ANC ANGEL MEDICAL CENTER INC: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- ANC ANGEL MEDICAL CENTER INC (EIN 56-6000064)
- Tax period
- 2015-10-01 to 2016-09-30
- Filed
- 2017-08-15
- IRS object ID
- 201742279349301034
- Schema version
- 2015v3.0
- 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 ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-08-15T08:09:37-05:00 | ReturnTs |
| Tax Period End | 2016-09-30 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 566000064 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ANGEL MEDICAL CENTER INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | ANGE | BusinessNameControlTxt |
| Phone | 8285248411 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 1209 | AddressLine1Txt |
| City | FRANKLIN | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 28744 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | LENA COCHRAN | PersonNm |
| Person Title | REGIONAL DIRECTOR - FINANCE | PersonTitleTxt |
| Phone | 8285248411 | PhoneNum |
| Signature | 2017-08-14 | SignatureDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | LENA COCHRAN | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 1209 | AddressLine1Txt |
| City | FRANKLIN | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 28744 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $62,229,484 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | MISSION-HEALTH.ORG/MEMBER-HOSPITALS.PHP | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1933 | FormationYr |
| Legal Domicile State | NC | LegalDomicileStateCd |
| Activity Or Mission | PROVISION OF HEALTHCARE SERVICES | ActivityOrMissionDesc |
| Voting Members Governing Body | 16 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 11 | VotingMembersIndependentCnt |
| Total Employee | 482 | TotalEmployeeCnt |
| Total Volunteers | 108 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $186,222 | PYContributionsGrantsAmt |
| CY Contributions Grants | $195,094 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $58,395,937 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $61,562,961 | CYProgramServiceRevenueAmt |
| PY Investment Income | -$61,417 | PYInvestmentIncomeAmt |
| CY Investment Income | -$193,401 | CYInvestmentIncomeAmt |
| PY Other Revenue | $165,898 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $58,686,640 | PYTotalRevenueAmt |
| CY Total Revenue | $61,564,654 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $4,500 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $3,168 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $31,350,014 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $21,487,396 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $77,254 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $25,641,624 | PYOtherExpensesAmt |
| CY Other Expenses | $36,873,151 | CYOtherExpensesAmt |
| PY Total Expenses | $56,996,138 | PYTotalExpensesAmt |
| CY Total Expenses | $58,363,715 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,690,502 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $3,200,939 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $38,287,323 | TotalAssetsBOYAmt |
| Total Assets EOY | $37,823,794 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $17,762,801 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $14,098,333 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $20,524,522 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $23,725,461 | NetAssetsOrFundBalancesEOYAmt |
| Mission | DEDICATED PROFESSIONALS PROVIDING COMPASSIONATE HEALTHCARE TO ALL. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $54,515,939 | ExpenseAmt |
| Grant | $3,168 | GrantAmt |
| Revenue | $61,562,961 | RevenueAmt |
| Desc | THE ORGANIZATION PROVIDES QUALITY MEDICAL HEALTHCARE SERVICES TO PEOPLE IN ITS SERVICE AREA REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE, OR ABILITY TO PAY. ALTHOUGH REIMBURSEMENT FOR SERVICES RENDERED IS CRITICAL TO THE OPERATION AND STABILITY OF THE ORGANIZATION, IT IS RECOGNIZED THAT NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PAY FOR ESSENTIAL MEDICAL SERVICES. THE ORGANIZATION FURTHER RECOGNIZES THAT ITS MISSION IS TO SERVE THE COMMUNITY WITH RESPECT TO PROVIDING HEALTHCARE SERVICES AND EDUCATION. TO THIS END, THE ORGANIZATION PROVIDES FREE CARE, SUBSIDIZED CARE, AND CARE AT BELOW COST TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS. HEALTHCARE ACTIVITIES AND SCREENINGS, PROGRAMS AND EDUCATION TO SUPPORT THE COMMUNITY'S HEALTH ARE ALSO PROVIDED EACH YEAR. | Desc |
