BLUE RIDGE HEALTHCARE HOSPITALS INC: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- BLUE RIDGE HEALTHCARE HOSPITALS INC (EIN 56-0529976)
- Tax period
- 2011-01-01 to 2011-12-31
- Filed
- 2012-11-08
- IRS object ID
- 201223139349300637
- Schema version
- 2011v1.2
- 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 I
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-11-08T10:05:41-06:00 | Timestamp |
| Tax Period End Date | 2011-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 410746749 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLIFTONLARSONALLEN LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 101 N TRYON STREET SUITE 1000 | AddressLine1 |
| City | CHARLOTTE | City |
| State | NC | State |
| ZIP Code | 28246 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 560529976 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GRACE HOSPITAL INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | GRAC | NameControl |
| Phone | 8285805000 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2201 SOUTH STERLING STREET | AddressLine1 |
| City | MORGANTON | City |
| State | NC | State |
| ZIP Code | 28655 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | ROBERT G FRITTS | Name |
| Title | SENIOR VP FINANCE/CFO | Title |
| Phone | 8285805000 | Phone |
| Date Signed | 2012-11-06 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | GREGORY W JOHNS | Name |
| PTIN | P00535091 | PTIN |
| Phone | 7049985200 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | KENNETH W WOOD | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2201 SOUTH STERLING STREET | AddressLine1 |
| City | MORGANTON | City |
| State | NC | State |
| ZIP Code | 28655 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 135011007 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.BLUERIDGEHEALTH.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1906 | YearFormation |
| State Legal Domicile | NC | StateLegalDomicile |
| Activity Or Mission Description | IMPROVING THE HEALTH OF OUR COMMUNITIES BY PROVIDING EXCELLENT AND COMPASSIONATE CARE. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 15 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 13 | NbrIndependentVotingMembers |
| Total Nbr Employees | 1138 | TotalNbrEmployees |
| Total Nbr Volunteers | 83 | TotalNbrVolunteers |
| Total Gross UBI | 1503458 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 588840 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 575389 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 106468654 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 112599210 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 3501698 | InvestmentIncomePriorYear |
| Investment Income Current Year | 6001070 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 2759811 | OtherRevenuePriorYear |
| Other Revenue Current Year | 1946499 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 113319003 | TotalRevenuePriorYear |
| Total Revenue Current Year | 121122168 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 273479 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 234702 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 43680548 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 48039667 | 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 | 65221334 | OtherExpensePriorYear |
| Other Expenses Current Year | 67302953 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 109175361 | TotalExpensesPriorYear |
| Total Expenses Current Year | 115577322 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 4143642 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 5544846 | RevenuesLessExpensesCY |
| Total Assets BOY | 198574101 | TotalAssetsBOY |
| Total Assets EOY | 196282646 | TotalAssetsEOY |
| Total Liabilities BOY | 69545712 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 67311417 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 129028389 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 128971229 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | GRACE HOSPITAL IS COMMITTED TO IMPROVING THE HEALTH OF OUR COMMUNITIES BY PROVIDING EXCELLENT AND COMPASSIONATE CARE. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 17284211 | Expense |
| Grants | 234702 | Grants |
| Revenue | 15072205 | Revenue |
| Description | GRACE HOSPITAL PROVIDED 23,517 DAYS OF CARE TO 5,935 PATIENTS ADMITTED. GRACE HOSPITAL HAS 184 BEDS AND OFFERS A BROAD SCOPE OF SERVICES. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 13356706 | Expense |
| Revenue | 25191591 | Revenue |
| Description | GRACE HOSPITAL'S SURGICAL SERVICES PERFORMED 1,327 INPATIENT SURGERIES AND 3,524 OUTPATIENT SURGERIES. ORTHOPEDICS, GENERAL SURGERY, SPINE SURGERY, AND OB/GYN ARE THE MAJOR SURGICAL SPECIALITIES OFFERED. | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 5381054 | Expense |
| Revenue | 14759869 | Revenue |
| Description | EMERGENCY ROOM SAW 39,131 PATIENTS DURING THE YEAR. THE ED IS OPEN 24 HOURS A DAY, 7 DAYS A WEEK AND IS ABLE TO TAKE CARE OF ANY TYPE OF EMERGENCY OR PROBLEM. | Description |
Activity Other ActivityOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 59986760 | Expense |
| Revenue | 55988429 | Revenue |
| Description | OTHER PROGRAMS | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Other Program Service Exp | 59986760 | TotalOfOtherProgramServiceExp |
