2012-03-22T13:37:45-05:00 2011-09-30 CLIFTONLARSONALLEN LLP 101 N TRYON STREET SUITE 1000 CHARLOTTE NC 28246 990 2010-10-01 260436856 JOHNSTON HEALTH ENTERPRISES INC JOHN 9199348171 509 N BRIGHT LEAF BLVD SMITHFIELD NC 27577 EDDIE KLEIN 9199348171 2012-03-22 1 GREGORY W JOHNS 7049985200 2010 2016-02-24 21:20:13Z EDDIE KLEIN 509 N BRIGHT LEAF BLVD SMITHFIELD NC 27577 2089722 0 X HTTP://WWW.JOHNSTONHEALTH.ORG/ X 2007 NC TO SUPPORT JOHNSTON MEMORIAL HOSPITAL FOR THE PROVISION OF HEALTH CARE. 3 1 0 1 0 0 1994609 241709 810946 1845989 0 2024 1103 0 2806658 2089722 0 0 0 0 1346 17292 0 0 0 1222750 2938481 1224096 2955773 1582562 -866051 17102213 16485766 13246230 13495834 3855983 2989932 X THE ORGANIZATION IS SPECIFICALLY ORANIZED AND SHALL BE OPERATED EXCLUSIVELY FOR THE PURPOSES OF SUPPORTING AND PERFORMING THE FUNCTIONS OF JOHNSTON MEMORIAL HOSPITAL AUTHORITY BY PLANNING, FINANCING, CONSTRUCTING, FURNISHING, AND EQUIPPING, OPERATING AND MAINTAINING FACILITIES, ACTIVITIES AND PROGRAMS FOR THE PROVISION OF HEALTH CARE. 0 0 2495243 1845989 JOHNSTON HEALTH ENTERPRISES SUPPORTED AND PERFORMED THE FUNCTIONS OF JOHNSTON MEMORIAL HOSPITAL AUTHORITY FOR THE PROVISION OF HEALTH CARE. 2495243 1 1 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 3 1 0 0 0 0 0 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X X KEVIN CIELINSKI 9199386629 509 N BRIGHT LEAF BLVD SMITHFIELD NC 27577 RALPH STEWART 1.00 X 0 0 0 CHARLES ELLIOTT 1.00 X 0 300000 78812 EDDIE KLEIN 1.00 X 0 235000 60277 0 535000 139089 0 0 1 0 REX HEALTHCARE 4420 LAKE BOONE TRAIL RALEIGH NC 27607 MANAGEMENT SERVICES 498996 1 241709 241709 PATIENT SERVICE 621300 1466894 1466894 379095 379095 1845989 2024 2024 2089722 1845989 0 2024 17292 17292 498996 498996 253674 252450 1224 61385 61385 459306 459306 759734 759734 LEASES AND RENTALS 851830 851830 SUPPLIES 3181 3181 50375 50375 2955773 2495243 460530 0 484532 1411002 477056 245494 85886 210170 15688388 1278027 15138841 14410361 5000 915898 203739 17102213 16485766 363526 273513 9367306 8444389 3515398 4777932 13246230 13495834 X 3855983 2989932 3855983 2989932 17102213 16485766 -866051 0 X X 0 1 1 X 0 X X X X 0 0 0 JOHNSTON MEMORIAL HOSPITAL AUTHORITY 830444059 3 1 1 1 0 1 0 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 3656155 3656155 8453497 479953 7973544 0 2340665 769789 1570876 1238071 28285 1209786 14410361 INTERCOMPANY PAYABLE 4777932 4777932 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE ORGANIZATION WAS ORGANIZED PURSUANT TO CHAPTER 131 OF THE NORTH CAROLINA GENERAL STATUTES AS A NON-PROFIT ORGANIZATION AND IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 115 OF THE INTERNAL REVENUE CODE. THE ORGANIZATION IS EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. X 0 0 0 0 0 0 0 0 0 CHARLES ELLIOTT 0 300000 0 0 0 0 0 0 0 78812 0 378812 0 0 EDDIE KLEIN 0 235000 0 0 0 0 0 0 0 60277 0 295277 0 0 SUPPLEMENTAL INFORMATION PART III SCHEDULE J, PART II, LINE 1: FORM 990, PART VII, LINE 5: CERTAIN OFFICERS WERE COMPENSATED BY QUORUM HEALTH RESOURCES, AN UNRELATED ORGANIZATION, FOR SERVICES PROVIDED FOR JOHNSTON MEMORIAL HOSPITAL AUTHORITY, A RELATED ORGANZATION. FORM 990, PART VI, SECTION A, LINE 7A THE DIRECTORS OF THE ORGANIZATION ARE APPOINTED BY THE BOARD OF COMMISIONERS OF JOHNSTON MEMORIAL HOSPITAL AUTHORITY AS PROVIDED IN THE ORGANIZATION'S BYLAWS FOR SUCH TERMS AS MAY BE SPECIFIED IN SUCH BYLAWS. FORM 990, PART VI, SECTION A, LINE 7B THE BYLAWS OF THE ORGANIZATION MAY BE ADOPTED AND AMENDED BY THE BOARD OF DIRECTORS SUBJECT TO THE APPROVAL OF THE BOARD OF COMMISSIONERS OF JOHNSTON MEMORIAL HOSPITAL AUTHORITY. SEE THE RESPONSE TO LINE 7A ABOVE. FORM 990, PART VI, SECTION B, LINE 11 A COPY OF THE FORM 990 WAS PROVIDED TO EACH VOTING BOARD MEMBER PRIOR TO THE FILING DATE. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION HAS A CONFLICT OF INTEREST POLICY WHICH IS REVIEWED, ACCEPTED, AND SIGNED BY EACH OFFICER AND VOTING BOARD MEMBER ON AN ANNUAL BASIS. PURSUANT TO THIS POLICY, EACH OFFICER AND BOARD MEMBER WILL RECUSE THEMSELVES FROM ANY DISCUSSION AND VOTE FOR WHICH A CONFLICT FOR THEMSELVES OR THEIR FAMILY. FORM 990, PART VI, SECTION B, LINE 15 THE PROCESS FOR DETERMINING COMPENSATION WAS LAST PERFORMED IN 2010. FORM 990, PART VI, SECTION C, LINE 18 PHOTOCOPIES OF THE FORM 990 AND FORM 1023 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 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XII, LINE 2C: AUDIT COMMITTEE PROCESSES HAVE NOT CHANGED FROM THE PRIOR YEAR. JOHNSTON MEMORIAL HOSPITAL AUTHORITY 509 BRIGHT LEAF BLVD SMITHFIELD NC 27577 830444059 HEALTHCARE NC 501 GOV'T N/A 0 0 0 1 0 0 0 0 0 1 0 0 0 1 1 0 0 0 0 JOHNSTON MEMORIAL HOSPITAL AUTHORITY C 241709 TRANSFER