2016-08-15T16:08:08-05:00 2015-09-30 990 2014-10-01 560562293 TRANSYLVANIA COMMUNITY HOSPITAL INC TRAN 8288849111 PO BOX 1116 BREVARD NC 28712 THERESA PARKER REGIONAL DIRECTOR OF FINANCE 8288849111 2016-08-15 2014 2016-09-27 15:27:22Z TRANSYLVANIA REGIONAL HOSPITAL PO BOX 1116 BREVARD NC 28712 68995063 0 X HTTP://WWW.MISSION-HEALTH.ORG/ABOUT-TRANSYLVANIA- X 1933 NC PROVISION OF MEDICAL SERVICES 14 10 603 140 14163 12138 698038 1950466 64065380 66114418 968708 776133 338408 154046 66070534 68995063 36165 478891 0 0 31991413 30588662 0 0 0 29832931 31691528 61860509 62759081 4210025 6235982 78766658 79135375 25323692 20461796 53442966 58673579 X TRANSYLVANIA COMMUNITY HOSPITAL PROMOTES WELLNESS AND PROVIDES ACCESS TO QUALITY HEALTH SERVICES FOR THE PEOPLE IN THE REGION. 0 0 48762961 478891 66100255 GIVING BACK TO THE COMMUNITY.AS A NOT-FOR-PROFIT HOSPITAL, THE ORGANIZATION IS COMMITTED TO GIVING BACK TO THE COMMUNITY HELPING THOSE WHO ARE UNINSURED OR UNDERINSURED AS WELL AS PROVIDING HEALTH EDUCATION AND BENEFITS FOR THE WELL BEING OF THE ENTIRE COMMUNITY. - THE ORGANIZATION OFFERS FREE OR LOW-COST EDUCATIONAL PROGRAMS FOR THE COMMUNITY EACH MONTH. PROGRAMS FEATURE TIMELY HEALTH TOPICS, AND ARE PRESENTED BY PHYSICIANS, NURSES, NURSE EDUCATORS, DIETITIANS AND OTHER CLINICAL PROFESSIONALS. - THE ORGANIZATION OFFERS HEALTHCARE SERVICES THAT ARE NEEDED BY THIS COMMUNITY, REGARDLESS OF WHETHER OR NOT A MARGIN IS ACHIEVED BY PROVIDING CARE. EXAMPLES INCLUDE: EMERGENCY SERVICES AND BIRTHING CENTER.- THE ORGANIZATION WAS AN ACTIVE PARTICIPANT IN THE 16-COUNTY REGIONAL HEALTH NEEDS ASSESSMENT PROJECT: WNC HEALTHY IMPACT. THIS INNOVATIVE EFFORT HELPED TRANSYLVANIA TEAM WITH HEALTH DEPARTMENTS AND HOSPITALS ACROSS WESTERN NORTH CAROLINA TO IDENTIFY CRITICAL COMMUNITY HEALTH NEEDS AND PUT RESOURCES WHERE THEY ARE MOST NEEDED TO IMPROVE THE HEALTH AND LIVES OF RESIDENTS IN THIS COMMUNITY AND ACROSS THE REGION. TRANSYLVANIA WORKED CLOSELY WITH THE TRANSYLVANIA COUNTY DEPARTMENT OF PUBLIC HEALTH TO DEVELOP A COMMUNITY HEALTH NEEDS ASSESSMENT FOR TRANSYLVANIA COUNTY.- THE ORGANIZATION CONTINUED A CARE MANAGEMENT PROGRAM FOR COPD PATIENTS IN OUR COMMUNITY SUPPORTED BY GRANT FUNDING.- THE ORGANIZATION ALONG WITH THE TRANSYLVANIA COUNTY HEALTH DEPARTMENT, THE FREE CLINIC AND OTHERS-WORKED COLLABORATIVELY TO BRING A BLUE RIDGE COMMUNITY HEALTH SERVICES CLINIC TO OUR LOCAL COMMUNITY. THE BREVARD HEALTH CENTER WAS OPENED TO INCREASE ACCESS TO AFFORDABLE, COMPREHENSIVE HEALTH SERVICES IN TRANSYLVANIA COUNTY. THIS FEDERAL HEALTH CENTER OFFERS A FULL SPECTRUM OF HEALTH SERVICES TO RESIDENTS, INCLUDING PRIMARY CARE FOR ADULTS AND CHILDREN, DENTAL SERVICES, MEDICATION ASSISTANCE AND BEHAVIORAL HEALTH.- THE ORGANIZATION IMPLEMENTED A PALLIATIVE CARE PROGRAM WITH SUPPORT FROM THE TRANSYLVANIA REGIONAL HOSPITAL FOUNDATION TO MEET THE INCREASING NEEDS FOR THIS SERVICE IN OUR COMMUNITY. THIS LOCAL SERVICE PROVIDES COMPASSIONATE, EXPERT MEDICAL CARE TO RELIEVE AND PREVENT THE SUFFERING OF PATIENTS IN OUR COMMUNITY WHO ARE UNDERGOING TREATMENT FOR CURABLE ILLNESSES AND THOSE LIVING WITH CHRONIC DISEASES, AS WELL AS PATIENTS WHO ARE NEARING THE END OF LIFE. 48762961 1 1 0 0 0 0 0 0 0 1 1 0 1 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 1 X 0 0 603 1 1 1 0 0 0 0 0 0 0 0 0 X 14 10 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 NC X MISSION FINANCE DEPARTMENT 8282577063 400 RIDGEFIELD CT STE 100 ASHEVILLE NC 28806 JOHN HOLBROOK CHAIRMAN 10.00 X X 0 0 0 ROSWELL BOWERS VICE-CHAIRMAN/TREASURER 4.00 X X 0 0 0 PARKER PLATT SECRETARY 2.00 X X 0 0 0 G RUFFIN BENTON III MD BOARD MEMBER 1.00 X 0 0 0 RICHARD BOCK MD BOARD MEMBER 1.00 8.00 X 0 0 