FURP.ORG / PUBLIC DATA EXPLORER

LENOIR MEMORIAL HOSPITAL INC: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
LENOIR MEMORIAL HOSPITAL INC (EIN 56-6000674)
Tax period
2011-10-01 to 2012-09-30
Filed
2013-08-05
IRS object ID
201312179349300136
Schema version
2011v1.5
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)
Timestamp2013-08-05T12:37:34-05:00Timestamp
Tax Period End Date2012-09-30TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN560747981EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1DIXON HUGHES GOODMAN LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1500 RIDGEFIELD COURTAddressLine1
CityASHEVILLECity
StateNCState
ZIP Code28806ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN566000674EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1LENOIR MEMORIAL HOSPITAL INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlLENONameControl
Phone2525227927Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1100 AIRPORT ROADAddressLine1
CityKINSTONCity
StateNCState
ZIP Code28501ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameSARAH MAYOName
TitleCFOTitle
Phone2525227927Phone
Date Signed2013-08-05DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameAMY BIBBYName
PTINP00445891PTIN
Phone8282542254Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonGARY BLACKNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1100 AIRPORT ROADAddressLine1
CityKINSTONCity
StateNCState
ZIP Code28501ZIPCode
FieldValueIRS element (for citing)
Gross Receipts137608639GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.LENOIRMEMORIAL.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1950YearFormation
State Legal DomicileNCStateLegalDomicile
Activity Or Mission DescriptionPROVIDING EXCEPTIONAL HEALTHCARE AS AN OUTSTANDING COMMUNITY HOSPITALActivityOrMissionDescription
Nbr Voting Members Governing Body17NbrVotingMembersGoverningBody
Nbr Independent Voting Members15NbrIndependentVotingMembers
Total Nbr Employees1199TotalNbrEmployees
Total Nbr Volunteers295TotalNbrVolunteers
Total Gross UBI322053TotalGrossUBI
Net Unrelated Business Txbl Income41353NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year110980ContributionsGrantsPriorYear
Contributions Grants Current Year131987ContributionsGrantsCurrentYear
Program Service Revenue Prior Year118066876ProgramServiceRevenuePriorYear
Program Service Revenue CY129791518ProgramServiceRevenueCY
Investment Income Prior Year4259213InvestmentIncomePriorYear
Investment Income Current Year3034377InvestmentIncomeCurrentYear
Other Revenue Prior Year3319392OtherRevenuePriorYear
Other Revenue Current Year3601285OtherRevenueCurrentYear
Total Revenue Prior Year125756461TotalRevenuePriorYear
Total Revenue Current Year136559167TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year199111GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY179893GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year54822042SalariesEtcPriorYear
Salaries Etc Current Year58615229SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year57831TotalFundrsngExpCurrentYear
Other Expense Prior Year67132607OtherExpensePriorYear
Other Expenses Current Year77225464OtherExpensesCurrentYear
Total Expenses Prior Year122153760TotalExpensesPriorYear
Total Expenses Current Year136020586TotalExpensesCurrentYear
Revenues Less Expenses Prior Year3602701RevenuesLessExpensesPriorYear
Revenues Less Expenses CY538581RevenuesLessExpensesCY
Total Assets BOY180459030TotalAssetsBOY
Total Assets EOY189443013TotalAssetsEOY
Total Liabilities BOY49550658TotalLiabilitiesBOY
Total Liabilities EOY51277192TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY130908372NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY138165821NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionTHE MISSION OF LENOIR MEMORIAL IS TO ENSURE EXCEPTIONAL HEALTHCARE FOR THE PEOPLE WE SERVE.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense116425079Expense
Grants179893Grants
Revenue132229675Revenue
DescriptionSTRATEGIC PRIORITIES FOCUS ON DELIVERING HEALTHCARE SERVICES CONSISTENT WITH COMMUNITY NEED. SERVICES ARE PROVIDED TO INDIVIDUALS REGARDLESS OF THE RACE, CREED, SEX, NATURAL ORIGIN AND/OR AN INDIVIDUAL'S INABILITY TO PAY.THE ORGANIZATION'S MOST RECENT COMMUNITY HEALTH REPORT IS LOCATED ON THE HOSPITAL WEBSITE AT WWW.LENOIRMEMORIAL.ORG.LMH PROVIDES LEADERSHIP AND EMPLOYEE EXPERTISE TO THE COMMUNITY ON AND OFF SITE. COMMUNITY BENEFIT OPERATIONS INCLUDED IN THIS AREA. HIGHLIGHTS INCLUDE BUT NOT LIMITED TO:COMMUNITY HEALTH NEEDS ASSESSMENT LENOIR MEMORIAL HOSPITAL AND THE LENOIR COUNTY HEALTH DEPARTMENT LED AN EFFORT IN 2011 THAT TOOK A STRUCTURED APPROACH TO REVIEW PUBLIC HEALTH DATA, CONDUCT SURVEYS, AND FOSTER COMMUNITY DISCUSSIONS AND INPUT INTO AN ASSESSMENT. THE PRIORITIZATION PROCESS IDENTIFIED FOUR PRIORITY ISSUES FOR THE COMMUNITY: OBESITY ( PHYSICAL ACTIVITY AND NUTRITION), DIABETES, HIGH BLOOD PRESSURE, AND RESPONSIBLE PARENTING. STRATEGIES WERE DEVELOPED FOR EACH AREA AND ACTIVITIES IMPLEMENTED IN 2012 AND REPORTED ON AT THE LENOIR COUNTY ALLIANCE FOR A HEALTHY COMMUNITY COALITION.LENOIR COUNTY CHILDHOOD OBESITY PREVENTION TASK FORCELENOIR MEMORIAL IS AN ACTIVE PARTNER IN A NEWLY FORMED LENOIR COUNTY CHILDHOOD OBESITY PREVENTION TASK FORCE THAT HAS REPRESENTATIVES FROM THE LOCAL SCHOOLS, COUNTY GOVERNMENT, AND KEY COMMUNITY AGENCIES. DURING 2012, TWO LOCAL SCHOOLS WERE TARGETED FOR PHYSICAL ACTIVITY AND NUTRITION EDUCATION PROGRAMS REACHING STUDENTS AND FAMILIES IN THE NEIGHBORHOOD. FUEL FOR SUCCESS, A YEAR-LONG NUTRITION EDUCATION PROGRAM LED BY DIETITIANS WAS INITIATED AT SE ELEMENTARY. PROJECT DIGG, A COMPREHENSIVE SCHOOL SITE GARDENING PROGRAM AT SAVANNAH- CONTENTNEA SCHOOL WAS INITIATED WITH PLANS FOR REPLICATION AT OTHER SCHOOLS. MORE INFORMATION ABOUT THE ACTIVITIES OF THE TASK FORCE CAN BE FOUND AT HTTP://WWW.LENOIRCOUNTYNCHEALTHYKIDS.COM/. LENOIR MEMORIAL IS PROVIDING A STAFF DIETITIAN TO ASSIST WITH THE COMMON GROUND OF ENC, A COMMUNITY GARDENING PROJECT IN AN EFFORT TO INCREASE ACCESS TO FRESH FRUITS AND VEGETABLES FOR PEOPLE WHO COULD NOT OTHERWISE AFFORD IT.COMMUNITY COALITION ACTIVITIESLENOIR MEMORIAL PROVIDES LEADERSHIP AND ADMINISTRATIVE SUPPORT FOR COMMUNITY HEALTH COALITIONS. THE LENOIR COUNTY ALLIANCE FOR A HEALTHY COMMUNITY MEETS ON A MONTHLY BASIS FOR COMMUNITY NETWORKING AND INFORMATION SHARING. THE LENOIR-GREENE ASTHMA COALITION MEETS FOUR TIMES A YEAR TO INCREASE COMMUNITY AWARENESS ABOUT ASTHMA.SUPPORT GROUPSCOORDINATED 16 HOSPITAL BASED GROUPS, ATTENDED BY 1905 PARTICIPANTS. A STROKE SUPPORT GROUP WAS REORGANIZED THIS YEAR. THE UPGRADING OF A MEETING ROOM THIS YEAR IN THE MINGES WELLNESS CENTER HAS ALLOWED MOST SUPPORT GROUPS TO HOST MEETINGS MORE CONVENIENTLY NOW.FOUR COMMUNITY BLOOD PRESSURE MACHINESPROVIDED 49,920 SCREENING BLOOD PRESSURES INCLUDING SITES FOR BLOOD PRESSURE MACHINES AT VERNON PARK MALL AND A MACHINE THAT TRAVELS TO VARIOUS COMMUNITY CHURCHES EACH MONTH.SCREENING EVENTSPROVIDED EARLY DETECTION SCREENING EVENTS OF DISEASES/ DISORDERS/RISKS INCLUDING COLORECTAL, SKIN, PROSTATE CANCERS, MAMMOGRAM, CHOLESTEROL, AND BLOOD PRESSURES. A FIRST-TIME CHRONIC KIDNEY DISEASE SCREENING WAS PROVIDED IN SEPTEMBER, 2012 BY UNC AT THE HOSPITAL AND 27 HIGH RISK INDIVIDUALS WERE SCREENED.COMMUNITY AIR QUALITY PROGRAMPROVIDED OUTDOOR FLAGS FOR ALL GREENE COUNTY SCHOOL SITES FOR AN AIR ALERT PROGRAM . THROUGH THE PARTNERSHIP OF THE LENOIR-GREENE ASTHMA COALITION AND NC AIR, DIFFERENT COLORED PENNANT FLAGS FLY TO SIGNIFY THE OUTDOOR AIR QUALITY FOR EASTERN NC AS TESTED DAILY BY THE EPA IN ROCKY MOUNT, NC.LIGHTEN UP LENOIRIMPLEMENTED A FREE COMMUNITY-WIDE WEIGHT LOSS CHALLENGE THROUGH AN ONLINE WEB-BASED APPLICATION. NEARLY 1000 PARTICIPANTS LOST ALMOST 6000 POUNDS DURING THREE 16 WEEK SESSIONS. THE SITE WAS LOADED WITH THOUSANDS OF HEALTHY RECIPES, EXERCISE VIDEOS, AND INFORMATION ABOUT SPECIAL COMMUNITY LIGHTEN UP LENOIR EDUCATIONAL EVENTS. OVER 35 LOCAL EMPLOYERS PARTICIPATED WITH TEAMS IN THE FUN COMPETITIVE EVENT. LOCAL COMPANIES WHO SUPPORTED THE CAMPAIGN WITH A TEAM WERE ABLE TO LIST THEIR COMPANY AS A SPONSOR AT NO FEE. THE KINSTON FREE PRESS RAN ARTICLES AND STORIES TO SPUR ON ATTENDANCE AND AWARENESS AND SPONSORED A BEST TEAM NAME CONTEST.LENOIR MEMORIAL COMMUNITY WALKING TRACK AVERAGES OVER 700 WALKERS PER MONTH. ALLOWED TWO EXTERNAL NOT-FOR-PROFIT GROUPS TO HOST WALK CAMPAIGNS ON THE TRACK ON TWO SEPARATE SATURDAY MORNINGS.CORPORATE HEALTH SERVICESSERVICES INCLUDED 100 CORPORATE CLIENTS, 240 WORKSITE WELLNESS VISITS WITH 2819 EMPLOYEE CONTACTS. FLU SHOTS, CPR TRAINING, AND TARGETED HEALTH EDUCATION IS PROVIDED.LIVING THE GOOD LIFE IN EASTERN NCSPONSOR FOR THE KINSTON/LENOIR COUNTY CHAMBER OF COMMERCE EVENT WHICH FOCUSED ON REGIONAL HEALTHY LIVING ISSUES. OVER 2000 PARTICIPANTS AT VERNON PARK MALL RECEIVED DIABETES RISK FACTOR EDUCATION AND HEALTHY FOOD SAMPLES. HEART HEALTHY LENOIRCOLLABORATION WITH UNC CENTER FOR POPULATION HEALTH AND HEALTH DISPARITIES IS ONGOING IN A 5 YEAR NIH GRANT TO REDUCE STROKE AND HEART DISEASE IN LENOIR COUNTY. THE PROJECT IS OVERSEEN BY RESEARCHERS AT UNC, ASSISTING IN THE COORDINATION OF PROCESSES TO IMPLEMENT A BLOOD PRESSURE STUDY WITH 600 LOCAL PARTICIPANTS. THIS PROJECT INCLUDES SIX PHYSICIAN PRACTICES AND THE IMPLEMENTATION OF STANDARDIZED HYPERTENSION GUIDELINES, HOME BLOOD PRESSURE MONITORING AND TELEPHONE COACHING AS AN EVIDENCE-BASED APPROACH FOR BETTER HYPERTENSION MANAGEMENT. THE PROJECT PARTNERSHIP INCLUDES A LOCAL ADVISORY COMMITTEE ON WHICH SEVERAL HOSPITAL LEADERS SERVE. COMMUNITY HEALTH EDUCATION PROGRAMMING PROVIDED 4151PARTICIPANTS ON AND OFF-SITE PROGRAMMING. PROGRAMMING INCLUDED 55 ALIVE, INFANT CPR, QUITSMART, EXERCISE, NUTRITION AND OTHER HEALTH EDUCATION CLASSES. SHREDDING EVENTTHIS FALL, 2012 EVENT ALLOWED AREA RESIDENTS TO SAFELY AND CONFIDENTIALLY DISPOSE OF OLD PERSONAL RECORDS AND DOCUMENTS BY PARTNERING WITH CINTAS FOR THE FREE EVENT. OVER 125 RESIDENTS UTILIZED THE EVENT.STROKE PREVENTION AND CARELENOIR MEMORIAL PARTNERED WITH THE ENC STROKE NETWORK TO PROVIDE STAFF WITH ADVANCED STROKE LIFE SUPPORT EDUCATION, IMPLEMENTED A STROKE TEAM, AND IS COLLABORATING WITH LENOIR COUNTY EMS IN A COUNTY-WIDE EFFORT TO DECREASE STROKE TREATMENT TIMES AND INCREASE COMMUNITY AWARENESS OF STROKE RISK FACTORS. LENOIR MEMORIAL BEGAN INCORPORATING THE CDC MILLION HEARTS RISK FACTOR CAMPAIGN AWARENESS IN HOSPITAL SOCIAL MEDIADIABETES WELLNESS PROGRAMLOCATED IN THE MINNIE P. STACKHOUSE DIABETES CENTER, WITHIN LENOIR MEMORIAL HOSPITAL, THE DIABETES WELLNESS PROGRAM PROVIDED FREE DIABETES SELF-MANAGEMENT EDUCATION TO 139 INDIVIDUALS LIVING WITH DIABETES. OUTREACH EDUCATION AND SCREENINGS WERE PROVIDED MONTHLY REACHING 1446 COMMUNITY MEMBERS. ADDITIONALLY, A GRANT FROM KATE B. REYNOLDS CHARITABLE TRUST ALLOWED A REGISTERED DIETITIAN TO PROVIDE MEDICAL NUTRITION COUNSELING FOR 185 INDIVIDUALS DURING THIS YEAR. FOUR AFRICAN AMERICAN CHURCHES RECEIVED TARGETED WEIGHT LOSS EDUCATION IN AN EFFORT TO PREVENT TYPE 2 DIABETES RISK FACTORS AND COMPLICATIONSPINK HILL WELLNESS CENTERDIABETES AND PRE-DIABETES EDUCATION WAS PROVIDED ON-SITE IN PINK HILL IN ORDER TO IDENTIFY PERSONS AT RISK FOR DIABETES AND PROVIDE DIABETES SELF- MANAGEMENT EDUCATION BY A CERTIFIED DIABETES EDUCATOR AND A REGISTERED DIETITIANBREASTFEEDING SUPPORT GROUPA LOCAL BREAST FEEDING COALITION WAS INITIATED BY THE HOSPITAL IN AN EFFORT TO INCREASE BREASTFEEDING EDUCATION AND AWARENESS. LMH HAS PARTNERED WITH THE CAROLINA GLOBAL BREASTFEEDING INSTITUTE TO IMPROVE OUR PRACTICES RELATED TO BREASTFEEDING EDUCATION AND SUPPORT OF OUR FAMILIES. AS A RESULT, WE HAVE OBTAINED 4 OUT OF 5 BREASTFEEDING STARS AND HAVE SEEN AN INCREASE OF OUR EXCLUSIVE BREASTFEEDING RATE BY 83% OVER THE PAST TWO YEARS. THE FAMILY BIRTH CENTER IS WORKING WITH THE NC HEALTHY START FOUNDATION TO PUT STANDARDS IN PLACE FOR THE INFANT SAFE SLEEP HOSPITAL MODEL OF EXCELLENCE REGARDING COMMUNITY EDUCATION FOR INFANT SAFE SLEEP PRACTICES. THE FAMILY BIRTH CENTER IS ALSO IMPLEMENTING A PURPLE CRYING EDUCATION PROGRAM IN AN EFFORT TO JOIN OTHER HOSPITALS IN NC TO REDUCE THE INCIDENCE OF SHAKEN BABY SYNDROME BY 50% BY THE YEAR 2014FOOD DRIVELENOIR MEMORIAL EMPLOYEES PROVIDE TIME AND LEADERSHIP TO COLLECT FOOD FOR THE NEEDY FAMILIES IN LENOIR COUNTYLIVING WILLSTHE HIS DEPARTMENT OF LENOIR MEMORIAL HOSPITAL PROVIDED ASSISTANCE TO COMMUNITY MEMBERS IN COMPLETING EMERGENCY PREPARDNESSLENOIR MEMORIAL PARTICIPATES IN THE LOCAL EMERGENCY PLANNING COMMITTEE, AND AS A MEMBER OF THE LENOIR COUNTY TEAM IN THE EASTERN REGIONAL ADVISORY COUNCIL OF 29 COUNTIES TO PLAN, COORDINATE, AND EXECUTE DISASTER READINESS AND DRILLS. ONE COUNTY-WIDE DRILL WAS PERFORMED. A DECONTAMINATION TRAILER WAS GIVEN TO LENOIR COUNTY EMERGENCY MANAGEMENT IN ORDER TO PROVIDE COUNTY WIDE DECONTAMINATION SERVICES.Description

