THE OUTER BANK HOSPITAL INC: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- THE OUTER BANK HOSPITAL INC (EIN 56-2112733)
- Tax period
- 2012-10-01 to 2013-09-30
- Filed
- 2014-08-13
- IRS object ID
- 201402259349300905
- 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
- Form 990
- Schedule A
- Schedule C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2014-08-13T08:18:40-05:00 | Timestamp |
| Tax Period End Date | 2013-09-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 420714325 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MCGLADREY LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1 S WACKER DRIVE STE 800 | AddressLine1 |
| City | CHICAGO | City |
| State | IL | State |
| ZIP Code | 60606 | 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 | 562112733 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | The Outer Banks Hospital Inc | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | OUTE | NameControl |
| Phone | 2528475129 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2100 Stantonsburg Road | AddressLine1 |
| City | Greenville | City |
| State | NC | State |
| ZIP Code | 27835 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | David Hughes | Name |
| Title | Secretary/Treasurer | Title |
| Phone | 2528475129 | Phone |
| Date Signed | 2014-08-13 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Wayne Harder | Name |
| PTIN | P00294296 | PTIN |
| Phone | 3126343400 | Phone |
| 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 | Ronald Sloan | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2100 Stantonsburg Road | AddressLine1 |
| City | Greenville | City |
| State | NC | State |
| ZIP Code | 27835 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 63613289 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | www.theouterbankshospital.com | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 2002 | YearFormation |
| State Legal Domicile | NC | StateLegalDomicile |
| Activity Or Mission Description | To provide a wide range of quality services to the residents and visitors of the Outer Banks. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 10 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 9 | NbrIndependentVotingMembers |
| Total Nbr Employees | 360 | TotalNbrEmployees |
| Total Nbr Volunteers | 52 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 0 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 0 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 49887752 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 62434669 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 62754 | InvestmentIncomePriorYear |
| Investment Income Current Year | 88388 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 74201 | OtherRevenuePriorYear |
| Other Revenue Current Year | 1079310 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 50024707 | TotalRevenuePriorYear |
| Total Revenue Current Year | 63602367 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 49500 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 19682933 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 21038717 | 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 | 20946321 | OtherExpensePriorYear |
| Other Expenses Current Year | 33481470 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 40629254 | TotalExpensesPriorYear |
| Total Expenses Current Year | 54569687 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 9395453 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 9032680 | RevenuesLessExpensesCY |
| Total Assets BOY | 60754128 | TotalAssetsBOY |
| Total Assets EOY | 59601069 | TotalAssetsEOY |
| Total Liabilities BOY | 6273475 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 7747736 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 54480653 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 51853333 | NetAssetsOrFundBalancesEOY |
| Mission Description | To enhance the quality of life for the people and communities we serve, touch and support. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 36231952 | Expense |
| Grants | 49500 | Grants |
| Revenue | 49086390 | Revenue |
| Description | Outpatient and Emergency Services:Provided emergency services to 22,691 patients 24 hours a day for 365 days. Provided outpatient diagnostic and therapeutic services to 22,522 patients. Performed 1,675 outpatient surgical procedures. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 9852953 | Expense |
| Revenue | 13348279 | Revenue |
| Description | Inpatient Services:Provided inpatient care 24 hours a day for 365 days to 1,405 patients. Delivered 371 babies. Performed 544 inpatient surgical procedures. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 46084905 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 0 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 1 | 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 | 1 | ReportProgRelInvest |
| Report Other Assets | 0 | 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 | 1 | GrantsToOrganizations |
