2020-05-04T11:41:53-05:00 2019-06-30 BDO USA LLP 421 Fayetteville Street Suite 300 Raleigh NC 27601 990 2018-07-01 560554202 Caldwell Memorial Hospital % MICHAEL BUNCH CALD 8287575100 321 Mulberry Street SW Lenoir NC 28645 MICHAEL BUNCH CFO 8287575100 2020-04-27 true SANDRA L FEINSMITH P01064157 9192781936 2020-05-04 38.132.154.29 69472520201255000005 2020-05-04 P EF2991C9A21BE3EFA88C6B14E99CCE4945012704 F1629F6A3F74945AEE6FE2E323340EE9C36B3F52 2018 2020-11-06 18:47:13Z Laura J Easton 321 Mulberry Street SW Lenoir NC 28645 154045029 false X www.caldwellmemorial.org X 1945 NC To provide safe, effective, compassionate care and to promote healthy lifestyles to our community. 15 12 1015 148 830758 -571349 10056048 15872415 120364435 136176010 268004 1107109 914869 889495 131603356 154045029 0 0 0 0 62054927 68105030 0 0 0 59701984 74247037 121756911 142352067 9846445 11692962 86425728 97819298 28952397 28653005 57473331 69166293 X To provide safe, effective, compassionate care and to promote healthy lifestyles to our community. false false 121118538 0 135860292 SINCE OPENING IN 1951, CALDWELL MEMORIAL HOSPITAL HAS CONTINUED TO GROW AND CHANGE IN ORDER TO BETTER MEET THE NEEDS OF OUR COMMUNITY. THE MISSION OF CALDWELL MEMORIAL HOSPITAL IS TO PROVIDE SAFE, EFFECTIVE, COMPASSIONATE CARE AND TO PROMOTE HEALTHY LIFESTYLES TO OUR COMMUNITY. ANCHORED BY A 110-BED ACUTE CARE FACILITY, CALDWELL MEMORIAL HOSPITALS SERVICES INCLUDE A VAST ARRAY OF MEDICAL AND SURGICAL SERVICES. AMONG SERVICES OFFERED, BUT BY NO MEANS A COMPLETE LIST, ARE CAROTID ARTERY STENTING; CARDIOVASCULAR AND ENDOVASCULAR CARE; RADIATION ONCOLOGY; COMPUTER-ASSISTED ORTHOPEDIC SURGERY; NEUROLOGY AND MEMORY CARE; PAIN MANAGEMENT; A FULLY STAFFED 24-HOUR EMERGENCY DEPARTMENT; CALDWELL PHYSICIANS CLINICS CONVENIENTLY LOCATED COUNTY-WIDE; DIAGNOSTIC SERVICES; OUTPATIENT SURGERY; PLUS URGENT CARE; AND THE QUEST 4 LIFE WELLNESS CENTER. MULTIPLE EDUCATIONAL AND COUNSELING PROGRAMS ARE AVAILABLE FOR A WIDE ARRAY OF HEALTHCARE NEEDS INCLUDING CANCER, DIABETES, NUTRITION, JOINT CARE, PRE-NATAL CLASSES AND PARENTING SKILLS. CALDWELL PHYSICIANS IS A DIVISION OF CALDWELL MEMORIAL HOSPITAL. WITH PRACTICES IN COMMUNITIES COUNTYWIDE, CALDWELL PHYSICIANS PROVIDES THE PRIMARY AND SPECIALTY HEALTHCARE, DIAGNOSTICS AND TREATMENTS THAT OUR COMMUNITY NEEDS IN CONVENIENT LOCATIONS NEAR THEIR HOMES. CALDWELL PHYSICIANS INCLUDES: ANDERSON MEDICAL PARK, ANDERSON PLUS URGENT CARE, BLOWING ROCK MEDICAL, BLOWING ROCK PLUS URGENT CARE, LAUREL PARK WOMENS HEALTH - LENOIR, LAUREL PARK WOMENS HEALTH - GRANITE FALLS, MULBERRY PEDIATRICS, ROBBINS MEDICAL PARK, ROBBINS PULMONOLOGY, ROBBINS EAR, NOSE, THROAT AND ALLERGY, ROBBINS PLUS URGENT CARE, ROBBINS CARDIOLOGY, ROBBINS SURGICAL, SOUTHFORK MEDICAL PARK, RIVERCREST MEDICAL PARK, RIVERCREST PLUS URGENT CARE, THE FALLS PEDIATRICS, WESTPOINTE MEDICAL PRACTICE, CALDWELL UROLOGY ASSOCIATES, CALDWELL FOOT & ANKLE, AND THE FALLS PEDIATRICS PLUS URGENT CARE. 121118538 true true false true false false false false false false true true false false true true false true false false false false false false false false true true false false true false false false false false false false false false false false false false true true false false false true 63 0 true 1015 true true true false false false false false false false false