EAST CAROLINA HEALTH: Form 990, tax year 2010
View the entire original 990 at ProPublica ↗
- Organization
- EAST CAROLINA HEALTH (EIN 56-0989789)
- Tax period
- 2010-10-01 to 2011-09-30
- Filed
- 2012-03-07
- IRS object ID
- 201210679349300416
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-03-07T08:52:33-06:00 | Timestamp |
| Tax Period End Date | 2011-09-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DIXON HUGHES GOODMAN LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 500 RIDGEFIELD COURT | AddressLine1 |
| City | ASHEVILLE | City |
| State | NC | State |
| ZIP Code | 28806 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2010-10-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 560989789 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HALIFAX REGIONAL MEDICAL CENTER INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | HALI | NameControl |
| Phone | 2525358011 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 250 SMITH CHURCH ROAD | AddressLine1 |
| City | ROANOKE RAPIDS | City |
| State | NC | State |
| ZIP Code | 27870 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | SHERRY JENSEN | Name |
| Title | CFO | Title |
| Phone | 2525358011 | Phone |
| Date Signed | 2012-03-07 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | AMY BIBBY | Name |
| Phone | 8282542254 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2010 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | WILL MAHONE | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 250 SMITH CHURCH ROAD | AddressLine1 |
| City | ROANOKE RAPIDS | City |
| State | NC | State |
| ZIP Code | 27870 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 104438739 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.HALIFAXMEDICALCENTER.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1972 | YearFormation |
| State Legal Domicile | NC | StateLegalDomicile |
| Activity Or Mission Description | TO PROVIDE MEDICAL SERVICES TO THE RESIDENTS OF HALIFAX COUNTY AND SURROUNDING COUNTIES. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 15 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 12 | NbrIndependentVotingMembers |
| Total Nbr Employees | 969 | TotalNbrEmployees |
| Total Nbr Volunteers | 110 | TotalNbrVolunteers |
| Total Gross UBI | 258294 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | -41442 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 138124 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 431163 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 100452858 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 102548054 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 379341 | InvestmentIncomePriorYear |
| Investment Income Current Year | 670004 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 709529 | OtherRevenuePriorYear |
| Other Revenue Current Year | 698525 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 101679852 | TotalRevenuePriorYear |
| Total Revenue Current Year | 104347746 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 41804281 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 42600232 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 55035846 | OtherExpensePriorYear |
| Other Expenses Current Year | 58456445 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 96840127 | TotalExpensesPriorYear |
| Total Expenses Current Year | 101056677 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 4839725 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 3291069 | RevenuesLessExpensesCY |
| Total Assets BOY | 74579254 | TotalAssetsBOY |
| Total Assets EOY | 81164352 | TotalAssetsEOY |
| Total Liabilities BOY | 35056228 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 42443699 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 39523026 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 38720653 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | PLACING PATIENTS FIRST BY PROVIDING EXCELLENT AND COMPASSIONATE HEALTHCARE SERVICES. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 94938263 | Expense |
| Revenue | 102289760 | Revenue |
| Description | PROVIDING QUALITY HEALTHCARE IS ONLY PART OF THE HOSPITAL'S CONTRIBUTION TO THE COMMUNITY. WITH OVER 1,000 EMPLOYEES, HALIFAX REGIONAL IS ONE OF THE REGION'S LARGEST EMPLOYERS. MANY OF THE APPROXIMATELY 60 PHYSICIANS ON THE HOSPITAL STAFF HIRE THEIR OWN EMPLOYEES AS WELL AND INVEST IN DEVELOPING THEIR PRACTICES, EXTENDING ECONOMIC IMPACT. THE MEDICAL CENTER PURCHASES MILLIONS OF DOLLARS OF GOODS AND SERVICES FROM THE REGION.WITH ITS ABUNDANT NATURAL RESOURCES AND STRATEGIC LOCATION, THE HOSPITAL'S MARKET IS DYNAMIC AND OFFERS EXCITING OPPORTUNITIES. AT HALIFAX REGIONAL, THE STAFF IS COMMITTED TO GROWING TO MEET THE EVOLVING HEALTHCARE NEEDS OF THE WONDERFUL PEOPLE WHO MAKE ITS REGION SPECIAL.SIGNIFICANT ACCOMPLISHMENTS INCLUDE: - TRANSITIONED TO A NEW MEDICAL DIRECTOR OF WOODSIDE WITH DR. MAMEDI, DR. SEKARAN BECAME THE DIRECTOR OF THE SLEEP LAB. - PLANNED AND OBTAINED FINANCING FOR THE OUTPATIENT, REGISTRATION, AND SURGERY PHASE I CONSTRUCTION AND RENOVATION PROJECT. - IMPLEMENTED MASTER FACILITY PLAN WITH GROUNDBREAKING OF