2011-06-01T08:35:58-05:00 2010-09-30 DIXON HUGHES GOODMAN LLP 500 Ridgefield Court Asheville NC 28806 990 2009-10-01 560989789 HALIFAX REGIONAL MEDICAL CENTER INC HALI 2525358011 250 SMITH CHURCH ROAD ROANOKE RAPIDS NC 27870 SHERRY JENSEN 2525358011 2011-05-31 1 Michael Rauchwarg 8282542254 2009 2016-02-24 21:20:13Z WILL MAHONE 250 SMITH CHURCH ROAD ROANOKE RAPIDS NC 27870 101690406 0 X www.halifaxmedicalcenter.org X 1972 NC TO PROVIDE MEDICAL SERVICES TO THE RESIDENTS OF HALIFAX COUNTY AND SURROUNDING COUNTIES. 15 13 1038 95 326719 0 136125 138124 98659685 100452858 106310 379341 687962 709529 99590082 101679852 58000 0 0 42863327 41804281 42000 0 56000 53745963 55035846 96709290 96840127 2880792 4839725 69017119 74579254 33339347 35056228 35677772 39523026 HALIFAX REGIONAL MEDICAL CENTER EXISTS TO MEET THE HEALTHCARE NEEDS OF OUR COMMUNITY BY PROVIDING EXCELLENT AND COMPASSIONATE SERVICES AND ALWAYS PLACING PATIENTS FIRST. 0 0 90936529 100126139 PROVIDING QUALITY HEALTHCARE IS ONLY PART OF THE HOSPITAL'S CONTRIBUTION TO THE COMMUNITY. WITH OVER 1,000 EMPLOYEES, HALIFAX REGIONAL IS ONE OF THE REGION'S LARGEST EMPLOYERS. MANY OF THE APPROXIMATELY 60 PHYSICIANS ON THE HOSPITAL STAFF HIRE THEIR OWN EMPLOYEES AS WELL AND INVEST IN DEVELOPING THEIR PRACTICES, EXTENDING ECONOMIC IMPACT. THE MEDICAL CENTER PURCHASES MILLIONS OF DOLLARS OF GOODS AND SERVICES FROM THE REGION.WITH ITS ABUNDANT NATURAL RESOURCES AND STRATEGIC LOCATION, THE HOSPITAL'S MARKET IS DYNAMIC AND OFFERS EXCITING OPPORTUNITIES. AT HALIFAX REGIONAL, THE STAFF IS COMMITTED TO GROWING TO MEET THE EVOLVING HEALTHCARE NEEDS OF THE WONDERFUL PEOPLE WHO MAKE ITS REGION SPECIAL.SIGNIFICANT ACCOMPLISHMENTS INCLUDE: 1. CONTINUED DEVELOPMENT OF THE BOARD OF DIRECTORS WITH TWO NEW MEMBERS. 2. TWO NURSES WERE SELECTED AS ONE OF "THE GREAT 100 NURSES" AS IDENTIFIED BY THE NORTH CAROLINA NURSES ASSOCIATION. THEY WERE SARAH HARRIS AND AUDREY HARDY. 3. RECRUITMENT OF 2 NEW PHYSICIANS: WOUND CARE (1) AND RADIOLOGY (1). 4. OPENED OUR WOUND CARE CLINIC WITH DR. CACERES AND PATIENT VOLUMES WERE SO OVERWHELMING, WE HAD TO RELOCATE FOR ADDITIONAL SPACE. 5. IMPLEMENTED ONLINE PHARMACIST REVIEW FOR EVENING AND WEEKEND COVERAGE OF THE DISPENSING OF PHYSICIAN PHARMACY ORDERS WITH INCREASED PATIENT SAFETY. THIS IS THE FIRST TIME THE MEDICAL CENTER HAS HAD 24/7 COVERAGE BY PHARMACISTS. 6. DEVELOPED MASTER FACILITY PLAN PHASING FOR SURGERY CONSTRUCTION AND RENOVATION PROJECT AND APPLIED FOR CONSTRUCTION LOAN. 7. ACQUIRED ULTRASOUND MACHINE FOR ANESTHESIA SERVICE FOR ULTRASOUND GUIDED NERVE BLOCKS IN THE OPERATING ROOMS WITH IMPROVED SUCCESS RATES AND INCREASED PATIENT SAFETY. 