2013-02-26T09:07:43-06:00 2011-06-30 DIXON HUGHES GOODMAN LLP 500 RIDGEFIELD COURT ASHEVILLE NC 28806 990 2010-07-01 560619359 GASTON MEMORIAL HOSPITAL INC GAST 7048342000 2525 COURT DRIVE PO BOX 1747 GASTONIA NC 280531747 DAVID O'CONNOR 7048342000 2013-02-25 1 AMY BIBBY 8282542254 2010 2016-03-07 17:11:31Z X DAVID O'CONNOR 2525 COURT DRIVE PO BOX 1747 GASTONIA NC 280531747 410972492 0 X WWW.CAROMONT.ORG X 1945 NC TO PROVIDE EXCEPTIONAL HEALTH CARE TO THE COMMUNITIES WE SERVE. 14 11 3023 291 619518 74649 373678 119286 378127914 405735809 112375 41896 5155165 5018302 383769132 410915293 88799 257503 0 0 157119443 163004927 0 0 0 200992995 214831055 358201237 378093485 25567895 32821808 324420647 332063801 314318521 307061339 10102126 25002462 TO PROVIDE EXCEPTIONAL HEALTH CARE TO THE COMMUNITIES WE SERVE. 0 0 351817543 257503 405678029 GASTON MEMORIAL HOSPITAL PROVIDES INPATIENT, OUTPATIENT, EMERGENCY, AND SURGICAL SERVICES TO THE RESIDENTS OF GASTON COUNTY AND SURROUNDING AREAS AT ITS 435 BED ACUTE CARE FACILITY.PLEASE SEE SCHEDULE O FOR A CONTINUATION OF OUR PROGRAM SERVICE ACCOMPLISHMENTS. 351817543 1 1 0 1 0 0 0 0 1 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 1 0 0 0 0 1 341 0 1 3023 1 1 1 0 0 0 0 0 0 0 0 0 X 14 11 0 0 1 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 NC X X DAVID O'CONNOR 7048342000 2525 COURT DRIVE GASTONIA NC 28054 H SPURGEON MACKIE JR 1.00 X X 0 0 0 SHEILA S REILLY PHD 1.00 X X 0 0 0 DR ROBERT D CROUCH 1.00 X X 0 0 0 WILLIAM K GARY SR 1.00 X X 0 0 0 MARY FRANCES FORRESTER 1.00 X 0 0 0 KELVIN C HARRIS MD 1.00 X 0 231676 17761 JAMES H HOWARD JR 1.00 X 0 0 0 JAMES R BEAM 1.00 X 0 0 0 RICHARD K CRAIG 1.00 X 0 0 0 MICKEY PRICE 1.00 X 0 0 0 DR KATHY DRUM 1.00 X 0 0 0 DAVID ALLEN SMITH 1.00 X 0 0 0 M VINCENT QUINN 1.00 X 0 0 0 W BARRY SMITH 1.00 X 0 0 0 DR JOHN L SCHEITLER 1.00 X 20855 0 0 DR H CLAYTON THOMASON III 1.00 X 30000 0 0 VALINDA L RUTLEDGE 40.00 X 1076425 0 38634 DAVID O'CONNOR 40.00 X 692572 0 39820 MARIA LONG 40.00 X 487588 0 33654 JAMES D HUBER 40.00 X 527556 0 24567 STEVEN A RUBIN 40.00 X 461803 0 48507 TERRY L JONES 40.00 X 816277 0 90600 W K HARWELL 40.00 X 446012 0 139707 ANDREA K SERRA 40.00 X 385625 0 46032 MICHAEL R JOHNSON 40.00 X 288841 0 61392 ROWENA BUFFETT TIMMS 40.00 X 306035 0 17060 KATHLEEN L BESSON 40.00 X 276676 0 44064 WAYNE F SHOVELIN 0.00 X 5914978 0 0 11731243 231676 601798 113 1 1 0 SHARED (SIEMENS) MEDICAL SOLUTIONS 51 VALLEY STREAM PARKWAY MALVERN PA 19355 INFORMATION SYSTEMS 4991005 MORRISON MANAGEMENT SPECIALISTS INC 3 WACHOVIA CENTER STE 3000 401 S CHARLOTTE NC 28202 FOOD SERVICES MANAGEMENT 4248818 ARAMARK CTS 12483 COLLECTIONS CENTER DRIVE CHICAGO IL 60693 BIOMED SERVICES 2140200 GASTON ANESTHESIA ASSOCIATES PO BOX 601713 CHARLOTTE NC 28260 CRNA SERVICES 2126193 REHABCARE GROUP 7733 FORSYTH BLVD STE 1700 ST LOUIS MO 63105 OP REHAB SERVICES 1268959 46 119286 119286 PATIENT SERVICES REVEN 621500 404550934 404068809 482125 PARTNERSHIP INCOME 541900 853266 851585 1681 AUXILIARY INCOME 621500 331609 219897 111712 405735809 99095 99095 57199 -57199 -57199 -57199 PHARMACY REVENUE 621500 2173456 2173456 CAFETERIA & VENDING IN 722210 2048851 2048851 DISCOUNTS & REBATES 621500 537738 537738 258257 24000 234257 5018302 410915293 405678029 619518 4498460 257503 257503 4508634 919053 3589581 54468 54468 127338862 116843848 10495014 5979786 5343975 635811 15821584 14199224 1622360 9301593 8312586 989007 509315 509315 418205 57011 361194 27388 27388 263852 263852 39084210 35888182 3196028 1056718 138623 918095 2655004 1568135 1086869 373125 373125 9167315 9167315 123150 63134 60016 799649 324511 475138 11114018 11114018 26833269 26833269 1369881 1369881 MEDICAL SUPPLIES 73237048 72963654 273394 BAD DEBT 40115742 40115742 EQUIPMENT 5529915 5497322 32593 RECRUITING 1681816 1647401 34415 MISCELLANEOUS 418078 135444 282634 53357 53357 378093485 351817543 26275942 0 -3285 -5240 33966858 43641842 5676105 6558153 7706644 8288591 490703793 285794159 207276220 204909634 17892 9873 349220 380625 2311646 2311646 67119347 65968677 324420647 332063801 34757005 39454843 219898498 213332101 59663018 54274395 314318521 307061339 X 10102126 24995463 6999 10102126 25002462 324420647 332063801 X 32821808 -17921472 X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 263852 263852 0 EXPLANATION OF OTHER LOBBYING ACTIVITIES: PART II-B, LINE 1I: ANNUAL DUES WERE PAID TO THE NORTH CAROLINA HOSPITAL ASSOCIATION AND THE AMERICAN HOSPITAL ASSOCIATION, OF WHICH $25,112 WAS DETERMINED TO BE EXPENDITURES USED IN LOBBYING ACTIVITIES BY THESE ORGANIZATIONS. AN ADDITIONAL $238,740 IN LEGAL FEES WERE PAID FOR LOBBYING EXPENDITURES. 6513 966 480 6999 1.00000 0 0 3501129 3501129 267380455 118189925 149190530 203864992 162915961 40949031 15957217 4688273 11268944 204909634 PREPAID PENSION OBLIGATION 36084752 DEFERRED FINANCING COSTS 4760905 OTHER RECEIVABLES 3655234 457B PLAN ASSETS 4342068 DEFERRED CHARGE - INTEREST RATE SWAP 17125718 65968677 457B PLAN LIABILITY 4342068 ESTIMATED 3RD PARTY SETTLEMENTS 32804817 CAPITAL LEASE OBLIGATION 1792 INTEREST RATE SWAP LIABILITY 17125718 54274395 410915293 378093485 32821808 -47 -17921425 -17921472 14900336 368966543 -47 -41948703 -41948750 410915293 0 410915293 336144782 0 336144782 41948703 41948703 378093485 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: THE ORGANIZATION'S ENDOWMENT FUNDS ARE USED FOR ONCOLOGY MEDICATIONS. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE SYSTEM IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE SYSTEM HAS DETERMINED THAT IT DOES NOT HAVE ANY UNRECOGNIZED TAX BENEFITS OR OBLIGATIONS AS OF JUNE 30, 2011 AND 2010, RESPECTIVELY. PART XI, LINE 8 - OTHER ADJUSTMENTS: EQUITY TRANSFER -17,921,425. PART XII, LINE 2D - OTHER ADJUSTMENTS: BAD DEBT -40,115,744. SWAP INTEREST EXPENSE -1,832,959. PART XIII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT 40,115,744. SWAP INTEREST EXPENSE 1,832,959. 1 1 1 X 1 X 1 1 1 0 1 1 13811326 13811326 0.04090 61404820 51517409 9887411 0.02930 822409 694576 127833 0.00040 76038555 52211985 23826570 0.07060 2283238 5000 2278238 0.00670 3171427 3171427 0.00940 597214 597214 0.00180 6051879 5000 6046879 0.01790 82090434 52216985 29873449 0.08850 1898904 1898904 0.00560 1898904 1898904 0.00560 1 12531533 1083546 126962175 109077053 17885122 X 1 1 1 1 GASTON MEMORIAL HOSPITAL INCORPORATED

2525 COURT DRIVE GASTONIA NC 28054

