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ANC TRANSYLVANIA COMMUNITY HOSPITAL INC: Form 990, tax year 2019

View the entire original 990 at ProPublica ↗

Organization
ANC TRANSYLVANIA COMMUNITY HOSPITAL INC (EIN 56-0562293)
Tax period
2019-10-01 to 2020-09-30
Filed
2021-08-15
IRS object ID
202112279349300211
Schema version
2019v5.2
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

FieldValueIRS element (for citing)
Return2021-08-15T17:20:21-05:00ReturnTs
Tax Period End2020-09-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN366055558PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1GRANT THORNTON LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line11415 VANTAGE PARK DRIVE SUITE 500AddressLine1Txt
CityCHARLOTTECityNm
State AbbreviationNCStateAbbreviationCd
ZIP28203ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2019-10-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN560562293EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1ANC TRANSYLVANIA COMMUNITY HOSPITAL INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlANCTBusinessNameControlTxt
Phone8475831618PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1425 W NEW ENGLAND AVENUE NO 300AddressLine1Txt
CityWINTER PARKCityNm
State AbbreviationFLStateAbbreviationCd
ZIP32789ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonMATTHEW RUBINPersonNm
Person TitleCFOPersonTitleTxt
Phone8475831618PhoneNum
Signature2021-08-15SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonMICHELE N MELCHIORPreparerPersonNm
PTINP00488037PTIN
Phone7046323500PhoneNum
FieldValueIRS element (for citing)
Tax2019TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerMATTHEW RUBINPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1425 W NEW ENGLAND AVENUE NO 300AddressLine1Txt
CityWINTER PARKCityNm
State AbbreviationFLStateAbbreviationCd
ZIP32789ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$15,374GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressN/AWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1933FormationYr
Legal Domicile StateNCLegalDomicileStateCd
Activity Or MissionTO IMPROVE THE HEALTH OF THE PEOPLE OF WESTERN NC. THE ORGANIZATION IS CURRENTLY (SEE SCHEDULE O)ActivityOrMissionDesc
Voting Members Governing Body2VotingMembersGoverningBodyCnt
Voting Members Independent2VotingMembersIndependentCnt
Total Employee367TotalEmployeeCnt
Total Volunteers2TotalVolunteersCnt
Total Gross UBI$15,374TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$9,805NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$2,010,008PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$26,028,541PYProgramServiceRevenueAmt
CY Program Service Revenue$15,374CYProgramServiceRevenueAmt
PY Investment Income-$485,073PYInvestmentIncomeAmt
CY Investment Income$0CYInvestmentIncomeAmt
PY Other Revenue$0PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$27,553,476PYTotalRevenueAmt
CY Total Revenue$15,374CYTotalRevenueAmt
PY Grants And Similar Paid$178,178PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$7,182,145PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$0CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$12,062,263PYOtherExpensesAmt
CY Other Expenses$0CYOtherExpensesAmt
PY Total Expenses$19,422,586PYTotalExpensesAmt
CY Total Expenses$0CYTotalExpensesAmt
PY Revenues Less Expenses$8,130,890PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$15,374CYRevenuesLessExpensesAmt
Total Assets BOY$54,155TotalAssetsBOYAmt
Total Assets EOY$64,407TotalAssetsEOYAmt
Total Liabilities BOY$0TotalLiabilitiesBOYAmt
Total Liabilities EOY$0TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$54,155NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$64,407NetAssetsOrFundBalancesEOYAmt
MissionTO IMPROVE THE HEALTH OF THE PEOPLE OF WESTERN NC. THE ORGANIZATION IS CURRENTLY IN PROCESS OF WIND DOWN FOR EVENTUAL DISSOLUTION.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$0ExpenseAmt
Grant$0GrantAmt
Revenue$0RevenueAmt
DescTHE ORGANIZATION'S OPERATIONS CEASED DUE TO SALE OF A SUBSTANTIAL PORTION OF ITS ASSETS, INCLUDING THE HOSPITAL FACILITY, ON 2/1/19. THE ENTITY IS IN THE PROCESS OF WIND DOWN AND EVENTUAL DISSOLUTION OF REMAINING ASSETS FOR EVENTUAL TERMINATION. THE ENTITY HAD NO ACTIVITY DURING THE YEAR, OTHER THAN INCOME FROM AN INVESTMENT THAT HAS NOT YET BEEN DISPOSED.Desc
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi Endowments0DonorRstrOrQuasiEndowmentsInd
