HRH of NC Inc: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- HRH of NC Inc (EIN 56-0714394)
- Tax period
- 2011-10-01 to 2012-09-30
- Filed
- 2013-08-14
- IRS object ID
- 201312269349303796
- 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 D
- Schedule H
- Schedule I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-08-14T17:06:51-05:00 | Timestamp |
| Tax Period End Date | 2012-09-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 621517792 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PERSHING YOAKLEY & ASSOCIATES PC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | ONE CHEROKEE MILLS 2220 SUTHERLAND | AddressLine1 |
| City | KNOXVILLE | City |
| State | TN | State |
| ZIP Code | 379192363 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-10-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 560714394 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HARRIS REGIONAL HOSPITAL INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | HARR | NameControl |
| Phone | 8285867000 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 68 HOSPITAL ROAD | AddressLine1 |
| City | SYLVA | City |
| State | NC | State |
| ZIP Code | 28779 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | MICHAEL MCKNIGHT | Name |
| Title | CFO | Title |
| Phone | 8285867000 | Phone |
| Date Signed | 2013-08-14 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | DEBORAH O ERNSBERGER | Name |
| PTIN | P00364912 | PTIN |
| Phone | 8656730844 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | MICHAEL MCKNIGHT | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 68 HOSPITAL ROAD | AddressLine1 |
| City | SYLVA | City |
| State | NC | State |
| ZIP Code | 28779 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 101559414 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.WESTCARE.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1960 | YearFormation |
| State Legal Domicile | NC | StateLegalDomicile |
| Activity Or Mission Description | TO PROVIDE HIGH QUALITY, COST EFFECTIVE HEALTHCARE TARGETED TO THE NEEDS OF THE PEOPLE WE SERVE. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 14 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 13 | NbrIndependentVotingMembers |
| Total Nbr Employees | 1376 | TotalNbrEmployees |
| Total Nbr Volunteers | 84 | TotalNbrVolunteers |
| Total Gross UBI | 84305 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | -91450 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 281071 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 486091 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 93234104 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 99127809 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 674494 | InvestmentIncomePriorYear |
| Investment Income Current Year | 553903 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 1180443 | OtherRevenuePriorYear |
| Other Revenue Current Year | 799785 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 95370112 | TotalRevenuePriorYear |
| Total Revenue Current Year | 100967588 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 496052 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 421704 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 53420334 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 44241376 | 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 | 47510036 | OtherExpensePriorYear |
| Other Expenses Current Year | 64017206 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 101426422 | TotalExpensesPriorYear |
| Total Expenses Current Year | 108680286 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -6056310 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -7712698 | RevenuesLessExpensesCY |
| Total Assets BOY | 67370962 | TotalAssetsBOY |
| Total Assets EOY | 62732089 | TotalAssetsEOY |
| Total Liabilities BOY | 46742920 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 54751034 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 20628042 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 7981055 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | HARRIS REGIONAL HOSPITAL, INC. IS A MEMBER OF THE WESTCARE HEALTH SYSTEM ("WESTCARE"). THE MISSION OF WESTCARE IS TO PROVIDE HIGH QUALITY, COST EFFECTIVE HEALTHCARE TARGETED TO THE NEEDS OF THE PEOPLE WE SERVE. WESTCARE'S VISION IS EXCELLENCE IN CARE, SERVICE, AND VALUE - ONE PATIENT AT A TIME. WESTCARE'S CORE VALUES ARE COMPASSION, ACCOUNTABILITY, RESPECT, AND EXCELLENCE WHICH TOGETHER COMPRISE "WE C.A.R.E." | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 91892815 | Expense |
| Grants | 421704 | Grants |
| Revenue | 99127809 | Revenue |
| Description | HARRIS REGIONAL HOSPITAL ("THE HOSPITAL") IS DEDICATED TO THE PROMOTION OF HEALTH AND WELLNESS FOR THE RESIDENTS OF WESTERN NORTH CAROLINA AND SURROUNDING COMMUNITIES. HARRIS REGIONAL HOSPITAL IS AN 86-BED ACUTE CARE FACILITY LOCATED IN SYLVA, NORTH CAROLINA. HARRIS REGIONAL HAS BEEN A VITAL PART OF THE COMMUNITY AND REGION THROUGHOUT ITS HISTORY. A FULLY ACCREDITED, NOT-FOR-PROFIT COMMUNITY HOSPITAL, HARRIS REGIONAL HAS EXPERIENCED STRONG GROWTH IN RECENT YEARS, WITH MAJOR EXPANSIONS IN 1997, 1986, 1989, 1994, AND 1995. THE HOSPITAL'S MEDICAL STAFF HAS THE DIVERSITY AND PROFESSIONAL TALENTS OF MANY HOSPITALS TWICE ITS SIZE. TOGETHER WITH THE QUALIFIED STAFF, THEY SUCCESSFULLY PROVIDE PATIENTS THE FINEST IN MEDICAL CARE. HARRIS REGIONAL HOSPITAL OFFERS MANY SERVICES TO HELP DIAGNOSE AND TREAT ALMOST ANY NEED. SERVICES INCLUDE: OUTPATIENT SURGERY, LABORATORY SERVICES, IMAGING SERVICES, PULMONARY REHABILITATION SERVICES, BIRTHING CENTER, TRANSITIONAL CARE UNIT, INTENSIVE CARE UNIT, PHARMACY, EMERGENCY DEPARTMENT, DIETARY SERVICES, OCCUPATIONAL HEALTH, SOCIAL SERVICES, SPORTS MEDICINE, AND PASTORAL SERVICE. | Description |