| Total Program Service Expenses | $54,515,939 | 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 | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | 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 | 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 | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | 0 | 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 | 482 | 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 |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 16 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 11 | 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 | 0 | 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 | 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 | 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 SUITE 100 | AddressLine1Txt |
| City | ASHEVILLE | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 28806 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (26 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|
| KEN STONEBRAKER | |||||||||
| CHAIRPERSON | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| CONNIE HAIRE | |||||||||
| TREASURER | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| JANE C KIMSEY | |||||||||
| VICE-CHAIRPERSON | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| JOHNNY MIRA-KNIPPEL | |||||||||
| SECRETARY | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| CHARLES BARRIER MD | |||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| DAVID FRANKS MD | |||||||||
| BOARD MEMBER | 40.00 | Yes (X) | $0 | $245,346 | $10,937 | ||||
| CHUCK TRENTHAM MD | |||||||||
| BOARD MEMBER | 40.00 | Yes (X) | $168,069 | $0 | $0 | ||||
| JANET J GREENE | |||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| JOSEPH COLLINS | |||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| GEORGE RENFRO | |||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| ROBERT BEDNAREK | |||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $322,366 | $33,182 | 59.00 | |||
| JAN UNGER | |||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| LADSON GADDY-DUBAC MD | |||||||||
| BOARD MEMBER | 40.00 | Yes (X) | $54,957 | $209,680 | $13,995 | ||||
| KATHY GUYETTE | |||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $543,135 | $79,029 | 59.00 | |||
| DALE WEST | |||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| KEN MURPHY | |||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| MARK NAKAGAWA | |||||||||
| REG DIR - FIN UNTIL MAR 2016 | 25.00 | Yes (X) | $0 | $164,022 | $29,932 | 25.00 | |||
| SHEILA PRICE | |||||||||
| CHIEF NURSING OFFICER | 50.00 | Yes (X) | $158,348 | $0 | $5,376 | ||||
| LENA COCHRAN | |||||||||
| REG DIR - FIN BEG DEC 2015 | 20.00 | Yes (X) | $0 | $12,564 | $608 | 20.00 | |||
| KAREN GORBY | |||||||||
| CNO BEG AUG 2016 | 50.00 | Yes (X) | $0 | $0 | $0 | ||||
| AMOS HADDOCK MD | |||||||||
| PHYSICIAN | 40.00 | $0 | $395,172 | $32,378 | Yes (X) | ||||
| GILBERTO ROBLES MD | |||||||||
| PHYSICIAN | 40.00 | $124,682 | $328,044 | $28,796 | Yes (X) | ||||
| TRAVIS PETRICEK MD | |||||||||
| PHYSICIAN | 40.00 | $125,239 | $274,587 | $15,042 | Yes (X) | ||||
| LAURA VERDE MD | |||||||||
| PHYSICIAN | 40.00 | $0 | $388,892 | $26,625 | Yes (X) | ||||
| MICHAEL KEGAN MD | |||||||||
| PHYSICIAN | 40.00 | $0 | $434,876 | $31,848 | Yes (X) | ||||
| JAMES BROSS | |||||||||
| FORMER CEO | 0.00 | $0 | $341,426 | $14,585 | 0.00 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $631,295 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $3,660,110 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $322,333 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 9 | 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
Contractor Name ContractorName
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JOHNSON CONTROLS INC | BusinessNameLine1Txt |
Contractor Address ContractorAddress
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 430 ROPER MOUNTAIN ROAD SUITE J | AddressLine1Txt |
| City | GREENVILLE | CityNm |
| State Abbreviation | SC | StateAbbreviationCd |
| ZIP | 29615 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Services | EQUIPMENT MAINTENANCE SERVICES | ServicesDesc |
| Compensation | $106,241 | CompensationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 1 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $82,044 | RelatedOrganizationsAmt |
