2014-08-15T14:49:55-05:00 2013-09-30 621517792 PERSHING YOAKLEY & ASSOCIATES PC ONE CHEROKEE MILLS 2220 SUTHERLAND AVE KNOXVILLE TN 379192363 990 2012-10-01 560714394 HARRIS REGIONAL HOSPITAL INC HARR 8285867000 68 HOSPITAL ROAD SYLVA NC 28779 MICHAEL MCKNIGHT 8285867000 2014-08-15 1 DEBORAH O ERNSBERGER P00364912 8656730844 2012 2015-11-30 17:44:51Z MICHAEL MCKNIGHT 68 HOSPITAL ROAD SYLVA NC 28779 97700872 0 X WWW.WESTCARE.ORG X 1960 NC TO PROVIDE HIGH QUALITY, COST EFFECTIVE HEALTHCARE TARGETED TO THE NEEDS OF THE PEOPLE WE SERVE. 14 14 1227 37 91891 -35840 486091 425623 99127809 92811350 553903 557937 799785 3307655 100967588 97102565 421704 362113 0 0 44241376 37767867 0 0 0 64017206 61326620 108680286 99456600 -7712698 -2354035 62732089 58182544 54751034 48750369 7981055 9432175 X HARRIS REGIONAL HOSPITAL, INC. IS A MEMBER OF THE WESTCARE HEALTH SYSTEM ("WESTCARE"). THE MISSION OF WESTCARE IS TO PROVIDE HIGH QUALITY, COST EFFECTIVE HEALTHCARE TARGETED TO THE NEEDS OF THE PEOPLE WE SERVE. WESTCARE'S VISION IS EXCELLENCE IN CARE, SERVICE, AND VALUE - ONE PATIENT AT A TIME. WESTCARE'S CORE VALUES ARE COMPASSION, ACCOUNTABILITY, RESPECT, AND EXCELLENCE WHICH TOGETHER COMPRISE "WE C.A.R.E." 0 0 84083624 362113 92811350 HARRIS REGIONAL HOSPITAL ("THE HOSPITAL") IS DEDICATED TO THE PROMOTION OF HEALTH AND WELLNESS FOR THE RESIDENTS OF WESTERN NORTH CAROLINA AND SURROUNDING COMMUNITIES. HARRIS REGIONAL HOSPITAL IS AN 86-BED ACUTE CARE FACILITY LOCATED IN SYLVA, NORTH CAROLINA. HARRIS REGIONAL HAS BEEN A VITAL PART OF THE COMMUNITY AND REGION THROUGHOUT ITS HISTORY. A FULLY ACCREDITED, NOT-FOR-PROFIT COMMUNITY HOSPITAL, HARRIS REGIONAL HAS EXPERIENCED STRONG GROWTH IN RECENT YEARS, WITH MAJOR EXPANSIONS IN 1997, 1986, 1989, 1994, AND 1995. THE HOSPITAL'S MEDICAL STAFF HAS THE DIVERSITY AND PROFESSIONAL TALENTS OF MANY HOSPITALS TWICE ITS SIZE. TOGETHER WITH THE QUALIFIED STAFF, THEY SUCCESSFULLY PROVIDE PATIENTS THE FINEST IN MEDICAL CARE. HARRIS REGIONAL HOSPITAL OFFERS MANY SERVICES TO HELP DIAGNOSE AND TREAT ALMOST ANY NEED. SERVICES INCLUDE: OUTPATIENT SURGERY, LABORATORY SERVICES, IMAGING SERVICES, PULMONARY REHABILITATION SERVICES, BIRTHING CENTER, TRANSITIONAL CARE UNIT, INTENSIVE CARE UNIT, PHARMACY, EMERGENCY DEPARTMENT, DIETARY SERVICES, OCCUPATIONAL HEALTH, SOCIAL SERVICES, SPORTS MEDICINE, AND PASTORAL SERVICE. 84083624 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 58 0 1 1227 1 1 1 0 0 0 0 0 0 0 0 0 X 14 14 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 NC X JOY FREEMAN 8285867653 68 HOSPITAL ROAD SYLVA NC 28779 X HEATHER BAKER 1.00 2.00 X 0 0 0 JOHN BUENTING MD 1.00 2.00 X 0 0 0 DANIEL ALLISON 1.00 2.00 X 0 0 0 CLIFFORD FAULL 1.00 2.00 X 0 0 0 MARTHA ANDERSON MD 1.00 2.00 X 0 0 0 LOWELL CRISP 1.00 2.00 X 0 0 0 ELIZABETH JOHNS 1.00 2.00 X 0 0 0 JOE HURT 1.00 2.00 X 0 0 0 TIMOTHY LEWIS 1.00 2.00 X 0 0 0 STEPHANIE TREADWAY 1.00 2.00 X 0 0 0 MARK TYSON 1.00 2.00 X 0 0 0 ANN MARIE WRIGHT 1.00 2.00 X 0 0 0 CHUCK WOOTEN 1.00 2.00 X 0 0 0 DAVID THOMAS MD 1.00 2.00 X 0 0 0 STEPHEN HEATHERLY 40.00 1.00 X 194269 0 27566 MICHAEL