| Total Program Service Expense | 91892815 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | 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 | 0 | 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 | 0 | TaxExemptBonds |
| 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 | 0 | 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 | 54 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 1376 | 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 | 13 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 1 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | 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 | JOY FREEMAN | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 8285867653 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 68 HOSPITAL ROAD | AddressLine1 |
| City | SYLVA | City |
| State | NC | State |
| ZIP Code | 28779 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (28 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| LAWRENCE F SUPIK MD | |||||||
| TRUSTEE/ORTHOPEDIC SPECIALIST | 1.00 | X | 466948 | 36923 | 0 | ||
| FRED ALEXANDER | |||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | ||
| DANIEL M ALLISON | |||||||
| VICE CHAIR | 1.00 | X | 0 | 0 | 0 | ||
| JAMES A MANRING | |||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | ||
| MARTHA F ANDERSON MD | |||||||
| SECRETARY | 1.00 | X | 0 | 0 | 0 | ||
| LOWELL B CRISP | |||||||
| TREASURER | 1.00 | X | 0 | 0 | 0 | ||
| ELIZABETH B JOHNS | |||||||
| CHAIR | 1.00 | X | 0 | 0 | 0 | ||
| HEATHER C BAKER | |||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | ||
| TIMOTHY C LEWIS | |||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | ||
| JOHN BUENTING MD | |||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | ||
| CLIFFORD FAULL | |||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | ||
| STEPHANIE A TREADWAY | |||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | ||
| MARK TYSON | |||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | ||
| ANN MARIE WRIGHT | |||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | ||
| MICHAEL POORE | |||||||
| MEDWEST CEO THRU 2/20/12 | 40.00 | 444193 | 444193 | 0 | X | ||
| STEPHEN HEATHERLY | |||||||
| MPN CEO THRU 2/20/12; WESTCARE CEO | 40.00 | 94945 | 192288 | 0 | X | ||
| WYLEY GENE WINTERS | |||||||
| MEDWEST CFO TERM 12/31/11 | 40.00 | 264073 | 264073 | 0 | X | ||
| ROSE COYNE | |||||||
| MEDWEST CFO 1/12 - 8/27/12 | 40.00 | 0 | 0 | 0 | X | ||
| MICHAEL MCKNIGHT | |||||||
| WESTCARE CFO STARTING 8/27/12 | 40.00 | 0 | 0 | 0 | X | ||
| DALE CHERNICH | |||||||
| MEDWEST CIO TERM 2/19/12 | 40.00 | 164970 | 164970 | 0 | X | ||
| GREG COPEN | |||||||
| MEDWEST CIO STARTING 8/1/11 | 40.00 | 40899 | 40899 | 0 | X | ||
| DWAYNE HOOKS | |||||||
| MEDWEST CNO THRU 2/20/12 | 40.00 | 235732 | 235732 | 0 | X | ||
| TYSON SMITH MD | |||||||
| MEDWEST CMO | 40.00 | 205584 | 205584 | 0 | X | ||
| TODD D DAVIS MD | |||||||
| PRIMARY CARE PHYSICIAN | 40.00 | 442299 | 35330 | 0 | X | ||
| MARTIN A SENICKI MD | |||||||
| ORTHOPEDIC SPECIALIST | 40.00 | 486065 | 37023 | 0 | X | ||
| WILLIAM M RALSTON MD | |||||||
| ORTHOPEDIC SPECIALIST | 40.00 | 413516 | 34750 | 0 | X | ||
| JEROME M MARCHUK MD | |||||||
| UROLOGIST | 40.00 | 437350 | 36706 | 0 | X | ||
| RYAN M SLECHTA MD | |||||||
| ORTHOPEDIC SPECIALIST | 40.00 | 369916 | 30869 | 0 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 4066490 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 1759340 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 0 | TotalOtherCompensation |
| Number Individuals GT100 K | 29 | NumberIndividualsGT100K |
| Formers Listed | 0 | 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 |
|---|---|---|---|---|---|
| CAROLINAS HEALTHCARE SYSTEM | |||||
| PO BOX 32861 | CHARLOTTE | NC | 28232 | MANAGEMENT SERVICES | 1698825 |
| ADP INC | |||||
| 201 REGENCY EXECUTIVE PARK DRIVE | CHARLOTTE | NC | 28217 | PAYROLL SERVICES | 531340 |
| ALLIANCE HEALTHCARE SERVICES | |||||
| 100 BAYVIEW CIRCLE SUITE 400 | NEWPORT BEACH | CA | 92660 | DIAGNOSTIC IMAGING SERVICES | 401290 |
| OSBORNE COMPANY INC | |||||
| 515 SOUTH KENNEDY AVENUE PO BOX | EDEN | NC | 27289 | GENERAL CONTRACTOR | 391318 |
| PLUS LINEN & UNIFORM SERVICES | |||||
| PO BOX 1188 | CANTON | NC | 28716 | LAUNDRY SERVICES | 310519 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 51 | NumberOfContractorsGT100K |
| Related Organizations | 180878 | RelatedOrganizations |
| Government Grants | 127500 | GovernmentGrants |
| All Other Contributions | 177713 | AllOtherContributions |
| Total Contributions | 486091 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (4 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue | ExclusionExclusionAmount |
|---|---|---|---|---|---|
| NET PATIENT REVENUE | 621990 | 98481085 | 98396780 | 84305 | |