OUTPATIENT, REGISTRATION, AND SURGERY PHASE I CONSTRUCTION AND RENOVATION PROJECT. - RECRUITED THREE PHYSICIAN PRACTICE MANAGEMENT SEMINARS FOR LOCAL PHYSICIANS STAFF. - REDUCED ENVIRONMENTAL SERVICES TURNAROUND TIME FOR CLEANING AN INPATIENT ROOM FROM AN AVERAGE OF 3.5 HOURS TO 60 MINUTES. - RECEIVED FIRST TIME ACCREDITATION OF OUR DIABETES PROGRAM THROUGH AMERICAN ASSOCIATION OF DIABETES EDUCATORS.IMPLEMENTED ELECTRONIC MEDICAL RECORD PROCESS IN THE EMERGENCY CARE CENTER. - REPLACED 200 OF OUR 600 PC'S AND LAPTOPS TO MAINTAIN CURRENT TECHNOLOGY. - EMPLOYEE CAMPAIGNS RAISED OVER $149,000 FOR THE UNITED WAY AND THE HALIFAX REGIONAL FOUNDATION. - COMPLETED SLEEP LAB RENOVATIONS AND EXPANDED TO SIX DAYS PER WEEK WITH NEW REGISTERED SLEEP LAB TECH. - COMPLETED PHASE I OF GI LAB RENOVATIONS. COMPLETED RENOVATION OF MEDICAL CENTER CHAPEL BY VOLUNTEERS. - CREDENTIALED ALL CARDIOLOGY ULTRASOUND STAFF. - THE MEDICAL CENTER AWARDED $47,000 IN TUITION REIMBURSEMENT. - INCREASED USE OF OBSERVATION STATUS OR OUR PATIENTS TO PREVENT READMISSIONS. - IMPLEMENTED JOINT VENTURE WITH RURAL HEALTH GROUP (RHG) FOR MEDICAL CENTER SCHEDULING STAFF TO PLAN FOLLOW UP APPOINTMENTS FOR RHG PATIENTS. - OPENED RENOVATED AREA IN ECC FOR BEHAVIORAL HEALTH PATIENTS TO INCREASE OVERALL CAPACITY. - EXPANDED THE USE OF AUTOMATED DISPENSING UNITES FOR PHARMACY IN AMBULATORY CARE UNIT, RADIOLOGY, AND POST ANESTHESIA CARE UNIT. - CREATED NEW PHARMACY TECHNICIAN POSITION IN SURGERY DEPARTMENT TO ASSIST NURSING AND ANESTHESIA STAFF. - INSTALLED UPFRONT INSURANCE VERIFICATION SOFTWARE TO IDENTIFY INSURANCE AND DEDUCTIONS FOR PATIENTS AND INCREASE CASH COLLECTIONS AND INSTALLED NEW SOFTWARE TO IDENTIFY PATIENT'S FINANCIAL STATUS TO QUALITY FOR CHARITY CARE STATUS. - CREATED NEW POSITIONS OF CLINICAL NURSE AUDITOR AND ACCESS NURSE TO IDENTIFY UTILIZATION STATUS OF PATIENTS AND INCREASE USE OF OBSERVATION STATUS AND DECREASE READMISSIONS. - HEALTHLINK DEVELOPMENT OF TWO NEW COMMUNITY SUPPORT GROUPS FOR CHILDHOOD OBESITY AND BARIATRIC SUPPORT. - LAUNCHED NEW PROCESS IMPROVEMENT PROJECT CALLED THE "PARTNERS PROJECT" UTILIZING FRONTLINE STAFF AND MANAGERS IN 7 WEEKLY TEAMS TO IMPROVE PATIENT FLOW AND PATIENT EXPERIENCE. | Description |
| Total Program Service Expense | 94938263 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 1 | LobbyingActivities |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 1 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 1 | FinancialStmtAttached |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 1 | TaxExemptBonds |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBonds |
| Escrow Account | 0 | EscrowAccount |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 1 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transaction Related Entity | 1 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 87 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 969 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 1 | UnrelatedBusinessIncome |
| Form990-T Filed | 1 | Form990-TFiled |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 15 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 12 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | NC | StatesWhereCopyOfReturnIsFiled |
| Other Website | X | OtherWebsite |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SHERRY JENSEN | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 2525358005 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 250 SMITH CHURCH ROAD | AddressLine1 |
| City | ROANOKE RAPIDS | City |
| State | NC | State |
| ZIP Code | 27870 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (23 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| VERNON BRYANT | ||||||||
| CHAIRMAN | 1.00 | X | X | 1100 | 0 | 0 | ||
| BOB PATTERSON | ||||||||
| VICE CHAIR | 1.00 | X | X | 1000 | 0 | 0 | ||
| TOM LYNCH | ||||||||
| TREASURER | 1.00 | X | X | 1050 | 0 | 0 | ||
| JAMES PIERCE | ||||||||
| SECRETARY | 1.00 | X | X | 800 | 0 | 0 | ||
| JOHNNY DRAPER | ||||||||
| PAST CHAIR | 1.00 | X | 1100 | 0 | 0 | |||
| DR NATARAJAN RAJAN | ||||||||
| CHIEF OF STAFF | 1.00 | X | 0 | 0 | 0 | |||
| DR GERARDO MARADIAGA | ||||||||
| PAST CHIEF OF STAFF | 1.00 | X | 100 | 0 | 0 | |||
| ERNEST L BARNER | ||||||||
| BOARD MEMBER | 1.00 | X | 700 | 0 | 0 | |||
| DREWERY BEALE | ||||||||
| BOARD MEMBER | 1.00 | X | 900 | 0 | 0 | |||
| WILLIAM HODGE | ||||||||
| BOARD MEMBER | 1.00 | X | 1100 | 0 | 0 | |||
| REV JOHN W SMITH | ||||||||
| BOARD MEMBER | 1.00 | X | 250 | 0 | 0 | |||
| EVELYN DAWSON | ||||||||
| BOARD MEMBER | 1.00 | X | 550 | 0 | 0 | |||
| FANNIE GREEN | ||||||||
| BOARD MEMBER | 1.00 | X | 600 | 0 | 0 | |||
| J HUGH BAZEMORE | ||||||||
| BOARD MEMBER | 1.00 | X | 1100 | 0 | 0 | |||
| WILL MAHONE | ||||||||
| PRESIDENT / CEO | 40.00 | X | X | 327913 | 0 | 67358 | ||
| SHERRY JENSEN | ||||||||
| VP FINANCE / CFO | 40.00 | X | 217152 | 0 | 30925 | |||
| KAREN DANIELS | ||||||||
| VP NURSING / CNO | 40.00 | 181182 | 0 | 31034 | X | |||
| MICHAEL ADCOCK | ||||||||
| VP (UNTIL 07/11) | 40.00 | 171067 | 0 | 37189 | X | |||
| STEVEN HILL | ||||||||
| CRNA | 40.00 | 218514 | 0 | 37100 | X | |||
