CHARLES A CANNON JR MEMORIAL HOSPITAL INC: Form 990, tax year 2009
View the entire original 990 at ProPublica ↗
- Organization
- CHARLES A CANNON JR MEMORIAL HOSPITAL INC (EIN 56-0529974)
- Tax period
- 2009-10-01 to 2010-09-30
- Filed
- 2011-02-15
- IRS object ID
- 201100469349302300
- Schema version
- 2009v1.7
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2011-02-15T15:31:02-06:00 | Timestamp |
| Tax Period End Date | 2010-09-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GOODMAN & COMPANY L L P | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 111 FRANKLIN RD SE SUITE 501 | AddressLine1 |
| City | ROANOKE | City |
| State | VA | State |
| ZIP Code | 240112114 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2009-10-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 560529974 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHARLES A CANNON JR MEMORIAL HOSPITAL INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | CHAR | NameControl |
| Phone | 8282624119 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 434 hospital drive | AddressLine1 |
| City | LINVILLE | City |
| State | NC | State |
| ZIP Code | 28646 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | kevin b may | Name |
| Title | cfo | Title |
| Phone | 8282624119 | Phone |
| Date Signed | 2011-02-14 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Michael P Norton | Name |
| Phone | 5409896144 | Phone |
| Date Prepared | 2011-02-14 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2009 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | KEVIN b MAY | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 434 hospital drive | AddressLine1 |
| City | LINVILLE | City |
| State | NC | State |
| ZIP Code | 28646 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 21676445 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c | X | Organization501c |
| Web Site | WWW.APPRHS.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1957 | YearFormation |
| State Legal Domicile | NC | StateLegalDomicile |
| Activity Or Mission Description | TO PROVIDE HEALTH CARE SERVICES TO ENHANCE THE QUALITY OF LIFE FOR THE COMMUNITY OF LINVILLE, NORTH CAROLINA. THIS INCLUDES A BEHAVORIAL HEALTH CENTER, NEW LIFE CENTER, PATIENT CARE CENTER, DIAGNOSTIC SERVICES, EMERGENCY DEPARTMENT AND A CRITICAL CARE UNIT. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 15 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 15 | NbrIndependentVotingMembers |
| Total Nbr Employees | 0 | TotalNbrEmployees |
| Total Nbr Volunteers | 94 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 401265 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 605360 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 24625049 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 20795236 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 172234 | InvestmentIncomePriorYear |
| Investment Income Current Year | -127794 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 6150 | OtherRevenuePriorYear |
| Other Revenue Current Year | 216833 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 25204698 | TotalRevenuePriorYear |
| Total Revenue Current Year | 21489635 | TotalRevenueCurrentYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 9148154 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 12095784 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 16735064 | OtherExpensePriorYear |
| Other Expenses Current Year | 9059281 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 25883218 | TotalExpensesPriorYear |
| Total Expenses Current Year | 21155065 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -678520 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 334570 | RevenuesLessExpensesCY |
| Total Assets BOY | 29090302 | TotalAssetsBOY |
| Total Assets EOY | 29203737 | TotalAssetsEOY |
| Total Liabilities BOY | 10601220 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 9653546 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 18489082 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 19550191 | NetAssetsOrFundBalancesEOY |
| Mission Description | TO PROVIDE HEALTH CARE SERVICES TO ENHANCE THE QUALITY OF LIFE FOR THE COMMUNITY OF LINVILLE, NORTH CAROLINA. THIS INCLUDES A BEHAVORIAL HEALTH CENTER, NEW LIFE CENTER, PATIENT CARE CENTER, DIAGNOSTIC SERVICES, EMERGENCY DEPARTMENT AND A CRITICAL CARE UNIT. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 15931001 | Expense |
| Grants | 0 | Grants |
| Revenue | 20884275 | Revenue |
| Description | HEALTHCARE SERVICES PROVIDED FOR THE COMMUNITY OF LINVILLE, NORTH CAROLINA, CONSISTED OF THE FOLLOWING:ER VISITS 9,457DISCHARGES 2,370DAYS OF CARE 10,083 | Description |
| Total Program Service Expense | 15931001 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | 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 |
| Balance Sheet Amounts Reported | 1 | BalanceSheetAmountsReported |
| 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 |
| Grants To Organizations | 0 | 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 | 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 | 0 | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 0 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 0 | NumberOfEmployees |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| 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 |
| Nbr Voting Governing Body Members | 15 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 15 | 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 | 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 |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CORPORATE FINANCE | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 8282624100 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 336 DEERFIELD ROAD | AddressLine1 |
