2023-04-28T11:05:36-05:00 2022-06-30 BDO USA LLP 421 Fayetteville Street Suite 300 Raleigh NC 27601 990 2021-07-01 560554202 Caldwell Memorial Hospital Inc % KAREN SHADOWENS CALD 8287575100 321 Mulberry Street SW Lenoir NC 28645 Karen Shadowens CFO 8287575100 2023-04-27 true Karen Shadowens 999009999 SANDRA L FEINSMITH P01064157 9192781936 2023-04-25 2 2021 2023-04-26 12:10:37Z Laura J Easton 321 Mulberry Street SW Lenoir NC 28645 179319128 false X www.caldwellmemorial.org X 1945 NC TO PROVIDE SAFE, EFFECTIVE, COMPASSIONATE CARE AND TO PROMOTE HEALTHY LIFESTYLES TO OUR COMMUNITY . 14 11 1187 78 601701 0 654131 262545 159413768 170098117 167258 268850 1545735 8689616 161780892 179319128 0 0 0 0 71743138 83030181 0 0 0 86677252 92845408 158420390 175875589 3360502 3443539 105948361 122705147 34580759 48225066 71367602 74480081 X TO PROVIDE SAFE, EFFECTIVE, COMPASSIONATE CARE AND TO PROMOTE HEALTHY LIFESTYLES TO OUR COMMUNITY. false false 151838915 0 177962566 SINCE opening in 1951, Caldwell Memorial Hospital, Inc. has continued to grow and change in order to better meet the needs of our community. The mission of Caldwell Memorial Hospital, Inc. is to provide safe, effective, compassionate care and to promote healthy lifestyles to our community. anchored by a 137-bed acute care facility, caldwell memorial hospital, inc.'s services include a vast array of medical and surgical services. Among services offered, but by no means a complete list, are carotid artery stenting; cardiovascular and endovascular care; radiation oncology; computer-assisted orthopedic surgery; neurology and memory care; pain management; a fully staffed 24-hour emergency department; caldwell physicians clinics conveniently located county-wide; diagnostic services; outpatient surgery; plus urgent care; and the quest 4 life wellness center. multiple educational and counseling programs are available for a wide array of healthcare needs including cancer, diabetes, nutrition and joint care, among others. In July of 2020 the new state of the art jonas hill hospital and clinic, a division of Caldwell Memorial Hospital, Inc., was opened adjacent to the hospital. the inpatient division of jonas hill has 27 beds for adult inpatient behaviorial health hospitalization and is equipped to treat a wide variety of conditions including but not limited to anxiety, attention deficit hyperactivity disorder, bipolar disorder, depression, post-traumatic stress disorder and schizophrenia. the facility features a unique outdoor area that allows patients to exercise, meditate and enjoy some fresh air. in the summer of 2021, an outpatient clinic was opened to complement and add to the services provided by Jonas hill. the clinic offers continuing care for adult inpatients as well as outpatient care for adolescents. the clinic provides support for patients and families during their recovery. services provided include but are not limited to medication management; individual therapy and counseling; group therapy and counseling; and family therapy and counseling. 