MOUNTAIN VISTA HEALTH PARK INC: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization: MOUNTAIN VISTA HEALTH PARK INC (EIN 56-1255030)
Tax period: 2010-10-01 to 2011-09-30
Filed: 2012-03-09
IRS object ID: 201240699349300124
Schema version: 2010v3.4
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 C
Schedule D
Schedule O

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2012-03-09T16:43:27-06:00	Timestamp
Tax Period End Date	2011-09-30	TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	DAVIDSON HOLLAND WHITESELL & CO PLLC	BusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

Field	Value	IRS element (for citing)
Address Line1	209 13TH AVE PLACE NW SUITE 200	AddressLine1
City	HICKORY	City
State	NC	State
ZIP Code	28601	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990	ReturnType
Tax Period Begin Date	2010-10-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	561255030	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	MOUNTAIN VISTA HEALTH PARK INC	BusinessNameLine1

Field	Value	IRS element (for citing)
Name Control	MOUN	NameControl
Phone	3368592181	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	POST OFFICE BOX 1547	AddressLine1
City	DENTON	City
State	NC	State
ZIP Code	27239	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	MARIE PALMER	Name
Title	TREASURER	Title
Phone	3368592181	Phone
Date Signed	2012-03-09	DateSigned
Authorize Third Party	1	AuthorizeThirdParty

Preparer Preparer

Field	Value	IRS element (for citing)
Name	SUSAN M BALKE	Name
Phone	8283222070	Phone

Field	Value	IRS element (for citing)
Tax Year	2010	TaxYear
Build TS	2016-02-24 21:20:13Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Name Of Principal Officer Person	MARIE PALMER	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

Field	Value	IRS element (for citing)
Address Line1	POST OFFICE BOX 1547	AddressLine1
City	DENTON	City
State	NC	State
ZIP Code	27239	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	6157089	GrossReceipts
Group Return For Affiliates	0	GroupReturnForAffiliates
Organization501c3	X	Organization501c3
Web Site	N/A	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	1971	YearFormation
State Legal Domicile	NC	StateLegalDomicile
Activity Or Mission Description	PROVIDE QUALITY LONG-TERM NURSING CARE FOR RESIDENTS.	ActivityOrMissionDescription
Nbr Voting Members Governing Body	9	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	9	NbrIndependentVotingMembers
Total Nbr Employees	159	TotalNbrEmployees
Total Nbr Volunteers	17	TotalNbrVolunteers
Total Gross UBI	0	TotalGrossUBI
Net Unrelated Business Txbl Income	0	NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year	0	ContributionsGrantsPriorYear
Contributions Grants Current Year	0	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	5830748	ProgramServiceRevenuePriorYear
Program Service Revenue CY	6112172	ProgramServiceRevenueCY
Investment Income Prior Year	41798	InvestmentIncomePriorYear
Investment Income Current Year	43117	InvestmentIncomeCurrentYear
Other Revenue Prior Year	2400	OtherRevenuePriorYear
Other Revenue Current Year	1800	OtherRevenueCurrentYear
Total Revenue Prior Year	5874946	TotalRevenuePriorYear
Total Revenue Current Year	6157089	TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year	0	GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY	0	GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year	0	BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	3204432	SalariesEtcPriorYear
Salaries Etc Current Year	3297246	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	2333361	OtherExpensePriorYear
Other Expenses Current Year	2391648	OtherExpensesCurrentYear
Total Expenses Prior Year	5537793	TotalExpensesPriorYear
Total Expenses Current Year	5688894	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	337153	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	468195	RevenuesLessExpensesCY
Total Assets BOY	4301178	TotalAssetsBOY
Total Assets EOY	4743215	TotalAssetsEOY
Total Liabilities BOY	463497	TotalLiabilitiesBOY
Total Liabilities EOY	437339	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	3837681	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	4305876	NetAssetsOrFundBalancesEOY
Mission Description	TO PROVIDE QUALITY LONG-TERM SKILLED NURSING CARE AND ASSISTED LIVING SERVICES TO THE SOUTH DAVIDSON COUNTY COMMUNITY.	MissionDescription
Significant New Program Services	0	SignificantNewProgramServices
Significant Change	0	SignificantChange
Expense	4754912	Expense
Revenue	6112172	Revenue
Description	MOUNTAIN VISTA HEALTH PARK, INC. IS A CORPORATION WHICH PROVIDES LONG-TERM NURSING CARE AND ADULT CARE HOME SERVICES. THE FACILITY HAS 60 NURSING AND 60 ADULT-CARE BEDS. WE OFFER SERVICES TO THE PUBLIC WITHOUT REGARD TO RELIGION OR ETHNICITY.DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2011, WE PROVIDED 21,550 DAYS OF CARE FOR RESIDENTS NEEDING NURSING CARE; WE PROVIDED 19,899 DAYS OF SERVICES FOR OTHER LEVELS OF CARE.	Description
Total Program Service Expense	4754912	TotalProgramServiceExpense
Described In501 C3	1	DescribedIn501C3
Schedule B Required	0	ScheduleBRequired
Political Activities	0	PoliticalActivities
Lobbying Activities	1	LobbyingActivities
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	0	ReportOtherAssets
Report Other Liabilities	1	ReportOtherLiabilities
Report Fin48 Footnote	1	ReportFin48Footnote
Independent Audit Financial Stmt	1	IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt	0	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	0	Hospital
Grants To Organizations	0	GrantsToOrganizations
Grants To Individuals	0	GrantsToIndividuals
Schedule J Required	0	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	0	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	6	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Number Of Employees	159	NumberOfEmployees
Employment Tax Returns Filed	1	EmploymentTaxReturnsFiled
Unrelated Business Income	0	UnrelatedBusinessIncome
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
Indoor Tanning Services	0	IndoorTanningServices
Info In Schedule O Part VI	X	InfoInScheduleOPartVI
Nbr Voting Governing Body Members	9	NbrVotingGoverningBodyMembers
Number Independent Voting Members	9	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	0	InvestmentInJointVenture
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	TULLOCK MANAGEMENT COMPANY	BusinessNameLine1