Report Land Building Equipment0ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other Liabilities0ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control Ent0TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee367EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (1)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (1)Form990TFiledInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members2GoverningBodyVotingMembersCnt
Independent Voting Member2IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesYes (1)DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn Body0Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEO0CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldNCStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1ANC HEALTHCARE INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone8475831618PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1INC 425 NEW ENGLAND AVE STE 300AddressLine1Txt
CityPARKCityNm
State AbbreviationFLStateAbbreviationCd
ZIP32789ZIPCd
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd
No Listed Persons CompensatedYes (X)NoListedPersonsCompensatedInd

Form990 Part VII Section A Form990PartVIISectionAGrp (7 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerInd
DAVID FRANKLIN
FORMER DIRECTOR0.000.00Yes (X)$0$810,034$18,517
PAUL MCDOWELL
FORMER DIRECTOR0.000.00Yes (X)$0$420,838$15,020
KATHY GUYETTE
FORMER DIRECTOR0.000.00Yes (X)$0$395,680$10,219
DR JOHN GARRETT
CHAIR0.253.75$0$0$0Yes (X)Yes (X)
TOM MAHER
VICE CHAIR0.254.00$0$0$0Yes (X)Yes (X)
NEIL LURIA
CEO, CHIEF WIND-DOWN OFF.0.2511.75$0$0$0Yes (X)
MATTHEW RUBIN
CFO, SEC, TREAS0.2511.75$0$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$1,626,552TotReportableCompRltdOrgAmt
Total Other Compensation$43,756TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (1)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescJOINT VENTURE INCOMEDesc
Business900099BusinessCd
Total Revenue Column$15,374TotalRevenueColumnAmt
Unrelated Business Revenue$15,374UnrelatedBusinessRevenueAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$15,374TotalProgramServiceRevenueAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$15,374TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$15,374UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$54,155BOYAmt
EOY$64,407EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$54,155BOYAmt
EOY$64,407EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$54,155BOYAmt
EOY$64,407EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$54,155BOYAmt
EOY$64,407EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$54,155BOYAmt
EOY$64,407EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$15,374ReconcilationRevenueExpnssAmt
Other Changes In Net Assets-$5,122OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Total Book Value Land Buildings$0TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp

FieldValueIRS element (for citing)
DescINVESTMENT IN JOINT VENTUREDesc
Book Value$64,407BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Other Assets$64,407TotalBookValueOtherAssetsAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART X, LINE 2:FormAndLineReferenceDesc
ExplanationTHE ORGANIZATION IS INCLUDED IN THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS WITH ANC HEALTHCARE. FOLLOWING IS THE FOOTNOTE FROM THE CONSOLIDATED FINANCIALS: ANC APPLIES THE PROVISIONS OF FINANCIAL ACCOUNTING STANDARDS BOARD (FASB) ACCOUNTING STANDARDS CODIFICATION (ASC) TOPIC 740, INCOME TAXES, IN ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES. ASC TOPIC 740 PROVIDES GUIDANCE ON WHEN TAX POSITIONS ARE RECOGNIZED IN AN ENTITY'S FINANCIAL STATEMENTS AND HOW THE VALUES OF THESE POSITIONS ARE DETERMINED. THERE IS CURRENTLY NO SIGNIFICANT IMPACT ON ANC'S CONSOLIDATED FINANCIAL STATEMENTS AS A RESULT OF THE APPLICATION OF ASC TOPIC 740.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (1)SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (3 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
DAVID FRANKLIN
FORMER DIRECTOR$0$92,345$0$115,156$0$602,533$0$17,608$0$909$0$828,551$0$601,943
PAUL MCDOWELL
FORMER DIRECTOR$0$59,927$0$87,750$0$273,161$0$11,848$0$3,172$0$435,858$0$272,789
KATHY GUYETTE
FORMER DIRECTOR$0$47,980$0$76,831$0$270,869$0$9,194$0$1,026$0$405,900$0$269,896

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 3COMPENSATION REFLECTED IN THIS FORM 990 IS FOR CALENDAR 2019 AND WAS PAID BY A RELATED ORGANIZATION. IT IS FOR THE PERIOD OF TIME PRIOR TO THE SALE OF THE ASSETS, AT WHICH TIME EMPLOYEES WERE TERMINATED.