MCKNIGHT 40.00 1.00 X 71398 0 3756 GREG COPEN 40.00 1.00 X 147714 0 30767 TYSON SMITH MD 40.00 1.00 X 316557 0 54063 JUDSON GARBARINO 40.00 0.00 X 210403 0 4104 GAIL GIBSON 40.00 0.00 X 186859 0 16161 CHRISTOPHER RICH 40.00 0.00 X 179637 0 18573 NORMAN PILLSBURY 40.00 0.00 X 179085 0 13168 BARBARA MAILMAN 40.00 0.00 X 178751 0 7220 1664673 0 175378 15 0 1 0 HAYWOOD REGIONAL MEDICAL CENTER 262 LEROY GEORGE DRIVE CLYDE NC 28721 PHYSICIAN SERVICES 9630098 CAROLINAS HEALTHCARE SYSTEM PO BOX 32861 CHARLOTTE NC 28232 MANAGEMENT SERVICES 2550864 CROTHALL SERVICES GROUP 136 FAIRVIEW ROAD MOORESVILLE NC 28117 JANITORIAL SERVICES 1606550 MORRISON MANAGEMENT SPECIALISTS 1000 BLYTHE BOULEVARD CHARLOTTE NC 28203 FOOD SERVICES 775639 ALLSCRIPTS 8529 SIX FORKS ROAD FORUM IV RALEIGH NC 27615 MANAGEMENT SERVICES 634680 31 196572 78715 150336 425623 NET PATIENT REVENUE 621990 92133254 92041363 91891 COUNTY EMS 621910 562055 562055 LIFELINE 621990 199284 199284 GAIN-INV. IN AFFILIATES 523000 -83243 -83243 92811350 556866 556866 71 71 572657 598307 -25650 -25650 -25650 1000 0 1000 1000 1000 EHR INCENTIVE REVENUE 900099 1940764 1940764 MISCELLANEOUS INCOME 900099 804454 804454 MEALS & VENDING 722210 329651 329651 258436 258436 3333305 97102565 92802702 91891 3782349 X 356763 356763 5350 5350 1079647 894811 184836 29800011 24698249 5101762 1277285 1058614 218671 3412467 2828253 584214 2198457 1822081 376376 1229857 1019305 210552 831734 689341 142393 64198 53207 10991 18407731 15256329 3151402 44553 36926 7627 4177198 3462062 715136 1249020 1035188 213832 921714 763917 157797 1128640 935417 193223 4092777 3392094 700683 760045 629925 130120 BAD DEBTS 9299052 9299052 MEDICAL SUPPLIES 7739978 6414894 1325084 REPAIRS & MAINTENANCE 4715750 3908414 807336 LEASES 1882832 1560491 322341 4781541 3962941 818600 99456600 84083624 15372976 0 6504 5000 2852407 3245017 9684648 9323632 1456458 1198568 1004087 1183886 98560334 70510490 31124902 28049844 11791759 11119309 824592 956434 478674 335853 3508058 2765001 62732089 58182544 12726768 11954954 6127 116505 12217180 11032407 804626 687673 28996333 24958830 54751034 48750369 X 7377923 8869466 603132 562709 7981055 9432175 62732089 58182544 X -2354035 -69129 3874284 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 2327987 2327987 43435069 33760895 9674174 907580 907580 36126067 30739203 5386864 15763631 6010392 9753239 28049844 ACCRUED PENSION COST 6615402 OBLIGATIONS UNDER CAPITAL LEASE AGREEMENTS 9912944 ESTIMATED PHYSICIAN GUARANTEE LIABILITY 195676 DUE TO RELATED PARTY UNDER INTEGRATION AGREEMENT 5668027 DUE TO RELATED PARTIES 2566781 24958830 X DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: WESTCARE, HARRIS, AND SWAIN ARE EXEMPT FROM INCOME TAXES UNDER THE PROVISIONS OF SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. ACCORDINGLY, NO PROVISION FOR INCOME TAXES HAS BEEN INCLUDED IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS RELATED TO THESE ORGANIZATIONS. PROCOR, INC. IS A TAXABLE ENTITY AND ACCOUNTS FOR INCOME TAXES IN ACCORDANCE WITH FASB ASC 740, INCOME TAXES. THE ORGANIZATIONS HAVE NO UNCERTAIN TAX POSITIONS AT SEPTEMBER 30, 2013. 1 1 1 X 1 X 1 1 1 0 1 1 2443429 2443429 0.02710 2178549 2178549 0.02420 4621978 4621978 0.05130 33383 33383 0.00040 22671 22671 0.00030 56054 56054 0.00070 4678032 4678032 0.05200 1 4542386 0 25337151 24474939 862212 X 1 1 1 WESTERN REGIONAL RADIATION THERAPY CENTER HEALTH SERVICES 0.33330 0.00000 0.00000 1 1 HARRIS REGIONAL HOSPITAL

