2014-08-06T15:32:49-05:00 2013-09-30 560747981 DIXON HUGHES GOODMAN LLP 500 RIDGEFIELD COURT ASHEVILLE NC 28806 990 2012-10-01 560562293 TRANSYLVANIA COMMUNITY HOSPITAL INC TRAN 8288849111 PO BOX 1116 BREVARD NC 28712 MARC NAKAGAWA 8288849111 2014-08-06 1 AMY BIBBY P00445891 8282542254 2012 2015-11-30 17:44:51Z TRANSYLVANIA REGIONAL HOSPITAL MARC NAKAGAWA PO BOX 1116 BREVARD NC 28712 77214589 0 X WWW.TRHOSPITAL.ORG X 1933 NC PROVISION OF MEDICAL SERVICES 13 9 689 180 0 0 902548 1946734 66901721 72078595 833574 2414322 843400 755399 69481243 77195050 288654 65647 0 0 29492336 30757643 0 0 0 40489605 40175191 70270595 70998481 -789352 6196569 61123845 75885413 23588066 23145585 37535779 52739828 X TRANSYLVANIA REGIONAL HOSPITAL PROMOTES WELLNESS AND PROVIDES ACCESS TO QUALITY HEALTH SERVICES FOR THE PEOPLE IN OUR REGION. 0 0 58429635 65647 72090439 GIVING BACK TO THE COMMUNITYAS A NOT-FOR-PROFIT HOSPITAL, TRANSYLVANIA REGIONAL HOSPITAL IS COMMITTED TO GIVING BACK TO THE COMMUNITY TO HELP THOSE WHO ARE UNINSURED OR UNDERINSURED AS WELL AS PROVIDING HEALTH EDUCATION AND BENEFITS FOR THE WELL BEING OF THE ENTIRE COMMUNITY. THE PAST YEAR WAS A CHALLENGING YEAR FOR OUR COMMUNITY AS WE EXPERIENCED THE LINGERING EFFECTS OF A DEPRESSED ECONOMY. THIS HAS LEFT MANY IN OUR COMMUNITY WITHOUT HEALTH INSURANCE AND STRUGGLING TO MAKE ENDS MEET. DESPITE CHALLENGING FINANCIAL TIMES FOR THE HOSPITAL, TRH CONTINUED TO GENEROUSLY HELP THOSE IN NEED.IN 2013, TRH PROVIDED $7.5 MILLION IN CONTRIBUTIONS TO THE COMMUNITY. THESE BENEFITS CAME IN MANY FORMS INCLUDING $2.2 MILLION IN CHARITY CARE FOR 3,500 PEOPLE. THE HOSPITAL ALSO PROVIDED ANOTHER $3.6 MILLION IN CARE FOR 4,400 PEOPLE THROUGH NON-COLLECTIBLE SERVICES. AN ADDITIONAL $1.2 MILLION WAS PROVIDED FOR GOVERNMENT SPONSORED HEALTHCARE INCLUDING INDIGENT CARE PROGRAMS. FINALLY, $502,000 WAS PROVIDED FOR COMMUNITY BENEFIT PROGRAMS INCLUDING THE DONATION OF STAFF TIME AND RESOURCES. HERE ARE JUST A FEW OF THE SERVICES SUPPORTED:- TRH OFFERS FREE OR LOW-COST EDUCATIONAL PROGRAMS FOR THE COMMUNITY EACH MONTH. PROGRAMS FEATURE TIMELY HEALTH TOPICS, AND ARE PRESENTED BY PHYSICIANS, NURSES, NURSE EDUCATORS, DIETITIANS AND OTHER CLINICAL PROFESSIONALS. MORE THAN 1,000 MEMBERS OF THE COMMUNITY TOOK ADVANTAGE OF THESE EDUCATIONAL OPPORTUNITIES - HELD AT THE HOSPITAL.- TRH OFFERS HEALTHCARE SERVICES THAT ARE NEEDED BY THIS COMMUNITY, REGARDLESS OF WHETHER OR NOT A MARGIN IS ACHIEVED BY PROVIDING CARE. EXAMPLES INCLUDE: EMERGENCY SERVICES AND BIRTHING CENTER.- TRH RECRUITED SEVERAL PHYSICIANS TO THE COMMUNITY IN 2013 TO EXPAND ACCESS TO HEALTHCARE FOR OUR RESIDENTS, INCLUDING A NEW FAMILY PRACTICE PHYSICIAN, A NEW INTERNIST, A FAMILY PRACTICE PHYSICIAN'S ASSISTANT, A NEW OB-GYN SPECIALIST; AND A PAIN MANAGEMENT SPECIALIST TO EXPAND CARE FOR THE COMMUNITY.- TRANSYLVANIA REGIONAL HOSPITAL LAUNCHED A STATE-OF-THE ART ELECTRONIC HEALTH RECORD (EHR) SYSTEM IN 2013 THAT PROVIDES EXPANDED RECORDS OF EACH PATIENT'S CARE. THE LAUNCH IS PART OF A LARGER MISSION HEALTH INITIATIVE TO IMPROVE CARE ACROSS THE REGION.- TRH PRIORITIZES DONATIONS OF STAFF TIME, MEETING SPACE, SUPPLIES, EQUIPMENT AND ADVERTISING FOR COMMUNITY GROUPS. SOME GROUPS THAT BENEFITED FROM IN-KIND DONATIONS WERE: MARCH OF DIMES, UNITED WAY, CHAMBER OF COMMERCE, S.A.F.E., AMERICAN RED CROSS, RELAY FOR LIFE, PROJECT LAZARUS COMMUNITY-BASED OVERDOSE PREVENTION, THE TRANSYLVANIA COUNTY SCHOOL SYSTEM, TRANSYLVANIA PARTNERSHIP FOR HEALTH, TRANSYLVANIA COUNTY ECONOMIC DEVELOPMENT, WNC HEALTHY IMPACT AND OTHERS.- TRH TEAMED WITH THE YMCA OF WESTERN NORTH CAROLINA IN 2013 TO STUDY THE FEASIBILITY OF BUILDING A MEDICAL WELLNESS FACILITY TO IMPROVE THE HEALTH AND WELLNESS OF TRANSYLVANIA COUNTY RESIDENTS.- TRH WAS AN ACTIVE PARTICIPANT IN THE 16-COUNTY REGIONAL HEALTH NEEDS ASSESSMENT PROJECT: WNC HEALTHY IMPACT. THIS INNOVATIVE EFFORT HELPED TRH TEAM WITH HEALTH DEPARTMENTS AND HOSPITALS ACROSS WESTERN NORTH CAROLINA TO IDENTIFY CRITICAL COMMUNITY HEALTH NEEDS AND PUT RESOURCES WHERE THEY ARE MOST NEEDED TO IMPROVE THE HEALTH AND LIVES OF RESIDENTS IN THIS COMMUNITY AND ACROSS THE REGION. TRH WORKED CLOSELY WITH THE TRANSYLVANIA COUNTY DEPARTMENT OF PUBLIC HEALTH TO DEVELOP A COMMUNITY HEALTH NEEDS ASSESSMENT FOR TRANSYLVANIA COUNTY.