ANC TRANSYLVANIA COMMUNITY HOSPITAL INC: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
ANC TRANSYLVANIA COMMUNITY HOSPITAL INC (EIN 56-0562293)
Tax period
2011-10-01 to 2012-09-30
Filed
2013-05-13
IRS object ID
201331339349300303
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)
Timestamp2013-05-13T05:42:19-05:00Timestamp
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)
EIN560562293EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1TRANSYLVANIA COMMUNITY HOSPITAL INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlTRANNameControl
Phone8288849111Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 1116AddressLine1
CityBREVARDCity
StateNCState
ZIP Code28712ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameMARC NAKAGAWAName
TitleCFOTitle
Phone8288849111Phone
Date Signed2013-05-08DateSigned
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

Doing Business As DoingBusinessAs

FieldValueIRS element (for citing)
Business Name Line1TRANSYLVANIA REGIONAL HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Name Of Principal Officer PersonROBERT J BEDNAREKNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1PO BOX 1116AddressLine1
CityBREVARDCity
StateNCState
ZIP Code28712ZIPCode
FieldValueIRS element (for citing)
Gross Receipts69635294GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.TRHOSPITAL.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1933YearFormation
State Legal DomicileNCStateLegalDomicile
Activity Or Mission DescriptionPROVISION OF MEDICAL SERVICESActivityOrMissionDescription
Nbr Voting Members Governing Body12NbrVotingMembersGoverningBody
Nbr Independent Voting Members9NbrIndependentVotingMembers
Total Nbr Employees677TotalNbrEmployees
Total Nbr Volunteers176TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year1136909ContributionsGrantsPriorYear
Contributions Grants Current Year902548ContributionsGrantsCurrentYear
Program Service Revenue Prior Year60779930ProgramServiceRevenuePriorYear
Program Service Revenue CY66901721ProgramServiceRevenueCY
Investment Income Prior Year631182InvestmentIncomePriorYear
Investment Income Current Year833574InvestmentIncomeCurrentYear
Other Revenue Prior Year688096OtherRevenuePriorYear
Other Revenue Current Year843400OtherRevenueCurrentYear
Total Revenue Prior Year63236117TotalRevenuePriorYear
Total Revenue Current Year69481243TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year461381GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY288654GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year27021236SalariesEtcPriorYear
Salaries Etc Current Year29492336SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year38755610OtherExpensePriorYear
Other Expenses Current Year40489605OtherExpensesCurrentYear
Total Expenses Prior Year66238227TotalExpensesPriorYear
Total Expenses Current Year70270595TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-3002110RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-789352RevenuesLessExpensesCY
Total Assets BOY62254697TotalAssetsBOY
Total Assets EOY61123845TotalAssetsEOY
Total Liabilities BOY22938584TotalLiabilitiesBOY
Total Liabilities EOY23588066TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY39316113NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY37535779NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionTRANSYLVANIA REGIONAL HOSPITAL PROMOTES WELLNESS AND PROVIDES ACCESS TO QUALITY HEALTH SERVICES FOR THE PEOPLE IN OUR REGION.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense57017483Expense
Grants288654Grants
Revenue66761614Revenue
DescriptionGIVING BACK TO THE COMMUNITYAS A NOT-FOR-PROFIT HOSPITAL, TRANSYLVANIA REGIONAL HOSPITAL IS COMMITTED TO GIVING BACK TO THE COMMUNITY TO HELP THOSE WHO ARE UNINSURED OR UNDERINSURED AS WELL AS PROVIDING HEALTH EDUCATION AND BENEFITS FOR THE WELL BEING OF THE ENTIRE COMMUNITY. 2012 WAS ANOTHER TOUGH YEAR FOR OUR COMMUNITY AS WE EXPERIENCED THE LINGERING EFFECTS OF A DEPRESSED ECONOMY. THIS HAS LEFT MANY IN OUR COMMUNITY WITHOUT HEALTH INSURANCE AND STRUGGLING TO MAKE ENDS MEET. DESPITE CHALLENGING FINANCIAL TIMES FOR THE HOSPITAL, TRH CONTINUED TO GENEROUSLY HELP THOSE IN NEED IN 2012.IN 2012, TRH PROVIDED $6.6 MILLION IN CONTRIBUTIONS TO THE COMMUNITY. THESE BENEFITS CAME IN MANY FORMS INCLUDING $1.7 MILLION IN CHARITY CARE FOR 2,382 PEOPLE. THE HOSPITAL ALSO PROVIDED ANOTHER $3.2 MILLION IN CARE FOR 4,263 PEOPLE THROUGH NON-COLLECTIBLE SERVICES. AN ADDITIONAL $1.3 MILLION WAS PROVIDED FOR GOVERNMENT SPONSORED HEALTHCARE INCLUDING INDIGENT CARE PROGRAMS. FINALLY, $350,000 WAS PROVIDED FOR COMMUNITY BENEFIT PROGRAMS INCLUDING THE DONATION OF STAFF TIME AND RESOURCES. HERE ARE JUST A FEW OF THE SERVICES SUPPORTED:- TRH OFFERS FREE OR LOW-COST EDUCATIONAL PROGRAMS FOR THE COMMUNITY EACH MONTH. PROGRAMS FEATURE TIMELY HEALTH TOPICS, AND ARE PRESENTED BY PHYSICIANS, NURSES, NURSE EDUCATORS, DIETITIANS AND OTHER CLINICAL PROFESSIONALS. MORE THAN 1,000 MEMBERS OF THE COMMUNITY TOOK ADVANTAGE OF THESE EDUCATIONAL OPPORTUNITIES HELD AT THE HOSPITAL IN BREVARD.- TRH OFFERS HEALTHCARE SERVICES THAT ARE NEEDED BY THIS COMMUNITY, REGARDLESS OF WHETHER OR NOT A MARGIN IS ACHIEVED BY PROVIDING CARE. EXAMPLES INCLUDE: EMERGENCY SERVICES AND BIRTHING CENTER.- TRH PRIORITIZES DONATIONS OF STAFF TIME, MEETING SPACE, SUPPLIES, EQUIPMENT AND ADVERTISING FOR COMMUNITY GROUPS. SOME GROUPS THAT BENEFITED FROM IN-KIND DONATIONS WERE: MARCH OF DIMES, UNITED WAY, CHAMBER OF COMMERCE, S.A.F.E, AMERICAN RED CROSS, RELAY FOR LIFE, PROJECT LAZARUS COMMUNITY-BASED OVERDOSE PREVENTION, THE TRANSYLVANIA COUNTY SCHOOL SYSTEM, THE FREE CLINIC, TRANSYLVANIA PARTNERSHIP FOR HEALTH, TRANSYLVANIA COUNTY ECONOMIC DEVELOPMENT, WNC HEALTHY IMPACT AND OTHERS.- TRH RECRUITED SEVERAL PHYSICIANS TO THE COMMUNITY IN 2012 TO EXPAND ACCESS TO HEALTHCARE FOR OUR RESIDENTS, INCLUDING A NEW FAMILY PRACTICE PHYSICIAN AND A UROLOGY PHYSICIAN'S ASSISTANT TO EXPAND CARE FOR THE COMMUNITY.- IN 2012, TRH WAS AN ACTIVE PARTICIPANT IN THE INNOVATIVE 16-COUNTY REGIONAL HEALTH NEEDS ASSESSMENT PROJECT: WNC HEALTHY IMPACT. THIS INNOVATIVE EFFORT WILL HELP TRH TEAM WITH HEALTH DEPARTMENTS AND HOSPITALS ACROSS WESTERN NORTH CAROLINA TO IDENTIFY CRITICAL COMMUNITY HEALTH NEEDS AND PUT RESOURCES WHERE THEY ARE MOST NEEDED TO IMPROVE THE HEALTH AND LIVES OF RESIDENTS IN THIS COMMUNITY AND ACROSS THE REGION.