CHARLES A CANNON JR MEMORIAL HOSPITAL INC: Form 990, tax year 2018
View the entire original 990 at ProPublica ↗
- Organization
- CHARLES A CANNON JR MEMORIAL HOSPITAL INC (EIN 56-0529974)
- Tax period
- 2018-10-01 to 2019-09-30
- Filed
- 2020-08-05
- IRS object ID
- 202012189349300901
- Schema version
- 2018v3.2
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2020-08-05T08:13:13-05:00 | ReturnTs |
| Tax Period End | 2019-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 560747981 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DIXON HUGHES GOODMAN LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 500 RIDGEFIELD COURT | AddressLine1Txt |
| City | ASHEVILLE | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 28806 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2018-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 560529974 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHARLES A CANNON JR MEMORIAL | BusinessNameLine1Txt |
| Business Name Line2 | HOSPITAL INC | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | CHAR | BusinessNameControlTxt |
| Phone | 8287377000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 434 HOSPITAL DR | AddressLine1Txt |
| City | LINVILLE | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 28646 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | KEVIN B MAY | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 8287377000 | PhoneNum |
| Signature | 2020-08-03 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | AMY BIBBY | PreparerPersonNm |
| PTIN | P00445891 | PTIN |
| Phone | 8282542254 | PhoneNum |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 47.27.82.235 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2020-08-03 | IPDt |
| IP Tm | 08:31:24 | IPTm |
| IP Timezone | ED | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | BEC9594289F9DCBB4F655B5045764FC48E5A1487 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2018 | TaxYr |
| Build TS | 2020-11-06 18:47:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | CHARLES MANTOOTH | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 434 HOSPITAL DR | AddressLine1Txt |
| City | LINVILLE | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 28646 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $24,916,591 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.APPRHS.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1957 | FormationYr |
| Legal Domicile State | NC | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE HEALTH CARE SERVICES TO ENHANCE THE QUALITY OF LIFE FOR THE CITIZENS OF AVERY COUNTY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 15 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 11 | VotingMembersIndependentCnt |
| Total Employee | 206 | TotalEmployeeCnt |
| Total Volunteers | 60 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $447,896 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $22,850,582 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $23,181,085 | CYProgramServiceRevenueAmt |
| PY Investment Income | $35,309 | PYInvestmentIncomeAmt |
| CY Investment Income | $5,727 | CYInvestmentIncomeAmt |
| PY Other Revenue | $607,068 | PYOtherRevenueAmt |
| CY Other Revenue | $1,281,883 | CYOtherRevenueAmt |
| PY Total Revenue | $23,492,959 | PYTotalRevenueAmt |
| CY Total Revenue | $24,916,591 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $12,601,923 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $12,771,812 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $14,294,984 | PYOtherExpensesAmt |
| CY Other Expenses | $14,032,720 | CYOtherExpensesAmt |
| PY Total Expenses | $26,896,907 | PYTotalExpensesAmt |
| CY Total Expenses | $26,804,532 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$3,403,948 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$1,887,941 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $25,542,498 | TotalAssetsBOYAmt |
