GASTON MEMORIAL HOSPITAL INC: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization: GASTON MEMORIAL HOSPITAL INC (EIN 56-0619359)
Tax period: 2011-07-01 to 2012-06-30
Filed: 2013-04-04
IRS object ID: 201310949349300321
Schema version: 2011v1.5
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
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule H
Schedule I
Schedule J
Schedule K
Schedule L
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2013-04-04T11:32:40-05:00	Timestamp
Tax Period End Date	2012-06-30	TaxPeriodEndDate

Preparer Firm PreparerFirm

Field	Value	IRS element (for citing)
EIN	560747981	EIN

Preparer Firm Business Name PreparerFirmBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	DIXON HUGHES GOODMAN LLP	BusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

Field	Value	IRS element (for citing)
Address Line1	500 RIDGEFIELD COURT	AddressLine1
City	ASHEVILLE	City
State	NC	State
ZIP Code	28806	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990	ReturnType
Tax Period Begin Date	2011-07-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	560619359	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	GASTON MEMORIAL HOSPITAL INC	BusinessNameLine1

Field	Value	IRS element (for citing)
Name Control	GAST	NameControl
Phone	7048342000	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	2525 COURT DRIVE PO BOX 1747	AddressLine1
City	GASTONIA	City
State	NC	State
ZIP Code	280531747	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	DAVID O'CONNOR	Name
Title	CFO	Title
Phone	7048342000	Phone
Date Signed	2013-03-21	DateSigned
Authorize Third Party	1	AuthorizeThirdParty

Preparer Preparer

Field	Value	IRS element (for citing)
Name	AMY BIBBY	Name
PTIN	P00445891	PTIN
Phone	8282542254	Phone

Field	Value	IRS element (for citing)
Tax Year	2011	TaxYear
Build TS	2016-02-25 16:41:14Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Name Of Principal Officer Person	DAVID O'CONNOR	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

Field	Value	IRS element (for citing)
Address Line1	2525 COURT DRIVE PO BOX 1747	AddressLine1
City	GASTONIA	City
State	NC	State
ZIP Code	280531747	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	426092983	GrossReceipts
Group Return For Affiliates	0	GroupReturnForAffiliates
Organization501c3	X	Organization501c3
Web Site	WWW.CAROMONT.ORG	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	1945	YearFormation
State Legal Domicile	NC	StateLegalDomicile
Activity Or Mission Description	TO PROVIDE EXCEPTIONAL HEALTH CARE TO THE COMMUNITIES WE SERVE.	ActivityOrMissionDescription
Nbr Voting Members Governing Body	14	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	12	NbrIndependentVotingMembers
Total Nbr Employees	3105	TotalNbrEmployees
Total Nbr Volunteers	261	TotalNbrVolunteers
Total Gross UBI	510357	TotalGrossUBI
Net Unrelated Business Txbl Income	38600	NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year	119286	ContributionsGrantsPriorYear
Contributions Grants Current Year	1181292	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	405735809	ProgramServiceRevenuePriorYear
Program Service Revenue CY	416290990	ProgramServiceRevenueCY
Investment Income Prior Year	41896	InvestmentIncomePriorYear
Investment Income Current Year	6070	InvestmentIncomeCurrentYear
Other Revenue Prior Year	5018302	OtherRevenuePriorYear
Other Revenue Current Year	8515831	OtherRevenueCurrentYear
Total Revenue Prior Year	410915293	TotalRevenuePriorYear
Total Revenue Current Year	425994183	TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year	257503	GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY	283868	GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year	0	BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	163004927	SalariesEtcPriorYear
Salaries Etc Current Year	169254959	SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year	0	TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	0	TotalFundrsngExpCurrentYear
Other Expense Prior Year	214831055	OtherExpensePriorYear
Other Expenses Current Year	218624236	OtherExpensesCurrentYear
Total Expenses Prior Year	378093485	TotalExpensesPriorYear
Total Expenses Current Year	388163063	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	32821808	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	37831120	RevenuesLessExpensesCY
Total Assets BOY	332063801	TotalAssetsBOY
Total Assets EOY	360052108	TotalAssetsEOY
Total Liabilities BOY	307061339	TotalLiabilitiesBOY
Total Liabilities EOY	326403841	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	25002462	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	33648267	NetAssetsOrFundBalancesEOY
Mission Description	TO PROVIDE EXCEPTIONAL HEALTH CARE TO THE COMMUNITIES WE SERVE.	MissionDescription
Significant New Program Services	0	SignificantNewProgramServices
Significant Change	0	SignificantChange
Expense	363488761	Expense
Grants	283868	Grants
Revenue	416789262	Revenue
Description	GASTON MEMORIAL HOSPITAL PROVIDES INPATIENT, OUTPATIENT, EMERGENCY, SURGICAL, WELLNESS AND PREVENTIVE CARE 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.	Description
Total Program Service Expense	363488761	TotalProgramServiceExpense
Described In501 C3	1	DescribedIn501C3
Schedule B Required	1	ScheduleBRequired
Political Activities	0	PoliticalActivities
Lobbying Activities	1	LobbyingActivities
Subject To Proxy Tax	0	SubjectToProxyTax
Donor Advised Funds	0	DonorAdvisedFunds
Conservation Easements	0	ConservationEasements
Collections Of Art	0	CollectionsOfArt
Credit Counseling	0	CreditCounseling
Term Or Permanent Endowments	1	TermOrPermanentEndowments
Report Land Bldg Equip	1	ReportLandBldgEquip
Report Invest Oth Securities	0	ReportInvestOthSecurities
Report Prog Rel Invest	0	ReportProgRelInvest
Report Other Assets	1	ReportOtherAssets
Report Other Liabilities	1	ReportOtherLiabilities
Report Fin48 Footnote	1	ReportFin48Footnote
Independent Audit Financial Stmt	0	IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt	1	ConsolidatedAuditFinancialStmt
School	0	School
Foreign Office	0	ForeignOffice
Foreign Activities	0	ForeignActivities
More Than5000 K To Organizations	0	MoreThan5000KToOrganizations
More Than5000 K To Individuals	0	MoreThan5000KToIndividuals
Professional Fundraising	0	ProfessionalFundraising
Fundraising Activities	0	FundraisingActivities
Gaming	0	Gaming
Hospital	1	Hospital
Financial Stmt Attached	1	FinancialStmtAttached
Grants To Organizations	1	GrantsToOrganizations
Grants To Individuals	1	GrantsToIndividuals
Schedule J Required	1	ScheduleJRequired
Tax Exempt Bonds	1	TaxExemptBonds
Invest Tax Exempt Bonds	0	InvestTaxExemptBonds
Escrow Account	0	EscrowAccount
On Behalf Of Issuer	0	OnBehalfOfIssuer
Excess Benefit Transaction	0	ExcessBenefitTransaction
Prior Excess Benefit Transaction	0	PriorExcessBenefitTransaction
Loan To Officer Or DQP	0	LoanToOfficerOrDQP
Grant To Related Person	0	GrantToRelatedPerson
Bsnss Rltnshp With Organization	0	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	1	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	0	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	0	DeductibleNonCashContributions
Deductible Contributions Of Art	0	DeductibleContributionsOfArt
Terminated	0	Terminated
Partial Liquidation	0	PartialLiquidation
Disregarded Entity	0	DisregardedEntity
Related Entity	1	RelatedEntity
Related Org Controlled Entity	0	RelatedOrgControlledEntity
Transaction Related Entity	0	TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org	0	TransfersToExemptNonChrtblOrg
Activities Conducted Partnership	0	ActivitiesConductedPartnership
Schedule O Required	1	ScheduleORequired
Number Forms Transmitted With1096	419	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Compliance With Backup Witholding	1	ComplianceWithBackupWitholding
Number Of Employees	3105	NumberOfEmployees
Employment Tax Returns Filed	1	EmploymentTaxReturnsFiled
Unrelated Business Income	1	UnrelatedBusinessIncome
Form990-T Filed	1	Form990-TFiled
Foreign Financial Account	0	ForeignFinancialAccount
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTrans
Taxable Party Notification	0	TaxablePartyNotification
Non Deductible Contributions	0	NonDeductibleContributions
Quid Pro Quo Contributions	0	QuidProQuoContributions
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOf
Funds To Pay Premiums	0	FundsToPayPremiums
Premiums Paid	0	PremiumsPaid
Indoor Tanning Services	0	IndoorTanningServices
Info In Schedule O Part VI	X	InfoInScheduleOPartVI
Nbr Voting Governing Body Members	14	NbrVotingGoverningBodyMembers
Number Independent Voting Members	12	NumberIndependentVotingMembers
Family Or Business Relationship	0	FamilyOrBusinessRelationship
Delegation Of Management Duties	0	DelegationOfManagementDuties
Changes To Organizing Docs	0	ChangesToOrganizingDocs
Material Diversion Or Misuse	0	MaterialDiversionOrMisuse
Members Or Stockholders	1	MembersOrStockholders
Election Of Board Members	1	ElectionOfBoardMembers
Decisions Subject To Approval	1	DecisionsSubjectToApproval
Minutes Of Governing Body	1	MinutesOfGoverningBody
Minutes Of Committees	1	MinutesOfCommittees
Officer Mailing Address	0	OfficerMailingAddress
Local Chapters	0	LocalChapters
Form990 Provided To Governing Body	1	Form990ProvidedToGoverningBody
Conflict Of Interest Policy	1	ConflictOfInterestPolicy
Annual Disclosure Covered Persons	1	AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement	1	RegularMonitoringEnforcement
Whistleblower Policy	1	WhistleblowerPolicy
Document Retention Policy	1	DocumentRetentionPolicy
Compensation Process CEO	1	CompensationProcessCEO
Compensation Process Other	1	CompensationProcessOther
Investment In Joint Venture	1	InvestmentInJointVenture
Written Policy Or Procedure	1	WrittenPolicyOrProcedure
States Where Copy Of Return Is Filed	NC	StatesWhereCopyOfReturnIsFiled
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	DAVID O'CONNOR	BusinessNameLine1

