CHARLES A CANNON JR MEMORIAL HOSPITAL INC: Form 990, tax year 2020
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- Organization
- CHARLES A CANNON JR MEMORIAL HOSPITAL INC (EIN 56-0529974)
- Tax period
- 2020-10-01 to 2021-09-30
- Filed
- 2022-08-04
- IRS object ID
- 202222169349300807
- Schema version
- 2020v4.0
- 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 ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-08-04T09:35:30-05:00 | ReturnTs |
| Tax Period End | 2021-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 580914992 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DRAFFIN & TUCKER LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 71309 | AddressLine1Txt |
| City | ALBANY | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 317081309 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2020-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 560529974 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHARLES A CANNON JR MEMORIAL | BusinessNameLine1Txt |
| Business Name Line2 | HOSPITAL INC | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | CHAR | BusinessNameControlTxt |
| Phone | 8287377000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 434 HOSPITAL DRIVE | AddressLine1Txt |
| City | LINVILLE | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 28646 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MATT THOMAS | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 8287377000 | PhoneNum |
| Signature | 2022-07-31 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | MATT | PersonFirstNm |
| Person Last | THOMAS | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | WILLIAM EDWARD PHILLIPS | PreparerPersonNm |
| PTIN | P00451499 | PTIN |
| Phone | 2298837878 | PhoneNum |
| Preparation | 2022-08-02 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2020 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | CHARLES MANTOOTH | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 434 HOSPITAL DRIVE | AddressLine1Txt |
| City | LINVILLE | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 28646 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $29,108,246 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | HTTPS://AAPRHS.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1957 | FormationYr |
| Legal Domicile State | NC | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE HEALTHCARE SERVICES TO ENHANCE THE QUALITY OF LIFE FOR THE CITIZENS OF AVERY COUNTY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 15 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 12 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 29 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $3,187,722 | PYContributionsGrantsAmt |
| CY Contributions Grants | $7,190,511 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $20,403,069 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $21,151,190 | CYProgramServiceRevenueAmt |
| PY Investment Income | $565 | PYInvestmentIncomeAmt |
| CY Investment Income | $67,763 | CYInvestmentIncomeAmt |
| PY Other Revenue | $580,561 | PYOtherRevenueAmt |
| CY Other Revenue | $334,105 | CYOtherRevenueAmt |
| PY Total Revenue | $24,171,917 | PYTotalRevenueAmt |
| CY Total Revenue | $28,743,569 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $13,448,712 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $14,831,314 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $12,739,593 | PYOtherExpensesAmt |
| CY Other Expenses | $10,767,547 | CYOtherExpensesAmt |
| PY Total Expenses | $26,188,305 | PYTotalExpensesAmt |
| CY Total Expenses | $25,598,861 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$2,016,388 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $3,144,708 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $39,397,771 | TotalAssetsBOYAmt |
| Total Assets EOY | $40,286,861 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $31,716,135 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $35,271,558 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $7,681,636 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $5,015,303 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO PROVIDE HEALTHCARE SERVICES TO ENHANCE THE QUALITY OF LIFE FOR THE CITIZENS OF AVERY COUNTY. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $22,255,182 | ExpenseAmt |
| Revenue | $21,194,764 | RevenueAmt |