| COUNTY EMS | 621910 | 461327 | 461327 | ||
| LIFELINE | 621990 | 221087 | 221087 | ||
| GAIN-INV. IN AFFILIATE | 523000 | -35690 | -$35,690 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 99127809 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 549192 | TotalRevenueColumn |
| Exclusion | $549,192 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 66 | TotalRevenueColumn |
| Exclusion | $66 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 543797 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 591826 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -48029 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -48029 | TotalRevenueColumn |
| Exclusion | -$48,029 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 4645 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 0 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 4645 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 4645 | TotalRevenueColumn |
| Exclusion | $4,645 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount |
|---|---|---|---|
| MEALS & VENDING | 722210 | 377375 | $377,375 |
| MISCELLANEOUS INCOME | 900099 | 268997 | $268,997 |
| N.A. RELEASED FROM RES | 900099 | 230752 | $230,752 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -29310 | TotalRevenueColumn |
| Exclusion | -$29,310 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 847814 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 100967588 | TotalRevenueColumn |
| Related Or Exempt Function Income | 99079194 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 84305 | UnrelatedBusinessRevenue |
| Exclusion | $1,317,998 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 415204 | Total |
| Program Services | 415204 | ProgramServices |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6500 | Total |
| Program Services | 6500 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1417520 | Total |
| Program Services | 1172147 | ProgramServices |
| Management And General | 245373 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 33866855 | Total |
| Program Services | 28004502 | ProgramServices |
| Management And General | 5862353 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1350460 | Total |
| Program Services | 1116695 | ProgramServices |
| Management And General | 233765 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5221883 | Total |
| Program Services | 4317975 | ProgramServices |
| Management And General | 903908 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2384658 | Total |
| Program Services | 1971874 | ProgramServices |
| Management And General | 412784 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1287413 | Total |
| Program Services | 1064562 | ProgramServices |
| Management And General | 222851 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 680529 | Total |
| Program Services | 562729 | ProgramServices |
| Management And General | 117800 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 530 | Total |
| Program Services | 438 | ProgramServices |
| Management And General | 92 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 15908849 | Total |
| Program Services | 13155027 | ProgramServices |
| Management And General | 2753822 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 73937 | Total |
| Program Services | 61139 | ProgramServices |
| Management And General | 12798 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4029921 | Total |
| Program Services | 3332342 | ProgramServices |
| Management And General | 697579 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1225712 | Total |
| Program Services | 1013541 | ProgramServices |
| Management And General | 212171 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1406610 | Total |
| Program Services | 1163126 | ProgramServices |
| Management And General | 243484 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1321569 | Total |
| Program Services | 1092805 | ProgramServices |
| Management And General | 228764 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4133024 | Total |
| Program Services | 3417598 | ProgramServices |
| Management And General | 715426 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 764695 | Total |
| Program Services | 632326 | ProgramServices |
| Management And General | 132369 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| BAD DEBTS | 11277243 | 11277243 | |
| MEDICAL SUPPLIES | 8988649 | 7432714 | 1555935 |
| REPAIRS & MAINTENANCE | 4729741 | 3911023 | 818718 |
| LEASES | 1979952 | 1637222 | 342730 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6208832 | Total |
| Program Services | 5134083 | ProgramServices |
| Management And General | 1074749 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 108680286 | Total |
| Program Services | 91892815 | ProgramServices |
| Management And General | 16787471 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5842 | BOY |
| EOY | 6504 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2783521 | BOY |
| EOY | 2852407 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10756672 | BOY |
| EOY | 9684648 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1347460 | BOY |
| EOY | 1456458 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 591954 | BOY |
