2012-10-15T15:58:12-05:00 2011-12-31 561037874 STOUT STUART MCGOWEN & KING LLP POST OFFICE BOX 1440 BURLINGTON NC 272161440 990 2011-01-01 560529994 ALAMANCE REGIONAL MEDICAL CENTER INC ALAM 3365387460 PO BOX 202 BURLINGTON NC 272160202 REX STREET 3365387460 2012-09-21 PATRICIA B RHODES P00018002 3362267343 2012-09-21 2011 2016-02-24 21:20:13Z REX STREET 1240 HUFFMAN MILL ROAD BURL NC 27215 258411790 0 X WWW.ARMC.COM X 1937 NC COMPREHENSIVE COMMUNITY HOSPITAL AND HEALTH CARE SERVICES 23 19 2127 562 0 0 38320 29516 220464972 230322065 4438674 3716526 -5816 2015834 224936150 236083941 0 0 0 0 98169966 102983162 0 0 0 117051462 121098836 215221428 224081998 9714722 12001943 250436238 256616809 82764439 82955032 167671799 173661777 HEALTHCARE ORG. COMMITTED TO IMPROVE THE HEALTH OF THE CITIZENS OF ALAMANCE COUNTY AND ITS SURROUNDING COMMUNITIES THROUGH THE PROVISION OF A CONTINUUM OF HIGH QUALITY CLINICAL, EDUC., PREVENTIVE-WELLNESS, AND SUPPORT SERV. IN A SAFE AND FRIENDLY ENVIRONMENT. 0 0 165030817 230322065 ACUTE HOSPITAL CARE PROVIDED TO THE COMMUNITY 165030817 1 0 0 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 260 0 2127 1 1 1 1 CJ 0 0 0 0 0 0 X 23 19 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 NC CA IL X X REX STREET 3365387460 PO BOX 202 BURLINGTON NC 272160202 FD HORNADAY III 0.00 X 0 0 0 THOMAS E CHANDLER 0.00 X 0 0 0 DAVID JORDAN MD 2.00 X 23470 0 0 JAMES A BARNWELL JR 0.00 X 0 0 0 ALLEN E GANT JR 0.00 X 0 0 0 NANCY HEMRIC 0.00 X 0 0 0 JAMES G MCCLURE 0.00 X 0 0 0 ALAN J WHITE PHD 0.00 X 0 0 0 BERT KLEIN III MD 2.00 X 15218 0 0 MICHAEL HOLT 0.00 X 0 0 0 THOMAS E CHANDLER JR 0.00 X 0 0 0 AARON P NOBLE JR PHD 0.00 X 0 0 0 BARBARA TAPSCOTT PHD 0.00 X 0 0 0 CARL STEINBICKER 0.00 X 0 0 0 SHAWN SMITH 0.00 X 0 0 0 PAUL H JUENGEL MD 2.00 X 39000 0 0 BILL SMITH 0.00 X 0 0 0 CHAPMAN T MCQUEEN MD 3.00 X 53548 0 0 ALAN H NORTON 0.00 X 0 0 0 JOHN A PETERSON JR 0.00 X 0 0 0 JUAN SANCHIZ 0.00 X 0 0 0 WILLIAM BRADLEY HAYES 0.00 X 0 0 0 MARILYN BURNS 0.00 X 0 0 0 GLENN CHYRSTAL 40.00 X 1115578 0 42256 JANAK CHOKSI 40.00 X 816684 0 41478 SANDEEP PANDIT 40.00 X 453000 0 22328 JOHN CURRIN JR 40.00 X 521896 0 334493 TIMOTHY FINNEGAN 40.00 X 428037 0 21067 JANE YBANEZ 40.00 X 413987 0 16182 REX A STREET 40.00 X 317168 0 150212 RICHARD DONAHEY 40.00 X 281936 0 207549 CAROL L HUDSON 40.00 X 267808 0 164888 ROBERT E BYRD 40.00 X 200284 0 113849 PRESTON HAMMOCK 40.00 X 141812 0 12771 GWENDOLYN GILLIS 40.00 X 161898 0 15287 VICKI MORAN 40.00 X 89091 0 15500 5340415 0 1157860 32 0 1 0 EMCARE INC 7032 NW COLLECTION CENTER DRIVE CHICAGO IL 60693 ER PHYSICIANS 6233719 SIEMENS FINANCIAL 2809 COLLECTION CENTER DRIVE CHICAGO IL 60693 MIS SUPPORT SERVICES 3069172 PRIMEDOC OF BURLINGTON PA PO BOX 7568 ASHEVILLE NC 28802 HOSPITALIST SERVICES 1897867 ECLIPSYS CORP LOCK BOX 077133 PHILADELPHIA PA 191710133 SOFTWARE MAINTENANCE 1292729 PRIVATE DIAGNOSTIC CLINIC PO BOX 3179 DURHAM NC 27710 PHYSICIAN SERVICES 491673 34 29516 29516 OUTPATIENT REVENUES 175992776 175992776 INPATIENT REVENUES 47015150 47015150 OTHER OPERATING REVENU 4709095 4709095 OCCUPATIONAL HEALTH 1708516 1708516 CAFETERIA REVENUES 896528 896528 230322065 1683964 367288 1316676 24263432 96979 22177739 150110 2085693 -53131 2032562 2032562 RENT REVENUE 1153273 1153273 OTHER NON-OP. REV. 541900 862561 862561 2015834 236083941 232721915 0 3332510 1508080 1508080 80148287 57976024 22172263 21326795 15569200 5757595 2333460 23335 2310125 2680535 26805 2653730 11550349 8778265 2772084 MEDICAL SUPPLIES 41561129 