510
MARIA LONG
EVP CHIEF LEGAL OFFICER/ASST. SECRETARY1.0049.00Yes (X)$0$381,516$72,932
DR MICHAEL R TAMBERELLA
PHYSCIAN40.00$816,566$0$30,154Yes (X)
DR OMER L SHEDD
PHYSCIAN40.00$798,039$0$28,292Yes (X)
DR DUSTIN P LETTS
PHYSCIAN40.00$876,357$0$29,772Yes (X)
DR JAMES P GREELISH
PHYSCIAN40.00$1,266,390$0$32,545Yes (X)
DR MARK A THOMPSON
PHYSCIAN40.00$702,395$0$32,676Yes (X)
RANDALL L KELLEY
FORMER OFFICER0.000.00$0$690,063$48,062Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$4,459,747TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$2,258,720TotReportableCompRltdOrgAmt
Total Other Compensation$502,861TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K138IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (1)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1CityContractorAddress/USAddress/CityStateContractorAddress/USAddress/StateZIP CodeContractorAddress/USAddress/ZIPCodeServicesServicesDescCompensationCompensationAmt
ATHENA HEALTH INC
311 ARSENAL STREETWATERTOWNMA02472PHYSICIAN MANAGEMENT APPLICATION SYSTEMS$4,177,299
COGENT HEALTHCARE OF NORTH CAROLINA PC
5410 MARYLAND WAY SUITE 300BRENTWOODTN37027HOSPITAL PHYSICIAN SERVICES$1,736,000
WEATHERBY LOCUMS INC
5003 SOUTH MIAMI BLVDDURHAMNC27703LOCUM TENENS$776,018
MEDICUS CONSULTING SERVICES LLC
7 INDUSTRIAL WAY UNIT 5SALEMNC03079LOCUM TENENS$697,757
OPTIMED HOSPITALISTS PLLC
557 BROOKDALE DRIVESTATESVILLENC28677HOSPITAL PHYSICIAN SERVICES$606,400
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K13CntrctRcvdGreaterThan100KCnt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescPATIENT SERVIDesc
Business621400BusinessCd
Total Revenue Column$92,461,244TotalRevenueColumnAmt
Related Or Exempt Func Income$92,461,244RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$92,461,244TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$781,626TotalRevenueColumnAmt
Exclusion$781,626ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$14,764,084SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$11,682,409SecuritiesAmt
Other$144,652OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$3,081,675SecuritiesAmt
Other-$144,652OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,937,023TotalRevenueColumnAmt
Exclusion$2,937,023ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmt
MISCELLANEOUS621400$1,931,253$1,931,253
MEANINGFUL USE900099$1,099,953$1,099,953
MANAGEMENT FEE INCOME561000$37,057$37,057
FieldValueIRS element (for citing)
Other Revenue Total$3,068,263OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$99,248,156TotalRevenueColumnAmt
Related Or Exempt Func Income$92,461,244RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$6,786,912ExclusionAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$68,126,837TotalAmt
Program Services$64,767,655ProgramServicesAmt
Management And General$3,359,182ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$2,219,708TotalAmt
Program Services$2,028,263ProgramServicesAmt
Management And General$191,445ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$5,938,958TotalAmt
Program Services$5,403,527ProgramServicesAmt
Management And General$535,431ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$3,494,597TotalAmt
Program Services$3,305,464ProgramServicesAmt
Management And General$189,133ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$6,975TotalAmt
Program Services$6,975ProgramServicesAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$5,126,152TotalAmt
Program Services$4,657,437ProgramServicesAmt
Management And General$468,715ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$62,356TotalAmt
Program Services$57,748ProgramServicesAmt
Management And General$4,608ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$2,709,619TotalAmt
Program Services$2,610,351ProgramServicesAmt
Management And General$99,268ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$6,076,758TotalAmt
Program Services$5,826,421ProgramServicesAmt
Management And General$250,337ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$94,473TotalAmt
Program Services$53,416ProgramServicesAmt
Management And General$41,057ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$3TotalAmt
Program Services$3ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$1,586,766TotalAmt
Program Services$1,382,706ProgramServicesAmt
Management And General$204,060ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$1,502,222TotalAmt
Program Services$1,490,023ProgramServicesAmt
Management And General$12,199ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (3 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmt
MEDICAL SUPPLIES$10,487,235$10,487,235
BAD DEBT$4,185,613$4,185,613
BIOMED$155,807$155,807

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$111,774,079TotalAmt
Program Services$106,418,644ProgramServicesAmt
Management And General$5,355,435ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$197,435BOYAmt
EOY$1,320,286EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$5,265,023BOYAmt
EOY$7,258,071EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$200,000BOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$954,735BOYAmt
EOY$710,954EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$136,497BOYAmt
EOY$189,294EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$20,400,582LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$7,260,938LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$9,124,312BOYAmt
