ANC ANGEL MEDICAL CENTER INC: Form 990, tax year 2010
View the entire original 990 at ProPublica ↗
- Organization
- ANC ANGEL MEDICAL CENTER INC (EIN 56-6000064)
- Tax period
- 2010-10-01 to 2011-09-30
- Filed
- 2012-08-14
- IRS object ID
- 201232279349301693
- 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 G
- Schedule H
- Schedule J
- Schedule K
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-08-14T11:52:11-05:00 | 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 | 566000064 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ANGEL MEDICAL CENTER INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | ANGE | NameControl |
| Phone | 8285248411 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 1209 | AddressLine1 |
| City | FRANKLIN | City |
| State | NC | State |
| ZIP Code | 28744 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | JEFF RUSH | Name |
| Title | INTERM CFO | Title |
| Phone | 8285248411 | Phone |
| Date Signed | 2012-08-14 | 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 | JEFF RUSH | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 1209 | AddressLine1 |
| City | FRANKLIN | City |
| State | NC | State |
| ZIP Code | 28744 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 46718503 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.ANGELMED.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1933 | YearFormation |
| State Legal Domicile | NC | StateLegalDomicile |
| Activity Or Mission Description | PROVISION OF HEALTHCARE SERVICES | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 17 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 17 | NbrIndependentVotingMembers |
| Total Nbr Employees | 432 | TotalNbrEmployees |
| Total Nbr Volunteers | 177 | TotalNbrVolunteers |
| Total Gross UBI | 300384 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 87990 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 228561 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 803239 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 41353719 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 44621112 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 48586 | InvestmentIncomePriorYear |
| Investment Income Current Year | 13528 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 1141914 | OtherRevenuePriorYear |
| Other Revenue Current Year | 1139700 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 42772780 | TotalRevenuePriorYear |
| Total Revenue Current Year | 46577579 | 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 | 15082613 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 19703106 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 138436 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 31656564 | OtherExpensePriorYear |
| Other Expenses Current Year | 27317690 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 46739177 | TotalExpensesPriorYear |
| Total Expenses Current Year | 47020796 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -3966397 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -443217 | RevenuesLessExpensesCY |
| Total Assets BOY | 32794138 | TotalAssetsBOY |
| Total Assets EOY | 31086811 | TotalAssetsEOY |
| Total Liabilities BOY | 21005163 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 19471021 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 11788975 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 11615790 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | DEDICATED PROFESSIONALS PROVIDING COMPASSIONATE AND SUPERIOR HEALTHCARE TO ALL. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 42459238 | Expense |
| Revenue | 44781484 | Revenue |
| Description | ANGEL MEDICAL CENTER, INC. (AMC) PROVIDES QUALITY MEDICAL HEALTHCARE SERVICES TO PEOPLE IN ITS SERVICE AREA REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE, OR ABILITY TO PAY. ALTHOUGH REIMBURSMENT FOR SERVICES RENDERED IS CRITICAL TO THE OPERATION AND STABILITY OF AMC, IT IS RECOGNIZED THAT NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PAY FOR ESSENTIAL MEDICAL SERVICES. AMC FURTHER RECOGNIZES THAT ITS MISSION IS TO SERVE THE COMMUNITY WITH RESPECT TO PROVIDING HEALTHCARE SERVICES AND EDUCATION. TO THIS END, AMC PROVIDES FREE CARE, SUBSIDIZED CARE, CARE AT BELOW COST TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS, AND HEALTHCARE ACTIVITIES, PROGRAMS AND EDUCATION TO SUPPORT THE COMMUNITY. DURING FISCAL YEAR ENDED SEPTEMBER 30, 2011, AMC PROVIDED HEALTHCARE SERVICE TO 1,544 INPATIENTS WITH A TOTAL OF 5,392 PATIENT DAYS, 49,412 OUTPATIENT VISITS, AND 14,622 EMERGENCY PATIENT VISITS.CHARITY CARE IS ALSO PROVIDED THROUGH MANY REDUCED PRICE SERVICES AND FREE PROGRAMS OFFERED THROUGHOUT THE YEAR BASED UPON ACTIVITIES AND SERVICES WHICH AMC BELIEVES WILL SERVE A BONA FIDE COMMUNITY HEALTH NEED. AMC IS VERY INVOLVED IN THE COMMUNITY WORKING WITH OTHER HEALTH PROGRAMS AND OFFERING NUMEROUS ACTIVITY AND EDUCATIONAL OPPORTUNITIES FOR THE PEOPLE IN ITS SERVICE AREA. AMC HAS REGULAR COMMUNITY ACTIVITIES AND EDUCATION PROGRAMS, SUCH AS, DIABETES MANAGEMENT, CPR TRAINING, FIRST AID TRAINING, OSTEOPOROSIS EDUCATION, PREPARED CHILDBIRTH EDUCATION, TEDDY BEAR CLINIC, SMOKING CESSATION CLASSES, ETC., THAT IT OFFERS TO THE PUBLIC FOR NOMINAL FEES OR FREE. SUPPORT GROUPS FOR DIABETES, HEARING LOSS, HEALING HEARTS, AND OSTEOPOROSIS ARE OFFERED BY THE HOSPITAL. ADDITIONALLY, EMPLOYEES OF AMC SERVE ON NUMEROUS HEALTHCARE COMMITTEES AND BOARDS IN THE COMMUNITY AND GIVE FINANCIALLY THROUGH PROJECTS AND PROGRAMS ENDORSED BY AMC. | Description |
