MERCY RESTORATIVE CARE HOSPITAL INC: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- MERCY RESTORATIVE CARE HOSPITAL INC (EIN 75-3054855)
- Tax period
- 2013-08-01 to 2014-07-31
- Filed
- 2015-06-15
- IRS object ID
- 201531669349301073
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2015-06-15T15:20:22-05:00 | ReturnTs |
| Tax Period End | 2014-07-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 410746749 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLIFTONLARSONALLEN LLP | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 101 N TRYON STREET SUITE 1000 | AddressLine1 |
| City | CHARLOTTE | City |
| State | NC | State |
| ZIP Code | 28246 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2013-08-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 753054855 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MERCY RESTORATIVE CARE HOSPITAL INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | MERC | BusinessNameControlTxt |
| Phone | 7046678050 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 10648 PARK ROAD | AddressLine1 |
| City | CHARLOTTE | City |
| State | NC | State |
| ZIP Code | 28210 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DAN DUNMYER | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 7046678050 | PhoneNum |
| Signature | 2015-06-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | JOHN NORMAN | PreparerPersonNm |
| PTIN | P01506766 | PTIN |
| Phone | 7049985200 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2016-04-25 22:37:26Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Change | Yes (X) | AddressChangeInd |
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CAROLINAS SPECIALTY HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | DAN DUNMYER | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 10648 PARK ROAD | AddressLine1 |
| City | CHARLOTTE | City |
| State | NC | State |
| ZIP Code | 28210 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $22,172,300 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.CSHNC.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2002 | FormationYr |
| Legal Domicile State | NC | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE LONG TERM ACUTE CARE SERVICES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 202 | TotalEmployeeCnt |
| Total Volunteers | 18 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $20,822,254 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $21,439,929 | CYProgramServiceRevenueAmt |
| PY Investment Income | $768,912 | PYInvestmentIncomeAmt |
| CY Investment Income | $731,648 | CYInvestmentIncomeAmt |
| PY Other Revenue | $27,789 | PYOtherRevenueAmt |
| CY Other Revenue | $723 | CYOtherRevenueAmt |
| PY Total Revenue | $21,618,955 | PYTotalRevenueAmt |
| CY Total Revenue | $22,172,300 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $9,569,970 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $10,774,006 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $9,475,597 | PYOtherExpensesAmt |
| CY Other Expenses | $9,971,709 | CYOtherExpensesAmt |
| PY Total Expenses | $19,045,567 | PYTotalExpensesAmt |
| CY Total Expenses | $20,745,715 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $2,573,388 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $1,426,585 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $22,867,219 | TotalAssetsBOYAmt |
| Total Assets EOY | $42,725,713 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $2,292,197 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $20,464,477 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $20,575,022 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $22,261,236 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO PROMOTE AND IMPROVE THE HEALTH STATUS OF THE COMMUNITY BY PROVIDING LONG TERM ACUTE CARE SERVICES. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $16,896,015 | ExpenseAmt |
| Revenue | $21,439,929 | RevenueAmt |
| Desc | PROVIDED LONG TERM ACUTE CARE SERVICES THROUGH THE OPERATION OF A 40 BED HOSPITAL-WITHIN-A-HOSPITAL. | Desc |