0 DANA CHRISTIANSON MD BOARD MEMBER 1.00 X 0 0 0 JOE COHEN MD CHIEF OF STAFF 3.00 0.00 X 0 0 0 KATHY GUYETTE BOARD MEMBER 1.00 59.00 X 0 392403 68958 ANN YOUNG BOARD MEMBER 1.00 59.00 X 0 517481 28495 CATHY LANDIS PRESIDENT AND CNO 50.00 3.00 X X 107921 0 5135 MARK LEMEL MD VICE CHIEF OF STAFF 10.00 40.00 X 0 511685 24508 JAMES CRUICKSHANK BOARD MEMBER 1.00 X 0 0 0 KENNETH RACHT BOARD MEMBER 1.00 2.00 X 0 0 0 ORA WELLS MD BOARD MEMBER 1.00 X 0 0 0 MARC NAKAGAWA REGIONAL DIRECTOR - FINANCE 24.00 26.00 X 135357 0 29937 CRAIG JAMES INTERIM CEO THROUGH DEC 2014 4.00 36.00 X 0 354309 52417 REBECCA CARTER COO THROUGH DEC 2014 1.00 49.00 X 0 189617 17803 ELIZABETH PELLETIER CRNA 40.00 X 177540 0 27668 LAUREL JOHNSON CRNA 40.00 X 175847 0 13812 MARK EMORY DIRECTOR 40.00 X 136954 0 10154 JOSEPH ROMESBURG PHARMACIST 40.00 X 134301 0 19637 MARK CREASMAN PHARMACIST 40.00 X 181585 0 22205 ROBERT BEDNAREK FORMER CEO 0.00 40.00 X 0 360131 28205 1049505 2325626 348934 14 1 1 0 0 1803137 92057 55272 1950466 NET PATIENT SERVICE REVENUE 621400 57704721 57704721 OTHER REVENUE 621610 8409697 8395534 14163 66114418 135918 135918 12710 0 12710 12710 12710 515739 124476 0 0 515739 124476 640215 640215 PARTNERSHIP INCOME IN BREVARD MRI 900099 141336 141336 141336 68995063 66100255 14163 930179 X 478891 478891 26660363 19218629 7441734 309468 215749 93719 2421995 1688519 733476 1196836 834387 362449 2911637 2267508 644129 14320 14320 20813 20813 40937 40937 8058511 7545063 513448 12944 549 12395 245227 162958 82269 382410 229446 152964 1911927 1625138 286789 47410 24598 22812 106715 90708 16007 2935772 2495406 440366 1020067 1020067 PHARMACEUTICALS 6077560 5165926 911634 MEDICAL SUPPLIES 4903666 4168116 735550 MAINTENANCE 1825626 1551782 273844 EQUIPMENT 642598 546208 96390 533388 453380 80008 62759081 48762961 13996120 0 5493828 7164738 824735 907368 8284141 10634181 1739013 1503309 1446912 99425 54674 36481630 7559955 32194097 28921675 6184048 5779975 3616345 3601465 16232001 16396546 2595716 4227841 78766658 79135375 4484428 4196483 9154 12860000 12023224 1456783 0 6522481 4232935 25323692 20461796 X 37762018 42992631 14058404 14058404 1622544 1622544 53442966 58673579 78766658 79135375 X 6235982 -1006191 822 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 14390788 11515 569275 1612246 13359332 14115217 280750 182293 187472 14390788 6044727 8353318 460965 743793 14115217 0.86000 0.13000 0.01000 0 1 1 7111000 7111000 19803975 4194717 15609258 5700 2850 2850 8030566 2651681 5378885 1530389 710707 819682 28921675 INTEREST IN NET ASSETS OF TRANSYLVANIA REGIONAL HOSPITAL FOUNDATION 15680947 C INTEREST IN TRANSYLVANIA HOSPITAL IMAGING SERVICES, LLC. 643167 C INTEREST IN BLUE RIDGE DME 54432 C INTEREST IN TRANSYLVANIA SERVICES, INC. 18000 C 16396546 BOND ISSUE COSTS, NET OF AMORTIZATION 122933 RECEIVABLES FROM AFFILIATED ORGANIZATIONS 2973388 GOODWILL 1131520 4227841 ESTIMATED THIRD PARTY RESERVES 4232935 4232935 X PART V, LINE 4: TRANSYLVANIA REGIONAL HOSPITAL FOUNDATION, INC., A RELATED ORGANIZATION MAINTAINS ENDOWMENTS TO BE USED FOR THE HOSPITAL'S EXEMPT PURPOSE OF PROVIDING HEALTHCARE TO ITS COMMUNITY. ENDOWMENTS ARE MAINTAINED TO ASSIST WITH CHARITABLE HEALTHCARE FUNDING. PART X, LINE 2: 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. 