2015-08-14T11:33:11-05:00 2014-09-30 366055558 Grant Thornton LLP 201 S College Street Suite 2500 Charlotte NC 28244 990 2013-10-01 263627231 Mission Medical Associates Inc MISS 8282138222 PO Box 5325 Asheville NC 28813 Paul McDowell VP, Finance 8282138222 2015-08-14 1 P00488037 7046323500 2013 2016-04-25 22:37:26Z Paul McDowell PO Box 5325 Asheville NC 28813 92176988 0 X www.missionmd.org X 2008 NC Provide Physician Services in areas that are insufficiently served. 5 3 736 3 0 0 270331 165525 72810467 91228159 3609 -3122 0 0 73084407 91390562 50 1066 0 0 88904466 106944088 0 0 0 17569952 24029084 106474468 130974238 -33390061 -39583676 28467608 21190061 128798644 161104773 -100331036 -139914712 X Provide Physician Services in areas that are insufficiently served.Continued on Schedule O.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. 0 0 124747345 1066 91228159 The Organization provided physician services in specialty practices including Family Medicine, Pediatrics, Cardiology, Children's Dental, Neurology, Orthopedic Trauma, Trauma Surgery, Weight Management, and Hospitalists. 33 new physicians were recruited to the area and the Organization served over 93,000 patients at 31 practice locations. The Organization provided physician services in specialty practices including Family Medicine, Pediatrics, Neonatology, Cardiology, Children's Dental, Neurology, Orthopedic Trauma, Trauma Surgery, Orthopedics, Weight Management, GI Services, Infectious Disease, and Hospitalists. 54 new providers, including neonatologists, infectious disease specialists, and 25 new providers to Transylvania Regional Hospital, a critical access provider affiliated with Mission Health System were recruited to the area and the Organization served over 130,000 patients at 48 practice locations. Benefits to the community included over $3 million in charity care based on foregone charges.Other accomplishments of the Organization's individual physicians which include volunteering in the local community and recognition for excellence and quality of healthcare service are highlighted below, continuing on Schedule O.Telehealth was set up in 22 Western North Carolina community locations to provide education to school RNs, practice MAs and nurses regarding pediatric hypertension and hyperlipidemia. Six cardiologists and one advanced practitioner ranked in the top ten percent of the Professional Research Consultants (PRC) National Excellence in Healthcare and presented with Service Excellence Awards from Mission. The Pediatric Endocrinology practice was recognized as PRC's Top Performer for 2014. The Top Performer Award is PRC's highest honor and is given annually to each healthcare facility that scores at or above the 100th percentile for the overall quality of care percent "excellent" score in PRC's national client database. A Developmental-Behavioral pediatric specialist again participated with the International Hospital for Children in the annual pediatric Spina Bifida evaluation clinics in Belize, Central America. The Mission Children's Neonatal Follow Up clinic as well as several pediatric providers were recognized as 5 star recipients for outstanding patient satisfaction. Several physicians donated their time to the Medical Ministry of the Asheville-Buncombe County Christian Ministry serving uninsured and underinsured residents of Buncombe County. Several cardiologists and primary care physicians provided community education across Western North Carolina. 124747345 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 79 0 1 736 1 0 0 0 0 0 0 0 0 0 0 X 5 3 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X Mission Medical Associates 8282138222 400 Ridgefield Court Suite 100 Asheville NC 28806 Ernest E Ferguson Chairman 1.00 X X 0 0 0 George M BilbreyJrMD Director 1.00 4.00 X 0 0 0 William E Lee Secretary/Treasurer 1.00 3.00 X X 0 0 0 Paul C Flanders MD Director 1.00 40.00 X 0 42348 0 Robert W Fields MD Director 40.00 X 74925 0 11071 Dr Jill Hoggard Green President/CEO 6.00 54.00 X 0 681995 104093 Paul McDowell VPFinance 6.00 54.00 X 0 415728 84009 Angela Wills COO 15.00 45.00 X 60438 181314 46516 Charles M LeCroy MD Physician 40.00 X 646342 0 