ANC MISSION MEDICAL ASSOCIATES INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
ANC MISSION MEDICAL ASSOCIATES INC (EIN 26-3627231)
Tax period
2012-10-01 to 2013-09-30
Filed
2014-08-13
IRS object ID
201432259349301613
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)
Timestamp2014-08-13T11:11:50-05:00Timestamp
Tax Period End Date2013-09-30TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN366055558EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1Grant Thornton LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1201 S College Street Suite 2500AddressLine1
CityCharlotteCity
StateNCState
ZIP Code28244ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN263627231EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Mission Medical Associates IncBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlMISSNameControl
Phone8282138222Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO Box 5325AddressLine1
CityAshevilleCity
StateNCState
ZIP Code28813ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameCheryl WilliamsName
TitleVP FinanceTitle
Phone8282138222Phone
Date Signed2014-08-13DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
PTINP00488037PTIN
Phone7046323500Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonPaul McDowellNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1PO Box 5325AddressLine1
CityAshevilleCity
StateNCState
ZIP Code28813ZIPCode
FieldValueIRS element (for citing)
Gross Receipts73935287GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web Sitewww.missionmd.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation2008YearFormation
State Legal DomicileNCStateLegalDomicile
Activity Or Mission DescriptionProvide Physician Services in areas that are insufficiently served.ActivityOrMissionDescription
Nbr Voting Members Governing Body3NbrVotingMembersGoverningBody
Nbr Independent Voting Members3NbrIndependentVotingMembers
Total Nbr Employees686TotalNbrEmployees
Total Nbr Volunteers3TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year522059ContributionsGrantsPriorYear
Contributions Grants Current Year270331ContributionsGrantsCurrentYear
Program Service Revenue Prior Year62639163ProgramServiceRevenuePriorYear
Program Service Revenue CY72810467ProgramServiceRevenueCY
Investment Income Prior Year3763InvestmentIncomePriorYear
Investment Income Current Year3609InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year63164985TotalRevenuePriorYear
Total Revenue Current Year73084407TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY50GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year73515640SalariesEtcPriorYear
Salaries Etc Current Year88904466SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year15835050OtherExpensePriorYear
Other Expenses Current Year17569952OtherExpensesCurrentYear
Total Expenses Prior Year89350690TotalExpensesPriorYear
Total Expenses Current Year106474468TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-26185705RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-33390061RevenuesLessExpensesCY
Total Assets BOY14854442TotalAssetsBOY
Total Assets EOY28467608TotalAssetsEOY
Total Liabilities BOY81795417TotalLiabilitiesBOY
Total Liabilities EOY128798644TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY-66940975NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY-100331036NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionProvide Physician Services in areas that are insufficiently served.Continued on Schedule O.Mission Medical Associates mission is to provide physician services in predominantly rural areas that are insufficiently served, thereby improving the health care of the general public. In many cases this involves recruiting and placing primary care physicians, as well as pediatric and adult specialty services close to where people live and work.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense101831320Expense
Grants50Grants
Revenue72810467Revenue
DescriptionThe Organization provided physician services in specialty practices including Family Medicine, Pediatrics, Cardiology, Children's Dental, Neurology, Orthopedic Trauma, Trauma Surgery, Weight Management, and Hospitalists. 33 new physicians were recruited to the area and the Organization served over 93,000 patients at 31 practice locations. Benefits to the community included almost $1.4 million in charity care.Other accomplishments of the Organizations individual physicians which include volunteering in the local community and recognition for excellence and quality of healthcare service are highlighted below, continuing on Schedule O.Four cardiologists ranked in the top ten percent of the Professional Research Consultants (PRC) National Excellence in Healthcare and presented with Service Excellence Awards from Mission. The Cardiology Research department was recognized by Thrombolysis In Myocardial Infarction Study Group as Center of Excellence for clinical research trials. The Weight Management Clinic established a collaborative care model with providers of the Cherokee Indian Hospital Authority including the ability to conduct Tele Health visits. A Developmental-Behavioral pediatric specialist again participated with the International Hospital for Children in the annual pediatric Spina Bifida evaluation clinics in Belize, Central America. The Pediatric Endocrinology practice and the Childrens Dental practice as well as several pediatric providers were recognized as 5 star recipients for outstanding patient satisfaction. Several physicians donated their time to the Medical Ministry of the Asheville-Buncombe County Christian Ministry serving uninsured and underinsured residents of Buncombe County. An outpatient neurologist remotely presented a poster at the 2013 International Stroke Conference in Honolulu.Description
Total Program Service Expense101831320TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
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 Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
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
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
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 Entity0RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109679NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees686NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
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 Members3NbrVotingGoverningBodyMembers
Number Independent Voting Members3NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
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
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1Mission Medical AssociatesBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number8282138222TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1400 Ridgefield Court Suite 100AddressLine1
CityAshevilleCity
StateNCState
ZIP Code28806ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (12 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationAverage Hours Per Week RelatedAverageHoursPerWeekRelatedHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
Ernest E Ferguson
Chairman1.00XX000
George M BilbreyJrMD
Director1.00X0003.00
William E Lee
Secretary/Treasurer1.00XX0002.00
Cheryl Williams
Exec Dir Finance60.00X145026025350
Dr Jill Hoggard Green
President/CEO6.00X065691810313854.00
Paul McDowell
VPFinance-Jan2013toPresent6.00X00054.00
Charles M LeCroy MD
Physician40.00634092058787X
Harold Frisch MD
Physician40.00582432036001X
William Shillinglaw MD
Physician40.00491927041406X
James Usedom MD
Physician40.00458628041487X
Jan Pattanayak MD
Physician40.00455607035902X
Marc Westle DO
Former CEO0.001234163015557495560.00X
FieldValueIRS element (for citing)
Total Reportable Comp From Org2891128TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs958473TotalReportableCompFrmRltdOrgs
Total Other Compensation417026TotalOtherCompensation
Number Individuals GT100 K388NumberIndividualsGT100K
Formers Listed1FormersListed
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
Navigant Consulting
4511 Paysphere CircleChicagoIL606740045Management Services506244
Blue Ridge Bone & Joint
129 McDowell StreetAshevilleNC28801Medical Services496846
Locumtenenscom
PO Box 405547AtlantaGA303845547Physician Services282172
Honnie Patricia Spencer
284 Knoxview LnMooresvilleNC281179630Medical Services249470
Mediscribes Inc
4509 Lisa LnNew AlbanyIN471509373Transcription239287
FieldValueIRS element (for citing)
Number Of Contractors GT100 K12NumberOfContractorsGT100K
Related Organizations270331RelatedOrganizations
Total Contributions270331TotalContributions

