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COLUMBUS REGIONAL HEALTHCARE SYSTEM: Form 990, tax year 2013

View the entire original 990 at ProPublica ↗

Organization
COLUMBUS REGIONAL HEALTHCARE SYSTEM (EIN 56-0538020)
Tax period
2013-10-01 to 2014-09-30
Filed
2015-07-01
IRS object ID
201521829349300522
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)
Return2015-07-01T11:02:50-05:00ReturnTs
Tax Period End2014-09-30TaxPeriodEndDt

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 Begin2013-10-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN560538020EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1COLUMBUS REGIONAL HEALTHCARE SYSTEMBusinessNameLine1
FieldValueIRS element (for citing)
Business Name ControlCOLUBusinessNameControlTxt
Phone9106421703PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1500 JEFFERSON STREETAddressLine1
CityWHITEVILLECity
StateNCState
ZIP Code28472ZIPCode

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonSIGNING OFFICERPersonNm
Person TitleCFOPersonTitleTxt
Phone9106421703PhoneNum
Signature2015-07-01SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonAMY BIBBYPreparerPersonNm
PTINP00445891PTIN
Phone8282542254PhoneNum
FieldValueIRS element (for citing)
Tax2013TaxYr
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerHENRY HAWTHORNEPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1500 JEFFERSON STREETAddressLine1
CityWHITEVILLECity
StateNCState
ZIP Code28472ZIPCode
FieldValueIRS element (for citing)
Gross Receipts$85,886,729GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.CRHEALTHCARE.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1937FormationYr
Legal Domicile StateNCLegalDomicileStateCd
Activity Or MissionSERVING THE CITIZENS BY PROVIDING COMMUNITY SERVICES, HEALTH EDUCATION, AND CHARITY CARE.ActivityOrMissionDesc
Voting Members Governing Body10VotingMembersGoverningBodyCnt
Voting Members Independent10VotingMembersIndependentCnt
Total Employee757TotalEmployeeCnt
Total Volunteers26TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$9,903PYContributionsGrantsAmt
CY Contributions Grants$5,793CYContributionsGrantsAmt
PY Program Service Revenue$88,006,602PYProgramServiceRevenueAmt
CY Program Service Revenue$83,661,993CYProgramServiceRevenueAmt
PY Investment Income$1,374,003PYInvestmentIncomeAmt
CY Investment Income$1,139,521CYInvestmentIncomeAmt
PY Other Revenue$111,081PYOtherRevenueAmt
CY Other Revenue$133,911CYOtherRevenueAmt
PY Total Revenue$89,501,589PYTotalRevenueAmt
CY Total Revenue$84,941,218CYTotalRevenueAmt
PY Grants And Similar Paid$50,936PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$51,520CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$36,967,762PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$32,887,618CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$9,850CYTotalFundraisingExpenseAmt
PY Other Expenses$48,261,339PYOtherExpensesAmt
CY Other Expenses$48,785,957CYOtherExpensesAmt
PY Total Expenses$85,280,037PYTotalExpensesAmt
CY Total Expenses$81,725,095CYTotalExpensesAmt
PY Revenues Less Expenses$4,221,552PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$3,216,123CYRevenuesLessExpensesAmt
Total Assets BOY$125,379,787TotalAssetsBOYAmt
Total Assets EOY$129,234,626TotalAssetsEOYAmt
Total Liabilities BOY$36,710,510TotalLiabilitiesBOYAmt
Total Liabilities EOY$36,791,292TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$88,669,277NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$92,443,334NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionWE WILL BE THE PRIMARY HEALTHCARE HOME FOR THE CITIZENS OF COLUMBUS COUNTY AND SURROUNDING COMMUNITIES.WE PROMISE TO PUT OUR PATIENTS FIRST, PROVIDING HEALTHCARE SERVICES THAT RAISE STANDARDS FOR SAFETY, QUALITY, SERVICE, COMPASSION, AND EFFICIENCY. WE WILL PROMOTE HEALTH, WELLNESS, AND PREVENTION INITIATIVES. AND WE WILL SERVE AS A GATEWAY FOR OUR COMMUNITY TO ACCESS THE ENTIRE SPECTRUM OF HEALTHCARE RESOURCES, WHETHER LOCAL OR DISTANT.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$72,689,956ExpenseAmt
Grant$51,520GrantAmt
Revenue$83,661,993RevenueAmt
DescWE WILL BE THE COMMUNITY'S FIRST CHOICE FOR HEALTHCARE SERVICES, RECOGNIZED FOR OUR LEADERSHIP IN HELPING OUR REGION BECOME ONE OF THE HEALTHIEST IN THE STATE. WE WILL BE THE PRIMARY HEALTHCARE HOME FOR THE CITIZENS OF COLUMBUS COUNTY AND SURROUNDING COMMUNITIES. WE PROMISE TO PUT OUR PATIENTS FIRST, PROVIDING HEALTHCARE SERVICES THAT RAISE STANDARDS FOR SAFETY, QUALITY, SERVICE, COMPASSION, AND EFFICIENCY. WE WILL PROMOTE HEALTH, WELLNESS, AND PREVENTION INITIATIVES, AND WE WILL SERVE AS A GATEWAY FOR OUR COMMUNITY TO ACCESS THE ENTIRE SPECTRUM OF HEALTHCARE RESOURCES, WHETHER LOCAL OR DISTANT. OUR VALUES START WITH THE RECOGNITION OF OUR PRIMARY ROLE AS A CARE-GIVING HEALTH SYSTEM: THE NEEDS OF OUR PATIENTS COME FIRST.Desc
Total Program Service Expenses$72,689,956TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
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 InvstYes (1)ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
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 HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt BondsYes (1)TaxExemptBondsInd
Invest Tax Exempt Bonds0InvestTaxExemptBondsInd
Escrow Account0EscrowAccountInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
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 EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control Ent0TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document152IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee757EmployeeCnt
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 Members10GoverningBodyVotingMembersCnt
Independent Voting Member10IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesYes (1)DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local ChaptersYes (1)LocalChaptersInd
Policies Reference ChaptersYes (1)PoliciesReferenceChaptersInd
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 VentureYes (1)InvestmentInJointVentureInd
Written Policy Or ProcedureYes (1)WrittenPolicyOrProcedureInd
States Where Copy Of Return Is FldNCStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1CARL BIBER CFOBusinessNameLine1
FieldValueIRS element (for citing)
Phone9106421703PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1500 JEFFERSON STREETAddressLine1
CityWHITEVILLECity
StateNCState
ZIP Code28472ZIPCode

