ANC MCDOWELL HOSPITAL INC: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
ANC MCDOWELL HOSPITAL INC (EIN 56-0623938)
Tax period
2011-10-01 to 2012-09-30
Filed
2013-08-14
IRS object ID
201332269349302713
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)
Timestamp2013-08-14T13:28:17-05:00Timestamp
Tax Period End Date2012-09-30TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN366055558EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1GRANT THORNTON LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1201 S COLLEGE STREET SUITE 2500AddressLine1
CityCHARLOTTECity
StateNCState
ZIP Code28244ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN560623938EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1The McDowell Hospital IncBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlMCDONameControl
Phone8286595196Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1430 Rankin DriveAddressLine1
CityMarionCity
StateNCState
ZIP Code287520730ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameClint StewartName
TitleVP Finance, Business OperationsTitle
Phone8286595196Phone
Date Signed2013-08-14DateSigned

Preparer Preparer

FieldValueIRS element (for citing)
PTINP00488037PTIN
Phone7046323500Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonClint StewartNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1430 Rankin DriveAddressLine1
CityMarionCity
StateNCState
ZIP Code287520730ZIPCode
FieldValueIRS element (for citing)
Gross Receipts39075011GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web Sitewww.McDhospital.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1927YearFormation
State Legal DomicileNCStateLegalDomicile
Activity Or Mission DescriptionProvide acute care inpatient, outpatient and emergency medical care.ActivityOrMissionDescription
Nbr Voting Members Governing Body15NbrVotingMembersGoverningBody
Nbr Independent Voting Members10NbrIndependentVotingMembers
Total Nbr Employees542TotalNbrEmployees
Total Nbr Volunteers102TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year286786ContributionsGrantsPriorYear
Contributions Grants Current Year517250ContributionsGrantsCurrentYear
Program Service Revenue Prior Year43415304ProgramServiceRevenuePriorYear
Program Service Revenue CY38375852ProgramServiceRevenueCY
Investment Income Prior Year156681InvestmentIncomePriorYear
Investment Income Current Year83585InvestmentIncomeCurrentYear
Other Revenue Prior Year54411OtherRevenuePriorYear
Other Revenue Current Year39496OtherRevenueCurrentYear
Total Revenue Prior Year43913182TotalRevenuePriorYear
Total Revenue Current Year39016183TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year21532212SalariesEtcPriorYear
Salaries Etc Current Year20337875SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year25791542OtherExpensePriorYear
Other Expenses Current Year18100091OtherExpensesCurrentYear
Total Expenses Prior Year47323754TotalExpensesPriorYear
Total Expenses Current Year38437966TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-3410572RevenuesLessExpensesPriorYear
Revenues Less Expenses CY578217RevenuesLessExpensesCY
Total Assets BOY21481602TotalAssetsBOY
Total Assets EOY26798255TotalAssetsEOY
Total Liabilities BOY20526438TotalLiabilitiesBOY
Total Liabilities EOY18264874TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY955164NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY8533381NetAssetsOrFundBalancesEOY
Mission DescriptionSee Page 1, Part I, Line 1MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense31495742Expense
Revenue38529795Revenue
DescriptionDuring the year, McDowell Hospital has committed to promoting Health in our Community through diverse and innovative programs, designed to reach a broad-range target population and create the highest impact, with a special emphasis on the uninsured and underinsured. These programs include our Rural Dental Health Grant, opening of 2 new Rural Health Clinic's within the last year and half, the continuation of our Sports Medicine Program through our local school system, All About Women health fair event, National Cancer Survivor Day Celebration, and a quarterly magazine publication To Your Health. While not an exhaustive list, these programs provide an example of our efforts to promote healthy living within our community.Description
Total Program Service Expense31495742TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
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 Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP1LoanToOfficerOrDQP
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 With109642NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees542NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members15NbrVotingGoverningBodyMembers
Number Independent Voting Members10NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
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 Procedure0WrittenPolicyOrProcedure
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1Finance DepartmentBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number8286595196TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1430 Rankin DriveAddressLine1
CityMarionCity
StateNCState
ZIP Code287520730ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (23 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
Harold Walker
Chairman2.00XX000
Bobbie Young
Vice-Chairman2.00XX000
Jed Rankin
Secretary/Treasurer2.00XX000
Keith Holtsclaw
Trustee1.00X023337810562
Norman Guthrie
Trustee1.00X000
William Evans
Trustee1.00X000
Mark Burton MD
Trustee1.00X000
John Karas
Trustee1.00X000
Chip Cross
Trustee1.00X000
George Renfro
Trustee1.00X000
R Marshall Dark
Trustee1.00X000
Robert A Morrow MD
Chief of Staff50.00XX287707028149
John Maher
Trustee50.00X026244920785
George Green MD
Trustee50.00X326646020250
Sonya Greck
Interim CEO Sep 2011-Feb 201250.00XX27680000
Lynn Boggs
CEO as of Feb 201250.00XX000
Clint Stewart
VP Finance & Business Operations50.00X83059019094
Tommy Ginn MD
Physician40.00281326023118X
Andrea Moore MD
physician40.00253297019569X
John Rowland MD
Physician40.0017358208996X
Leigh Meeks MD
physician40.00164066022073X
William J Horan MD
physician40.00276100012842X
Ed Hannon
Former CEO through May 201150.0020826908917X
FieldValueIRS element (for citing)
Total Reportable Comp From Org2330852TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs495827TotalReportableCompFrmRltdOrgs
Total Other Compensation194355TotalOtherCompensation
Number Individuals GT100 K15NumberIndividualsGT100K
Formers Listed1FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
JOHNSON CONTROLS INC
PO Box 905240CharlotteNC289205240Professional Services770661
High Country Anesthesia
193 Valley Stran DrBooneNC286078890Anesthesia Services753775
HORIZON CSA LLC
PO BOX 102289AtlantaGA303682289Maintenance Services476806
GEM CONSTRUCTORS INC
2024 Nix Creek Rd Ste AMarionNC287529610Construction Services359073
MORRISON MGMT SPECIALISTS INC
PO BOX 102289AtlantaGA303682289Food Services338050
FieldValueIRS element (for citing)
Number Of Contractors GT100 K22NumberOfContractorsGT100K
Related Organizations453530RelatedOrganizations
Government Grants13720GovernmentGrants
All Other Contributions50000AllOtherContributions
Noncash Contributions447430NoncashContributions
Total Contributions517250TotalContributions