151838915 true true false true false false false false false false true false false false true true false true false false false false false false false false true true false false true false false false false false false true false false false false false false true true false false false true 144 0 true 1187 true true true false false false false false false false false false false false X 14 11 false false false false true true true true true false false true true true true true true true true false X KAREN SHADOWENS 8287575100 321 MULBERRY STREET SW Lenoir NC 28645 X CHRIS ELLINGTON DIRECTOR 2.0 58.0 X 0 1100753 190571 JENYUNG CHIU MEDICAL PRACTICE PHYSICIAN 60.0 0.0 X 813566 0 31790 JAMES HATHORN MEDICAL PRACTICE PHYSICIAN 60.0 0.0 X 824822 0 15384 RALPH DUCKETT MEDICAL PRACTICE PHYSICIAN 60.0 0.0 X 709984 0 25177 JUSTIN WALKER MEDICAL PRACTICE PHYSICIAN 60.0 0.0 X 689377 0 27406 RANDAL BAST MEDICAL PRACTICE PHYSICIAN 60.0 0.0 X 631713 0 30281 LAURA J EASTON PRESIDENT & CEO 60.0 0.0 X X 441634 0 34470 DAVID A LOWRY CMO 60.0 0.0 X 438035 0 34470 MICHAEL L BUNCH CFO 60.0 0.0 X 294752 0 18571 REBECCA T SMITH COO 60.0 0.0 X 285756 0 25339 JOHN D POWELL MD DIRECTOR 2.0 0.0 X 281888 0 16490 DONITA M DAMRON VP PHYSICIAN SERVICES 60.0 0.0 X 212974 0 21293 KAREN SHADOWENS CFO 60.0 0.0 X 0 144650 10226 stephen l farris MD Director 2.0 0.0 X 12000 0 0 JOSEPH GIBBONS DIRECTOR/CHAIRMAN 4.0 0.0 X X 0 0 0 DAVID SMITH DIRECTOR/VICE CHAIRMAN 4.0 0.0 X X 0 0 0 JANET AIKEN DIRECTOR 2.0 0.0 X 0 0 0 MICHAEL CHAMBERLAIN DIRECTOR 2.0 0.0 X 0 0 0 JERRY CHURCH DIRECTOR 2.0 0.0 X 0 0 0 BOB FLOYD DIRECTOR 2.0 0.0 X 0 0 0 WILLIAM HOWARD III DIRECTOR 2.0 0.0 X 0 0 0 TERRY HUNT DIRECTOR 2.0 0.0 X 0 0 0 DOUGLAS JOHNSON DIRECTOR 2.0 0.0 X 0 0 0 JEFFREY KEVERLINE MD DIRECTOR 2.0 0.0 X 0 0 0 DIANA MCCLINTON MD DIRECTOR 2.0 0.0 X 0 0 0 MARK POARCH DIRECTOR 2.0 0.0 X 0 0 0 ALAN STILES DIRECTOR 2.0 0.0 X 0 0 0 CRYSTAL THOMAS DIRECTOR 2.0 0.0 X 0 0 0 5636501 1245403 481468 108 false true false MOUNTAIN EMERGENCY PHYSICIANS 319 Springwood Drive NE VALDESE NC 28690 Physician Services 2192924 WEATHERBY LOCUMS INC 15300 WESTON PARKWAY SUITE 105 CARY NC 27513 Staffing 1218752 ENDURACARE ACUTE CARE SERVICES 381 RIVERSIDE DRIVE SUITE 440 FRANKLIN TN 37064 Therapy Program Mgmt 1201630 QUALIVIS LLC 1601 ASSEMBLY STREET UNIT 1439 COLUMBIA SC 29201 Staffing 1129500 AON RISK SERVICES CENTRAL INC 4220 DUNCAN AVENUE SUITE 401 ST LOUIS MO 63110 Financial Services 619184 29 233164 29381 262545 PATIENT SERVICES 621500 166103579 166103579 QUEST4LIFE WELLNESS CENTER REVENUE 713990 592130 592130 OTHER PROGRAM SERVICES REVENUE 900099 3402408 3076556 325852 170098117 268850 9571 259279 0 0 508886 0 508886 0 508886 508886 0 0 0 0 0 0 0 0 0 0 CARES ACT STIMULUS 900099 8151482 8151482 OTHER REVENUE 900099 29248 29248 8180730 179319128 177360865 601701 1094017 X 0 0 0 0 2360104 2360104 0 66237877 54977437 11260440 1220811 1017032 203779 8787122 8017479 769643 4424267 4036758 387509 0 63524 63524 61202 61202 7712 7712 0 0 17986686 11691346 6295340 0 17878 17878 952942 952942 0 0 2079325 2079325 455314 273187 182127 0 11128 11128 516158 516158 1834196 1834196 10112607 10112607 985817 985817 PATIENT CARE SUPPLIES & SERV 23834965 23834965 BAD DEBT EXPENSE 14739517 14739517 HOME OFFICE ALLOCATION 14671668 14231516 440152 MINOR EQUIPMENT AND R&M 1606205 1558019 48186 2908564 2814810 93754 175875589 151838915 24036674 0 15137755 16509411 0 0 0 0 17753507 17989535 0 0 0 0 0 0 3934334 3986463 2747276 2932618 186555484 112340026 59022741 74215458 1447884 1124173 5670232 5714218 234632 233271 0 0 0 0 105948361 122705147 20839308 27542428 0 0 10084411 5465183 0 0 0 0 0 0 601972 14956346 0 0 3055068 261109 34580759 48225066 X 71367602 74480081 0 0 71367602 74480081 105948361 122705147 3443539 -331060 X X false true X true true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 7712 7712 false SCHEDULE C, PART II-B, LINE 1, LOBBYING ACTIVITIES: ANNUAL DUES WERE PAID TO THE AMERICAN HOSPITAL ASSOCIATION AND NORTH CAROLINA HOSPITAL ASSOCIATION. A PERCENTAGE, DETERMINED BY THE ORGANIZATIONS, WAS ESTIMATED TO BE EXPENDITURES USED IN LOBBYING ACTIVITIES BY THESE ORGANIZATIONS. 