41335488 225641 PURCHASED SERVICES 26763783 17288657 9475126 BAD DEBT EXPENSE 18548744 18548744 0 OTHER EXPENSES 6168447 801916 5366531 11492389 4682383 6810006 224081998 165030817 59051181 0 28719425 32516450 25406459 28287346 9364258 9997994 5428004 5578742 1739099 1737878 230440877 126352614 105534398 104088263 68540223 67578672 5704372 6831464 250436238 256616809 22500653 27546404 43810663 41401894 9789207 7496699 6663916 6510035 82764439 82955032 X 167470529 173518684 201270 143093 167671799 173661777 250436238 256616809 X 12001943 -6011964 X 0 1 1 X 0 X 11068480 11068480 107563373 40304972 67258401 4068893 2696000 1372893 106042580 83351642 22690938 1697551 1697551 104088263 BOARD DESIGNATED/DONOR RESTRICTED 62728362 F HELD BY TRUSTEE 4850310 F 67578672 LIABILITY FOR PROJECTED BENEFIT OBLIGATION 6510035 6510035 236083941 224081998 12001943 -4113614 618827 -2517177 -6011964 5989979 231970327 -4113614 -4113614 236083941 0 236083941 226511483 2429485 2429485 224081998 0 224081998 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE ORGANIZATION HAD A FOOTNOTE DISCLOSURE IN THE FINANCIAL STATEMENTS THAT ADDRESSED FIN 48. AT 12/31/2011, THE ORGANIZATION DID NOT RECORD ANY LIABILITIES RELATED TO UNCERTAIN TAX POSITIONS. PART XI, LINE 8 - OTHER ADJUSTMENTS: NET ASSETS RELEASED FROM RESTRICTION -87,692. TRANSFER TO AFFILIATE -2,429,485. TOTAL TO SCHEDULE D, PART XI, LINE 8: -2,517,177. PART XIII, LINE 2D - OTHER ADJUSTMENTS: TRANSFER TO AFFILIATE 2,429,485. 1 1 1 X 1 X 1 1 1 0 1 1 19431 8606713 8606713 0.04190 6232 22832952 17241042 5591910 0.02720 25663 31439665 17241042 14198623 0.06910 66 87600 1797519 499811 1297708 0.00630 11 1158 2561905 20620 2541285 0.01240 2 1700 1270192 134818 1135374 0.00550 3 3 358111 175544 182567 0.00090 21 10092 553025 725 552300 0.00270 103 100553 6540752 831518 5709234 0.02780 103 126216 37980417 18072560 19907857 0.09690 0 2 8240 8240 0.00000 2 50 8357 8357 0.00000 0 0 3 3311 48732 173 48559 0.00020 0 4 1640 1223947 1223947 0.00600 11 5001 1289276 173 1289103 0.00620 1 7863785 3900000 86999882 95251310 -8251428 X 1 1 1 MEBANE MEDICAL INVESTORS LLC OWNERSHIP OF BUILDING HOUSING OUTPATIENT SURGERY CENTER, MEDICAL OFFICES 0.51000 0.13910 2 AND URGENT CARE CENTER 3 PREMIERE PURCHASING PARTNERS LP GROUP PURCHASING 0.00002 1 1 ALAMANCE REGIONAL MEDICAL CENTER INC

PO BOX 202 1240 HUFFMAN MILL ROAD BURLINGTON NC 27215

X X X ALAMANCE REGIONAL MEDICAL CENTER 1 1 1 150.000000000000 1 300.000000000000 1 X X X X 1 1 X X X X X X 1 0 1 X 0 0 PART I, LINE 7G: THE HOSPITAL REIMBURSES CERTAIN PHYSICIANS FOR TAKING EMERGENCY DEPARTMENT CALL FOR UNINSURED PATIENTS. THE COSTS ASSOCIATED WITH PHYSICIAN CALL INCLUDED IN PART 1, LINE 7G ARE $1,012,395. PART I, L7 COL(F): BAD DEBTS OF $18,548,745 WERE ELIMINATED FROM TOTAL EXPENSES REPORTED ON 990 PART IX, LINE 25 TO CALCULATE THE PERCENTAGES PER INSTRUCTIONS. PART II: ALAMANCE REGIONAL IS INVOLVED IN NUMEROUS ACTIVITIES DESIGNED TO PROMOTE BUILDING OUR COMMUNITY. THESE ARE NOT LISTED AS PART OF THE CHARITY CARE OR OTHER COMMUNITY BENEFITS, AND ARE NOT INCLUDED ELSEWHERE IN THE REPORT. THESE ACTIVITIES INCLUDE:PHYSICAL IMPROVEMENTS AND HOUSING: ALAMANCE REGIONAL PARTNERS WITH LOCAL MUNICIPALITIES, INCLUDING ELON AND THE CITY OF BURLINGTON ON THE DEVELOPMENT OF PARKS AND PLAYGROUNDS TO PROMOTE PHYSICAL RECREATION. WE HAVE DONATED SIGNIFICANT FUNDS TO DEVELOP WALKING TRAILS AND INSTALL FITNESS EQUIPMENT AT SEVERAL CITY PARKS.ECONOMIC DEVELOPMENT: WE WORK TO CREATE NEW EMPLOYMENT OPPORTUNITIES