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Net Patient Revenue6211104467335444673354
PhysContSvcsRelatedOrgs9000992488660724886607
Other Patient Revenue90009932505063250506
FieldValueIRS element (for citing)
Total Program Service Revenue72810467TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column4149TotalRevenueColumn
Exclusion$4,149ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real850340Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real850340Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real0Real

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other540Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other-540Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-540TotalRevenueColumn
Exclusion-$540ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column73084407TotalRevenueColumn
Related Or Exempt Function Income72810467RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$3,609ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total50Total
Program Services50ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total172721Total
Management And General172721ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total138688Total
Management And General138688ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total76710340Total
Program Services74129889ProgramServices
Management And General2580451ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total2364997Total
Program Services2293610ProgramServices
Management And General71387ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total5583177Total
Program Services5235523ProgramServices
Management And General347654ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total3934543Total
Program Services3742456ProgramServices
Management And General192087ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total150Total
Management And General150ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total152043Total
Management And General152043ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total48Total
Management And General48ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total7822256Total
Program Services7408418ProgramServices
Management And General413838ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total9792Total
Program Services9792ProgramServices

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total672613Total
Program Services581967ProgramServices
Management And General90646ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total385417Total
Program Services385417ProgramServices

Occupancy Occupancy

FieldValueIRS element (for citing)
Total3163352Total
Program Services2997408ProgramServices
Management And General165944ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total703827Total
Program Services641157ProgramServices
Management And General62670ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total780907Total
Program Services642563ProgramServices
Management And General138344ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total1166724Total
Program Services1163665ProgramServices
Management And General3059ManagementAndGeneral

Other Expenses OtherExpenses (3 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
Departmental Supplies160345015975465904
Other628339520825107514
Medical Equipment Lease481034481034