| KENNETH HARTZ | ||||||||
| CRNA | 40.00 | 196086 | 0 | 42924 | X | |||
| CLAUDE DEITTRICH | ||||||||
| CRNA | 40.00 | 194194 | 0 | 21033 | X | |||
| STEVEN ULSAS | ||||||||
| CRNA | 40.00 | 196854 | 0 | 3661 | X | |||
| JOHN CAMPBELL | ||||||||
| CRNA | 40.00 | 185905 | 0 | 41802 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1899217 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 313026 | TotalOtherCompensation |
| Number Individuals GT100 K | 28 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| HALIFAX EMERGENCY GROUP | |||||
| 9820 DEPRAM RD | ZEBULON | NC | 27597 | ED PHYSICIAN SERVICES | 3927764 |
| THEREX INC | |||||
| DEPT AT 952740 | ATLANTA | GA | 31192 | PT CONTRACT SERVICES | 1419407 |
| COMP HEALTH INC | |||||
| 6440 MILLROCK DR | SALT LAKE CITY | UT | 84121 | CONTRACT NURSING | 565977 |
| SOUTHEAST ACUTE CARE | |||||
| PO BOX 565 | STATEBORO | GA | 30419 | DIALYSIS SERVICES | 329150 |
| DIVERSIFIED CLINICAL SERVICES | |||||
| 4500 SALISBURY RD | JACKSONVILLE | FL | 32216 | CONTRACT MEDICAL SERVICE | 121232 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 6 | NumberOfContractorsGT100K |
| Related Organizations | 43558 | RelatedOrganizations |
| All Other Contributions | 387605 | AllOtherContributions |
| Total Contributions | 431163 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (4 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue |
|---|---|---|---|---|
| NET PATIENT SERVICE RE | 541380 | 101711004 | 101711004 | |
| OTHER PATIENT SERVICES | 900099 | 516244 | 258310 | 257934 |
| PURCHASE DISCOUNTS | 541900 | 307752 | 307392 | 360 |
| PHARMACY | 446110 | 13054 | 13054 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 102548054 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 664285 | TotalRevenueColumn |
| Exclusion | $664,285 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 58866 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 90768 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -31902 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -31902 | TotalRevenueColumn |
| Exclusion | -$31,902 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 5944 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 225 | Securities |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -225 | Securities |
| Other | 5944 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 5719 | TotalRevenueColumn |
| Exclusion | $5,719 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount |
|---|---|---|---|
| FOOD/VENDING REVENUE | 900099 | 552374 | $552,374 |
| COFFEE SHOP | 453000 | 178053 | $178,053 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 730427 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 104347746 | TotalRevenueColumn |
| Related Or Exempt Function Income | 102289760 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 258294 | UnrelatedBusinessRevenue |
| Exclusion | $1,368,529 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 961179 | Total |
| Program Services | 485765 | ProgramServices |
| Management And General | 475414 | ManagementAndGeneral |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 64060 | Total |
| Program Services | 64060 | ProgramServices |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 33433403 | Total |
| Program Services | 30522574 | ProgramServices |
| Management And General | 2910829 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1460828 | Total |
| Program Services | 1317230 | ProgramServices |
| Management And General | 143598 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4232502 | Total |
| Program Services | 3816450 | ProgramServices |
| Management And General | 416052 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2448260 | Total |
| Program Services | 2207598 | ProgramServices |
| Management And General | 240662 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 258220 | Total |
| Management And General | 258220 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 154574 | Total |
| Management And General | 154574 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 127755 | Total |
| Management And General | 127755 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 14025 | Total |
| Management And General | 14025 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 12457557 | Total |
| Program Services | 12391925 | ProgramServices |
| Management And General | 65632 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 207774 | Total |
| Program Services | 207774 | ProgramServices |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 17611329 | Total |
| Program Services | 16799995 | ProgramServices |
| Management And General | 811334 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 667840 | Total |
| Program Services | 667840 | ProgramServices |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1088630 | Total |
| Program Services | 1088630 | ProgramServices |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 201039 | Total |
| Program Services | 163930 | ProgramServices |
| Management And General | 37109 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 793817 | Total |
