RANDOLPH HOSPITAL INC: Form 990, tax year 2019

View the entire original 990 at ProPublica ↗

Organization
RANDOLPH HOSPITAL INC (EIN 56-0530234)
Tax period
2019-10-01 to 2020-09-30
Filed
2021-08-13
IRS object ID
202132259349300638
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)
Return2021-08-13T11:13:35-05:00ReturnTs
Tax Period End2020-09-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN410746749PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1CLIFTONLARSONALLEN LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1227 WEST TRADE STREET SUITE 800AddressLine1Txt
CityCHARLOTTECityNm
State AbbreviationNCStateAbbreviationCd
ZIP28202ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2019-10-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN560530234EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1RANDOLPH HOSPITAL INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlRANDBusinessNameControlTxt
Phone3366255151PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1364 WHITE OAK STREETAddressLine1Txt
CityASHEBOROCityNm
State AbbreviationNCStateAbbreviationCd
ZIP27203ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonLORETTA LONGPersonNm
Person TitleCFOPersonTitleTxt
Phone3366255151PhoneNum
Signature2021-08-13SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonJOHN NORMANPreparerPersonNm
PTINP01506766PTIN
Phone7049985200PhoneNum
Preparation2021-08-13PreparationDt
FieldValueIRS element (for citing)
Tax2019TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1RANDOLPH HEALTHBusinessNameLine1Txt
FieldValueIRS element (for citing)
Principal OfficerANGELA P ORTHPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1364 WHITE OAK STREETAddressLine1Txt
CityASHEBOROCityNm
State AbbreviationNCStateAbbreviationCd
ZIP27203ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$116,846,277GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.RANDOLPHHEALTH.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1928FormationYr
Legal Domicile StateNCLegalDomicileStateCd
Activity Or MissionTO PROVIDE QUALITY HEALTH CARE AND TO PROMOTE HEALTH AND WELLNESS.ActivityOrMissionDesc
Voting Members Governing Body11VotingMembersGoverningBodyCnt
Voting Members Independent11VotingMembersIndependentCnt
Total Employee1038TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$268,355PYContributionsGrantsAmt
CY Contributions Grants$4,208,010CYContributionsGrantsAmt
PY Program Service Revenue$111,573,860PYProgramServiceRevenueAmt
CY Program Service Revenue$112,515,268CYProgramServiceRevenueAmt
PY Investment Income$749,058PYInvestmentIncomeAmt
CY Investment Income$98,899CYInvestmentIncomeAmt
PY Other Revenue$506,871PYOtherRevenueAmt
CY Other Revenue$24,100CYOtherRevenueAmt
PY Total Revenue$113,098,144PYTotalRevenueAmt
CY Total Revenue$116,846,277CYTotalRevenueAmt
PY Grants And Similar Paid$3,369,932PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$2,769,268CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$46,603,742PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$47,180,821CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$64,873CYTotalFundraisingExpenseAmt
PY Other Expenses$63,120,389PYOtherExpensesAmt
CY Other Expenses$61,713,149CYOtherExpensesAmt
PY Total Expenses$113,094,063PYTotalExpensesAmt
CY Total Expenses$111,663,238CYTotalExpensesAmt
PY Revenues Less Expenses$4,081PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$5,183,039CYRevenuesLessExpensesAmt
Total Assets BOY$107,729,245TotalAssetsBOYAmt
Total Assets EOY$118,605,955TotalAssetsEOYAmt
Total Liabilities BOY$62,873,190TotalLiabilitiesBOYAmt
Total Liabilities EOY$68,138,216TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$44,856,055NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$50,467,739NetAssetsOrFundBalancesEOYAmt
MissionRANDOLPH HOSPITAL'S MISSION IS TO PROVIDE QUALITY HEALTH CARE AND TO FOSTER HEALTH AND WELLNESS IN OUR COMMUNITIES.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$100,619,175ExpenseAmt
Grant$2,769,268GrantAmt
Revenue$112,614,167RevenueAmt
DescRANDOLPH HOSPITAL, A NOT-FOR-PROFIT, 145-BED COMMUNITY HOSPITAL WAS ESTABLISHED IN 1928 WITH THE APPROVAL OF A COOPERATIVE PLAN WITH THE DUKE ENDOWMENT AT A JOINT MEETING OF THE ASHEBORO ROTARY CLUB, THE KIWANIS CLUB, THE CHAMBER OF COMMERCE, THE TOWN COUNCIL AND INTERESTED CITIZENS. THE PLAN CALLED FOR THE BUILDING OF A 40-BED HOSPITAL.Desc
Total Program Service Expenses$100,619,175TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi Endowments0DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related InvstYes (1)ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To IndividualsYes (1)GrantsToIndividualsInd
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 EntityYes (1)DisregardedEntityInd
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 Document137IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee1038EmployeeCnt
Employment Tax Returns Filed0EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
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 Members11GoverningBodyVotingMembersCnt
Independent Voting Member11IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
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 ChaptersYes (1)LocalChaptersInd
Policies Reference ChaptersYes (1)PoliciesReferenceChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
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 CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1LORETTA LONG CFOBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone3366298810PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1364 WHITE OAK STREETAddressLine1Txt
CityASHEBOROCityNm
State AbbreviationNCStateAbbreviationCd
ZIP27203ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (20 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
MICHAEL C MILLER
SECRETARY2.00Yes (X)Yes (X)$0$0$0
GLENN MAC PUGH
CHAIR4.00Yes (X)Yes (X)$0$0$0
SAMUEL A RANKIN JR
VICE CHAIR2.00Yes (X)Yes (X)$0$0$0
DAVID BRYANT
BOARD MEMBER2.00Yes (X)$0$0$0
LINDA BROWN
BOARD MEMBER2.00Yes (X)$0$0$0
T REYNOLDS LISK
BOARD MEMBER2.00Yes (X)$0$0$0
CRIS R RICHARDSON MD
BOARD MEMBER2.00Yes (X)$0$0$0
ROBERT S SHACKLEFORD JR PHD
BOARD MEMBER2.00Yes (X)$0$0$0
D CRANDFORD KNOTT
BOARD MEMBER2.00Yes (X)$0$0$0
ELBERT J LASSITER
BOARD MEMBER2.00Yes (X)$0$0$0
THOMAS E LAWRENCE MD
BOARD MEMBER2.00Yes (X)$0$0$0
LORETTA M LONG
CFO35.00Yes (X)$153,958$0$5,304
CHARLES B WEST
CMO40.00Yes (X)$286,561$0$6,209
BARBARA E WOLFE
VP40.00$206,595$0$6,609Yes (X)
ROBERT S CLAUSER
VP36.00$224,125$0$9,175Yes (X)
TREMONTEO CRAWFORD
VP40.00$181,382$0$3,916Yes (X)
LISA D HAMPTON
DIRECTOR40.00$181,079$0$1,220Yes (X)
AMY TROY
DIRECTOR40.00$117,889$0$3,826Yes (X)
JENNIFER WHITLEY
PHARMACIST40.00$105,770$0$7,532Yes (X)
CHRISTOPHER PARRISH
PHARMACIST40.00$115,971$0$9,325Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,573,330TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$53,116TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K11IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
CONE HEALTH
1200 NORTH ELM STREETGREENSBORONC27401HOSPITALIST,LAB,PHARM,MGT FEE$6,179,409
ANKURA CONSULTING GROUP
1220 19TH STREET NW STE 700WASHINGTONDC20036CONSULTING$1,703,075
NELSON MULLINS RILEY SCARBOROUGH A07081
1320 MAIN STREET 17TH FLOORCOLUMBIASC29211LEGAL SERVICES$1,075,060
SODEXHO INC & AFFILIATES
PO BOX 536922ATLANTAGA303536922FOOD MANAGEMENT SERVICES$693,287
HEALOGICS WOUND CARE A06555
PO BOOX 551187JACKSONVILLEFL32255PROFESSIONAL SERVICES$528,753
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K37CntrctRcvdGreaterThan100KCnt
Government Grants$4,208,010GovernmentGrantsAmt
Total Contributions$4,208,010TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
PATIENT SERVICE REVENU621400$98,661,218$98,661,218
MRI OF ASHEBORO LLC621400$926,114$926,114
CANCER CENTER REVENUE621400$578,350$578,350