8. RE-ENGINEERED THE PHYSYCIANS' BILLING OFFICE (PBO) WITH RETRAINING FOR ALL STAFF WITH ESTABLISHED BEST PRACTICES, ONLINE BILL PAY, AND BEGAN SERVING PRIVATE PRACTICES SUCH AS RADIOLOGY AND WOUND CARE. 9. PROVIDED FIVE PHYSICIAN PRACTICE MANAGEMENT SEMINARS FOR THE OFFICE STAFF OF OUR PHYSICIANS. 10. SIGNIFICANTLY IMPROVED OUR RELATIONSHIP WITH RURAL HEALTH GROUP WORKING ON JOINT VENTURES OF OUR HIV SUPPORT GROUP AND UNINSURED CASE MANAGEMENT. 11. DEVELOPED AND IMPLEMENTED A STRUCTURED PLAN FOR IMPROVED CLEANLINESS OF THE MEDICAL CENTER FACILITY WITH BASELINE INSPECTION SCORE OF 51.9% INCREASING TO 84.8%. 12. RELOCATED MAMMOGRAPHY CENTER TO RIVERSTONE MEDICAL PLAZA BUILDING NEAR THE MRI SCANNER FOR THE SERVICE OF PATIENTS AND EFFICIENCY OF THE RADIOLOGIST. 13. RECEIVED REACCREDITATION OF LAB FROM THE COLLEGE OF AMERICAN PATHOLOGISTS. 14. INSTALLED TUBE TRANSPORT SYSTEM FROM EMERGENCY ROOM TO LABORATORY FOR IMPROVED TURN AROUND TIMES. 15. REPLACED THE HARDWARE FOR THE HOSPITAL INFORMATION SYSTEM AND SIGNIFICANTLY UPGRADED THE MAINFRAME OPERATING SYSTEM TO A NEW VERSION. 16. REPLACED 200 OF OUR 600 PCS AND LAPTOPS TO MAINTAIN CURRENT TECHNOLOGY. 17. RECRUITMENT OF NEW FOUNDATION AND VOLUNTEER SERVICES COORDINATOR, GEOFFREY HARDEE. 18. EMPLOYEE CAMPAIGNS RAISED OVER $94,000 FOR THE UNITED WAY AND THE HALIFAX REGIONAL FOUNDATION. 19. THE MEDICAL CENTER AWARDED $78,000 IN TUITION REIMBURSEMENT FOR UNDERGRADUATE AND GRADUATE DEGREES. 20. APPLIED FOR AND RECEIVED THE FOLLOWING FINANCIAL GRANTS: GRANTING AGENCY: AMOUNT: DUKE ENDOWMENT (HEART FAILURE PROGRAM) $ 72,816HALIFAX REGIONAL FOUNDATION 33,501 HALIFAX REGIONAL AUXILIARY 28,996N.C. ASSOCIATION OF FREE CLINICS 15,000 ROANOKE VALLEY UNITED WAY RVMM FREE CLINIC 11,250ROANOKE VALLEY UNITED WAY HIV SUPPORT GROUP 2,500UNC STROKE GRANT 1,290GREGORY B. DAVIS - HIV GRANT 150UPPER COASTAL PLAINS INCUMBENT WORKFORCE DEV. 7,563UNIVERSITY OF MARYLAND HEART FAILURE COLLABORATIVE 1,000 TOTAL FOR FY2010 $174,066 90936529 1 1 0 1 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 1 1 0 0 1 76 0 1 1038 1 1 1 0 0 0 0 0 0 0 0 15 13 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 NC X X SHERRY JENSEN 2525358005 250 SMITH CHURCH ROAD ROANOKE RAPIDS NC 27870 JOHNNY DRAPER 1.00 X X 1100 0 0 VERNON BRYANT 1.00 X X 1100 0 0 TOM LYNCH 1.00 X X 1000 0 0 BOB PATTERSON 1.00 X X 950 0 0 J HUGH BAZEMORE 1.00 X 1000 0 0 GERARDO MARADIAGA 1.00 X 0 0 0 ERNEST BARNER 