STANLY REGIONAL MEDICAL CENTER: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
STANLY REGIONAL MEDICAL CENTER (EIN 56-0556760)
Tax period
2012-10-01 to 2013-09-30
Filed
2014-08-14
IRS object ID
201412269349301401
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

FieldValueIRS element (for citing)
Timestamp2014-08-14T09:13:35-05:00Timestamp
Tax Period End Date2013-09-30TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN410746749EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1CLIFTONLARSONALLEN LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1101 N TRYON STREET SUITE 1000AddressLine1
CityCHARLOTTECity
StateNCState
ZIP Code28246ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN560556760EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1STANLY REGIONAL MEDICAL CENTERBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlSTANNameControl
Phone7049844393Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1POST OFFICE BOX 1489AddressLine1
CityALBEMARLECity
StateNCState
ZIP Code28002ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameNYKOLA SAMILOName
TitleVP, CFOTitle
Phone7049844000Phone
Date Signed2014-08-08DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameJOHN NORMANName
PTINP01506766PTIN
Phone7049985200Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonALFRED TAYLORNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1301 YADKIN ROADAddressLine1
CityALBEMARLECity
StateNCState
ZIP Code28001ZIPCode
FieldValueIRS element (for citing)
Gross Receipts105107460GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.STANLY.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1945YearFormation
State Legal DomicileNCStateLegalDomicile
Activity Or Mission DescriptionTO FACILITATE IMPROVING THE HEALTH OF PEOPLE IN THE COMMUNITIES WE SERVE.ActivityOrMissionDescription
Nbr Voting Members Governing Body13NbrVotingMembersGoverningBody
Nbr Independent Voting Members12NbrIndependentVotingMembers
Total Nbr Employees888TotalNbrEmployees
Total Nbr Volunteers116TotalNbrVolunteers
Total Gross UBI6015059TotalGrossUBI
Net Unrelated Business Txbl Income-342176NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year597039ContributionsGrantsPriorYear
Contributions Grants Current Year530863ContributionsGrantsCurrentYear
Program Service Revenue Prior Year103661704ProgramServiceRevenuePriorYear
Program Service Revenue CY98818771ProgramServiceRevenueCY
Investment Income Prior Year1283320InvestmentIncomePriorYear
Investment Income Current Year642175InvestmentIncomeCurrentYear
Other Revenue Prior Year-2339593OtherRevenuePriorYear
Other Revenue Current Year511033OtherRevenueCurrentYear
Total Revenue Prior Year103202470TotalRevenuePriorYear
Total Revenue Current Year100502842TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year54915GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY78400GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year47922158SalariesEtcPriorYear
Salaries Etc Current Year47236362SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year48706087OtherExpensePriorYear
Other Expenses Current Year50108712OtherExpensesCurrentYear
Total Expenses Prior Year96683160TotalExpensesPriorYear
Total Expenses Current Year97423474TotalExpensesCurrentYear
Revenues Less Expenses Prior Year6519310RevenuesLessExpensesPriorYear
Revenues Less Expenses CY3079368RevenuesLessExpensesCY
Total Assets BOY116240531TotalAssetsBOY
Total Assets EOY116138826TotalAssetsEOY
Total Liabilities BOY41648937TotalLiabilitiesBOY
Total Liabilities EOY37266024TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY74591594NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY78872802NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionSTANLY REGIONAL MEDICAL CENTER'S MISSION IS TO FACILITATE IMPROVING THE HEALTH OF PEOPLE IN THE COMMUNITIES WE SERVE, BY PROVIDING QUALITY SERVICES THAT ARE COMPREHENSIVE, AFFORDABLE AND DELIVERED: COMPASSIONATELY, APPROPRIATELY, RESPONSIBLY, EFFICIENTLY. THE HOSPITAL USES ITS RESOURCES TO EFFECTIVELY AND EFFICIENTLY PROVIDE QUALITY HEALTH CARE TO THE RESIDENTS OF STANLY COUNTY AND THE IMMEDIATELY SURROUNDING AREAS IN A PASSIONATE AND RESPONSIVE MANNER. IN KEEPING WITH THE HOSPITAL'S MISSION THE HOSPITAL:-PROVIDES CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS WITH REIMBURSEMENT AT A LEVEL BELOW THE COST OF PROVIDING THAT CARE;-PROVIDES BAD DEBT AND CHARITY CARE;-PROVIDES HEALTH ACTIVITIES, SPACE AND PROGRAMS TO SUPPORT THE COMMUNITY.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense63162761Expense
Grants78400Grants
Revenue93956920Revenue
DescriptionSTANLY REGIONAL MEDICAL CENTER PROVIDED APPROXIMATELY 20,600 INPATIENT DAYS OF CARE AND APPROXIMATELY 79,000 OUTPATIENT VISITS (EXCLUDING LABS) DURING 2013. DISCHARGES WERE APPROXIMATELY 4,600.AS STATED ABOVE, STANLY REGIONAL PROVIDED HEALTH CARE TO MEDICARE AND MEDICAID PATIENTS WITH REIMBURSEMENT BELOW THE HOSPITAL'S COST. THE HOSPITAL RECOGNIZES THESE AMOUNTS AS A FORM OF UNCOMPENSATED CARE IN MEETING ITS MISSION.Description
Total Program Service Expense63162761TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities1LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities1ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets1ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Financial Stmt Attached1FinancialStmtAttached
Grants To Organizations0GrantsToOrganizations
Grants To Individuals1GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109686NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees888NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income1UnrelatedBusinessIncome
Form990-T Filed1Form990-TFiled
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members13NbrVotingGoverningBodyMembers
Number Independent Voting Members12NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties1DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledNCStatesWhereCopyOfReturnIsFiled
Other WebsiteXOtherWebsite
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1PENNY PATRICKBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number7049844643TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1301 YADKIN ROADAddressLine1
CityALBEMARLECity
StateNCState
ZIP Code28001ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (22 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationAverage Hours Per Week RelatedAverageHoursPerWeekRelatedOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
LARRY BAUCOM
CHAIRMAN1.00X000
DAVID W HORTON SR
VICE CHAIRMAN1.00X000
ELBERT L WHIT WHITLEY JR
SECOND VICE CHAIRMAN1.00X000
DARRELL ALMOND
IMMEDIATE PAST CHAIRMAN1.00X000
MICHAEL G HARWOOD
BOARD MEMBER1.00X000
KRISTI JACKSON
BOARD MEMBER1.00X000
SHERRILL SMITH
BOARD MEMBER1.00X000
JACK P JORDAN
BOARD MEMBER1.00X000
DAWN ALLEN
BOARD MEMBER1.00X000
STEPHEN CHAMBERS
BOARD MEMBER1.00X000
DR RUFUS S LEFLER III
BOARD MEMBER1.00X000
DR MICHAEL MCLEOD
BOARD MEMBER1.00X02629623111539.00
DR MIKE BOHNSACK
BOARD MEMBER1.00X000
ALFRED P TAYLOR
PRESIDENT, CEO40.00328888053442X
NYKOLA SAMILO
VICE-PRESIDENT, CFO40.00212304042833X
JUDY DORAN
CNE40.00154155013602X
BRAD MARINO
VP PHYSICIAN NETWORK/SURGE40.00156107020247X
ANJANA M YOUNG
DIRECTOR ANESTHESIOLOGY40.00224061019172X
JEFFREY B PITMAN
ANESTHESIOLOGIST40.0022356605755X
WILLIAM R DENNIS
ANESTHESIOLOGIST40.00183901020289X
KELLY J NEW
ANESTHESIOLOGIST40.00183066021202X
SUZANNE MCLESTER
ANESTHESIOLOGIST40.00184780021237X
FieldValueIRS element (for citing)
Total Reportable Comp From Org1850828TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs262962TotalReportableCompFrmRltdOrgs
Total Other Compensation248894TotalOtherCompensation
Number Individuals GT100 K27NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
CAROLINAS MEDICAL CENTER
1000 BLYTHE BLVDCHARLOTTENC28203MANAGEMENT SERVICES3948910
LEIDOS HEALTH LLC
705 E MAIN STWESTFIELDIN46074SOFTWARE CONVERSION1054816
CAROLINAS HOSPITALIST GROUP STANLY
400 GOLF ACRESCHARLOTTENC28208HOSPITALIST678794
TRUSTAFF
4270 GLENDALE MILFORD RDCINCINNATIOH45242NURSE STAFFING661994
DIVERSIFIED CLINICAL SERVICES
PO BOX 636981CINCINNATIOH48263WOUND CARE STAFF541590
FieldValueIRS element (for citing)
Number Of Contractors GT100 K25NumberOfContractorsGT100K
All Other Contributions530863AllOtherContributions
Total Contributions530863TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenue
PATIENT REVENUE6214008762930387629303
UNRELATED PHARMACY62140060150596015059