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total106474468Total
Program Services101831320ProgramServices
Management And General4643148ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY1207735BOY
EOY1376761EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY500000BOY
EOY250000EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY7578485BOY
EOY19916483EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY98393BOY
EOY141771EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY180123BOY
EOY72241EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY567825BOY
EOY569246EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis8003185LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec2585734LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY4040961BOY
EOY5417451EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY550000BOY
EOY550000EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY130920BOY
EOY173655EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY14854442BOY
EOY28467608EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY81671945BOY
EOY128629579EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY123472BOY
EOY169065EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY81795417BOY
EOY128798644EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY-66940975BOY
EOY-100331036EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY-66940975BOY
EOY-100331036EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY14854442BOY
EOY28467608EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses-33390061ReconcilationRevenueExpenses
Reconcilation Other Changes0ReconcilationOtherChanges
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)
Publicly Supported Org509a2XPubliclySupportedOrg509a2

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

FieldValueIRS element (for citing)
Current Tax Year Minus3 Years28304CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years83582CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year522059CurrentTaxYearMinus1Year
Current Tax Year270331CurrentTaxYear
Total904276Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus3 Years37457774CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years65683995CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year62639164CurrentTaxYearMinus1Year
Current Tax Year72810467CurrentTaxYear
Total238591400Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus3 Years37486078CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years65767577CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year63161223CurrentTaxYearMinus1Year
Current Tax Year73080798CurrentTaxYear
Total239495676Total

Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Amts From Subst Contributors AmtsFromSubstContributors

FieldValueIRS element (for citing)
Total0Total

Support From DQ Ps Etc SupportFromDQPsEtc

FieldValueIRS element (for citing)
Total0Total
FieldValueIRS element (for citing)
Public Support Total509239495676PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus3 Years26366CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years16538CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year411176CurrentTaxYearMinus1Year
Current Tax Year854489CurrentTaxYear
Total1308569Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus3 Years26366CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years16538CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year411176CurrentTaxYearMinus1Year
Current Tax Year854489CurrentTaxYear
Total1308569Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus3 Years37512444CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years65784115CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year63572399CurrentTaxYearMinus1Year
Current Tax Year73935287CurrentTaxYear
Total240804245Total
FieldValueIRS element (for citing)
First5 Years509XFirst5Years509

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 D IRS990ScheduleD

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis3498646OtherCostOrOtherBasis
Depreciation531081Depreciation
Book Value2967565BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis3287442OtherCostOrOtherBasis
Depreciation1218227Depreciation
Book Value2069215BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis1217097OtherCostOrOtherBasis
Depreciation836426Depreciation
Book Value380671BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings5417451TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionOther Deferred CompensationDescription
Amount$169,065Amount
FieldValueIRS element (for citing)
Total Of Amounts169065TotalOfAmounts
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
ExplanationMission applies the provisions of FASB ASC Topic 740 for Income Taxes in accounting for uncertainty in income taxes. ASC 740 provides guidance on when tax positions are recognized in an entity's financial statements and how the values of these positions are determined. There is currently no impact on Mission's combined financial statements as a result of application of ASC 740. Mission Medical Associates is included in the combined financial statements described above.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 Plan1SupplementalNonqualRetirePlan
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 (8 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
Cheryl Williams
Exec Dir Finance100550020569023907083390170110170376000
Dr Jill Hoggard Green
President/CEO0444915020756304440084808018330076005600
Charles M LeCroy MD
Physician5092940118291065070140400447470692879000
Harold Frisch MD
Physician4573020123038020920100000260010618433000
William Shillinglaw MD
Physician457498025466089630170000244060533333000
James Usedom MD
Physician3336730781230468320170000244870500115000
Jan Pattanayak MD
Physician3315810781230459030100000259020491509000
Marc Westle DO
Former CEO12282319651701037505931288172933426489991439914970835021800

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
Return ReferencePart I, Line 4bReturnReference
ExplanationDr. Marc Westle, $34,557 Dr. Jill Hoggard Green $81,346Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (7 entries)