PART I, LINE 4BTHE FOLLOWING INDIVIDUALS PARTICIPATED IN A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN OF A RELATED ORGANIZATION. THE CONTRIBUTIONS TO THE SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN ARE INCLUDED ON SCHEDULE J, PART II, COLUMN C AS PART OF DEFERRED COMPENSATION. DAVID FRANKLIN $16,571 PAUL MCDOWELL $9,948 KATHY GUYETTE $7,309 THE FOLLOWING INDIVIDUALS RECEIVED A PAYMENT FROM A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN OF A RELATED ORGANIZATION. THE PAYMENTS ARE INCLUDED ON SCHEDULE J, PART II, COLUMN B(III). DAVID FRANKLIN $601,943 PAUL MCDOWELL $272,789 KATHY GUYETTE $269,896

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (11 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART I, LINE 1, DESCRIPTION OF ORGANIZATION MISSION:IN PROCESS OF WIND DOWN FOR EVENTUAL DISSOLUTION.
FORM 990, PART VI, SECTION A, LINE 3THE ORGANIZATION IS IN PROCESS OF WINDING DOWN THE AFFAIRS OF THE HEALTH SYSTEM AND AS SUCH THE BOARD HAS ENGAGED AN UNRELATED THIRD PARTY (ACTING UNDER THE BOARD'S SUPERVSION) TO CARRY OUT THE FUNCTIONS OF MANAGEMENT DURING THIS TIME. ALL CURRENT OFFICERS LISTED IN PART VII ARE EMPLOYEES OF THE INDEPENDENT CONTRACTOR.
FORM 990, PART VI, SECTION A, LINE 6THE ORGANIZATION FORMERLY KNOWN AS TRANSYLVANIA COMMUNITY HOSPITAL, INC. IS A MEMBERSHIP CORPORATION, OF WHICH THE SOLE MEMBER (THE "MEMBER") IS ANC HEALTHCARE.
FORM 990, PART VI, SECTION A, LINE 7AEFFECTIVE FEBRUARY 1, 2019: THE CORPORATION SHALL HAVE ONLY ONE (1) MEMBER, WHICH SHALL BE ANC HEALTHCARE, INC. (THE "PARENT"), AN ORGANIZATION WHICH IS EXEMPT UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE, AND ITS SUCCESSORS AND ASSIGNS. ANY DIRECTOR MAY BE REMOVED, EITHER FOR OR WITHOUT CAUSE, BY THE PARENT BOARD. ANY POSITION OF ANY DIRECTOR THAT HAS BEEN REMOVED AS PROVIDED IN THIS SECTION 4.3 SHALL BE FILLED BY THE PARENT BOARD.