X X X 4 DIAGNOSTIC IMAGING CENTERS AND 6 OP SERIVCE CENTER GASTON MEMORIAL HOSPITAL INC 1 PART I, LINE 3C: REGARDLESS OF INCOME, ASSETS ARE ALSO USED TO DETERMINE IF A PATIENT QUALIFIES FOR CHARITY. BELOW IS THE VERBIAGE FROM THIS POLICY:EXEMPT ASSETSTHE PRIMARY RESIDENCE ON UP TO (1) ACRE OF LAND, ONE AUTOMOBILE FOR EACH WORKING AGED ADULT, AND OTHER ASSETS, INCLUDING BUT NOT LIMITED TO, RETIREMENT FUNDS, INVESTMENTS AND OTHER FINANCIAL ASSETS, CASH VALUE OF LIFE INSURANCE POLICIES, AND EQUITY IN PROPERTY OR REAL ASSETS, TOTALING UP TO $25,000 ARE EXEMPT FROM CONSIDERATION AS ASSETS IN DETERMINING CHARITY CARE ELIGIBILITY. ANNUAL INCOME FROM PROPERTY OF REAL ASSETS WILL BE DEDUCTED FROM THE AMOUNT OF EQUITY IN THE ASSET WHEN CALCULATING THE EXEMPTION. PART I, LINE 7: THE COSTING METHODOLOGY USED IS A COST ACCOUNTING SYSTEM. ALL PATIENT SEGMENTS ARE INCLUDED. THIS SYSTEM ASSIGNS DIRECT COSTS TO SUPPLIES, PROCEDURES, ROUTINE AND SPECIALTY ROOM RATES BASED ON THE DEPARTMENT OF ORIGINATION. FIXED COSTS ARE ALLOCATED BASED ON STATISTICAL BASIS. THESE COSTS ARE THEN AGGREGATED AT THE PATIENT LEVEL AND TABULATED BY PAYOR TYPE. NO COST TO CHARGE RATIOS WERE USED IN THE CALCULATIONS. PART I, LINE 7G: THESE COSTS DO NOT INCLUDE ANY AMOUNTS ASSOCIATED WITH A PHYSICIAN'S CLINIC. PART I, L7 COL(F): $40,115,744 BAD DEBT EXPENSE REMOVED FROM TOTAL EXPENSES PRIOR TO CALCULATING PERCENT OF TOTAL EXPENSE. PART II: WORKFORCE DEVELOPMENT - CAROMONT HEALTH'S RECRUITMENT OF PHYSICIANS INTO THE FIVE COUNTIES THE SYSTEM SERVES IS DRIVEN BY THE CHANGING LANDSCAPE OF HEALTHCARE REFORM. THE SYSTEM RECRUITS BASED ON IDENTIFIED COMMUNITY HEALTHCARE NEEDS. THE SYSTEM'S GOAL IS TO BE PRO-ACTIVE AND ANTICIPATORY SO THAT THE HEALTHCARE NEEDS OF THE COMMUNITY ARE MET IN A QUALITY DRIVEN AND CONVENIENT MANNER. PART III, LINE 4: THE SYSTEM DESCRIBED IN PART 1 LINE 7 WAS USED FOR PART III LINE 2. TOTAL CHARGES AND THE CHARGES WRITTEN OFF TO BAD DEBT WERE TABULATED AT THE PATIENT LEVEL. THE DETAILED COST OF THE PATIENT WAS MULTIPLIED BY THE RATIO OF CHARGES WRITTEN OFF/TOTAL CHARGES PER PATIENT TO ASSIGN THE COST TO THE PATIENT. BECAUSE OF THIS COST BASED METHOD, DISCOUNTS AND PAYMENTS WOULD BE THE DIFFERENCE BETWEEN THE TOTAL CHARGES AND THE CHARGES WRITTEN OFF TO BAD DEBT.RATIONALE FOR PART III, LINE 3: CHARGES FOR SERVICES PROVIDED IN THE EMERGENCY DEPT ARE EVALUATED FOR CHARITY BASED ON MEANS TESTING. CHARGES FOR SERVICES PROVIDED ELSEWHERE IN THE HOSPITAL ARE EVALUATED FOR CHARITY BASED ON APPLICATIONS FILED BY PATIENTS. IF NO APPLICATION IS FILED, THE UNPAID AMOUNT IS WRITTEN-OFF TO BAD DEBT. THE % OF PATIENTS QUALIFYING FOR CHARITY IN THE EMERGENCY DEPT WAS APPLIED TO THE REMAINDER OF THE HOSPITAL TO DETERMINE THE % OF BAD DEBT PATIENTS WHO COULD HAVE BEEN CHARITY. THE BAD DEBT WRITE-OFFS WERE CONVERTED TO COST USING THE METHODOLOGIES DESCRIBED ABOVE.THE ORGANIZATION'S FINANCIAL STATEMENTS DO NOT CONTAIN A FOOTNOTE ON BAD DEBT EXPENSE. BAD DEBT EXPENSE IS REPORTED AS A DEDUCTION FROM PATIENT REVENUE. PART III, LINE 8: THE MEDICARE COST REPORT STANDARD COSTING METHODOLOGY WAS FOLLOWED WHEN FILING THE COST REPORT. THIS IS A STEP DOWN METHODOLOGY THAT APPLIES THE AVERAGE PATIENT COST TO MEDICARE PATIENTS. THE COST REPORT ALSO DOES NOT ALLOW HOSPITALS TO REPORT ALL OPERATING COSTS. BECAUSE OF THESE TWO ISSUES, THE MEDICARE COST REPORT METHODOLOGY UNDERSTATES THE TRUE COST OF TREATING MEDICARE PATIENTS. PART III, LINE 9B: THE POLICY CONTAINS PROVISIONS ON THE COLLECTION PRACTICES TO BE FOLLOWED FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR CHARITY CARE OR FINANCIAL ASSISTANCE. BELOW IS VERBIAGE FROM THE CHARITY POLICY:GASTON MEMORIAL HOSPITAL OFFERS MEDICAL SERVICES FREE OR AT A REDUCED RATE THROUGH THE CHARITY CARE PROGRAM. DETERMINATION OF FULL OR PARTIAL CHARITY CARE WILL BE BASED ON THE PATIENT'S INCOME, FAMILY SIZE, AND ASSETS. POTENTIAL ELIGIBILITY EXISTS ONLY AFTER REIMBURSEMENT EFFORTS FROM ALL OTHER THIRD PARTY RESOURCES, FEDERAL, STATE, AND LOCAL ASSISTANCE PROGRAMS HAVE BEEN EXHAUSTED. PART I, LINE 6A: THE ORGANIZATION COMMUNITY BENEFIT REPORT MADE AVAILABLE TO THE PUBLIC CONTAINS COMMUNITY BENEFITS FOR ALL RELATED ORGANIZATIONS TO THE HOSPITAL. PART VI, LINE 2: CAROMONT HEALTH ESTABLISHES COMMUNITY PRIORITIES THROUGH A NUMBER OF MECHANISMS:- LEADERSHIP OPINIONS ARE SOUGHT TO HELP IDENTIFY NEEDED SERVICES IN THE COMMUNITY. TELEPHONE SURVEYS ARE CONDUCTED ON A PERIODIC BASIS TO GATHER OPINIONS FROM RESIDENTS IN THE SERVICE AREA; THE MOST RECENT STUDY WAS COMPLETED IN THE SPRING OF 2009.- PATIENT SATISFACTION DATA IS ANALYZED TO DETERMINE WHERE AND/OR HOW SERVICES NEED TO BE IMPROVED.- SERVICE AREA DATA (VITAL STATISTICS, DEMOGRAPHICS AND UTILIZATION) ARE ANALYZED FOR TRENDS. THIS INFORMATION IS COORDINATED WITH PUBLIC HEALTH DATA TO DETERMINE VOIDS AND SERVICE AREA HEALTH PROBLEMS.- FINDINGS FROM COMMUNITY SURVEYS/REPORTS PUBLISHED BY OTHER ORGANIZATIONS (UNITED WAY, CHAMBER OF COMMERCE, PARTNERSHIP FOR CHILDREN, GASTON COUNTY, ETC.) ARE GATHERED AND REVIEWED FOR PERTINENCE TO COMMUNITY HEALTH PROBLEMS.- GASTON MEMORIAL HOSPITAL THROUGH THE GCHC IN CONJUNCTION WITH THE GASTON COUNTY HEALTH DEPARTMENT CONDUCTS A COMMUNITY ASSESSMENT EVERY FOUR YEARS. THE MOST RECENT STUDY WAS FALL, 2008. THIS ASSESSMENT GATHERS OPINIONS AND IS COMBINED WITH PUBLIC HEALTH DATA TO DETERMINE THE TOP FOUR COMMUNITY-WIDE HEALTH ISSUES. SERVICE AREA STRENGTHS, WEAKNESSES AND OPPORTUNITIES ARE USED AS A BASIS FOR ESTABLISHING COMMUNITY PRIORITIES. ALL THIS INFORMATION IS USED TO ESTABLISH ORGANIZATIONAL PRIORITIES, IDENTIFY AGENCIES AND ORGANIZATIONS TO BE INVOLVED IN RESOLVING COMMUNITY ISSUES, AND IMPLEMENT PROGRAMS TO RESOLVE IDENTIFIED ISSUES. GOALS, OBJECTIVES AND STRATEGIES ARE ESTABLISHED AND THE PROGRESS IS EVALUATED ON AN ANNUAL BASIS.- BOARD MEMBERS, SENIOR MANAGEMENT AND DEPARTMENT DIRECTORS ARE INVOLVED IN NUMEROUS ORGANIZATIONS. THROUGH THIS NETWORK OF RELATIONSHIPS, FURTHER INFORMATION ABOUT THE COMMUNITY AND THE NEEDS OF AREA RESIDENTS AND ORGANIZATIONS ARE USED IN THE DEVELOPMENT OF PROGRAMS AND SERVICES AVAILABLE THOUGH CAROMONT HEALTH. PART VI, LINE 3: PATIENTS ARE NOTIFIED IN SEVERAL WAYS ABOUT THEIR ELIGIBILITY FOR ASSISTANCE. BROCHURES ARE DISTRIBUTED AND VERBAL COMMUNICATION BETWEEN STAFF AND PATIENT IS PROACTIVE. IN ADDITION, THE HOSPITAL HAS HIRED STAFF TO ASSIST UNINSURED AND UNDERINSURED PATIENTS WITH ENROLLMENT IN VARIOUS PUBLIC PROGRAMS, INCLUDING MEDICAID. PART VI, LINE 4: GASTON COUNTY, WHICH IS THE COUNTY LOCATED TO THE WEST OF THE CHARLOTTE NC, IS THE HOSPITAL'S PRIMARY MARKET. LINCOLN, CLEVELAND, AND MECKLENBURG COUNTIES ARE THE HOSPITAL'S SECONDARY MARKET. THERE ARE NO OTHER ACUTE CARE HOSPITALS IN THE PRIMARY SERVICE AREA. ACCORDING TO THE U.S. CENSUS BUREAU, GASTON COUNTY HAD A POPULATION OF 206,086 (2010), A MEDIAN HOUSEHOLD INCOME OF $43,253 (2006-2010), AND 16.6% PERSONS BELOW POVERTY LEVEL (2006-2010). DURING FISCAL YEAR 2011, 8% OF THE HOSPITAL'S GROSS CHARGES WERE FROM UNINSURED PATIENTS AND 17% WAS FROM MEDICAID PATIENTS. PART VI, LINE 6: STEPS TOWARDS ACCOUNTABLE CARETHE INSTITUTE FOR HEALTHCARE IMPROVEMENT HAS ESTABLISHED A TRIO OF