| Grants To Individuals | 1 | 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 | 1 | 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 | 360 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| 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 | 10 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 9 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | 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 | 0 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 0 | ConflictOfInterestPolicy |
| Whistleblower Policy | 0 | WhistleblowerPolicy |
| Document Retention Policy | 0 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| Other Website | X | OtherWebsite |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | Todd Warlitner | NamePerson |
| Telephone Number | 2528475129 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2100 Stantonsburg Road | AddressLine1 |
| City | Greenville | City |
| State | NC | State |
| ZIP Code | 27835 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (18 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Average Hours Per Week RelatedAverageHoursPerWeekRelated | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| Linda Palombo | ||||||||
| Chairman | 2.00 | 0.00 | X | 0 | 0 | 0 | ||
| Ernest Larkin | ||||||||
| Vice Chairman | 2.00 | 0.00 | X | 0 | 0 | 0 | ||
| Beulah Charity Ashby | ||||||||
| Board Director | 2.00 | 0.00 | X | 0 | 0 | 0 | ||
| Christine Petzing MD | ||||||||
| Board Director | 2.00 | 0.00 | X | 0 | 0 | 0 | ||
| Roger Robertson | ||||||||
| Board Director | 2.00 | 46.00 | X | 0 | 400870 | 90819 | ||
| Terry Wheeler | ||||||||
| Board Director | 2.00 | 0.00 | X | 0 | 0 | 0 | ||
| Jody Midgette | ||||||||
| Board Director | 2.00 | 0.00 | X | 0 | 0 | 0 | ||
| Arthur Keeney | ||||||||
| Board Director | 2.00 | 6.00 | X | 0 | 0 | 0 | ||
| Steve Rodriquez | ||||||||
| Board Director | 2.00 | 0.00 | X | 0 | 0 | 0 | ||
| Bob Guanci | ||||||||
| Board Director | 2.00 | 0.00 | X | 0 | 0 | 0 | ||
| Todd Warlitner | ||||||||
| VP, Business Operations | 40.00 | 0.00 | 141717 | 0 | 55650 | X | ||
| Ronald Sloan | ||||||||
| President, Outer Banks Hospital | 40.00 | 0.00 | 226561 | 0 | 59818 | X | ||
| Judy Bruno | ||||||||
| VP, Clinical Operations | 40.00 | 0.00 | 138081 | 0 | 48210 | X | ||
| Gary Hunter | ||||||||
| Anesthesiologist | 40.00 | 0.00 | 404254 | 0 | 40418 | X | ||
| Monte Thompson | ||||||||
| Director, Pharmacy | 40.00 | 0.00 | 146345 | 0 | 29131 | X | ||
| Mary Moseley | ||||||||
| Pharmacist | 40.00 | 0.00 | 102297 | 0 | 37565 | X | ||
| Edward Heise | ||||||||
| Director, Emergency - AMU | 40.00 | 0.00 | 124391 | 0 | 31976 | X | ||
| Mary Terrell Parnell | ||||||||
| Pharmacist | 40.00 | 0.00 | 125942 | 0 | 19206 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1409588 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 400870 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 412793 | TotalOtherCompensation |
| Number Individuals GT100 K | 10 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| Aviation Anesthesia Association Inc | |||||
| 158 Battlefield Court | Manteo | NC | 27954 | CRNA Staffing | 312233 |
| GE Medical Systems | |||||
| PO Box 402076 | Atlanta | GA | 30384 | Equipment Service/Repair | 291373 |
| Frank X Biondi | |||||
| PO Box 1464 | Nags Head | NC | 27959 | CRNA Staffing | 271016 |
| Shared Hospitals Services Corp | |||||
| 3530 Elmhurst Lane | Portsmouth | VA | 23701 | Contract Employees | 199819 |
| Shiftwise | |||||
| PO Box 70870 | St Paul | MN | 55170 | Staff Management | 185804 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 9 | NumberOfContractorsGT100K |
Program Service Revenue ProgramServiceRevenue (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| Outpatient Revenue | 622110 | 48803194 | 48803194 |
| Inpatient Revenue | 622110 | 13631475 | 13631475 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 62434669 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 99310 | TotalRevenueColumn |
| Exclusion | $99,310 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 191579 | 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 | 191579 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 191579 | TotalRevenueColumn |
| Exclusion | $191,579 | ExclusionAmount |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 10922 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -10922 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -10922 | TotalRevenueColumn |
| Exclusion | -$10,922 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount |
|---|---|---|---|
| Employee Pharmacy | 900099 | 363623 | $363,623 |
| I/C Environmental Services | 900099 | 197225 | $197,225 |
| Cafeteria Meals | 722210 | 91190 | $91,190 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 235693 | TotalRevenueColumn |
| Exclusion | $235,693 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 887731 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 63602367 | TotalRevenueColumn |
| Related Or Exempt Function Income | 62434669 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $1,167,698 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 43500 | Total |
