2014-08-15T10:24:33-05:00 2013-09-30 560747981 DIXON HUGHES GOODMAN LLP 500 RIDGEFIELD COURT ASHEVILLE NC 28806 990 2012-10-01 562005198 COMMUNITY CAREPARTNERS INC COMM 8282742400 PO BOX 5779 ASHEVILLE NC 28813 GREGORY K DIXON 8282742400 2014-08-15 1 AMY BIBBY P00445891 8282542254 2012 2015-11-30 17:44:51Z GREGORY K DIXON PO BOX 5779 ASHEVILLE NC 28813 79736407 0 1 X WWW.CAREPARTNERS.ORG X 1996 NC HELPING PEOPLE LIVE FULLY THROUGH LIFE'S JOURNEY. 19 18 1224 861 0 0 1276412 3319679 75758077 76134515 111077 32938 178760 165182 77324326 79652314 68389 47698 0 0 56810517 57922371 0 0 0 21108115 22960233 77987021 80930302 -662695 -1277988 26713386 24774929 12156855 10217116 14556531 14557813 X HELPING PEOPLE LIVE FULLY THROUGH LIFE'S JOURNEY. 0 0 24755395 47698 4112334 ON ANY GIVEN DAY IN FY13, COMMUNITY CAREPARTNERS WAS SERVING OVER 3,000 PATIENTS THROUGH OUR COMPREHENSIVE PROGRAMS IN REHABILITATION, HOME HEALTH, HOSPICE AND ADULT CARE THAT COMPOSE OUR UNIQUE POST-ACUTE CONTINUUM OF CARE. OUR 1,100 EMPLOYEES ARE COMMITTED TO PROVIDING EXCEPTIONAL CARE, EVERY DAY. AT THE BEGINNING OF 2013, CAREPARTNERS INITIATED DISCUSSIONS TO BECOME PART OF THE MISSION HEALTH SYSTEM, SERVING 18 COUNTIES OF WESTERN NORTH CAROLINA. WITH OUR RAPIDLY CHANGING HEALTH CARE ENVIRONMENT, NEW MODELS OF CARE AND DECLINING REIMBURSEMENT, BOTH MISSION AND CAREPARTNERS REALIZED THE NEED TO AFFILIATE AND DEVELOP A SEAMLESS CONTINUUM OF CARE FROM ACUTE CARE TO POST-ACUTE SERVICES. THE AFFILIATION WAS COMPLETED AT THE END OF FY13 (WITH AN EFFECTIVE DATE OF OCTOBER 01, 2013), AND CAREPARTNERS BECAME THE POST-ACUTE CARE ARM OF THE MISSION HEALTH SYSTEM. THE AFFILIATION ACHIEVES THE FOLLOWING GOALS:- IMPROVES ACCESS TO AND DELIVERY OF SERVICES ACROSS THE REGION BY PROVIDING FOR SAFE, SMOOTH AND EFFICIENT TRANSITIONS OF CARE.- INTEGRATES MISSION'S ACUTE CARE EXPERTISE WITH CAREPARTNERS' POST-ACUTE EXPERTISE.- ALLOWS PATIENT DATA TO FLOW ACROSS THE SYSTEM TO ENABLE SAFE, HIGH QUALITY AND EFFICIENT CARE.- ENHANCES THE QUALITY OF CARE WHILE REDUCING COST THROUGH THE ACHIEVEMENT OF MAXIMUM EFFICIENCIES.- PROVIDES FOR INNOVATION AND DEVELOPMENT OF NEW PROGRAMS TO MEET COMMUNITY NEEDS. SOME OF THE SPECIFIC ACCOMPLISHMENTS FOR EACH OF OUR SERVICE AREAS INCLUDE:OUTPATIENT THERAPY: THE OUTPATIENT THERAPY PROGRAM ADMITTED NEARLY 5,000 PATIENTS, PERFORMED OVER 100,000 PROCEDURES AND CONDUCTED OVER 26,000 VISITS IN FY13. THE PROGRAM IMPLEMENTED A NEW ELECTRONIC DOCUMENTATION SYSTEM THAT ACHIEVED: INCREASED COMPLIANCE IN DOCUMENTATION AND CHARGING; IMPROVED EFFICIENCIES; AND INCREASED EFFICIENCIES IN OUTCOME DATA COLLECTION. IN ADDITION TO IMPLEMENTATION OF THE EMR, PACE: THE PROGRAM OF ALL-INCLUSIVE CARE FOR THE ELDERLY ("PACE") PROVIDES COMMUNITY-BASED CARE AND SERVICES TO PEOPLE WHO OTHERWISE NEED NURSING HOME LEVEL OF CARE. PACE PROVIDES ALL THE CARE AND SERVICES COVERED BY MEDICARE AND MEDICAID, AS AUTHORIZED BY THE INTERDISCIPLINARY TEAM, AS WELL AS ADDITIONAL MEDICALLY-NECESSARY CARE AND SERVICES NOT COVERED BY MEDICARE AND MEDICAID. OUR PROGRAM IS CURRENTLY IN DEVELOPMENT WITH AN ANTICIPATED OPENING TO PARTICIPANTS IN OCTOBER 2014. DURING 2013, WE WORKED THROUGH THE APPLICATION APPROVAL PROCESS WITH CMS, NC DIVISION OF MEDICAL ASSISTANCE AND NC DIVISION OF AGING AND ADULT SERVICES. THE FACILITY WAS COMPLETED IN EARLY 2014 AND WE BEGAN THE PROCESS OF HIRING KEY STAFF TO HELP DEVELOP THE MANY SYSTEMS THAT WILL ALLOW US TO EFFECTIVELY CARE FOR OUR PARTICIPANTS. HOW WE USE OUR EXCESS REVENUES:WHILE CAREPARTNERS HAS A MINIMAL