Form990 Part VII Section A Form990PartVIISectionAGrp (19 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
DR SAM WHEATLEY
CHAIRMAN1.00Yes (X)Yes (X)$0$0$0
FREDA GORE
VICE-CHAIRMAN1.00Yes (X)Yes (X)$0$0$0
FORREST RIGGS
SECRETARY/TREASURER1.00Yes (X)Yes (X)$0$0$0
TERRAY SUGGS
TRUSTEE1.00Yes (X)$0$0$02.00
CARL MEARES JR
TRUSTEE1.00Yes (X)$0$0$0
ANDY MARTIN
TRUSTEE1.00Yes (X)$0$0$0
THOMAS JONES
TRUSTEE1.00Yes (X)$0$0$0
DR DAVID GRECO
TRUSTEE1.00Yes (X)$0$0$0
TRENT BURROUGHS
TRUSTEE1.00Yes (X)$0$0$0
GILES BYRD
TRUSTEE1.00Yes (X)$0$0$0
HENRY HAWTHORNE
PRESIDENT60.00Yes (X)$309,384$0$52,4213.00
CARL BIBER
VP OF FINANCE60.00Yes (X)$188,749$0$35,8153.00
CRAIG SLATER
VP OF MEDICAL STAFF60.00Yes (X)$316,746$0$35,989
TODD HOWELL
VP OPERATIONS40.00$161,406$0$19,8793.00Yes (X)
RICHARD WHEELER
CRNA40.00$211,684$0$18,641Yes (X)
GLORIA MILLER
CRNA40.00$237,654$0$21,595Yes (X)
JEFF SAVAGE
CRNA40.00$235,637$0$26,872Yes (X)
JOHN SCACHERI
CRNA40.00$211,460$0$26,165Yes (X)
KENNETH KERR
CRNA40.00$214,642$0$12,644Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$2,087,362TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$250,021TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K10IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other SrcsYes (1)CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1CityContractorAddress/USAddress/CityStateContractorAddress/USAddress/StateZIP CodeContractorAddress/USAddress/ZIPCodeServicesServicesDescCompensationCompensationAmt
MONTEITH CONSTRUCTION
32 N FRONT STREETWILMINGTONNC28405CONSTRUCTION$3,141,068
CAROLINAS HEALTHCARE SYSTEM
PO BOX 32861CHARLOTTENC28232MANAGEMENT FIRM$1,902,835
CROTHALL HEALTHCARE
13028 COLLECTIONS CENTER DRCHICAGOIL60693MANAGEMENT FIRM$1,842,399
TOTAL HEALTH & REHAB SERVICES
109 E WYCHE STREETWHITEVILLENC28472PHYSICAL THERAPY$1,463,590
MORRISON HEALTHCARE
PO BOX 102289ATLANTAGA30368MANAGEMENT FIRM$1,183,451
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K15CntrctRcvdGreaterThan100KCnt
All Other Contributions$5,793AllOtherContributionsAmt
Total Contributions$5,793TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
PATIENT SERVICE REVENUE621990$81,591,898$81,591,898
ANCILLARY REVENUE621990$2,070,095$2,070,095
FieldValueIRS element (for citing)
Total Program Service Revenue$83,661,993TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,898,461TotalRevenueColumnAmt
Exclusion$1,898,461ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$216,722RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$115,605RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$101,117RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$101,117TotalRevenueColumnAmt
Exclusion$101,117ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Other$68,304OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$827,244SecuritiesAmt
Other$0OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities-$827,244SecuritiesAmt
Other$68,304OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$758,940TotalRevenueColumnAmt
Exclusion-$758,940ExclusionAmt
FieldValueIRS element (for citing)
Gross Sales Of Inventory$35,456GrossSalesOfInventoryAmt
Cost Of Goods Sold$2,662CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$32,794TotalRevenueColumnAmt
Exclusion$32,794ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$84,941,218TotalRevenueColumnAmt
Related Or Exempt Func Income$83,661,993RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$1,273,432ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$51,520TotalAmt
Program Services$51,520ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$889,710TotalAmt
Management And General$889,710ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$24,756,891TotalAmt
Program Services$23,433,194ProgramServicesAmt
Management And General$1,323,697ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$233,778TotalAmt
Program Services$213,602ProgramServicesAmt
Management And General$20,176ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$5,074,805TotalAmt
Program Services$4,636,828ProgramServicesAmt
Management And General$437,977ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$1,932,434TotalAmt
Program Services$1,765,657ProgramServicesAmt
Management And General$166,777ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$90,699TotalAmt
Program Services$6,247ProgramServicesAmt
Management And General$84,452ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$151,370TotalAmt
Management And General$151,370ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$12,703,635TotalAmt
Program Services$10,451,818ProgramServicesAmt
Management And General$2,251,817ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$346,128TotalAmt
Program Services$92,571ProgramServicesAmt
Management And General$253,557ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$3,372,377TotalAmt
Program Services$1,892,112ProgramServicesAmt
Management And General$1,472,863ManagementAndGeneralAmt
Fundraising$7,402FundraisingAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$19,237TotalAmt
Program Services$19,237ProgramServicesAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$1,723,326TotalAmt
Program Services$1,684,584ProgramServicesAmt
Management And General$38,742ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$91,789TotalAmt
Program Services$58,035ProgramServicesAmt
Management And General$31,306ManagementAndGeneralAmt
Fundraising$2,448FundraisingAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$980,264TotalAmt
Management And General$980,264ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$5,686,826TotalAmt
Program Services$5,493,886ProgramServicesAmt
Management And General$192,940ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$667,516TotalAmt
Management And General$667,516ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
BAD DEBT$12,743,121$12,743,121
MEDICAL SUPPLIES$9,869,063$9,869,063
FOOD$328,645$271,941$56,704
MISCELLANEOUS$11,961$6,540$5,421