OBJECTIVES CALLED THE TRIPLE AIM, WHICH CAROMONT HEALTH HAS ADOPTED: - IMPROVE THE HEALTH OF THE POPULATION - ENHANCE THE PATIENT EXPERIENCE (QUALITY, ACCESS, RELIABILITY) - CONTROL COSTSTHESE THREE OBJECTIVES ARE ALL CRITICAL COMPONENTS IN BEING WHAT IS KNOWN IN THE INDUSTRY AS AN ACCOUNTABLE CARE ORGANIZATION (ACO). IN OUR STEPS TOWARD BECOMING AN ACO, CAROMONT HEALTH IS UNDERTAKING CHANGES THAT WILL LEAD TO BETTER COORDINATED CARE WITH BETTER OUTCOMES AT LOWER COSTS FOR PATIENTS. WE ARE ALSO EMBRACING THE "MEDICAL HOME" CONCEPT, WHICH IS A NATIONAL INITIATIVE DESIGNED TO IMPROVE HEALTH CARE QUALITY. MEDICAL HOMES ARE PATIENT CENTERED, TEAM-BASED APPROACHES TO CARE THAT HAVE BEEN SHOWN TO REDUCE HOSPITAL ADMISSIONS AND DECREASE COSTS. COMMUNITY HEALTHOUR COMMUNITY HEALTH INITIATIVES ARE FOCUSED PRIMARILY ON DISEASE PREVENTION AND BETTER MANAGEMENT OF CHRONIC ILLNESSES. THAT INCLUDES WORKING WITH LOCAL EMPLOYERS ON INNOVATIVE PROGRAMS AND COLLABORATING WITH OUR HEALTH CARE NEIGHBORS. THROUGH INNOVATION AND A FOCUS ON COMMUNITY WELLNESS, CAROMONT HEALTH IS DETERMINED TO MAKE UPCOMING CHANGES IN HEALTHCARE TO HAVE A POSITIVE IMPACT ON THE PEOPLE WE SERVE. TOBACCO CESSATION PROGRAMIN ORDER TO PROVIDE A HEALTHY ENVIRONMENT FOR OUR PATIENTS, FAMILIES AND STAFF, CAROMONT HEALTH AND ITS AFFILIATE CAMPUSES HAVE BEEN TOBACCO-FREE SINCE JANUARY 2007. IN FEBRUARY 2011, CAROMONT RECEIVED THE "GOLD STAR STANDARD HOSPITALS" DESIGNATION FROM NORTH CAROLINA PREVENTION PARTNERS FOR EXCELLENCE IN OUR EMPLOYEE TOBACCO CESSATION PROGRAMS. ALL EMPLOYEES WHO USE TOBACCO MAY PARTICIPATE IN A "QUIT PROGRAM", WHICH PROVIDES THEM WITH INCENTIVES IF THEY QUIT USING TOBACCO AND REMAIN TOBACCO-FREE FOR AT LEAST SIX MONTHS.GASTON COUNTY HEALTH SUMMITCAROMONT HEALTH HOSTED A HIGH PROFILE, PUBLIC CONVERSATION ABOUT THE HEALTH OF OUR COMMUNITY DURING THE 2011 GASTON COUNTY HEALTH SUMMIT, WHICH WAS HELD IN LATE MARCH. THE EVENT BROUGHT TOGETHER LEADERS FROM ORGANIZATIONS AND BUSINESSES SUCH AS CAROMONT HEALTH, COMMUNITY HEALTH PARTNERS, GASTON COMMUNITY HEALTHCARE COMMISSION, GASTON COUNTY DEPARTMENT OF SOCIAL SERVICES, GASTON COUNTY HEALTH DEPARTMENT, GASTON FAMILY HEALTH SERVICES, PATHWAYS, PHARR YARNS AND THE YMCA. ATTENDEES DISCUSSED WHERE OUR COMMUNITY STANDS IN TERMS OF HEALTH, INCLUDING WAYS TO IMPROVE HEALTH AND THE RELATIONSHIP BETWEEN BUSINESSES AND A COMMUNITY'S HEALTHCARE PROVIDERS. THE GASTON COUNTY HEALTH COALITION'S GOAL IS TO IMPROVE THE HEALTH STATUS OF OUR COMMUNITY, PARTICULARLY IN TERMS OF CHRONIC DISEASE MANAGEMENT. COMMUNITY CONVERSATIONS SUCH AS THE GASTON COUNTY HEALTH SUMMIT ARE HELPING DIVERSE GROUPS WORK TOGETHER TO MEET THOSE GOALS.HEALTHNET GASTONHEALTHNET GASTON (HNG) IS A PROGRAM DESIGNED TO PROVIDE COMPREHENSIVE HEALTH CARE SERVICES TO LOW-INCOME, UNINSURED RESIDENTS OF GASTON COUNTY. ITS SERVICES INCLUDE: A MEDICAL HOME/PRIMARY CARE PHYSICIAN SERVICES, SPECIALTY PHYSICIAN SERVICES, MEDICATION ASSISTANCE, CASE MANAGEMENT/HEALTH COACHING ACTIVITIES, AND HOSPITAL SERVICES. HNG OPERATES THROUGH THE LEADERSHIP AND COLLABORATION OF ITS FOUR FOUNDING STRATEGIC PARTNERS, INCLUDING: GASTON MEMORIAL HOSPITAL, GASTON FAMILY HEALTH SERVICES, COMMUNITY HEALTH PARTNERS, GASTON COMMUNITY HEALTH CARE COMMISSION. OTHER STRATEGIC PARTNERS INVOLVED WITH THIS INITIATIVE INCLUDE COMMUNITY 241 PHYSICIANS, GASTON COUNTY DEPARTMENT OF SOCIAL SERVICES, GASTON COUNTY HEALTH DEPARTMENT, AND OTHER LOCAL LEADERS.COMMUNITY HEALTH IMPROVEMENT ADVOCACYCAROMONT HEALTH HAS SIGNIFICANTLY IMPACTED ITS COMMUNITY IN PROVIDING MANY DIFFERENT HEALTH IMPROVEMENT PROJECTS, GROUPS, EVENTS, EDUCATION PROGRAMS, ETC. PART VI, LINE 7: CAROMONT HEALTH IN GASTONIA, NORTH CAROLINA IS A REGIONAL, INDEPENDENT, NOT-FOR-PROFIT HEALTH CARE SYSTEM. IT ENCOMPASSES GASTON MEMORIAL HOSPITAL WITH 435-BEDS; COURTLAND TERRACE, A 96-BED SKILLED NURSING FACILITY; GASTON HOSPICE WHICH INCLUDES THE 12-BED ROBIN JOHNSON HOUSE INPATIENT FACILITY, AND CAROMONT MEDICAL GROUP, A NETWORK OF 44 PRIMARY AND SPECIALTY PHYSICIAN OFFICES. CAROMONT HEALTH'S VISION IS TO BE A NATIONALLY RECOGNIZED LEADER AND VALUED PARTNER IN PROMOTING INDIVIDUAL HEALTH AND VIBRANT COMMUNITIES.COURTLAND TERRACE IS A 96-BED SKILLED NURSING FACILITY.GASTON HOSPICE HOSTS THE 12 BED ROBIN JOHNSON HOUSE INPATIENT FACILITY.CAROMONT MEDICAL GROUP IS A NETWORK OF 45 PRIMARY AND SPECIALTY PHYSICIAN OFFICES IN 5 COUNTIES AND IN 2 STATES.CAROMONT HEALTH HAS 3 OFF-SITE IMAGING LOCATIONS, 2 SAME-DAY SURGERY CENTERS AND 1 OCCUPATIONAL MEDICINE CLINIC.THE GASTON MEMORIAL HOSPITAL FOUNDATION (A SUBSIDIARY OF CAROMONT HEALTH) WAS ESTABLISHED IN 1985. IN ADDITION TO THE FOUNDATION UTILIZING ITS INVESTMENT EARNINGS FOR DONATIONS, CAROMONT HEALTH DONATES UP TO 10% OF ITS OPERATING INCOME TO THE GMH FOUNDATION EACH YEAR.DURING FISCAL YEAR 2011, OVER $700,000 IN DONATIONS WERE DISTRIBUTED TO CHARITABLE CAUSES THROUGHOUT GASTON COUNTY. FUNDS WERE GIVEN FOR THE FOLLOWING ORGANIZATIONS:GASTON FAMILY HEALTH SERVICES, GASTON TOGETHER, HEALTH NET GASTON, UNITED WAY, ALLIANCE CHILD/YOUTH. IN ADDITION, FOUNDATION GRANTS WERE PROVIDED TO FOR THE FOLLOWING: INDIGENT MEDICATIONS TRANSITIONAL CARE, GREAT 100, AND WAYNE F. SHOVELIN SCHOLARSHIP. REPORTS FILED WITH STATES PART VI, LINE 7 NC 1 CATAWBA LANDS CONSERVANCY 105 W MOREHEAD STREET CHARLOTTE NC 28232 581969605 501(C)(3) 5000 FMV COMMUNITY ASSISTANCE CHARLOTTE CHAMBER OF COMMERCE PO BOX 32785 CHARLOTTE NC 28232 560173610 501(C)(3) 10000 FMV COMMUNITY ASSISTANCE UNITED WAY OF GASTON COUNTY 200 EAST FRANKLIN BLVD GASTONIA NC 28052 560653356 501(C)(3) 7590 FMV COMMUNITY ASSISTANCE COMMUNITY FOUNDATION OF GASTON COUNTY 1201 E GARRISON BLVD GASTONIA NC 28053 581340834 501(C)(3) 22500 FMV COMMUNITY ASSISTANCE CRAMERTON POLICE DEPT 155 NORTH MAIN ST CRAMERTON NC 28032 580891982 GOVERNMENTAL 22842 FMV COMMUNITY ASSISTANCE DANIEL STOWE GARDENS 6500 SOUTH NEW HOPE ROAD BELMONT NC 28012 208362933 501(C)(3) 20000 FMV COMMUNITY ASSISTANCE GASTON ARTS COUNCIL PO BOX 242 GASTONIA NC 28053 561257449 501(C)(3) 6000 FMV COMMUNITY ASSISTANCE GASTON COLLEGE FOUNDATION 201 HIGHWAY 321 SOUTH DALLAS NC 28034 237079454 501(C)(3) 5000 FMV COMMUNITY ASSISTANCE GASTON COUNTY SCHOOLS 943 OSCEOLA STREET GASTONIA NC 28053 566001032 GOVERNMENTAL 10000 FMV COMMUNITY ASSISTANCE GASTON GAZETTE PO BOX 1538 GASTONIA NC 28053 580904885 N/A 6750 FMV COMMUNITY ASSISTANCE GASTON HOSPICE 258 E GARRISON BLVD GASTONIA NC 28054 581341530 501(C)(3) 5000 FMV COMMUNITY ASSISTANCE GASTON REGIONAL CHAMBER 601 W FRANKLIN BLVD GASTONIA NC 28053 560232990 GOVERNMENTAL 32275 FMV COMMUNITY ASSISTANCE GASTONIA GRIZZLIES PO BOX 177 GASTONIA NC 28053 421554288 501(C)(3) 7000 FMV COMMUNITY ASSISTANCE HEALTHCORPS FOUNDATION 191 7TH AVE NEW YORK NY 10011 261269358 501(C)(3) 10000 FMV