IN AN AREA THAT TRADITIONALLY HAS HIGH UNEMPLOYMENT RATES. THE ORGANIZATION IS HEAVILY INVOLVED WITH THE CHAMBER OF COMMERCE AND THE MEBANE BUSINESS ASSOCIATION, WITH STAFF MEMBERS SITTING ON SEVERAL BOARDS AND COMMITTEES DESIGNED TO PROMOTE ECONOMIC GROWTH.COMMUNITY SUPPORT: ALAMANCE REGIONAL PROVIDES SUPPORT FOR NUMEROUS COMMUNITY AGENCIES INCLUDING OUR LOCAL CITY FIRE AND POLICE DEPARTMENT. THE HOSPITALS CLINICAL ENGINEERING STAFF MAINTAINS ALL OF THE LIFESAVING EQUIPMENT FOUND IN THE CARS AND FIRE TRUCKS. THE HOSPITAL IS ALSO HEAVILY INVOLVED IN COUNTY-WIDE EMERGENCY PREPAREDNESS INITIATIVES. COALITION BUILDING: THE HOSPITAL PARTICIPATES IN NUMEROUS COMMUNITY COALITIONS AIMED AT ADDRESSING HEALTH AND SAFETY ISSUES. THESE INCLUDE, BUT ARE NOT LIMITED TO, HEALTHY MOTHERS, HEALTHY BABIES, THE ALAMANCE PARTNERSHIP FOR CHILDREN, THE SAFE KIDS COALITION, HEALTHY ALAMANCE.WORKFORCES DEVELOPMENT: ALAMANCE REGIONAL IS A MAJOR SUPPORTER OF ALAMANCE COMMUNITY COLLEGE, THE PIEDMONT TRIAD ALLIED HEALTH REGIONAL SKILLS PARTNERSHIP, THE RAD-TECH PROGRAM AND LOCAL SCHOOL CAREER FAIRS. COLLABORATION WITH THESE PROGRAMS AND INSTITUTIONS ALLOWS THE HOSPITAL TO HELP TRAIN AND RECRUIT HEALTH PROFESSIONALS WHICH ARE NEEDED IN OUR TRADITIONALLY UNDERSERVED AREA.PHYSICIAN RECRUITMENT: THE HOSPITAL PLACES SIGNIFICANT RESOURCES INTO THE RECRUITMENT OF PHYSICIANS TO SERVE OUR LOCAL COMMUNITY. OTHER: ALAMANCE REGIONAL DONATES EXPIRED EQUIPMENT AND SUPPLIES TO AREA MISSION PROGRAMS PART III, LINE 4: THE CORPORATION MAINTAINS RECORDS TO IDENTIFY AND MONITOR THE LEVEL OF CHARITY CARE IT PROVIDES. THESE RECORDS INCLUDE THE AMOUNT OF UNCOLLECTED CHARGES FOR SERVICES AND SUPPLIES FURNISHED BY THE HEALTHCARE FACILITIES UNDER THEIR FINANCIAL ASSISTANCE AND COLLECTIONS POLICY. THE CORPORATIONS FINANCIAL ASSISTANCE AND COLLECTIONS POLICY PROVIDES FOR UP TO 100% REDUCTION OF CHARGES FOR BOTH INDIGENT AND UNINSURED WHEN THE GUARANTOR SUPPLIES THE NECESSARY DOCUMENTATION. WHEN PROOF OF MEDICAL INDIGENCE IS NOT SUPPLIED, THE UNCOLLECTIBLE AMOUNT IS REFLECTED IN THE CORPORATIONS PROVISION FOR BAD DEBT. IN ADDITION TO IDENTIFYING SPECIFIC CHARITY ACCOUNTS IN ACCORDANCE WITH ITS FINANCIAL ASSISTANCE AND COLLECTION POLICY, THE CORPORATION DEEMED CERTAIN SPECIFIC PATIENT ACCOUNTS ELIGIBLE FOR FINANCIAL ASSISTANCE BASED ON FAMILY SIZE, INCOME AND CREDIT SCORE OBTAINED FROM A THIRD PARTY SERVICE. PART III, LINE 8: THE HOSPITAL IS REPORTING COSTS CALCULATED USING THE NORTH CAROLINA HOSPITAL ASSOCIATION ANDI COMMUNITY BENEFIT COST-TO-CHARGE RATIO DATED 4/11/2012. PART III, LINE 9B: THE HOSPITAL'S BAD DEBT POLICY REFERS TO THE FINANCIAL ASSISTANCE POLICY FOR HANDLING OF PATIENTS KNOWN TO QUALIFY FOR CHARITY OR FINANCIAL ASSISTANCE. ALAMANCE REGIONAL MEDICAL CENTER PART V, SECTION B, LINE 19D: BASED ON FEDERAL POVERTY GUIDELINES, PATIENT IS CHARGED ON SLIDING SCALE PART VI, LINE 2: ALAMANCE REGIONAL MEDICAL CENTER SUBSIDIZES THE SALARY OF THE DIRECTOR OF HEALTHY ALAMANCE, A SUBSIDIARY OF HEALTHY CAROLINIANS. THROUGH THIS PARTNERSHIP, THE HOSPITAL HAS SUPPORTED HEALTHY ALAMANCE IN CONDUCTING A COMMUNITY HEALTH ASSESSMENT EVERY THREE YEARS AND CREATING PROGRAMS THAT ADDRESS HEALTH DISPARITIES. THIS COMMUNITY ASSESSMENT IS A COMPREHENSIVE REPORT THAT IS CONDUCTED IN CONJUNCTION WITH NUMEROUS LOCAL AGENCIES INCLUDING ALAMANCE REGIONAL MEDICAL CENTER, UNITED WAY AND THE ALAMANCE COUNTY HEALTH DEPARTMENT. THE ASSESSMENT ALLOWS THE HOSPITAL TO FOCUS ON HEALTH NEEDS IN ORDER TO MEET ITS MISSION OF IMPROVING