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$12,349,586TotalRevenueColumnAmt
Related Or Exempt Func Income$12,349,586RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$112,515,268TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$98,899TotalRevenueColumnAmt
Related Or Exempt Func Income$98,899RelatedOrExemptFuncIncomeAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescCOFFEE/GIFT SHOPDesc
Business453220BusinessCd
Total Revenue Column$24,100TotalRevenueColumnAmt
Exclusion$24,100ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$24,100OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$116,846,277TotalRevenueColumnAmt
Related Or Exempt Func Income$112,614,167RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$24,100ExclusionAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$2,769,268TotalAmt
Program Services$2,769,268ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$36,010,816TotalAmt
Program Services$34,102,620ProgramServicesAmt
Management And General$1,868,342ManagementAndGeneralAmt
Fundraising$39,854FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$2,182,307TotalAmt
Program Services$1,850,602ProgramServicesAmt
Management And General$329,528ManagementAndGeneralAmt
Fundraising$2,177FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$6,277,966TotalAmt
Program Services$5,333,627ProgramServicesAmt
Management And General$938,128ManagementAndGeneralAmt
Fundraising$6,211FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$2,709,732TotalAmt
Program Services$2,297,856ProgramServicesAmt
Management And General$409,169ManagementAndGeneralAmt
Fundraising$2,707FundraisingAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$7,457,881TotalAmt
Program Services$4,944,580ProgramServicesAmt
Management And General$2,513,301ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$2,199,376TotalAmt
Management And General$2,199,376ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$82,273TotalAmt
Management And General$82,273ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$7,101,961TotalAmt
Program Services$7,087,763ProgramServicesAmt
Management And General$12,779ManagementAndGeneralAmt
Fundraising$1,419FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$112,351TotalAmt
Program Services$80,895ProgramServicesAmt
Management And General$28,873ManagementAndGeneralAmt
Fundraising$2,583FundraisingAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$8,593,329TotalAmt
Program Services$7,467,604ProgramServicesAmt
Management And General$1,117,132ManagementAndGeneralAmt
Fundraising$8,593FundraisingAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$1,739,594TotalAmt
Program Services$1,676,970ProgramServicesAmt
Management And General$62,624ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$3,142,479TotalAmt
Program Services$2,974,939ProgramServicesAmt
Management And General$167,540ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$187,040TotalAmt
Program Services$159,922ProgramServicesAmt
Management And General$26,372ManagementAndGeneralAmt
Fundraising$746FundraisingAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$792TotalAmt
Program Services$792ProgramServicesAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$526,031TotalAmt
Program Services$526,031ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$4,223,071TotalAmt
Program Services$4,223,071ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$1,003,224TotalAmt
Management And General$1,003,224ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmt
BAD DEBT$14,935,767$14,935,767
MEDICAL SUPPLIES$9,895,700$9,895,700
MISCELLANEOUS$386,197$291,168$94,446$583
RECRUITMENT$126,083$126,083

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$111,663,238TotalAmt
Program Services$100,619,175ProgramServicesAmt
Management And General$10,979,190ManagementAndGeneralAmt
Fundraising$64,873FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$2,648,037BOYAmt
EOY$5,230,096EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$9,008,745BOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$10,754,356BOYAmt
EOY$9,162,508EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$2,384,411BOYAmt
EOY$2,218,063EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$1,409,616BOYAmt
EOY$930,794EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$156,097,714LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$116,247,641LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$43,913,965BOYAmt
EOY$39,850,073EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$1,499,360BOYAmt
EOY$19,994,013EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$8,787,144BOYAmt
EOY$9,365,494EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$27,323,611BOYAmt
EOY$31,854,914EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$107,729,245BOYAmt
EOY$118,605,955EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$11,552,942BOYAmt
EOY$18,377,852EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$24,574,678BOYAmt
EOY$19,500,673EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$26,745,570BOYAmt
EOY$30,259,691EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$62,873,190BOYAmt
EOY$68,138,216EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$44,404,758BOYAmt
EOY$45,647,049EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$451,297BOYAmt
EOY$4,820,690EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$44,856,055BOYAmt
EOY$50,467,739EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$107,729,245BOYAmt
EOY$118,605,955EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$5,183,039ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$428,645OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS Audited0FSAuditedInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other Organizations0GrantsOtherOrganizationsInd
Direct Contact Legislators0DirectContactLegislatorsInd
Rallies Demonstrations0RalliesDemonstrationsInd
Other ActivitiesYes (1)OtherActivitiesInd
Other Activities$10,979OtherActivitiesAmt
Total Lobbying Expenditures$10,979TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART II-B, LINE 1:FormAndLineReferenceDesc
ExplanationA PORTION OF THE DUES PAID TO THE NORTH CAROLINA HOSPITAL ASSOCIATION AND THE AMERICAN HOSPITAL ASSOCIATION WERE ATTRIBUTABLE TO LOBBYING ACTIVITIES CARRIED OUT BY THOSE ORGANIZATIONS ON BEHALF OF THEIR MEMBERS.ExplanationTxt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,582,897OtherCostOrOtherBasisAmt
Book Value$2,582,897BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$82,552,302OtherCostOrOtherBasisAmt
Depreciation$50,365,719DepreciationAmt
Book Value$32,186,583BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$5,072,861OtherCostOrOtherBasisAmt
Depreciation$1,755,218DepreciationAmt
Book Value$3,317,643BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$63,983,036OtherCostOrOtherBasisAmt
Depreciation$63,327,126DepreciationAmt
Book Value$655,910BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,906,618OtherCostOrOtherBasisAmt
Depreciation$799,578DepreciationAmt
Book Value$1,107,040BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$39,850,073TotalBookValueLandBuildingsAmt