FORM 990, PART VI, SECTION A, LINE 7BEFFECTIVE FEBRUARY 1, 2019: THE BOARD OF DIRECTORS SHALL NOT TAKE OR AGREE TO TAKE ANY OF THE FOLLOWING ACTIONS WITHOUT THE PRIOR WRITTEN CONSENT OF THE PARENT BOARD, WHICH CONSENT MAY BE WITHHELD, CONDITIONED OR DELAYED IN THE ABSOLUTE DISCRETION OF THE PARENT BOARD: (I) ISSUE, SELL (OR OTHER DISPOSITION), SPLIT, COMBINE OR RECLASSIFY ANY SHARES OF THE CAPITAL STOCK (OR EQUIVALENT EQUITY INTERESTS) OF THE CORPORATION, GRANT OF ANY OPTIONS, WARRANTS OR OTHER RIGHTS TO PURCHASE OR OBTAIN (INCLUDING UPON CONVERSION, EXCHANGE OR EXERCISE) ANY CAPITAL STOCK (OR OTHER EQUITY INTERESTS), OR DECLARATION OR PAYMENT OF ANY DIVIDENDS OR DISTRIBUTIONS ON OR IN RESPECT OF ANY CAPITAL STOCK (OR OTHER EQUITY INTERESTS) OR REDEMPTION, PURCHASE OR ACQUISITION OF ANY CAPITAL STOCK (OR OTHER EQUITY INTERESTS); (II) MATERIALLY CHANGE IN ANY METHOD OF ACCOUNTING OR ACCOUNTING PRACTICE OF THE CORPORATION OR ITS CASH MANAGEMENT PRACTICES OR POLICIES, PRACTICES, EXCEPT AS REQUIRED BY THE U.S. GENERALLY ACCEPTED ACCOUNTING PRINCIPLES; (III) TRANSFER, ASSIGN, SELL OR OTHERWISE DISPOSE OF ANY OF THE ASSETS OF THE CORPORATION OUTSIDE OF THE ORDINARY COURSE OF BUSINESS; (IV) TRANSFER, ASSIGN OR GRANT OF ANY LICENSE OR SUBLICENSE OF ANY MATERIAL RIGHTS UNDER OR WITH RESPECT TO ANY INTELLECTUAL PROPERTY OF THE CORPORATION; (V) MATERIALLY DAMAGE, DESTROY OR LOSE THE PROPERTY OR ASSETS OF THE CORPORATION; (VI) INVEST IN ANY MATERIAL CAPITAL EXPENDITURES OR LOAN (OR FORGIVE ANY LOAN) TO ANY PERSON OR ENTITY; (VII) ACCELERATE, TERMINATE, MATERIALLY MODIFY OR CANCEL ANY MATERIAL CONTRACT OR AGREEMENT TO WHICH THE CORPORATION IS A PARTY OR OTHERWISE BOUND; (VIII) (I) GRANT OF ANY BONUSES, WHETHER MONETARY OR OTHERWISE, OR INCREASE IN ANY WAGES, SALARY, SEVERANCE, PENSION OR OTHER COMPENSATION OR BENEFITS IN RESPECT OF CURRENT OR FORMER EMPLOYEES, OFFICERS, DIRECTORS, INDEPENDENT CONTRACTORS OR CONSULTANTS, EXCEPT AS MAY BE REQUIRED BY APPLICABLE LAWS (II) MATERIALLY CHANGE THE TERMS OF EMPLOYMENT FOR ANY EMPLOYEE OR ANY TERMINATION OF ANY EMPLOYEES, OR (III) ACCELERATE THE VESTING OR PAYMENT OF ANY COMPENSATION OR BENEFIT FOR ANY CURRENT OR FORMER EMPLOYEE, OFFICER, DIRECTOR, INDEPENDENT CONTRACTOR OR CONSULTANT; (IX) ENTER INTO A NEW LINE OF BUSINESS MATERIALLY DIFFERENT FROM THE BUSINESS OF THE CORPORATION, OR ABANDON OR DISCONTINUE LINES OF BUSINESS; (X) ADOPT ANY PLAN OF MERGER, DIVISION, CONSOLIDATION, REORGANIZATION, LIQUIDATION OR DISSOLUTION OR FILE OF A PETITION IN BANKRUPTCY UNDER ANY PROVISIONS OF FEDERAL OR STATE BANKRUPTCY LAW OR CONSENT TO THE FILING OF ANY BANKRUPTCY PETITION