THE HEALTH OF THE COMMUNITY AND THE SURROUNDING AREAS. THE LAST ASSESSMENT WAS CONDUCTED IN 2011. THE ASSESSMENT DOCUMENT INCLUDES PRIMARY AND SECONDARY DATA FROM A VARIETY OF SOURCES. SECONDARY DATA SPECIFIC TO ALAMANCE COUNTY WAS COLLECTED AND ANALYZED FROM THE NC STATE CENTER FOR HEALTH STATISTICS, US CENSUS, AND THE BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS). PRIMARY DATA WAS GATHERED FROM A COMMUNITY WIDE PHONE SURVEY CONDUCTED BY THE ELON UNIVERSITY POLL CENTER, FOCUS GROUPS, AND FEEDBACK FROM COMMUNITY LEADERS. ALL OF THESE METHODS WERE UTILIZED IN ORDER TO RECOGNIZE GAPS IN SERVICES ALONG WITH INDENTIFYING THE TOP HEALTH AND SOCIAL ISSUES IN OUR COUNTY.ACCESS TO HEALTHCARE, OBESITY, MENTAL HEALTH AND SUBSTANCE ABUSE WERE FOUND TO BE THE TOP HEALTH PRIORITY AREAS BASED ON THE COMMUNITY ASSESSMENT FINDINGS AND PRIORITY PROCESS. ALAMANCE REGIONAL MEDICAL CENTER IS PARTNERING WITH HEALTHY ALAMANCE, ALAMANCE COUNTY HEALTH DEPARTMENT, UNITED WAY, AND MANY OTHER NON-PROFITS TO STRATEGICALLY ADDRESS THESE AREAS TOGETHER. ALAMANCE REGIONAL HAS DEVISED A COMMUNITY BENEFIT STRATEGIC PLAN THAT OUTLINES SPECIFIC GOALS AND OBJECTIVES FOR EACH OF THESE HEALTH PRIORITY AREAS.THE NEXT COUNTY-WIDE ASSESSMENT IS PLANNED FOR 2015. ALAMANCE REGIONAL MEDICAL CENTER IS HEAVILY INVOLVED IN THE PLANNING OF THIS UPCOMING ASSESSMENT. PART VI, LINE 3: FINANCIAL ASSISTANCE INFORMATION IS PROVIDED BY REGISTRATION STAFF, ED DISCHARGE STAFF, BILLING STATEMENT MESSAGES, ADMISSION BOOKLETS, AND IN FINANCIAL COUNSELING APPOINTMENTS. FINANCIAL ASSISTANCE INFORMATION IS ALSO POSTED ON THE HOSPITALS WEBSITE WWW.ARMC.COM. THE HOSPITALS CHARITY APPLICATION IS AVAILABLE IN BOTH ENGLISH AND SPANISH WITH INTERPRETER SERVICES AVAILABLE FOR PATIENTS NEEDING INFORMATION IN LANGUAGES OTHER THAN ENGLISH AND SPANISH.PATIENTS ARE GIVEN FINANCIAL ASSISTANCE CONTACT INFORMATION AT VARIOUS POINTS OF THE HOSPITAL TO INCLUDE REGISTRATION, CASHIER AND THE DEPARTMENT IN WHICH THEY ARE RECEIVING SERVICES. ALL SELF-PAY IN-PATIENTS /OBSERVATION PATIENTS ARE VISITED BY A HOSPITAL FINANCIAL COUNSELOR TO DISCUSS POSSIBLE FINANCIAL ASSISTANCE. SELF-PAY PATIENTS SCHEDULING OUTPATIENT PROCEDURES ARE INFORMED OF THE OPTION TO CONTACT FINANCIAL COUNSELORS TO DISCUSS FINANCIAL ASSISTANCE. PART VI, LINE 4: ALAMANCE COUNTY IS LOCATED BETWEEN TWO METROPOLITAN AREAS, THE RESEARCH TRIANGLE TOTHE EAST AND THE PIEDMONT TRIAD TO THE WEST. THE LARGEST PORTION OF ALAMANCE COUNTYS WESTERN BORDER IS SHARED WITH GUILFORD COUNTY, AND TO A SMALL DEGREE ROCKINGHAM AND RANDOLPH COUNTIES. TO THE NORTH, THE COUNTY IS BORDERED BY CASWELL COUNTY, TO THE EAST BY ORANGE COUNTY, AND TO THE SOUTH AND EAST BY CHATHAM COUNTY.ALAMANCE COUNTY CONSISTS OF NINE MUNICIPALITIES. BURLINGTON IS THE MOST POPULATED CITY IN THE COUNTY, AND GRAHAM IS THE COUNTY SEAT. ALAMANCE COUNTY IS UNIQUE IN THAT IT SHARES TWO TOWNS WITH NEIGHBORING COUNTIES. GIBSONVILLE IS SHARED WITH GUILFORD COUNTY TO THE WEST AND MEBANE IS SHARED WITH ORANGE COUNTY TO THE EAST.THE COUNTY LAND AREA IS 428 SQUARE MILES, WITH AN ELEVATION OF 656 FEET ABOVE SEA LEVEL, AND APPROXIMATELY 70 PERCENT OF THE COUNTYS POPULATION LIVES IN URBAN AREAS. AREAS OF URBAN DEVELOPMENT LIE PREDOMINANTLY IN A SMALL CENTRAL AREA OF THE COUNTY ALONG INTERSTATE 40, WHILE THE NORTHERN AND SOUTHERN AREAS OF THE COUNTY ARE PRIMARILY RURAL.ALAMANCE COUNTY LIES IN A WARM TEMPERATE CLIMATIC ZONE AND ENJOYS MILD YEAR-ROUND WEATHER CONDITIONS. AVERAGE ANNUAL RAINFALL IS APPROXIMATELY 45 