false false false X 15 12 false false false false true true true true true false false true true true true true true true true false X MICHAEL BUNCH 8287575100 321 MULBERRY STREET SW Lenoir NC 28645 X Michael Chamberlain Director 2.0 0.0 X 0 0 0 Jerry Church Director 2.0 0.0 X 0 0 0 Richard Coffey Director/Chairman 2.0 0.0 X X 0 0 0 Chris Ellington Director 2.0 58.0 X 0 1148254 173340 Joseph Gibbons Director 2.0 0.0 X 0 0 0 William Howard III Director 2.0 0.0 X 0 0 0 Doug Johnson Director 2.0 0.0 X 0 0 0 Bill Johnson Director 2.0 0.0 X 0 0 0 Jeffrey Keverline MD Director/Vice Chairman 2.0 0.0 X X 0 0 0 Diana McClinton MD Director 2.0 0.0 X 0 0 0 Gary Park Director 2.0 58.0 X 0 2623154 553104 Richard Pearce MD Director 2.0 0.0 X 0 0 0 David Smith Director 2.0 0.0 X 0 0 0 Alan Stiles Director 2.0 0.0 X 0 0 0 Crystal Thomas Director 2.0 0.0 X 0 0 0 Boyd Wilson Director/Secretary & Treasurer 2.0 0.0 X X 0 0 0 John Powell MD Director 2.0 0.0 X 271365 0 36846 Laura Easton Director/President & CEO 60.0 0.0 X X 370472 0 41875 Rebecca Smith COO & CNO 60.0 0.0 X 267931 0 20946 Michael Bunch CFO 60.0 0.0 X 74275 0 3601 David Lowery MD CMO 60.0 0.0 X 378942 0 38877 Donita Damron VP Physician Services 60.0 0.0 X 179842 0 22622 Randal Bast Medical Practice Physician 60.0 0.0 X 657243 0 28946 Philip Jenkins Medical Practice Physician 60.0 0.0 X 458598 0 25375 Thomas Young Medical Practice Physician 60.0 0.0 X 426410 0 31729 Robert Dacus Medical Practice Physician 60.0 0.0 X 418434 0 33625 John Edmunds Medical Practice Physician 60.0 0.0 X 410943 0 27780 Shawn Hartley Former Officer 0.0 0.0 X 101302 0 0 4015757 3771408 1038666 88 true true false DLP Cardiac Partners LLC 3700 Arco Cop Office Suite 450 CHARLOTTE NC 27273 Cath Lab 707637 Staffency LLC 221 W College Avenue Floor 2 APPLETON WI 54911 HEALTHCARE STAFFING 428935 Horizon CSA LLC 265 Pit Road MOORESVILLE NC 28115 Medical Equipment 389904 Hayes Locums LLC 6700 N Andrews Avenue 600 FORT LAUDERDALE FL 33309 Healthcare Staffing 289993 James R Vannoy Sons Construction 1608 US Hwy 221 North JEFFERSON NC 28640 Construction 287797 9 14410240 1462175 15872415 PATIENT SERVICES 621500 133551598 133551598 QUEST4LIFE WELLNESS CENTER REVENUE 713990 830758 830758 OTHER PROGRAM SERVICES REVENUE 900099 2018181 1625861 392320 JOINT VENTURE INCOME 541900 -334186 -334186 OTHER REVENUE 900099 109659 109659 136176010 254048 254048 0 0 812893 812893 0 812893 812893 853061 853061 853061 853061 0 0 0 0 0 0 0 0 0 GAIN/LOSS ON FA DISPOSAL 900099 76752 76752 OTHER REVENUE 900099 -150 -150 76602 154045029 135029534 830758 2312322 0 0 0 0 1824921 1824921 54756523 45447913 9308610 1017586 847730 169856 7058067 6439869 618198 3447933 3145938 301995 0 0 1614654 1614654 23442 23442 15942 15942 0 0 8324969 5419542 2905427 262877 262877 897436 897436 491231 491231 0 4608110 4608110 587783 352668 235115 0 5369 5369 90421 90421 0 6156502 6156502 758483 758483 PATIENT CARE CUPPLIES & SERVIC 19072682 19072682 BAD DEBT EXPENSE 15290818 15290818 MINOR EQUIPMENT AND R&M 1165368 1130407 34961 HOME OFFICE ALLOCATION 12819000 8973301 3845699 2061950 1995487 66463 142352067 121118538 21233529 0 758086 10959818 0 0 0 0 15008376 15572996 0 0 0 0 0 0 4554741 4026377 2770034 1846651 147044064 91031700 51283011 56012364 2853865 1578594 5888065 7051223 1736825 771275 0 0 1572725 0 86425728 97819298 