- TRH CONTINUED A CARE MANAGEMENT PROGRAM FOR COPD PATIENTS IN OUR COMMUNITY SUPPORTED BY GRANT FUNDING.- FOUR TRH PRIMARY CARE MEDICAL PRACTICES RECEIVED PATIENT-CENTERED MEDICAL HOME (PCMH) NATIONAL RECOGNITION IN ORDER TO DELIVER TEAM-BASED MEDICAL CARE TO PATIENTS IN OUR COMMUNITY TO MAXIMIZE HEALTH OUTCOMES FOR RESIDENTS OF ALL AGES.- TRH PARTICIPATED IN THE N.C. STROKE INITIATIVE IN 2013 TO ENSURE THE BEST PRACTICES IN STROKE CARE ARE EMPLOYED IN PATIENT CARE AT THE HOSPITAL AND TO BUILD PUBLIC AWARENESS OF THE RISKS OF STROKE.- TRH-ALONG WITH THE TRANSYLVANIA COUNTY HEALTH DEPARTMENT, THE FREE CLINIC AND OTHERS-WORKED COLLABORATIVELY TO BRING A BLUE RIDGE COMMUNITY HEALTH SERVICES CLINIC TO OUR LOCAL COMMUNITY. THE NEW BREVARD HEALTH CENTER OPENED IN FALL 2012 ON THE TRH CAMPUS TO INCREASE ACCESS TO AFFORDABLE, COMPREHENSIVE HEALTH SERVICES IN TRANSYLVANIA COUNTY. THE NEW FEDERAL HEALTH CENTER OFFERS A FULL SPECTRUM OF HEALTH SERVICES TO RESIDENTS, INCLUDING PRIMARY CARE FOR ADULTS AND CHILDREN, DENTAL SERVICES, MEDICATION ASSISTANCE AND BEHAVIORAL HEALTH.- TRH IMPLEMENTED A PALLIATIVE CARE PROGRAM WITH SUPPORT FROM THE TRH FOUNDATION TO MEET THE INCREASING NEEDS FOR THIS SERVICE IN OUR COMMUNITY. THIS LOCAL SERVICE PROVIDES COMPASSIONATE, EXPERT MEDICAL CARE TO RELIEVE AND PREVENT THE SUFFERING OF PATIENTS IN OUR COMMUNITY WHO ARE UNDERGOING TREATMENT FOR CURABLE ILLNESSES AND THOSE LIVING WITH CHRONIC DISEASES, AS WELL AS PATIENTS WHO ARE NEARING THE END OF LIFE. 58429635 1 1 0 1 0 0 0 0 0 1 1 0 1 1 1 1 0 1 0 0 0 0 0 0 1 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 75 0 1 689 1 0 0 0 0 0 1 1 0 0 0 0 X 13 9 0 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 NC X MARC NAKAGAWA 8288849111 260 HOSPITAL DRIVE BREVARD NC 28712 JOHN F HOLBROOK 1.00 X X 0 0 0 KENNETH G RACHT 1.00 X X 0 0 0 WILLIAM A TOWLER 1.00 1.00 X X 0 0 0 THELMA ERICKSON 1.00 X X 0 0 0 ROBERT J BEDNAREK 40.00 1.00 X X 302355 0 52735 JIM KELLING MD 1.00 X 0 287109 15919 JOE COHEN MD 1.00 X 0 0 0 CHARLES AYSCUE 1.00 59.00 X 0 628515 121966 JOHN MAHER 1.00 60.00 X 0 321703 77140 JACK CECIL 1.00 2.70 X 0 0 0 ERNESTO E DE LA TORRE 1.00 X 0 0 0 CAMY BROWN 1.00 X 0 0 0 DICK LARSON 1.00 X 0 0 0 ORA J WELLS MD 1.00 X 0 0 0 ROSWELL S BOWERS 1.00 X 0 0 0 ROBERT MAXWELL 1.00 X 0 0 0 MARC NAKAGAWA 40.00 1.00 X 108686 0 8867 REBECCA W CARTER 40.00 1.00 X 184396 0 13002 ELIZABETH A PELLETIER 40.00 X 165140 0 30396 LAUREL D JOHNSON 40.00 X 162858 0 17353 JUDITH H MCKAY 40.00 X 159695 0 15396 MARK E CREASMAN 40.00 X 163416 0 21916 DONALD BAYSE 40.00 X 127957 0 11174 1374503 1237327 385864 16 0 1 0 MORRISON MANAGEMENT SPECIALISTS PO BOX 102289 ATLANTA GA 303682289 FOOD SERVICES 1533852 REHAB SERVICES OF BREVARD LLC 376A GOVERNMENT ST MOBILE AL 36693 PHYSICAL THERAPY SERVICES 1415737 TRANSYL EMERG PHYS PLLC 3107 STIRLING RD 300 FT LAUDERDALE FL 33312 E/R PHYSICIAN SERVICES 1245153 COMPREHENSIVE HOSPITALIST SERVICES OF NC 300 SOUTH PARK ROAD STE 400 HOLLYWOOD FL 33021 HOSPITALIST PHY. SERV. 1181803 HORIZON CSA LLC 265 PIT ROAD MOORESVILE NC 28115 EQUIP. MAINTENANCE SERV. 914891 19 49046 35130 1637256 169456 55846 1946734 NET PATIENT SERVICE REVENUE 621400 66165865 66165865 EHR INCENTIVE PAYMENT 900099 2737301 2737301 OTHER PATIENT SERVICE 621610 1446202 1446202 PHARMACY AND MEDICAL SUPPLIES 446110 1288051 1288051 AFFILIATED MANAGEMENT SERVICES 900099 340466 340466 100710 100710 72078595 246870 246870 11844 0 11844 11844 11844 2166452 1000 0 0 2166452 1000 2167452 2167452 29395 35130 19539 9856 9856 CAFETERIA/VENDING 722210 339397 339397 PARTNERSHIP INCOME IN BREVARD MRI 900099 306391 306391 NET AUXILIARY 900099 58639 58639 29272 29272 733699 77195050 72090439 0 3157877 X 65647 65647 785326 785326 23093020 16647042 6445978 775915 540937 234978 4412354 3076119 1336235 1691028 1178918 512110 931162 725165 205997 117730 117730 86357 86357 5428 5428 1386 1386 12714219 11904133 810086 101703 4316 97387 3279764 2179467 1100297 3000 3000 3435032 3435032 231677 120203 111474 42963 21671 21292 102041 102041 3404568 3404568 551439 551439 BAD DEBT 7349946 7349946 MEDICAL SUPPLIES 5632840 5632840 EQUIPMENT LEASE 2095923 2010529 85394 MISCELLANEOUS 88013 31061 56952 70998481 58429635 12568846 0 2832839 2158418 770230 790043 6158627 8564761 448428 712968 1839865 1557930 282421 