CHARLES A CANNON JR MEMORIAL HOSPITAL INC: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- CHARLES A CANNON JR MEMORIAL HOSPITAL INC (EIN 56-0529974)
- Tax period
- 2012-10-01 to 2013-09-30
- Filed
- 2014-05-05
- IRS object ID
- 201401259349301000
- Schema version
- 2012v2.1
- 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) |
|---|---|---|
| Timestamp | 2014-05-05T11:29:06-05:00 | Timestamp |
| Tax Period End Date | 2013-09-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 560747981 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DIXON HUGHES GOODMAN LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 111 FRANKLIN RD SE SUITE 501 | AddressLine1 |
| City | ROANOKE | City |
| State | VA | State |
| ZIP Code | 240112114 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-10-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 560529974 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHARLES A CANNON JR MEMORIAL HOSPITAL INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | CHAR | NameControl |
| Phone | 8282624119 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 434 HOSPITAL DRIVE | AddressLine1 |
| City | LINVILLE | City |
| State | NC | State |
| ZIP Code | 28646 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | KEVIN B MAY | Name |
| Title | CFO | Title |
| Phone | 8282624119 | Phone |
| Date Signed | 2014-02-12 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | MICHAEL P NORTON | Name |
| PTIN | P00430694 | PTIN |
| Phone | 5409896144 | Phone |
| Date Prepared | 2014-02-12 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | KEVIN B MAY | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 434 HOSPITAL DRIVE | AddressLine1 |
| City | LINVILLE | City |
| State | NC | State |
| ZIP Code | 28646 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 22138301 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.APPRHS.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1957 | YearFormation |
| State Legal Domicile | NC | StateLegalDomicile |
| Activity Or Mission Description | TO PROVIDE HEALTH CARE SERVICES TO ENHANCE THE QUALITY OF LIFE FOR THE COMMUNITY OF LINVILLE. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 14 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 14 | NbrIndependentVotingMembers |
| Total Nbr Employees | 0 | TotalNbrEmployees |
| Total Nbr Volunteers | 90 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 325060 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 642397 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 20178161 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 21189610 | ProgramServiceRevenueCY |
| Investment Income Prior Year | -49397 | InvestmentIncomePriorYear |
| Investment Income Current Year | 5835 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 208420 | OtherRevenuePriorYear |
| Other Revenue Current Year | 300459 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 20662244 | TotalRevenuePriorYear |
| Total Revenue Current Year | 22138301 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 13425732 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 13352629 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 8844684 | OtherExpensePriorYear |
| Other Expenses Current Year | 8887694 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 22270416 | TotalExpensesPriorYear |
| Total Expenses Current Year | 22240323 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -1608172 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -102022 | RevenuesLessExpensesCY |
| Total Assets BOY | 27703569 | TotalAssetsBOY |
| Total Assets EOY | 27668729 | TotalAssetsEOY |
| Total Liabilities BOY | 10432375 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 10165298 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 17271194 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 17503431 | NetAssetsOrFundBalancesEOY |
| Mission Description | TO PROVIDE HEALTH CARE SERVICES TO ENHANCE THE QUALITY OF LIFE FOR THE COMMUNITY OF LINVILLE. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 17520137 | Expense |
| Revenue | 21490758 | Revenue |
| Description | CHARLES A. CANNON, JR. MEMORIAL HOSPITAL IN LINVILLE IS A 25-BED ACUTE CARE HOSPITAL WITH A 10-BED INPATIENT BEHAVIORAL HEALTH UNIT. THE FULL-SERVICE EMERGENCY DEPARTMENT, IMAGING DEPARTMENT, LABORATORY, NEW LIFE CENTER, OUTPATIENT BEHAVIORAL HEALTH, REHABILITATION CENTER OFFERING PHYSICAL AND OCCUPATIONAL THERAPIES, SLEEP CENTER, AND CARDIOPULMONARY REHABILITATION ROUND OUT THE LIST OF SERVICES. | Description |