Activity2 Activity2

FieldValueIRS element (for citing)
DescriptionCONTINUATION OF COMMUNITY BENEFITSPHYSICIAN RECRUITMENT LENOIR MEMORIAL PROVIDED PHYSICIAN RECRUITMENT SERVICES FOR PROVIDORS IN ORDER TO MEET COMMUNITY NEEDS IN A MEDICALLY UNDERSERVED GEOGRAPHIC AREA. PRIORITY AREAS INCLUDE, BUT ARE NOT LIMITED TO GENERAL SURGERY, INTERNAL MEDICINE, PEDIATRICS, AND ORTHOPEDICS. FOUR PROVIDORS WERE SUCCESSFULLY RECRUITED TO AREA PRACTICES. TUMOR BOARDLMH COORDINATES A COMPREHENSIVE CANCER PROGRAM THAT INVOLVES COMMUNITY PHYSICIAN EDUCATION AND PLANNING FOR COMMUNITY CANCER TREATMENT.NURSING EDUCATION LENOIR MEMORIAL PROVIDES PRECEPTORS AND ACTS AS A TRAINING FACILITY FOR NURSING STUDENTS FROM COLLEGES ACROSS EASTERN NC AS WELL AS AWARDS SCHOLARSHIPS.LANGUAGE INTERPRETATIONLENOIR MEMORIAL HOSPITAL PROVIDED LANGUAGE INTERPREATION SERVICES TO EXTERNAL AGENCIES AT NO CHARGE. FINANCIAL CASE WORKERS LENOIR MEMORIAL PROVIDES HALF THE SALARIES OF TWO, ON SITE, DSS, CASE WORKERS IN ORDER TO PROMOTE AND SUPPORT ACCESS TO HEALTHCARE. MENTORING PROGRAMTWELVE LMH MANAGEMENT TEAM MEMBERS PARTICIPATE IN A COMMUNITY MENTORING PROGRAM IN LENOIR COUNTY IN ORDER TO MENTOR ELEMENTARY SCHOOL CHILDEN IN AN UNDERSERVED SCHOOL DISTRICT. LEADERS ARE MATCHED WITH SPECIFIC CHILDREN OVER THE SCHOOL YEAR AND PROVIDE SUPPORT DIRECTLY TO STUDENTS BY COACHING, HELPING WITH HOMEWORK, AND READING TO THEIR CHILD. MENTORS ALSO PROVIDE FINANCIAL SUPPPORT FOR SCHOOL SUPPLIES AND EDUCATIONAL MATERIALS.Description
FieldValueIRS element (for citing)
Total Program Service Expense116425079TotalProgramServiceExpense
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 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
Hospital1Hospital
Financial Stmt Attached1FinancialStmtAttached
Grants To Organizations1GrantsToOrganizations
Grants To Individuals1GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds1TaxExemptBonds
Invest Tax Exempt Bonds0InvestTaxExemptBonds
Escrow Account0EscrowAccount
On Behalf Of Issuer0OnBehalfOfIssuer
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 Contributions1DeductibleNonCashContributions
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 With1096170NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees1199NumberOfEmployees
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 Members17NbrVotingGoverningBodyMembers
Number Independent Voting Members15NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
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 Venture1InvestmentInJointVenture
Written Policy Or Procedure1WrittenPolicyOrProcedure
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 Line1MICHELLE MITTEN CPA FINANCE DIRBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number2525227927TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1100 AIRPORT ROADAddressLine1
CityKINSTONCity
StateNCState
ZIP Code28501ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (27 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
GARY BLACK
CEO40.00XX447381071412
KAY HARRELL
CHAIRPERSON2.00XX000
MARY M CAULEY EDD
BOARD MEMBER2.00X000
RAY COLLIER JR
BOARD MEMBER2.00X000
RALPH LEE COX MD
BOARD MEMBER2.00X000
DEXTER FLOYD
BOARD MEMBER2.00X000
OSCAR SKIP GREENE III
BOARD MEMBER2.00X000
MICHEL HADDAD MD
BOARD MEMBER2.00X1250000
CLIFTON HARRISON
BOARD MEMBER2.00X000
AGNES HO
BOARD MEMBER2.00X000
ADRIAN KING
BOARD MEMBER2.00X000
WILLIAM ANTHONY LAWSON JR
BOARD MEMBER2.00X000
THOMAS A PHARO
BOARD MEMBER2.00X000
DAPHNE POLLOCK
BOARD MEMBER2.00X000
LADDIE M CRISP JR MD
BOARD MEMBER2.00X137500
ARMISTEAD MAUCK
BOARD MEMBER2.00X000
CARLTON YOUNGER JR
BOARD MEMBER2.00X000
JIM DOBBINS
VP - HUMAN RESOUCES40.00X207198028530
SARAH MAYO
CFO40.00X256345034735
WILLIAM LEASE
VP - PLANT AND FACILITY40.00X201030015474
ROSILAND MCDONALD
VP - NURSING SERVICES40.00X206784015481
DALE HARDY
PHARMACY DIRECTOR40.00172889014876X
SCOTT STEGBAUER MD
ORTHOPEDIC SURGEON40.00513011021498X
ARTHUR HUNSINGER
CRNA40.00198974016696X
CONNIE MANGEL
CRNA40.00188655016207X
GEORGE YVETTE
CRNA40.00196821015840X
MARK HENNING
CRNA40.00198833015987X
FieldValueIRS element (for citing)
Total Reportable Comp From Org2801796TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation266736TotalOtherCompensation
Number Individuals GT100 K29NumberIndividualsGT100K
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
LENOIR HM SERVICES
PO BOX 82368LAFAYETTELA705982368HOSPITALIST STAFFING1231003
CHARLES H CLASSEN JR PLLC
2007 STANTON ROADKINSTONNC28504CONTRACT ORTHOPEDIC SURGEON392500
K&L GATES LLP
925 FOURTH AVE STE 2900SEATTLEWA98104LEGAL COUNCIL264771
DR PREECHA BHOTIWIHOK
1910 STANTON ROADKINSTONNC28504CONTRACT ANESTHESIA SERVICES202447
EMERGENCY MEDICINE PHYSICIANS
PO BOX 71-4287COLUMBUSOH432714287EMERGENCY DEPARTMENT PHYSICIAN SERVICES201000
FieldValueIRS element (for citing)
Number Of Contractors GT100 K10NumberOfContractorsGT100K
Related Organizations81750RelatedOrganizations
All Other Contributions50237AllOtherContributions
Noncash Contributions40322NoncashContributions
Total Contributions131987TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenue
PATIENT SERVICES621990129070323129070323
AUXILLARY SERVICE REVE6219905827015745318170
WELLNESS CENTER REVEUN713940163237163237
LAB REVENUE541380691043455234552
PRINTING REVENUE32310093989398

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

FieldValueIRS element (for citing)
Total Revenue Column-103245TotalRevenueColumn
Unrelated Business Revenue-103245UnrelatedBusinessRevenue
FieldValueIRS element (for citing)
Total Program Service Revenue129791518TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column3142508TotalRevenueColumn
Unrelated Business Revenue3571UnrelatedBusinessRevenue
Exclusion$3,138,937ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Personal1735448Personal

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Personal0Personal

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Personal1735448Personal

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column1735448TotalRevenueColumn
Related Or Exempt Function Income1365841RelatedOrExemptFunctionIncome
Unrelated Business Revenue369607UnrelatedBusinessRevenue

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other108131Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other-108131Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-108131TotalRevenueColumn
Exclusion-$108,131ExclusionAmount
FieldValueIRS element (for citing)
Gross Sales Of Inventory1653448GrossSalesOfInventory
Cost Of Goods Sold941341CostOfGoodsSold

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column712107TotalRevenueColumn
Related Or Exempt Function Income518715RelatedOrExemptFunctionIncome
Unrelated Business Revenue193392UnrelatedBusinessRevenue

