2011-08-12T16:07:15-05:00 2010-09-30 PERSHING YOAKLEY & ASSOCIATES PC ONE CHEROKEE MILLS 2220 SUTHERLAND KNOXVILLE TN 379192363 990 2009-10-01 560714394 Harris Regional Hospital Inc HARR 8285867000 68 Hospital Road Sylva NC 28779 W GENE WINTERS 8285867000 2011-08-12 1 8656730844 2009 2016-02-24 21:20:13Z W GENE WINTERS 68 Hospital Road Sylva NC 28779 94164773 0 X www.westcare.org X 1960 NC to provide high quality, cost effective healthcare targeted to the needs of the people we serve. 14 13 1385 120 331290 161105 1386168 1882562 86226488 89188598 959610 294651 2567107 2149927 91139373 93515738 51797 31899 0 46234183 48904576 0 0 42024030 47004319 88310010 95940794 2829363 -2425056 71545105 74422414 36316174 44341324 35228931 30081090 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." 0 0 85031275 31899 89188598 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. THE HOSPITAL'S PRIMARY SERVICE AREA CONSISTS OF JACKSON, MACON, SWAIN AND GRAHAM COUNTIES OF WESTERN NORTH CAROLINA. MORE THAN 50 PERCENT OF THE HOSPITAL'S PATIENTS COME FROM OUTSIDE OF JACKSON COUNTY.HARRIS REGIONAL HOSPITAL IS A SHORT-TERM, ACUTE CARE FACILITY. THE 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. 85031275 1 1 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 68 0 1 1385 1 1 1 0 0 0 0 0 0 0 0 14 13 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 NC X Lena Cochran 8285867157 68 Hospital Road Sylva NC 28779 MR FRED ALEXANDER 1.00 X 0 0 0 DR NOELLE KEHRBERG 1.00 X 0 0 0 MR DANIEL ALLISON 1.00 X 0 0 0 MR JIM MANRING 1.00 X 0 0 0 Ms MARTHA ANDERSON MD 1.00 X 0 0 0 MR JERRY MCKINNEY 1.00 X 0 0 0 MR JOHN BURTON 1.00 X 0 0 0 MR DENNIS SANDERS 1.00 X 0 0 0 MR BOB CARPENTER 1.00 X 0 0 0 MS STEPHANIE TREADWAY 1.00 X 0 0 0 MR LOWELL CRISP 1.00 X 0 0 0 Mr DAVID ZIMMERMAN MD 1.00 X 0 0 0 Mr EARL HADDOCK 1.00 X 31500 0 0 MR MARK LEONARD FACHE 50.00 X X 261511 0 27770 MS ELIZABETH JOHNS 1.00 X 0 0 0 Mr WAVERLY GREEN MD 40.00 X 129359 0 16133 Mr GENE COUCH PHD 1.00 X 0 0 0 MR STEPHEN L HEATHERLY 50.00 X 200013 0 4361 Mr MARTIN SENICKI MD 50.00 X 639903 0 17840 Mr LAWRENCE SUPIK MD 50.00 X 551246 0 23069 Mr WILLIAM J HANDLEY MD 50.00 X 471709 0 14691 Mr WILLIAM L SIMS MD 50.00 X 320329 0 331 Ms STEPHANIE B HORNBUCKLE MD 50.00 X 299998 0 16261 2905568 0 120456 33 0 1 0 aramark cts 12483 collection center drive chicago IL 60693 contract labor 851478 Michael Hightower MD 35 Facility Drive Clyde NC 28721 Physician Services 469118 opex & AVERAOPEX consulting 6294 Hillcrest Road medford OR 97504 software consulting 440762 Dixon Huges PO Box 3049 Asheville NC 28802 Accounting services 414011 ALLIANCE HEALTHCARE SERVICES 100 BAYVIEW CIRCLE SUITE 400 NEWPORT BEACH CA 92660 DIAGNOSTIC IMAGING 395762 72 302919 596298 983345 1882562 NEt patient revenue 621110 87950674 87623481 327193 other aux services 621110 923981 923981 lifeline 621110 227301 227301 gain-inv. in affiliate 621110 88232 88232 loss-discontinued ops 621110 -1590 -1590 89188598 251440 251440 71 71 818620 649035 169585 169585 169585 43140 43140 43140 43140 miscellaneous income 621110 737507 737507 Meals & Vending 722210 728332 4097 724235 discounts 621110 346294 346294 168209 168209 1980342 93515738 87623481 331290 3678405 31899 31899 620644 31500 589144 40025502 35468844 4556658 1017719 888876 128843 4536180 3961900 574280 2704531 2362137 342394 883568 771708 111860 817990 714432 103558 65600 57295 8305 5616300 4905276 711024 130358 113855 16503 3828025 3343397 484628 1236573 1080023 156550 1119638 977892 141746 640508 559420 81088 3928217 3430905 497312 1100322 