Invst Program Related Org InvstProgramRelatedOrgGrp (2 entries)

DescDescBook ValueBookValueAmtMethod ValuationMethodValuationCd
INVESTMENT IN RCC$6,477,040F
DUE FROM RCC JV$2,888,454F
FieldValueIRS element (for citing)
Total Book Value Program Rltd$9,365,494TotalBookValueProgramRltdAmt

Other Assets Org OtherAssetsOrgGrp (5 entries)

DescDescBook ValueBookValueAmt
OTHER RECEIVABLES$1,461,518
ASSETS LIMITED AS TO USE$370,561
INVESTMENT IN AFFILIATES$3,006,544
DUE FROM AFFILIATES$25,978,243
OTHER LONG-TERM ASSETS$1,038,048
FieldValueIRS element (for citing)
Total Book Value Other Assets$31,854,914TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)

DescDescAmtAmt
MINIMUM PENSION LIABILITY$11,144,255
INTEREST RATE SWAP$2,563,000
DUE TO AFFILIATES$17,553,983
ESTIMATED THIRD PARTY SETTLEMENT-$1,001,547
FieldValueIRS element (for citing)
Total Liability$30,259,691TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART X, LINE 2:FormAndLineReferenceDesc
ExplanationTHE HOSPITAL, RHMG, PIH, STAYWELL, AND FOUNDATION ARE EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. NEWCO AND CPSC ARE LIMITED LIABILITY COMPANIES, WHICH DO NOT PRODUCE TAXABLE INCOME TO THEIR NOT-FOR-PROFIT OWNER. THE SYSTEM HAS DETERMINED IT DOES NOT HAVE ANY MATERIAL UNRECOGNIZED TAX BENEFITS OR OBLIGATIONS AS OF SEPTEMBER 30, 2020.ExplanationTxt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd
Percent200Yes (X)Percent200Ind
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd
Percent300Yes (X)Percent300Ind
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance Budget0FinancialAssistanceBudgetInd
Annual Community Bnft ReportYes (1)AnnualCommunityBnftReportInd
Report Publically AvailableYes (1)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$8,560,656TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$8,560,656NetCommunityBenefitExpnsAmt
Total Expense0.08850TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$10,982,821TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$11,979,499DirectOffsettingRevenueAmt
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$131,289TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$78,578DirectOffsettingRevenueAmt
Net Community Benefit Expns$52,711NetCommunityBenefitExpnsAmt
Total Expense0.00050TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$19,674,766TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$12,058,077DirectOffsettingRevenueAmt
Net Community Benefit Expns$8,613,367NetCommunityBenefitExpnsAmt
Total Expense0.08900TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$19,674,766TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$12,058,077DirectOffsettingRevenueAmt
Net Community Benefit Expns$8,613,367NetCommunityBenefitExpnsAmt
Total Expense0.08900TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$4,346,798BadDebtExpenseAmt
Bad Debt Expense Attributable$3,694,779BadDebtExpenseAttributableAmt
Reimbursed By Medicare$33,910,986ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$37,905,626CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$3,994,640MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (1)FinancialAssistancePrvsnInd

Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp

Entity Name EntityName

FieldValueIRS element (for citing)
Business Name Line11 RANDOLPH NEWCO LLCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Primary ActivitiesMEDICAL EQUIPMENT RENTALPrimaryActivitiesTxt
Org Profit Or Ownership0.83030OrgProfitOrOwnershipPct
Physicians Profit Or Ownership0.16970PhysiciansProfitOrOwnershipPct
FieldValueIRS element (for citing)
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1RANDOLPH HOSPITAL INCORPORATEDBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1364 WHITE OAK STREETAddressLine1Txt
CityASHEBOROCityNm
State AbbreviationNCStateAbbreviationCd
ZIP27203ZIPCd
FieldValueIRS element (for citing)
Website AddressWWW.RANDOLPHHEALTH.ORGWebsiteAddressTxt
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1RANDOLPH HOSPITAL INCORPORATEDBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY0TaxExemptHospitalCYOrPYInd
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Prior CHNA ImpactYes (X)PriorCHNAImpactInd
CHNA Conducted18CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts0CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsYes (1)CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLSEE PART VIOwnWebsiteURLTxt
Other WebsiteYes (X)OtherWebsiteInd
Other Website URLSEE PART VIOtherWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Rpt Available Thru Other MethodYes (X)RptAvailableThruOtherMethodInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt18ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (1)StrategyPostedWebsiteInd
Strategy Website URLSEE PART VIStrategyWebsiteURLTxt
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care200.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care300.000000000000FPGFamilyIncmLmtDscntCarePct
Income Level CriteriaYes (X)IncomeLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Residency CriteriaYes (X)ResidencyCriteriaInd
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLWWW.RANDOLPHHOSPITAL.ORGFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLWWW.RANDOLPHHOSPITAL.ORGFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLWWW.RANDOLPHHOSPITAL.ORGFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP TranslatedYes (X)FAPTranslatedInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Collection Activities0CollectionActivitiesInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Other Actions TakenYes (X)OtherActionsTakenInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Look Back Medicare PrivateYes (X)LookBackMedicarePrivateInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
RANDOLPH HOSPITAL INCORPORATEDPART V, SECTION B, LINE 5: IN THE FALL OF 2018, RANDOLPH COUNTY PUBLIC HEALTH JOINED WITH RANDOLPH HEALTH, TO ESTABLISH THE ASSESSMENT FRAMEWORK AND A TIMELINE FOR DATA COLLECTION AND ANALYSIS, PRIORITIZATION OF HEALTH CONCERNS AND DEVELOPMENT OF COMMUNITY HEALTH IMPROVEMENT PLANS (CHIP). DATA COLLECTION AND ANALYSIS TOOK PLACE FROM SEPTEMBER 2018 - SEPTEMBER 2019. PRIMARY DATA WAS COLLECTED FROM THE COMMUNITY IN TWO DIFFERENT WAYS: DISTRIBUTION OF PAPER SURVEYS AND AN INTERNET SURVEY.WITH TECHNOLOGY CONTINUING TO ADVANCE, MORE OF AN EMPHASIS WAS PLACED ON ON-LINE SURVEYS ALTHOUGH, PAPER SURVEYS WERE STILL AN IMPORTANT TOOL. IN ADDITION TO ON-LINE SURVEYS, PAPER SURVEYS WERE DISTRIBUTED TO AGENCIES AND ORGANIZATIONS WITHIN THE COUNTY USING THE CONVENIENCE SAMPLE METHOD. ALL SURVEYS DISTRIBUTED WERE IN BOTH ENGLISH AND SPANISH. OF THE 1,500 TOTAL DISTRIBUTED SURVEYS, 927 WERE RETURNED FOR A RESPONSE RATE OF 62%. AN INTERNET SURVEY WAS DEVELOPED USING SURVEY MONKEY. THE INTERNET SURVEY WAS ACCESSIBLE THROUGH THE RANDOLPH COUNTY GOVERNMENT WEBSITE AS WELL AS THE RANDOLPH HEALTH WEBSITE. IN AN EFFORT TO PROMOTE THE INTERNET SURVEY, PRESS RELEASES RAN IN ALL AREA NEWSPAPERS, AS WELL AS PROMOTED VIA SOCIAL MEDIA.TO ENSURE A SOLID REPRESENTATION FROM KEY SECTORS, THE SURVEY WAS SENT TO RANDOLPH COUNTY GOVERNMENT DEPARTMENT HEADS AND DIRECTORS FROM VARIOUS AGENCIES OR REPRESENTATIVES WITHIN THE COUNTY. THE MAJOR SOURCE FOR SECONDARY DATA IN THE 2019 RANDOLPH COUNTY COMMUNITY HEALTH ASSESSMENT INCLUDED:- NORTH CAROLINA STATE CENTER FOR HEALTH STATISTICS- NORTH CAROLINA DEPARTMENT OF HEALTH & HUMAN SERVICES- CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC)- CECIL G. SHEPS CENTER FOR HEALTH SERVICES RESEARCH- US CENSUS DEPARTMENTAS APPLICABLE, RANDOLPH COUNTY STATISTICS HAVE BEEN COMPARED WITH STATE STATISTICS AS WELL AS FOUR PEER COUNTIES. THESE PEER COUNTIES WERE IDENTIFIED BASED UPON AGE, RACE AND POVERTY CHARACTERISTICS AND ARE SELECTED FROM A GROUP OF COUNTIES WITHIN THE SAME POPULATION RANGE AS THE SUBJECT COUNTY.FOR RANDOLPH COUNTY, THE FOLLOWING FOUR PEER COUNTIES WERE IDENTIFIED: CRAVEN, DAVIDSON, HARNETT AND JOHNSTON. THEREFORE, IN ADDITION TO NORTH CAROLINA STATISTICS, THESE FOUR COUNTIES WERE USED FOR COMPARISON THROUGHOUT THE ASSESSMENT PROCESS.