Field	Value	IRS element (for citing)
Telephone Number	3369985001	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	5190 US HWY 158	AddressLine1
City	ADVANCE	City
State	NC	State
ZIP Code	27006	ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (11 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Individual Trustee Or DirectorIndividualTrusteeOrDirector	OfficerOfficer	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation	Key EmployeeKeyEmployee	FormerFormer
DEWEY SNIDER
PRESIDENT	0.30	X	X	0	0	0
JIM KELLEY
VICE PRESIDENT	0.30	X	X	0	0	0
MARIE PALMER
TREASURER	0.40	X	X	0	0	0
JEANETTE SKEEN
SECRETARY	0.30	X	X	0	0	0
ANNE BEAM
ASST TREASURER	0.30	X	X	0	0	0
CHARLES HEDRICK
DIRECTOR	0.30	X		0	0	0
TONY JACKSON
DIRECTOR	0.30	X		0	0	0
DALE FUTRELL
DIRECTOR	0.30	X		0	0	0
KURT BEYELOR
DIRECTOR	0.30	X		0	0	0
KATHY MCDONALD
KEY EMPLOYEE	40.00			96874	0	9336	X
CLIFTON BAKER
FORMER DIRECTOR	0.30			0	0	0		X

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	0	TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs	0	TotalReportableCompFrmRltdOrgs
Total Other Compensation	0	TotalOtherCompensation
Number Individuals GT100 K	0	NumberIndividualsGT100K
Formers Listed	0	FormersListed
Total Comp GT150 K	0	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
LEGACY HEALTHCARE SERVICES INC
PO BOX 951003	CLEVELAND	OH	44193	PHYSICAL, SPEECH & OCCUPATIONAL THERAPY	562237
BLUE CROSS BLUE SHIELD
PO BOX 580017	CHARLOTTE	NC	28258	GROUP MEDICAL INSURANCE	451228
TULLOCK MANAGEMENT COMPANY
PO BOX 1678	CLEMMONS	NC	27012	MANAGEMENT SERVICES	305936
US FOOD SERVICE
125 FORT MILL PARKWAY	FORT MILL	SC	29715	FOOD SERVICE AND SUPPLY	155468
YADKIN VALLEY HEALTHCARE
17955 SOUTH HIGHWAY 109	DENTON	NC	27239	MEDICATIONS AND PHARMACY SERVICES	113471