1 1 X 1 X 1 X 1 1 1 0 1 1 1998613 1998613 0.03180 5752492 4277426 1475066 0.02350 7751105 4277426 3473679 0.05530 58448 58448 0.00090 39088 39088 0.00060 97536 97536 0.00150 7848641 4277426 3571215 0.05680 270452 270452 0.00430 270452 270452 0.00430 1 2757980 23026 22529252 21863693 665559 X 1 1 1 1 TRANSYLVANIA REGIONAL HOSPITAL 260 HOSPITAL DRIVE BREVARD NC 28712 WWW.TRHOSPITAL.ORG H0111 X X X X TRANSYLVANIA COMMUNITY HOSPITAL INC 1 0 0 1 X X X X X X X X X 12 1 1 1 1 X SEE PART VI X SEE PART VI X 1 13 1 SEE PART VI 0 0 1 X 200.000000000000 400.000000000000 X X X 1 1 X X X X 1 X HTTPS://WWW.MISSION-HEALTH.ORG/FINANCIAL-ASSISTANCE.PHP X X X X X 1 X 0 X X X X 1 X X X 0 0 TRANSYLVANIA COMMUNITY HOSPITAL, INC. PART V, SECTION B, LINE 5: AFTER GATHERING ALL PUBLICLY AVAILABLE SECONDARY HEALTH DATA FOR THE PRIMARY SERVICE AREA, THE TRANSYLVANIA COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT EMPLOYED A STRATIFIED RANDOM SAMPLE OF 200 RESIDENTS OF TRANSYLVANIA COUNTY, N.C. TO SUPPLEMENT THE SECONDARY CORE DATASET, MEET ADDITIONAL STAKEHOLDER DATA NEEDS, AND HEAR FROM COMMUNITY MEMBERS ABOUT THEIR CONCERNS AND PRIORITIES, A COMMUNITY SURVEY, 2012 WNC HEALTHY IMPACT SURVEY, WAS DEVELOPED AND IMPLEMENTED IN 16 COUNTIES ACROSS WESTERN NORTH CAROLINA. THE SURVEY INSTRUMENT WAS DEVELOPED BY WNC HEALTHY IMPACT'S DATA WORKGROUP, CONSULTING TEAM, AND LOCAL PARTNERS WITH ASSISTANCE FROM PROFESSIONAL RESEARCH CONSULTANTS, INC. (PRC). MANY OF THE QUESTIONS ARE DERIVED FROM THE CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC), BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS), AS WELL AS OTHER PUBLIC HEALTH SURVEYS; OTHER QUESTIONS WERE DEVELOPED SPECIFICALLY FOR WNC HEALTHY IMPACT TO ADDRESS PARTICULAR ISSUES OF INTEREST TO COMMUNITIES IN WESTERN NORTH CAROLINA. EACH COUNTY WAS GIVEN THE OPPORTUNITY TO INCLUDE THREE ADDITIONAL QUESTIONS OF PARTICULAR INTEREST TO THEIR COUNTY, WHICH WERE ASKED OF THEIR COUNTY'S RESIDENTS. TO ENSURE THE BEST REPRESENTATION OF THE POPULATION SURVEYED, A TELEPHONE INTERVIEW METHODOLOGY (ONE THAT INCORPORATES BOTH LANDLINE AND CELL PHONE INTERVIEWS) WAS EMPLOYED. THE SAMPLE DESIGN USED FOR THIS REGIONAL EFFORT CONSISTED OF A STRATIFIED RANDOM SAMPLE OF 3,300 INDIVIDUALS AGE 18 AND OLDER IN WESTERN NORTH CAROLINA. OUR COUNTY'S SAMPLE SIZE WAS 200.THE INTERVIEWS WERE CONDUCTED IN EITHER ENGLISH OR SPANISH, AS PREFERRED BY RESPONDENTS. FOR THE TRANSYLVANIA COUNTY FINDINGS, THE MAXIMUM ERROR RATE IS 6.9%. IN ADDITION, SEVERAL COMMUNITY-WIDE LISTENING SESSIONS WERE CONDUCTED TO HEAR THE COMMUNITY'S CONCERNS AND TO RANK THE COMMUNITY HEALTH PRIORITIES BASED ON THE SURVEY RESULTS. TRANSYLVANIA COMMUNITY HOSPITAL, INC. PART V, SECTION B, LINE 6A: REGIONAL PARTNERSHIP:TRANSYLVANIA REGIONAL HOSPITAL'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. TRANSYLVANIA COMMUNITY HOSPITAL, INC. PART V, SECTION B, LINE 6B: TRANSYLVANIA COUNTY DEPARTMENT OF PUBLIC HEALTH TRANSYLVANIA COMMUNITY HOSPITAL, INC. PART V, SECTION B, LINE 20E: INFORMATION ABOUT THE HOSPITAL'S FINANICAL ASSISTANCE IS AVAILABLE ONLINE. THE FINANCIAL ASSISTANCE PROGRAM IS REVIEWED WITH PATIENTS DURING FINANCIAL COUSELING WITH PATIENTS WHILE IN THE HOSPITAL, DURING PROACTIVE OUTBOUND CALLS, AND IN DURING INCOMING CALLS TO THE BUSINESS OFFICE CUSTOMER SERVICE DEPARTMENT. TRANSYLVANIA COMMUNITY HOSPITAL, INC. PART V, SECTION B, LINE 22D: IT IS THE INTENT OF THIS POLICY THAT ALL UNINSURED PATIENTS QUALIFYING UNDER THE POLICY WILL RECEIVE A DISCOUNT EQUIVALENT TO THE DISCOUNT RECEIVED BY MEDICARE AND COMMERCIALLY INSURED PATIENTS. THIS MINIMUM DISCOUNT LEVEL FOR UNINSURED PATIENTS IS CALCULATED AT LEAST ANNUALLY BY DIVIDING THE SUM OF ALL MEDICARE AND COMMERCIAL INSURANCE PAYMENTS FOR EMERGENCY AND OTHER MEDICALLY NECESSARY CARE FROM CLAIMS THAT HAVE BEEN PAID IN FULL, BY THE SUM OF THE ASSOCIATED GROSS CHARGES FOR THOSE CLAIMS. PART V SECTION B LINE 7A WWW.MISSION-HEALTH.ORG/ABOUT-TRANSYLVANIA-REGIONAL-HOSPITAL.PHP PART V SECTION B LINE 7B HTTPS://WWW.MISSION-HEALTH.ORG/COMMUNITY-HEALTH-NEEDS-ASSESSMENT.PHP