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmount
DIETARY AND CAFETERIA900099906570$906,570
GIFT SHOP900099189474$189,474
VENDING90009957686$57,686
FieldValueIRS element (for citing)
Total Other Revenue1153730TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column136559167TotalRevenueColumn
Related Or Exempt Function Income131727199RelatedOrExemptFunctionIncome
Unrelated Business Revenue515445UnrelatedBusinessRevenue
Exclusion$4,184,536ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total37000Total
Program Services37000ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total142893Total
Program Services142893ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total1682474Total
Program Services339494ProgramServices
Management And General1297335ManagementAndGeneral
Fundraising45645Fundraising

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total44582089Total
Program Services36411180ProgramServices
Management And General8170909ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total1622387Total
Program Services1288758ProgramServices
Management And General332028ManagementAndGeneral
Fundraising1601Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total7230362Total
Program Services5743503ProgramServices
Management And General1479725ManagementAndGeneral
Fundraising7134Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total3497917Total
Program Services2778602ProgramServices
Management And General715864ManagementAndGeneral
Fundraising3451Fundraising

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total49632Total
Management And General49632ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total347114Total
Management And General347114ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total75722Total
Management And General75722ManagementAndGeneral

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total254612Total
Management And General254612ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total8747444Total
Program Services7105354ProgramServices
Management And General1642090ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total379673Total
Program Services51849ProgramServices
Management And General327824ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total14126970Total
Program Services9534009ProgramServices
Management And General4592961ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total2356473Total
Program Services2356473ProgramServices

Occupancy Occupancy

FieldValueIRS element (for citing)
Total3115018Total
Program Services3016360ProgramServices
Management And General98658ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total97698Total
Program Services56019ProgramServices
Management And General41679ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total61661Total
Program Services37816ProgramServices
Management And General23845ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total39263Total
Program Services132ProgramServices
Management And General39131ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total7684475Total
Program Services7684475ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total62340Total
Program Services62340ProgramServices

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
BAD DEBT EXPENSE2946997429469974
MEDICAL SUPPLIES98014949801494
RECRUITMENT499404499404
MISCELLANEOUS56497795048547

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total136020586Total
Program Services116425079ProgramServices
Management And General19537676ManagementAndGeneral
Fundraising57831Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY3112445BOY
EOY6194893EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY17442567BOY
EOY15111537EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY11573208BOY
EOY12372280EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY3059169BOY
EOY3089169EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY1353423BOY
EOY1424388EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis150439365LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec88009309LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY63086764BOY
EOY62430056EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY76644225BOY
EOY83427286EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY4187229BOY
EOY5393404EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY180459030BOY
EOY189443013EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY9026065BOY
EOY10167086EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY10130696BOY
EOY10340391EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY19364230BOY
EOY18940000EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY6500000BOY
EOY6000000EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY4529667BOY
EOY5829715EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY49550658BOY
EOY51277192EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY93704950BOY
EOY100909661EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY37203422BOY
EOY37256160EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY130908372BOY
EOY138165821EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY180459030BOY
EOY189443013EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses538581ReconcilationRevenueExpenses
Reconcilation Other Changes6718868ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
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$7,647OtherActivitiesAmount
Total Lobbying Expenditures IIB7647TotalLobbyingExpendituresIIB
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
ExplanationTHE ORGANIZATION IS A MEMBER OF THE NORTH CAROLINA HOSPITAL ASSOCIATION. A PORTION OF THE DUES PAID TO THAT ORGANIZATION ARE ALLOCATED EACH YEAR TO LOBBYING EFFORTS ON BEHALF OF ITS MEMBERSHIP BODY. FOR THE YEAR, APPROXIMATELY $7,647 HAS BEEN ALLOCATED TO LOBBYING EXPENDITURES.Explanation

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis425406OtherCostOrOtherBasis
Book Value425406BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis71058179OtherCostOrOtherBasis
Depreciation31410497Depreciation
Book Value39647682BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis77811087OtherCostOrOtherBasis
Depreciation56598812Depreciation
Book Value21212275BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis1144693OtherCostOrOtherBasis
Book Value1144693BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings62430056TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS$5,595,823
CAPITAL LEASE OBLIGATION$233,892
FieldValueIRS element (for citing)
Total Of Amounts5829715TotalOfAmounts
Total Revenue136559167TotalRevenue
Total Expenses136020586TotalExpenses
Excess Or Deficit For Year538581ExcessOrDeficitForYear
Net Unrealized GL On Investments6718868NetUnrealizedGLOnInvestments
Total Adjustments6718868TotalAdjustments
Excess Or Deficit Per FS7257449ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt114749402TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments6718868NetUnrealizedGainsInvestments
Other Revenues941341OtherRevenues
Revenue Not Rptd F9907660209RevenueNotRptdF990
Revenue Subtotal107089193RevenueSubtotal
Other Revenues Not Included29469974OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt29469974RevenueNotRptdOnFinStmt
Total Revenue Per Form990136559167TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt107491953TotExpensesEtcAuditedFinclStmt
Other Expenses Included941341OtherExpensesIncluded
Expenses Not Rptd F990941341ExpensesNotRptdF990
Expenses Subtotal106550612ExpensesSubtotal
Other Expenses Not Included29469974OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt29469974ExpensesNotRptdOnFinStmt
Total Expenses Per Form990136020586TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (5 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:PART X:THE HOSPITAL AND FOUNDATION ARE EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE; ACCORDINGLY, THE ACCOMPANYING FINANCIAL STATEMENTS DO NOT REFLECT A PROVISION OR LIABILITY FOR FEDERAL AND STATE INCOME TAXES. THE HOSPITAL AND THE FOUNDATION HAVE DETERMINED THAT THEY DO NOT HAVE ANY MATERIAL UNRECOGNIZED TAX BENEFITS OR OBLIGATIONS AS OF SEPTEMBER 30, 2012. THE HOSPITAL AND FOUNDATION BELIEVE THEY ARE NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO SEPTEMBER 30, 2009.
PART XII, LINE 2D - OTHER ADJUSTMENTS:COST OF GOODS SOLD 941,341.
PART XII, LINE 4B - OTHER ADJUSTMENTS:PROVISION FOR BAD DEBTS 29,469,974.
PART XIII, LINE 2D - OTHER ADJUSTMENTS:COSTS OF GOODS SOLD 941,341.
PART XIII, LINE 4B - OTHER ADJUSTMENTS:PROVISION FOR BAD DEBTS 29,469,974.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
FPG Reference Free Care1FPGReferenceFreeCare
Pcent100XPcent100
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent250XPcent250
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget1ExpensesExceededBudget
Unable To Provide Care0UnableToProvideCare
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available1ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense822816TotalCommunityBenefitExpense
Direct Offsetting Revenue259480DirectOffsettingRevenue
Net Community Benefit Expense563336NetCommunityBenefitExpense
Percent Of Total Expense0.00530PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense19028611TotalCommunityBenefitExpense
Direct Offsetting Revenue18650255DirectOffsettingRevenue
Net Community Benefit Expense378356NetCommunityBenefitExpense
Percent Of Total Expense0.00360PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense19851427TotalCommunityBenefitExpense
Direct Offsetting Revenue18909735DirectOffsettingRevenue
Net Community Benefit Expense941692NetCommunityBenefitExpense
Percent Of Total Expense0.00890PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense829082TotalCommunityBenefitExpense
Direct Offsetting Revenue154912DirectOffsettingRevenue
Net Community Benefit Expense674170NetCommunityBenefitExpense
Percent Of Total Expense0.00630PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense825293TotalCommunityBenefitExpense
Net Community Benefit Expense825293NetCommunityBenefitExpense
Percent Of Total Expense0.00770PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense4266244TotalCommunityBenefitExpense
Direct Offsetting Revenue3504795DirectOffsettingRevenue
Net Community Benefit Expense761449NetCommunityBenefitExpense
Percent Of Total Expense0.00710PercentOfTotalExpense

Research Research

FieldValueIRS element (for citing)
Total Community Benefit Expense23382TotalCommunityBenefitExpense
Net Community Benefit Expense23382NetCommunityBenefitExpense
Percent Of Total Expense0.00020PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense171573TotalCommunityBenefitExpense
Net Community Benefit Expense171573NetCommunityBenefitExpense
Percent Of Total Expense0.00160PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense6115574TotalCommunityBenefitExpense
Direct Offsetting Revenue3659707DirectOffsettingRevenue
Net Community Benefit Expense2455867NetCommunityBenefitExpense
Percent Of Total Expense0.02290PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense25967001TotalCommunityBenefitExpense
Direct Offsetting Revenue22569442DirectOffsettingRevenue
Net Community Benefit Expense3397559NetCommunityBenefitExpense
Percent Of Total Expense0.03180PercentOfTotalExpense