EOY$13,139,644EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$52,679,518BOYAmt
EOY$38,398,441EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$3,523,153BOYAmt
EOY$3,448,153EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$685,545BOYAmt
EOY$624,598EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$72,766,218BOYAmt
EOY$65,089,441EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$8,224,707BOYAmt
EOY$10,029,156EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$8,224,707BOYAmt
EOY$10,029,156EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$64,541,511BOYAmt
EOY$55,060,285EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$64,541,511BOYAmt
EOY$55,060,285EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$72,766,218BOYAmt
EOY$65,089,441EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$12,525,923ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$3,044,697NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus1 Year$25,293CurrentTaxYearMinus1YearAmt
Total$25,293TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$75,579,994CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$74,250,177CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$88,855,499CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$87,106,169CurrentTaxYearMinus1YearAmt
Current Tax Year$92,461,244CurrentTaxYearAmt
Total$418,253,083TotalAmt

Gross Receipts Non Unrlt Bus GrossReceiptsNonUnrltBusGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$1,032,851CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$655,676CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,161,305CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$2,333,958CurrentTaxYearMinus1YearAmt
Current Tax Year$3,068,263CurrentTaxYearAmt
Total$8,252,053TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$76,612,845CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$74,905,853CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$90,016,804CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$89,465,420CurrentTaxYearMinus1YearAmt
Current Tax Year$95,529,507CurrentTaxYearAmt
Total$426,530,429TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$426,530,429PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$1,471,631CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,701,412CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,457,535CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,435,414CurrentTaxYearMinus1YearAmt
Current Tax Year$781,626CurrentTaxYearAmt
Total$6,847,618TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$1,471,631CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,701,412CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,457,535CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,435,414CurrentTaxYearMinus1YearAmt
Current Tax Year$781,626CurrentTaxYearAmt
Total$6,847,618TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$78,084,476CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$76,607,265CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$91,474,339CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$90,900,834CurrentTaxYearMinus1YearAmt
Current Tax Year$96,311,133CurrentTaxYearAmt
Total$433,378,047TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.98420PublicSupportCY509Pct
Public Support PY5090.98270PublicSupportPY509Pct
Investment Income CY0.01580InvestmentIncomeCYPct
Investment Income PY0.01730InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,620,218OtherCostOrOtherBasisAmt
Book Value$2,620,218BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$8,445,239OtherCostOrOtherBasisAmt
Depreciation$1,619,077DepreciationAmt
Book Value$6,826,162BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$219,065OtherCostOrOtherBasisAmt
Depreciation$14,379DepreciationAmt
Book Value$204,686BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$9,116,060OtherCostOrOtherBasisAmt
Depreciation$5,627,482DepreciationAmt
Book Value$3,488,578BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$13,139,644TotalBookValueLandBuildingsAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$97,983,950TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$3,044,697NetUnrealizedGainsInvstAmt
Other Revenue-$4,271,846OtherRevenueAmt
Revenue Not Reported-$1,227,149RevenueNotReportedAmt
Revenue Subtotal$99,211,099RevenueSubtotalAmt
Other Revenues Not Included$37,057OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$37,057RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$99,248,156TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$107,465,176TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included-$37,057OtherExpensesIncludedAmt
Expenses Not Reported-$37,057ExpensesNotReportedAmt
Expenses Subtotal$107,502,233ExpensesSubtotalAmt
Other Expenses Not Included$4,271,846OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$4,271,846ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$111,774,079TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART X, LINE 2:THE SYSTEM IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE SYSTEM HAS DETERMINED THAT IT DOES NOT HAVE ANY UNRECOGNIZED TAX BENEFITS OR OBLIGATIONS AS OF JUNE 30, 2014 AND 2013, RESPECTIVELY. FISCAL YEARS ENDING ON OR AFTER JUNE 30, 2011 REMAIN SUBJECT TO EXAMINATION BY FEDERAL AND STATE TAX AUTHORITIES.