| Program Services | 793817 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3272746 | Total |
| Program Services | 3272746 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 730756 | Total |
| Program Services | 500982 | ProgramServices |
| Management And General | 229774 | ManagementAndGeneral |
Other Expenses OtherExpenses (3 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| BAD DEBT EXPENSE | 20619065 | 20619065 | |
| RECRUITMENT | 162129 | 162129 | |
| MISCELLANEOUS EXPENSES | 89189 | 17882 | 71307 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 101056677 | Total |
| Program Services | 94938263 | ProgramServices |
| Management And General | 6118414 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9860154 | BOY |
| EOY | 8060547 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4178130 | BOY |
| EOY | 2188820 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 13322408 | BOY |
| EOY | 12807176 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1116735 | BOY |
| EOY | 1174571 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1094848 | BOY |
| EOY | 1118829 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 67270731 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 45010982 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 22441539 | BOY |
| EOY | 22259749 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8854799 | BOY |
| EOY | 16875432 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 89574 | BOY |
| EOY | 79725 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 13621067 | BOY |
| EOY | 16599503 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 74579254 | BOY |
| EOY | 81164352 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9441088 | BOY |
| EOY | 8899131 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 15460376 | BOY |
| EOY | 21179840 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10154764 | BOY |
| EOY | 12364728 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 35056228 | BOY |
| EOY | 42443699 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 39506357 | BOY |
| EOY | 38493632 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 16669 | BOY |
| EOY | 227021 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 39523026 | BOY |
| EOY | 38720653 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 74579254 | BOY |
| EOY | 81164352 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 3291069 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -4093442 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | Volunteers |
| Paid Staff Or Management | 0 | PaidStaffOrManagement |
| Media Advertisements | 0 | MediaAdvertisements |
| Mailings Members | 0 | MailingsMembers |
| Publications Or Broadcast | 0 | PublicationsOrBroadcast |
| Grants Other Organizations | 0 | GrantsOtherOrganizations |
| Direct Contact Legislators | 0 | DirectContactLegislators |
| Rallies Demonstrations | 0 | RalliesDemonstrations |
| Other Activities | 1 | OtherActivities |
| Other Activities | $14,025 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 14025 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | 0 | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | EXPLANATION OF OTHER LOBBYING ACTIVITIES: | Identifier |
| Return Reference | PART II-B, LINE 1I: | ReturnReference |
| Explanation | THE ORGANIZATION IS A MEMBER OF THE AMERICAN HOSPITAL ASSOCIATION AND THE NORTH CAROLINA HOSPITAL ASSOCIATION. A PORTION OF DUES PAID TO THESE ORGANIZATIONS IS ALLOCATED TO LOBBYING EFFORTS ON BEHALF OF THE MEMBERSHIP BODY. THE PORTION OF DUES PAID TO THESE ORGANIZATIONS FOR THE YEAR THAT CONSTITUED LOBBYING WAS APPROXIMATELY $ 14,025. | Explanation |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 932707 | OtherCostOrOtherBasis |
| Book Value | 932707 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 31861428 | OtherCostOrOtherBasis |
| Depreciation | 22151790 | Depreciation |
| Book Value | 9709638 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1281997 | OtherCostOrOtherBasis |
| Depreciation | 891314 | Depreciation |
| Book Value | 390683 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 31596902 | OtherCostOrOtherBasis |
| Depreciation | 21967878 | Depreciation |
| Book Value | 9629024 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1597697 | OtherCostOrOtherBasis |
| Book Value | 1597697 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 22259749 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (3 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| OTHER RECEIVABLES | 1819744 |
| DUE FROM ROANOKE VALLEY HEALTH SERVICES, INC. | 14344942 |
| UNAMORTIZED BOND ISSUANCE COSTS | 434817 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 16599503 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities (2 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| THIRD PARTY PAYOR SETTLEMENT | $2,284,451 |
| PENSION PLAN CONTRIBUTION LIABILITY | $10,080,277 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 12364728 | TotalOfAmounts |
| Total Revenue | 104347746 | TotalRevenue |
| Total Expenses | 101056677 | TotalExpenses |
| Excess Or Deficit For Year | 3291069 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | -8016 | NetUnrealizedGLOnInvestments |