| Total Program Service Expense | 17520137 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 1 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 1 | FinancialStmtAttached |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 0 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 0 | NumberOfEmployees |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 14 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 14 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 1 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KEVIN B MAY | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 8282624100 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 336 DEERFIELD ROAD | AddressLine1 |
| City | BOONE | City |
| State | NC | State |
| ZIP Code | 28607 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (18 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Average Hours Per Week RelatedAverageHoursPerWeekRelated | OfficerOfficer |
|---|---|---|---|---|---|---|---|
| PAUL MILLER JR | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| JOHN BLACKBURN | |||||||
| VICE CHAIR | 1.00 | X | 0 | 0 | 0 | ||
| JOE MILLER | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| SUSAN ROGGENKAMP | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| KENNETH WILCOX | |||||||
| PAST CHAIR | 1.00 | X | 0 | 0 | 0 | ||
| KEITH TESTER | |||||||
| CHAIR | 1.00 | X | 0 | 0 | 0 | ||
| SAM ADAMS | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| CHARLES BAKER MD | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| JACK HOWARD | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| PATTIE TENNILLE | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| JAN WINKLER | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| KIM MILLER | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| NATHAN MILLER | |||||||
| COUNTY COMMISSION REPRESENTATIVE | 1.00 | X | 0 | 0 | 0 | ||
| MARK MURREY MD | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| RICHARD SPARKS | |||||||
| CEO ARHS | 1.00 | 0 | 352223 | 130722 | 40.00 | X | |
| KEVIN MAY | |||||||
| CFO ARHS | 1.00 | 0 | 265470 | 20035 | 40.00 | X | |
| CHARLES MANTOOTH | |||||||
| CEO CMH | 40.00 | 0 | 219303 | 19578 | X | ||
| CARMEN LACEY | |||||||
| PRESIDENT, CMH | 40.00 | 0 | 100125 | 15113 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 0 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 937121 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 185448 | TotalOtherCompensation |
| Number Individuals GT100 K | 0 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
| Number Of Contractors GT100 K | 0 | NumberOfContractorsGT100K |
| All Other Contributions | 642397 | AllOtherContributions |
| Total Contributions | 642397 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| PROG.SERV.REVENUE-RELATED-990 | 900099 | 21101564 | 21101564 |
| CAFETERIA REVENUE | 900099 | 88046 | 88046 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 21189610 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 5146 | TotalRevenueColumn |
| Exclusion | $5,146 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 195750 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 0 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 195750 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 195750 | TotalRevenueColumn |
| Related Or Exempt Function Income | 195750 | RelatedOrExemptFunctionIncome |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 689 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 0 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 689 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 689 | TotalRevenueColumn |
| Related Or Exempt Function Income | 689 | RelatedOrExemptFunctionIncome |
Other Revenue Misc OtherRevenueMisc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | MISCELLANEOUS REVENUE | Description |
| Business Code | 900099 | BusinessCode |
| Total Revenue Column | 104709 | TotalRevenueColumn |
| Related Or Exempt Function Income | 104709 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 104709 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 22138301 | TotalRevenueColumn |