| Total Program Service Expenses | $16,896,015 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | 0 | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 197 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 202 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 9 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 9 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (1) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | 0 | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | NC | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DAN DUNMYER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7046678050 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 10648 PARK ROAD | AddressLine1 |
| City | CHARLOTTE | City |
| State | NC | State |
| ZIP Code | 28210 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionAGrp (13 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| C NEAL ALEXANDER JR | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| LYSA LONG | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| EDWARD BETHEA | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| CHERYL ATKINSON | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| NANCY M GEEDEY | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| SANFORD BENJAMIN MD | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| JOYCE KORZEN | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| C CURTIS COPENHAVER | |||||||
| CHAIRMAN OF THE BOARD | 4.00 | $0 | $0 | $0 | Yes (X) | ||
| DAVID THOMAS | |||||||
| TREASURER / SECRETARY | 2.00 | $0 | $0 | $0 | Yes (X) | ||
| DAN DUNMYER | |||||||
| CEO | 40.00 | $0 | $0 | $0 | Yes (X) | ||
| JOANNE TYO | |||||||
| CFO | 40.00 | $0 | $0 | $0 | Yes (X) | ||
| TESHIA DAVIS-CARR | |||||||
| CCO | 40.00 | $0 | $0 | $0 | Yes (X) | ||
| HAJRUDIN BEGIC | |||||||
| RN | 40.00 | $117,835 | $0 | $0 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $117,835 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $0 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 2 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | 0 | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1 | CityContractorAddress/USAddress/City | StateContractorAddress/USAddress/State | ZIP CodeContractorAddress/USAddress/ZIPCode | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| BLUE CROSS BLUE SHIELD | |||||
| PO BOX 580017 | CHARLOTTE | NC | 28258 | HEALTH CARE INSURANCE | $1,293,467 |
| CMC MERCY HOSPITAL | |||||
| PO BOX 32861 ATTN JULIE FRANCE | CHARLOTTE | NC | 28232 | MEDICAL SUPPLIES | $1,181,835 |
| ACUITY HEALTHCARE | |||||
| 10200 MALLARD CREEK RD | CONCORD | NC | 28262 | MGMT FEES AND LABOR | $978,814 |
| CAROLINAS HEALTHCARE SYS | |||||
| PO BOX 32861 ATTN JULIE FRANCE | CHARLOTTE | NC | 28232 | MEDICAL SUPPLIES | $583,771 |
| MARSH USA INC | |||||
| 121 RIVER STREET | HOBOKEN | NJ | 07030 | LIABILITY INSURANCE | $314,144 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 17 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PATIENT REVENUE | Desc |
| Business | 621400 | BusinessCd |
| Total Revenue Column | $21,439,929 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $21,439,929 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $21,439,929 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $731,648 | TotalRevenueColumnAmt |
| Exclusion | $731,648 | ExclusionAmt |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $723 | TotalRevenueColumnAmt |
| Exclusion | $723 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $723 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $22,172,300 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $21,439,929 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $732,371 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,617,476 | TotalAmt |
| Program Services | $5,859,717 | ProgramServicesAmt |
| Management And General | $1,757,759 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,493,095 | TotalAmt |
| Program Services | $2,367,183 | ProgramServicesAmt |
| Management And General | $125,912 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $663,435 | TotalAmt |
| Management And General | $663,435 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $335,983 | TotalAmt |
| Program Services | $54,463 | ProgramServicesAmt |
| Management And General | $281,520 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $137,610 | TotalAmt |
| Management And General | $137,610 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $61,642 | TotalAmt |