| Government Grants | $31,805 | GovernmentGrantsAmt |
| All Other Contributions | $81,245 | AllOtherContributionsAmt |
| Total Contributions | $195,094 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT SERVICES REVENUE | 900099 | $59,438,656 | $59,438,656 |
| OTHER OPERATING REVENUE | 900099 | $2,124,305 | $2,124,305 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $61,562,961 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $22,904 | TotalRevenueColumnAmt |
| Exclusion | $22,904 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $438,312 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $438,312 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $10,213 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $226,518 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -$216,305 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$216,305 | TotalRevenueColumnAmt |
| Exclusion | -$216,305 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $61,564,654 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $61,562,961 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | -$193,401 | 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 | $3,168 | TotalAmt |
| Program Services | $3,168 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $494,819 | TotalAmt |
| Program Services | $395,855 | ProgramServicesAmt |
| Management And General | $98,964 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,057,341 | TotalAmt |
| Program Services | $15,181,033 | ProgramServicesAmt |
| Management And General | $1,828,107 | ManagementAndGeneralAmt |
| Fundraising | $48,201 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $224,590 | TotalAmt |
| Program Services | $199,885 | ProgramServicesAmt |
| Management And General | $24,705 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,373,211 | TotalAmt |
| Program Services | $2,112,158 | ProgramServicesAmt |
| Management And General | $254,347 | ManagementAndGeneralAmt |
| Fundraising | $6,706 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,337,435 | TotalAmt |
| Program Services | $1,190,317 | ProgramServicesAmt |
| Management And General | $147,118 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $687,179 | TotalAmt |
| Program Services | $584,102 | ProgramServicesAmt |
| Management And General | $103,077 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,770 | TotalAmt |
| Management And General | $22,770 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,713 | TotalAmt |
| Management And General | $12,713 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,642,922 | TotalAmt |
| Program Services | $15,435,710 | ProgramServicesAmt |
| Management And General | $207,212 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $72,682 | TotalAmt |
| Management And General | $72,099 | ManagementAndGeneralAmt |
| Fundraising | $583 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $503,840 | TotalAmt |
| Program Services | $443,379 | ProgramServicesAmt |
| Management And General | $60,078 | ManagementAndGeneralAmt |
| Fundraising | $383 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $654,985 | TotalAmt |
| Program Services | $261,994 | ProgramServicesAmt |
| Management And General | $392,991 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,346,687 | TotalAmt |
| Program Services | $2,090,825 | ProgramServicesAmt |
| Management And General | $234,669 | ManagementAndGeneralAmt |
| Fundraising | $21,193 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $99,867 | TotalAmt |
| Program Services | $88,881 | ProgramServicesAmt |
| Management And General | $10,798 | ManagementAndGeneralAmt |
| Fundraising | $188 | FundraisingAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $36,573 | TotalAmt |
| Management And General | $36,573 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $117,869 | TotalAmt |
| Program Services | $117,869 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,521,772 | TotalAmt |
| Program Services | $2,521,772 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $303,632 | TotalAmt |
| Program Services | $258,087 | ProgramServicesAmt |
| Management And General | $45,545 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| PHARMACEUTICALS | $8,119,538 | $8,119,538 | |
| MEDICAL SUPPLIES | $4,183,820 | $4,183,820 | |
| REPAIRS AND MAINTENANCE | $227,569 | $193,434 | $34,135 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,318,733 | TotalAmt |