AGAINST IT UNDER ANY SIMILAR LAW; (XI) ENTER INTO OR AGREE TO ENTER INTO AN ACQUISITION BY MERGER OR CONSOLIDATION WITH, OR BY PURCHASE OF A SUBSTANTIAL PORTION OF THE ASSETS OR STOCK OF, OR BY ANY OTHER MANNER, ANY BUSINESS OR ANY PERSON, OR ENTITY OR ANY DIVISION THEREOF; PURCHASE, LEASE OR OTHERWISE ACQUIRE THE RIGHT TO OWN, USE OR LEASE ANY PROPERTY OR ASSETS FOR AN AMOUNT IN EXCESS OF $20,000, INDIVIDUALLY (IN THE CASE OF A LEASE, PER ANNUM) OR $50,000 IN THE AGGREGATE (IN THE CASE OF A LEASE, FOR THE ENTIRE TERM OF THE LEASE, NOT INCLUDING ANY OPTION TERM), EXCEPT FOR PURCHASES OF INVENTORY OR SUPPLIES IN THE ORDINARY COURSE OF BUSINESS; CHANGE OR RESCIND ANY TAX ELECTION, AMEND ANY MATERIAL TAX RETURN OR TAKE ANY POSITION ON ANY MATERIAL TAX RETURN; OR ENTER INTO A CONTRACT OR AGREEMENT TO DO ANY OF THE FOREGOING, OR TAKE ANY ACTION OR OMIT TO TAKE ANY ACTION THAT WOULD RESULT IN ANY OF THE FOREGOING.
FORM 990, PART VI, SECTION B, LINE 11BTHE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM. A FINAL COPY OF THE FORM 990 WAS PROVIDED TO THE BOARD OF DIRECTORS THE WEEK AFTER FILING WITH THE IRS.
FORM 990, PART VI, SECTION B, LINE 12CTHE ORGANIZATION'S CONFLICT OF INTEREST EXPECTATION IS STATED AT THE BEGINNING OF EACH BOARD MEETING. EDUCATION ABOUT THE RESPONSIBILITIES OF A BOARD MEMBER INCLUDING CONFLICTS OF INTEREST IS PROVIDED DURING ORIENTATION FOR NEW BOARD MEMBERS. BOARD MEETINGS BEGIN WITH A COMMENT SUMMARIZING THE CONFLICT OF INTEREST EXPECTATION, THE DUTY TO DISCLOSE CONFLICTS, AND THE DUTY TO RECUSE IF A CONFLICT IS PRESENT. IF A CONFLICT OF INTEREST IS IDENTIFIED, THE INTERESTED PERSON DOES NOT PARTICIPATE IN ANY DECISION RELATING TO THE ISSUE. A CONFLICT OF INTEREST IS A PARTICULAR RELATIONSHIP OR ARRANGEMENT THAT WOULD REASONABLY BE EXPECTED TO EXERT AN INFLUENCE ON THE INDIVIDUAL'S JUDGMENT AND PRECLUDE THE INDIVIDUAL FROM BEING AN INDEPENDENT DIRECTOR OR BEING INDEPENDENT WITH RESPECT TO THE ISSUE UNDER CONSIDERATION. IN ADDITION TO BOARD MEMBERS, THE ORGANIZATION'S CONFLICT OF INTEREST EXPECTATION APPLIES TO THE ORGANIZATION'S OFFICERS AND DIRECTORS, AS WELL AS IMMEDIATE FAMILY MEMBERS OF SUCH INTERESTED PERSONS AND ENTITIES IN WHICH INTERESTED PERSONS HAVE A MATERIAL FINANCIAL INTEREST. THE ORGANIZATION EXPECTS THAT ALL INTERESTED PERSONS DISCLOSE ANY AND ALL CONFLICTS OF INTEREST IN ACCORDANCE WITH THE IRS GUIDELINES FOR TAX-EXEMPT ENTITIES AS WELL AS ANY OTHER APPLICABLE STATE OR FEDERAL LAW. INTERNAL AND EXTERNAL AUDITORS OR OUTSIDE COUNSEL WILL PERIODICALLY REVIEW AND ADVISE TO DETERMINE WHETHER THE ORGANIZATION IS IN COMPLIANCE WITH THE EXPECTATION AND APPLICABLE LAW.