| Program Services | 43500 | ProgramServices |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6000 | Total |
| Program Services | 6000 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 506359 | Total |
| Program Services | 478877 | ProgramServices |
| Management And General | 27482 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 16543108 | Total |
| Program Services | 15645249 | ProgramServices |
| Management And General | 897859 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 611588 | Total |
| Program Services | 600484 | ProgramServices |
| Management And General | 11104 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2201080 | Total |
| Program Services | 2109471 | ProgramServices |
| Management And General | 91609 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1176582 | Total |
| Program Services | 1104405 | ProgramServices |
| Management And General | 72177 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 16620 | Total |
| Management And General | 16620 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 41535 | Total |
| Management And General | 41535 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 12000 | Total |
| Management And General | 12000 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4404093 | Total |
| Program Services | 3498954 | ProgramServices |
| Management And General | 905139 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 141753 | Total |
| Management And General | 141753 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3568690 | Total |
| Program Services | 3568690 | ProgramServices |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 11076 | Total |
| Program Services | 11076 | ProgramServices |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 921334 | Total |
| Program Services | 921334 | ProgramServices |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 257933 | Total |
| Program Services | 257933 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2370268 | Total |
| Program Services | 2370268 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 475712 | Total |
| Program Services | 475712 | ProgramServices |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| Bad Debt Expense | 8527084 | 8527084 | |
| Chargeable Patient Supp | 6432066 | 6432066 | |
| Shared Services Expense | 6243509 | 6243509 | |
| Recruitment | 57797 | 33802 | 23995 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 54569687 | Total |
| Program Services | 46084905 | ProgramServices |
| Management And General | 8484782 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5001596 | BOY |
| EOY | 3925123 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8203952 | BOY |
| EOY | 8954795 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1028991 | BOY |
| EOY | 1149000 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 175039 | BOY |
| EOY | 204338 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 43234085 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 24678089 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 18402531 | BOY |
| EOY | 18555996 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 25789275 | BOY |
| EOY | 24838770 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2152744 | BOY |
| EOY | 1973047 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 60754128 | BOY |
| EOY | 59601069 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4561626 | BOY |
| EOY | 5779072 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1711849 | BOY |
| EOY | 1968664 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6273475 | BOY |
| EOY | 7747736 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 54480653 | BOY |
| EOY | 51853333 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 54480653 | BOY |
| EOY | 51853333 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 60754128 | BOY |
| EOY | 59601069 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 9032680 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -11660000 | 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 C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | Volunteers |
| Paid Staff Or Management | 0 | PaidStaffOrManagement |
| Media Advertisements | 0 | MediaAdvertisements |
| Mailings Members | 0 | MailingsMembers |
| Publications Or Broadcast | 0 | PublicationsOrBroadcast |
| Grants Other Organizations | 0 | GrantsOtherOrganizations |
| Direct Contact Legislators | 0 | DirectContactLegislators |
| Rallies Demonstrations | 0 | RalliesDemonstrations |
| Other Activities | 1 | OtherActivities |
| Other Activities | $12,000 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 12000 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | 0 | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Explanation of Lobbying Activities: | Identifier |
| Return Reference | Part II-B, Line 1: | ReturnReference |
| Explanation | Dues to NCHA are allocated 25.23% to lobbying. | Explanation |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1694182 | OtherCostOrOtherBasis |
| Book Value | 1694182 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 28168800 | OtherCostOrOtherBasis |
| Depreciation | 15546555 | Depreciation |