- TRH CONTINUED A CARE MANAGEMENT PROGRAM IN 2012 FOR COPD PATIENTS IN OUR COMMUNITY SUPPORTED BY GRANT FUNDING.- FOUR TRH PRIMARY CARE MEDICAL PRACTICES COMPLETED WORK TO RECEIVE PATIENT-CENTERED MEDICAL HOME (PCMH) NATIONAL RECOGNITION IN ORDER TO DELIVER TEAM-BASED MEDICAL CARE TO PATIENTS IN OUR COMMUNITY TO MAXIMIZE HEALTH OUTCOMES FOR RESIDENTS OF ALL AGES.- TRH CONTINUED THE SUCCESSFUL LIGHTEN UP 4 LIFE WEIGHT LOSS PROGRAM IN 2012 IN OUR COMMUNITY. MORE THAN 2,000 POUNDS HAVE BEEN LOST BY RESIDENTS OF THIS COMMUNITY. TRANSYLVANIA REGIONAL HOSPITAL IS COMMITTED TO MAKING TRANSYLVANIA COUNTY A HEALTHIER COMMUNITY.- IN 2012, TRH WITH THE SUPPORT OF MISSION HEALTH SYSTEM BROUGHT A STATE-OF-THE-ART TELEMEDICINE ROBOT TO OUR LOCAL EMERGENCY DEPARTMENT IN BREVARD. THIS ROBOT ALLOWS OUR LOCAL ED PHYSICIANS TO CONSULT IN REAL-TIME WITH STROKE-SPECIALIZED NEUROLOGISTS FROM MISSION HEALTH IN ASHEVILLE TO ASSIST IN THE DIAGNOSIS AND RAPID TREATMENT OF STROKE PATIENTS AT TRH. THE VALUABLE TIME SAVED AND EXPERTISE PROVIDED BY THE ROBOTIC LINK IS HELPING TO SAVE LIVES IN OUR COMMUNITY AND BEGIN TREATMENT FASTER TO PREVENT THE MOST DAMAGING EFFECTS OF STROKE. TRH WILL ALSO HAVE THE CAPACITY TO USE THE TELEMEDICINE ROBOT TO LINK UP WITH OTHER SPECIALISTS NOT CURRENTLY AVAILABLE IN OUR COMMUNITY.- TRH PARTICIPATED IN THE N.C. STROKE INITIATIVE IN 2012 TO ENSURE THE BEST PRACTICES IN STROKE CARE ARE EMPLOYED IN PATIENT CARE AT THE HOSPITAL AND TO BUILD PUBLIC AWARENESS OF THE RISKS OF STROKE.- TRH ALONG WITH THE TRANSYLVANIA COUNTY HEALTH DEPARTMENT, THE FREE CLINIC AND OTHERS WORKED COLLABORATIVELY TO HELP BRING A BLUE RIDGE COMMUNITY HEALTH SERVICES CLINIC TO OUR LOCAL COMMUNITY. THE NEW BREVARD HEALTH CENTER SET TO OPEN IN FALL 2012 ON THE TRH CAMPUS WILL INCREASE ACCESS TO AFFORDABLE, COMPREHENSIVE HEALTH SERVICES IN TRANSYLVANIA COUNTY. THE NEW FEDERAL HEALTH CENTER WILL OFFER A FULL SPECTRUM OF HEALTH SERVICES TO RESIDENTS, INCLUDING PRIMARY CARE FOR ADULTS AND CHILDREN, DENTAL SERVICES, MEDICATION ASSISTANCE AND BEHAVIORAL HEALTH.- TRH IN 2012 BEGAN IMPLEMENTING A PALLIATIVE CARE PROGRAM WITH SUPPORT FROM THE TRH FOUNDATION TO MEET THE INCREASING NEEDS FOR THIS SERVICE IN OUR COMMUNITY. THIS LOCAL SERVICE WILL PROVIDE COMPASSIONATE, EXPERT MEDICAL CARE TO RELIEVE AND PREVENT THE SUFFERING OF PATIENTS IN OUR COMMUNITY WHO ARE UNDERGOING TREATMENT FOR CURABLE ILLNESSES AND THOSE LIVING WITH CHRONIC DISEASES, AS WELL AS PATIENTS WHO ARE NEARING THE END OF LIFE.Description
Total Program Service Expense57017483TotalProgramServiceExpense
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 Invest1ReportProgRelInvest
Report Other Assets1ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Financial Stmt Attached1FinancialStmtAttached
Grants To Organizations1GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
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 Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109673NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees677NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions1QuidProQuoContributions
Quid Pro Quo Disclosure1QuidProQuoDisclosure
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members12NbrVotingGoverningBodyMembers
Number Independent Voting Members9NumberIndependentVotingMembers
Family Or Business Relationship1FamilyOrBusinessRelationship
Delegation Of Management Duties1DelegationOfManagementDuties
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 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 Line1MARC NAKAGAWABusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number8288849111TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1260 HOSPITAL DRIVEAddressLine1
CityBREVARDCity
StateNCState
ZIP Code28712ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (21 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationHighest Compensated EmployeeHighestCompensatedEmployee
ROBERT O MAXWELL
CHAIRMAN1.00XX000
JOHN F HOLBROOK
VICE CHAIR / SECRETARY1.00XX000
DICK LARSON
TREASURER1.00XX000
CHARLES AYSCUE
MHS REPRESENTATIVE / BOARD MEMBER1.00XX000
JOHN FAV CECIL
MHS REPRESENTATIVE / BOARD MEMBER1.00X000
THELMA ERICKSON
BOARD MEMBER1.00X000
JIM KELLING MD
CHIEF OF STAFF / BOARD MEMBER1.00X024587116214
JOHN MAHER
MHS REPRESENTATIVE / BOARD MEMBER1.00X000
KENNETH G RACHT
BOARD MEMBER1.00X000
WILLIAM A TOWLER
BOARD MEMBER1.00X000
ORA J WELLS MD
BOARD MEMBER1.00X3904500
ROBERT J BEDNAREK
PRESIDENT / CEO40.00XX289424027321
REBECCA W CARTER
COO40.00X132798016278
LINDA L COYE
CFO (THRU JANUARY 2012)40.00X13033403606
JEFFREY W RUSH
INTERIM CFO (JANUARY 2012 - JUNE 2012)40.00X000
MARC NAKAGAWA
CFO (JUNE 2012 - PRESENT)40.00X000
ELIZABETH A PELLETIER
LEAD CRNA40.00165250019088X
LAUREL D JOHNSON
CRNA40.0015404308258X
JUDITH H MCKAY
CRNA40.00151942014145X
MARK E CREASMAN
PHARMACIST40.00132488016599X
KIMBERLY L PHILLIPS
PHARMACIST40.00122604016246X
FieldValueIRS element (for citing)
Total Reportable Comp From Org1317928TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs245871TotalReportableCompFrmRltdOrgs
Total Other Compensation137755TotalOtherCompensation
Number Individuals GT100 K12NumberIndividualsGT100K
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
WELLS FARGO TPA
PO BOX 535100ATLANTAGA303535100BENEFITS ADMINISTRATION4119524
AMERISOURCE BERGEN DRUG CORP
PO BOX 5804NEW YORKNY100875804MEDICAL PRODUCTS2652068
TRANSYL EMERG PHYS PLLC
3107 STIRLING RD 300FT LAUDERDALEFL33312E/R PHYSICIAN SERVICES1312741
MORRISON MANAGEMENT SPECIALISTS
PO BOX 102289ATLANTAGA303682289FOOD SERVICES1277094
REHAB SERVICES OF BREVARD LLC
376A GOVERNMENT STMOBILEAL36693PHYSICAL THERAPY SERVICES1272325
FieldValueIRS element (for citing)
Number Of Contractors GT100 K50NumberOfContractorsGT100K
Federated Campaigns52524FederatedCampaigns
Related Organizations561545RelatedOrganizations
Government Grants196403GovernmentGrants
All Other Contributions92076AllOtherContributions
Total Contributions902548TotalContributions