FORM 990, PART VI, SECTION B, LINE 15COMPENSATION REFLECTED IN THIS FORM 990 IS FOR CALENDAR 2019 AND WAS PAID BY A RELATED ORGANIZATION. IT IS FOR THE PERIOD OF TIME PRIOR TO THE SALE OF THE ASSETS, AT WHICH TIME EMPLOYEES WERE TERMINATED. THE FOLLOWING REFLECTS THE POLICIES AND PROCESSES IN PLACE THAT ARE RELEVANT TO THE COMPENSATION REFLECTED IN THIS FORM 990. THE ORGANIZATION DOES NOT COMPENSATE ITS CEO, OFFICERS, OR KEY EMPLOYEES. A RELATED ORGANIZATION DRAWS WAGE COMPARISON DATA FROM OUTSIDE EXECUTIVE COMPENSATION CONSULTANTS TO ENSURE COMPENSATION LEVELS ARE AT FAIR MARKET VALUE. THE HUMAN RESOURCES AND COMPENSATION COMMITTEE OF THE RELATED ORGANIZATION ("COMMITTEE") REVIEWS THIS DATA AND RECOMMENDS TO THE BOARD OF THE RELATED ORGANIZATION ANY REVISIONS TO THE OVERALL PHILOSOPHY AND POLICY TO GUIDE THE DETERMINATION OF COMPENSATION AND BENEFIT PACKAGES FOR EXECUTIVES WHICH INCLUDES THE CEO, THE CFO, AND PRESIDENT AS WELL AS ALL OTHER EXECUTIVES, WHICH WOULD INCLUDE ALL KEY EMPLOYEES. THE COMMITTEE KEEPS AND DISTRIBUTES MINUTES OF ALL ITS MEETINGS TO ITS MEMBERS. ITEMS OF A SENSITIVE NATURE ARE REFERENCED IN THE MINUTES WITH DETAILED, SUPPORTING DOCUMENTATION RETAINED ON FILE. THE COMMITTEE ALSO DISCLOSES ANY POTENTIAL CONFLICTS OF INTEREST SITUATIONS TO THE COMMITTEE CHAIRMAN THAT MAY AFFECT THEIR INDEPENDENT DIRECTORS' STATUS AS SOON AS THEY ARISE, AND MAINTAINS COMPLETE DOCUMENTATION OF ALL MATTERS DISCUSSED BY THE COMMITTEE. THE COMMITTEE OBTAINS EDUCATION AND TRAINING TO EXERCISE ALL RESPONSIBILITIES EFFECTIVELY AND KEEPS ABREAST OF SIGNIFICANT DEVELOPMENTS IN EXECUTIVE COMPENSATION PRACTICES AND REGULATIONS, AND ENSURES THAT ALL ASPECTS OF THE HEALTH SYSTEM AND HOSPITAL EXECUTIVE COMPENSATION ADHERE TO ALL RELEVANT REGULATORY REQUIREMENTS, AND REVIEWS THE COMMITTEE CHARTER ANNUALLY REVISING AS APPROPRIATE AND CONDUCTS AN ANNUAL EVALUATION OF THE COMMITTEE'S PERFORMANCE.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST AT THE ORGANIZATION'S ADMINISTRATIVE OFFICE.
FORM 990, PART VII:COMPENSATION REFLECTED IN THIS FORM 990 IS FOR CALENDAR 2019 AND WAS PAID BY A RELATED ORGANIZATION. IT IS FOR THE PERIOD OF TIME PRIOR TO THE SALE OF THE ASSETS, AT WHICH TIME EMPLOYEES WERE TERMINATED.