| Book Value | 12622245 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 13355250 | OtherCostOrOtherBasis |
| Depreciation | 9131534 | Depreciation |
| Book Value | 4223716 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 15853 | OtherCostOrOtherBasis |
| Book Value | 15853 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 18555996 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities (2 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| Due to third party payors | $1,683,664 |
| Reserve for professional liability losses | $285,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 1968664 | 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 | The Outer Banks Hospital, Inc. has been determined to qualify as a tax-exempt organization under Section 501(c)(3) of the Internal Revenue Code. The Outer Banks Hospital, Inc. has reviewed its tax positions for all open years and has concluded that no material liabilities exist as of September 30, 2013 and 2012. The Outer Banks Hospital files tax returns with the U.S. federal and State of North Carolina jurisdictions. With few exceptions, The Outer Banks Hospital is no longer subject to U.S. federal examinations by tax authorities for years before 2009. | Explanation |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent200 | X | Pcent200 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent200 D | X | Pcent200D |
| 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 | 1677106 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1677106 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03070 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 4848248 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3967712 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 880536 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01610 | PercentOfTotalExpense |
Unreimbursed Costs UnreimbursedCosts
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 0 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 6525354 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3967712 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2557642 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04680 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 16 | NumberOfActivitiesOrPrograms |
| Persons Served | 6965 | PersonsServed |
| Total Community Benefit Expense | 1139404 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 14646 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1124758 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02060 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 3 | NumberOfActivitiesOrPrograms |
| Persons Served | 22 | PersonsServed |
| Total Community Benefit Expense | 47602 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 47602 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00090 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 0 | NumberOfActivitiesOrPrograms |
| Persons Served | 0 | PersonsServed |
| Total Community Benefit Expense | 0 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
Research Research
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 0 | NumberOfActivitiesOrPrograms |
| Persons Served | 0 | PersonsServed |
| Total Community Benefit Expense | 0 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 6 | NumberOfActivitiesOrPrograms |
| Persons Served | 14736 | PersonsServed |
| Total Community Benefit Expense | 236254 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 236254 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00430 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 25 | NumberOfActivitiesOrPrograms |
| Persons Served | 21723 | PersonsServed |
| Total Community Benefit Expense | 1423260 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 14646 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1408614 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02580 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 25 | NumberOfActivitiesOrPrograms |
| Persons Served | 21723 | PersonsServed |
| Total Community Benefit Expense | 7948614 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3982358 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3966256 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.07260 | PercentOfTotalExpense |
Community Support CommunitySupport
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Total Community Building Expense | 11941 | TotalCommunityBuildingExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Building Expense | 11941 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00020 | PercentOfTotalExpense |
Coalition Building CoalitionBuilding
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Total Community Building Expense | 16289 | TotalCommunityBuildingExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Building Expense | 16289 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00030 | PercentOfTotalExpense |
Workforce Development WorkforceDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Total Community Building Expense | 14135 | TotalCommunityBuildingExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Building Expense | 14135 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00030 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 3 | NumberOfActivitiesOrPrograms |