2754303 2754303 88662719 44648911 44013808 41546 5539 36007 70465709 61052209 9413500 24631207 6633367 17997840 74215458 0 THIRD PARTY 261109 DEFERRED FEE PLAN LIABILITY 0 RAC SETTLEMENT 0 261109 X SCHEDULE D, PART X, LINE 2: THE HOSPITAL AND FOUNDATION ARE NONPROFIT CORPORATIONS AND HAVE BEEN RECOGNIZED AS TAX-EXEMPT, PURSUANT TO SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. NO PROVISION FOR INCOME TAXES HAS BEEN MADE IN THE ACCOMPANYING COMBINED FINANCIAL STATEMENTS. true true X true X 250. false true true false true false 7236587 7236587 0.04490 25851822 27620910 33088409 27620910 7236587 0.04490 737150 737150 0.00460 737150 737150 0.00460 33825559 27620910 7973737 0.04950 true 14739517 64297481 76797338 -12499857 X true true AMERICAN HOME PATIEN HEALTHCARE 0.25 0.75 LAUREL PARK MOB MEDICAL OFFICE BUILDING 0.15 0.85 PRIME SURGICAL SUITE AMBULATORY SURGERY CENTER 0.71 0.29 1 1 CALDWELL MEMORIAL HOSPITAL inc 321 MULBERRY STREET SW Lenoir NC 28645 www.caldwellmemorial.org H0061 X X X DISPROPORTIONATE SHARE HOSPITAL CALDWELL MEMORIAL HOSPITAL inc 1 false false true X X X X X X X X 19 true false false true X See Part V X true 19 true See Part V false true X 250. 0. X true true X X X X true X SEE PART V X SEE PART V X SEE PART V X X X X X X true X false X X X true X false false PART V, SECTION B, LINE 5 CALDWELL MEMORIAL HOSPITAL, inc. (CMH) DEVELOPED A BROAD ONLINE SURVEY FOR THE COMMUNITY TO PARTICIPATE IN. THIS SURVEY WAS READILY AVAILABLE ON SEVERAL PLATFORMS, INCLUDING CMH'S WEBSITE AND FACEBOOK PAGE AND PROVIDED TO CMH EMPLOYEES. A HARD COPY OF THE SURVEY WAS DISTRIBUTED TO LOCAL PHARMACIES, BUSINESSES, COMMUNITY CENTERS, URGENT CARES/CLINICS AND PHYSICIAN PRACTICES, WITH OVER 800 RESPONSES RECEIVED. AFTER DEPLOYING THE SURVEY AND IDENTIFYING THE SIGNIFICANT NEEDS OF THE COMMUNITY, CMH MET WITH A SELECT DIVERSE GROUP OF COMMUNITY MEMBERS TO DISCUSS THE INITIAL FINDINGS OF THE SURVEY AND CMH'S PREVIOUS CHNA. PART V, SECTION B, LINE 7a HTTPS://WWW.CALDWELLMEMORIAL.ORG/ABOUT-US/-COMMUNITY-HEALTH-NEEDS- ASSESSMENT/ Part V, SECTION B, LINE 10a HTTPS://WWW.CALDWELLMEMORIAL.ORG/ABOUT-US/-COMMUNITY-HEALTH-NEEDS- ASSESSMEnt/ PART V, SECTION B, LINE 11 CMH HAS IDENTIFIED THE FOLLOWING THREE AREAS AS REPRESENTING THE MOST SIGNIFICANT HEALTH NEEDS FOR CALDWELL COUNTY: SUBSTANCE ABUSE CALDWELL SERVICES, PROGRAMS AND RESOURCES AVAILABLE TO RESPOND TO THIS NEED: - CALDWELL WILL PROVIDE LOCKBOXES FOR PATIENTS AND FAMILY MEMBERS SO THAT THEY CAN SECURE HOME MEDICATIONS TO PREVENT MISUSE OR DIVERSION - CALDWELL LAUNCHED AN OPIOID STEWARDSHIP PROGRAM IN AUGUST 2019, WHICH WILL LIMIT THE NUMBER OF ORAL OPIATES DISPENSED FOLLOWING SURGICAL PROCEDURES BY AN ESTIMATED 30% - CALDWELL'S EMERGENCY DEPARTMENT IS PARTICIPATING IN A UNC HCS OPIOID STEWARDSHIP PROGRAM TO REDUCE THE NUMBER OF OPIOIDS DISPENSED FOLLOWING EMERGENCY DEPARTMENT VISITS - CALDWELL IS PARTICIPATING IN A UNC HCS INITIATIVE TO IMPROVE THE INPATIENT TREATMENT OF INPATIENTS UNDERGOING ACUTE ETHANOL