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

FieldValueIRS element (for citing)
Total Revenue Column5174409TotalRevenueColumn
Related Or Exempt Function Income5174409RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue98818771TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column1166209TotalRevenueColumn
Exclusion$1,166,209ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities4080584Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities4604618Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities-524034Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-524034TotalRevenueColumn
Exclusion-$524,034ExclusionAmount

Other Revenue Misc OtherRevenueMisc (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
EQUITY EARNINGS900099536442536442
SETTLEMENT OF PENSION ANNUITY CON900099-25409-25409
FieldValueIRS element (for citing)
Total Other Revenue511033TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column100502842TotalRevenueColumn
Related Or Exempt Function Income93314745RelatedOrExemptFunctionIncome
Unrelated Business Revenue6015059UnrelatedBusinessRevenue
Exclusion$642,175ExclusionAmount
FieldValueIRS element (for citing)
Info In Schedule O Part IXXInfoInScheduleOPartIX

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total78400Total
Program Services78400ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total372079Total
Management And General372079ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total35562468Total
Program Services31618634ProgramServices
Management And General3943834ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total1218118Total
Management And General1218118ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total7553375Total
Program Services110429ProgramServices
Management And General7442946ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total2530322Total
Program Services2215176ProgramServices
Management And General315146ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total1006330Total
Management And General1006330ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total67739Total
Management And General67739ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total75342Total
Management And General75342ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total9758248Total
Program Services5952062ProgramServices
Management And General3806186ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total994499Total
Program Services47477ProgramServices
Management And General947022ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total1750580Total
Program Services1307591ProgramServices
Management And General442989ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total4436005Total
Management And General4436005ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total1568585Total
Program Services1114883ProgramServices
Management And General453702ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total30052Total
Program Services19305ProgramServices
Management And General10747ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total184311Total
Program Services84012ProgramServices
Management And General100299ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total1177317Total
Management And General1177317ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total5946907Total
Program Services2629971ProgramServices
Management And General3316936ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total1106905Total
Management And General1106905ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
SUPPLIES, REPAIRS AND M1770537917158747546632
MRI/GAP ASSESSMENT FEES26049682604968
MISCELLANEOUS770253396689373564
DUES AND SUBSCRIPTIONS707286248588458698

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total218006Total
Program Services180797ProgramServices
Management And General37209ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total97423474Total
Program Services63162761ProgramServices
Management And General34260713ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY3975731BOY
EOY5947485EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY16595926BOY
EOY13201654EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY2459616BOY
EOY2339151EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY1664454BOY
EOY1208634EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis148380611LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec100198169LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY49114981BOY
EOY48182442EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY34165629BOY
EOY35965608EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY8264194BOY
EOY9293852EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY116240531BOY
EOY116138826EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY8913339BOY
EOY7465500EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY20139197BOY
EOY22016581EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY12596401BOY
EOY7783943EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY41648937BOY
EOY37266024EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY73372723BOY
EOY78166322EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY1218871BOY
EOY706480EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY74591594BOY
EOY78872802EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY116240531BOY
EOY116138826EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses3079368ReconcilationRevenueExpenses
Reconciliation Unrealized Invest1134192ReconciliationUnrealizedInvest
Reconcilation Donated Services710755ReconcilationDonatedServices
Reconcilation Other Changes-643107ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement ConsolidatedXFinancialStatementConsolidated
FieldValueIRS element (for citing)
Audit Committee1AuditCommittee
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0Volunteers
Paid Staff Or Management0PaidStaffOrManagement
Media Advertisements0MediaAdvertisements
Mailings Members0MailingsMembers
Publications Or Broadcast0PublicationsOrBroadcast
Grants Other Organizations0GrantsOtherOrganizations
Direct Contact Legislators0DirectContactLegislators
Rallies Demonstrations0RalliesDemonstrations
Other Activities1OtherActivities
Other Activities$20,109OtherActivitiesAmount
Total Lobbying Expenditures IIB20109TotalLobbyingExpendituresIIB
Not Described In501c30NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierEXPLANATION OF LOBBYING ACTIVITIES:Identifier
Return ReferencePART II-B, LINE 1:ReturnReference
ExplanationA PORTION OF MEMBER ORGANIZATION DUES ARE ATTRIBUTABLE TO LOBBYING.Explanation

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis8385970OtherCostOrOtherBasis
Book Value8385970BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis76101666OtherCostOrOtherBasis
Depreciation58069212Depreciation
Book Value18032454BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis52310306OtherCostOrOtherBasis
Depreciation33995894Depreciation
Book Value18314412BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis11582669OtherCostOrOtherBasis
Depreciation8133063Depreciation
Book Value3449606BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings48182442TotalOfBookValueLandBuildings

Other Securities OtherSecurities

FieldValueIRS element (for citing)
DescriptionINVESTMENTSDescription
Book Value35965608BookValue
Method Of ValuationFMethodOfValuation
FieldValueIRS element (for citing)
Total Of Book Value Securities35965608TotalOfBookValueSecurities

Other Assets OtherAssets (3 entries)

DescriptionDescriptionBook ValueBookValue
OTHER RECEIVABLES3166960
ADVANCES TO AFFILIATES1045786
OTHER ASSETS5081106
FieldValueIRS element (for citing)
Total Book Value Other Assets9293852TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS$3,693,167
PENSION LIABILITY$4,090,776
FieldValueIRS element (for citing)
Total Of Amounts7783943TotalOfAmounts
Footnote In Part XIIIXFootnoteInPartXIII