| Related Or Exempt Function Income | 21490758 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $5,146 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | X | InfoInScheduleOPartIX |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 10555373 | Total |
| Program Services | 9042913 | ProgramServices |
| Management And General | 1512460 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2105417 | Total |
| Program Services | 2105417 | ProgramServices |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 691839 | Total |
| Program Services | 658488 | ProgramServices |
| Management And General | 33351 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1890 | Total |
| Management And General | 1890 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2505457 | Total |
| Program Services | 2204921 | ProgramServices |
| Management And General | 300536 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 630 | Total |
| Program Services | 630 | ProgramServices |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1949792 | Total |
| Program Services | 1943141 | ProgramServices |
| Management And General | 6651 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 726036 | Total |
| Program Services | 195493 | ProgramServices |
| Management And General | 530543 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 32681 | Total |
| Program Services | 30733 | ProgramServices |
| Management And General | 1948 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3179 | Total |
| Program Services | 3179 | ProgramServices |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 286692 | Total |
| Management And General | 286692 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1333860 | Total |
| Program Services | 553269 | ProgramServices |
| Management And General | 780591 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 123118 | Total |
| Program Services | 123118 | ProgramServices |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Management And GeneralManagementAndGeneral | Program ServicesProgramServices |
|---|---|---|---|
| CORP. ALLOCATIONS | 1046419 | 1046419 | |
| EQUIPMENT RENTAL AND MA | 302278 | 302278 | |
| EQUIPMENT RENTAL AND MA | 157191 | 157191 | |
| MISCELLANEOUS | 152011 | 152011 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 266460 | Total |
| Program Services | 204546 | ProgramServices |
| Management And General | 61914 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 22240323 | Total |
| Program Services | 17520137 | ProgramServices |
| Management And General | 4720186 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2075884 | BOY |
| EOY | 1205553 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 806066 | BOY |
| EOY | 0 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3670818 | BOY |
| EOY | 5487423 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 563427 | BOY |
| EOY | 502536 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 171283 | BOY |
| EOY | 72762 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 36886174 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 19421592 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 16927927 | BOY |
| EOY | 17464582 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3488164 | BOY |
| EOY | 2935873 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 27703569 | BOY |
| EOY | 27668729 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 396918 | BOY |
| EOY | 306622 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7146251 | BOY |
| EOY | 7434575 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2889206 | BOY |
| EOY | 2424101 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10432375 | BOY |
| EOY | 10165298 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 16361379 | BOY |
| EOY | 16593616 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 909815 | BOY |
| EOY | 909815 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 17271194 | BOY |
| EOY | 17503431 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 27703569 | BOY |
| EOY | 27668729 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | -102022 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 334259 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | 1 | AuditCommittee |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| 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) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1220002 | OtherCostOrOtherBasis |
