HARNETT HEALTH SYSTEM FOUNDATION: Form 990EZ, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
HARNETT HEALTH SYSTEM FOUNDATION (EIN 20-1929953)
Tax period
2010-10-01 to 2011-09-30
Filed
2012-08-01
IRS object ID
201202149349200410
Schema version
2010v3.4
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)
Timestamp2012-08-01T09:30:36-05:00Timestamp
Tax Period End Date2011-09-30TaxPeriodEndDate

Preparer Firm PreparerFirm

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 Type990EZReturnType
Tax Period Begin Date2010-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN201929953EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1BETSY JOHNSON REGIONAL HOSPITAL FOUNDATIONBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlBETSNameControl
Phone9108911000Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1800 TILGHMAN DRIVEAddressLine1
CityDUNNCity
StateNCState
ZIP Code28334ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameTC GODWINName
TitleCHAIRMANTitle
Phone9108911000Phone
Date Signed2012-08-01DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameAMY BIBBYName
Phone8282542254Phone
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990-EZ IRS990EZ

FieldValueIRS element (for citing)
Method Of Accounting CashXMethodOfAccountingCash
Web SiteWWW.BJRH.ORG/FOUNDATIONWebSite
Organization501c3XOrganization501c3
Gross Receipts134433GrossReceipts
Info In Schedule O Part IXInfoInScheduleOPartI
Contributions Gifts Grants Etc125776ContributionsGiftsGrantsEtc
Investment Income217InvestmentIncome
Fundraising Gross Income8440FundraisingGrossIncome
Special Events Direct Expenses8440SpecialEventsDirectExpenses
Special Events Net Income Loss0SpecialEventsNetIncomeLoss
Total Revenue125993TotalRevenue
Grants And Similar Amounts Paid152470GrantsAndSimilarAmountsPaid
Other Expenses Total568OtherExpensesTotal
Total Expenses153038TotalExpenses
Excess Or Deficit For Year-27045ExcessOrDeficitForYear
Net Assets Or Fund Balances BOY386545NetAssetsOrFundBalancesBOY
Other Changes In Net Assets0OtherChangesInNetAssets
Net Assets Or Fund Balances EOY359500NetAssetsOrFundBalancesEOY

Cash Savings And Investments CashSavingsAndInvestments

FieldValueIRS element (for citing)
BOY386545BOY
EOY359500EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY386545BOY
EOY359500EOY

Sum Of Total Liabilities SumOfTotalLiabilities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Net Assets Or Fund Balances NetAssetsOrFundBalances

FieldValueIRS element (for citing)
BOY386545BOY
EOY359500EOY
FieldValueIRS element (for citing)
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Primary Exempt PurposeTHE FOUNDATION'S PURPOSE IS TO SUPPLEMENT, ENHANCE, AND ENRICH THE FACILITIES, PROGRAMS, AND SERVICES PROVIDED BY HARNETT HEALTH SYSTEM, INC. THE FOUNDATION'S GOAL IS TO SUPPORT THE HOSPITAL'S EFFORTS IN ENHANCING SERVICES AND PROGRAMS IN AN ATTEMPT TO ALLOW MORE PATIENTS THE OPPORTUNITY TO REMAIN CLOSE TO HOME WHERE THEY CAN BE NEAR LOVED ONES DURING THIS CRITICAL TIME.PrimaryExemptPurpose