Physical Improvements And Housing PhysicalImprovementsAndHousing

FieldValueIRS element (for citing)
Number Of Activities Or Programs0NumberOfActivitiesOrPrograms

Economic Development EconomicDevelopment

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Total Community Building Expense657TotalCommunityBuildingExpense
Net Community Building Expense657NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Number Of Activities Or Programs3NumberOfActivitiesOrPrograms
Total Community Building Expense64931TotalCommunityBuildingExpense
Net Community Building Expense64931NetCommunityBuildingExpense
Percent Of Total Expense0.00060PercentOfTotalExpense

Environmental Improvements EnvironmentalImprovements

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Total Community Building Expense38411TotalCommunityBuildingExpense
Net Community Building Expense38411NetCommunityBuildingExpense
Percent Of Total Expense0.00040PercentOfTotalExpense

Leadership Development LeadershipDevelopment

FieldValueIRS element (for citing)
Number Of Activities Or Programs0NumberOfActivitiesOrPrograms

Coalition Building CoalitionBuilding

FieldValueIRS element (for citing)
Number Of Activities Or Programs0NumberOfActivitiesOrPrograms

Health Improvement Advocacy HealthImprovementAdvocacy

FieldValueIRS element (for citing)
Number Of Activities Or Programs0NumberOfActivitiesOrPrograms

Workforce Development WorkforceDevelopment

FieldValueIRS element (for citing)
Number Of Activities Or Programs2NumberOfActivitiesOrPrograms
Total Community Building Expense591425TotalCommunityBuildingExpense
Net Community Building Expense591425NetCommunityBuildingExpense
Percent Of Total Expense0.00560PercentOfTotalExpense

Other Other

FieldValueIRS element (for citing)
Number Of Activities Or Programs0NumberOfActivitiesOrPrograms

Total Total

FieldValueIRS element (for citing)
Number Of Activities Or Programs7NumberOfActivitiesOrPrograms
Total Community Building Expense695424TotalCommunityBuildingExpense
Net Community Building Expense695424NetCommunityBuildingExpense
Percent Of Total Expense0.00660PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported0BadDebtExpenseReported
Bad Debt Expense$10,941,216BadDebtExpenseAmount
Amount Attributable To3750126AmountAttributableTo
Amount Reimbursed By Medicare47420420AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare47567865CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-147445MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
OtherXOther
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care1ProvisionForCharityCare
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 Line1LENOIR MEMORIAL HOSPITAL INCBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1100 AIRPORT ROADAddressLine1
CityKINSTONCity
StateNCState
ZIP Code28501ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Er24 HoursXEr24Hours
Er OtherXErOther
OtherDISPROPORTIONARE SHARE HOSPITALOther

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1LENOIR MEMORIAL HOSPITAL INCBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
Eligibility Criteria Explained1EligibilityCriteriaExplained
Uses FPG Free1UsesFPGFree
FPG Free Percent100.000000000000FPGFreePercent
Uses FPG Discounted1UsesFPGDiscounted
FPG Discount Percent250.000000000000FPGDiscountPercent
Explains Basis1ExplainsBasis
Income LevelXIncomeLevel
Asset LevelXAssetLevel
Medical IndigencyXMedicalIndigency
Insurance StatusXInsuranceStatus
Other FactorsXOtherFactors
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
Collection Activities0CollectionActivities
Nondiscrim Emergency Care Policy1NondiscrimEmergencyCarePolicy
Used Other MethodXUsedOtherMethod
Amounts Generally Billed0AmountsGenerallyBilled
Gross Charges0GrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities2NumberOfOtherFacilities

Other Facilities OtherFacilities (2 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
LENOIR ORTHOPEDICS
701 DOCTORS DRIVEKINSTONNC28501ORTHOPEDIC CENTER
LENOIR SURGICAL
701 DOCTORS DRIVEKINSTONNC28501SURGERY CENTER

Form990 Schedule H Part VI Form990ScheduleHPartVI (14 entries)