RANDOLPH HOSPITAL INCORPORATEDPART V, SECTION B, LINE 6B: RANDOLPH COUNTY HEALTH DEPARTMENT
RANDOLPH HOSPITAL INCORPORATEDPART V, SECTION B, LINE 7D: BOTH RANDOLPH COUNTY AND RANDOLPH HOSPITAL WEBSITES HAVE POSTED THE COMMUNITY HEALTH NEEDS ASSESSMENT AND EXECUTIVE SUMMARY. THE ASSESSMENT IS ALSO IN ALL SEVEN RANDOLPH COUNTY LIBRARIES. TWENTY-FIVE DATA BOOKS AND 150 EXECUTIVE SUMMARIES WILL BE ORDERED AND PRINTED FOR DISTRIBUTION THROUGHOUT THE COMMUNITY.
RANDOLPH HOSPITAL INCORPORATEDPART V, SECTION B, LINE 11: IN AUGUST 2019, ADVISORY COMMITTEE MEMBERS MET TO IDENTIFY LEADING COMMUNITY HEALTH CONCERNS IN RANDOLPH COUNTY. DURING THE MEETING, MEMBERS REVIEWED HEALTH CONCERNS IDENTIFIED THROUGH SURVEYS AS WELL AS THE INFORMATION GATHERED THROUGH SECONDARY RESEARCH. THROUGH NOMINAL GROUP TECHNIQUE THE COMMITTEE SELECTED 15 COMMUNITY HEALTH CONCERNS SOME OF WHICH INCLUDE: OBESITY, MENTAL HEALTH, SUBSTANCE ABUSE, ACCESS TO CARE, TOBACCO, SEXUALLY TRANSMITTED DISEASES, CHRONIC DISEASE MANAGEMENT AND INJURY PREVENTION. AFTER MUCH DISCUSSION, THE COMMITTEE AGREED TO FOCUS ON THREE PRIORITY HEALTH CONCERNS:1. FOCUS AREA: EARLY AND MIDDLE CHILDHOOD A. INCREASE THE PROPORTION OF CHILDREN WHO ARE READY FOR SCHOOL IN ALL FIVE DOMAINS OF HEALTHY DEVELOPMENT: PHYSICAL DEVELOPMENT, SOCIAL-EMOTIONAL DEVELOPMENT, APPROACHES TO LEARNING, LANGUAGE AND COGNITIVE DEVELOPMENT B. INCREASE THE PROPORTION OF PARENTS WHO READ TO THEIR YOUNG CHILD2. FOCUS AREA: HEALTH-RELATED QUALITY OF LIFE AND WELL-BEING A. INCREASE THE PROPORTION OF ADULTS WHO SELF-REPORT GOOD OR BETTER PHYSICAL AND MENTAL HEALTH 3. FOCUS AREA: MENTAL HEALTH A. DECREASE THE AVERAGE NUMBER OF POOR MENTAL HEALTH DAYS AMONG ADULTS B. REDUCE THE RATE OF MENTAL HEALTH-RELATED VISITS TO THE EMERGENCY DEPARTMENT BY THE EXPANSION OF BEHAVIORAL HEALTH SERVICES WITHIN THE PRIMARY CARE SETTINGIT IS IMPORTANT TO NOTE THAT ALTHOUGH THE ADVISORY COMMITTEE IDENTIFIED FIFTEEN HEALTH ISSUES, THE DECISION WAS MADE TO LIMIT THE FOCUS TO MAKE A LARGER IMPACT ON THE TOP THREE AREAS THAT HAD THE OPPORTUNITY TO IMPROVE THE OVERALL HEALTH OF THE COMMUNITY. THE IDENTIFIED PRIORITY AREAS ARE ALSO IN LINE WITH THE AREAS IDENTIFIED DURING THE RANDOLPH COUNTY STRATEGIC PLANNING PROCESS. THE ENTIRE COUNTY IS NOW ALIGNED WITH FOCUSING ON THE SAME HEALTH PRIORITY AREAS--CREATING, A COORDINATED AND UNITED COUNTY-WIDE EFFORT TO ADDRESS THE HEALTH OF OUR COMMUNITY.
RANDOLPH HOSPITAL INCORPORATEDPART V, SECTION B, LINE 20E: THE HOSPITAL ESTABLISHES DURING PRE-REGISTRATION WHETHER A PATIENT IS COVERED BY INSURANCE. IF THE PATIENT IS NOT COVERED BY INSURANCE, THE HOSPITAL MAKES THE PATIENT AWARE OF THE FINANCIAL ASSISTANCE POLICY.
FieldValueIRS element (for citing)
Facility25FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (25 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
1 - RH STAYWELL SENIOR CARE
809 CURRY DRIVEASHEBORONC27205PACE CENTER
2 - RHMG ATHLETIC TRAINING
600 W SALISBURY ST STE AASHEBORONC27203ATHLETIC TRAINING
3 - RH CANCER CENTER
364 WHITE OAK STASHEBORONC27203CANCER TREATMENT
4 - RHMG CHC BETTERCARE
600 W SALISBURY ST STE BASHEBORONC27203CORPORATE HEALTH & WELLNESS
5 - RHMG DEEP RIVER P T -ASHEBORO
600 W SALISBURY ST STE AASHEBORONC27203PHYSICAL THERAPY
6 - RHMG DEEP RIVER P T -RAMSEUR
701 LIBERTY STRAMSEURNC27316PHYSICAL THERAPY
7 - RHMG DEEP RIVER P T -RANDLEMAN
148 POINTE SOUTH DRIVERANDLEMANNC27317PHYSICAL THERAPY
8 - RH DIABETES CENTER
208-D FOUST STASHEBORONC27203DIABETES TREATMENT
9 - RHMG EAR NOSE & THROAT
124 N PARK STASHEBORONC27203EAR NOSE AND THROAT
10 - RHMG ENDOSCOPY CENTER
700 SUNSET AVEASHEBORONC27203ENDOSCOPY
11 - RHMG FAMILY PRACTICE - LIBERTY
504 N GREENSBOROLIBERTYNC27298FAMILY MEDICINE
12 - RHMG FAMILY PRACTICE - RANDLEMAN
670 W ACADEMY STRANDLEMANNC27317FAMILY MEDICINE
13 - RHMG FAMILY PRACTICE - SEAGROVE
514 N BROAD STSEAGROVENC27341FAMILY MEDICINE
14 - RHMG FAMILY PRACTICE & WELLNESS
132-C W MILLER STASHEBORONC27203FAMILY MEDICINE
15 - RHMG FITNESS CENTER
600 W SALISBURY ST STE AASHEBORONC27203FITNESS CENTER
16 - RHMG GASTROENTEROLOGY
700 SUNSET AVEASHEBORONC27203GASTROENTEROLOGY
17 - RHHOME HEALTH
341 N FAYETTEVILLE STASHEBORONC27203HOME HEALTH
18 - RHMG INTERNAL MEDICINE
237-A N FAYETTEVILLE STASHEBORONC27203INTERNAL MEDICINE
19 - RH MRI CENTER
237 N FAYETTEVILLE ST STE BASHEBORONC27203MRI
20 - RHMG ORTHOPEDICS & SPORTS MEDICINE
503 N FAYETTEVILLE STASHEBORONC27203ORTHOPEDICS/SPORTS MEDICINE
21 - RHMGPEDIATRICS
713 S FAYETTEVILLE STASHEBORONC27203PEDIATRICS
22 - RHMG P T & SPORTS MEDICINE
503 N FAYETTEVILLE STASHEBORONC27203PHYSICAL THERAPY
23 - RH SURGERY CENTER
724 THOMAS STASHEBORONC27203SURGICAL CENTER
24 - RHMG UROLOGY
132-C W MILLER STASHEBORONC27203UROLOGY
25 - RH WOUND CARE & HYPERBARIC CENTER
212 FOUST STASHEBORONC27203WOUND CARE