| Program Services | $1,134,112 | ProgramServicesAmt |
| Management And General | $184,621 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $58,363,715 | TotalAmt |
| Program Services | $54,515,939 | ProgramServicesAmt |
| Management And General | $3,770,522 | ManagementAndGeneralAmt |
| Fundraising | $77,254 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,024,244 | BOYAmt |
| EOY | $1,537,388 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $286,031 | BOYAmt |
| EOY | $185,741 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $24,704 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,115,806 | BOYAmt |
| EOY | $11,055,621 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $293,440 | BOYAmt |
| EOY | $293,440 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,510,417 | BOYAmt |
| EOY | $1,582,389 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $124,010 | BOYAmt |
| EOY | $46,249 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $30,566,372 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $7,468,110 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,703,526 | BOYAmt |
| EOY | $23,098,262 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $229,849 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $38,287,323 | BOYAmt |
| EOY | $37,823,794 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,055,800 | BOYAmt |
| EOY | $3,779,493 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,113,125 | BOYAmt |
| EOY | $2,716,684 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,570,000 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,876 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $7,602,156 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,762,801 | BOYAmt |
| EOY | $14,098,333 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,382,940 | BOYAmt |
| EOY | $23,588,624 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $141,582 | BOYAmt |
| EOY | $136,837 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,524,522 | BOYAmt |
| EOY | $23,725,461 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $38,287,323 | BOYAmt |
| EOY | $37,823,794 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $3,200,939 | ReconcilationRevenueExpnssAmt |
| 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
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,480,000 | OtherCostOrOtherBasisAmt |
| Book Value | $3,480,000 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $13,297,483 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,342,927 | DepreciationAmt |
| Book Value | $9,954,556 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,317,396 | OtherCostOrOtherBasisAmt |
| Depreciation | $423,541 | DepreciationAmt |
| Book Value | $2,893,855 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $7,965,986 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,032,076 | DepreciationAmt |
| Book Value | $4,933,910 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,505,507 | OtherCostOrOtherBasisAmt |
| Depreciation | $669,566 | DepreciationAmt |
| Book Value | $1,835,941 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $23,098,262 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| INTERCOMPANY NOTE PAYABLE - MISSION HEALTH SYSTEM | $7,145,000 |
| INTERCOMPANY LIABILITIES | $457,156 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $7,602,156 | 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 |
| Percent400 | Yes (X) | Percent400Ind |
| 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 | $2,144,796 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,144,796 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03670 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $7,777,265 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,651,605 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $125,660 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00220 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $9,922,061 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,651,605 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,270,456 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03890 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $122,365 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $122,365 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00210 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $528,220 