PART V SECTION B LINE 10A HTTPS://WWW.MISSION-HEALTH.ORG/COMMUNITY-HEALTH-NEEDS-ASSESSMENT.PHP PART V, SECTION B, LINE 16 FINANCIAL ASSISTANCE POLICY WEBSITE AVAILABILITY TRANSYLVANIA COMMUNITY HOSPITAL, INC. PART V, SECTION B, LINE 16C WEBSITE: HTTPS://WWW.MISSION-HEALTH.ORG/FINANCIAL-ASSISTANCE.PHP 9 TRH OUTPATIENT REHABILITATION 92 CHESTNUT STREET BREVARD NC 28712 OUTPATIENT REHAB TOXAWAY HEALTH CENTER 16825 ROSMAN HWY LAKE TOXAWAY NC 28747 PROVIDER-BASED CLINICS BREVARD FAMILY PRACTICE 187 MEDICAL PARK DR BREVARD NC 28712 PROVIDER-BASED CLINICS MEDICAL ASSOCIATES OF TRH 377 GALLIMORE ROAD BREVARD NC 28712 PROVIDER-BASED CLINICS BREVARD INTERNAL MEDICINE & PULMONOLOGY 159 MEDICAL PARK DR SUITE B BREVARD NC 28712 PROVIDER-BASED CLINICS KOALA 23 MEDICAL PARK CIRCLE BREVARD NC 28712 OUTPATIENT BREVARD CANCER & INFUSION CENTER 89 HOSPITAL DR BREVARD NC 28712 OUTPATIENT TRANSYLVANIA HOSPITAL IMAGING SERVICES 301 HOSPITAL DRIVE BREVARD NC 28712 MEDICAL IMAGING BREVARD MRI 301 HOSPITAL DRIVE BREVARD NC 28712 MEDICAL IMAGING PART I, LINE 7: THE ORGANIZATION 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: THE ORGANIZATION PARTICIPATES IN COALITION BUILDING IN THE COMMUNITY AND STATE TO HELP ADVOCATE THE HEALTH NEEDS OF OUR AREA. THROUGH PARTICIPATION, THE HOSPITAL GUARANTEES A FOCUSED DISCUSSION ON THE HEALTH CARE ISSUES THAT DIRECTLY IMPACT TRANSYLVANIA COUNTY. PART III, LINE 2: BAD DEBT EXPENSE IS COMPLETED AT THE ESTIMATED COST TO PROVIDE THE SERVICES WHICH WERE UNCOLLECTIBLE. CHARITABLE DISCOUNTS AND OTHER DISCOUNTS DECREASE NET PATIENT REVENUE AS REPORTED ON PAGE 9 OF THE CORE FORM OF THE 990. RECOVERIES OF PREVIOUS BAD DEBT WRITTEN OFF ARE NETTED AGAINST BAD DEBT EXPENSE BEFORE REDUCING TO COST BASIS. 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 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 III LINE 3 THE AMOUNT OF THE ORGANIZATION'S BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY WAS ESTIMATED USING PATIENTS WITH BAD DEBTS FOR MEDICAL BILLS DURING THE FISCAL YEAR WHO ALSO RECEIVED FINANCIAL ASSISTANCE FOR 100% OF THEIR MEDICAL BILLS IN ANOTHER PART OF THE FISCAL YEAR. THE AMOUNT ON LINE 3 IS THE ESTIMATED COST OF PROVIDING THE SERVICES WRITTEN OFF AS BAD DEBTS. PART VI, LINE 2: THE ORGANIZATION USES MULTIPLE TOOLS TO ASSESS THE CURRENT AND FUTURE HEALTH CARE NEEDS OF THE COMMUNITY IT SERVES INCLUDING: - CONDUCTING ENVIRONMENTAL ASSESSMENTS- REVIEWING MARKET SHARE DATA FOR EXISTING SERVICES - COMPILING A MEDICAL STAFF DEVELOPMENT PLAN EVERY TWO YEARS THAT ASSESSES PHYSICIAN NEED PER POPULATION ADJUSTED FOR DEMOGRAPHICS. ALSO, TRH ACTIVELY PARTICIPATES IN THE TRANSYLVANIA COUNTY HEALTH DEPARTMENT'S REQUIRED ASSESSMENT OF HEALTH NEEDS EVERY THREE YEARS. IN FY 2012, TRH BEGAN EXTENSIVE PLANNING WITH THE LOCAL HEALTH DEPARTMENT TO CONDUCT A FORMAL COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). A DETAILED SURVEY AND COMPILATION OF PRIMARY AND SECONDARY HEALTH DATA FOR TRANSYLVANIA COUNTY, N.C., WAS COMPLETED IN FALL 2012. THE FINDINGS OF THIS CHNA, ALONG WITH EXTENSIVE COMMUNITY INPUT SESSIONS, WERE USED BY TRH IN FISCAL YEAR 2014 TO IDENTIFY THE PRIORITY HEALTH ISSUES IN TRANSYLVANIA COUNTY. IN SEPTEMBER 2014, THE BOARD OF TRUSTEES FORMALLY ADOPTED THE FOLLOWING HEALTH ISSUES AS PRIORITIES FOR THE COMMUNITY SERVED: 1) OBESITY 2) DENTAL HEALTH 3) MENTAL HEALTH/SUBSTANCE ABUSE 4) AGING POPULATION. PART VI, LINE 3: THE ORGANIZATION PLACES SIGNAGE FOR ITS PATIENT FINANCIAL ASSISTANCE POLICIES IN PATIENT AREAS IN THE HOSPITAL, IN THE PATIENT ACCOUNTING OFFICE, AND THE PATIENT REGISTRATION AREA. AT THE POINT OF REGISTRATION AND PRE-REGISTRATION, PATIENTS ARE NOTIFIED OF THE PATIENT