| Desc | CHARLES A. CANNON, JR MEMORIAL HOSPITAL IN LINVILLE IS A 25-BED ACUTE CARE HOSPITAL WITH A 10-BED INPATIENT BEHAVIORAL HEALTH UNIT. THE FULL-SERVICE EMERGENCY DEPARTMENT, IMAGING DEPARTMENT, LABORATORY, OUTPATIENT BEHAVIORAL HEALTH, REHABILITATION CENTER OFFERING PHYSICAL AND OCCUPATIONAL THERAPIES, AND CARDIOPULMONARY REHABILITATION COMPLETE THE LIST OF SERVICES OFFERED. | Desc |
| Total Program Service Expenses | $22,255,182 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | Yes (true) | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 0 | EmployeeCnt |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 15 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 12 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (true) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | false | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | false | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MATT THOMAS | PersonNm |
| Phone | 8282624100 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 336 DEERFIELD RD | AddressLine1Txt |
| City | BOONE | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 28607 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (19 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd |
|---|---|---|---|---|---|---|---|
| CHARLES MANTOOTH | |||||||
| CEO | 1.00 | 44.00 | Yes (X) | $0 | $566,808 | $72,440 | |
| PAUL DAGHER MD | |||||||
| TRUSTEE | 1.00 | 42.00 | $0 | $421,793 | $37,132 | Yes (X) | |
| KEVIN MAY | |||||||
| CFO LEFT 1/2 | 1.00 | 44.00 | Yes (X) | $0 | $356,376 | $27,704 | |
| CARMEN LACEY | |||||||
| CMH PRES | 40.00 | 1.00 | Yes (X) | $0 | $170,002 | $34,819 | |
| MATT THOMAS | |||||||
| CFO | 1.00 | 44.00 | Yes (X) | $0 | $112,118 | $3,612 | |
| SAM ADAMS | |||||||
| TRUSTEE | 1.00 | 3.00 | $0 | $0 | $0 | Yes (X) | |
| JOHN BLACKBURN | |||||||
| TRUSTEE | 1.00 | 3.00 | $0 | $0 | $0 | Yes (X) | |
| TOM DALE | |||||||
| CHAIR | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| JIM DEAL | |||||||
| VICE CHAIR | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| BILLY KENNEDY | |||||||
| TRUSTEE | 1.00 | 2.00 | $0 | $0 | $0 | Yes (X) | |
| BRETT LOFTIS | |||||||
| TRUSTEE | 1.00 | 2.00 | $0 | $0 | $0 | Yes (X) | |
| CHARLES BAKER MD | |||||||
| TRUSTEE | 1.00 | 1.00 | $0 | $0 | $0 | Yes (X) | |
| KIM MILLER | |||||||
| TRUSTEE | 1.00 | 3.00 | $0 | $0 | $0 | Yes (X) | |
| MEAGAN PHILLIPS | |||||||
| TRUSTEE | 1.00 | 2.00 | $0 | $0 | $0 | Yes (X) | |
| MARY LOUISE ROBERTS | |||||||
| TRUSTEE | 1.00 | 3.00 | $0 | $0 | $0 | Yes (X) | |
| KENT TARBUTTON | |||||||
| TRUSTEE | 1.00 | 2.00 | $0 | $0 | $0 | Yes (X) | |
| PATTIE TENNILLE | |||||||
| TRUSTEE | 1.00 | 2.00 | $0 | $0 | $0 | Yes (X) | |
| KENNETH WILCOX | |||||||
| TRUSTEE | 1.00 | 4.00 | $0 | $0 | $0 | Yes (X) | |
| JAN WINKLER | |||||||
| TRUSTEE | 1.00 | $0 | $0 | $0 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tot Reportable Comp Rltd Org | $1,627,097 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $175,707 | TotalOtherCompensationAmt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
| Government Grants | $7,190,511 | GovernmentGrantsAmt |
| Total Contributions | $7,190,511 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | NET PATIENT SERVICE REVENUE | Desc |
| Business | 621990 | BusinessCd |
| Total Revenue Column | $21,151,190 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $21,151,190 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $21,151,190 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $3,543 | TotalRevenueColumnAmt |
| Exclusion | $3,543 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $220,464 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $194,540 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $25,924 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $25,924 | TotalRevenueColumnAmt |
| Exclusion | $25,924 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $226,703 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $162,483 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $64,220 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $64,220 | TotalRevenueColumnAmt |
| Exclusion | $64,220 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $12,017 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $7,654 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,363 | TotalRevenueColumnAmt |
| Exclusion | $4,363 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|---|
| CAFETERIA AND VENDING | 722210 | $260,244 | $260,244 | |
| MISCELLANEOUS REVENUES | 621990 | $41,578 | $41,578 | |