ExplanationExplanationIdentifierIdentifierReturn ReferenceReturnReference
PART I, LINE 3C: IN ADDITION TO DETERMINING ELIGIBILITY FOR FREE OR REDUCED-PRICE CARE USING INCOME LEVELS AND FEDERAL POVERTY GUIDELINES, PATIENTS MAY ALSO QUALIFY FOR FINANCIAL ASSISTANCE BASED UPON THEIR ELIGIBILITY FOR SUBSIDIZED HOUSING UNDER HUD GUIDELINES. ALTHOUGH THE HOSPITAL PREFERS TO BE ABLE TO DISCUSS OPTIONS FOR FINANCIAL ASSISTANCE WITH HEALTHCARE COSTS - INCLUDING POSSIBLE ELIGIBILITY FOR MEDICAID OR OTHER PROGRAMS - WITH PATIENTS, IF EFFORTS TO DO SO PROVE UNSUCCESSFUL, ELIGIBILITY FOR LMH'S FINANCIAL ASSISTANCE PROGRAM MAY BE DETERMINED BASED UPON PATIENT ADDRESS IN A SUBSIDIZED HOUSING COMMUNITY. COMMUNITIES MEETING THIS DEFINITION, AS WELL AS INCOME AND ASSET CRITERIA FOR RESIDENTS, ARE REVIEWED PERIODICALLY WITH THE LOCAL HOUSING AUTHORITY. ADDITIONALLY, PATIENTS FACING EXTENSIVE MEDICAL COSTS WHO DO NOT MEET STANDARD FINANCIAL INDIGENCE CRITERIA BASED UPON INCOME LEVEL MAY QUALIFY FOR DISCOUNTED CARE IF THEY ARE DETERMINED TO BE "MEDICALLY INDIGENT"; THAT IS, HAVING INCURRED COSTS OF CARE IN EXCESS OF 20% OF FAMILY GROSS INCOME, AND FOR WHICH PAYMENT WOULD REQUIRE LIQUIDATION OF THOSE ASSETS CRITICAL TO LIVING OR EARNING A LIVING. THEREFORE, FINANCIAL AND OTHER ASSETS MUST BE FULLY DISCLOSED BY PATIENTS SEEKING THIS DESIGNATION IN ORDER FOR A MEDICAL INDIGENCE DETERMINATION TO BE MADE. ADDITIONALLY, DISCOUNTS FOR PROMPT PAYMENT OF BALANCES ARE AVAILABLE FOR ALL UNINSURED PATIENTS, AND ARE TIERED BASED UPON THE AMOUNT OWED (LARGER DISCOUNTS ARE APPLIED TO HIGHER BALANCES). PATIENT ACCOUNT LIAISONS (PALS) AND FINANCIAL COUNSELORS SCREEN PATIENTS FOR FINANCIAL ASSISTANCE EITHER AT THE POINT OF SERVICE OR AFTER SERVICE HAS BEEN RENDERED. THE STAFF ALSO UTILIZES A SOFTWARE SYSTEM THAT SCREENS PATIENTS FOR MEDICAID ELIGIBILITY AS WELL AS FINANCIAL ASSISTANCE. PALS INTERVIEW SCHEDULED PATIENTS PRIOR TO SERVICE, AFTER ADMISSION AS AN INPATIENT AND AFTER SERVICE IS RECEIVED THROUGH THE EMERGENCY DEPARTMENT REGARDING THEIR LIABILITY AND DISCUSS OPTIONS FOR PAYMENT INCLUDING FINANCIAL ASSISTANCE. FINANCIAL COUNSELORS CONTACT PATIENTS AFTER THEY RECEIVE A STATEMENT FOR SERVICES TO DISCUSS PAYMENT OPTIONS INCLUDING FINANCIAL ASSISTANCE.
PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 29469974.
PART II: LENOIR MEMORIAL PARTNERS WITH AREA ORGANIZATIONS TO PROVIDE COMMUNITY HEALTH PROGRAMMING, HEALTH COALITION WORK, AND IN-KIND LEADERSHIP TO AREA BOARDS, AND NON-PROFITS. HOSPITAL LEADERSHIP TEAM MEMBERS SERVE ON COMMUNITY TASK FORCES AND ACTION GROUPS. SOME OF THESE INCLUDE THE LENOIR COUNTY SCHOOL HEALTH ADVISORY COMMITTEE, EASTERN AHEC, KINSTON-LENOIR COUNTY CHAMBER OF COMMERCE, PRIDE OF KINSTON, LENOIR COMMITTEE OF 100, LENOIR-GREENE UNITED WAY, KINSTON COMMUNITY HEALTH CENTER, LENOIR COUNTY ALLIANCE FOR A HEALTHY COMMUNITY, THE COMMUNITY MARKETING COMMITTEE, AND LENOIR-GREENE ASTHMA COALITION. LENOIR ALSO PARTICIPATES IN A MENTORING PROGRAM WITH SOUTH EAST ELEMENTARY SCHOOL. LENOIR PROVIDES MEETING SPACE FOR VARIOUS LOCAL COMMITTEES. WE WERE A SPONSOR OF THE 2011 LIVING THE GOOD LIFE EVENT AT VERNON PARK MALL WITH OVER 100 AREA AGENCIES AND BUSINESSES PARTICIPATING IN THE HEALTHY LIVING EVENT. DURING 2011, LENOIR MEMORIAL COMPLETED A GOLDEN LEAF FOUNDATION INITIATIVE FOR WORKFORCE DEVELOPMENT LEADERSHIP WHICH MENTORED AND TRAINED 25 NEW CERTIFIED NURSING ASSISTANTS FOR THE LOCAL HEALTHCARE WORKFORCE. LENOIR MEMORIAL PROVIDES WORKSITE WELLNESS CARE TO AREA BUSINESS AND INDUSTRY AND PROVIDED EMPLOYEE HEALTH SERVICES IN FY11 TO 108 CORPORATE CLIENTS WITH 234 REGIONAL SITE VISITS. LENOIR ALSO DONATED A DECONTAMINATION TRAILER TO LCEM.
PART III, LINE 4: THE TOTAL BAD DEBT EXPENSE FOR FY12 WAS MULTIPLIED BY THE COST-CHARGE RATIO TO ESTIMATE TOTAL BAD DEBT AT COST.BAD DEBT ACCOUNTS WERE GEOCODED TO DETERMINE THE CENSUS TRACT WHICH CORRESPONDED TO THE ADDRESS ON FILE FOR EACH BAD DEBT ACCOUNT. THE AVERAGE PERCENTAGE OF HOUSEHOLDS FOR EACH CENSUS TRACT WHICH MET THE LMH CHARITY CARE GUILDELINES WAS THEN APPLIED TO DETERMINE AN ESTIMATED PERCENTAGE OF BAD DEBT WHICH COULD BE ATTRIBUTED TO PATIENTS ELIGIBLE UNDER THE LMH CHARITY CARE POLICY.
PART III, LINE 8: THE MEDICARE COST REPORT WAS USED TO DETERMINE MEDICARE ALLOWABLE COSTS OF CARE.
PART III, LINE 9B: THE HOSPITAL SENDS PATIENTS A STATEMENT EACH MONTH NOTING THE BALANCE DUE. INFORMATION IS INCLUDED ON THE STATEMENT REGARDING OPTIONS FOR PAYMENT INCLUDING FINANCIAL ASSISTANCE AND CONTACT NUMBERS. SELF PAY PATIENTS ARE OFFERED A PROMPT PAY DISCOUNT. NOTIFICATION OF THE DISCOUNT IS INCLUDED ON THE PATIENT'S STATEMENTS.FINANCIAL COUNSELORS AND PATIENT ACCOUNT LIAISONS ARE TRAINED TO INFORM PATIENTS OF FINANCIAL ASSISTANCE AS AN OPTION SHOULD THEY HAVE DIFFICULTY PAYING THEIR ACCOUNTS. THE PALS UTILIZE A SOFTWARE SYSTEM (RAMP) THAT SCREENS PATIENTS FOR POTENTIAL MEDICAID ELIGIBILITY AND FOR FINANCIAL ASSISTANCE. THE SCREENING IS BASED ON SOME PRELIMINARY QUESTIONS, AND THEN PATIENTS ARE SCHEDULED FOR AN INTERVIEW TO COMPLETE THE APPLICATION AND SUBMIT THE NECESSARY DOCUMENTS. PATIENTS RECEIVING LESS THAN 100% FINANCIAL ASSISTANCE WILL BE REQUESTED TO MAKE PAYMENT ARRANGEMENTS FOR THE REMAINING BALANCE.TELEPHONE CONTACTS TO DISCUSS ACCOUNT BALANCES WITH PATIENTS AND OFFER OPTIONS FOR RESOLUTION ARE ATTEMPTED ON MOST ACCOUNTS. THE HOSPITAL WILL OFFER PAYMENT PLANS TO PATIENTS THAT ARE ABLE TO PAY WITH A MINIMUM MONTHLY PAYMENT OF $50.00. PATIENTS ARE ALSO OFFERED ASSISTANCE WITH MEDICAID ELIGIBILITY APPLICATIONS. IF THE PATIENT IS NONRESPONSIVE AFTER RECEIVING THREE STATEMENTS (90 DAYS FROM DATE OF SERVICE OR LAST PAYMENT DATE), THE ACCOUNT MAY BE FORWARDED TO A COLLECTION AGENCY FOR FURTHER COLLECTION PROCEDURES. THE HOSPITAL DOES NOT UTILIZE PRACTICES SUCH AS GARNISHMENTS, LIENS, AND PERSONAL ATTACHMENTS AS PART OF THE COLLECTION PROCESS.