FINANCIAL ASSISTANCE POLICY. IN THE PATIENT ACCOUNTING OFFICE, THE AVAILABLE FINANCIAL ASSISTANCE PROGRAMS ARE VERBALLY COMMUNICATED BY FINANCIAL COUNSELORS TO PATIENTS WHO MIGHT BE ELIGIBLE. BILLING STATEMENTS ARE PRINTED WITH INVITATIONS TO SEEK PATIENT FINANCIAL ASSISTANCE THROUGH THE PATIENT ACCOUNTING OFFICE. IN ADDITION TO THIS, THE EMERGENCY DEPARTMENT UTILIZES A HEALTH RESOURCE NAVIGATOR TO HELP FIND FINANCIAL ASSISTANCE RESOURCES FOR SELF-PAY PATIENTS. THE PATIENT FINANCIAL ASSISTANCE POLICY ALSO RESIDES ON THE HOSPITAL'S WEBSITE, HTTP://WWW.TRHOSPITAL.ORG/PATIENTS/FINANCIAL-ASSISTANCE PART VI, LINE 4: THE PRIMARY SERVICE AREA FOR THE ORGANIZATION IS TRANSYLVANIA COUNTY, NORTH CAROLINA, WITH A RESIDENT POPULATION OF 33,000 INCLUDING GLOUCESTER TOWNSHIP IN THE UPPER END OF THE COUNTY, WHICH IS FEDERALLY DESIGNATED AS A MEDICALLY UNDERSERVED AREA. NEARLY 12.5% OF TRANSYLVANIA COUNTY'S TOTAL RESIDENT POPULATION HAVE A HOUSEHOLD INCOME BELOW THE FEDERAL POVERTY LEVEL. TRANSYLVANIA REGIONAL HOSPITAL IS THE ONLY LOCAL HOSPITAL SERVING THIS PRIMARY SERVICE AREA.TRANSYLVANIA REGIONAL HOSPITAL'S SECONDARY COVERAGE AREA INCLUDES 15,000 ADDITIONAL RESIDENTS IN SOUTHERN JACKSON COUNTY, NORTH CAROLINA, INCLUDING THE MEDICALLY UNDERSERVED AREA OF CASHIERS TOWNSHIP, AS WELL AS WESTERN HENDERSON COUNTY, NC WHICH HAS A FEDERALLY DESIGNATED MEDICALLY UNDERSERVED POPULATION OF LOW INCOME, MIGRANT FARM WORKERS. BESIDES TRANSYLVANIA REGIONAL HOSPITAL, THREE ADDITIONAL COMMUNITY HOSPITALS PROVIDE SOME COVERAGE TO THESE 15,000 RESIDENTS IN THE SECONDARY COVERAGE AREA; HOWEVER, TRANSYLVANIA REGIONAL HOSPITAL IS IN MANY CASES THE CLOSEST, MOST READILY ACCESSIBLE PROVIDER OF CARE FOR MANY OF THESE RESIDENTS. PART VI, LINE 5: AS A NOT-FOR-PROFIT HOSPITAL, THE ORGANIZATION IS COMMITTED TO GIVING BACK TO THE COMMUNITY TO HELP THOSE WHO ARE UNINSURED OR UNDERINSURED AS WELL AS PROVIDING HEALTH EDUCATION AND BENEFITS FOR THE WELL BEING OF THE ENTIRE COMMUNITY. FISCAL YEAR 2014 WAS A CHALLENGING YEAR FOR OUR COMMUNITY AS WE EXPERIENCED THE LINGERING EFFECTS OF A DEPRESSED ECONOMY. THIS HAS LEFT MANY IN OUR COMMUNITY WITHOUT HEALTH INSURANCE AND STRUGGLING TO MAKE ENDS MEET. DESPITE CHALLENGING FINANCIAL TIMES FOR THE HOSPITAL, TRH CONTINUED TO GENEROUSLY HELP THOSE IN NEED. IN FISCAL YEAR 2014, TRH PROVIDED $7.5 MILLION IN CONTRIBUTIONS TO THE COMMUNITY. THESE BENEFITS CAME IN MANY FORMS INCLUDING $2.2 MILLION IN CHARITY CARE FOR 3,500 PEOPLE. THE HOSPITAL ALSO PROVIDED ANOTHER $3.6 MILLION IN CARE FOR 4,400 PEOPLE THROUGH NON-COLLECTIBLE SERVICES. AN ADDITIONAL $1.2 MILLION WAS PROVIDED FOR GOVERNMENT SPONSORED HEALTHCARE INCLUDING INDIGENT CARE PROGRAMS. FINALLY, $502,000 WAS PROVIDED FOR COMMUNITY BENEFIT PROGRAMS INCLUDING THE DONATION OF STAFF TIME AND RESOURCES. PART VI, LINE 6: THE ORGANIZATION 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 HEALTHCARE 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.ANGEL MEDICAL CENTER, INC. SERVES AS A COMMUNITY HOSPITAL IN MACON 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 1 TRANSYLVANIA REGIONAL HOSPITAL FOUNDATION INC 223 W JORDAN STREET BREVARD NC 28712 561458024 501(C)(3) 478891 OPERATIONAL ASSISTANCE FUNDRAISING SUPPORT. 