FORM 990, PART XI, LINE 9:CURRENT YEAR ACTIVITY NOT RECORDED ON THE BOOKS,AND DISTRIBUTIONS PAID DIRECTLY TO ANC HEALTHCARE,THE PARENT OF THIS ENTITY -5,122.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (9 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationIndDirect Controlling NADirectControllingNACd
ANC HIGHLANDS-CASHIERS HOSPITAL INC
425 W NEW ENGLAND AVE NO 300WINTER PARKFL32789560509400HOSPITALNC501(C)(3)LINE 3ANC INC0
MISSION HOSPITAL INC
425 W NEW ENGLAND AVE NO 300WINTER PARKFL32789560532141HOSPITALNC501(C)(3)LINE 3ANC INC0
MISSION HEALTH SYSTEM FOUNDATION INC
425 W NEW ENGLAND AVE NO 300WINTER PARKFL32789561881331FOUNDATIONNC501(C)(3)LINE 7ANC INC0
ANC MEDICAL ASSOCIATES INC
425 W NEW ENGLAND AVE NO 300WINTER PARKFL32789263627231PHYSICIAN GRPNC501(C)(3)LINE 10ANC INC0
ANC MCDOWELL HOSPITAL INC
425 W NEW ENGLAND AVE NO 300WINTER PARKFL32789560623938HOSPITALNC501(C)(3)LINE 3ANC INC0
ANC BLUE RIDGE HOSPITAL INC
425 W NEW ENGLAND AVE NO 300WINTER PARKFL32789561025032HOSPITALNC501(C)(3)LINE 3ANC INC0
ANC TRANSYLVANIA PHYSICIAN SERVICES INC
425 W NEW ENGLAND AVE NO 300WINTER PARKFL32789561920816PHYSICIAN SERVICENC501(C)(3)LINE 3TCH INCYes (1)
ANC ANGEL MEDICAL CENTER INC
425 W NEW ENGLAND AVE NO 300WINTER PARKFL32789586000064HOSPITALNC501(C)(3)LINE 3ANC INC0
ANC HEALTHCARE INC
425 W NEW ENGLAND AVE NO 300WINTER PARKFL32789581450888SUPPORTINGNC501(C)(3)LINE 12A, I0N/A

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (5 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdDirect Controlling NADirectControllingNACdPredominant Income TypePredominantIncomeTypeTxtDisproportionate AllocationsDisproportionateAllocationsIndGeneral Or Managing PartnerGeneralOrManagingPartnerIndBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtShare Of Total IncomeShareOfTotalIncomeAmtShare Of EOY AssetsShareOfEOYAssetsAmtUBI Code VUBICodeVAmtOwnershipOwnershipPct
ASHEVILLE IMAGING LLP
425 NEW ENGLAND AVENUEWINTER PARKFL32789561907111DISCONTINUED OPRTNNCN/AN/A00
ASHEVILLE MRI
425 NEW ENGLAND AVENUEWINTER PARKFL32789561665863DISCONTINUED OPRTNNCN/AN/A00
BLUE RIDGE DME
425 W NEW ENGLAND AVENUEWINTER PARKFL32789263570174EQUIPMENT SALESNCUNRELATED0Yes (1)TCH$15,374$69,538$15,3740.04000
HEALTHCARE LIMITED LIABILITY
425 W ENGLAND NEW AVENUEWINTER PARKFL32789RENTALNCN/AN/A00
ANC SPECIALTY HOSPITAL
425 NEW ENGLAND AVENUEWINTER PARKFL32789LT ACUTE CARENCN/AN/A00

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtShare Of Total IncomeShareOfTotalIncomeAmtOwnershipOwnershipPctControlled OrganizationControlledOrganizationIndDirect Controlling NADirectControllingNACd
TRANSYLVANIA SERVICES INC
425 W NEW ENGLAND AVENUEWINTER PARKFL32789561448199REAL ESTATENCTCH INCC$29,9061.00000Yes (1)
AVENU HEALTH INC
425 W NEW ENGLAND AVENUEWINTER PARKFL32789823337055HEATHCARE CLINICNCC0N/A
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

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