| DISCOUNTS & REBATES | 621990 | $1,996 | $1,996 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $303,818 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $28,743,569 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $21,194,764 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $358,294 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,231,597 | TotalAmt |
| Program Services | $10,687,550 | ProgramServicesAmt |
| Management And General | $1,544,047 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,870,966 | TotalAmt |
| Program Services | $1,634,850 | ProgramServicesAmt |
| Management And General | $236,116 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $728,751 | TotalAmt |
| Program Services | $636,783 | ProgramServicesAmt |
| Management And General | $91,968 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,036,443 | TotalAmt |
| Program Services | $3,506,534 | ProgramServicesAmt |
| Management And General | $529,909 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,874,691 | TotalAmt |
| Program Services | $1,412,872 | ProgramServicesAmt |
| Management And General | $461,819 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,133 | TotalAmt |
| Program Services | $17,133 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $667,623 | TotalAmt |
| Program Services | $624,294 | ProgramServicesAmt |
| Management And General | $43,329 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $107,032 | TotalAmt |
| Program Services | $97,036 | ProgramServicesAmt |
| Management And General | $9,996 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $31,352 | TotalAmt |
| Program Services | $27,732 | ProgramServicesAmt |
| Management And General | $3,620 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $248,271 | TotalAmt |
| Management And General | $248,271 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,386,757 | TotalAmt |
| Program Services | $1,296,756 | ProgramServicesAmt |
| Management And General | $90,001 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $101,796 | TotalAmt |
| Program Services | $84,313 | ProgramServicesAmt |
| Management And General | $17,483 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $1,849,408 | $1,849,408 | |
| REPAIRS & MAINTENANCE | $250,204 | $250,204 | |
| DUES & SUBSCRIPTIONS | $84,204 | $46,623 | $37,581 |
| MISCELLANEOUS EXPENSE | $83,804 | $75,799 | $8,005 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $28,829 | TotalAmt |
| Program Services | $7,295 | ProgramServicesAmt |
| Management And General | $21,534 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $25,598,861 | TotalAmt |
| Program Services | $22,255,182 | ProgramServicesAmt |
| Management And General | $3,343,679 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,693,635 | BOYAmt |
| EOY | $1,270 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $11,702,798 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,699,242 | BOYAmt |
| EOY | $3,744,447 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,778 | BOYAmt |
| EOY | $20,139 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $676,944 | BOYAmt |
| EOY | $582,833 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $117,445 | BOYAmt |
| EOY | $197,528 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $49,438,744 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $26,171,653 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,882,367 | BOYAmt |
| EOY | $23,267,091 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $367,461 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,305,360 | BOYAmt |
| EOY | $403,294 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $39,397,771 | BOYAmt |
| EOY | $40,286,861 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,442,629 | BOYAmt |
| EOY | $637,725 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $74,370 | BOYAmt |
| EOY | $81,000 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,968,736 | BOYAmt |
| EOY | $7,183,540 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,230,400 | BOYAmt |
| EOY | $27,369,293 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $31,716,135 | BOYAmt |
| EOY | $35,271,558 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,771,821 | BOYAmt |
| EOY | $4,105,488 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $909,815 | BOYAmt |
| EOY | $909,815 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,681,636 | BOYAmt |
| EOY | $5,015,303 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $39,397,771 | BOYAmt |