| Other | -$4,085,426 | OtherAmount |
| Total Adjustments | -4093442 | TotalAdjustments |
| Excess Or Deficit Per FS | -802373 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 100345072 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | -8016 | NetUnrealizedGainsInvestments |
| Other Revenues | -3994658 | OtherRevenues |
| Revenue Not Rptd F990 | -4002674 | RevenueNotRptdF990 |
| Revenue Subtotal | 104347746 | RevenueSubtotal |
| Revenue Not Rptd On Fin Stmt | 0 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 104347746 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 101147445 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | 90768 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 90768 | ExpensesNotRptdF990 |
| Expenses Subtotal | 101056677 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 101056677 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (4 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | PART X: | THE MEDICAL CENTER IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE; ACCORDINGLY, THE ACCOMPANYING COMBINED FINANCIAL STATEMENTS DO NOT REFLECT A PROVISION OR LIABILITY FOR FEDERAL AND STATE INCOME TAXES. THE MEDICAL CENTER HAS DETERMINED THAT IT DOES NOT HAVE ANY MATERIAL UNRECOGNIZED TAX BENEFITS OR OBLIGATIONS AS OF SEPTEMBER 30, 2011 AND 2010. THE MEDICAL CENTER BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO SEPTEMBER 30, 2008. |
| PART XI, LINE 8 - OTHER ADJUSTMENTS: | CHANGE IN VALUE OF DEFINED PENSION PLAN -3,455,395. TRANSFER OF EQUITY -630,031. | |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | RENTAL EXPENSES 90,768. CHANGE IN VALUE OF DEFINED PENSION PLAN -3,455,395. TRANSFER OF EQUITY -630,031. | |
| PART XIII, LINE 2D - OTHER ADJUSTMENTS: | RENTAL EXPENSES NET W/ REVENUES 90,768. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent200 | X | Pcent200 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent250 | X | Pcent250 |
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 1 | ExpensesExceededBudget |
| Unable To Provide Care | 0 | UnableToProvideCare |
| Annual Community Benefit Report | 1 | AnnualCommunityBenefitReport |
| Report Publically Available | 1 | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 963890 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 963890 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01200 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 15038330 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 12093018 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2945312 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03660 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 16002220 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 12093018 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3909202 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04860 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1131302 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 351224 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 780078 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00970 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 858703 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 858703 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01070 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 4547 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 4547 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1994552 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 351224 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1643328 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02050 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 17996772 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 12444242 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 5552530 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.06910 | PercentOfTotalExpense |
Economic Development EconomicDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 6 | NumberOfActivitiesOrPrograms |
| Total Community Building Expense | 6687 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 6687 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Environmental Improvements EnvironmentalImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Total Community Building Expense | 762 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 762 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Workforce Development WorkforceDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 2 | NumberOfActivitiesOrPrograms |
| Total Community Building Expense | 22000 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 22000 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00030 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 9 | NumberOfActivitiesOrPrograms |
| Total Community Building Expense | 29449 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 29449 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00040 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $6,587,539 | BadDebtExpenseAmount |