961021 139301 Bad Debts 9735752 9735752 Medical Supplies 7698882 6724204 974678 Repairs & Maintenance 3382515 2954289 428226 Leases 1892350 1652778 239572 Recruitment & Retention 420253 367049 53204 4507468 3936823 570645 95940794 85031275 10909519 0 6434 6458 3525217 2229578 12068997 10713855 1497108 1492239 561926 429954 90971247 58546088 23372440 32425159 8717751 10376214 11959987 10577385 1206831 9835245 4964741 71545105 74422414 10438051 9801707 204070 222335 16596392 14855506 9077661 19461776 36316174 44341324 X 34147877 29668113 1081054 412977 35228931 30081090 71545105 74422414 X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 2327987 2327987 42648609 29672616 12975993 33244851 26408254 6836597 12749800 2465218 10284582 32425159 9621696 F ASSETS LIMITED AS TO USE 112147 F LONG TERM INVESTMENTS 843542 F 10577385 other assets 6884 deferred financing costs, net 293740 other receivables, net 1751035 due from related parties 1541748 due from related party, under integration agreement 1371334 4964741 due to third party payors 593903 accrued pension cost 8081254 interest rate swap 782555 capital leases 9797288 ESTIMATED PHYSICIAN GUARANTEE LIABILITY 206776 19461776 Part X: Description of Uncertain Tax Positions Under FIN 48: 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. In 2010, ProCor, Inc. adopted the uncertain tax positions provisions of FASB ASC 740. The adoption of these provisions had no material impact on the Organizations' consolidated financial statements. ProCor, Inc. has no uncertain tax positions at September 30, 2010 and 2009. 1 1 1 X 1 X 1 1 1 0 1 1 1117585 1117585 0.01300 9556007 9556007 0.11090 10673592 10673592 0.12390 91031 26250 64781 0.00080 38359 38359 0.00040 129390 26250 103140 0.00120 10802982 26250 10776732 0.12510 1300445 1300445 0.01510 1300445 1300445 0.01510 1 3581199 0 25055377 23251202 1804175 X 1 1 Carolinas Health System Healthcare Managment Western Regional Radiation Therapy Center Health services 0.30000 0.00000 0.00000 HARRIS REGIONAL HOSPITAL

68 HOSPITAL ROAD WAYNESVILLE NC 28779

X X X MOUNTAIN TRACE NURSING CENTER

417 FOX TRACE ROAD SYLVA NC 28779

NURSING HOME FACILITY 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, Line 7f: Bad debt expense included in FOrm 990, part IX, line 25, column (a) is $9,735,752. The Hospital excluded the full amount, $9,735,752, 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.UNINSURED DISCOUNTS AND BAD DEBTS INCLUDE THE COST OF SERVICES TO UNINSURED OR UNDERINSURED PATIENTS AND TO PATIENTS WHO OTHERWISE DO NOT PAY FOR THEIR HEALTHCARE SERVICES. DURING fiscal year 2010, THE ORGANIZATION BEGAN APPLYING A 40% DISCOUNT AT TIME OF BILLING FOR SERVICES PROVIDED TO UNINSURED PATIENTS. GROSS CHARGES SO DISCOUNTED ARE EXCLUDED FROM PATIENT REVENUE. 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 Hospitals 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 patients 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 Hospitals 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. The Hospital, along with assistance from ProCor, strives to meet each patients financial responsibilities. If this isnt successful, past due amounts will be 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 VI, Line 2: The hospital completes an annual survey, which includes charity care and community benefit information. The hospital submits this survey with its financial assistance policy to the North Carolina Hospital Association ("NCHA"). The hospital's charity care and community benefit data along with its financial assistance policy is available for viewing on the NCHA public website. The hospital's financial data is reported using guidelines developed by NCHA and its members.Outside of the information submitted to the NCHA, the hospital does not formally assess the health care needs of the community it serves. However, any new physician positions created are approved by the board of trustees and evaluated for the overall benefit provided to the community. 