PART V, SECTION B, LINE 11H: SLIDING SCALED BASED ON PERCENTAGE OF FPGLENOIR MEMORIAL HOSPITAL, INC.
PART V, SECTION B, LINE 13G: SIGNS ARE POSTED NOTIFYING PATIENTS OF THE AVAILABILITY OF FINANCIAL ASSISTANCE AND INCLUDED ON PATIENT'S STATEMENTS. BROCHURES ARE ALSO PROVIDED NOTIFYING OF PATIENTS AVAILABILITY.LENOIR MEMORIAL HOSPITAL, INC.
PART V, SECTION B, LINE 19D: THE MAXIMUM AMOUNT CHARGED IS BASED ON A SLIDING SCALE OF 250% OF FPG. PATIENT WOULD BE BILLED 75%.LENOIR MEMORIAL HOSPITAL, INC.
PART VI, LINE 2: LENOIR MEMORIAL WORKS CLOSELY WITH THE LENOIR COUNTY HEALTH DEPARTMENT TO CONDUCT THE COMMUNITY HEALTH ASSESSMENT PROCESS FOR LENOIR COUNTY, OUR LARGEST POPULATION SERVED. LOCAL DEMOGRAPHIC AND HEALTH STATISTICS ARE COMPILED ALONG WITH THE COMMUNITY SURVEY DATA ABOUT PERCEIVED HEALTH ISSUES IN ORDER TO DEVELOP TARGETED COMMUNITY HEALTH STRATEGIES. LENOIR MEMORIAL ALSO PARTNERS WITH LENOIR, GREENE AND JONES COUNTIES IN HEALTHY CAROLINIANS LOCAL TASK FORCES. ANNUAL CANCER REPORTING AND HOSPITAL DIAGNOSIS TRENDS ARE USED TO PRIORITIZE PROGRAMMING, SERVICES, AND INITIATIVES AS WELL AS PHYSICIAN NEEDS ASSESSMENTS.
PART VI, LINE 3: - THE HOSPITAL HAS POSTED SIGNS INFORMING PATIENTS OF PAYMENT OPTIONS INCLUDING THE FINANCIAL ASSISTANCE PROGRAM IN THE CASHIER'S OFFICE AND REGISTRATION AREAS OF THE HOSPITAL. - BROCHURES (PATIENT FINANCIAL HEALTH GUIDELINES) ARE PUBLISHED EXPLAINING "WHAT YOU NEED TO KNOW ABOUT PAYING FOR YOUR HEALTH SERVICES," AND INCLUDE INFORMATION REGARDING THE AVAILABILITY OF OUR FINANCIAL ASSISTANCE PROGRAM. THESE BROCHURES ARE INCLUDED AS PART OF THE INPATIENT ADMISSION INFORMATION PACKET, ARE ON DISPLAY IN WAITING ROOMS THROUGHOUT THE HOSPITAL AND ARE PROVIDED TO PATIENTS DURING INTERVIEWS SHOULD THEY HAVE ANY QUESTIONS. THE BROCHURE OFFERS ASSISTANCE THROUGH THE HOSPITAL INTERPRETER FOR SPANISH SPEAKING PATIENTS AND THE HOSPITAL HAS ACCESS TO TRANSLATION TELEPHONES FOR OTHER LANGUAGES.- THE FINANCIAL ASSISTANCE POLICY OVERVIEW IS ALSO INCLUDED ON THE HOSPITAL'S WEBSITE. - INFORMATION REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE IS INCLUDED ON PATIENT'S STATEMENT.- THE FINANCIAL COUNSELORS AND PATIENT ACCOUNT LIAISONS DISCUSS FINANCIAL ASSISTANCE AS AN OPTION FOR PATIENTS THAT CONTACT THE HOSPITAL WITH CONCERNS ABOUT PAYING THEIR ACCOUNT WITH PATIENTS AND THEIR FAMILY MEMBERS (WITH APPROPRIATE CONSENT). - THE HOSPITAL ALSO SCREENS SELF PAY PATIENTS FOR MEDICAID OR OTHER GOVERNMENT PROGRAMS.
PART VI, LINE 4: LENOIR MEMORIAL HOSPITAL IS LOCATED IN KINSTON, NORTH CAROLINA (POPULATION 21,677), WHICH IS THE COUNTY SEAT AND LARGEST TOWN IN LENOIR COUNTY (POPULATION 59,495); KINSTON AND OTHER LENOIR COUNTY MUNICIPALITIES CONSTITUTE THE HOSPITAL'S PRIMARY SERVICE AREA. LMH IS DESIGNATED A SOLE COMMUNITY HOSPITAL BY CMS. THOUGH STRONG ECONOMIC AND CORRESPONDING POPULATION GROWTH OCCURRED THROUGHOUT MUCH OF NORTH CAROLINA DURING THE MOST RECENT DECADE (2000-2010), LOCAL TRENDS DID NOT FOLLOW SUIT. LENOIR COUNTY WAS ONE OF ONLY SEVEN COUNTIES STATEWIDE THAT LOST POPULATION (-.3%), VS. THE NC AVERAGE OF +18.5%. KINSTON'S DECLINE WAS EVEN STEEPER, AT -8.5%. OVER THE LAST TWO DECADES THE LOCAL AREA HAS WITNESSED THE CLOSING OR SIGNIFICANT DOWNSIZING OF FORMERLY LARGE EMPLOYERS - PARTICULARLY LIGHT MANUFACTURING ENTERPRISES - AS LESS EXPENSIVE LABOR HAS BEEN SOUGHT OVERSEAS. IN THE MOST RECENT YEARS, THE AREA'S CHALLENGES HAVE BEEN EXACERBATED BY THE DRAMATIC NATIONWIDE ECONOMIC DOWNTURN, AND LENOIR COUNTY'S UNEMPLOYMENT RATE HAS TYPICALLY EXCEEDED BOTH STATE AND NATIONAL AVERAGES. THE COUNTY HAS BEEN DESIGNATED TIER 1 - I.E., THE RANKING GIVEN TO THE MOST ECONOMICALLY DISTRESSED COUNTIES IN THE STATE - BY THE NC DEPARTMENT OF COMMERCE. POVERTY LEVELS IN KINSTON AND LENOIR COUNTY EXCEED STATE AVERAGES; IN 2010 THE COUNTY'S POVERTY LEVEL WAS RANKED THIRD HIGHEST FOR COUNTIES WITH POPULATIONS GREATER THAN 20,000 BY THE NC JUSTICE CENTER. THE ECONOMICALLY DISADVANTAGED PERCENTAGE OF CHILDREN IN LENOIR COUNTY SCHOOLS FOR 2009-2010 WAS 66.53%, AND ALL SCHOOLS WITH ELEMENTARY AND MIDDLE GRADES WERE TITLE 1. PORTIONS OF KINSTON ARE DESIGNATED AS HEALTH PROFESSIONAL SHORTAGE AREAS. THE TABLE BELOW PROVIDES SELECTED POPULATION, INCOME, AND POVERTY STATISTICS FROM THE US CENSUS BUREAU, INCLUDING THE AMERICAN COMMUNITY SURVEY. KINSTON LENOIR COUNTY NORTH CAROLINAPOP. CHANGE, 2000-2010 - 8.5% - 0.3% 18.5%PERCENT BELOW POV. LV, 2010 34.1% 22.7% 15.5%MEDIAN HOUSEHOLD INCOME, $27,725 $33,625 $45,570CHILDREN IN POVERTY, 2010 50.4% 31.2% 21.6%THE HISTORICAL DEPENDENCE UPON FARMING AND LIGHT MANUFACTURING JOBS, AS WELL AS POVERTY AND EDUCATION LEVELS THAT ARE HIGHER AND LOWER, RESPECTIVELY, THAN NC AVERAGES WILL LIKELY CONTINUE TO BE LIMITING FACTORS TO CONSISTENTLY STRONG OR RAPID ECONOMIC GROWTH. IN ORDER TO ADDRESS THESE CHALLENGES, NUMEROUS AREA ORGANIZATIONS CONTINUE TO WORK TOWARD DEVELOPMENT INITIATIVES THAT WILL CREATE LONG TERM SOCIAL AND ECONOMIC IMPROVEMENT.
PART VI, LINE 5: THE HOSPITAL BOARD IS COMPRISED OF UNRELATED COMMUNITY MEMBERS. LOCAL PHYSICIANS HAVE PRIVILEDGES IN A MAJORITY OF HOSPITAL DEPARTMENTS. SURPLUS FUNDS MAY BE USED TO PURCHASE CAPTIAL EQUIPMENT OR OTHER MEDICAL EQUIPMENT USED IN PATIENT CARE. THEY ARE ALSO USED TO PURCHASE TECHNOLOGY, SUCH AS COMPUTER EQUIPMENT, SOFTWARE, AND CONNECTIVITY. THESE FUNDS ALSO SUPPORT GENERAL BUILDING REFURBISHMENTS AS WELL AS REPAIRS AND MAINTENANCE.
NCREPORTS FILED WITH STATESPART VI, LINE 7

