2011-02-15T15:22:53-06:00 2010-09-30 LarsonAllen LLP 101 N Tryon Street Suite 1000 Charlotte NC 28246 990 2009-10-01 561892763 Stanly Medical Services Inc STAN 7049820636 320 Yadkin Street Albemarle NC 28801 nykola samilo 7049820636 2011-02-15 1 7049985200 2009 2016-02-24 21:20:13Z brad marino 320 Yadkin Street Albemarle NC 28801 13633345 0 X www.stanlymedicalservices.org X 1994 NC To promote, improve, and enhance the health and welfare of communities in or outside of this state. 5 2 158 0 0 0 19143 20384 13121277 13609817 388 0 3366 3144 13144174 13633345 0 0 10884646 11835273 0 0 4406607 4410882 15291253 16246155 -2147079 -2612810 3207713 3952765 2287474 2601820 920239 1350945 1) To promote, improve, and enhance the health and welfare of communities in or outside of this state through the support of or involvement in the recruitment, formation, development, management, equipping, and maintenance of healthcare services provided in affiliation with the health care system of which Stanly Regional Medical Center, Inc., a North Carolina nonprofit corporation exempt from federal income tax under Section 501(c)(3) of the code, is an affiliate and other health care providers located in and around Albemarle, Stanly County, North Carolina (a medically underserved area). 2) To provide funds, property, or other benefits for the benefit of other medically underserved areas in or outside of this state. 3) To promote and carry on educational activities related to the care of the sick, injured, or related to the promotion of health. 4) To promote or carry out such other activities as may be deemed advisable for the betterment of the general health of the communities served. 0 0 14441612 12971401 Health ServicesProvided healthcare in a provider's office setting. Services included general patient services, laboratory services, and x-ray services. 478430 641560 Central Lab 14920042 1 1 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 9 0 158 1 0 0 0 0 0 0 0 0 0 5 2 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X LeAnne Callahan 7049844568 301 yadkin street Albemarle NC 28001 James E Jim Cameron 1.00 X 0 0 0 Joel Huneycutt 1.00 X 0 0 0 Michael McLeod 1.00 X X 306426 0 10496 alfred taylor 1.00 X X 0 0 0 nykola samilo 1.00 X X 0 0 0 Brad Marino 40.00 X 0 149150 17295 Eric John Mallico 40.00 X 539440 0 8071 Joseph Zucker 40.00 X 436939 0 11023 Timothy Hall 40.00 X 419369 0 10952 Keenya Little 40.00 X 355993 0 5121 Edward Williams 40.00 X 349466 0 5094 2407633 149150 68052 21 0 1 0 Eclinical Works LLC po box 847950 boston MA 02284 technical support 172940 Staff Care PO Box 281923 atlanta GA 30384 locums coverage 169784 D & Y po box 635715 cincinnati OH 45263 locums coverage 115652 0 19146 1238 20384 patient revenue 621300 13481076 13481076 128741 128741 13609817 3144 3144 3144 13633345 13612961 0 0 333422 333422 9409844 8984859 424985 332572 307571 25001 1222656 1046253 176403 536779 479650 57129 6510 6510 65803 65803 475339 464951 10388 9426 7327 2099 302712 302712 973537 894441 79096 16410 5523 10887 2717 320 2397 188612 139695 48917 79846 76281 3565 Medical Supplies 923464 923464 Bad Debt Expense 717879 717879 Utilities 267413 222026 45387 Maintenance/Repairs 254179 232002 22177 Cleaning/Laundry 127035 115088 11947 16246155 14920042 1326113 0 483952 1160802 1952454 1979812 72442 106873 3167045 2529637 647250 637408 51615 67870 3207713 3952765 1477792 1687598 809682 914222 2287474 2601820 X 887923 1350945 32316 0 920239 1350945 3207713 3952765 X 0 1 1 X 0 X 33145 71189 19143 20382 143859 10434694 9268830 11420767 13121277 13609817 57855385 10434694 9301975 11491956 13140420 13630199 57999244 0 0 0 57999244 1361 5024 2342 364 9091 1361 5024 2342 364 9091 2035 3390 3144 8569 10438090 9306999 11494298 13144174 13633343 58016904 0.99970 0.99960 0.00020 0.00020 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 12880 9040 3840 3154165 2520597 633568 637408 pension liability 910774 advances from affiliates 3448 914222 X X X X X 0 0 0 0 0 0 0 0 0 Michael McLeod 289926 0 0 0 16500 0 0 0 10496 0 316922 0 0 0 Brad Marino 0 149150 0 0 0 0 0 0 0 17295 0 166445 0 0 Eric John Mallico 522940 0 0 0 16500 0 0 0 8071 0 547511 0 0 0 Joseph Zucker 414939 0 0 0 22000 0 0 0 11023 0 447962 0 0 0 Timothy Hall 402869 0 0 0 16500 0 0 0 10952 0 430321 0 0 0 Keenya Little 342980 0 0 0 13013 0 0 0 5121 0 361114 0 0 0 Edward Williams 332966 0 0 0 16500 0 0 0 5094 0 354560 0 0 0 Form 990, Part VI, Section A, line 3 three employees (CEO, COO, CFO) are employed by The Charlotte-Mecklenburg Hospital Authority d/b/a Carolinas HealthCare System ("CHS") and leased to the organization through a management agreement. As such, their compensation information is not required on Part VII. Form 990, Part VI, Section B, line 11 The CFO and Controller will review the draft, copies will be emailed to the board members, and the draft will be reviewed at the Board Meeting. Form 990, Part VI, Section B, line 12c The Bylaws address what constitutes conflicts of interest, the responsibility of disclosure of each member, how conflicts (and potential conflicts) are addressed, and each member of the board of directors files a conflict of interest statement annually which is reviewed by the Board Chair and is maintained by the corporate secretary. Members with potential conflicts are asked to excuse themselves from voting on matters that are of potential conflict. Form 990, Part VI, Section B, line 15 Compensation of top executives and top management and other officers and key employees is determined through an independent consultant's review of market comparison studies. This process was last performed in 2008. Form 990, Part VI, Section C, line 19 These documents are made available to the public upon request. form 990, part xi, line 2c: this process has not changed from the prior year. Stanly Regional Medical Center Foundation Inc 301 yadkin street albemarle NC 28001 561698181 Charity NC 501(c)(3) 170(b)(1)(A)(vi) N/A Stanly Regional Medical Center Inc 301 yadkin street albemarle NC 28001 560556760 Hospital NC 501(c)(3) 170(b)(1)(A)(iii) N/A Stanly Manor Inc 625 Bethany Road albemarle NC 28001 561623092 long-term healthcare NC 501(c)(3) 509(a)(2) N/A Stanlex Inc 907 north second street albemarle NC 28001 561532751 healthcare NC 501(c)(3) 509(a)(3) N/A 0 0 1 0 1 0 0 0 0 1 0 0 0 1 0 0 0 1 stanly regional medical center inc R 1454128 stanly regional medical center inc J 682604 stanly regional medical center inc E 1757812