Program Service Revenue ProgramServiceRevenue (4 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
NET PATIENT SERVICE RE6214006282147562821475
PHARMACY AND MEDICAL S44611024077972407797
OTHER PATIENT SERVICE62161015713851571385
LIFELINE RENTALS900099101064101064
FieldValueIRS element (for citing)
Total Program Service Revenue66901721TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column252555TotalRevenueColumn
Exclusion$252,555ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real13944Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real0Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real13944Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column13944TotalRevenueColumn
Related Or Exempt Function Income13944RelatedOrExemptFunctionIncome

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities735070Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities0Securities
Other154051Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities735070Securities
Other-154051Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column581019TotalRevenueColumn
Related Or Exempt Function Income581019RelatedOrExemptFunctionIncome

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeExclusionExclusionAmount
AFFILIATED MANAGEMENT900099399577399577
CAFETERIA/VENDING722210360054$360,054
NET AUXILIARY90009969825$69,825
FieldValueIRS element (for citing)
Total Other Revenue829456TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column69481243TotalRevenueColumn
Related Or Exempt Function Income67896261RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$682,434ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total288654Total
Program Services288654ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total731195Total
Management And General731195ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total22520352Total
Program Services15906766ProgramServices
Management And General6613586ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total745007Total
Program Services509672ProgramServices
Management And General235335ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total3893645Total
Program Services2663707ProgramServices
Management And General1229938ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total1602137Total
Program Services907984ProgramServices
Management And General694153ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total476549Total
Program Services343309ProgramServices
Management And General133240ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total105596Total
Management And General105596ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total103305Total
Management And General103305ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total5466Total
Management And General5466ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total12365425Total
Program Services11168433ProgramServices
Management And General1196992ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total99430Total
Program Services2178ProgramServices
Management And General97252ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total3619120Total
Program Services2305063ProgramServices
Management And General1314057ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total3549401Total
Program Services3549401ProgramServices

Travel Travel

FieldValueIRS element (for citing)
Total222006Total
Program Services119909ProgramServices
Management And General102097ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total21199Total
Program Services16993ProgramServices
Management And General4206ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total117526Total
Program Services117526ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total3560886Total
Program Services3560886ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total536183Total
Management And General536183ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
BAD DEBT74141837414183
MEDICAL SUPPLIES72532237253223
EQUIPMENT LEASE93250586057171934
MISCELLANEOUS1076022902578577

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total70270595Total
Program Services57017483ProgramServices
Management And General13253112ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY1514578BOY
EOY2832839EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
EOY770230EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY6570537BOY
EOY6158627EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY7500BOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
EOY448428EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY2153050BOY
EOY1839865EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY367900BOY
EOY282421EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis62755569LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec31115751LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY33615673BOY
EOY31639818EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY10925657BOY
EOY9772062EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY3889102BOY
EOY4085439EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
EOY198474EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY3210700BOY
EOY3095642EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY62254697BOY
EOY61123845EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY4776942BOY
EOY6414098EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
EOY81586EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY14409167BOY
EOY14411702EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY3752475BOY
EOY2680680EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY22938584BOY
EOY23588066EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY35770768BOY
EOY34410295EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY3545345BOY
EOY3125484EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY39316113BOY
EOY37535779EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY62254697BOY
EOY61123845EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-789352ReconcilationRevenueExpenses
Reconcilation Other Changes-990982ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
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$5,466OtherActivitiesAmount
Total Lobbying Expenditures IIB5466TotalLobbyingExpendituresIIB
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 AMERICAN HOSPITAL ASSOCIATION (AHA), THE NORTH CAROLINA HOSPITAL ASSOCIATION (NCHA), AND THE NATIONAL RURAL HEALTH ASSOCIATION (NRHA). A PORTION OF THE DUES PAID IS ALLOCATED TO LOBBYING EFFORTS PERFORMED BY THESE ORGANIZATIONS ON BEHALF OF ITS MEMBERSHIP BODY. FOR THE YEAR, THE LOBBYING PORTION OF MEMBERSHIP DUES IS ESTIMATED TO BE APPROXIMATELY $ 5,466.Explanation

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Endowments Held By Related Orgs1EndowmentsHeldByRelatedOrgs

Land Land

FieldValueIRS element (for citing)
Investment Cost Or Other Basis221222InvestmentCostOrOtherBasis
Other Cost Or Other Basis764012OtherCostOrOtherBasis
Book Value985234BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis27285866OtherCostOrOtherBasis
Depreciation11000312Depreciation
Book Value16285554BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis2698715OtherCostOrOtherBasis
Depreciation1136762Depreciation
Book Value1561953BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis30115019OtherCostOrOtherBasis
Depreciation18978677Depreciation
Book Value11136342BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis1670735OtherCostOrOtherBasis
Book Value1670735BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings31639818TotalOfBookValueLandBuildings

Investments Program Related InvestmentsProgramRelated (3 entries)

DescriptionDescriptionBook ValueBookValueMethod Of ValuationMethodOfValuation
INTEREST IN NET ASSETS OF TRANSYLVANIA REGIONAL HOSPITAL FOUNDATION3540341C
INTEREST IN BREVARD MRI, LLC501661C
INTEREST IN BLUE RIDGE DME43437C
FieldValueIRS element (for citing)
Total Of Book Value Program Related4085439TotalOfBookValueProgramRelated

Other Assets OtherAssets (4 entries)