SURPLUS OF FUNDS MOST YEARS, EVERY DOLLAR IS REINVESTED IN THE ORGANIZATION TO CONTINUALLY IMPROVE THE QUALITY OF OUR SERVICES AND MEET THE COMMUNITY'S NEEDS. DURING THE PAST YEAR, THESE FUNDS HAVE BEEN USED TO PURCHASE A NEW ELECTRONIC MEDICAL RECORD SYSTEM FOR OUR HOME HEALTH, HOSPICE, PALLIATIVE CARE AND PRIVATE DUTY PROGRAMS THAT WILL ENHANCE SERVICES TO OUR PATIENTS. IN ADDITION, NEW INPATIENT AND OUTPATIENT THERAPY EQUIPMENT WAS PURCHASED, ALONG WITH UPGRADES OF OUR FACILITIES. ANY EXCESS FUNDS ARE USED TO ENHANCE EXISTING SERVICES AND EXPAND SERVICES TO SERVE UNMET NEEDS IN THE COMMUNITY. 17210029 28257528 REHABILITATION HOSPITAL: THE REHABILITATION HOSPITAL SERVED 1,341 PATIENTS IN FY13. PATIENT SATISFACTION CONTINUED TO BE VERY STRONG, WITH THE HOSPITAL SCORING IN THE TOP 20% OF THE ORGANIZATIONS PARTICIPATING IN OUR INDUSTRY-SPECIFIC DATABASE. OUR OUTCOME MEASURES, FUNCTIONAL INDEPENDENT MEASURE (FIM), SHOWED AN IMPROVEMENT OVER THE PAST YEAR WITH AN AVERAGE OF 2.61 IMPROVEMENT COMPARED TO A TARGET OF 2.56. IN THE PAST YEAR, WE CONTRACTED WITH A NEW FOOD DELIVERY SERVICE, MORRISON'S, WHICH OFFERS A "CATER TO YOU" PROGRAM FOCUSED ON PATIENT SATISFACTION. WE ADDED MORE PSYCHOLOGY HOURS TO PROVIDE EXPANDED ACCESSIBILITY TO PSYCHOLOGY SERVICES FOR OUR PATIENTS AND ENHANCED OUR VOLUNTEER PROGRAM, UTILIZING VOLUNTEERS FOR MID-STAY PATIENT SATISFACTION SURVEYS AS WELL AS MUSIC THERAPY AND PATIENT VISITS. WE HAVE CONTINUED A PATIENT ADVISORY COUNCIL WHICH SERVES AS A MEANS TO INVOLVE PAST PATIENTS WHO ARE NOW IN THE COMMUNITY TO GIVE FEEDBACK REGARDING THEIR HOSPITAL STAY AND OPPORTUNITIES FOR IMPROVEMENT. WE CONTINUE TO SERVE AS A CLINICAL AFFILIATION SITE FOR THERAPY AND NURSING STUDENTS IN THE SURROUNDING COUNTIES AS WELL AS THE SOUTHEASTERN STATES. IN ADDITION, WE PROVIDE OPPORTUNITIES FOR HIGH SCHOOL STUDENTS TO SHADOW AT OUR FACILITY AND CONTINUE TO PARTICIPATE IN COMMUNITY ACTIVITIES SUCH AS STROKE SCREENINGS, OVERSIGHT OF SUPPORT GROUPS, AND COMMUNITY ORGANIZED EVENTS TO RAISE MONEY FOR COMMUNITY PROGRAMS. WE CONTINUE TO OFFER SPECIALIZED PROGRAMS TO OUR PATIENTS SUCH AS VESTIBULAR THERAPY, LYMPHEDEMA THERAPY, WHEELCHAIR SEATING, AND POOL THERAPY. 14497785 21491146 HOSPICE: FOR FY13, HOSPICE ADMITTED 1,014 PATIENTS WITH A TOTAL OF 1,456 PATIENTS SERVED IN OUR HOSPICE PROGRAM. THE AVERAGE DAILY CENSUS IN HOSPICE HOME CARE WAS 258 AND THE AVERAGE DAILY CENSUS FOR OUR SOLACE HOSPICE INPATIENT FACILITY WAS 20. HOSPICE CONTINUES TO PROVIDE CARE AND SERVICES 24/7 WITH ADMISSIONS TO HOSPICE SEVEN DAYS A WEEK. OUR FAMILY SATISFACTION SCORES REMAINED VERY HIGH WITH 93.3% STATING THAT THEY WOULD RECOMMEND OUR HOSPICE TO OTHERS. DEYTA, A NATIONAL COMPANY THAT MEASURES HOSPICE PATIENT AND FAMILY SATISFACTION, RECOGNIZED OUR PROGRAM AS ONE OF THE TOP 10% IN THE COUNTRY IN 2013. THIS AWARD IS EARNED BY CONTINUED HIGH SCORES IN 17 VARIABLES OF THE SATISFACTION SURVEY. OUR BEREAVEMENT PROGRAM SERVED 2,589 INDIVIDUALS IN OUR COMMUNITY BY PROVIDING INDIVIDUAL COUNSELING, GROUP SESSIONS, AND COMMUNITY PROGRAMS IN OUR SCHOOLS. THESE PROGRAMS ARE OFFERED TO HOSPICE FAMILIES AND TO OUR LARGER COMMUNITY. PALLIATIVE CARE: THE SUPPORTIVE AND PALLIATIVE CARE PROGRAM CONTINUED TO EXPAND ITS SERVICES IN FY13. OUR HOSPITAL INPATIENT PALLIATIVE CARE PROGRAM TRANSITIONED TO A NEW MODEL OF CARE DELIVERY TO TIMELY RESPOND TO NEEDS AND ADDED CHAPLAIN SERVICES TO THE PROGRAM. WE PROVIDED 1,357 INITIAL CONSULTS ACROSS ALL THREE AREAS OF SERVICE, INCLUDING AN ACUTE CARE HOSPITAL PROGRAM, A COMMUNITY BASED