| Total Of Other Program Service Rev | 55988429 | TotalOfOtherProgramServiceRev |
| Total Program Service Expense | 96008731 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 1 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| 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 | 1 | 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 | 1 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| 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 | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 1 | 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 | 0 | RelatedOrgControlledEntity |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 1 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 1138 | 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 | 13 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 1 | 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 | 1 | LocalChapters |
| Policies Reference Chapters | 1 | PoliciesReferenceChapters |
| 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 | 1 | InvestmentInJointVenture |
| Written Policy Or Procedure | 1 | WrittenPolicyOrProcedure |
| States Where Copy Of Return Is Filed | NC | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PATRICIA MOLL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 8285805000 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2201 SOUTH STERLING STREET | AddressLine1 |
| City | MORGANTON | City |
| State | NC | State |
| ZIP Code | 28655 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
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 |
|---|---|---|---|---|---|---|---|---|
| KENNETH W WOOD | ||||||||
| PRESIDENT / CEO | 50.00 | X | X | 0 | 0 | 0 | ||
| J MICHAEL BRIDGES | ||||||||
| CHAIRMAN | 1.00 | X | 0 | 0 | 0 | |||
| MH MCCRARY | ||||||||
| VICE CHAIRMAN | 1.00 | X | 0 | 0 | 0 | |||
| JAMES ROSTAN | ||||||||
| SECRETARY | 1.00 | X | 0 | 0 | 0 | |||
| JEFF CARSWELL | ||||||||
| TREASURER | 1.00 | X | 0 | 0 | 0 | |||
| PHILIP TATE | ||||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | |||
| CLAY RICHARDSON MD | ||||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | |||
| KENNETH BONFIELD MD | ||||||||
| BOARD MEMBER | 1.00 | X | 0 | 1104 | 0 | |||
| S ANDREWS DEEKENS MD | ||||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | |||
| LISA BUFF | ||||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | |||
| JOHN BRANSTROM | ||||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | |||
| DORIS FULLWOOD | ||||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | |||
| SHERROD SALSBURY III | ||||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | |||
| ALAN GRIFFIN | ||||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | |||
| ALLEN VANNOPPEN | ||||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | |||
| CHARLES RICE | ||||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | |||
| ROBERT G FRITTS | ||||||||
| SENIOR VP FINANCE/CFO | 50.00 | X | 0 | 0 | 0 | |||
| KATHY BAILEY | ||||||||
| EXECUTIVE VP/COO | 50.00 | X | 0 | 0 | 0 | |||
| LAURA LAMBETH | ||||||||
| PRESIDENT | 50.00 | 247376 | 0 | 25197 | X | |||
| THOMAS EURE | ||||||||
| CORPORATE COMPLIANCE OFFIC | 40.00 | 198767 | 0 | 35294 | X | |||
| ANTHONY FRASCA MD | ||||||||
| PSYCHIATRIST | 40.00 | 272209 | 0 | 22659 | X | |||
| BYRON STROTHER MD | ||||||||
| PSYCHIATRIST | 40.00 | 267334 | 0 | 32322 | X | |||
| JOSEPH MAZZOLA MD | ||||||||
| SR. VICE-PRESIDENT | 40.00 | 262548 | 0 | 24432 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1248234 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 1104 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 139904 | TotalOtherCompensation |
| Number Individuals GT100 K | 20 | 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 |
|---|---|---|---|---|---|
| NURSE ANESTHESIA OF NORTH CAROLINA | |||||
| PO BOX 6633 | HIGH POINT | NC | 28277 | CRNA STAFFING | 1924424 |
| ARAMARK CTS | |||||
| 12483 COLLECTIONS CENTER DR | CHICAGO | IL | 60693 | FACILITIES SERVICE MANAGEMENT | 1174574 |
| ENDURACARE THERAPY MANAGEMENT | |||||
| DEPT AT 952922 GEMINO HC | ATLANTA | GA | 31192 | REHABILITATION THERAPY SERVICES | 1099758 |
| ARAMARK FACILITIES | |||||
| 22506 NETWORK PLACE | CHICAGO | IL | 60673 | FACILITIES SERVICES MANAGEMENT | 918871 |
| TRINITY HEALTHCARE STAFFING GROUP | |||||
| 1708 TRAWICK RAOD 220 | RALEIGH | NC | 27604 | STAFFING | 682956 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 35 | NumberOfContractorsGT100K |
| Government Grants | 45591 | GovernmentGrants |
| All Other Contributions | 529798 | AllOtherContributions |
| Total Contributions | 575389 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| PATIENT REVENUE | 621400 | 103373467 | 103373467 |
| INTER-FACILITY REVENUE | 621400 | 9514229 | 9514229 |
| INTEGRATION OPERATING | 900099 | -600521 | -600521 |
Total Oth Program Service Revenue TotalOthProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 312035 | TotalRevenueColumn |
| Related Or Exempt Function Income | 312035 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 112599210 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 2303753 | TotalRevenueColumn |
| Exclusion | $2,303,753 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 636996 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 0 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 636996 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 636996 | TotalRevenueColumn |