236696 66237998 34371097 31639818 31866901 9772062 8879260 4085439 16331828 198474 3095642 4786608 61123845 75885413 6414098 5982842 81586 0 14411702 13643264 2680680 3519479 23588066 23145585 X 34410295 36783888 3125484 14413596 1542344 37535779 52739828 61123845 75885413 X 6196569 -1277067 10284547 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 5428 5428 0 EXPLANATION OF LOBBYING ACTIVITIES: PART II-B, LINE 1: THE ORGANIZATION IS A MEMBER OF THE AMERICAN HOSPITAL ASSOCIATION (AHA), THE NORTH CAROLINA HOSPITAL ASSOCIATION (NCHA), AND THE NATIONAL RURAL HEALTH ASSOCIATION (NRHA). A PORTION OF THE DUES PAID IS ALLOCATED TO LOBBYING EFFORTS PERFORMED BY THESE ORGANIZATIONS ON BEHALF OF ITS MEMBERSHIP BODY. FOR THE YEAR, THE LOBBYING PORTION OF MEMBERSHIP DUES IS ESTIMATED TO BE APPROXIMATELY $ 5,428. 6044727 8353318 460965 743793 14115217 0.88620 0.10920 0.00460 0 1 1 221222 764012 985234 27342710 11898989 15443721 2922245 1298514 1623731 34250225 21107302 13142923 737584 66292 671292 31866901 INTEREST IN NET ASSETS OF TRANSYLVANIA REGIONAL HOSPITAL FOUNDATION 15761600 C INTEREST IN BREVARD MRI, LLC 508052 C INTEREST IN BLUE RIDGE DME 44176 C INTEREST IN TRANSYLVANIA SERVICES, INC. 18000 C 16331828 OTHER RECEIVABLES 3168095 BOND ISSUE COSTS, NET OF AMORTIZATI 295408 RECEIVABLE FROM AFFILIATED ORGANIZATION 1142532 ESTIMATED THIRD PARTY PAYOR SETTLEMENT 180573 4786608 DUE TO AFFILIATED ORGANIZATIONS 3519479 3519479 X DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: TRANSYLVANIA REGIONAL HOSPITAL FOUNDATION, INC A RELATED ORGANIZATION MAINTAINS ENDOWMENTS TO BE USED FOR THE HOSPITAL'S EXEMPT PURPOSE OF PROVIDING HEALTHCARE TO ITS COMMUNITY. ENDOWMENTS ARE MAINTAINED TO ASSIST WITH CHARITABLE HEALTHCARE FUNDING. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: THE ASSOCIATION, THE HOSPITAL, THE FOUNDATION, AND TPSI ARE INCORPORATED AS NONPROFIT ORGANIZATIONS UNDER THE LAWS OF NORTH CAROLINA AND ARE EXEMPT FROM INCOME TAXES UNDER THE PROVISIONS OF SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. BREVARD MRI, WITH THE CONSENT OF ITS SHAREHOLDERS, HAS ELECTED TO BE TREATED AS A PARTNERSHIP FOR FEDERAL AND NORTH CAROLINA INCOME TAX PURPOSES. IN LIEU OF CORPORATE INCOME TAXES, EARNINGS AND LOSSES AFTER THAT DATE ARE INCLUDED IN THE INCOME TAX RETURNS OF THE SHAREHOLDERS; ACCORDINGLY, THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS DO NOT REFLECT A PROVISION OR LIABILITY FOR FEDERAL AND STATE INCOME TAXES. INCOME TAXES FOR TSI ARE PROVIDED FOR THE TAX EFFECTS OF TRANSACTIONS REPORTED IN THE CONSOLIDATED FINANCIAL STATEMENTS AND CONSIST OF TAXES CURRENTLY DUE PLUS DEFERRED TAX EXPENSE OR MINUS DEFERRED TAX BENEFIT RELATED PRIMARILY TO DIFFERENCES ARISING FROM THE METHODS OF CALCULATING DEPRECIATION FOR FINANCIAL AND INCOME TAX REPORTING. AN EVALUATION OF THE PROBABILITY OF BEING ABLE TO REALIZE THE FUTURE BENEFITS OF DEFERRED TAX ASSETS IS MADE. A VALUATION ALLOWANCE IS PROVIDED FOR THE PORTION OF THE DEFERRED TAX ASSET WHEN IT IS MORE LIKELY THAN NOT THAT SOME PORTION OR ALL OF THE DEFERRED TAX ASSET WILL NOT BE REALIZED. THE ORGANIZATIONS HAVE DETERMINED THAT NO MATERIAL UNRECOGNIZED TAX BENEFITS OR OBLIGATIONS EXIST FOR OPEN TAX YEARS AS OF SEPTEMBER 30, 2013. FISCAL YEARS ENDING ON OR AFTER SEPTEMBER 30, 2010 REMAIN SUBJECT TO EXAMINATION BY FEDERAL AND STATE TAX AUTHORITIES. PART XI, LINE 2D - OTHER ADJUSTMENTS: NET CHANGE IN VALUE OF INTEREST IN FOUNDATION INCOME FROM AFFILIATED ORGANIZATIONS BAD DEBTS INCLUDED WITH REVENUE OTHER NET CHANGE IN ASSETS PART XI, LINE 4B - OTHER ADJUSTMENTS: TRANSFERS TO AFFILIATES PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBTS INCLUDED WITH REVENUE EXPENSES INCURRED FOR FOUNDATION NONOPERATING EXPENSE RECLASSIFICATION OTHER CHANGE IN NET ASSETS GOLF TOURNAMENT 64525 35130 29395 19539 64525 35130 29395 19539 19539 9856 1 1 X 1 X 1 X 0 1 0 1 1 1945980 1945980 0.03060 6349846 4260091 2089755 0.03280 8295826 4260091 4035735 0.06340 94200 94200 0.00150 226550 226550 0.00360 168847 168847 0.00270 489597 489597 0.00780 8785423 4260091 4525332 0.07120 12649 12649 0.00020 12649 12649 0.00020 1 7349946 2989223 36015409 31921096 4094313 X 1 1 1 BREVARD MRI AT TRANSYLVANIA COMMUNITY HOSPITAL LLC MRI SERVICES 0.50000 0.50000 1 1 TRANSYLVANIA REGIONAL HOSPITAL