DescriptionDescriptionBook ValueBookValue
OTHER RECEIVABLES1212322
BOND ISSUE COSTS, NET OF AMORTIZATI327053
RECEIVABLE FROM AFFILIATED ORGANIZATION497965
ESTIMATED THIRD PARTY PAYOR SETTLEMENT1058302
FieldValueIRS element (for citing)
Total Book Value Other Assets3095642TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
ESTIMATED THIRD PARTY PAYOR SETTLEMENTS$1,878,102
DUE TO AFFILIATED ORGANIZATIONS$802,578
FieldValueIRS element (for citing)
Total Of Amounts2680680TotalOfAmounts
Total Revenue69481243TotalRevenue
Total Expenses70270595TotalExpenses
Excess Or Deficit For Year-789352ExcessOrDeficitForYear
Net Unrealized GL On Investments1214027NetUnrealizedGLOnInvestments
Prior Period Adjustments25406PriorPeriodAdjustments
Other-$2,230,415OtherAmount
Total Adjustments-990982TotalAdjustments
Excess Or Deficit Per FS-1780334ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt60589054TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments1214027NetUnrealizedGainsInvestments
Other Revenues-7445621OtherRevenues
Revenue Not Rptd F990-6231594RevenueNotRptdF990
Revenue Subtotal66820648RevenueSubtotal
Other Revenues Not Included2660595OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt2660595RevenueNotRptdOnFinStmt
Total Revenue Per Form99069481243TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt62369388TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal62369388ExpensesSubtotal
Other Expenses Not Included7901207OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt7901207ExpensesNotRptdOnFinStmt
Total Expenses Per Form99070270595TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (6 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS:PART V, LINE 4:TRANSYLVANIA REGIONAL HOSPITAL FOUNDATION, A RELATED ORGANIZATION, HOLDS ENDOWMENT FUNDS FOR THE BENEFIT OF THE ORGANIZATION.
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:PART X:THE ASSOCIATION, THE HOSPITAL, THE FOUNDATION, AND TPSI ARE INCORPORATED AS NONPROFIT ORGANIZATIONS UNDER THE LAWS OF NORTH CAROLINA AND ARE EXEMPT FROM INCOME TAXES UNDER THE PROVISIONS OF SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. BREVARD MRI, WITH THE CONSENT OF ITS SHAREHOLDERS, HAS ELECTED TO BE TREATED AS A PARTNERSHIP FOR FEDERAL AND NORTH CAROLINA INCOME TAX PURPOSES. IN LIEU OF CORPORATE INCOME TAXES, EARNINGS AND LOSSES AFTER THAT DATE ARE INCLUDED IN THE INCOME TAX RETURNS OF THE SHAREHOLDERS; ACCORDINGLY, THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS DO NOT REFLECT A PROVISION OR LIABILITY FOR FEDERAL AND STATE INCOME TAXES. INCOME TAXES FOR TSI ARE PROVIDED FOR THE TAX EFFECTS OF TRANSACTIONS REPORTED IN THE CONSOLIDATED FINANCIAL STATEMENTS AND CONSIST OF TAXES CURRENTLY DUE PLUS DEFERRED TAX EXPENSE OR MINUS DEFERRED TAX BENEFIT RELATED PRIMARILY TO DIFFERENCES ARISING FROM THE METHODS OF CALCULATING DEPRECIATION FOR FINANCIAL AND INCOME TAX REPORTING. AN EVALUATION OF THE PROBABILITY OF BEING ABLE TO REALIZE THE FUTURE BENEFITS OF DEFERRED TAX ASSETS IS MADE. A VALUATION ALLOWANCE IS PROVIDED FOR THE PORTION OF THE DEFERRED TAX ASSET WHEN IT IS MORE LIKELY THAN NOT THAT SOME PORTION OR ALL OF THE DEFERRED TAX ASSET WILL NOT BE REALIZED. THE ORGANIZATIONS HAVE DETERMINED THAT NO MATERIAL UNRECOGNIZED TAX BENEFITS OR OBLIGATIONS EXIST FOR OPEN TAX YEARS AS OF SEPTEMBER 30, 2012. FISCAL YEARS ENDING ON OR AFTER SEPTEMBER 30, 2009 REMAIN SUBJECT TO EXAMINATION BY FEDERAL AND STATE TAX AUTHORITIES.
PART XI, LINE 8 - OTHER ADJUSTMENTS:TRANSFERS TO AFFILIATES -2,660,595. NET CHANGE IN INTEREST OF FOUNDATION -417,861. EXPENSES INCURRED FOR FOUNDATION 288,654. INCOME FROM AFFILIATED ORGANIZATION 406,425. LOSS ON SALE OF EQUIPMENT 152,962. TOTAL TO SCHEDULE D, PART XI, LINE 8: -2,230,415.
PART XII, LINE 2D - OTHER ADJUSTMENTS:NET CHANGE IN VALUE OF INTEREST IN FOUNDATION -417,861. INCOME FROM AFFILIATED ORGANIZATIONS 406,425. BAD DEBTS INCLUDED WITH REVENUE -7,414,183. OTHER NET CHANGE IN ASSETS -20,002.
PART XII, LINE 4B - OTHER ADJUSTMENTS:TRANSFERS TO AFFILIATES 2,660,595.
PART XIII, LINE 4B - OTHER ADJUSTMENTS:BAD DEBTS INCLUDED WITH REVENUE 7,414,183. EXPENSES INCURRED FOR FOUNDATION 288,654. NONOPERATING EXPENSE RECLASSIFICATION 152,962. OTHER CHANGE IN NET ASSETS 45,408.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free Care1FPGReferenceFreeCare
Pcent100XPcent100
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent250XPcent250
Free Disc Care Medically Indigent0FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget0ExpensesExceededBudget
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available1ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense1744952TotalCommunityBenefitExpense
Net Community Benefit Expense1744952NetCommunityBenefitExpense
Percent Of Total Expense0.02780PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense6744837TotalCommunityBenefitExpense
Direct Offsetting Revenue5441562DirectOffsettingRevenue
Net Community Benefit Expense1303275NetCommunityBenefitExpense
Percent Of Total Expense0.02070PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense8489789TotalCommunityBenefitExpense
Direct Offsetting Revenue5441562DirectOffsettingRevenue
Net Community Benefit Expense3048227NetCommunityBenefitExpense
Percent Of Total Expense0.04850PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense83269TotalCommunityBenefitExpense
Net Community Benefit Expense83269NetCommunityBenefitExpense
Percent Of Total Expense0.00130PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense250521TotalCommunityBenefitExpense
Net Community Benefit Expense250521NetCommunityBenefitExpense
Percent Of Total Expense0.00400PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense333790TotalCommunityBenefitExpense
Net Community Benefit Expense333790NetCommunityBenefitExpense
Percent Of Total Expense0.00530PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense8823579TotalCommunityBenefitExpense
Direct Offsetting Revenue5441562DirectOffsettingRevenue
Net Community Benefit Expense3382017NetCommunityBenefitExpense
Percent Of Total Expense0.05380PercentOfTotalExpense

Coalition Building CoalitionBuilding

FieldValueIRS element (for citing)
Total Community Building Expense13707TotalCommunityBuildingExpense
Net Community Building Expense13707NetCommunityBuildingExpense
Percent Of Total Expense0.00020PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Total Community Building Expense13707TotalCommunityBuildingExpense
Net Community Building Expense13707NetCommunityBuildingExpense
Percent Of Total Expense0.00020PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported1BadDebtExpenseReported
Bad Debt Expense$3,211,006BadDebtExpenseAmount
Amount Reimbursed By Medicare32720045AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare32515414CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall204631MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