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$81,725,095TotalAmt
Program Services$72,689,956ProgramServicesAmt
Management And General$9,025,289ManagementAndGeneralAmt
Fundraising$9,850FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$20,105BOYAmt
EOY$26,009EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$2,082,564BOYAmt
EOY$6,031,228EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$10,269,795BOYAmt
EOY$10,548,399EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$1,889,871BOYAmt
EOY$1,829,145EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$954,014BOYAmt
EOY$1,023,076EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$97,542,807LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$52,239,647LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$45,208,323BOYAmt
EOY$45,303,160EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$46,277,028BOYAmt
EOY$39,226,704EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$12,147,038BOYAmt
EOY$16,280,881EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$3,362,462BOYAmt
EOY$3,242,855EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$3,168,587BOYAmt
EOY$5,723,169EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$125,379,787BOYAmt
EOY$129,234,626EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$6,949,510BOYAmt
EOY$6,950,475EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$25,237,154BOYAmt
EOY$24,236,431EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$1,397,810BOYAmt
EOY$1,519,919EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$3,126,036BOYAmt
EOY$4,084,467EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$36,710,510BOYAmt
EOY$36,791,292EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$88,381,474BOYAmt
EOY$90,255,500EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$287,803BOYAmt
EOY$2,187,834EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$88,669,277BOYAmt
EOY$92,443,334EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$125,379,787BOYAmt
EOY$129,234,626EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$3,216,123ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$1,174,193NetUnrlzdGainsLossesInvstAmt
Prior Period Adjustments-$616,259PriorPeriodAdjustmentsAmt
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)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other Organizations0GrantsOtherOrganizationsInd
Direct Contact Legislators0DirectContactLegislatorsInd
Rallies Demonstrations0RalliesDemonstrationsInd
Other ActivitiesYes (1)OtherActivitiesInd
Other Activities$3,751OtherActivitiesAmt
Total Lobbying Expenditures$3,751TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART II-B, LINE 1:FormAndLineReferenceDesc
ExplanationTHE ORGANIZATION IS A MEMBER OF THE AMERICAN HOSPITAL ASSOCIATION. A PORTION OF THE MEMBERSHIP DUES PAID TO THAT ORGANIZATION IS ALLOCATED TO LOBBYING EXPENDITURES ON BEHALF OF ITS MEMBERSHIP BODY. FOR 2014, THE AMOUNT OF DUES ALLOCATED TO LOBBYING EXPENDITURES WAS APPROXIMATELY $1,871. THE ORGANIZATION IS A MEMBER OF THE NORTH CAROLINA HOSPITAL ASSOCIATION. A PORTION OF THE MEMBERSHIP DUES PAID TO THAT ORGANIZATION IS ALLOCATED TO LOBBYING EXPENDITURES ON BEHALF OF ITS MEMBERSHIP BODY. FOR 2014, THE AMOUNT OF DUES ALLOCATED TO LOBBYING EXPENDITURES WAS $1,880.ExplanationTxt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,145,423OtherCostOrOtherBasisAmt
Book Value$1,145,423BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$41,047,829OtherCostOrOtherBasisAmt
Depreciation$18,503,739DepreciationAmt
Book Value$22,544,090BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$53,225,014OtherCostOrOtherBasisAmt
Depreciation$33,735,908DepreciationAmt
Book Value$19,489,106BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,124,541OtherCostOrOtherBasisAmt
Book Value$2,124,541BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$45,303,160TotalBookValueLandBuildingsAmt