| Total Program Service Expense | 42459238 | 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 | 0 | 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 | 1 | 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 | 0 | 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 | 35 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 432 | 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 | 17 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 17 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 1 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 1 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | 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 | TRACY GIHL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 8283694420 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 120 RIVERVIEW STREET | AddressLine1 |
| City | FRANKLIN | City |
| State | NC | State |
| ZIP Code | 28734 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (29 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 |
|---|---|---|---|---|---|---|---|---|
| RANDOLPH BULGIN | ||||||||
| CHAIRPERSON | 1.00 | X | X | 0 | 0 | 0 | ||
| JAN UNGER | ||||||||
| VICE-CHAIRPERSON | 1.00 | X | X | 0 | 0 | 0 | ||
| EDWARD R SHATLEY | ||||||||
| TREASURER | 1.00 | X | X | 0 | 0 | 0 | ||
| MONTY C BECK | ||||||||
| SECRETARY | 1.00 | X | X | 0 | 0 | 0 | ||
| GUS WILDE MD | ||||||||
| MEMBER-AT-LARGE | 1.00 | X | 0 | 0 | 0 | |||
| KEN STONEBRAKER | ||||||||
| MEMBER-AT-LARGE | 1.00 | X | 0 | 0 | 0 | |||
| JOE COLLINS | ||||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | |||
| DAVID FRANKS MD | ||||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | |||
| JANE C KIMSEY | ||||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | |||
| JOHNNY MIRA-KNIPPEL | ||||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | |||
| JANET J GREENE | ||||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | |||
| THOMAS QUIGLEY | ||||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | |||
| MARLA ANN D'ASCOLI | ||||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | |||
| CONNIE HAIRE | ||||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | |||
| JOHN MAHER | ||||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | |||
| GEORGE RENFRO | ||||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | |||
| BOB JONES | ||||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | |||
| TIM HUBBS | ||||||||
| CEO | 50.00 | X | 182465 | 0 | 10052 | |||
| CLIFF HENDREN | ||||||||
| CFO | 50.00 | X | 68305 | 0 | 6418 | |||
| MARTIN WADEWITZ | ||||||||
| COO | 50.00 | X | 90218 | 0 | 25515 | |||
| SHEILA PRICE | ||||||||
| CNO | 50.00 | X | 7904 | 0 | 588 | |||
| VICTOR ADAN MD | ||||||||
| DIRECTOR ER PHYSICIANS | 50.00 | 275525 | 0 | 43315 | X | |||
| MICHAEL D SHEAFFER MD | ||||||||
| DIRECTOR HOSPITALISTS | 50.00 | 212078 | 0 | 35123 | X | |||
| MICHAEL D GOLIGHTLY MD | ||||||||
| DIRECTOR ANGEL URGEANT CARE | 50.00 | 177824 | 0 | 12356 | X | |||
| MAHENDRABHAI PATEL MD | ||||||||
| PHYSICIAN | 50.00 | 210844 | 0 | 54145 | X | |||
| GILBERTO ROBLES MD | ||||||||
| PHYSICIAN | 50.00 | 378030 | 0 | 35414 | X | |||
| TRAVIS PETRICEK MD | ||||||||
| PHYSICIAN | 50.00 | 349770 | 0 | 26839 | X | |||
| NELSON P DAVIS MD | ||||||||
| PHYSICIAN | 50.00 | 273840 | 0 | 28302 | X | |||
| SUSAN L MEDLOCK MD | ||||||||
| PHYSICIAN | 50.00 | 209930 | 0 | 32143 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 2436733 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 310210 | TotalOtherCompensation |
| Number Individuals GT100 K | 18 | 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 |
|---|---|---|---|---|---|
| CLINICAL COLLEAGUES | |||||
| 613 TATUM AVENUE | COLLINGSWOOD | NJ | 08108 | CRNA SERVICES | 1596840 |
| HORIZON CONTRACTORS LLC | |||||
| 267 PIT ROAD | MOORESVILLE | NC | 28115 | BIO-MED SERVICES | 443648 |
| TRIANGLE CONSTRUCTION CO INC | |||||
| PO BOX 6266 | GREENVILLE | SC | 29606 | CONTRACTOR SERVICES | 248072 |
| BARRINGTON CONTRACTING INC | |||||
| PO BOX 1577 | FRANKLIN | NC | 28744 | CONTRACTOR SERVICES | 219393 |
| DIXON HUGHES GOODMAN LLP | |||||
| 500 RIDGEFIELD COURT | ASHEVILLE | NC | 28802 | ACCOUNTING SERVICES | 169727 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 7 | NumberOfContractorsGT100K |
| Fundraising Events | 13434 | FundraisingEvents |
| Related Organizations | 32930 | RelatedOrganizations |
| Government Grants | 116434 | GovernmentGrants |
| All Other Contributions | 640441 | AllOtherContributions |
| Total Contributions | 803239 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | NET PATIENT SERVICES | Description |
| Business Code | 621400 | BusinessCode |
| Total Revenue Column | 44621112 | TotalRevenueColumn |
| Related Or Exempt Function Income | 44621112 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 44621112 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 13454 | TotalRevenueColumn |
| Exclusion | $13,454 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 428141 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 134555 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 293586 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 293586 | TotalRevenueColumn |
| Exclusion | $293,586 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 212 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 138 | Securities |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -138 | Securities |