Field	Value	IRS element (for citing)
Telephone Number	7048342000	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	2525 COURT DRIVE	AddressLine1
City	GASTONIA	City
State	NC	State
ZIP Code	28054	ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (27 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Individual Trustee Or DirectorIndividualTrusteeOrDirector	OfficerOfficer	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation	Key EmployeeKeyEmployee	Highest Compensated EmployeeHighestCompensatedEmployee	FormerFormer
H SPURGEON MACKIE JR
CHAIRMAN	1.00	X	X	0	0	0
SHEILA S REILLY PHD
VICE CHAIR	1.00	X	X	0	0	0
DR ROBERT D CROUCH
SECRETARY	1.00	X	X	0	0	0
M VINCENT QUINN
TREASURER	1.00	X	X	0	0	0
MARY FRANCES FORRESTER
DIRECTOR	1.00	X		0	0	0
KELVIN C HARRIS MD
DIRECTOR	1.00	X		0	201000	18540
JAMES W BAILEY
DIRECTOR	1.00	X		0	0	0
JAMES R BEAM
DIRECTOR	1.00	X		0	0	0
RICHARD K CRAIG
DIRECTOR	1.00	X		0	0	0
MICKEY PRICE
DIRECTOR	1.00	X		0	0	0
SUSIE BROWN
DIRECTOR	1.00	X		0	0	0
DAVID ALLEN SMITH
DIRECTOR	1.00	X		0	0	0
W BARRY SMITH
DIRECTOR	1.00	X		0	0	0
DR RODNEY SMITH
CHIEF-OF-STAFF	1.00	X		0	0	0
DAVID O'CONNOR
CFO/ASST. TREASURER	40.00		X	569491	0	38816
MARIA LONG
EVP GEN. COUNSEL/ASST. SEC	40.00		X	432347	0	38015
RANDALL L KELLEY
CEO (AS OF DECEMBER 2011)	40.00		X	0	0	0
DOUG LUCKETT
EVP/COO	40.00			632444	0	24893	X
JERRY LEVINE
EVP/CMO	40.00			499821	0	9099	X
W K HARWELL
VP PATIENT CARE SERVICES -	40.00			405621	0	36402		X
ANDREA K SERRA
VP WELLNESS	40.00			316345	0	47908		X
MICHAEL R JOHNSON
AVP, CIO	40.00			328377	0	64465		X
ROWENA BUFFETT TIMMS
VP OF PUBLIC POLICY	40.00			315687	0	29283		X
KATHLEEN BESSON
VP OF CLINICAL OPS	40.00			327712	0	58686		X
VALINDA L RUTLEDGE
FORMER CEO	0.00			766972	0	18607			X
STEVEN A RUBIN
FORMER KEY EMPLOYEE	0.00			230680	0	0			X
TERRY L JONES
FORMER KEY EMPLOYEE	0.00			318198	0	7463			X

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	5143695	TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs	201000	TotalReportableCompFrmRltdOrgs
Total Other Compensation	392177	TotalOtherCompensation
Number Individuals GT100 K	130	NumberIndividualsGT100K
Formers Listed	1	FormersListed
Total Comp GT150 K	1	TotalCompGT150K
Compensation From Other Sources	0	CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1	CityAddressOfContractor/AddressUS/City	StateAddressOfContractor/AddressUS/State	ZIP CodeAddressOfContractor/AddressUS/ZIPCode	Description Of ServicesDescriptionOfServices	CompensationCompensation
MORRISON MANAGEMENT SPECIALISTS INC
3 WACHOVIA CENTER STE 3000 401 S	CHARLOTTE	NC	28202	FOOD SERVICES MANAGEMENT	4459749
SHARED (SIEMENS) MEDICAL SOLUTIONS
51 VALLEY STREAM PARKWAY	MALVERN	PA	19355	INFORMATION SYSTEMS	3236487
ARAMARK HEALTHCARE
10510 TWIN LAKES PARKWAY	CHARLOTTE	NC	28259	BIOMED SERVICES	3073394
GASTON ANESTHESIA ASSOCIATES
1550B UNION ROAD	GASTONIA	NC	28082	CRNA SERVICES	2176019
MCKESSON HBOC MCKESSON INFO SOLUTIONS
PO BOX 98347	CHICAGO	IL	606938347	INFORMATION SYSTEMS	1182433

Field	Value	IRS element (for citing)
Number Of Contractors GT100 K	50	NumberOfContractorsGT100K
Related Organizations	1131072	RelatedOrganizations
All Other Contributions	50220	AllOtherContributions
Total Contributions	1181292	TotalContributions

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome	Unrelated Business RevenueUnrelatedBusinessRevenue
PATIENT SERVICES REVEN	621500	414247255	414247255
AUXILIARY INCOME	621500	1100647	602864	497783
PARTNERSHIP INCOME	541900	943088	930514	12574

Field	Value	IRS element (for citing)
Total Program Service Revenue	416290990	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	104870	TotalRevenueColumn
Exclusion	$104,870	ExclusionAmount

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

Field	Value	IRS element (for citing)
Other	98800	Other

Gain Or Loss GainOrLoss

Field	Value	IRS element (for citing)
Other	-98800	Other

Net Gain Or Loss Investments NetGainOrLossInvestments

Field	Value	IRS element (for citing)
Total Revenue Column	-98800	TotalRevenueColumn
Exclusion	-$98,800	ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	ExclusionExclusionAmount
INFO SYSTEMS MEANINGFU	621500	3240391	$3,240,391
PHARMACY REVENUE	621500	2501523	$2,501,523
CAFETERIA & VENDING IN	722210	2112273	$2,112,273