| Management And General | $61,642 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,307,155 | TotalAmt |
| Program Services | $3,101,743 | ProgramServicesAmt |
| Management And General | $205,412 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $133,680 | TotalAmt |
| Program Services | $127,097 | ProgramServicesAmt |
| Management And General | $6,583 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $81,152 | TotalAmt |
| Program Services | $3,217 | ProgramServicesAmt |
| Management And General | $77,935 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,754 | TotalAmt |
| Management And General | $24,754 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $498,269 | TotalAmt |
| Program Services | $446,852 | ProgramServicesAmt |
| Management And General | $51,417 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $65,564 | TotalAmt |
| Program Services | $54,579 | ProgramServicesAmt |
| Management And General | $10,985 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,648 | TotalAmt |
| Program Services | $11,020 | ProgramServicesAmt |
| Management And General | $3,628 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $636,951 | TotalAmt |
| Program Services | $636,951 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,118,207 | TotalAmt |
| Program Services | $1,118,207 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $164,682 | TotalAmt |
| Program Services | $164,682 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| PATIENT CARE SUPPLIES | $2,561,237 | $2,561,237 |
| BAD DEBT EXPENSE | $183,649 | $183,649 |
| PATIENT CARE EQUIPMENT | $105,179 | $105,179 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $541,347 | TotalAmt |
| Program Services | $100,239 | ProgramServicesAmt |
| Management And General | $441,108 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $20,745,715 | TotalAmt |
| Program Services | $16,896,015 | ProgramServicesAmt |
| Management And General | $3,849,700 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,300,008 | BOYAmt |
| EOY | $5,536,277 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,403,198 | BOYAmt |
| EOY | $2,843,740 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,184 | BOYAmt |
| EOY | $55,223 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $205,873 | BOYAmt |
| EOY | $166,259 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $22,131,500 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $1,446,335 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,203,213 | BOYAmt |
| EOY | $20,685,165 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,529,192 | BOYAmt |
| EOY | $13,318,323 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,202,551 | BOYAmt |
| EOY | $120,726 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,867,219 | BOYAmt |
| EOY | $42,725,713 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,538,575 | BOYAmt |
| EOY | $2,859,283 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $17,438,620 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $753,622 | BOYAmt |
| EOY | $166,574 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,292,197 | BOYAmt |
| EOY | $20,464,477 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,575,022 | BOYAmt |
| EOY | $22,261,236 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,575,022 | BOYAmt |
| EOY | $22,261,236 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,867,219 | BOYAmt |
| EOY | $42,725,713 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $1,426,585 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $259,629 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule D IRS990ScheduleD
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $16,613,768 | OtherCostOrOtherBasisAmt |
| Depreciation | $609,172 | DepreciationAmt |
| Book Value | $16,004,596 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,126,588 | OtherCostOrOtherBasisAmt |
| Depreciation | $54,897 | DepreciationAmt |
| Book Value | $2,071,691 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,183,780 | OtherCostOrOtherBasisAmt |
| Depreciation | $637,610 | DepreciationAmt |
| Book Value | $2,546,170 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $207,364 | OtherCostOrOtherBasisAmt |