| Other | 212 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 74 | TotalRevenueColumn |
| Exclusion | $74 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Fundraising Events | 28262 | GrossIncomeFundraisingEvents |
| Cntrbtns Rprtd Fundraising Events | 13434 | CntrbtnsRprtdFundraisingEvents |
| Fundraising Direct Expenses | 6231 | FundraisingDirectExpenses |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 22031 | TotalRevenueColumn |
| Exclusion | $22,031 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue | ExclusionExclusionAmount |
|---|---|---|---|---|---|
| CATERING/MEALSERVICE | 722320 | 460756 | 160372 | 300384 | |
| CAFETERIA & VENDING | 722210 | 225256 | $225,256 | ||
| PURCHASE DISCOUNTS | 900099 | 24888 | $24,888 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 113183 | TotalRevenueColumn |
| Exclusion | $113,183 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 824083 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 46577579 | TotalRevenueColumn |
| Related Or Exempt Function Income | 44781484 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 300384 | UnrelatedBusinessRevenue |
| Exclusion | $692,472 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1354825 | Total |
| Program Services | 714449 | ProgramServices |
| Management And General | 640376 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 14620372 | Total |
| Program Services | 12911017 | ProgramServices |
| Management And General | 1648616 | ManagementAndGeneral |
| Fundraising | 60739 | Fundraising |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 251529 | Total |
| Program Services | 214533 | ProgramServices |
| Management And General | 36040 | ManagementAndGeneral |
| Fundraising | 956 | Fundraising |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2014947 | Total |
| Program Services | 1718576 | ProgramServices |
| Management And General | 288710 | ManagementAndGeneral |
| Fundraising | 7661 | Fundraising |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1461433 | Total |
| Program Services | 1246477 | ProgramServices |
| Management And General | 209400 | ManagementAndGeneral |
| Fundraising | 5556 | Fundraising |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 38491 | Total |
| Management And General | 38491 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 131143 | Total |
| Management And General | 131143 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 95337 | Total |
| Management And General | 95337 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6849995 | Total |
| Program Services | 6395260 | ProgramServices |
| Management And General | 452422 | ManagementAndGeneral |
| Fundraising | 2313 | Fundraising |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 108785 | Total |
| Program Services | 12022 | ProgramServices |
| Management And General | 96763 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7960419 | Total |
| Program Services | 7581232 | ProgramServices |
| Management And General | 371010 | ManagementAndGeneral |
| Fundraising | 8177 | Fundraising |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 236302 | Total |
| Program Services | 98557 | ProgramServices |
| Management And General | 137745 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 548396 | Total |
| Program Services | 548396 | ProgramServices |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 129109 | Total |
| Program Services | 104529 | ProgramServices |
| Management And General | 21928 | ManagementAndGeneral |
| Fundraising | 2652 | Fundraising |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 494665 | Total |
| Program Services | 494665 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2233061 | Total |
| Program Services | 2233061 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 465151 | Total |
| Program Services | 465151 | ProgramServices |
Other Expenses OtherExpenses (3 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral | FundraisingFundraising |
|---|---|---|---|---|
| BAD DEBT EXPENSE | 7290987 | 7290987 | ||
| MISCELLANEOUS EXPENSES | 565186 | 430326 | 84478 | 50382 |
| RECRUITMENT | 170663 | 170663 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 47020796 | Total |
| Program Services | 42459238 | ProgramServices |
| Management And General | 4423122 | ManagementAndGeneral |
| Fundraising | 138436 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1830076 | BOY |
| EOY | 774786 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2536270 | BOY |
| EOY | 1839604 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4542239 | BOY |
| EOY | 5234333 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 500829 | BOY |
| EOY | 292145 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1109278 | BOY |
| EOY | 1245888 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 583100 | BOY |
| EOY | 667456 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 59809288 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 39784801 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 20271218 | BOY |
| EOY | 20024487 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1421128 | BOY |
| EOY | 1008112 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 32794138 | BOY |
| EOY | 31086811 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2758632 | BOY |
| EOY | 2732309 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 335930 | BOY |
| EOY | 268621 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 15565000 | BOY |
| EOY | 14485000 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 176643 | BOY |