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Recipient Table RecipientTable

Recipient Name Business RecipientNameBusiness

FieldValueIRS element (for citing)
Business Name Line1LENOIR MEMORIAL HOSPITAL FOUNDATION INCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1100 AIRPORT ROADAddressLine1
CityKINSTONCity
StateNCState
ZIP Code28501ZIPCode
FieldValueIRS element (for citing)
EIN Of Recipient581584139EINOfRecipient
IRC Section501(C)(3)IRCSection
Amount Of Cash Grant5500AmountOfCashGrant
Method Of ValuationN/AMethodOfValuation
Description Of Non Cash AssistanceN/ADescriptionOfNonCashAssistance
Purpose Of GrantOPERATIONAL SUPPORTPurposeOfGrant
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants1TotalNbrOf501C3AndGovtGrants

Form990 Schedule I Part III Form990ScheduleIPartIII (3 entries)

Type Of GrantTypeOfGrantNumber Of RecipientsNumberOfRecipientsAmount Of Cash GrantAmountOfCashGrantMethod Of ValuationMethodOfValuationDescription Of Non Cash AssistanceDescriptionOfNonCashAssistance
SCHOLARSHIPS721953N/AN/A
ASSISTANCE WITH PURCHASE OF MEDICATION6835734N/AN/A
STIPEND FOR HEALTHCARE PROGRAM12814N/AN/A

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: THE ORGANIZATION PROVIDES PRE-APPROVED FUNDS TO SELECTED ORGANIZATIONS AND INDIVIDUALS BASED UPON APPROVED CRITERIA. THE FUNDS ARE ONLY DISBURSED FOR THE APPROVED ACTIVITIES.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 (11 entries)

Base 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
GARY BLACK
35905502191406641206134101007105187930384570
JIM DOBBINS
1674830102610294540202510827902357280160360
SARAH MAYO
2180850132010250590260140872102910800162580
WILLIAM LEASE
168584010080022366071230835102165040156460
ROSILAND MCDONALD
1665330978103047007413080680222265000
DALE HARDY
1475010800001738806707081690187765000
SCOTT STEGBAUER MD
472324024187016500098000116980534509000
ARTHUR HUNSINGER
1523980400004257608122085740215670000
CONNIE MANGEL
1391990400004545607728084790204862000
GEORGE YVETTE
1477410400004508007902079380212661000
MARK HENNING
1549140400003991908077079100214820000

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
Return ReferencePART I, LINE 4BReturnReference
ExplanationTHE FOLLOWING INDIVIDUALS RECEIVED AMOUNTS FROM A 457F PLAN: GARY BLACK, CEO, $38,457; JAMES CLINE DOBBINS, VP HUMAN RESOURCES, $16,036; WILLIAM LEASE, VP PLANT AND FACILITY, $15,646; SARAH MAYO, CFO, $16,258; ROSALIND MCDONALD, VP BURSING, $11,411Explanation

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1NORTH CAROLINA MEDICAL CARE COMMISSIONBusinessNameLine1
FieldValueIRS element (for citing)
Issuer EIN521309402IssuerEIN
CUSIP Number657902Y63CUSIPNumber
Date Issued2005-09-22DateIssued
Issue Price22000000IssuePrice
Description Of PurposeCAPITAL PROJECTSDescriptionOfPurpose
Defeased0Defeased
On Behalf Of Issuer0OnBehalfOfIssuer
Pool Financing0PoolFinancing