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

Form990 Schedule H Part IV Form990ScheduleHPartIV

Name Of Entity NameOfEntity

FieldValueIRS element (for citing)
Business Name Line11 BREVARD MRI AT TRANSYLVANIA COMMUNITY HOSPITAL LLCBusinessNameLine1
FieldValueIRS element (for citing)
Description Ent Primary ActivityMRI SERVICESDescriptionEntPrimaryActivity
Organization Profit Or Ownership0.50000OrganizationProfitOrOwnership
Physicans Profit Or Ownership0.50000PhysicansProfitOrOwnership
FieldValueIRS element (for citing)
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1TRANSYLVANIA REGIONAL HOSPITALBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1260 HOSPITAL DRIVEAddressLine1
CityBREVARDCity
StateNCState
ZIP Code28712ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Critical Access HospitalXCriticalAccessHospital
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1TRANSYLVANIA COMMUNITY HOSPITAL INCBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
CHNA Conducted0CHNAConducted
Eligibility Criteria Explained1EligibilityCriteriaExplained
Uses FPG Free1UsesFPGFree
FPG Free Percent100.000000000000FPGFreePercent
Uses FPG Discounted1UsesFPGDiscounted
FPG Discount Percent300.000000000000FPGDiscountPercent
Explains Basis1ExplainsBasis
Income LevelXIncomeLevel
Asset LevelXAssetLevel
Explains Application Method1ExplainsApplicationMethod
Includes Publicity Measures1IncludesPublicityMeasures
Available On RequestXAvailableOnRequest
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 Facilities9NumberOfOtherFacilities

Other Facilities OtherFacilities (9 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
TRH OUTPATIENT REHABILITATION
92 CHESTNUT STREETBREVARDNC28712OUTPATIENT REHAB
TRH HOME CARE SERVICES
1234 ASHEVILLE HWYBREVARDNC28712HOME CARE
BREVARD MRI
301 HOSPITAL DRIVEBREVARDNC28712IMAGING CENTER
TOXAWAY HEALTH CENTER
16825 ROSMAN HWYLAKE TOXAWAYNC28747PROVIDER-BASED CLINICS
BREVARD FAMILY PRACTICE
187 MEDICAL PARK DRBREVARDNC28712PROVIDER-BASED CLINICS
MEDICAL ASSOCIATES OF TRH
377 GALLIMORE ROADBREVARDNC28712PROVIDER-BASED CLINICS
BREVARD INTERNAL MEDICINE & PULMONOLOGY
159 MEDICAL PARK DR SUITE BBREVARDNC28712PROVIDER-BASED CLINICS
KOALA
23 MEDICAL PARK CIRCLEBREVARDNC28712OUTPATIENT
BREVARD CANCER & INFUSION CENTER
89 HOSPITAL DRBREVARDNC28712OUTPATIENT

Form990 Schedule H Part VI Form990ScheduleHPartVI (13 entries)