| EOY | 137247 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2168958 | BOY |
| EOY | 1847844 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 21005163 | BOY |
| EOY | 19471021 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11520997 | BOY |
| EOY | 11310236 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 165970 | BOY |
| EOY | 203546 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 102008 | BOY |
| EOY | 102008 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11788975 | BOY |
| EOY | 11615790 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 32794138 | BOY |
| EOY | 31086811 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | -443217 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 270032 | 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 | $2,061 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 2061 | 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. EACH YEAR, THESE ORGANIZATIONS ENGAGE IN LOBBYING ACTIVITIES ON BEHALF OF THEIR MEMBERSHIP BODIES. FOR THE CURRENT YEAR, APPROXIMATELY 29% OF THOSE DUES HAVE BEEN ALLOCATED TO LOBBYING EXPENDITURES. | Explanation |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1794040 | OtherCostOrOtherBasis |
| Book Value | 1794040 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 31161818 | OtherCostOrOtherBasis |
| Depreciation | 18508598 | Depreciation |
| Book Value | 12653220 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1224517 | OtherCostOrOtherBasis |
| Depreciation | 908621 | Depreciation |
| Book Value | 315896 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 25363363 | OtherCostOrOtherBasis |
| Depreciation | 20367582 | Depreciation |
| Book Value | 4995781 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 265550 | OtherCostOrOtherBasis |
| Book Value | 265550 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 20024487 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities (2 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS | $1,673,462 |
| INTEREST RATE SWAP LIABILITY | $174,382 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 1847844 | TotalOfAmounts |
| Total Revenue | 46577579 | TotalRevenue |
| Total Expenses | 47020796 | TotalExpenses |
| Excess Or Deficit For Year | -443217 | ExcessOrDeficitForYear |
| Other | $270,032 | OtherAmount |
| Total Adjustments | 270032 | TotalAdjustments |
| Excess Or Deficit Per FS | -173185 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 46988397 | TotRevenueEtcAuditedFinclStmt |
| Other Revenues | 410818 | OtherRevenues |
| Revenue Not Rptd F990 | 410818 | RevenueNotRptdF990 |
| Revenue Subtotal | 46577579 | RevenueSubtotal |
| Revenue Not Rptd On Fin Stmt | 0 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 46577579 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 47161582 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | 140786 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 140786 | ExpensesNotRptdF990 |
| Expenses Subtotal | 47020796 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 47020796 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (4 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | PART X: | THE HOSPITAL IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE ORGANIZATION HAS DETERMINED THAT IT DOES NOT HAVE ANY MATERIAL UNRECOGNIZED TAX BENEFITS OR OBLIGATIONS AS OF SEPTEMBER 30, 2011. FISCAL YEARS ENDING ON OR AFTER SEPTEMBER 30, 2008 REMAIN SUBJECT TO EXAMINATION BY FEDERAL AND STATE TAX AUTHORITIES. |
| PART XI, LINE 8 - OTHER ADJUSTMENTS: | CHANGE IN FAIR VALUE OF INTEREST RATE SWAP 270,032. | |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | RENTAL EXPENSES 134,555. FUNDRAISING EVENT EXPENSES 6,231. CHANGE IN FAIR VALUE OF INTEREST RATE SWAP 270,032. | |
| PART XIII, LINE 2D - OTHER ADJUSTMENTS: | RENTAL EXPENSES 134,555. FUNDRAISING EVENT EXPENSES 6,231. |
Schedule G IRS990ScheduleG
Events Information EventsInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | OKTOBERFEST 2010 | NameOfEvent1 |
| Gross Receipts Event1 | 33250 | GrossReceiptsEvent1 |
| Charitable Contributions Event1 | 10384 | CharitableContributionsEvent1 |
| Gross Revenue Event1 | 22866 | GrossRevenueEvent1 |
| Non Cash Prizes Event1 | 634 | NonCashPrizesEvent1 |
| Rent Facility Costs Event1 | 300 | RentFacilityCostsEvent1 |
| Food And Beverage Event1 | 3662 | FoodAndBeverageEvent1 |
| Other Direct Expenses Event1 | 1244 | OtherDirectExpensesEvent1 |
| Name Of Event2 | 5K WALK/RUN | NameOfEvent2 |
| Gross Receipts Event2 | 8446 | GrossReceiptsEvent2 |
| Charitable Contributions Event2 | 3050 | CharitableContributionsEvent2 |
| Gross Revenue Event2 | 5396 | GrossRevenueEvent2 |
| Non Cash Prizes Event2 | 355 | NonCashPrizesEvent2 |
| Other Direct Expenses Event2 | 36 | OtherDirectExpensesEvent2 |
| Gross Receipts Total | 41696 | GrossReceiptsTotal |
| Charitable Contributions Total | 13434 | CharitableContributionsTotal |
| Gross Revenue Total Events | 28262 | GrossRevenueTotalEvents |
| Non Cash Prizes Total Events | 989 | NonCashPrizesTotalEvents |
| Rent Facility Costs Total Events | 300 | RentFacilityCostsTotalEvents |
| Food And Beverage Total Events | 3662 | FoodAndBeverageTotalEvents |
| Other Direct Expenses Total Events | 1280 | OtherDirectExpensesTotalEvents |
| Direct Expense Summary Events | 6231 | DirectExpenseSummaryEvents |
| Net Income Summary | 22031 | NetIncomeSummary |
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 | 0 | FPGReferenceFreeCare |