Miscellaneous Revenue MiscellaneousRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	661644	TotalRevenueColumn
Related Or Exempt Function Income	536846	RelatedOrExemptFunctionIncome
Exclusion	$124,798	ExclusionAmount

Field	Value	IRS element (for citing)
Total Other Revenue	8515831	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	425994183	TotalRevenueColumn
Related Or Exempt Function Income	416317479	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	510357	UnrelatedBusinessRevenue
Exclusion	$7,985,055	ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

Field	Value	IRS element (for citing)
Total	283868	Total
Program Services	283868	ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

Field	Value	IRS element (for citing)
Total	3100966	Total
Program Services	620193	ProgramServices
Management And General	2480773	ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

Field	Value	IRS element (for citing)
Total	50489	Total
Program Services	50489	ProgramServices

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	132359758	Total
Program Services	121258848	ProgramServices
Management And General	11100910	ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

Field	Value	IRS element (for citing)
Total	6162628	Total
Program Services	5544975	ProgramServices
Management And General	617653	ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	17776072	Total
Program Services	15994456	ProgramServices
Management And General	1781616	ManagementAndGeneral

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	9805046	Total
Program Services	8822330	ProgramServices
Management And General	982716	ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

Field	Value	IRS element (for citing)
Total	429212	Total
Program Services	429212	ProgramServices

Fees For Services Legal FeesForServicesLegal

Field	Value	IRS element (for citing)
Total	1380808	Total
Management And General	1380808	ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	153331	Total
Management And General	153331	ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

Field	Value	IRS element (for citing)
Total	189621	Total
Program Services	189621	ProgramServices

Fees For Services Other FeesForServicesOther

Field	Value	IRS element (for citing)
Total	37158158	Total
Program Services	33321983	ProgramServices
Management And General	3836175	ManagementAndGeneral

Advertising Advertising

Field	Value	IRS element (for citing)
Total	606959	Total
Program Services	142502	ProgramServices
Management And General	464457	ManagementAndGeneral

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	2598302	Total
Program Services	1318816	ProgramServices
Management And General	1279486	ManagementAndGeneral

Information Technology InformationTechnology

Field	Value	IRS element (for citing)
Total	518422	Total
Program Services	518422	ProgramServices

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	8484857	Total
Program Services	8484857	ProgramServices

Travel Travel

Field	Value	IRS element (for citing)
Total	150687	Total
Program Services	95779	ProgramServices
Management And General	54908	ManagementAndGeneral

Conferences Meetings ConferencesMeetings

Field	Value	IRS element (for citing)
Total	700450	Total
Program Services	359983	ProgramServices
Management And General	340467	ManagementAndGeneral

Interest Interest

Field	Value	IRS element (for citing)
Total	8921803	Total
Program Services	8921803	ProgramServices

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	24485291	Total
Program Services	24485291	ProgramServices

Insurance Insurance

Field	Value	IRS element (for citing)
Total	2832173	Total
Program Services	2832173	ProgramServices

Other Expenses OtherExpenses (4 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices	Management And GeneralManagementAndGeneral
MEDICAL SUPPLIES	71746396	71746396
BAD DEBT	46253615	46253615
EQUIPMENT	5449852	5429921	19931
NC MEDICAID ASSESSMENT	5227709	5227709

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	1336590	Total
Program Services	1155519	ProgramServices
Management And General	181071	ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	388163063	Total
Program Services	363488761	ProgramServices
Management And General	24674302	ManagementAndGeneral
Fundraising	0	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	-5240	BOY
EOY	-4752	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	43641842	BOY
EOY	45721542	EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

Field	Value	IRS element (for citing)
BOY	6558153	BOY
EOY	6266707	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	8288591	BOY
EOY	9982612	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	481869602	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	278352438	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	204909634	BOY
EOY	203517164	EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

Field	Value	IRS element (for citing)
BOY	9873	BOY
EOY	8152	EOY

Investments Program Related InvestmentsProgramRelated

Field	Value	IRS element (for citing)
BOY	380625	BOY
EOY	439199	EOY

Intangible Assets IntangibleAssets

Field	Value	IRS element (for citing)
BOY	2311646	BOY
EOY	2311646	EOY

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
BOY	65968677	BOY
EOY	91809838	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	332063801	BOY
EOY	360052108	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	39454843	BOY
EOY	39871306	EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

Field	Value	IRS element (for citing)
BOY	213332101	BOY
EOY	207464861	EOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	54274395	BOY
EOY	79067674	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	307061339	BOY
EOY	326403841	EOY

Field	Value	IRS element (for citing)
Follow SFAS117	X	FollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	24995463	BOY
EOY	33640118	EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	6999	BOY
EOY	8149	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	25002462	BOY
EOY	33648267	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	332063801	BOY
EOY	360052108	EOY

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	X	InfoInScheduleOPartXI
Reconcilation Revenue Expenses	37831120	ReconcilationRevenueExpenses
Reconcilation Other Changes	-29185315	ReconcilationOtherChanges
Info In Schedule O Part XII	X	InfoInScheduleOPartXII
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	0	AccountantCompileOrReview
FS Audited	1	FSAudited
Audit Committee	1	AuditCommittee
Financial Statement Consolidated	X	FinancialStatementConsolidated
Federal Grant Audit Required	0	FederalGrantAuditRequired

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital170b1 Aiii	X	Hospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

Field	Value	IRS element (for citing)
Contributor Number	RESTRICTED	ContributorNumber

Contributor Name Business ContributorNameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor Address US ContributorAddressUS

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Aggregate Contributions	RESTRICTED	AggregateContributions

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	0	Volunteers
Paid Staff Or Management	0	PaidStaffOrManagement
Media Advertisements	0	MediaAdvertisements
Mailings Members	0	MailingsMembers
Publications Or Broadcast	0	PublicationsOrBroadcast
Grants Other Organizations	0	GrantsOtherOrganizations
Direct Contact Legislators	0	DirectContactLegislators
Rallies Demonstrations	0	RalliesDemonstrations
Other Activities	1	OtherActivities
Other Activities	$189,621	OtherActivitiesAmount
Total Lobbying Expenditures IIB	189621	TotalLobbyingExpendituresIIB
Not Described In501c3	0	NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

Field	Value	IRS element (for citing)
Identifier	EXPLANATION OF LOBBYING ACTIVITIES:	Identifier
Return Reference	PART II-B, LINE 1:	ReturnReference
Explanation	ANNUAL DUES WERE PAID TO THE NORTH CAROLINA HOSPITAL ASSOCIATION AND THE AMERICAN HOSPITAL ASSOCIATION, OF WHICH $25,275 WAS DETERMINED TO BE EXPENDITURES USED IN LOBBYING ACTIVITIES BY THESE ORGANIZATIONS. AN ADDITIONAL $164,346 IN LEGAL FEES WERE PAID FOR LOBBYING EXPENDITURES.	Explanation

Schedule D IRS990ScheduleD

Current Year CurrentYear

Field	Value	IRS element (for citing)
Beginning Of Year Balance	6999	BeginningOfYearBalance
Contributions	1500	Contributions
Investment Earnings Or Losses	221	InvestmentEarningsOrLosses
Other Expenditures	571	OtherExpenditures
End Of Year Balance	8149	EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

Field	Value	IRS element (for citing)
Beginning Of Year Balance	6513	BeginningOfYearBalance
Investment Earnings Or Losses	966	InvestmentEarningsOrLosses
Administrative Expenses	480	AdministrativeExpenses
End Of Year Balance	6999	EndOfYearBalance

Field	Value	IRS element (for citing)
Board Designated EOY Balance	1.00000	BoardDesignatedEOYBalance
Endowments Held By Unrelated Orgs	0	EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs	0	EndowmentsHeldByRelatedOrgs