| EOY | $40,286,861 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $3,144,708 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | -$5,811,041 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (true) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (true) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $909,815 | BeginningYearBalanceAmt |
| End Year Balance | $909,815 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $909,815 | BeginningYearBalanceAmt |
| End Year Balance | $909,815 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $909,815 | BeginningYearBalanceAmt |
| End Year Balance | $909,815 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $909,815 | BeginningYearBalanceAmt |
| End Year Balance | $909,815 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $909,815 | BeginningYearBalanceAmt |
| End Year Balance | $909,815 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prmnnt Endowment Balance EOY | 1.00000 | PrmnntEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | false | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | false | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,220,002 | OtherCostOrOtherBasisAmt |
| Book Value | $1,220,002 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $27,796,362 | OtherCostOrOtherBasisAmt |
| Depreciation | $16,721,598 | DepreciationAmt |
| Book Value | $11,074,764 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,847,482 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,671,319 | DepreciationAmt |
| Book Value | $176,163 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $10,425,288 | OtherCostOrOtherBasisAmt |
| Depreciation | $7,778,736 | DepreciationAmt |
| Book Value | $2,646,552 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $8,149,610 | OtherCostOrOtherBasisAmt |
| Book Value | $8,149,610 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $23,267,091 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)
| DescDesc | AmtAmt |
|---|---|
| DUE TO RELATED PARTIES | $23,889,728 |
| MEDICARE ADVANCE PAYMENT | $2,547,886 |
| THIRD PARTY SETTLEMENTS | $923,000 |
| ACCRUED INTEREST | $8,679 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $27,369,293 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE D, PAGE 2, PART V, LINE 4 | THE ASSETS HELD IN THE ENDOWMENT FUND ARE PARCELS OF LAND TO BE USED FOR THE PURPOSE OF PROMOTING THE HEALTH, CARE AND WELL-BEING OF THE CITIZENS AND RESIDENTS OF AVERY COUNTY AND SURROUNDING COUNTIES. UPON THE PROPERTY CEASING TO BE USED FOR THAT PURPOSE, THE PROPERTY IS TO REVERT TO THE GRANTOR, ITS HEIRS, SUCCESSORS AND ASSIGNS. |
| SCHEDULE D, PAGE 3, PART X | ARHS AND THE COMPANIES FOR WHICH IT SERVICES AS SOLE MEMBER ARE NOT-FOR- PROFIT CORPORATIONS AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND ARE EXEMPT FROM FEDERAL AND STATE INCOME TAXES ON RELATED INCOME. ACCORDINGLY, NO PROVISION FOR INCOME TAXES HAS BEEN CONSIDERED IN THE ACCOMPANYING FINANCIAL STATEMENTS. THE SYSTEM HAS DETERMINED IT DOES NOT HAVE ANY MATERIAL UNRECOGNIZED TAX BENEFITS OR OBLIGATIONS AS OF SEPTEMBER 30, 2021. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (true) | ExpensesExceedBudgetInd |
| Unable To Provide Care | false | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (true) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (true) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $368,422 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $368,422 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01430 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,397,716 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,171,957 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $225,759 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00870 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,766,138 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,171,957 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $594,181 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02300 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $12,094 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $12,094 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00050 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,135,685 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,236,721 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $898,964 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03480 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $14,563 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $14,563 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00060 