PART XI, LINE 2D - OTHER ADJUSTMENTS:BAD DEBT -4,185,613. INVESTMENT MANAGEMENT FEES NETTED WITH REVENUE -86,233.
PART XI, LINE 4B - OTHER ADJUSTMENTS:MANAGEMENT FEE INCOME NET WITH FEES EXPENSE 37,057.
PART XII, LINE 2D - OTHER ADJUSTMENTS:MANAGEMENT FEE INCOME NET WITH FEES EXPENSE -37,057.
PART XII, LINE 4B - OTHER ADJUSTMENTS:BAD DEBT 4,185,613. INVESTMENT MANAGEMENT FEES 86,233.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
Written Employment ContractYes (X)WrittenEmploymentContractInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance PaymentYes (1)SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (1)SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgYes (1)CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsYes (1)CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
DOUG LUCKETT
CEO/PRESIDENT$0$590,205$0$121,154$0$780$0$113,546$0$16,372$0$842,057$0$0
DAVID O'CONNOR
EVP/CFO/ASST. TREASURER$0$362,570$0$111,268$0$1,164$0$82,348$0$16,162$0$573,512$0$0
MARIA LONG
EVP CHIEF LEGAL OFFICER/ASST. SECRET$0$294,902$0$85,720$0$894$0$70,934$0$1,998$0$454,448$0$0
DR MICHAEL R TAMBERELLA
PHYSCIAN$583,876$0$232,690$0$0$0$12,911$0$17,243$0$846,720$0$0$0
DR OMER L SHEDD
PHYSCIAN$536,458$0$261,581$0$0$0$11,273$0$17,019$0$826,331$0$0$0
DR DUSTIN P LETTS
PHYSCIAN$570,801$0$305,556$0$0$0$12,607$0$17,165$0$906,129$0$0$0
DR JAMES P GREELISH
PHYSCIAN$1,007,840$0$44,550$0$214,000$0$14,617$0$17,928$0$1,298,935$0$0$0
DR MARK A THOMPSON
PHYSCIAN$581,940$0$120,455$0$0$0$15,433$0$17,243$0$735,071$0$0$0
RANDALL L KELLEY
FORMER OFFICER$0$347,736$0$0$0$342,327$0$43,999$0$4,063$0$738,125$0$0

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINES 4A-BTHE FOLLOWING INDIVIDUALS RECEIVED DEFERRED COMPENSATION ALLOCATIONS BY RELATED ORGANIZATION GASTON MEMORIAL HOSPITAL FROM A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP): DAVID O'CONNOR - $ 69,504 MARIA LONG - 55,601 DOUG LUCKETT - 107,551 RANDALL L. KELLEY - 37,456 RANDALL L. KELLEY RECEIVED A SEVERANCE PAYMENT BY RELATED ORGANIZATION GASTON MEMORIAL HOSPITAL IN THE AMOUNT OF $331,138.
PART I, LINE 6CERTAIN CAROMONT MEDICAL GROUP INC. PHYSICIAN'S COMPENSATION PACKAGES ARE BASED ON THE INDIVIDUAL PHYSICIAN'S NET RESULTS FROM OPERATIONS AS CALCULATED BASED SOLEY ON HIS/HER NET CHARGES LESS HIS/HER ALLOCABLE SHARE OF CLINIC OVERHEAD COSTS. EXECUTIVE INCENTIVE COMPENSATION PLAN FOR ALL KEY EMPLOYEES BASED ON THE ACHIEVEMENT OF ANNUAL BUSINESS OBJECTIVES AND FINANCIAL PERFORMANCE OF THE CONSOLIDATED SYSTEM. MANAGER INCENTIVE PLAN BASED ON CONSOLIDATED CORPORATE AND INDIVIDUAL PERFORMANCE GOALS.