Field	Value	IRS element (for citing)
Number Of Contractors GT100 K	5	NumberOfContractorsGT100K

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome
ROUTINE NURSING CARE	623000	6098138	6098138
ANCILLARIES	623000	14034	14034

Field	Value	IRS element (for citing)
Total Program Service Revenue	6112172	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	43117	TotalRevenueColumn
Exclusion	$43,117	ExclusionAmount

Gross Rents GrossRents

Field	Value	IRS element (for citing)
Real	1800	Real

Rental Income Or Loss RentalIncomeOrLoss

Field	Value	IRS element (for citing)
Real	1800	Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	1800	TotalRevenueColumn
Exclusion	$1,800	ExclusionAmount

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	6157089	TotalRevenueColumn
Related Or Exempt Function Income	6112172	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	0	UnrelatedBusinessRevenue
Exclusion	$44,917	ExclusionAmount

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	2939673	Total
Program Services	2733179	ProgramServices
Management And General	206494	ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	140147	Total
Program Services	99994	ProgramServices
Management And General	40153	ManagementAndGeneral

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	217426	Total
Program Services	202101	ProgramServices
Management And General	15325	ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

Field	Value	IRS element (for citing)
Total	305936	Total
Management And General	305936	ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

Field	Value	IRS element (for citing)
Total	10107	Total
Management And General	10107	ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	23350	Total
Management And General	23350	ManagementAndGeneral

Advertising Advertising

Field	Value	IRS element (for citing)
Total	3413	Total
Management And General	3413	ManagementAndGeneral

Travel Travel

Field	Value	IRS element (for citing)
Total	16602	Total
Program Services	9269	ProgramServices
Management And General	7333	ManagementAndGeneral

Interest Interest

Field	Value	IRS element (for citing)
Total	33	Total
Management And General	33	ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	81382	Total
Program Services	80635	ProgramServices
Management And General	747	ManagementAndGeneral

Insurance Insurance

Field	Value	IRS element (for citing)
Total	326424	Total
Program Services	310299	ProgramServices
Management And General	16125	ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices	Management And GeneralManagementAndGeneral
SUPPLIES	454707	451561	3146
CONTRACT SERVICES	436659	434398	2261
MEDICAID SETTLEMENT	261974		261974
RAW FOOD	211549	211549
UTILITIES	166280	149055	17225

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	93232	Total
Program Services	72872	ProgramServices
Management And General	20360	ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	5688894	Total
Program Services	4754912	ProgramServices
Management And General	933982	ManagementAndGeneral
Fundraising	0	Fundraising

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
BOY	3080941	BOY
EOY	3215939	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	464980	BOY
EOY	536615	EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

Field	Value	IRS element (for citing)
BOY	13644	BOY
EOY	14974	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	44351	BOY
EOY	39919	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	3407104	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	2569712	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	598830	BOY
EOY	837392	EOY

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
BOY	98432	BOY
EOY	98376	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	4301178	BOY
EOY	4743215	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	437714	BOY
EOY	407201	EOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	25783	BOY
EOY	30138	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	463497	BOY
EOY	437339	EOY

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

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	3796811	BOY
EOY	4265006	EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	40870	BOY
EOY	40870	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	3837681	BOY
EOY	4305876	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	4301178	BOY
EOY	4743215	EOY

Field	Value	IRS element (for citing)
Reconcilation Revenue Expenses	468195	ReconcilationRevenueExpenses
Reconcilation Other Changes	0	ReconcilationOtherChanges
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	0	AccountantCompileOrReview
FS Audited	1	FSAudited
Audit Committee	0	AuditCommittee
Financial Statement Separate	X	FinancialStatementSeparate
Federal Grant Audit Required	0	FederalGrantAuditRequired

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Publicly Supported Org509a2	X	PubliclySupportedOrg509a2

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	124111	CurrentTaxYearMinus4Years
Current Tax Year Minus2 Years	2440	CurrentTaxYearMinus2Years
Total	126551	Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	4860585	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	5096209	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	5756949	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	5830748	CurrentTaxYearMinus1Year
Current Tax Year	6112172	CurrentTaxYear
Total	27656663	Total