| Exclusion | $636,996 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 17513155 | Securities |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 13815838 | Securities |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 3697317 | Securities |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 3697317 | TotalRevenueColumn |
| Exclusion | $3,697,317 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | 127727 | GrossSalesOfInventory |
| Cost Of Goods Sold | 73001 | CostOfGoodsSold |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 54726 | TotalRevenueColumn |
| Related Or Exempt Function Income | 54726 | RelatedOrExemptFunctionIncome |
Other Revenue Misc OtherRevenueMisc (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Unrelated Business RevenueUnrelatedBusinessRevenue | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|---|
| UNRELATED BUSINESS INC | 624110 | 1503458 | 1503458 | |
| INTEGRATION CAPITAL | 900099 | -1641842 | -1641842 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1393161 | TotalRevenueColumn |
| Exclusion | $1,393,161 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 1254777 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 121122168 | TotalRevenueColumn |
| Related Or Exempt Function Income | 111012094 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 1503458 | UnrelatedBusinessRevenue |
| Exclusion | $8,031,227 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 234702 | Total |
| Program Services | 234702 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 272573 | Total |
| Program Services | 272573 | ProgramServices |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 38791666 | Total |
| Program Services | 27027136 | ProgramServices |
| Management And General | 11764530 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 504029 | Total |
| Program Services | 349928 | ProgramServices |
| Management And General | 154101 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5916908 | Total |
| Program Services | 4128515 | ProgramServices |
| Management And General | 1788393 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2554491 | Total |
| Program Services | 1784714 | ProgramServices |
| Management And General | 769777 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 277414 | Total |
| Management And General | 277414 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 82800 | Total |
| Management And General | 82800 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 11872 | Total |
| Management And General | 11872 | ManagementAndGeneral |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 224243 | Total |
| Management And General | 224243 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 17420078 | Total |
| Program Services | 16427123 | ProgramServices |
| Management And General | 992955 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 960589 | Total |
| Management And General | 960589 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 202152 | Total |
| Management And General | 202152 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2021245 | Total |
| Program Services | 2021245 | ProgramServices |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 280071 | Total |
| Program Services | 280071 | ProgramServices |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2418119 | Total |
| Program Services | 2418119 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7866891 | Total |
| Program Services | 7866891 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1915641 | Total |
| Management And General | 1915641 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices |
|---|---|---|
| BAD DEBT | 18056055 | 18056055 |
| SUPPLIES | 10699718 | 10699718 |
| INTERCOMPANY | 2703563 | 2703563 |
| DIETARY SUPPLIES | 892279 | 892279 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1270223 | Total |
| Program Services | 846099 | ProgramServices |
| Management And General | 424124 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 115577322 | Total |
| Program Services | 96008731 | ProgramServices |
| Management And General | 19568591 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 597214 | BOY |
| EOY | 2105699 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3484324 | BOY |
| EOY | 3906225 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 15260567 | BOY |
| EOY | 15316765 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 15247732 | BOY |
| EOY | 10556269 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1701514 | BOY |
| EOY | 1514823 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 435877 | BOY |
| EOY | 817535 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 176042068 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 101201262 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 79358482 | BOY |
| EOY | 74840806 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 15961988 | BOY |
| EOY | 14797339 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 66526403 | BOY |
| EOY | 72427185 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 198574101 | BOY |
| EOY | 196282646 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7897960 | BOY |
| EOY | 7788064 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 32257290 | BOY |
| EOY | 30735438 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1628670 | BOY |