WITHDRAWAL - ALL LICENSED MEDICAL PROVIDERS ON STAFF AT CALDWELL ARE REQUIRED TO COMPLETE TRAINING IN OPIOID PRESCRIBING PER THE NORTH CAROLINA STOP ACT ADDITIONALLY, CALDWELL CONSTRUCTED JONAS HILL BEHAVIORAL HEALTH PAVILION WHICH OPENED IN THE SUMMER OF 2020. JONAS HILL WILL PROVIDE INPATIENT AND OUTPATIENT BEHAVIORAL HEALTH SERVICES BUT WILL ALSO TREAT PATIENTS WITH DUAL DIAGNOSES OF BEHAVIORAL HEALTH ILLNESS AND SUBSTANCE ABUSE. APPROXIMATELY 30% OR MORE OF BEHAVIORAL HEALTH PATIENTS CARRY DUAL DIAGNOSES OF BEHAVIORAL ILLNESS AND SUBSTANCE ABUSE. MENTAL ILLNESS CALDWELL SERVICES, PROGRAMS AND RESOURCES AVAILABLE TO RESPOND TO THIS NEED: - EMPLOYEE ASSISTANCE PROGRAM AVAILABLE TO EMPLOYEES AND FAMILY MEMBERS - FIVE COUNSELING SESSIONS - OUTPATIENT DEPRESSION SCREENINGS AVAILABLE AT ALL CLINICS; INCLUDING PHQ2 AND PHQ9 SCREENINGS - COLLABORATION WITH STATE - MEDICAID FUNDED LOCAL MANAGEMENT ENTITY (LME), VAYA HEALTH, TO PROVIDE MENTAL HEALTH SCREENS IN EMERGENCY DEPARTMENT - CRISIS COLLABORATIVE TEAM, CONSISTING OF VARIOUS COMMUNITY HEALTH STAKE HOLDERS, THAT MEETS EVERY OTHER MONTH - MENTAL HEALTH RESOURCE GUIDE AVAILABLE AT ALL CLINICS - EMERGENCY DEPARTMENT RENOVATION FOR 5 PSYCHIATRIC ROOMS; INCLUDING ONE ADOLESCENT ROOM - QUALIFIED CASE MANAGEMENT PROFESSIONAL WHO ASSISTS WITH MENTAL HEALTH SCREENINGS - PARTNERING WITH PROJECT LAZARUS, TO BATTLE PRESCRIPTION DRUG ABUSE - CALDWELL PROMOTES THE USE OF 'BLACK BOXES' TO DISPOSE OF PRESCRIPTION MEDICATIONS AND CONTROLLED SUBSTANCES - SYSTEM WIDE PROTOCOL FOR THE USE OF NARCAN ADDITIONALLY, CALDWELL IS FIRMLY POSITIONED AND COMMITTED TO CREATING AN INNOVATIVE RURAL BEHAVIORAL HEALTH PROGRAM FOR WESTERN NC. WORKING COLLABORATIVELY WITH LOCAL MENTAL HEALTH PARTNERS, CALDWELL WILL ACHIEVE THE GOAL OF MAKING MENTAL HEALTHCARE AS ROUTINE, ACCESSIBLE AND UNDERSTANDABLE AS PHYSICAL HEALTHCARE. THE NEWLY OPENED JONAS HILL HOSPITAL & CLINIC WILL MEET A CRITICAL NEED FOR INCREASED RURAL INPATIENT PSYCHIATRIC HOSPITAL BEDS AND NEW PSYCHIATRIC OUTPATIENT SERVICES IN OUR COMMUNITY AND REGION. CHRONIC DISEASE CALDWELL SERVICES, PROGRAMS AND RESOURCES AVAILABLE TO RESPOND TO THIS NEED: - PERFORM NUMEROUS SCREENINGS AND TRACK METRICS IN CLINICS TO MEASURE AND ADDRESS WHEN STATISTICS ARE ABOVE CERTAIN LEVELS - CHAMP PROGRAM, WHICH EVALUATES PATIENTS FALL RISK - PROVIDE SMOKING CESSATION ASSESSMENT/COUNSELING FOR INPATIENTS AND REFERRING OUT PATIENTS TO QUEST FOR LIFE - EMPLOYEE TRACK CLINIC, CLINIC PROVIDED TO EMPLOYEES AND FAMILY MEMBERS, PROVIDERS MONITOR CHRONIC ILLNESS - DIABETES AND NUTRITION SERVICES PROVIDED THROUGH THE QUEST FOR LIFE - ANNUAL CANCER SCREENING DAY PROVIDED BY MCCREARY CANCER CENTER - CT SCREENINGS FOR LUNG CANCER - PROVIDING FREE HIGH SCHOOL EKG SCREENINGS AND PHYSICALS - PROVIDE REDUCED COST MAMMOGRAPHY AND CHEST X-RAY INTERPRETATIONS FOR THE HEALTH DEPARTMENT ADDITIONALLY, CALDWELL WILL ASSESS POPULATION DEMOGRAPHICS AND FACILITATE SPECIFIC STEPS TO ADDRESS TOP CHRONIC DISEASE OUTLIERS IN THE COUNTY. COMMUNITY OUTREACH AND EDUCATION WILL BE IMPERATIVE TO ADDRESS THIS NEED. CALDWELL WILL IMPLEMENT LEAN PERFORMANCE IMPROVEMENT INITIATIVES FOR TEAM TO IMPROVE POPULATION METRICS WITH CHRONIC DISEASE. THE REMAINING TOP HEALTH ISSUES THAT CALDWELL WILL NOT BE ADDRESSING INCLUDE THE FOLLOWING: OBESITY, CANCER, SMOKING AND TOBACCO USE, CHILD ABUSE, DOMESTIC ABUSE, VIOLENT BEHAVIOR, ABUSIVE/VIOLENT BEHAVIOR