Invst Program Related Org InvstProgramRelatedOrgGrp (4 entries)

DescDescBook ValueBookValueAmtMethod ValuationMethodValuationCd
INVESTMENT IN CHRN$14,587,524F
INVESTMENT IN CRHO$302,719F
INVESTMENT IN CRP II$1,033,966F
INVESTMENT IN CR DIAGNOSTICS$356,672F
FieldValueIRS element (for citing)
Total Book Value Program Rltd$16,280,881TotalBookValueProgramRltdAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescESTIMATED THIRD-PARTY PAYOR SETTLEMENTSDesc
Amt$4,084,467Amt
FieldValueIRS element (for citing)
Total Liability$4,084,467TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART X, LINE 2:FormAndLineReferenceDesc
ExplanationINCOME TAXES- THE SYSTEM IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE; ACCORDINGLY, THE ACCOMPANYING FINANCIAL STATEMENTS DO NOT REFLECT A PROVISION OR LIABILITY FOR FEDERAL AND STATE INCOME TAXES. THE SYSTEM HAS DETERMINED THAT IT DOES NOT HAVE ANY MATERIAL UNRECOGNIZED TAX BENEFITS OR OBLIGATIONS AS OF SEPTEMBER 30, 2014. THE SYSTEM BELIEVES THEY ARE NO LONGER SUBJECT TO INCOME TAXES EXAMINATIONS FOR YEARS PRIOR TO SEPTEMBER 30, 2011.ExplanationTxt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd
Percent100Yes (X)Percent100Ind
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd
Percent400Yes (X)Percent400Ind
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed BudgetYes (1)ExpensesExceedBudgetInd
Unable To Provide Care0UnableToProvideCareInd
Annual Community Bnft ReportYes (1)AnnualCommunityBnftReportInd
Report Publically AvailableYes (1)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$2,250,670TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$2,250,670NetCommunityBenefitExpnsAmt
Total Expense0.03260TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,060,535TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,060,535NetCommunityBenefitExpnsAmt
Total Expense0.01540TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$3,311,205TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$3,311,205NetCommunityBenefitExpnsAmt
Total Expense0.04800TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,650TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,650NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$2,000TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$2,000NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$52,020TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$52,020NetCommunityBenefitExpnsAmt
Total Expense0.00080TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$55,670TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$55,670NetCommunityBenefitExpnsAmt
Total Expense0.00080TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$3,366,875TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$3,366,875NetCommunityBenefitExpnsAmt
Total Expense0.04880TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense Reported0BadDebtExpenseReportedInd
Bad Debt Expense$12,743,121BadDebtExpenseAmt
Reimbursed By Medicare$25,428,561ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$61,703,060CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$36,274,499MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn0FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1COLUMBUS REGIONAL HEALTHCARE SYSTEMBusinessNameLine1