| EOY | 1004087 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 98028022 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 66903120 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 31786967 | BOY |
| EOY | 31124902 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 13926528 | BOY |
| EOY | 11791759 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1108715 | BOY |
| EOY | 824592 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1021969 | BOY |
| EOY | 478674 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4041334 | BOY |
| EOY | 3508058 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 67370962 | BOY |
| EOY | 62732089 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8862178 | BOY |
| EOY | 12726768 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 67510 | BOY |
| EOY | 6127 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 13363736 | BOY |
| EOY | 12217180 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 626648 | BOY |
| EOY | 804626 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 23822848 | BOY |
| EOY | 28996333 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 46742920 | BOY |
| EOY | 54751034 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 20191015 | BOY |
| EOY | 7377923 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 437027 | BOY |
| EOY | 603132 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 20628042 | BOY |
| EOY | 7981055 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 67370962 | BOY |
| EOY | 62732089 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | -7712698 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -4934289 | ReconcilationOtherChanges |
| 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 D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 2327987 | OtherCostOrOtherBasis |
| Book Value | 2327987 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 43246050 | OtherCostOrOtherBasis |
| Depreciation | 29672617 | Depreciation |
| Book Value | 13573433 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 907408 | OtherCostOrOtherBasis |
| Book Value | 907408 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 35793254 | OtherCostOrOtherBasis |
| Depreciation | 26408254 | Depreciation |
| Book Value | 9385000 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 15753323 | OtherCostOrOtherBasis |
| Depreciation | 10822249 | Depreciation |
| Book Value | 4931074 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 31124902 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (5 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| OTHER ASSETS | 9074 |
| DEFERRED FINANCING COSTS, NET | 245121 |
| OTHER RECEIVABLES | 1386154 |
| DUE FROM RELATED PARTIES | 1407675 |
| ESTIMATED THIRD PARTY PAYOR SETTLEMENTS, NET | 460034 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 3508058 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities (6 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| ACCRUED PENSION COST | $9,848,002 |
| INTEREST RATE SWAP | $88,475 |
| OBLIGATIONS UNDER CAPITAL LEASE AGREEMENTS | $10,773,040 |
| ESTIMATED PHYSICIAN GUARANTEE LIABILITY | $338,649 |
| DUE TO RELATED PARTY UNDER INTEGRATION AGREEMENT | $6,383,198 |
| DUE TO RELATED PARTIES | $1,564,969 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 28996333 | TotalOfAmounts |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | Identifier |
| Return Reference | PART X: | ReturnReference |
| Explanation | WESTCARE, HARRIS, AND SWAIN ARE EXEMPT FROM INCOME TAXES UNDER THE PROVISIONS OF SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. ACCORDINGLY, NO PROVISION FOR INCOME TAXES HAS BEEN INCLUDED IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS RELATED TO THESE ORGANIZATIONS. PROCOR, INC. IS A TAXABLE ENTITY AND ACCOUNTS FOR INCOME TAXES IN ACCORDANCE WITH FASB ASC 740, INCOME TAXES. THE ORGANIZATIONS HAVE NO UNCERTAIN TAX POSITIONS AT SEPTEMBER 30, 2012. | Explanation |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent150 | X | Pcent150 |
| 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 | 1059907 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 1059907 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01090 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 4740877 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 4740877 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04870 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 5800784 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 5800784 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.05960 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1337003 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 1337003 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01370 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 17450 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 17450 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00020 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1354453 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 1354453 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01390 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 7155237 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 7155237 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.07350 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $6,094,031 | BadDebtExpenseAmount |