| 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 | 0 | ExpensesExceededBudget |
| 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 | 584375 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 22591 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 561784 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01410 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 5090442 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3659303 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1431139 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03600 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 5674817 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3681894 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1992923 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.05010 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 52447 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1396 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 51051 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00130 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 359599 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 359599 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00910 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 412046 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1396 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 410650 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01040 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 6086863 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3683290 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2403573 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.06050 | PercentOfTotalExpense |
Community Support CommunitySupport
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 9832 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 9832 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00020 | PercentOfTotalExpense |
Coalition Building CoalitionBuilding
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 3394 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 3394 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Health Improvement Advocacy HealthImprovementAdvocacy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 419 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 419 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Workforce Development WorkforceDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 11011 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 11011 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00030 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 24656 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 24656 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00060 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReported |
| Bad Debt Expense | $2,793,552 | BadDebtExpenseAmount |
| Amount Attributable To | 1448177 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 15423772 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 16559705 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -1135933 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 0 | WrittenDebtCollectionPolicy |
| 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 | ANGEL MEDICAL CENTER INC | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 120 RIVERVIEW STREET | AddressLine1 |
| City | FRANKLIN | City |
| State | NC | State |
| ZIP Code | 28734 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| Critical Access Hospital | X | CriticalAccessHospital |
| 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 IN 2010 PER IRS ANNOUNCEMENT 2011-37 | 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 | 3 | NumberOfOtherFacilities |
Other Facilities OtherFacilities (3 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Facility TypeFacilityType |
|---|---|---|---|---|
| ANGEL HOME HEALTH AND HOSPICE | ||||
| 170 CHURCH STREET | FRANKLIN | NC | 28734 | HOME HEALTH; SKILLED NURSING |
| ANGEL PHYSICIAN PRACTICES | ||||
| MEDICAL PARK DRIVE | FRANKLIN | NC | 28734 | PHYSICIAN OFFICES |
| ANGEL URGENT CARE | ||||
| 195 FRANKLIN PLAZA DRIVE | FRANKLIN | NC | 28734 | RURAL HEALTH CLINIC |
Form990 Schedule H Part VI Form990ScheduleHPartVI (12 entries)
| ExplanationExplanation | IdentifierIdentifier | Return ReferenceReturnReference |
|---|---|---|
| PART I, LINE 7: WORKSHEET 2 OF THE 2010 SCHEDULE H INSTRUCTIONS WAS USED TO DERIVE A COST-TO-CHARGE RATIO USED IN THE CALCULATION OF COMMUNITY BENEFIT EXPENSE AT COST. | ||
| PART I, L7 COL(F): THE AMOUNT OF TOTAL EXPENSE ON FORM 990, PART IX, LINE 25 CONTAINS A BAD DEBT EXPENSE OF $7,290,987 THAT WAS REMOVED FOR THE CALCULATION OF TOTAL CHARITY CARE PERCENTAGE FOR PART I, LINE 7. | ||