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 1B:BOARD MEMBER INDEPENDENCE: IN CALENDAR YEAR 2014, THE BOARD OF DIRECTORS OF CAROMONT HEALTH CONDUCTED A COMPREHENSIVE REVIEW OF BEST PRACTICES REGARDING INDEPENDENCE OF BOARD MEMBERS. THIS REVIEW RESULTED IN THE DEVELOPMENT OF A BOARD POLICY ON INDEPENDENCE OF BOARD MEMBERS. USING IRS REGULATIONS AND GUIDANCE, INDUSTRY BEST PRACTICES, GUIDANCE AND COMMENTARY APPLICABLE TO NON-PROFIT HEALTHCARE INSTITUTIONS, AND ADVICE OF COUNSEL, THE BOARD OF DIRECTORS DEVELOPED AND IMPLEMENTED A ROBUST POLICY THAT DEFINES INDEPENDENT AND NON-INDEPENDENT DIRECTORS AND CLASSIFIES DIRECTORS ON AN ANNUAL BASIS AS INDEPENDENT AND NON-INDEPENDENT. USING THE IRS REPORTING REQUIREMENTS AS A MINIMUM SET OF CRITERIA FOR DETERMINING THE INDEPENDENT STATUS OF BOARD MEMBERS, THE BOARD'S POLICY GOES BEYOND THE MINIMUM CRITERIA AND DEFINES ADDITIONAL CRITERIA THAT RENDER A BOARD MEMBER NON-INDEPENDENT. ONCE DETERMINED TO HAVE A DISQUALIFYING CONDITION THAT RENDERS THE MEMBER NON-INDEPENDENT, A BOARD MEMBER WHOSE DISQUALIFYING CONDITION HAS BEEN REMEDIED MAY ONLY BE RESTORED TO INDEPENDENT STATUS FOLLOWING A SPECIFIED TIME LIMIT DEFINED IN THE POLICY. IN REPORTING THE NUMBER OF INDEPENDENT DIRECTORS IN PART I, LINE 4 AND PART VI, SECTION A, LINE 1B, THE BOARD OF DIRECTORS HAS DETERMINED THAT IT WILL REPORT THE NUMBER DETERMINED BY ITS POLICY, RECOGNIZING THAT THIS MAY BE A STRICTER INTERPRETATION THAN THE IRS REQUIRES. IN SEATING BOARD COMMITTEES, SUCH AS THE EXECUTIVE COMPENSATION COMMITTEE AND THE AUDIT FINANCE AND INVESTMENT COMMITTEE, THE BOARD DETERMINES A DIRECTOR'S ELIGIBILITY TO SERVE ON THOSE COMMITTEES BASED ON APPLICATION OF THE BOARD'S DEFINITION OF INDEPENDENCE.
FORM 990, PART VI, SECTION A, LINE 6THE SOLE MEMBER OF THE CORPORATION SHALL BE CAROMONT HEALTH, INC., A NORTH CAROLINA NOT-FOR-PROFIT CORPORATION.
FORM 990, PART VI, SECTION A, LINE 7ATHE BOARD OF DIRECTORS SHALL CONSIST OF THREE (3) MEMBERS, ALL OF WHOM SHALL BE APPOINTED BY THE BOARD OF DIRECTORS OF CAROMONT HEALTH, INC.
FORM 990, PART VI, SECTION A, LINE 7BTHE FOLLOWING POWERS OF THE CORPORATION SHALL BE RESERVED TO CAROMONT HEALTH, INC., THE PARENT CORPORATION AND HOLDING COMPANY OF THE CORPORATION: (A) FINANCIAL POWERS, INCLUDING THE POWER TO APPROVE AN OPERATING BUDGET FOR THE CORPORATION, POWER TO APPROVE COMPENSATION PLANS, AND POWER TO ASSUME DEBT ON BEHALF OF THE CORPORATION; (B) GOVERNING POWERS, INCLUDING THE POWER TO APPROVE ALL CHANGES TO THE GOVERNING DOCUMENTS OF THE CORPORATION AND POWER TO APPROVE THE MISSION, VISION AND VALUES OF THE CORPORATION; AND (C) STRATEGIC POWERS, INCLUDING THE POWER TO APPROVE ALL CERTIFICATE OF NEED APPLICATIONS WHICH THE CORPORATION MAY FILE IN ANY STATE, AND THE POWER TO APPROVE ALL SALE OR LEASE TRANSACTIONS OF THE CORPORATION.
FORM 990, PART VI, SECTION B, LINE 11THE ORGANIZATION'S FORM 990 WAS REVIEWED BY THE AUDIT FINANCE INVESTMENT COMMITTEE OF THE BOARD OF DIRECTORS AND BY THE FULL BOARD BEFORE THE FORM WAS FILED WITH THE IRS.