| EOY | 738731 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 27761792 | BOY |
| EOY | 28049184 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 69545712 | BOY |
| EOY | 67311417 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 128998053 | BOY |
| EOY | 128939095 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 30336 | BOY |
| EOY | 32134 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 129028389 | BOY |
| EOY | 128971229 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 198574101 | BOY |
| EOY | 196282646 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 5544846 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -5602006 | 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 | $11,872 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 11872 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | 0 | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | EXPLANATION OF LOBBYING ACTIVITIES: | Identifier |
| Return Reference | PART II-B, LINE 1: | ReturnReference |
| Explanation | MEMBERSHIP DUES TO AMERICAN HOSPITAL ASSOCIATION AND NORTH CAROLINA HEALTH CARE FACILITIES ASSOCIATION. | Explanation |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 977206 | OtherCostOrOtherBasis |
| Book Value | 977206 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 102536161 | OtherCostOrOtherBasis |
| Depreciation | 48481489 | Depreciation |
| Book Value | 54054672 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 68191540 | OtherCostOrOtherBasis |
| Depreciation | 50376423 | Depreciation |
| Book Value | 17815117 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 4337161 | OtherCostOrOtherBasis |
| Depreciation | 2343350 | Depreciation |
| Book Value | 1993811 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 74840806 | TotalOfBookValueLandBuildings |
Other Securities OtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | INVESTMENTS | Description |
| Book Value | 14797339 | BookValue |
| Method Of Valuation | F | MethodOfValuation |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Securities | 14797339 | TotalOfBookValueSecurities |
Other Assets OtherAssets (4 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| OTHER ASSETS | 4825694 |
| BOARD DESIGNATED FOR SCHOLARSHIPS | 129354 |
| BOARD DESIGNATED AS FUNDED DEPRECIATION | 67349084 |
| GUILD | 123053 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 72427185 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities (3 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| DUE TO BLUE RIDGE HEALTH SYSTEMS, INC. | $24,828,824 |
| THIRD PARTY SETTLEMENTS | $3,219,615 |
| GUILD | $745 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 28049184 | TotalOfAmounts |
| Total Revenue | 121122168 | TotalRevenue |
| Total Expenses | 115577322 | TotalExpenses |
| Excess Or Deficit For Year | 5544846 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | -5605354 | NetUnrealizedGLOnInvestments |
| Other | $3,348 | OtherAmount |
| Total Adjustments | -5602006 | TotalAdjustments |
| Excess Or Deficit Per FS | -57160 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 115383513 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | -5605354 | NetUnrealizedGainsInvestments |
| Other Revenues | -829684 | OtherRevenues |
| Revenue Not Rptd F990 | -6435038 | RevenueNotRptdF990 |
| Revenue Subtotal | 121818551 | RevenueSubtotal |
| Other Revenues Not Included | -696383 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | -696383 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 121122168 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 115456410 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | 751109 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 751109 | ExpensesNotRptdF990 |
| Expenses Subtotal | 114705301 | ExpensesSubtotal |
| Other Expenses Not Included | 872021 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | 872021 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 115577322 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (6 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | PART X: | THE FILING ORGANIZATION IS A TAX-EXEMPT ORGANIZATION AS DEFINED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE FILING ORGANIZATION'S INCOME TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL AND STATE AUTHORITIES. THE FILING ORGANIZATION IS NOT AWARE OF ANY ACTIVITIES THAT WOULD JEOPARDIZE ITS TAX-EXEMPT STATUS. THE FILING ORGANIZATION IS NOT AWARE OF ANY ACTIVITIES THAT ARE SUBJECT TO TAX ON UNRELATED BUSINESS INCOME OR EXCISE OR OTHER TAXES. THE FILING ORGANIZATION ADOPTED THE INCOME TAX STANDARD FOR UNCERTAIN TAX POSITIONS. THIS STANDARD CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN AN ORGANIZATION'S FINANCIAL STATEMENTS IN ACCORDANCE WITH THE INCOME TAX STANDARD. THIS STANDARD PRESCRIBES RECOGNITION AND MEASUREMENT OF TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN ON A TAX RETURN THAT ARE NOT CERTAIN TO BE REALIZED. THIS STANDARD HAD NO IMPACT ON THE FILING ORGANIZATION'S FINANCIAL STATEMENTS FOR THE YEARS ENDED DECEMBER 31, 2011 OR DECEMBER 31, 2010. |
| PART XI, LINE 8 - OTHER ADJUSTMENTS: | MISCELLANEOUS 3,348. | |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | INVESTMENT FEES -224,243. RECLASSED EXPENSES -607,239. RELEASES FROM RESTRICTION 1,798. | |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | GUILD 54,726. DISTRIBUTIONS-PARTNERSHIPS -751,109. RENTAL EXPENSES | |