1.00 X 650 0 0 DREWERY BEALE 1.00 X 750 0 0 WILLIAM HODGE 1.00 X 1100 0 0 REV JOHN W SMITH 1.00 X 150 0 0 EVELYN DAWSON 1.00 X 500 0 0 FANNIE GREENE 1.00 X 150 0 0 NEAL PHILLIPS 1.00 X 200 0 0 JAMES PIERCE 1.00 X 0 0 0 WILL MAHONE 40.00 X X 295786 0 56578 SHERRY JENSEN 40.00 X 208597 0 29218 KAREN DANIELS 40.00 X 173505 0 32170 STEVE HILL 40.00 X 207724 0 34730 CLAUDE DIETRICH 40.00 X 196935 0 31763 JOHN CAMPBELL 40.00 X 162207 0 36234 JEANNIE SCHULTZ 40.00 X 161029 0 30135 KENNETH HARTZ 40.00 X 203076 0 39690 1617509 0 290518 8 0 1 0 HALIFAX EMERGENCY GROUP 9820 DEPRAM RD ZEBULON NC 27597 ED PHYSICIAN SERVICES 3590016 THEREX DEPT AT 952740 ATLANTA GA 31192 PT CONTRACT SERVICES 1295071 SODEXO PO BOX 536922 ATLANTA GA 30353 DIETARY CONTRACT SERVICES 537721 SOUTHEAST ACUTE CARE PO BOX 565 STATEBORO GA 30419 DIALYSIS SERVICES 357875 HALIFAX LINEN 405 WEST LITTLETON RD ROANOKE RAPIDS NC 27870 LINEN CLEANING 351993 14 21501 116623 138124 NET PATIENT SERVICE RE 541380 99999586 99681895 317691 PURCHASE DISCOUNTS 541900 387148 378120 9028 PHARMACY 446110 15228 15228 50896 50896 100452858 321098 321098 56116 10554 45562 45562 45562 49978 8265 49978 8265 58243 58243 FOOD/VENDING REVENUE 900099 492805 492805 COFFEE SHOP 453000 145814 145814 MISCELLANEOUS 900099 25348 25348 663967 101679852 100126139 326719 1088870 697281 86832 610449 32701670 29966750 2734920 1320749 1188458 132291 4710542 4238716 471826 2374039 2136246 237793 202693 202693 51367 51367 109612 109612 10481109 10410625 14484 56000 209811 209811 17668368 16812930 855438 623967 623967 1194461 1194461 197263 176190 21073 834433 834433 3821191 3821191 855389 619353 236036 BAD DEBT EXPENSE 18572528 18572528 MISCELLANEOUS EXPENSES 111876 44038 67838 RECRUITMENT 101778 101778 96840127 90936529 5847598 56000 11983122 14038284 12411198 13322408 1056217 1116735 1149692 1094848 64888323 42446784 23742078 22441539 5547558 8854799 98289 89574 13028965 13621067 69017119 74579254 8531495 9441088 16200912 15460376 300829 8306111 10154764 33339347 35056228 X 35648275 39506357 29497 16669 35677772 39523026 69017119 74579254 X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 13393 13393 0 Part II-B, Line 1i: Explanation of Other Lobbying Activities: THE ORGANIZATION IS A MEMBER OF THE AMERICAN HOSPITAL ASSOCIATION AND THE NORTH CAROLINA HOSPITAL ASSOCIATION. A PORTION OF DUES PAID TO THESE ORGANIZATIONS IS ALLOCATED TO LOBBYING EFFORTS ON BEHALF OF THE MEMBERSHIP BODY. THE PORTION OF DUES PAID TO THESE ORGANIZATIONS FOR THE YEAR THAT CONSTITUED LOBBYING WAS APPROXIMATELY $ 13,393. 