| PART II: COMMUNITY SUPPORT- AMC IS VERY INVOLVED WITH HEALTH PROMOTION IN THE SURROUNDING AREA. IN 2010, 262 VOLUNTEER HOURS WERE SPENT SERVING ON BOARDS AND COMMITTEES THAT HELP IMPROVE THE OVERALL HEALTH IN MACON COUNTY. SUCH BOARDS INCLUDED A MEDICATION ASSISTANCE PROGRAM, MACON PROGRAM FOR PROGRESS, REACH AND KIDS PLACE, (ORGANIZATIONS HELPING BATTERED WOMEN AND CHILDREN). AMC ALSO ORGANIZES MULTIPLE BLOOD DRIVES EACH YEAR AND WILL CONTINUE TO BE A RED CROSS DONOR SITE.COALITION BUILDING- ANGEL MEDICAL CENTER HAS AN ACTIVE COMMUNITY RELATIONS BOARD THAT MEETS REGULARLY TO DISCUSS THE HOSPITAL AND ITS RELATIONSHIP TO THE COMMUNITY. OUR PUBLIC RELATIONS DIRECTORS SPENDS AN AVERAGE OF FIVE HOURS A MONTH PREPARING, CONDUCTING AND DOING FOLLOW UP.COMMUNITY HEALTH IMPROVEMENT ADVOCACY- REPRESENTATIVES FROM NUTRITION SERVICES AND COMMUNITY EDUCATION PARTICIPATED IN THE PLANNING OF THE "LIGHTEN UP FOR LIFE" PROGRAM IN MACON COUNTY. THIS PROGRAM IS A TEAM EFFORT TO BECOME HEALTHIER BY WORKING TOGETHER TO EAT RIGHT AND LOSE WEIGHT.WORKFORCE DEVELOPMENT- VOLUNTEERS FROM NURSING AND ALLIED HEALTH DEPARTMENTS PARTICIPATE ANNUALLY IN A PROGRAM WITH THE LOCAL HIGH SCHOOL THAT ALLOWS STUDENTS FROM THE HEALTH OCCUPATIONS CLASS TO OBSERVE AND LEARN FROM ACTUAL EXPERIENCE RATHER THAN JUST CLASS ROOM ACTIVITIES. THREE HUNDRED SEVENTY-SIX VOLUNTEER HOURS WERE SPENT WITH THESE STUDENTS, THE MAJORITY OF WHICH GO ON TO PURSUE A DEGREE IN SOME AREA OF HEALTHCARE. | ||
| PART III, LINE 4: THERE IS NO FOOTNOTE ADDRESSING BAD DEBT IN THE ORGANIZATION'S FINANCIAL STATEMENTS.THE ORGANIZATION USED THE ANDI METHODOLOGY, WHICH USES A FACILITY-WIDE RATIO OF COST TO CHARGES AS DESCRIBED IN 2010 NCHA COMMUNITY BENEFITS GUIDELINES, TO DETERMINE BAD DEBT AT COST FOR THE PURPOSE OF PART III, LINE 2.APPROXIMATELY 81% OF THE ORGANIZATIONS'S BAD DEBT WRITE-OFFS ARE SELF PAY PATIENTS, AND APPROXIMATELY 64% OF THOSE ARE UNEMPLOYED. UNDER THE ASSUMPTION THAT SELF-PAY, UNEMPLOYED PERSONS WOULD LIKELY HAVE QUALIFIED FOR THE FINANCIAL ASSISTANCE POLICY, APPROXIMATELY 52% OF BAD DEBT WOULD QUALIFY AS COMMUNITY BENEFIT. $ 2,793,552 X 81% X 64% = $ 1,448,177 | ||
| PART III, LINE 8: THE ORGANIZATION USED ITS MEDICARE COST REPORT TO DETERMINE AMOUNTS REPORTED IN PART III, LINES 5 AND 6.THE FULL SHORTFALL SHOULD BE CONSIDERED A COMMUNITY BENEFIT. MEDICARE PATIENTS PROVIDE APPROXIMATELY 52% OF AMC'S REVENUE. APPROXIMATELY 4% OF BAD DEBT EXPENSE AND 7% OF CHARITY CARE ARE ATTRIBUTABLE TO MEDICARE PATIENTS. IN ADDITION, MANY OF OUR COMMUNITY BENEFIT PROGRAMS ARE DIRECTED TOWARD OLDER PATIENTS, MANY OF WHOM ARE ON MEDICARE. | ||
| PART I, LINE 7E: THE COMMUNITY BENEFIT EXPENSE AMOUNT LISTED ON SCHEDULE H, PAGE 1, LINE 7E IS COMPRISED OF THE FOLLOWING COMMUNITY-BUIDING ACTIVITIES:HEALTH EDUCATION LECTURES AND WORKSHOPS $ 12,457HEALTH SCREENINGS AND FAIRS $ 7,685PUBLIC SERVICE ANNOUNCEMENTS/INTERVIEWS $ 266SUPPORT GROUPS $ 3,293CHILD BIRTH CLASSES $ 1,235 | ||
| PART VI, LINE 2: ANGEL MEDICAL CENTER ASSESSES THE HEALTH CARE NEEDS OF THE COMMUNITY THROUGH CONDUCTING A STRATEGIC PLANNING PROCESS THAT LOOKS AT A NUMBER OF INDICATORS THAT PROVIDE INPUT FOR PROVISION OF SERVICES FOR THE COMMUNITY. THE PROCESS INCLUDES BUT IS NOT LIMITED TO: - PARTICIPATION IN THE HEALTHY CAROLINIANS OF MACON COUNTY'S HEALTH ASSESSMENT. THIS ASSESSMENT INCLUDES PHONE SURVEYS, FOCUS GROUPS AND INTERVIEWS WITH LOCAL BUSINESS, COMMUNITY AND HEALTH CARE LEADERS. - AMC PARTICIPATES IN THE HEALTHY CAROLINIANS OF MACON COUNTY'S YOUTH RISK BEHAVIOR ASSESSMENT. - A NUMBER OF AMC EMPLOYEES PARTICIPATE IN VARIOUS HEALTHY CAROLINIANS OF MACON COUNTY COMMITTEES. THESE INCLUDE ACCESS TO CARE, CHRONIC DISEASE, COMMUNITY NEEDS ASSESSMENT, ELDERCARE AND CAREGIVERS, ENVIRONMENTAL QUALITY, STRENGTHENING FAMILIES, SUBSTANCE ABUSE AND MENTAL HEALTH. ANGEL MEDICAL CENTER HAS AN ACTIVE COMMUNITY RELATIONS BOARD THAT MEETS REGULARLY TO DISCUSS THE HOSPITAL AND ITS RELATIONSHIP TO THE COMMUNITY. THE CENTER HAS AN ACTIVE BOARD OF DIRECTORS THAT MEETS REGULARLY TO DISCUSS HOSPITAL OPERATIONS, QUALITY, PATIENT SAFETY AND THE NEEDS OF THE COMMUNITY. THE BOARD HAS AN ACTIVE PLANNING AND DEVELOPMENT COMMITTEE THAT MEETS MONTHLY, AND WORKS ACTIVELY ON THE PLANNING PROCESS FOR THE HOSPITAL AND ROUTINELY ASSESS THE PROVISION OF SERVICES FOR THE COMMUNITY. THE HOSPITAL CEO AND THE DIRECTOR OF THE MACON COUNTY HEALTH DEPARTMENT MEET ROUTINELY TO DISCUSS VARIOUS HEALTH CARE INITIATIVES, PROCESSES AND PROGRAMS. IN ADDITION, A NUMBER OF HOSPITAL EMPLOYEES ARE INVOLVED IN A NUMBER OF COMMUNITY ORGANIZATIONS THAT MEET THE VARIOUS NEEDS OF MACON COUNTY RESIDENTS. THESE INCLUDE BUT ARE NOT LIMITED TO: - REACH THE COUNTIES DOMESTIC VIOLENCE AND SEXUAL ASSAULT AGENCY; - KIDS PLACE, AN AGENCY FOR ABUSED CHILDREN; - CARENET, AN AGENCY THAT PROVIDES FOOD AND OTHER ESSENTIALS TO THOSE IN NEED; - THE COMMUNITY CARE CLINIC OF FRANKLIN, A FREE CLINIC OFFERING HEATH CARE SERVICES TO THE RESIDENTS OF MACON COUNTY; AND - THE FRANKLIN AREA CHAMBER OF COMMERCE. ADDITIONALLY, AMC ADMINISTRATION PARTICIPATES ON A NUMBER OF REGIONAL AND STATE BOARDS OR ORGANIZATIONS THAT PROVIDE INPUT INTO TRENDS AND CHANGES THAT MAY IMPACT THE PROVISION OF HEALTH CARE IN OUR COMMUNITY. | ||
| PART VI, LINE 3: THE ORGANIZATION EMPLOYS A SOCIAL WORKER WHOSE RESPONSIBILTY IT IS TO ENROLL PATIENTS IN FEDERAL, STATE, OR LOCAL PROGRAMS. WE POST OUR CHARITY CARE POLICY IN THE REGISTRATION AREAS. THE CURRENT INDIGENT CARE POLICY IS POSTED AT THE REGISTRATION AREAS. PATIENT'S ARE ENCOURAGED TO SPEAK WITH A PATIENT COUNSELOR. | ||
| PART VI, LINE 4: AMC SERVES A POPULATION OF APPROXIMATELY 34,000 PEOPLE, 23.8% OF WHICH ARE OVER THE AGE 65, 16.9% OF WHICH IS BELOW POVERTY LEVEL AND 10.1% OF WHICH ARE UNEMPLOYED. THE AVERAGE ANNUAL HOUSEHOLD INCOME OF THE POPULATION IS ROUGHLY $38,615. THE MINORITY ETHNIC DEMOGRAPHICS OF THE AREA IS WIDE-SPREAD INCLUDING AN HISPANIC POPULATION OF 6.6%, AN AFRICAN-AMERICAN POPULATION OF 1.3% AND OTHER MINORITY POPULATIONS TOTALING 1.1%. MACON COUNTY SEES APPROXIMATELY A 1.4% ANNUAL INCREASE IN ITS POPULATION. THE STATISTICS ARE ACCORDING TO THE US CENSUS BUREAU. | ||