68 HOSPITAL ROAD WAYNESVILLE NC 28779

X X X HARRIS REGIONAL HOSPITAL 1 1 X X X X X X X X X 12 1 1 1 X X X X X X X X X X 0 0 1 1 150.000000000000 1 300.000000000000 1 X X X 1 1 X X X X X 1 0 1 X 0 0 PART I, LINE 7: COST IS DERIVED FROM THE ACTUAL EXPENSE DATA ACCUMULATED WITHIN THE HOSPITAL GENERAL LEDGER WHICH ADDRESSES ALL PATIENT SEGMENTS (INPATIENT, OUTPATIENT, EMERGENCY ROOM, PRIVATE INSURANCE, MEDICAID, MEDICARE, UNINSURED, AND SELF-PAY). THE HOSPITAL ALLOCATES THOSE EXPENSES TO ALL PATIENT SEGMENTS AT THE PROCEDURE LEVEL BASED ON A COST-TO-CHARGE RATIO. PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 9299052. PART III, LINE 4: A COST-TO-CHARGE RATIO WAS ALSO USED TO DETERMINE BAD DEBT COST. THE TOTAL OPERATING EXPENSE WAS DIVIDED BY PATIENT REVENUES TO CALCULATE AN OVERALL RATIO THAT WAS THEN APPLIED TO THE BAD DEBT EXPENSE TO ARRIVE AT COST.PER THE WESTCARE, INC. AND AFFILIATES AUDITED CONSOLIDATED FINANCIAL STATEMENTS AS OF AND FOR THE YEAR ENDED SEPTEMBER 30, 2013: FOR UNINSURED AND UNDERINSURED PATIENTS THAT DO NOT QUALIFY FOR FINANCIAL ASSISTANCE, THE ORGANIZATIONS RECOGNIZE REVENUE ON THE BASIS OF ITS STANDARD RATES, DISCOUNTED ACCORDING TO POLICY, FOR SERVICES RENDERED. HISTORICAL EXPERIENCE HAS SHOWN A SIGNIFICANT PROPORTION OF THE ORGANIZATIONS' UNINSURED PATIENTS, IN ADDITION TO A GROWING PROPORTION OF THE ORGANIZATIONS' INSURED PATIENTS, WILL BE UNABLE OR WILLING TO PAY FOR THEIR RESPONSIBLE AMOUNTS FOR THE SERVICES PROVIDED. IN ORDER TO ESTIMATE THE NET REALIZABLE VALUE OF THE REVENUES AND ACCOUNTS RECEIVABLES ASSOCIATED WITH THIRD-PARTY PAYERS AND UNINSURED PATIENTS, MANAGEMENT REGULARLY ANALYZES COLLECTION HISTORY. BASED ON THESE HISTORICAL COLLECTION ANALYSES, THE ORGANIZATIONS RECORD A PROVISION FOR BAD DEBTS AND AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS FOR THIRD-PARTY AND UNINSURED PATIENT ACCOUNTS RECEIVABLE BALANCES FOR WHICH THE PATIENT IS RESPONSIBLE. PART III, LINE 8: MEDICARE ALLOWABLE COSTS WERE REPORTED USING THE HOSPITAL'S FILED MEDICARE COST REPORT (C/R). THE C/R USES A COST TO CHARGE RATIO BASED ON A STEP-DOWN ALLOCATION METHODOLOGY. IN CARING FOR THE PATIENT, THERE ARE SEVERAL SERVICES THAT ARE CONSIDERED NON-ALLOWABLE BY CMS SUCH AS: TRANSPORTATION OF A PATIENT, COMFORT ITEMS TO INCLUDE A TELEVISION OR A TELEPHONE. ADDITIONAL NON-ALLOWABLE COSTS INCLUDE THE RECRUITMENT OF PHYSICIANS, PHYSICIAN GUARANTEES AND A PORTION OF THE BAD DEBT ASSOCIATED WITH THE CARE OF THE PATIENT. PART III, LINE 9B: IT IS THE POLICY OF THE HOSPITAL TO PURSUE COLLECTION OF PATIENT BALANCES FROM PATIENTS WHO HAVE THE ABILITY TO PAY FOR THESE SERVICES. THE HOSPITAL'S COLLECTION PRACTICES APPLY TO ALL PATIENTS, CHARITY CARE AND NON-CHARITY