Land Land

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	341972	OtherCostOrOtherBasis
Book Value	341972	BookValue

Buildings Buildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	264712414	OtherCostOrOtherBasis
Depreciation	124040880	Depreciation
Book Value	140671534	BookValue

Leasehold Improvements LeaseholdImprovements

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	5206433	OtherCostOrOtherBasis
Depreciation	4752848	Depreciation
Book Value	453585	BookValue

Equipment Equipment

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	197264696	OtherCostOrOtherBasis
Depreciation	149558710	Depreciation
Book Value	47705986	BookValue

Other Land Buildings OtherLandBuildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	14344087	OtherCostOrOtherBasis
Book Value	14344087	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	203517164	TotalOfBookValueLandBuildings

Other Assets OtherAssets (6 entries)

DescriptionDescription	Book ValueBookValue
PREPAID PENSION OBLIGATION	41484454
DEFERRED FINANCING COSTS	4443036
OTHER RECEIVABLES	5960144
457B PLAN ASSETS	4838369
DEFERRED CHARGE - INTEREST RATE SWAP	34779242
457F PLAN ASSETS	304593

Field	Value	IRS element (for citing)
Total Book Value Other Assets	91809838	TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (4 entries)

DescriptionDescription	AmountAmount
457B PLAN LIABILITY	$4,838,369
ESTIMATED 3RD PARTY SETTLEMENTS	$39,145,470
INTEREST RATE SWAP LIABILITY	$34,779,242
457F PLAN LIABILITY	$304,593

Field	Value	IRS element (for citing)
Total Of Amounts	79067674	TotalOfAmounts
Total Revenue	425994183	TotalRevenue
Total Expenses	388163063	TotalExpenses
Excess Or Deficit For Year	37831120	ExcessOrDeficitForYear
Net Unrealized GL On Investments	-64	NetUnrealizedGLOnInvestments
Other	-$29,185,251	OtherAmount
Total Adjustments	-29185315	TotalAdjustments
Excess Or Deficit Per FS	8645805	ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt	350555255	TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments	-64	NetUnrealizedGainsInvestments
Other Revenues	-75438864	OtherRevenues
Revenue Not Rptd F990	-75438928	RevenueNotRptdF990
Revenue Subtotal	425994183	RevenueSubtotal
Revenue Not Rptd On Fin Stmt	0	RevenueNotRptdOnFinStmt
Total Revenue Per Form990	425994183	TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt	341909450	TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F990	0	ExpensesNotRptdF990
Expenses Subtotal	341909450	ExpensesSubtotal
Other Expenses Not Included	46253613	OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt	46253613	ExpensesNotRptdOnFinStmt
Total Expenses Per Form990	388163063	TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (5 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
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, 2012 AND 2011, RESPECTIVELY.
PART XI, LINE 8 - OTHER ADJUSTMENTS:		INTERCOMPANY TRANSFER TO AFFILIATE -27,147,201. CHANGE IN VALUE OF INTEREST RATE SWAP -2,038,050. TOTAL TO SCHEDULE D, PART XI, LINE 8: -29,185,251.
PART XII, LINE 2D - OTHER ADJUSTMENTS:		BAD DEBT -46,253,613. CHANGE IN VALUE OF INTEREST RATE SWAP -2,038,050. INTERCOMPANY TRANSFERS -27,147,201.
PART XIII, LINE 4B - OTHER ADJUSTMENTS:		BAD DEBT 46,253,613.

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Charity Care Policy	1	CharityCarePolicy
Written Policy	1	WrittenPolicy
FPG Reference Free Care	1	FPGReferenceFreeCare
Pcent200	X	Pcent200
FPG Reference Discounted Care	1	FPGReferenceDiscountedCare
Pcent300	X	Pcent300
Free Disc Care Medically Indigent	1	FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care	1	AmountsBudgetedForCharityCare
Expenses Exceeded Budget	1	ExpensesExceededBudget
Unable To Provide Care	0	UnableToProvideCare
Annual Community Benefit Report	1	AnnualCommunityBenefitReport
Report Publically Available	1	ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

Field	Value	IRS element (for citing)
Total Community Benefit Expense	12241895	TotalCommunityBenefitExpense
Net Community Benefit Expense	12241895	NetCommunityBenefitExpense
Percent Of Total Expense	0.03580	PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

Field	Value	IRS element (for citing)
Total Community Benefit Expense	65004753	TotalCommunityBenefitExpense
Direct Offsetting Revenue	56888511	DirectOffsettingRevenue
Net Community Benefit Expense	8116242	NetCommunityBenefitExpense
Percent Of Total Expense	0.02370	PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

Field	Value	IRS element (for citing)
Total Community Benefit Expense	137484	TotalCommunityBenefitExpense
Direct Offsetting Revenue	122641	DirectOffsettingRevenue
Net Community Benefit Expense	14843	NetCommunityBenefitExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Total Charity Care TotalCharityCare

Field	Value	IRS element (for citing)
Total Community Benefit Expense	77384132	TotalCommunityBenefitExpense
Direct Offsetting Revenue	57011152	DirectOffsettingRevenue
Net Community Benefit Expense	20372980	NetCommunityBenefitExpense
Percent Of Total Expense	0.05950	PercentOfTotalExpense

Community Health Services CommunityHealthServices

Field	Value	IRS element (for citing)
Total Community Benefit Expense	1142432	TotalCommunityBenefitExpense
Direct Offsetting Revenue	10140	DirectOffsettingRevenue
Net Community Benefit Expense	1132292	NetCommunityBenefitExpense
Percent Of Total Expense	0.00330	PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

Field	Value	IRS element (for citing)
Total Community Benefit Expense	1760822	TotalCommunityBenefitExpense
Net Community Benefit Expense	1760822	NetCommunityBenefitExpense
Percent Of Total Expense	0.00510	PercentOfTotalExpense

Research Research

Field	Value	IRS element (for citing)
Total Community Benefit Expense	603262	TotalCommunityBenefitExpense
Direct Offsetting Revenue	151773	DirectOffsettingRevenue
Net Community Benefit Expense	451489	NetCommunityBenefitExpense
Percent Of Total Expense	0.00130	PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

Field	Value	IRS element (for citing)
Total Community Benefit Expense	893824	TotalCommunityBenefitExpense
Net Community Benefit Expense	893824	NetCommunityBenefitExpense
Percent Of Total Expense	0.00260	PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

Field	Value	IRS element (for citing)
Total Community Benefit Expense	4400340	TotalCommunityBenefitExpense
Direct Offsetting Revenue	161913	DirectOffsettingRevenue
Net Community Benefit Expense	4238427	NetCommunityBenefitExpense
Percent Of Total Expense	0.01230	PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

Field	Value	IRS element (for citing)
Total Community Benefit Expense	81784472	TotalCommunityBenefitExpense
Direct Offsetting Revenue	57173065	DirectOffsettingRevenue
Net Community Benefit Expense	24611407	NetCommunityBenefitExpense
Percent Of Total Expense	0.07180	PercentOfTotalExpense

Workforce Development WorkforceDevelopment

Field	Value	IRS element (for citing)
Total Community Building Expense	998773	TotalCommunityBuildingExpense
Net Community Building Expense	998773	NetCommunityBuildingExpense
Percent Of Total Expense	0.00290	PercentOfTotalExpense

Total Total

Field	Value	IRS element (for citing)
Total Community Building Expense	998773	TotalCommunityBuildingExpense
Net Community Building Expense	998773	NetCommunityBuildingExpense
Percent Of Total Expense	0.00290	PercentOfTotalExpense

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	1	BadDebtExpenseReported
Bad Debt Expense	$14,686,473	BadDebtExpenseAmount
Amount Attributable To	1021512	AmountAttributableTo
Amount Reimbursed By Medicare	126364371	AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare	113446447	CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall	12917924	MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