AND SUICIDE. WHILE CALDWELL RECOGNIZES THESE HEALTH NEEDS, THEIR RESOURCES ARE BETTER USED IN ADDRESSING THE TOP THREE HEALTH PRIORITIES LISTED ABOVE. Part V, Section B, Line 15e PROVIDED SEVERAL WAYS TO RETURN THE COMPLETED APPLICATION; SUCH AS, IN THE ENVELOPE PROVIDED, UPLOAD TO PROVIDED WEBSITE AND FAX NUMBER. PART V, SECTION B, LINES 16A-C HTTPS://WWW.CALDWELLMEMORIAL.ORG/PATIENTS-VISITORS/BILLING-FINANCIAL-ASSIS TANCE/ Part V, Section B, Line 20d to assist patients who may be eligible for financial assistance, but circumstances prevent completion of a full application, a presumptive determination may be utilized. 9 Community Pharmacy 321 Mulberry Street SW LENOIR NC 28645 retail/employee pharmacy Quest 4 life wellness center 1031 morganton Blvd LENOIR NC 28645 wellness center CALDWELL physicians network 321 Mulberry Street SW lenoir NC 28645 Physician Practice caldwell memorial sleep CENTER 270 pine mountain road hudson NC 28638 sleep center the center for wound management 401 MULBERRY STREET LENOIR NC 28645 wound care center george m hancock surgery center 1031 MORGANTON BLVD LENOIR NC 28645 OP surgery center CENTER FOR DIABETES HEALTH 1031 morganton blvd LENOIR NC 28645 diabetes education and support pain management center 1031 morganton blvd LENOIR NC 28645 pain management laurel park breast center college avenue lenoir NC 28645 breast health PART I, LN 7 COL(F) THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25(B) BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGES IN THIS COLUMN, IS $14,739,517. PART III, LINE 2 THE ORGANIZATION'S BAD DEBT EXPENSE AS REPORTED ON THE AUDITED FINANCIAL STATEMENTS AND FORM 990, PART IX. THE COST-TO-CHARGE RATIO FOR THE YEAR WAS APPLIED TO THE GROSS BAD DEBT CHARGES FOR THE YEAR. PART III, LINE 3 THE ORGANIZATION'S BAD DEBT DOES NOT INCLUDE ANY AMOUNTS ATTRIBUTABLE TO THOSE PATIENTS WHO APPLIED FOR AND RECEIVED FINANCIAL ASSISTANCE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. PART III, LINE 4 NET PATIENT SERVICE REVENUE IS REPORTED AT THE ESTIMATED NET REALIZABLE AMOUNTS FROM PATIENTS, THIRD-PARTY PAYORS, AND OTHERS FOR SERVICES RENDERED, INCLUDING ESTIMATED RETROACTIVE ADJUSTMENTS DUE TO FUTURE AUDITS, REVIEWS, AND INVESTIGATIONS. RETROACTIVE ADJUSTMENTS ARE ACCRUED ON AN ESTIMATED BASIS IN THE PERIOD THE RELATED SERVICES ARE RENDERED, AND SUCH AMOUNTS ARE ADJUSTED IN FUTURE PERIODS AS ADJUSTMENTS BECOME KNOWN OR AS YEARS ARE NO LONGER SUBJECT TO SUCH AUDITS, REVIEWS, AND INVESTIGATIONS. PART III, LINE 9B The hospital does not subject any patients who qualified for financial assistance guidelines to a collection agency. PART VI, LINE 2 FEDERAL REGULATIONS SURROUNDING CHNA REQUIRE LOCAL INPUT FROM REPRESENTATIVES OF PARTICULAR DEMOGRAPHIC SECTORS. FOR THIS REASON, CALDWELL MEMORIAL HOSPITAL, inc. (CMH) DEVELOPED A STANDARD PROCESS OF GATHERING COMMUNITY INPUT. CALDWELL MEMORIAL HOSPITAL, inc. (CMH) DEVELOPED A BROAD ONLINE SURVEY FOR THE COMMUNITY TO PARTICIPATE IN. THIS SURVEY WAS READILY AVAILABLE ON SEVERAL PLATFORMS, INCLUDING CMH'S WEBSITE AND FACEBOOK PAGE AND PROVIDED TO CMH EMPLOYEES. A HARD COPY OF THE SURVEY WAS DISTRIBUTED TO LOCAL PHARMACIES, BUSINESSES, COMMUNITY CENTERS, URGENT CARES/CLINICS AND PHYSICIAN PRACTICES, WITH OVER 800 RESPONSES RECEIVED. AFTER DEPLOYING THE SURVEY AND IDENTIFYING THE SIGNIFICANT NEEDS OF THE COMMUNITY, CMH MET WITH A SELECT DIVERSE GROUP OF COMMUNITY