FORM 990, PART VI, SECTION B, LINE 12CEACH EMPLOYEE AND DIRECTOR SHALL FULLY AND TRUTHFULLY COMPLETE A QUESTIONNAIRE CONCERNING POTENTIAL AND ACTUAL CONFLICTS OF INTEREST ANNUALLY. SUCH QUESTIONNAIRE SHALL IDENTIFY THE INDIVIDUAL'S OBLIGATION TO IMMEDIATELY MAKE THE CORPORATE RESPONSIBILITY OFFICER AWARE IN WRITING OF ANY POTENTIAL OR ACTUAL CONFLICTS OF INTEREST AS THEY MAY ARISE AND CONTAIN SAID INDIVIDUAL'S AGREEMENT TO ABIDE BY ALL TERMS AND CONDITIONS OF THIS POLICY AS A CONDITION OF RETAINING THEIR POSITION. SUCH QUESTIONNAIRES ARE REVIEWED ANNUALLY BY THE CHIEF LEGAL OFFICER AND THE CORPORATE RESPONSIBILITY OFFICER. QUESTIONNAIRES SUBMITTED BY DIRECTORS ARE REVIEWED ANNUALLY BY THE NOMINATING COMMITTEE OF THE BOARD.
FORM 990, PART VI, SECTION B, LINE 15THE CEO, CFO, COO AND CHIEF LEGAL OFFICER ARE COMPENSATED FOR THEIR SERVICES BY GASTON MEMORIAL HOSPITAL, A SUBSIDIARY OF CAROMONT HEALTH, INC. THE COMPENSATION OF ALL CAROMONT EXECUTIVES FOR EACH YEAR IS ESTABLISHED BY THE COMPENSATION COMMITTEE OF THE CAROMONT HEALTH BOARD OF DIRECTORS, BASED ON GUIDANCE AND OPINIONS PROVIDED BY AN INDEPENDENT, THIRD-PARTY COMPENSATION CONSULTANT. PURSUANT TO THE COMMITTEE CHARTER FOR THE COMPENSATION COMMITTEE OF THE BOARD, THE BOARD OF DIRECTORS APPROVES THE EXECUTIVE COMPENSATION PHILOSOPHY, WHICH ESTABLISHES THE PARAMETERS FOR ALL EXECUTIVE COMPENSATION DECISIONS. THE BOARD OF DIRECTORS DELEGATES ALL COMPENSATION DECISIONS FOR ALL EXECUTIVES TO THE COMPENSATION COMMITTEE, PROVIDED SUCH DECISIONS ARE CONSISTENT WITH THE COMPENSATION PHILOSOPHY. BOARD APPROVAL MUST BE OBTAINED WHEN COMPENSATION DECISIONS DEVIATE FROM THE COMPENSATION PHILOSOPHY. BOARD MEMBERS WHO SERVE ON THE COMPENSATION COMMITTEE ARE INDEPENDENT AND FREE OF ANY CONFLICT OF INTEREST. ANY COMPENSATION COMMITTEE MEMBER WHO DEVELOPS A CONFLICT OF INTEREST DURING HIS/HER TERM WITH RESPECT TO THE DISCUSSION OF ANY EXECUTIVE'S COMPENSATION LEAVES THE MEETING AND DOES NOT PARTICIPATE IN THE DISCUSSION OR DECISION-MAKING BY THE REMAINING INDEPENDENT MEMBERS OF THE COMPENSATION COMMITTEE. THE COMPENSATION COMMITTEE RETAINS JURISDICTION OVER THE TOTAL COMPENSATION PACKAGE FOR EXECUTIVES AND REVIEWS EXECUTIVE BENEFITS AND PERQUISITES AS WELL AS TOTAL CASH COMPENSATION. COMPENSATION FOR THE CEO IS ESTABLISHED THROUGH A PROCESS OF PERFORMANCE EVALUATION, COMPARISON WITH COMPARABLE MARKET DATA AND DETERMINATION BY THE COMPENSATION COMMITTEE OF ACCEPTABLE SALARY RANGE AND PERCENTILE RANKING. ALL COMPENSATION DECISIONS FOR THE CEO ARE APPROVED BY THE COMPENSATION COMMITTEE, AS LONG AS THE COMPENSATION DECISIONS ARE CONSISTENT WITH THE EXECUTIVE COMPENSATION PHILOSOPHY. THE PROCESS FOR DETERMINING COMPENSATION FOR EXECUTIVE MANAGEMENT, UTILIZES COMPENSATION SURVEYS AND STUDIES. FULL COLLECTED COMPENSATION INFORMATION AND ANY COMPENSATION OPINIONS PROVIDED DURING THESE PROCESSES WILL BE KEPT WITH THE COMPENSATION COMMITTEE OR BOARD MINUTES, AS APPLICABLE.