Supplemental Information Detail SupplementalInformationDetail (11 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 6A:NORTH CAROLINA HOSPITAL ASSOCIATION
PART I, LN 7 COL(F):UNINSURED PATIENTS NOT QUALIFYING FOR FINANCIAL ASSISTANCE OR STATE, FEDERAL, AND /OR GRANT FUND PROGRAMS ARE RESPONSIBLE FOR A DISCOUNTED PAYMENT AMOUNT IN ACCORDANCE WITH IRS SECTION 501(R). PAYMENT PLANS ARE OFFERED THROUGH RANDOLPH HOSPITAL WITH NO INCURRED INTEREST CHARGES. THE PATIENT FINANCIAL SERVICES DEPARTMENT OF RANDOLPH HOSPITAL PROVIDES A MONTHLY STATEMENT, MAKES TELEPHONE CONTACT, AND/OR SENDS COLLECTION LETTERS. UNCOLLECTED DELIQUENT ACCOUNTS MAY BE REFERRED TO AN EXTERNAL COLLECTION AGENCY OR ATTORNEY FOR CONTINUED COLLECTION. ALL INTERNAL AND EXTERNAL COLLECTIONS PROCESSES COMPLY WITH THE FAIR DEBT COLLECTION PRACTICES ACT (FDCPA).
PART III, LINE 2:THE ORGANIZATION APPLIED THE COST-TO CHARGE RATIO TO ITS BAD DEBT CHARGES TO ARRIVE AT THE COST OF BAD DEBT REPORTED ON PART III, LINE 2.
PART III, LINE 3:THE ORGANIZATION ESTIMATES FROM HISTORICAL PERSPECTIVE AND EXPERIENCE THAT APPROXIMATELY 85% OF BAD DEBT EXPENSE MAY BE ATTRIBUTABLE TO COMMUNITY BENEFIT.
PART III, LINE 4:THE ORGANIZATION'S FINANCIAL STATEMENTS DO NOT INCLUDE A FOOTNOTE ON BAD DEBT. BAD DEBT EXPENSE WAS OBTAINED FROM AUDITED FINANCIAL STATEMENTS.
PART III, LINE 8:THE HOSPITAL TRADITIONALLY INCURS A SHORTFALL IN PROVIDING MEDICARE SERVICES AND CONSIDERS THE ENTIRE SHORTFALL AS A COMMUNITY BENEFIT. MEDICARE DOES NOT REIMBURSE THE HOSPITAL ENOUGH TO COVER ITS COSTS ASSOCIATED WITH PROVIDING MEDICARE SERVICES, YET THE HOSPITAL CONTINUES TO FULFILL ITS MISSION OF PROVIDING SERVICES TO ITS COMMUNITY REGARDLESS OF THE REIMBURSEMENT LEVELS. AS SUCH, THE HOSPITAL BELIEVES THAT IT IS APPROPRIATE TO REPORT THIS SHORTFALL AS PART OF ITS COMMUNITY BENEFIT. THE BAD DEBT INCLUDED AS UNCOMPENSATED CARE REPRESENTS THE COST OF PROVIDING THOSE SERVICES, CALCULATED USING THE COST TO CHARGE RATIO OF THE CHARGES RECORDED IN THE FINANCIAL STATEMENTS AS BAD DEBT.
PART III, LINE 9B:RANDOLPH HOSPITAL IS COMMITTED TO ASSISTING PATIENTS THAT DO NOT HAVE THE FINANCIAL RESOURCES TO PAY FOR THEIR HEALTH CARE SERVICES. THE HOSPITAL MAKES AVAILABLE FINANCIAL COUNSELING TO DETERMINE THE APPROPRIATE DISPOSITION OF THE PATIENT ACCOUNT. A MEDICAL ASSISTANCE COUNSELOR REVIEWS ACCOUNTS FOR POSSIBLE FINANCIAL ASSISTANCE FROM STATE, FEDERAL, AND/OR ENDOWMENT FUNDS PROGRAMS. RANDOLPH HOSPITAL PROVIDES CHARITY TO PATIENTS WHO MEET CRITERIA AS OUTLINED IN THE FINANCIAL ASSISTANCE POLICY. ANY PATIENT/GUARANTOR WHO REFUSES TO COMPLETE THE APPLICATION WILL BE CONSIDERED AS HAVING THE ABILITY TO PAY HIS ACCOUNT AND HANDLED ACCORDINGLY.
PART VI, LINE 2:THE HOSPITAL WORKS WITH THE RANDOLPH COUNTY HEALTH DEPARTMENT ON AN ONGOING BASIS TO ASSESS THE HEALTH CARE NEEDS OF THE COMMUNITY IT SERVES. ADDITIONAL ASSISTANCE IS PROVIDED BY COMMUNITY INSTITUTIONS, BUSINESSES, AGENCIES AND INDIVIDUALS WITH AN INTEREST IN IMPROVING THE HEALTH STATUS OF RANDOLPH COUNTY RESIDENTS.
PART VI, LINE 3:THE HOSPITAL HAS A DEDICATED PATIENT FINANCIAL TEAM THAT TAKES A PROACTIVE APPROACH TO COUNSELING AND EDUCATING PATIENTS ON THE HEALTHCARE BILLING PROCESS AND CREATING CUSTOMIZED PAYMENT OPTIONS TO HELP ALLEVIATE INITIAL FINANCIAL BURDENS. IF IT APPEARS THAT A PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE, OUR TEAM WILL HELP THE PATIENT DETERMINE WHICH ROUTE IS MOST APPROPRIATE FOR THEIR SITUATION. THE HOSPITAL ASSESSES AT THE TIME OF REGISTRATION AND DURING INTERVIEWS WITH FINANCIAL COUNSELORS WHETHER A PATIENT MIGHT QUALIFY FOR FINANCIAL ASSISTANCE AND PROVIDES LITERATURE TO THE PATIENT AT THAT TIME. THE HOSPITAL ALSO WIDELY COMMUNICATES THE AVAILABILITY OF THE FINANCIAL ASSISTANCE POLICY ON ITS WEBSITE, BILLING STATEMENTS, AND SIGNS POSTED CONSPICUOUSLY THROUGH OUT ITS FACILITIES.
PART VI, LINE 4:THE US CENSUS BUREAU REPORTED AN ESTIMATED POPULATION OF APPROXIMATELY 143,149 IN RANDOLPH COUNTY FOR THE YEAR 2017. THIS WAS AN INCREASE OF ALMOST 1% FROM THE YEAR 2010 WHEN THE POPULATION WAS REPORTED TO BE APPROXIMATELY 141,752. THE ESTIMATED POPULATION IN NORTH CAROLINA IN 2017 WAS 10,052,564 WHICH WAS AN INCREASE OF 5.4% FROM 2010.SIMILAR TO NORTH CAROLINA AS A WHOLE, THE POPULATION OF RANDOLPH COUNTY IS DIVIDED ALMOST EQUALLY BETWEEN MALES (49.3%-RC, 48.7%-NC) AND FEMALES (50.7%-RC, 51.3%-NC). RESIDENTS OF RANDOLPH COUNTY ARE PREDOMINATELY WHITE (84.9%), FOLLOWED BY HISPANIC (11.1%) AND BLACK (6.3%). THE HISPANIC POPULATION IN RANDOLPH COUNTY (11.1%) IS HIGHER WHEN COMPARED TO NORTH CAROLINA (9.1%) AS A WHOLE. THE BLACK POPULATION IN RANDOLPH COUNTY (6.3%) IS LOWER WHEN COMPARED TO NORTH CAROLINA (21.5%).FROM AN ECONOMIC STANDPOINT, PERSONAL INCOME PER CAPITA FOR RANDOLPH COUNTY WAS AT $36,339 IN 2017, BELOW THE AVERAGE PER CAPITA INCOME FOR ALL RESIDENTS OF NORTH CAROLINA. THE PERCENTAGE OF MEDICAID ELIGIBLE PATIENTS IN RANDOLPH COUNTY IN 2017 IS 25.2%, EXCEEDING THE AVERAGE LEVEL IN NORTH CAROLINA. UNEMPLOYMENT RATES FOR RANDOLPH COUNTY IN 2018 IS APPROXIMATELY 3.7% OF THE WORKFORCE, SLIGHTLY ABOVE THE NORTH CAROLINA RATE OF 3.6%.
PART VI, LINE 7, REPORTS FILED WITH STATESNC