PROGRAM THAT SERVES PATIENTS IN MULTIPLE SETTINGS IN SEVERAL COUNTIES IN WESTERN NORTH CAROLINA, AND OUR OUTPATIENT PALLIATIVE CARE CLINIC. CAREPARTNERS ALSO GRADUATED ONE FELLOW IN THE NEW ACGME-APPROVED HOSPICE AND PALLIATIVE CARE FELLOWSHIP PROGRAM AND ENROLLED TWO NEW FELLOWS FOR THE 2013-14 YEAR. 16447820 22273407 HOME HEALTH: AS WESTERN NORTH CAROLINA CONTINUES TO HAVE ONE OF THE FASTEST GROWING ELDERLY POPULATIONS IN THE COUNTRY, OUR HOME HEALTH PROGRAM EXPANDED TO MEET THE DEMAND FOR IN-HOME SERVICES. DURING THIS YEAR, THE PROGRAM SERVED OVER 7,350 PATIENTS WITH AN AVERAGE DAILY CENSUS OF OVER 1,500 PATIENTS. OUR HOME HEALTH PROGRAM SERVES A WIDE SPECTRUM OF OUR COMMUNITY NEEDS, RANGING FROM NEONATAL ABSTINENCE TO JOINT REPLACEMENT TO STROKES TO COMPLICATED SURGICAL WOUNDS TO OUR CHRONIC DISEASE POPULATION. THE UNIQUE NEEDS OF OUR PATIENT POPULATION REQUIRE A STAFF OF GENERALISTS AND SPECIALISTS, AND THIS YEAR STAFF CONTINUED TO RECEIVE A WIDE VARIETY OF CLINICAL IN-SERVICE TRAINING TO ENSURE THESE NEEDS ARE MET. WORKING WITH OUR REGIONAL TERTIARY HOSPITAL, MISSION HOSPITAL, OUR CLINICAL SPECIALIST WORKED WITH PULMONOLOGY LEADERS TO ENSURE A SAFE TRANSITION OF THESE COPD PATIENTS. THIS PROGRAM CREATED A SAFE TRANSITION HOME AND RELIED ON TELEMONITORING SUPPORT IN CONJUNCTION WITH HOME HEALTH SERVICES. DURING THIS YEAR WE TRANSITIONED TO A NEW ELECTRONIC MEDICAL RECORD AND ADDED NUMEROUS TECHNOLOGICAL SERVICES. THE TRANSITION WAS TIME CONSUMING, BUT PROVIDES A MORE ROBUST AND COMPREHENSIVE ELECTRONIC RECORD OF THE PATIENTS' CARE. THE ENTIRE CAREPARTNERS' CLINICAL AND ADMINISTRATIVE TEAM REMAINS PATIENT FOCUSED, AS DEMONSTRATED BY THE CONTINUED IMPROVEMENT IN OUR PATIENT OUTCOME SCORES AND PATIENT SATISFACTION SCORES. ADULT DAY: ADULT DAY SERVICES EXPANDED SERVICES TO OUR COMMUNITY IN A VARIETY OF WAYS DURING FY13. OUR ASHEVILLE-BASED ADULT DAY CARE/HEALTH CENTER COMPLETED A MAJOR RENOVATION AND EXPANSION, AND INCREASED ITS CERTIFIED CAPACITY TO SERVE UP TO 82 PARTICIPANTS PER DAY. APPROXIMATELY 200 BUNCOMBE COUNTY RESIDENTS PARTICIPATED IN THE ADULT DAY PROGRAM IN FY13. THE CENTER PROVIDED SHORT TERM OVERNIGHT RESPITE SERVICES 11 MONTHS OF THE YEAR. THE SERVICE WAS VERY SUCCESSFUL IN MEETING NEEDS OF BOTH CAREGIVERS AND PARTICIPANTS, WITH STAYS RANGING FROM 2 -14 NIGHTS. THE CLUB CAREPARTNERS- GROUP DAY RESPITE PROGRAM GREW THROUGHOUT THE YEAR SERVING AN AVERAGE OF 10 MEMBERS EACH DAY. CAREPARTNERS BEGAN OFFERING ADULT DAY CARE/HEALTH SERVICES IN HENDERSON COUNTY, AVERAGING 20 PARTICIPANTS IN ATTENDANCE PER DAY.PRIVATE DUTY: THE PRIVATE DUTY PROGRAM GREW TREMENDOUSLY DURING FY13 TO SERVE PATIENT NEEDS, RANGING FROM THREE HOURS A DAY TO 24 HOURS A DAY, SEVEN DAYS A WEEK. WITH AN AVERAGE DAILY CENSUS OF 225 PATIENTS, WE'VE EXPERIENCED RECORD VOLUMES. WE'VE FOCUSED THIS YEAR ON IMPROVING PATIENT SATISFACTION WITH AN "EXCEPTIONAL CARE, EVERY DAY" CAMPAIGN/ACTION PLAN. WE ARE ALSO PARTICIPATING IN A BENCHMARKING STUDY WHICH PROVIDES MORE TARGETS TO ASSESS OUR SERVICES. AS WE LOOK AHEAD, OUR FOCUS WILL TURN TO HIRING AND MANAGING CASES WITH BENEFITED STAFF VS PRN STAFF. 