Field	Value	IRS element (for citing)
Cost To Charge Ratio	X	CostToChargeRatio

Field	Value	IRS element (for citing)
Written Debt Collection Policy	1	WrittenDebtCollectionPolicy
Provision For Charity Care	1	ProvisionForCharityCare
Number Of Hospital Facilities	1	NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

Field	Value	IRS element (for citing)
Facility Number	1	FacilityNumber

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	GASTON MEMORIAL HOSPITAL INCORPORATED	BusinessNameLine1

Address Address

Field	Value	IRS element (for citing)
Address Line1	2525 COURT DRIVE	AddressLine1
City	GASTONIA	City
State	NC	State
ZIP Code	28054	ZIPCode

Field	Value	IRS element (for citing)
Licensed Hospital	X	LicensedHospital
General Medical And Surgical	X	GeneralMedicalAndSurgical
Er24 Hours	X	Er24Hours
Other	4 DIAGNOSTIC IMAGING CENTERS AND 6 OP SERIVCE CENTER	Other

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	GASTON MEMORIAL HOSPITAL INC	BusinessNameLine1

Field	Value	IRS element (for citing)
Hospital Facility Number	1	HospitalFacilityNumber
Eligibility Criteria Explained	1	EligibilityCriteriaExplained
Uses FPG Free	1	UsesFPGFree
FPG Free Percent	200.000000000000	FPGFreePercent
Uses FPG Discounted	1	UsesFPGDiscounted
FPG Discount Percent	300.000000000000	FPGDiscountPercent
Explains Basis	1	ExplainsBasis
Income Level	X	IncomeLevel
Asset Level	X	AssetLevel
Medical Indigency	X	MedicalIndigency
Other Factors	X	OtherFactors
Explains Application Method	1	ExplainsApplicationMethod
Includes Publicity Measures	1	IncludesPublicityMeasures
Posted On Website	X	PostedOnWebsite
Provided On Admission	X	ProvidedOnAdmission
Available On Request	X	AvailableOnRequest
Other Publicity	X	OtherPublicity
Actions On Nonpayment	1	ActionsOnNonpayment
Collection Activities	0	CollectionActivities
Nondiscrim Emergency Care Policy	1	NondiscrimEmergencyCarePolicy
Average Negotiated Rates	X	AverageNegotiatedRates
Amounts Generally Billed	0	AmountsGenerallyBilled
Gross Charges	0	GrossCharges

Form990 Schedule H Part VI Form990ScheduleHPartVI (20 entries)

ExplanationExplanation	IdentifierIdentifier	Return ReferenceReturnReference
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, L7 COL(F): 46,253,615 BAD DEBT EXPENSE REMOVED FROM TOTAL EXPENSES PRIOR TO CALCULATING PERCENT OF TOTAL EXPENSE.
PART I, LINE 6A: THE ORGANIZATION COMMUNITY BENEFIT REPORT MADE AVAILABLE TO THE PUBLIC CONTAINS COMMUNITY BENEFITS FOR ALL RELATED ORGANIZATIONS TO THE HOSPITAL.
CAROMONT HEALTH IS INVOLVED IN APPROXIMATELY 75 RESEARCH STUDIES, APPROXIMATELY HALF OF WHICH ARE CLINICAL TRIALS COOPERATIVE GROUP PROGRAM STUDIES SPONSORED BY THE NATIONAL CANCER INSTITUTE (NCI). CAROMONT HEALTH ALSO PARTICIPATES IN DRUG AND DEVICE STUDIES SPONSORED BY VARIOUS PHARMACEUTICAL, BIOTECHNOLOGY, AND DEVICE COMPANIES, AS WELL AS UNFUNDED NURSING AND PHARMACY RESEARCH STUDIES.	RESEARCH ACTIVITIES:	PART I, LINE H
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 V, SECTION B, LINE 11H: TOTAL CHARGES ARE THE SAME FOR ALL. PATIENT AMOUNT DUE IS ZERO OR A TIERED DISCOUNT FOR CHARITY ELIGIBLE PATIENTS BASED ON WHAT WAS CHECKED.	GASTON MEMORIAL HOSPITAL, INC.
PART V, SECTION B, LINE 13G: BROCHURES AT REGISTRATION SITES. PROACTIVELY COMMUNICATING VERBALLY OR IN WRITING TO SCHEDULED PATIENTS PRIOR TO SERVICE. COMMUNICATING IN-HOUSE, DURING SERVICE, OR AFTER.	GASTON MEMORIAL HOSPITAL, INC.
PART V, SECTION B, LINE 15E: COLLECTION ACTIONS ARE TAKEN AFTER REASONABLE EFFORTS HAVE BEEN MADE TO DETERMINE PATIENT'S ELIGIBILITY FOR ASSISTANCE.	GASTON MEMORIAL HOSPITAL, INC.
PART V, SECTION B, LINE 16E: COLLECTION ACTIONS ARE TAKEN AFTER REASONABLE EFFORTS HAVE BEEN MADE TO DETERMINE PATIENT'S ELIGIBILITY FOR ASSISTANCE.	GASTON MEMORIAL HOSPITAL, INC.
PART V, SECTION B, LINE 17E: BROCHURES AT REGISTRATION SITES. PROACTIVELY COMMUNICATING VERBALLY OR IN WRITING TO SCHEDULED PATIENTS PRIOR TO SERVICE. COMMUNICATING IN-HOUSE, DURING SERVICE, OR AFTER.	GASTON MEMORIAL HOSPITAL, INC.
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 WILL HAVE CONCLUDE IN THE FALL OF 2012. 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: THE PROCESS IS CONSISTENT. ATTEMPTS TO INFORM PATIENTS ARE MADE AS SOON AS POSSBLE (PRIOR TO, TIME OF, DURING, OR AT DISCHARGE) BUT CERTAINLY PRIOR TO THIRD PARTY PLACEMENT FOR COLLECTION. 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 207,031 (2011), A MEDIAN HOUSEHOLD INCOME OF $43,253 (2006-2010), AND 16.6% PERSONS BELOW POVERTY LEVEL (2006-2010). DURING FISCAL YEAR 2012, 8.4% OF THE HOSPITAL'S GROSS CHARGES WERE FROM UNINSURED PATIENTS AND 16.2% WAS FROM MEDICAID PATIENTS.
PART VI, LINE 5: 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 6: 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.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.
NC	REPORTS FILED WITH STATES	PART VI, LINE 7

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Records Maintained	1	RecordsMaintained

Recipient Table RecipientTable (13 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EIN Of RecipientEINOfRecipient	IRC SectionIRCSection	Amount Of Cash GrantAmountOfCashGrant	Purpose Of GrantPurposeOfGrant
AMERICAN HEART ASSOCIATION
222 SOUTH CHURCH STREET SUITE 303	CHARLOTTE	NC	28202	135613797	501(C)(3)	25000	COMMUNITY ASSISTANCE
BELMONT ABBEY COLLEGE
100 BELMONT-MT HOLLY ROAD	BELMONT	NC	28012	560547498	501(C)(3)	5100	COMMUNITY ASSISTANCE
CLEVELAND COMMUNITY COLLEGE
137 SOUTH POST ROAD	SHELBY	NC	28152	560848556	501(C)(3)	24268	COMMUNITY ASSISTANCE
COMMUNITY FOUNDATION OF GASTON COUNTY
1201 E GARRISON BLVD	GASTONIA	NC	28053	581340834	501(C)(3)	36500	COMMUNITY ASSISTANCE
DANIEL STOWE GARDENS
6500 SOUTH NEW HOPE ROAD	BELMONT	NC	28012	208362933	501(C)(3)	20000	COMMUNITY ASSISTANCE
GASTON HOSPICE
258 E GARRISON BLVD	GASTONIA	NC	28054	581341530	501(C)(3)	5000	COMMUNITY ASSISTANCE
GASTON REGIONAL CHAMBER
601 W FRANKLIN BLVD	GASTONIA	NC	28053	560232990	501(C)(6)	15300	COMMUNITY ASSISTANCE
LIFE IN THE CAROLINAS
7804 FAIRVIEW ROAD	CHARLOTTE	NC	28226	262693974	N/A	5000	COMMUNITY ASSISTANCE
THE MCADENVILLE FOUNDATION INC
100 MAIN STREET	MCADENVILLE	NC	28101	560623961	501(C)(3)	11000	COMMUNITY ASSISTANCE
MONTCROSS AREA CHAMBER OF COMMERCE
PO BOX 368	BELMONT	NC	28012	560710166	501(C)(6)	6500	COMMUNITY ASSISTANCE
MOUNT HOLLY COMMUNITY DEVELOPMENT FOUNDATION
1068 SOUTH MAIN STREET	MT HOLLY	NC	28120	200738339	501(C)(3)	100000	COMMUNITY ASSISTANCE
MOUNT HOLLY FARMER'S MKT
120 OAKLAND STREET	MT HOLLY	NC	28120	260464156	N/A	5200	COMMUNITY ASSISTANCE
THE SCHIELE MUSEUM
1500 E GARRISON BLVD	GASTONIA	NC	28054	560770432	501(C)(3)	25000	COMMUNITY ASSISTANCE