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 20% of its population as uninsured. The population of Jackson county is just over 40,000 and according to the U.S. Census Bureau, Sylva has a population of 2,457. Jackson county has a median household income of $37,823 with 20.5% of the population living below the poverty level. Part VI, Line 5: COMMUNITY BUILDING PROGRAMS INCLUDE THE UNREIMBURSED COST OF VARIOUS EDUCATION AND RESEARCH PROGRAMS, NON-BILLED MEDICAL SERVICES, IN-KIND DONATIONS, AND OTHER SERVICES THAT MEET A STRONG COMMUNITY NEED, BUT DO NOT PAY FOR THEMSELVES. EXAMPLES OF THESE COMMUNITY BENEFIT PROGRAMS INCLUDE MEDICATION ASSISTANCE and INCREASED ACCESS TO PHYSICIAN SERVICES. Additionally, during fiscal year 2010, the hospital provided the Flourish Womens Conference with health screenings and hosted key speakers presenting inspirational messages for women; the hospital's orthopeadic department provided knee screenings; and the hospital's pediatric offices presented topics on child health and safety. Part VI, Line 6: 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 7: 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. In addition to the hospitals, MedWest operates the outpatient facilities, Harris Medical Park in Sylva, Swain Medical Park in Bryson City, Medical Park of Franklin and is a partner in Mountain Regional Cancer Centers with a state-of-the-art radiation therapy facility in Sylva. MedWest serves 160,000 people in Haywood, Jackson, Swain, Macon, and Graham counties with a medical staff of more than 230 physicians, many of whom are part of an employed physician network. 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 1 X Procedure for Monitoring Grants in the U.S.: Part I, Line 2: 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. X X X 0 0 0 0 0 0 0 0 0 MR MARK LEONARD FACHE 240464 0 0 0 21047 0 9930 0 17840 0 289281 0 0 0 MR STEPHEN L HEATHERLY 200013 0 0 0 0 0 8873 0 8920 0 217806 0 0 0 Mr MARTIN SENICKI MD 639903 0 0 0 0 0 0 0 17840 0 657743 0 0 0 Mr LAWRENCE SUPIK MD 551246 0 0 0 0 0 5229 0 17840 0 574315 0 0 0 Mr WILLIAM J HANDLEY MD 471709 0 0 0 0 0 0 0 14691 0 486400 0 0 0 Mr WILLIAM L SIMS MD 320329 0 0 0 0 0 0 0 16228 0 336557 0 0 0 Ms STEPHANIE B HORNBUCKLE MD 299998 0 0 0 0 0 0 0 16261 0 316259 0 0 0 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: Waverly Green, M.D., board of trustees member, and Earl Haddock, former board of trustees member, received compensation for medical services provided to a related organization, not for their services as board of trustee members. WESTCARE INC 68 HOSPITAL ROAD SYLVA NC 28779 561967734 HOSPITAL NC 501(c)(3) Line 3 N/A SWAIN COUNTY HOSPITAL 68 HOSPITAL ROAD SYLVA NC 28779 560629325 HOSPITAL NC 501(c)(3) Line 3 N/A medWest Health System Inc 68 HOSPITAL ROAD SYLVA NC 28779 271472706 Healthcare management NC 501(c)(3) Line 11c, III-FI N/A WESTERN REGIONAL RADIATION THERAPY CENTER 68 HOSPITAL ROAD SYLVA NC 28779 561849395 HEALTH SERVICES NC N/A RELATED 63848 692730 0 1 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 0 0 0 0 0 0 0 0 0 0 1 1 0 1 0 1 0 0