US Address USAddress

FieldValueIRS element (for citing)
Address Line1500 JEFFERSON STREETAddressLine1
CityWHITEVILLECity
StateNCState
ZIP Code28472ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1COLUMBUS REGIONAL HEALTHCARE SYSTEMBusinessNameLine1
FieldValueIRS element (for citing)
Facility1FacilityNum
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Information GapsYes (X)InformationGapsInd
CHNA Conducted13CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts0CHNAConductedWithOtherFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLSEE PART VOwnWebsiteURLTxt
Rpt Available Upon RequestYes (X)RptAvailableUponRequestInd
Adopt Implementation StrategyYes (X)AdoptImplementationStrategyInd
Exec Implementation StrategyYes (X)ExecImplementationStrategyInd
Prioritize Health NeedsYes (X)PrioritizeHealthNeedsInd
All Needs AddressedYes (1)AllNeedsAddressedInd
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Used Deter Elig Free CareYes (1)FPGUsedDeterEligFreeCareInd
FPG Family Incm Lmt Free Care100.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Used Determ Elig Dscnt CareYes (1)FPGUsedDetermEligDscntCareInd
FPG Family Incm Lmt Dscnt Care400.000000000000FPGFamilyIncmLmtDscntCarePct
Explained BasisYes (1)ExplainedBasisInd
Income LevelYes (X)IncomeLevelInd
Asset LevelYes (X)AssetLevelInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
Attached To InvoiceYes (X)AttachedToInvoiceInd
Posted In Emergency RoomYes (X)PostedInEmergencyRoomInd
Posted In Admission OfficeYes (X)PostedInAdmissionOfficeInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Permit Report To Credit AgencyYes (X)PermitReportToCreditAgencyInd
Collection Activities0CollectionActivitiesInd
FAP Notified All PatientsYes (X)FAPNotifiedAllPatientsInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Other Method UsedYes (X)OtherMethodUsedInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
COLUMBUS REGIONAL HEALTHCARE SYSTEMPART V, SECTION B, LINE 3: TERRIE PRIEST - VP COMMUNITY RELATIONS AND BETH BROWN - COMMUNITY OUTREACH COORDINATOR WERE PART OF THE COLUMBUS COUNTY COMMUNITY HEALTH ASSESSMENT TEAM. THE CCCHA WAS A 16 PERSON TEAM THAT INCLUDED REPRESENTATIVES FROM THE COUNTY HEALTH DEPARTMENT, THE COMMUNITY HEALTH CENTER AND VARIOUS COMMUNITY ORGANIZATIONS.
COLUMBUS REGIONAL HEALTHCARE SYSTEMPART V, SECTION B, LINE 5D: THE ORGANIZATION'S CHNA IS MADE AVAILABLE TO THE PUBLIC AT:HTTP://WWW.CRHEALTHCARE.ORG/WP-CONTENT/UPLOADS/2015/03/COLUMBUS_REGIONAL_CHNA_2012.PDF
COLUMBUS REGIONAL HEALTHCARE SYSTEMPART V, SECTION B, LINE 6I: OTHER HEALTH NEEDS WERE NOT ADDRESSED BECAUSE THE HOSPITAL DOESN'T HAVE THE RESOURCES AVAILABLE TO ADDRESS THOSE NEEDS.
COLUMBUS REGIONAL HEALTHCARE SYSTEMPART V, SECTION B, LINE 20D: THE HOSPITAL FACILITY IS IN THE PROCESS OF ADOPTING A METHOD FOR COMPUTING AMOUNT GENERALLY BILLED THAT WILL BE IN COMPLIANCE WITH THE REGULATIONS UNDER SECTION 1.501(R)-4 WHEN FINAL GUIDANCE IS AVAILABLE.
FieldValueIRS element (for citing)
Facility5FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (5 entries)

Address Line1USAddress/AddressLine1CityUSAddress/CityStateUSAddress/StateZIP CodeUSAddress/ZIPCodeFacilityFacilityTxt
SOUTHEAST PRIMARY CARE
619 JEFFERSON STREETWHITEVILLENC28472OTHER OUTPATIENT CLINIC
SOUTH COLUMBUS MEDICAL CENTER
14508 JAMES B WHITE HWY STABOR CITYNC28463OTHER OUTPATIENT CLINIC
BALDWIN WOODS DIAGNOSTICS
619 JEFFERSON STREETWHITEVILLENC28472DIAGNOSTIC CENTER
DONAYRE CANCER CARE CENTER
711 NORTH FRANKLIN STREETWHITEVILLENC28472OTHER OUTPATIENT CLINIC
CAROLINA UROLOGY ASSOCIATES
720 JEFFERSON STREETWHITEVILLENC28472OTHER OUTPATIENT CLINIC