Field	Value	IRS element (for citing)
Total Nbr Of501 C3 And Govt Grants	9	TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations	4	TotalNbrOfOtherOrganizations

Form990 Schedule I Part III Form990ScheduleIPartIII

Field	Value	IRS element (for citing)
Type Of Grant	ONCOLOGY PHARMACY ASSISTANCE	TypeOfGrant
Number Of Recipients	9	NumberOfRecipients
Amount Of Cash Grant	571	AmountOfCashGrant

Form990 Schedule I Part IV Form990ScheduleIPartIV

Field	Value	IRS element (for citing)
Identifier	PROCEDURE FOR MONITORING GRANTS IN THE U.S.:	Identifier
Return Reference	PART I, LINE 2:	ReturnReference
Explanation	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.	Explanation

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Club Dues Or Fees	X	ClubDuesOrFees
Written Policy Re T And E Expenses	1	WrittenPolicyReTAndEExpenses
Substantiation Required	1	SubstantiationRequired
Compensation Committee	X	CompensationCommittee
Independent Consultant	X	IndependentConsultant
Written Employment Contract	X	WrittenEmploymentContract
Compensation Survey	X	CompensationSurvey
Board Or Committee Approval	X	BoardOrCommitteeApproval
Severance Payment	1	SeverancePayment
Supplemental Nonqual Retire Plan	0	SupplementalNonqualRetirePlan
Equity Based Comp Arrangement	0	EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org	0	CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs	0	CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org	1	CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs	1	CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments	0	AnyNonFixedPayments
Initial Contract Exception	0	InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (13 entries)

Base Compensation Filing OrgBaseCompensationFilingOrg	Comp Based On Related OrgsCompBasedOnRelatedOrgs	Bonus Filing OrgBonusFilingOrg	Bonus Related OrgsBonusRelatedOrgs	Other Compensation Filing OrgOtherCompensationFilingOrg	Other Compensation Related OrgsOtherCompensationRelatedOrgs	Deferred Comp Filing OrgDeferredCompFilingOrg	Deferred Comp Related OrgsDeferredCompRelatedOrgs	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg	Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs	Total Compensation Filing OrgTotalCompensationFilingOrg	Total Compensation Related OrgsTotalCompensationRelatedOrgs	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg	Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
KELVIN C HARRIS MD
0	161597	0	39403	0	0	0	5103	0	13437	0	219540	0	0
DAVID O'CONNOR
332181	0	182565	0	54745	0	9800	0	29016	0	608307	0	0	0
MARIA LONG
274556	0	150300	0	7491	0	7350	0	30665	0	470362	0	0	0
DOUG LUCKETT
408322	0	195743	0	28379	0	2450	0	22443	0	657337	0	0	0
JERRY LEVINE
315104	0	162887	0	21830	0	0	0	9099	0	508920	0	0	0
W K HARWELL
237700	0	112114	0	55807	0	0	0	36402	0	442023	0	0	0
ANDREA K SERRA
189939	0	95298	0	31108	0	5799	0	42109	0	364253	0	0	0
MICHAEL R JOHNSON
238694	0	62460	0	27223	0	7350	0	57115	0	392842	0	0	0
ROWENA BUFFETT TIMMS
175619	0	115975	0	24093	0	4641	0	24642	0	344970	0	0	0
KATHLEEN BESSON
213542	0	91460	0	22710	0	6676	0	52010	0	386398	0	0	0
VALINDA L RUTLEDGE
338137	0	260451	0	168384	0	6750	0	11857	0	785579	0	0	0
STEVEN A RUBIN
55249	0	0	0	175431	0	0	0	0	0	230680	0	0	0
TERRY L JONES
0	0	0	0	318198	0	0	0	7463	0	325661	0	0	0

Form990 Schedule J Part III Form990ScheduleJPartIII (4 entries)

Return ReferenceReturnReference	ExplanationExplanation
PART I, LINE 1A	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 2012 THIS BENEFIT WAS PROVIDED TO THE CEO AND CFO.
PART I, LINE 3	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.
PART I, LINE 4A	DURING THE YEAR THE ORGANIZATION PAID SEVERANCE PAYMENTS TO A FORMER OFFICER AND FORMER KEY EMPLOYEES IDENTIFIED BELOW. STEVEN A. RUBIN, FORMER KEY EMPLOYEE $174,972 TERRY L. JONES, FORMER KEY EMPLOYEE $318,198
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.

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)

Issuer EINIssuerEIN	CUSIP NumberCUSIPNumber	Date IssuedDateIssued	Issue PriceIssuePrice	Description Of PurposeDescriptionOfPurpose	DefeasedDefeased	On Behalf Of IssuerOnBehalfOfIssuer	Pool FinancingPoolFinancing
NORTH CAROLINA MEDICAL CARE COMMISSION
521309402	65820HVF7	2003-01-23	120000000	SEE PART VI	0	0	0
NORTH CAROLINA MEDICAL CARE COMMISSION
521309402	65820HG64	2008-01-31	118400000	SEE PART VI	0	0	0

Form990 Schedule K Part II Form990ScheduleKPartII (2 entries)

Amount RetiredAmountRetired	Total ProceedsTotalProceeds	Capitalized InterestCapitalizedInterest	Issuance Costs From ProceedsIssuanceCostsFromProceeds	Credit EnhancementCreditEnhancement	Capital ExpendituresCapitalExpenditures	Other Spent ProceedsOtherSpentProceeds	Year Of Subst CompletionYearOfSubstCompletion	Current RefundingCurrentRefunding	Advance RefundingAdvanceRefunding	Final Allocation MadeFinalAllocationMade	Adequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind
800000	123594002	5150936	1256069	3386000	91583288	22217709	2005	0	1	1	1
24630000	118649797	610174	917471	1553717	28952424	86616011	2009	1	0	1	1

Form990 Schedule K Part III Form990ScheduleKPartIII (2 entries)

Owning Bond Financed PropertyOwningBondFinancedProperty	Any Lease ArrangementsAnyLeaseArrangements	Mngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprty	Engage Bond Counsel ContractsEngageBondCounselContracts	Any Research AgreementsAnyResearchAgreements	Engage Bond Counsel ResearchEngageBondCounselResearch	Prcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthers	Percentage Of Prvt Business Re UBIPercentageOfPrvtBusinessReUBI	Total Private Business UseTotalPrivateBusinessUse	Post Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs
0	0	1	1	1	1	0.00010	0.00000	0.00010	1
0	0	1	1	1	1	0.00010	0.00010	0.00020	1

