2021-08-15T17:20:21-05:00 2020-09-30 366055558 GRANT THORNTON LLP 1415 VANTAGE PARK DRIVE SUITE 500 CHARLOTTE NC 28203 990 2019-10-01 560562293 ANC TRANSYLVANIA COMMUNITY HOSPITAL INC ANCT 8475831618 425 W NEW ENGLAND AVENUE NO 300 WINTER PARK FL 32789 MATTHEW RUBIN CFO 8475831618 2021-08-15 1 MICHELE N MELCHIOR P00488037 7046323500 2019 2022-09-23 18:48:47Z MATTHEW RUBIN 425 W NEW ENGLAND AVENUE NO 300 WINTER PARK FL 32789 15374 0 X N/A X 1933 NC TO IMPROVE THE HEALTH OF THE PEOPLE OF WESTERN NC. THE ORGANIZATION IS CURRENTLY (SEE SCHEDULE O) 2 2 367 2 15374 9805 2010008 0 26028541 15374 -485073 0 0 0 27553476 15374 178178 0 0 0 7182145 0 0 0 0 12062263 0 19422586 0 8130890 15374 54155 64407 0 0 54155 64407 TO IMPROVE THE HEALTH OF THE PEOPLE OF WESTERN NC. THE ORGANIZATION IS CURRENTLY IN PROCESS OF WIND DOWN FOR EVENTUAL DISSOLUTION. 0 0 0 0 0 THE 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. 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 0 0 367 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 2 2 0 1 0 0 1 1 1 1 1 0 0 0 1 1 1 1 1 0 0 0 NC X ANC HEALTHCARE INC 8475831618 INC 425 NEW ENGLAND AVE STE 300 PARK FL 32789 X X DAVID FRANKLIN FORMER DIRECTOR 0.00 0.00 X 0 810034 18517 PAUL MCDOWELL FORMER DIRECTOR 0.00 0.00 X 0 420838 15020 KATHY GUYETTE FORMER DIRECTOR 0.00 0.00 X 0 395680 10219 DR JOHN GARRETT CHAIR 0.25 3.75 X X 0 0 0 TOM MAHER VICE CHAIR 0.25 4.00 X X 0 0 0 NEIL LURIA CEO, CHIEF WIND-DOWN OFF. 0.25 11.75 X 0 0 0 MATTHEW RUBIN CFO, SEC, TREAS 0.25 11.75 X 0 0 0 0 1626552 43756 0 1 1 0 0 JOINT VENTURE INCOME 900099 15374 15374 15374 15374 0 15374 0 0 0 0 0 54155 64407 54155 64407 0 0 X 54155 64407 54155 64407 54155 64407 X 15374 -5122 X 0 1 X 1 0 X 0 INVESTMENT IN JOINT VENTURE 64407 64407 X PART X, LINE 2: THE 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. 0 1 0 0 0 0 0 0 0 DAVID FRANKLIN FORMER DIRECTOR 0 92345 0 115156 0 602533 0 17608 0 909 0 828551 0 601943 PAUL MCDOWELL FORMER DIRECTOR 0 59927 0 87750 0 273161 0 11848 0 3172 0 435858 0 272789 KATHY GUYETTE FORMER DIRECTOR 0 47980 0 76831 0 270869 0 9194 0 1026 0 405900 0 269896 PART I, LINE 3 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. PART I, LINE 4B THE 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 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 3 THE 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 6 THE 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 7A EFFECTIVE 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 7B EFFECTIVE 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 11B THE 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 12C THE 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 15 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. 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 19 THE 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. ANC HIGHLANDS-CASHIERS HOSPITAL INC 425 W NEW ENGLAND AVE NO 300 WINTER PARK FL 32789 560509400 HOSPITAL NC 501(C)(3) LINE 3 ANC INC 0 MISSION HOSPITAL INC 425 W NEW ENGLAND AVE NO 300 WINTER PARK FL 32789 560532141 HOSPITAL NC 501(C)(3) LINE 3 ANC INC 0 MISSION HEALTH SYSTEM FOUNDATION INC 425 W NEW ENGLAND AVE NO 300 WINTER PARK FL 32789 561881331 FOUNDATION NC 501(C)(3) LINE 7 ANC INC 0 ANC MEDICAL ASSOCIATES INC 425 W NEW ENGLAND AVE NO 300 WINTER PARK FL 32789 263627231 PHYSICIAN GRP NC 501(C)(3) LINE 10 ANC INC 0 ANC MCDOWELL HOSPITAL INC 425 W NEW ENGLAND AVE NO 300 WINTER PARK FL 32789 560623938 HOSPITAL NC 501(C)(3) LINE 3 ANC INC 0 ANC BLUE RIDGE HOSPITAL INC 425 W NEW ENGLAND AVE NO 300 WINTER PARK FL 32789 561025032 HOSPITAL NC 501(C)(3) LINE 3 ANC INC 0 ANC TRANSYLVANIA PHYSICIAN SERVICES INC 425 W NEW ENGLAND AVE NO 300 WINTER PARK FL 32789 561920816 PHYSICIAN SERVICE NC 501(C)(3) LINE 3 TCH INC 1 ANC ANGEL MEDICAL CENTER INC 425 W NEW ENGLAND AVE NO 300 WINTER PARK FL 32789 586000064 HOSPITAL NC 501(C)(3) LINE 3 ANC INC 0 ANC HEALTHCARE INC 425 W NEW ENGLAND AVE NO 300 WINTER PARK FL 32789 581450888 SUPPORTING NC 501(C)(3) LINE 12A, I N/A 0 ASHEVILLE IMAGING LLP 425 NEW ENGLAND AVENUE WINTER PARK FL 32789 561907111 DISCONTINUED OPRTN NC N/A N/A 0 0 ASHEVILLE MRI 425 NEW ENGLAND AVENUE WINTER PARK FL 32789 561665863 DISCONTINUED OPRTN NC N/A N/A 0 0 BLUE RIDGE DME 425 W NEW ENGLAND AVENUE WINTER PARK FL 32789 263570174 EQUIPMENT SALES NC TCH UNRELATED 15374 69538 0 15374 1 0.04000 HEALTHCARE LIMITED LIABILITY 425 W ENGLAND NEW AVENUE WINTER PARK FL 32789 RENTAL NC N/A N/A 0 0 ANC SPECIALTY HOSPITAL 425 NEW ENGLAND AVENUE WINTER PARK FL 32789 LT ACUTE CARE NC N/A N/A 0 0 TRANSYLVANIA SERVICES INC 425 W NEW ENGLAND AVENUE WINTER PARK FL 32789 561448199 REAL ESTATE NC TCH INC C 29906 1.00000 1 AVENU HEALTH INC 425 W NEW ENGLAND AVENUE WINTER PARK FL 32789 823337055 HEATHCARE CLINIC NC N/A C 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0