22032945 24325859 0 0 0 0 0 0 0 0 0 0 3883011 1401725 0 0 3036441 2925421 28952397 28653005 X 57473331 69166293 0 0 0 0 57473331 69166293 86425728 97819298 11692962 X X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 15942 15942 false PART II-B, LINE 1, LOBBYING ACTIVITIES Annual dues were paid to the American Hospital Association and North Carolina Hospital Association. A percentage, determined by the organizations, was estimated to be expenditures used in lobbying activities by these organizations. 0 2754303 2754303 73882050 37188230 36693820 63745453 52444560 11300893 6662258 1398910 5263348 56012364 OTHER ASSETS 7051223 7051223 0 THIRD PARTY 1346827 DEFERRED FEE PLAN LIABILITY 1578594 2925421 X PART X, LINE 2 THE HOSPITAL AND FOUNDATION ARE NONPROFIT CORPORATIONS AND HAVE BEEN RECOGNIZED AS TAX-EXEMPT, PURSUANT TO SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. NO PROVISION FOR INCOME TAXES HAS BEEN MADE IN THE ACCOMPANYING COMBINED FINANCIAL STATEMENTS. true true X true X 250. false true true false true true 6209643 6209643 0.04360 19703259 19050293 652966 0.00460 25912902 19050293 6862609 0.04820 166467 166467 0.00120 166467 166467 0.00120 26079369 19050293 7029076 0.04940 true 15290818 10103617 49609234 62409290 -12800056 X true true AMERICAN HOME PATIEN HEALTHCARE 0.25 0.75 GUARDIAN HEALTHCARE HEALTHCARE 0.5 0.5 LAUREL PARK MOB MEDICAL OFFICE BUILDING 0.149 0.851 PRIME SURGICAL SUITE AMBULATORY SURGERY CENTER 0.57 0.43 1 1 CALDWELL MEMORIAL HOSPITAL 321 MULBERRY STREET SW Lenoir NC 28645 H0061 X X X DISPROPORTIONATE SHARE HOSPITAL CALDWELL MEMORIAL HOSPITAL 1 false false true X X X X X X X X X 17 true false true true X See Part V X true 17 true See Part V false true X 250. 0. false true X X X true X SEE PART V X SEE PART V X SEE PART V X X X X X X true X false X X X X true X false false PART V, SECTION B, LINE 5 CALDWELL MEMORIAL HOSPITAL (CMH) DEPLOYED A SURVEY TO LOCAL EXPERT ADVISORS TO GAIN INPUT ON LOCAL HEALTH NEEDS AND THE NEEDS OF PRIORITY POPULATIONS. LOCAL EXPERT ADVISORS WERE LOCAL INDIVIDUALS SELECTED ACCORDING TO CRITERIA REQUIRED BY THE FEDERAL GUIDELINES AND REGULATIONS AND THE HOSPITALS DESIRE TO REPRESENT THE REGIONS GEOGRAPHICALLY AND ETHNICALLY DIVERSE POPULATION. CMH RECEIVED INPUT FROM 19 LOCAL EXPERT ADVISORS REPRESENTING THE BROAD INTEREST OF THE COMMUNITY SERVED. IN ADDITION TO SURVEYING THE LOCAL EXPERT ADVISORS, CMH SOLICITED WRITTEN COMMENTS FROM THE COMMUNITY ABOUT ITS 2017 CHNA. part v, section b, line 6b quorum health resources PART V, SECTION B, LINE 7a https://www.caldwellmemorial.org/about-us/-community-health-needs- assessment/ Part V, SECTION B, LINE 10a https://www.caldwellmemorial.org/about-us/-community-health-needs- assessment/ PART V, SECTION B, LINE 11 THE HOSPITAL HAS IDENTIFIED THE FOLLOWING AREAS AS REPRESENTING THE SIGNIFICANT HEALTH NEEDS FOR CALDWELL COUNTY: 1. MENTAL HEALTH AND SUBSTANCE ABUSE 2. CHRONIC DISEASE 3. OBESITY 4. CANCER 5. HEART DISEASE THE HOSPITAL HAS DEVELOPED IMPLEMENTATION STRATEGIES FOR THREE OF THE FIVE NEEDS (MENTAL HEALTH & SUBSTANCE ABUSE, CHRONIC DISEASE, AND CANCER; OBESITY AND HEART DISEASE ARE ADDRESSED WITHIN CHRONIC DISEASE) INCLUDING ACTIVITIES TO CONTINUE/PURSUE, COMMUNITY PARTNERS TO WORK ALONGSIDE, AND LEADING AND LAGGING INDICATORS TO TRACK. THE HOSPITAL ALSO IDENTIFIED FOURTEEN OTHER