INCHES, WHILE AVERAGE ANNUAL FROZEN PRECIPITATION IS FOUR INCHES.ACCORDING TO THE FIGURES IN THE 2010 US CENSUS AND THE STATE CENTER FOR HEALTH STATISTICSALAMANCE COUNTY HAS A POPULATION OF APPROXIMATELY 151,131 PERSONS, WITH A POPULATION DENSITY OF 351 PERSONS PER SQUARE MILE. ACCORDING TO THE US CENSUS, THE COUNTY POPULATION WAS PROJECTED TO INCREASE BY 12.8% BETWEEN 2000 AND 2010. ALAMANCE COUNTY SURPASSED THAT GOAL BY GROWING 15% DURING THIS TIME PERIOD.ALAMANCE COUNTY HAS A LOWER PROPORTION OF AFRICAN AMERICANS AND ASIANS THAN THE STATE, YET THE COUNTY HAS A 65% GREATER PROPORTION OF LATINOS THAN THE STATE. LATINOS MAKE UP 11% OF THE COUNTYS POPULATION.IN 2010, THE COUNTY AVERAGED 11% UNEMPLOYMENT RATE, WHILE THE STATE SHOWED 10%. THIS RATE HAS GREATLY INCREASED SINCE 2004 (US CENSUS BUREAU). REGARDING EMPLOYMENT STATUS, IT IS ESTIMATED THAT 63.5% OF ALAMANCE COUNTY RESIDENTS OVER 16 YEARS OLD ARE IN THE LABOR FORCE, SLIGHTLY LOWER THAN THE STATES PERCENTAGE OF 65.5% (US CENSUS BUREAU). IN 2008, THE OVERALL POVERTY RATE FOR ALAMANCE COUNTY WAS 16.6% WHICH IS GREATER THAN THE STATE RATE OF 14.6% (US CENSUS BUREAU). CHILDREN LIVING IN POVERTY ARE ESTIMATED AT 18%, WHICH IS SLIGHTLY LOWER THAN THE STATE AVERAGE AT 19.5% IN 2007 (WWW.NCCHILD.ORG).THE 2006-2008 MEAN FAMILY INCOME FOR ALAMANCE COUNTY IS $54,772, WHICH IS 12% BELOW THE STATE AVERAGE FAMILY INCOME OF $62,270 (US CENSUS BUREAU). ALAMANCE COUNTYS 2005 RATE OF UNINSURED WAS 17.5%, RANKING IT THE 40TH COUNTY IN THE STATE FOR UNINSURED. THE STATE HAS A SLIGHTLY HIGHER RATE OF UNINSURED AT 18.6% (NC-CATCH, NC STATE CENTER FOR HEALTH STATISTICS).ALAMANCE COUNTY HAS MANY ASSETS THAT HELP PROVIDE FOR THE QUALITY OF LIFE AND HEALTH OF ITS RESIDENTS. LABCORP (LABORATORY CORPORATION OF AMERICA) IS THE LARGEST PRIVATE EMPLOYER IN THE COUNTY AND ALAMANCE-BURLINGTON SCHOOL SYSTEM IS THE LARGEST PUBLIC EMPLOYER. ELON UNIVERSITY, A NATIONALLY RECOGNIZED FOUR YEAR LIBERAL ARTS COLLEGE IS ALSO WITHIN THE COUNTY, AS IS ALAMANCE COMMUNITY COLLEGE, WHICH OFFERS A VARIETY OF EDUCATION AND TRAINING PROGRAMS FOR MORE THAN 20,000 STUDENTS. PART VI, LINE 5: MEDICAL STAFF PRIVILEGES ARE OFFERED TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY.ALAMANCE REGIONALS BOARD OF DIRECTORS IS COMPRISED OF 23 LOCAL COMMUNITY LEADERS, BUSINESS AND MEDICAL PROFESSIONALS, ALL OF WHOM RESIDE IN THE HOSPITALS PRIMARY SERVICE AREA. THESE LEADERS PROVIDE COUNTLESS HOURS OF VOLUNTEER SERVICE AND PROVIDE VALUABLE OVERSIGHT TO THE ORGANIZATIONS OVERALL OPERATION. THEY ARE INVOLVED IN THE COMMUNITY NEEDS ASSESSMENT, FUNDRAISING AS WELL AS GENERAL STEWARDSHIP FOR THE ORGANIZATION IN THE COMMUNITY.SURPLUS FUNDS FROM ALAMANCE REGIONAL ARE REINVESTED IN OUR COMMUNITY. THEY HELP THE HOSPITAL MAINTAIN ACCESS TO PATIENT SERVICES, BUT ARE ALSO USED TO IMPROVE ACCESS. FUNDS HELP THE ORGANIZATION PURCHASE NEW EQUIPMENT, AS WELL AS EXPAND EDUCATIONAL OPPORTUNITIES ON IMPORTANT HEALTH RELATED TOPICS. X 1 1 X X X X X X 0 1 0 0 0 0 0 0 0 GLENN CHYRSTAL 729061 0 382982 0 3535 0 26300 0 15956 0 1157834 0 0 0 JANAK CHOKSI 768360 0 42566 0 5758 0 26300 0 15178 0 858162 0 0 0 SANDEEP PANDIT 348261 0 104379 0 360 0 14012 0 8316 0 475328 0 0 0 JOHN CURRIN JR 496812 0 17500 0 7584 0 321395 0 13098 0 856389 0 0 0 TIMOTHY FINNEGAN 294532 0 133235 0 270 0 13565 0 7502 0 449104 0 0 0 JANE YBANEZ 297524 0 116163 0 300 0 10814 0 5368 0 430169 0 0 0 REX A STREET 304796 0 10850 0 1522 0 139475 0 10737 0 467380 0 0 0 RICHARD DONAHEY 270399 0 9658 0 1879 0 198392 