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,162,342 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,236,721 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $925,621 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03590 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,928,480 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,408,678 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,519,802 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05890 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $3,457,816 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $172,891 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $6,761,566 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $6,841,651 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$80,085 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost Accounting System | Yes (X) | CostAccountingSystemInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHARLES A CANNON JR MEMORIAL | BusinessNameLine1Txt |
| Business Name Line2 | HOSPITAL | BusinessNameLine2Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 434 HOSPITAL DRIVE | AddressLine1Txt |
| City | LINVILLE | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 28646 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | HTTPS://APPRHS.ORG | WebsiteAddressTxt |
| State License | H0037 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Other | PSYCH, SWB SNF | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHARLES A CANNON JR MEMORIAL | BusinessNameLine1Txt |
| Business Name Line2 | HOSPITAL | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| Other | Yes (X) | OtherInd |
| CHNA Conducted | 19 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (true) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (true) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | HTTPS://APPRHS.ORG | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 19 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | HTTPS://APPRHS.ORG | StrategyWebsiteURLTxt |
| Strategy Attached | false | StrategyAttachedInd |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 300.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | HTTPS://APPRHS.ORG/FINANCIAL-ASSISTANC | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | HTTPS://APPRHS.ORG/FINANCIAL-ASSISTANC | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | HTTPS://APPRHS.ORG/FINANCIAL-ASSISTANC | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FACILITY 1, CHARLES A CANNON JR MEMORIAL - PART V, LINE 3E | THE PRIORITIZATION OF SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY IS IDENTIFIED AND THE METHODOLOGY FOR PRIORITIZING EACH NEED IS DESCRIBED ON PAGE 12 OF THE 2019 CHNA. |
| FACILITY 1, CHARLES A CANNON JR MEMORIAL - PART V, LINE 5 | FOR THE 2019 CHNA, ARHS SELECTED TOP PRIORITIES BY ANALYZING AVERY COUNTY'S COMMUNITY HEALTH REPORT AS PUBLISHED BY TOE RIVER HEALTH DISTRICT AND WATAUGA AND ASHE COUNTIES' COMMUNITY HEALTH REPORTS AS PUBLISHED BY THE APPALACHIAN DISTRICT HEALTH DEPARTMENT. A CHA PLANNING COMMITTEE, COMPRISED OF MULTI-DISCIPLINARY STAKEHOLDERS AND COMMUNITY LEADERS FROM ASHE AND WATAUGA COUNTIES, MET IN JUNE 2017 TO GUIDE IMPLEMENTATION OF THE CHA TIMELINE AND ENSURE THE PROCESS ENGAGED THE COMMUNITY IN AN INCLUSIVE AND RESPECTFUL MANNER. DEVELOPMENT OF THE COMMUNITY HEALTH OPINION SURVEY TOOL WAS GUIDED BY CDC DEMOGRAPHIC DATA COLLECTION STANDARDS, NACCHO GUIDELINES FOR CONDUCTING A COMMUNITY HEALTH ASSESSMENT, BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM, YOUTH RISK BEHAVIOR SURVEY, WNC HEALTHY IMPACT INITIATIVE, AND THE 2014 WATAUGA COUNTY COMMUNITY HEALTH OPINION SURVEY. SEVERAL KEY COMMUNITY PARTNERS PROVIDED INPUT ON SURVEY QUESTIONS, SUCH AS OASIS, HIGH COUNTRY AREA AGENCY ON AGING, WESTERN YOUTH NETWORK, ASHE MEMORIAL HOSPITAL AND APPALACHIAN REGIONAL HEALTHCARE SYSTEM. APPALACHIAN DISTRICT BOARD OF HEALTH MEMBERS PROVIDED INPUT ABOUT THE SURVEY QUESTIONS AND DISTRIBUTION POINTS. MEMBERS OF THE WATAUGA SUBSTANCE ABUSE PREVENTION COALITION PROVIDED GUIDANCE AND SUPPORT ON SURVEY DEVELOPMENT AND DISTRIBUTION. THE INJURY AND VIOLENCE PREVENTION BRANCH OF THE DIVISION OF PUBLIC HEALTH ALSO PROVIDED GUIDANCE ON QUESTION DEVELOPMENT. |
| FACILITY 1, CHARLES A CANNON JR MEMORIAL - PART V, LINE 6A | WATAUGA MEDICAL CENTER, A RELATED ORGANIZATION LOCATED AT 336 DEERFIELD ROAD, BOONE, NC, ASSISTED IN CONDUCTING THE 2019 CHNA. |