HEALTH NEEDS DURING ITS CHNA PROCESS, BUT DUE TO RESOURCE CONSTRAINTS, DID NOT DEVELOP STRATEGIES TO ADDRESS THOSE ADDITIONAL HEALTH NEEDS. THE HOSPITAL INTENDS TO ADdRESS THE SIGNIFICANT HEALTH NEEDS IDENTIFIED ABOVE IN THE FOLLOWING WAY: MENTAL HEALTH AND SUBSTANCE ABUSE THE HOSPITAL INTENDS TO ADD AN IN-HOUSE PSYCHIATRIC UNIT THAT WILL RECRUIT PSYCHIATRISTS, COUNSELORS, SOCIAL WORKERS, AND MENTAL HEALTH TECHNICIANS TO MANAGE THE SERVICES AND IMPROVE ACCESS TO MENTAL HEALTH CARE. THE UNIT WILL ALSO INCLUDE AN OUTPATIENT PSYCHIATRIC CLINIC. THE HOSPITAL EXPECTS TO COLLABORATE WITH THE UNC HEALTH SYSTEM TO LEARN FROM OTHER FACILITIES AND IMPLEMENT THE BEST PROGRAM POSSIBLE. THE HOSPITAL WILL ALSO PILOT A PROGRAM WITH ONE PRIMARY CARE PHYSICIAN TO OFFER TELEMEDICINE PSYCHIATRIC SERVICES IN PARTNERSHIP WITH UNC. IF THE PILOT IS SUCCESSFUL, CMH WILL CONSIDER EXPANDING THE PROGRAM TO OTHER PROVIDERS. THE HOSPITAL WILL ALSO CONTINUE DISCUSSING OPTIONS FOR THE USE OF TELEPSYCHIATRY IN THE EMERGENCY DEPARTMENT. THE HOSPITAL WILL DEVELOP A SYSTEM-WIDE PROTOCOL FOR THE USE OF NARCAN IN EMERGENCY DEPARTMENT. CHRONIC DISEASE (ALSO INCLUDES OBESITY AND HEART DISEASE) THE HOSPITAL PLANS TO TAKE THE FOLLOWING STEPS TO ADDRESS THIS NEED: - WORKING TO HAVE ALL PRACTICES CERTIFIED AS PATIENT-CENTERED MEDICAL HOMES - BRINGING IN INTENSIVIST CARE MANAGER - ADDING OUTPATIENT NUTRITION AND DIABETES SERVICES TO ADDITIONAL PRIMARY CARE PRACTICES - ENHANCING MAMMOGRAPHY SERVICES BY ADDING 3D MAMMOGRAPHY CANCER THE HOSPITAL PLANS TO TAKE THE FOLLOWING STEPS TO ADDRESS THIS NEED: - ENHANCING MAMMOGRAPHY SERVICES BY ADDING 3D MAMMOGRAPHY PART V, LINE 16A, FAP WEBSITE HTTP://CALDWELLMEMORIAL.ORG/FINANCIAL-ASSISTANCE-POLICY/ PART V, LINE 16B, FAP APPLICATION WEBSITE HTTP://CALDWELLMEMORIAL.ORG/FINANCIAL-ASSISTANCE-POLICY/ PART V, LINE 16C, FAP PLAIN LANGUAGE SUMMARY WEBSITE HTTP://CALDWELLMEMORIAL.ORG/FINANCIAL-ASSISTANCE-POLICY/ 9 COMMUNITY PHARMACY 321 MULBERRY STREET SW LENOIR NC 28645 RETAIL/EMPLOYEE PHARMACY QUEST 4 LIFE WELLNESS CENTER 1031 MORGANTON BLVD LENOIR NC 28645 WELLNESS CENTER CALDWELL PHYSICIANS NETWORK 321 MULBERRY STREET SW LENOIR NC 28645 PHYSICIAN PRACTICE CALDWELL MEMORIAL SLEEP CENTER 270 PINE MOUNTAIN ROAD HUDSON NC 28638 SLEEP CENTER THE CENTER FOR WOUND MANAGEMENT 401 MULBERRY STREET LENOIR NC 28645 WOUND CARE CENTER GEORGE M HANCOCK SURGERY CENTER 1031 MORGANTON BLVD LENOIR NC 28645 OP SURGERY CENTER CENTER FOR DIABETES HEALTH 1031 MORGANTON BLVD LENOIR NC 28645 DIABETES EDUCATION AND SUPPORT PAIN MANAGEMENT CENTER 1031 MORGANTON BLVD LENOIR NC 28645 PAIN MANAGEMENT LAUREL PARK BREAST CENTER COLLEGE AVENUE LENOIR NC 28645 BREAST HEALTH PART I, LINE 3C CALDWELL PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS FINANCIAL ASSISTANCE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. BECAUSE CALDWELL DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS FINANCIAL ASSISTANCE, THEY ARE NOT REPORTED AS NET PATIENT SERVICE REVENUE. THE CRITERIA FOR FINANCIAL ASSISTANCE, WHILE NOT ALL INCLUSIVE, CONSIDERS THE PATIENTS INCOME, THEIR FINANCIAL STATUS INCLUDING THE EXTENT OF FINANCIAL OBLIGATIONS FOR HEALTH CARE SERVICES, AND ANY OTHER PERTINENT FACTORS DEEMED APPROPRIATE BY CALDWELL IN ASSESSING THE PATIENTS ABILITY TO PAY FOR THEIR SERVICES. PART I, LINE 7 WORKSHEET FROM SCHEDULE H INSTRUCTIONS