1 0 0 1 0 0 0 0 0 0 0 KATHY GUYETTE BOARD MEMBER 0 314800 0 0 0 77603 0 58525 0 10433 0 461361 0 50814 ANN YOUNG BOARD MEMBER 0 359687 0 90000 0 67794 0 18200 0 10295 0 545976 0 0 MARK LEMEL MD VICE CHIEF OF STAFF 0 375677 0 124563 0 11445 0 11016 0 13492 0 536193 0 0 MARC NAKAGAWA REGIONAL DIRECTOR - FINANCE 134252 0 0 0 1105 0 5748 0 24189 0 165294 0 0 0 CRAIG JAMES INTERIM CEO THROUGH DEC 2014 0 229747 0 93991 0 30571 0 37457 0 14960 0 406726 0 0 REBECCA CARTER COO THROUGH DEC 2014 0 177032 0 0 0 12585 0 7137 0 10666 0 207420 0 0 ELIZABETH PELLETIER CRNA 176686 0 0 0 854 0 4519 0 23149 0 205208 0 0 0 LAUREL JOHNSON CRNA 174890 0 0 0 957 0 8824 0 4988 0 189659 0 0 0 JOSEPH ROMESBURG PHARMACIST 133705 0 0 0 596 0 3987 0 15650 0 153938 0 0 0 MARK CREASMAN PHARMACIST 151078 0 0 0 30507 0 6300 0 15905 0 203790 0 0 0 ROBERT BEDNAREK FORMER CEO 0 246193 0 49894 0 64044 0 9735 0 18470 0 388336 0 0 PART I, LINE 3 COMPENSATION FOR OFFICERS AND EXECUTIVES ARE SET BY MISSION HEALTH SYSTEM. SEE SCHEDULE O FOR ADDITIONAL DETAIL. PART I, LINE 4B DIRECTORS, OFFICERS, KEY EMPLOYEES AND TOP FIVE EMPLOYEES WHO PARTICIPATED IN A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN WITH CONTRIBUTION AMOUNTS. THESE AMOUNTS ARE DISCLOSED IN THE DEFERRED COMPENSATION SECTION OF SCHEDULE J. KATHY GUYETTE $45,525 CRAIG JAMES $28,580 DIRECTORS, OFFICERS, KEY EMPLOYEES AND TOP FIVE EMPLOYEES WHO RECEIVED PAYMENTS FROM A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN. THESE PAYMENTS ARE INCLUDED IN OTHER REPORTABLE COMPENSATION ON SCHEDULE J, PAGE 2. KATHY GUYETTE $50,814 CRAIG JAMES $29,248 ROBERT BEDNAREK$ 7,412 A NORTH CAROLINA MEDICAL CARE COMMISSION 521309402 2011-08-24 14655000 CURRENT REFUNDING 0 0 0 A 2620000 14655000 14655000 2006 1 0 1 1 A 0 0 0 0 0 0 1 A 0 0 1 1 1 0 0 0 1 A 1 DATE REBATE COMPUTATION PERFORMED ISSUER NAME: NORTH CAROLINA MEDICAL CARE COMMISSION DATE THE REBATE COMPUTATION WAS PERFORMED: 09/09/2011 SCHEDULE K, PART II, LINE 11, OTHER SPENT PROCEEDS: THE AMOUNT PRESENT ON PART II, LINE 11 REPRESENTS AMOUNTS USED TO CURRENTLY REFUND PRIOR ISSUES DATED NOVEMBER 20, 1997 AND MARCH 9, 2009. SERIES 1997 REFUNDING: $ 2,255,000 SERIES 2009 REFUNDING: 12,400,000 TOTAL TO LINE 11: $ 14,655,000 PART V, LINE 1A THE DISBURSEMENTS OF THE ORGANIZATION ARE PAID BY OF MISSION HEALTH SYSTEM, INC. ITS PARENT COMPANY. THE NUMBER REPORTED ON PART V LINE 1A IS 0 AND ANY 1099'S THAT WOULD OTHERWISE BE ASSOCIATED WITH THE ORGANIZATION ARE INCLUDED ON PART V LINE 1A OF MISSION HEALTH SYSTEM'S 990. FORM 990, PART VI, SECTION A, LINE 1 THE TERM OF OFFICE OF THE ELECTED MEMBER OF THE EXECUTIVE COMMITTEE SHALL BE ONE YEAR OR UNTIL A SUCCESSOR SHALL HAVE BEEN DULY ELECTED BY THE BOARD OF TRUSTEES. ANY VACANCY IN THE POSITION OF THE ELECTED MEMBER OF THE EXECUTIVE COMMITTEE SHALL BE FILLED AS SOON AS POSSIBLE AFTER THE OCCURRENCE OF THE VACANCY. THE EXECUTIVE COMMITTEE SHALL HAVE POWER TO TRANSACT ALL REGULAR BUSINESS OF THE HOSPITAL DURING THE PERIODS BETWEEN MEETINGS OF THE BOARD OF TRUSTEES SUBJECT TO ANY PRIOR LIMITATION IMPOSED BY THE BOARD OF TRUSTEES AND WITH THE UNDERSTANDING THAT ALL MATTERS OF MAJOR IMPORTANCE SHALL, EXCEPT IN EMERGENCY, BE REFERRED TO THE BOARD OF TRUSTEES. MINUTES OF THE EXECUTIVE COMMITTEE MEETINGS WILL BE SUBMITTED TO THE BOARD, AND ITS ACTIONS SHALL BE SUBJECT TO APPROVAL AT THE NEXT REGULAR BOARD MEETING. FORM 990, PART VI, SECTION A, LINE 6 THE HOSPITAL IS A MEMBERSHIP CORPORATION, OF WHICH THE SOLE MEMBER (THE "MEMBER") IS MISSION HEALTH SYSTEM, INC. FORM 990, PART VI, SECTION A, LINE 7A THE BOARD OF TRUSTEES WILL CONSIST OF NOT LESS THAN 11 AND NOT MORE THAN 16 VOTING MEMBERS. UP TO TWO TRUSTEES MAY BE APPOINTED BY MISSION AT ANY TIME (THE "MISSION TRUSTEES") AND IN ALL EVENTS, AT LEAST A MAJORITY OF THE TRUSTEES MUST BE COMMUNITY TRUSTEES. TRUSTEES OTHER THAN MISSION TRUSTEES ARE REFERRED TO HEREIN AS "COMMUNITY TRUSTEES." THERE WILL BE NOT LESS THAN NINE (9) AND NO MORE THAN THIRTEEN (13) COMMUNITY TRUSTEES. THE HOSPITAL SHALL EACH YEAR, NO LATER THAN THE MONTH OF AUGUST, SUBMIT FOR RATIFICATION TO THE MEMBER THE NAMES OF PERSONS TO FILL