16447820 22273407 72911029 1 1 0 0 0 0 0 0 0 0 1 0 1 0 1 1 1 0 0 0 0 0 0 0 0 0 1 1 0 1 1 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 1 56 0 1 1224 1 0 0 0 0 0 0 0 0 0 0 X 19 18 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 NC X GREGORY K DIXON CFO 8282742400 68 SWEETEN CREEK ROAD ASHEVILLE NC 28803 TRACY BUCHANAN 40.00 X X 260061 0 108077 CHARLES C CAMPBELL 1.00 X X 0 0 0 JEFF GOULD 1.00 X X 0 0 0 LARRY HARRIS 1.00 X X 0 0 0 BRADY BLACKBURN 1.00 X X 0 0 0 DENNIS KING ED D 1.00 X 0 0 0 K RAY BAILEY 1.00 X 0 0 0 DAVID L CAPPIELLO MD 1.00 X 0 0 0 CAROLYN COWARD 1.00 X 0 0 0 SHARON HATHAWAY MD 1.00 X 0 0 0 KERRY A FRIEDMAN 1.00 X 0 0 0 JOEL ROSENBER MD 1.00 X 0 0 0 EILEEN HUTCHSION 1.00 X 0 0 0 PATSY KEEVER 1.00 X 0 0 0 TRENT MCCAIN MD 1.00 X 0 0 0 CHARLES PINE 1.00 X 0 0 0 ROBBY RUSSELL 1.00 X 0 0 0 MYRON W SMITH III MD 1.00 X 0 0 0 KATHERINE E VOLATILE MD 1.00 X 0 0 0 GARY BOWERS 40.00 X 206086 0 95194 GREGORY DIXON 40.00 X 180712 0 74130 CHRISTOPHER MIN 40.00 X 211715 0 9363 JOHN P LANGLOIS 40.00 X 207439 0 23840 JOY DEGUZMAN 40.00 X 243436 0 24509 VIRGINIA BARNHARDT 40.00 X 163437 0 17417 MARIANNE SOUFAS 40.00 X 162896 0 11475 1635782 0 364005 25 0 1 0 J BRENDLE MEDIA LLC (DBA) JACQUELYN N 6 INDIAN PLACE ASHEVILLE NC 28805 ADVERTISING 124264 1 182237 3137442 3319679 PROGRAM SERVICE FEES 621110 75152125 75152125 OTHER OPERATING INCOME 621110 707940 707940 INVESTMENT IN ASH HOSPITAL 621110 274450 274450 76134515 117031 117031 84093 -84093 -84093 -84093 CAFETERIA & VENDING 722210 165182 165182 165182 79652314 76134515 0 198120 47698 47698 924260 924260 45756659 42129426 3627233 1365488 1232350 133138 6036004 5447480 588524 3839960 3465555 374405 98770 98770 76086 76086 6399811 5963354 436457 155985 155698 287 2942535 2270119 672416 276702 273301 3401 4718355 4377234 341121 1318604 1217195 101409 514 400 114 216 212 4 1612647 1612647 638154 638154 MEDICAL SUPPLIES 2963134 2963134 BAD DEBT 1753489 1753489 MISCELLANEOUS 3494 3494 SPECIAL EVENTS 1737 1737 80930302 72911029 8019273 0 1752 1650 7496315 4519195 8534805 10956714 378324 391484 597837 528967 22193751 15787841 6581617 6405910 1546281 0 1061865 1295974 514590 675035 26713386 24774929 11428949 9765950 353612 374294 451166 12156855 10217116 X 14244869 14246151 311662 311662 14556531 14557813 26713386 24774929 -1277988 1279270 0 X 0 1 X 1 0 X 1502020 1613837 1686371 546617 3319679 8668524 64539011 63815417 70258700 76487872 76134415 351235415 217582 207455 191817 178760 165182 960796 66258613 65636709 72136888 77213249 79619276 360864735 0 0 0 360864735 811730 150664 112104 126726 117031 1318255 811730 150664 112104 126726 117031 1318255 67070343 65787373 72248992 77339975 79736307 362182990 0.99640 0.99370 0.00360 0.00630 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 312000 16000 16000 312000 312000 15000 15000 312000 309000 3000 15000 15000 312000 303000 6000 15000 15000 309000 298000 5000 14000 14000 303000 1.00000 1 0 10597758 6900140 3697618 11595993 8887701 2708292 6405910 INVESTMENT IN NCHEWCF 40652 F INVESTMENT IN ADVANCED SERVICES 500000 C INVESTMENT IN ASHEVILLE SPECIALTY HOSPITAL 755322 C 1295974 ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS 451166 451166 X 79178095 1279270 1279270 77898825 1753489 1753489 79652314 79176813 0 79176813 1753489 1753489 80930302 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: CAREPARTNERS IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE ("IRC") AND IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501 (A) OF THE IRC. CAREPARTNERS HAS DETERMINED THEY DO NOT HAVE ANY MATERIAL UNRECOGNIZED TAX BENEFITS OR OBLIGATIONS AS OF SEPTEMBER 30, 2013. FISCAL YEARS ENDING ON OR AFTER 2010 REMAIN SUBJECT TO EXAMINATION BY FEDERAL AND STATE TAX AUTHORITIES. PART XI, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 1,753,489. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 1,753,489. 1 1 1 X 1 X 0 1 1 0 1 1 428698 428698 0.00540 8692528 6251468 2441060 0.03080 36829 28419 8410 0.00010 9158055 6279887 2878168 0.03630 116057 1475 114582 0.00140 1525126 814276 710850 0.00900 83734 83734 0.00110 1724917 815751 909166 0.01150 10882972 7095638 3787334 0.04780 3396 19746 19746 0.00020 3396 19746 19746 0.00020 0 1215572 45813324 44086062 1727262 X 1 1 1 1 COMMUNITY CAREPARTNERS INC