| Amount Attributable To | 790500 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 39184240 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 39071668 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | 112572 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HALIFAX REGIONAL MEDICAL CENTER | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 250 SMITH CHURCH ROAD | AddressLine1 |
| City | ROANOKE RAPIDS | City |
| State | NC | State |
| ZIP Code | 27870 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Er24 Hours | X | Er24Hours |
| Other | DISPROPORTIONATE SHARE HOSPITAL | Other |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NA FOR 2010 | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 1 | NumberOfOtherFacilities |
Other Facilities OtherFacilities
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HALIFAX HEALTHLINK | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1620 E 10TH ST 148 | AddressLine1 |
| City | ROANOKE RAPIDS | City |
| State | NC | State |
| ZIP Code | 27870 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Type | COMMUNITY EDUCATION | FacilityType |
Form990 Schedule H Part VI Form990ScheduleHPartVI (14 entries)
| ExplanationExplanation | IdentifierIdentifier | Return ReferenceReturnReference |
|---|---|---|
| PART I, LINE 7: THE ORGANIZATION CALCULATES AN INTERNAL COST-TO-CHARGES RATIO USED TO COMPUTE CHARITY CARE, UNREIMBURSED MEDICAID, AND SUBSIDIZED HEALTH SERVICES AT COST FOR PURPOSES OF PART I, LINE 7. | ||
| PART I, LINE 7G: SUBSIDIZED HEALTH SERVICES REPORTED ON LINE 7(G) INCLUDE A PSYCH UNIT AND LABOR/DELIVERY UNIT. | ||
| PART I, L7 COL(F): THE TOTAL EXPENSE LISTED ON FORM 990, PART XI, LINE 25 CONTAINS BAD DEBT EXPENSE OF $20,619,065 WHICH HAS BEEN REMOVED FOR PURPOSES OF THE CALCULATION OF CHARITY CARE PERCENTAGE FOR PART I, LINE 7, COLUMN (F). | ||
| PART II: HOSPITAL EMPLOYEES ROUTINELY DEVOTE THEIR TIME TO SERVICE ON THE CITY COUNCIL AND THE LOCAL CHAMBER OF COMMERCE TO PROMOTE COMMUNITY ECONOMIC DEVELOPMENT. IN ADDITION, HOSPITAL EMPLOYEES ALSO DEVOTED TIME TO EMERGENCY PREPAREDNESS CAUSES, AND THE HOSPITAL GAVE TO SUPPORT THE ROANOKE VALLEY CHAMBER'S BUILDING FUND AND THE BUSINESS EDUCATION PARTNERSHIP.IN THE TAX YEAR, THE HOSPITAL WORKED TO RECRUIT TWO OB-GYN PHYSICIANS TO THE AREA. | ||
| PART III, LINE 4: THERE IS NOT A FOOTNOTE IN THE FINANCIAL STATEMENTS TO DESCRIBE THE BAD DEBT EXPENSE.THE METHODOLOGY USED TO DETERMINE BAD DEBT AT COST IS THE ANDI METHODOLOGY WHICH USES A FACILITY WIDE COST TO CHARGE RATIO AS DESCRIBED IN THE 2010 NCHA COMMUNITY BENEFITS GUIDELINES.THE PERCENTAGE OF THE POPULATION BELOW THE POVERTY LINE IN OUR SERVICE AREA IS APPROXIMATELY 25%. BASED ON OUR PAST EXPERIENCE WITH PATIENTS WITH UNPAID CHARGES, ABOUT 10 TO 12% WOULD QUAILFY FOR CHARITY CARE IF THE APPROPRIATE DOCUMENTATION WERE RETURNED. | ||
| PART III, LINE 8: APPROXIMATELY 50% OF THE HOSPITAL'S TOTAL CHARGES ARE FROM MEDICARE. APPROXIMATELY 16% OF THE POPULATION OF HALIFAX COUNTY IS AGE 65 AND OVER. THE HOSPITAL HAS A RESPONSIBILITY TO THE COMMUNITY TO PROVIDE QUALITY CARE, AND THE SHORTFALL FOR OUR MEDICARE COST OF CARE SHOULD BE CONSIDERED A COMMUNITY BENEFIT. | ||
| PART III, LINE 9B: HALIFAX REGIONAL MEDICAL CENTER WORKS TO QUALIFY PATIENTS FOR FINANCIAL ASSISTANCE BEFORE ASSIGNING UNPAID ACCOUNTS TO OUTSIDE COLLECTION AGENCIES. THE HOSPITAL PURCHASED SOFTWARE SERIVCES THIS YEAR TO MAKE IT EASIER TO QUALIFY PATIENTS FOR CHARITY CARE. WE ALSO WORK WITH VANGUARD SERVICES TO HELP PATIENTS QUALIFY FOR MEDICAID AND OTHER INSURANCES. HRMC STRIVES TO HELP PATIENTS QUALIFY FOR APPROPRIATE FINANCIAL ASSISTANCE BEFORE SENDING ACCOUTNS TO BAD DEBT COLLECTION AGENCIES. | ||
| THE COMMUNITY HEALTH IMPROVEMENTS SERVICES NOTES ON PART I, LINE 7(E) INCLUDE THE FOLLOWING; | ||
| PART VI, LINE 2: THE HOSPITAL WORKS CLOSELY WITH THE LOCAL HEALTH DEPARTMENTS TO DETERMINE THE HEALTH NEEDS OF OUR COMMUNITY. CASE MANAGERS ALSO PROVIDE FEEDBACK INFORMATION ON OUR PATIENT NEEDS. OUR BOARD OF DIRECTORS IS COMPRISED OF LOCAL COMMUNITY LEADERS AND HAS VALUABLE INFORMATION ABOUT THE NEEDS OF OUR COMMUNITY. RECENTLY, THE HOSPITAL HAS BEGUN WORKING WITH THE AREA HEALTH DEPARTMENTS AND OTHER AGENCIES ON OUR COMMUNITY HEALTH ASSESSMENT REQUIRED IN FY'13. | ||
| PART VI, LINE 3: THE HOSPITAL'S CHARITY CARE POLICY IS POSTED ON THE WEBSITE AND ON SIGNAGE THROUGHTOUT THE HOSPITAL FACILITY. OUR COLLECTORS ARE FAMILIAR WITH THE POLICY AND APPLY IT AS APPROPRIATE WHEN COLLECTING PATIENT ACCOUNTS. TO REDUCE THE LIKELIHOOD OF QUALIFIED CHARITABLE RECIPIENTS ESCAPING BENEFITS UNDER THE POLICY, WE HAVE IMPLEMENTED SOFTWARE THIS YEAR THAT ALLOWS OUR STAFF TO MORE EASILY IDENTIFY QUALIFIED CASES. | ||
| PART VI, LINE 4: THE HOSPITAL'S PRIMARY SERVICE AREA CONSISTS OF HALIFAX COUNTY AND NORTHAMPTON COUNTY, NORTH CAROLINA. THE POPULATION OF HALIFAX COUNTY IN 2010 WAS 54,691. THE PERSONS OVER 65 YEARS OF AGE WAS 16.2% AND PEOPLE LIVING BELOW THE POVERTY LEVEL IS ESTIMATED AT 23.8%.NORTHAMPTON COUNTY POPULATION IN 2010 WAS 22,099. PEOPLE OVER 65 YEARS OF AGE WAS 19.6%. THE UNEMPLOYMENT RATE IN BOTH COUNTIES IS APPROXIMATELY 12%. 80% OF HRMC'S REVENUE MIX COMES FROM MEDICARE, MEDICAID, AND SELF PAY. | ||