40737 Harold Frisch MD Physician 40.00 X 576788 0 40454 William Shillinglaw MD Physician 40.00 X 600869 0 43030 Thomas Large Physician 40.00 X 556894 0 30910 Jan Pattanayak MD Physician 40.00 X 566407 0 35678 Marc Westle DO Former CEO 0.00 60.00 X 0 378945 81227 Cheryl Williams FormerFinOff/CurrDirFin 60.00 X 142873 0 27703 3225536 1700330 545428 225 1 1 0 Locumtenenscom PO Box 405547 Atlanta GA 303845547 Physician Services 536417 Insight Telepsychiatry LLC PO Box 306 Marlton NJ 080530289 Medical Services 459127 Blue Ridge Bone & Joint 129 McDowell Street Asheville NC 28801 Medical Services 441342 Honnie Patricia Spencer 284 Knoxview Ln Mooresville NC 281179630 Medical Services 222300 Vista Staffing Solutions None Los Angeles CA 900740834 Medical Services 222300 12 165525 165525 Net Patient Revenue 621110 54151184 54151184 PhysContSvcsRelatedOrgs 900099 34817756 34817756 Other Patient Revenue 900099 2259219 2259219 91228159 16993 16993 766311 766311 0 20115 -20115 -20115 -20115 91390562 91228159 0 -3122 1066 1066 70644 70644 299044 299044 93276382 91120334 2156048 2589779 2516207 73572 5805122 5519665 285457 4903117 4733021 170096 2722 2722 191338 191338 3784 3784 10992255 9964358 1027897 23437 14255 9182 378559 330307 48252 108515 108515 4669612 4518176 151436 937960 905644 32316 2163 2163 969527 869081 100446 1405160 1398122 7038 Other 2063106 596188 1466918 Departmental Supplies 1750706 1730681 20025 Medical Equipment Lease 530240 530240 0 130974238 124747345 6226893 0 1376761 1395173 250000 250000 19916483 9188852 141771 850299 72241 98985 569246 865235 11051643 3276529 5417451 7775114 550000 550000 173655 216403 28467608 21190061 128629579 160733729 169065 371044 128798644 161104773 X -100331036 -139914712 -100331036 -139914712 28467608 21190061 -39583676 0 X 0 1 X 1 0 X 28304 83582 522059 270331 165525 1069801 37457774 65683995 62639164 72810467 91228159 329819559 37486078 65767577 63161223 73080798 91393684 330889360 0 0 0 330889360 26366 16538 411176 854489 783304 2091873 26366 16538 411176 854489 783304 2091873 37512444 65784115 63572399 73935287 92176988 332981233 0.99370 0.00630 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 4692947 622165 4070782 4460958 1722063 2738895 1897738 932301 965437 7775114 Other Deferred Compensation 212519 Capital Lease 158525 371044 X Part X, Line 2: Mission applies the provisions of FASB ASC Topic 740 for Income Taxes 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 Mission's combined financial statements as a result of application of ASC 740. Mission Medical Associates is included in the combined financial statements described above. X X X X X 0 1 0 0 0 0 0 0 0 Dr Jill Hoggard Green President/CEO 0 502426 0 165000 0 14569 0 85114 0 18979 0 786088 0 0 Paul McDowell VPFinance 0 337792 0 75000 0 2936 0 63182 0 20827 0 499737 0 0 Angela Wills COO 49058 147174 11250 33750 130 390 8478 25433 3151 9454 72067 216201 0 0 Charles M LeCroy MD Physician 585047 0 37501 0 23794 0 17500 0 23237 0 687079 0 0 0 Harold Frisch MD Physician 526230 0 37453 0 13105 0 15300 0 25154 0 617242 0 0 0 William Shillinglaw MD Physician 457108 0 121744 0 22017 0 17500 0 25530 0 643899 0 0 0 Thomas Large Physician 508467 0 37115 0 11312 0 6462 0 24448 0 587804 0 0 0 Jan Pattanayak MD Physician 400767 0 147520 0 18120 0 10200 0 25478 0 602085 0 0 0 Marc Westle DO Former CEO 0 332679 0 0 0 46266 0 56840 0 24387 0 460172 0 0 Cheryl Williams FormerFinOff/CurrDirFin 108432 0 17901 0 16540 0 9050 0 18653 0 170576 0 0 0 Part I, Line 4b Persons who Participated in a supplemental non-qualified retirement plan (reported under deferred comp on Schedule J) Dr. Marc Westle $39,340 Dr. Jill Hoggard Green $74,914 Paul McDowell $63,182 Angela Wills $33,911 Persons who received payment from a supplemental non-qualified retirement plan (included in Other Reportable Compensation on Schedule J Dr. Marc Westle $14,926 Dr. Jill Hoggard Green $ 4,671 Form 990, Part VI, Section A, line 6 Mission Health System, Inc is the sole member of Mission Medical Associates, Inc. Form 990, Part VI, Section A, line 7a The following action of the corporation requires the prior approval of the Member: (i) appointment and removal of Board