Form990 Schedule D Part XIII Form990ScheduleDPartXIII

FieldValueIRS element (for citing)
IdentifierDESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:Identifier
Return ReferencePART X, LINE 2:ReturnReference
ExplanationTHE SYSTEM, HOSPITAL, FOUNDATION, STANLEX, SMS AND MANOR ARE NON PROFIT ORGANIZATIONS UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND ARE EXEMPT FROM INCOME TAX ON REVENUE EARNED FROM THEIR TAX-EXEMPT STATUS. ALLIANCE AND LIFESMART ARE FOR-PROFIT ENTITIES AND THEREFORE, RECORD INCOME TAX EXPENSE/BENEFIT, AS APPLICABLE. THE SYSTEM, HOSPITAL, FOUNDATION, STANLEX, SMS AND MANOR'S INCOME TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL, STATE, AND LOCAL AUTHORITIES. THE SYSTEM, HOSPITAL, FOUNDATION, STANLEX, SMS AND MANOR ARE NOT AWARE OF ANY ACTIVITIES THAT WOULD JEOPARDIZE THEIR TAX-EXEMPT STATUSES. THE SYSTEM, HOSPITAL, FOUNDATION, STANLEX, SMS AND MANOR ARE NOT AWARE OF ANY ACTIVITIES THAT ARE SUBJECT TO TAX ON UNRELATED BUSINESS INCOME OR EXCISE OR OTHER TAXES. THE TAX RETURNS FOR THE YEARS 2009 TO 2012 ARE OPEN TO EXAMINATION BY FEDERAL, LOCAL, AND STATE AUTHORITIES. THE SYSTEM HAS ADOPTED THE INCOME TAX STANDARD ISSUED BY FINANCIAL ACCOUNTING STANDARDS BOARD IN LIGHT OF ITS STATUS AS AN ORGANIZATION EXEMPT FROM FEDERAL AND STATE INCOME TAXES. THIS STANDARD CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN AN ORGANIZATION'S FINANCIAL STATEMENTS IN ACCORDANCE WITH THE INCOME TAX STANDARD. THIS STANDARD PRESCRIBES RECOGNITION AND MEASUREMENT OF TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN ON A TAX RETURN THAT ARE NOT CERTAIN TO BE REALIZED.Explanation

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
FPG Reference Free Care1FPGReferenceFreeCare
Pcent200XPcent200
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent300XPcent300
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget0ExpensesExceededBudget
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available1ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense3741062TotalCommunityBenefitExpense
Direct Offsetting Revenue316225DirectOffsettingRevenue
Net Community Benefit Expense3424837NetCommunityBenefitExpense
Percent Of Total Expense0.03520PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense17553400TotalCommunityBenefitExpense
Direct Offsetting Revenue11497967DirectOffsettingRevenue
Net Community Benefit Expense6055433NetCommunityBenefitExpense
Percent Of Total Expense0.06220PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

FieldValueIRS element (for citing)
Total Community Benefit Expense267993TotalCommunityBenefitExpense
Direct Offsetting Revenue142336DirectOffsettingRevenue
Net Community Benefit Expense125657NetCommunityBenefitExpense
Percent Of Total Expense0.00130PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense21562455TotalCommunityBenefitExpense
Direct Offsetting Revenue11956528DirectOffsettingRevenue
Net Community Benefit Expense9605927NetCommunityBenefitExpense
Percent Of Total Expense0.09870PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense471918TotalCommunityBenefitExpense
Net Community Benefit Expense471918NetCommunityBenefitExpense
Percent Of Total Expense0.00480PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense8081TotalCommunityBenefitExpense
Net Community Benefit Expense8081NetCommunityBenefitExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense479999TotalCommunityBenefitExpense
Net Community Benefit Expense479999NetCommunityBenefitExpense
Percent Of Total Expense0.00490PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense22042454TotalCommunityBenefitExpense
Direct Offsetting Revenue11956528DirectOffsettingRevenue
Net Community Benefit Expense10085926NetCommunityBenefitExpense
Percent Of Total Expense0.10360PercentOfTotalExpense

Workforce Development WorkforceDevelopment

FieldValueIRS element (for citing)
Total Community Building Expense147910TotalCommunityBuildingExpense
Net Community Building Expense147910NetCommunityBuildingExpense
Percent Of Total Expense0.00150PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Total Community Building Expense147910TotalCommunityBuildingExpense
Net Community Building Expense147910NetCommunityBuildingExpense
Percent Of Total Expense0.00150PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported1BadDebtExpenseReported
Bad Debt Expense$5,484,487BadDebtExpenseAmount
Amount Reimbursed By Medicare26672301AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare29531117CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-2858816MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care1ProvisionForCharityCare

Form990 Schedule H Part IV Form990ScheduleHPartIV (2 entries)

Description Ent Primary ActivityDescriptionEntPrimaryActivityOrganization Profit Or OwnershipOrganizationProfitOrOwnership
1 WEST STANLY IMAGING
RADIOLOGY JOINT VENTURE0.51000
2 STANLY REGIONAL WEST LLC
MEDICAL PROPERTY DEVELOPMENT/LEASING COMPANY0.24200
FieldValueIRS element (for citing)
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1STANLY REGIONAL MEDICAL CENTER INCBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1301 YADKIN STREETAddressLine1
CityALBEMARLECity
StateNCState
ZIP Code28001ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Er24 HoursXEr24Hours
OtherINPATIENT REHABILIATION UNIT AND INPATIENT PSYCHIATRIC UNITOther