932707 932707 31274306 20000000 11274306 1281997 910523 371474 30938317 21536261 9402056 460996 460996 22441539 OTHER RECEIVABLES 1145211 DUE FROM ROANOKE VALLEY HEALTH SERVICES, INC. 12146365 UNAMORTIZED BOND ISSUANCE COSTS 329491 13621067 THIRD PARTY PAYOR SETTLEMENT 3108048 PENSION PLAN CONTRIBUTION LIABILITY 7046716 10154764 101679852 96840127 4839725 49012 -1043483 -994471 3845254 100695935 49012 -1032929 -983917 101679852 0 101679852 96850681 10554 10554 96840127 0 96840127 Part XI, Line 8 - Other Adjustments: CHANGE IN VALUE OF DEFINED PENSION PLAN: -1043483. Part XII, Line 2d - Other Adjustments: RENTAL EXPENSES: 10554. CHANGE IN VALUE OF DEFINED PENSION PLAN: -1043483. Part XIII, Line 2d - Other Adjustments: RENTAL EXPENSES NET W/ REVENUES: 10554. 1 1 1 X 1 X 1 1 0 1 1 510903 510903 0.00650 16687905 13239836 3448069 0.04410 17198808 13239836 3958972 0.05060 593318 111457 481861 0.00620 34676 34676 0.00040 627994 111457 516537 0.00660 17826802 13351293 4475509 0.05720 7 14182 14182 0.00020 1 7576 7576 0.00010 8 21758 21758 0.00030 0 6134512 736141 38280598 39028407 -747809 X 1 0 HALIFAX REGIONAL MEDICAL CENTER

250 SMITH CHURCH ROAD ROANOKE RAPIDS NC 27870

X X X DISPROPORTIONATE SHARE HOSPITAL Part I, Line 7: WORKSHEET 2 OF THE 2009 SCHEDULE H INSTRUCTIONS WAS USED TO COMPUTE A COST-TO-CHARGES RATIO USED TO COMPUTE COMMUNITY BENEFIT EXPENSES AT COST FOR PURPOSES OF PART I, LINE 7. Part I, Line 7f: THE TOTAL EXPENSE LISTED ON FORM 990, PART XI, LINE 25 CONTAINS BAD DEBT EXPENSE OF $18,572,528 WHICH HAS BEEN REMOVED FOR PURPOSES OF THE CALCULATION OF CHARITY CARE PERCENTAGE FOR PART I, LINE 7, COLUMN (F). Part III, Line 4: THERE IS NOT A FOOTNOTE IN THE FINANCIAL STATEMENTS TO DESCRIBE THE BAD DEBT EXPENSE.THE METHODOLOGY USED TO DETERMINE BAD DEBT AT COST IS THE ANDI METHODOLOGY WHICH USES A FACILITY WIDE COST TO CHARGE RATIO AS DESCRIBED IN THE 2010 NCHA COMMUNITY BENEFITS GUIDELINES.THE PERCENTAGE OF THE POPULATION BELOW THE POVERTY LINE IN OUR SERVICE AREA IS APPROXIMATELY 25%. BASED ON OUR PAST EXPERIENCE WITH PATIENTS WITH UNPAID CHARGES, ABOUT 10 TO 12% WOULD QUAILFY FOR CHARITY CARE IF THE APPROPRIATE DOCUMENTATION WERE RETURNED. Part III, Line 8: 53% OF HRMC'S TOTAL CHARGES ARE FROM MEDICARE. 