CARE, CONSISTENTLY AND FAIRLY REGARDLESS OF INSURANCE STATUS. AFTER THE PATIENT VISIT HAS BEEN CONCLUDED, A SUMMARY OF THE CHARGES WILL BE MAILED TO THE PATIENT FOR REVIEW. IF INSURANCE INFORMATION WAS PROVIDED UPON REGISTRATION, A CLAIM WILL BE SUBMITTED TO THE INSURANCE CARRIER ON THE PATIENT'S BEHALF. AFTER INSURANCE PROCESSING, THE PATIENT WILL RECEIVE A STATEMENT EXPLAINING THE INSURANCE RESPONSE AND OUTLINING THE PATIENT'S REMAINING BALANCE. SELF-PAY PATIENTS ARE ELIGIBLE TO RECEIVE A 20% PROMPT DISCOUNT IF THE ACCOUNT IS PAID IN FULL PRIOR TO OR ON THE DATE OF SERVICES. A 15% DISCOUNT WILL BE ISSUED IF PAYMENT IS MADE WITHIN 25 DAYS OF SERVICE. ADDITIONALLY, PATIENTS LACKING ADEQUATE RESOURCES TO PAY FOR MEDICAL CARE MAY QUALIFY FOR THE HOSPITAL'S CARE ASSISTANCE PROGRAM WHICH PROVIDES EXTENDED PAYMENT PLANS AND/OR PROMPT PAY DISCOUNTS UP TO 20% FOR PAYMENT IN FULL WITHIN 5 DAYS OF THE DISCHARGE AND ASSISTS PATIENTS IN APPLYING FOR STATE PROGRAMS TO MEET THEIR MEDICAL NEEDS. IF PAYMENT FOR SERVICES IS NOT RECEIVED IN FULL WITHIN 25 DAYS, THE ACCOUNT IS FORWARDED TO PROCOR BILLING SERVICES. THIS SERVICE ALLOWS FOR PATIENTS TO MAKE FINANCIAL ARRANGEMENTS THAT ARE BOTH ACCEPTABLE TO THE PATIENT AND TO THE HOSPITAL. FINANCIAL COUNSELORS DILIGENTLY WORK WITH PATIENTS AND EVALUATE NEW INFORMATION LEARNED DURING THE COLLECTION PROCESS TO DETERMINE IF COLLECTION ACTIVITIES SHOULD BE CEASED OR IF THE PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE. PAST DUE AMOUNTS ARE FORWARDED TO AN OUTSIDE COLLECTION AGENCY, WITH SUBSTANTIAL EXPERIENCE IN COLLECTION OF PATIENT ACCOUNTS, ONLY AFTER ALL ESTABLISHED STEPS HAVE BEEN UNDERTAKEN WITHOUT SUCCESS. HARRIS REGIONAL HOSPITAL PART V, SECTION B, LINE 3: THE ASSESSMENT WAS CONDUCTED IN CONJUNCTION WITH AREA HEALTH DEPARTMENTS AND AS PART OF THE REGIONAL WNC HEALTHY IMPACT COLLABORATION. HARRIS REGIONAL HOSPITAL PART V, SECTION B, LINE 4: TO ASSESS THE HEALTH OF HARRIS REGIONAL HOSPITAL'S COMMUNITY, HARRIS COLLABORATED WITH WNC HEALTHY IMPACT. WNC HEALTHY IMPACT IS A PARTNERSHIP BETWEEN HOSPITALS AND HEALTH DEPARTMENTS ACROSS A 16-COUNTY REGION IN WESTERN NORTH CAROLINA TO IMPROVE COMMUNITY HEALTH. MORE INFORMATION ABOUT THIS INNOVATIVE REGIONAL COLLABORATION, COUNTY-WIDE COMMUNITY HEALTH ASSESSMENTS, AND OVERALL REGIONAL FINDINGS ARE MADE WIDELY AVAILABLE TO THE PUBLIC AT WWW.WNCHEALTHYIMPACT.COM. HARRIS REGIONAL HOSPITAL PART V, SECTION B, LINE 7: SUBSTANCE ABUSE IN ADOLESCENTS AND THE NEED FOR POSITIVE TEEN ACTIVITIES WAS A COMMUNITY HEALTH NEED PRIORITIZED IN THE HARRIS COUNTY COMMUNITY HEALTH ASSESSMENT. HARRIS BELIEVES THIS HEALTH NEED CAN BE MORE ADEQUATELY ADDRESSED BY EXISTING PROGRAMS IN THE COMMUNITY SUCH AS WESTERN NORTH CAROLINA TEEN INSTITUTE AND ORGANIZATIONS IN THE COMMUNITY SUCH AS SMOKY MOUNTAIN CENTER. WESTERN NORTH CAROLINA TEEN INSTITUTE AND PREVENTION SERVICES ("WNCTIPS") IS A DEPARTMENT OF THE MOUNTAIN PROJECTS ORGANIZATION. THE WNCTIPS MISSION IS TO INCREASE RESILIENCE IN YOUTH, FAMILIES, AND COMMUNITIES THROUGH TARGETED EFFORTS TO REDUCE SUBSTANCE ABUSE AND OTHER RISKY BEHAVIORS. WNCTIPS