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 7:THE ORGANIZATION USED WORKSHEET 2 OF THE 2013 SCHEDULE H INSTRUCTIONS TO COMPUTE A COST-TO-CHARGES RATIO USED TO CALCULATE CHARITY CARE AND UNREIMBURSED MEDICAID AT COST.
PART I, LN 7 COL(F):TOTAL EXPENSES REPORTED ON FORM 990, PART IX, LINE 25 CONTAINS A BAD DEBT EXPENSE OF $12,743,121 THAT HAS BEEN REMOVED FOR PURPOSES OF COMPUTING PERCENTAGE OF TOTAL EXPENSE ON COLUMN (F).
PART III, LINE 4:THE ORGANIZATION'S FINANCIAL STATEMENTS DO NOT INCLUDE FOOTNOTE ON BAD DEBT EXPENSE.
PART III, LINE 8:THE MEDICARE COST REPORT WAS USED TO CALCULATE THE OVERALL SHORTFALL. THE ORGANIZATION BELIEVES THE ENTIRE SHORTFALL SHOULD BE CONSIDERED COMMUNITY BENEFIT.
PART VI, LINE 2:THE ORGANIZATION PERFORMS A PERIODIC COMMUNITY NEEDS ASSESSMENT THAT ADDRESSES THE NEEDS OF THE SURROUNDING AREA. THE MOST RECENT NEEDS ASSESSMENT WAS PERFORMED IN SPRING OF 2013.
PART VI, LINE 3:A PATIENT PRESENTED AS SELF PAY IS ASKED TO SPEAK WITH A FINANCIAL COUNSELOR OR THE CONTRACTED MEDICAID ELIGIBILITY SPECIALIST WHO WILL EVALUATE FOR MEDICAID ELIGIBILITY. IF NOT ELIGIBLE FOR MEDICAID, CHARITY CARE GUIDELINES ARE REVIEWED WITH PATIENT AND PROCESSED AS NEEDED.
PART VI, LINE 4:THE PERIODIC COMMUNITY NEEDS ASSESSMENT PERFORMED TAKES INTO ACCOUNT GEOGRAPHIC AND DEMOGRAPHIC DATA FOCUSED ON CONSTITUENCY IN COLUMBUS COUNTY AND THE SURROUNDING APPLLICABLE COUNTIES IN THE REGION. DATA PARTS INCLUDE AGE, GENDER, MIGRATION TRENDS, THE ECONOMIC ENVIRONMENT, ETC. COLUMBUS COUNTY IS LOCATED IN SOUTHEASTERN NORTH CAROLINA AND COVERS A LAND MASS OF OVER 959 SQUARE MILES. POPULATION OF COLUMBUS COUNTY IS 57,246 WITH A RACIAL MAKEUP OF THE FOLLOWING: CAUCASIAN 60.5%, AFRICAN AMERICAN 30%, HISPANIC 4.7% AND NATIVE AMERICAN 3.5%. THERE ARE 21,758 HOUSEHOLDS IN COLUMBUS COUNTY AVERAGING 2.52 PEOPLE PER HOUSEHOLD. MEDIAN HOUSEHOLD INCOME IS AT $35,026 AND PEOPLE LIVINGS BELOW POVERTY LEVEL IS AT 25%
PART VI, LINE 5:THE HOSPITAL FURTHERS ITS EXEMPT PURPOSE BY PROMOTING THE HEALTH OF THE COMMUNITY BY EXTENDING MEDICAL STAFF PRIVILEDGES TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY FOR MOST OF ITS DEPARTMENTS. THE SURPLUS OF FUNDS, IF ANY, ARE USED TO PURCHSE MEDICAL EQUIPMENT AND IMPROVING PATIENT CARE. THE ORGANIZATION'S BOARD IS COMPRISED OF MOSTLY UNREALTED, LOCAL RESIDENTS TO ENSURE THAT THE VOICE OF COMMUNITY IS HEARD.
PART VI, LINE 7, REPORTS FILED WITH STATESNC

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeYes (X)CompensationCommitteeInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
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 Orgs0CompBsdNetEarnsRltdOrgsInd
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
HENRY HAWTHORNE
PRESIDENT$245,050$0$62,174$0$2,160$0$23,064$0$29,357$0$361,805$0$1,111$0
CARL BIBER
VP OF FINANCE$153,091$0$34,240$0$1,418$0$14,865$0$20,950$0$224,564$0$0$0
CRAIG SLATER
VP OF MEDICAL STAFF$194,807$0$47,580$0$74,359$0$20,769$0$15,220$0$352,735$0$0$0
TODD HOWELL
VP OPERATIONS$152,880$0$0$0$8,526$0$5,701$0$14,178$0$181,285$0$0$0
RICHARD WHEELER
CRNA$188,646$0$38$0$23,000$0$4,642$0$13,999$0$230,325$0$0$0
GLORIA MILLER
CRNA$218,699$0$38$0$18,917$0$11,011$0$10,584$0$259,249$0$0$0
JEFF SAVAGE
CRNA$218,099$0$38$0$17,500$0$12,616$0$14,256$0$262,509$0$0$0
JOHN SCACHERI
CRNA$193,922$0$38$0$17,500$0$11,987$0$14,178$0$237,625$0$0$0
KENNETH KERR
CRNA$191,607$0$38$0$22,997$0$3,978$0$8,666$0$227,286$0$0$0