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1STANLY REGIONAL MEDICAL CENTER INCBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
CHNA Conducted1CHNAConducted
Community DefinitionXCommunityDefinition
Community DemographicsXCommunityDemographics
Existing ResourcesXExistingResources
How Data ObtainedXHowDataObtained
Community Health NeedsXCommunityHealthNeeds
Identifying ProcessXIdentifyingProcess
Consulting ProcessXConsultingProcess
Needs Assessment Conducted12NeedsAssessmentConducted
Take Into Account1TakeIntoAccount
Other Facilities0OtherFacilities
CHNA Widely Available1CHNAWidelyAvailable
Own WebsiteXOwnWebsite
On RequestXOnRequest
Adopt Implement StrategyXAdoptImplementStrategy
Execute Implement StrategyXExecuteImplementStrategy
Develop Community PlanXDevelopCommunityPlan
Participate Community PlanXParticipateCommunityPlan
Include Operational PlansXIncludeOperationalPlans
Adopt BudgetXAdoptBudget
Prioritize Health NeedsXPrioritizeHealthNeeds
Prioritize ServicesXPrioritizeServices
All Needs Addressed0AllNeedsAddressed
Organization Incur Excise Tax0OrganizationIncurExciseTax
Eligibility Criteria Explained1EligibilityCriteriaExplained
Uses FPG Free1UsesFPGFree
FPG Free Percent200.000000000000FPGFreePercent
Uses FPG Discounted1UsesFPGDiscounted
FPG Discount Percent300.000000000000FPGDiscountPercent
Explains Basis1ExplainsBasis
Income LevelXIncomeLevel
Asset LevelXAssetLevel
Medical IndigencyXMedicalIndigency
Insurance StatusXInsuranceStatus
Uninsured DiscountXUninsuredDiscount
Explains Application Method1ExplainsApplicationMethod
Includes Publicity Measures1IncludesPublicityMeasures
Posted On WebsiteXPostedOnWebsite
Posted In Emergency RoomXPostedInEmergencyRoom
Posted In Admission OfficeXPostedInAdmissionOffice
Available On RequestXAvailableOnRequest
Other PublicityXOtherPublicity
Actions On Nonpayment1ActionsOnNonpayment
Permit Report To Credit AgencyXPermitReportToCreditAgency
Permit LawsuitXPermitLawsuit
Permit Lien On ResidenceXPermitLienOnResidence
Collection Activities1CollectionActivities
Report To Credit AgencyXReportToCreditAgency
LawsuitXLawsuit
Lien On ResidenceXLienOnResidence
Notify Upon AdmissionXNotifyUponAdmission
Notify Before DischargeXNotifyBeforeDischarge
Notified All PatientsXNotifiedAllPatients
Documented DeterminationXDocumentedDetermination
Other Actions TakenXOtherActionsTaken
Nondiscrim Emergency Care Policy1NondiscrimEmergencyCarePolicy
Used Other MethodXUsedOtherMethod
Amounts Generally Billed0AmountsGenerallyBilled
Gross Charges1GrossCharges

Form990 Schedule H Part VI Form990ScheduleHPartVI (20 entries)