| Book Value | 1220002 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 22562332 | OtherCostOrOtherBasis |
| Depreciation | 9879790 | Depreciation |
| Book Value | 12682542 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 3299922 | OtherCostOrOtherBasis |
| Depreciation | 1858415 | Depreciation |
| Book Value | 1441507 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 9803918 | OtherCostOrOtherBasis |
| Depreciation | 7683387 | Depreciation |
| Book Value | 2120531 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 17464582 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (4 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| AUWIL | 366685 |
| INTEREST IN ARHF | 2518736 |
| OWNERSHIP EQUITY-OTHER | 11089 |
| CONSTRUCTION IN PROGRESS | 39363 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 2935873 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities (3 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| DUE TO AFFILIATE | $2,557,101 |
| ESTIMATED THIRD-PARTY SETTLEMENTS | -$623,000 |
| MISCELLANEOUS | $490,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 2424101 | TotalOfAmounts |
| Footnote In Part XIII | X | FootnoteInPartXIII |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | Identifier |
| Return Reference | PART X, LINE 2: | ReturnReference |
| Explanation | ARHS AND THE COMPANIES FOR WHICH IT SERVES AS SOLE MEMBER ARE NOT-FOR-PROFIT CORPORATIONS AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND ARE EXEMPT FROM FEDERAL AND STATE INCOME TAXES ON RELATED INCOME. ACCORDINGLY, NO PROVISION FOR INCOME TAXES HAS BEEN MADE IN THE ACCOMPANYING COMBINED FINANCIAL STATEMENTS. THE SYSTEM HAS DETERMINED IT DOES NOT HAVE ANY MATERIAL UNRECOGNIZED TAX BENEFITS OR OBLIGATIONS AS OF SEPTEMBER 30, 2013. FISCAL YEARS ENDING ON OR AFTER SEPTEMBER 30, 2010 REMAIN SUBJECT TO EXAMINATION BY FEDERAL AND STATE TAXING AUTHORITIES. | Explanation |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
Other Percentage OtherPercentage
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Free Other Percentage | 175.000000000000 | FreeOtherPercentage |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent250 | X | Pcent250 |
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 1 | ExpensesExceededBudget |
| Unable To Provide Care | 0 | UnableToProvideCare |
| Annual Community Benefit Report | 1 | AnnualCommunityBenefitReport |
| Report Publically Available | 1 | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 547325 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 547325 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02460 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 2521821 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1191448 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1330373 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.05980 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 3069146 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1191448 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1877698 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.08440 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 37399 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 37399 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00170 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 22187 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 22187 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00100 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 31332 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 31332 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00140 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 90918 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 90918 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00410 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 3160064 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1191448 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1968616 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.08850 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $1,686,762 | BadDebtExpenseAmount |
| Amount Attributable To | 84338 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 12152673 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 12152673 | CostOfCareReimbursedByMedicare |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost Accounting System | X | CostAccountingSystem |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