PROVIDES VARIOUS PREVENTION SERVICES INCLUDING CLASSES, PRESENTATIONS, RESOURCES, NETWORKING, AND ALTERNATIVE ACTIVITIES. WNCTIPS IS BASED IN SYLVA, NORTH CAROLINA. SMOKY MOUNTAIN CENTER PROVIDES SCREENING, ASSESSMENT AND REFERRAL FOR MENTAL HEALTH, DEVELOPMENTAL DISABILITY, AND SUBSTANCE ABUSE SERVICES THROUGHOUT FIFTEEN WESTERN NORTH CAROLINA COUNTIES.ADDITIONALLY, THE JACKSON COUNTY COMMUNITY HEALTH ASSESSMENT PRIORITIZED THE NEED TO PROVIDE HEALTHIER FOOD OPTIONS IN THE COMMUNITY. THOUGH MEDWEST IS ADDRESSING NUTRITION EDUCATION AND NUTRITION WITHIN THE JACKSON COUNTY PUBLIC SCHOOL SYSTEM, HARRIS RECOGNIZES THAT IT ISN'T FULLY MEETING THE PRIORITIZED NEED AS IDENTIFIED BY THE JACKSON COUNTY COMMUNITY HEALTH ASSESSMENT. HARRIS BELIEVES IMPROVING THE FOOD OPTIONS OF THE COMMUNITY IS BEST LEFT UP TO LOCAL GOVERNMENT TO ATTRACT HEALTHY FOOD STORES AND RESTAURANTS TO THE AREA. HARRIS REGIONAL HOSPITAL PART V, SECTION B, LINE 20D: THE HOSPITAL USED MEDICARE RATES TIMES THE MARKUP PERCENTAGE FOR THAT FISCAL YEAR. PART VI, LINE 2: IN ORDER TO UNDERSTAND THE HEALTH NEEDS OF THE COMMUNITIES WE SERVE AND BEST PRIORITIZE OUR HEALTHCARE EFFORTS, MEDWEST HEALTH SYSTEM CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT ("CHNA") FOR MEDWEST-HARRIS AND MEDWEST-SWAIN. THE ASSESSMENTS WERE CONDUCTED IN CONJUNCTION WITH AREA HEALTH DEPARTMENTS AND AS PART OF THE REGIONAL WNC HEALTHY IMPACT COLLABORATION. THE DETERMINATION OF COMMUNITY HEALTH NEEDS TOOK INTO ACCOUNT COMMUNITY DEMOGRAPHICS, SOCIO-ECONOMIC FACTORS AND COMMUNITY INPUT. THE ASSESSMENT AND REPORT ARE IN ALIGNMENT WITH THE FEDERAL IRS COMMUNITY BENEFIT REPORTING REQUIREMENTS THAT AFFECT ALL STATE-LICENSED 501(C)(3) HOSPITALS. THE PRIORITIES IDENTIFIED IN THE ASSESSMENT HAVE BEEN ACCEPTED BY THE BOARD OF DIRECTORS. PART VI, LINE 3: TO COMMUNICATE THE HOSPITAL'S FINANCIAL POLICY TO THE PATIENT, THE HOSPITAL'S WEBSITE HAS A "PATIENTS AND VISITORS" MENU WHERE PATIENTS CAN GO TO VIEW INFORMATION ABOUT PAYMENT POLICIES, INSURANCE INFORMATION, AND THE HOSPITAL FINANCIAL ASSISTANCE (CARE ASSISTANCE) PROGRAM. THE WEBSITE GIVES THREE PHONE NUMBERS THAT PATIENTS CAN USE TO CONTACT A FINANCIAL COUNSELOR TO DISCUSS THEIR INDIVIDUAL FINANCIAL ALTERNATIVES. THE HOSPITAL'S CHARITY CARE POLICY AND FINANCIAL ASSISTANCE CONTACT INFORMATION IS POSTED IN THE ADMISSIONS AREAS, EMERGENCY AREAS, AND OTHER AREAS OF THE HOSPITAL'S FACILITIES IN WHICH ELIGIBLE PATIENTS MAY BE PRESENT. ALL STAFF WITH PATIENT CONTACT ARE KNOWLEDGEABLE ABOUT THE CHARITY CARE POLICY (ADMITTING AND BILLING CLERKS, NURSING AND MEDICAL STAFFS, SOCIAL WORKERS, CHAPLAINS, PATIENT ADVOCATES, ETC.). PART VI, LINE 4: THE HOSPITAL IS LOCATED IN SYLVA, JACKSON COUNTY, WHICH IS IN RURAL WESTERN NORTH CAROLINA. APPROXIMATELY 55% OF THE PATIENTS SERVED BY HARRIS RESIDE IN JACKSON COUNTY. MORE THAN 15% OF THE PATIENTS SERVED BY HARRIS RESIDE IN JACKSON'S NEIGHBORING COUNTY, SWAIN. BOTH GEORGRAPHIC AND DEMOGRAPHIC FACTORS SPECIFIC TO JACKSON AND SWAIN COUNTIES ARE DETAILED WITHIN THE HARRIS REGIONAL HOSPITAL COMMUNITY HEALTH NEEDS ASSESSMENT AVAILABLE ON