VACANCIES AMONG THE COMMUNITY TRUSTESS CAUSED BY THE EXPIRATION OF THE TERMS OF OFFICE OR OTHERWISE. THE RATIFICATION OF THE COMMUNITY TRUSTEES BY THE MEMBER SHALL TAKE PLACE BEFORE THE END OF SEPTEMBER. FORM 990, PART VI, SECTION A, LINE 7B FOR SO LONG AS IT IS THE MEMBER, MISSION HEALTH SYSTEM, NC. AND ITS SUCCESSORS AND ASSIGNS ("MISSION OR "MEMBER"), SHALL HAVE THE AUTHORITY TO APPROVE THE FOLLOWING REGARDING THE HOSPITAL WITHOUT ANY SEPARATE OR FURTHER ACTION B THE BOARD OF TRUSTEES OF THE HOSPITAL: (A) ANY AMENDMENT TO THE ARTICLES OF INCORPORATION OR BYLAWS; PROVIDED HOWEVER, THE TERMS OF SECTION III.3 OF THESE BYLAWS MAY NOT BE AMENDED AT ANY TIME WITHOUT THE JOINT APPROVAL OF MISSION AND TRANSYLVANIA COMMUNITY HOSPITAL ("HOSPITAL") (B) THE MISSION, VISION AND VALUES STATEMENTS AND ANY AMENDMENTS THERETO. (C) THE SALE, LEASE OR OTHER TRANSFER OF A MATERIAL PORTION, SUBSTANTIALLY ALL OR ALL OF THE ASSETS OF THE HOSPITAL. (D) THE PLEDGE OF, OR GRANTING OF ANY LIEN OR ENCUMBRANCE ON, A MATERIAL PORTION, SUBSTANTIALLY ALL OR ALL OF THE ASSETS OF THE HOSPITAL TO SECURE THE OBLIGATIONS OF THE HOSPITAL OR ANY OF ITS SUBSIDIARIES. (E) THE PURCHASE, LEASE, PLEDGE OR SALE OF REAL OR PERSONAL PROPERTY OUTSIDE THE ORDINARY COURSE OF BUSINESS. (F) THE DISSOLUTION OR ANY MERGER, SALE, CONSOLIDATION OR OTHER BUSINESS COMBINATION. (G) THE FORMATION AND GOVERNING DOCUMENTS OF, AND INVESTMENT BY THE HOSPITAL IN, ANY NEW CORPORATION, PARTNERSHIP OR EQUITY OR CONTRACTUAL JOINT VENTURE IN WHICH THE HOSPITAL PROPOSES TO HAVE AN INTEREST THROUGH MEMBERSHIP, VOTING STOCK OR OTHER EQUITY PARTICIPATION. (H) THE REMOVAL OF THE PRESIDENT/CHIEF NURSING OFFICER OF THE HOSPITAL. (I) ANY DEBT ISSUANCE OR INCURRENCE, REFINANCING AND RETIREMENT OF DEBT, INCLUDING WITHOUT LIMITATION INDEBTEDNESS FOR BORROWED MONEY AND CAPITAL LEASES, INCLUDING ANY PROPOSALS AND RECOMMENDATIONS AS TO SAME BY THE BOARD OF TRUSTESS. (J) THE CAPITAL AND OPERATING BUDGETS (BASED ON RECOMMENDATIONS FROM THE BOARD OF TRUSTESS) AND ANY EXPENDITURES THAT WOULD CAUSE ANY LINE ITEM EXPENSE IN ANY APPROVED BUDGET TO EXCEED THE LIMITS ESTABLISHED FROM TIME TO TIME BY MISSION BASED ON RECOMMENDATIONS FROM THE BOARD OF TRUSTEES. (K) STRATEGIC AND FINANCIAL PLANS, INCLUDING ANY PROPOSALS AND RECOMMENDATIONS FOR REVISIONS TO SAME BY THE BOARD OF TRUSTEES. (L) THE SELECTION OF EXTERNAL AUDITORS AND LEGAL COUNSEL; PROVIDED HOWEVER, THE COMMUNITY DIRECTORS (AS DEFINED IN THE BYLAWS OF THE MEMBER) SHALL HAVE THE EXCLUSIVE RIGHT TO SELECT LEGAL COUNSEL TO ENFORCE THE HOSPITAL'S RIGHTS UNDER THE AFFILIATION AGREEMENT. FORM 990, PART VI, SECTION B, LINE 11 THE ORGANIZATION PROVIDES DATA TO THE SENIOR TREASURY ANALYST OF TAX SERVICES FOR MISSION HEALTH SYSTEM, INC. THE 990 IS PREPARED AND REVIEWED BY MANAGEMENT PRIOR TO THE REVIEW BY THE ORGANIZATION'S FINANCE COMMITTEE. 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 ORGANIZATION'S CONFLICT OF INTEREST POLICY IS REVIEWED AND UPDATED ANNUALLY. EDUCATION ABOUT THE POLICY AND THE RESPONSIBILITIES OF A BOARD MEMBER OCCURS ANNUALLY AND FOR NEW BOARD MEMBERS DURING ORIENTATION. IF A CONFLICT OF INTEREST IS IDENTIFIED, THE MEMBER IS RECUSED FROM DISCUSSION AND A VOTE ON THE CONFLICTING MATTER, AND MAY BE EXCUSED. THE POLICY IS ADHERED TO DURING MEETINGS IN EXECUTIVE SESSION FOR CEO EVALUATION AND COMPENSATION DISCUSSION, AUDIT PLANNING, AND OTHER TIMES AS REQUIRED. 