16.2% OF THE POPULATION OF HALIFAX COUNTY IS AGE 65 AND OVER. WE HAVE A RESPONSIBILITY TO THIS COMMUNITY TO PROVIDE QUALITY CARE. THE SHORTFALL FOR OUR COST OF CARE SHOULD BE CONSIDERED A COMMUNITY BENEFIT. Part V: THE ORGANIZATION INCLUDES THE FOLLOWING CENTERS AND SPECIALTY DEPARTMENTS WITHIN THE FACILITY LISTED ON PART V: - BIRTHING CENTER - CARDIAC AND VASCULAR CENTER - JOINT CARE CENTER - SLEEP CENTERIN ADDITION TO THE FACILITY LISTED ON PART V REQUIRED TO BE LISTED AS A FACILITY LICENSED AS A HOSPITAL, THE ORGANIZATION ALSO OPERATES (DIRECTLY OR THROUGH JOINT VENTURE) THE FOLLOWING FACILITIES: - ONE DIGESTIVE HEALTH CENTER - ONE HEALTHLINK EVENT CENTER - ONE SURGERY CENTER - ONE PHYICAL THERAPY CENTER THE COMMUNITY HEALTH IMPROVEMENTS SERVICES NOTES ON PART I, LINE 7E INCLUDE THE FOLLOWING; THE ROANOKE VALLEY MEDICAL MINISTRIES FREE CLINIC, PATIENT EDUCATION, THE MEDICAL LIBRARY, HALIFAX HEALTHLINKS, HIV PROGRAMS, AND THE CASE MANAGEMENT HEART FAILURE PROGRAM. Part VI, Line 2: HRMC WORKS CLOSELY WITH THE LOCAL HEALTH DEPARTMENT TO DETERMINE THE HEALTHCARE NEEDS OF OUR COMMUNITY. OUR CASE MANAGERS AND OTHER STAFF PROVIDE FEEDBACK ON HEALTHCARE NEEDS THEY SEE WHEN WORKING WITH OUR PATIENTS. OUR BOARD OF DIRECTORS IS COMPRISED OF LOCAL COMMUNITY RESIDENTS AND LEADERS, AND THEY GIVE VALUABLE INFORMATION ABOUT SERVICES THAT ARE NEEDED IN OUR COMMUNITY. Part VI, Line 3: HRMC POSTS ITS CHARITY CARE POLICY ON OUR WEBSITE. WE ALSO INFORM PATIENTS WITH SIGNAGE THROUGHOUT THE HOSPITAL. COLLECTORS APPLY THE CHARITY CARE POLICY AS APPROPRIATE WHEN ATTEMPTING COLLECTIONS FROM OUR PATIENTS. THE HOSPITAL CURRENTLY RELIES ON THE PATIENT TO ASSESS HIS OR HER FINANCIAL SITUATION AND APPROACH THE HOSPITAL REGARDING CHARITY CARE, GIVEN THE INFORMATION ON THE AVAILABLE POLICIES THAT IS PROVIDED. THE HOSPITAL IS ADOPTING A NEW POLICY IN THE COMING YEAR THAT, IN COOPERATION WITH EXPERIAN, WILL ALLOW IT TO REVIEW CREDIT STANDINGS AND WAGES UPON PATIENT ARRIVAL TO HELP ASSESS AND DETERMINE WHO MAY QUALIFY FOR FINANCIAL ASSISTANCE. Part VI, Line 4: HALIFAX REGIONAL PRIMARILY SERVICES THE CITIZENS OF HALIFAX, NORTHAMPTON, AND WARREN COUNTIES. WE ARE A RURAL, SOLE COMMUNITY PROVIDER IN A DESIGNATED MEDICALLY UNDERSERVED AREA. THE POPULATION OF THESE THREE COUNTIES IS AROUND 95,000. THE RACIAL/ETHNIC DEMOGRAPHICS ARE APPROXIMATELY 53% AFRICAN AMERICAN, 41% CAUCASIAN, AND 6% OTHER. THE UNEMPLOYMENT RATE FOR THESE COUNTIES RANGES FROM 11.7% TO 12.4% COMPARED TO A RATE OF 9.7% FOR NORTH CAROLINA. THE AVERAGE INCOME IS $30,000. THE PERCENTAGE OF CITIZENS WHO LIVE BELOW THE POVERTY LINE IS ABOUT 25% COMPARED TO 15.1% FOR NORTH CAROLINA. Part VI, Line 5: PARTICIPATING IN LOCAL CHAMBER ACTIVITIES PROMOTES ECONOMIC DEVELOPMENT IN THE COMMUNITY. ONE OF OUR EMPLOYEES SERVICES ON THE ROANOKE RAPIDS CITY