Program Service Revenue ProgramServiceRevenue (4 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeExclusionExclusionAmount
Net Patient Service Re9000993586403435864034
Other Operating Revenu90009924711432471143
Cafeteria Revenue722210194618$194,618
MRI Partnership621990-153943-153943
FieldValueIRS element (for citing)
Total Program Service Revenue38375852TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column4968TotalRevenueColumn
Exclusion$4,968ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real81972Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real42476Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real39496Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column39496TotalRevenueColumn
Exclusion$39,496ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities94969Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities0Securities
Other16352Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities94969Securities
Other-16352Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column78617TotalRevenueColumn
Exclusion$78,617ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column39016183TotalRevenueColumn
Related Or Exempt Function Income38181234RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$317,699ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total964505Total
Program Services260416ProgramServices
Management And General704089ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total15289749Total
Program Services12690492ProgramServices
Management And General2599257ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total86978Total
Program Services72192ProgramServices
Management And General14786ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total3033331Total
Program Services2517665ProgramServices
Management And General515666ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total963312Total
Program Services799549ProgramServices
Management And General163763ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total83443Total
Management And General83443ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total46179Total
Management And General46179ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total7793893Total
Program Services6624809ProgramServices
Management And General1169084ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total94064Total
Program Services79954ProgramServices
Management And General14110ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total261572Total
Program Services222336ProgramServices
Management And General39236ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total601602Total
Program Services481282ProgramServices
Management And General120320ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total77755Total
Program Services59094ProgramServices
Management And General18661ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total298128Total
Program Services232540ProgramServices
Management And General65588ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total1556056Total
Program Services1244845ProgramServices
Management And General311211ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total529606Total
Program Services450165ProgramServices
Management And General79441ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
Medical Supplies31352082664927470281
Pharmaceuticals17589581758958
Repairs & Maintenance975882487273488609
Equipment Leases631086631086