Form990 Schedule K Part IV Form990ScheduleKPartIV (2 entries)

Form8038 T FiledForm8038TFiled	Variable Rate IssueVariableRateIssue	Hedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecds	Business Name Line2NameOfHedgeProvider/BusinessNameLine2	Term Of HedgeTermOfHedge	Superintegrated HedgeSuperintegratedHedge	Hedge TerminatedHedgeTerminated	Gross Proceeds Invested In GICGrossProceedsInvestedInGIC	Gross Proceeds InvestedGrossProceedsInvested	Exception To RebateExceptionToRebate
MERRILL LYNCH
0	1	1	CAPITAL SERVICES	31.600000000000	1	1	0	0	0
MERRILL LYNCH
0	0	1	DERIVATIVE PRODUCTS	21.000000000000	1	1	0	0	1

Form990 Schedule K Part VI Form990ScheduleKPartVI (8 entries)

IdentifierIdentifier	ExplanationExplanation	Return ReferenceReturnReference
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 - THE SYSTEM USED THE PROCEEDS FROM THESE BONDS FOR VARIOUS CAPITAL IMPROVEMENTS, INCLUDING, BUT NOT LIMITED TO A NEW WOMEN'S CENTER AND PARKING DECK, RENOVATIONS TO EXISTING FACILITIES, AND EQUIPMENT. IN ADDITION, PROCEEDS WERE USED TO REFUND IN ADVANCE OF THEIR MATURITIES $17,000,000 IN PRINCIPAL AMOUNT OF THE SERIES 1998 HOSPITAL REVENUE BONDS, ISSUED ON AUGUST 27, 1998. ISSUE B - THE SYSTEM USED THE PROCEEDS FROM THE BONDS FOR VARIOUS CAPITAL IMPROVEMENTS, INCLUDING, BUT NOT LIMITED TO, THE RENOVATION OF CERTAIN FLOORS OF THE PATIENT TOWER, RENOVATION OF THE DAY OF SURGERY UNIT, INSTALLATION OF FIRE SPRINKLERS IN NON-SPRINKLED AREAS, AND THE UPGRADE OF LIFE SAFETY AND CRITICAL POWER. IN ADDITION, THE HOSPITAL USED THE PROCEEDS TO REFUND THE AGGREGATE PRINCIPAL AMOUNT OF THE SERIES 1995 REVENUE BONDS, ISSUED ON NOVEMBER 15, 1995, IN THE AMOUNT OF $41,210,000 AND TO REFUND THE AGGREGATE PRINCIPAL AMOUNT OF THE SERIES 1998 REVENUE BONDS, ISSUED ON AUGUST 27, 1998, IN THE AMOUNT OF $49,710,000.
PART II, LINE 3 COLUMN A,	LINE 3 COLUMN (A) INCLUDES THE TOTAL INVESTMENT EARNINGS ON BOND PROCEEDS IN THE AMOUNT OF $ 3,594,002.	INVESTMENT EARNINGS INCLUDED IN TOTAL PROCEEDS OF ISSUE:
PART II, LINE 3 COLUMN B,	LINE 3 COLUMN (B) INCLUDES THE TOTAL INVESTMENT EARNINGS ON BOND PROCEEDS IN THE AMOUNT OF $ 249,798.	INVESTMENT EARNINGS INCLUDED IN TOTAL PROCEEDS OF ISSUE:
PART II, LINE 11; OTHER SPENT PROCEEDS:	OTHER SPENT PROCEEDS INCLUDE 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. SEE THE RESPONSE FOR PART I, COLUMN (F) FOR DETAILS.
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.

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV

Name Of Interested Person NameOfInterestedPerson

Field	Value	IRS element (for citing)
Name Person	LUCINDA DAVIS	NamePerson

Field	Value	IRS element (for citing)
Relationship	FAMILY MEMBER OF DIRECTOR, JAMES BEAM	Relationship
Amount Of Transaction	50489	AmountOfTransaction
Description Of Transaction	COMPENSATION AS EMPLOYEE	DescriptionOfTransaction
Sharing Of Revenues	0	SharingOfRevenues

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (12 entries)