Program Service Accomplishment ProgramServiceAccomplishment

FieldValueIRS element (for citing)
Description Program Service AccomBETSY JOHNSON REGIONAL HOSPITAL FOUNDATION IS COMMITTED TO IMPROVING THE HEALTH AND COMFORT OF THE PEOPLE IN THE COMMUNITIES THAT WE SERVE BY MAKING POSSIBLE NEEDED DEVELOPMENT IN OUR FACILITIES AS WELL AS PROVIDING STATE-OF-THE-ART EQUIPMENT. THE CONTRIBUTIONS BELOW FOLLOW THEIR MISSION STATEMENT ABOVE:(DIRECT CONTRIBUTIONS TO HARNETT HEALTH SYSTEM)DIGITAL MAMMOGRAPHY $ 50,000GAMMA FINDER PROBE GENUINE SLEEVES $ 25,370MEDICAL MANAGEMENT PROGRAM $ 2,500BREAST NAVIGATION $ 7,500(OTHER SUPPORT)CANCER CENTER MEALS $ 12,669 CANCER PATIENT ASSISTANCE PROGRAM $ 10,607SCHOLARSHIPS $ 12,533DescriptionProgramServiceAccom
Grants And Allocations152470GrantsAndAllocations
Program Service Expenses153038ProgramServiceExpenses
FieldValueIRS element (for citing)
Total Program Service Expenses153038TotalProgramServiceExpenses
Info In Schedule O Part IVXInfoInScheduleOPartIV

Officer Director Trustee Key Empl OfficerDirectorTrusteeKeyEmpl (12 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeTitleTitleAvg Hours Per Wk Devoted To PositionAvgHoursPerWkDevotedToPositionCompensationCompensationContri To Empl Benefit Plans EtcContriToEmplBenefitPlansEtcExpense Account Other AllowancesExpenseAccountOtherAllowances
TC GODWIN
800 TILGHMAN DRIVEDUNNNC28334CHAIRMAN2.00000
ABE ELMORE
800 TILGHMAN DRIVEDUNNNC28334VICE CHAIRMAN1.00000
PAULA POPE
800 TILGHMAN DRIVEDUNNNC28334SECRETARY5.30000
SHARON STEVENS
800 TILGHMAN DRIVEDUNNNC28334TREASURER1.30000
CHARLIE CARPENTER
800 TILGHMAN DRIVEDUNNNC28334BOARD MEMBER1.00000
JANE REGISTER
800 TILGHMAN DRIVEDUNNNC28334BOARD MEMBER1.40000
JEFFREY SURLES
800 TILGHMAN DRIVEDUNNNC28334BOARD MEMBER1.40000
MIKE BLACKMON
800 TILGHMAN DRIVEDUNNNC28334BOARD MEMBER1.00000
GINGER BARBOUR
800 TILGHMAN DRIVEDUNNNC28334BOARD MEMBER1.00000
PAT MARSHALL
800 TILGHMAN DRIVEDUNNNC28334BOARD MEMBER1.00000
BILLY TART
800 TILGHMAN DRIVEDUNNNC28334BOARD MEMBER1.00000
TOWNSEND QUINN
800 TILGHMAN DRIVEDUNNNC28334BOARD MEMBER1.00000
FieldValueIRS element (for citing)
Info In Schedule O Part VXInfoInScheduleOPartV
Activities Not Previously Rpt0ActivitiesNotPreviouslyRpt
Made Changes To Orgnzng Etc Doc0MadeChangesToOrgnzngEtcDoc
Organization Had UBI0OrganizationHadUBI
Organization Dissolved Etc0OrganizationDissolvedEtc
Direct Indirect Political Expend0DirectIndirectPoliticalExpend
Made Loans To From Officers0MadeLoansToFromOfficers
Tax Imposed Under IRC49110TaxImposedUnderIRC4911
Tax Imposed Under IRC49120TaxImposedUnderIRC4912
Tax Imposed Under IRC49550TaxImposedUnderIRC4955
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTrans
Amount Of Tax Imposed On Org Mgr0AmountOfTaxImposedOnOrgMgr
Amount Of Tax Reimbursed By Org0AmountOfTaxReimbursedByOrg
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1DEBORAH WHITTINGTONBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1800 TILGHAM DRIVEAddressLine1
CityDUNNCity
StateNCState
ZIP Code28344ZIPCode
FieldValueIRS element (for citing)
Telephone Number9108911000TelephoneNumber
FieldValueIRS element (for citing)
Foreign Financial Account0ForeignFinancialAccount
Foreign Office0ForeignOffice
Maintain Any Donor Advised Funds0MaintainAnyDonorAdvisedFunds
Does Org Have Hospital0DoesOrgHaveHospital
Tanning Services Provided0TanningServicesProvided
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction With Control Entity0TransactionWithControlEntity
Engage Political Cmpgn Activities0EngagePoliticalCmpgnActivities
Engage In Lobbying Activities0EngageInLobbyingActivities
Operating School0OperatingSchool
Trnsfrs Exempt Non Char Related Org0TrnsfrsExemptNonCharRelatedOrg
Part VI Of Comp Of Highest Paid EmplNONEPartVIOfCompOfHighestPaidEmpl
Part VIA Hghst Paid Cntrct Prof SerNONEPartVIAHghstPaidCntrctProfSer
Filed Schedule A1FiledScheduleA