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total256659Total
Program Services218159ProgramServices
Management And General38500ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total38437966Total
Program Services31495742ProgramServices
Management And General6942224ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY3310BOY
EOY3544EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY564254BOY
EOY3332637EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY5344828BOY
EOY5967008EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY10126BOY
EOY4204EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY109204BOY
EOY85896EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY577195BOY
EOY684710EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY292431BOY
EOY292064EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis36413130LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec20558181LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY14127256BOY
EOY15854949EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY389542BOY
EOY237218EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY63456BOY
EOY336025EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY21481602BOY
EOY26798255EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY2291589BOY
EOY2534084EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY867059BOY
EOY2299955EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY2740000BOY
EOY0EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY141530BOY
EOY77129EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY14486260BOY
EOY13353706EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY20526438BOY
EOY18264874EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY882872BOY
EOY8464118EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY72292BOY
EOY69263EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY955164BOY
EOY8533381EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY21481602BOY
EOY26798255EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses578217ReconcilationRevenueExpenses
Reconcilation Other Changes7000000ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement BothXFinancialStatementBoth
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 D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis449525OtherCostOrOtherBasis
Book Value449525BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis18697580OtherCostOrOtherBasis
Depreciation8473934Depreciation
Book Value10223646BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis797651OtherCostOrOtherBasis
Depreciation155994Depreciation
Book Value641657BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis15576166OtherCostOrOtherBasis
Depreciation11813923Depreciation
Book Value3762243BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis892208OtherCostOrOtherBasis
Depreciation114330Depreciation
Book Value777878BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings15854949TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (4 entries)

DescriptionDescriptionAmountAmount
Swap Payable$235,527
Note Payable to Mission Health System$11,351,941
Current due to other related parties$1,765,149
Other Liabilities$1,089
FieldValueIRS element (for citing)
Total Of Amounts13353706TotalOfAmounts
Total Revenue39016183TotalRevenue
Total Expenses38437966TotalExpenses
Excess Or Deficit For Year578217ExcessOrDeficitForYear
Other$7,000,000OtherAmount
Total Adjustments7000000TotalAdjustments
Excess Or Deficit Per FS7578217ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt46058659TotRevenueEtcAuditedFinclStmt
Other Revenues7042476OtherRevenues
Revenue Not Rptd F9907042476RevenueNotRptdF990
Revenue Subtotal39016183RevenueSubtotal
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form99039016183TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt38480442TotExpensesEtcAuditedFinclStmt
Other Expenses Included42476OtherExpensesIncluded
Expenses Not Rptd F99042476ExpensesNotRptdF990
Expenses Subtotal38437966ExpensesSubtotal
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form99038437966TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (4 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Description of Uncertain Tax Positions Under FIN 48:Part X:Income Taxes: The hospital applies the provisions of FASB ASC 740, Income Taxes, in accounting for uncertainty in income taxes. ASC 740 provides guidance on when tax positions are recognized in an entity's financial statements and how the values of these positions are determined. There is currently no impact on the Hospital's financial statements as a results of the application of ASC 740.
Part XI, Line 8 - Other Adjustments:Transfer from Mission Health System 7,000,000.
Part XII, Line 2d - Other Adjustments:Rental Expenses 42,476. Transfer from Mission Health System 7,000,000.
Part XIII, Line 2d - Other Adjustments:Rental Expenses 42,476.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
FPG Reference Free Care1FPGReferenceFreeCare
Pcent150XPcent150
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent300XPcent300
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
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 Expense747716TotalCommunityBenefitExpense
Net Community Benefit Expense747716NetCommunityBenefitExpense
Percent Of Total Expense0.01950PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense6761239TotalCommunityBenefitExpense
Direct Offsetting Revenue8005711DirectOffsettingRevenue
Net Community Benefit Expense-1244472NetCommunityBenefitExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense7508955TotalCommunityBenefitExpense
Direct Offsetting Revenue8005711DirectOffsettingRevenue
Net Community Benefit Expense-496756NetCommunityBenefitExpense
Percent Of Total Expense0.01950PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense629418TotalCommunityBenefitExpense
Net Community Benefit Expense629418NetCommunityBenefitExpense
Percent Of Total Expense0.01640PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense13836TotalCommunityBenefitExpense
Net Community Benefit Expense13836NetCommunityBenefitExpense
Percent Of Total Expense0.00040PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense2069482TotalCommunityBenefitExpense
Net Community Benefit Expense2069482NetCommunityBenefitExpense
Percent Of Total Expense0.05380PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense12141TotalCommunityBenefitExpense
Net Community Benefit Expense12141NetCommunityBenefitExpense
Percent Of Total Expense0.00030PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense2724877TotalCommunityBenefitExpense
Net Community Benefit Expense2724877NetCommunityBenefitExpense
Percent Of Total Expense0.07090PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense10233832TotalCommunityBenefitExpense
Direct Offsetting Revenue8005711DirectOffsettingRevenue
Net Community Benefit Expense2228121NetCommunityBenefitExpense
Percent Of Total Expense0.09040PercentOfTotalExpense