IS USED TO COMPUTE A COST-TO-CHARGE RATIO TO CALCULATE FINANCIAL ASSISTANCE AND UNREIMBURSED MEDICAID AT COST. PART I, LN 7 COL(F) UNCOLLECTIBLE ACCOUNTS - THE HOSPITAL HAS PROVIDED SERVICES TO PERSONS WHO HAVE NOT PAID FOR SUCH SERVICES EITHER BECAUSE THEY HAVE BEEN UNWILLING OR UNABLE TO PAY. EFFORTS ARE MADE BY THE HOSPITAL TO DETERMINE IF A PATIENT MEETS FINANCIAL ASSISTANCE POLICY GUIDELINES THAT ARE ESTABLISHED BY THE HOSPITAL. IF THESE GUIDELINES ARE MET AND CAN BE VERIFIED, THEN SUCH AMOUNTS ARE INCLUDED IN FINANCIAL ASSISTANCE. UNTIL SUCH TIME, SUCH AMOUNTS ARE COMBINED IN THE PROVISION FOR UNCOLLECTIBLE ACCOUNTS BECAUSE THEY HAVE NOT BEEN VERIFIED OR DOCUMENTED AS FINANCIAL ASSISTANCE DUE TO LACK OF SUPPORTING FINANCIAL INFORMATION. IN SOME CASES, PATIENTS WHO WOULD (OR COULD) QUALIFY FOR FINANCIAL ASSISTANCE ARE UNWILLING OR UNABLE TO PRODUCE THE NECESSARY INFORMATION TO SUBSTANTIATE THEIR QUALIFICATION. THUS, THE PROVISION FOR UNCOLLECTIBLE ACCOUNTS INCLUDE AMOUNTS THAT WOULD OTHErWISE QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE HOSPITAL'S GUIDELINES. THE ESTIMATED COST OF UNREIMBURSED SERVICES ATTRIBUTABLE TO THE PROVISION FOR UNCOLLECTIBLE ACCOUNTS - EFFECTIVELY "FREE" SERVICES PROVIDED TO PATIENTS - HAS BEEN DETERMINED BY APPLYING A COST TO CHARGE RATIO TO THE AMOUNT OF THE PROVISION FOR UNCOLLECTIBLE ACCOUNTS. PART III, LINE 2 THE COST FOR BAD DEBT EXPENSES WAS CALCULATED BY APPLYING THE COST-TO-CHARGE RATIO FOR THE YEAR TO THE GROSS BAD DEBT CHARGES FOR THE YEAR. PART III, LINE 3 THE ESTIMATE FOR BAD DEBT EXPENSES ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE FINANCIAL ASSISTANCE POLICY WAS CALCULATED BY APPLYING THE COST-TO-CHARGE RATIO FOR THE YEAR TO THE GROSS BAD DEBT CHARGES ATTRIBUTABLE TO UNINSURED PATIENTS DURING THE YEAR. PART III, LINE 4 Net patient service revenue is reported at the estimated net realizable amounts from patients, third-party payors, and others for services rendered, including estimated retroactive adjustments due to future audits, reviews, and investigations. Retroactive adjustments are accrued on an estimated basis in the period the related services are rendered, and such amounts are adjusted in future periods as adjustments become known or as years are no longer subject to such audits, reviews, and investigations. PART III, Line 9b THE HOSPITAL DOES NOT SUBJECT ANY PATIENTS TO A COLLECTION AGENCY WHO HAS QUALIFIED FOR FINANCIAL ASSISTANCE GUIDELINES. PART VI, LINE 2 FEDERAL REGULATIONS SURROUNDING CHNA REQUIRE LOCAL INPUT FROM REPRESENTATIVES OF PARTICULAR DEMOGRAPHIC SECTORS. FOR THIS REASON, THE HOSPITAL DEVELOPED A STANDARD PROCESS OF GATHERING COMMUNITY INPUT. IN ADDITION TO GATHERING DATA FROM THE ABOVE SOURCES: - WE DEPLOYED A CHNA "ROUND 1" SURVEY TO OUR LOCAL EXPERT ADVISORS TO GAIN INPUT ON LOCAL HEALTH NEEDS AND THE NEEDS OF PRIORITY POPULATIONS. LOCAL EXPERT ADVISORS WERE LOCAL INDIVIDUALS SELECTED ACCORDING TO CRITERIA REQUIRED BY THE FEDERAL GUIDELINES AND REGULATIONS AND THE HOSPITAL'S DESIRE TO REPRESENT THE REGION'S GEOGRAPHICALLY AND ETHNICALLY DIVERSE POPULATION. WE RECEIVED COMMUNITY INPUT FROM 19 LOCAL EXPERT ADVISORS. SURVEY RESPONSES STARTED JUNE 2, 2017, AND ENDED WITH THE LAST RESPONSE ON JUNE 12, 2017. - INFORMATION ANALYSIS AUGMENTED BY LOCAL OPINIONS SHOWED HOW CALDWELL COUNTY RELATES TO ITS