COMMUNITY ASSISTANCE HOLY ANGELS FOUNDATION 6600 WILKINSON BLVD BELMONT NC 28012 561762654 501(C)(3) 10150 FMV COMMUNITY ASSISTANCE MOUNT HOLLY FARMER'S MKT 120 OAKLAND STREET MT HOLLY NC 28120 260464156 N/A 5000 FMV COMMUNITY ASSISTANCE MOUNT HOLLYDAYS PO BOX 787 MT HOLLY NC 28120 262310697 501(C)(3) 12000 FMV COMMUNITY ASSISTANCE NC PREVENTION PARTNERS 88 VILCOM CIRCLE CHAPEL HILL NC 27514 311722051 501(C)(3) 5000 FMV COMMUNITY ASSISTANCE NC PHYSICIANS HEALTH PROGRAM 220 HORIZON DRIVE SUITE 201 RALEIGH NC 27615 561846599 501(C)(3) 5500 FMV COMMUNITY ASSISTANCE THE MINT MUSEUM 500 S TRYON STREET CHARLOTTE NC 28202 560670666 501(C)(3) 10000 FMV COMMUNITY ASSISTANCE 18 2 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: OTHER ORGANIZATIONS THAT RECEIVE GRANT FUNDS MAY BE REQUIRED TO SUBMIT MONTHLY REPORTS THAT ARE MONITORED BY MANAGEMENT AND/OR THE BOARD OF DIRECTORS. ALL GRANTS DECISIONS ARE DOCUMENTED. X X X 1 1 X X X X X 1 1 0 0 0 1 1 0 0 KELVIN C HARRIS MD 0 161344 0 69928 0 404 0 5100 0 12661 0 249437 0 0 VALINDA L RUTLEDGE 577086 0 316937 0 182402 0 3613 0 35021 0 1115059 0 30281 0 DAVID O'CONNOR 322191 0 135109 0 235272 0 7350 0 32470 0 732392 0 81255 0 MARIA LONG 240185 0 107347 0 140056 0 7350 0 26304 0 521242 0 54573 0 JAMES D HUBER 274883 0 140994 0 111679 0 7211 0 17356 0 552123 0 70783 0 STEVEN A RUBIN 217271 0 94066 0 150466 0 6796 0 41711 0 510310 0 56875 0 TERRY L JONES 341070 0 325548 0 149659 0 7350 0 83250 0 906877 0 82864 0 W K HARWELL 221202 0 96137 0 128673 0 6724 0 132983 0 585719 0 55017 0 ANDREA K SERRA 184674 0 75521 0 125430 0 5614 0 40418 0 431657 0 48208 0 MICHAEL R JOHNSON 230017 0 45810 0 13014 0 7108 0 54284 0 350233 0 0 0 ROWENA BUFFETT TIMMS 166689 0 61153 0 78193 0 0 0 17060 0 323095 0 0 0 KATHLEEN L BESSON 198430 0 39191 0 39055 0 5953 0 38111 0 320740 0 0 0 WAYNE F SHOVELIN 0 0 0 0 5914978 0 0 0 0 0 5914978 0 472568 0 PART I, LINE 1A TRAVEL FOR COMPANIONS - IF A SPOUSE OR COMPANION IS EXPECTED TO ATTEND AN EVENT, IT MUST BE APPROVED IN ADVANCE AND THE EXPENSES OF THE SPOUSE OR COMPANION WILL BE TREATED AS TAXABLE COMPENSATION AND ADDED TO THE EMPLOYEE'S W2 OR A 1099 WILL BE ISSUED AT THE END OF THE CALENDAR YEAR. DURING FY 2011 THIS BENEFIT WAS PROVIDED TO THE CEO AND SOME BOARD MEMBERS. TAX INDEMNIFICATION AND GROSS-UP PAYMENTS - REIMBURSEMENT FOR CERTAIN TAXABLE BENEFIT COSTS (I.E. CELL PHONES) WILL BE GROSSED UP FOR ANY TAX OBLIGATIONS. HEALTH OR SOCIAL CLUB DUES OR INITIATION FEES - A PERCENTAGE OF PERSONAL USE OF DUES PAYMENTS FOR MEMBERSHIP IN A HEALTH OR FITNESS CLUB OR A SOCIAL OR RECREATIONAL CLUB WILL BE ADDED TO THE EMPLOYEE'S W-2 AT THE END OF THE CALENDAR YEAR. DURING FY 2011 THIS BENEFIT WAS PROVIDED TO THE CEO AND CFO. PART I, LINES 4A-B WAYNE F. SHOVELIN, FORMER CEO PARTICIPATED IN A SUPPLEMENTAL SALARY CONTINUATION RETIREMENT PLAN. GROSS PAYMENTS FOR 2010 WERE $5,914,978. PLEASE REFER TO THE SCHEDULE O DISCLOSURE FOR PART VI, SECTION B, LINE 15 FOR MORE DETAIL. PART I, LINE 6 CERTAIN CAROMONT MEDICAL GROUP INC. PHYSICIAN'S COMPENSATION PACKAGES ARE BASED ON THE INDIVIDUAL PHYSICIAN'S NET RESULTS FROM OPERATIONS AS CALCULATED BASED SOLEY ON HIS/HER NET CHARGES LESS HIS/HER ALLOCABLE SHARE OF CLINIC OVERHEAD COSTS. EXECUTIVE INCENTIVE COMPENSATION PLAN FOR ALL KEY EMPLOYEES BASED ON THE ACHIEVEMENT OF ANNUAL BUSINESS OBJECTIVES AND FINANCIAL PERFORMANCE OF THE CONSOLIDATED SYSTEM. MANAGER INCENTIVE PLAN BASED ON CONSOLIDATED CORPORATE AND INDIVIDUAL PERFORMANCE GOALS. NORTH CAROLINA MEDICAL CARE COMMISSION 521309402 65820HVF7 2003-01-23 120000000 PLEASE SEE SUPPLEMENTAL INFORMATION 0 0 0 NORTH CAROLINA MEDICAL CARE COMMISSION 521309402 65820HG64 2008-01-01 118400000 PLEASE SEE SUPPLEMENTAL INFORMATION 0 0 0 700000 123222025 5150936 1256069 3386000 91583999 21845020 2005 0 1 1 1 18190000 118629570 610174 917471 1553717 28947486 86600722 2009 1 0 1 1 0 0 1 0 1 0.00000 0.00000 0.00000 1 0 0 1 0 1 0.00000 0.00000 0.00000 1 0 1 1 MERRILL LYNCH CAPITAL SERVICES 31.600000000000 0 0 0 0 0 0 1 1 MERRILL LYNCH DERIVATIVE PRODUCTS 21.000000000000 0 0 0 0 1 SCHEDULE K SUPPLENTAL INFORMATION THREE 501(C)(3) ORGANIZATIONS WITHIN THE PARENT-SUBSIDIARY CONTROLLED GROUP BENEFIT FROM THE BONDS AS FOLLOWS: GASTON MEMORIAL HOSPITAL, INC. (56-0619359); CAROMONT HEALTH, INC. (58-1636959); CAROMONT HEALTH SERVICES, INC. (56-1455630). GASTON MEMORIAL HOSPITAL, INC. HOLDS THE LIABILITY FOR THE BONDS, PER AUDITED FINANCIAL STATEMENTS. PART I, LINE A, COLUMN C THIS BOND ISSUE INCLUDES TWO CUSIPS MATURING ON THE SAME DATE: 65820HVG5 AND 65820HVF7 PART I, COLUMN (F) DESCRIPTION OF PURPOSE ISSUE A - NEW CONSTRUCTION OF HOSPITAL FACILITIES, PURCHASE OF HOSPITAL EQUIPMENT, PARTIAL REFUNDING OF SERIES 1998 BONDS ISSUED ON AUGUST 27,1998 ISSUE B - RENOVATION OF HOSPITAL FACILITIES, PURCHASE OF HOSPITAL EQUIPMENT, REFUNDING OF ENTIRE SERIES 1995 BONDS ISSUED ON NOVEMBER 15, 1995, REFUNDING OF ENTIRE SERIES 1998 BONDS ISSUED ON AUGUST 27, 1998 PART II, LINE 11 OTHER SPENT PROCEEDS WERE DEPOSITS MADE INTO A REFUNDING ESCROW ACCOUNT ALONG WITH INTEREST EARNED ON THE ACCOUNT, BOTH OF WHICH WERE SUBSEQUENTLY USED TO PAY PRINCIPLE AND INTEREST ON THE REFUNDED BONDS. PART IV, LINES 2 AND 3A, COLUMN B THE SERIES 2008 BONDS WERE ORIGINALLY ISSUED AS VARIABLE BONDS BEARING INTEREST AT WEEKLY RATES. CAROMONT HEALTH, INC. ENTERED INTO INTEREST SWAP AGREEMENTS TO HEDGE ITS INTEREST RISK WITH RESPECT TO A PORTION OF THE SERIES 2008 BONDS. ON SEPTEMBER 1, 2010, THE SERIES 2008 BONDS WERE CONVERTED TO FIXED INTEREST RATES TO MATURITY. HOWEVER, THE INTEREST RATE SWAPS WERE NOT TERMINATED IN CONNECTION WITH SUCH FIXED RATE CONVERSION AND REMAIN IN EFFECT. PART IV, LINE 3C, COLUMN B THIS BOND ISSUE HAS TWO HEDGE TERMS: 11.0 YEARS AND 21.0 YEARS AMENDED RETURN: THE 2010 SCHEDULE K WAS AMENDED TO CORRET AN ERROR ON PART II, COLUMM (B), LINE 10. THE AMOUNT IN THE ORIGINAL FILING WAS OVERSTATED BY $1 MILLION. THE AMOUNT HAS BEEN AMENDED TO CORRECTLY STATE THE AMOUNT $28,947,486. LUCINDA DAVIS FAMILY MEMBER OF DIRECTOR, JAMES BEAM 54468 COMPENSATION AS EMPLOYEE 0 FORM 990, PART VI, SECTION A, LINE 4 THE ORGANIZATION AMENDED ITS BYLAWS WHICH INCLUDED REVISIONS THAT SPECIFICALLY OUTLINE POWERS OF THE PARENT ORGANIZATION AND SOLE MEMBER OF THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF THE CORPORATION SHALL BE CAROMONT HEALTH, INC., A NORTH CAROLINA NOT-FOR-PROFIT CORPORATION. FORM 990, PART VI, SECTION A, LINE 7A THE BOARD OF DIRECTORS SHALL CONSIST OF FOURTEEN (14) MEMBERS, ALL OF WHOM SHALL BE THE MEMBERS OF THE BOARD OF DIRECTORS OF CAROMONT HEALTH, INC., AND ALL OF WHOM SHALL BE APPOINTED BY THE BOARD OF DIRECTORS OF CAROMONT HEALTH. FORM 990, PART VI, SECTION A, LINE 7B THE FOLLOWING POWERS OF THE CORPORATION SHALL BE RESERVED TO CAROMONT