Workforce Development WorkforceDevelopment

FieldValueIRS element (for citing)
Total Community Building Expense6949TotalCommunityBuildingExpense
Net Community Building Expense6949NetCommunityBuildingExpense
Percent Of Total Expense0.00020PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Total Community Building Expense6949TotalCommunityBuildingExpense
Net Community Building Expense6949NetCommunityBuildingExpense
Percent Of Total Expense0.00020PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported1BadDebtExpenseReported
Bad Debt Expense$4,038,928BadDebtExpenseAmount
Amount Reimbursed By Medicare11175902AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare10547849CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall628053MedicareSurplusOrShortfall

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 McDowell MRIBusinessNameLine1
FieldValueIRS element (for citing)
Description Ent Primary ActivityMedical Imaging ServicesDescriptionEntPrimaryActivity
Organization Profit Or Ownership0.51000OrganizationProfitOrOwnership
Officers Etc Profit Or Ownership0.00000OfficersEtcProfitOrOwnership
Physicans Profit Or Ownership0.49000PhysicansProfitOrOwnership
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 Line1The McDowell HospitalBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1430 Rankin DriveAddressLine1
CityMarionCity
StateNCState
ZIP Code28752ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1The McDowell Hospital IncBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
Eligibility Criteria Explained1EligibilityCriteriaExplained
Uses FPG Free1UsesFPGFree
FPG Free Percent150.000000000000FPGFreePercent
Uses FPG Discounted1UsesFPGDiscounted
FPG Discount Percent300.000000000000FPGDiscountPercent
Explains Basis1ExplainsBasis
Income LevelXIncomeLevel
Asset LevelXAssetLevel
Medical IndigencyXMedicalIndigency
Medicaid MedicareXMedicaidMedicare
Other FactorsXOtherFactors
Explains Application Method1ExplainsApplicationMethod
Includes Publicity Measures1IncludesPublicityMeasures
Available On RequestXAvailableOnRequest
Actions On Nonpayment1ActionsOnNonpayment
Collection Activities0CollectionActivities
Nondiscrim Emergency Care Policy1NondiscrimEmergencyCarePolicy
Used Other MethodXUsedOtherMethod
Amounts Generally Billed1AmountsGenerallyBilled
Gross Charges0GrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities11NumberOfOtherFacilities

Other Facilities OtherFacilities (11 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
McDowell MRI
430 Rankin AvenueMarionNC28752Outpatient MRI - Imaging Services
McDowell Wound Care
31 East Medical Court Suite 2MarionNC28752Outpatient Wound Services
McDowell Orthopedics
60 Medical South CourtMarionNC28752Outpatient Orthopedic Services
McDowell Surgical Services
31 East Medical Court Suite 1MarionNC28752Outpatient Surgical Services
Health Plus of McDowell Hospital
472 Rankin AvenueMarionNC28752Primary Care Walk-in Clinic
McDowellOBGYN SugarHillPrimaryCare
1633 Sugar Hill RoadMarionNC28752Primary Care Services
Family Medicine - Nebo
339 Nebo School RoadNeboNC28761Primary Care Services
Family Medicine - Glendwood
5623 US Highway 221 SMarionNC28752Primary Care Services
McDowell Pediatrics
387 US 70 WestMarionNC28752Primary Care - Pediatrics
McDowell Pain Clinic
136 Creek View CourtMarionNC28752Primary Care Services
McDowell Outpatient Rehab Services
348 Grace Corpening DriveMarionNC28752Outpatient Rehabilitation Services

Form990 Schedule H Part VI Form990ScheduleHPartVI (13 entries)