MEMBERS TO DISCUSS THE INITIAL FINDINGS OF THE SURVEY AND CMH'S PREVIOUS CHNA. PART VI, LINE 3 CALDWELL MEMORIAL HOSPITAL, inc. (CMH) PROVIDES NEEDED HEALTHCARE SERVICES TO ANYONE REGARDLESS OF THAT PERSON'S ABILITY TO PAY. CMH'S FINANCIAL ASSISTANCE POLICY IS DESIGNED TO ASSIST PATIENTS WHO ARE FINANCIALLY UNABLE TO PAY FOR HEALTHCARE SERVICES. A LINK TO THE POLICY CAN BE FOUND ON THE CMH PUBLIC WEBSITE. CMH DISPLAYS INFORMATION REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE IN ITS EMERGENCY ROOM, REGISTRATION AREAS IN THE HOSPITAL AND CLINICS, AND FINANCIAL COUNSELOR OFFICES. A LINK IS ALSO PROVIDED ON THE HOSPITAL'S WEBSITE TO THE AVAILABILITY OF FINANCIAL ASSISTANCE AND ITS FINANCIAL ASSISTANCE POLICY, ALONG WITH AN ON-LINE APPLICATION. INPATIENT CASE MANAGERS ALSO PROVIDE INFORMATION TO THE PATIENTS REGARDING AVAILABLE PROGRAMS AND THE ORGANIZATION'S FINANCIAL POLICY. CONSULTATION WITH FINANCIAL COUNSELORS IS ALSO AVAILABLE TO ALL PATIENTS AS NEEDED. PART VI, LINE 4 THE PRIMARY SERVICE AREA FOR CALDWELL MEMORIAL HOSPITAL, inc. IS CALDWELL COUNTY WITH A LIMITED NUMBER OF PATIENTS FROM THE SURROUNDING COUNTIES OF BURKE, WATAUGA AND CATAWBA. OF THE MULTIPLE INCORPORATED MUNICIPALITIES IN CALDWELL COUNTY, CMH RECEIVED 90.03% OF ITS PATIENTS FROM COLLETTSVILLE, GRANITE FALLS, HUDSON AND LENOIR. CALDWELL COUNTY IS IN THE NW SECTION OF NC IN THE FOOTHILLS OF THE BLUE RIDGE MOUNTAINS AND IS BOUND ON THE NW BY WATAUGA COUNTY, ON THE NE BY WILKES COUNTY, ON THE EAST BY ALEXANDER COUNTY, ON THE SOUTH BY CATAWBA AND BURKE COUNTIES AND ON THE WEST BY BURKE AND AVERY COUNTIES. THE POPULATION IS JUST OVER 80,000 WITH 51% FEMALE AND 49% MALE. THE POPULATION MAKEUP IS 87.1% WHITE, 5.4% HISPANIC, 4.9% BLACK OR AFRICAN AMERICAN AND 2.6% OTHER. THE LARGEST INCOME GROUP IS $25-50K AND LARGEST AGE GROUP IS 35-54 YEARS OLD. PART VI, LINE 5 CALDWELL MEMORIAL HOSPITAL, inc. PROVIDES FINANCIAL SUPPORT TO 2 COMMUNITY AGENCIES: THE HELPING HANDS CLINIC (PROVIDING CARE TO THE UNINSURED) AND THE SATIE AND JE BROYHILL CALDWELL SENIOR CENTER (FOCUS ON THE LIVES AND ADVOCACY OF SENIORS). OTHER COMMUNITY INVOLVEMENT INCLUDES BUT NOT LIMITED TO: ANNUAL PROSTATE SCREENING, HEALTH FAIRS, SUPPORT AND INVOLVEMENT IN THE CALDWELL COMMUNITY GARDEN WHICH HELPS FOSTER COMMUNITY GARDENING, REPRESENTATION BY ORGANIZATION REPRESENTATIVES ON LOCAL HEALTH CARE RELATED BOARDS (BOARD OF HEALTH, HOSPICE, AND CHILD PROTECTION TEAM.) CALDWELL MEMORIAL HEALTHWORKS WHICH IS OCCUPATIONAL, INDUSTRIAL AND WORKER'S COMP MEDICINE DESIGNED TO ASSIST EMPLOYERS TOWARD IMPROVING QUALITY OF HEALTHCARE. PART VI, LINE 6 CALDWELL MEMORIAL HOSPITAL, inc. IS PART OF THE UNC HEALTH CARE SYSTEM. UNC HEALTH CARE IS A NOT-FOR-PROFIT INTEGRATED HEALTH CARE SYSTEM OWNED BY THE STATE OF NORTH CAROLINA AND BASED IN CHAPEL HILL. ORIGINALLY ESTABLISHED NOV. 1, 1998, UNC HEALTH CARE CURRENTLY COMPRISES UNC HOSPITALS AND ITS PROVIDER NETWORK, THE CLINICAL PROGRAMS OF THE UNC SCHOOL OF MEDICINE, AND TEN AFFILIATE HOSPITALS AND HOSPITAL SYSTEMS ACROSS THE STATE. COLLECTIVELY, THIS GROUP OF HEALTH CARE PROVIDERS WORKS TOGETHER TO MAKE SURE THAT ALL OF THE COMMUNITIES SERVED RECEIVED THE HIGHEST QUALITY OF CARE. X X X X X false true false false false true true false false LAURA J EASTON PRESIDENT & CEO 350864 0 90770 0 0 0 13000 0 21470 0 476104 0 0 0 REBECCA T SMITH COO 224394 0 61362 0 0 0 10953 0 14386 0 311095 0 0 