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 PRESIDENT & CNO, THE CFO, 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 18 PHOTOCOPIES OF RECENT FILINGS OF THE FORM 990 ARE AVAILABLE UPON REQUEST AT THE ORGANIZATION'S ADMINISTRATIVE OFFICE. FORM 990, PART VI, SECTION C, LINE 19 PHOTOCOPIES OF THE ORGANIZATION'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST AT THE ORGANIZATION'S ADMINISTRATIVE OFFICE. AN ANNUAL REPORT OF THE ORGANIZATION'S FINANCIAL STATEMENTS IS AVAILABLE ON THE ORGANIZATION'S WEBSITE AND IS PUBLISHED ANNUALLY IN THE LOCAL NEWSPAPER. FORM 990, PART IX, LINE 11G MEDICAL FEES: PROGRAM SERVICE EXPENSES 3,778,051. MANAGEMENT AND GENERAL EXPENSES 257,100. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,035,151. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 1,935,557. MANAGEMENT AND GENERAL EXPENSES 131,716. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,067,273. OTHER FEES: PROGRAM SERVICE EXPENSES 1,831,455. MANAGEMENT AND GENERAL EXPENSES 124,632. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,956,087. FORM 990, PART XI, LINE 9: OTHER CHANGES IN NET ASSETS 822. OTHER FORM 990, PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. TRANSYLVANIA HOSPITAL IMAGING SERVICES LLC 260 HOSPITAL DRIVE BREVARD NC 28712 MEDICAL IMAGING NC -3320 1351691 TRANSYLVANIA COMMUNITY HOSPITAL INC TRANSYLVANIA REGIONAL HOSPITAL FOUNDATION INC PO BOX 2440 BREVARD NC 28712 561458024 FOUNDATION NC 501(C)(3) LINE 11A, I TRANSYLVANIA COMMUNITY HOSPITAL INC 1 TRANSYLVANIA PHYSICIAN SERVICES INC 260 HOSPITAL DRIVE BREVARD NC 28712 561920816 PHYSICIAN SERVICES NC 501(C)(3) LINE 3 TRANSYLVANIA COMMUNITY HOSPITAL INC 1 MISSION HEALTH SYSTEM INC 400 RIDGEFIELD COURT SUITE 100 ASHEVILLE NC 28806 581450888 SUPPORTING ORGANIZATION NC 501(C)(3) LINE 11A, I N/A 0 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 BLUE RIDGE REGIONAL HOSPITAL INC PO 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 ANGEL MEDICAL CENTER INC PO BOX 1209 FRANKLIN NC 28744 566000064 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 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 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 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 COMMUNITY CAREPARTNERS INC PO BOX 5779 ASHEVILLE NC 28813 562005198 LONG TERM REHABILITATION NC 501(C)(3) LINE 9 MISSION HEALTH SYSTEM INC 0 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 N/A BLUE RIDGE-TKC LLC 5935 CARNEGIE BOULEVARD CHARLOTTE NC 28209 471382912 REAL ESTATE RENTAL NC N/A BREVARD MRI AT TRANSYLVANIA COMMUNITY HOSPITAL LLC 260 HOSPITAL DRIVE BREVARD NC 28712 203281110 HEALTHCARE NC TRANSYLVANIA COMMUNITY HOSPITAL INC RELATED 156020 0 1 0.50000 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 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 BOULEVARD CHARLOTTE NC 28209 471390107 REAL ESTATE NC N/A TRANSYLVANIA HEALTHCARE II LIMITED PARTNERSHIP 2 MEDICAL PARK DR BREVARD NC 28712 200333230 RENTAL NC N/A WESTERN NC HEALTHCARE INNOVATORS III LLC 5935 CARNEGIE BOULEVARD CHARLOTTE NC 28209 464053310 REAL ESTATE RENTAL NC N/A WESTERN NC HEALTHCARE INNOVATORS LLC 5935 CARNEGIE BOULEVARD 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 TRANSYLVANIA SERVICES INC 260 HOSPITAL DRIVE BREVARD NC 28712 561448199 REAL ESTATE NC TRANSYLVANIA COMMUNITY HOSPITAL INC C 845236 6770357 1.00000 1 MISSION VENTURES INC 400 RIDGEFIELD CT SUITE 100 ASHEVILLE NC 28806 561341621 HOLDING COMPANY NC N/A C 0 DOGWOOD INSURANCE COMPANY LTD PO BOX 30600 THE GRAND PAVILION COM GRAND CAYMAN CJ CAPTIVE INSURANCE ENTITY CJ N/A C 0 MISSION HEALTH PARTNERS INC 509 BILTMORE AVE ASHEVILLE NC 28801 465566095 CLINICALLY INTEGRATED NETWORK NC N/A C 0 1 0 1 1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 TRANSYLVANIA REGIONAL HOSPITAL FOUNDATION INC C 1796632 CASH BREVARD MRI AT TRANSYLVANIA COMMUNITY HOSPITAL K 375238 CASH BREVARD MRI AT TRANSYLVANIA COMMUNITY HOSPITAL S 628583 CASH