ExplanationExplanationIdentifierIdentifierReturn ReferenceReturnReference
Part I, Line 7: McDowell used worksheets 1 through 8 provided by the IRS, using the cost to charge ratio method. For physician clinics, as described in subsidized health services, actual costs were used plus indirect costs calculated using the Medicare cost report because the cost to charge ratio did not accurately capture costs for those areas. The financials include all patient segments, including inpatient, outpatient, emergency room, private insurance, Medicaid, Medicare, uninsured, and self-pay. A cost to charge ratio was generated using the IRS Worksheet 2 and used for all community benefits reported except for subsidized services which used direct expenses plus overhead to more accurately report the costs involved. See note on subsidized health services.
Part II: Recruitment of physicians in underserved areas.
Part III, Line 4: McDowell Hospital does not disclose the cost of bad debt in the footnotes of the financials; however it reports the cost of bad debt as part of a report to the North Carolina Hospital Association's data initiative. The financial statements net bad debt against patient revenues to arrive at "Net Patient Revenue less Provision for bad Debts".
Part III, Line 8: Per the instructions, the Medicare cost report is the basis for calculating the costs using costs related to the revenue reported. Using the full costing method, there would be a shortfall estimated at $1,594,109 which would be a benefit to the community. This shortfall is a benefit to the community based upon the fact that prices were not raised to cover the shortfall.
Part III, Line 9b: Patients who qualify for financial assistance and other charity care are notified using the process described in the education of patients' eligibility in Part VI, on line 3.
Part V, Section B, Line 11h: In addition to the factors indicated on this form, the hospital has a Catastrophic Clause included in our policy which provides an additional reduction to patients whose portion of a bill, for which they are ultimately responsible (after all other discounts have been applied), exceeds $10,000. This policy applies not only to patients who qualify under our financial assistance policy, but also includes patients whose income exceeds 300% of the federal poverty guidelines.The McDowell Hospital, Inc.
Part V, Section B, Line 19d: Our policy in effect during the filing year did not specify how discounts were computed. However, in addition to discounts offered to patients qualifying under our financial assistance policy, the hospital provided additional discounts in cases of catastrophic events. See the narrative for Part V, Section B, Line 11h. Our current policy utilizes the lookback method in determining amounts generally billed to patients for emergency or other medically necessary care provided to patients under our financial assistance policy. This is computed annually and involves an averaging methodology (as provided by proposed Internal Revenue Regulations) of claims paid by both Medicare and all privately insured patients.The McDowell Hospital, Inc.
Part V, Section B, Line 20: Under our old policy that was in effect during the tax year, the majority of patients who were eligible for financial assistance received a greater discount than those with insurance. Our current policy now in effect provides more specific limiations, as described in the answer to question 19.The McDowell Hospital, Inc.
Part VI, Line 3: McDowell Hospital provides information to our patients regarding how they will be billed for patient care and about their eligibility for assistance under federal, state, or local government programs or under the organization's charity care policy in the following ways:During the registration process we verify insurance information on each patient. If there is no insurance, the patients are asked a series of questions to determine potential Medicaid eligibility. If the patient is determined to have potential eligibility the patient's account information is forwarded to our onsite DSS worker for further inquiries and possibly an appointment is scheduled to complete a Medicaid application.If the patient does not meet eligibility requirements, other options such as payment arrangements and/or financial assistance is discussed. At this time, the patient may be given a financial assistance application (Charity Care) to complete and return to the Business Office for processing. After the notifications and processes referenced above have been completed, standard debt collection policies are in effect for the portion of the bill for which the patient is responsible.In addition to going through this process verbally with our patients our internet web site includes the following information:About Your BillWe are here to help. If you have any questions or concerns about the statements you receive, please call us as soon as possible at 659-5000.InsuranceThe first step is to check with your insurance company before any inpatient or outpatient procedures to be sure that you have met their requirements, such as a referral from a primary care physician. Also be sure to ask your insurance provider about any deductibles or co-pays that may be your responsibility. McDowell Hospital will