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $528,220 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00910 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,286 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,286 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $652,871 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $652,871 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01120 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $10,574,932 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,651,605 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,923,327 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05010 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $300 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $300 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $300 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $300 | NetCommunityBenefitExpnsAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $3,603,324 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $16,120 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $22,982,905 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $22,160,151 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $822,754 | 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 | ANGEL MEDICAL CENTER INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 120 RIVERVIEW STREET | AddressLine1Txt |
| City | FRANKLIN | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 28734 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.ANGELMED.ORG | WebsiteAddressTxt |
| State License | H0034 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| 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 | ANGEL MEDICAL CENTER 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 |
| Information Gaps | Yes (X) | InformationGapsInd |
| 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 VI | OwnWebsiteURLTxt |
| Other Website | Yes (X) | OtherWebsiteInd |
| Other Website URL | SEE PART VI | OtherWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 13 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | SEE PART VI | StrategyWebsiteURLTxt |
| Strategy Attached | 0 | StrategyAttachedInd |
| 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 | 400.000000000000 | 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 |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | HTTPS://WWW.MISSION-HEALTH.ORG/FINANCIAL-ASSISTANCE.PHP | 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 |
| FAP Notice Displayed | Yes (X) | FAPNoticeDisplayedInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Other Method Used | Yes (X) | OtherMethodUsedInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| ANGEL MEDICAL CENTER, INC. | PART V, SECTION B, LINE 5: IN THE RANDOM-SAMPLE SURVEY THAT WAS ADMINISTERED IN OUR COUNTY AS PART OF THIS REGIONAL COMMUNITY HEALTH ASSESSMENT, APPROXIMATELY 200 COMMUNITY MEMBERS COMPLETED A QUESTIONNAIRE REGARDING THEIR HEALTH STATUS, HEALTH BEHAVIORS, INTERACTIONS WITH CLINICAL CARE SERVICES, SUPPORT FOR CERTAIN HEALTH-RELATED POLICIES, AND FACTORS THAT IMPACT THEIR QUALITY OF LIFE. IN ADDITION, IN OUR COUNTY, COMMUNITY MEMBERS AND PARTNERS WERE INVOLVED IN: - A COLLECTION AND REVIEW OF KEY HEALTH STATISTICS, COMPARING MACON COUNTY RESULTS WITH PEER COUNTIES AND NC RESULTS. IN ADDITION, TRENDS IN MACON COUNTY RESULTS WERE REVIEWED. - A QUANTITATIVE RESEARCH STUDY OF RESIDENTS, SELECTED AT RANDOM, AND INTERVIEWED USING A COMPREHENSIVE HEALTH QUESTIONNAIRE. - A SERIES OF COMMUNITY FOCUS GROUPS. THESE DISCUSSION GROUPS CONSISTED OF MACON RESIDENTS REPRESENTING IMPORTANT COMMUNITY PERSPECTIVES, SUCH AS SENIOR CITIZENS, STUDENTS, THE LATINO COMMUNITY, HIGHLANDS RESIDENTS, AND PRIVATE BUSINESSES. - INTERVIEWS WITH SELECTED COMMUNITY LEADERS WITH PERSPECTIVES ON HEALTH. |
| ANGEL MEDICAL CENTER, INC. | PART V, SECTION B, LINE 6A: REGIONAL PARTNERSHIP:ANGEL MEDICAL CENTER'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 CAROLINAREGION 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. |
| ANGEL MEDICAL CENTER, INC. | PART V, SECTION B, LINE 6B: MACON COUNTY DEPARTMENT OF PUBLIC HEALTH |