Return ReferenceReturnReferenceExplanationExplanation
Form 990, Part VI, Section A, line 6Mission Health System, Inc is the sole member of Mission Medical Associates, Inc.
Form 990, Part VI, Section A, line 7aThe following action of the corporation requires the prior approval of the Member: (i) appointment and removal of Board members; (j) appointment and removal of President/Chief Executive Officer; and (k) approval of employment agreement and compensation of President/Chief Executive Officer.
Form 990, Part VI, Section A, line 7bThe following actions of the corporation require the prior approval of the Member: (a) amendment or repeal of the bylaws or articles of the corporation; (b) sale of assets of the corporation valued in excess of $1 million ; (c) merger or dissolution of the corporation; (d) selection of auditors; (e) adoption of strategic plans, and capital and operating budgets; (f) transactions in excess of $5 Million; (g) filing for bankruptcy; (h) incurring debt (external to the Member and its subsidiaries/affiliates) (i) appointment and removal of Board members; (j) appointment and removal of President/Chief Executive Officer; and (k) approval of compensation of President/Chief Executive Officer.
Form 990, Part VI, Section B, line 11A draft of the Form 990 is prepared by the Director of Tax Services at Mission Health System. The Form 990 is reviewed by the organization's CEO, CFO, General Counsel and Compliance Officer of Mission Health System as well as Management at Mission Medical Associates . In addition, an outside accounting firm is engaged to review and sign the 990 and prepare the return for final filing with the IRS. Before filing, highlights of Form 990 are reviewed by Board Committees which may include the Executive Committee; Audit and Compliance Committee; Finance and Property Committee and Human Resources and Compensation Committee of Mission Health System. After committee review, a draft of the 990 is provided to the Board of Directors at Mission Health System and Mission Medical Associates for review. Highlights of Form 990 are specifically reviewed with the board and they have the opportunity to ask questions and suggest improvements or provide corrections. If there are changes as a result of board review, a corrected Form 990 will be provided for final approval before filing. After final approval, the Form 990 will be filed with the IRS.
Form 990, Part VI, Section B, line 12cThe Organizations 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 interested person does not participate in any decision relating to the transaction issue. A conflict of interest is a particular relationship or arrangement that would reasonably be expected to exert an influence on the individual's judgment and preclude the individual from being an Independent Director or being independent with respect to the transaction under consideration. In addition to board members, the organization's conflict of interest policy applies to members of senior leadership, medical staff, clinical service line leaders, elected medical staff leaders, departmental directors, staff members working in the purchasing department, and all other staff members with purchasing authority, as well as immediate family members of such interested persons and entities in which interested persons have a material financial interest. The organization's policy is for all interested persons to disclose any and all conflicts of interest in accordance with the IRS guidelines for tax-exempt entities as well as any other applicable state or federal law. Upon initial assumption of duties, interested persons are provided with a copy of the conflict of interest policy and submit a conflict of interest disclosure statement. Thereafter, the statements will be completed annually. Periodically all staff members are asked to complete a conflict of interest disclosure statement. Internal and external auditors, General Counsel or outside counsel will periodically conduct a review of the disclosure process to determine whether the organization is in compliance with the policy.
Form 990, Part VI, Section B, line 15The Organization draws wage comparison data from outside executive compensation consultants to ensure compensation levels are at fair market value The Human Resources and Compensation Committee (Committee) reviews this data and recommends to the Board any revisions to the overall philosophy and policy to guide the determination of compensation and benefit packages for executives which includes the CEO, the CFO, and President as well as all other executives, which would include all key employees. The Committee keeps and distributes minutes of all its meetings to its members. Items of a sensitive nature are referenced in the minutes with detailed, supporting documentation retained on file. The Committee also discloses any potential conflicts of interest situations to the Committee Chairman that may affect their independent directors' status as soon as they arise, and maintains complete documentation of all matters discussed by the Committee. The Committee obtains education and training to exercise all responsibilities effectively and keeps abreast of significant developments in executive compensation practices and regulations, and ensures that all aspects of Mission Health System and Hospital executive compensation adhere to all relevant regulatory requirements, and reviews the Committee charter annually revising as appropriate and conducts an annual evaluation of the Committee's performance.
Form 990, Part VI, Section C, line 19The conflict of interest policy and financial statements are available upon request. Articles of Incorporation are available through the North Carolina Secretary of State website.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (13 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusControlled OrgControlledOrgBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
Mission Health System Inc
509 Biltmore AvenueAshevilleNC28803581450888Parent Company Support Services, Mission Hospital & AffiliatesNC501(c)(3)Line 11a, I0
Mission Hospital Inc
509 Biltmore AvenueAshevilleNC28803560532141Acute Care HospitalNC501(c)(3)Line 30Mission Health System Inc
Mission Healthcare Foundation Inc
980 Hendersonville RoadAshevilleNC28803561881331FoundationNC501(c)(3)Line 70Mission Health System Inc
The McDowell Hospital Inc
430 Rankin DriveMarionNC28752560623938Community HospitalNC501(c)(3)Line 30Mission Health System Inc
Blue Ridge Regional Hospital
Post Office Box 9Spruce PineNC28777561025032Community HospitalNC501(c)(3)Line 30Mission Health System Inc
Blue Ridge Regional Hospital Foundation
PO Box 247Spruce PineNC28777582172660FoundationNC501(c)(3)Line 11a, I0Blue Ridge Regional Hospital Inc
Transylvania Health System Inc
260 Hospital DriveBrevardNC28712561456987DissolvedNC501(c)(3)Line 11b, II0Dissolved June 2013
Transylvania Regional Hospital Foundation
PO Box 2440BrevardNC28712561458024FoundationNC501(c)(3)Line 11a, I0Transylvania Community Hospital
Transylvania Physician Services Inc
260 Hospital DriveBrevardNC28712561920816HealthcareNC501(c)(3)Line 30Transylvania Community Hospital
Transylvania Community Hospital (DBA Transylvania Regional HOspital)
260 Hospital DriveBrevardNC28712560562293HealthcareNC501(c)(3)Line 30Mission Health System Inc
McDowell Healthcare Foundation Inc
430 Rankin DriveMarionNC28752463395393Supporting OrganizationNC501(c)(3)Line 70The McDowell Hospital Inc
Angel Medical Center Auxiliary
PO Box 1209FranklinNC28744562133719Supporting OrganizationNC501(c)(3)Line 11a, I0Angel Medical Center Inc
Angel Medical Center
PO Box 1209FranklinNC28712566000064Community HospitalNC501(c)(3)Line 30Mission Health System Inc