ExplanationExplanationIdentifierIdentifierReturn ReferenceReturnReference
PART I, LINE 3C: IN ADDITION TO THE FPG-DETERMINED ELIGIBILITY FOR FREE AND DISCOUNTED CARE, A DISCOUNT IS OFFERED TO SELF-PAY PATIENTS FOR THEIR TIMELY PAYMENT WITHIN 60 DAYS FROM THEIR INITIAL STATEMENT DATE.
PART I, LINE 7: THE ORGANIZATION USED THEIR COST ACCOUNTING SYSTEM TO COMPUTE A COST-TO-CHARGES RATIO USED TO CALCULATE FINANCIAL ASSISTANCE AND UNREIMBURSED MEDICAID AT COST.
PART I, L7 COL(F): FOR THE PURPOSES OF CALCULATING PERCENTAGE OF TOTAL EXPENSE FOR LINE 7, COL (F), TOTAL EXPENSE FROM FORM 990, PART IX, LINE 25 HAS BEEN ADJUSTED FOR $(7,414,183).
PART II: THE HOSPITAL PARTICIPATES IN COALITION BUILDING IN THE COMMUNITY AND STATE TO HELP ADVOCATE THE HEALTH NEEDS OF OUR AREA. THROUGH PARTICIPATION, THE HOSPITAL GUARANTEES A FOCUSED DISCUSSION ON THE HEALTH CARE ISSUES THAT DIRECTLY IMPACT TRANSYLVANIA COUNTY.
PART III, LINE 4: REFER TO PAGE 15 OF THE NOTES TO CONSOLIDATED FINANCIAL STATEMENTS. PATIENT ACCOUNTS ARE CONSIDERED UNCOLLECTABLE AFTER EXHAUSTING IN-HOUSE COLLECTION PROCEDURES, WHICH USUALLY TAKES 59 DAYS FROM DISCHARGE DATE FOR SELF-PAY PATIENTS AND LONGER FOR UNINSURED PATIENTS. WHEN THE ACCOUNT IS CONSIDERED UNCOLLECTABLE, IT IS THEN SENT TO AN OUTSIDE AGENCY, WHICH HAS 180 DAYS TO ACTIVELY ATTEMPT COLLECTIONS. WHEN THE ACCOUNT HAS BEEN INACTIVE FOR 180 DAYS WHILE AT AN OUTSIDE COLLECTION AGENCY, THE ACCOUNT IS RETURNED TO THE HOSPITAL FROM THE COLLECTION AGENCY, AND IT IS CONSIDERED A BAD DEBT ACCOUNT AND EXPENSED. THE TOTAL BAD DEBT EXPENSE FOR THE FISCAL YEAR IS THEN REDUCED TO COST UTILIZING A COST-TO-CHARGE RATIO (CCR). THE FORMULA FOR THE CCR IS (ADJUSTED COSTS / ADJUSTED CHARGES). THE COST-TO-CHARGE RATIO IS CALCULATED FROM THE INCOME STATEMENT. TOTAL OPERATING EXPENSES LESS BAD DEBT, OTHER OPERATING INCOME, AND DIRECT COMMUNITY BENEFIT COSTS MAKE THE COST COMPONENT OF THE RATIO AND GROSS PATIENT CHARGES LESS DIRECT COMMUNITY BENEFIT REVENUES MAKE UP THE CHARGES COMPONENT OF THE RATIO.
PART III, LINE 9B: THE HOSPITAL DOES HAVE A WRITTEN DEBT COLLECTION POLICY, WHICH DOES NOT DIFFERENTIATE COLLECTION PRACTICE GUIDELINES FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR CHARITY CARE OR FINANCIAL ASSISTANCE. IN SOME CASES, A PATIENT WHO QUALIFIES FOR PARTIAL FINANCIAL ASSISTANCE WILL STILL HAVE OUTSTANDING DEBT WITH THE HOSPITAL. THROUGH MULTIPLE NOTIFICATION OF COLLECTION ATTEMPTS, COMMUNICATED OPPORTUNITIES FOR DISCOUNTS, ASSISTANCE AND PAYMENT PLAN ARRANGEMENTS, AND PERSONAL FACE-TO-FACE CONSULTATIONS, THE HOSPITAL MAKES REASONABLE EFFORTS TO COLLECT DEBT. THE HOSPITAL DOES NOT UTILIZE CREDIT ACCEPTANCE PROCEDURES TO VET OUT PATIENTS. IN GENERAL, THE HOSPITAL CONTINUOUSLY MONITORS SELF-PAY ACCOUNTS TO TARGET ACCOUNTS THAT ARE SLOW TO PAY IN ORDER TO IDENTIFY ACCOUNTS THAT ARE POTENTIAL CHARITY CARE OR FINANCIAL ASSISTANCE ELIGIBLE PATIENTS.
PART V, SECTION B, LINE 19D: THE HOSPITAL HAS ONE FEE SCHEDULE THAT IS UTILIZED TO DETERMINE THE MAXIMUM AMOUNT THAT CAN BE CHARGED TO PATIENTS ELIGIBLE UNDER THE FACILITY'S FINANCIAL ASSISTANCE POLICY.TRANSYLVANIA COMMUNITY HOSPITAL, INC.
PART VI, LINE 2: TRANSYLVANIA REGIONAL HOSPITAL USES MULTIPLE TOOLS TO ASSESS THE CURRENT AND FUTURE HEALTH CARE NEEDS OF THE COMMUNITY IT SERVES INCLUDING: - CONDUCTING ENVIRONMENTAL ASSESSMENTS; - REVIEWING MARKET SHARE DATA FOR EXISTING SERVICES; AND - COMPILING A MEDICAL STAFF DEVELOPMENT PLAN EVERY TWO YEARS THAT ASSESSES PHYSICIAN NEED PER POPULATION ADJUSTED FOR DEMOGRAPHICS. TRH ALSO ACTIVELY PARTICIPATES IN THE TRANSYLVANIA COUNTY HEALTH DEPARTMENT'S REQUIRED ASSESSMENT OF HEALTH NEEDS EVERY FOUR YEARS. IN FY 2012, TRH BEGAN EXTENSIVE PLANNING WITH THE LOCAL HEALTH DEPARTMENT TO CONDUCT A FORMAL COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). A DETAILED SURVEY AND COMPILATION OF PRIMARY AND SECONDARY HEALTH DATA FOR TRANSYLVANIA COUNTY, N.C, WAS COMPLETED IN FALL 2012. THE FINDINGS OF THIS SURVEY ALONG WITH EXTENSIVE COMMUNITY INPUT WILL BE USED BY TRH IN FY 2013. IN ADDITION, THE TRH BOARD OF TRUSTEES IS MADE UP OF RESIDENTS OF THE ORGANIZATION'S SERVICE AREA WHO CAN VOICE THE NEEDS OF THE COMMUNITY.