| Total Community Building Expense | 42365 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 42365 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00080 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $3,243,884 | BadDebtExpenseAmount |
| Amount Attributable To | 0 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 16766126 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 16274263 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | 491863 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
Form990 Schedule H Part IV Form990ScheduleHPartIV (2 entries)
| Description Ent Primary ActivityDescriptionEntPrimaryActivity | Organization Profit Or OwnershipOrganizationProfitOrOwnership | Officers Etc Profit Or OwnershipOfficersEtcProfitOrOwnership | Physicans Profit Or OwnershipPhysicansProfitOrOwnership |
|---|---|---|---|
| 1 The Outer Banks Hospital Medical Office Building LLC | |||
| Provision of space for providing Health Care | 1.00000 | 0.00000 | 0.00000 |
| 2 Outer Banks Professional Services LLC | |||
| Provision of Primary and Urgent Health Care | 1.00000 | 0.00000 | 0.00000 |
| 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 | The Outer Banks Hospital Inc | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4800 South Croatan Highway | AddressLine1 |
| City | Nags Head | City |
| State | NC | State |
| ZIP Code | 27959 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| 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 | The Outer Banks Hospital Inc | 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 |
| Execute Implement Strategy | X | ExecuteImplementStrategy |
| Develop Community Plan | X | DevelopCommunityPlan |
| Participate Community Plan | X | ParticipateCommunityPlan |
| Include Operational Plans | X | IncludeOperationalPlans |
| Adopt Budget | X | AdoptBudget |
| Prioritize Health Needs | X | PrioritizeHealthNeeds |
| Prioritize Services | X | PrioritizeServices |
| All Needs Addressed | 0 | 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 | 200.000000000000 | FPGDiscountPercent |
| Explains Basis | 1 | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Asset Level | X | AssetLevel |
| Medical Indigency | X | MedicalIndigency |
| Insurance Status | X | InsuranceStatus |
| Uninsured Discount | X | UninsuredDiscount |
| State Regulation | X | StateRegulation |
| Explains Application Method | 1 | ExplainsApplicationMethod |
| Includes Publicity Measures | 1 | IncludesPublicityMeasures |
| Posted On Website | X | PostedOnWebsite |
| Posted In Emergency Room | X | PostedInEmergencyRoom |
| Posted In Admission Office | X | PostedInAdmissionOffice |
| Available On Request | X | AvailableOnRequest |
| Actions On Nonpayment | 1 | ActionsOnNonpayment |
| Collection Activities | 0 | CollectionActivities |
| Notify Upon Admission | X | NotifyUponAdmission |
| Notify Before Discharge | X | NotifyBeforeDischarge |
| Notified All Patients | X | NotifiedAllPatients |
| Documented Determination | X | DocumentedDetermination |
| Nondiscrim Emergency Care Policy | 1 | NondiscrimEmergencyCarePolicy |
| Average Negotiated Rates | X | AverageNegotiatedRates |
| Amounts Generally Billed | 0 | AmountsGenerallyBilled |
| Gross Charges | 0 | GrossCharges |
Form990 Schedule H Part VI Form990ScheduleHPartVI (17 entries)
| ExplanationExplanation | IdentifierIdentifier | Return ReferenceReturnReference |
|---|---|---|
| Part I, Line 6a: In addition to the Community Benefit Report for TOBH, information regarding this entity is found in the annual report for University Health Systems of Eastern Carolina d/b/a Vidant Health. | ||
| Part I, Line 7: Costs were calculated using the estimated cost to charge ratio from The North Carolina Hospital Association's Advocacy Needs Data Initiative which is the standard for reporting community benefits in North Carolina. | ||
| Part I, L7 Col(f): In connection with the Presumptive Eligibility consideration of the Affordable Care Act, The Outer Banks Hospital does not reflect any bad debt in connection with FAP-eligible patients. These patients are presumed to be part of the Medicaid population and afforded coverage as such. | ||
| Part II: The community building activities of The Outer Banks Hospital involve services that are otherwise not provided by other organizations in the patient area. | ||
| Part III, Line 4: The financial statements of The Outer Banks Hospital are presented on a consolidated basis as part of the consolidated financial statements of Vidant Health; the text of the footnote from page 20 is presented below:Patient Accounts ReceivablePatient Accounts Receivable are reported net of estimated allowances for contractual adjustments and allowances for bad debts. Estimated allowances for bad debts are approximately $135.1 million and $112.7 million as of September 30, 2013 and 2012, respectively. | ||