file a claim with your insurance company, but deductibles and co-pays must be paid at the time of service.UninsuredIf you do not have insurance then you must pay 'up front' at the time of the visit. However, please do not let this stop you from seeking the medical care you need. If you can't pay your bill due to lack of insurance or limited income, a Patient Representative is available to help you apply for financial assistance.Financial AssistanceOur process for determining financial assistance is kept strictly confidential and eligibility is determined on an individual basis. The steps for requesting financial assistance include:Call a Patient Representative at 659-5000Participate in a brief phone interview to determine eligibilityFinancial assistance application is mailed to you or we can schedule an appointment to discuss the application processYou will need to provide specific financial information.Decision about assistance is made once all paperwork is completeMcDowell Hospital determines eligibility for assistance by following the household income guidelines established by the U.S. Department of Health and Human Services. After we review your assistance application, we may determine that you qualify for a discount, Medicaid benefits, or other state assistance available to North Carolina residents.MedicaidIf you have Medicaid, be sure to bring your card with you each time you visit the hospital for any medical services. Medicaid may require you to be referred by your primary care doctor and they may not cover certain services. The best way to be sure is to call your case worker at the Department of Social Services.Medicare PatientsPlease be aware that we are required by law to ask certain questions about your retirement and insurance coverage every time you receive services at McDowell Hospital. We send a claim to your supplemental insurance company before submitting a bill to Medicare. You are responsible for any part of your bill that's not covered by supplemental insurance and Medicare.Contact InformationIf you have any questions, you can send them through our online form, or feel free to call 828-659-5000.If you need help outside of normal business hours, please leave a message in the business office and a patient representative will return your call.
Part VI, Line 4: McDowell Hospital is the only hospital in McDowell County, providing services to a community of over 45,000 members. Our Mission is to serve the healthcare needs of our community, giving comprehensive, cost-effective quality care without regard to race, color, creed or ability to pay. We provide quality care to the community of McDowell County, including the City of Marion, as well as the surrounding communities of Old Fort, Glenwood, Little Switzerland, Nebo, Pleasant Gardens, and North Cove. The ethnic breakdown for the population served includes Caucasian, Hispanic, African American, Asian/Other. Over the year, our community has seen great economic challenges with unemployment hovering over 11%. The NC Department of Commerce ranks each county in NC based on economic well-being and assign each "Tier" designation. The 40 Most distressed counties are designated as Tier 1. McDowell County is considered a Tier 1 county. The economic situation in McDowell County has created increased demand for charitable healthcare at TMH. The uninsured and underserved residents of McDowell County are able to utilize the Hospital's Emergency Department and multiple Rural Health Clinics throughout the county to obtain Healthcare services.
Part VI, Line 5: See Program Service Accomplishments on page 2 of 990.
Part VI, Line 6: The McDowell Hospital is part of an affiliated health care system with the respective roles of the organization and its affiliates described bellow in promiting the health of the communities served.Mission Health System, Inc. is the parent organization for the charitable organizations of Mission Hospital, Inc.; Mission Healthcare Foundation, Inc.; Mission Medical Associates, Inc; Blue Ridge Regional Hospital, Inc.; and The McDowell Hospital, Inc.Mission Hospital, Inc. is a regional integrated health system providing superior care and service to patients and their families through a full continuum of integrated services, education, and research. It serves as a trauma center to people of Western North Carolina and the surrounding counties. Mission Medical Associates mission is to provide physician services in predominantly rural areas that are insufficiently served, thereby improving the health care of the general public. In many cases this involves recruiting and placing primary care physicians, as well as pediatric and adult specialty services close to where people live and work.Blue Ridge Regional Hospital serves as a community hospital in Mitchell, Yancey and surrounding counties.The McDowell Hospital serves as a community hospital in McDowell and the surrounding counties.Mission Healthcare Foundation, Inc. supports the mission and programs of Mission Hospital, Inc. and Mission Health System, Inc. and of other organizations that are tax exempt under the provisions of Section 501(c)(3) of the Internal Revenue Code and works to benefit the community and region served by the entities listed above.
NCReports Filed With StatesPart VI, Line 7