THE HOSPITAL'S WEBSITE AT HTTPS://WESTCAREHEALTH.ORG. PART VI, LINE 5: THE HOSPITAL IS DEDICATED TO SERVING THE COMMUNITY BY IMPROVING THE QUALITY OF LIFE OF THE COMMUNITY THROUGH BETTER HEALTH. THE HOSPITAL IS COMMITTED TO PROVIDING QUALITY HEALTH CARE SERVICES IN A CARING ENVIRONMENT THAT FULFILLS THE NEEDS OF OUR PATIENTS, PHYSICIANS, EMPLOYERS, EMPLOYEES, AND COMMUNITY. THE HOSPITAL OPERATES AN EMERGENCY ROOM OPEN TO ALL PERSONS, WITHOUT REGARD TO THE ABILITY TO PAY. THE HOSPITAL USES ANY SURPLUS FUNDS TO IMPROVE THE QUALITY OF PATIENT CARE, EXPAND, OR IMPROVE ITS FACILITIES, AND ADVANCE ITS MEDICAL TRAINING, EDUCATION AND RESEARCH PROGRAMS. THE HOSPITAL'S BOARD OF DIRECTORS CONSISTS OF INDIVIDUALS REPRESENTING THE COMMUNITY. THE HOSPITAL MAINTAINS AN OPEN MEDICAL STAFF, WITH MEMBERSHIP AND PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS AND HEALTHCARE PROFESSIONALS. IN THESE AND OTHER RESPECTS, THE HOSPITAL IS ORGANIZED AND OPERATED IN A MANNER THAT PROMOTES THE HEALTH OF THE COMMUNITY AND THEREFORE FULFILLS CHARITABLE PURPOSES WITHIN THE MEANING OF INTERNAL REVENUE CODE SECTION 501(C)(3). PART VI, LINE 6: HARRIS REGIONAL HOSPITAL IS OWNED BY THE WESTCARE HEALTH SYSTEM, A GROWING, WELL-RESPECTED, NON-PROFIT HEALTH CARE PROVIDER THAT DELIVERS A FULL SPECTRUM OF HEALTH CARE FOR OVER 80,000 PEOPLE LIVING IN FOUR COUNTIES. WESTCARE HEALTH SYSTEM ("WESTCARE") WAS FORMED IN FEBRUARY 1997 WITH THE ESTABLISHMENT OF A COMBINATION BUSINESS AGREEMENT BETWEEN HARRIS REGIONAL HOSPITAL AND SWAIN COUNTY HOSPITAL TO DEVELOP A FULL SPECTRUM OF HEALTH SERVICES FOR WESTERN NORTH CAROLINA. WESTCARE ALSO OWNS THREE MEDICAL PARKS, WESTCARE MEDICAL PARK OF FRANKLIN LOCATED IN MACON COUNTY, WESTCARE MEDICAL PARK OF BRYSON CITY LOCATED IN SWAIN COUNTY, AND WESTCARE MEDICAL PARK OF SYLVA LOCATED IN JACKSON COUNTY. WESTCARE ALSO OPERATES MOUNTAIN REGIONAL CANCER CENTERS, TWO STATE OF THE ART RADIATION THERAPY FACILITIES PROVIDING ALL ASPECTS OF COMPREHENSIVE RADIATION THERAPY SERVICES. WESTCARE EMPLOYS ALMOST 1200 FULL AND PART TIME EMPLOYEES AND HAS A MEDICAL STAFF OF OVER 90 PHYSICIANS REPRESENTING 22 SPECIALTIES. WESTCARE IS GOVERNED BY A BOARD OF TRUSTEES, WHICH IS DRAWN FROM COMMUNITY LEADERS IN EACH OF THE FOUR PRIMARY COUNTIES IT SERVES. WESTCARE IS MANAGED AND OPERATED BY THE PEOPLE OF WESTERN NORTH CAROLINA, FOR THE PEOPLE OF WESTERN NORTH CAROLINA.IN JANUARY 2010, WESTCARE ENTERED INTO A JOINT OPERATING AGREEMENT WITH HAYWOOD REGIONAL MEDICAL CENTER IN WAYNESVILLE, NORTH CAROLINA, TO FORM MEDWEST HEALTH SYSTEM ("MEDWEST"). MEDWEST CONSISTS OF 323 LICENSED BEDS SYSTEM-WIDE. MEDWEST IS ALSO AFFILIATED WITH CAROLINAS HEALTHCARE SYSTEM, ONE OF THE SOUTHEAST'S LEADING HEALTHCARE SYSTEMS. PATIENTS BENEFIT FROM THE HOSPITAL'S AFFILIATION WITH A HEALTHCARE SYSTEM WHERE THEY CAN BE EFFICIENTLY MOVED ALONG AN INTEGRATED, COMPREHENSIVE CONTINUUM OF CARE AS THEIR HEALTH STATUS DICTATES. REPORTS FILED WITH STATES PART VI, LINE 7 NC 1 AMERICAN RED CROSS 2025 E STREET NW WASHINGTON DC 200065009 530196605 501(C)(3) 265520 GENERAL DONATION GOOD SAMARITAN CLUB OF JACKSON