| Total Assets EOY | $26,240,839 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $13,956,533 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $16,542,815 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $11,585,965 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $9,698,024 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO PROVIDE HEALTH CARE SERVICES TO ENHANCE THE QUALITY OF LIFE FOR THE CITIZENS OF AVERY COUNTY. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $22,109,622 | ExpenseAmt |
| Revenue | $23,181,085 | RevenueAmt |
| Desc | CHARLES A. CANNON, JR. MEMORIAL HOSPITAL IN LINVILLE IS A 25-BED ACUTE CARE HOSPITAL WITH A 10-BED INPATIENT BEHAVIORAL HEALTH UNIT. THE FULL-SERVICE EMERGENCY DEPARTMENT, IMAGING DEPARTMENT, LABORATORY, OUTPATIENT BEHAVIORAL HEALTH, REHABILITATION CENTER OFFERING PHYSICAL AND OCCUPATIONAL THERAPIES, AND CARDIOPULMONARY REHABILITATION ROUND OUT THE LIST OF SERVICES. | Desc |
| Total Program Service Expenses | $22,109,622 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 206 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 15 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 11 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (1) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KEVIN B MAY | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 8282624100 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 336 DEERFIELD ROAD | AddressLine1Txt |
| City | BOONE | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 28607 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (19 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|
| KIM MILLER | ||||||||
| CHAIR | 1.00 | 3.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| THOMAS DALE | ||||||||
| VICE CHAIR | 1.00 | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| SAM ADAMS | ||||||||
| TRUSTEE | 1.00 | 3.00 | Yes (X) | $0 | $0 | $0 | ||
| CHARLES BAKER MD | ||||||||
| TRUSTEE | 1.00 | 41.00 | Yes (X) | $0 | $219,449 | $18,739 | ||
| JOHN BLACKBURN | ||||||||
| TRUSTEE | 1.00 | 3.00 | Yes (X) | $0 | $0 | $0 | ||
| PAUL DAGHER MD | ||||||||
| TRUSTEE | 1.00 | 2.00 | Yes (X) | $0 | $300,197 | $20,238 | ||
| KENNETH WILCOX | ||||||||
| TRUSTEE | 1.00 | 4.00 | Yes (X) | $0 | $0 | $0 | ||
| JIM DEAL | ||||||||
| TRUSTEE | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| BILLY KENNEDY | ||||||||
| COUNTY COMMISION REP. | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| BRETT LOFTIS | ||||||||
| TRUSTEE | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| JOE MILLER | ||||||||
| TRUSTEE | 1.00 | 4.00 | Yes (X) | $0 | $0 | $0 | ||
| MARY LOUISE ROBERTS | ||||||||
| TRUSTEE | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| PATTIE TENNILLE | ||||||||
| TRUSTEE | 1.00 | 3.00 | Yes (X) | $0 | $0 | $0 | ||
| KENT TARBUTTON | ||||||||
| TRUSTEE | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| JAN WINKLER | ||||||||
| TRUSTEE | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| KEVIN MAY | ||||||||
| CFO | 1.00 | 44.00 | Yes (X) | $0 | $376,571 | $22,637 | ||
| CARMEN LACEY | ||||||||
| PRESIDENT, CMH | 40.00 | 1.00 | Yes (X) | $0 | $150,525 | $15,714 | ||
| CHARLES MANTOOTH | ||||||||
| CEO | 1.00 | 44.00 | Yes (X) | $0 | $529,942 | $24,327 | ||
| RICHARD SPARKS | ||||||||
| FORMER CEO | 0.00 | $0 | $227,747 | $5,600 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,804,431 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $107,255 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $447,896 | AllOtherContributionsAmt |
| Total Contributions | $447,896 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT SERVICE REVENUE | 621990 | $22,794,815 | $22,794,815 |
| EHR MEANINGFUL USE | 621990 | $386,270 | $386,270 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $23,181,085 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,784 | TotalRevenueColumnAmt |
| Exclusion | $1,784 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $200,316 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $200,316 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $200,316 | TotalRevenueColumnAmt |
| Exclusion | $200,316 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $3,943 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $0 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $3,943 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $3,943 | TotalRevenueColumnAmt |
| Exclusion | $3,943 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $33,415 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $0 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $33,415 | TotalRevenueColumnAmt |
| Exclusion | $33,415 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| FOUNDATION REIMBURSEMENT | 900099 | $692,428 | $692,428 |
| CAFETERIA REVENUE | 900099 | $322,394 | $322,394 |
| MISCELLANEOUS REVENUE | 900099 | $33,330 | $33,330 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $1,048,152 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $24,916,591 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $23,181,085 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,287,610 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,406,573 | TotalAmt |
| Program Services | $9,132,444 | ProgramServicesAmt |
| Management And General | $1,274,129 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,727,536 | TotalAmt |
| Program Services | $1,516,025 | ProgramServicesAmt |
| Management And General | $211,511 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $637,703 | TotalAmt |
| Program Services | $559,626 | ProgramServicesAmt |
| Management And General | $78,077 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $239 | TotalAmt |
| Management And General | $239 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,171,173 | TotalAmt |
| Program Services | $3,767,425 | ProgramServicesAmt |
| Management And General | $403,748 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $558 | TotalAmt |
| Program Services | $558 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $519,548 | TotalAmt |
| Program Services | $518,733 | ProgramServicesAmt |
| Management And General | $815 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $586,259 | TotalAmt |
| Program Services | $5,979 | ProgramServicesAmt |
| Management And General | $580,280 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $20,055 | TotalAmt |
| Program Services | $18,629 | ProgramServicesAmt |
| Management And General | $1,426 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,526 | TotalAmt |
| Program Services | $3,526 | ProgramServicesAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $202,752 | TotalAmt |
| Management And General | $202,752 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,605,816 | TotalAmt |
| Program Services | $607,177 | ProgramServicesAmt |
| Management And General | $998,639 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $114,888 | TotalAmt |
| Program Services | $114,888 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| BAD DEBT EXPENSE | $3,552,232 | $3,552,232 | |
| DRUGS & MEDICAL SUPPLIE | $1,734,808 | $1,734,808 | |
| CORP. ALLOCATIONS | $706,492 | $706,492 | |
| FOOD | $285,619 | $285,619 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $528,755 | TotalAmt |
| Program Services | $291,953 | ProgramServicesAmt |
| Management And General | $236,802 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,804,532 | TotalAmt |
| Program Services | $22,109,622 | ProgramServicesAmt |
| Management And General | $4,694,910 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $634,200 | BOYAmt |
| EOY | $486,785 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,765,840 | BOYAmt |
| EOY | $2,996,068 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $600,904 | BOYAmt |
| EOY | $640,662 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $207,795 | BOYAmt |
| EOY | $171,491 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $39,392,595 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $23,811,686 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,137,086 | BOYAmt |
| EOY | $15,580,909 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,196,673 | BOYAmt |
| EOY | $6,364,924 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,542,498 | BOYAmt |
| EOY | $26,240,839 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $490,364 | BOYAmt |
| EOY | $832,641 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $202,452 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,839,915 | BOYAmt |
| EOY | $5,041,382 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,626,254 | BOYAmt |
| EOY | $10,466,340 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,956,533 | BOYAmt |
| EOY | $16,542,815 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,676,150 | BOYAmt |
| EOY | $8,788,209 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $909,815 | BOYAmt |
| EOY | $909,815 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,585,965 | BOYAmt |
| EOY | $9,698,024 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,542,498 | BOYAmt |
| EOY | $26,240,839 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$1,887,941 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,220,002 | OtherCostOrOtherBasisAmt |
| Book Value | $1,220,002 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $21,901,130 | OtherCostOrOtherBasisAmt |
| Depreciation | $13,458,651 | DepreciationAmt |
| Book Value | $8,442,479 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,472,213 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,965,822 | DepreciationAmt |
| Book Value | $1,506,391 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $8,744,836 | OtherCostOrOtherBasisAmt |
| Depreciation | $6,618,760 | DepreciationAmt |
| Book Value | $2,126,076 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,054,414 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,768,453 | DepreciationAmt |
| Book Value | $2,285,961 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $15,580,909 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (4 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| ASSETS USE WHICH IS LIMITED | $367,749 |
| INTEREST IN ARHF | $5,825,675 |
| ESTIMATED THIRD-PARTY SETTLEMENTS | $170,000 |
| DEPOSITS | $1,500 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $6,364,924 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| DUE TO AFFILIATE | $10,395,340 |
| MISCELLANEOUS | $71,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $10,466,340 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | ARHS AND THE COMPANIES FOR WHICH IT SERVES AS SOLE MEMBER ARE NOT-FOR-PROFIT CORPORATIONS AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND ARE EXEMPT FROM FEDERAL AND STATE INCOME TAXES ON RELATED INCOME. ACCORDINGLY, NO PROVISION FOR INCOME TAXES HAS BEEN MADE IN THE ACCOMPANYING COMBINED FINANCIAL STATEMENTS. CRBR IS A LIMITED LIABILITY COMPANY THAT HAS NOT ELECTED TO BE TAXED AS A CORPORATION UNDER CURRENT TREASURY REGULATIONS. AS SUCH, CRBR IS A DISREGARDED ENTITY FOR FEDERAL INCOME TAX PURPOSES AND DOES NOT HAVE TO FILE AN ANNUAL FEDERAL RETURN. RATHER ITS TAX RESULTS ARE REFLECTED ON THE ANNUAL TAX FILINGS OF ITS MEMBER AS IF THE ACTIVITIES OF CRBR WERE ACTIVITIES OF ITS MEMBER. THE SYSTEM HAS DETERMINED IT DOES NOT HAVE ANY MATERIAL UNRECOGNIZED TAX BENEFITS OR OBLIGATIONS AS OF SEPTEMBER 30, 2019. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $312,484 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $312,484 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01340 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,235,199 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,575,222 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,659,977 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07140 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,547,683 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,575,222 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,972,461 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08480 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $33,200 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $33,200 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00140 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $33,200 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $33,200 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00140 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,580,883 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,575,222 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,005,661 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08620 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $1,963,244 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $98,162 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $9,849,481 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $9,849,481 | CostOfCareReimbursedByMedcrAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost Accounting System | Yes (X) | CostAccountingSystemInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHARLES A CANNON JR MEMORIAL HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 434 HOSPITAL DRIVE | AddressLine1Txt |
| City | LINVILLE | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 28646 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHARLES A CANNON JR MEMORIAL HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| CHNA Conducted | 18 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (1) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (1) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | SEE SUPPLEMENTAL INFORMATION | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 18 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | SEE SUPPLEMENTAL INFORMATION | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 300.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Income Level Criteria | Yes (X) | IncomeLevelCriteriaInd |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | HTTPS://WWW.APPRHS.ORG/PATIENTS/FINANCIAL-ASSISTANCE | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | SEE PART V, PAGE 8 | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | SEE PART V, PAGE 8 | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| CHARLES A CANNON JR MEMORIAL HOSPITAL | PART V, SECTION B, LINE 5: THROUGH THE USE OF SURVEYS, FOCUS GROUPS, INTERVIEWS, COMMUNITY MEMBERS, LOCAL GOVERNMENT AND BUSINESS LEADERS, AND HEALTH PROFESSIONALS CAME TOGETHER TO IDENTIFY AND PRIORITIZE HEALTH ISSUES. LACK OF ADEQUATE TRANSPORTATION, LACK OF EDUCATION RELATING TO HEALTHY LIFESTYLE BEHAVIORS, AND A HIGH NUMBER OF SENIOR RESIDENTS WITH MULTIPLE CHRONIC DISEASES WERE ALL IDENTIFIED AS PRIORITY ISSUES.A COMMUNITY-WIDE, 76-QUESTION SURVEY WAS CONDUCTED TO GIVE RESIDENTS AN OPPORTUNITY TO EXPRESS CONCERNS AND OPINIONS ABOUT THE QUALITY OF LIFE IN AVERY COUNTY. THIS INCLUDED QUESTIONS ABOUT THE QUALITY OF LIFE, ECONOMY, EDUCATION, ENVIRONMENT, HEALTH, HOUSING, LEISURE ACTIVITIES, SAFETY, SOCIAL ISSUES, TRANSPORTATION, AND EMERGENCY PREPAREDNESS. SURVEYS WERE EMAILED AND PASSED OUT STRATEGICALLY ACROSS THE COUNTY IN AN EFFORT TO REACH A WIDE VARIETY OF POPULATION. A TOTAL OF 220 SURVEYS WERE INCLUDED IN THE FINAL ANALYSIS. BASED ON FINDINGS FROM THE COMMUNITY SURVEY COMBINED WITH SECONDARY HEALTH DATA, IN AUGUST 2016, HEALTHY CAROLINIANS OF AVERY COUNTY MEMBERS IDENTIFIED THE CHIEF HEALTH CONCERNS FOR THE COUNTY. |
| CHARLES A CANNON JR MEMORIAL HOSPITAL | PART V, SECTION B, LINE 6A: THE HOSPITAL FACILITY CONDUCTED A CHNA WITH WATAGUA MEDICAL CENTER. |
| CHARLES A CANNON JR MEMORIAL HOSPITAL | PART V, SECTION B, LINE 6B: THE HOSPITAL FACILITY CONDUCTED THE CHNA WITH APPALACHIAN DISTRICT HEALTH DEPARTMENT, TOE RIVER HEALTH DISTRICT, AND HEALTHY CAROLINIANS OF AVERY COUNTY. |
| CHARLES A CANNON JR MEMORIAL HOSPITAL | PART V, SECTION B, LINE 11: THE ORGANIZATION'S IMPLEMENTATION STRATEGY DESCRIBES HOW THE FACILITY IS ADDRESSING THE FOLLOWING NEEDS:MENTAL & BEHAVIORAL HEALTHCHRONIC DISEASE CARE & PREVENTIONPHYSICAL ACTIVITY & NUTRITIONSEVERAL NEEDS OUTLINED IN THE CHNA PROCESS SUCH AS CHILD ABUSE/NEGLECT, DENTAL PROBLEMS, ALCOHOL AND/OR DRUG USE, AND SEXUALLY TRANSMITTED DISEASE, HAVE NOT BEEN ADDRESSED IN THIS PLAN. IN INITIAL DISCUSSION AND SUBSEQUENT PRIORITIZATION, ARHS CONSIDERED THE LEVELS TO WHICH SOME NEEDS WERE ALREADY BEING ADDRESSED IN THE SERVICE AREA. ADDITIONALLY, SOME COMMUNITY NEEDS FALL OUT OF THE SCOPE OF EXPERTISE AND RESOURCES OF THE HOSPITAL. |
| CHARLES A CANNON JR MEMORIAL HOSPITAL | PART V, SECTION B, LINE 16J: INCLUDED IN THE ADMISSION PACKET THAT PATIENTS RECEIVE. PATIENT FINANCIAL ADVOCATE AT THE HOSPITALS VISIT SELF-PAY PATIENTS AND MAKE THEM AWARE OF AVAILABLE FINANCIAL ASSISTANCE. |
| COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY URL | HTTPS://WWW.APPRHS.ORG/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/ |
| FINANCIAL ASSISTANCE APPLICATION URL | HTTPS://APPRHS.ORG/FINANCIAL-ASSISTANCE/ |
| PLAIN LANGUAGE SUMMARY URL | HTTPS://APPRHS.ORG/FINANCIAL-ASSISTANCE/ |
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 7, COLUMN (F): | THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 3,552,232. |
| PART III, LINE 4: | AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IS RECORDED BASED ON HISTORICAL BAD DEBT EXPERIENCE AND MANAGEMENT'S EVALUATION OF THE ACCOUNTS RECEIVABLE. BALANCES ARE WRITTEN OFF AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN MADE. |
| PART III, LINE 9B: | CHARITY WRITE-OFFS ARE SEGREGATED FROM NORMAL BAD DEBTS THROUGH A SEPARATE TRANSACTION CODE. FAMILY INCOME BELOW 175% OF FPG ARE ELIGIBLE FOR 100% WRITE-OFF. PARTIAL WRITE-OFF IS AVAILABLE BETWEEN FAMILY INCOME BETWEEN 200% AND 300% OF FPG. |
| PART VI, LINE 2: | THE HOSPITAL FACILITY RECENTLY CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY. PLEASE SEE WEBSITE HTTPS://WWW.APPRHS.ORG/COMMUNITY-HEALTH-NEEDS-ASSESSMENT |
| PART VI, LINE 3: | PATIENTS ARE EDUCATED ABOUT THEIR ELIGIBILITY FOR ASSISTANCE UNDER FEDERAL, STATE, OR LOCAL GOVERNMENT PROGRAMS OR UNDER THE FINANCIAL ASSISTANCE POLICY(FAP). DURING PRE-REGISTRATION AND REGISTRATION, PATIENTS CAN BE INTERVIEWED BY A PATIENT FINANCIAL ADVOCATE TO DETERMINE WHETHER THE PATIENT HAS A NEED FOR FINANCIAL ASSISTANCE OR POTENTIAL ELIGIBILITY UNDER GOVERNMENT PROGRAMS. |
| PART VI, LINE 4: | THE COMMUNITY CONSISTS OF ASHE, AVERY, AND WATAUGA COUNTIES. A POPULATION OF APPROXIMATELY 98,000 PEOPLE IN NORTHWESTERN NORTH CAROLINA. PLEASE READ THE RECENT COMMUNITY HEALTH NEEDS ASSESSMENT FOR AN IN-DEPTH LOOK AT THE DEMOGRAPHICS BY USING WEBSITE HTTPS://WWW.APPRHS.ORG/COMMUNITY-HEALTH-NEEDS-ASSESSMENT |
| PART VI, LINE 5: | APPALACHIAN REGIONAL HEALTHCARE SYSTEM (ARHS) STAYS COMMITTED TO PROMOTING HEALTH IN THE HIGH COUNTRY, ENHANCING QUALITY OF LIFE AND SIMPLY "MAKING LIFE BETTER." THE HEALTHCARE SYSTEM OFFERS A VARIETY OF HEALTH EDUCATION PROGRAMS, PREVENTION PROGRAMS, AND HEALTH SCREENINGS TO ENCOURAGE HEALTHY LIFESTYLES FOR RESIDENTS AND VISITORS. IN ADDITION TO PARTNERING WITH LOCAL HEALTH DEPARTMENTS TO CONDUCT HEALTH NEEDS ASSESSMENTS, ARHS HOSTS ANNUAL HEALTH FAIRS IN OUR PRIMARY SERVICE AREA, WATAUGA AND AVERY COUNTIES. WE ALSO ATTEMPT TO ADDRESS THE NEEDS OF LOW INCOME, UNINSURED RESIDENTS THROUGH TWO PROGRAMS - APPALACHIAN HEALTHCARE PROJECT AND THE LATINO HEALTH PROGRAM.APPALACHIAN HEALTHCARE PROJECT IS A COLLABORATIVE EFFORT AMONG THE MEDICAL COMMUNITY TO PROVIDE HEALTHCARE FOR LOW INCOME, UNINSURED RESIDENTS OF WATAUGA AND AVERY COUNTIES. THE PROJECT ENROLLS PERSONS WHO MEET PROGRAM GUIDELINES AND COORDINATES HEALTH CARE ON THE INDIVIDUAL'S BEHALF. COORDINATION OF HEALTH CARE INCLUDES: MANAGING REFERRALS TO SPECIALISTS, HELPING PATIENTS GET ACCESS TO MEDICATIONS, AND PATIENT CASE MANAGEMENT. MEDICAL PROVIDERS DONATE MUCH NEEDED CARE TO INDIVIDUALS WHO QUALIFY.THE LATINO HEALTH PROGRAM OF APPALACHIAN REGIONAL HEALTHCARE SYSTEM SEEKS TO IMPROVE THE HEALTH AND WELL-BEING OF LATINOS IN WATAUGA AND AVERY COUNTIES THROUGH INCREASED ACCESS TO CARE, HEALTH EDUCATION, AND OTHER ENABLING SERVICES.APPALACHIAN HEALTHCARE PROJECT AND THE LATINO HEALTH PROGRAM PROVIDE MORE THAN $2.5 MILLION IN MEDICAL ASSISTANCE TO APPROXIMATELY 500 LOW INCOME, UNINSURED RESIDENTS ANNUALLY. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (6 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CHARLES BAKER MD | ||||||||||||||
| TRUSTEE | $0 | $215,766 | $0 | $0 | $0 | $3,683 | $0 | $7,473 | $0 | $11,266 | $0 | $238,188 | $0 | $0 |
| PAUL DAGHER MD | ||||||||||||||
| TRUSTEE | $0 | $299,006 | $0 | $0 | $0 | $1,191 | $0 | $7,353 | $0 | $12,885 | $0 | $320,435 | $0 | $0 |
| KEVIN MAY | ||||||||||||||
| CFO | $0 | $343,738 | $0 | $0 | $0 | $32,833 | $0 | $16,355 | $0 | $6,282 | $0 | $399,208 | $0 | $0 |
| CARMEN LACEY | ||||||||||||||
| PRESIDENT, CMH | $0 | $145,760 | $0 | $0 | $0 | $4,765 | $0 | $8,640 | $0 | $7,074 | $0 | $166,239 | $0 | $0 |
| CHARLES MANTOOTH | ||||||||||||||
| CEO | $0 | $518,700 | $0 | $10,000 | $0 | $1,242 | $0 | $14,877 | $0 | $9,450 | $0 | $554,269 | $0 | $0 |
| RICHARD SPARKS | ||||||||||||||
| FORMER CEO | $0 | $59,135 | $0 | $0 | $0 | $168,612 | $0 | $0 | $0 | $5,600 | $0 | $233,347 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 4B | FormAndLineReferenceDesc |
| Explanation | THE FOLLOWING PERSONS RECEIVED A PAYMENT FROM A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: KEVIN MAY - $29,317 CARMEN LACEY - 2,850 RICHARD SPARKS - 168,612 | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 1 | THE EXECUTIVE COMMITTEE SHALL CONSIST OF THE CHAIRMAN OF THE BOARD OF TRUSTEES, THE VICE CHAIRMAN OF THE BOARD OF TRUSTEES, THE IMMEDIATE PAST CHAIRMAN OF THE BOARD OF TRUSTEES (IF STILL A MEMBER OF THE BOARD OF TRUSTEES), AND THREE (3) OTHER TRUSTEES. THE CHAIRMAN SHALL APPOINT THE MEMBERS OF THE EXECUTIVE COMMITTEE AND SHALL SERVE AS ITS CHAIRMAN. IN THE ABSENCE OF A QUORUM OF THE ENTIRE BOARD OF TRUSTEES, THE EXECUTIVE COMMITTEE OR A MAJORITY THEREOF SHALL HAVE FULL AUTHORITY TO ACT IN ALL MATTERS RELATING TO CANNON MEMORIAL HOSPITAL BUSINESS, INCLUDING, BUT NOT LIMITED TO ALL THINGS DEEMED NECESSARY AND EXPEDIENT IN THE GOVERNANCE, MANAGEMENT, AND CONTROL OF THE BUSINESS AND AFFAIRS OF THE CORPORATION, INCLUDING MATTERS RELATING TO EXECUTIVE COMPENSATION, AND SHALL HAVE AND EXERCISE THE POWER AND AUTHORITY OF THE BOARD OF TRUSTEES TO TRANSACT ALL REGULAR BUSINESS OF THE CORPORATION WHEN THE BOARD OF TRUSTEES IS NOT IN SESSION, EXCEPT AS PROHIBITED IN ARTICLE V, SECTION 3 HEREIN. FURTHER, THE EXECUTIVE COMMITTEE OR A MAJORITY THEREOF SHALL HAVE FULL AUTHORITY TO ACT ON BEHALF OF CANNON MEMORIAL HOSPITAL AT ANY CALLED OR SPECIAL MEETING. WHEN THE EXECUTIVE COMMITTEE EXERCISES THE POWER AND AUTHORITY OF THE BOARD OF TRUSTEES, SUCH ACTION IS SUBJECT TO RATIFICATION BY THE BOARD OF TRUSTEES. |
| FORM 990, PART VI, SECTION A, LINE 3 | PARENT COMPANY, APPALACHIAN REGIONAL HEALTH CARE SYSTEM (ARHS) OVERSEES CMH OPERATIONS. ALSO NOTE THAT SALARIES AND OTHER COMMON EXPENSES INCURRED BY ARHS ARE ALLOCATED APPROPRIATELY TO CMH. PAYMENTS TO VENDORS ARE PAID THROUGH ARHS AND ALL 1099S ARE ISSUED THROUGH ARHS. |
| FORM 990, PART VI, SECTION A, LINE 6 | THE SOLE MEMBER IS APPALACHIAN REGIONAL HEALTHCARE SYSTEM. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE TRUSTEES OF THE SOLE MEMBER SHALL ALSO SERVE AS THE TRUSTEES OF THE FILING ORGANIZATION. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE SVP/CFO REVIEWS THE 990 AND THEN IT IS MADE AVAILABLE TO THE BOARD UPON COMPLETION. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE CONFLICT OF INTEREST POLICY IS REVIEWED ANNUALLY. |
| FORM 990, PART VI, SECTION B, LINE 15A | INTEGRATED HEALTHCARE STRATEGIES (IHS) CONDUCTED AN INDEPENDENT COMPENSATION AND BENEFIT ANALYSIS FOR THE CEO AND ENTIRE SENIOR EXECUTIVE TEAM IN JANUARY 2018. COMPARATIVE DATA WAS USED IN THIS ANALYSIS FROM NATIONAL AND REGIONAL PEER GROUPS (HEALTH SYSTEM'S WITH COMPARABLE NET REVENUE, STRUCTURE, AND ORGANIZATIONAL COMPLEXITY. BENCHMARK DATA INCLUDED HIS AND SULLIVAN COTTER.) |
| FORM 990, PART VI, SECTION C, LINE 19 | GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE PROVIDED UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 2,048,415. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,048,415. CONTRACT LABOR: PROGRAM SERVICE EXPENSES 1,719,010. MANAGEMENT AND GENERAL EXPENSES 403,748. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,122,758. |
| FORM 990. PART XII, LINE 2C | THE PROCESS HAS NOT CHANGED SINCE THE PRIOR YEAR. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (6 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|
| APPALACHIAN REGIONAL HEALTHCARE SYSTEM | ||||||||||
| PO BOX 2600 | BOONE | NC | 28607 | 201067022 | PARENT COMPANY | NC | 501(C)(3) | LINE 12B, II | 0 | |
| BLOWING ROCK HOSPITAL INC | ||||||||||
| PO BOX 148 | BLOWING ROCK | NC | 28605 | 560513181 | POST ACUTE CARE AND REHABILITATION CENTER | NC | 501(C)(3) | LINE 3 | Yes (1) | APPALACHIAN REGIONAL HEALTHCARE SYSTEM INC |
| WATAUGA MEDICAL CENTER INC | ||||||||||
| 336 DEERFIELD RD | BOONE | NC | 28607 | 560510824 | HOSPITAL | NC | 501(C)(3) | LINE 3 | Yes (1) | APPALACHIAN REGIONAL HEALTHCARE SYSTEM INC |
| APPALACHIAN REGIONAL HEALTHCARE FOUNDATION | ||||||||||
| 336 DEERFIELD RD | BOONE | NC | 28607 | 204625618 | PHILANTHROPIC ORGANIZATION FOR THE SYSTEM | NC | 501(C)(3) | LINE 7 | Yes (1) | APPALACHIAN REGIONAL HEALTHCARE SYSTEM INC |
| APPALACHIAN REGIONAL MEDICAL ASSOCIATES INC | ||||||||||
| PO BOX 2600 | BOONE | NC | 28607 | 205755130 | EMPLOYMENT ALTERNATIVE TO BOTH NEW AND ESTABLISHED PHYSICIAN PRACTICES | NC | 501(C)(3) | LINE 11 | Yes (1) | APPALACHIAN REGIONAL HEALTHCARE SYSTEM INC |
| ARHS PROPERTIES INC | ||||||||||
| 336 DEERFIELD RD | BOONE | NC | 28607 | 203470765 | HOLD FUTURE PURCHASE OF NON-PROFIT LAND ACQUISITIONS | NC | 501(C)(3) | LINE 12B, II | Yes (1) | APPALACHIAN REGIONAL HEALTHCARE SYSTEM INC |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SLOOP MEDICAL OFFICE PLAZA CONDOMINIUM ASSOCIATION | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 434 HOSPITAL DRIVE | AddressLine1Txt |
| City | LINVILLE | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 28646 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 593761777 | EIN |
| Primary Activities | RENTAL | PrimaryActivitiesTxt |
| Legal Domicile State | NC | LegalDomicileStateCd |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Entity Type | C | EntityTypeTxt |
| Controlled Organization | 0 | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (1) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
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