PART VI, LINE 3: TRANSYLVANIA REGIONAL HOSPITAL PLACES SIGNAGE FOR ITS PATIENT FINANCIAL ASSISTANCE POLICIES IN PATIENT AREAS IN THE HOSPITAL, IN THE PATIENT ACCOUNTING OFFICE, AND THE PATIENT REGISTRATION AREA. AT THE POINT OF REGISTRATION AND PRE-REGISTRATION, PATIENTS ARE NOTIFIED OF THE PATIENT FINANCIAL ASSISTANCE POLICY. IN THE PATIENT ACCOUNTING OFFICE, THE AVAILABLE FINANCIAL ASSISTANCE PROGRAMS ARE VERBALLY COMMUNICATED BY FINANCIAL COUNSELORS TO PATIENTS WHO MIGHT BE ELIGIBLE. BILLING STATEMENTS ARE PRINTED WITH INVITATIONS TO SEEK PATIENT FINANCIAL ASSISTANCE THROUGH THE PATIENT ACCOUNTING OFFICE. IN ADDITION TO THIS, THE EMERGENCY DEPARTMENT UTILIZES A HEALTH RESOURCE NAVIGATOR TO HELP FIND FINANCIAL ASSISTANCE RESOURCES FOR SELF-PAY PATIENTS. THE PATIENT FINANCIAL ASSISTANCE POLICY ALSO RESIDES ON THE HOSPITAL'S WEBSITE, HTTP://WWW.TRHOSPITAL.ORG/PATIENTS/FINANCIAL.PHP.
PART VI, LINE 4: THE PRIMARY SERVICE AREA FOR TRANSYLVANIA REGIONAL HOSPITAL IS TRANSYLVANIA COUNTY, NORTH CAROLINA, WITH A RESIDENT POPULATION OF 33,000 INCLUDING GLOUCESTER TOWNSHIP IN THE UPPER END OF THE COUNTY, WHICH IS FEDERALLY DESIGNATED AS A MEDICALLY UNDERSERVED AREA. NEARLY 12.5% OF TRANSYLVANIA COUNTY'S TOTAL RESIDENT POPULATION HAS A HOUSEHOLD INCOME BELOW THE FEDERAL POVERTY LEVEL. TRANSYLVANIA REGIONAL HOSPITAL IS THE ONLY LOCAL HOSPITAL SERVING THIS PRIMARY SERVICE AREA.TRANSYLVANIA REGIONAL HOSPITAL'S SECONDARY COVERAGE AREA INCLUDES 15,000 ADDITIONAL RESIDENTS IN SOUTHERN JACKSON COUNTY, NORTH CAROLINA, INCLUDING THE MEDICALLY UNDERSERVED AREA OF CASHIERS TOWNSHIP, AS WELL AS WESTERN HENDERSON COUNTY, NC WHICH HAS A FEDERALLY DESIGNATED MEDICALLY UNDERSERVED POPULATION OF LOW INCOME, MIGRANT FARM WORKERS. BESIDES TRANSYLVANIA REGIONAL HOSPITAL, THREE ADDITIONAL COMMUNITY HOSPITALS PROVIDE SOME COVERAGE TO THESE 15,000 RESIDENTS IN THE SECONDARY COVERAGE AREA; HOWEVER, TRANSYLVANIA REGIONAL HOSPITAL IS IN MANY CASES THE CLOSEST, MOST READILY ACCESSIBLE PROVIDER OF CARE FOR MANY OF THESE RESIDENTS.
PART VI, LINE 5: A MAJORITY OF THE ORGANIZATION'S GOVERNING BODY IS COMPRISED OF PERSONS WHO RESIDE IN THE PRIMARY SERVICE AREA AND WHO ARE NEITHER EMPLOYEES OR INDEPENDENT CONTRACTORS OF THE ORGANIZATION. IN ADDITION, THE ORGANIZATION EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY FOR ALL OF ITS DEPARTMENTS. TRANSYLVANIA REGIONAL HOSPITAL APPLIES THE SURPLUS OF ITS FUNDS DIRECTLY TO PATIENT CARE. FOR EXAMPLE, CAPITAL ACQUISITIONS OF MEDICAL EQUIPMENT AND EXPANDED PATIENT FACILITIES ARE FUNDED DIRECTLY BY SUPLUS OF FUNDS, AND PATIENT CARE IS BENEFITED BY THESE ACQUISITIONS.AS A NOT-FOR-PROFIT HOSPITAL, TRANSYLVANIA REGIONAL HOSPITAL IS COMMITTED TO GIVING BACK TO THE COMMUNITY TO HELP THOSE WHO ARE UNINSURED OR UNDERINSURED AS WELL AS PROVIDING HEALTH EDUCATION AND BENEFITS FOR THE WELL BEING OF THE ENTIRE COMMUNITY. 2012 WAS ANOTHER TOUGH YEAR FOR OUR COMMUNITY AS WE EXPERIENCED THE LINGERING EFFECTS OF A DEPRESSED ECONOMY. THIS HAS LEFT MANY IN OUR COMMUNITY WITHOUT HEALTH INSURANCE AND STRUGGLING TO MAKE ENDS MEET. DESPITE CHALLENGING FINANCIAL TIMES FOR THE HOSPITAL, TRH CONTINUED TO GENEROUSLY HELP THOSE IN NEED. IN 2012, TRH PROVIDED $6.6 MILLION IN CONTRIBUTIONS TO THE COMMUNITY. THESE BENEFITS CAME IN MANY FORMS INCLUDING $1.7 MILLION IN CHARITY CARE FOR 2,382 PEOPLE. THE HOSPITAL ALSO PROVIDED ANOTHER $3.2 MILLION IN CARE FOR 4,263 PEOPLE THROUGH NON-COLLECTIBLE SERVICES. AN ADDITIONAL $1.3 MILLION WAS PROVIDED FOR GOVERNMENT SPONSORED HEALTHCARE INCLUDING INDIGENT CARE PROGRAMS. FINALLY, $350,000 WAS PROVIDED FOR COMMUNITY BENEFIT PROGRAMS INCLUDING THE DONATION OF STAFF TIME AND RESOURCES.
PART VI, LINE 6: THE ORGANIZATION IS NOT PART OF AN AFFILIATED HEALTH CARE SYSTEM.
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 Line1TRANSYLVANIA REGIONAL HOSPITAL FOUNDATION INCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1223 W JORDAN STREETAddressLine1
CityBREVARDCity
StateNCState
ZIP Code28712ZIPCode
FieldValueIRS element (for citing)
EIN Of Recipient561458024EINOfRecipient
IRC Section501(C)(3)IRCSection
Amount Of Cash Grant288654AmountOfCashGrant
Purpose Of GrantOPERATIONAL ASSISTANCEPurposeOfGrant
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants1TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations0TotalNbrOfOtherOrganizations