| FACILITY 1, CHARLES A CANNON JR MEMORIAL - PART V, LINE 6B | ARHS ANALYZED CHNAS PUBLISHED BY APPALACHIAN DISTRICT HEALTH DEPARTMENT AND TOE RIVER HEALTH DISTRICT TO DETERMINE HOW ARHS HOSPITALS CAN CONTRIBUTE TO ADDRESSING THE DEFINED HEALTH PRIORITIES. THIS REPORT WILL FOCUS ON THE NEEDS OF OUR THREE MAIN SERVICE AREAS: ASHE, AVERY AND WATAUGA. CHNAS WERE CONDUCTED IN EACH COUNTY; ASHE AND WATAUGA BY APPALACHIAN DISTRICT HEALTH DEPARTMENT AND AVERY BY TOE RIVER HEALTH DISTRICT. |
| FACILITY 1, CHARLES A CANNON JR MEMORIAL - PART V, LINE 11 | WATAUGA, ASHE, AND AVERY'S TOP 10 HEALTH ISSUES, LEADING CAUSES OF DEATH, AND HEALTH PRIORITIES (AS OUTLINED IN COMMUNITY HEALTH REPORTS) WERE COMPILED AND PRESENTED TO THE ARHS SENIOR LEADERSHIP TEAM. THEY SELECTED WMC AND CMH PRIORITIES BASED ON ARHS'S ABILITY TO IMPLEMENT OBJECTIVES AND ACTION STEPS THAT WILL CONTRIBUTE TO ADDRESSING EACH COUNTY'S DEFINED PRIORITIES. CMH'S, THE FILING ORGANIZATION, TOP 3 HEALTH PRIORITIES INCLUDE: - MENTAL/BEHAVIORAL HEALTH - CHRONIC DISEASE CARE AND PREVENTION - PHYSICAL ACTIVITY/NUTRITION SEVERAL NEEDS OUTLINED IN THE CHNA PROCESS SUCH AS CHILD ABUSE/NEGLECT, DENTAL PROBLEMS, ALCOHOL AND/OR DRUG USE, AND SEXUALLY TRANSMITTED DISEASE, HAVE NOT BEEN ADDRESSED IN THIS PLAN. IN INITIAL DISCUSSION AND SUBSEQUENT PRIORITIZATION, ARHS CONSIDERED THE LEVELS TO WHICH SOME NEEDS WERE ALREADY BEING ADDRESSED IN THE SERVICE AREA. ADDITIONALLY, SOME COMMUNITY NEEDS FALL OUT OF THE SCOPE OF EXPERTISE AND RESOURCES OF THE HOSPITAL. BOTH 2016 AND 2019 COMMUNITY HEALTH NEEDS ASSESSMENTS AND THE RELATED IMPLEMENTATION STRATEGIES CAN BE FOUND AT THE FOLLOWING ADDRESS: HTTPS://APPRHS.ORG/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/ |
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE H, PART I, LINE 7, COLUMN (F) | IN DERIVING THE DENOMINATOR TO BE USED FOR COLUMN (F), THE FOLLOWING ADJUSTMENTS WERE MADE TO THE TOTAL EXPENSES REPORTED ON FORM 990, PART IX, LINE 25: FORM 990, PART IX, LINE 25 25,598,858 ADD: EXPENSES ON PART VIII 202,195 DENOMINATOR FOR COLUMN (F) 25,801,053 |
| SCHEDULE H, PART I, LINE 7 | THE DATA REPORTED IN THIS AREA IS REPORTED AS INSTRUCTED BY CATHOLIC HEALTH ASSOCIATION'S "A GUIDE FOR PLANNING AND REPORTING COMMUNITY BENEFITS, 2008". SEE ALSO THE DESCRIPTION FOR PART III, LINE 2. |
| SCHEDULE H, PART III, LINE 2 | AMOUNTS INCLUDED ON PART III LINE 2 REPRESENT THE AMOUNT OF CHARGES CONSIDERED UNCOLLECTIBLE AFTER REASONABLE ATTEMPTS TO COLLECT, AND WRITTEN OFF TO BAD DEBT EXPENSE. |
| SCHEDULE H, PART III, LINE 3 | THE FIGURE ON PART III LINE 3 REPRESENTS MANAGEMENT'S ESTIMATE (APPROXIMATELY 5%) BASED ON AN ANALYSIS OF SELF PAY PATIENTS' ABILITY TO PAY THEIR OUTSTANDING ACCOUNT. THIS ANALYSIS INCLUDES REVIEWING THE PATIENT'S CREDIT HISTORY, INCOME LEVELS AND OVERALL COLLECTIBILITY OF THE ACCOUNT. |
| SCHEDULE H, PART III, LINE 4 | THE SYSTEM PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED ON AN EVALUATION OF THE OVERALL COLLECTABILITY OF THE ACCOUNTS RECEIVABLE. AS ACCOUNTS ARE KNOWN TO BE UNCOLLECTIBLE, THE ACCOUNTS ARE CHARGED AGAINST THE ALLOWANCE. |
| SCHEDULE H, PART III, LINE 8 | MEDICARE ALLOWABLE COSTS ARE COMPUTED IN ACCORDANCE WITH COST REPORTING METHODOLOGIES UTILIZED ON THE MEDICARE COST REPORT AND IN ACCORDANCE WITH RELATED REGULATIONS. INDIRECT COSTS ARE ALLOCATED TO DIRECT SERVICE AREAS USING THE MOST APPROPRIATE STATISTICAL BASIS. |
| SCHEDULE H, PART III, LINE 9B | CHARITY WRITE-OFFS ARE SEGREGATED FROM NORMAL BAD DEBTS THROUGH A SEPARATE TRANSACTION CODE. FAMILY INCOME BELOW 200% OF FEDERAL POVERTY GUIDELINES (FPG) ARE ELIGIBLE FOR 100% WRITE-OFF. PARTIAL WRITE-OFF IS AVAILABLE FOR FAMILY INCOME BETWEEN 200% AND 300% OF FPG. |
| SCHEDULE H, PART VI, LINE 2 | APPLACHIAN REGIONAL HEALTHCARE SYSTEM (ARHS) STAYS COMMITTED TO PROMOTING HEALTH IN THE HIGH COUNTRY, ENHANCING QUALITY OF LIFE AND SIMPLY MAKING LIFE BETTER. THE HEALTHCARE SYSTEM OFFERS A VARIETY OF HEALTH EDUCATION PROGRAMS, PREVENTION PROGRAMS AND HEALTH SCREENINGS TO ENCOURAGE HEALTHY LIFESTYLES FOR RESIDENTS AND VISITORS. IN ADDITION TO PARTNERING WITH LOCAL HEALTH DEPARTMENTS TO CONDUCT HEALTH NEEDS ASSESSMENTS, ARHS HOSTS ANNUAL HEALTH FAIRS IN OUR PRIMARY SERVICE AREA, WATAUGA AND AVERY COUNTIES. WE ALSO ATTEMPT TO ADDRESS THE NEEDS OF LOW INCOME, UNINSURED RESIDENTS THROUGH TWO PROGRAMS - APPLACHIAN HEALTHCARE PROJECT AND THE LATINO HEALTH PROGRAM WHICH ARE DISCUSSED FURTHER BELOW. |