ExplanationExplanationIdentifierIdentifierReturn ReferenceReturnReference
PART I, LINE 3C: WE USE THE FEDERAL POVERTY GUIDELINES AT 300% AS PUBLISHED BY THE US DEPT OF HEALTH AND HUMAN SERVICES. WE USE INCOME AND LIST OF ASSETS TO DETERMINE ELIGIBILITY.
PART I, LINE 7: THE ORGANIZATION USED THE IRS WORKSHEETS TO CALCULATE THE AMOUNTS REPORTED ON SCHEDULE H.
PART I, LINE 7G: N/A. NO SUBSIDIZED HEALTH SERVICES PROVIDED.
PART I, L7 COL(F): THE ORGANIZATION DOES NOT HAVE A PROCESS FOR ESTIMATING THE AMOUNT OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY FINANCIAL ASSISTANCE POLICY. THE ORGANIZATION MAKES ITS BEST EFFORT TO DETERMINE FINANCIAL ASSISTANCE ELIGIBILITY WITH EVERY PATIENT.
PART II: STANLY REGIONAL RECRUITS PHYSICIANS NEEDED TO PROVIDE ADEQUATE CARE AND PROMOTE HEALTH AMONG OUR COMMUNITY. PHYSICIANS RECRUITED RECENTLY INCLUDE FAMILY MEDICINE, GENERAL SURGERY, ORTHOPEDICS, GASTROENTROLOGY AND UROLOGY. ALSO, A MEMBER OF THE EXECUTIVE LEADERSHIP TEAM PARTICIPATES IN COMMUNITY COMMITTEES - LOCAL EMERGENCY PLANNING COMMITTEE AND ENVIRONMENTAL AFFAIRS BOARD.
PART III, LINE 4: BAD DEBT EXPENSE IS CALCULATED BY ANALYZING THE AGING OF ACCOUNTS FROM THEIR SERVICE DATE AND APPLYING A RESERVE PERCENTAGE BASED ON THE AGING BUCKET THAT THEY FALL INTO. AGING BUCKETS ARE AS FOLLOWS: IN-HOUSE/UNBILLED @ 6%; < 30 DAYS @ 6%; 31-60 DAYS @ 30%; 61-90 DAYS @ 45%; 91-120 DAYS @ 60%; 121-150 DAYS @ 100%; >150 DAYS @ 100%. BAD DEBT WRITE OFFS AND RECOVERIES ARE POSTED TO THE BAD DEBT ALLOWANCE ACCOUNT AND THE ALLOWANCE ACCOUNT IS THEN ADJUSTED TO MATCH THE CALCULATED AMOUNT PER THE AGING MODEL.
PART III, LINE 8: THE ORGANIZATION USED THE IRS WORKSHEETS TO CALCULATE THE AMOUNTS REPORTED ON SCHEDULE H.
PART III, LINE 9B: THERE ARE NO COLLECTION EFFORTS AS SOON AS AN ACCOUNT IS IDENTIFIED AS CHARITY CARE OR FINANCIAL ASSISTANCE IF IT IS 100%. WE APPLY THE FULL ADJUSTMENT AT TIME OF APPROVAL. FOR ACCOUNTS THAT HAVE ONLY PARTIAL FINANCIAL ASSISTANCE THE REMAINING BALANCE FOLLOWS COLLECTION PROCESS DEFINED FOR ALL OTHER ACCOUNTS.
PART V, SECTION B, LINE 3: REPRESENTATIVES FROM THE LOCAL HEALTH DEPARTMENT AND UNITED WAY WERE INVOLVED IN CONDUTING THE CHNA, FOCUS GROUPS AND COLLOBORATED IN THE FINAL WRITTEN DOCUMENT AND INPLEMENTATION STRATEGY.STANLY REGIONAL MEDICAL CENTER, INC.
PART V, SECTION B, LINE 7: STANLY REGIONAL MEDICAL CENTER HAS NOT ADDRESSED THE COMMUNITY CONCERN REVOLVING AROUNG ILLEGAL DRUG USE AS THIS IS BEST ADDRESSED BY LOCAL LAW ENFORCEMENT AND IT OUTSIDE OF THE SCOPE OF SERVICES PROVIDED BY THE HOSPITAL. SRMC HAS CHOSEN TO WORK ON OBESITY/DIABETES AND CANCER IN CONJUNCTION WITH THE LOCAL HEALTH DEPARTMENT. LACK OF PHYSICAL ACTIVITY WILL BE ADDRESSED INDIRECTLY THROUGH THE OBESITY/DIABETES INITIATIVES.STANLY REGIONAL MEDICAL CENTER, INC.
PART V, SECTION B, LINE 14G: AVAILABLILITY OF FINANCIAL ASSISTANCE POLICY IS NOTED ON EACH BILLING STATEMENTSTANLY REGIONAL MEDICAL CENTER, INC.
PART V, SECTION B, LINE 18E: SEND LETTER TO POTENTIAL PATIENTS AFTER DISCHARGE.STANLY REGIONAL MEDICAL CENTER, INC.
PART V, SECTION B, LINE 20D: ALL PATIENTS REGARDLESS OF COVERAGE ARE CHARGED THE SAME AMOUNT FOR ALL PROCEDURES.STANLY REGIONAL MEDICAL CENTER, INC.
PART V, SECTION B, LINE 22: SAME AMOUNT IS CHARGED FOR ALL PATIENTS, THEN FINANCIAL ASSISTANCE ADJUSTMENT IS TAKEN WHEN APPROVED.STANLY REGIONAL MEDICAL CENTER, INC.