| ANGEL MEDICAL CENTER, INC. | PART V, SECTION B, LINE 22D: THE ORGANIZATION USED THE LOOK-BACK METHOD IN DETERMINING AGB FOR ANY EMERGENCY OR OTHER MEDICALLY NECESSARY CARE IT PROVIDES TO A FAP-ELIGIBLE INDIVIDUAL. THE AGB PERCENTAGE WAS BE CALCULATED ANNUALLY BY DIVIDING THE SUM OF ALL CLAIMS FOR EMERGENCY AND MEDICALLY NECESSARY CARE THAT HAVE BEEN PAID IN FULL DURING A PRIOR 12-MONTH PERIOD BY THE SUM OF THE ASSOCIATED GROSS CHARGES FOR THOSE CLAIMS. CLAIMS PAID INCLUDE CLAIMS PAID BY BOTH MEDICARE FEE-FOR-SERVICE AND ALL PRIVATE HEALTH INSURERS AS PRIMARY PAYERS, TOGETHER WITH ANY ASSOCIATED PORTIONS OF THESE CLAIMS PAID BY MEDICARE BENEFICIARIES OR INSURED INDIVIDUALS IN THE FORM OF CO-PAYMENTS, CO-INSURANCE OR DEDUCTIBLES. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 11 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (11 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - ANGEL URGENT CARE | ||||
| 195 FRANKLIN PLAZA DRIVE | FRANKLIN | NC | 28734 | RURAL HEALTH CLINIC |
| 2 - ANGEL PHYSICIAN PRACTICES | ||||
| MEDICAL PARK DRIVE | FRANKLIN | NC | 28734 | PHYSICIAN CLINIC |
| 3 - MISSION WOMEN'S CARE SYLVA | ||||
| 111 CENTRAL ST | SYLVA | NC | 28779 | PHYSICIAN CLINIC |
| 4 - CARDIAC REHAB AT ANGEL MEDICAL CENTER | ||||
| 55 MEDICAL PARK DR | FRANKLIN | NC | 28734 | REHABILITATION |
| 5 - ANGEL ORTHOPAEDICS | ||||
| 56 MEDICAL PARK DR | FRANKLIN | NC | 28734 | ORTHOPAEDICS |
| 6 - ANGEL PEDIATRICS | ||||
| 56 MEDICAL PARK DR | FRANKLIN | NC | 28734 | PEDIATRICS |
| 7 - ANGEL SURGICAL ASSOCIATES | ||||
| 121 RIVERVIEW ST | FRANKLIN | NC | 28734 | OUTPATIENT |
| 8 - ANGEL PRIMARY CARE | ||||
| 190 RIVERVIEW ST | FRANKLIN | NC | 28734 | PHYSICIAN CLINIC |
| 9 - ANGEL REHAB CENTER | ||||
| 834 DEPOT ST | FRANKLIN | NC | 28734 | REHABILITATION |
| 10 - COUMADIN CLINIC | ||||
| 834 DEPOT ST | FRANKLIN | NC | 28734 | OUTPATIENT |
| 11 - ANGEL INFUSION CENTER | ||||
| 834 DEPOT ST | FRANKLIN | NC | 28734 | INFUSION |
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 7: | THE NCHA ANDI REPORTS WERE USED 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: | COMMUNITY SUPPORT: AMC IS VERY INVOLVED WITH HEALTH PROMOTION IN THE SURROUNDING AREA. IN 2016, VOLUNTEERS FROM AMC SERVED ON BOARDS AND COMMITTEES THAT HELP IMPROVE THE OVERALL HEALTH IN MACON COUNTY. ORGANIZATIONS SERVED INCLUDED THOSE HELPING BATTERED WOMEN AND CHILDREN, MENTAL HEALTH PROVIDERS, AND THE MACON COUNTY PUBLIC HEALTH DEPARTMENT. AMC ALSO ORGANIZES MULTIPLE BLOOD DRIVES EACH YEAR AND CONTINUES TO BE A RED CROSS DONOR SITE. COALITION BUILDING: ANGEL MEDICAL CENTER HAS AN ACTIVE COMMUNITY RELATIONS BOARD THAT MEETS REGULARLY TO DISCUSS THE HOSPITAL AND ITS RELATIONSHIP TO THE COMMUNITY. EMPLOYEES PARTICIPATE IN VARIOUS POLICY COUNCILS IN THE COUNTY SUCH AS MACON PROGRAM FOR PROGRESS THAT ADDRESSES THE NEEDS OF UNDERPRIVILEGED CHILDREN. COMMUNITY HEALTH IMPROVEMENT ADVOCACY: REPRESENTATIVES FROM PUBLIC RELATIONS AND COMMUNITY EDUCATION ON PLANNING BOARDS AND COMMITTEES MEET TO PROMOTE HEALTHY LIVING IN MACON COUNTY. SUCH PROGRAMS INCLUDE LIGHTEN UP FOR LIFE, COMMUNITY HEALTH PLANNING AND AN AMERICAN CANCER SOCIETY STUDY, ALL OF THESE PROMOTE A HEALTHIER LIFESTYLE TO HELP PREVENT POTENTIAL HEALTH PROBLEMS IN HIGH RISK INDIVIDUALS. WORKFORCE DEVELOPMENT: VOLUNTEERS FROM NURSING AND ALLIED HEALTH DEPARTMENTS PARTICIPATE ANNUALLY IN A PROGRAM WITH THE LOCAL HIGH SCHOOL AND COMMUNITY COLLEGE THAT ALLOWS STUDENTS FROM HEALTH OCCUPATIONS CLASSES TO OBSERVE AND LEARN FROM ACTUAL EXPERIENCE RATHER THAN JUST CLASS ROOM ACTIVITIES. |
| 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 ARE NOTIFIED USING THE PROCESS DESCRIBED IN THE EDUCATION OF PATIENTS' ELIGIBILITY IN PART VI, ON LINE 3. |
| PART VI, LINE 2: | ANGEL MEDICAL CENTER PARTICIPATES IN A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) EVERY THREE YEARS, WITHT HE MOST RECENT ASSESSMENT COMPLETED IN 2015. |
| PART VI, LINE 3: | THE CURRENT INDIGENT CARE POLICY IS POSTED AT THE REGISTRATION AREAS. PATIENTS ARE ENCOURAGED TO SPEAK WITH A PATIENT COUNSELOR TO SEEK FINANCIAL ASSISTANCE. |
| PART VI, LINE 4: | ANGEL MEDICAL CENTER SERVES MACON COUNTY, NC WITH A POPULATION OF APPROXIMATELY 32,600, 23.8% OF WHICH ARE OVER THE AGE 65, 21.3% OF WHICH ARE BELOW POVERTY LEVEL AND 6.1% OF WHICH ARE UNEMPLOYED. THE AVERAGE ANNUAL HOUSEHOLD INCOME IS ALMOST $38,000. THE ETHNIC DEMOGRAPHICS OF THE AREA INCLUDE 6.6% HISPANIC POPULATION, 1.3% AFRICAN AMERICAN POPULATION AND OTHER MINORITY POPULATIONS TOTALING 4.9%. THESE STATISTICS ARE ACCORDING TO THE US CENSUS BUREAU AND THE EMPLOYMENT SECURITIES COMMISSION OF NC. |
| PART VI, LINE 5: | SEE PROGRAM SERVICES ACCOMPLISHMENTS ON PAGE 2 OF THE 990. |