68 SWEETEN CREEK RD ASHEVILLE NC 28803

X REHAB, OUTPATIENT, HOSPICE COMMUNITY CAREPARTNERS INC 1 1 X X X X X X X X X 12 1 0 1 X X X X X X X X X X 1 0 1 1 150.000000000000 1 300.000000000000 1 X X X X X 1 1 X X X 1 0 0 X X 0 1 5 CAREPARTNERS OUTPATIENT NORTH CLINIC

204 STONE RIDGE BLVD ASHEVILLE NC 28804

OUTPATIENT CLINIC CAREPARTNERS OUTPATIENT SOUTH CLINIC

3 TOWN SQUARE BLVD ASHEVILLE NC 28803

OUTPATIENT CLINIC CAREPARTNERS OUTPATIENT EAST CLINIC

2358 US HWY 70 SWANNANOA NC 28778

OUTPATIENT CLINIC CAREPARTNERS OUTPATIENT WEST CLINIC

1390 SAND HILL RD SUITE 1 CANDLER NC 28715

OUTPATIENT CLINIC ORTHOTICS & PROSTHETICS CLINIC - ASH

639 BILTMORE AVE ASHEVILLE NC 28801

ORTHOTICS AND PROSTHETICS CLINIC PART I, LINE 3C: PATIENTS THAT MEET THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES FEDERAL POVERTY AND THE INDIGENT CARE POLICY GUIDELINES WILL BE APPROVED FOR A DISCOUNT BASED ON A SLIDING SCALE (ATTACHED) RANGING FROM 25% TO 100% OF CHARGES. FEDERAL POVERTY GUIDELINES ARE UPDATED ANNUALLY AND PUBLISHED IN THE FEDERAL REGISTER. PART I, LINE 7: WORKSHEET 2 OF THE 2012 SCHEDULE H INSTRUCTIONS WAS USED TO DERIVE A COST-TO-CHARGES RATIO THAT THE ORGANIZATION USED TO COMPUTE COMMUNITY BENEFIT EXPENSES AT COST FOR LINES 7(A) AND 7(B). PART I, LINE 7G: PALLIATIVE CARE (COMFORT CARE) IS A CHOICE FOR THOSE WHO ARE NOT READY FOR HOSPICE. PATIENTS WHO HAVE A SERIOUS OR CHRONIC, LIFE-LIMITING ILLNESS THAT MAY STILL RESPOND TO CURE-ORIENTED TREATMENT MAY WISH TO PARTICIPATE IN THE CAREPARTNERS PALLIATIVE CARE PROGRAM. PALLIATIVE CARE, OR COMFORT CARE, BENEFITS PATIENTS THROUGHOUT ALL STAGES OF THEIR ILLNESS. IT OPTIMIZES QUALITY OF LIFE BY ANTICIPATING, PREVENTING AND TREATING THE DISTRESS OF LIVING WITH A SERIOUS ILLNESS. PART I, L7 COL(F): THE AMOUNT OF TOTAL EXPENSE ON FORM 990, PART XI, LINE 25 CONTAINS A BAD DEBT EXPENSE OF $1,753,489 THAT HAS BEEN REMOVED FOR PURPOSES OF CALCULATING LINE 7, COLUMN (F). PART III, LINE 4: THERE IS NO FOOTNOTE ADDRESSING BAD DEBT IN THE ORGANIZATION'S FINANCIAL STATEMENTS.THE ANDI METHODOLOGY, WHICH USED A FACILITY-WIDE RATIO OF COST TO CHARGES AS DESCRIBED IN 2012 NCHA COMMUNITY BENEFITS GUIDELINES, IS USED TO DETERMINE THE BAD DEBT EXPENSE. PART III, LINE 9B: PATIENTS WHO ARE KNOWN TO QUALIFY FOR A SLIDING SCALE DISCOUNT ARE GIVEN A DISCOUNT OF BETWEEN 100% AND 15% BASED ON FINANCIAL NEED. THE NORMAL COLLECTION PROCEDURES ARE FOLLOWED FOR THE REMAINING BALANCE. COMMUNITY CAREPARTNERS, INC. PART V, SECTION B, LINE 3: CAREPARTNERS ASSIGNED THE V.P. OF MARKETING TO REPRESENT THE ORGANIZATION TO WORK LOCALLY AND REGIONALLY ON A COMMUNITY HEALTH IMPROVEMENT PROCESS TO ASSESS THE HEALTH NEEDS, DEVELOP COLLABORATIVE PLANS, TAKE COORDINATED ACTION, AND ASSIST WITH EVALUATING PROGRESS AND IMPACT. AS A MEMBER OF SENIOR LEADERSHIP, HE IS ABLE TO INTERNALLY COMMUNICATE THE COMMUNITY'S NEEDS AND DIRECT ORGANIZATIONAL RESOURCES TO MEET THOSE NEEDS. THE MARKETING DEPARTMENT ALSO HAS A COMMUNITY OUTREACH COORDINATOR WHO LIAISONS WITH LOCAL HEALTH AGENCIES TO IDENTIFY GAPS AND TO PROVIDE APPROPRIATE ORGANIZATIONAL RESOURCES. CAREPARTNERS ALSO HAS BOTH CLINICAL AND NON-CLINICAL STAFF REPRESENTATION WITH THE BUNCOMBE COUNTY