| Amount Attributable To | 0 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 25209333 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 25841667 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -632334 | 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 |
Form990 Schedule H Part IV Form990ScheduleHPartIV
Name Of Entity NameOfEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 1 WESTERN REGIONAL RADIATION THERAPY CENTER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Ent Primary Activity | HEALTH SERVICES | DescriptionEntPrimaryActivity |
| Organization Profit Or Ownership | 0.33330 | OrganizationProfitOrOwnership |
| Officers Etc Profit Or Ownership | 0.00000 | OfficersEtcProfitOrOwnership |
| Physicans Profit Or Ownership | 0.00000 | PhysicansProfitOrOwnership |
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | HARRIS REGIONAL HOSPITAL | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 68 HOSPITAL ROAD | AddressLine1 |
| City | WAYNESVILLE | City |
| State | NC | State |
| ZIP Code | 28779 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HARRIS REGIONAL HOSPITAL | 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 | 150.000000000000 | FPGFreePercent |
| Uses FPG Discounted | 1 | UsesFPGDiscounted |
| FPG Discount Percent | 300.000000000000 | FPGDiscountPercent |
| Explains Basis | 1 | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Asset Level | X | AssetLevel |
| Insurance Status | X | InsuranceStatus |
| Explains Application Method | 1 | ExplainsApplicationMethod |
| Includes Publicity Measures | 1 | IncludesPublicityMeasures |
| Posted On Website | X | PostedOnWebsite |
| Attached To Invoices | X | AttachedToInvoices |
| Posted In Emergency Room | X | PostedInEmergencyRoom |
| Posted In Admission Office | X | PostedInAdmissionOffice |
| Available On Request | X | AvailableOnRequest |
| Actions On Nonpayment | 1 | ActionsOnNonpayment |
| Collection Activities | 0 | CollectionActivities |
| Nondiscrim Emergency Care Policy | 1 | NondiscrimEmergencyCarePolicy |
| Used Other Method | X | UsedOtherMethod |
| Amounts Generally Billed | 0 | AmountsGenerallyBilled |
| Gross Charges | 0 | GrossCharges |
Form990 Schedule H Part VI Form990ScheduleHPartVI (12 entries)
| ExplanationExplanation | IdentifierIdentifier | Return ReferenceReturnReference |
|---|---|---|
| PART I, LINE 7: COST IS DERIVED FROM THE ACTUAL EXPENSE DATA ACCUMULATED WITHIN THE HOSPITAL GENERAL LEDGER WHICH ADDRESSES ALL PATIENT SEGMENTS (INPATIENT, OUTPATIENT, EMERGENCY ROOM, PRIVATE INSURANCE, MEDICAID, MEDICARE, UNINSURED, AND SELF-PAY). THE HOSPITAL ALLOCATES THOSE EXPENSES TO ALL PATIENT SEGMENTS AT THE PROCEDURE LEVEL BASED ON A COST-TO-CHARGE RATIO. | ||
| PART I, L7 COL(F): BAD DEBT EXPENSE INCLUDED IN FORM 990, PART IX, LINE 24, COLUMN (A) IS $11,277,243. THE HOSPITAL EXCLUDED THE FULL AMOUNT, $11,277,243, FOR PURPOSES OF CALCULATING THE PERCENTAGE IN COLUMN (F), ON PART I, LINE 7. | ||
| PART III, LINE 4: A COST-TO-CHARGE RATIO WAS ALSO USED TO DETERMINE BAD DEBT COST. THE TOTAL OPERATING EXPENSE WAS DIVIDED BY PATIENT REVENUES TO CALCULATE AN OVERALL RATIO THAT WAS THEN APPLIED TO THE BAD DEBT EXPENSE TO ARRIVE AT COST.PER THE WESTCARE, INC. AND AFFILIATES AUDITED CONSOLIDATED FINANCIAL STATEMENTS AS OF AND FOR THE YEAR ENDED SEPTEMBER 30, 2012: FOR UNINSURED AND UNDERINSURED PATIENTS THAT DO NOT QUALIFY FOR FINANCIAL ASSISTANCE, THE ORGANIZATIONS RECOGNIZE REVENUE ON THE BASIS OF ITS STANDARD RATES, DISCOUNTED ACCORDING TO POLICY, FOR SERVICES RENDERED. HISTORICAL EXPERIENCE HAS SHOWN A SIGNIFICANT PROPORTION OF THE ORGANIZATIONS' UNINSURED PATIENTS, IN ADDITION TO A GROWING PROPORTION OF THE ORGANIZATIONS' INSURED PATIENTS, WILL BE UNABLE OR WILLING TO PAY FOR THEIR RESPONSIBLE AMOUNTS FOR THE SERVICES PROVIDED. IN ORDER TO ESTIMATE THE NET REALIZABLE VALUE OF THE REVENUES AND ACCOUNTS RECEIVABLES ASSOCIATED WITH THIRD-PARTY PAYORS AND UNINSURED PATIENTS, MANAGEMENT REGULARLY ANALYZES COLLECTION HISTORY. BASED ON THESE HISTORICAL COLLECTION ANALYSES, THE ORGANIZATIONS RECORD A PROVISION FOR BAD DEBTS AND AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS FOR THIRD-PARTY AND UNINSURED PATIENT ACCOUNTS RECEIVABLE BALANCES FOR WHICH THE PATIENT IS RESPONSIBLE. | ||
| PART III, LINE 8: MEDICARE ALLOWABLE COSTS WERE REPORTED USING THE HOSPITAL'S FILED MEDICARE COST REPORT (C/R). THE C/R USES A COST TO CHARGE RATIO BASED ON A STEP-DOWN ALLOCATION METHODOLOGY. IN CARING FOR THE PATIENT, THERE ARE SEVERAL SERVICES THAT ARE CONSIDERED NON-ALLOWABLE BY CMS SUCH AS: TRANSPORTATION OF A PATIENT, COMFORT ITEMS TO INCLUDE A TELEVISION OR A TELEPHONE. ADDITIONAL NON-ALLOWABLE COSTS INCLUDE THE RECRUITMENT OF PHYSICIANS, PHYSICIAN GUARANTEES AND A PORTION OF THE BAD DEBT ASSOCIATED WITH THE CARE OF THE PATIENT. | ||