| PART XIII, LINE 2D - OTHER ADJUSTMENTS: | RENTAL EXPENSES DISTRIBUTIONS-PARTNERSHIPS 751,109. | |
| PART XIII, LINE 4B - OTHER ADJUSTMENTS: | RECLASSED EXPENSES 607,239. INVESTMENT FEES 224,243. GUILD 40,539. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent100 | X | Pcent100 |
| 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 | 5484547 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1928758 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3555789 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03650 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 18182537 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 10154149 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 8028388 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.08230 | PercentOfTotalExpense |
Unreimbursed Costs UnreimbursedCosts
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 372832 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 219315 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 153517 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00160 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 24039916 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 12302222 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 11737694 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.12040 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 217720 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 217720 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00220 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 41322 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 41322 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00040 | PercentOfTotalExpense |
Research Research
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 312256 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 312256 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00320 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 165825 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 165825 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00170 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 737123 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 737123 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00750 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 24777039 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 12302222 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 12474817 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.12790 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $5,501,856 | BadDebtExpenseAmount |
| Amount Attributable To | 1873356 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 22554404 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 26666001 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -4111597 | 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 |
Form990 Schedule H Part IV Form990ScheduleHPartIV (3 entries)
| Description Ent Primary ActivityDescriptionEntPrimaryActivity | Organization Profit Or OwnershipOrganizationProfitOrOwnership | Officers Etc Profit Or OwnershipOfficersEtcProfitOrOwnership | Physicans Profit Or OwnershipPhysicansProfitOrOwnership |
|---|---|---|---|
| 1 BLUE RIDGE CARDIOLOGY | |||
| HEART CATH SVCS | 0.50000 | 0.00000 | 0.00000 |
| 2 CAROLINAS HEALTHCARE SYSTEM | |||
| MANAGEMENT SERVICES | 0.00000 | 0.00000 | 0.00000 |
| 3 CHS - HEALTHY HOME | |||
| HOME NURSING & THERAPY | 0.18000 | 0.00000 | 0.00000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | GRACE HOSPITAL INC | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2201 SOUTH STERLING STREET | AddressLine1 |
| City | MORGANTON | City |
| State | NC | State |
| ZIP Code | 28655 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GRACE HOSPITAL INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| Eligibility Criteria Explained | 1 | EligibilityCriteriaExplained |
| Uses FPG Free | 1 | UsesFPGFree |
| FPG Free Percent | 120.000000000000 | FPGFreePercent |
| Uses FPG Discounted | 1 | UsesFPGDiscounted |
| FPG Discount Percent | 250.000000000000 | FPGDiscountPercent |
| Explains Basis | 1 | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Asset Level | X | AssetLevel |
| Medical Indigency | X | MedicalIndigency |
| Insurance Status | X | InsuranceStatus |
| Uninsured Discount | X | UninsuredDiscount |
| Explains Application Method | 1 | ExplainsApplicationMethod |
| Includes Publicity Measures | 1 | IncludesPublicityMeasures |
| Posted On Website | X | PostedOnWebsite |
| Available On Request | X | AvailableOnRequest |
| Other Publicity | X | OtherPublicity |
| Actions On Nonpayment | 1 | ActionsOnNonpayment |
| Collection Activities | 0 | CollectionActivities |
| Nondiscrim Emergency Care Policy | 1 | NondiscrimEmergencyCarePolicy |
| Used Other Method | X | UsedOtherMethod |
| Amounts Generally Billed | 0 | AmountsGenerallyBilled |
| Gross Charges | 0 | GrossCharges |
Form990 Schedule H Part VI Form990ScheduleHPartVI (14 entries)
| ExplanationExplanation | IdentifierIdentifier | Return ReferenceReturnReference |
|---|---|---|
| PART I, LINE 3C: GRACE HOSPITAL USES THE SLIDING SCALE PROVIDED IN THE FEDERAL POVERTY INCOME GUIDELINES PUBLISHED ANNUALLY BY THE DEPARTMENT OF HEALTH AND HUMAN SERVICES TO DETERMINE ELIGIBILITY. AN ASSET TEST IS USED TO DETERMINE ELIGIBILITY FOR FREE OR DISCOUNTED CARE.PART I, LINE 6A:COMMUNITY BENEFIT REPORT IS PREPARED FOR BLUE RIDGE HEALTHCARE SYSTEM (BRHS) WHICH INCLUDES GRACE HOSPITAL, GRACE NURSING CENTER, VALDESE NURSING CENTER, VALDESE GENERAL HOSPITAL, AND BLUE RIDGE HEALTHCARE MEDICAL GROUP. | ||