INFRASTRUCTURE TO ADDRESS THEIR CHIP STRATEGIES. EFFORTS WERE MADE TO ALIGN THE RIGHT CLINICAL AND OPERATIONAL RESOURCES WITHIN CAREPARTNERS TO BEST SUPPORT THE COUNTY EFFORTS. COMMUNITY CAREPARTNERS, INC. PART V, SECTION B, LINE 14G: OUR FINANCIAL COUNSELORS REVIEW ALL NO PAYOR SOURCES PRIOR TO ADMISSION. COMMUNITY CAREPARTNERS, INC. PART V, SECTION B, LINE 20D: PERCENT DISCOUNT OFF OF GROSS CHARGES OR 15% DISCOUNT FOR SELF PAY IF NOT ELIGIBLE FOR INDIGENT. COMMUNITY CAREPARTNERS, INC. PART V, SECTION B, LINE 22: ALL PATIENTS ARE CHARGE (GROSS REVENUE) THE SAME. A 15% DISCOUNT OFF GROSS CHARGES FOR INELIGIBLE PATIENTS IS APPLIED TO THEIR ACCOUNT. IF ELIGIBLE FOR INDIGENT, THE QUALIFIED PERCENT IS APPLIED TO GROSS CHARGES AND A CONTRACTUAL IS APPLIED TO THE PATIENT ACCOUNT. PART VI, LINE 2: CAREPARTNERS DEFINES ITS PRIMARY SERVICE COMMUNITY AS BUNCOMBE COUNTY AND COMMITS RESOURCES TO ITS IDENTIFIED HEALTH NEEDS. CAREPARTNERS PARTNERS WITH BUNCOMBE COUNTY DEPARTMENT OF HEALTH AND WNC HEALTHY IMPACT TO CONDUCT A COMMUNITY HEALTH NEED ASSESSMENT (CHNA) IN BUNCOMBE COUNTY EVERY THREE YEARS TO DETERMINE COMMUNITY HEALTH NEEDS. THE MOST RECENT CHNA WAS COMPLETED ON DECEMBER 3, 2012. CAREPARTNERS ALSO HAS CLOSE WORKING RELATIONSHIPS WITH MISSION HOSPITAL (THE REGIONAL HOSPITAL IN WNC), LONG TERM CARE FACILITIES, REGIONAL HOSPITALS AND PHYSICIAN PRACTICES. WE HAVE DESIGNATED STAFF WHOM LIAISON WITH THESE ORGANIZATIONS ON A DAILY, WEEKLY, AND MONTHLY BASIS TO LEARN ABOUT THE NEEDS OF THEIR PATIENTS. OUR CLINICAL SERVICES COMMITTEE IS COMPRISED OF LOCAL PHYSICIANS AND HEALTHCARE PROVIDERS FROM THROUGHOUT THE WNC REGION. THEY ARE CHARGED WITH IDENTIFYING UNMET HEALTHCARE NEEDS AND CREATING SYSTEMS AND PROCESSES TO MEET THOSE NEEDS. DURING OUR STRATEGIC PLANNING PROCESS, CAREPARTNERS SENIOR LEADERSHIP ANALYZES THE ENVIRONMENT AND SEEKS INPUT OF STAKEHOLDERS WITHIN THE ORGANIZATION AS WELL AS THE COMMUNITY. MANY CAREPARTNERS STAFF SIT ON NUMEROUS COMMUNITY HEALTHCARE RELATED BOARDS OR ACT AS MEMBERS OF THE ORGANIZATIONS. PART VI, LINE 3: WHEN PATIENTS ARE PREPARING FOR DISCHARGE FROM THE ACUTE CARE ORGANIZATION, THE DISCHARGE PLANNER WILL NOTIFY THE LIAISONS IF THE PATIENTS HAVE NO PAYER SOURCE. THE LIAISONS ASSESS THE PATIENTS' ABILITY TO COMMUNICATE AND UNDERSTAND FINANCIAL INFORMATION AND THEY NOTIFY THE FINANCIAL COUNSELOR. SHE/HE WILL WORK WITH THE PATIENT AND/OR FAMILY MEMBER TO GATHER THE FINANCIAL INFORMATION AND EDUCATE THEM ON THE ASSISTANCE AVAILABLE, INCLUDING MEDICAID, VOCATIONAL REHABILITATION, PROJECT ACCESS, AND THE CHARITY CARE PROVIDED BY CAREPARTNERS HEALTH SERVICES. ONCE THE FINANCIAL COUNSELOR HAS GATHERED ALL OF THE REQUIRED DOCUMENTS, SHE/HE WILL FORWARD THEM TO MEDICAID OR ANY PROGRAMS FOR WHICH THE PATIENT MAY QUALIFY. ALL OFFICES HAVE SIGNS UP IN BOTH ENGLISH AND SPANISH INFORMING PATIENTS THAT ASSISTANCE IS AVAILABLE. INTERPRETERS ARE PROVIDED WHERE NECESSARY. THERE ARE DEDICATED STAFF AVAILABLE TO ASSIST PATIENTS IN THIS MANNER. CAREPARTNERS FOLLOWS THE MEDICAID GUIDELINES ON WHAT DOCUMENTS AND INFORMATION WE COLLECT. THE CHARITY ASSISTANCE WILL RANGE FROM 100% FREE CARE TO A 15% DISCOUNT DEPENDING ON THE FINANCIAL NEED. PART VI, LINE 4: CAREPARTNERS HEALTH SERVICES IS THE ONLY POST-ACUTE CONTINUUM IN WNC. MOST OF OUR SERVICES ARE PROVIDED IN BUNCOMBE, HENDERSON, AND HAYWOOD COUNTIES (WHERE WE HAVE OFFICES) BUT WE ALSO REACH MORE RURAL COMMUNITIES LIKE MITCHELL, YANCEY, TRANSYLVANIA, MCDOWELL, AND MADISON. MEDIAN HOUSEHOLD INCOME FOR BUNCOMBE COUNTY IS $44,206 AS