| PART VI, LINE 6: | ANGEL MEDICAL CENTER 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.BLUE RIDGE REGIONAL HOSPITAL SERVES AS A COMMUNITY HOSPITAL IN MITCHELL, YANCEY AND SURROUNDING COUNTIES.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 OF 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.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 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DAVID FRANKS MD | ||||||||||||||
| BOARD MEMBER | $0 | $242,991 | $0 | $162 | $0 | $2,193 | $0 | $1,056 | $0 | $9,881 | $0 | $256,283 | $0 | $0 |
| CHUCK TRENTHAM MD | ||||||||||||||
| BOARD MEMBER | $168,069 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $168,069 | $0 | $0 | $0 |
| ROBERT BEDNAREK | ||||||||||||||
| BOARD MEMBER | $0 | $242,967 | $0 | $0 | $0 | $79,399 | $0 | $9,960 | $0 | $23,222 | $0 | $355,548 | $0 | $30,791 |
| LADSON GADDY-DUBAC MD | ||||||||||||||
| BOARD MEMBER | $44,690 | $204,592 | $0 | $162 | $10,267 | $4,926 | $1,356 | $5,250 | $1,421 | $5,968 | $57,734 | $220,898 | $0 | $0 |
| KATHY GUYETTE | ||||||||||||||
| BOARD MEMBER | $0 | $360,580 | $0 | $142,400 | $0 | $40,155 | $0 | $66,890 | $0 | $12,139 | $0 | $622,164 | $0 | $34,027 |
| MARK NAKAGAWA | ||||||||||||||
| REG DIR - FIN UNTIL MAR 2016 | $0 | $138,610 | $0 | $24,270 | $0 | $1,142 | $0 | $5,940 | $0 | $23,992 | $0 | $193,954 | $0 | $0 |
| SHEILA PRICE | ||||||||||||||
| CHIEF NURSING OFFICER | $54,284 | $0 | $0 | $0 | $104,064 | $0 | $1,639 | $0 | $3,737 | $0 | $163,724 | $0 | $0 | $0 |
| AMOS HADDOCK MD | ||||||||||||||
| PHYSICIAN | $0 | $373,260 | $0 | $16,853 | $0 | $5,059 | $0 | $15,900 | $0 | $16,478 | $0 | $427,550 | $0 | $0 |
| GILBERTO ROBLES MD | ||||||||||||||
| PHYSICIAN | $90,515 | $324,905 | $0 | $162 | $34,167 | $2,977 | $1,343 | $5,640 | $4,101 | $17,712 | $130,126 | $351,396 | $0 | $0 |
| TRAVIS PETRICEK MD | ||||||||||||||
| PHYSICIAN | $68,674 | $274,192 | $0 | $162 | $56,565 | $233 | $1,343 | $5,640 | $1,568 | $6,491 | $128,150 | $286,718 | $0 | $0 |
| LAURA VERDE MD | ||||||||||||||
| PHYSICIAN | $0 | $370,927 | $0 | $16,853 | $0 | $1,112 | $0 | $10,600 | $0 | $16,025 | $0 | $415,517 | $0 | $0 |
| MICHAEL KEGAN MD | ||||||||||||||
| PHYSICIAN | $0 | $365,438 | $0 | $16,853 | $0 | $52,585 | $0 | $15,181 | $0 | $16,667 | $0 | $466,724 | $0 | $0 |
| JAMES BROSS | ||||||||||||||
| FORMER CEO | $0 | $144,353 | $0 | $44,591 | $0 | $152,482 | $0 | $5,700 | $0 | $8,885 | $0 | $356,011 | $87,670 | $87,670 |
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 | OFFICERS AS WELL AS KEY EMPLOYEES AND TOP FIVE HIGHEST COMPENSATED EMPLOYEES WHO RECEIVED SEVERANCE PAYMENTS. JIM BROSS $63,692 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 $53,640 JIM BROSS $16,540 OFFICERS AS WELL AS KEY EMPLOYEES AND TOP FIVE HIGHEST COMPENSATED EMPLOYEES WHO RECEIVED PAYMENTS FROM A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN. KATHY GUYETTE $34,027 JIM BROSS $87,670 ROBERT BEDNAREK $30,791 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 7A | MISSION HEALTH SYSTEM, INC. A NORTH CAROLINA NONPROFIT CORPORATION, HAS THE RIGHT TO APPOINT UP TO SEVEN MEMBERS OF THE GOVERNING BODY. |
| 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/CEO, (J) THE OPTION TO REMOVE THE PRESIDENT/CEO. |
| FORM 990, PART VI, SECTION B, LINE 11 | THE ORGANIZATION PROVIDES DATA TO THE SENIOR TREASURY ANALYST OF 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 BOARD OF DIRECTORS CIRCULATES A CONFLICT OF INTEREST POLICY ANNUALLY, REQUIRING ALL VOTING BOARD MEMBERS TO REVIEW, SIGN, AND RETURN. MEMBERS PRESENTING A POTENTIAL CONFLICT OF INTEREST RECUSE THEMSELVES BEFORE ANY DISCUSSION OR VOTE ON A TOPIC THAT INCLUDES AN INTERESTED PARTY OR TRANSACTION. |
| 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 REVISES 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 AND CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST AT THE ORGANIZATION'S ADMINISTRATIVE OFFICE. ANGEL MEDICAL CENTER'S FY 2015 AUDITED FINANCIAL STATEMENTS ARE ATTACHED TO THIS RETURN. |
| FORM 990, PART IX, LINE 11G | CONTRACT LABOR: PROGRAM SERVICE EXPENSES 12,406,749. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 12,406,749. INTERCOMPANY FEES: PROGRAM SERVICE EXPENSES 1,806,774. MANAGEMENT AND GENERAL EXPENSES 123,602. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,930,376. OTHER FEES: PROGRAM SERVICE EXPENSES 678,029. MANAGEMENT AND GENERAL EXPENSES 46,384. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 724,413. OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 544,158. MANAGEMENT AND GENERAL EXPENSES 37,226. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 581,384. |