| PART III, LINE 9B: IT IS THE POLICY OF THE HOSPITAL TO PURSUE COLLECTION OF PATIENT BALANCES FROM PATIENTS WHO HAVE THE ABILITY TO PAY FOR THESE SERVICES. THE HOSPITAL'S COLLECTION PRACTICES APPLY TO ALL PATIENTS, CHARITY CARE AND NON-CHARITY CARE, CONSISTENTLY AND FAIRLY REGARDLESS OF INSURANCE STATUS. AFTER THE PATIENT VISIT HAS BEEN CONCLUDED, A SUMMARY OF THE CHARGES WILL BE MAILED TO THE PATIENT FOR REVIEW. IF INSURANCE INFORMATION WAS PROVIDED UPON REGISTRATION, A CLAIM WILL BE SUBMITTED TO THE INSURANCE CARRIER ON THE PATIENT'S BEHALF. AFTER INSURANCE PROCESSING, THE PATIENT WILL RECEIVE A STATEMENT EXPLAINING THE INSURANCE RESPONSE AND OUTLINING THE PATIENTS REMAINING BALANCE. SELF-PAY PATIENTS ARE ELIGIBLE TO RECEIVE A 20% PROMPT DISCOUNT IF THE ACCOUNT IS PAID IN FULL PRIOR TO OR ON THE DATE OF SERVICES. A 15% DISCOUNT WILL BE ISSUED IF PAYMENT IS MADE WITHIN 25 DAYS OF SERVICE. ADDITIONALLY, PATIENTS LACKING ADEQUATE RESOURCES TO PAY FOR MEDICAL CARE MAY QUALIFY FOR THE HOSPITAL'S CARE ASSISTANCE PROGRAM WHICH PROVIDES EXTENDED PAYMENT PLANS AND/OR PROMPT PAY DISCOUNTS UP TO 20% FOR PAYMENT IN FULL WITHIN 5 DAYS OF THE DISCHARGE AND ASSISTS PATIENTS IN APPLYING FOR STATE PROGRAMS TO MEET THEIR MEDICAL NEEDS. IF PAYMENT FOR SERVICES IS NOT RECEIVED IN FULL WITHIN 25 DAYS, THE ACCOUNT IS FORWARDED TO PROCOR BILLING SERVICES. THIS SERVICE ALLOWS FOR PATIENTS TO MAKE FINANCIAL ARRANGEMENTS THAT ARE BOTH ACCEPTABLE TO THE PATIENT AND TO THE HOSPITAL. FINANCIAL COUNSELORS DILIGENTLY WORK WITH PATIENTS AND EVALUATE NEW INFORMATION LEARNED DURING THE COLLECTION PROCESS TO DETERMINE IF COLLECTION ACTIVITIES SHOULD BE CEASED OR IF THE PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE. PAST DUE AMOUNTS ARE FORWARDED TO AN OUTSIDE COLLECTION AGENCY, WITH SUBSTANTIAL EXPERIENCE IN COLLECTION OF PATIENT ACCOUNTS, ONLY AFTER ALL ESTABLISHED STEPS HAVE BEEN UNDERTAKEN WITHOUT SUCCESS. | ||
| PART V, SECTION B, LINE 19D: THE HOSPITAL USED MEDICARE RATES TIMES THE MARKUP PERCENTAGE FOR THAT FISCAL YEAR. | HARRIS REGIONAL HOSPITAL | |
| PART VI, LINE 2: HARRIS REGIONAL HOSPITAL IS COMPLETING A FORMAL COMMUNITY HEALTH NEEDS ASSESSMENT TO COMPLY WITH INTERNAL REVENUE CODE SECTION 501(R) REQUIREMENTS. THE HARRIS REGIONAL HOSPITAL'S COMMUNITY HEALTH NEEDS ASSESSMENT WILL BE FINALIZED AND MADE WIDELY AVAILABLE TO THE PUBLIC BY SEPTEMBER 30, 2013. | ||
| PART VI, LINE 3: TO COMMUNICATE THE HOSPITAL'S FINANCIAL POLICY TO THE PATIENT, THE HOSPITAL'S WEBSITE HAS A "PATIENTS AND VISITORS" MENU WHERE PATIENTS CAN GO TO VIEW INFORMATION ABOUT PAYMENT POLICIES, INSURANCE INFORMATION, AND THE HOSPITAL FINANCIAL ASSISTANCE (CARE ASSISTANCE) PROGRAM. THE WEBSITE GIVES THREE PHONE NUMBERS THAT PATIENTS CAN USE TO CONTACT A FINANCIAL COUNSELOR TO DISCUSS THEIR INDIVIDUAL FINANCIAL ALTERNATIVES. THE HOSPITAL'S CHARITY CARE POLICY AND FINANCIAL ASSISTANCE CONTACT INFORMATION IS POSTED IN THE ADMISSIONS AREAS, EMERGENCY AREAS, AND OTHER AREAS OF THE HOSPITAL'S FACILITIES IN WHICH ELIGIBLE PATIENTS MAY BE PRESENT. ALL STAFF WITH PATIENT CONTACT ARE KNOWLEDGEABLE ABOUT THE CHARITY CARE POLICY (ADMITTING AND BILLING CLERKS, NURSING AND MEDICAL STAFFS, SOCIAL WORKERS, CHAPLAINS, PATIENT ADVOCATES, ETC.). | ||
| PART VI, LINE 4: THE HOSPITAL IS LOCATED IN SYLVA, JACKSON COUNTY, WHICH IS IN RURAL WESTERN NORTH CAROLINA. JACKSON COUNTY IS A FEDERALLY DESIGNATED MEDICALLY UNDERSERVED AREA WITH NEARLY 21% OF ITS POPULATION AS UNINSURED. THE POPULATION OF JACKSON COUNTY IS JUST OVER 40,000 AND HAS A MEDIAN HOUSEHOLD INCOME OF $36,826 WITH 19.5% OF THE POPULATION LIVING BELOW THE POVERTY LEVEL. | ||
| PART VI, LINE 5: THE HOSPITAL IS DEDICATED TO SERVING THE COMMUNITY BY IMPROVING THE QUALITY OF LIFE OF THE COMMUNITY THROUGH BETTER HEALTH. THE HOSPITAL IS COMMITTED TO PROVIDING QUALITY HEALTH CARE SERVICES IN A CARING ENVIRONMENT THAT FULFILLS THE NEEDS OF OUR PATIENTS, PHYSICIANS, EMPLOYERS, EMPLOYEES, AND COMMUNITY. THE HOSPITAL OPERATES AN EMERGENCY ROOM OPEN TO ALL PERSONS, WITHOUT REGARD TO THE ABILITY TO PAY. THE HOSPITAL USES ANY SURPLUS FUNDS TO IMPROVE THE QUALITY OF PATIENT CARE, EXPAND, OR IMPROVE ITS FACILITIES, AND ADVANCE ITS MEDICAL TRAINING, EDUCATION AND RESEARCH PROGRAMS. THE HOSPITAL'S BOARD OF DIRECTORS CONSISTS OF INDIVIDUALS REPRESENTING THE COMMUNITY. THE HOSPITAL MAINTAINS AN OPEN MEDICAL STAFF, WITH MEMBERSHIP AND PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS AND HEALTHCARE PROFESSIONALS. IN THESE AND OTHER RESPECTS, THE HOSPITAL IS ORGANIZED AND OPERATED IN A MANNER THAT PROMOTES THE HEALTH OF THE COMMUNITY AND THEREFORE FULFILLS CHARITABLE PURPOSES WITHIN THE MEANING OF INTERNAL REVENUE CODE SECTION 501(C)(3). | ||
| PART VI, LINE 6: HARRIS REGIONAL HOSPITAL IS OWNED BY THE WESTCARE HEALTH SYSTEM, A GROWING, WELL-RESPECTED, NON-PROFIT HEALTH CARE PROVIDER THAT DELIVERS A FULL SPECTRUM OF HEALTH CARE FOR OVER 80,000 PEOPLE LIVING IN FOUR COUNTIES. WESTCARE HEALTH SYSTEM ("WESTCARE") WAS FORMED IN FEBRUARY 1997 WITH THE ESTABLISHMENT OF A COMBINATION BUSINESS AGREEMENT BETWEEN HARRIS REGIONAL HOSPITAL AND SWAIN COUNTY HOSPITAL TO DEVELOP A FULL SPECTRUM OF HEALTH SERVICES FOR WESTERN NORTH CAROLINA. WESTCARE ALSO OWNS THREE MEDICAL PARKS, WESTCARE MEDICAL PARK OF FRANKLIN LOCATED IN MACON COUNTY, WESTCARE MEDICAL PARK OF BRYSON CITY LOCATED IN SWAIN COUNTY, AND WESTCARE MEDICAL PARK OF SYLVA LOCATED IN JACKSON COUNTY. WESTCARE ALSO OPERATES MOUNTAIN REGIONAL CANCER CENTERS, TWO STATE OF THE ART RADIATION THERAPY FACILITIES PROVIDING ALL ASPECTS OF COMPREHENSIVE RADIATION THERAPY SERVICES. WESTCARE EMPLOYS ALMOST 1200 FULL AND PART TIME EMPLOYEES AND HAS A MEDICAL STAFF OF OVER 90 PHYSICIANS REPRESENTING 22 SPECIALTIES. WESTCARE IS GOVERNED BY A BOARD OF TRUSTEES, WHICH IS DRAWN FROM COMMUNITY LEADERS IN EACH OF THE FOUR PRIMARY COUNTIES IT SERVES. WESTCARE IS MANAGED AND OPERATED BY THE PEOPLE OF WESTERN NORTH CAROLINA, FOR THE PEOPLE OF WESTERN NORTH CAROLINA.IN JANUARY 2010, WESTCARE ENTERED INTO A JOINT OPERATING AGREEMENT WITH HAYWOOD REGIONAL MEDICAL CENTER IN WAYNESVILLE, NORTH CAROLINA, TO FORM MEDWEST HEALTH SYSTEM ("MEDWEST"). MEDWEST CONSISTS OF 323 LICENSED BEDS SYSTEM-WIDE. MEDWEST IS ALSO AFFILIATED WITH CAROLINAS HEALTHCARE SYSTEM, ONE OF THE SOUTHEAST'S LEADING HEALTHCARE SYSTEMS. PATIENTS BENEFIT FROM THE HOSPITAL'S AFFILIATION WITH A HEALTHCARE SYSTEM WHERE THEY CAN BE EFFICIENTLY MOVED ALONG AN INTEGRATED, COMPREHENSIVE CONTINUUM OF CARE AS THEIR HEALTH STATUS DICTATES. | ||