Gross Receipts From Non UBI GrossReceiptsFromNonUBI

Field	Value	IRS element (for citing)
Current Tax Year	1800	CurrentTaxYear
Total	1800	Total

Total509 Total509

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	4984696	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	5096209	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	5759389	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	5830748	CurrentTaxYearMinus1Year
Current Tax Year	6113972	CurrentTaxYear
Total	27785014	Total

Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons

Field	Value	IRS element (for citing)
Total	0	Total

Amts From Subst Contributors AmtsFromSubstContributors

Field	Value	IRS element (for citing)
Total	0	Total

Support From DQ Ps Etc SupportFromDQPsEtc

Field	Value	IRS element (for citing)
Total	0	Total

Field	Value	IRS element (for citing)
Public Support Total509	27785014	PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	86083	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	73727	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	52361	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	44198	CurrentTaxYearMinus1Year
Current Tax Year	43117	CurrentTaxYear
Total	299486	Total

Investment Income And UBTI InvestmentIncomeAndUBTI

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	86083	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	73727	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	52361	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	44198	CurrentTaxYearMinus1Year
Current Tax Year	43117	CurrentTaxYear
Total	299486	Total

Total Support Total TotalSupportTotal

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	5070779	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	5169936	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	5811750	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	5874946	CurrentTaxYearMinus1Year
Current Tax Year	6157089	CurrentTaxYear
Total	28084500	Total

Field	Value	IRS element (for citing)
Public Support Percentage509	0.98930	PublicSupportPercentage509
Prior Year Support Percentage	0.98900	PriorYearSupportPercentage
Investment Income Percentage	0.01070	InvestmentIncomePercentage
Prior Yr Invest Income Percentage	0.01100	PriorYrInvestIncomePercentage
Thirty Three Percnt Tests CY509	X	ThirtyThreePercntTestsCY509

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Political Expenditures	766	PoliticalExpenditures
Volunteers	0	Volunteers
Paid Staff Or Management	0	PaidStaffOrManagement
Media Advertisements	0	MediaAdvertisements
Mailings Members	0	MailingsMembers
Publications Or Broadcast	0	PublicationsOrBroadcast
Grants Other Organizations	0	GrantsOtherOrganizations
Direct Contact Legislators	0	DirectContactLegislators
Rallies Demonstrations	0	RalliesDemonstrations
Other Activities	1	OtherActivities
Other Activities	$766	OtherActivitiesAmount
Total Lobbying Expenditures IIB	766	TotalLobbyingExpendituresIIB
Not Described In501c3	0	NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV (2 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
ORGANIZATIONS DIRECT AND INDIRECT POLITICAL CAMPAIGN ACTIVITIES:	PART I-A, LINE 1:	A PORTION OF THE DUES PAID TO THE NORTH CAROLINA HEALTH CARE FACILITIES ASSOCIATION BY THE ENTITY WERE ATTRIBUTABLE TO LOBBYING ACTIVITIES.
EXPLANATION OF OTHER LOBBYING ACTIVITIES:	PART II-B, LINE 1I:	A PORTION OF THE DUES PAID TO THE NORTH CAROLINA HEALTH CARE FACILITIES ASSOCIATION BY THE ENTITY WERE ATTRIBUTABLE TO LOBBYING ACTIVITIES.

Schedule D IRS990ScheduleD

Land Land

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	19358	OtherCostOrOtherBasis
Book Value	19358	BookValue

Buildings Buildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	1382938	OtherCostOrOtherBasis
Depreciation	1049002	Depreciation
Book Value	333936	BookValue

Leasehold Improvements LeaseholdImprovements

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	1401764	OtherCostOrOtherBasis
Depreciation	1063282	Depreciation
Book Value	338482	BookValue

Equipment Equipment

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	524477	OtherCostOrOtherBasis
Depreciation	397832	Depreciation
Book Value	126645	BookValue

Other Land Buildings OtherLandBuildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	78567	OtherCostOrOtherBasis
Depreciation	59596	Depreciation
Book Value	18971	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	837392	TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
Description	PATIENT FUNDS	Description
Amount	$30,138	Amount