| Part III, Line 8: The shortfall of Medicare revenue to Medicare was calculated according to the cost to charge ratio. Allowable costs of care should be considered community benefit because in the area served by TOBH, there are no other providers available to provide the required services. Therefore, the care would become a government obligation and is treated as a community benefit provided by TOBH. | ||
| Part III, Line 9b: Recommended patient accounts will continue to go through the accounts receivable billing cycle as normal. When the account reaches the customer service/collections manager, financial counseling supervisor or patient accounts supervisor, based on the information given, a decision will be made whether to proceed with collection or refer the account for approval of charity care. The process will occur as follows: I. Financial counselors will try to locate third party payors. If not eligible for any third party coverage (including charities), they may, based upon the financial information received, recommend the patient for charity care. II. Patient counselors will review for any third party payors and verify employment and assets. A charity care application will need to be completed along with tax return, pay stubs, social security award letter and other financial information as may be required. III. The patient accounts supervisor, financial counseling supervisor or customer service/collections manager, based upon account balance and the information given, will make a decision whether to proceed with collection or refer the patient account for approval for charity care.Presumptive eligibility for charity care - there are occasions in which a patient may appear eligible for a charity care discount, but there is no financial assistance information available to support financial aid. A. Some patients are presumed to be eligible for charity care discounts on the basis of individual life circumstances (e.g., homelessness, patients with no income, bankruptcy, deceased patients with no estate or spouse, etc). B. Through the assistance of a third party vendor and certain algorithms, in conjuction with our charity policy guidelines, all accounts, prior to outside collection agency referral, will be tested for presumptive charity. C. The accounts deemed charity will be adjusted and the remaining accounts will be referred to an outside collection agency. D. Once the agency has had the accounts for six months and has deemed them uncollectible, the accounts with balances of $1,200 or greater will remain with the agency and be kept on the patient's credit file. E. The accounts returned to the hospital will be placed in a unique financial class and will not be pursued for collections. | ||
| Part V, Section B, Line 3: The CHNA document is the culmination of a partnership between the Dare County Department of Public Health (DCDPH) and The Outer Banks Hospital (TOBH). In communities where there is an active Healthy Carolinians coalition, the CHNA partnership also usually includes that entity. Healthy Carolinians is "a network of public-private partnerships across North Carolina that shares the common goal of helping all North Carolinians to be healthy." The members of local coalitions are representatives of the agencies and organizations that serve the health and human service needs of the local population, as well as representatives from businesses, communities of faith, schools and civic groups. In Dare County, the local Healthy Carolinians coalition is Healthy Carolinians of the Outer Banks (HCOB). The community health assessment, which is both a process and a document, investigates and describes the current health status of the community, what has changed since the last assessment, and what still needs to change to improve the health of the community. The process involves the collection and analysis of a large range of data, including demographic, socioeconomic and health statistics, environmental data, and professional and public opinion. The document is a summary of all the available evidence and serves as a resource until the next assessment. The completed CHNA serves as the basis for prioritizing the community's health needs, and culminates in planning to meet those needs. | The Outer Banks Hospital, Inc. | |
| Part V, Section B, Line 5c: The CHNA is available at: https://www.vidanthealth.com/uploadedFiles/UHSEastMain/UHS_East/CHNA_reports/TOBH%20CHNA%202013.pdf | The Outer Banks Hospital, Inc. | |
| Part V, Section B, Line 7: Certain community needs may not be fully documented or addressed in the Community Health Needs Assessment. These needs are generally those which other organizations share an overlap with The Outer Banks Hospital. TOBH is not equipped to handle all needs and has prioritized those that it can fully address. | The Outer Banks Hospital, Inc. | |
| Part V, Section B, Line 14g: The full policy is not available on the facility website. In lieu of the policy, a concise summary is provided with pertinent details and phone numbers for additional information. | The Outer Banks Hospital, Inc. | |