| 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 (5 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EIN Of RecipientEINOfRecipient | IRC SectionIRCSection | Amount Of Cash GrantAmountOfCashGrant | Purpose Of GrantPurposeOfGrant |
|---|---|---|---|---|---|---|---|
| AMERICAN RED CROSS | |||||||
| 2025 E STREET NW | WASHINGTON | DC | 200065009 | 530196605 | 501(C)(3) | 333564 | GENERAL DONATION |
| WCU FOUNDATION | |||||||
| 315 HF ROBINSON ADMINISTRATION BLDG | CULLOHOWEE | NC | 28723 | 237159170 | 501(C)(3) | 17750 | GENERAL DONATION |
| MARCH OF DIMES | |||||||
| 1275 MAMARONECK AVENUE | WHITE PLAINS | NY | 10605 | 131846366 | 501(C)(3) | 7500 | GENERAL DONATION |
| GOOD SAMARITAN CLUB OF JACKSON COUNTY | |||||||
| 538 SCOTTS CREEK ROAD | SYLVA | NC | 28779 | 562266536 | 501(C)(3) | 37500 | GENERAL DONATION |
| NORTH CAROLINA HOSPITAL ASSOCIATION | |||||||
| PO BOX 4449 | CARY | NC | 27519 | 560641290 | 501(C)(6) | 7137 | GENERAL DONATION |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 4 | TotalNbrOf501C3AndGovtGrants |
| Total Nbr Of Other Organizations | 1 | TotalNbrOfOtherOrganizations |
Form990 Schedule I Part III Form990ScheduleIPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Type Of Grant | SCHOLARSHIPS | TypeOfGrant |
| Number Of Recipients | 11 | NumberOfRecipients |
| Amount Of Cash Grant | 6500 | 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: THE ORGANIZATION HAS GUIDELINES IN PLACE THAT ARE TO BE USED IN REVIEWING THE ELIGIBILITY OF GRANTEES. ALL GRANTS REQUIRE WRITTEN DOCUMENTATION AND APPROPRIATE LEVELS OF APPROVAL. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | 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 | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (12 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| LAWRENCE F SUPIK MD | |||||||||||||
| 466948 | 36923 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 466948 | 36923 | 0 | 0 |
| MICHAEL POORE | |||||||||||||
| 444193 | 444193 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 444193 | 444193 | 0 | 0 |
| STEPHEN HEATHERLY | |||||||||||||
| 91449 | 159881 | 0 | 27916 | 3496 | 4491 | 0 | 0 | 0 | 0 | 94945 | 192288 | 0 | 0 |
| WYLEY GENE WINTERS | |||||||||||||
| 264073 | 264073 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 264073 | 264073 | 0 | 0 |
| DALE CHERNICH | |||||||||||||
| 164970 | 164970 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 164970 | 164970 | 0 | 0 |
| DWAYNE HOOKS | |||||||||||||
| 235732 | 235732 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 235732 | 235732 | 0 | 0 |
| TYSON SMITH MD | |||||||||||||
| 205584 | 205584 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 205584 | 205584 | 0 | 0 |
| TODD D DAVIS MD | |||||||||||||
| 442299 | 35330 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 442299 | 35330 | 0 | 0 |
| MARTIN A SENICKI MD | |||||||||||||
| 486065 | 37023 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 486065 | 37023 | 0 | 0 |
| WILLIAM M RALSTON MD | |||||||||||||
| 413516 | 34750 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 413516 | 34750 | 0 | 0 |
| JEROME M MARCHUK MD | |||||||||||||
| 437350 | 36706 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 437350 | 36706 | 0 | 0 |
| RYAN M SLECHTA MD | |||||||||||||
| 369916 | 30869 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 369916 | 30869 | 0 | 0 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (8 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| FORM 990, PART VI, SECTION A, LINE 3 | PURSUANT TO THE INTEGRATION AGREEMENT, BY AND AMONG WESTCARE, INC., HAYWOOD REGIONAL MEDICAL CENTER, THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY, INC. (D/B/A CAROLINAS HEALTHCARE SYSTEM) AND MEDWEST HEALTH SYSTEM, INC. (THE "SYSTEM"), WESTCARE, INC. HAS DELEGATED TO THE SYSTEM THE GENERAL AUTHORITY TO DIRECT AND OPERATE WESTCARE, INC. AND ITS RELATED ENTITIES, AND HAYWOOD REGIONAL MEDICAL CENTER ("HAYWOOD") HAS DELEGATED TO THE SYSTEM THE GENERAL AUTHORITY TO DIRECT AND OPERATE HAYWOOD AND ITS RELATED ENTITIES; PROVIDED, HOWEVER, THAT THE GENERAL AUTHORITY DELEGATED TO THE SYSTEM BY WESTCARE, INC. AND HAYWOOD IS LIMITED BY THE RETENTION BY WESTCARE, INC. AND HAYWOOD OF CERTAIN POWERS AND AUTHORITY OVER THEIR RESPECTIVE ACTIVITIES AND THE ACTIVITIES OF THEIR RESPECTIVE RELATED ENTITIES, AS DESCRIBED IN THE INTEGRATION AGREEMENT. | |
| FORM 990, PART VI, SECTION B, LINE 11 | THE TAX RETURN IS PREPARED BY AN UNRELATED, INDEPENDENT ACCOUNTING FIRM AND SUBMITTED TO SENIOR MANAGEMENT WITHIN THE ORGANIZATION FOR INTERNAL REVIEW. COPIES ARE THEN PROVIDED TO EACH BOARD MEMBER FOR REVIEW PRIOR TO FILING. | |