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment1SeverancePayment
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 (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
Keith Holtsclaw
0173417053859061020532905233024394000
Robert A Morrow MD
26572600021981044420237070315856000
John Maher
0259839000261000020785028323400
George Green MD
326496000150049690152810346896000
Sonya Greck
276800000000000276800000
Tommy Ginn MD
26663000014696035490195690304444000
Andrea Moore MD
2452060008091000195690272866000
John Rowland MD
168644000493801625073710182578000
Leigh Meeks MD
1581980005868032560188170186139000
William J Horan MD
26264600013454000128420288942000
Ed Hannon
9454200011372708917000217186000

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
Return ReferencePart I, Line 4aReturnReference
ExplanationEd Hannon 113,075Explanation

Schedule L IRS990ScheduleL

Loan Table LoanTable

FieldValueIRS element (for citing)
Name PersonAndrea Moore MDNamePerson
Purpose Of LoanRecruitment GuaranteePurposeOfLoan
Loan From OrganizationXLoanFromOrganization
Original Principal$27,513OriginalPrincipalAmount
Balance Due4204BalanceDue
Default0Default
Approved By Board1ApprovedByBoard
Written Agreement1WrittenAgreement
FieldValueIRS element (for citing)
Total Balance Due4204TotalBalanceDue

Schedule M IRS990ScheduleM

Other Non Cash Contributions Table OtherNonCashContributionsTable

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
DescriptionEquipmentDescription
Number Of Contributions1NumberOfContributions
Noncash Contribs Rptd F990447430NoncashContribsRptdF990
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 (9 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
Form 990, Part VI, Section A, line 3Sonya Greck, an independent contractor, served as interim Chief Executive Officer from October 2011 through February 2012.
Form 990, Part VI, Section A, line 6Mission Health System, Inc, a 501(c)(3) is the parent company of The McDowell Hospital. It is the sole member of The McDowell Hospital.
Form 990, Part VI, Section A, line 7aMission Health System, as sole member, has sole voting control of The McDowell Hospital, Incorporated. As the sole member of the corporation, Mission shall have the following rights at all times with respect to the corporation: Approval of any amendments to the articles of incorporation or bylaws of the corporation. Approval of the mission, vision and values statements of the corporation and any amendments thereto. Election and removal of three (3) Mission members of the Board of Directors and approval of the Community Directors selected and submitted to Mission for approval by its Board of Directors. Approval of the election of the President/Chief Executive Officer, provided however, that said approval shall not be unreasonably withheld.
Form 990, Part VI, Section A, line 7bMission Health System, Inc has reserve powers related to approval of the sale, lease or other transfer of substantially all the assets of McDowell. Approval of (i) the pledge of all or substantially all of the assets of the corporation, (ii) the purchase or sale of property outside the ordinary course of business, and (iii) long-term borrowing (for a term of more than one (1) year) by the corporation above financial and other limits reasonably recommended by MISSION for the corporation's Board approval unless such borrowing is applied to pay in full all indebtedness owed by the corporation to Mission. Election and removal of three (3) Mission members of the Board of Directors and approval of the Community Directors selected and submitted to Mission for approval by its Board of Directors. Approval of the formation and governance of any new corporations, partnerships or joint ventures, above financial and other limits approved by Mission for the corporation's Board approval, in which the corporation has an interest through membership, voting stock or other equity participation. Approval of the capital and operating budgets of the corporation. Approval of the election of the President/Chief Executive Officer, provided however, that said approval shall not be unreasonably withheld.
Form 990, Part VI, Section B, line 11The organization provides data to the treasury analyst of tax services for Mission Health System, Inc. The 990 is prepared and reveiwed by management then reviewed by an independent accounting firm prior to review by The McDowell Hospital finance committee. After review by the board, and revisions for any clarifications or corrections, the full copy of the 990 is provided to the board prior to filing the 990.
Form 990, Part VI, Section B, line 12cThe Independent Directors will review Conflicts of Interest and Disabling Situations, consider any issues involving conflicts and make determinations as to whether a particular relationship or arrangement would disable an individual from serving as a fiduciary for the Board or would reasonably be expected to exert an influence on the individual's judgment and therefore preclude the individual from being an Independent Director. The Board may retain counsel from outside audit, legal, governance or other experts. Any determination of percent of revenue or income received by an individual or entity may be based on certifications from outside auditors of disclosures made directly by the individual to the audit firm. Procedures Upon Determination of a Conflict of Interest: The Interested Person shall not participate in any discussion or vote regarding the business relationship issue, and shall not be present in the meeting room for any part of the discussion or vote relating to the business relationship issue. The Board of Directors will discuss the business relationship but will not formally approve such business relationship unless the disinterested members of the Board have decided by majority vote that the business relationship is in the best interests of and for the benefit of McDowell, and is fair and reasonable thereto in all respects.
Form 990, Part VI, Section B, line 15Each year the Board reviews the overall philosophy and policy used to guide the determination of executive compensation. Executive compensation decisions are made within the parameters of the overall philosophy and policy approved by the Board, with support from outside executive compensation consultants to ensure compensation levels are at fair market value. The board approves contracts, compensation, and business transactions with Disqualified Persons other than executives. The Board also has the following responsibilities: Conducting a periodic review of executive compensation philosophy and policies and practices. Determining which positions are eligible for the executive compensation plan. Establishing and approving the salary parameters for the CEO, others eligible under the executive compensation plan, and employees who are Disqualified Persons. Establishing and approving the terms of all incentives, benefits or programs included in the executive compensation plan. Reviewing and approving all employment contracts for the CEO and all others eligible under the executive compensation plan, and recommending amendments or termination of these arrangements. Reviewing the performance and determining the compensation of the CEO and others defined as eligible under the executive compensation plan based on the achievement of shared and personal goals. Sole responsibility to retain qualified compensation and benefits consultants and other professional advisors as the need may arise, and to terminate their contracts. Conferring with members of management to assist the Board in performing its duties, so long as their role remains technical in nature.
Form 990, Part VI, Section C, line 19The McDowell Hospital makes its governing documents, conflict of interest policy available to the public upon request. The financial statements are attached to this form 990 or are available upon request.
Form 990, Part XI, line 5:Transfer from Mission Health System 7,000,000. Total to Form 990, Part XI, Line 5: 7,000,000.Changes in Net Assets or Fund Balances:

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (6 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
Mission Hospital Inc
509 Biltmore AvenueAshevilleNC28801560532141Acute Care HospitalNC501(c)(3)Line 3Mission Health System Inc0
Mission Healthcare Foundation Inc
980 Hendersonville RoadAshevilleNC28803561881331FoundationNC501(c)(3)Line 7Mission Health System Inc0
Mission Health System Inc
509 Biltmore AvenueAshevilleNC28803581450888Parent Company/Support ServicesNC501(c)(3)Line 11a, I0
Mission Medical Associates Inc
213 Ridgefield CourtAshevilleNC28806263627231Employed Physician GroupNC501(c)(3)Line 9Mission Health System Inc0
Blue Ridge Regional Hospital
Post Office Box 9Spruce PineNC28777561025032Community HospitalNC501(c)(3)Line 3Mission Health System Inc0
Blue Ridge Regional Hospital Foundation
PO Box 247Spruce PineNC28777582172660FoundationNC501(c)(3)Line 7Mission Health System Inc0

Form990 Schedule R Part III Form990ScheduleRPartIII (5 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
Imaging Realty LLP
534 Biltmore AvenueAshevilleNC28801561907203Medical BuildingNCN/A
MSJHS and CCP Joint Development Company LLC
428 Biltmore AvenueAshevilleNC28801562250464Long Term Acute Care HospitalNCN/A
McDowell MRI LLC
414 Rankin AvenueMarionNC28752753046378Medical ImagingNCRelated20632188059010.51000
Blue Ridge DME LLC
125 Hospital DriveSpruce PineNC28777263570174Home Medical Equipment & Supplies SalesNCN/A
Asheville Imaging LLP
534 Biltmore AvenueAshevilleNC28801561907201Outpatient ServicesNCN/A

Form990 Schedule R Part IV Form990ScheduleRPartIV (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateDirect Controlling Entity NADirectControllingEntityNAType Of EntityTypeOfEntityAddress Line1AddressForeign/AddressLine1CountryAddressForeign/CountryLegal Domicile Foreign CountryLegalDomicileForeignCountry
Horizon Health Corp
213 Ridgefield CourtAshevilleNC28806561341621Holding CompanyNCN/AC
Horizon Management Services
213 Ridgefield CourtAshevilleNC28806561341624Patient Billing and Collection Services, Medical PropertyNCN/AC
Dogwood Insurance Company Ltd
Captive Insurance EntityN/ACThe Grant Pavilion Commercial CentrCJCJ
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other 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 Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs1PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (2 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
McDowell MRI
I64219FMV
McDowell MRI
K212158FMV

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