| PART VI, LINE 6: HALIFAX REGIONAL MEDICAL CENTER WORKS CLOSELY WITH THE AREA COUNTY HEALTH DEPARTMENTS TO DO COMMUNITY HEALTH ASSESSMENTS AND DETERMINE HEALTH NEEDS IN THE AREA. HRMC ALSO WORKS CLOSELY WITH THE RURAL HEALTH GROUP AND HAS IMPLEMENTED A CASE MANAGEMENT PROGRAM FOR HEART FAILURE PATIENTS. HRMC PROVIDES COMMUNTIY HEALTH INFORMATION, EDUCATION, AND EXERCISE THROUGH OUR HEALTHLINKS IN THE LOCAL MALL. ON THE HRMC WEBSITE, THERE IS A LINK TO SIGN UP FOR FREE HEALTHED EMAILS THAT CONTAIN FREE TIPS FOR A HEALTHY LIFESTYLE AND NOTICES ABOUT HEALTHY ACTIVITIES AND EDUCATION.A MAJORITY OF THE ORGANIZATION'S GOVERNING BODY IS COMPRISED OF PERSONS WHO RESIDE IN THE ORGANIZATION'S PRIMARY SERVICE AREA AND WHO ARE NEITHER EMPLOYEES NOR INDEPENDENT CONTRACTORS OF THE ORGANIZATION NOR FAMILY MEMBERS THEREOF. THE ORGANIZATION EXTENDS MEDICAL STAFF PRIVILEDGES TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY FOR MANY OF ITS DEPARTMENTS.ANY SURPLUS OF FUNDS IS REINVESTED INTO THE HOSPITAL BY PURCHASE NEW EQUIPMENT AND REPLACE EXISTING EQUIPMENT, UPDATE THE BUILDING STRUCTURE, AND IMPROVE OPERATIONS. WE ALSO USE FUNDS TO IMPROVE QUALITY OF CARE AND PROVIDE EDUCATIONAL OPPORTUNITIES FOR STAFF MEMBERS. | ||
| PART VI, LINE 7: THE ORGANIZATION IS NOT PART OF AN AFFILIATED HEALTH CARE SYSTEM. | ||
| NC | REPORTS FILED WITH STATES | PART VI, LINE 7 |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 1 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 1 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (9 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| WILL MAHONE | |||||||||||||
| 261320 | 0 | 52297 | 0 | 14296 | 0 | 38500 | 0 | 28858 | 0 | 395271 | 0 | 0 | 0 |
| SHERRY JENSEN | |||||||||||||
| 186489 | 0 | 30663 | 0 | 0 | 0 | 15059 | 0 | 15866 | 0 | 248077 | 0 | 0 | 0 |
| KAREN DANIELS | |||||||||||||
| 155840 | 0 | 25342 | 0 | 0 | 0 | 22000 | 0 | 9034 | 0 | 212216 | 0 | 0 | 0 |
| MICHAEL ADCOCK | |||||||||||||
| 146387 | 0 | 24680 | 0 | 0 | 0 | 16500 | 0 | 20689 | 0 | 208256 | 0 | 0 | 0 |
| STEVEN HILL | |||||||||||||
| 218514 | 0 | 0 | 0 | 0 | 0 | 21725 | 0 | 15375 | 0 | 255614 | 0 | 0 | 0 |
| KENNETH HARTZ | |||||||||||||
| 196086 | 0 | 0 | 0 | 0 | 0 | 22000 | 0 | 20924 | 0 | 239010 | 0 | 0 | 0 |
| CLAUDE DEITTRICH | |||||||||||||
| 194194 | 0 | 0 | 0 | 0 | 0 | 447 | 0 | 20586 | 0 | 215227 | 0 | 0 | 0 |
| STEVEN ULSAS | |||||||||||||
| 196854 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 3661 | 0 | 200515 | 0 | 0 | 0 |
| JOHN CAMPBELL | |||||||||||||
| 185905 | 0 | 0 | 0 | 0 | 0 | 21174 | 0 | 20628 | 0 | 227707 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)
| Return ReferenceReturnReference | ExplanationExplanation |
|---|---|
| PART I, LINE 4B | THE ORGANIZATION PROVIDES A SUPPLEMENTAL NON-QUALIFIED ANNUITY PLAN TO THE CEO. FOR 2010, WILL MAHONE ACCRUED $14,148 UNDER THIS PLAN. IT IS REPORTED ON SCHEDULE J, PART II, COLUMN B(III) AS OTHER REPORTABLE COMPENSATION. |
| PART I, LINE 7 | THE OFFICERS LISTED BELOW ARE RECIPIENTS OF NON-FIXED PAYMENTS FROM THE ORGANIZATION. THE CEO AND VICE PRESIDENT RECEIVE AT-RISK SALARY PAYMENTS FROM THE ORGANIZATION BASED ON REACHING BALANCED SCORECARD OBJECTIVES. THE AMOUNT AVAILABLE IS THE AT-RISK SALARY AVAILABLE FOR THE INDIVIDUAL POSITIONS. FOR 2010, THE FOLLOWING OFFICERS RECEIVED PAYMENTS UNDER THIS PLAN: WILL MAHONE $ 52,262 SHERRY JENSEN 30,633 KAREN DANIELS 25,302 MICHAEL ADCOCK 24,665 |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NORTH CAROLINA MEDICAL CARE COMMISSION | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Issuer EIN | 521309402 | IssuerEIN |
| CUSIP Number | NONEAVAIL | CUSIPNumber |
| Date Issued | 2011-07-28 | DateIssued |
| Issue Price | 6500000 | IssuePrice |
| Description Of Purpose | CAPITAL ACQUISITION | DescriptionOfPurpose |
| Defeased | 0 | Defeased |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Pool Financing | 0 | PoolFinancing |
Form990 Schedule K Part II Form990ScheduleKPartII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Proceeds | 6500332 | TotalProceeds |
| Amount In Reserve Fund | 26543 | AmountInReserveFund |
| Issuance Costs From Proceeds | 130000 | IssuanceCostsFromProceeds |
| Capital Expenditures | 927183 | CapitalExpenditures |
| Amount Unspent | 5572140 | AmountUnspent |
| Year Of Subst Completion | 2011 | YearOfSubstCompletion |
| Current Refunding | 0 | CurrentRefunding |
| Advance Refunding | 0 | AdvanceRefunding |
| Final Allocation Made | 0 | FinalAllocationMade |
| Adequate Books And Recds Maintaind | 1 | AdequateBooksAndRecdsMaintaind |
Form990 Schedule K Part III Form990ScheduleKPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Owning Bond Financed Property | 0 | OwningBondFinancedProperty |
| Any Lease Arrangements | 0 | AnyLeaseArrangements |
| Mngment Cntrct Bond Financd Prprty | 0 | MngmentCntrctBondFinancdPrprty |
| Any Research Agreements | 0 | AnyResearchAgreements |
| Bond Counsel Routinely Engaged | 1 | BondCounselRoutinelyEngaged |
| Prcntge Prvt Business Use By Others | 0.00000 | PrcntgePrvtBusinessUseByOthers |
| Percentage Of Prvt Business Re UBI | 0.00000 | PercentageOfPrvtBusinessReUBI |