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records Maintained0GrantRecordsMaintainedInd

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp

FieldValueIRS element (for citing)
Grant TypeCHARITY CARE ASSISTANCE TO PATIENTS QUALIFYING UNDER RANDOLPH HOSPITAL'S CHARITY CARE POLICY.GrantTypeTxt
Recipient2600RecipientCnt
Cash Grant$2,769,268CashGrantAmt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeYes (X)CompensationCommitteeInd
Form990 Of Other OrganizationsYes (X)Form990OfOtherOrganizationsInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
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 (6 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
LORETTA M LONG
CFO$153,958$0$0$0$0$0$0$0$5,304$0$159,262$0$0$0
CHARLES B WEST
CMO$286,561$0$0$0$0$0$0$0$6,209$0$292,770$0$0$0
BARBARA E WOLFE
VP$206,595$0$0$0$0$0$0$0$6,609$0$213,204$0$0$0
ROBERT S CLAUSER
VP$224,125$0$0$0$0$0$0$0$9,175$0$233,300$0$0$0
TREMONTEO CRAWFORD
VP$181,382$0$0$0$0$0$0$0$3,916$0$185,298$0$0$0
LISA D HAMPTON
DIRECTOR$181,079$0$0$0$0$0$0$0$1,220$0$182,299$0$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 4BFormAndLineReferenceDesc
ExplanationCERTAIN MEMBERS OF THE SENIOR MANAGEMENT TEAM PARTICIPATE IN THE RANDOLPH HOSPITAL, INC. DEFERRED COMPENSATION PLAN. UNDER THIS PLAN, AN ANNUAL CONTRIBUTION IS MADE INTO A TRUST FOR EACH PARTICIPANT BASED ON A PERCENTAGE (10% OR 15%) OF THEIR SALARY. EACH PARTICIPANT DIRECTS THE INVESTMENT OF HIS/HER ACCOUNT BALANCE. DURING 2018, ROBERT CLAUSER, ANGELA ORTH, AND BARBARA WOLFE RECEIVED PAYOUTS FROM THE PLAN OF $58,682, $37,247, AND $48,101, RESPECTIVELY.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 1THERE STANDS AN EXECUTIVE COMMITTEE CONSISTING OF THE CHAIRMAN, VICE CHAIRMAN, CHAIRMAN-ELECT, SECRETARY, CHAIRMAN OF THE FINANCE, AUDIT, INVESTMENT AND RETIREMENT COMMITTEE, AND UP TO TWO OTHER DIRECTORS AS DESIGNATED BY THE CHAIRMAN. THE COMMITTEE HAS AND MAY EXERCISE THE AUTHORITY OF THE BOARD IN THE MANAGEMENT OF THE ORGANIZATION, TO THE EXTENT PERMITTED BY LAW, DURING THE INTERVALS BETWEEN MEETINGS OF THE BOARD.
FORM 990, PART VI, SECTION A, LINE 6THE CORPORATION SHALL HAVE ONE CLASS OF MEMBERS CONSISTING OF AT LEAST 23 MEMBERS AND NEVER CONSISTING OF MORE THAN 30 MEMBERS. FOUR MEMBERS SHALL BE EX OFFICIO, AS INDICATED BELOW. THE REMAINDER SHALL BE ELECTED AS PROVIDED IN DETAIL IN THE BYLAWS. THE PRINCIPAL CRITERION FOR SELECTION OF CORPORATE MEMBERS SHALL BE THE PERSON'S QUALIFICATIONS TO EVENTUALLY SERVE AS A DIRECTOR OF RANDOLPH HOSPITAL, AS SET FORTH IN THE BYLAWS. AS CANDIDATES BECOME AVAILABLE, THE MEMBERS MAY EXPAND OR CONTRACT THEIR NUMBER, WITHIN THE LIMITS STATED ABOVE, IN ORDER TO PROVIDE AN ADEQUATE POOL OF MEMBERS WHO ARE QUALIFIED TO SERVE AS DIRECTORS. IN ADDITION TO THE ELECTED MEMBERS, THE MAYOR OF ASHEBORO, NORTH CAROLINA, THE CHAIRMAN OF THE BOARD OF COMMISSIONERS OF RANDOLPH COUNTY, NORTH CAROLINA, THE RANDOLPH COUNTY SUPERINTENDENT OF SCHOOLS, CITY OF ASHEBORO SUPERINTENDENT OF SCHOOLS, AND THE COUNTY HEALTH OFFICER OF RANDOLPH COUNTY, NORTH CAROLINA, SHALL BE EX OFFICIO MEMBERS OF THE CORPORATION.
FORM 990, PART VI, SECTION A, LINE 7ATHE DIRECTORS SHALL BE ELECTED BY THE MEMBERS AT THE ANNUAL MEETING OF THE CORPORATE MEMBERS FROM NOMINATIONS RECEIVED BOTH FROM THE GOVERNANCE COMMITTEE AND FROM THE FLOOR AT THE ANNUAL MEETING. IF ANY DIRECTORS SHALL SERVE ONE-YEAR TERMS, AND SHALL CONTINUE TO SERVE UNTIL THEIR SUCCESSORS ARE ELECTED. DIRECTORS MAY BE RE-ELECTED. ANY DIRECTOR MAY BE REMOVED FROM OFFICE AT ANY TIME, WITH OR WITHOUT CAUSE, BY A MAJORITY VOTE OF THE MEMBERS OF THE CORPORATION.
FORM 990, PART VI, SECTION A, LINE 7BCHANGES TO THE BYLAWS, SALE OR MERGER OF THE HOSPITAL MUST BE APPROVED BY THE MEMBERS.
FORM 990, PART VI, SECTION B, LINE 11BTHE 990 IS REVIEWED AT THE FAIR (FINANCE, AUDIT, INVESTMENT AND RETIREMENT) COMMITTEE PRIOR TO FILING WITH THE IRS. ALL OF THE BOARD MEMBERS ARE INVITED TO ATTEND. ANYONE NOT AT THE MEETING IS GIVEN A COPY OF THE 990 AND IS INVITED TO ASK QUESTIONS.
FORM 990, PART VI, SECTION B, LINE 12CRANDOLPH HOSPITAL HAS A PART TIME CORPORATE COMPLIANCE OFFICER CHARGED WITH EDUCATING THE BOARD, OFFICERS, AND OTHER EMPLOYEES ON THE CONFLICT OF INTEREST POLICY. ALL NEW EMPLOYEES ARE GIVEN INFORMATION UPON ORIENTATION, AND ALL CURRENT EMPLOYEES ARE REQUIRED TO TAKE ANNUAL EDUCATION ON COMPLIANCE WITH THE POLICY. THERE IS A CORPORATE COMPLIANCE MEETING TO UPDATE KEY INDIVIDUALS ON NEW ISSUES AND NEW INFORMATION REGARDING CORPORATE COMPLIANCE. THE MEMBERS OF THE BOARD OF DIRECTORS ARE REQUIRED ANNUALLY TO READ, SIGN, AND REMIT A COPY OF THE POLICY TO THE BOARD CHAIR. ALL BOARD MEMBERS ARE AWARE OF THE POLICY AND IN CASE OF ANY CONFLICT OF INTEREST, THEY WILL RECUSE THEMSELVES.
FORM 990, PART VI, SECTION B, LINE 15RANDOLPH HOSPITAL USES COMPETITIVE MARKET SURVEYS, FROM SUCH ORGANIZATIONS AS NCHHRA AND VASHHRA, TO DETERMINE APPROPRIATE COMPENSATION LEVELS FOR EXECUTIVES THAT ARE COMMENSURATE WITH ORGANIZATIONS OF SIMILAR SIZE AND STRUCTURE. PERIODICALLY, AN EXTERNAL FIRM IS USED TO EVALUATE COMPENSATION. A COMPENSATION COMMITTEE OF THE BOARD HAS FINAL DETERMINATION OF COMPENSATION LEVELS FOR TOP EXECUTIVES.
FORM 990, PART VI, SECTION C, LINE 19PHOTOCOPIES OF THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST AT THE ORGANIZATION'S ADMINISTRATIVE OFFICE.
FORM 990, PART XI, LINE 9:CHANGE IN MINIMUM PENSION LIABILITY -1,644,274. LOSS ON INVESTMENT IN AFFILIATES -244,398. CHANGE IN NET UNREALIZED GAINS ON OTHER THAN TRADING SECURITIES 8,237. NET ASSETS RELEASED FROM RESTRICTIONS FOR CAPITAL 2,309,080.