COMPARED TO $38,658 IN MADISON COUNTY. POPULATION GROWTH THAT HAS OCCURRED IN THE WNC REGION IS GENERALLY CONFINED TO THOSE OVER AGE 64. UNLIKE MANY AREAS, THIS GROWTH IS CHARACTERIZED NOT BY A NATURALLY-AGING NATIVE POPULATION BUT BY A TREMENDOUS INFLUX OF NON-NATIVE RETIREES. CAREPARTNERS SERVES A HIGHER PERCENTAGE OF OLDER ADULTS DUE TO THE NATURE OF OUR SERVICES - HOME HEALTH, HOSPICE, REHABILITATION HOSPITAL, PALLIATIVE CARE, AND ADULT DAY CARE. WE DO SERVE YOUNGER POPULATIONS BUT AS A WHOLE, OUR TYPICAL PATIENT IS 45 YEARS OR OLDER. OUR LARGEST PAYOR IS MEDICARE. WNC HAS HISTORICALLY HAD A SMALL PERCENTAGE OF AFRICAN-AMERICAN RESIDENTS WHEN COMPARED TO THE STATE OVERALL AND THIS TREND SHOWS NO SIGNS OF CHANGING. HISPANCIS, HOWEVER, HAVE QUINTUPLED THEIR PRESENCE IN THE AREA SINCE 1990 AND ARE ON TRACK TO MAINTAIN INCREASES IN THEIR REPRESENTATION OVER THE NEXT TWO DECADES. THE UNEMPLOYMENT RATE IN THE WNC REGION HAS DECREASED OVER THE PAST YEAR. PART VI, LINE 5: CAREPARTNERS HEALTH SERVICES HAS BEEN AN INTEGRAL PART OF THE WNC COMMUNITY SINCE ITS FOUNDING IN 1939. ALTHOUGH OUR TYPE OF CARE HAS CHANGED THROUGH THE YEARS, THE LEVEL OF CARE WE PROVIDE CONTINUES TO STRIVE FOR EXCELLENCE. WE ARE BEDROCK TO THIS COMMUNITY BY PROVIDING MORE THAN JUST GREAT POST-ACUTE SERVICES. WE FOSTER GOOD HEALTH AND NUTRITION BY SPONSORING BOTH MALL WALKER PROGRAMS AT THE LOCAL MALLS. TWICE A YEAR WE HOST AN EIGHT WEEK COMPREHENSIVE EDUCATIONAL SERIES (MINDFUL LIVING) OPEN TO THE COMMUNITY. TOPICS RANGE FROM AGING IN PLACE TO NUTRITION ON HOW TO CREATE YOUR WILL. WE HOST NUMEROUS SUPPORT GROUPS ON OUR CAMPUS EACH MONTH AND ARE INVOLVED IN NUMEROUS COMMUNITY WIDE HEALTH FAIRS. CAREPARTNERS IS ALSO PROACTIVE IN OFFERING NEW SERVICES TO BENEFIT THOSE MOST NEEDY WITHIN OUR COMMUNITY. CAREPARTNERS BEGAN CONSTRUCTION ON A PACE (PROGRAM OF ALL-INCLUSIVE CARE FOR THE ELDERLY) SITE THAT WILL PROVIDE MEDICAL CARE AND SOCIAL SERVICES TO THE ELDERLY OF BUNCOMBE AND HENDERSON COUNTIES. STAFF PARTICIPATE IN LOCAL AGING CONSORTIUMS AND LEADERS OF AGING ISSUES SUCH AS FALL PREVENTION AND CHRONIC ILLNESSES. ALL OF OUR COMMUNITY ACTIVITIES FOCUS ON DISEASE PREVENTION AND MANAGEMENT AS WELL AS CONNECTING THE LARGER COMMUNITY TO RESOURCES WITHIN CAREPARTNERS AND ACROSS WNC.ANY SURPLUS OF FUNDS IS RETURNED TO THE COMMUNITY THROUGH IMPROVING THE QUALITY OF PATIENT CARE OR EXPANDING TYPES OF CARE THAT ARE PROVIDED TO REACH MORE PATIENTS. REPORTS FILED WITH STATES PART VI, LINE 7 NC 1 SCHOLARSHIPS - EMPLOYEES 15 32298 SCHOLARSHIPS - LOCAL SCHOOLS 14 1400 SCHOLARSHIPS 15 14000 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: THE ORGANIZATION REQUIRES THAT POTENTIAL GRANT RECIPIENTS INDICATE HOW THE FUNDS WILL BE USED IN ORDER TO ENSURE THAT THE FUNDS WILL BE USED PROPERLY AND IN ACCORDANCE WITH THE ORGANIZATION'S EXEMPT PURPOSE. THE ORGANIZATION ALSO TOURS THE FACILITIES OF A POTENTIAL RECIPIENT TO GAIN A THOROUGH UNDERSTANDING OF THEIR OPERATIONS. AFTER A GRANT IS AWARDED, THE ORGANIZATION MEETS WITH THE MANAGMENT OF THE RECIPIENT ORGANIZATION TO REVIEW HOW THE FUNDS ARE BEING USED. A REPORT IS GIVEN TO THE BOARD OF DIRECTORS RELATED TO THESE FINDINGS. ON OCCASIONS THE GRANT RECIPIENT WILL ALSO PRESENT THEIR OUTCOMES DIRECTLY TO THE BOARD OF DIRECTORS. X 1 1 X X X X 0 1 0 0 0 1 0 0 0 TRACY BUCHANAN 198533 0 40203 0 21325 0 95681 0 12396 0 368138 0 0 0 GARY BOWERS 152723 0 33053 0 20310 0 78820 0 16374 0 301280 0 0 0 GREGORY DIXON 134969 0 28276 0 17467 0 64428 0 9702 0 254842 0 0 0 CHRISTOPHER MIN 168504 0 