0 9157 0 489485 0 0 0 CAROL L HUDSON 255611 0 9028 0 3169 0 160942 0 3946 0 432696 0 0 0 ROBERT E BYRD 192292 0 6840 0 1152 0 106582 0 7267 0 314133 0 0 0 PRESTON HAMMOCK 135720 0 5600 0 492 0 5808 0 6963 0 154583 0 0 0 GWENDOLYN GILLIS 154100 0 5600 0 2198 0 9345 0 5942 0 177185 0 0 0 PART I, LINE 1A THE ORGANIZATION PAYS THE BUSINESS PORTION OF THE COUNTRY CLUB DUES FOR ONE OF ITS OFFICERS. THE ORGANIZATION HAS A WRITTEN POLICY ON HOW THIS AMOUNT IS PAID AND REPORTED AS COMPENSATION. PART I, LINE 4B PART I, LINE 4B: NONQUALIFIED DEFERRED COMPENSATION PLAN - AMOUNT SHOWN IS CURRENT YEAR ACCRUAL OF PROJECTED BENEFIT OBLIGATION JOHN G. CURRIN, JR $295,795 CAROL HUDSON $145,383 RICHARD DONAHEY $182,068 ROBERT BYRD $94,447 REX STREET $121,741 FORM 990, PART VI, SECTION A, LINE 2 THERE ARE FOUR MEMBERS ON THE BOARD OF DIRECTORS WHO ARE RELATED. FORM 990, PART VI, SECTION B, LINE 11 THE BOARD OF DIRECTORS DELEGATES TO THE AUDIT/CORPORATE COMPLIANCE COMMITTEE THE RESPONSIBILITY OF REVIEWING FORM 990 IN DETAIL WITH THE HOSPITAL'S EXTERNAL AUDITORS (THE PREPARER) PRIOR TO ITS FILING. ON 8/27/2012, PRIOR TO THE FILING, THE AUDIT/CORPORATE COMPLIANCE COMMITTEE MET, REVIEWED AND RECEIVED A COPY OF FORM 990 AND VOTED ON 9/4/2012 TO ACCEPT THE FORM 990 AS PRESENTED. ON 9/4/2012, PRIOR TO THE FILING, THE BOARD OF DIRECTORS MET AND ACCEPTED THE AUDIT/CORPORATE COMPLIANCE COMMITTEE RECOMMENDATION. AT THIS MEETING, EVERY BOARD MEMBER WAS GIVEN THE OPPORTUNITY TO REVIEW AND RECEIVE A COPY OF THE FORM 990. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION HAS A CONFLICT OF INTEREST POLICY WHICH IS REVIEWED, ACCEPTED, AND SIGNED BY EACH OFFICER AND VOTING BOARD MEMBER ON AN ANNUAL BASIS. PURSUANT TO THIS POLICY, EACH OFFICER AND BOARD MEMBER WILL RECUSE THEMSELVES FROM ANY DISCUSSION AND VOTE FOR WHICH A CONFLICT EXIST FOR THEMSELVES OR THEIR FAMILY. DETERMINATIONS OF WHETHER A CONFLICT EXISTS ARE MADE AT A MANAGEMENT, BOARD MEMBER, OFFICER AND INDIVIDUAL LEVEL. ACTUAL CONFLICTS ARE REVIEWED BY THE BOARD WITHOUT PRESENCE OF THE INTERESTED PARTY. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD OF DIRECTORS APPOINTS A COMPENSATION COMMITTEE WHICH RETAINS THE SERVICES OF AN INDEPENDENT COMPENSATION CONSULTANT TO GATHER COMPARATIVE DATA WITH WHICH TO MAKE RECOMMENDATIONS TO THE BOARD ON MATTERS OF EXECUTIVE COMPENSATION. SPECIFIC GROUP AND INDIVIDUAL PERFORMANCE INDICATORS ARE ESTABLISHED AND FACTORED IN ALONG WITH COMPARISONS OF COMPARABLE EXTERNAL FACTORS SUCH AS THE SIZE OF THE ORGANIZATION, THE GEOGRAPHIC LOCATION OF THE ORGANIZATION, AND THE EXECUTIVE'S TENURE. THIS PROCESS IS CONDUCTED ANNUALLY FOR THE CEO, CFO, SENIOR VICE PRESIDENTS AND OFFICERS OF THE ORGANIZATION. THE ORGANIZATION FOLLOWS THE PROCESS DESCRIBED IN THE TREASURY REGULATION 4958(6)(C) FOR ESTABLISHING THE REBUTTABLE PRESUMPTION OF REASONABLENESS IN THE REVIEW, APPROVAL, AND DOCUMENTATION OF OFFICER AND SENIOR EXECUTIVE COMPENSATION. FORM 990, PART VI, SECTION C, LINE 18 THE ORGANIZATION'S FORM 990 IS AVAILABLE FOR PUBLIC INSPECTION AT GUIDESTAR.COM OR IN THE ADMINISTRATIVE OFFICES AT ALAMANCE REGIONAL MEDICAL CENTER, INC. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES THESE DOCUMENTS AVAILABLE UPON REQUEST AT THE ADMINISTRATIVE OFFICES. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED LOSSES ON INVESTMENTS: -4,113,614. PRIOR PERIOD ADJUSTMENTS: 618,827. NET ASSETS RELEASED FROM RESTRICTION -87,692. TRANSFER TO AFFILIATE -2,429,485. TOTAL TO FORM 990, PART XI, LINE 5: -6,011,964. FORM 990, PART V, LINE 4B ALAMANCE REGIONAL MEDICAL CENTER, INC. INVESTS LONG TERM SAVINGS FUNDS IN MANY DIFFERENT INVESTMENTS. ONE OF THESE INVESTMENTS IS AS A LIMITED PARTNER IN AN INVESTMENT PARTNERSHIP MANAGED BY A NORTH CAROLINA INVESTMENT FIRM. ONE OF THE INVESTMENTS INSIDE THIS LIMITED PARTNERSHIP IS IN A CAYMAN ISLANDS INVESTMENT FUND. THE INVESTMENT COMMITTEE OF THE BOARD SETS POLICY GOVERNING INVESTMENTS AND REVIEWS ALL INVESTMENTS ON A REGULAR BASIS. SCHEDULE H, LINE 7 ALAMANCE REGIONAL 2011 COMMUNITY BENEFIT INVENTORY TRADITIONAL CHARITY CARE AND OTHER FINANCIAL ASSISTANCE ON BEHALF OF UNINSURED AND LOW-INCOME PERSONS MEANS-TESTED PUBLIC PROGRAMS WITH UNPAID COSTS COMMUNITY HEALTH IMPROVEMENT SERVICES: HEALTH EDUCATION ( CLASSES OR LECTURES, SUPPORT GROUPS, SELF HELP PROGRAMS) HEALTH FAIRS HEALTH SMART AD HEALTHY WOMAN ACE ADVANCE DIRECTIVES ALAMANCE BURLINGTON SCHOOL SYSTEM ALAMANCE CARES FREE HIV TESTING ALAMANCE COMMUNITY COLLEGE ALAMANCE ELDER CARE ALAMANCE MINORITY CANCER AWARENESS PROGRAM ALAMANCE PARTNERSHIP FOR CHILDREN ALAMAP AMERICAN CANCER SOCIETY RESOURCE ROOM ARMC MED ALERT ARTHRITIS SUPPORT GROUP ASK THE DOCTOR ASSISTANCE TO ENROLLMENT IN PUBLIC PROGRAMS ASSOCIATION OF HOME AND HOSPICE BACK TO SCHOOL HEALTH & SAFETY FAIR BCCCP BE HEALTHY NOW BIG BROTHER/BIG SISTER CLASSES BONE DENSITY SCREENINGS BOOT CAMP FOR NEW DADS BREAST CANCER SUPPORT GROUP BREAST HEALTH EVENTS BREASTFEEDING AND INFANT NUTRITION CALENDAR FOR ALL SUPPORT GROUPS CANCER REGISTRY CANCER SURVIVOR'S CELEBRATION CARE FOR YOUR HEART CARE GIVER RESOURCE FAIR CARE PROGRAM CARE QUEST CAREER FAIRS CASH DONATIONS CASH DONATIONS NATURAL DISASTERS CASH DONATIONS CHARITY EVENTS CASH DONATIONS EMERGENCY ASSISTANCE CBISA GENERAL ACCOUNTING CBISA COMMUNITY BENEFIT EDUCATION CBISA SOFTWARE CHAMBER OF COMMERCE CHARLES DREW CENTER CLINICAL ENGINEERING SERVICES CLINICAL ROTATIONS RESPIRATORY THERAPY CLINICAL ROTATIONS NURSING CLINICAL ROTATIONS DMIN CLINICAL ROTATIONS LAB CLINICAL ROTATIONS OCCUPATIONAL THERAPY CLINICAL ROTATIONS OTHER CLINICAL ROTATIONS PHYSICAL THERAPY COALITION BUILDING SAFE KIDS COLLABORATIVE GRANT WRITING COMMUNITY BENEFIT ASSIGNED STAFF COMMUNITY BENEFIT OTHER RESOURCES COMMUNITY BOARD AND COMMITTEE LEADERSHIP COMMUNITY EVENT ADVERTISING COMMUNITY FOUNDATION COMMUNITY HEALTH ASSESSMENT COMMUNITY HEALTH SCREENINGS CONGESTIVE HEART FAILURE CLINIC CONSUMER HEALTH LIBRARY DIABETES EDUCATION DIABETES SUPPORT GROUP EACP EARL PARDUE CARDIOLOGY FUND ELON UNIVERSITY PA PROGRAM EMERGENCY PREPAREDNESS ACTIVITIES FIBRO CARE FUNDRAISING FOR ARMC CHARITABLE FOUNDATION FUNDRAISING FOR COMMUNITY PROGRAMS GENETIC RISK ASSESSMENTS GRANT WRITING HEALTH FAIRS HEALTH SMART AD HEALTHY ALAMANCE HEALTHY MOTHERS HEALTHY BABIES HEALTHY WOMAN HEART AND LUNG SUPPORT GROUP HEART SMART WOMEN HIGH SCHOOL HEALTH OCCUPATIONS SHADOWING HOSPICE GALA IN KIND DONATIONS FOOD/WATER/REFRESHMENTS IN KIND DONATIONS DEVELOPMENT OF EDUCATION/ADVERTISING MATERIALS IN KIND DONATIONS ANCILLARY SERVICES IN KIND DONATIONS MEDICAL SUPPLIES AND EQUIPMENT IN KIND DONATIONS MEETING SPACE INFANT CPR AND CHILD SAFETY INFECTION CONTROL INSTITUTIONAL REVIEW BOARD INTERPRETER SERVICES JCCRP JDRF KIDS CAN KIDS FITNESS LACTATION CONSULTATIONS LEGS FOR LIFE 5K LEGS FOR LIFE VASCULAR SCREENING MARCH OF DIMES MEBANE BUSINESS ASSOCIATION NCNA CONTINUING EDUCATION NEW LEAF SOCIETY NUTRITION MATTERS OPEN DOOR CLINIC PATRICIA BYNUM FUND PEDIATRIC ASTHMA CENTER PEDIATRIC ORIENTATION PROGRAM (POP) PHARMACY RESIDENCY PROGRAM