| PART VI, LINE 6: AMC'S BOARD OF DIRECTORS IS MADE UP OF A CROSS SECTION OF THE COMMUNITY DEDICATED TO ITS IMPROVEMNT. STAFF PRIVILEGES ARE EXTENDED TO AREA PHYSICIANS WHO ARE BOARD CERTIFIED, ALLOWING CERTAIN SPECIALTY SERVICES TO PATIENTS WHO WOULD OTHERWISE HAVE TO TRAVEL FOR TREATMENT. AMC IS WORKING TO EXPAND OUTPATIENT TREATMENTS SUCH AS ADDITIONAL CHEMOTHERAPY SERVICES. AMC FOUNDATION RAISES FUNDS FOR GAP SERVICES PROVIDED TO MAMMOGRAPHY AND CARDIAC REHAP PATIENTS THAT ARE NON OR UNDER INSURED.ALL SURPLUS IS PUT BACK INTO ANGEL MEDICAL CENTER THROUGH CAPITAL PURCHASES AND OPERATING EXPENSES. | ||
| 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) |
|---|---|---|
| Form990 Of Other Organizations | X | Form990OfOtherOrganizations |
| Compensation Survey | X | CompensationSurvey |
| 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 | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| TIM HUBBS | |||||||||||||
| 175265 | 0 | 0 | 0 | 7200 | 0 | 0 | 0 | 10052 | 0 | 192517 | 0 | 0 | 0 |
| VICTOR ADAN MD | |||||||||||||
| 275105 | 0 | 420 | 0 | 0 | 0 | 33001 | 0 | 10314 | 0 | 318840 | 0 | 0 | 0 |
| MICHAEL D SHEAFFER MD | |||||||||||||
| 202078 | 0 | 10000 | 0 | 0 | 0 | 22000 | 0 | 13123 | 0 | 247201 | 0 | 0 | 0 |
| MICHAEL D GOLIGHTLY MD | |||||||||||||
| 171220 | 0 | 0 | 0 | 6604 | 0 | 0 | 0 | 12356 | 0 | 190180 | 0 | 0 | 0 |
| MAHENDRABHAI PATEL MD | |||||||||||||
| 200844 | 0 | 10000 | 0 | 0 | 0 | 44000 | 0 | 10145 | 0 | 264989 | 0 | 0 | 0 |
| GILBERTO ROBLES MD | |||||||||||||
| 378030 | 0 | 0 | 0 | 0 | 0 | 22001 | 0 | 13413 | 0 | 413444 | 0 | 0 | 0 |
| TRAVIS PETRICEK MD | |||||||||||||
| 346142 | 0 | 0 | 0 | 3628 | 0 | 16500 | 0 | 10339 | 0 | 376609 | 0 | 0 | 0 |
| NELSON P DAVIS MD | |||||||||||||
| 266272 | 0 | 7568 | 0 | 0 | 0 | 27463 | 0 | 839 | 0 | 302142 | 0 | 0 | 0 |
| SUSAN L MEDLOCK MD | |||||||||||||
| 204080 | 0 | 5850 | 0 | 0 | 0 | 22000 | 0 | 10143 | 0 | 242073 | 0 | 0 | 0 |
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 | 657902S6S | CUSIPNumber |
| Date Issued | 2007-03-22 | DateIssued |
| Issue Price | 18500000 | IssuePrice |
| Description Of Purpose | HEALTHCARE FACILITY REVENUE BONDS | 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) |
|---|---|---|
| Amount Retired | 4015000 | AmountRetired |
| Total Proceeds | 18500000 | TotalProceeds |
| Issuance Costs From Proceeds | 266550 | IssuanceCostsFromProceeds |
| Credit Enhancement | 25000 | CreditEnhancement |
| Capital Expenditures | 5183960 | CapitalExpenditures |
| Other Spent Proceeds | 13024490 | OtherSpentProceeds |
| Year Of Subst Completion | 2007 | YearOfSubstCompletion |
| Current Refunding | 1 | CurrentRefunding |
| Advance Refunding | 0 | AdvanceRefunding |
| Final Allocation Made | 1 | 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 |
| 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 | 1 | HedgeIdentifiedInBooksAndRecds |
Name Of Hedge Provider NameOfHedgeProvider
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WACHOVIA | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Term Of Hedge | 5.000000000000 | TermOfHedge |
| Superintegrated Hedge | 0 | SuperintegratedHedge |
| Hedge Terminated | 0 | HedgeTerminated |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGIC |
| Gross Proceeds Invested | 1 | GrossProceedsInvested |
| Exception To Rebate | 1 | ExceptionToRebate |
Form990 Schedule K Part V Form990ScheduleKPartV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | SCHEDULE K SUPPLENTAL INFORMATION | Identifier |
| Explanation | BOND (A): THE QUALIFIED HOSPITAL BONDS WERE ISSUED IN PART TO REFUND A PRIOR ISSUE DATED NOVEMBER 21, 1997. THE PRIOR BONDS WERE CALLED AND REDEEMED BY MARCH 22, 2007. IN ADDITION, THE ISSUE WAS USED TO ACQUIRE NON-REAL ESTATE EQUIPMENT WITH VARIOUS RECOVERY PERIODS. | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (12 entries)
| IdentifierIdentifier | ExplanationExplanation | Return ReferenceReturnReference |
|---|---|---|
| FORM 990, PART VI, SECTION A, LINE 1 | THE EXECUTIVE COMMITTEE IS COMPOSED OF THE CHAIRMAN, VICE CHAIRMAN, SECRETARY, TREASURER, AND TWO TRUSTEES AT LARGE ELECTED BY THE BOARD. THE CHAIRMAN OF THE BOARD SERVES AS THE CHAIRMAN OF THE EXECUTIVE COMMITTEE. THE EXECUTIVE COMMITTEE HAS THE POWER AND AUTHORITY OF THE BOARD TO TRANSACT ALL REGULAR BUSINESS OF THE HOSPITAL IN THE INTERVALS BETWEEN MEETINGS OF THE BOARD, SUBJECT TO ANY PRIOR LIMITATIONS IMPOSED BY THE BOARD OR BY STATUTE. ALL ACTIONS OF THE EXECUTIVE COMMITTEE SHALL BE REPORTED AT THE NEXT REGULAR MEETING OF THE BOARD. | |
| FORM 990, PART VI, SECTION A, LINE 3 | ON MAY 19, 2011, THE ORGANIZATION EXECUTED A MANAGEMENT AGREEMENT WITH MISSION HEALTH SYSTEM, INC., A NORTH CAROLINA NONPROFIT CORPORATION. THE TERM OF THE AGREEMENT IS TEN YEARS. THE AGREEMENT PROVIDES FOR A RANGE OF ADMINISTRATIVE MANAGEMENT SERVICES FOR THE ORGANIZATION INCLUDING BUT NOT LIMITED TO: (1) STRATEGIES FOR DEVELOPING AND MAINTAINING PRIMARY CARE, SURGICAL AND MEDICAL SECONDARY CARE, TERTIARY CARE AND OUTREACH CLINICS (2) RECRUITMENT AND CONTRACTING FOR CERTAIN MEDICAL SERVICES (3) IMPROVING FINANCIAL VIABILITY OF PHYSICIAN CONTRACTS (4) STAFF EDUCATION AND TRAINING (5) CREDENTIALING (6) MAINTAINING AN APPROPRIATE MANAGEMENT TEAM (7) CORPORATE COMPLIANCE MISSION HEALTH SYSTEM, INC. ALSO RESERVES THE RIGHT TO REQUIRE THE CEO OF THE ORGANIZATION TO BECOME A MISSION EMPLOYEE, WHO WOULD BE REPORTABLE TO BOTH THE BOARDS OF MISSION HEATH SYSTEMS AND THE ORGANIZATION'S. AS OF THE END OF THE CURRENT TAX YEAR, MISSION HAD NOT EXERCISED THAT OPTION. | |