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1NORTH CAROLINA MEDICAL CARE COMMISSIONBusinessNameLine1
FieldValueIRS element (for citing)
Bond Issuer EIN521309402BondIssuerEIN
CUSIP65821DQR5CUSIPNum
Bond Issued2013-02-07BondIssuedDt
Issue Price$26,188,219IssuePriceAmt
PurposeSEE PART VIPurposeDesc
Defeased0DefeasedInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Pool Financing0PoolFinancingInd

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Total Proceeds$26,188,379TotalProceedsAmt
In Reserve Fund$1,789,132InReserveFundAmt
Issuance Costs From Proceeds$521,980IssuanceCostsFromProceedsAmt
Capital Expenditures$16,486,469CapitalExpendituresAmt
Other Spent Proceeds$7,390,817OtherSpentProceedsAmt
Substantial Completion2014SubstantialCompletionYr
Current Refunding0CurrentRefundingInd
Advance Refunding0AdvanceRefundingInd
Final Allocation Made0FinalAllocationMadeInd
Adequate Books And Rec MaintYes (1)AdequateBooksAndRecMaintInd

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Owning Bond Financed Property0OwningBondFinancedPropertyInd
Any Lease Arrangements0AnyLeaseArrangementsInd
Mgmt Contract Bond Fincd Prop0MgmtContractBondFincdPropInd
Any Research Agreements0AnyResearchAgreementsInd
Private Bus Use By Others0.00000PrivateBusUseByOthersPct
Private Bus Concerning UBI0.00000PrivateBusConcerningUBIPct
Total Private Business Use0.00000TotalPrivateBusinessUsePct
Bond Iss Meet Prvt Sec Pymt Test0BondIssMeetPrvtSecPymtTestInd
Change In Use Bond Financed Prop0ChangeInUseBondFinancedPropInd
Procs Nonqualified Bond Remdtd0ProcsNonqualifiedBondRemdtdInd

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Form8038 T Filed0Form8038TFiledInd
Rebate Not Due YetYes (1)RebateNotDueYetInd
Exception To Rebate0ExceptionToRebateInd
No Rebate Due0NoRebateDueInd
Variable Rate Issue0VariableRateIssueInd
Hedge Identified In Bks And Rec0HedgeIdentifiedInBksAndRecInd
Gross Proceeds Invested In GIC0GrossProceedsInvestedInGICInd
Gross Proceeds Invested0GrossProceedsInvestedInd
Written Proc To Monitor Reqs0WrittenProcToMonitorReqsInd

Procedures Corrective Action ProceduresCorrectiveActionGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Procedures Corrective Action0ProceduresCorrectiveActionInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE K, PART I, COLUMN FFormAndLineReferenceDesc
ExplanationTHE PURPOSE OF THE SERIES 2013A BONDS ARE TO: 1. PAY OR REIMBURSE THE SYSTEM FOR PAYING, A PORTION OF THE COST OF THE PROJECT, 2. REFINANCE CERTAIN INDEBTEDNESS INCURRED ON BEHALF OF THE SYSTEM, 3. FUND A DEBT SERVICE RESERVE FUND, AND 4. PAY CERTAIN EXPENSES OF ISSUING THE 2013A BONDS.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 3EFFECTIVE NOVEMBER 26, 2007, CRHS ENTERED INTO A NINE-YEAR MANAGEMENT SERVICES AGREEMENT WITH THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY WHICH DOES BUSINESS AS CAROLINAS HEALTHCARE SYSTEM (CHS) TO MANAGE THE SYSTEM ON A DAY-TO-DAY BASIS.
FORM 990, PART VI, SECTION B, LINE 11THE ORGANIZATION'S 990 WAS REVIEWED BY MANAGEMENT BEFORE FILING WITH THE IRS. THE FORM WAS PRESENTED TO THE FINANCE COMMITTEE AND BOARD OF DIRECTORS AT A MEETING BEFORE RETURN WAS SUBMITTED TO THE IRS.
FORM 990, PART VI, SECTION B, LINE 12CTHE BOARD OF TRUSTEES COMPLETES A CONFLICT OF INTEREST FORM ANNUALLY. ALL EMPLOYEES AT ORIENTATION AND ANNUALLY, DURING HEALTH AND SAFETY EDUCATION ARE SURVEYED REGARDING ANY SITUATIONS THAT MAY CONSTITUTE AS A CONFLICT OF INTEREST. ANY EMPLOYEE FORMS WITH AN AFFIRMATIVE RESPONSE ARE FORWARDED TO THE COMPLIANCE OFFICER FOR REVIEW. THE BOARD OF TRUSTEES FORMS ARE SUBMITTED TO THE COMPLIANCE OFFICER FOR REVIEW AS WELL. ANY QUESTIONS OR CONCERNS ARE DISCUSSED WITH CEO.
FORM 990, PART VI, SECTION B, LINE 15COMPENSATION FOR THE CEO AND CFO ARE DETERMINED BY CAROLINAS HEALTHCARE SYSTEM (CHS) BY EXTERNAL INFORMATION EACH YEAR. THE BOARD OF TRUSTEES REVIEWS AND APPROVES THE COMPENSATION. THE BOARD OF TRUSTEES CONSIDERS RECOMMENDATIONS BASED ON AVAILABLE MARKET DATA AS THEY REVIEW AND APPROVE COMPENSATION FOR OTHER MEMBERS OF CRHS EXECUTIVE STAFF ON AN ANNUAL BASIS. ALL DECISIONS REGARDING COMPENSATION ARE DOCUMENTED.
FORM 990, PART VI, SECTION C, LINE 18THE ORGANIZATION'S FORM 990 IS MADE AVAILABLE TO THE PUBLIC UPON REQUEST AND ON WWW.GUIDESTAR.ORG.
FORM 990, PART VI, SECTION C, LINE 19CRHS MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. IN ADDITION, THE CONFLICT OF INTEREST STATEMENT IS AVAILABILE IN PATIENT LITERATURE.
FORM 990, PART IX, LINE 11GCONSULTING: PROGRAM SERVICE EXPENSES 173,532. MANAGEMENT AND GENERAL EXPENSES 225,603. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 399,135. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 10,278,286. MANAGEMENT AND GENERAL EXPENSES 2,026,214. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 12,304,500.
FORM 990, PART XII, LINE 2CTHIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.
FORM 990, PART VI, LINE 3THE ORGANIZATION IS UTILIZING PART VII AND SCHEDULE J OF THE FORM 990 TO REPORT THE COMPENSATION PAID TO THE CEO AND CFO BY THE MANAGEMENT COMPANY FOR SERVICES PROVIDED TO THE FILING ORGANIZATION. THE COMPENSATION HAS BEEN REPORTED IN THE FILING ORGANIZATION'S COMPENSATION COLUMNS.

