2013-03-14T15:03:46-05:00 2012-09-30 560747981 DIXON HUGHES GOODMAN LLP 111 FRANKLIN RD SE SUITE 501 ROANOKE VA 240112114 990 2011-10-01 560529974 CHARLES A CANNON JR MEMORIAL HOSPITAL INC CHAR 8282624119 434 HOSPITAL DRIVE LINVILLE NC 28646 KEVIN B MAY 8282624119 2013-03-04 1 MICHAEL P NORTON P00430694 5409896144 2013-03-04 2011 2016-03-07 17:11:31Z KEVIN B MAY 434 HOSPITAL DRIVE LINVILLE NC 28646 20749344 0 X WWW.APPRHS.ORG X 1957 NC TO PROVIDE HEALTH CARE SERVICES TO ENHANCE THE QUALITY OF LIFE FOR THE COMMUNITY OF LINVILLE. 14 14 0 90 0 0 77719 325060 19820513 20178161 19742 -49397 188882 208420 20106856 20662244 0 0 0 0 12699913 13425732 0 0 0 8854565 8844684 21554478 22270416 -1447622 -1608172 27723828 27703569 9319408 10432375 18404420 17271194 TO PROVIDE HEALTH CARE SERVICES TO ENHANCE THE QUALITY OF LIFE FOR THE COMMUNITY OF LINVILLE. 0 0 17429326 20319481 HEALTHCARE SERVICES PROVIDED FOR THE COMMUNITY OF LINVILLE, NORTH CAROLINA, CONSISTED OF THE FOLLOWING:ER VISITS 9,860 DISCHARGES 2,124 DAYS OF CARE 9,054 17429326 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 14 14 0 1 0 0 0 0 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X KEVIN B MAY 8282624100 336 DEERFIELD ROAD BOONE NC 28607 PAUL MILLER JR 1.00 X 0 0 0 JOHN BLACKBURN 1.00 X 0 0 0 JIM DEAL 1.00 X 0 0 0 JOE MILLER 1.00 X 0 0 0 SUSAN ROGGENKAMP 1.00 X 0 0 0 KENNETH WILCOX 1.00 X 0 0 0 KEITH TESTER 1.00 X 0 0 0 SAM ADAMS 1.00 X 0 0 0 CHARLES BAKER MD 1.00 X 0 0 0 MARGARET HAYDEN 1.00 X 0 0 0 JACK HOWARD 1.00 X 0 0 0 PATTIE TENNILLE 1.00 X 0 0 0 JAN WINKLER 1.00 X 0 0 0 MARK MURREY MD 1.00 X 0 0 0 MARK VANNOY 1.00 X 0 0 0 RICHARD SPARKS 40.00 X 0 358851 131660 KEVIN MAY 40.00 X 0 247481 25449 CHUCK MANTOOTH 40.00 X 0 170135 20653 CARMEN LACEY 40.00 X 0 100222 25047 0 876689 202809 0 0 1 0 0 325060 325060 PROG.SERV.REVENUE-RELA 900099 20101399 20101399 CAFETERIA REVENUE 900099 76762 76762 20178161 17703 17703 121082 0 121082 121082 121082 20000 87100 -67100 -67100 -67100 MISCELLANEOUS 900099 87338 87338 87338 20662244 20319481 0 17703 10951448 9489222 1462226 1807851 1807851 666433 634748 31685 6602 6602 2051025 1765499 285526 478 478 2406588 2405037 1551 740281 194107 546174 25148 24672 476 2919 2919 420039 420039 1222282 446311 775971 130207 130207 CORP. ALLOCATIONS 1004748 1004748 EQUIPMENT RENTAL AND MA 300822 300822 EQUIPMENT RENTAL AND MA 211846 211846 MINOR EQUIPMENT 112332 112332 209367 115121 94246 22270416 17429326 4841090 0 2158322 2075884 803320 806066 3426455 3670818 510497 563427 145580 171283 36193333 19265406 17671998 16927927 3007656 3488164 27723828 27703569 339872 396918 7533509 7146251 1446027 2889206 9319408 10432375 X 17407505 16361379 996915 909815 18404420 17271194 27723828 27703569 X -1608172 474946 X X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1220001 1220001 21812832 9159389 12653443 3241949 1678272 1563677 9918551 8427745 1490806 16927927 AUWIL 366087 INTEREST IN ARHF 2184477 OWNERSHIP EQUITY-OTHER 22094 CONSTRUCTION IN PROGRESS 12485 BOND ISSUE COST 903021 3488164 DUE TO AFFILIATE 2976259 ESTIMATED THIRD-PARTY SETTLEMENTS -537053 MISCELLANEOUS 450000 2889206 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: ARHS AND THE COMPANIES FOR WHICH IT SERVES AS SOLE MEMBER ARE NOT-FOR-PROFIT CORPORATIONS AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND ARE EXEMPT FROM FEDERAL AND STATE INCOME TAXES ON RELATED INCOME. ACCORDINGLY, NO PROVISION FOR INCOME TAXES HAS BEEN MADE IN THE ACCOMPANYING COMBINED FINANCIAL STATEMENTS. THE SYSTEM HAS DETERMINED IT DOES NOT HAVE ANY MATERIAL UNRECOGNIZED TAX BENEFITS OR OBLIGATIONS AS OF SEPTEMBER 30, 2012. FISCAL YEARS ENDING ON OR AFTER SEPTEMBER 30, 2009 REMAIN SUBJECT TO EXAMINATION BY FEDERAL AND STATE TAXING AUTHORITIES. 1 1 1 X 175.000000000000 1 X 1 1 1 0 1 1 591639 591639 0.02660 2791798 1284479 1507319 0.06770 3383437 1284479 2098958 0.09430 35623 35623 0.00160 29117 29117 0.00130 31660 31660 0.00140 96400 96400 0.00430 3479837 1284479 2195358 0.09860 1 1659833 82992 11522254 11522254 X 1 1 1 APPALACHIAN REGIONAL HEALTHCARE SYSTEM SOLE MEMBER OF CHARLES A. CANNON JR., MEMORIAL HOSPITAL, INC. 1.00000 1 1 CHARLES A CANNON JR MEMORIAL HOSPITAL