| Depreciation | $144,656 | DepreciationAmt |
| Book Value | $62,708 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $20,685,165 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | THIRD PARTY RESERVE | Desc |
| Amt | $166,574 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $166,574 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $21,988,651 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $21,988,651 | RevenueSubtotalAmt |
| Other Revenues Not Included | $183,649 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $183,649 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $22,172,300 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $20,562,066 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $20,562,066 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $183,649 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $183,649 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $20,745,715 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART X, LINE 2: | THE HOSPITAL IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE WITH EXEMPTION FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE HOSPITAL'S INCOME TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL, STATE, AND LOCAL AUTHORITIES. MANAGEMENT IS NOT AWARE OF ANY ACTIVITIES THAT WOULD JEOPARDIZE THEIR TAX-EXEMPT STATUS. MANAGEMENT IS NOT AWARE OF ANY SIGNIFICANT ACTIVITIES THAT ARE SUBJECT TO TAX ON UNRELATED BUSINESS INCOME OR EXCISE OR OTHER TAXES. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | PROVISION FOR DOUBTFUL ACCOUNTS (SHOWN AS EXPENSES ON 990) 183,649. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | PROVISION FOR DOUBTFUL ACCOUNTS (SHOWN AS EXPENSES ON 990) 183,649. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent200 D | Yes (X) | Percent200DInd |
| Free Care Medically Indigent | 0 | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | 0 | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $129,715 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $129,715 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00630 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $409,203 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $212,638 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $196,565 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00960 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $538,918 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $212,638 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $326,280 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01590 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,243 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $3,243 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,243 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $3,243 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $542,161 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $212,638 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $329,523 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01610 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $183,649 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $15,045,770 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $12,911,400 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $2,134,370 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | 0 | FinancialAssistancePrvsnInd |
Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp
Entity Name EntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 1 ACUITY HEALTHCARE LP | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Primary Activities | HOSPITAL MANAGEMENT | PrimaryActivitiesTxt |
| Org Profit Or Ownership | 0.00000 | OrgProfitOrOwnershipPct |
| Ofcr Etc Profit Or Ownership | 0.00000 | OfcrEtcProfitOrOwnershipPct |
| Physicians Profit Or Ownership | 0.00000 | PhysiciansProfitOrOwnershipPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MERCY RESTORATIVE CARE INC | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 10648 PARK ROAD | AddressLine1 |
| City | CHARLOTTE | City |
| State | NC | State |