Field	Value	IRS element (for citing)
Total Of Amounts	30138	TotalOfAmounts
Total Revenue	6157089	TotalRevenue
Total Expenses	5688894	TotalExpenses
Excess Or Deficit For Year	468195	ExcessOrDeficitForYear
Total Adjustments	0	TotalAdjustments
Excess Or Deficit Per FS	468195	ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt	6157056	TotRevenueEtcAuditedFinclStmt
Revenue Not Rptd F990	0	RevenueNotRptdF990
Revenue Subtotal	6157056	RevenueSubtotal
Other Revenues Not Included	33	OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt	33	RevenueNotRptdOnFinStmt
Total Revenue Per Form990	6157089	TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt	5688861	TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F990	0	ExpensesNotRptdF990
Expenses Subtotal	5688861	ExpensesSubtotal
Other Expenses Not Included	33	OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt	33	ExpensesNotRptdOnFinStmt
Total Expenses Per Form990	5688894	TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (3 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:	PART X:	EFFECTIVE OCTOBER 1, 2009, THE ORGANIZATION IMPLEMENTED THE NEW ACCOUNTING REQUIREMENTS ASSOCIATED WITH UNCERTAINTY IN INCOME TAXES USING THE PROVISIONS OF FINANCIAL ACCOUNTING STANDARDS BOARD ("FASB") ASC 740, INCOME TAXES. USING THAT GUIDANCE, TAX POSITIONS INITIALLY NEED TO BE RECOGNIZED IN THE FINANCIAL STATEMENTS WHEN IT IS MORE-LIKELY-THAN-NOT THE POSITIONS WILL BE SUSTAINED UPON EXAMINATION BY THE TAX AUTHORITIES. IT ALSO PROVIDES GUIDANCE FOR DE-RECOGNITION, CLASSIFICATION, INTEREST AND PENALTIES, ACCOUNTING IN INTERIM PERIODS, DISCLOUSURE AND TRANSITION. AS OF SEPTEMBER 30, 2011, THE ORGANIZATION HAS NO UNCERTAIN TAX POSITIONS THAT QUALIFY FOR EITHER RECOGNITION OR DISCLOSURE IN THE FINANCIAL STATEMENTS.
PART XII, LINE 4B - OTHER ADJUSTMENTS:		INTEREST EXPENSES NETTED AGAINST INCOME ON FINANCIAL STATEMENTS 33.
PART XIII, LINE 4B - OTHER ADJUSTMENTS:		INTEREST EXPENSES NETTED AGAINST INCOME ON FINANCIAL STATEMENTS 33.

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (5 entries)

IdentifierIdentifier	ExplanationExplanation	Return ReferenceReturnReference
FORM 990, PART VI, SECTION A, LINE 3	MOUNTAIN VISTA HEALTH PARK CONTRACTS TULLOCK MANAGEMENT COMPANY TO PERFORM VARIOUS OPERATIONAL MANAGEMENT DUTIES
FORM 990, PART VI, SECTION B, LINE 11	A DRAFT COPY OF FORM 990 IS GIVEN TO THE DIRECTORS FOR REVIEW PRIOR TO BEING SIGNED BY THE APPROPRIATE OFFICER OF THE GOVERNING BODY.
	CONFLICT OF INTEREST POLICY IS REVIEWED ANNUALLY	FORM 990, PART VI, SECTION B, LINE 12C
	OFFICERS RECEIVE NO COMPENSATION. KEY EMPLOYEES COMPENSATION IS REVIEWED BY THE MANAGEMENT COMPANY AND THE ADMINISTRATOR ANNUALLY. COMPENSATION RATES FOR KEY EMPLOYEES ARE COMMENSURATE WITH SIMILAR POSITIONS AS COMPARED WITH INDUSTRY DATA.	FORM 990, PART VI, SECTION B, LINE 15
	DOCUMENTS ARE AVAILABLE UPON REQUEST TO THE MANAGEMENT COMPANY DURING NORMAL BUSINESS HOURS.	FORM 990, PART VI, SECTION C, LINE 19