Form990 Schedule K Part II Form990ScheduleKPartII

FieldValueIRS element (for citing)
Amount Retired3060000AmountRetired
Total Proceeds22021552TotalProceeds
Issuance Costs From Proceeds178646IssuanceCostsFromProceeds
Credit Enhancement20213CreditEnhancement
Capital Expenditures9657270CapitalExpenditures
Year Of Subst Completion2005YearOfSubstCompletion
Current Refunding1CurrentRefunding
Advance Refunding0AdvanceRefunding
Final Allocation Made1FinalAllocationMade
Adequate Books And Recds Maintaind1AdequateBooksAndRecdsMaintaind

Form990 Schedule K Part III Form990ScheduleKPartIII

FieldValueIRS element (for citing)
Owning Bond Financed Property0OwningBondFinancedProperty
Any Lease Arrangements0AnyLeaseArrangements
Mngment Cntrct Bond Financd Prprty0MngmentCntrctBondFinancdPrprty
Any Research Agreements0AnyResearchAgreements
Percentage Of Prvt Business Re UBI0.00150PercentageOfPrvtBusinessReUBI
Total Private Business Use0.00150TotalPrivateBusinessUse
Post Issuance Compliance Procdrs1PostIssuanceComplianceProcdrs

Form990 Schedule K Part IV Form990ScheduleKPartIV

FieldValueIRS element (for citing)
Form8038 T Filed0Form8038TFiled
Variable Rate Issue1VariableRateIssue
Hedge Identified In Books And Recds0HedgeIdentifiedInBooksAndRecds
Gross Proceeds Invested In GIC0GrossProceedsInvestedInGIC
Gross Proceeds Invested0GrossProceedsInvested
Exception To Rebate1ExceptionToRebate
FieldValueIRS element (for citing)
Fed Tax Requirements ComplianceXFedTaxRequirementsCompliance

Form990 Schedule K Part VI Form990ScheduleKPartVI

FieldValueIRS element (for citing)
IdentifierSCHEDULE K SUPPLENTAL INFORMATIONIdentifier
ExplanationTHE PURPOSE OF THE ISSUE WAS TO ACCOMPLISH A CONVERSION OF THE HOSPITAL FROM PUBLIC TO A PRIVATE, NONPROFIT HOSPITAL IN ORDER TO PROVIDE GREATER OPERATING FLEXIBILITY AFFORDED PRIVATE, NONPROFIT HOSPITALS UNDER NORTH CAROLINA LAW. IN ADDITION TO REDEEMING PRIOR BONDS, A PORTION OF THE PROCEEDS WERE USED TO FUND VARIOUS CAPITAL PROJECTS THAT ENHANCED PATIENT CARE, SAFETY, AND COMMUNITY ACCESS TO HEALTH SERVICES.Explanation

Schedule M IRS990ScheduleM

Other Non Cash Contributions Table OtherNonCashContributionsTable

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
DescriptionEQUIPMENTDescription
Number Of Contributions1NumberOfContributions
Noncash Contribs Rptd F99040322NoncashContribsRptdF990
Method Of Determining RevenuesFMVMethodOfDeterminingRevenues
FieldValueIRS element (for citing)
Any Property That Must Be Held0AnyPropertyThatMustBeHeld
Review Process Unusual NC Gifts0ReviewProcessUnusualNCGifts
Third Parties Used0ThirdPartiesUsed

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (6 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
FORM 990, PART VI, SECTION B, LINE 11THE ORGANIZATION'S ACCOUNTING FIRM PRESENTED THE FORM 990 TO THE BOARD OF DIRECTORS AT A SCHEDULED BOARD MEETING. EACH VOTING DIRECTOR OF THE BOARD RECEIVED A COPY OF THE FORM 990.
FORM 990, PART VI, SECTION B, LINE 12CUPON THEIR APPOINTMENT TO THE BOARD, AND BEFORE ACTUALLY PARTICIPATING IN MEETINGS, MEMBERS MUST READ THE CONFLICTS OF INTEREST POLICY AND DISCLOSE ANY FINANCIAL INTERESTS THAT COULD CREATE A CONFLICT OF INTEREST. AS LONG AS THEY CONTINUE TO SERVE ON THE BOARD, MEMBERS THEN COMPLETE THESE FINANCIAL RELATIONSHIP DISCLOSURE STATEMENTS ON AN ANNUAL BASIS. IF SUCH INTERESTS ARE NOT DISCLOSED, THE CEO, BOARD CHAIR, OR ANY OTHER BOARD MEMBER MAY BRING THE FINANCIAL INTEREST OR ACTUAL/POSSIBLE CONFLICT TO THE ATTENTION OF THE BOARD; THUS THE ENTIRE BOARD IS RESPONSIBLE FOR ONGOING MONITORING OF POTENTIAL CONFLICTS AND THEIR DISCLOSURE. INTENTIONAL FAILURE TO DISCLOSE SUCH FINANCIAL INTERESTS WILL, BY POLICY, RESULT IN APPROPRIATE CORRECTIVE ACTION BY THE BOARD. SHOULD A CONFLICT OF INTEREST ARISE IN CONDUCTING THE BUSINESS OF THE HOSPITAL, THE AFFECTED MEMBER(S) MAY NOT PARTICIPATE IN DISCUSSION REGARDING THE RELEVANT TRANSACTION, AND DEPENDING UPON THE SPECIFIC NATURE OF THE MATTER, THE BOARD CAN TAKE A RANGE OF ACTIONS, SUCH AS APPOINTING A DISINTERESTED PERSON TO INVESTIGATE POSSIBLE ALTERNATIVES, REQUIRING THE INTERESTED PERSON TO REFRAIN FROM PERFORMING ANY FUNCTIONS RELATED TO THE INTEREST CREATING THE CONFLICT, OR REQUIRING THE INTERESTED PERSON TO DIVEST HIMSELF OF THE CONFLICT-CREATING INTEREST IN ORDER TO REMAIN ON THE BOARD. EDUCATION AND COMPLIANCE FORMS ARE UPDATED ANNUALLY BY THE HOSPITAL'S CORPORATE COMPLIANCE OFFICER.
FORM 990, PART VI, SECTION B, LINE 15THE HUMAN RESOURCES COMMITTEE OF THE BOARD OF DIRECTORS CONTRACTS WITH AN OUTSIDE, INDEPENDENT, PROFESSIONAL FIRM TO EXAMINE AND REVIEW THE WAGES AND BENEFITS OF THE CEO AND TOP MANAGEMENT OFFICIALS OF THE HOSPITAL EACH YEAR.
FORM 990, PART VI, SECTION C, LINE 18PHOTOCOPIES OF THE FORM 990 ARE AVAILABLE UPON REQUEST AT THE ORGANIZATION'S ADMINISTRATIVE OFFICE. ADDITIONALLY, RECENT FILINGS OF THE FORM 990 ARE AVAILABLE ONLINE AT WWW.GUIDESTAR.ORG.
FORM 990, PART VI, SECTION C, LINE 19THE HOSPITAL MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART XI, LINE 5:NET UNREALIZED GAINS ON INVESTMENTS: 6,718,868.CHANGES IN NET ASSETS OR FUND BALANCES:

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNAControlled OrgControlledOrg
LENOIR MEMORIAL HOSPITAL FOUNDATION INC
100 AIRPORT ROADKINSTONNC28501581584139SUPPORT THE CHARITABLE, EDUCATIONAL, AND SCIENTIFIC PURPOSES OF LMH, INC.NC501(C)(3)LINE 11A, IN/A0
LENOIR HEALTH SERVICES INC
100 AIRPORT ROADKINSTONNC28501581705689SUPPORT CHARITABLE, EDUCATIONAL, AND SCIENTIFIC PURPOSES OF LMH, INC.NC501(C)(3)LINE 11A, IN/A0

Form990 Schedule R Part III Form990ScheduleRPartIII (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateDirect Controlling Entity NADirectControllingEntityNAPredominant Income TypePredominantIncomeTypeShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsDisproportionate AllocationsDisproportionateAllocationsGeneral Or Managing PartnerGeneralOrManagingPartner
PAMLICO MEDICAL EQUIPMENT LLC
628 EAST TWELFTH STREETWASHINGTONNC27889562101748RENTAL/SALES OF MEDICAL EQUIPMENTNCN/AUNRELATED-10356031051501
SPRING ARBOR OF KINSTON LP
800 HETHWOOD BOULEVARDBLACKSBURGVA24060522118245RENTAL REAL ESTATEVAN/ARELATED12669100
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
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
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 Orgs1PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities1SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (3 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolved
LENOIR MEMORIAL HOSPITAL FOUNDATION
M83449
LENOIR MEMORIAL HOSPITAL FOUNDATION
C44750
LENOIR MEMORIAL HOSPITAL VOLUNTEERS
C37000