0 MICHAEL L BUNCH CFO 233917 0 60635 0 200 0 6952 0 11619 0 313323 0 0 0 KAREN SHADOWENS CFO 0 100650 0 15000 0 29000 0 2829 0 7397 0 154876 0 0 DAVID A LOWRY CMO 348684 0 87252 0 2099 0 13000 0 21470 0 472505 0 0 0 DONITA M DAMRON VP PHYSICIAN SERVICES 168903 0 44071 0 0 0 6907 0 14386 0 234267 0 0 0 JAMES HATHORN MEDICAL PRACTICE PHYSICIAN 392959 0 0 0 431863 0 9879 0 5505 0 840206 0 0 0 JENYUNG CHIU MEDICAL PRACTICE PHYSICIAN 647062 0 53300 0 113204 0 10380 0 21410 0 845356 0 0 0 RALPH DUCKETT MEDICAL PRACTICE PHYSICIAN 503073 0 200588 0 6323 0 13000 0 12177 0 735161 0 0 0 JUSTIN WALKER MEDICAL PRACTICE PHYSICIAN 543739 0 100000 0 45638 0 9750 0 17656 0 716783 0 0 0 RANDAL BAST MEDICAL PRACTICE PHYSICIAN 351319 0 0 0 280394 0 12669 0 17612 0 661994 0 0 0 CHRIS ELLINGTON DIRECTOR 0 750688 0 274907 0 75158 0 177880 0 12691 0 1291324 0 0 JOHN D POWELL MD DIRECTOR 168261 0 12092 0 101535 0 7918 0 8572 0 298378 0 0 0 SCHEDULE J, PART I, LINE 4B: LAURA EASTON (CEO) HAS A SECURED BENEFIT PLAN WHICH IS INCLUDED IN THE STUDY COMPLETED BY THE INDEPENDENT COMPENSATION CONSULTANT; THE LOAN UNDER THIS ARRANGEMENT IS RECORDED ON THE FINANCIAL STATEMENTS AND FULLY SECURED BY LIFE INSURANCE ON THE LIFE OF THE CEO. SCHEDULE J, PART I, LINE 6: EMPLOYEES IN MANAGERIAL ROLES PARTICIPATE IN AN INCENTIVE COMPENSATION PLAN APPROVED ANNUALLY BY THE UNC HCS BOARD OF DIRECTORS. THE COMPENSATION EARNED UNDER THIS PLAN IS BASED PARTLY ON THE NET EARNINGS OF THE ORGANIZATION AND THE UNC HCS. OTHER PERFORMANCE MEASURES USED TO DETERMINE INCENTIVE COMPENSATION ARE PATIENT SATISFACTION, PATIENT CARE QUALITY OUTCOMES AND INNOVATIVE INITIATIVES TO IMPROVE OPERATIONS AND CARE DELIVERY. EMPLOYED PHYSICIANS ARE PAID ON A PRODUCTIVITY BASIS BASED ON RVU'S GENERATED IN THEIR PRACTICE OPERATIONS AND THESE ARE TIED TO MGMA BENCHMARKS. Naomi Hunt Daughter of Board Director 87016 Compensation false Jonathan Smith PA Son of Board Director 100516 Compensation false FORM 990, PART VI, SECTION A, LINE 1: THE EXECUTIVE/FINANCE COMMITTEE SHALL HAVE THE POWER TO TRANSACT ALL REGULAR BUSINESS OF THE HOSPITAL DURING THE PERIOD BETWEEN THE MEETINGS OF THE BOARD OF DIRECTORS, SUBJECT TO ANY PRIOR LIMITATION IMPOSED BY THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 6: THE UNIVERSITY OF NORTH CAROLINA HEALTH CARE SYSTEM IS A MEMBER. FORM 990, PART VI, SECTION A, LINE 7A: THE UNIVERSITY OF NORTH CAROLINA HEALTH CARE SYSTEM IS A MEMBER AND THEY HAVE THE POWER TO APPOINT BOARD MEMBERS AND APPROVE GOVERNANCE DECISIONS. FORM 990, PART VI, SECTION A, LINE 7B: THE UNIVERSITY OF NORTH CAROLINA HEALTH CARE SYSTEM AS A MEMBER HAS APPROVAL RIGHTS TO ALL GOVERNANCE DECISIONS. FORM 990, PART VI, SECTION B, LINE 11B: THE FORM 990 WAS PREPARED BY AN INDEPENDENT ACCOUNTANT WITH ASSISTANCE AND OVERSIGHT BY MANAGEMENT. THE FULL BOARD RECEIVED A COPY OF THE FORM 990 FOR THEIR REVIEW AND FOR ANY QUESTIONS. THE FULL BOARD VOTED FOR A FINAL APPROVAL OF THE FORM 990. FORM 990, PART VI, SECTION B, LINE 12C: THE AUDIT AND COMPLIANCE COMMITTEE OF THE BOARD ANNUALLY REVIEWS THE CONFLICT OF INTEREST STATEMENTS. MINUTES OF BOARD MEETINGS REFLECT ANY DECLARED CONFLICT OF INTEREST. FORM 990, PART VI, SECTION B, LINE 15: THE ORGANIZATION COMPLETES THE REBUTTABLE PRESUMPTION OF REASONABLENESS AS DESCRIBED IN TREASURY REGULATION 4958(6)(C) FOR EACH OFFICER AND KEY EMPLOYEE. THIS PROCESS IS PERFORMED BY AN OUTSIDE INDEPENDENT