| FORM 990, PART VI, SECTION B, LINE 12C | THE ORGANIZATION REQUIRES THAT EACH BOARD OF TRUSTEES MEMBER AND PRINCIPAL OFFICER REVIEWS THE CONFLICT OF INTEREST POLICY AND PROVIDES DISCLOSURE OF ANY ACTIVITIES WHICH COULD CONSTITUTE A CONFLICT OF INTEREST OR POTENTIAL CONFLICT OF INTEREST. ADDITIONALLY, BOARD OF TRUSTEES MEMBERS ARE ASKED TO RECUSE THEMSELVES ON ANY MATTERS OF INTEREST BEFORE THE BOARD IN WHICH A CONFLICT OF INTEREST MAY EXIST. ANY SUCH RECUSAL IS DOCUMENTED WITHIN THE MINUTES OF THE BOARD OR COMMITTEE. | |
| FORM 990, PART VI, SECTION B, LINE 15 | THE BOARD OF TRUSTEES REVIEWS AND APPROVES THE COMPENSATION OF EXECUTIVES AND OTHER OFFICERS. STATE AND NATIONAL COMPARABILITY DATA IS USED TO ASSIST IN DETERMINING APPROPRIATE COMPENSATION. | |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. | |
| FORM 990, PART VII, SECTION A, | MEDWEST AND THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY D/B/A CAROLINAS HEALTHCARE SYSTEM (CHS), A NORTH CAROLINA HOSPITAL AUTHORITY, ARE PARTIES IN A MANAGEMENT SERVICES AGREEMENT (MSA). THROUGH THIS AGREEMENT, MEDWEST HAS GRANTED CHS FULL POWER, AUTHORITY AND RESPONSIBILITY FOR THE MANAGEMENT OF MEDWEST, SUBJECT TO THE GENERAL OVERSIGHT OF THE MEDWEST BOARD OF DIRECTORS. THE TERMS OF THE MSA REQUIRE MEDWEST TO PAY CHS AN ANNUAL MANAGEMENT FEE BASED ON MEDWEST'S NET OPERATING REVENUES. IN ADDITION, CHS IS REQUIRED TO FURNISH MEDWEST WITH A CHIEF EXECUTIVE OFFICER, CHIEF FINANCIAL OFFICER AND VARIOUS OTHER EXECUTIVE POSITIONS AND MEDWEST IS REQUIRED TO REIMBURSE CHS FOR THE SALARY AND BENEFITS OF THESE INDIVIDUALS. CHS MAY ALSO PROVIDE PROJECT-SPECIFIC CONSULTING OR PROJECT-MANAGEMENT SERVICES AS REQUESTED FOR ADDITIONAL FEES. | MANAGEMENT COMPANY COMPENSATION: |
| FORM 990, PART VII, SECTION A, | LAWRENCE SUPIK, M.D., BOARD OF TRUSTEES MEMBER, RECEIVED COMPENSATION FOR MEDICAL SERVICES PROVIDED TO THE ORGANIZATION, NOT FOR SERVICES AS A BOARD OF TRUSTEES MEMBER. | BOARD OF TRUSTEES COMPENSATION: |
| FORM 990, PART XI, LINE 5: | NET UNREALIZED GAINS ON INVESTMENTS: 953,801. NET ASSETS RELEASED FOR CAPITAL 92,231. CHANGE IN TEMPORARILY RESTRICTED NET ASSETS 166,105. CHANGE IN ACCRUED PENSION COST -470,067. REQUIRED SETTLEMENT - INTEGRATION AGREEMENT -5,495,481. CONTRIBUTION FROM RELATED PARTY -180,878. TOTAL TO FORM 990, PART XI, LINE 5: -4,934,289. | CHANGES IN NET ASSETS OR FUND BALANCES: |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (4 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrgControlledOrg | Direct Controlling Entity NADirectControllingEntityNA |
|---|---|---|---|---|---|---|---|---|---|---|---|
| WESTCARE INC | |||||||||||
| 68 HOSPITAL ROAD | SYLVA | NC | 28779 | 561967734 | HOSPITAL | NC | 501(C)(3) | LINE 3 | MEDWEST HEALTH SYSTEM INC | 0 | |
| SWAIN COUNTY HOSPITAL INC | |||||||||||
| 68 HOSPITAL ROAD | SYLVA | NC | 28779 | 560629325 | HOSPITAL | NC | 501(C)(3) | LINE 3 | WESTCARE INC | 0 | |
| MEDWEST HEALTH SYSTEM INC | |||||||||||
| 68 HOSPITAL ROAD | SYLVA | NC | 28779 | 271472706 | HEALTHCARE MANAGEMENT | NC | 501(C)(3) | LINE 11C, III-FI | 0 | N/A | |
| HAYWOOD REGIONAL MEDICAL CENTER | |||||||||||
| 262 LEROY GEORGE DRIVE | CLYDE | NC | 28721 | 566000535 | HOSPITAL AUTHORITY | NC | 501(C)(1) | MEDWEST HEALTH SYSTEM INC | 0 | ||
Form990 Schedule R Part III Form990ScheduleRPartIII
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WESTERN REGIONAL RADIATION THERAPY CENTER | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 68 HOSPITAL ROAD | AddressLine1 |
| City | SYLVA | City |
| State | NC | State |
| ZIP Code | 28779 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 561849395 | EIN |
| Primary Activity | HEALTH SERVICES | PrimaryActivity |
| Legal Domicile State | NC | LegalDomicileState |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HARRIS REGIONAL HOSPITAL INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Predominant Income Type | RELATED | PredominantIncomeType |
| Share Of Total Income | -51886 | ShareOfTotalIncome |
| Share Of EOY Assets | 714021 | ShareOfEOYAssets |
| Disproportionate Allocations | 0 | DisproportionateAllocations |
| General Or Managing Partner | 1 | GeneralOrManagingPartner |
| Percentage Ownership | 0.33330 | PercentageOwnership |
Form990 Schedule R Part IV Form990ScheduleRPartIV (3 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Direct Controlling Entity NADirectControllingEntityNA | Type Of EntityTypeOfEntity |
|---|---|---|---|---|---|---|---|---|
| WESTCARE HEALTH CORPORATION | ||||||||
| 68 HOSPITAL ROAD | SYLVA | NC | 38779 | 562039181 | HEALTHCARE MANAGEMENT | NC | N/A | C |
| PROCOR INC | ||||||||
| 68 HOSPITAL ROAD | SYLVA | NC | 28779 | 562039184 | HEALTHCARE MANAGEMENT | NC | N/A | C |
| WESTERN CAROLINA PHYSICIAN NETWORK DBA MEDWEST PHYSICIAN NETWORK | ||||||||
| 262 LEROY GEORGE DRIVE | CLYDE | NC | 28721 | 261870386 | HEALTHCARE SERVICES | NC | N/A | C |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 1 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 1 | 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 | 0 | 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 | 0 | 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 | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |