ANC BLUE RIDGE HOSPITAL INC: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- ANC BLUE RIDGE HOSPITAL INC (EIN 56-1025032)
- Tax period
- 2016-10-01 to 2017-09-30
- Filed
- 2018-08-15
- IRS object ID
- 201802279349300435
- Schema version
- 2016v3.0
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2018-08-15T07:54:39-05:00 | ReturnTs |
| Tax Period End | 2017-09-30 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2016-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 561025032 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BLUE RIDGE REGIONAL HOSPITAL INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | BLUE | BusinessNameControlTxt |
| Phone | 8287654201 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 9 | AddressLine1Txt |
| City | SPRUCE PINE | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 287770009 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | CLINT STEWART | PersonNm |
| Person Title | REGIONAL DIRECTOR OF FINANCE | PersonTitleTxt |
| Phone | 8287654201 | PhoneNum |
| Signature | 2018-08-14 | SignatureDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | CLINT STEWART | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 9 | AddressLine1Txt |
| City | SPRUCE PINE | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 287770009 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $47,898,373 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | MISSIONHEALTH.ORG/MEMBER-HOSPITALS/BLUE-RIDGE | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1971 | FormationYr |
| Legal Domicile State | NC | LegalDomicileStateCd |
| Activity Or Mission | TO IMPROVE THE HEALTH OF THE PEOPLE OF WESTERN NORTH CAROLINA AND THE SURROUNDING REGION. | ActivityOrMissionDesc |
| Voting Members Governing Body | 12 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 8 | VotingMembersIndependentCnt |
| Total Employee | 371 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $163,306 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $154,467 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $364,564 | PYContributionsGrantsAmt |
| CY Contributions Grants | $62,779 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $41,480,789 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $46,439,087 | CYProgramServiceRevenueAmt |
| PY Investment Income | $285,558 | PYInvestmentIncomeAmt |
| CY Investment Income | $475,272 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $42,130,911 | PYTotalRevenueAmt |
| CY Total Revenue | $46,977,138 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $128,407 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $129,066 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $17,505,337 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $18,814,026 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $26,747,696 | PYOtherExpensesAmt |
| CY Other Expenses | $27,772,627 | CYOtherExpensesAmt |
| PY Total Expenses | $44,381,440 | PYTotalExpensesAmt |
| CY Total Expenses | $46,715,719 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$2,250,529 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $261,419 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $53,570,397 | TotalAssetsBOYAmt |
| Total Assets EOY | $55,628,142 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $19,174,856 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $20,674,415 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $34,395,541 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $34,953,727 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | GUIDING PRINCIPLES SERVE PEOPLE AS A NOT-FOR-PROFIT HEALTH SYSTEM GOVERNED BY A VOLUNTARY COMMUNITY BOARD. ENSURE SUSTAINABILITY THROUGH STEWARDSHIP OF THE REGION'S ASSETS. SIGNIFICANTLY ENHANCE THE QUALITY OF SERVICES PROVIDED TO PATIENTS IN A COMPASSIONATE AND COST-EFFECTIVE MANNER. COLLABORATE IN ORDER TO IMPROVE ACCESS ACROSS THE ENTIRE CONTINUUM OF CARE. PROMOTE WELLNESS AND HEALTH TO BENEFIT THE REGION. ELIMINATE PREVENTABLE INCIDENTS OF PATIENT HARM.2020 VISION: A REGIONAL INTEGRATED HEALTH SYSTEM PROVIDING MEDICAL CARE AND SERVICE TO PATIENTS AND THEIR FAMILIES THROUGH A FULL CONTINUUM OF INTEGRATED SERVICES, EDUCATION, AND RESEARCH. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $37,678,181 | ExpenseAmt |
| Grant | $129,066 | GrantAmt |
| Revenue | $46,237,567 | RevenueAmt |
| Desc | BLUE RIDGE REGIONAL HOSPITAL BELIEVES THAT PATIENT AND FAMILY-CENTERED CARE IS THE BEST APPROACH TO MEETING OUR PATIENTS' HEALTHCARE NEEDS. PATIENT AND FAMILY-CENTERED CARE MEANS PATIENTS, THEIR FAMILIES, DOCTORS, NURSES AND OTHER HEALTHCARE PROFESSIONALS FORM A PARTNERSHIP THAT BENEFITS EVERYONE.A FAMILY MEMBER IS RECOGNIZED AS ANYONE WHO PATIENTS REGARD AS SIGNIFICANT IN THEIR LIVES. FAMILIES ARE NOT CONSIDERED VISITORS, BUT ESSENTIAL PARTICIPANTS IN CARE AND DECISIONS THAT AFFECT THE TOTAL HEALING OF THE PATIENT. THE COMPONENTS OF FAMILY-CENTERED CARE ARE RESPECT AND DIGNITY; INFORMATION SHARING; AND PARTICIPATION AND COLLABORATION.THE GOAL IN CARING FOR PATIENTS AT BLUE RIDGE REGIONAL HOSPITAL IS THE SAME FOR PHYSICIANS, MEDICAL STAFF AND FAMILIES TO PROVIDE THE BEST CARE AND OUTCOME FOR THE PATIENT. IT TAKES A COMBINATION OF MODERN MEDICINE, COMPASSIONATE CARE, ADVANCED TECHNOLOGY, DEDICATED STAFF, AS WELL AS CARE PROVIDED BY FAMILIES TO REACH THE BEST POSSIBLE OUTCOME. THE STAFF AT BLUE RIDGE REGIONAL HOSPITAL IS DEDICATED TO CREATING THIS TYPE OF EXPERIENCE FOR EVERY PATIENT AND FAMILY MEMBER WHO ENTERS OUR DOORS. | Desc |
| Total Program Service Expenses | $37,678,181 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | 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 | Yes (1) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | Yes (1) | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | 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 | Yes (1) | 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 | Yes (1) | 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 | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| 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 | 371 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| 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 |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 12 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 8 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | 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 | Yes (1) | 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 | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | Yes (1) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | Yes (1) | WrittenPolicyOrProcedureInd |
| States Where Copy Of Return Is Fld | NC | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MISSION FINANCE DEPARTMENT | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 8282577063 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 400 RIDGEFIELD CT STE 100 | AddressLine1Txt |
| City | ASHEVILLE | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 28806 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (21 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 | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|
| MARTHA TYNER | |||||||||
| CHAIR | 8.00 | 0.00 | Yes (X) | Yes (X) | $0 | $900 | $0 | ||
| ALEXANDER GLOVER | |||||||||
| VICE CHAIR | 2.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| RICHARD MONTAGUE | |||||||||
| SECRETARY/TREASURER | 2.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| JOHN BOYD PHD | |||||||||
| DIRECTOR | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| GABRIEL CADE | |||||||||
| DIRECTOR | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| ROBERT MURPHY MD | |||||||||
| DIRECTOR | 2.00 | 40.00 | Yes (X) | $0 | $498,461 | $31,957 | |||
| JEFF D'AGOSTINO | |||||||||
| DIRECTOR | 2.00 | 58.00 | Yes (X) | $0 | $309,372 | $64,112 | |||
| BILL SLAGLE | |||||||||
| DIRECTOR | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| KATHY GUYETTE | |||||||||
| DIRECTOR | 1.00 | 59.00 | Yes (X) | $0 | $603,433 | $100,941 | |||
| BYRON PHILLIPS | |||||||||
| DIRECTOR | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| CHRIS DERIENZO | |||||||||
| DIRECTOR | 2.00 | 58.00 | Yes (X) | $0 | $467,481 | $98,788 | |||
| ALLEN PETERSON | |||||||||
| DIRECTOR | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| REBECCA CARTER | |||||||||
| CHIEF NURSING OFFICE | 48.00 | 2.00 | Yes (X) | $248,679 | $0 | $16,660 | |||
| CLINT STEWART | |||||||||
| REGIONAL DIRECTOR- FINANCE | 24.00 | 26.00 | Yes (X) | $0 | $161,194 | $25,273 | |||
| ALEX CHAPPELEAR | |||||||||
| PHYSICIAN | 40.00 | 0.00 | $0 | $271,521 | $22,903 | Yes (X) | |||
| ALLISON SHARP | |||||||||
| PHYSICIAN | 40.00 | 0.00 | $0 | $237,163 | $14,237 | Yes (X) | |||
| KEVIN TORREY | |||||||||
| PHYSICIAN | 40.00 | 0.00 | $0 | $263,513 | $22,707 | Yes (X) | |||
| SHEHLA KAHN | |||||||||
| PHYSICIAN | 40.00 | 0.00 | $0 | $378,420 | $31,651 | Yes (X) | |||
| STEPHEN NORTH | |||||||||
| PHYSICIAN | 40.00 | 0.00 | $0 | $255,043 | $13,551 | Yes (X) | |||
| SONYA JOHNSON | |||||||||
| FORMER REGIONAL DIRECTOR - FINANCE | 0.00 | 50.00 | $0 | $154,818 | $16,650 | Yes (X) | |||
| OSCAR WEINMEISTER | |||||||||
| FORMER CEO | 0.00 | 60.00 | $0 | $376,465 | $37,198 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $248,679 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $3,977,784 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $496,628 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 10 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| SPRUCE PINE EMERGENCY SERVICES | |||||
| 7032 COLLECTIONS CENTER DR | CHICAGO | IL | 60693 | MEDICAL SERVICES | $975,258 |
| ALLCARE CLINICAL ASSOCIATES PA | |||||
| 76 PEACHTREE RD STE 300 | ASHEVILLE | NC | 28803 | ANESTHESIA SERVICES | $700,000 |
| COMPREHENSIVE PAIN CONSULTANTS OF THE CA | |||||
| PO BOX 254 | SKYLAND | NC | 28776 | MEDICAL SERVICES | $643,766 |
| MORRISON MGMT SPECIALISTS INC | |||||
| PO BOX 102289 | ATLANTA | GA | 30368 | FOOD & NUTRITION MANAGEMENT | $313,474 |
| LOCUMTENENSCOM | |||||
| PO BOX 405547 | ATLANTA | GA | 30384 | STAFFING SERVICES | $231,947 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 8 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $62,779 | RelatedOrganizationsAmt |
| Total Contributions | $62,779 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| NET PATIENT REVENUE | 900099 | $45,328,612 | $45,328,612 | |
| OTHER PROGRAM SERVICE | 900099 | $908,955 | $908,955 | |
| PARTNERSHIP REVENUE | 900099 | $201,520 | $38,214 | $163,306 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $46,439,087 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $67,601 | TotalRevenueColumnAmt |
| Exclusion | $67,601 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $94,884 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $94,884 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $1,233,322 | SecuritiesAmt |
| Other | $700 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $826,351 | SecuritiesAmt |
| Other | $0 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $406,971 | SecuritiesAmt |
| Other | $700 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $407,671 | TotalRevenueColumnAmt |
| Exclusion | $407,671 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $46,977,138 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $46,275,781 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $163,306 | UnrelatedBusinessRevenueAmt |
| Exclusion | $475,272 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $129,066 | TotalAmt |
| Program Services | $129,066 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $250,242 | TotalAmt |
| Program Services | $125,121 | ProgramServicesAmt |
| Management And General | $125,121 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,915,468 | TotalAmt |
| Program Services | $10,187,891 | ProgramServicesAmt |
| Management And General | $4,727,577 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $261,315 | TotalAmt |
| Program Services | $173,762 | ProgramServicesAmt |
| Management And General | $87,553 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,273,850 | TotalAmt |
| Program Services | $1,512,001 | ProgramServicesAmt |
| Management And General | $761,849 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,113,151 | TotalAmt |
| Program Services | $760,329 | ProgramServicesAmt |
| Management And General | $352,822 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,019,457 | TotalAmt |
| Program Services | $866,538 | ProgramServicesAmt |
| Management And General | $152,919 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $49,900 | TotalAmt |
| Management And General | $49,900 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,856 | TotalAmt |
| Management And General | $7,856 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $29,529 | TotalAmt |
| Management And General | $29,529 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,034,261 | TotalAmt |
| Program Services | $11,321,206 | ProgramServicesAmt |
| Management And General | $1,713,055 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $53,556 | TotalAmt |
| Management And General | $53,556 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $139,176 | TotalAmt |
| Program Services | $118,300 | ProgramServicesAmt |
| Management And General | $20,876 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $478,110 | TotalAmt |
| Program Services | $406,395 | ProgramServicesAmt |
| Management And General | $71,715 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,965,818 | TotalAmt |
| Program Services | $1,670,945 | ProgramServicesAmt |
| Management And General | $294,873 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $88,399 | TotalAmt |
| Program Services | $75,139 | ProgramServicesAmt |
| Management And General | $13,260 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,075 | TotalAmt |
| Management And General | $9,075 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,714 | TotalAmt |
| Program Services | $19,714 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,663,940 | TotalAmt |
| Program Services | $2,264,349 | ProgramServicesAmt |
| Management And General | $399,591 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $61,428 | TotalAmt |
| Program Services | $52,214 | ProgramServicesAmt |
| Management And General | $9,214 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| PHARMACEUTICALS | $4,331,032 | $4,331,032 | |
| MEDICAL SUPPLIES | $2,773,397 | $2,773,397 | |
| REPAIRS AND MAINTENANCE | $628,433 | $534,168 | $94,265 |
| UNRELATED BUSINESS INCO | $52,512 | $52,512 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $367,034 | TotalAmt |
| Program Services | $304,102 | ProgramServicesAmt |
| Management And General | $62,932 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $46,715,719 | TotalAmt |
| Program Services | $37,678,181 | ProgramServicesAmt |
| Management And General | $9,037,538 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,305,775 | BOYAmt |
| EOY | $2,711,573 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,503,905 | BOYAmt |
| EOY | $8,316,801 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $893,111 | BOYAmt |
| EOY | $901,667 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,524 | BOYAmt |
| EOY | $5,138 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $65,000,941 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $30,149,173 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $34,020,970 | BOYAmt |
| EOY | $34,851,768 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,544,508 | BOYAmt |
| EOY | $3,764,062 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,267,602 | BOYAmt |
| EOY | $2,224,736 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,026,002 | BOYAmt |
| EOY | $2,852,397 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $53,570,397 | BOYAmt |
| EOY | $55,628,142 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,258,954 | BOYAmt |
| EOY | $5,129,387 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $291,959 | BOYAmt |
| EOY | $155,763 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,623,943 | BOYAmt |
| EOY | $15,389,265 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,174,856 | BOYAmt |
| EOY | $20,674,415 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $34,395,541 | BOYAmt |
| EOY | $34,953,727 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $34,395,541 | BOYAmt |
| EOY | $34,953,727 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $53,570,397 | BOYAmt |
| EOY | $55,628,142 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $261,419 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $296,767 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| 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 B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $206,499 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $29,594 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $236,093 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $192,350 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $14,149 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $206,499 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $206,874 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | -$14,524 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $192,350 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $188,912 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $17,962 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $206,874 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $175,030 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $13,882 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $188,912 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prmnnt Endowment Balance EOY | 0.47000 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.53000 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | Yes (1) | EndowmentsHeldRelatedOrgInd |
| Related Org List Sch R | 0 | RelatedOrgListSchRInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,498,577 | OtherCostOrOtherBasisAmt |
| Book Value | $2,498,577 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $41,117,205 | OtherCostOrOtherBasisAmt |
| Depreciation | $16,958,471 | DepreciationAmt |
| Book Value | $24,158,734 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,981,582 | OtherCostOrOtherBasisAmt |
| Depreciation | $699,694 | DepreciationAmt |
| Book Value | $2,281,888 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $16,193,042 | OtherCostOrOtherBasisAmt |
| Depreciation | $12,386,689 | DepreciationAmt |
| Book Value | $3,806,353 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,210,535 | OtherCostOrOtherBasisAmt |
| Depreciation | $104,319 | DepreciationAmt |
| Book Value | $2,106,216 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $34,851,768 | TotalBookValueLandBuildingsAmt |
Invst Program Related Org InvstProgramRelatedOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | INVESTMENT IN PARTNERSHIPS | Desc |
| Book Value | $2,852,397 | BookValueAmt |
| Method Valuation | C | MethodValuationCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Program Rltd | $2,852,397 | TotalBookValueProgramRltdAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)
| DescDesc | AmtAmt |
|---|---|
| NOTE PAYABLE TO RELATED PARTIES | $10,514,473 |
| NOTE PAYABLE TO UNRELATED PARTIES | $58,218 |
| RESERVE FOR THIRD PARTY | $4,871,811 |
| BOND ISSUANCE COSTS | -$55,237 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $15,389,265 | 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 | THE ORGANIZATION IS INCLUDED IN MISSION HEALTH SYSTEM'S CONSOLIDATED AUDIT WHICH APPLIES THE PROVISIONS OF FASB ASC TOPIC 740, INCOME TAXES (ASC 740), IN ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES. ASC 740 PROVIDES GUIDANCE ON WHEN TAX POSITIONS ARE RECOGNIZED IN AN ENTITY'S FINANCIAL STATEMENTS AND HOW THE VALUES OF THESE POSITIONS ARE DETERMINED. THERE IS CURRENTLY NO IMPACT ON THE CONSOLIDATED FINANCIAL STATEMENTS AS A RESULT OF THE APPLICATION OF ASC 740. | 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 | $1,965,182 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,965,182 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04210 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,849,983 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,916,301 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $933,682 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02000 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $7,815,165 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,916,301 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,898,864 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06210 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $22,904 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $22,904 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00050 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $243,724 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $243,724 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00520 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $109,855 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $109,855 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00240 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $376,483 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $376,483 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00810 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $8,191,648 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,916,301 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,275,347 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07020 | TotalExpensePct |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $53,578 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $53,578 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00110 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $53,578 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $53,578 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00110 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $2,459,031 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $3,598 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $15,574,638 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $14,875,783 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $698,855 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| 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 | BLUE RIDGE REGIONAL HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 125 HOSPITAL DRIVE | AddressLine1Txt |
| City | SPRUCE PINE | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 28777 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | MISSIONHEALTH.ORG/MEMBER-HOSPITALS/BLU | WebsiteAddressTxt |
| State License | H0169 | StateLicenseNum |
| 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 | BLUE RIDGE REGIONAL HOSPITAL INC | 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 |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 15 | 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 PART V, SECTION C | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Rpt Available Thru Other Method | Yes (X) | RptAvailableThruOtherMethodInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 16 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | SEE PART V, SECTION C | 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 |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Other Method | Yes (X) | OtherMethodInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | SEE PART V, SECTION C | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | SEE PART V, SECTION C | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | SEE PART V, SECTION C | 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 |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| 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 (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| BLUE RIDGE REGIONAL HOSPITAL, INC. | PART V, SECTION B, LINE 5: THE COMMUNITY HEALTH NEEDS ASSESSMENT FOR BLUE RIDGE REGIONAL HOSPITAL WAS CONDUCTED IN PARTNERSHIP WITH TOE RIVER HEALTH DISTRICT, THE LOCAL PUBLIC HEALTH AGENCY SERVING MITCHELL, YANCEY AND AVERY COUNTIES. IN THE COLLABORATIVE ASSESSMENT PROCESS FOR OUR COMMUNITY, THE TOE RIVER HEALTH DISTRICT HEALTH DEPARTMENT IS A KEY PARTNER. THEY PROVIDED COORDINATION FOR THE LOCAL PROCESS THAT WE HELP SUPPORT AND PARTNER TO IMPLEMENT. OUR PROCESS INCLUDED INPUT REGARDING THE NEEDS OF MEDICALLY UNDERSERVED, LOW-INCOME, AND MINORITY POPULATIONS IN TWO WAYS. (1) AS PART OF OUR COLLABORATIVE DATA COLLECTION EFFORT, A COMMUNITY-WIDE TELEPHONE SURVEY WAS CONDUCTED TO BETTER UNDERSTAND THE SPECIFIC HEALTH NEEDS AND STATUS OF ALL OF THE COMMUNITY, WHICH INCLUDES THESE SPECIAL POPULATIONS. (2) IN ADDITION, A SURVEY OF KEY INFORMANTS WAS CONDUCTED TO GAIN INPUT FROM THE INDIVIDUALS AND ORGANIZATIONS IN OUR COMMUNITY REPRESENTING THE INTERESTS OF THESE POPULATIONS IN THEIR LOCAL EFFORTS. |
| BLUE RIDGE REGIONAL HOSPITAL, INC. | PART V, SECTION B, LINE 6A: REGIONAL PARTNERSHIP:BLUE RIDGE'S COLLABORATIVE COMMUNITY HEALTH IMPROVEMENT EFFORT IS ALSO SUPPORTED BY A COMPREHENSIVE PARTNERSHIP WITH OTHER REGIONAL HOSPITALS AND LOCAL HEALTH DEPARTMENTS. THIS INITIATIVE, KNOWN AS WNC HEALTHY IMPACT, REPRESENTS 16 COUNTIES ACROSS THE WESTERN NORTH CAROLINA REGION WORKING COLLABORATIVELY TO IMPROVE COMMUNITY HEALTH. INFORMATION ABOUT THIS INNOVATIVE REGIONAL COLLABORATION, COUNTY-WIDE COMMUNITY HEALTH ASSESSMENTS, AND OVERALL REGIONAL FINDINGS, ARE MADE WIDELY AVAILABLE TO THE PUBLIC AT WWW.WNCHEALTHYIMPACT.COM. |
| BLUE RIDGE REGIONAL HOSPITAL, INC. | PART V, SECTION B, LINE 6B: THE CHNA WAS DONDUCTED WITH THE MITCHELL COUNTY HEALTH DEPARTMENT,YANCEY COUNTY HEALTH DEPARTMENT AND THE TOE RIVER HEALTH DISTRICT. |
| BLUE RIDGE REGIONAL HOSPITAL, INC. | PART V, SECTION B, LINE 7D: ORGANIZATION'S WEBSITE: HTTPS://MISSIONHEALTH.ORG/WP- CONTENT/UPLOADS/2018/04/2016-BLUE-RIDGE-REGIONAL-HOSPITAL-COMMUNITY-HEALTH-NEEDS-ASSESSMENT-CHNA.PDF |
| BLUE RIDGE REGIONAL HOSPITAL, INC. | PART V, SECTION B, LINE 15E: THE ORGANIZATION'S STAFF WORK IN COLLABORATION WITH THE PATIENT AND APPROPRIATE COMMUNITY HEALTH AND HUMAN SERVICES AGENCIES AND OTHER ORGANIZATIONS THAT ASSIST PEOPLE IN NEED OF HEALTH CARE SERVICES TO DETERMINE AVAILABLE FUNDING SOURCES. |
| PART V, SECTION B, LINE 10A | HTTPS://MISSIONHEALTH.ORG/WP-CONTENT/UPLOADS/2018/04/2013-BLUE-RIDGE-REGIONAL-HOSPITAL-IMPLEMENTATION-STRATEGY.PDF |
| PART V, SECTION B, LINE 16A | HTTPS://MISSIONHEALTH.ORG/WP-CONTENT/UPLOADS/2018/05/FINASSDISCOUNT_POLICY_04.PDF |
| PART V, SECTION B, LINE 16B | HTTPS://MISSIONHEALTH.ORG/WP-CONTENT/UPLOADS/2018/05/PATIENT_FINANCIAL_ASSISTANCE_PAGE.PDF |
| PART V, SECTION B, LINE 16C | HTTPS://MISSIONHEALTH.ORG/WP-CONTENT/UPLOADS/2018/03/FINASSISTPLAIN_LANGUAGE_SUMMARY_4.PDF |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 5 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - MISSION HEALTH MAUZY-PHILLIPS CENTER | ||||
| 189 HOSPITAL DRIVE | SPRUCE PINE | NC | 28777 | PHYSICIAN CLINIC |
| 2 - BLUE RIDGE MEDICAL CENTER YANCEY CAMPUS | ||||
| 800 MEDICAL CENTER CAMPUS DRIVE | BURNSVILLE | NC | 28714 | RURAL HEALTH CLINIC, RADIOLOGY AND LAB |
| 3 - BLUE RIDGE REGIONAL HOSPITAL REHAB SVCS | ||||
| 222 HOSPITAL DRIVE | SPRUCE PINE | NC | 28777 | REHABILITATION AND FITNESS CENTER |
| 4 - MISSION COMM PRIM CARE-GRASSY CREEK | ||||
| 11728 NC-226 | SPRUCE PINE | NC | 28777 | RURAL HEALTH CLINIC |
| 5 - BLUE RIDGE REGIONAL HOSPITAL REHAB SVCS | ||||
| 155 LOVE FOX ROAD | BURNSVILLE | NC | 28714 | REHABILITATION |
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 7: | BLUE RIDGE REGIONAL HOSPITAL USED THE NCHA ANDI REPORTS WHICH ARE BASED ON THE IRS GUIDELINES TO DERIVE A COST-TO-CHARGE RATIO USED IN THE CALCULATION OF COMMUNITY BENEFIT EXPENSE AT COST. |
| PART II, COMMUNITY BUILDING ACTIVITIES: | SERVING THE COMMUNITY FOR OVER 55 YEARS, BLUE RIDGE REGIONAL HOSPITAL PLAYS A VITAL ROLE IN THE DEVELOPMENT AND SUPPORT OF THE REGION IT SERVES. BLUE RIDGE REGIONAL HOSPITAL PROVIDES PRIVILEGES AND SPACES FOR VISITING SPECIALTY PHYSICIANS ON A REGULAR BASIS. THIS ARRANGEMENT ALLOWS COMMUNITY RESIDENTS TO RECEIVE NEEDED SPECIALTY CARE NEEDING TO TRAVEL 50 OR MORE MILES ONE WAY. EMPLOYEES AT BLUE RIDGE REGIONAL HOSPITAL PARTICIPATE AND ARE MEMBERS OF MULTIPLE AGENCIES THAT SERVE THE COMMUNITY AS WELL AS MANY NON-PROFIT ORGANIZATIONS.WORKFORCE DEVELOPMENT - AS AN UNDERSERVED COMMUNITY WITH EVIDENT MEDICAL SHORTAGE IN ALL AREAS OF GENERAL AND SPECIALTY HEALTH CARE, BLUE RIDGE STRIVES TO RECRUIT, OBTAIN AND RETAIN PHYSICIANS AND OTHER HEALTH CARE PROVIDERS TO PROVIDE SERVICES FOR MEMBERS OF THE SURROUNDING COMMUNITIES. |
| PART III, LINE 2: | THE ORGANIZATION USES A COST TO CHARGE RATIO TO ESTIMATE BAD DEBT. |
| PART III, LINE 3: | THE ORGANIZATION USES THE COST TO CHARGE RATIO APPLIED TO BAD DEBTS RECLASSIFIED TO CHARITY CARE AS OF THE MOST RECENT DATE AVAILABLE AFTER YEAR END. |
| PART III, LINE 4: | THE ORGANIZATION IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS FOR MISSION HEALTH SYSTEM. THE COST OF THE ORGANIZATION'S BAD DEBT IS INCLUDED IN TOTAL COST OF UNCOLLECTIBLE ACCOUNTS REPORTED ON THESE AUDITED FINANCIALS. |
| PART III, LINE 8: | PER THE INSTRUCTIONS, THE MEDICARE COST REPORT IS THE BASIS FOR CALCULATING THE COSTS USING ALLOWABLE COSTS RELATED TO THE REVENUE REPORTED. |
| PART III, LINE 9B: | PATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE AND OTHER CHARITY CARE ARENOTIFIED USING THE PROCESS DESCRIBED IN THE EDUCATION OF PATIENTS'ELIGIBILITY IN PART VI, ON LINE 3.MISSION'S STATED POLICY WITH RESPECT TO FINANCIAL ASSISTANCE: "MISSIONHOSPITAL WILL MAKE EVERY EFFORT TO THOROUGHLY SCREEN ALL PATIENTS THAT AREUNINSURED OR UNDERINSURED IN AN EFFORT TO IDENTIFY A SOURCE OF FINANCIALSPONSORSHIP. ONLY AFTER A FINAL DETERMINATION IS MADE THAT THE PATIENT ISNOT ELIGIBLE FOR ANY SOURCE OF FUNDING TO COVER THE MEDICAL EXPENSES WILLTHE ACCOUNT BE ELIGIBLE FOR CONSIDERATION OF FINANCIAL ASSISTANCE."AFTER THE NOTIFICATIONS AND PROCESSES REFERENCED ABOVE HAVE BEENCOMPLETED, STANDARD DEBT COLLECTION POLICIES ARE IN EFFECT FOR THE PORTIONOF THE BILL FOR WHICH THE PATIENT IS RESPONSIBLE. |
| PART VI, LINE 2: | THE ORGANIZATION PARTICIPATES IN A COMMUNITY HEALTH NEEDS ASSESSMENT WITH THE MOST RECENT ASSESSMENT COMPLETED IN 2016. BLUE RIDGE REGIONAL HOSPITAL SERVES BOTH YANCEY AND MITCHELL COUNTIES IN WESTERN NORTH CAROLINA. BOTH COUNTIES ARE SMALL AND RURAL WITH POPULATIONS OF: MITCHELL - 15,579 AND YANCEY - 17,818. POPULATION GROWTH IS SEEN ONLY IN THE OVER 65 AGE GROUP. BOTH COUNTIES ARE PREDOMINANTLY WHITE WITH LESS THAN 1% AFRICAN AMERICAN AND 5% HISPANIC RESIDENTS. LOCATED IN THE NORTHERN MOUNTAINS OF WNC, BOTH COUNTIES ARE BEAUTIFUL, CLEAN AND GREEN. BOTH COUNTIES ARE ALSO GEOGRAPHICALLY ISOLATED WITH HIGHER RATES OF UNEMPLOYMENT AND POVERTY THAN MOST NC COUNTIES. BOTH COUNTIES ARE RATED AT TIER 1 COUNTY RELATED TO ECONOMIC DISTRESS. MITCHELL AND YANCEY COUNTY RESIDENTS HAVE A HIGHER THAN EXPECTED RATE OF CHRONIC ILLNESSES INCLUDING HEART DISEASE AND RESPIRATORY DISEASE. HEALTH RELATED RISK FACTORS INCLUDE HIGHER RATES OF OBESITY OR OVERWEIGHT RESIDENTS, SMOKE MORE THAN MOST NORTH CAROLINIANS AND PARTICIPATE IN LESS PHYSICIAN ACTIVITY. THE FOLLOWING SECTION DESCRIBES HOW DATA WAS OBTAINED, COMPILED AND ANALYZED IN OUR ASSESSMENT PROCESS. WNC HEALTHY IMPACT IS A PARTNERSHIP AND COORDINATED PROCESS BETWEEN HOSPITALS AND HEALTH DEPARTMENTS IN WESTERN NORTH CAROLINA TO IMPROVE COMMUNITY HEALTH. AS PART OF A LARGER, AND CONTINUOUS, COMMUNITY HEALTH IMPROVEMENT PROCESS, THESE PARTNERS ARE COLLABORATING TO CONDUCT COMMUNITY HEALTH (NEEDS) ASSESSMENTS ACROSS WESTERN NORTH CAROLINA WWW.WNCHEALTHYIMPACT.COM. BLUE RIDGE REGIONAL HOSPITAL IS ALSO INVOLVED IN THIS REGIONAL/LOCAL VISION AND COLLABORATION. PARTICIPATING COUNTIES INCLUDE: BUNCOMBE, CHEROKEE, CLAY, GRAHAM, HAYWOOD, HENDERSON, JACKSON, MACON, MADISON, MCDOWELL, MITCHELL, POLK, RUTHERFORD, SWAIN, TRANSYLVANIA AND YANCEY. THE DATA REVIEWED AS PART OF OUR COMMUNITY'S HEALTH NEEDS ASSESSMENT CAME FROM THE WNC HEALTHY IMPACT REGIONAL CORE SET OF DATA. WNC HEALTHY IMPACT'S CORE REGIONAL DATASET INCLUDES SECONDARY (EXISTING) AND PRIMARY (NEWLY COLLECTED) DATA COMPILED TO REFLECT A COMPREHENSIVE LOOK AT HEALTH. THE FOLLOWING DATA SET ELEMENTS AND COLLECTION ARE SUPPORTED BY WNC HEALTHY IMPACT DATA CONSULTING TEAM, A SURVEY VENDOR, AND PARTNER DATA NEEDS AND INPUT: -A COMPREHENSIVE SET OF PUBLICALLY AVAILABLE SECONDARY DATA METRICS WITH OUR TARGET POPULATION COMPARED TO THE OTHER WNC REGIONS AS "PEER" -SET OF MAPS ACCESSED FROM COMMUNITY COMMONS AND NC CENTER FOR HEALTH STATISTICS -TELEPHONE SURVEY OF A RANDOM SAMPLE OF ADULTS IN THE COUNTY -EMAIL KEY-INFORMANT SURVEY THROUGHOUT THE COLLABORATIVE HEALTH NEEDS ASSESSMENT PROCESS IN OUR COMMUNITY, INPUT WAS OBTAINED IN A NUMBER OF WAYS. SEE BELOW FOR A LIST OF THE ORGANIZATIONS THAT PROVIDED INPUT INTO THIS PROCESS, THE PERIOD OF TIME THEY WERE INVOLVED, HOW THEIR INPUT WAS OBTAINED, AND THE NATURE AND EXTENT OF THEIR |
| PART VI, LINE 3: | BLUE RIDGE REGIONAL HOSPITAL PROVIDES INFORMATION TO OUR PATIENTS REGARDING HOW TO APPLY FOR FINANCIAL ASSISTANCE/CHARITY CARE IN THE FOLLOWING WAYS: A PLAIN LANGUAGE DESCRIPTION OF THE FINANCIAL ASSISTANCE POLICY IS POSTED ON THE HOSPITAL FACILITY'S WEBSITE, ATTACHED TO BILLING INVOICES, POSTED IN THE EMERGENCY ROOMS OR WAITING ROOMS AND IN THE ADMISSIONS OFFICES. IT IS ALSO PROVIDED IN WRITING TO PATIENTS ON ADMISSION TO THE HOSPITAL FACILITY, AND UPON REQUEST. THE ORGANIZATION'S INTERNET WEBSITE AND BROCHURES CONTAIN INFORMATION ABOUT FINANCIAL ASSISTANCE THAT OFFER HELP IN OBTAINING FINANCIAL ASSISTANCE, OPTIONS FOR INSURANCE PROCESSING AND PAYMENT FOR SERVICES. IN ADDITION, ASSISTANCE IS OFFERED TO HELP IN DETERMINING IF A PATIENT QUALIFIES FOR STATE AGENCY PROGRAMS AND MEDICAID BENEFITS AS WELL AS ASSISTANCE WITH THE APPLICATION PROCESS. THE WEBSITE AND BROCHURES EXPLAIN THAT THE HOSPITAL OFFERS DISCOUNTS BASED ON CERTAIN CRITERIA, AND NOTES THE RANGE OF DISCOUNTS AND HOW HOUSEHOLD INCOME GUIDELINES ARE USED TO DETERMINE DISCOUNT ELIGIBILITY.THE PATIENT IS DIRECTED TO CALL THE CUSTOMER SERVICE CENTER OR VISIT THE HOSPITAL'S BUSINESS OFFICE AND LISTS THE HOURS THE OFFICE AND CENTER ARE OPEN.THERE ARE ALSO MESSAGES ON PATIENT BILLS GIVING INFORMATION ON FINANCIAL ASSISTANCE AND HOW TO CONTACT THE HOSPITAL IF THEY HAVE QUESTIONS OR WANT TO APPLY. |
| PART VI, LINE 4: | BLUE RIDGE REGIONAL HOSPITAL SERVES THE RURAL MOUNTAINOUS AREA OF MITCHELL, YANCEY, LOWER AVERY AND UPPER MCDOWELL COUNTIES IN WESTERN NORTH CAROLINA. THE POPULATION SERVED IS A LARGELY INDIGENT POPULATION AND AN EVER-INCREASING ELDERLY POPULATION. IN 2016 MORE THAN 75% OF THE PATIENT POPULATION WERE MEDICAID, MEDICARE OR SELF-PAY PATIENTS. |
| PART VI, LINE 5: | THE ORGANIZATION EARNED A 3-STAR RATING IN 2016 FOR MEDICARE HOSPITAL COMPARE FROM CENTERS FOR MEDICARE & MEDICAID SERVICES.THE ORGANIZATION EARNED THE BEST NEW MEDICAL OFFICE BUILDINGS AND OTHER OUTPATIENT FACILITIES (25,000 TO 49,999 SQUARE FEET) AWARD IN 2015 FROM HEALTHCARE REAL ESTATE INSIGHTTHE ORGANIZATION EARNED A COMMUNITY VALUE FIVE-STAR AWARD IN 2014 FROM CLEVERLEY & ASSOCIATES |
| PART VI, LINE 6: | BLUE RIDGE REGIONAL HOSPITAL IS PART OF AN AFFILIATED HEALTH CARE SYSTEM WITH THE RESPECTIVE ROLES OF THE ORGANIZATION AND ITS AFFILIATES DESCRIBED BELOW IN PROMOTING THE HEALTH OF THE COMMUNITIES SERVED.MISSION HEALTH SYSTEM, INC. IS THE PARENT ORGANIZATION FOR THE CHARITABLE ORGANIZATIONS OF MISSION HOSPITAL, INC.; MISSION HEALTH SYSTEM FOUNDATION, INC.; MISSION MEDICAL ASSOCIATES, INC; BLUE RIDGE REGIONAL HOSPITAL, INC.;THE MCDOWELL HOSPITAL, INC.;ANGEL MEDICAL CENTER, INC.; TRANSYLVANIA COMMUNITY HOSPITAL, INC.;HIGHLANDS-CASHIERS HOSPITAL, INC. AND COMMUNITY CAREPARTNERS, INC.THE SYSTEM'S MISSION IS TO OPERATE AN INTEGRATED HEALTH CARE SYSTEM FOR THE BENEFIT OF THE RESIDENTS OF WESTERN NORTH CAROLINA.MISSION HOSPITAL, INC. IS A REGIONAL INTEGRATED HEALTH FACILITY PROVIDING SUPERIOR CARE AND SERVICE TO PATIENTS AND THEIR FAMILIES THROUGH A FULL CONTINUUM OF INTEGRATED SERVICES, EDUCATION, AND RESEARCH. IT SERVES AS A TRAUMA CENTER TO PEOPLE OF WESTERN NORTH CAROLINA AND THE SURROUNDING COUNTIES. MISSION MEDICAL ASSOCIATES' MISSION IS TO PROVIDE PHYSICIAN SERVICES IN PREDOMINANTLY RURAL AREAS THAT ARE INSUFFICIENTLY SERVED, THEREBY IMPROVING THE HEALTH CARE OF THE GENERAL PUBLIC. IN MANY CASES THIS INVOLVES RECRUITING AND PLACING PRIMARY CARE PHYSICIANS, AS WELL AS PEDIATRIC AND ADULT SPECIALTY SERVICES CLOSE TO WHERE PEOPLE LIVE AND WORK.THE MCDOWELL HOSPITAL SERVES AS A COMMUNITY HOSPITAL IN MCDOWELL AND THE SURROUNDING COUNTIES.MISSION HEALTH SYSTEM FOUNDATION, INC. SUPPORTS THE MISSION AND PROGRAMS OF MISSION HOSPITAL, INC. AND MISSION HEALTH SYSTEM, INC. AND OTHER ORGANIZATIONS THAT ARE TAX EXEMPT UNDER THE PROVISIONS OF SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND WORKS TO BENEFIT THE COMMUNITY AND REGION SERVED BY THE ENTITIES LISTED ABOVE.ANGEL MEDICAL CENTER, INC. SERVES AS A COMMUNITY HOSPITAL IN MACON AND SURROUNDING COUNTIES.TRANSYLVANIA COMMUNITY HOSPITAL, INC. SERVES AS A COMMUNITY HOSPITAL IN TRANSYLVANIA AND SURROUNDING COUNTIES.HIGHLANDS-CASHIERS HOSPITAL, INC. SERVES AS A COMMUNITY HOSPITAL FOR JACKSON AND MACON AND SURROUNDING COUNTIES.COMMUNITY CAREPARTNERS, INC. OPERATES AN INPATIENT FACILITY FOR ACUTE REHABILITATION LOCATED IN ASHEVILLE, NORTH CAROLINA, AND PROVIDES A WIDE VARIETY OF POST-ACUTE CARE SERVICES TO RESIDENTS OF WESTERN NORTH CAROLINA, INCLUDING REHABILITATION, HOME HEALTH, ADULT CARE, AND HOSPICE AND PALLIATIVE CARE.MSJHS AND CCP JOINT DEVELOPMENT COMPANY DBA ASHEVILLE SPECIALTY HOSPITAL OPERATES AN INPATIENT FACILITY FOR LONG-TERM ACUTE CARE. |
| PART VI, LINE 7, REPORTS FILED WITH STATES | NC |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | 0 | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BLUE RIDGE REGIONAL HOSPITAL FOUNDATION | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 247 | AddressLine1Txt |
| City | SPRUCE PINE | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 28777 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 582172660 | RecipientEIN |
| Cash Grant | $117,248 | CashGrantAmt |
| Purpose Of Grant | SUPPORT OF OPERATIONS. | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | Total501c3OrgCnt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | Yes (1) | 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 (13 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ROBERT MURPHY MD | ||||||||||||||
| DIRECTOR | $0 | $480,636 | $0 | $17,143 | $0 | $682 | $0 | $7,596 | $0 | $24,361 | $0 | $530,418 | $0 | $0 |
| JEFF D'AGOSTINO | ||||||||||||||
| DIRECTOR | $0 | $287,775 | $0 | $20,000 | $0 | $1,597 | $0 | $42,450 | $0 | $21,662 | $0 | $373,484 | $0 | $0 |
| KATHY GUYETTE | ||||||||||||||
| DIRECTOR | $0 | $381,762 | $0 | $121,907 | $0 | $99,764 | $0 | $91,928 | $0 | $9,013 | $0 | $704,374 | $0 | $93,390 |
| CHRIS DERIENZO | ||||||||||||||
| DIRECTOR | $0 | $368,118 | $0 | $98,194 | $0 | $1,169 | $0 | $77,352 | $0 | $21,436 | $0 | $566,269 | $0 | $0 |
| REBECCA CARTER | ||||||||||||||
| CHIEF NURSING OFFICE | $192,017 | $0 | $44,517 | $0 | $12,145 | $0 | $5,871 | $0 | $10,789 | $0 | $265,339 | $0 | $0 | $0 |
| CLINT STEWART | ||||||||||||||
| REGIONAL DIRECTOR- FINANCE | $0 | $127,834 | $0 | $22,905 | $0 | $10,455 | $0 | $4,019 | $0 | $21,254 | $0 | $186,467 | $0 | $0 |
| ALEX CHAPPELEAR | ||||||||||||||
| PHYSICIAN | $0 | $254,516 | $0 | $8,902 | $0 | $8,103 | $0 | $579 | $0 | $22,324 | $0 | $294,424 | $0 | $0 |
| ALLISON SHARP | ||||||||||||||
| PHYSICIAN | $0 | $214,362 | $0 | $9,296 | $0 | $13,505 | $0 | $5,463 | $0 | $8,774 | $0 | $251,400 | $0 | $0 |
| KEVIN TORREY | ||||||||||||||
| PHYSICIAN | $0 | $252,319 | $0 | $10,275 | $0 | $919 | $0 | $9,204 | $0 | $13,503 | $0 | $286,220 | $0 | $0 |
| SHEHLA KAHN | ||||||||||||||
| PHYSICIAN | $0 | $340,871 | $0 | $22,331 | $0 | $15,218 | $0 | $7,364 | $0 | $24,287 | $0 | $410,071 | $0 | $0 |
| STEPHEN NORTH | ||||||||||||||
| PHYSICIAN | $0 | $237,977 | $0 | $4,061 | $0 | $13,005 | $0 | $3,626 | $0 | $9,925 | $0 | $268,594 | $0 | $0 |
| SONYA JOHNSON | ||||||||||||||
| FORMER REGIONAL DIRECTOR - FINANCE | $0 | $134,268 | $0 | $20,105 | $0 | $445 | $0 | $5,486 | $0 | $11,164 | $0 | $171,468 | $0 | $0 |
| OSCAR WEINMEISTER | ||||||||||||||
| FORMER CEO | $0 | $163,044 | $0 | $37,647 | $0 | $175,774 | $0 | $20,210 | $0 | $16,988 | $0 | $413,663 | $0 | $91,092 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3 | COMPENSATION FOR OFFICERS AND EXECUTIVES ARE SET BY MISSION HEALTH SYSTEM. SEE SCHEDULE O FOR ADDITIONAL DETAIL. |
| PART I, LINES 4A-B | SEVERANCE PAY - OSCAR WEINMESITER $51,104 OFFICERS AS WELL AS KEY EMPLOYEES AND TOP FIVE HIGHEST COMPENSATED EMPLOYEES WHO PARTICIPATED IN A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN WITH CONTRIBUTION AMOUNTS. KATHY GUYETTE $ 78,678 CHRIS DERIENZO $ 65,561 GWEN MCKINNEY $ 27,545 JEFF D'AGOSTINO $ 42,450 OSCAR WEINMEISTER $ 13,446 OFFICERS AS WELL AS KEY EMPLOYEES AND TOP FIVE HIGHEST COMPENSATED EMPLOYEES WHO RECEIVED PAYMENTS FROM A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN. KATHY GUYETTE $ 93,390 OSCAR WEINMEISTER $ 91,092 |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | BYRON PHILLIPS | PersonNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | BOARD MEMBER | RelationshipDescriptionTxt |
| Transaction | $176,481 | TransactionAmt |
| Transaction | MR. PHILLIPS IS A MANAGING PARTNER OF GREAT MEADOWS, LLC WHICH LEASES 2 LOCATIONS TO THE ORGANIZATION AND A RELATED ORGANIZATION. LEASE PAYMENTS ARE BASED ON ARMS-LENGTH NEGOTIATED TERMS AT FAIR MARKET VALUE. | TransactionDesc |
| Sharing Of Revenues | 0 | SharingOfRevenuesInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | THE SOLE MEMBER OF THE CORPORATION IS MISSION HEALTH SYSTEM, INC. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE DIRECTORS OF THE CORPORATION SHALL BE APPOINTED AT THE ANNUAL MEETING OF THE SOLE MEMBER (MISSION HEALTH SYSTEM) OF THE CORPORATION. THE TWO EX-OFFICO DIRECTORS SHALL BE EX-OFFICIO BOARD MEMBERS WHO SERVE IN THE POSITIONS OF CHIEF EXECUTIVE OFFICER OF THE CORPORATION AND CHIEF OF STAFF OF THE HOSPITAL. THE BOARD OF DIRECTORS OF THE CORPORATION SHALL ELECT THE INDIVIDUALS TO SERVE AS COMMUNITY DIRECTORS AS SOON AS REASONABLY POSSIBLE SUBSEQUENT TO THE APPOINTMENT OF THE SOLE MEMBER'S DIRECTORS. THE COMMUNITY DIRECTORS ELECTED MUST BE APPROVED BY THE MEMBER OF THE CORPORATION; HOWEVER, SAID APPROVAL SHALL NOT BE ARBITRARILY AND CAPRICIOUSLY WITHHELD. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE SOLE MEMBER HAS THE FOLLOWING RIGHTS WITH RESPECT TO THE CORPORATION (A) APPROVAL OF THE GOVERNING INSTRUMENTS OF THE CORPORATION, (B) APPROVAL OF THE MISSION, VISION, AND VALUES STATEMENT, (C) ELECTION AND REMOVAL OF THE BOARD OF DIRECTORS, (D) APPROVAL OF THE PLEDGE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION, THE PURCHASE OR SALE OF PROPERTY, AND LONG-TERM BORROWING, (E) APPROVAL OF DISSOLUTION, MERGER, SALE, OR CONSOLIDATION, (F) APPROVAL OF THE FORMATION AND GOVERNANCE OF NEW CORPORATIONS, PARTNERSHIPS, OR JOINT VENTURES (ABOVE FINANCIAL AND OTHER LIMITS), (G) APPROVAL OF THE CAPITAL AND OPERATING BUDGET, (H) APPROVAL OF THE CONSOLIDATION, MATERIAL EXPANSION, OR ELIMINATION OF ANY CLINICAL SERVICE, (I) APPROVAL OF THE ELECTION OF THE PRESIDENT/CNO, (J) THE OPTION TO REMOVE THE PRESIDENT/CNO. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE ORGANIZATION PROVIDES DATA TO THE MANAGER OF TREASURY SERVICES FOR MISSION HEALTH SYSTEM, INC. THE 990 IS PREPARED AND REVIEWED BY MANAGEMENT PRIOR TO THE REVIEW BY THE ORGANIZATION'S BOARD OF DIRECTORS. AFTER REVIEW BY THE BOARD, AND REVISIONS FOR ANY CLARIFICATIONS OR CORRECTIONS, THE FULL COPY OF THE 990 IS PROVIDED TO THE BOARD PRIOR TO FILING THE 990. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE INDEPENDENT DIRECTORS REVIEW CONFLICTS OF INTEREST AND DISABLING SITUATIONS, CONSIDER ANY ISSUES INVOLVING CONFLICTS AND MAKE DETERMINATIONS AS TO WHETHER A PARTICULAR RELATIONSHIP OR ARRANGEMENT WOULD DISABLE AN INDIVIDUAL FROM SERVING AS A FIDUCIARY FOR THE BOARD OR WOULD REASONABLY BE EXPECTED TO EXERT AN INFLUENCE ON THE INDIVIDUAL'S JUDGMENT AND THEREFORE PRECLUDE THE INDIVIDUAL FROM BEING AN INDEPENDENT DIRECTOR. THE BOARD MAY RETAIN COUNSEL FROM OUTSIDE AUDIT, LEGAL, GOVERNANCE OR OTHER EXPERTS. PROCEDURES UPON DETERMINATION OF A CONFLICT OF INTEREST: THE INTERESTED PERSON SHALL NOT PARTICIPATE IN ANY DISCUSSION OR VOTE REGARDING THE BUSINESS RELATIONSHIP ISSUE, AND SHALL NOT BE PRESENT IN THE MEETING ROOM FOR ANY PART OF THE DISCUSSION OR VOTE RELATING TO THE BUSINESS RELATIONSHIP ISSUE. THE BOARD OF DIRECTORS WILL DISCUSS THE BUSINESS RELATIONSHIP BUT WILL NOT FORMALLY APPROVE SUCH BUSINESS RELATIONSHIP UNLESS THE DISINTERESTED MEMBERS OF THE BOARD HAVE DECIDED BY MAJORITY VOTE THAT THE BUSINESS RELATIONSHIP IS IN THE BEST INTERESTS OF AND FOR THE BENEFIT OF BLUE RIDGE AND IS FAIR AND REASONABLE THERETO IN ALL RESPECTS. |
| FORM 990, PART VI, SECTION B, LINE 15 | A RELATED ORGANIZATION DRAWS WAGE COMPARISON DATA FROM OUTSIDE EXECUTIVE COMPENSATION CONSULTANTS TO ENSURE COMPENSATION LEVELS ARE AT FAIR MARKET VALUE THE HUMAN RESOURCES AND COMPENSATION COMMITTEE OF THE RELATED ORGANIZATION(COMMITTEE) REVIEWS THIS DATA AND RECOMMENDS TO THE BOARD OF THE RELATED ORGANIZATION ANY REVISIONS TO THE OVERALL PHILOSOPHY AND POLICY TO GUIDE THE DETERMINATION OF COMPENSATION AND BENEFIT PACKAGES FOR EXECUTIVES WHICH INCLUDES THE CEO, THE CFO, AND PRESIDENT AS WELL AS ALL OTHER EXECUTIVES, WHICH WOULD INCLUDE ALL KEY EMPLOYEES. THE COMMITTEE KEEPS AND DISTRIBUTES MINUTES OF ALL ITS MEETINGS TO ITS MEMBERS. ITEMS OF A SENSITIVE NATURE ARE REFERENCED IN THE MINUTES WITH DETAILED, SUPPORTING DOCUMENTATION RETAINED ON FILE. THE COMMITTEE ALSO DISCLOSES ANY POTENTIAL CONFLICTS OF INTEREST SITUATIONS TO THE COMMITTEE CHAIRMAN THAT MAY AFFECT THEIR INDEPENDENT DIRECTORS' STATUS AS SOON AS THEY ARISE, AND MAINTAINS COMPLETE DOCUMENTATION OF ALL MATTERS DISCUSSED BY THE COMMITTEE. THE COMMITTEE OBTAINS EDUCATION AND TRAINING TO EXERCISE ALL RESPONSIBILITIES EFFECTIVELY AND KEEPS ABREAST OF SIGNIFICANT DEVELOPMENTS IN EXECUTIVE COMPENSATION PRACTICES AND REGULATIONS, AND ENSURES THAT ALL ASPECTS OF MISSION HEALTH SYSTEM AND HOSPITAL EXECUTIVE COMPENSATION ADHERE TO ALL RELEVANT REGULATORY REQUIREMENTS, AND REVIEWS THE COMMITTEE CHARTER ANNUALLY REVISING AS APPROPRIATE AND CONDUCTS AN ANNUAL EVALUATION OF THE COMMITTEE'S PERFORMANCE. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST AT THE ORGANIZATION'S ADMINISTRATIVE OFFICE. |
| FORM 990, PART IX, LINE 11G | CONTRACT LABOR - MEDICAL: PROGRAM SERVICE EXPENSES 9,274,944. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 9,274,944. CONTRACT LABOR - NON MEDICAL: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 12,930. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 12,930. MEDICAL FEES: PROGRAM SERVICE EXPENSES 346,137. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 346,137. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 1,401,653. MANAGEMENT AND GENERAL EXPENSES 1,401,653. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,803,306. OTHER EXPENSES: PROGRAM SERVICE EXPENSES 298,472. MANAGEMENT AND GENERAL EXPENSES 298,472. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 596,944. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (15 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| BLUE RIDGE REGIONAL HOSPITAL FOUNDATION INC | |||||||||||
| PO BOX 247 | SPRUCE PINE | NC | 28777 | 582172660 | FOUNDATION | NC | 501(C)(3) | LINE 11A, I | BLUE RIDGE REGIONAL HOSPITAL INC | Yes (1) | |
| MISSION HEALTH SYSTEM INC | |||||||||||
| 400 RIDGEFIELD COURT SUITE 100 | ASHEVILLE | NC | 28806 | 581450888 | SUPPORTING ORGANIZATION | NC | 501(C)(3) | LINE 11A, I | 0 | N/A | |
| MISSION HOSPITAL INC | |||||||||||
| 400 RIDGEFIELD COURT SUITE 100 | ASHEVILLE | NC | 28806 | 560532141 | ACUTE CARE HOSPITAL | NC | 501(C)(3) | LINE 3 | MISSION HEALTH SYSTEM INC | 0 | |
| MISSION HEALTH SYSTEM FOUNDATION INC | |||||||||||
| 400 RIDGEFIELD COURT SUITE 100 | ASHEVILLE | NC | 28806 | 561881331 | FOUNDATION | NC | 501(C)(3) | LINE 7 | MISSION HEALTH SYSTEM INC | 0 | |
| MISSION MEDICAL ASSOCIATES INC | |||||||||||
| 400 RIDGEFIELD COURT SUITE 100 | ASHEVILLE | NC | 28806 | 263627231 | PHYSICIAN SERVICES | NC | 501(C)(3) | LINE 9 | MISSION HEALTH SYSTEM INC | 0 | |
| THE MCDOWELL HOSPITAL INC | |||||||||||
| 430 RANKIN DRIVE | MARION | NC | 28752 | 560623938 | COMMUNITY HOSPITAL | NC | 501(C)(3) | LINE 3 | MISSION HEALTH SYSTEM INC | 0 | |
| MCDOWELL HEALTHCARE FOUNDATION INC | |||||||||||
| 430 RANKIN DRIVE | MARION | NC | 28752 | 463395393 | FOUNDATION | NC | 501(C)(3) | LINE 7 | THE MCDOWELL HOSPITAL INC | 0 | |
| TRANSYLVANIA COMMUNITY HOSPITAL INC | |||||||||||
| 260 HOSPITAL DRIVE | BREVARD | NC | 28712 | 560562293 | COMMUNITY HOSPITAL | NC | 501(C)(3) | LINE 3 | MISSION HEALTH SYSTEM INC | 0 | |
| TRANSYLVANIA REGIONAL HOSPITAL FOUNDATION INC | |||||||||||
| PO BOX 2440 | BREVARD | NC | 28712 | 561458024 | FOUNDATION | NC | 501(C)(3) | LINE 11A, I | TRANSYLVANIA COMMUNITY HOSPITAL INC | 0 | |
| ANGEL MEDICAL CENTER INC | |||||||||||
| PO BOX 1209 | FRANKLIN | NC | 28744 | 566000064 | COMMUNITY HOSPITAL | NC | 501(C)(3) | LINE 3 | MISSION HEALTH SYSTEM INC | 0 | |
| TRANSYLVANIA PHYSICIAN SERVICES INC | |||||||||||
| 260 HOSPITAL DRIVE | BREVARD | NC | 28712 | 561920816 | PHYSICIAN SERVICES | NC | 501(C)(3) | LINE 3 | TRANSYLVANIA COMMUNITY HOSPITAL INC | 0 | |
| ANGEL MEDICAL CENTER AUXILIARY INC | |||||||||||
| PO BOX 1209 | FRANKLIN | NC | 28744 | 562133719 | SUPPORTING ORGANIZATION | NC | 501(C)(3) | LINE 12A, I | ANGEL MEDICAL CENTER INC | 0 | |
| COMMUNITY CAREPARTNERS INC | |||||||||||
| PO BOX 5779 | ASHEVILLE | NC | 28813 | 562005198 | LONG TERM REHABILITATION | NC | 501(C)(3) | LINE 10 | MISSION HEALTH SYSTEM INC | 0 | |
| HIGHLANDS-CASHIERS HOSPITAL INC | |||||||||||
| PO BOX 190 | HIGHLANDS | NC | 28741 | 560509400 | COMMUNITY HOSPITAL | NC | 501(C)(3) | LINE 3 | MISSION HEALTH SYSTEM INC | 0 | |
| HIGHLANDS-CASHIERS PHYSICIAN SERVICES INC | |||||||||||
| PO BOX 742 | HIGHLANDS | NC | 28741 | 452422428 | PHYSICIAN SERVICES | NC | 501(C)(3) | LINE 12A, I | HIGHLANDS-CASHIERS HOSPITAL INC | 0 | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (14 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Predominant Income TypePredominantIncomeTypeTxt | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd | OwnershipOwnershipPct |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ASHEVILLE IMAGING LLP | ||||||||||||||
| 534 BILTMORE AVENUE | ASHEVILLE | NC | 28801 | 561907201 | MEDICAL IMAGING | NC | N/A | |||||||
| ASHEVILLE MRI | ||||||||||||||
| PO BOX 2959 | ASHEVILLE | NC | 28802 | 561665863 | MEDICAL IMAGING | NC | N/A | |||||||
| BLUE RIDGE DME LLC | ||||||||||||||
| 125 HOSPITAL DRIVE | SPRUCE PINE | NC | 28777 | 263570174 | HOME MEDICAL EQUIPMENT AND SUPPLIES SALES | NC | BLUE RIDGE REGIONAL HOSPITAL INC | RELATED | $294,493 | $1,045,076 | 0 | Yes (1) | 0.96000 | |
| BLUE RIDGE-TKC LLC | ||||||||||||||
| 5935 CARNEGIE BLVD | CHARLOTTE | NC | 28209 | 471382912 | REAL ESTATE RENTAL | NC | BLUE RIDGE REGIONAL HOSPITAL INC | RELATED | $145,524 | $3,187,870 | 0 | Yes (1) | 1.00000 | |
| HEALTHCARE III LIMITED PARTNERSHIP | ||||||||||||||
| 260 HOSPITAL DRIVE | BREVARD | NC | 28712 | 561599596 | RENTAL | NC | N/A | |||||||
| HEALTHCARE LIMITED LIABILITY COMPANY VII | ||||||||||||||
| 260 HOSPITAL DRIVE | BREVARD | NC | 28712 | 200343455 | RENTAL | NC | N/A | |||||||
| IMAGING REALTY LLP | ||||||||||||||
| 534 BILTMORE AVENUE | ASHEVILLE | NC | 28801 | 561907203 | MEDICAL BUILDING | NC | N/A | |||||||
| MCDOWELL MRI LLC | ||||||||||||||
| 414 RANKIN DRIVE | MARION | NC | 28752 | 753046378 | DISSOLVED DECEMBER 2016 | NC | N/A | |||||||
| MSJHS AND CCP JOINT DEVELOPMENT COMPANY LLC | ||||||||||||||
| 428 BILTMORE AVENUE | ASHEVILLE | NC | 28801 | 562250464 | LONG TERM ACUTE CARE HOSITAL | NC | N/A | |||||||
| SPRUCE PINE HEALTHCARE LLC | ||||||||||||||
| 5935 CARNEGIE BLVD | CHARLOTTE | NC | 28209 | 471390107 | REAL ESTATE | NC | BLUE RIDGE REGIONAL HOSPITAL INC | RELATED | -$53,944 | $5,301,831 | Yes (1) | Yes (1) | 1.00000 | |
| TRANSYLVANIA HEALTHCARE II LIMITED PARTNERSHIP | ||||||||||||||
| 2 MEDICAL PARK DRIVE | BREVARD | NC | 28712 | 200333230 | RENTAL | NC | N/A | |||||||
| WESTERN NC HEALTHCARE INNOVATORS LLC | ||||||||||||||
| 5935 CARNEGIE BLVD | CHARLOTTE | NC | 28209 | 800787882 | REAL ESTATE RENTAL | NC | N/A | |||||||
| WESTERN REGIONAL RADIATION THERAPY CENTER | ||||||||||||||
| 68 HOSPITAL DRIVE | SYLVA | NC | 28779 | 561849395 | RADIATION THERAPY | NC | N/A | |||||||
| WNC STONE CENTER | ||||||||||||||
| 509 BILTMORE AVENUE | ASHEVILLE | NC | 28801 | 272152974 | LITHOTRIPTER RENTAL | NC | N/A | |||||||
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (4 entries)
| Address Line1ForeignAddress/AddressLine1Txt | CountryForeignAddress/CountryCd | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd | Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Legal Domicile StateLegalDomicileStateCd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DOGWOOD INSURANCE COMPANY LTD | ||||||||||||
| THE GRANT PAVILION COMMERCIAL CENTR | CJ | CAPTIVE INSURANCE ENTITY | CJ | N/A | C | 0 | ||||||
| TRANSYLVANIA SERVICES INC | ||||||||||||
| REAL ESTATE | N/A | C | 0 | 260 HOSPITAL DRIVE | BREVARD | NC | 28712 | 561448199 | NC | |||
| MISSION HEALTH PARTNERS INC | ||||||||||||
| CLINICALLY INTEGRATED NETWORK | N/A | C | 0 | 509 BILTMORE AVENUE | ASHEVILLE | NC | 28801 | 465566095 | NC | |||
| HEALTHY STATE INC | ||||||||||||
| ADMINISTRATIVE | N/A | C | 0 | 509 BILTMORE AVENUE | ASHEVILLE | NC | 28801 | 812108613 | NC | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | 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 | Yes (1) | 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 | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (3 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| BLUE RIDGE DME LLC | ||
| S | $173,220 | FMV |
| BLUE RIDGE REGIONAL HOSPITAL FOUNDATION INC | ||
| C | $60,031 | FMV |
| BLUE RIDGE REGIONAL HOSPITAL FOUNDATION INC | ||
| B | $117,248 | FMV |
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