HEALTH, INC., THE PARENT CORPORATION AND HOLDING COMPANY OF THE CORPORATION: (A) FINANCIAL POWERS, INCLUDING THE POWER TO APPROVE AN OPERATING BUDGET FOR THE CORPORATION, POWER TO APPROVE COMPENSATION PLANS, AND POWER TO ASSUME DEBT ON BEHALF OF THE CORPORATION; (B) GOVERNING POWERS, INCLUDING THE POWER TO APPROVE ALL CHANGES TO THE GOVERNING DOCUMENTS OF THE CORPORATION AND POWER TO APPROVE THE MISSION, VISION AND VALUES OF THE CORPORATION; AND (C) STRATEGIC POWERS, INCLUDING THE POWER TO APPROVE ALL CERTIFICATE OF NEED APPLICATIONS WHICH THE CORPORATION MAY FILE IN ANY STATE, AND THE POWER TO APPROVE ALL SALE OR LEASE TRANSACTIONS OF THE CORPORATION. FORM 990, PART VI, SECTION B, LINE 11 THE ORGANIZATION'S FORM 990 WAS REVIEWED BY THE AUDIT FINANCE INVESTMENT COMMITTEE OF THE BOARD OF DIRECTORS PRIOR TO PRESENTATION TO THE FULL BOARD BEFORE THE FORM WAS FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C EACH APPLICABLE EMPLOYEE AND DIRECTOR SHALL FULLY AND TRUTHFULLY COMPLETE A QUESTIONNAIRE CONCERNING POTENTIAL AND ACTUAL CONFLICTS OF INTEREST ANNUALLY. SUCH QUESTIONNAIRE SHALL IDENTIFY THE EMPLOYEE'S OBLIGATION TO IMMEDIATELY MAKE THE PRESIDENT AWARE IN WRITING OF ANY POTENTIAL OR ACTUAL CONFLICTS OF INTEREST AS THEY MAY ARISE AND CONTAIN SAID EMPLOYEE'S AGREEMENT TO ABIDE BY ALL TERMS AND CONDITIONS OF THIS POLICY AS A CONDITION OF RETAINING THEIR POSITION. SUCH QUESTIONNAIRES SHALL BE REVIEWED ANNUALLY BY THE EXECUTIVE VICE PRESIDENT/GENERAL COUNSEL AND THE CORPORATE RESPONSIBILITY OFFICER. FORM 990, PART VI, SECTION B, LINE 15 THE CEO, CFO/ASSISTANT TREASURER AND EVP GENERAL COUNSEL/ASSISTANT SECRETARY ARE COMPENSATED FOR THEIR SERVICES BY GASTON MEMORIAL HOSIPIAL, A SUBSIDIARY OF CAROMONT HEALTH, INC. THE COMPENSATION OF ALL CAROMONT EXECUTIVES FOR EACH YEAR IS ESTABLISHED BY THE COMPENSATION COMMITTEE OF THE CAROMONT HEALTH BOARD OF DIRECTORS, BASED ON GUIDANCE AND OPINIONS PROVIDED BY AN INDEPENDENT, THIRD-PARTY COMPENSATION CONSULTANT. BOARD MEMBERS WHO SERVE ON THE COMPENSATION COMMITTEE ARE INDEPENDENT AND FREE OF ANY CONFLICT OF INTEREST. ANY COMPENSATION COMMITTEE MEMBER WHO DEVELOPS A CONFLICT OF INTEREST DURING HIS/HER TERM WITH RESPECT TO THE DISCUSSION OF ANY EXECUTIVE'S COMPENSATION LEAVES THE MEETING AND DOES NOT PARTICIPATE IN THE DISCUSSION OR DECISION-MAKING BY THE REMAINING INDEPENDENT MEMBERS OF THE COMPENSATION COMMITTEE. THE COMPENSATION COMMITTEE RETAINS JURISDICTION OVER THE TOTAL COMPENSATION PACKAGE FOR EXECUTIVES AND REVIEWS EXECUTIVE BENEFITS AND PERQUISITES AS WELL AS TOTAL CASH COMPENSATION. COMPENSATION FOR THE CEO IS ESTABLISHED THROUGH A PROCESS OF PERFORMANCE EVALUATION, COMPARISON WITH COMPARABLE MARKET DATA AND DETERMINATION BY THE COMPENSATION COMMITTEE OF ACCEPTABLE SALARY RANGE AND PERCENTILE RANKING. ALL COMPENSATION DECISIONS FOR THE CEO ARE RECOMMENDED BY THE COMPENSATION COMMITTEE AND APPROVED BY THE BOARD OF DIRECTORS. COMPENSATION FOR ALL OTHER EXECUTIVES IS ESTABLISHED THROUGH PERFORMANCE EVALUATION, COMPARISON WITH COMPARABLE MARKET DATA AND DETERMINATION BY THE CEO OF ACCEPTABLE SALARY RANGE AND PERCENTILE RANKING. ALL COMPENSATION DECISIONS FOR EXECUTIVES ARE RECOMMENDED BY THE CEO AND APPROVED BY THE COMPENSATION COMMITTEE. FULL COLLECTED COMPENSATION INFORMATION AND ANY COMPENSATION OPINIONS PROVIDED DURING THESE PROCESSES WILL BE KEPT WITH THE COMPENSATION COMMITTEE OR BOARD MINUTES, AS APPLICABLE. IN 2009, THE BOARD OF DIRECTORS, BY AND THROUGH THE COMPENSATION COMMITTEE, CONDUCTED TWO DETAILED REVIEWS OF THE RETIREMENT BENEFIT TO BE PAID TO ITS RETIRING CEO. IN CONDUCTING THESE REVIEWS, THE COMPENSATION COMMITTEE WORKED THROUGH AN EVALUATION OF THE RETIRING CEO'S PERFORMANCE DURING HIS 33-YEAR TENURE WITH THE ORGANIZATION. THE COMPENSATION COMMITTEE CONCLUDED THAT IN THE AREAS OF FINANCE AND QUALITY MEASURES, THE RETIRING CEO'S PERFORMANCE CONSISTENTLY EXCEEDED EXPECTATIONS AND HAS POSITIONED CAROMONT HEALTH AS A LEADER IN THE REGION. HIS PERFORMANCE IN THE AREA OF PATIENT SATISFACTION HAS, IN THE MISSION-CRITICAL AREA OF EMERGENCY SERVICES, EXCEEDED THE BOARD OF DIRECTOR'S EXPECTATIONS. OVERALL, AND OVER THE ARC OF HIS CAREER AT CAROMONT, THE RETIRING CEO'S LEADERSHIP HAS LED CAROMONT HEALTH FROM A MERE COMMUNITY HOSPITAL INTO A REGIONAL HEALTHCARE POWERHOUSE. THE COMMITTEE CONCLUDED THAT HIS LEADERSHIP HAD OUTPERFORMED THE REGION AND FULFILLED THE COMMUNITY'S DESIRE TO KEEP ITS HEALTHCARE SYSTEM UNDER LOCAL CONTROL, THEREBY JUSTIFYING HIS RETIREMENT PAYMENT AS FAIR AND REASONABLE COMPENSATION FOR OUTSTANDING PERFORMANCE. FORM 990, PART VI, SECTION C, LINE 18 THE ORGANIZATION'S FORM 990 IS MADE AVAILABLE TO THE PUBLIC UPON REQUEST AND ON WWW.GUIDESTAR.ORG. FORM 990, PART VI, SECTION C, LINE 19 AT THIS TIME, THE ORGANIZATION'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT MADE AVAILABLE TO THE PUBLIC. THE ENTIRE ORGANIZATION'S COMBINED FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON REQUEST. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED LOSSES ON INVESTMENTS: -47. EQUITY TRANSFER -17,921,425. TOTAL TO FORM 990, PART XI, LINE 5: -17,921,472. STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS: FORM 990, PART III, LINE 4A THE VISION OF CAROMONT HEALTH, LED BY OUR FLAGSHIP GASTON MEMORIAL HOSPITAL, IS TO BE A NATIONALLY RECOGNIZED LEADER AND VALUED PARTNER IN PROMOTING INDIVIDUAL HEALTH AND VIBRANT COMMUNITIES. CAROMONT HEALTH IS THE HEALTH CARE PROVIDER OF CHOICE FOR GASTON, LINCOLN AND CLEVELAND COUNTIES. THESE ARE RAPIDLY GROWING COMMUNITIES AND WE INTEND TO GROW WITH THE COMMUNITIES WE SERVE. CAROMONT HEALTH IS THE ONLY HEALTH CARE SYSTEM IN GASTON COUNTY WITH ACUTE CARE BEDS FOR THE FORESEEABLE FUTURE. WE CONTINUE TO ATTRACT TOP MEDICAL PROFESSIONALS FROM AROUND THE COUNTRY, WHILE RETAINING SOME OF THE AREA'S BEST PHYSICIANS AND NURSES. WE CONTINUE TO FORM INNOVATIVE COLLABORATIONS TO UPGRADE OUR TECHNOLOGY, CREATING BETTER OUTCOMES FOR OUR PATIENTS AND BETTER MANAGEMENT OF TIME AND MONEY. AND WE WILL CONTINUE TO PLAN NEW FACILITIES AS OUR COMMUNITY CONTINUES TO GROW. OUR GROWING COMMUNITY BRINGS WITH IT CHANGE IN TERMS OF DEMOGRAPHICS, AS WELL ASINFRASTRUCTURE NEEDS. AT THE SAME TIME, THE NATION'S HEALTH CARE INFRASTRUCTURE IS ON THE VERGE OF A SYSTEMIC OVERHAUL WITH FAR-REACHING IMPLICATIONS. FORTUNATELY, CAROMONT IS FOCUSED ON THE FUTURE AND TAKING STEPS TO PREPARE FOR ANTICIPATED CHANGES. WE BELIEVE THAT WE ARE WELL-POSITIONED, NOT ONLY TO EMBRACE THE COMING INNOVATIONS IN OUR NATION'S HEALTH CARE SYSTEM, BUT TO ACTUALLY AFFECT CHANGE THAT WILL BRING ABOUT A HEALTHIER, MORE VIBRANT COMMUNITY. KEY SERVICES AT GASTON MEMORIAL HOSPITAL: - THE BIRTHPLACE IS A WORLD-CLASS BIRTHING CENTER DEDICATED TO FAMILY-FOCUSED CARE IN A SERENE, HOMELIKE ENVIRONMENT - 2,604 