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org170b1 AviXPubliclySupportedOrg170b1Avi

Gifts Grants Contrib Received170 GiftsGrantsContribReceived170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years323882CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years68260CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years126001CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year290872CurrentTaxYearMinus1Year
Current Tax Year125776CurrentTaxYear
Total934791Total

Total170 Total170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years323882CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years68260CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years126001CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year290872CurrentTaxYearMinus1Year
Current Tax Year125776CurrentTaxYear
Total934791Total
FieldValueIRS element (for citing)
Amounts Subst Contributors Total23254AmountsSubstContributorsTotal
Public Support Total170911537PublicSupportTotal170

Gross Investment Income170 GrossInvestmentIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years1273CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years1654CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years1185CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year412CurrentTaxYearMinus1Year
Current Tax Year217CurrentTaxYear
Total4741Total
FieldValueIRS element (for citing)
Total Support939532TotalSupport
Gross Receipts From Admissions Etc97563GrossReceiptsFromAdmissionsEtc
Public Support Pertcentage1700.97020PublicSupportPertcentage170
Public Support Pertcent Prior Year0.97490PublicSupportPertcentPriorYear
Thirty Three Percnt Tests CY170XThirtyThreePercntTestsCY170

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 G IRS990ScheduleG

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1GOLF TOURNAMENT/GALANameOfEvent1
Gross Receipts Event1129791GrossReceiptsEvent1
Charitable Contributions Event1121351CharitableContributionsEvent1
Gross Revenue Event18440GrossRevenueEvent1
Rent Facility Costs Event13500RentFacilityCostsEvent1
Other Direct Expenses Event14940OtherDirectExpensesEvent1
Gross Receipts Total129791GrossReceiptsTotal
Charitable Contributions Total121351CharitableContributionsTotal
Gross Revenue Total Events8440GrossRevenueTotalEvents
Rent Facility Costs Total Events3500RentFacilityCostsTotalEvents
Other Direct Expenses Total Events4940OtherDirectExpensesTotalEvents
Direct Expense Summary Events8440DirectExpenseSummaryEvents
Net Income Summary0NetIncomeSummary

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (3 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
OTHER INVESTMENT INCOMEFORM 990-EZ, PART I, LINE 4INTEREST 217..
GRANTS AND SIMILAR AMOUNTS PAIDFORM 990-EZ, PART I, LINE 10ACTIVITY CLASSIFICATION: ASSET ACQUISITION SUPPORT (SEE PART III, LINE 28 FOR DETAILS) . GRANTEE NAME: HARNETT HEALTH SYSTEM, INC.. GRANTEE ADDRESS: 800 TILGHMAN DRIVE DUNN, NC 28334. GRANTEE RELATIONSHIP: RELATED ORGANIZATION. PROPERTY DESCRIPTION: CASH. AMOUNT GIVEN: 85,370.
OTHER EXPENSESFORM 990-EZ, PART I, LINE 16DESCRIPTION: BANK FEES. AMOUNT: 568.

Transfer Prsnl Bnft Contracts Decl TransferPrsnlBnftContractsDecl

FieldValueIRS element (for citing)
DeclarationTHE ORGANIZATION DID NOT, DURING THE YEAR, RECEIVE ANY FUNDS, DIRECTLY,OR INDIRECTLY, TO PAY PREMIUMS ON A PERSONAL BENEFIT CONTRACT.THE ORGANIZATION, DID NOT, DURING THE YEAR, PAY ANY PREMIUMS, DIRECTLY,OR INDIRECTLY, ON A PERSONAL BENEFIT CONTRACT.Declaration

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