| Part VI, Line 2: The organization assesses community need in conjunction with the state affiliated county health departments and other local health care organizations. See also Schedule H, Part V, Section B, lines 1-7 | ||
| Part VI, Line 3: Information is available on the organization's website and at registration for patients. In addition, face-to-face financial counseling is available to patients and their families in the central business office. | ||
| Part VI, Line 4: See Schedule O, Part III | ||
| Part VI, Line 5: See Schedule O, Part III | ||
| Part VI, Line 6: See Schedule O, Part III | ||
| NC | Reports Filed With States | Part VI, Line 7 |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 1 | RecordsMaintained |
Form990 Schedule I Part III Form990ScheduleIPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Type Of Grant | Scholarships | TypeOfGrant |
| Number Of Recipients | 6 | NumberOfRecipients |
| Amount Of Cash Grant | 6000 | AmountOfCashGrant |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Procedure for Monitoring Grants in the U.S.: | Identifier |
| Return Reference | Part I, Line 2: | ReturnReference |
| Explanation | Schedule I, Part I, Line 2: The Outer Banks Hospital has a Community Benefits Grants Review Committee consisting of local representatives to guide the support and grantmaking process. Scholarships are provided through the health careers program, with scholarship funds provided directly to the students' institutions. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 1 | 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 (7 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Roger Robertson | ||||||||||||||
| Board Director | 0 | 362398 | 0 | 36780 | 0 | 1692 | 0 | 70556 | 0 | 20263 | 0 | 491689 | 0 | 0 |
| Todd Warlitner | ||||||||||||||
| VP, Business Operations | 132804 | 0 | 8913 | 0 | 0 | 0 | 15235 | 0 | 40415 | 0 | 197367 | 0 | 0 | 0 |
| Ronald Sloan | ||||||||||||||
| President, Outer Banks Hospital | 197438 | 0 | 29123 | 0 | 0 | 0 | 23473 | 0 | 36345 | 0 | 286379 | 0 | 0 | 0 |
| Judy Bruno | ||||||||||||||
| VP, Clinical Operations | 129245 | 0 | 8836 | 0 | 0 | 0 | 14577 | 0 | 33633 | 0 | 186291 | 0 | 0 | 0 |
| Gary Hunter | ||||||||||||||
| Anesthesiologist | 403754 | 0 | 500 | 0 | 0 | 0 | 0 | 0 | 40418 | 0 | 444672 | 0 | 0 | 0 |
| Monte Thompson | ||||||||||||||
| Director, Pharmacy | 145845 | 0 | 500 | 0 | 0 | 0 | 0 | 0 | 29131 | 0 | 175476 | 0 | 0 | 0 |
| Edward Heise | ||||||||||||||
| Director, Emergency - AMU | 123891 | 0 | 500 | 0 | 0 | 0 | 0 | 0 | 31976 | 0 | 156367 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)
| Return ReferenceReturnReference | ExplanationExplanation |
|---|---|
| Part I, Line 3 | The Top Management Official is the President who is an employee of TOBH. The compensation is determined by the Compensation and Benefits Committee of the Vidant Health Board using comparative data from like organizations and input from consultants. This process is performed every two years, the last year being 2012. It will be performed again in fiscal year 2014. Compensation of other officers and key employees is also determined by the Compensation and Benefits Committee of the VH Board using comparative data from like organizations and input from consultants. This process is performed every two years, the last year being 2012. It will be performed again in fiscal year 2014. All compensation discussions and actions are documented and approved in the minutes of the Committee. |
| Part I, Line 4b | The following individual participated in a supplemental non-qualified retirement plan during the year. The yearly change of such plan is included in their compensation per Schedule J, Part II, column C: - Roger Robertson, $19,716 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (8 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| Form 990, Part VI, Section A, line 6 | According to the Organization's amended and restated bylaws, Article II, the Organization has two members, East Carolina Health and Chesapeake Hospital Authority. | |
| Form 990, Part VI, Section A, line 7a | The members elect the Board of Directors. | |
| Form 990, Part VI, Section A, line 7b | The following actions shall not be taken without unanimous consent of the members: possess property, invest funds, additional capital contributions, admit members, merger or dissolution, amendment, certificate of need litigation, sale of assets, and business of the Corporation. | |
| Form 990, Part VI, Section B, line 11 | The Form 990 is made available to Board Members by posting to a Board Member's website. Any Board Member who does not have the ability to access the return in this manner will receive a copy via electronic or regular mail. The return is also reviewed by the Chief Financial Officer, Chief General Counsel and the Chief Audit and Compliance Officer of University Health Systems prior to filing. | |
| Form 990, Part VI, Section B, line 12 | All Officers, Board Members and Key Employees are required to complete a yearly comprehensive conflict of interest questionnaire. These responses are reviewed by legal counsel and any potential or actual conflicts are brought to the Board for disposition. Board Members are instructed to report any potential conflicts arising during the year for review. Board Members are required to recuse themselves from voting on issues in which they are deemed to have a conflict. | |