26727 0 16484 0 3165 0 6198 0 221078 0 0 0 JOHN P LANGLOIS 179598 0 11057 0 16784 0 7567 0 16273 0 231279 0 0 0 JOY DEGUZMAN 186883 0 39953 0 16600 0 8236 0 16273 0 267945 0 0 0 VIRGINIA BARNHARDT 140445 0 21848 0 1144 0 1144 0 16273 0 180854 0 0 0 MARIANNE SOUFAS 123068 0 8002 0 31826 0 5277 0 6198 0 174371 0 0 0 PART I, LINE 1A THE ORGANIZAION PROVIDED TAX GROSS-UPS FOR THE VEHICLE PROVIDED TO THE CEO. THESE ITEMS WERE INCLUDED IN THE RECIPIENTS' INCOME. PART I, LINE 4B THE FOLLOWING INDIVIDUALS PARTICIPATED IN A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN (457(F)) AND/OR DEFINED BENEFIT PLAN FOR 2012, AS FOLLOWS. THE AMOUNTS ARE REPRESENTED IN PART II, COLUMN (C): TRACY BUCHANAN - $87,244 GARY BOWERS - 71,727 GREGORY DIXON- 61,360 PART I, LINE 6 THE ORGANIZATION HAS A PAY FOR PERFORMANCE (PFP) PLAN. GOALS INCLUDED OVERALL PROFIT MARGIN AND OVERALL PERFORMANCE INDEX SCORE. PFP PAYMENTS ARE BASED ON GOALS ESTABLISHED AND APPROVED BY THE BOARD IN ADVANCE OF THE BEGINNING OF EACH YEAR. THE AMOUNT OF THIS POSSIBLE PAYMENT IS CONSIDERED IN THE DETERMINATION OF THE APPROPRIATE COMPENSATION FOR EACH POSITION. NANCY BOWERS WIFE OF GARY BOWERS, COO 61520 COMPENSATION 0 FORM 990, PART VI, SECTION A, LINE 1 THE EXECUTIVE COMMITTEE SHALL CONSIST OF THE CHAIRMAN, VICE CHAIRMAN AND IMMEDIATE PAST CHAIRMAN OF THE BOARD OF DIRECTORS, THE SECRETARY AND TREASURER OF THE CORPORATION, AND SUCH OTHER MEMBER OR MEMBERS OF THE BOARD OF DIRECTORS AS THE CHAIRMAN MAY APPOINT. THE EXECUTIVE COMMITTEE SHALL HOLD SCHEDULED MEETINGS AS NECESSARY AND SPECIAL MEETINGS AT THE CALL OF THE CHAIRMAN OR AS CALLED BY HIM AT THE REQUEST OF ANY MEMBER OF THE COMMITTEE, AND IT SHALL HAVE THE POWER TO TRANSACT ALL REGULAR BUSINESS OF THE CORPORATION DURING THE INTERIM BETWEEN THE MEETINGS OF THE BOARD OF DIRECTORS, UNLESS PROHIBITED BY THE ARTICLES OF INCORPORATION, OR BY THESE BYLAWS, OR BY A RESOLUTION OF THE BOARD OF DIRECTORS. MINUTES OF ALL MEETINGS OF THIS COMMITTEE SHALL BE KEPT AND RECORDED IN THE MINUTE BOOK OF THE CORPORATION. FORM 990, PART VI, SECTION B, LINE 11 THE 990 WAS PRESENTED TO THE BOARD AT A MEETING LEAD BY THE TAX PREPARERS. COPIES WERE SENT TO MEMBERS NOT IN ATTENDANCE. FORM 990, PART VI, SECTION B, LINE 12C A CONFLICT OF INTEREST DISCLOSURE IS SENT TO EACH NEW BOARD AND/OR GOVERNANCE COMMITTEE MEMBER AND TO ALL BOARD MEMBERS ON AN ANNUAL BASIS. THIS INFORMATION IS SUPPLIED BY EACH BOARD AND/OR GOVERNANCE COMMITTEE MEMBER, SIGNED AND DATED, AND RETURNED TO THE PRESIDENT'S OFFICE FOR THE CORPORATION'S PERMANENT FILES. FORM 990, PART VI, SECTION B, LINE 15 AN ANNUAL REVIEW OF MARKET DATA AND ORGANIZATIONAL PARITY IS CONDUCTED THROUGH THE HUMAN RESOURCES/COMPENSATION DEPARTMENT ON ALL SENIOR LEADERSHIP POSITIONS. THIS YEAR THAT REVIEW INCLUDED INPUT FROM MISSION HEALTH SYSTEM. RECOMMENDATIONS ARE MADE REGARDING SALARY ADJUSTMENTS AND ARE REVIEWED AND APPROVED AT THE BOARD LEVEL AS PART OF THE BUDGET PROCESS. FORM 990, PART VI, SECTION C, LINE 18 THE ORGANIZATION'S FORM 990 IS AVAILABLE UPON REQUEST. IN ADDITION, RECENT FILINGS OF THE FORM 990 ARE MADE AVAILABLE ONLINE AT WWW.GUIDESTAR.ORG. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, FINANCIAL STATEMENTS, AND CONFLICT OF INTEREST POLICY ARE MADE AVAILABLE UPON REQUEST. MSJHS AND CCP JOINT DEVELOPMENT COMPANY LLC DBA ASHEVILLE SPECIALTY HOSPITA 428 BILTMORE AVENUE ASHEVILLE NC 28801 562250464 HEALTHCARE NC MISSION HOSPITAL INC LONG-TERM ACUTE CARE 4717142 1135472 0 1 0.33330 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0