members; (j) appointment and removal of President/Chief Executive Officer; and (k) approval of employment agreement and compensation of President/Chief Executive Officer. Form 990, Part VI, Section A, line 7b The following actions of the corporation require the prior approval of the Member: (a) amendment or repeal of the bylaws or articles of the corporation; (b) sale of assets of the corporation valued in excess of $1 million ; (c) merger or dissolution of the corporation; (d) selection of auditors; (e) adoption of strategic plans, and capital and operating budgets; (f) transactions in excess of $5 Million; (g) filing for bankruptcy; (h) incurring debt (external to the Member and its subsidiaries/affiliates) (i) appointment and removal of Board members; (j) appointment and removal of President/Chief Executive Officer; and (k) approval of compensation of President/Chief Executive Officer. Form 990, Part VI, Section B, line 11 A draft of the Form 990 is prepared by the Director of Tax Services at Mission Health System. The Form 990 is reviewed by the organization's CEO, CFO, General Counsel and Compliance Officer of Mission Health System as well as Management at Mission Medical Associates . In addition, an outside accounting firm is engaged to review and sign the 990 and prepare the return for final filing with the IRS. Before filing, highlights of Form 990 are reviewed by Board Committees which may include the Executive Committee; Audit and Compliance Committee; Finance and Property Committee and Human Resources and Compensation Committee of Mission Health System. After committee review, a draft of the 990 is provided to the Board of Directors at Mission Health System and Mission Medical Associates for review. Highlights of Form 990 are specifically reviewed with the board and they have the opportunity to ask questions and suggest improvements or provide corrections. If there are changes as a result of board review, a corrected Form 990 will be provided for final approval before filing. After final approval, the Form 990 will be filed with the IRS. Form 990, Part VI, Section B, line 12c The Organizations 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 interested person does not participate in any decision relating to the transaction issue. A conflict of interest is a particular relationship or arrangement that would reasonably be expected to exert an influence on the individual's judgment and preclude the individual from being an Independent Director or being independent with respect to the transaction under consideration. In addition to board members, the organization's conflict of interest policy applies to members of senior leadership, medical staff, clinical service line leaders, elected medical staff leaders, departmental directors, staff members working in the purchasing department, and all other staff members with purchasing authority, as well as immediate family members of such interested persons and entities in which interested persons have a material financial interest. The organization's policy is for all interested persons to disclose any and all conflicts of interest in accordance with the IRS guidelines for tax-exempt entities as well as any other applicable state or federal law. Upon initial assumption of duties, interested persons are provided with a copy of the conflict of interest policy and submit a conflict of interest disclosure statement. Thereafter, the statements will be completed annually. Periodically all staff members are asked to complete a conflict of interest disclosure statement. Internal and external auditors, General Counsel or outside counsel will periodically conduct a review of the disclosure process to determine whether the organization is in compliance with the policy. Form 990, Part VI, Section B, line 15 The 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 (Committee) reviews this data and recommends to the Board any revisions to the overall philosophy and policy to guide the determination of compensation and benefit packages for executives which includes the CEO, the CFO, and President as well as all other executives, which would include all key employees. The Committee