COUNCIL AND IN THIS CAPACITY ALSO PROMOTES ECONOMIC DEVELOPMENT COMMUNITY SUPPORT. THE TIME INCLUDED IN PART II IS TIME THE HOSPITAL AFFORDS HIM TO PARTICIPATE IN COUNCIL ACTIVITIES. Part VI, Line 6: HALIFAX REGIONAL WORKS CLOSELY WITH THE COUNTY HEALTH DEPARTMENT TO DO COMMUNITY ASSESSMENTS AND COLLABORATE ON VARIOUS PROJECTS TO SERVE THE COMMUNITY. WE ALSO WORK CLOSELY WITH A LOCAL RURAL HEALTH CLINIC AND CURRENTLY ARE COLLABORATING TO IMPLEMENT A CASE MANAGEMENT PROGRAM TO PROVIDE ON-GOING CARE ONCE THE PATIENT IS DISCHARGED FROM THE HOSPITAL. WE PROVIDE COMMUNITY HEALTH INFORMATION, EDUCATION, AND AN EXERCISE PROGRAM THROUGH OUR HEALTHLINKS DEPARTMENT SET IN OUR LOCAL MALL.A MAJORITY OF THE ORGANIZATION'S GOVERNING BODY IS COMPRISED OF PERSONS WHO RESIDE IN THE ORGANIZATION'S PRIMARY SERVICE AREA AND WHO ARE NEITHER EMPLOYEES NOR INDEPENDENT CONTRACTORS OF THE ORGANIZATION NOR FAMILY MEMBERS THEREOF. THE ORGANIZATION EXTENDS MEDICAL STAFF PRIVILEDGES TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY FOR MANY OF ITS DEPARTMENTS. NC X X X X X 0 0 0 0 0 0 0 1 0 WILL MAHONE 251000 0 36783 0 8003 0 38562 0 18016 0 352364 0 0 0 SHERRY JENSEN 183285 0 22754 0 2558 0 14905 0 14313 0 237815 0 0 0 KAREN DANIELS 152654 0 18808 0 2043 0 22000 0 10170 0 205675 0 0 0 STEVE HILL 205612 0 600 0 1512 0 20736 0 13994 0 242454 0 0 0 CLAUDE DIETRICH 196123 0 50 0 762 0 12016 0 19747 0 228698 0 0 0 JOHN CAMPBELL 161946 0 20 0 241 0 16500 0 19734 0 198441 0 0 0 JEANNIE SCHULTZ 160461 0 0 0 568 0 22000 0 8135 0 191164 0 0 0 KENNETH HARTZ 201577 0 50 0 1449 0 22000 0 17690 0 242766 0 0 0 Part I, Line 7 THE OFFICERS LISTED BELOW ARE RECIPIENTS OF NON-FIXED PAYMENTS FROM THE ORGANIZATION. THE CEO AND VICE PRESIDENT RECEIVE AT-RISK SALARY PAYMENTS FROM THE ORGANIZATION BASED ON REACHING BALANCED SCORECARD OBJECTIVES. THE AMOUNT AVAILABLE IS THE AT-RISK SALARY AVAILABLE FOR THE INDIVIDUAL POSITIONS. FOR 2009, THE FOLLOWING OFFICERS RECEIVED PAYMENTS UNDER THIS PLAN: WILL MAHONE $ 36,783 SHERRY JENSEN 22,754 KAREN DANIELS 18,808 PAULA ELIAS DAUGHTER-IN-LAW OF DREWERY BEALE, BOARD MEMBER 18515 COMPENSATION AS AN EMPLOYEE OF ORGANIZATION 0 Form 990, Part VI, Section B, line 11 THE RETURN WAS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM WITH ASSISTANCE AND INFORMATION PROVIDED BY MANAGEMENT. THE HOSPITAL PROVIDED EVERY VOTING BOARD MEMBER A COPY OF THE DRAFT 990 PRIOR TO A SCHEDULED MEETING. DETAILS OF THE RETURN WERE DISCUSSED WITH MANAGEMENT AND THE FINANCE COMMITTEE OF THE BOARD, WHO THEN DELIVERED A REPORT TO