| SCHEDULE H, PART VI, LINE 3 | PATIENTS ARE EDUCATED ABOUT THEIR ELIGIBILITY FOR ASSISTANCE UNDER FEDERAL, STATE OR LOCAL GOVERNMENT PROGRAMS OR UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY (FAP). DURING PRE-REGISTRATION AND REGISTRATION, PATIENTS CAN BE INTERVIEWED BY A PATIENT FINANCIAL ADVOCATE TO DETERMINE WHETHER THE PATIENT HAS A NEED FOR FINANCIAL ASSISTANCE OR POTENTIAL ELIGIBILITY UNDER GOVERNMENT PROGRAMS. |
| SCHEDULE H, PART VI, LINE 4 | THE COMMUNITY CONSISTS OF ASHE, AVERY, AND WATAUGA COUNTIES, A POPULATION OF APPROXIMATELY 98,000 PEOPLE IN NORTHWESTERN NORTH CAROLINA. PLEASE REFER TO THE RECENT COMMUNITY HEALTH NEEDS ASSESSMENT FOR AN IN-DEPTH LOOK AT THE DEMOGRAPHICS. BOTH THE 2016 AND 2019 CHNAS ARE AVAILABLE AT HTTPS://AAPRHS.ORG/COMMUNITY-HEALTH-NEEDS-ASSESSMENT. |
| SCHEDULE H, PART VI, LINE 5 | APPLACHIAN REGIONAL HEALTHCARE SYSTEM (ARHS) STAYS COMMITTED TO PROMOTING HEALTH IN THE HIGH COUNTRY, ENHANCING QUALITY OF LIFE AND SIMPLY MAKING LIFE BETTER. THE HEALTHCARE SYSTEM OFFERS A VARIETY OF HEALTH EDUCATION PROGRAMS, PREVENTION PROGRAMS AND HEALTH SCREENINGS TO ENCOURAGE HEALTHY LIFESTYLES FOR RESIDENTS AND VISITORS. IN ADDITION TO PARTNERING WITH LOCAL HEALTH DEPARTMENTS TO CONDUCT HEALTH NEEDS ASSESSMENTS, ARHS HOSTS ANNUAL HEALTH FAIRS IN OUR PRIMARY SERVICE AREA, WATAUGA AND AVERY COUNTIES. WE ALSO ATTEMPT TO ADDRESS THE NEEDS OF LOW INCOME, UNINSURED RESIDENTS THROUGH TWO PROGRAMS - APPLACHIAN HEALTHCARE PROJECT AND THE LATINO HEALTH PROGRAM. APPALACHIAN HEALTHCARE PROJECT IS A COLLABORATIVE EFFORT AMONG THE MEDICAL COMMUNITY TO PROVIDE HEALTHCARE FOR LOW INCOME, UNINSURED RESIDENTS OF WATAUGA AND AVERY COUNTIES. THE PROJECT ENROLLS PERSONS WHO MEET PROGRAM GUIDELINES AND COORDINATES HEALTH CARE ON THE INDIVIDUAL'S BEHALF. COORDINATION OF HEALTH CARE INCLUDES MANAGING REFERRALS TO SPECIALISTS, HELPING PATIENTS GET ACCESS TO MEDICATIONS, AND PATIENT CASE MANAGEMENT. MEDICAL PROVIDERS DONATE MUCH NEEDED CARE TO INDIVIDUALS WHO QUALIFY. THE LATINO HEALTH PROGRAM OF ARHS SEEKS TO IMPROVE THE HEALTH AND WELL-BEING OF LATINOS IN WATAUGA AND AVERY COUNTIES THROUGH INCREASED ACCESS TO CARE, HEALTH EDUCATION, AND OTHER ENABLING SERVICES. BOTH PROVIDE MORE THAN 2.5 MILLION IN MEDICAL ASISTANCE TO APPROXIMATELY 500 LOW INCOME, UNINSURED RESIDENTS ANNUALLY. THE GOVERNING BODY OF THE HOSPITAL FACILITY IS PRIMARILY COMPRISED OF PERSONS WHO ARE NOT EMPLOYEES OR CONTRACTORS (NOR FAMILY MEMBERS THEREOF) AND WHO REPRESENT A BROAD SPECTRUM OF THE COMMUNITY. THE HOSPITAL'S MEDICAL STAFF IS OPEN TO ALL QUALIFIED PHYSICIANS IN THE REGION. SURPLUS FUNDS ARE REINVESTED IN THE FACILITIES AND OPERATIONS. THE HOSPITAL PARTICIPATES IN THE MEDICARE AND MEDICAID PROGRAMS, AND OFFER FINANCIAL ASSISTANCE TO INDIVIDUALS SATISFYING ELIGIBILITY REQUIREMENTS. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | Yes (true) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (4 entries)
| TitleTitleTxt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Bonus Related OrganizationsBonusRelatedOrganizationsAmt |
|---|---|---|---|---|---|---|
| CHARLES MANTOOTH | ||||||
| CEO | $552,256 | $14,552 | $63,561 | $8,879 | $639,248 | |
| PAUL DAGHER MD | ||||||
| TRUSTEE | $283,482 | $2,281 | $7,205 | $29,927 | $458,925 | $136,030 |
| KEVIN MAY | ||||||
| CFO LEFT 1/21 | $227,396 | $128,980 | $14,957 | $12,747 | $384,080 | |
| CARMEN LACEY | ||||||
| CMH PRES | $167,955 | $2,047 | $25,123 | $9,696 | $204,821 | |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE J, PAGE 1, PART I, LINE 3 | NONE OF THE INDIVIDUAL BOARD MEMBERS OR OFFICERS ARE COMPENSATED BY THE FILING ORGANIZATION AND THE ORGANIZATION MUST RELY ON THE METHODS EMPLOYED BY THE RELATED ORGANIZATION, ARHS, TO DETERMINE REASONABLE COMPENSATION FOR THE INDIVIDUALS. COMPENSATION DETERMINATION BY ARHS INCLUDES AN INDEPENDENT COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT AND SURVEYS, AND BOARD APPROVAL. THESE METHODS ARE WELL DOCUMENTED. |
| SCHEDULE J, PAGE 1, PART I, LINE 4 | CHARLES MANTOOTH 0 55,161 0 KEVIN MAY 110,629 11,775 0 CARMEN LACEY 0 20,631 0 |