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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| ANGEL MEDICAL CENTER AUXILIARY INC | |||||||||||
| PO BOX 1209 | FRANKLIN | NC | 28744 | 562133719 | SUPPORTING ORGANIZATION | NC | 501(C)(3) | LINE 11A, I | ANGEL MEDICAL CENTER 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 MEDICAL ASSOCIATES INC | |||||||||||
| 400 RIDGEFIELD COURT SUITE 100 | ASHEVILLE | NC | 28806 | 263627231 | EMPLOYED PHYSICIAN GROUP | 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 | |
| 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 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 | |
| BLUE RIDGE REGIONAL HOSPITAL INC | |||||||||||
| P O BOX 9 | SPRUCE PINE | NC | 28777 | 561025032 | COMMUNITY HOSPITAL | NC | 501(C)(3) | LINE 3 | MISSION HEALTH SYSTEM INC | 0 | |
| BLUE RIDGE REGIONAL HOSPITAL FOUNDATION | |||||||||||
| PO BOX 247 | SPRUCE PINE | NC | 28777 | 582172660 | FOUNDATION | NC | 501(C)(3) | LINE 11A, I | BLUE RIDGE REGIONAL 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 | |
| TRANSYLVANIA PHYSICIAN SERVICES INC | |||||||||||
| 260 HOSPITAL DRIVE | BREVARD | NC | 28712 | 561920816 | PHYSICIAN SERVICES | NC | 501(C)(3) | LINE 3 | TRANSYLVANIA COMMUNITY HOSPITAL 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 | |
| COMMUNITY CAREPARTNERS INC | |||||||||||
| PO BOX 5779 | ASHEVILLE | NC | 28813 | 562005198 | LONG TERM REHABILITATION | NC | 501(C)(3) | LINE 9 | 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 11A, I | HIGHLANDS-CASHIERS HOSPITAL INC | 0 | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (16 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|
| ASHEVILLE IMAGING LLP | |||||||
| 534 BILTMORE AVENUE | ASHEVILLE | NC | 28801 | 561907201 | MEDICAL IMAGING SERVICES | NC | N/A |
| ASHEVILLE MRI | |||||||
| PO BOX 2959 | ASHEVILLE | NC | 28802 | 561665863 | IMAGING SERVICES | NC | N/A |
| BLUE RIDGE DME LLC | |||||||
| 125 HOSPITAL DRIVE | SPRUCE PINE | NC | 28777 | 263570174 | HOME MEDICAL EQUIPMENT AND SUPPLIES SALES | NC | N/A |
| BLUE RIDGE-TKC LLC | |||||||
| 5935 CARNEGIE BLVD | CHARLOTTE | NC | 28209 | 471382912 | REAL ESTATE RENTAL | NC | N/A |
| 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 RANKING DRIVE | MARION | NC | 28752 | 753046378 | MEDICAL IMAGING | NC | N/A |
| MSJHS AND CCP JOINT DEVELOPMENT COMPANY LLC | |||||||
| 428 BILTMORE AVENUE | ASHEVILLE | NC | 28801 | 562250464 | LONG TERM ACUTE CARE HOSPITAL | NC | N/A |
| SPRUCE PINE HEALTHCARE LLC | |||||||
| 5935 CARNEGIE BLVD | CHARLOTTE | NC | 28209 | 471390107 | REAL ESTATE | NC | N/A |
| TRANSYLVANIA HEALTHCARE II LIMITED PARTNERSHIP | |||||||
| 2 MEDICAL PARK DRIVE | BREVARD | NC | 28712 | 200333230 | RENTAL | NC | N/A |
| WESTERN NC HEALTHCARE INNOVATORS III LLC | |||||||
| 5935 CARNEGIE BLVD | CHARLOTTE | NC | 28209 | 464053310 | REAL ESTATE 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 |
| BREVARD MRI AT TRANSYLVANIA COMMUNITY HOSPITAL LLC | |||||||
| 260 HOSPITAL DRIVE | BREVARD | NC | 28712 | 203281110 | MEDICAL IMAGING | NC | N/A |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd | Address Line1ForeignAddress/AddressLine1Txt | CityForeignAddress/CityNm | CountryForeignAddress/CountryCd | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MISSION VENTURES INC | |||||||||||||
| 400 RIDGEFIELD COURT SUITE 100 | ASHEVILLE | NC | 28806 | 561341621 | DISSOLVED SEPTEMBER 7, 2016 | NC | N/A | C | 0 | ||||
| DOGWOOD INSURANCE COMPANY LTD | |||||||||||||
| CAPTIVE INSURANCE ENTITY | N/A | C | 0 | THEGRANDPAVILIONCOMMERCIALCENTREPOB | GRAND CAYMAN | CJ | CJ | ||||||
| TRANSYLVANIA SERVICES INC | |||||||||||||
| 260 HOSPITAL DRIVE | BREVARD | NC | 28712 | 561448199 | REAL ESTATE | NC | N/A | C | 0 | ||||
| MISSION HEALTH PARTNERS INC | |||||||||||||
| 509 BILTMORE AVENUE | ASHEVILLE | NC | 28801 | 465566095 | CLINICALLY INTEGRATED NETWORK | NC | N/A | C | 0 | ||||
| HEALTHY STATE INC | |||||||||||||
| 509 BILTMORE AVENUE | ASHEVILLE | NC | 28801 | 812108613 | ADMINISTRATIVE | NC | N/A | C | 0 | ||||
| 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 | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |
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