Return ReferenceReturnReference	ExplanationExplanation	IdentifierIdentifier
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 HOSPITAL, A SUBSIDIARY OF CAROMONT HEALTH, INC. THE COMPENSATION OF ALL CAROMONT EXECUTIVES FOR EACH YEAR IS ESTABLISHED BY THE COMPENSATION COMMITTEE OF THE CAROMONT HEALTH BOARD OF DIRECTORS, BASED ON GUIDANCE AND OPINIONS PROVIDED BY AN INDEPENDENT, THIRD-PARTY COMPENSATION CONSULTANT. 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. THE PROCESS FOR DETERMINING COMPENSATION FOR EXECUTIVE DIRECTORS AND MANAGEMENT, UTILIZES COMPENSATION SURVEYS AND STUDIES. FULL COLLECTED COMPENSATION INFORMATION AND ANY COMPENSATION OPINIONS PROVIDED DURING THESE PROCESSES WILL BE KEPT WITH THE COMPENSATION COMMITTEE OR BOARD MINUTES, AS APPLICABLE.
FORM 990, PART VI, SECTION C, LINE 18	THE ORGANIZATION'S FORM 990 IS MADE AVAILABLE TO THE PUBLIC UPON REQUEST.
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.
FORM 990, PART XI, LINE 5:	NET UNREALIZED LOSSES ON INVESTMENTS: -64. INTERCOMPANY TRANSFER TO AFFILIATE -27,147,201. CHANGE IN VALUE OF INTEREST RATE SWAP -2,038,050. TOTAL TO FORM 990, PART XI, LINE 5: -29,185,315.	CHANGES IN NET ASSETS OR FUND BALANCES:
PART XII, LINE 2C	THE PROCESS HAS NOT CHANGED FROM LAST YEAR.
FORM 990, PART III, LINE 4A	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. 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 AS INFRASTRUCTURE 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. MISSION AND VISION CAROMONT HEALTH'S MISSION IS TO PROVIDE EXCEPTIONAL HEALTH CARE TO THE COMMUNITIES WE SERVE. OUR VISION IS TO BE A NATIONALLY RECOGNIZED LEADER AND VALUED PARTNER IN PROMOTING INDIVIDUAL HEALTH AND VIBRANT COMMUNITIES. WE HOLD THE FOLLOWING VALUES FOR CAROMONT HEALTH. EACH IS IMPORTANT AND THEIR ORDER REFLECTS NO PARTICULAR HIERARCHY. AS WE HONOR THESE VALUES DAILY, OUR COMMITMENT TO OUR MISSION IS UNWAVERING. -QUALITY PATIENT CARE - WE STRIVE TO BE A LEADER IN PROVIDING QUALITY PATIENT CARE IN A SAFE AND FAMILY CENTERED ENVIRONMENT. -RESPECT FOR THE INDIVIDUAL - WE RESPECT EACH PERSON'S DIGNITY, RIGHT TO PRIVACY, AND DIVERSE BELIEFS. WE TREAT OTHERS AS WE WOULD LIKE TO BE TREATED. -INTEGRITY - WE WILL BE GUIDED BY WHAT IS RIGHT. -OPEN AND RESPONSIBLE COMMUNICATION - WE EMPHASIZE LISTENING, RESPONSIVENESS AND MUTUAL UNDERSTANDING. -PRIDE OF OWNERSHIP - WE BELIEVE EACH PERSON IS EMPOWERED FOR ACTION AS NEEDED AND MUST ASSUME PERSONAL RESPONSIBILITY AND ACCOUNTABILITY. -CUSTOMER SERVICE AND PATIENT SATISFACTION- WE ARE COMMITTED TO THE HIGHEST LEVEL IN BOTH ENDEAVORS. -FISCAL RESPONSIBILITY - WE KNOW THAT THE SOUND USE OF ALL RESOURCES IS FUNDAMENTAL TO OUR SUCCESS. -TEAMWORK- WE ARE PARTICIPATIVE AND WORK COOPERATIVELY. THE WELLBEING OF OUR PATIENTS IS DEPENDENT ON THE CONTRIBUTIONS OF ALL. -INNOVATION - WE ENCOURAGE NEW IDEAS, OPENNESS TO CHANGE, AND CREATIVITY. CAROMONT HEALTH QUALITY: -HEALTH GRADES CLINICAL EXCELLENCE RECIPIENT -GOLD STAR STANDARD HOSPITAL FOR TOBACCO CESSATION EFFORTS -U.S. NEWS AND WORLD REPORT'S BEST HOSPITALS AWARD -BECKER'S HOSPITAL REVIEW TOP COMMUNITY HOSPITAL AWARD, 2011 -CARECHEX #1 IN NC FOR CORONARY BYPASS SURGERY, HEART ATTACK TREATMENT, HEART FAILURE TREATMENT, AND PNEUMONIA CARE -COMMISSION ON CANCER (COC) OUTSTANDING ACHIEVEMENT AWARD (OAA), 2011 -HEALTHIEST EMPLOYER AWARD BY CHARLOTTE BUSINESS JOURNAL, 2012 -THOMSON AND REUTERS 50 TOP CARDIOVASCULAR HOSPITAL, 2012 -THOMPSON AND REUTERS 100 TOP HOSPITAL, 2012 -PREMIER ALLIANCE QUALITY ADVISOR TOP PERFORMER AWARD -HEALTH GRADES DISTINGUISHED HOSPITAL AWARD FOR CLINICAL EXCELLENCE, 2012 -HEALTH GRADES EXCELLENCE AWARD FOR EMERGENCY MEDICINE, 2012 -HEALTH GRADES AMERICAS 100 BEST FOR CARDIAC CARE, CARDIAC SURGERY, SPINE SURGERY, WOMEN'S HEALTH, 2012 -LEAPFROG HOSPITAL SAFETY SCORESM GRADE A FOR PATIENT SAFETY, 2012 -BECKER'S HOSPITAL REVIEW 100 BEST COMMUNITY HOSPITAL, 2012 CAROMONT HEALTH STRATEGY AND OBJECTIVES: CAROMONT HEALTH UNDERTAKES A COMPREHENSIVE ASSESSMENT OF ITS SERVICES EVERY YEAR TO DETERMINE STRATEGIC CHANGES REQUIRED TO ADDRESS THE CHANGING HEALTHCARE ENVIRONMENT, AND THUS THE OVERALL PROGRAM DIRECTIONS THAT NEED TO BE PURSUED. ON AN ANNUAL BASIS, GOALS AND OBJECTIVES ARE ESTABLISHED THAT WILL ALLOW PROGRESS TOWARDS THE DESIRED DIRECTION. MANY OF CAROMONT HEALTH'S FISCAL YEAR 2012 STRATEGIES AND OBJECTIVES WERE CREATED TO IMPROVE THE HEALTH OF THE COMMUNITY. CAROMONT HEALTH HAS SIGNIFICANTLY IMPACTED ITS COMMUNITY IN PROVIDING MANY DIFFERENT HEALTH IMPROVEMENT PROJECTS, GROUPS, EVENTS, EDUCATION PROGRAMS, ETC. INCLUDING THE FOLLOWING: HEALTHNET GASTON: HEALTHNET 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. UNITED WAY: CAROMONT HEALTH IS A PACE SETTER ORGANIZATION FOR UNITED WAY AND IN FISCAL YEAR 2012. GASTON COMMUNITY HEALTHCARE COMMISSION: IN 1992 THE GASTON COMMUNITY HEALTHCARE COMMISSION (GCHC) WAS ESTABLISHED WITH GASTON MEMORIAL HOSPITAL AS A SPONSORING ORGANIZATION. THE PURPOSE OF THIS ORGANIZATION IS TO DEVELOP A WORKABLE COMMUNITY-WIDE AGENDA THROUGH A PROBLEM SOLVING NETWORK OF ORGANIZATIONS AND INDIVIDUALS TO IMPROVE HEALTH STATUS OF GASTON COUNTY RESIDENTS. AS A CERTIFIED HEALTHY CAROLINIAN PARTNERSHIP, INITIATIVES ARE BASED ON THE MOST RECENT COMMUNITY HEALTH ASSESSMENT, COORDINATED BY BOARD THAT IS REPRESENTATIVE OF THE COMMUNITY, AND DOCUMENT THE IMPACT THAT THESE INITIATIVES HAVE ON HEALTH STATUS. THESE EFFORTS FOCUS ON IMPROVING THE HEALTH OF CHILDREN, ASSISTING RESIDENTS OF ALL AGES TO MAKE HEALTHIER LIFE STYLES CHOICES, IMPROVING ACCESS TO MEDICAL CARE, AND DECREASING THE COST OF MEDICAL SERVICES. CAROMONT HEALTH HEART WALK: THIS IS AN ANNUAL EVENT TO RAISE MONEY FOR THE GASTON HEART SOCIETY. IT IS A ONE MILE FUN WALK ON THE CAROMONT HEALTH CAMPUSES. PATIENT ADVOCACY - MEDICAID ELIGIBILITY DEPARTMENT (PATIENT FINANCIAL SERVICES): GASTON MEMORIAL HOSPITAL HAS DEVELOPED A PROGRAM TO ASSIST UNINSURED AND UNDERINSURED COMMUNITY MEMBERS WITH ENROLLMENT IN PUBLIC PROGRAMS.	STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS:
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.	COMMON PAYMASTER

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (6 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivitiesPrimaryActivities	Legal Domicile StateLegalDomicileState	Exempt Code SectionExemptCodeSection	Public Charity StatusPublicCharityStatus	Direct Controlling Entity NADirectControllingEntityNA	Controlled OrgControlledOrg	Business Name Line1DirectControllingEntityName/BusinessNameLine1
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		0	CAROMONT HEALTH INC
GASTON MEMORIAL HOSPITAL FOUNDATION INC
2527 COURT DRIVE	GASTONIA	NC	28054	561479699	FOUNDATION	NC	501(C)(3)	LINE 9		0	CAROMONT HEALTH INC
CAROMONT MEDICAL GROUP INC
2528 COURT DRIVE	GASTONIA	NC	28054	561479712	MEDICAL GROUP	NC	501(C)(3)	LINE 9		0	CAROMONT HEALTH INC
HOSPICE OF GASTON COUNTY INC
2529 COURT DRIVE	GASTONIA	NC	28054	581341530	HOSPICE CARE	NC	501(C)(3)	LINE 7		0	CAROMONT HEALTH INC
GASTON EMERGENCY PHYSICIANS INC
2531 COURT DRIVE	GASTONIA	NC	28054	562209423	SUPPORTING ORGANIZATION	NC	501(C)(3)	LINE 11A, I		0	CAROMONT HEALTH INC

Field	Value	IRS element (for citing)
Receipt Of Int Ann Rents Royalties	0	ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org	1	GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org	1	GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org	0	LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org	0	LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org	0	SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org	0	PurchaseOfAssetsFromOtherOrg
Exchange Of Assets	0	ExchangeOfAssets
Rental Of Facilities To Other Orgs	1	RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs	0	RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs	0	PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs	0	PerformOfServicesByOtherOrgs
Sharing Of Facilities	1	SharingOfFacilities
Sharing Of Paid Employees	1	SharingOfPaidEmployees
Reimbursement Paid To Other Org	1	ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org	1	ReimbursementPaidByOtherOrg
Other Transfer To Other Org	1	OtherTransferToOtherOrg
Other Transfer From Other Org	1	OtherTransferFromOtherOrg