keeps and distributes minutes of all its meetings to its members. Items of a sensitive nature are referenced in the minutes with detailed, supporting documentation retained on file. The Committee also discloses any potential conflicts of interest situations to the Committee Chairman that may affect their independent directors' status as soon as they arise, and maintains complete documentation of all matters discussed by the Committee. The Committee obtains education and training to exercise all responsibilities effectively and keeps abreast of significant developments in executive compensation practices and regulations, and ensures that all aspects of Mission Health System and Hospital executive compensation adhere to all relevant regulatory requirements, and reviews the Committee charter annually revising as appropriate and conducts an annual evaluation of the Committee's performance. Form 990, Part VI, Section C, line 19 The conflict of interest policy and financial statements are available upon request. Articles of Incorporation are available through the North Carolina Secretary of State website. Mission Health System Inc 400 Ridgefield Court Suite 100 Asheville NC 28806 581450888 Supporting Organization NC 501(c)(3) Line 11a, I 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 Mission Healthcare Foundation Inc 400 Ridgefield Court Suite 100 Asheville NC 28806 561881331 Foundation NC 501(c)(3) Line 7 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 Blue Ridge Regional Hospital Post Office 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 Regional Hospital Foundation PO Box 2440 Brevard NC 28712 561458024 Foundation NC 501(c)(3) Line 11a, I Transylvania Community Hospital 0 Transylvania Physician Services Inc 260 Hospital Drive Brevard NC 28712 561920816 Physician Services NC 501(c)(3) Line 3 Transylvania Community Hospital 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 McDowell Healthcare Foundation Inc 430 Rankin Drive Marion NC 28752 463395393 Foundation NC 501(c)(3) Line 11a, I The McDowell Hospital Inc 0 Angel Medical Center Auxiliary PO Box 1209 Franklin NC 28744 562133719 Supporting Organization NC 501(c)(3) Line 11a, I Angel Medical Center Inc 0 Angel Medical Center PO Box 1209 Franklin NC 28712 566000064 Community Hospital NC 501(c)(3) Line 3 Mission Health System 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 Imaging Realty LLP 534 Biltmore Avenue Asheville NC 28801 561907203 Medical Building 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 Asheville Imaging 534 Biltmore Avenue Asheville NC 28801 561907201 Medical Imaging NC N/A Blue Ridge DME LLC 125 Hospital Drive Spruce Pine NC 28777 263570174 Home Medical Supplies NC N/A McDowell MRI LLC 414 Rankin Avenue Marion NC 28752 753046378 Medical Imaging NC N/A Brevard MRI at Transylvania Community Hospital LLC 260 Hospital Drive Brevard NC 28712 203281110 Medical Imaging NC N/A Transylvania Healthcare II Limited Partnership 2 Medical Park Drive Brevard NC 28712 200333230 Rental NC N/A Healthcare III LP 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 Western NC Healthcare InnovatorsLLC 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 Asheville MRI PO Box 2959 Asheville NC 28802 561665863 Imaging Services NC N/A WNC Stone Center 509 Biltmore Avenue Asheville NC 28801 272152974 Lithotripter Rental NC N/A Western NC Healthcare Innovators III LLC 5935 Carnegie Blvd Charlotte NC 28209 464053310 Real Estate Rental NC N/A Blue Ridge TKC LLC 5935 Carnegie Blvd Charlotte NC 28209 471382912 Real Estate Rental NC N/A Spruce Pine Healthcare LLC 5935 Carnegie Blvd Charlotte NC 28209 471390107 Real Estate NC N/A Mission Ventures Inc 400 Ridgefield Court Suite 100 Asheville NC 28806 561341621 Holding Company NC N/A C 0 Horizon Management Services Inc Liquidated September 2014 Asheville NC 28806 561341624 Patient Billing and Collection Services, Medical Property NC N/A C 0 Dogwood Insurance Company The Grand Pavilion Commercial Centr Cayman Islands CJ Captive Insurance Company CJ N/A C 0 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 28806 465566095 Clinically Integrated Network NC N/A C 0 0 0 1 0 0 0 0 0 0 1 1 1 1 1 1 1 1 0 1