Form990 Schedule R Part III Form990ScheduleRPartIII (13 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateDirect Controlling Entity NADirectControllingEntityNA
Imaging Realty LLP
534 Biltmore AvenueAshevilleNC28801561907203Medical BuildingNCN/A
MSJHS and CCP Joint Development Company LLC
428 Biltmore AvenueAshevilleNC28801562250464Long Term Acute Care HospitalNCN/A
Asheville Imaging
534 Biltmore AvenueAshevilleNC28801561907201Medical ImagingNCN/A
Blue Ridge DME LLC
125 Hospital DriveSpruce PineNC28777263570174Home Medical SuppliesNCN/A
McDowell MRI LLC
Medical ImagingMarionNC28752753046378Medical ImagingNCN/A
Brevard MRI at Transylvania
260 Hospital DriveBrevardNC28712203281110HealthcareNCN/A
Transylania Healthcare II LP
2 Medical Park DriveBrevardNC28712200333230RentalNCN/A
Healthcare III LP
260 Hospital DriveBrevardNC28712561599596RentalNCN/A
Healthcare Limited Liability Company VII
260 Hospital DriveBrevardNC28712200343455RentalNCN/A
Western NC Healthcare InnovatorsLLC
5935 Carnegie BlvdCharlotteNC28209800787882Real Estate RentalNCN/A
Western Regional Radiation Therapy Center
68 Hospital DriveSylvaNC28779561849395NCN/A
Asheville MRI
PO Box 2959AshevilleNC28802561665863NCN/A
WNC Stone Center
509 Biltmore AvenueAshevilleNC28801272152974NCN/A

Form990 Schedule R Part IV Form990ScheduleRPartIV (4 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateDirect Controlling Entity NADirectControllingEntityNAType Of EntityTypeOfEntityControlled OrgControlledOrgAddress Line1AddressForeign/AddressLine1CityAddressForeign/CityCountryAddressForeign/CountryLegal Domicile Foreign CountryLegalDomicileForeignCountry
Horizon Health Corp
213 Ridgefield CourtAshevilleNC28806561341621Holding CompanyNCN/AC0
Horizon Management Services Inc
213 Ridgefield CourtAshevilleNC28806561341624Patient Billing and Collection Services, Medical PropertyNCN/AC0
Dogwood Insurance Company
Captive Insurance CompanyN/AC0The Grand Pavilion Commercial CentrCayman IslandsCJCJ
Transylvania Services Inc
260 Hospital DriveBrevardNC28712561448199Real EstateNCN/AC0
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
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 Orgs1RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs1PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

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