| PART I, L7 COL(F): BAD DEBT COST FROM LINE 2 IS BASED ON TOTAL BAD DEBT EXPENSE MULTIPLIED BY THE COST-TO-CHARGE RATIO. CHARITY INCLUDED ON LINE 3 IS CALCULATED BASED ON A STATISTICAL SAMPLE OF SELF PAY PATIENTS THAT QUALIFY FOR CHARITY CARE FROM THE OUTPATIENT SETTING. PER NOTE 8 OF BLUE RIDGE'S AUDITED FINANCIAL STATEMENTS, "UNINSURED DISCOUNTS AND BAD DEBTS - INCLUDES THE COST OF SERVICES PROVIDED TO UNINSURED OR UNDERINSURED PATIENTS AND TO PATIENTS WHO OTHERWISE DO NOT PAY FOR THEIR HEALTHCARE SERVICES." | ||
| PART II: NOT APPLICABLE FOR GRACE HOSPITAL. | ||
| PART III, LINE 4: BRHC'S COST OR 'INVESTMENT IN' ITS MISSION TO CREATE AND OPERATE A COMPREHENSIVE SYSTEM TO PROVIDE HEALTH CARE AND RELATED SERVICES, INCLUDING EDUCATION AND RESEARCH PROGRAMS, FOR THE BENEFIT OF THE PEOPLE IT SERVES, IS MEASURED USING THE FOLLOWING CATEGORIES OF COMMUNITY BENEFIT:COSTS OF FINANCIAL ASSISTANCE TO INDIGENT PATIENTS - INCLUDES THE COST OF SERVICES PROVIDED TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER THE BRHC FINANCIAL ASSISTANCE POLICIES, WHICH PROVIDE CARE WITHOUT CHARGE OR AT DISCOUNTED RATES TO UNINSURED PATIENTS. KEY ELEMENTS USED TO DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE INCLUDE A PATIENTS DEMONSTRATED ABILITY TO PAY BASED ON FAMILY SIZE AND HOUSEHOLD INCOME RELATIVE TO FEDERAL INCOME POVERTY GUIDELINES.COSTS OF DISCOUNTS EXTENDED TO UNINSURED PATIENTS AND BAD DEBT COSTS BY PATIENTS WHO DO NOT PAY FOR SERVICES - INCLUDES THE COST OF SERVICES PROVIDED TO UNINSURED OR UNDERINSURED PATIENTS AND TO PATIENTS WHO OTHERWISE DO NOT PAY FOR THEIR HEALTH CARE SERVICES.LOSSES INCURRED BY SERVING MEDICARE AND MEDICAID PATIENTS - REPRESENTS THE UNREIMBURSED COST OF SERVICES PROVIDED TO PATIENTS WHO QUALIFY FOR FEDERAL AND/OR STATE GOVERNMENT HEALTH CARE BENEFITS.COMMUNITY BENEFIT PROGRAMS - INCLUDES THE UNREIMBURSED COST OF VARIOUS EDUCATION AND RESEARCH PROGRAMS, NON-BILLED MEDICAL SERVICES, IN-KIND DONATIONS, AND OTHER SERVICES THAT MEET A STRONG COMMUNITY NEED, BUT DO NOT PAY FOR THEMSELVES AND WOULD BE CUT BASED SOLELY ON FINANCIAL CONSIDERATIONS ALONE. | ||
| PART III, LINE 8: THE MEDICARE COST REPORT IS PREPARED USING THE AUDITED TRIAL BALANCE FOR GRACE HOSPITAL. THE COST REPORT IS PREPARED IN ACCORDANCE WITH ALL APPLICABLE RULES AND REGULATIONS. AS A 501(C)(3) ORGANIZATION, GRACE HOSPITAL ACCEPTS ALL PATIENTS WITHOUT REGARD TO THE INSURANCE OR LACK OF INSURANCE. | ||
| PART III, LINE 9B: IF FINANCIAL ASSISTANCE IS 100% NO COLLECTION EFFORTS ARE MADE AS ACCOUNT BALANCE IS 0. IF PARTIAL FINANCIAL ASSISTANCE, NORMAL COLLECTION PROCEDURES APPLY FOR PATIENT RESPONSIBILTY AMOUNTS. | ||
| PART V, SECTION B, LINE 13G: PATIENT ROOM VISIT FROM FINANCIAL COUNSELOR AND SOCIAL WORKER. CONTACT INFO. ON WEBSITE AND PATIENT STATEMENTS. | GRACE HOSPITAL, INC. | |
| PART V, SECTION B, LINE 19D: ALL PATIENTS RECEIVE SAME CHARGE BASED ON SERVICES PROVIDED. DISCOUNT FOR FINANCIAL ASSISTANCE IS DETERMINED BY POLICY WHICH INCLUDES AN UNINSURED DISCOUNT OF 30% FOR THAT POPULATION. | GRACE HOSPITAL, INC. | |
| PART VI, LINE 2: GRACE HOSPITAL PERFORMS OUTREACH SERVICES AND HEALTH EDUCATION OPPORTUNITIES FOR THE COMMUNITY SERVED. FEEDBACK FROM THESE EFFORTS ALONG WITH THE EVALUATION OF THE PATIENTS SERVED ARE CONSIDERED IN ASSESSING THE COMMUNITIES HEALTH CARE NEEDS. IN ADDITION, THE ORGANIZATION HAS CONDUCTED EXTENSIVE RESEARCH INTO THE AREAS MOST SERIOUS HEALTH THREATS AND DEVELOPED A PLAN TO FOCUS ATTENTION ON THESE ISSUES. | ||
| PART VI, LINE 3: ALL SELF PAY ED PATIENTS ARE SCREENED FOR CHARITY AND-OR FINANCIAL ASSISTANCE IN THE ED AREA. PATIENT SEEN IN OUTPATIENT SURGERY AND INPATIENT SETTINGS ARE SCREENED DURING OR PRIOR TO SERVICES. MONTHLY STATEMENTS REFERENCE THE PHONE NUMBERS TO CALL FOR FINANCIAL ASSISTANCE. | ||
| PART VI, LINE 4: BRHCS PRIMARY SERVICE AREA INCLUDES THREE COUNTIES (BURKE, MCDOWELL, CALDWELL); PATIENTS FROM A NUMBER OF OTHER OUTLYING COUNTIES ARE ALSO SERVED BY BRHC. THE POPULATION IS PREDOMINANTLY CAUCASIAN. SIGNIFICANT MINORITIES INCLUDE HMONG, AFRICAN-AMERICAN AND HISPANIC RESIDENTS. THE AREA IS ECONOMICALLY DEPRESSED DUE TO THE LOSS OF TRADITIONAL FURNITURE AND TEXTILE INDUSTRIES. | ||
| PART VI, LINE 5: BRHC IS GOVERNED BY A VOLUNTEER COMMUNITY BOARD OF DIRECTORS. BRHC SYSTEM IS SERVED BY OPEN MEDICAL STAFFS. THE SYSTEM IS ALSO SUPPORTED BY A GROWING BRHC VOLUNTEERS CORPS WHO CONTRIBUTE THOUSANDS OF HOURS IN SERVICE ANNUALLY. BRHC ACTIVELY RECRUITS PRIMARY CARE PHYSICIANS AND PHYSICIAN SPECIALISTS TO MEET SPECIFIC MEDICAL NEEDS IN THE COMMUNITY. | ||
| PART VI, LINE 6: GRACE HOSPITAL IS PART OF BLUE RIDGE HEALTHCARE SYSTEM. BLUE RIDGE SERVES BURKE COUNTY, NC AND SURROUNDING COUNTIES. BLUE RIDGE IS AFFILIATED WITH CAROLINAS HEALTHCARE SYSTEM BASED IN CHARLOTTE, NC. | ||
| NC | REPORTS FILED WITH STATES | PART VI, LINE 7 |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 1 | RecordsMaintained |
Recipient Table RecipientTable (5 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EIN Of RecipientEINOfRecipient | IRC SectionIRCSection | Amount Of Cash GrantAmountOfCashGrant | Purpose Of GrantPurposeOfGrant | Amount Of Non Cash AssistanceAmountOfNonCashAssistance | Method Of ValuationMethodOfValuation |