PART VI, LINE 2: STANLY REGIONAL WORKS IN PARTNERSHIP WITH THE STANLY COUNTY HEALTH DEPARTMENT AND OTHER AREA AGENCIES TO CONDUCT A COMMUNITY HEALTH NEEDS ASSESSMENT. THE FINDINGS FROM THIS REPORT ARE USED TO HELP OUR ORGANIZATION TARGET SPECIFIC DEMOGRAPHICS AND RELATED HEALTH CONCERNS AND ILLNESSES WITH SIGNIFICANT PREVALENCE IN OUR SERVICE AREA. IN ADDITION TO THIS LOCAL EFFORT, STANLY REGIONAL ALSO RELIES ON STATISTICS PROVIDED BY THE NORTH CAROLINA HOSPITAL ASSOCIATION AND VARIOUS DISEASE-SPECIFIC AGENCIES SUCH AS THE NORTH CAROLINA STROKE ASSOCIATION TO OBTAIN NEEDS ASSESSMENT INFORMATION.
PART VI, LINE 3: WE HAVE OUR POLICY POSTED ON OUR WEBSITE AS WELL AS THROUGH THE NC HOSPITAL ASSOCIATION. WE OFFER "ABOUT YOUR BILL" BROCHURES THAT HAVE DIFFERENT BILLING PROCEDURES INCLUDING OUR FINANCIAL ASSISTANCE. WE HAVE BILLING STAFF AVAILABLE M-F, 8:30 - 5:00 TO ASSIST AND ANSWER QUESTIONS RELATING TO OUR FINANCIAL ASSISTANCE POLICY.
PART VI, LINE 4: THE PROFILES OF STANLY REGIONAL MEDICAL CENTER AUDIENCES CONSIST OF THE FOLLOWING GEOGRAPHIC AND DEMOGRAPHIC FACTORS. (1) CENTRAL SERVICE AREA - THE CENTRAL SERVICE AREA CONSISTS OF ALBEMARLE, NORWOOD, NEW LONDON, AND BADIN. THE MEDIAN INCOME FOR THIS AREA IS $45,179.00. THE 2008 POPULATION FOR THIS AREA WAS 44,042. THE 2013 PROJECTED POPULATION FOR THIS AREA IS 44,930. THE AVERAGE AGE OF THIS AREA IS 39. (2) WESTERN SERVICE AREA - THE WESTERN SERVICE AREA CONSISTS OF OAKBORO, STANFIELD, RICHFIELD, LOCUST, MISENHEIMER, GOLD HILL, AND MT. PLEASANT. THE MEDIAN INCOME FOR THIS AREA IS $48,764.00. THE 2008 POPULATION FOR THIS AREA WAS 18,724. THE 2013 PROJECTED POPULATION FOR THIS AREA IS 19,402. THE AVERAGE AGE OF THIS AREA IS 37. (3) EASTERN SERVICE AREA - THE EASTERN SERVICE AREA CONSISTS OF MT. GILEAD AND TROY. THE MEDIAN INCOME FOR THIS AREA IS $39,652. THE 2008 POPULATION FOR THIS AREA WAS 14,707. THE 2013 PROJECTED POPULATION FOR THIS AREA IS 14,931. THE AVERAGE AGE OF THIS AREA IS 39.
PART VI, LINE 5: STANLY REGIONAL PROMOTES WELLNESS AND DISEASE MANAGEMENT IN THE COMMUNITIES IT SERVES BY HOSTING NUMEROUS HEALTH SCREENINGS TARGETING HIGH BLOOD PRESSURE, STROKE PREVENTION, HEART DISEASE AND DIABETES. THESE SCREENINGS TAKE PLACE THROUGH CIVIC GROUPS, AREA CHURCHES, COMMUNITY GROUPS AND GEOGRAPHIC SERVICE AREA EVENTS AND FESTIVALS. OUR EMPLOYEES ALSO SERVE AS MEMBERS OF A SPEAKER'S BUREAU WHERE THEY SERVE AS GUEST LECTURERS ON HEALTHCARE TOPICS OF INTEREST TO ORGANIZATIONS, SCHOOLS AND PUBLIC FORUMS.IN ADDITION TO DISEASE-SPECIFIC HEALTH SCREENINGS AND EDUCATION, THE HOSPITAL WORKS CLOSELY WITH OTHER AREA NOT-FOR-PROFITS TO CULTIVATE THE COMMUNITY'S NEEDS (HABITAT FOR HUMANITY, ADOPT-A-HIGHWAY, COMMUNITY TABLE, GROUP HOMES FOR THE AUTISTIC, ETC). THROUGH COMMUNITY EFFORTS AND INITIATIVES, THE HOSPITAL'S EMPLOYEES HAVE ASSISTED IN BUILDING AND CLEAN UP PROJECTS, AS WELL AS FEEDING AND CARING FOR THOSE LESS FORTUNATE IN THE AREA. STANLY REGIONAL ALSO DONATES MEDICAL SUPPLIES AS NEEDED TO AREA CHURCH GROUPS LEAVING FOR OVERSEAS MISSION TRIPS.
PART VI, LINE 6: EFFECTIVE MARCH 1, 2009, THE PARENT COMPANY ENTERED INTO A MANAGEMENT SERVICES AGREEMENT WITH THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY D/B/A CAROLINAS HEALTHCARE SYSTEM (CHS).
NCREPORTS FILED WITH STATESPART VI, LINE 7