COUNTY 538 SCOTTS CREEK ROAD SYLVA NC 28779 562266536 501(C)(3) 37500 GENERAL DONATION NORTH CAROLINA HOSPITAL ASSOCIATION PO BOX 4449 CARY NC 27519 560641290 501(C)(6) 7137 GENERAL DONATION 3 0 SCHOLARSHIPS 15 4800 INDIGENT ASSISTANCE 1 550 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: THE ORGANIZATION HAS GUIDELINES IN PLACE THAT ARE TO BE USED IN REVIEWING THE ELIGIBILITY OF GRANTEES. ALL GRANTS REQUIRE WRITTEN DOCUMENTATION AND APPROPRIATE LEVELS OF APPROVAL. X X X 0 0 0 0 0 0 0 0 0 STEPHEN HEATHERLY 193635 0 0 0 634 0 4387 0 23179 0 221835 0 0 0 GREG COPEN 129107 0 7755 0 10852 0 8418 0 22349 0 178481 0 0 0 TYSON SMITH MD 309777 0 0 0 6780 0 26520 0 27543 0 370620 0 0 0 JUDSON GARBARINO 210403 0 0 0 0 0 0 0 4104 0 214507 0 0 0 GAIL GIBSON 186859 0 0 0 0 0 0 0 16161 0 203020 0 0 0 CHRISTOPHER RICH 179637 0 0 0 0 0 0 0 18573 0 198210 0 0 0 NORMAN PILLSBURY 179085 0 0 0 0 0 0 0 13168 0 192253 0 0 0 BARBARA MAILMAN 178751 0 0 0 0 0 0 0 7220 0 185971 0 0 0 FORM 990, PART VI, SECTION A, LINE 3 PURSUANT TO THE INTEGRATION AGREEMENT, BY AND AMONG WESTCARE, INC., HAYWOOD REGIONAL MEDICAL CENTER, THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY, INC. (D/B/A CAROLINAS HEALTHCARE SYSTEM) AND MEDWEST HEALTH SYSTEM, INC. (THE "SYSTEM"), WESTCARE, INC. HAS DELEGATED TO THE SYSTEM THE GENERAL AUTHORITY TO DIRECT AND OPERATE WESTCARE, INC. AND ITS RELATED ENTITIES, AND HAYWOOD REGIONAL MEDICAL CENTER ("HAYWOOD") HAS DELEGATED TO THE SYSTEM THE GENERAL AUTHORITY TO DIRECT AND OPERATE HAYWOOD AND ITS RELATED ENTITIES; PROVIDED, HOWEVER, THAT THE GENERAL AUTHORITY DELEGATED TO THE SYSTEM BY WESTCARE, INC. AND HAYWOOD IS LIMITED BY THE RETENTION BY WESTCARE, INC. AND HAYWOOD OF CERTAIN POWERS AND AUTHORITY OVER THEIR RESPECTIVE ACTIVITIES AND THE ACTIVITIES OF THEIR RESPECTIVE RELATED ENTITIES, AS DESCRIBED IN THE INTEGRATION AGREEMENT. FORM 990, PART VI, SECTION B, LINE 11 THE TAX RETURN IS PREPARED BY AN UNRELATED, INDEPENDENT ACCOUNTING FIRM AND SUBMITTED TO SENIOR MANAGEMENT WITHIN THE ORGANIZATION FOR INTERNAL REVIEW. COPIES ARE THEN PROVIDED TO EACH BOARD MEMBER FOR REVIEW PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION REQUIRES THAT EACH BOARD OF TRUSTEES MEMBER AND PRINCIPAL OFFICER REVIEWS THE CONFLICT OF INTEREST POLICY AND PROVIDES DISCLOSURE OF ANY ACTIVITIES WHICH COULD CONSTITUTE A CONFLICT OF INTEREST OR POTENTIAL CONFLICT OF INTEREST. ADDITIONALLY, BOARD OF TRUSTEES MEMBERS ARE ASKED TO RECUSE THEMSELVES ON ANY MATTERS OF INTEREST BEFORE THE BOARD IN WHICH A CONFLICT OF INTEREST MAY EXIST. ANY SUCH RECUSAL IS DOCUMENTED WITHIN THE MINUTES OF THE BOARD OR COMMITTEE. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD OF TRUSTEES REVIEWS AND APPROVES THE COMPENSATION OF EXECUTIVES AND OTHER OFFICERS. STATE AND NATIONAL COMPARABILITY DATA IS USED TO ASSIST IN DETERMINING APPROPRIATE COMPENSATION. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. MANAGEMENT COMPANY COMPENSATION: FORM 990, PART VII, SECTION A, MEDWEST AND THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY D/B/A CAROLINAS HEALTHCARE SYSTEM (CHS), A NORTH CAROLINA HOSPITAL AUTHORITY, ARE PARTIES IN A MANAGEMENT SERVICES AGREEMENT (MSA). THROUGH THIS AGREEMENT, MEDWEST HAS GRANTED CHS FULL POWER, AUTHORITY AND RESPONSIBILITY FOR THE MANAGEMENT OF MEDWEST, SUBJECT TO THE GENERAL OVERSIGHT OF THE MEDWEST BOARD OF DIRECTORS. THE TERMS OF THE MSA REQUIRE MEDWEST TO PAY CHS AN ANNUAL MANAGEMENT FEE BASED ON MEDWEST'S NET OPERATING REVENUES. IN ADDITION, CHS IS REQUIRED TO FURNISH MEDWEST WITH A CHIEF EXECUTIVE OFFICER, CHIEF FINANCIAL OFFICER AND VARIOUS OTHER EXECUTIVE POSITIONS AND MEDWEST IS REQUIRED TO REIMBURSE CHS FOR THE SALARY AND BENEFITS OF THESE INDIVIDUALS. CHS MAY ALSO PROVIDE PROJECT-SPECIFIC CONSULTING OR PROJECT-MANAGEMENT SERVICES AS REQUESTED FOR ADDITIONAL FEES. AVERAGE HOURS PER WEEK FOR RELATED ORGANIZATIONS: PART VII, SECTION A, LINE 1(A), COLUMN (B), THE ORGANIZATION'S OFFICERS SERVE THE SYSTEM AND THEREFORE ALL OF THE ENTITIES WITHIN THE SYSTEM. THE OFFICERS DO NOT ALLOCATE THEIR TIME BETWEEN ENTITIES BUT SERVE EACH ENTITY AS AN OFFICER ON A FULL-TIME BASIS. OTHER FEES FORM 990, PART IX, LINE 11G CONTRACTED PHYSICIAN EXPENSE: PROGRAM SERVICE EXPENSES 8,319,521. MANAGEMENT AND GENERAL EXPENSES 1,718,511. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 10,038,032. OUTSIDE SERVICE EXPENSE: PROGRAM SERVICE EXPENSES 3,899,627. MANAGEMENT AND GENERAL EXPENSES 805,521. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,705,148. PROFESSIONAL FEES : PROGRAM SERVICE EXPENSES 1,947,436. MANAGEMENT AND GENERAL EXPENSES 402,269. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,349,705. MEDICAL DIRECTOR FEES : PROGRAM SERVICE EXPENSES 124,113. MANAGEMENT AND GENERAL EXPENSES 25,637. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 149,750. CONTRACT PERSONNEL: PROGRAM SERVICE EXPENSES 965,632. MANAGEMENT AND GENERAL EXPENSES 199,464. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,165,096. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 9: CHANGE IN ACCRUED PENSION COST 3,355,685. REQUIRED SETTLEMENT - INTEGRATION AGREEMENT 715,171. CONTRIBUTION FROM RELATED PARTY -196,572. WESTCARE INC 68 HOSPITAL ROAD SYLVA NC 28779 561967734 HOSPITAL NC 501(C)(3) LINE 3 MEDWEST HEALTH SYSTEM INC 0 SWAIN COUNTY HOSPITAL INC 68 HOSPITAL ROAD SYLVA NC 28779 560629325 HOSPITAL NC 501(C)(3) LINE 3 WESTCARE INC 0 MEDWEST HEALTH SYSTEM INC 68 HOSPITAL ROAD SYLVA NC 28779 271472706 HEALTHCARE MANAGEMENT NC 501(C)(3) LINE 11C, III-FI N/A 0 HAYWOOD REGIONAL MEDICAL CENTER 262 LEROY GEORGE DRIVE CLYDE NC 28721 566000535 HOSPITAL AUTHORITY NC 501(C)(1) MEDWEST HEALTH SYSTEM INC 0 WESTERN REGIONAL RADIATION THERAPY CENTER 68 HOSPITAL ROAD SYLVA NC 28779 561849395 HEALTH SERVICES NC HARRIS REGIONAL HOSPITAL INC RELATED -24987 668236 0 1 0.33330 WESTCARE HEALTH CORPORATION 68 HOSPITAL ROAD SYLVA NC 38779 562039181 HEALTHCARE MANAGEMENT NC N/A C 0 PROCOR INC 68 HOSPITAL ROAD SYLVA NC 28779 562039184 HEALTHCARE MANAGEMENT NC N/A C 0 WESTERN CAROLINA PHYSICIAN NETWORK INC PO BOX 279 CLYDE NC 28721 261870386 HEALTHCARE SERVICES NC N/A C 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0