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 SUBSIDIZES TRANSYLVANIA REGIONAL HOSPITAL FOUNDATION, INC.'S OPERATIONS.Explanation

Schedule J IRS990ScheduleJ

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

Form990 Schedule J Part II Form990ScheduleJPartII (5 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
JIM KELLING MD
0204035041836000896107253026208500
ROBERT J BEDNAREK
267073000223510160560112650316745000
ELIZABETH A PELLETIER
164939000311043570147310184338000
LAUREL D JOHNSON
15389100015207066011920162301000
JUDITH H MCKAY
15163100031107660064850166087000

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
Date Issued2011-08-24DateIssued
Issue Price14655000IssuePrice
Description Of PurposeCURRENT REFUNDINGDescriptionOfPurpose
Defeased0Defeased
On Behalf Of Issuer0OnBehalfOfIssuer
Pool Financing0PoolFinancing

Form990 Schedule K Part II Form990ScheduleKPartII

FieldValueIRS element (for citing)
Amount Retired235000AmountRetired
Total Proceeds14655000TotalProceeds
Other Spent Proceeds14655000OtherSpentProceeds
Year Of Subst Completion2006YearOfSubstCompletion
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
Prcntge Prvt Business Use By Others0.00000PrcntgePrvtBusinessUseByOthers
Percentage Of Prvt Business Re UBI0.00000PercentageOfPrvtBusinessReUBI
Total Private Business Use0.00000TotalPrivateBusinessUse
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, PART II, LINE 11, OTHER SPENT PROCEEDS:Identifier
ExplanationTHE AMOUNT PRESENT ON PART II, LINE 11 REPRESENTS AMOUNTS USED TO CURRENTLY REFUND PRIOR ISSUES DATED NOVEMBER 20, 1997 AND MARCH 9, 2009. SERIES 1997 REFUNDING: $ 2,255,000 SERIES 2009 REFUNDING: 12,400,000 TOTAL TO LINE 11: $ 14,655,000Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (12 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
FORM 990, PART VI, SECTION A, LINE 2ROBERT J. BEDNAREK AND CHARLES AYSCUE HAVE A BUSINESS RELATIONSHIP.
FORM 990, PART VI, SECTION A, LINE 3IN AN AGREEMENT EFFECTIVE JANUARY 1, 2011, MISSION HEALTH SYSTEM, INC., A 501(C)(3) HEALTHCARE ORGANIZATION, COMMENCED PROVIDING ADMINISTRATIVE MANAGEMENT SERVICES CONSISTENT WITH THE STANDARDS OF THE HEALTHCARE INDUSTRY FOR AN INDEPENDENT HOSPITAL MANAGEMENT COMPANY CONTRACTING AT AN ARM'S LENGTH BASIS TO PROVIDE COMPREHENSIVE HOSPITAL MANAGEMENT SERVICES. AS PART OF THE AGREEMENT, THE HOSPITAL CEO, DIRECTOR OF INFORMATION SERVICES, AND LATER THE INTERIM CFO AND CFO, WOULD BECOME EMPLOYEES OF MISSION HEALTH SYSTEM, INC. AND CONTINUE TO PROVIDE SERVICE TO THE ORGANIZATION.
FORM 990, PART VI, SECTION A, LINE 6THE ORGANIZATION IS A NONSTOCK, NONPROPRIETARY, TAX-EXEMPT MEMBER CORPORATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND HAS AS ITS SOLE MEMBER TRANSYLVANIA HEALTH SYSTEM, INC.
FORM 990, PART VI, SECTION A, LINE 7ATRUSTEES ARE NOMINATED TO THE BOARD BY THE GOVERNANCE COMMITTEE OF THE BOARD, APPROVED BY THE FULL HOSPITAL BOARD, AND ARE RATIFIED BY THE BOARD OF THE MEMBER ORGANIZATION. TRUSTEES ARE SUBJECT TO REMOVAL BY THE MEMBER AT ANY TIME WITHOUT CAUSE.
FORM 990, PART VI, SECTION A, LINE 7BTHE SOLE MEMBER HAS THE RESERVE POWER TO APPROVE BOARD MEMBERS AND APPROVE NEW DEBT. IN ADDITION, IT IS WITIN THE SOLE MEMBER'S POWER TO SUPERVISE AND CONTROL ALL MAJOR OPERATIONAL ASPECTS OF THE HOSPITAL. THE ADMINISTRATIVE POWERS OF THE HOSPITAL ARE VESTED IN THE BOARD OF TRUSTEES, WHICH HAVE CHARGE, CONTROL, AND MANAGEMENT OF THE PROPERTY, AFFAIRS AND FUNDS OF THE HOSPITAL, INCLUDING BUT NOT LIMITED TO: (A) THE SALE, LEASE, EXCHANGE, PLEDGE, OR MORTGAGE OF ANY PART OF THE ASSETS OF THE HOSPITAL, OR ANY CONTRACT OPTION OR OTHER AGREEMENT WITH RESPECT TO THE SALE, LEASE, EXCHANGE, PLEDGE OR MORTGAGE OF THE ASSETS OF THE HOSPITAL; PROVIDED HOWEVER, THAT ANY SUCH TRANSACTION ABOVE A LIMIT SPECIFIED BY THE SYSTEM MUST FIRST BE APPROVED BY THE SYSTEM; AND (B) THE ELECTION OF ALL EXECUTIVE OFFICERS OF THE HOSPITAL AND THE DIRECTION OF THE OFFICERS IN THE DUTIES PRESCRIBED IN THESE BYLAWS AND IN SUCH OTHER SPECIAL DUTIES AS THE BOARD OF TRUSTEES DEEMS FROM TIME TO TIME APPROPRIATE AND IN THE BEST INTERESTS OF THE HOSPITAL. (C) THE EXERCISE OF ALL OTHER POWERS EXPLICITLY DELEGATED BY THE SYSTEM. SUBJECT TO THE APPROVAL OF THE SYSTEM, THE BOARD OF TRUSTEES SHALL HAVE THE POWER TO (I) AMEND OR RESTATE THE HOSPITAL'S ARTICLES OF INCORPORATION; (II) AMEND OR RESTATE THE BYLAWS; AND (III) MERGE, CONSOLIDATE, REORGANIZE OR DISSOLVE THE HOSPITAL; PROVIDED, HOWEVER, THAT IN NO EVENT SHALL THE HOSPITAL'S ARTICLES OF INCORPORATION OR BYLAWS AS PRESENTLY IN EFFECT OR AS HEREAFTER AMENDED, CONFLICT WITH THE SYSTEM'S ARTICLES OF INCORPORATION OR BYLAWS.
FORM 990, PART VI, SECTION B, LINE 11THE RETURN WAS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM WITH ASSISTANCE AND INFORMATION PROVIDED BY MANAGEMENT. THE RETURN WAS THEN REVIEWED BY THE HOSPITAL FINANCE COMMITTEE OF THE BOARD AND A COPY DISTRIBUTED TO EVERY VOTING BOARD MEMBER. AGENDA TIME WAS RESERVED AT A SCHEDULED BOARD MEETING PRIOR TO THE FILING OF THE 990 FOR MANAGMENT RESPONSE TO MEMBERS' QUESTIONS AND COMMENTS.
FORM 990, PART VI, SECTION B, LINE 12CTHE ORGANIZATION'S CONFLICT OF INTEREST POLICY IS REVIEWED AND UPDATED ANNUALLY. EDUCATION ABOUT THE POLICY AND THE RESPONSIBILITIES OF A BOARD MEMBER OCCURS ANNUALLY AND FOR NEW BOARD MEMBERS DURING ORIENTATION. IF A CONFLICT OF INTEREST IS IDENTIFIED, THE MEMBER IS RECUSED FROM DISCUSSION AND A VOTE ON THE CONFLICTING MATTER, AND MAY BE EXCUSED. THE POLICY IS ADHERED TO DURING MEETINGS IN EXECUTIVE SESSION FOR CEO EVALUATION AND COMPENSATION DISCUSSION, AUDIT PLANNING, AND OTHER TIMES AS REQUIRED.
FORM 990, PART VI, SECTION B, LINE 15THE ORGANIZATION DRAWS WAGE COMPARISON DATA FROM TWO INDEPENDENT SOURCES, AND THE EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD REVIEWS THE INFORMATION AND SETS THE COMPENSATION PACKAGES FOR THE CEO AND IS INFORMED OF THE COMPENSATION PACKAGES OF THE CFO, COO, VP OF MARKETING, COO OF TPSI, DIRECTOR OF THE FOUNDATION, SYSTEM DIRECTOR OF HR AND FACILITY SERVICES. COMPENSATION PACKAGES FOR THE CEO ARE REVIEWED ANNUALLY. COMPENSATION FOR ALL OTHER POSITIONS ARE REVIEWED WHENEVER A CHANGE IN THE POSITION IS MADE. CHANGES FROM THE 2011 REVIEW WERE MADE EFFECTIVE FOR THE 2012 CALENDAR YEAR. BEGINNING MARCH 2011, THE ORGANIZATION BEGAN CONTRACTING THE SERVICES OF ITS CEO FROM MISSION HEALTH SYSTEM, A 501(C)(3) HEALTHCARE ORGANIZATION. COMPENSATION PER THIS AGREEMENT IS PAID THROUGH MISSION HEALTH SYSTEM FROM AN ESTABLISHED MANAGEMENT CONTRACT.
FORM 990, PART VI, SECTION C, LINE 18PHOTOCOPIES OF RECENT FILINGS OF THE FORM 990 ARE AVAILABLE UPON REQUEST AT THE ORGANIZATION'S ADMINISTRATIVE OFFICE. IN ADDITION, RECENT FILINGS OF THE FORM 990 ARE AVAILABLE ONLINE AT WWW.GUIDESTAR.ORG.
FORM 990, PART VI, SECTION C, LINE 19PHOTOCOPIES OF THE ORGANIZATION'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST AT THE ORGANIZATION'S ADMINISTRATIVE OFFICE. AN ANNUAL REPORT OF THE ORGANIZATION'S FINANCIAL STATEMENTS IS AVAILABLE ON THE ORGANIZATION'S WEBSITE AND IS PUBLISHED ANNUALLY IN THE LOCAL NEWSPAPER.
FORM 990, PART XI, LINE 5:NET UNREALIZED GAINS ON INVESTMENTS: 1,214,027. PRIOR PERIOD ADJUSTMENTS: 25,406. TRANSFERS TO AFFILIATES -2,660,595. NET CHANGE IN INTEREST OF FOUNDATION -417,861. EXPENSES INCURRED FOR FOUNDATION 288,654. INCOME FROM AFFILIATED ORGANIZATION 406,425. LOSS ON SALE OF EQUIPMENT 152,962. TOTAL TO FORM 990, PART XI, LINE 5: -990,982.CHANGES IN NET ASSETS OR FUND BALANCES:
FORM 990, PART XII, LINE 2C:THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNAControlled OrgControlledOrgBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
TRANSYLVANIA HEALTH SYSTEM INC
260 HOSPITAL DRIVEBREVARDNC28712561456987HEALTHCARENC501(C)(3)LINE 11B, IIN/A0
TRANSYLVANIA REGIONAL HOSPITAL FOUNDATION INC
PO BOX 2440BREVARDNC28712561458024SUPPORTING ORGANIZATIONNC501(C)(3)LINE 11A, I0TRANSYLVANIA HEALTH SYSTEM INC
TRANSYLVANIA PHYSICIAN SERVICES INC
260 HOSPITAL DRIVEBREVARDNC28712561920816HEALTHCARENC501(C)(3)LINE 30TRANSYLVANIA HEALTH SYSTEM INC

Form990 Schedule R Part III Form990ScheduleRPartIII (4 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 PartnerGeneralOrManagingPartnerPercentage OwnershipPercentageOwnership
BREVARD MRI AT TRANSYLVANIA COMMUNITY HOSPITAL LLC
260 HOSPITAL DRIVEBREVARDNC28712203281110HEALTHCARENCN/ARELATED348695501665010.50000
TRANSYLVANIA HEALTHCARE II LIMITED PARTNERSHIP
2 MEDICAL PARK DRBREVARDNC28712200333230RENTALNCN/A
HEALTHCARE III LIMITED PARTNERSHIP
260 HOSPITAL DRIVEBREVARDNC28712561599596RENTALNCN/A
HEALTHCARE LIMITED LIABILITY COMPANY VII
260 HOSPITAL DRIVEBREVARDNC28712200343455RENTALNCN/A

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1TRANSYLVANIA SERVICES INCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1260 HOSPITAL DRIVEAddressLine1
CityBREVARDCity
StateNCState
ZIP Code28712ZIPCode
FieldValueIRS element (for citing)
EIN561448199EIN
Primary ActivityREAL ESTATEPrimaryActivity
Legal Domicile StateNCLegalDomicileState
Direct Controlling Entity NAN/ADirectControllingEntityNA
Type Of EntityCTypeOfEntity
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties1ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org1GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org1LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org1LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs1RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs1RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs1PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities1SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org1OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (2 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
BREVARD MRI AT TRANSYLVANIA COMMUNITY HOSPITAL
J905987CASH
BREVARD MRI AT TRANSYLVANIA COMMUNITY HOSPITAL
A4644CASH

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