|---|---|---|---|---|---|---|---|---|---|
| BLUE RIDGE HEALTHCARE FOUNDATION INC | |||||||||
| 2201 SOUTH STERLING STREET | MORGANTON | NC | 28655 | 582063920 | 501(C)(3) | 19937 | MEMORIAL DONATIONS AND HEALTHCARE EQUIPMENT | ||
| BURKE CO - FOOTHILLS ALLIED HEALTH | |||||||||
| PO BOX 219 | MORGANTON | NC | 28655 | 566000280 | 501(C)(3) | 37800 | DONATION FOR HEALTHCARE EDUCATION CENTER | ||
| GOOD SAMARITAN CLINIC | |||||||||
| 305 W UNION ST | MORGANTON | NC | 28655 | 561939030 | 501(C)(3) | DONATED PHARMACEUTICALS | 50597 | RETAIL VALUE | |
| BURKE COUNTY COMMITTEE OF 100 INC | |||||||||
| PO BOX 1489 | MORGANTON | NC | 28655 | 208831851 | 501(C)(3) | 5000 | COMMUNITY BENEFIT | ||
| BURKE COUNTY PUBLIC SCHOOLS | |||||||||
| PO BOX 889 | MORGANTON | NC | 28655 | 560935935 | GOVERNMENTAL | 121368 | SCHOOL NURSES AND ATHLETIC TRAINERS | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 5 | TotalNbrOf501C3AndGovtGrants |
| Total Nbr Of Other Organizations | 0 | TotalNbrOfOtherOrganizations |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | PROCEDURE FOR MONITORING GRANTS IN THE U.S.: | Identifier |
| Return Reference | PART I, LINE 2: | ReturnReference |
| Explanation | SCHEDULE I, PART I, LINE 2: BLUE RIDGE HEALTHCARE SYSTEM EMPLOYEES AND THEIR FAMILY MEMBERS ARE FIRST CONSIDERED FOR FINANCIAL ASSISTANCE THROUGH SCHOLARSHIPS AND GRANTS IN AID. APPLICANTS PREPARING FOR WORK IN HEALTHCARE RELATED AREAS ARE CONSIDERED NEXT. GENERALLY, THIS DOES NOT INCLUDE AREAS OF STUDY SUCH AS ACCOUNTING OR INFORMATION SYSTEMS. FINANCIAL ASSISTANCE IS BASED ON THE INDIVIDUAL'S QUALIFICATIONS AND DEMONSTRATED FINANCIAL NEEDS. A GRADE POINT AVERAGE OF AT LEAST 2.5 ON A 4.0 SCALE IS REQUIRED. THE SCHOLARSHIP COMMITTEE MEETS TWICE A YEAR OR AS OFTEN AS NEEDED TO DECIDE ON RECIPIENTS. IF ALL APPLICATIONS SATISFY SELECTION CRITERIA, THEN MONIES ARE AWARDED BASED ON OTHER FINANCIAL ASSISTANCE AWARDED, DEMONSTRATED FINANCIAL NEED, AREA OF STUDY, AND GRADE POINT AVERAGE. ALL SELECTED APPLICATIONS INTERVIEWED BY THE SCHOLARSHIP COMMITTEE CHAIRPERSON. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Club Dues Or Fees | X | ClubDuesOrFees |
| Written Policy Re T And E Expenses | 1 | WrittenPolicyReTAndEExpenses |
| Substantiation Required | 1 | SubstantiationRequired |
| Compensation Committee | X | CompensationCommittee |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | 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 | 1 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 1 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (5 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| LAURA LAMBETH | |||||||||||||
| 187442 | 0 | 59934 | 0 | 0 | 0 | 7352 | 0 | 17845 | 0 | 272573 | 0 | 0 | 0 |
| THOMAS EURE | |||||||||||||
| 158485 | 0 | 33527 | 0 | 6755 | 0 | 7031 | 0 | 28263 | 0 | 234061 | 0 | 0 | 0 |
| ANTHONY FRASCA MD | |||||||||||||
| 272209 | 0 | 0 | 0 | 0 | 0 | 8846 | 0 | 13813 | 0 | 294868 | 0 | 0 | 0 |
| BYRON STROTHER MD | |||||||||||||
| 267334 | 0 | 0 | 0 | 0 | 0 | 9575 | 0 | 22747 | 0 | 299656 | 0 | 0 | 0 |
| JOSEPH MAZZOLA MD | |||||||||||||
| 262548 | 0 | 0 | 0 | 0 | 0 | 1584 | 0 | 22848 | 0 | 286980 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (4 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| PART I, LINE 1A | BENEFITS PROVIDED TO OFFICERS TO FACILITATE BUSINESS RELATIONSHIPS. | |
| PART I, LINE 3 | UNCHECKED ITEMS ARE CONDUCTED BY CHS AS PART OF THE MANAGEMENT AGREEMENT. THE ORGANIZATION COMPENSATION COMMITTEE REVIEWS AND APPROVES. | |
| PART I, LINE 6 | BONUSES ARE PAID IF THE ORGANIZATION'S RESULTS MEET CERTAIN PERFORMANCE INDICATORS. | |
| PART III | PART II: COMPENSATION FOR KENNETH WOOD, KATHY BAILEY, AND ROBERT FRITTS IS PAID BY CAROLINA HEALTH SYSTEMS THROUGH A MANAGEMENT SERVICE CONTRACT. | SUPPLEMENTAL INFORMATION |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV
Name Of Interested Person NameOfInterestedPerson
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | KENNETH WOOD | NamePerson |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship | VOTING BOARD MEMBER AND CEO | Relationship |
| Amount Of Transaction | 0 | AmountOfTransaction |
| Description Of Transaction | HIS COMPENSATION IS PAID BY CAROLINA HEALTH SYSTEM | DescriptionOfTransaction |
| Sharing Of Revenues | 0 | SharingOfRevenues |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (8 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| FORM 990, PART VI, SECTION A, LINE 3 | IN 1999, THE ORGANIZATION ENTERED INTO A MANAGEMENT SERVICES CONTRACT WITH CAROLINAS HEALTHCARE SYSTEM. THE TERMS OF THE CONTRACT CALL FOR THE ORGANIZATION TO PAY CAROLINAS HEALTHCARE SYSTEM AN ANNUAL MANAGEMENT FEE BASED UPON THE ORGANIZATION'S NET OPERATING REVENUES. IN ADDITION, CAROLINAS HEALTHCARE SYSTEM IS REQUIRED TO FURNISH THE ORGANIZATION WITH A CHIEF EXECUTIVE OFFICER, CHIEF OPERATING OFFICER, AND CHIEF FINANCIAL OFFICER. THE ORGANIZATION REIMBURSES CAROLINAS HEALTHCARE SYSTEM FOR THE SALARY AND BENEFITS' COST OF THESE INDIVIDUALS. | |
| FORM 990, PART VI, SECTION B, LINE 11 | THE CHIEF FINANCIAL OFFICER AND THE EXECUTIVE COMMITTEE WILL REVIEW THE PREPARED FORM 990 BEFORE IT IS FILED WITH THE IRS. A DRAFT OF FORM 990 WAS POSTED FOR ACCESS BY THE GOVERNING BODY BEFORE IT WAS FILED WITH THE IRS. | |