| Form 990, Part VI, Section B, line 15 | The Top Management Official is the President who is an employee of The Outer Banks Hospital, Inc. The compensation is determined by the Compensation and Benefits Committee of the Vidant Health Board using comparative data from like organizations and input from consultants. This process is performed every two years, the last year being 2012. It will be performed again in fiscal year 2014. Compensation of other officers and key employees is also determined by the Compensation and Benefits Committee of the VH Board using comparative data from like organizations and input from consultants. This process is performed every two years, the last year being 2012. It will be performed again in fiscal year 2014. All compensation discussions and actions are documented and approved in the minutes of the Committee. | |
| Form 990, Part VI, Section C, line 19 | The Organization makes its governing documents, conflict of interest policy, and financial statements available to the public upon request. | |
| Form 990, Part XI, line 9: | Net asset transfers to/from related parties -11,660,000. | Changes in Net Assets or Fund Balances: |
Schedule R IRS990ScheduleR
Form990 Schedule R Part I Form990ScheduleRPartI (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Total IncomeTotalIncome | EOY AssetsEOYAssets | Direct Controlling Entity NADirectControllingEntityNA |
|---|---|---|---|---|---|---|---|---|---|
| Outer Banks Professional Svcs LLC | |||||||||
| 604 Amanda Street | Manteo | NC | 27954 | 270484506 | Family Practice | NC | -998694 | 844397 | N/A |
| Outer Banks Medical Office Building LLC | |||||||||
| 4810 South Croatan Highway | Nags Head | NC | 27959 | 161740979 | Medical Office Building | NC | -686094 | 3996520 | N/A |
Form990 Schedule R Part II Form990ScheduleRPartII (11 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Direct Controlling Entity NADirectControllingEntityNA | Controlled OrgControlledOrg | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| University Health Systems of Eastern Carolina (DBA Vidant Health) | |||||||||||
| 2100 Stantonsburg Road | Greenville | NC | 27835 | 562141073 | Healthcare | NC | 501(c)(3) | Line 11c, III-FI | N/A | 0 | |
| Pitt County Memorial Hospital Inc (DBA Vidant Medical Center) | |||||||||||
| 2100 Stantonsburg Road | Greenville | NC | 27835 | 560585243 | Hospital | NC | 501(c)(3) | Line 3 | 0 | Vidant Health | |
| Surgicenter Services of Pitt Inc | |||||||||||
| 102 Bethesda Drive | Greenville | NC | 27835 | 561690553 | Healthcare | NC | 501(c)(3) | Line 11b, II | 0 | Vidant Medical Center | |
| East Carolina Health Inc (DBA Vidant Community Hospitals - Central) | |||||||||||
| 2100 Stantonsburg Road | Greenville | NC | 27835 | 562003393 | Hospital | NC | 501(c)(3) | Line 3 | 0 | Vidant Health | |
| East Carolina Health-Bertie (DBA Vidant Bertie Hospital) | |||||||||||
| 2100 Stantonsburg Road | Greenville | NC | 27835 | 562072002 | Hospital | NC | 501(c)(3) | Line 3 | 0 | Vidant Health | |
| East Carolina Health-Chowan (DBA Vidant Chowan Hospital) | |||||||||||
| 2100 Stantonsburg Road | Greenville | NC | 27835 | 562101090 | Hospital | NC | 501(c)(3) | Line 3 | 0 | Vidant Health | |
| East Carolina Health-Heritage (DBA Vidant Edgecombe Hospital) | |||||||||||
| 2100 Stantonsburg Road | Greenville | NC | 27835 | 562093700 | Hospital | NC | 501(c)(3) | Line 3 | 0 | Vidant Health | |
| East Carolina Health-Beaufort (DBA Vidant Beaufort Hospital) | |||||||||||
| 2100 Stantonsburg Road | Greenville | NC | 27835 | 452436270 | Hospital | NC | 501(c)(3) | Line 3 | 0 | Vidant Health | |
| Duplin General Hospital (DBA Vidant Duplin Hospital) | |||||||||||
| 2100 Stantonsburg Road | Greenville | NC | 27835 | 566011594 | Hospital | NC | 501(c)(3) | Line 3 | 0 | Vidant Health | |
| East Carolina Health Inc (DBA Vidant Roanoke-Chowan Hospital) | |||||||||||
| 2100 Stantonsburg Road | Greenville | NC | 27835 | 264634725 | Hospital | NC | 501(c)(3) | Line 3 | 0 | Vidant Health | |
| Pungo District Hospital Corporation (DBA Vidant Pungo Hospital) | |||||||||||
| 2100 Stantonsburg Road | Greenville | NC | 27835 | 560518757 | Hospital | NC | 501(c)(3) | Line 3 | 0 | Vidant Health | |
| 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 | 0 | 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 | 1 | 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 | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 1 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (5 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| Vidant Medical Center | ||
| P | 3577706 | Actual Cash Payment |
| East Carolina Health Inc | ||
| Q | 6996000 | Actual Cash Payment |
| Vidant Medical Group | ||
| J | 94582 | Actual Cash Payment |
| Vidant Medical Group | ||
| M | 3202488 | Actual Cash Payment |
| Vidant Chowan Hospital | ||
| P | 218205 | Actual Cash Payment |