260 HOSPITAL DRIVE BREVARD NC 28712

X X X X TRANSYLVANIA COMMUNITY HOSPITAL INC 1 1 X X X X X X X X 12 1 0 1 X X X X X X X X 1 0 1 1 200.000000000000 1 350.000000000000 1 X X X 1 1 X X X X X 1 0 1 X 0 0 9 TRH OUTPATIENT REHABILITATION

92 CHESTNUT STREET BREVARD NC 28712

OUTPATIENT REHAB TRH HOME CARE SERVICES

1234 ASHEVILLE HWY BREVARD NC 28712

HOME CARE BREVARD MRI

301 HOSPITAL DRIVE BREVARD NC 28712

IMAGING CENTER TOXAWAY HEALTH CENTER

16825 ROSMAN HWY LAKE TOXAWAY NC 28747

PROVIDER-BASED CLINICS BREVARD FAMILY PRACTICE

187 MEDICAL PARK DR BREVARD NC 28712

PROVIDER-BASED CLINICS MEDICAL ASSOCIATES OF TRH

377 GALLIMORE ROAD BREVARD NC 28712

PROVIDER-BASED CLINICS BREVARD INTERNAL MEDICINE & PULMONOLOGY

159 MEDICAL PARK DR SUITE B BREVARD NC 28712

PROVIDER-BASED CLINICS KOALA

23 MEDICAL PARK CIRCLE BREVARD NC 28712

OUTPATIENT BREVARD CANCER & INFUSION CENTER

89 HOSPITAL DR BREVARD NC 28712

OUTPATIENT PART I, LINE 3C: IN ADDITION TO THE FPG-DETERMINED ELIGIBILITY FOR FREE AND DISCOUNTED CARE, A DISCOUNT IS OFFERED TO SELF-PAY PATIENTS FOR THEIR TIMELY PAYMENT WITHIN 60 DAYS FROM THEIR INITIAL STATEMENT DATE. PART I, LINE 7: THE ORGANIZATION USED THEIR COST ACCOUNTING SYSTEM TO COMPUTE A COST-TO-CHARGES RATIO USED TO CALCULATE FINANCIAL ASSISTANCE AND UNREIMBURSED MEDICAID AT COST. PART I, L7 COL(F): FOR THE PURPOSES OF CALCULATING PERCENTAGE OF TOTAL EXPENSE FOR LINE 7, COL (F), TOTAL EXPENSE FROM FORM 990, PART IX, LINE 25 HAS BEEN ADJUSTED FOR $(7,349,946). PART II: THE HOSPITAL PARTICIPATES IN COALITION BUILDING IN THE COMMUNITY AND STATE TO HELP ADVOCATE THE HEALTH NEEDS OF OUR AREA. THROUGH PARTICIPATION, THE HOSPITAL GUARANTEES A FOCUSED DISCUSSION ON THE HEALTH CARE ISSUES THAT DIRECTLY IMPACT TRANSYLVANIA COUNTY. PART III, LINE 4: REFER TO PAGE 15 OF THE NOTES TO CONSOLIDATED FINANCIAL STATEMENTS. PATIENT ACCOUNTS ARE CONSIDERED UNCOLLECTABLE AFTER EXHAUSTING IN-HOUSE COLLECTION PROCEDURES, WHICH USUALLY TAKES 59 DAYS FROM DISCHARGE DATE FOR SELF-PAY PATIENTS AND LONGER FOR UNINSURED PATIENTS. WHEN THE ACCOUNT IS CONSIDERED UNCOLLECTABLE, IT IS THEN SENT TO AN OUTSIDE AGENCY, WHICH HAS 180 DAYS TO ACTIVELY ATTEMPT COLLECTIONS. WHEN THE ACCOUNT HAS BEEN INACTIVE FOR 180 DAYS WHILE AT AN OUTSIDE COLLECTION AGENCY, THE ACCOUNT IS RETURNED TO THE HOSPITAL FROM THE COLLECTION AGENCY, AND IT IS CONSIDERED A BAD DEBT ACCOUNT AND EXPENSED. THE TOTAL BAD DEBT EXPENSE FOR THE FISCAL YEAR IS THEN REDUCED TO COST UTILIZING A COST-TO-CHARGE RATIO (CCR). THE FORMULA FOR THE CCR IS (ADJUSTED COSTS / ADJUSTED CHARGES). THE COST-TO-CHARGE RATIO IS CALCULATED FROM THE INCOME STATEMENT. TOTAL OPERATING EXPENSES LESS BAD DEBT, OTHER OPERATING INCOME, AND DIRECT COMMUNITY BENEFIT COSTS MAKE THE COST COMPONENT OF THE RATIO AND GROSS PATIENT CHARGES LESS DIRECT COMMUNITY BENEFIT REVENUES MAKE UP THE CHARGES COMPONENT OF THE RATIO. PART III, LINE 9B: THE HOSPITAL DOES HAVE A WRITTEN DEBT COLLECTION POLICY, WHICH DOES NOT DIFFERENTIATE COLLECTION PRACTICE GUIDELINES FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR CHARITY CARE OR FINANCIAL ASSISTANCE. IN SOME CASES, A PATIENT WHO QUALIFIES FOR PARTIAL FINANCIAL ASSISTANCE WILL STILL HAVE OUTSTANDING DEBT WITH THE HOSPITAL. THROUGH MULTIPLE NOTIFICATION OF COLLECTION ATTEMPTS, COMMUNICATED OPPORTUNITIES FOR DISCOUNTS, ASSISTANCE AND PAYMENT PLAN ARRANGEMENTS, AND PERSONAL FACE-TO-FACE CONSULTATIONS, THE HOSPITAL MAKES REASONABLE EFFORTS TO COLLECT DEBT. THE HOSPITAL DOES NOT UTILIZE CREDIT ACCEPTANCE PROCEDURES TO VET OUT PATIENTS. IN GENERAL, THE HOSPITAL CONTINUOUSLY MONITORS SELF-PAY ACCOUNTS TO TARGET ACCOUNTS THAT ARE SLOW TO PAY IN ORDER TO IDENTIFY ACCOUNTS THAT ARE POTENTIAL CHARITY CARE OR FINANCIAL ASSISTANCE ELIGIBLE PATIENTS. TRANSYLVANIA COMMUNITY HOSPITAL, INC. PART V, SECTION B, LINE 3: AFTER GATHERING ALL PUBLICALLY AVAILABLE SECONDARY HEALTH DATA FOR OUR PRIMARY SERVICE AREA, THE TRANSYLVANIA COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT EMPLOYED A STRATIFIED RANDOM SAMPLE OF 200 RESIDENTS OF TRANSYLVANIA COUNTY, N.C. TO SUPPLEMENT THE SECONDARY CORE DATASET, MEET ADDITIONAL STAKEHOLDER DATA NEEDS, AND HEAR FROM COMMUNITY MEMBERS ABOUT THEIR CONCERNS AND PRIORITIES, A COMMUNITY SURVEY, 2012 WNC HEALTHY IMPACT SURVEY, WAS DEVELOPED AND IMPLEMENTED IN 16 COUNTIES ACROSS WESTERN NORTH CAROLINA. THE SURVEY INSTRUMENT WAS DEVELOPED BY WNC HEALTHY IMPACT'S DATA WORKGROUP, CONSULTING TEAM, AND LOCAL PARTNERS WITH ASSISTANCE FROM PROFESSIONAL RESEARCH CONSULTANTS, INC. (PRC). MANY OF THE QUESTIONS ARE DERIVED FROM THE CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC), BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS), AS WELL AS OTHER PUBLIC HEALTH SURVEYS; OTHER QUESTIONS WERE DEVELOPED SPECIFICALLY FOR WNC HEALTHY IMPACT TO ADDRESS PARTICULAR ISSUES OF INTEREST TO COMMUNITIES IN WESTERN NORTH CAROLINA. EACH COUNTY WAS GIVEN THE OPPORTUNITY TO INCLUDE THREE ADDITIONAL QUESTIONS OF PARTICULAR INTEREST TO THEIR COUNTY, WHICH WERE ASKED OF THEIR COUNTY'S RESIDENTS. TO ENSURE THE BEST REPRESENTATION OF THE POPULATION SURVEYED, A TELEPHONE INTERVIEW METHODOLOGY (ONE THAT INCORPORATES BOTH LANDLINE AND CELL PHONE INTERVIEWS) WAS EMPLOYED. THE SAMPLE DESIGN USED FOR THIS REGIONAL EFFORT CONSISTED OF A STRATIFIED RANDOM SAMPLE OF 3,300 INDIVIDUALS AGE 18 AND OLDER IN WESTERN NORTH CAROLINA. OUR COUNTY'S SAMPLE SIZE WAS 200.THE INTERVIEWS WERE CONDUCTED IN EITHER ENGLISH OR SPANISH, AS PREFERRED BY RESPONDENTS. FOR THE TRANSYLVANIA COUNTY FINDINGS, THE MAXIMUM ERROR RATE IS 6.9%. IN ADDITION, SEVERAL COMMUNITY-WIDE LISTENING SESSIONS WERE CONDUCTED TO HEAR THE COMMUNITY'S CONCERNS AND TO RANK THE COMMUNITY HEALTH PRIORITIES BASED ON THE SURVEY RESULTS. TRANSYLVANIA COMMUNITY HOSPITAL, INC. PART V, SECTION B, LINE 14G: -BROCHURES AVAILABLE AT PRACTICES AND HOSPITALS-FINANCIAL COUNSELORS REVIEW WITH PATIENTS TRANSYLVANIA COMMUNITY HOSPITAL, INC. PART V, SECTION B, LINE 20D: THE HOSPITAL USES THE AVERAGE OF COMMERICAL INSURANCE RATES INCLUDING MEDICARE. PART VI, LINE 2: TRANSYLVANIA REGIONAL HOSPITAL USES MULTIPLE TOOLS TO ASSESS THE CURRENT AND FUTURE HEALTH CARE NEEDS OF THE COMMUNITY IT SERVES INCLUDING: - CONDUCTING ENVIRONMENTAL ASSESSMENTS- REVIEWING MARKET SHARE DATA FOR EXISTING SERVICES - COMPILING A MEDICAL STAFF DEVELOPMENT PLAN EVERY TWO YEARS THAT ASSESSES PHYSICIAN NEED PER POPULATION ADJUSTED FOR DEMOGRAPHICS. ALSO, TRH ACTIVELY PARTICIPATES IN THE TRANSYLVANIA COUNTY HEALTH DEPARTMENT'S REQUIRED ASSESSMENT OF HEALTH NEEDS EVERY THREE YEARS. IN FY 2012, TRH BEGAN EXTENSIVE PLANNING WITH THE LOCAL HEALTH DEPARTMENT TO CONDUCT A FORMAL COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). A DETAILED SURVEY AND COMPILATION OF PRIMARY AND SECONDARY HEALTH DATA FOR TRANSYLVANIA COUNTY, N.C., WAS COMPLETED IN FALL 2012. THE FINDINGS OF THIS CHNA, ALONG WITH EXTENSIVE COMMUNITY INPUT SESSIONS, WERE USED BY TRH IN FY 2013 TO IDENTIFY THE PRIORITY HEALTH ISSUES IN TRANSYLVANIA COUNTY. IN SEPTEMBER 2013, THE TRH BOARD OF TRUSTEES FORMALLY ADOPTED THE FOLLOWING HEALTH ISSUES AS PRIORITIES FOR THE COMMUNITY WE SERVE: 1) OBESITY 2) DENTAL HEALTH 3) MENTAL HEALTH/SUBSTANCE ABUSE 4) AGING POPULATION. PART VI, LINE 3: TRANSYLVANIA REGIONAL HOSPITAL PLACES SIGNAGE FOR ITS PATIENT FINANCIAL ASSISTANCE POLICIES IN PATIENT AREAS IN THE HOSPITAL, IN THE PATIENT ACCOUNTING OFFICE, AND THE PATIENT REGISTRATION AREA. AT THE POINT OF REGISTRATION AND PRE-REGISTRATION, PATIENTS ARE NOTIFIED OF THE PATIENT FINANCIAL ASSISTANCE POLICY. IN THE PATIENT ACCOUNTING OFFICE, THE AVAILABLE FINANCIAL ASSISTANCE PROGRAMS ARE VERBALLY COMMUNICATED BY FINANCIAL COUNSELORS TO PATIENTS WHO MIGHT BE ELIGIBLE. BILLING STATEMENTS ARE PRINTED WITH INVITATIONS TO SEEK PATIENT FINANCIAL ASSISTANCE THROUGH THE PATIENT ACCOUNTING OFFICE. IN ADDITION TO THIS, THE EMERGENCY DEPARTMENT UTILIZES A HEALTH RESOURCE NAVIGATOR TO HELP FIND FINANCIAL ASSISTANCE RESOURCES FOR SELF-PAY PATIENTS. THE PATIENT FINANCIAL ASSISTANCE POLICY ALSO RESIDES ON THE HOSPITAL'S WEBSITE, HTTP://WWW.TRHOSPITAL.ORG/PATIENTS/FINANCIAL.PHP. PART VI, LINE 4: THE PRIMARY SERVICE AREA FOR TRANSYLVANIA REGIONAL HOSPITAL IS TRANSYLVANIA COUNTY, NORTH CAROLINA, WITH A RESIDENT POPULATION OF 33,000 INCLUDING GLOUCESTER TOWNSHIP IN THE UPPER END OF THE COUNTY, WHICH IS FEDERALLY DESIGNATED AS A MEDICALLY UNDERSERVED AREA. NEARLY 12.5% OF TRANSYLVANIA COUNTY'S TOTAL RESIDENT POPULATION HAS A HOUSEHOLD INCOME BELOW THE FEDERAL POVERTY LEVEL. TRANSYLVANIA REGIONAL HOSPITAL IS THE ONLY LOCAL HOSPITAL SERVING THIS PRIMARY SERVICE AREA.TRANSYLVANIA REGIONAL HOSPITAL'S SECONDARY COVERAGE AREA INCLUDES 15,000 ADDITIONAL RESIDENTS IN SOUTHERN JACKSON COUNTY, NORTH CAROLINA, INCLUDING THE MEDICALLY UNDERSERVED AREA OF CASHIERS TOWNSHIP, AS WELL AS WESTERN HENDERSON COUNTY, NC WHICH HAS A FEDERALLY DESIGNATED MEDICALLY UNDERSERVED POPULATION OF LOW INCOME, MIGRANT FARM WORKERS. BESIDES TRANSYLVANIA REGIONAL HOSPITAL, THREE ADDITIONAL COMMUNITY HOSPITALS PROVIDE SOME COVERAGE TO THESE 15,000 RESIDENTS IN THE SECONDARY COVERAGE AREA; HOWEVER, TRANSYLVANIA REGIONAL HOSPITAL IS IN MANY CASES THE CLOSEST, MOST READILY ACCESSIBLE PROVIDER OF CARE FOR MANY OF THESE RESIDENTS. PART VI, LINE 5: AS A NOT-FOR-PROFIT HOSPITAL, TRANSYLVANIA REGIONAL HOSPITAL IS COMMITTED TO GIVING BACK TO THE COMMUNITY TO HELP THOSE WHO ARE UNINSURED OR UNDERINSURED AS WELL AS PROVIDING HEALTH EDUCATION AND BENEFITS FOR THE WELL BEING OF THE ENTIRE COMMUNITY. 