BABIES DELIVERED IN 2010 - 52 SINGLE-ROOM BEDS DEVOTED TO MATERNITY CARE - 16-BED LEVEL III NEONATAL INTENSIVE CARE UNIT - CAROMONT HEART CENTER PROVIDES A FULL RANGE OF LIFE-SAVING CARDIAC CARE, INCLUDING OPEN HEART SURGERY - 2,096 DIAGNOSTIC CARDIAC CATHETERIZATIONS PERFORMED IN 2010 - 705 PERCUTANEOUS CORONARY INTERVENTIONS PERFORMED IN 2010 - STRATEGIC PARTNERSHIP WITH COLUMBIA UNIVERSITY MEDICAL CENTER'S HEARTSOURCE PROVIDES PHYSICIAN TRAINING, CLINICAL GUIDANCE AND ACCESS TO COLUMBIA RESEARCH TRIALS - CARDIAC RESEARCH PROGRAM BRINGS THE LATEST ADVANCES TO THE BEDSIDE - SUPPORT GROUPS AND EDUCATIONAL PROGRAMS PROMOTE AND HELP WITH HEALTHY LIFESTYLE CHANGES - CAROMONT CANCER CENTER IS THE ONLY HOSPITALBASED CANCER TREATMENT CENTER IN GASTON COUNTY THAT PROVIDES MEDICAL, RADIATION AND SURGICAL ONCOLOGY - ACCREDITED BY THE NATIONAL ORGANIZATION, AMERICAN COLLEGE OF SURGEONS-COMMISSION ON CANCER - CAROMONT COMPREHENSIVE BREAST CENTER GRANTED A THREE-YEAR/FULL ACCREDITATION DESIGNATION BY THE NATIONAL ACCREDITATION PROGRAM FOR BREAST CENTERS - PARTICIPATION IN CLINICAL TRIAL STUDIES AVAILABLE - "SYSTEM OF CARE" APPROACH INCLUDES PREVENTION, EDUCATION, TREATMENT, FOLLOW-UP AND SYMPTOM MANAGEMENT - CAROMONT CENTER FOR MENTAL WELLNESS HAS 63 LICENSED BEDS PROVIDING COMPREHENSIVE INPATIENT CARE FOR PATIENTS NEEDING PSYCHIATRIC TREATMENT - 165 ADMISSIONS PER MONTH - 24-HOUR ASSESSMENT STAFF COVERAGE IN EMERGENCY DEPARTMENT - 24-BED ADULT UNIT, 13-BED ADOLESCENT UNIT, 9-BED PRE-ADOLESCENT UNIT - BOARD CERTIFIED PSYCHIATRISTS IN ADULT AND CHILD/ADOLESCENT PSYCHIATRY - INDIVIDUAL AND GROUP COUNSELING, FAMILY THERAPY AND SUBSTANCE ABUSE EDUCATION - EMERGENCY SERVICES CARES FOR MORE THAN 100,000 PATIENTS EACH YEAR - 14,000-SQUARE-FOOT FACILITY - 45 TREATMENT ROOMS, 36 EMERGENCY DEPARTMENT EXAM ROOMS, 9 FAST TRACK EXPRESS CARE ROOMS, 4 TRAUMA ROOMS, 4 CRITICAL CARE ROOMS - 28 BOARD CERTIFIED EMERGENCY MEDICINE PHYSICIANS AND MORE THAN 200 EMERGENCY SERVICES EMPLOYEES - NC RACE PROGRAM PROVIDES RAPID TREATMENT FOR HEART ATTACK PATIENTS - NATIONALLY RECOGNIZED TRAUMA SURGEONS - CHEST PAIN CENTER AND STROKE PROGRAM ACCREDITATION SIGNIFICANT ACCOMPLISHMENTS IN FISCAL YEAR 2011: - CAROMONT HEALTH EMPLOYEE WELLNESS - CAROMONT HEALTH CONTINUES TO FOCUS ON INITIATIVES THAT ENSURE ACCOMPLISHING THE CORPORATE AND TRIPLE AIM GOALS OF 1) INCREASING THE NUMBER OF EMPLOYEES WHO EXERCISE 3 OR MORE TIMES A WEEK, 2) INCREASING THE NUMBER OF EMPLOYEES AT A HEALTHY WEIGHT, 3) INCREASING THE VOLUME OF HEALTHY CAFETERIA SALES, AND 4) INCREASING THE NUMBER OF EMPLOYEES WHO SUCCESSFULLY COMPLETE TOBACCO CESSATION CLASSES. WE CONTINUE TO EDUCATE/ENCOURAGE EMPLOYEES TO PARTICIPATE IN AGE AND GENDER APPROPRIATE HEALTH SCREENINGS AND IN IDENTIFYING BELIEFS HELD BY VARIOUS STAFF MEMBERS THAT SUGGEST A LACK OF NEED TO MAINTAIN HEALTH, THEN EDUCATE TO ENCOURAGE HEALTH MAINTENANCE. - EMPLOYER WELLNESS - IN DECEMBER, 2010, CAROMONT HEALTH CONVENED A GROUP OF HEALTH PARTNERS TO DISCUSS THE HEALTH STATUS OF GASTON COUNTY RESIDENTS. A REVIEW OF THE MOST RECENT (2008) GASTON COUNTY HEALTH ASSESSMENT WAS PERFORMED. AFTER DISCUSSION THE FOLLOWING MISSION STATEMENT WAS AGREED UPON: TO DECREASE THE INCIDENCE OF CHRONIC DISEASE WITHIN THEIR EMPLOYED POPULATION BY DECREASING THE RATE OF OBESITY (FOCUSING ON NUTRITION, ACTIVITY/EXERCISE), DECREASING TOBACCO USE AND INCREASING THE CONSTRUCTIVE MANAGEMENT OF PERSONAL STRESS. IN MARCH, 2011, CAROMONT HEALTH SPONSORED THE GASTON COUNTY HEALTH SUMMIT, INVITING HEALTH PARTNERS, LOCAL BUSINESSES, SOCIAL AGENCIES, MUNICIPALITIES AND GOVERNMENTAL AGENCIES. THE SUMMIT INCLUDED A REVIEW OF THE HEALTH STATUS OF AMERICANS AND ITS COST TO EMPLOYERS, A REVIEW OF THE GASTON COUNTY HEALTH ASSESSMENT AND THE COUNTY HEALTH RANKINGS. THE HISTORY, MISSION AND EMPLOYER-BASED STRATEGY OF THE GASTON COUNTY HEALTH COALITION WAS PRESENTED. THE IHI TRIPLE AIM FRAMEWORK WAS PRESENTED AND COMMENTS WERE MADE BY THE IHI BOARD CHAIR. THREE LOCAL EMPLOYERS PRESENTED THEIR ACTIVITIES AND ACCOMPLISHMENTS IN THE REALM OF EMPLOYEE WELLNESS. THE SUMMIT CULMINATED IN A CALL TO ACTION WITH MUCH DISCUSSION. AS A RESULT FIVE MORE EMPLOYERS COMMITTED TO THE WORK OF THE COALITION. PRESENTLY THERE ARE 12 EMPLOYERS REPRESENTED, WHICH INCLUDE 4 OF THE LARGEST EMPLOYERS IN GASTON COUNTY. THIS WORK IS DIVIDED INTO THREE PARTS: INCREASING HEALTH, DECREASING COST AND INCREASING EXPERIENCE OF CARE FOR A DEFINED POPULATION. THE MISSION OF THE INCREASING HEALTH WORKGROUP IS TO EDUCATE MEMBERS REGARDING OPPORTUNITIES TO DECREASE THEIR HEALTHCARE COSTS AND INCREASE THE HEALTH STATUS OF THEIR EMPLOYED LIVES AND TO COACH EMPLOYERS TO DEVELOP, IMPLEMENT AND SUCCESSFULLY SUSTAIN HEALTH INITIATIVES WITHIN THEIR EMPLOYEE BASE. TOOLS USED WILL INCLUDE WELLSOURCE'S HEALTH RISK APPRAISAL, PERSONAL REPORT, EXECUTIVE SUMMARY AND A PRODUCTIVITY AND ECONOMIC BENEFIT REPORT. CAROMONT HEALTH HAS AGREED TO PROVIDE HEALTH RISK APPRAISALS TO ORGANIZATIONS READY TO ACTIVELY PARTICIPATE. TO ENHANCE CARE, RESULTS OF THESE HEALTH SCREENS ARE SENT TO THE EMPLOYEE'S PRIMARY CARE PHYSICIAN. THE DECREASING COST WORK GROUP IS COLLECTING DATA FROM MEMBERS ABOUT THEIR CURRENT COSTS TO ASCERTAIN OPPORTUNITIES FOR COST SAVINGS. THEY ARE ALSO DISCUSSING THE NEED FOR A 24/7 NURSE TRIAGE LINE. THE EXPERIENCE OF CARE WORKGROUP IS DETERMINING THE CURRENT METHODS USED TO ACCESS CARE, DEVELOPING THE MOST APPROPRIATE METHODS TO ACCESS CARE AND WILL DEVELOP AN ACTION PLAN TO MOVE FROM CURRENT TO IDEAL STATE. EDUCATING POPULATIONS ON THESE METHODS WILL BE INCLUDED IN THIS WORK. - FAITH BASED COMMUNITIES - THE FAITH AND HEALTH MINISTRY OF GASTON COUNTY (FHMGC) IS A CAROMONT HEALTH SUPPORTED, CHURCH-BASED WELLNESS PROGRAM DESIGNED TO ENHANCE THE HEALTH STATUS OF THE RESIDENTS OF GASTON COUNTY BY 1)EMPOWERING INDIVIDUALS IN KNOWLEDGE OF AND ACCESS TO COMMUNITY RESOURCES AND AGENCIES, 2) ENHANCING AWARENESS OF THE ABUNDANT LIVING PROGRAM TO THE COMMUNITY, 3) ENHANCING THE PARTNERSHIP WITH CAROMONT HEALTH AND COMMUNITY RESOURCES AND 4) INCREASING THE AWARENESS OF LIFESTYLE RISK FACTORS FOR PREVENTABLE DISEASES. WITH THE CONGREGATIONAL MINISTER'S COMMITMENT, THE ESTABLISHMENT OF CONGREGATIONAL HEALTH MINISTRIES (WELLNESS COMMITTEES) AND THE INVOLVEMENT OF VOLUNTEER CONGREGATIONAL HEALTH PROMOTERS (TYPICALLY RNS) THE STRUCTURE IS ESTABLISHED TO PROVIDE THE SUPPORT, ENCOURAGEMENT, EDUCATION AND RESOURCES TO ENHANCE HEALTH OF CONGREGATION MEMBERS. IMPLEMENTING PROGRAMS IN 4-6 CHURCHES IS A SHORT TERM GOAL. FOUR LOCAL CHURCHES HAVE RECENTLY SIGNED COVENANTS TO PARTICIPATE AND THEIR NINE CONGREGATIONAL HEALTH PROMOTERS ARE IN THE PROCESS OF BEING TRAINED BY CAROMONT'S PARISH NURSE COORDINATOR. - IN FEBRUARY 2011, CAROMONT HEALTH OPENED OUR FIRST CLIC IMMEDIATE CARE