PHYSICIAN FEES (NO PAY ED) PHYSICIAN RECRUITMENT PHYSICIAN REFERRAL PHYSICIAN'S ASSISTANT FEASIBILITY TASK FORCE, ELON UNIVERSITY PIEDMONT TRIAD ALLIED HEALTH REGIONAL SKILLS PARTNERSHIP PINK IN THE CITY PINK RIBBON FUND PRENATAL EDUCATION PROGRAM PRESS RELEASES FOR SUPPORT GROUPS PROJECT LAUNCH PROSTATE CANCER SCREENING PROTOCOL PROGRAM RAD TECH PROGRAM RED CROSS BLOOD DRIVES REHAB STUDENT EDUCATION RELAY FOR LIFE SALVATION ARMY BELL RINGING SENIOR ADVANTAGE SEXUAL ASSAULT NURSE EXAMINER PROGRAM (SANE) SKIN CANCER SCREENING SPEAKERS BUREAU SPECIAL CARE NURSERY REUNION SPORTS MEDICINE SYMPOSIUM STROKE CARE TEAM ADVISORY STROKE SUPPORT GROUP STUDENT IMMUNIZATION PROGRAM STUDENT MENTORING PROGRAMS SUSAN G. KOMEN RACE FOR THE CURE TRANSPORTATION PROGRAMS UNDERSTANDING CANCER UNITED WAY UNITED WAY ANNUAL FUNDRAISER VICTORY JUNCTION GANG CAMP WEED AND SEED PROGRAM WEIGHT LOSS SUPPORT HEALTH CARE SUPPORT SERVICES (ENROLLMENT ASSISTANCE FOR GOVERNMENT-FUNDED HEALTH PROGRAM, INFORMATION AND REFERRAL, TRANSPORTATION TO IMPROVE ACCESS) ONCOLOGY TRANSPORTATION REHABILITATION TRANSPORTATION TAXI AND GAS VOUCHERS FOR LOW-INCOME PERSONS OTHER: LIFELINE RED CROSS BLOOD DRIVES SUPPLIES FOR BOY SCOUT CAMP AND RED CROSS DISASTER PROGRAM C. R. BYRD FUND PATRICIA BYNUM FUND EARL PARDUE CARDIOLOGY FUND INFANTS AND CHILDRENS FUND ONCOLOGY ANGELS FUND PINK RIBBON FUND CHILDHOOD ASTHMA FUND SEXUAL ASSAULT NURSE EXAMINER PROGRAM HEALTH PROFESSIONS EDUCATION HELPING TO PREPARE FUTURE HEALTH CARE PROFESSIONALS. NUMEROUS INTERNSHIP PROGRAMS NURSE SHADOWING PROGRAMS PHYSICAL THERAPY GRADUATE PROGRAM UNC STUDENTS IN NUCLEAR MEDICINE RAD-TECH PROGRAM UNC SCHOOL OF SOCIAL WORK PROGRAMS AND FINANCIAL ASSISTANCE FOR PHYSICIANS AND MEDICAL STUDENTS, NURSES AND NURSING STUDENTS, PASTORAL CARE RESIDENTS AND INTERNS AND OTHER HEALTH PROFESSIONALS. COMMUNITY HEALTH EDUCATION SCHOLARSHIP PROGRAM FREE IMMUNIZATION FOR ALAMANCE COUNTY NURSING STUDENTS EFFORTS TO GENERATE INTEREST IN THE HEALTH PROFESSIONS, SUCH AS MENTORING PROGRAMS JCCRP- JOINT COMMUNITY CLINICAL RESOURCE PLANNING HIGH SCHOOL STUDENT OBSERVATIONAL EXPERIENCES LOCAL SCHOOL CAREER FAIRS VISITATION PROGRAMS FOR NON-COMMUNITY AND FOREIGN PHYSICIANS SUBSIDIZED HEALTH SERVICES (MUST BE A DISTINCT SERVICE, NOT A SUBSET OF A SERVICE) EXAMPLES: EMERGENCY AND TRAUMA OUTPATIENT SERVICES OUTPATIENT HOSPICE AND PALLIATIVE CARE SERVICES PALLIATIVE CARE ON THE INPATIENT UNIT BEHAVIORAL HEALTH INPATIENT BEHAVIORAL HEALTH RESEARCH ACTIVITIES CLINICAL RESEARCH PHYSICAL THERAPY RESEARCH CANCER CENTER CLINICAL TRIALS COMMUNITY HEALTH RESEARCH HEALTHY ALAMANCE COMMUNITY ASSESSMENT RESEARCH ON INNOVATIVE HEALTH CARE DELIVERY PAGE 5, PART V QUESTION 3B A 990-T IS BEING FILED FOR THE ORGANIZATION BUT THERE IS NO UNRELATED BUSINESS INCOME FOR 2011. ALAMANCE REGIONAL MEDICAL CENTER FOUNDATION INC 144 LAKEWOOD COURT BURLINGTON NC 27215 581681560 RAISE FUNDS TO ENHANCE HEALTH SERVICES IN COMMUNITY NC 501(C)(3) 0 ARMC PHYSICIANS CARE INC 3940 LAKEWOOD BOULEVARD MEBANE NC 27302 562095382 PRIMARY CARE PHYSICIAN OFFICE NC 501(C)(3) 0 ALAMANCE EXTENDED CARE INC 1860 BROOKWOOD AVENUE BURLINGTON NC 27215 561681364 LONG-TERM CARE FACILITY NC 501(C)(3) 0 MEBANE MEDICAL INVESTORS LLC 4401 BARCLAY DOWNS DRIVE CHARLOTTE NC 28209 203931873 BUILDING HOUSING URGENT CARE CNTR, MED.OFFICES AND OUTPATIENT SURGERY CNTR NC 0 0 0.51000 0 1 0 1 0 0 0 0 0 0 0 0 0 1 0 0 1 1 ALAMANCE REGIONAL MEDICAL CENTER FOUNDATION INC B 128359 CASH ARMC PHYSICIANS CARE INC B 2321162 CASH