COMPENSATION SPECIALIST. THE CONSULTANT'S FINDINGS ARE PRESENTED TO THE HR COMMITTEE OF THE BOARD AND ARE ULTIMATELY APPROVED BY THE FULL BOARD. FORM 990, PART VI, SECTION C, LINE 18: PHOTOCOPIES OF THE FORM 990 ARE AVAILABLE UPON REQUEST AT THE ORGANIZATION'S ADMINISTRATIVE OFFICE. IN ADDITION, RECENT FILINGS OF THE FORM 990 ARE AVAILABLE ON GUIDESTAR.ORG. FORM 990, PART VI, SECTION C, LINE 19: THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, FINANCIAL STATEMENTS, AND CONFLICT OF INTEREST POLICY AVAILABLE UPON REQUEST. PLEASE USE THE ORGANIZATION'S "CONTACT US" LINK ON ITS WEBSITE FOR REQUESTS. FORM 990, PART VII, LINE 1B AVERAGE HOURS PER WEEK BOARD MEMBERS AND OFFICERS CONTRIBUTE THEIR TIME AND SERVICES UPON REQUEST AND ON AN AS-NEEDED BASIS, WHICH, THROUGHOUT THE YEAR, MAY DIFFER FROM THE AVERAGE NUMBER OF HOURS PER WEEK REPORTED ON PART VII, LINE 1B. FORM 990, PART XII, LINE 2C: NO CHANGE FROM PRIOR YEAR. FORM 990, PART XII, LINE 3B: ONCE THE FINANCIAL AUDIT WAS COMPLETED, THE AUDITORS BEGAN THE SINGLE AUDIT. THEY ARE SCHEDULED TO BE COMPLETED ON OR BEFORE 3/31/2023, WHICH IS THE EXTENDED DUE DATE. THE REQUIRED FY 2021 SINGLE AUDIT IS CURRENTLY IN PROCESS AND WILL BE COMPLETED ON OR BEFORE 3/31/2023. FORM 990 PART IX LINE 11G DESCRIPTION:CONTRACTED PROFESS SERVICES TOTAL FEES:9761417 FORM 990 PART IX LINE 11G DESCRIPTION:OUTSIDE SERVICES TOTAL FEES:8086377 FORM 990 PART IX LINE 11G DESCRIPTION:OTHER PROFESSIONAL FEES TOTAL FEES:138892 UNC HEALTH CARE SYSTEM 101 MANNING DRIVE Chapel Hill NC 27514 562206970 HEALTHCARE NC SECTION 115 UNC HEALTH C false UNC HOSPITALS 101 MANNING DRIVE CHAPEL HILL NC 27514 561118388 HEALTHCARE NC SECTION 115 UNC HEALTH C false CALDWELL MEMORIAL HOSPITAL FNDN INC PO BOX 1890 LENOIR NC 28645 581935514 SUPPORT OF CA NC 501(C)(3) LINE 7 CALDWELL MEM false CHATHAM HOSPITAL INC PO BOX 649 SILER CITY NC 27344 560611546 HEALTHCARE NC 501(C)(3) LINE 3 UNC HEALTH C false PIEDMONT TRIAD HEALTH SERVICES 101 MANNING DRIVE MEDICAL WIN CHAPEL HILL NC 27514 561497163 SUPPORT OF UN NC 501(C)(3) LINE 12B II UNC HEALTH C false REX HEALTHCARE INC 4220 LAKE BOONE TRAIL RALEIGH NC 27607 561509129 HEALTHCARE NC 501(C)(3) LINE 12A I UNC HEALTH C false REX HOSPITAL INC 4420 LAKE BOONE TRAIL RALEIGH NC 27607 561509260 HEALTHCARE NC 501(C)(3) LINE 3 UNC HEALTH C false THE REX HEALTHCARE FOUNDATION INC 4420 LAKE BOONE TRAIL RALEIGH NC 27607 566052117 SUPPORT OF RE NC 501(C)(3) LINE 12B II UNC HEALTH C false UNCPN 5221 Paramount Pkwy Suite 220 MORRISVILLE NC 27560 271081647 HEALTHCARE NC 501(C)(3) LINE 10 UNC HEALTH C false UNC ROCKINGHAM HEALTH CARE INC 117 EAST KINGS HIGHWAY EDEN NC 27288 823745228 HEALTHCARE NC 501(C)(3) LINE 3 UNC HEALTH C false prime surgical suites LLC 180 river bend drive granite falls NC 28630 463556921 surgical NC related -1243800 2228019 0 false 0.66180 UNC PHYSICIANS NETWORK GRP PRACTICES LLC 5221 Paramount Pkwy Suite 220 MORRISVILLE NC 27560 461416986 HEALTHCARE NC UNC HEALTHCARE C CORP 0 0 false UNC PHYSICIANS GRP PRACTICES II LLC 2500 Blue Ridge Road Ste 401 RALEIGH NC 27607 852823886 HEALTHCARE NC Rex Healthcare C CORP 0 0 false UNC Health Innovations Inc 4420 Lake Boone Trail RALEIGH NC 27607 871233049 OPERATION SUPPORT NC Rex Healthcare C CORP 0 0 false false false true false false false false false false false false false true true false true false false false Caldwell Memorial Hospital Foundation C 233164 CASH