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Txt
MRI OF ASHEBORO LLC
237 N FAYETTEVILLE STREET BASHEBORONC27203472225445IMAGING SERVICESNCRANDOLPH HOSPITAL INC
PIEDMONT INTEGRATED HEALTH LLC
364 WHITE OAK STREETASHEBORONC27203472221211CLINICALLY INTEGRATED NETWORKNCRANDOLPH HOSPITAL INC

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (4 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
RANDOLPH SPECIALTY GROUP
364 WHITE OAK STREETASHEBORONC27203113827203HEALTHCARENC501(C)(3)LINE 10RANDOLPH HOSPITAL INCYes (1)
RANDOLPH CANCER CENTER
373 N FAYETTEVILLE STREETASHEBORONC27203562181482HEALTHCARENC501(C)(3)LINE 12A, IRANDOLPH HOSPITAL INCYes (1)
RANDOLPH HOSPITAL COMMUNITY HEALTH FOUNDATION
364 WHITE OAK STREETASHEBORONC27203582240755SUPPORT ORGANIZATIONNC501(C)(3)LINE 12A, IRANDOLPH HOSPITAL INCYes (1)
STAYWELL SENIOR CARE
PO BOX 1048ASHEBORONC27204461289922HEALTHCARENC501(C)(3)LINE 12A, IRANDOLPH HOSPITAL INCYes (1)

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1RANDOLPH NEWCO LLCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1364 WHITE OAK STREETAddressLine1Txt
CityASHEBOROCityNm
State AbbreviationNCStateAbbreviationCd
ZIP27203ZIPCd
FieldValueIRS element (for citing)
EIN471905523EIN
Primary ActivitiesMEDICAL EQUIPMENT RENTALPrimaryActivitiesTxt
Legal Domicile StateNCLegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1RANDOLPH HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
Predominant Income TypeUNRELATEDPredominantIncomeTypeTxt
Share Of Total Income-$158,230ShareOfTotalIncomeAmt
Disproportionate Allocations0DisproportionateAllocationsInd
General Or Managing Partner0GeneralOrManagingPartnerInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (1)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgYes (1)LoansOrGuaranteesToOtherOrgInd
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 OrgYes (1)RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (1)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (1)PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (1)TransferToOtherOrgInd
Transfer From Other OrgYes (1)TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (10 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
RANDOLPH SPECIALTY GROUP
K$93,720CASH
RANDOLPH SPECIALTY GROUP
O-$10,059CASH
RANDOLPH SPECIALTY GROUP
Q$1,268,544CASH
RANDOLPH SPECIALTY GROUP
S$1,564,380CASH
RANDOLPH SPECIALTY GROUP
S$1,875,366CASH
RANDOLPH CANCER CENTER
J$249,000CASH
STAYWELL SENIOR CARE
L$669,541CASH
STAYWELL SENIOR CARE
O$23,371CASH
STAYWELL SENIOR CARE
Q$672,179CASH
COMMUNITY HEALTH FOUNDATION
C$2,250,000CASH

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