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Form990 Schedule I Part III Form990ScheduleIPartIII

FieldValueIRS element (for citing)
Type Of GrantEDUCATIONAL ASSISTANCETypeOfGrant
Number Of Recipients22NumberOfRecipients
Amount Of Cash Grant78400AmountOfCashGrant

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierPROCEDURE FOR MONITORING GRANTS IN THE U.S.:Identifier
Return ReferencePART I, LINE 2:ReturnReference
ExplanationSCHEDULE I, PART I, LINE 2: EMPLOYEES ARE GRANTED EDUCATION REIMBURSEMENT BASED ON NEED, AVAILABILITY, AND APPROPRIATE DOCUMENTATION.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (10 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
DR MICHAEL MCLEOD
BOARD MEMBER0258292046700009427021688029407700
ALFRED P TAYLOR
PRESIDENT, CEO2505140595420188320242910291510382330000
NYKOLA SAMILO
VICE-PRESIDENT, CFO172997037102022050189340238990255137000
JUDY DORAN
CNE13470301768501767011546020560167757000
BRAD MARINO
VP PHYSICIAN NETWORK/SURGE1561070000032430170040176354000
ANJANA M YOUNG
DIRECTOR ANESTHESIOLOGY2240610000084820106900243233000
JEFFREY B PITMAN
ANESTHESIOLOGIST223566000000057550229321000
WILLIAM R DENNIS
ANESTHESIOLOGIST1839010000037880165010204190000
KELLY J NEW
ANESTHESIOLOGIST1830660000058580153440204268000
SUZANNE MCLESTER
ANESTHESIOLOGIST1847800000038940173430206017000