2013 WAS A CHALLENGING YEAR FOR OUR COMMUNITY AS WE EXPERIENCED THE LINGERING EFFECTS OF A DEPRESSED ECONOMY. THIS HAS LEFT MANY IN OUR COMMUNITY WITHOUT HEALTH INSURANCE AND STRUGGLING TO MAKE ENDS MEET. DESPITE CHALLENGING FINANCIAL TIMES FOR THE HOSPITAL, TRH CONTINUED TO GENEROUSLY HELP THOSE IN NEED. IN 2013, TRH PROVIDED $7.5 MILLION IN CONTRIBUTIONS TO THE COMMUNITY. THESE BENEFITS CAME IN MANY FORMS INCLUDING $2.2 MILLION IN CHARITY CARE FOR 3,500 PEOPLE. THE HOSPITAL ALSO PROVIDED ANOTHER $3.6 MILLION IN CARE FOR 4,400 PEOPLE THROUGH NON-COLLECTIBLE SERVICES. AN ADDITIONAL $1.2 MILLION WAS PROVIDED FOR GOVERNMENT SPONSORED HEALTHCARE INCLUDING INDIGENT CARE PROGRAMS. FINALLY, $502,000 WAS PROVIDED FOR COMMUNITY BENEFIT PROGRAMS INCLUDING THE DONATION OF STAFF TIME AND RESOURCES. PART VI, LINE 6: AS A MEMBER OF THE NOT-FOR-PROFIT MISSION HEALTH SYSTEM, TRANSYLVANIA REGIONAL HOSPITAL HAS THE PRIMARY ROLE OF PROMOTING WELLNESS AND PROVIDING ACCESS TO QUALITY HEALTH SERVICES TO THE PEOPLE OF TRANSYLVANIA COUNTY, NC. MISSION HEALTH'S MISSION IS TO IMPROVE THE HEALTH OF THE PEOPLE OF WESTERN NORTH CAROLINA AND THE SURROUNDING REGION. REPORTS FILED WITH STATES PART VI, LINE 7 NC 1 TRANSYLVANIA REGIONAL HOSPITAL FOUNDATION INC 223 W JORDAN STREET BREVARD NC 28712 561458024 501(C)(3) 65647 CAPITAL EQUIPMENT NEEDS 1 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: THE ORGANIZATION SUBSIDIZES TRANSYLVANIA REGIONAL HOSPITAL FOUNDATION, INC.'S OPERATIONS. X X X X X 0 1 0 0 0 0 0 0 0 ROBERT J BEDNAREK 236337 0 49687 0 16331 0 39276 0 13459 0 355090 0 0 0 JIM KELLING MD 0 206276 0 76096 0 4737 0 8628 0 7291 0 303028 0 0 CHARLES AYSCUE 0 410784 0 166760 0 50971 0 117039 0 4927 0 750481 0 0 JOHN MAHER 0 260635 0 58433 0 2635 0 56048 0 21092 0 398843 0 0 REBECCA W CARTER 149421 0 16556 0 18419 0 7471 0 5531 0 197398 0 0 0 ELIZABETH A PELLETIER 161216 0 3621 0 303 0 5049 0 25347 0 195536 0 0 0 LAUREL D JOHNSON 162256 0 320 0 282 0 8267 0 9086 0 180211 0 0 0 JUDITH H MCKAY 158598 0 320 0 777 0 8022 0 7374 0 175091 0 0 0 MARK E CREASMAN 121175 0 5665 0 36576 0 5868 0 16048 0 185332 0 0 0 PART I, LINE 4B THE FOLLOWING RECEIVED SUPPLEMENTAL NON-QUALIFIED PLAN PAYMENTS FROM THE FILING ORGANIZATION: ROBERT BEDNAREK $31,970 MARC NAKAGAWA 1,660 THE FOLLOWING RECEIVED SUPPLEMENTAL NON-QUALIFIED PLAN PAYMENTS FROM A RELATED ORGANIZATION: CHARLES AYSCUE $102,039 JOHN MAHER 46,048 A NORTH CAROLINA MEDICAL CARE COMMISSION 521309402 2011-08-24 14655000 CURRENT REFUNDING 0 0 0 A 1005000 14655000 14655000 2006 1 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 A 0 0 1 0 1 0 0 0 0 SCHEDULE K, PART II, LINE 11, OTHER SPENT PROCEEDS: THE AMOUNT PRESENT ON PART II, LINE 11 REPRESENTS AMOUNTS USED TO CURRENTLY REFUND PRIOR ISSUES DATED NOVEMBER 20, 1997 AND MARCH 9, 2009. SERIES 1997 REFUNDING: $ 2,255,000 SERIES 2009 REFUNDING: 12,400,000 TOTAL TO LINE 11: $ 14,655,000 FORM 990, PART VI, SECTION A, LINE 1 THE EXECUTIVE COMMITTEE SHALL CONSIST OF THE BOARD CHAIRMAN, THE VICE CHAIRMAN, THE SECRETARY, THE TREASURER, THE PRESIDENT, THE CHIEF OF THE MEDICAL STAFF, THE CHAIR OF GOVERNANCE, AND THE CHAIR OF QUALITY. THE BOARD CHAIRMAN SHALL SERVE AS THE CHAIRMAN OF THE EXECUTIVE COMMITTEE. THE TERM OF OFFICE OF THE ELECTED MEMBER OF THE EXECUTIVE COMMITTEE SHALL BE ONE YEAR OR UNTIL A SUCCESSOR SHALL HAVE BEEN DULY ELECTED BY THE BOARD OF TRUSTEES. ANY VACANCY IN THE POSITION OF THE ELECTED MEMBER OF THE EXECUTIVE COMMITTEE SHALL BE FILLED AS SOON AS POSSIBLE AFTER THE OCCURRENCE OF THE VACANCY. THE EXECUTIVE COMMITTEE SHALL HAVE POWER TO TRANSACT ALL REGULAR BUSINESS OF THE HOSPITAL DURING THE PERIODS BETWEEN MEETINGS OF THE BOARD OF TRUSTEES SUBJECT TO ANY PRIOR LIMITATION IMPOSED BY THE BOARD OF TRUSTEES AND WITH THE UNDERSTANDING THAT ALL MATTERS OF MAJOR IMPORTANCE SHALL, EXCEPT IN EMERGENCY, BE REFERRED TO THE BOARD OF TRUSTEES. IN ORDER TO TRANSACT THE BUSINESS OF THE HOSPITAL, THE EXECUTIVE COMMITTEE SHALL HOLD A MEETING AT WHICH AT LEAST FIVE MEMBERS OF THE COMMITTEE ARE SIMULTANEOUSLY PRESENT IN PERSON OR BY TELEPHONE AND ALL MEMBERS HAVE BEEN GIVEN NOTICE OF THE MEETING. THIS NOTICE SHALL STATE THE BUSINESS FOR WHICH THE MEETING HAS BEEN CALLED, AND NO BUSINESS OTHER THAN THAT STATED IN THE NOTICE SHALL BE TRANSACTED AT SUCH MEETING. MINUTES OF THE EXECUTIVE COMMITTEE MEETINGS WILL BE SUBMITTED TO THE BOARD, AND ITS ACTIONS SHALL BE SUBJECT TO APPROVAL AT THE NEXT REGULAR BOARD MEETING. FORM 990, PART VI, SECTION A, LINE 3 IN OCTOBER 2012, TRANSYLVANIA REGIONAL HOSPITAL WAS AFFILIATED WITH MISSION HEALTH SYSTEM AND WAS NO LONGER BEING ONLY MANAGED BY THE MISSION HEALTH SYSTEM. THE CEO, CFO, AND DIRECTOR OF IT ARE MISSION HEALTH SYSTEM EMPLOYEES THAT TRH CONTRACTS FOR THEIR EXPERTISE. FORM 990, PART VI, SECTION A, LINE 6 THE HOSPITAL IS A MEMBERSHIP CORPORATION, OF WHICH THE SOLE MEMBER (THE "MEMBER") IS MISSION HEALTH SYSTEM, INC. FORM 990, PART VI, SECTION A, LINE 7A THE BOARD OF TRUSTEES WILL CONSIST OF NOT LESS THAN 11 AND NOT MORE THAN 15 VOTING MEMBERS. UP TO TWO TRUSTEES MAY BE APPOINTED BY MISSION AT ANY TIME (THE "MISSION TRUSTEES") AND IN ALL EVENTS, AT LEAST A MAJORITY OF THE TRUSTEES MUST BE COMMUNITY TRUSTEES. TRUSTEES OTHER THAN MISSION TRUSTEES ARE REFERRED TO HEREIN AS "COMMUNITY TRUSTEES." THERE WILL BE NOT LESS THAN NINE (9) AND NO MORE THAN THIRTEEN (13) COMMUNITY TRUSTEES. THE HOSPITAL SHALL EACH YEAR, NO LATER THAN THE MONTH OF AUGUST, SUBMIT FOR RATIFICATION TO THE MEMBER THE NAMES OF PERSONS TO FILL VACANCIES AMONG THE COMMUNITY TRUSTESS CAUSED BY THE EXPIRATION OF THE TERMS OF OFFICE OR OTHERWISE. THE RATIFICATION OF THE COMMUNITY TRUSTEES BY THE MEMBER SHALL TAKE PLACE BEFORE THE END OF SEPTEMBER. FORM 990, PART VI, SECTION A, LINE 7B FOR SO LONG AS IT IS THE MEMBER, MISSION HEALTH SYSTEM, NC. AND ITS SUCCESSORS AND ASSIGNS ("MISSION" OR "MEMBER"), SHALL HAVE THE AUTHORITY TO APPROVE THE