| FORM 990, PART VI, SECTION B, LINE 12C | CORPORATE COUNSEL, WHO REVIEWS ALL ANNUAL CONFLICT OF INTEREST DISCLOSURES, IS PRESENT AT EVERY BOARD MEETING TO ENSURE THAT ANY POTENTIAL CONFLICTS ARE APPROPRIATELY HANDLED BY MEMBERS ABSTAINING FROM VOTES AS APPROPRIATE. | |
| FORM 990, PART VI, SECTION B, LINE 15 | SUCH A PROCESS WAS PERFORMED FOR DETERMINING THE COMPENSATION OF THE ORGANIZATION'S PRESIDENT/CEO, CFO AND AND COO DURING 2011 AND KEY EMPLOYEE DURING 2011. | |
| FORM 990, PART VI, SECTION C, LINE 19 | BY-LAWS ARE AVAILABLE UPON REQUEST THROUGH CORPORATE COUNSEL. ARTICLES OF INCORPORATION ARE FILED WITH NC STATE AND ARE AVAILABLE ON THEIR WEBSITE. FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. | |
| FORM 990, PART VII, DESCRIPTION OF HOURS FOR RELATED ORGANIZATIONS: | OFFICERS AND KEY EMPLOYEES LISTED ON PART VII WORK AN AVERAGE OF 40-50 HOURS PER WEEK. THEIR TIME IS SHARED BETWEEN THE FILING ORGANIZATION AND OTHER RELATED ENTITIES LISTED ON SCHEDULE R. | |
| FORM 990, PART XI, LINE 5: | NET UNREALIZED LOSSES ON INVESTMENTS: -5,605,354. MISCELLANEOUS 3,348. TOTAL TO FORM 990, PART XI, LINE 5: -5,602,006. | CHANGES IN NET ASSETS OR FUND BALANCES: |
| FORM 990, PART XII, LINE 2C: | NO CHANGES FOR APPROVING AUDITED FINANCIAL STATEMENTS OR SELECTION OF INDEPENDENT ACCOUNTANTS HAVE OCCURRED FROM THE PRIOR YEAR. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part I Form990ScheduleRPartI
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GRACE HEALTH VENTURES INC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2201 SOUTH STERLING STREET | AddressLine1 |
| City | MORGANTON | City |
| State | NC | State |
| ZIP Code | 28655 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 561581317 | EIN |
| Primary Activities | RELATED | PrimaryActivities |
| Legal Domicile State | NC | LegalDomicileState |
| Total Income | -512 | TotalIncome |
| EOY Assets | 35284 | EOYAssets |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BLUE RIDGE HEALTHCARE SYSTEMS INC | BusinessNameLine1 |
Form990 Schedule R Part II Form990ScheduleRPartII (9 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Direct Controlling Entity NADirectControllingEntityNA | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|---|
| VALDESE GENERAL HOSPITAL INC | ||||||||||
| 720 MALCOLM BOULEVARD | VALDESE | NC | 28690 | 560634510 | HEALTHCARE | NC | 501(C)(3) | N/A | N/A | 0 |
| VALDESE NURSING HOME INC | ||||||||||
| 95 LOCUST STREET | RUTHERFORD COLLEGE | NC | 28671 | 581978560 | HEALTHCARE | NC | 501(C)(3) | 509(A)(2) | N/A | 0 |
| GRACE LIFECARE INC | ||||||||||
| 500 LENOIR ROAD | MORGANTON | NC | 28655 | 561722754 | HEALTHCARE | NC | 501(C)(3) | 509(A)(2) | N/A | 0 |
| GRACE NURSING CENTER INC | ||||||||||
| 109 FOOTHILLS DRIVE | MORGANTON | NC | 28655 | 561838369 | HEALTHCARE | NC | 501(C)(3) | 509(A)(2) | N/A | 0 |
| GRACE PROPERTIES INC | ||||||||||
| 500 LENOIR ROAD | MORGANTON | NC | 28655 | 561727514 | HEALTHCARE | NC | 501(C)(3) | 509(A)(3) | N/A | 0 |
| BLUE RIDGE FOUNDATION INC | ||||||||||
| 2201 SOUTH STERLING STREET | MORGANTON | NC | 28655 | 582063920 | HEALTHCARE | NC | 501(C)(3) | 509(A)(1) | N/A | 0 |
| BLUE RIDGE MEDICAL GROUP INC | ||||||||||
| 2201 SOUTH STERLING STREET | MORGANTON | NC | 28655 | 020777195 | HEALTHCARE | NC | 501(C)(3) | 509(A)(2) | N/A | 0 |
| BLUE RIDGE HEALTHCARE SYSTEMS INC | ||||||||||
| 2201 SOUTH STERLING STREET | MORGANTON | NC | 28655 | 562150313 | HEALTHCARE | NC | 501(C)(3) | 509(A)(3) | N/A | 0 |
| BLUE RIDGE MOBILE IMAGING LLC | ||||||||||
| 2201 SOUTH STERLING STREET | MORGANTON | NC | 28655 | 020777199 | HEALTHCARE | NC | 501(C)(3) | N/A | N/A | 0 |
Form990 Schedule R Part III Form990ScheduleRPartIII (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Predominant Income TypePredominantIncomeType | Share Of Total IncomeShareOfTotalIncome | Share Of EOY AssetsShareOfEOYAssets | Disproportionate AllocationsDisproportionateAllocations | General Or Managing PartnerGeneralOrManagingPartner | Percentage OwnershipPercentageOwnership |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| BLUE RIDGE CARDIOLOGY | |||||||||||||
| 2201 SOUTH STERLING STREET | MORGANTON | NC | 28655 | 753158601 | CARDIAC CATHETERIZATION SERVICES | NC | BRHC & MEDCATH | RELATED | 9769 | 330906 | 0 | 0 | 0.50000 |
| HEALTHY HOME LLC | |||||||||||||
| 4425 GOLF ACRES DR | CHARLOTTE | NC | 29202 | 261451047 | HOME HEALTH SERVICES | NC | THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY | RELATED | -119350 | -119350 | 0 | 0 | 0.18000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 1 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | 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 | 1 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 1 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 1 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 1 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 1 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (5 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| GRACE LIFECARE INC | ||
| P | 299052 | INTERCOMPANY ACTIVITY |
| BLUE RIDGE MEDICAL GROUP INC | ||
| P | 241625 | INTERCOMPANY ACTIVITY |
| BLUE RIDGE MEDICAL GROUP INC | ||
| J | 640649 | INTERCOMPANY ACTIVITY |
| BLUE RIDGE CARDIOLOGY | ||
| L | 1274423 | INTERCOMPANY ACTIVITY |
| BLUE RIDGE HEALTHCARE SYSTEMS INC | ||
| O | 3910380 | INTERCOMPANY ACTIVITY |
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