PEERS IN TERMS OF PRIMARY AND CHRONIC NEEDS AND OTHER ISSUES OF UNINSURED PERSONS, LOW-INCOME PERSONS, AND MINORITY GROUPS. RESPONDENTS COMMENTED ON WHETHER THEY BELIEVE CERTAIN POPULATION GROUPS ("PRIORITY POPULATIONS") NEED HELP TO IMPROVE THEIR CONDITION, AND IF SO, WHO NEEDS TO DO WHAT TO IMPROVE THE CONDITIONS OF THESE GROUPS. WHEN THE ANALYSIS WAS COMPLETE, WE PUT THE INFORMATION AND SUMMARY CONCLUSIONS BEFORE OUR LOCAL EXPERT ADVISORS WHO WERE ASKED TO AGREE OR DISAGREE WITH THE SUMMARY CONCLUSIONS. THEY WERE FREE TO AUGMENT POTENTIAL CONCLUSIONS WITH ADDITIONAL COMMENTS OF NEED. CONSULTATION WITH LOCAL EXPERTS OCCURRED AGAIN VIA AN INTERNET-BASED SURVEY (EXPLAINED BELOW) BEGINNING JUNE 22, 2017, AND ENDING JUNE 30, 2017. HAVING TAKEN STEPS TO IDENTIFY POTENTIAL COMMUNITY NEEDS, THE LOCAL EXPERTS THEN PARTICIPATED IN A STRUCTURED COMMUNICATION TECHNIQUE CALLED A "WISDOM OF CROWDS" METHOD. THE PREMISE OF THIS APPROACH RELIES ON A PANEL OF EXPERTS WITH THE ASSUMPTION THAT THE COLLECTIVE WISDOM OF PARTICIPANTS IS SUPERIOR TO THE OPINION OF ANY ONE INDIVIDUAL, REGARDLESS OF THEIR PROFESSIONAL CREDENTIALS. IN THE CALDWELL MEMORIAL HOSPITAL PROCESS, EACH LOCAL EXPERT HAD THE OPPORTUNITY TO INTRODUCE NEEDS PREVIOUSLY UNIDENTIFIED AND TO CHALLENGE CONCLUSIONS DEVELOPED FROM THE DATA ANALYSIS. WHILE THERE WERE A FEW OPINIONS OF THE DATA CONCLUSIONS NOT BEING COMPLETELY ACCURATE, MOST OF THE COMMENTS AGREED WITH OUR FINDINGS. WE DEVELOPED A LIST OF ALL NEEDS IDENTIFIED BY ANY OF THE ANALYZED DATA. THE LOCAL EXPERTS THEN ALLOCATED 100 POINTS AMONG THE LIST OF HEALTH NEEDS, INCLUDING THE OPPORTUNITY TO LIST ADDITIONAL NEEDS THAT WERE NOT IDENTIFIED FROM THE DATA. WE DIVIDED THE RANKED NEEDS INTO TWO GROUPS: "SIGNIFICANT"OTHER IDENTIFIED NEEDS." THE SIGNIFICANT NEEDS WERE PRIORITIZED BASED ON TOTAL POINTS CAST BY THE LOCAL EXPERTS IN DESCENDING ORDER, FURTHER RANKED BY THE NUMBER OF LOCAL EXPERTS CASTING ANY POINTS FOR THE NEED. BY OUR DEFINITION, A SIGNIFICANT NEED HAD TO INCLUDE ALL RANK ORDERED NEEDS UNTIL AT LEAST FIFTY PERCENT (50%) OF ALL POINTS WERE INCLUDED AND TO THE EXTENT POSSIBLE, REPRESENTED POINTS ALLOCATED BY A MAJORITY OF VOTING LOCAL EXPERTS. THE DETERMINATION OF THE BREAK POINT -- "SIGNIFICANT" AS OPPOSED TO "OTHER" -- WAS A QUALITATIVE INTERPRETATION BY THE CALDWELL MEMORIAL HOSPITAL EXECUTIVE TEAM WHERE A REASONABLE BREAK POINT IN RANK ORDER OCCURRED. PART VI, LINE 3 CALDWELL MEMORIAL HOSPITAL (CMH) PROVIDES NEEDED HEALTHCARE SERVICES TO ANYONE REGARDLESS OF THAT PERSON'S ABILITY TO PAY. CMH'S FINANCIAL ASSISTANCE POLICY IS DESIGNED TO ASSIST PATIENTS WHO ARE FINANCIALLY UNABLE TO PAY FOR HEALTHCARE SERVICES. a link to the POLICY CAN BE FOUND ON THE CMH PUBLIC website. CMH DISPLAYS INFORMATION REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE IN ITS EMERGENCY ROOM, REGISTRATION AREAS IN THE HOSPITAL AND CLINICS, and FINANCIAL COUNSELOR OFFICES. A LINK IS ALSO PROVIDED ON THE HOSPITAL'S WEBSITE TO THE AVAILABILITY OF FINANCIAL ASSISTANCE AND ITS FINANCIAL ASSISTANCE POLICY, ALONG WITH AN ON-LINE APPLICATION. INPATIENT CASE MANAGERS ALSO PROVIDE INFORMATION TO THE PATIENTS REGARDING AVAILABLE PROGRAMS AND THE ORGANIZation's FINANCIAL POLICY. CONSULTATION WITH FINANCIAL COUNSELORS IS ALSO AVAILABLE TO ALL PATIENTS AS NEEDED. PART VI, LINE 4 THE PRIMARY SERVICE AREA FOR