THE FULL BOARD PRIOR TO FILING THE RETURN WITH THE IRS. Form 990, Part VI, Section B, line 12c (BYLAWS, ARTICLE 2, SECTION 3) "ANY DUALITY OF INTEREST OR POSSIBLE CONFLICT OF INTEREST ON THE PART OF ANY GOVERNING BOARD MEMBER SHALL BE DISCLOSED TO THE OTHER MEMBERS OF THE BOARD OF DIRECTORS AND MADE A MATTER OF RECORD THROUGH AN ANNUAL PROCEDURE AND ALSO WHEN THE INTEREST BECOMES A MATTER OF BOARD ACTION. ANY GOVERNING BOARD MEMBER HAVING A DUALITY OF INTEREST OR POSSIBLE CONFLICT OF INTEREST ON ANY MATTER SHALL NOT VOTE OR USE PERSONAL INFLUENCE ON THAT MATTER, AND SHALL NOT BE COUNTED IN DETERMINING THE QUORUM FOR THE MEETING, EVEN WHERE PERMITTED BY LAW. THE MINUTES OF THE MEETING SHALL REFLECT THAT A DISCLOSURE WAS MADE, THE ABSTENTION FROM VOTING, AND THE QUORUM SITUATION. ANY EXISTING OR APPARENT CONFLICT OF INTEREST WILL BE REFERRED TO THE EXECUTIVE COMMITTEE OF THE BOARD FOR RESOLUTION." THE CONFLICT OF INTEREST POLICY IS REVIEWED ANNUALLY. BOARD MEMBERS AND HOSPITAL MANAGEMENT PERSONNEL ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST QUESTIONNAIRE EACH YEAR. Form 990, Part VI, Section B, line 15a THE ORGANIZATION ENGAGES AN OUTSIDE INDEPENDENT CONSULTANT FOR REVIEW OF COMPENSATION PACKAGES. THE CONSULTANT USES COMPARABLE POSITIONS AND BENCHMARKS TO EVALUATE THE SALARIES FOR THE CEO AND VICE PRESIDENTS. THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS REVIEWS THE CONSULTANT'S RECOMMENDATIONS, AND THE FULL BOARD APPROVES THE COMPENSATION PACKAGE SELECTED FOR THE CEO. THE CONSULTATION PROCESS FOR OTHER OFFICERS INVOLVES THE INDEPENDENT CONSULTANTS; HOWEVER, THE CEO HAS FINAL APPROVAL OVER COMPENSATION PACKAGES FOR VICE PRESIDENTS AND BELOW. Form 990, Part VI, Section C, line 18 RECENT FILINGS OF THE FORM 990 ARE AVAILABLE UPON REQUEST AT THE ORGANIZATION'S ADMINISTRATIVE OFFICE. IN ADDITION, RECENT FILINGS OF THE FORM 990 ARE AVAILABLE ONLINE AT WWW.GUIDESTAR.ORG. Form 990, Part VI, Section C, line 19 PHOTOCOPIES OF THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON WRITTEN REQUEST AT THE ORGANIZATION'S ADMINISTRATIVE OFFICE. HALIFAX REGIONAL MEDICAL CENTER FOUNDATION INC 250 SMITH CHURCH ROAD ROANOKE RAPIDS NC 27870 561698825 FUNDRAISING FOR ASSOCIATED CHARITABLE ORGANIZATION NC 501(c)(3) Line 7 N/A ROANOKE VALLEY HEALTH SERVICES INC 250 SMITH CHURCH ROAD ROANOKE RAPIDS NC 27870 561925492 HEALTHCARE NC 501(c)(3) Line 3 N/A 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 HALIFAX REGIONAL MEDICAL CENTER FOUNDATION INC C 21501 ROANOKE VALLEY HEALTH SERVICES INC P 297163