| SCHEDULE J, PART III | NONQUALIFIED DEFERRED COMPENSATION PLAN: THE SYSTEM HAS A NONQUALIFIED DEFERRED COMPENSATION PLAN FOR CERTAIN MEMBERS OF MANAGEMENT AND PHYSICIANS TO DEFER A PORTION OF THEIR COMPENSATION UNTIL RETIREMENT. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PAGE 6, PART VI, LINE 1A | THE EXECUTIVE COMMITTEE SHALL CONSIST OF THE CHAIRMAN OF THE BOARD OF TRUSTEES, THE VICE CHAIRMAN OF THE BOARD OF TRUSTEES, THE IMMEDIATE PAST CHAIRMAN OF THE BOARD OF TRUSTEES (IF STILL A MEMBER OF THE BOARD OF TRUSTEES), AND THREE OTHER TRUSTEES. THE CHAIRMAN SHALL APPOINT THE MEMBERS OF THE EXECUTIVE COMMITTEE AND SHALL SERVE AS ITS CHAIRMAN. IN THE ABSENCE OF A QUORUM OF THE ENTIRE BOARD OF TRUSTEES, THE EXECUTIVE COMMITTEE OR A MAJORITY THEREOF SHALL HAVE FULL AUTHORITY TO ACT IN ALL MATTERS RELATING TO CANNON MEMORIAL HOSPITAL BUSINESS, INCLUDING, BUT NOT LIMITED TO ALL THINGS DEEMED NECESSARY AND EXPEDIENT IN THE GOVERNANCE, MANAGEMENT, AND CONTROL OF THE BUSINESS AND AFFAIRS OF THE CORPORATION, INCLUDING MATTERS RELATING TO EXECUTIVE COMPENSATION, AND SHALL HAVE AND EXERCISE THE POWER AND AUTHORITY OF THE BOARD OF TRUSTEES TO TRANSACT ALL REGULAR BUSINESS OF THE CORPORATION WHEN THE BOARD OF TRUSTEES IS NOT IN SESSION, EXCEPT FOR CERTAIN PROHIBITED ACTIONS (ARTICLE V, SECTION 3 OF THE BYLAWS). FURTHER, THE EXECUTIVE COMMITTEE OR A MAJORITY THEREOF SHALL HAVE FULL AUTHORITY TO ACT ON BEHALF OF CANNON MEMORIAL HOSPITAL AT ANY CALLED OR SPECIAL MEETING. WHEN THE EXECUTIVE COMMITTEE EXERCISES THE POWER AND AUTHORITY OF THE BOARD OF TRUSTEES, SUCH ACTION IS SUBJECT TO RATIFICATION BY THE BOARD OF TRUSTEES. |
| FORM 990, PAGE 6, PART VI, LINE 3 | THE PARENT COMPANY AND SOLE MEMBER, APPALACHIAN REGIONAL HEALTHCARE SYSTEM (ARHS) OVERSEES THE ORGANIZATION'S OPERATIONS. ALSO SALARIES AND OTHER COMMON EXPENSES INCURRED BY ARHS ARE ALLOCATED APPROPRIATELY TO THE FILING ORGANIZATION. ALL PAYROLL RETURNS, INCLUDING W-2S, ARE ISSUED BY ARHS. PAYMENTS TO VENDORS ARE MADE THROUGH ARHS AND ALL 1099S ARE ISSUED BY ARHS. |
| FORM 990, PAGE 6, PART VI, LINE 6 | THE SOLE MEMBER IS APPALACHIAN REGIONAL HEALTHCARE SYSTEM, INC. |
| FORM 990, PAGE 6, PART VI, LINE 7A | THE TRUSTEES OF THE SOLE MEMBER SHALL ALSO SERVE AS THE TRUSTEES OF THE FILING ORGANIZATION. |
| FORM 990, PAGE 6, PART VI, LINE 11B | THE SVP/CFO REVIEWS THE 990 AND THEN IT IS MADE AVAILABLE TO THE BOARD UPON COMPLETION. |
| FORM 990, PAGE 6, PART VI, LINE 12C | THE CONFLICT OF INTEREST POLICY IS REVIEWED ANNUALLY AND APPLIES TO ALL EMPLOYEES, OFFICERS AND BOARD MEMBERS. SHOULD A CONFLICT EXIST, THE INDIVIDUAL IS RECUSED FROM DISCUSSION AND DECISION-MAKING PROCESS. |
| FORM 990, PAGE 6, PART VI, LINE 19 | GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE PROVIDED UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | CONTRACT LABOR 593,524 13,975 0 PHYSICIAN FEES 1,376,077 0 0 PURCHASED SERVICES 1,287,166 477,309 0 OUTSIDE SERVICES 226,074 0 0 CONSULTING 23,693 38,011 0 COLLECTION FEES 0 614 0 TOTAL 3,506,534 529,909 0 |
| FORM 990, PART XI, LINE 9 | EQUITY TRANSFERS -5,811,041 EQUITY TRANSFERS TO RELATED ORGANIZATIONS |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (6 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| APPALACHIAN REGIONAL HEALTHCARE SYS | |||||||||||
| PO BOX 2600 | BOONE | NC | 28607 | 201067022 | PARENT | NC | 501C3 | 12B | N/A | false | |
| BLOWING ROCK HOSPITAL INC | |||||||||||
| PO BOX 148 | BLOWING ROCK | NC | 28605 | 560513181 | REHAB CTR | NC | 501C3 | 3 | false | ARHS | |
| WATAUGA MEDICAL CENTER INC | |||||||||||
| 336 DEERFIELD RD | BOONE | NC | 28607 | 560510824 | HOSPITAL | NC | 501C3 | 3 | false | ARHS | |
| APPALACHIAN REGIONAL HEALTHCARE FDN | |||||||||||
| 336 DEERFIELD RD | BOONE | NC | 28607 | 204625618 | FOUNDATION | NC | 501C3 | 7 | false | ARHS | |
| APPALACHIAN REGIONAL MED ASSOC | |||||||||||
| PO BOX 2600 | BOONE | NC | 28607 | 205755130 | PHYSICIANS | NC | 501C3 | 10 | false | ARHS | |
| ARHS PROPERTIES INC | |||||||||||
| 336 DEERFIELD RD | BOONE | NC | 28607 | 203470765 | PROPERTY | NC | 501C3 | 12B | false | ARHS | |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SLOOP MED OFC PLAZA CONDO ASSOC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 434 HOSPITAL DRIVE | AddressLine1Txt |
| City | LINVILLE | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 28646 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 593761777 | EIN |
| Primary Activities | RENTAL | PrimaryActivitiesTxt |
| Legal Domicile State | NC | LegalDomicileStateCd |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Controlled Organization | false | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | false | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (true) | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (true) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (true) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (true) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
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