CLINIC. CLIC (WHICH STANDS FOR CONVENIENT, LOCAL, IMMEDIATE CARE) PROVIDES PATIENTS WITH IMMEDIATE ATTENTION TO THEIR ACUTE HEALTH CARE NEEDS, AS WELL AS INFORMATION, RESOURCES AND SUPPORT TO IMPROVE THEIR LONG-TERM HEALTH AND WELL-BEING. UNLIKE TRADITIONAL URGENT CARE CLINICS, CLIC PROVIDES USER-FRIENDLY, INTERACTIVE OPPORTUNITIES THAT CONNECT PATIENTS TO RESOURCES ACROSS A CONTINUUM OF CARE, INCLUDING STRESS MANAGEMENT, FITNESS AND NUTRITION. - LAST SEPTEMBER, CAROMONT HEALTH PERFORMED OUR 100TH DA VINCI ROBOTIC PROCEDURE. THE DA VINCI SYSTEM IS A SOPHISTICATED ROBOTIC PLATFORM THAT ALLOWS CAROMONT HEALTH TO PERFORM MORE COMPLICATED PROCEDURES IN A MINIMALLY INVASIVE WAY. THAT MEANS SMALLER INCISIONS, LESS PAIN FOR THE PATIENT, A FASTER RECOVERY TIME AND HIGHER PATIENT SATISFACTION. - IN 2011, CAROMONT HEALTH BEGAN USING ATHENAHEALTH'S CLOUD-BASED MEDICAL BILLING AND PRACTICE MANAGEMENT SERVICE TO INTEGRATE ELECTRONIC HEALTH RECORDS AND FACILITATE COMMUNICATION BETWEEN PHYSICIANS AND PATIENTS. PHYSICIANS HAVE EASIER ACCESS TO PATIENT INFORMATION AND CLINICAL DATA, ENHANCING EFFICIENCY, COORDINATION OF CARE AND USE OF TIME IN DIRECT PATIENT CARE. THE COMMUNICATOR SERVICE EXPANDS ACCESSIBILITY FOR PATIENTS AFTER-HOURS, STREAMLINES PATIENT PAYMENTS, RE-CAPTURES STAFF AND PHYSICIAN TIME AND REDUCES PAPER-BASED MAILING CAMPAIGNS. THE NEW ATHENAHEALTH SYSTEM HELPS CAROMONT PHYSICIANS DO WHAT THEY DO BEST - DELIVER EXCEPTIONAL HEALTH CARE, PROMOTE INDIVIDUAL WELLNESS AND ULTIMATELY CREATE A VIBRANT COMMUNITY. - THE GOLD STAR STANDARD HOSPITALS AWARD FROM THE NC PREVENTION PARTNERS RECOGNIZED CAROMONT'S HIGH STANDARD OF EXCELLENCE FOR TOBACCO CESSATION PROGRAMS OFFERED TO ITS EMPLOYEES. CAROMONT HEALTH HAS BEEN TOBACCO-FREE SINCE JANUARY 2007, AND HAD ALREADY IMPLEMENTED MANY TOBACCO CESSATION PROGRAMS FOR EMPLOYEES AND THE COMMUNITY. EMPLOYEES WHO COMPLETE A CERTIFICATION OF TOBACCO-FREE STATUS FOR AT LEAST 12 MONTHS CAN RECEIVE AN ANNUAL DEPOSIT TO THEIR HEALTH INSURANCE INCENTIVE ACCOUNT. - IN 2010, CAROMONT HEALTH HAD 41 ORGAN, TISSUE AND EYE DONORS THROUGH ITS DYNAMIC PARTNERSHIP WITH LIFESHARE OF THE CAROLINAS, AN ORGAN PROCUREMENT ORGANIZATION THAT IMPROVES THE QUALITY OF HUMAN LIFE BY ENCOURAGING PATIENTS TO DONATE ORGANS AND TISSUE. - CAROMONT HEALTH RECENTLY BROKE GROUND ON A SIGNIFICANT EXPANSION FOR ITS AFFILIATED HEALTH FACILITY, GASTON HOSPICE. NAMED AFTER A PIONEER OF GASTON COUNTY HOSPICE, THE ROBIN JOHNSON HOUSE IS DESIGNED TO DELIVER SHORT-TERM CARE AS AN ALTERNATIVE TO HOSPITALIZATION FOR THE MANAGEMENT OF PAIN AND SYMPTOMS. GASTON HOSPICE GREATLY NEEDED TO EXPAND THEIR INPATIENT FACILITY DUE TO THE CURRENT WAITING PERIOD. THE ROBIN JOHNSON HOUSE IS OFTEN FULL, AND PATIENTS HAVE TO WAIT A DAY OR TWO TO RECEIVE NEEDED CARE. THE NEW ADDITION AT THE ROBIN JOHNSON HOUSE IN DALLAS WILL ADD SEVEN ROOMS, BRINGING THE TOTAL FROM 12 TO 19, AND WILL ACCOMMODATE ADDITIONAL PATIENTS WITH QUALITY CARE AND COMFORT WITHOUT A WAIT. THE INPATIENT FACILITY EXPANSION WILL BRING MANY OPPORTUNITIES TO OUR CAROMONT HEALTH COMMUNITY. THE ROBIN JOHNSON HOUSE WILL BE BUILT AND FURNISHED THROUGH THE GENEROUS CONTRIBUTIONS OF INDIVIDUALS, BUSINESSES AND FOUNDATIONS. - IN APRIL 2011, CAROMONT HEALTH WAS RATED AS A TOP HOSPITAL IN THE CHARLOTTE METROPOLITAN AREA BY U.S. NEWS & WORLD REPORT. THE MAGAZINE'S "BEST HOSPITALS" RANKINGS EXAMINED NEARLY 5,000 HOSPITALS ACROSS THE NATION, AND CAROMONT HEALTH'S GASTON MEMORIAL HOSPITAL RANKED SECOND AMONG THE 16 CHARLOTTE-AREA HOSPITALS IN TERMS OF THEIR NATIONALLY RANKED SPECIALTIES. GASTON MEMORIAL HOSPITAL HAD SIX HIGH-PERFORMING SPECIALTIES, INCLUDING GYNECOLOGY, UROLOGY, GASTROENTEROLOGY, GERIATRICS, KIDNEY DISORDERS AND PULMONOLOGY. - BECKER'S HOSPITAL REVIEW PUBLISHED ITS 65 GREAT COMMUNITY HOSPITALS, AND GASTON MEMORIAL MADE THE LIST. HONORED HOSPITALS ARE RECOGNIZED AS HIGH-PERFORMING LEADERS IN PATIENT CARE, CLINICAL QUALITY AND COMMUNITY OUTREACH. THEY INCLUDE HOSPITALS WITH FEWER THAN 550 PATIENT BEDS AND MINIMAL TEACHING PROGRAMS. TO COMPILE THE LIST AND IDENTIFY OUTSTANDING CONTENDERS, THE BECKER'S HOSPITAL REVIEW EDITORIAL TEAM ANALYZED AND REVIEWED DATA FROM SOURCES INCLUDING U.S. NEWS & WORLD REPORT, HEALTHGRADES, AMERICAN NURSES CREDENTIALING CENTER AND THOMSON REUTERS. - CAROMONT HEALTH WAS ONE OF ONLY TWO HOSPITALS IN NORTH CAROLINA TO RECEIVE THE HEALTHGRADES DISTINGUISHED HOSPITAL FOR CLINICAL EXCELLENCE AWARD. HEALTHGRADES OBJECTIVELY IDENTIFIES HOSPITALS ACROSS 26 DIAGNOSES AND PROCEDURES TO FIND THE BEST PERFORMERS. THESE INSTITUTIONS ARE IN THE TOP 5% OF THE NATION IN MEASURES OF OVERALL PERFORMANCE, INCLUDING PATIENT CARE, OPERATIONAL EFFICIENCY AND FINANCIAL STABILITY. - CARECHEX IS A RATING SERVICE OF THE DELTA GROUP THAT MEASURES MEDICAL AND HOSPITAL QUALITY. FOR 2011, THE SERVICE RANKED CAROMONT HEALTH NO. 1 IN NORTH CAROLINA FOR CORONARY BYPASS SURGERY, HEART ATTACK TREATMENT, HEART FAILURE TREATMENT, AND PNEUMONIA CARE. CAROMONT RANKED AMONG THE TOP 10% OF U.S. HOSPITALS IN 11 DIFFERENT CATEGORIES. THIS COMPREHENSIVE EVALUATION PROVIDES FEEDBACK ON THE PROCESS OF CARE, OUTCOMES OF CARE AND PATIENT EXPERIENCES. - CAROMONT HEALTH RANKED AS A TOP PERFORMER IN THE PREMIER ALLIANCE QUALITYADVISOR DATABASE FOR COST OF CARE, LENGTH OF STAY, AND AVOIDABLE MORTALITY. PREMIER INC. ASSESSES THE PROCESSES AND OUTCOMES IN HOSPITAL SYSTEMS TO ENSURE THAT FACILITIES ARE ACHIEVING THEIR GOALS. THESE RANKINGS ALLOW MEMBERS TO MEASURE THEIR OUTCOMES AGAINST LEADING CLINICAL EFFICIENCY AND QUALITY PERFORMANCE BENCHMARKING APPLICATIONS IN THE HEALTH CARE INDUSTRY. THE STANDINGS ARE CALCULATED YEARLY ACROSS ALL PREMIER QUALITYADVISOR FACILITIES. - THE CAROMONT CANCER CENTER IS DESIGNATED AS A COMMUNITY HOSPITAL COMPREHENSIVE CANCER PROGRAM BY THE COMMISSION ON CANCER. THE CANCER CENTER ACHIEVED A FULL THREE-YEAR ACCREDITATION WITH COMMENDATION STATUS AND NATIONAL RECOGNITION AS A RECIPIENT OF THE "OUTSTANDING ACHIEVEMENT AWARD" DURING ITS LAST REVIEW. ONLY 7% OF SURVEYED HOSPITALS RECEIVE THIS AWARD. IN ADDITION, THE AMERICAN COLLEGE OF RADIOLOGY (ACR) HAS NATIONALLY ACCREDITED MAMMOGRAPHY, BREAST ULTRASOUND, BREAST MRI AND BIOPSY WITHIN THE CAROMONT PROGRAM. IN 2011, THE ACR NATIONALLY ACCREDITED THE RADIATION ONCOLOGY PROGRAM, MAKING IT THE ONLY NATIONALLY ACCREDITED PROGRAM WITHIN THE REGION. - CAROMONT HEALTH IS ACCREDITED BY THE SOCIETY OF CHEST PAIN CENTERS (SCPC), AN INTERNATIONAL ORGANIZATION DEDICATED TO ELIMINATING HEART DISEASE AS THE NUMBER ONE CAUSE OF DEATH WORLDWIDE. THE SCPC ACCREDITATION PROCESS GUARANTEES THAT HEALTH CARE FACILITIES MEET OR EXCEED THE QUALITY-OF-CARE MEASURES IN ACUTE CARDIAC MEDICINE. KEY AREAS IN WHICH AN ACCREDITED CHEST PAIN CENTER MUST DEMONSTRATE EXPERTISE INCLUDE INTEGRATING