FORM 990, PART VI, SECTION C, LINE 18THE ORGANIZATION'S FORM 990 IS MADE AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART VI, SECTION C, LINE 19AT THIS TIME, THE ORGANIZATION'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT MADE AVAILABLE TO THE PUBLIC. THE ENTIRE ORGANIZATION'S COMBINED FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON REQUEST.
PART XII, LINE 2CRESPONSIBILITY FOR OVERSIGHT OF THE AUDIT: THIS PROCESS HAS NOT CHANGED FROM PRIOR YEARS.

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp (7 entries)

Address Line1USAddress/AddressLine1CityUSAddress/CityStateUSAddress/StateZIP CodeUSAddress/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdTotal IncomeTotalIncomeAmtEnd Of Year AssetsEndOfYearAssetsAmtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
CAROMONT SPECIALITY GROUP LLC
2240 REMOUNT RDGASTONIANC28054522451748MEDICAL SERVICESNC$0$0CAROMONT MEDICAL GROUP INC
CAROMONT SOUTH POINT LLC
2240 REMOUNT RDGASTONIANC28054205453221MEDICAL SERVICESNC$13,207,997$885,482CAROMONT MEDICAL GROUP INC
CMG - GASTON WOMENS HEALTHCARE LLC
2240 REMOUNT RDGASTONIANC28054205894683MEDICAL SERVICESNC$4,993,550$315,559CAROMONT MEDICAL GROUP INC
CMG - FAMILY MEDICINE OF CLEVELAND COUNTY LLC
2240 REMOUNT RDGASTONIANC28054205925671MEDICAL SERVICESNC$0$0CAROMONT MEDICAL GROUP INC
ASHLEY WOMENS CMG LLC
2240 REMOUNT RDGASTONIANC28054264369018MEDICAL SERVICESNC$11,178,839$1,430,649CAROMONT MEDICAL GROUP INC
CS CMG LLC
2240 REMOUNT RDGASTONIANC28054272146660MEDICAL SERVICESNC$0$0CAROMONT MEDICAL GROUP INC
GS CMG LLC
2240 REMOUNT RDGASTONIANC28054272146801MEDICAL SERVICESNC$0$0CAROMONT MEDICAL GROUP INC

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (6 entries)

Address Line1USAddress/AddressLine1CityUSAddress/CityStateUSAddress/StateZIP CodeUSAddress/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtDirect Controlling NADirectControllingNACdControlled OrganizationControlledOrganizationIndBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
CAROMONT HEALTH INC
2525 COURT DRIVEGASTONIANC28054581636959MEDICAL SERVICESNC501(C)(3)LINE 11B, IIN/A0
CAROMONT HEALTH SERVICES INC
2526 COURT DRIVEGASTONIANC28054561455630OUTPATIENT SERVICESNC501(C)(3)LINE 30CAROMONT HEALTH INC
GASTON MEMORIAL HOSPITAL FOUNDATION INC
2527 COURT DRIVEGASTONIANC28054561479699FOUNDATIONNC501(C)(3)LINE 90CAROMONT HEALTH INC
HOSPICE OF GASTON COUNTY INC
2529 COURT DRIVEGASTONIANC28054581341530HOSPICE CARENC501(C)(3)LINE 70CAROMONT HEALTH INC
GASTON MEMORIAL HOSPITAL INC
2530 COURT DRIVEGASTONIANC28054560619359HOSPITALNC501(C)(3)LINE 30CAROMONT HEALTH INC
GASTON EMERGENCY PHYSICIANS INC
2531 COURT DRIVEGASTONIANC28054562209423SUPPORTING ORGANIZATIONNC501(C)(3)LINE 11A, I0CAROMONT HEALTH INC
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (1)TransferToOtherOrgInd
Transfer From Other OrgYes (1)TransferFromOtherOrgInd