FOLLOWING REGARDING THE HOSPITAL WITHOUT ANY SEPARATE OR FURTHER ACTION B THE BOARD OF TRUSTEES OF THE HOSPITAL: (A) ON AND AFTER OCTOBER 26, 2012, ANY AMENDMENT TO THE ARTICLES OF INCORPORATION OR BYLAWS; PROVIDED HOWEVER, THE TERMS OF SECTION III.3 OF THESE BYLAWS MAY NOT BE AMENDED AT ANY TIME WITHOUT THE JOINT APPROVAL OF MISSION AND TRANSYLVANIA COMMUNITY HOSPITAL ("HOSPITAL") (B) THE MISSION, VISION AND VALUES STATEMENTS AND ANY AMENDMENTS THERETO. (C) THE SALE, LEASE OR OTHER TRANSFER OF A MATERIAL PORTION, SUBSTANTIALLY ALL OR ALL OF THE ASSETS OF THE HOSPITAL. (D) THE PLEDGE OF, OR GRANTING OF ANY LIEN OR ENCUMBRANCE ON, A MATERIAL PORTION, SUBSTANTIALLY ALL OR ALL OF THE ASSETS OF THE HOSPITAL TO SECURE THE OBLIGATIONS OF THE HOSPITAL OR ANY OF ITS SUBSIDIARIES. (E) THE PURCHASE, LEASE, PLEDGE OR SALE OF REAL OR PERSONAL PROPERTY OUTSIDE THE ORDINARY COURSE OF BUSINESS. (F) THE DISSOLUTION OR ANY MERGER, SALE, CONSOLIDATION OR OTHER BUSINESS COMBINATION. (G) THE FORMATION AND GOVERNING DOCUMENTS OF, AND INVESTMENT BY THE HOSPITAL IN, ANY NEW CORPORATION, PARTNERSHIP OR EQUITY OR CONTRACTUAL JOINT VENTURE IN WHICH THE HOSPITAL PROPOSES TO HAVE AN INTEREST THROUGH MEMBERSHIP, VOTING STOCK OR OTHER EQUITY PARTICIPATION. (H) THE REMOVAL OF THE PRESIDENT/CHIEF EXECUTIVE OFFICER OF THE HOSPITAL. (I) ANY DEBT ISSUANCE OR INCURRENCE, REFINANCING AND RETIREMENT OF DEBT, INCLUDING WITHOUT LIMITATION INDEBTEDNESS FOR BORROWED MONEY AND CAPITAL LEASES, INCLUDING ANY PROPOSALS AND RECOMMENDATIONS AS TO SAME BY THE BOARD OF TRUSTESS. (J) THE CAPITAL AND OPERATING BUDGETS (BASED ON RECOMMENDATIONS FROM THE BOARD OF TRUSTESS) AND ANY EXPENDITURES THAT WOULD CAUSE ANY LINE ITEM EXPENSE IN ANY APPROVED BUDGET TO EXCEED THE LIMITS ESTABLISHED FROM TIME TO TIME BY MISSION BASED ON RECOMMENDATIONS FROM THE BOARD OF TRUSTEES. (K) STRATEGIC AND FINANCIAL PLANS, INCLUDING ANY PROPOSALS AND RECOMMENDATIONS FOR REVISIONS TO SAME BY THE BOARD OF TRUSTEES. (L) THE SELECTION OF EXTERNAL AUDITORS AND LEGAL COUNSEL; PROVIDED HOWEVER, THE COMMUNITY DIRECTORS (AS DEFINED IN THE BYLAWS OF THE MEMBER) SHALL HAVE THE EXCLUSIVE RIGHT TO SELECT LEGAL COUNSEL TO ENFORCE THE HOSPITAL'S RIGHTS UNDER THE AFFILIATION AGREEMENT. FORM 990, PART VI, SECTION B, LINE 11 THE RETURN WAS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM WITH ASSISTANCE AND INFORMATION PROVIDED BY MANAGEMENT. THE RETURN WAS THEN REVIEWED BY THE HOSPITAL FINANCE COMMITTEE OF THE BOARD AND A COPY DISTRIBUTED TO EVERY VOTING BOARD MEMBER. AGENDA TIME WAS RESERVED AT A SCHEDULED BOARD MEETING PRIOR TO THE FILING OF THE 990 FOR MANAGMENT RESPONSE TO MEMBERS' QUESTIONS AND COMMENTS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION'S CONFLICT OF INTEREST POLICY IS REVIEWED AND UPDATED ANNUALLY. EDUCATION ABOUT THE POLICY AND THE RESPONSIBILITIES OF A BOARD MEMBER OCCURS ANNUALLY AND FOR NEW BOARD MEMBERS DURING ORIENTATION. IF A CONFLICT OF INTEREST IS IDENTIFIED, THE MEMBER IS RECUSED FROM DISCUSSION AND A VOTE ON THE CONFLICTING MATTER, AND MAY BE EXCUSED. THE POLICY IS ADHERED TO DURING MEETINGS IN EXECUTIVE SESSION FOR CEO EVALUATION AND COMPENSATION DISCUSSION, AUDIT PLANNING, AND OTHER TIMES AS REQUIRED. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION DRAWS WAGE COMPARISON DATA FROM TWO INDEPENDENT SOURCES, AND THE EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD REVIEWS THE INFORMATION AND SETS THE COMPENSATION PACKAGES FOR THE CEO AND IS INFORMED OF THE COMPENSATION PACKAGES OF THE CFO, COO, VP OF MARKETING, COO OF TPSI, DIRECTOR OF THE FOUNDATION, SYSTEM DIRECTOR OF HR AND FACILITY SERVICES. COMPENSATION PACKAGES FOR THE CEO ARE REVIEWED ANNUALLY. COMPENSATION FOR ALL OTHER POSITIONS ARE REVIEWED WHENEVER A CHANGE IN THE POSITION IS MADE. CHANGES FROM THE 2011 REVIEW WERE MADE EFFECTIVE FOR THE 2012 CALENDAR YEAR. BEGINNING MARCH 2011, THE ORGANIZATION BEGAN CONTRACTING THE SERVICES OF ITS CEO FROM MISSION HEALTH SYSTEM, A 501(C)(3) HEALTHCARE ORGANIZATION. COMPENSATION PER THIS AGREEMENT IS PAID THROUGH MISSION HEALTH SYSTEM FROM AN ESTABLISHED MANAGEMENT CONTRACT. FORM 990, PART VI, SECTION C, LINE 18 PHOTOCOPIES OF RECENT FILINGS OF THE FORM 990 ARE AVAILABLE UPON REQUEST AT THE ORGANIZATION'S ADMINISTRATIVE OFFICE. IN ADDITION, RECENT FILINGS OF THE FORM 990 ARE AVAILABLE ONLINE AT WWW.GUIDESTAR.ORG. FORM 990, PART VI, SECTION C, LINE 19 PHOTOCOPIES OF THE ORGANIZATION'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST AT THE ORGANIZATION'S ADMINISTRATIVE OFFICE. AN ANNUAL REPORT OF THE ORGANIZATION'S FINANCIAL STATEMENTS IS AVAILABLE ON THE ORGANIZATION'S WEBSITE AND IS PUBLISHED ANNUALLY IN THE LOCAL NEWSPAPER. OTHER FEES FORM 990, PART IX, LINE 11G OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 840,077. MANAGEMENT AND GENERAL EXPENSES 318,647. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,158,724. SERVICE CONTRACT EXPENSE: PROGRAM SERVICE EXPENSES 821,475. MANAGEMENT AND GENERAL EXPENSES 202,040. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,023,515. CATERING SERVICES: PROGRAM SERVICE EXPENSES 14,524. MANAGEMENT AND GENERAL EXPENSES 35,503. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 50,027. REFERENCE LAB EXP: PROGRAM SERVICE EXPENSES 612,900. MANAGEMENT AND GENERAL EXPENSES 3,774. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 616,674. MEDICAL FEES: PROGRAM SERVICE EXPENSES 3,114,243. MANAGEMENT AND GENERAL EXPENSES 9,385. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,123,628. CONTRACT MANAGEMENT FEES: PROGRAM SERVICE EXPENSES 3,149,911. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,149,911. CONTRACT LABOR: PROGRAM SERVICE EXPENSES 3,351,003. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,351,003. COLLECTION FEES EXPENSE: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 240,737. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 240,737. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 9: TRANSFERS FROM MISSION HEALTH SYSTEM, INC. 7,758,283. NET EFFECT OF BUSINESS COMBINATION 266,081. EXPENSES INCURRED FOR FOUNDATION 18,977. INCOME FROM AFFILIATED ORGANIZATION 227,982. NET CHANGE IN INTEREST OF FOUNDATION 12,639,120. TRANSFER TO TRANSYLVANIA PHYSICIAN SERVICES, INC. -1,839,726. TRANSFER TO TRANSYLVANIA REGIONAL HOSPITAL FOUNDATION, INC. -8,786,170. FORM 990, PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. TRANSYLVANIA HEALTH SYSTEM INC 260 HOSPITAL DRIVE BREVARD NC 28712 561456987 HEALTHCARE NC 501(C)(3) LINE 11B, II N/A 0 TRANSYLVANIA REGIONAL HOSPITAL FOUNDATION INC PO BOX 2440 BREVARD NC 28712 561458024 SUPPORTING ORGANIZATION NC 501(C)(3) LINE 11A, I TRANSYLVANIA COMMUNITY HOSPITAL INC 1 TRANSYLVANIA PHYSICIAN SERVICES INC 260 HOSPITAL DRIVE BREVARD NC 28712 561920816 HEALTHCARE NC 501(C)(3) LINE 3 TRANSYLVANIA COMMUNITY HOSPITAL INC 1 MISSION HEALTH SYSTEM INC 400 RIDGEFIELD COURT SUITE 100 ASHEVILLE NC 28806 581450888 PARENT COMPANY SUPPORT NC 501(C)(3) LINE 11A, I N/A 0 MISSION MEDICAL ASSOCIATES INC 866 HENDERSONVILLE ROAD ASHEVILLE NC 28803 263627231 EMPLOYED PHYSICIAN GROUP NC 501(C)(3) LINE 9 MISSION HEALTH SYSTEM INC 0 THE MCDOWELL HOSPITAL INC 430 RANKIN AVENUE MARION NC 28742 560623938 COMMUNITY HOSPITAL NC 501(C)(3) LINE 3 MISSION HEALTH SYSTEM INC 0 MISSION HEALTHCARE FOUNDATION INC 980 HENDERSONVILLE ROAD ASHEVILLE NC 28803 561881331 FOUNDATION NC 501(C)(3) LINE 7 MISSION HEALTH SYSTEM INC 0 BLUE RIDGE REGIONAL HOSPITAL INC PO BOX 9 SPRUCE PINE NC 28777 561025032 COMMUNITY HOSPITAL NC 501(C)(3) LINE 3 MISSION HEALTH SYSTEM INC 0 BLUE RIDGE REGIONAL HOSPITAL FOUNDATION PO BOX 247 SPRUCE PINE NC 28777 582172660 HOSPITAL FOUNDATION NC 501(C)(3) LINE 11A, I BLUE RIDGE REGIONAL HOSPITAL 0 ANGEL MEDICAL CENTER INC PO BOX 1209 FRANKLIN NC 28744 566000064 COMMUNITY HOSPITAL NC 501(C)(3) LINE 3 MISSION HEALTH SYSTEM INC 0 MCDOWELL HEALTHCARE FOUNDATION INC 430 RANKIN AVENUE MARION NC 28752 463395393 SUPPORTING ORGANIZATION NC APPLIED FOR LINE 7 THE MCDOWELL HOSPITAL INC 0 MISSION HOSPITAL INC 428 BILTMORE AVENUE ASHEVILLE NC 28801 560532141 HOSPITAL NC 501(C)(3) LINE 3 MISSION HEALTH SYSTEM INC 0 BREVARD MRI AT TRANSYLVANIA COMMUNITY HOSPITAL LLC 260 HOSPITAL DRIVE BREVARD NC 28712 203281110 HEALTHCARE NC N/A TRANSYLVANIA HEALTHCARE II LIMITED PARTNERSHIP 2 MEDICAL PARK DR BREVARD NC 28712 200333230 RENTAL NC N/A HEALTHCARE III LIMITED PARTNERSHIP 260 HOSPITAL DRIVE BREVARD NC 28712 561599596 RENTAL NC N/A HEALTHCARE LIMITED LIABILITY COMPANY VII 260 HOSPITAL DRIVE BREVARD NC 28712 200343455 RENTAL NC N/A ASHEVILLE IMAGING LLP 534 BILTMORE AVENUE ASHEVILLE NC 28801 561907201 OUTPATIENT IMAGING SERVICE NC N/A IMAGING REALTY LLP 534 BILTMORE AVENUE ASHEVILLE NC 28801 561907203 MEDICAL OFFICE BUILDING NC N/A MSJHS AND CCP JOINT DEVELOPMENT COMPANY LLC 428 BILTMORE AVENUE ASHEVILLE NC 28801 562250464 LONG TERM ACUTE CARE HOSPITAL NC N/A BLUE RIDGE DME LLC 125 HOSPITAL DRIVE SPRUCE PINE NC 28777 263570174 HOME MEDICAL EQUIPMENT AND SUPPLIES SALES NC N/A MCDOWELL MRI LLC 414 RANKIN AVENUE MARION NC 28752 753046378 MEDICAL IMAGING NC N/A WESTERN NC HEALTHCARE INNOVATORS LLC 5935 CARNEGIE BOULEVARD CHARLOTTE NC 28209 800787882 REAL ESTATE RENTAL NC N/A WESTERN REGIONAL RADIATION THERAPY CENTER 68 HOSPITAL DRIVE SYLVA NC 28779 561849395 NC N/A ASHEVILLE MRI PO BOX 2959 ASHEVILLE NC 28802 561665863 NC N/A WNC STONE CENTER 509 BILTMORE AVENUE ASHEVILLE NC 28801 272152974 NC N/A TRANSYLVANIA SERVICES INC 260 HOSPITAL DRIVE BREVARD NC 28712 561448199 REAL ESTATE NC TRANSYLVANIA COMMUNITY HOSPITAL INC C 95250 6736381 1.00000 1 HORIZON HEALTH CORP 213 RIDGEFIELD COURT ASHEVILLE NC 28806 561341621 HOLDING COMPANY NC N/A C 0 HORIZON MANAGEMENT SERVICES INC 213 RIDGEFIELD COURT ASHEVILLE NC 28806 561341624 PATIENT BILLING AND COLLECTION SERVICES, MEDICAL PROPERTY NC N/A C 0 DOGWOOD INSURANCE COMPANY LTD PO BOX 30600 THE GRAND PAVILION COM CAYMAN ISLANDS CJ CAPTIVE INSURANCE ENTITY CJ N/A C 0 1 1 1 1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 0 BREVARD MRI AT TRANSYLVANIA COMMUNITY HOSPITAL K 826023 CASH TRANSYLVANIA REGIONAL HOSPITAL FOUNDATION INC B 65647 CASH TRANSYLVANIA REGIONAL HOSPITAL FOUNDATION INC C 1629756 CASH TRANSYLVANIA REGIONAL HOSPITAL FOUNDATION INC R 8786170 CASH TRANSYLVANIA PHYSICIAN SERVICES INC R 1839726 CASH