THE EMERGENCY DEPARTMENT WITH THE LOCAL EMERGENCY MEDICAL SYSTEM, CONTINUALLY SEEKING TO IMPROVE PROCESSES AND PROCEDURES, ENSURING THE ONGOING TRAINING OF ACCREDITED CHEST PAIN CENTER PERSONNEL AND SUPPORTING COMMUNITY OUTREACH AND EDUCATIONAL PROGRAMS. - THE NATIONAL ACCREDITATION PROGRAM FOR BREAST CENTERS (NAPBC) GRANTED CAROMONT'S NEW MULTIDISCIPLINARY BREAST CENTER NATIONAL ACCREDITATION IN 2011. NAPBC-ACCREDITATION IS GIVEN ONLY TO THOSE CENTERS THAT HAVE VOLUNTARILY COMMITTED TO PROVIDE THE BEST IN BREAST CANCER DIAGNOSIS AND TREATMENT. IN ADDITION, THESE CENTERS UNDERGO A RIGOROUS PERFORMANCE EVALUATION AND COMPLY WITH NAPBC STANDARDS FOR TREATING THE FULL SPECTRUM OF BREAST DISEASE. ACCORDING TO THE NAPBC, THE MULTIDISCIPLINARY BREAST CENTER AT CAROMONT DEMONSTRATES PROFICIENCY IN THE AREAS OF CENTER LEADERSHIP, PATIENT CLINICAL MANAGEMENT, RESEARCH, COMMUNITY OUTREACH, PROFESSIONAL EDUCATION AND QUALITY IMPROVEMENT. - THE JOINT COMMISSION RECERTIFIED CAROMONT HEALTH IN 2010 FOR ITS HIP AND KNEE PROGRAMS. THE RECERTIFICATION DEMONSTRATED CAROMONT'S COMPLIANCE WITH CONSENSUS-BASED NATIONAL STANDARDS, EFFECTIVE USE OF EVIDENCE-BASED CLINICAL PRACTICE GUIDELINES TO MANAGE AND OPTIMIZE CARE, AND AN ORGANIZED APPROACH TO PERFORMANCE MEASUREMENT AND IMPROVEMENT ACTIVITIES. IT REFLECTS CAROMONT'S COMMITMENT TO HIGH STANDARDS OF SERVICE. - THE CAROMONT MEDICAL STAFF INCLUDES PHYSICIAN COUNCILS - GROUPS OF PHYSICIANS FROM A RANGE OF DISCIPLINES FOCUSED ON A PARTICULAR PATIENT POPULATION, DISEASE CONDITION OR CARE CONTINUUM. THESE COUNCILS ARE USED AS FORUMS TO EVALUATE AND ALIGN NEW SERVICES, ENHANCE CARE COORDINATION, SHARPEN FOCUS AND STREAMLINE THE HEALTH CARE OPERATING SYSTEM. CAROMONT EXECUTIVES USE THE INFORMATION AND IDEAS THAT COME FROM PHYSICIAN COUNCILS TO MAKE IMPROVEMENTS THROUGHOUT THE HOSPITAL SYSTEM TO BETTER SERVE OUR PATIENTS. - THE NATIONAL COMMITTEE FOR QUALITY ASSURANCE IS A PRIVATE, NONPROFIT ORGANIZATION DEDICATED TO IMPROVING HEALTH CARE QUALITY. RECENTLY, SEVEN CAROMONT MEDICAL GROUP PRIMARY CARE PRACTICES RECEIVED NCQA LEVEL 3 RECOGNITION FROM THE PHYSICIAN PRACTICE CONNECTIONS - PATIENT-CENTERED MEDICAL HOME PROGRAM (PCMH). MEDICAL HOME PROGRAMS EMPHASIZE CARE, COORDINATION AND COMMUNICATION, WHICH ARE DESIGNED TO LEAD TO HIGHER QUALITY AND LOWER COSTS. CAROMONT HEALTH'S COMMITMENT TO QUALITY CARE IS BASED ON A CORE DESIRE TO ACHIEVE A HEALTHIER COMMUNITY. - THE CAROMONT ONCOLOGY COUNCIL FORMED THE MULTIDISCIPLINARY BREAST CENTER IN 2011 AS A NEW MODEL OF INTEGRATED ONCOLOGY CARE TO EXPEDITE COMPREHENSIVE TREATMENT, IMPROVE OUTCOMES, AND ULTIMATELY, SAVE LIVES. PATIENTS BENEFIT FROM A COMPREHENSIVE EVALUATION AND PERSONALIZED TREATMENT PLAN RECOMMENDED BY A MULTIDISCIPLINARY TEAM OF BOARD CERTIFIED MEDICAL ONCOLOGISTS, RADIATION ONCOLOGISTS, SURGEONS AND RADIOLOGISTS. THE MULTIDISCIPLINARY BREAST CENTER TEAM RECOGNIZES THE IMPORTANCE OF THE REFERRING PHYSICIANS IN ONGOING INTEGRATED CARE AND PROVIDES REFERRING PHYSICIANS WITH DETAILED DOCUMENTATION OF THE BREAST CENTER'S MULTIDISCIPLINARY TEAM'S FINDINGS AND RECOMMENDATIONS. - CAROMONT'S CANCER CENTER AND THE AMERICAN CANCER SOCIETY HAVE PARTNERED TO PROVIDE A CANCER RESOURCE CENTER THAT PROVIDES PATIENTS AND CAREGIVERS TIMELY INFORMATION AND SUPPORT TO HELP THEM MANAGE THE DIAGNOSIS OF CANCER. THE CENTER PROVIDES HIGHLY TRAINED VOLUNTEERS WHO CAN GUIDE CANCER PATIENTS THROUGH ALL CHALLENGES OF THE CANCER JOURNEY SUCH AS FINANCIAL CONCERNS, INSURANCE AND TRANSPORTATION. - CAROMONT HEALTH IS ENTERING THE SECOND YEAR OF OUR PARTNERSHIP WITH COLUMBIA UNIVERSITY MEDICAL CENTER'S HEARTSOURCE, A CLINICAL AND MANAGEMENT SERVICES GROUP FROM THE DIVISION OF CARDIOTHORACIC SURGERY AT NEW YORK PRESBYTERIAN HOSPITAL/COLUMBIA UNIVERSITY MEDICAL CENTER. THE RELATIONSHIP HAS PROVIDED CAROMONT HEALTH PHYSICIANS WITH EXPOSURE TO SOME OF THE MOST ADVANCED CARDIAC PROCEDURES, AS WELL AS ACCESS TO A SHARED QUALITY CONTROL DATABASE. IT ALSO ALLOWS FOR A HIGHER LEVEL OF FOCUS ON QUALITY OUTCOMES AND EVIDENCE-BASED CARE THAT MIGHT NOT EXIST IN ISOLATED, PRIVATE PRACTICES. - CAROMONT HEALTH AND NORTH CAROLINA'S LARGEST HEALTH INSURER, BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA, ANNOUNCED A COLLABORATIVE ARRANGEMENT TO OFFER PATIENTS A NEW HEALTH CARE DELIVERY AND REIMBURSEMENT MODEL FOR KNEE REPLACEMENTS. THE INNOVATIVE, VALUE-BASED INITIATIVE IS DESIGNED TO PROVIDE QUALITY CARE WITH IMPROVED CARE COORDINATION AT COMPETITIVE PRICING. SPECIFIC QUALITY AND PATIENT SATISFACTION MEASURES ARE BUILT IN TO THE 'BUNDLED KNEE' PLAN TO HELP ENSURE THAT PATIENT NEEDS GUIDE THE PROGRAM. - THE INSTITUTE FOR HEALTHCARE IMPROVEMENT HAS ESTABLISHED A TRIO OF OBJECTIVES CALLED THE TRIPLE AIM: - IMPROVE THE HEALTH OF THE POPULATION - ENHANCE THE PATIENT EXPERIENCE (QUALITY, ACCESS, RELIABILITY) - CONTROL COSTS THESE THREE OBJECTIVES ARE ALL CRITICAL COMPONENTS IN BEING WHAT IS KNOWN IN THE INDUSTRY AS AN ACCOUNTABLE CARE ORGANIZATION (ACO). IN TAKING STEPS TO BECOME AN ACO, CAROMONT HEALTH IS UNDERTAKING CHANGES THAT WILL LEAD TO BETTER COORDINATED CARE WITH BETTER OUTCOMES AT LOWER COSTS FOR PATIENTS. WE ARE ALSO EMBRACING THE "MEDICAL HOME" CONCEPT, WHICH IS A NATIONAL INITIATIVE DESIGNED TO IMPROVE HEALTH CARE QUALITY. MEDICAL HOMES ARE PATIENT CENTERED, TEAM-BASED APPROACHES TO CARE THAT HAVE BEEN SHOWN TO REDUCE HOSPITAL ADMISSIONS AND DECREASE COSTS. COMMON PAYMASTER FORM 990, PART V AND PART VII THE FILING ORGANIZATION USES A RELATED ORGANIZATION FOR ITS PAYROLL FUNCTION. ALL W-2S ARE FILED BY THE COMMON PAYMASTER. HOWEVER, AMOUNTS PAID BY THE COMMON PAYMASTER ARE TREATED AS IF PAID DIRECTLY BY THE ORGANIZATION FOR WHICH SERVICES ARE PERFORMED. AMENDED RETURN: THE 2010 FORM 990 WAS AMENDED TO CORRET AN ERROR ON SCHEDULE K, PART II, COLUMM (B), LINE 10. THE AMOUNT IN THE ORIGINAL FILING WAS OVERSTATED BY $1 MILLION. THE AMOUNT HAS BEEN AMENDED TO CORRECTLY STATE THE AMOUNT $28,947,486. CAROMONT HEALTH INC 2525 COURT DRIVE GASTONIA NC 28054 581636959 MEDICAL SERVICES NC 501(C)(3) LINE 11B, II N/A 0 CAROMONT HEALTH SERVICES INC 2526 COURT DRIVE GASTONIA NC 28054 561455630 OUTPATIENT SERVICES NC 501(C)(3) LINE 3 CAROMONT HEALTH INC 0 GASTON MEMORIAL HOSPITAL FOUNDATION INC 2527 COURT DRIVE GASTONIA NC 28054 561479699 FOUNDATION NC 501(C)(3) LINE 9 CAROMONT HEALTH INC 0 CAROMONT MEDICAL GROUP INC 2528 COURT DRIVE GASTONIA NC 28054 561479712 MEDICAL GROUP NC 501(C)(3) LINE 9 CAROMONT HEALTH INC 0 HOSPICE OF GASTON COUNTY INC 2529 COURT DRIVE GASTONIA NC 28054 581341530 HOSPICE CARE NC 501(C)(3) LINE 7 CAROMONT HEALTH INC 0 GASTON EMERGENCY PHYSICIANS INC 2531 COURT DRIVE GASTONIA NC 28054 562209423 SUPPORTING ORGANIZATION NC 501(C)(3) LINE 11A, I CAROMONT HEALTH INC 0 0 0 1 0 0 0 0 0 1 0 0 0 1 1 1 1 1 1