CALDWELL MEMORIAL HOSPITAL IS CALDWELL COUNTY WITH A LIMITED NUMBER OF PAtients FROM THE SURROUNDING COUNTIES OF BURKE, WATAUGA, AND CATAWBA. CALDWELL COUNTY IS IN THE NW SECTION OF NC IN THE FOOTHILLS OF THE BLUE RIDGE MOUNTAINS AND IS BOUNDED ON THE NW BY WATAUGA COUNTY, ON THE NE BY WILKES COUNTY, ON THE EAST BY ALEXANDER COUNTY, ON THE SOUTH BY CATAWBA AND BURKE COUNTIES, AND ON THE WEST BY BURKE AND AVERY COUNTIES. TODAY THERE ARE NINE INCORPORATED MUNICIPALITIES IN THE COUNTY: LENOIR, HUDSON, GRANITE FALLS, CEDAR ROCK, CAJAHS MOUNTAIN, GAMEWELL, SAWMILLS, AND PARTS OF BLOWING ROCK AND RHODHISS. POPULATION IS JUST OVER 81,000. MEDIAN INCOME IS $40,735. POPULATION MAKEUP IS 87.4% WHITE, 5.3% HISPANIC, 4.8% BLACK OR AFRICAN AMERICAN AND 2.4% OTHER. MEDIAN AGE IS 44.1 YEARS. 49.4%% ARE MALES AND 50.6% FEMALES. PART VI, LINE 5 CALDWELL MEMORIAL HOSPITAL PROVIDES FINANCIAL SUPPORT TO 2 COMMUNITY AGENCIES: THE HELPING HANDS CLINIC (PROVIDING CARE TO THE UNINSURED) AND THE SATIE AND JE BROYHILL CALDWELL SENIOR CENTER (FOCUS ON THE LIVES AND ADVOCACY OF SENIORS). OTHER COMMUNITY INVOLVEMENT INCLUDES BUT NOT LIMITED TO: ANNUAL PROSTATE SCREENING, HEALTH FAIRS, SUPPORT AND INVOLVEMENT IN THE CALDWELL COMMUNITY GARDEN WHICH HELPS FOSTER COMMUNITY GARDENING, REPRESENTATION BY ORGANIZATION REPRESENTATIVES ON LOCAL HEALTH CARE RELATED BOARDS (BOARD OF HEALTH, HOSPICE, AND CHILD PROTECTION TEAM.) CALDWELL MEMORIAL HEALTHWORKS WHICH IS OCCUPATIONAL, INDUSTRIAL AND WORKER'S COMP MEDICINE DESIGNED TO ASSIST EMPLOYERS TOWARD IMPROVING QUALITY OF HEALTHCARE. PART VI, LINE 6 CALDWELL MEMORIAL HOSPITAL IS PART OF THE UNC HEALTH CARE SYSTEM. UNC HEALTH CARE IS A NOT-FOR-PROFIT INTEGRATED HEALTH CARE SYSTEM OWNED BY THE STATE OF NORTH CAROLINA AND BASED IN CHAPEL HILL. ORIGINALLY ESTABLISHED NOV. 1, 1998, UNC HEALTH CARE CURRENTLY COMPRISES UNC HOSPITALS AND ITS PROVIDER NETWORK, THE CLINICAL PROGRAMS OF THE UNC SCHOOL OF MEDICINE, AND TEN AFFILIATE HOSPITALS AND HOSPITAL SYSTEMS ACROSS THE STATE. COLLECTIVELY, THIS GROUP OF HEALTH CARE PROVIDERS WORKS TOGETHER TO MAKE SURE THAT ALL OF THE COMMUNITIES SERVED RECEIVED THE HIGHEST QUALITY OF CARE. Part VI, Line 7, List of States Receiving Community Benefit Report nc true X X X X X false true false false false true true false false Chris Ellington Director 0 684185 0 231196 0 232873 0 152107 0 21233 0 1321594 0 180594 Gary Park Director 0 526087 0 507300 0 1589767 0 532111 0 20993 0 3176258 0 1461911 John Powell MD Director 222548 0 48458 0 359 0 11471 0 25375 0 308211 0 0 0 Laura Easton Director/President & CEO 310871 0 39928 0 19673 0 16500 0 25375 0 412347 0 0 0 Rebecca Smith COO & CNO 215261 0 27385 0 25285 0 13015 0 7931 0 288877 0 0 0 David Lowery MD CMO 316652 0 54701 0 7589 0 13502 0 25375 0 417819 0 0 0 Donita Damron VP Physician Services 159111 0 20595 0 136 0 5967 0 16655 0 202464 0 0 0 Randal Bast Medical Practice Physician 653680 0 3069 0 494 0 3571 0 25375 0 686189 0 0 0 Philip Jenkins Medical Practice Physician 458287 0 0 0 311 0 0 0 25375 0 483973 0 0 0 Thomas Young Medical Practice Physician 416071 0 10146 0 193 0 6354 0 25375 0 458139 0 0 0 Robert Dacus Medical Practice Physician 396829 0 21111 0 494 0 8250 0 25375 0 452059 0 0 0 John Edmunds Medical Practice Physician 398586 0 10895 0 1462 0 11125 0 16655 0 438723 0 0 0 Shawn Hartley Former