Form990 Schedule H Part IV Form990ScheduleHPartIV
Name Of Entity NameOfEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 1 APPALACHIAN REGIONAL HEALTHCARE SYSTEM | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Ent Primary Activity | SOLE MEMBER OF CHARLES A. CANNON JR., MEMORIAL HOSPITAL, INC. | DescriptionEntPrimaryActivity |
| Organization Profit Or Ownership | 1.00000 | OrganizationProfitOrOwnership |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHARLES A CANNON JR MEMORIAL HOSPITAL | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 434 HOSPITAL DRIVE | AddressLine1 |
| City | LINVILLE | City |
| State | NC | State |
| ZIP Code | 28646 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Critical Access Hospital | X | CriticalAccessHospital |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHARLES A CANNON JR MEMORIAL HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| CHNA Conducted | 1 | CHNAConducted |
| Community Definition | X | CommunityDefinition |
| Community Demographics | X | CommunityDemographics |
| Existing Resources | X | ExistingResources |
| How Data Obtained | X | HowDataObtained |
| Community Health Needs | X | CommunityHealthNeeds |
| Other Health Issues | X | OtherHealthIssues |
| Identifying Process | X | IdentifyingProcess |
| Consulting Process | X | ConsultingProcess |
| Needs Assessment Conducted | 12 | NeedsAssessmentConducted |
| Take Into Account | 1 | TakeIntoAccount |
| Other Facilities | 0 | OtherFacilities |
| CHNA Widely Available | 1 | CHNAWidelyAvailable |
| Own Website | X | OwnWebsite |
| On Request | X | OnRequest |
| Adopt Implement Strategy | X | AdoptImplementStrategy |
| All Needs Addressed | 1 | AllNeedsAddressed |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTax |
| Eligibility Criteria Explained | 1 | EligibilityCriteriaExplained |
| Uses FPG Free | 1 | UsesFPGFree |
| FPG Free Percent | 200.000000000000 | FPGFreePercent |
| Uses FPG Discounted | 1 | UsesFPGDiscounted |
| FPG Discount Percent | 300.000000000000 | FPGDiscountPercent |
| Explains Basis | 1 | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Asset Level | X | AssetLevel |
| Medical Indigency | X | MedicalIndigency |
| Explains Application Method | 1 | ExplainsApplicationMethod |
| Includes Publicity Measures | 1 | IncludesPublicityMeasures |
| Posted On Website | X | PostedOnWebsite |
| Attached To Invoices | X | AttachedToInvoices |
| Available On Request | X | AvailableOnRequest |
| Other Publicity | X | OtherPublicity |
| Actions On Nonpayment | 1 | ActionsOnNonpayment |
| Collection Activities | 0 | CollectionActivities |
| Nondiscrim Emergency Care Policy | 1 | NondiscrimEmergencyCarePolicy |
| Used Other Method | X | UsedOtherMethod |
| Amounts Generally Billed | 0 | AmountsGenerallyBilled |
| Gross Charges | 0 | GrossCharges |
Form990 Schedule H Part VI Form990ScheduleHPartVI (5 entries)
| ExplanationExplanation | IdentifierIdentifier |
|---|---|
| PART III, LINE 4: AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IS RECORDED BASED ON HISTORICAL BAD DEBT EXPERIENCE AND MANAGEMENT'S EVALUATION OF THE ACCOUNTS RECEIVABLE. BALANCES ARE WRITTEN OFF AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN MADE.WE ESTIMATE 5% OF CHARITY COSTS FAIRLY ESTIMATE AMOUNTS INCLUDED AS BAD DEBT THAT WOULD BE ELIGIBLE FOR CHARITY CARE BUT FAILED TO APPLY. | |
| PART III, LINE 9B: CHARITY WRITE-OFFS ARE SEGREGATED FROM NORMAL BAD DEBTS THROUGH A SEPARATE TRANSACTION CODE. FAMILY INCOME BELOW 175% OF FPG ARE ELIGIBLE FOR 100% WRITE-OFF. PARTIAL WRITE-OFF IS AVAILABLE BETWEEN FAMILY INCOME BETWEEN 175% AND 250% OF FPG. | |
| PART V, SECTION B, LINE 3: THE TASK FORCE INVOLVED CONSISTED OF PUBLIC HEALTH OFFICIALS, HOSPITAL STAFF, APPALACHIAN STATE UNIVERSITY, AND MENTAL HEALTH AND YOUTH ADVOCATES FOR THE COUNTY. COUNTY RESIDENTS WERE INFORMED OF THE ASSESSMENT THROUGH RADIO PUBLIC SERVICE ANNOUNCEMENTS, ADVERTISEMENTS ON AGENCY WEBSITES, AND WORD OF MOUTH. THE SURVEY WAS AVAILABLE ONLINE THROUGH SURVEY MONKEY, AND AT DESIGNATED COMMUNITY AGENCIES INCLUDING COUNTY HEALTH DEPARTMENTS, CHILDCARE CENTERS, COMMUNITY HEALTH CLINICS, AND OTHER HUMAN SERVICE AGENCIES. TELEPHONE INTERVIEWS WERE ALSO UTILIZED SURVEY RESPONDENTS REPRESENTED VARIOUS AGENCIES AND ORGANIZATIONS IN THE COMMUNITY. | CHARLES A CANNON JR MEMORIAL HOSPITAL |