| FORM 990, PART VI, SECTION A, LINE 4 | THE ORGANIZATION UPDATED ITS BYLAWS TO INCREASE THE MAXIMUM NUMBER OF MEMBERS OF THE BOARD OF DIRECTORS TO 21. | |
| FORM 990, PART VI, SECTION A, LINE 7A | MISSION HEALTH SYSTEMS, INC., A NORTH CAROLINA NONPROFIT CORPORATION, HAS THE RIGHT TO APPOINT UP TO SEVEN MEMBERS OF THE GOVERNING BODY. | |
| FORM 990, PART VI, SECTION A, LINE 7B | PER THE MANAGEMENT AGREEMENT DISCUSSED IN LINE 3 ABOVE, DURING THE TERM OF THE AGREEMENT THE FOLLOWING ACTIONS REQUIRE THE JOINT APPROVAL OF BOTH THE ORGANIZATION'S BOARD OF DIRECTORS AND THE BOARD OF MISSION HEALTH SYSTEM, INC.: (1) MATERIAL REDUCTION OR ELIMINATION OF MAJOR SERVICES LINES (2) CHANGE IN CERTAIN PHYSICIAN GROUPS PROVIDING HOSPITAL-BASED PHYSICIAN SERVICES (3) CHANGE IN NAME OF ORGANIZATION (4) AMENDMENT OF ARTICLES OF INCORPORATION AND/OR BYLAWS (5) ADOPTION OR MODIFICATION OF ANY STATEMENTS OR EXPRESSIONS OF MISSION, VALUES, AND VISIONS OF THE ORGANIZATION (6) SALE, LEASE, OR OTHER TRANSFER OF A MATERIAL PORTION OF THE ORGANIZATION'S ASSETS (7) ENCUMBRANCE ON A MATERIAL PORTION OF THE ORGANIZATION'S ASSETS (8) PURCHASE, SALE, LEASE, OR PLEDGE OF REAL PROPERTY OUTSIDE THE ORDINARY COURSE OF BUSINESS (9) DISSOLUTION, MERGER, OR CORPORATE BUSINESS COMBINATIONS (10) FORMATION OF NEW CORPORATIONS, PARTNERSHIPS, OR CONTRACTUAL JOINT VENTURES (11) HIRING OR REPLACEMENT OF THE ORGANIZATION'S CEO (MISSION RESERVES THE SOLE RIGHT TO REMOVE THE ORGANIZATION'S CEO) (12) TO ISSUE, REFINANCE, OR RETIRE DEBT (13) APPROVAL, ADOPTION, OR MODIFICATION OF CAPITAL OR OPERATING BUDGETS (14) APPROVAL, ADOPTION, OR MODIFICATION OF A STRATEGIC OR FINANCIAL PLAN (15) SELECTION OR RETENTION OF EXTERNAL AUDITORS AND LEGAL COUNSEL (WITH CERTAIN EXCEPTIONS) (16) FILING OF CERTAIN VOLUNTARY PETITIONS CONCERNING BANKRUPTCY, DEBT RELIEF, INSOLVENCY PLEAS, ETC. (17) MATERIAL MODIFICATION OF OFFICERS' INSURANCE CURRENTLY MAINTAINED | |
| FORM 990, PART VI, SECTION B, LINE 11 | THE RETURN WAS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM WITH ASSISTANCE AND OVERSIGHT BY MANAGEMENT. UPON COMPLETION AND REVIEW BY MANAGEMENT, THE RETURN WAS PROVIDED TO EACH VOTING BOARD MEMBER FOR DISCUSSION AND COMMENT BEFORE FILING WITH THE IRS. | |
| THE BOARD OF DIRECTORS CIRCULATES A CONFLICT OF INTEREST POLICY ANNUALLY, REQUIRING ALL VOTING BOARD MEMBERS TO REVIEW, SIGN, AND RETURN. MEMBERS PRESENTING A POTENTIAL CONFLICT OF INTEREST RECUSE THEMSELVES BEFORE ANY DISCUSSION OR VOTE ON A TOPIC THAT INCLUDES AN INTERESTED PARTY OR TRANSACTION. | FORM 990, PART VI, SECTION B, LINE 12C | |
| THE COMPENSATION PLAN FOR THE CEO INCLUDES A YEARLY REVIEW OF THE CEO'S ANNUAL BASE SALARY, A REVIEW OF PRE-APPROVED CRITERIA TO DETERMINE ANY INCENTIVE/BONUS, AND A GENERAL EVALUATION CONDUCTED BY THE EXECUTIVE COMMITTEE OF THE BOARD. THE REVIEW OF PERFORMANCE AND COMPENSATION ANALYSIS OF OTHER INDUSTRY CEOS' SALARIES INCLUDES BUT IS NOT LIMITED TO A REVIEW OF COMPILED DATA FROM PERRY & ASSOCIATES FOR NC HEALTHCARE HUMAN RESOURCES ASSOCIATION, YAFFE & COMPANY FOR NC HOSPITAL ASSOCIATION, AND SELECT WESTERN NORTH CAROLINA HOSPITALS IN THE IMMEDIATE AREA. THE CEO PRESENTS A CURRENT SELF-EVALUATION ALONG WITH THE NEXT FISCAL YEAR'S RECOMMENDED OBJECTIVES WITH WEIGHTED VALUES TO THE BOARD CHAIR. | 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 AND CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST AT THE ORGANIZATION'S ADMINISTRATIVE OFFICE. | FORM 990, PART VI, SECTION C, LINE 19 | |
| CHANGES IN NET ASSETS OR FUND BALANCES: | CHANGE IN FAIR VALUE OF INTEREST RATE SWAP 270,032. TOTAL TO FORM 990, PART XI, LINE 5: 270,032. | 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
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ANGEL MEDICAL CENTER AUXILIARY | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 1209 | AddressLine1 |
| City | FRANKLIN | City |
| State | NC | State |
| ZIP Code | 28744 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 562133719 | EIN |
| Primary Activities | SUPPORTING ORGANIZATION | PrimaryActivities |
| Legal Domicile State | NC | LegalDomicileState |
| Exempt Code Section | 501(C)(3) | ExemptCodeSection |
| Public Charity Status | LINE 11A, I | PublicCharityStatus |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ANGEL MEDICAL CENTER INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Org | 1 | ControlledOrg |
Form990 Schedule R Part IV Form990ScheduleRPartIV
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ANGEL HEALTHCARE ENTERPRISES INC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 1209 | AddressLine1 |
| City | FRANKLIN | City |
| State | NC | State |
| ZIP Code | 28734 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 562031765 | EIN |
| Primary Activity | PHARMACY (DORMANT) | PrimaryActivity |
| Legal Domicile State | NC | LegalDomicileState |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |
| Type Of Entity | C | TypeOfEntity |
| Percentage Ownership | 1.00000 | PercentageOwnership |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 1 | 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 | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 1 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable
Name Of Other Organization NameOfOtherOrganization
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ANGEL MEDICAL CENTER AUXILIARY | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | C | TransactionType |
| Amount Involved | 32930 | AmountInvolved |
| Method Of Amt Determination | CASH | MethodOfAmtDetermination |
Comments