Officer 99155 0 0 0 2147 0 0 0 0 0 101302 0 0 0 PART I, LINE 4B DURING THE CALENDAR YEAR 2018, THE FOLLOWING INDIVIDUALS RECEIVED DISTRIBUTIONS FROM A NON-QUALIFIED SUPPLEMENTAL RETIREMENT PLAN (457(F)): CHRIS ELLINGTON (DIRECTOR) $180,594 GARY PARK RECEIVED DISTRIBUTION OF $1,461,911. LAURA EASTON (CEO) HAS A SECURED BENEFIT PLAN WHICH IS INCLUDED IN THE STUDY COMPLETED BY THE INDEPENDENT COMPENSATION CONSULTANT; THE LOAN UNDER THIS ARRANGEMENT IS RECORDED ON THE FINANCIAL STATEMENTS AND FULLY SECURED BY LIFE INSURANCE ON THE LIFE OF THE CEO. PART I, LINE 6 Senior management has an incentive program which is partially earned based on profit margin and days cash on hand. The earned incentive is reviewed by the HR Committee of the Board and approved annually. Employed Physicians are paid on a productivity basis based on RVU's generated in their practice operations and these are tied to MGMA benchmarks. FORM 990, PART VI, SECTION A, LINE 1: THE EXECUTIVE/FINANCE COMMITTEE SHALL HAVE THE POWER TO TRANSACT ALL REGULAR BUSINESS OF THE HOSPITAL DURING THE PERIOD BETWEEN THE MEETINGS OF THE BOARD OF DIRECTORS, SUBJECT TO ANY PRIOR LIMITATION IMPOSED BY THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 6: THE UNIVERSITY OF NORTH CAROLINA HEALTH CARE SYSTEM IS A MEMBER. FORM 990, PART VI, SECTION A, LINE 7A: THE UNIVERSITY OF NORTH CAROLINA HEALTH CARE SYSTEM IS A MEMBER AND THEY HAVE THE POWER TO APPOINT BOARD MEMBERS AND APPROVE GOVERNANCE DECISIONS. FORM 990, PART VI, SECTION A, LINE 7B: THE UNIVERSITY OF NORTH CAROLINA HEALTH CARE SYSTEM AS A MEMBER HAS APPROVAL RIGHTS TO ALL GOVERNANCE DECISIONS. FORM 990, PART VI, SECTION B, LINE 11B: THE FORM 990 WAS PREPARED BY AN INDEPENDENT ACCOUNTANT WITH ASSISTANCE AND OVERSIGHT BY MANAGEMENT. THE FULL BOARD RECEIVED A COPY OF THE FORM 990 FOR THEIR REVIEW AND FOR ANY QUESTIONS. THE FULL BOARD VOTED FOR A FINAL APPROVAL OF THE FORM 990. FORM 990, PART VI, SECTION B, LINE 12C: THE AUDIT AND COMPLIANCE COMMITTEE OF THE BOARD ANNUALLY REVIEWS THE CONFLICT OF INTEREST STATEMENTS. MINUTES OF BOARD MEETINGS REFLECT ANY DECLARED CONFLICT OF INTEREST. FORM 990, PART VI, SECTION B, LINE 15: THE ORGANIZATION COMPLETES THE REBUTTABLE PRESUMPTION OF REASONABLENESS AS DESCRIBED IN TREASURY REGULATION 4958(6)(C) FOR EACH OFFICER AND KEY EMPLOYEE. THIS PROCESS IS PERFORMED BY AN OUTSIDE INDEPENDENT COMPENSATION SPECIALIST. THE CONSULTANT'S FINDINGS ARE PRESENTED TO THE HR COMMITTEE OF THE BOARD AND ARE ULTIMATELY APPROVED BY THE FULL BOARD. FORM 990, PART VI, SECTION C, LINE 18: PHOTOCOPIES OF THE FORM 990 ARE AVAILABLE UPON REQUEST AT THE ORGANIZATIONS ADMINISTRATIVE OFFICE. IN ADDITION, RECENT FILINGS OF THE FORM 990 ARE AVAILABLE ON GUIDESTAR.ORG. FORM 990, PART VI, SECTION C, LINE 19: THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, FINANCIAL STATEMENTS, AND CONFLICT OF INTEREST POLICY AVAILABLE UPON REQUEST. PLEASE USE THE ORGANIZATIONS "CONTACT US" LINK ON ITS WEBSITE FOR REQUESTS. FORM 990, PART VII, LINE 1B AVERAGE HOURS PER WEEK BOARD MEMBERS AND OFFICERS CONTRIBUTE THEIR TIME AND SERVICES UPON REQUEST AND ON AN AS-NEEDED BASIS, WHICH, THROUGHOUT THE YEAR, MAY DIFFER FROM THE AVERAGE NUMBER OF HOURS PER WEEK REPORTED ON PART VII, LINE 1B. FORM 990, PART XII, LINE 2C: NO CHANGE FROM PRIOR YEAR. 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