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp (3 entries)

Address Line1USAddress/AddressLine1CityUSAddress/CityStateUSAddress/StateZIP CodeUSAddress/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdTotal IncomeTotalIncomeAmtEnd Of Year AssetsEndOfYearAssetsAmtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
COLUMBUS REGIONAL SAME DAY SURGERY CENTER LLC
500 JEFFERSON STREETWHITEVILLENC28472204662182INACTIVE - AMBULATORY SURGERY CENTERNC$0$0COLUMBUS REGIONAL HEALTHCARE SYSTEM
COLUMBUS REGIONAL PROPERTIES LLC
500 JEFFERSON STREETWHITEVILLENC28472204662123INACTIVE - PROPERTY HOLDINGS FOR SURGEY CENTERNC$0$0COLUMBUS REGIONAL HEALTHCARE SYSTEM
COLUMBUS REGIONAL PROPERTIES II LLC
500 JEFFERSON STREETWHITEVILLENC28472274332231PROPERTY HOLDINGSNC$147,237$1,370,885COLUMBUS REGIONAL HEALTHCARE SYSTEM

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (4 entries)

Address Line1USAddress/AddressLine1CityUSAddress/CityStateUSAddress/StateZIP CodeUSAddress/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrganizationControlledOrganizationInd
COLUMBUS COUNTY HOSPITAL FOUNDATION INC
500 JEFFERSON STREETWHITEVILLENC28472010673231TO SUPPORT AND PROMOTE COLUMBUS REGIONAL HEALTHCARE SYSTEMNC501(C)(3)LINE 11A, ICOLUMBUS REGIONAL HEALTHCARE SYSTEMYes (1)
COLUMBUS REGIONAL HEALTH NETWORK
500 JEFFERSON STREETWHITEVILLENC28472263807951TO PROVIDE PRIMARY MEDICAL SERVICESNC501(C)(3)LINE 3COLUMBUS REGIONAL HEALTHCARE SYSTEMYes (1)
COLUMBUS REGIONAL HEALTH OUTREACH
500 JEFFERSON STREETWHITEVILLENC28472272325401HEALTHCARE SERVICESNC501(C)(3)LINE 3COLUMBUS REGIONAL HEALTHCARE SYSTEMYes (1)
COLUMBUS REGIONAL DIAGNOSTICS
500 JEFFERSON STREETWHITEVILLENC28472462091076HEALTHCARE SERVICESNC501(C)(3)LINE 3COLUMBUS REGIONAL HEALTHCARE SYSTEMYes (1)
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsYes (1)ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (1)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgYes (1)LoansOrGuaranteesToOtherOrgInd
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 Facilities0SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (1)TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (2 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
COLUMBUS REGIONAL HEALTH NETWORK
R$172,216CASH
COLUMBUS REGIONAL HEALTH NETWORK
A$169,556CASH