| ZIP Code | 28210 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MERCY RESTORATIVE CARE INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| CHNA Conducted | 13 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (1) | CHNAConductedWithOtherFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Rpt Available Upon Request | Yes (X) | RptAvailableUponRequestInd |
| Adopt Implementation Strategy | Yes (X) | AdoptImplementationStrategyInd |
| Exec Implementation Strategy | Yes (X) | ExecImplementationStrategyInd |
| All Needs Addressed | 0 | AllNeedsAddressedInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Used Deter Elig Free Care | Yes (1) | FPGUsedDeterEligFreeCareInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Used Determ Elig Dscnt Care | 0 | FPGUsedDetermEligDscntCareInd |
| Explained Basis | 0 | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| Posted On Website | Yes (X) | PostedOnWebsiteInd |
| Available On Request | Yes (X) | AvailableOnRequestInd |
| FAP Actions On Nonpayment | 0 | FAPActionsOnNonpaymentInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Nondis Emergency Care Policy | 0 | NondisEmergencyCarePolicyInd |
| No Emergency Care | Yes (X) | NoEmergencyCareInd |
| Other Reason | Yes (X) | OtherReasonInd |
| Other Method Used | Yes (X) | OtherMethodUsedInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| MERCY RESTORATIVE CARE, INC. | PART V, SECTION B, LINE 3: THE HOSPITAL RELIED HEAVILIY ON THE WORK PERFORMED BY THE MECKLENBURG COUNTY HEALTH DEPARTMENT IN COMPILING INFORMATION FOR THE CHNA. THE COUNTY DEVELOPED A HEALTH OPINION SURVEY FOR MECKLENBURG COUNTY RESIDENTS. THE SURVEY WAS OFFERED IN ENGLISH AND SPANISH AND WAS MADE AVAILABLE ONLINE THROUGH SURVEY MONKEY. THE COUNTY ALSO PROVIDED PAPER COPIES IN ENGLISH AND SPANISH TO THOSE THAT COULD NOT ACCESS THE ONLINE VERSIONS. LINKS TO THE ONLINE SURVEY WERE SENT VIA EMAIL TO EOMPLOYEES OF THE TOP 5 EMPLOYERS IN MECKLENBURG COUNTY, ELECTED OFFICIALS, HEADS OF NEIGHBORHOOD ASSOCIATIONS AND THROUGH OTHER VARIOUS CONTACT LISTS. ALL RECIPIENTS WERE ENCOURAGED TO SHARE THE LINK AMONG THEIR OWN CONTACTS. PAPER COPIES WERE DELIVERED TO ELEVEN LOCAL LIBRARIES RESPRESENTING ALL GEOGRAPHIC ARES OF THE COUNTY. FINALLY THERE WAS ALSO TARGETED DISTRIBUTION OF PAPER COPIES TO REACH SPECIFIC POPULATIONS, SUCH AS SENIOR CENTERS, SAFETY-NET CLINICS, HOMELESS SHELTERS, HEALTH EDUCATION CLASS FOR LATINAS, AN AFRICAN AMERICAN MALE YOUTH GROUP, AND AN ORGANIZATION THAT WORKS WITH INCARCERATED INDIVIDUALS. |
| MERCY RESTORATIVE CARE, INC. | PART V, SECTION B, LINE 4: NOVANT HEALTHCARE, CAROLINAS HEALTHCARE SYSTEM |
| MERCY RESTORATIVE CARE, INC. | PART V, SECTION B, LINE 7: BEING A SMALL SPECIALIZED ORGANIZATION, THE HOSPITAL HAS LIMITED RESOURCES TO ADDRESS THE MANY SIGNIFICANT NEEDS OF OUR COMMUNITY. AS SUCH, THE HOSPITAL IDENTIFIED CERTAIN NEEDS THAT IT BELIEVED IT COULD MOST GREATLY IMPACT OVER THE COMING YEARS. THOSE NEEDS INCLUDE CHRONIC DISEASE PREVENTION AND ACCESS TO CARE. |
| MERCY RESTORATIVE CARE, INC. | PART V, SECTION B, LINE 10: THE HOSPITAL DOES NOT OFFER DISCOUNTED CARE; INSTEAD, THE HOSPITAL OFFERS CHARITY CARE TO ALL PATIENTS WHO ARE ELIGIBLE TO PARTICIPATE. FOR THOSE THAT DO NOT HAVE INSURANCE, OR ARE NOT ELIGIBLE FOR MEDICARE OR MEDICAID, THE HOSPITAL'S CHARITY CARE POLICY STATES THAT THE HOSPITAL WILL PROVIDE THOSE INDIVIDUALS WITH UNCOMPENSATED CARE (CONSISTENT WITH THE HOSPITAL'S RESOURCES). PATIENTS WHO ARE DEEMED ELIGIBLE UNDER THE HOSPITAL'S GUIDELINES TO RECEIVE UNCOMPENSATED CARE MAY APPLY FOR RELIEF FROM RESPONSIBILITY FOR ALL OR A PORTION OF THE AMOUNT THEY OWE FOR SERVICES RENDERED BY THE HOSPITAL. |
| MERCY RESTORATIVE CARE, INC. | PART V, SECTION B, LINE 19C: WE ARE A HOSPITAL WITHIN A HOSPITAL AND DO NOT HAVE AN EMERGENCY ROOM. |
| MERCY RESTORATIVE CARE, INC. | PART V, SECTION B, LINE 20D: THE HOSPITAL DID NOT PROVIDE CARE FOR ANY EMERGENCY MEDICAL CONDITIONS. |
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3C: | MERCY RESTORATIVE CARE HOSPITAL, INC. ("THE HOSPITAL") BUDGETS AMOUNTS FOR AND PROVIDES FREE OR DISCOUNTED CARE TO MEDICALLY INDIGENT IN ACCORDANCE WITH THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY. THE GUIDLINE OF 200% OF FEDERAL POVERTY LEVEL IS USED, BASED UPON INCOME PROVIDED BY THE PATIENT ON THE FINANCIAL APPLICATION TO DETERMINE ELIGIBILITY. PROOF OF INCOME IS REQUIRED OF PATIENTS: W-2, COPIES OF PAYROLL CHECKS, TAX RETURNS, AND/OR BANK STATEMENTS, IF AVAILABLE. |