| Total Private Business Use | 0.00000 | TotalPrivateBusinessUse |
| Post Issuance Compliance Procdrs | 1 | PostIssuanceComplianceProcdrs |
Form990 Schedule K Part IV Form990ScheduleKPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form8038 T Filed | 0 | Form8038TFiled |
| Variable Rate Issue | 1 | VariableRateIssue |
| Hedge Identified In Books And Recds | 0 | HedgeIdentifiedInBooksAndRecds |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGIC |
| Gross Proceeds Invested | 0 | GrossProceedsInvested |
| Exception To Rebate | 1 | ExceptionToRebate |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV (2 entries)
| RelationshipRelationship | Amount Of TransactionAmountOfTransaction | Description Of TransactionDescriptionOfTransaction | Sharing Of RevenuesSharingOfRevenues |
|---|---|---|---|
| PAULA ELIAS | |||
| DAUGHTER-IN-LAW OF DREWERY BEALE, BOARD MEMBER | 33839 | COMPENSATION AS AN EMPLOYEE OF ORGANIZATION | 0 |
| MARIA MARADIAGA | |||
| SPOUSE OF GERARDO MARADIAGA, BOARD MEMBER | 30221 | COMPENSATION AS AN EMPLOYEE OF ORGANIZATION | 0 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (7 entries)
| IdentifierIdentifier | ExplanationExplanation | Return ReferenceReturnReference |
|---|---|---|
| FORM 990, PART VI, SECTION B, LINE 11 | THE RETURN WAS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM WITH ASSISTANCE AND INFORMATION PROVIDED BY MANAGEMENT. THE HOSPITAL PROVIDED EVERY VOTING BOARD MEMBER A COPY OF THE DRAFT 990 PRIOR TO A SCHEDULED MEETING. DETAILS OF THE RETURN WERE DISCUSSED WITH MANAGEMENT AND THE FINANCE COMMITTEE OF THE BOARD, WHO THEN DELIVERED A REPORT TO THE FULL BOARD PRIOR TO FILING THE RETURN WITH THE IRS. | |
| (BYLAWS, ARTICLE 2, SECTION 3) "ANY DUALITY OF INTEREST OR POSSIBLE CONFLICT OF INTEREST ON THE PART OF ANY GOVERNING BOARD MEMBER SHALL BE DISCLOSED TO THE OTHER MEMBERS OF THE BOARD OF DIRECTORS AND MADE A MATTER OF RECORD THROUGH AN ANNUAL PROCEDURE AND ALSO WHEN THE INTEREST BECOMES A MATTER OF BOARD ACTION. ANY GOVERNING BOARD MEMBER HAVING A DUALITY OF INTEREST OR POSSIBLE CONFLICT OF INTEREST ON ANY MATTER SHALL NOT VOTE OR USE PERSONAL INFLUENCE ON THAT MATTER, AND SHALL NOT BE COUNTED IN DETERMINING THE QUORUM FOR THE MEETING, EVEN WHERE PERMITTED BY LAW. THE MINUTES OF THE MEETING SHALL REFLECT THAT A DISCLOSURE WAS MADE, THE ABSTENTION FROM VOTING, AND THE QUORUM SITUATION. ANY EXISTING OR APPARENT CONFLICT OF INTEREST WILL BE REFERRED TO THE EXECUTIVE COMMITTEE OF THE BOARD FOR RESOLUTION." THE CONFLICT OF INTEREST POLICY IS REVIEWED ANNUALLY. BOARD MEMBERS AND HOSPITAL MANAGEMENT PERSONNEL ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST QUESTIONNAIRE EACH YEAR. | FORM 990, PART VI, SECTION B, LINE 12C | |
| THE ORGANIZATION ENGAGES AN OUTSIDE INDEPENDENT CONSULTANT FOR REVIEW OF COMPENSATION PACKAGES. THE CONSULTANT USES COMPARABLE POSITIONS AND BENCHMARKS TO EVALUATE THE SALARIES FOR THE CEO AND VICE PRESIDENTS. THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS REVIEWS THE CONSULTANT'S RECOMMENDATIONS, AND THE FULL BOARD APPROVES THE COMPENSATION PACKAGE SELECTED FOR THE CEO. THE CONSULTATION PROCESS FOR OTHER OFFICERS INVOLVES THE INDEPENDENT CONSULTANTS; HOWEVER, THE CEO HAS FINAL APPROVAL OVER COMPENSATION PACKAGES FOR VICE PRESIDENTS AND BELOW. | FORM 990, PART VI, SECTION B, LINE 15 | |
| PHOTOCOPIES 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 18 | |
| PHOTOCOPIES OF THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON WRITTEN REQUEST AT THE ORGANIZATION'S ADMINISTRATIVE OFFICE. | FORM 990, PART VI, SECTION C, LINE 19 | |
| CHANGES IN NET ASSETS OR FUND BALANCES: | NET UNREALIZED LOSSES ON INVESTMENTS: -8,016. CHANGE IN VALUE OF DEFINED PENSION PLAN -3,455,395. TRANSFER OF EQUITY -630,031. TOTAL TO FORM 990, PART XI, LINE 5: -4,093,442. | FORM 990, PART XI, LINE 5: |
| THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. | FORM 990, PART XII, LINE 2C: |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|---|
| HALIFAX REGIONAL MEDICAL CENTER FOUNDATION INC | ||||||||||
| 250 SMITH CHURCH ROAD | ROANOKE RAPIDS | NC | 27870 | 561698825 | FUNDRAISING FOR ASSOCIATED CHARITABLE ORGANIZATION | NC | 501(C)(3) | LINE 7 | HALIFAX REGIONAL MEDICAL CENTER INC | 1 |
| ROANOKE VALLEY HEALTH SERVICES INC | ||||||||||
| 250 SMITH CHURCH ROAD | ROANOKE RAPIDS | NC | 27870 | 561925492 | HEALTHCARE | NC | 501(C)(3) | LINE 3 | HALIFAX REGIONAL MEDICAL CENTER INC | 1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 1 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 1 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 1 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 1 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 1 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 1 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (4 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| ROANOKE VALLEY MEDICAL SERVICES | ||
| A | 5000 | FMV RENT |
| ROANOKE VALLEY MEDICAL SERVICES | ||
| B | 630031 | CASH |
| ROANOKE VALLEY MEDICAL SERVICES | ||
| Q | 2828609 | NET INTERCO. TRANS. |
| ROANOKE VALLEY MEDICAL SERVICES | ||
| D | 14344942 | INTERCO. A/R |
Comments