| PART V, SECTION B, LINE 14G: INCLUDED IN THE ADMISSION PACKET THAT PATIENTS RECEIVE. PATIENT FINANCIAL ADVOCATE AT THE HOSPITALS VISIT SELF-PAY PATIENTS AND MAKE THEM AWARE OF AVAILABLE FINANCIAL ASSISTANCE. | CHARLES A CANNON JR MEMORIAL HOSPITAL |
| PART V, SECTION B, LINE 20D: AVERAGE OF ALL COMMERCIAL PAYERS. | CHARLES A CANNON JR MEMORIAL HOSPITAL |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (3 entries)
| TitleTitle | Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| RICHARD SPARKS | ||||||||||||||
| CEO ARHS | 0 | 341401 | 0 | 0 | 0 | 10822 | 0 | 124372 | 0 | 6350 | 0 | 482945 | 0 | 0 |
| KEVIN MAY | ||||||||||||||
| CFO ARHS | 0 | 257759 | 0 | 0 | 0 | 7711 | 0 | 13975 | 0 | 6060 | 0 | 285505 | 0 | 0 |
| CHARLES MANTOOTH | ||||||||||||||
| CEO CMH | 0 | 213574 | 0 | 0 | 0 | 5729 | 0 | 11087 | 0 | 8491 | 0 | 238881 | 0 | 0 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (8 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| FORM 990, PART VI, SECTION A, LINE 3 | PARENT COMPANY, APPALACHIAN REGIONAL HEALTH CARE SYSTEM (ARHS) OVERSEES CMH OPERATIONS. ALSO NOTE THAT SALARIES AND OTHER COMMON EXPENSES INCURRED BY ARHS ARE ALLOCATED APPROPRIATELY TO CMH. PAYMENTS TO VENDORS ARE PAID THROUGH ARHS AND ALL 1099S ARE ISSUED THROUGH ARHS. | |
| FORM 990, PART VI, SECTION A, LINE 7B | APPROVAL MAY BE NEEDED BY THE PARENT COMPANY, APPALACHIAN REGIONAL HEALTH CARE SYSTEM. | |
| FORM 990, PART VI, SECTION B, LINE 11 | THE SVP/CFO AND THE VICE PRESIDENT OF FINANCE REVIEW THE 990 AND THEN IT IS MADE AVAILABLE TO THE BOARD UPON COMPLETION. | |
| FORM 990, PART VI, SECTION B, LINE 12C | REVIEW OF POLICY STATEMENT EACH YEAR. | |
| FORM 990, PART VI, SECTION B, LINE 15 | INDEPENDENT COMPENSATION AND BENEFIT ANALYSIS WAS PERFORMED BY HLF REWARDS CONSULTING IN APRIL 2013. THE EXECUTIVE COMMITTEE (COMPENSATION COMMITTEE) REVIEWED THIS INFORMATION TO ESTABLISH APPROPRIATENESS OF TOTAL COMPENSATION, COMPLY WITH INTERMEDIATE SANCTION REGULATIONS, AND DETERMINE EXCUTIVE COMPENSATION FOR CEO, COO, AND CFO POSITIONS. | |
| FORM 990, PART VI, SECTION C, LINE 19 | PROVIDED UPON REQUEST. | |
| FORM 990, PART IX, LINE 11G | PROFESSIONAL FEES : PROGRAM SERVICE EXPENSES 532,602. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 532,602. CONTRACT LABOR : PROGRAM SERVICE EXPENSES 1,672,319. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,672,319. CONTRACT LABOR : PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 300,536. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 300,536. | OTHER FEES |
| FORM 990, PART XI, LINE 9: | TRANSFERS FROM AFFILIATE 334,259. | CHANGES IN NET ASSETS OR FUND BALANCES: |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (6 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|
| APPALACHIAN REGIONAL HEALTHCARE SYSTEM | |||||||||
| PO BOX 2600 | BOONE | NC | 28607 | 201067022 | PARENT COMPANY | NC | 501(C)(3) | 11C | 0 |
| BLOWING ROCK HOSPITAL INC | |||||||||
| PO BOX 148 | BLOWING ROCK | NC | 28605 | 560513181 | HOSPITAL | NC | 501(C)(3) | 3 | 0 |
| WATAUGA MEDICAL CENTER INC | |||||||||
| 336 DEERFIELD RD | BOONE | NC | 28607 | 560510824 | HOSPITAL | NC | 501(C)(3) | 3 | 0 |
| APPALACHIAN REGIONAL HEALTHCARE FOUNDATION | |||||||||
| 336 DEERFIELD RD | BOONE | NC | 28607 | 204625618 | PHILANTHROPIC ORGANIZATION FOR THE SYSTEM | NC | 501(C)(3) | 7 | 0 |
| APPALACHIAN REGIONAL MEDICAL ASSOCIATES INC | |||||||||
| PO BOX 2600 | BOONE | NC | 28607 | 205755130 | EMPLOYMENT ALTERNATIVE TO BOTH NEW AND ESTABLISHED PHYSICIAN PRACTICES | NC | 501(C)(3) | 9 | 0 |
| ARHS PROPERTIES INC | |||||||||
| 336 DEERFIELD RD | BOONE | NC | 28607 | 203470765 | HOLD FUTURE PURCHASE OF NON-PROFIT LAND ACQUISITIONS | NC | 501(C)(3) | 9 | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 1 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Dividends Related Organization | 0 | DividendsRelatedOrganization |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 1 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable
Name Of Other Organization NameOfOtherOrganization
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | APPALACHIAN REGIONAL HEALTHCARE FOUNDATION | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | C | TransactionType |
| Amount Involved | 642397 | AmountInvolved |
| Method Of Amt Determination | ACTUAL | MethodOfAmtDetermination |
Comments