| PART I, LINE 7, COLUMN (F): | THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 183,649. |
| PART II, COMMUNITY BUILDING ACTIVITIES: | THE HOSPITAL DOES NOT ENGAGE IN ANY COMMUNITY BUILDING ACTIVITES DUE TO THE NATURE OF ITS EXISTENCE. |
| PART III, LINE 2: | THE HOSPITAL DOES NOT HAVE A PROCESS FOR ESTIMATING THAT AMOUNT OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE HOSPITAL'S CHARITY CARE POLICY. CHARITY DISCOUNTS ARE ADJUSTED OFF AND NOT INCLUDED IN BAD DEBTS. ANY PAYMENTS RECEIVED ARE NOT INCLUDED IN BAD DEBT EXPENSE ON ANY PATIENT. |
| PART III, LINE 4: | THE HOSPITAL PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS USING MANAGEMENT'S JUDGMENT AND HISTORICAL EXPERIENCE. PATIENTS ARE NOT REQUIRED TO PROVIDE COLLATERAL FOR SERVICES RENDERED. PAYMENT FOR SERVICES IS GENERALLY REQUIRED WITHIN 30 DAYS RECEIPT OF INVOICE OR CLAIM SUBMITTED. SELF-PAY ACCOUNT BALANCES PAST DUE MORE THAN 180 DAYS ARE CLASSIFIED AS UNCOLLECTIBLE. FEDERAL REGULATIONS REQUIRE A 120-DAY PERIOD OF COLLECTION EFFORTS ON MEDICARE ACCOUNTS BEFORE BEING CLASSIFIED AS UNCOLLECTIBLE. IN ADDITION, AN ALLOWANCE IS ESTIMATED FOR OTHER ACCOUNTS RECEIVABLE BASED ON HISTORICAL EXPERIENCE OF THE HOSPITAL. AT JULY 31, 2013 AND 2012, THE ALLOWANCE FOR DOUBTFUL ACCOUNTS WAS APPROXIMATELY $253,000 AND $663,000, RESPECTIVELY. |
| PART III, LINE 8: | MEDICARE INPATIENT ACUTE-CARE SERVICES PROVIDED BY THE HOSPITAL ARE PAID AT PROSPECTIVELY DETERMINED RATES PER DISCHARGE BASED PRIMARILY ON THE PATIENT'S DIAGNOSIS AND MARKET AREA WAGES. MEDICARE PAYS FOR THE OPERATING AND CAPITAL COSTS ASSOCIATED WITH HOSPITAL INPATIENT STAYS IN LONG TERM CARE HOSPITALS. PATIENTS MUST HAVE AN AVERAGE MEDICARE LENGTH OF STAY GREATER THAN 25 DAYS. |
| PART III, LINE 9B: | THE HOSPITAL DOES NOT PURSUE COLLECTIONS FROM PATIENTS THAT ARE ELIGIBLE FOR FINANCIAL ASSISTANCE. |
| PART VI, LINE 2: | MERCY RESTORATIVE CARE HOSPITAL, INC. D/B/A CAROLINAS SPECIALTY HOSPITAL (THE "HOSPITAL") IS A 40-BED LONG-TERM ACUTE CARE HOSPITAL. THE HOSPITAL WAS INCORPORATED UNDER THE LAWS OF NORTH CAROLINA FOR THE PURPOSE OF PROMOTING AND IMPROVING THE HEALTH STATUS OF THE COMMUNITY BY DEVELOPING AND PROVIDING LONG-TERM ACUTE CARE SERVICES FOR THE BENEFIT OF CITIZENS OF MECKLENBURG AND SURROUNDING COUNTIES. THE HOSPITAL BEGAN OPERATIONS IN JANUARY 2003. |
| PART VI, LINE 3: | THE HOSPITAL HAS A CHARITY CARE PROGRAM FOR THOSE WHO QUALIFY BASED ON INCOME STANDARDS. THE HOSPITAL PROVIDES FINANCIAL ASSISTANCE APPLICATIONS. CHARITY CARE POLICY IS AVAILABLE ON WEB SITE. |
| PART VI, LINE 4: | THE HOSPITAL PROVIDES SERVICES PRIMARILY TO THE RESIDENTS OF MECKLENBURG COUNTY, NORTH CAROLINA AND SURROUNDING COUNTIES, WITHOUT COLLATERAL OR OTHER PROOF OF ABILITY TO PAY. |
| PART VI, LINE 5: | THE HOSPITAL SPONSORED A HEALTHCARE CONVENTION. |
| PART VI, LINE 6: | THE HOSPITAL IS HOUSED IN ANOTHER HOSPITAL BUT ARE SEPARATE FOR PURPOSES OF SPONSORSHIP AND COMMUNITY RELATED HEALTHCARE EVENTS. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 3 | DURING THE YEAR, THE CEO AND CFO WERE EMPLOYED THROUGH A MANAGEMENT CONTRACT WITH ACUITY HEALTHCARE, LP, AN UNRELATED ORGANIZATION. AS SUCH, THEIR COMPENSATION INFORMATION IS NOT REQUIRED ON PART VII. |
| FORM 990, PART VI, SECTION B, LINE 11 | MANAGEMENT PERFORMED A REVIEW OF THE FORM 990 PRIOR TO APPROVING IT FOR FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | IF A BOARD MEMBER IS FOUND TO HAVE A CONFLICT, THEY ABSTAIN FROM THE VOTING PROCESS. |
| FORM 990, PART VI, SECTION B, LINE 15 | A CONFLICT-FREE BOARD DETERMINES APPROPRIATE COMPENSATION, RELYING ON COMPARABLE INFORMATION. BOARD REVIEWS AND DECIDES CEO ANNUAL COMPENSATION THROUGH CLOSED BOARD SESSION. ONE BOARD MEMBER IS AN HR RESPRESENTATIVE AND PARTICIPATES IN DISCUSSIONS. |
| FORM 990, PART VI, SECTION C, LINE 19 | GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE NOT AVAILABLE TO THE PUBLIC. |
| FORM 990, PART IX, LINE 11G | PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 3,101,743. MANAGEMENT AND GENERAL EXPENSES 205,412. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,307,155. |
| FORM 990, PART XII, LINE 2C: | THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. |