434 HOSPITAL DRIVE LINVILLE NC 28646

X X X X NOT REQUIRED 1 0 0 0 0 0 0 0 0 0 0 0 PART III, LINE 4: AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IS RECORDED BASED ON HISTORICAL BAD DEBT EXPERIENCE AND MANAGEMENT'S EVALUATION OF THE ACCOUNTS RECEIVABLE. BALANCES ARE WRITTEN OFF AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN MADE.WE ESTIMATE 5% OF CHARITY COSTS FAIRLY ESTIMATE AMOUNTS INCLUDED AS BAD DEBT THAT WOULD BE ELIGIBLE FOR CHARITY CARE BUT FAILED TO APPLY. PART III, LINE 9B: CHARITY WRITE-OFFS ARE SEGREGATED FROM NORMAL BAD DEBTS THROUGH A SEPARATE TRANSACTION CODE. FAMILY INCOME BELOW 175% OF FPG ARE ELIGIBLE FOR 100% WRITE-OFF. PARTIAL WRITE-OFF IS AVAILABLE BETWEEN FAMILY INCOME BETWEEN 175% AND 250% OF FPG. 0 0 0 0 0 0 0 0 0 RICHARD SPARKS 0 326529 0 30000 0 2322 0 125877 0 5783 0 490511 0 0 KEVIN MAY 0 246301 0 0 0 1180 0 19499 0 5950 0 272930 0 0 CHUCK MANTOOTH 0 169807 0 0 0 328 0 14703 0 5950 0 190788 0 0 FORM 990, PART VI, SECTION A, LINE 3 PARENT COMPANY, APPALACHIAN REGIONAL HEALTH CARE SYSTEM (ARHS) OVERSEES CMH OPERATIONS. ALSO NOTE THAT SALARIES AND OTHER COMON EXPENSES INCURRED BY ARHS ARE ALLOCATED APPROPRIATELY TO CMH. PAYMENTS TO VENDORS ARE PAID THROUGH ARHS AND ALL 1099'S ARE ISSUED THROUGH ARHS. FORM 990, PART VI, SECTION A, LINE 7B APPROVAL MAY BE NEEDED BY THE PARENT COMPANY, APPALACHIAN REGIONAL HEALTH CARE SYSTEM. FORM 990, PART VI, SECTION B, LINE 11 THE SVP/CFO AND THE VICE PRESIDENT OF FINANCE REVIEW THE 990 AND THEN IT IS MADE AVAILABLE TO THE BOARD UPON COMPLETION. FORM 990, PART VI, SECTION B, LINE 12C REVIEW OF POLICY STATEMENT EACH YEAR. FORM 990, PART VI, SECTION B, LINE 15 INDEPENDENT COMPENSATION AND BENEFIT ANALYSIS WAS PERFORMED BY FINDLEY DAVIES IN DECEMBER 2011. THE EXECUTIVE COMMITTEE (COMPENSATION COMMITTEE) REVIEWED THIS INFORMATION IN DECEMBER, 2012 TO ESTABLISH APPROPRIATENESS OF TOTAL COMPENSATION, COMPLY WITH INTERMEDIATE SANCTION REGULATIONS, AND DETERMINE EXECUTIVE COMPENSATION FOR CEO AND CFO POSITIONS. FORM 990, PART VI, SECTION C, LINE 19 PROVIDED UPON REQUEST. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: TRANSFERS FROM AFFILIATE 474,946. TOTAL TO FORM 990, PART XI, LINE 5: 474,946. PART XII, LINE 2C THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. APPALACHIAN REGIONAL HEALTHCARE SYSTEM PO BOX 2600 BOONE NC 28607 201067022 PARENT COMPANY NC 501(C)(3) 11C 0 BLOWING ROCK HOSPITAL INC PO BOX 148 BLOWING ROCK NC 28605 560513181 HOSPITAL NC 501(C)(3) 3 0 WATAUGA MEDICAL CENTER INC 336 DEERFIELD RD BOONE NC 28607 560510824 HOSPITAL NC 501(C)(3) 3 0 APPALACHIAN REGIONAL HEALTHCARE FOUNDATION 336 DEERFIELD RD BOONE NC 28607 204625618 PHILANTHROPIC ORGANIZATION FOR THE SYSTEM NC 501(C)(3) 7 0 APPALACHIAN REGIONAL MEDICAL ASSOCIATES INC PO BOX 2600 BOONE NC 28607 205755130 EMPLOYMENT ALTERNATIVE TO BOTH NEW AND ESTABLISHED PHYSICIAN PRACTICES NC 501(C)(3) 9 0 ARHS PROPERTIES INC 336 DEERFIELD RD BOONE NC 28607 203470765 HOLD FUTURE PURCHASE OF NON-PROFIT LAND ACQUISITIONS NC 501(C)(3) 9 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 APPALACHIAN REGIONAL HEALTHCARE FOUNDATION C 325060 ACTUAL