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
ExplanationA FORMER OFFICER RECEIVED A SEVERANCE PAYMENT DURING THE YEAR.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (8 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
FORM 990, PART VI, SECTION A, LINE 3THREE EMPLOYEES (CEO, COO, CFO) ARE EMPLOYED BY THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY D/B/A CAROLINAS HEALTHCARE SYSTEM ("CHS") AND LEASED TO THE ORGANIZATION THROUGH A MANAGEMENT AGREEMENT.
FORM 990, PART VI, SECTION B, LINE 11CFO AND CONTROLLER WILL REVIEW AND COPIES WILL BE EMAILED TO BOARD MEMBERS AND REVIEWED AT FINANCE COMMITTEE AND BOARD MEETINGS.
FORM 990, PART VI, SECTION B, LINE 12CEACH MEMBER OF THE BOARD OF DIRECTORS FILES A CONFLICT OF INTEREST STATEMENT ANNUALLY WHICH IS REVIEWED BY THE BOARD CHAIR AND IS MAINTAINED BY THE CORPORATE SECRETARY. MEMBERS WITH POTENTIAL CONFLICTS ARE ASKED TO EXCUSE THEMSELVES FROM VOTING ON MATTERS THAT ARE OF POTENTIAL CONFLICT.
FORM 990, PART VI, SECTION B, LINE 15CHS, WHICH LEASES THE CEO, COO, AND CFO TO THE ORGANIZATION THROUGH A MANAGEMENT AGREEMENT, CONDUCTS AN ANNUAL COMPENSATION THAT BENCHMARKS THE SALARIES OF THOSE THREE INDIVIDUALS TO THE SALARIES OF SIMILARLY SITUATED SERVICE PROVIDERS.
FORM 990, PART VI, SECTION C, LINE 19THESE DOCUMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART IX, LINE 11GINDEPENDENT CONTRACTOR SERVICES : PROGRAM SERVICE EXPENSES 5,952,062. MANAGEMENT AND GENERAL EXPENSES 3,806,186. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 9,758,248.OTHER FEES
FORM 990, PART XI, LINE 9:UNRECOGNIZED PENSION EXPENSE 3,831,435. TRANSFERS TO AFFILIATES, NET -3,962,151. CONTRIBUTIONS, NET 569,651. NET ASSETS RELEASED FROM RESTRICTION -710,755. NET ASSETS RELEASED FROM RESTRICTION -371,287.CHANGES IN NET ASSETS OR FUND BALANCES:
FORM 990, PART XII, LINE 2CTHE ORGANIZATION HAS A COMMITTEE THAT ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THE ORGANIZATION HAS NOT CHANGED ITS OVERSIGHT PROCESS OR SELECTION PROCESS DURING THE TAX YEAR.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (4 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNAControlled OrgControlledOrg
STANLY REGIONAL MEDICAL CENTER FOUNDATION INC
301 YADKIN STREETALBEMARLENC28001561698181CHARITYNC501(C)(3)170(B)(1)(A)(VI)N/A0
STANLY MEDICAL SERVICES INC
320 YADKIN STREETALBEMARLENC28001561892763HEALTHCARENC501(C)(3)509(A)(2)N/A0
STANLY MANOR INC
625 BETHANY ROADALBEMARLENC28001561623092LONG-TERM HEALTHCARENC501(C)(3)509(A)(2)N/A0
STANLEX INC
907 NORTH SECOND STREETALBEMARLENC28001561532751HEALTHCARENC501(C)(3)509(A)(3)N/A0

Form990 Schedule R Part III Form990ScheduleRPartIII (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateDirect Controlling Entity NADirectControllingEntityNAPredominant Income TypePredominantIncomeTypeDisproportionate AllocationsDisproportionateAllocationsGeneral Or Managing PartnerGeneralOrManagingPartnerPercentage OwnershipPercentageOwnership
STANLY REGIONAL WEST LLC
301 YADKIN STREETALBEMARLENC28001260512251HEALTHCARENCN/ARELATED010.24200
WEST STANLY IMAGING LLC
301 YADKIN STREETALBEMARLENC28001262414332HEALTHCARENCN/ARELATED010.51000

Form990 Schedule R Part IV Form990ScheduleRPartIV (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateDirect Controlling Entity NADirectControllingEntityNAType Of EntityTypeOfEntityPercentage OwnershipPercentageOwnershipControlled OrgControlledOrg
ALLIANCE MEDICAL INC
907 N SECOND STREETALBEMARLENC28002561682606HEALTHCARENCN/AC1.000000
LIFESMART INC
301 YADKIN STREETALBEMARLENC28001010790640HEALTHCARENCN/AC1.000000
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties1ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org1GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Dividends Related Organization0DividendsRelatedOrganization
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org1OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (8 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
STANLY MEDICAL SERVICES INC
A958042MARKET VALUE (RENTS)
STANLY REGIONAL MEDICAL CENTER FOUNDATION INC
B75000CASH VALUE
STANLY REGIONAL MEDICAL CENTER FOUNDATION INC
C99885GRANTS
STANLY REGIONAL MEDICAL CENTER FOUNDATION INC
M91666FUNDRAISING
STANLY REGIONAL MEDICAL CENTER FOUNDATION INC
O122868SALARY & BENEFITS
STANLY MEDICAL SERVICES INC
O178091FY SALARY & BENEFITS (BRAD MARINO
STANLY MEDICAL SERVICES INC
P2272151EXPENSES (WRITE-OFFS)
STANLY MEDICAL SERVICES INC
R1615000CASH VALUE (CASH TRANSFERS)

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