| City | boone | City |
| State | NC | State |
| ZIP Code | 28607 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | X | NoListedPersonsCompensated |
Form990 Part VII Section A Form990PartVIISectionA (19 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer |
|---|---|---|---|---|---|---|
| KENNETH WILCOX | ||||||
| CHAIR | 1.00 | X | 0 | 0 | 0 | |
| PAUL MILLER JR | ||||||
| VICE CHAIR | 1.00 | X | 0 | 0 | 0 | |
| SAM ADAMS | ||||||
| trustee | 1.00 | X | 0 | 0 | 0 | |
| WILLIAM ATKINS MD | ||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | |
| John Blackburn | ||||||
| trustee | 1.00 | X | 0 | 0 | 0 | |
| CHARLES BAKER MD | ||||||
| trustee | 1.00 | X | 0 | 0 | 0 | |
| JIM DEAL | ||||||
| trustee | 1.00 | X | 0 | 0 | 0 | |
| DALE GREENE | ||||||
| trustee | 1.00 | X | 0 | 0 | 0 | |
| MARGARET HAYDEN | ||||||
| trustee | 1.00 | X | 0 | 0 | 0 | |
| JACK HOWARD | ||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | |
| JOE MILLER | ||||||
| trustee | 1.00 | X | 0 | 0 | 0 | |
| SUSAN ROGGENKAMP | ||||||
| trustee | 1.00 | X | 0 | 0 | 0 | |
| KEITH TESTER | ||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | |
| PAttie TENNILLE | ||||||
| TRustee | 1.00 | X | 0 | 0 | 0 | |
| JAN WINKLER | ||||||
| TRUStee | 1.00 | X | 0 | 0 | 0 | |
| richard sparks | ||||||
| system ceo | 40.00 | 0 | 304397 | 109466 | X | |
| john barrett | ||||||
| system coo | 40.00 | 0 | 229509 | 23854 | X | |
| kevin may | ||||||
| system cfo | 40.00 | 0 | 223341 | 18873 | X | |
| charles mantooth | ||||||
| chief executive officer | 40.00 | 0 | 155820 | 15377 | X | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 0 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 913067 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 167570 | TotalOtherCompensation |
| Number Individuals GT100 K | 0 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
| Number Of Contractors GT100 K | 0 | NumberOfContractorsGT100K |
| All Other Contributions | 605360 | AllOtherContributions |
| Total Contributions | 605360 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Prog.serv.revenue-Rela | Description |
| Business Code | 900099 | BusinessCode |
| Total Revenue Column | 20795236 | TotalRevenueColumn |
| Related Or Exempt Function Income | 20795236 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 20795236 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 45466 | TotalRevenueColumn |
| Related Or Exempt Function Income | 45466 | RelatedOrExemptFunctionIncome |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 28278 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 28278 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 28278 | TotalRevenueColumn |
| Related Or Exempt Function Income | 28278 | RelatedOrExemptFunctionIncome |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 13550 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 186810 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -173260 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -173260 | TotalRevenueColumn |
| Related Or Exempt Function Income | -173260 | RelatedOrExemptFunctionIncome |
Other Revenue Misc OtherRevenueMisc (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| Miscellaneous | 900099 | 122001 | 122001 |
| cafeteria revenues | 900099 | 66554 | 66554 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 188555 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 21489635 | TotalRevenueColumn |
| Related Or Exempt Function Income | 20884275 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 9769976 | Total |
| Program Services | 8421835 | ProgramServices |
| Management And General | 1348141 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1725708 | Total |
| Program Services | 1484109 | ProgramServices |
| Management And General | 241599 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 600100 | Total |
| Program Services | 585381 | ProgramServices |
| Management And General | 14719 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 19011 | Total |
| Management And General | 19011 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1956867 | Total |
| Program Services | 1548198 | ProgramServices |
| Management And General | 408669 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 596 | Total |
| Program Services | 596 | ProgramServices |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2184146 | Total |
| Program Services | 2034769 | ProgramServices |
| Management And General | 149377 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 666919 | Total |
| Program Services | 189025 | ProgramServices |
| Management And General | 477894 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 25320 | Total |
| Program Services | 23963 | ProgramServices |
| Management And General | 1357 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1170 | Total |
| Program Services | 1170 | ProgramServices |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 531277 | Total |
| Management And General | 531277 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1756708 | Total |
| Program Services | 803763 | ProgramServices |
| Management And General | 952945 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 262353 | Total |
| Program Services | 262353 | ProgramServices |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| Equipment rental and ma | 607887 | 348060 | 259827 |
| Corp. allocations | 603993 | 603993 | |
| Debt forgiveness | 194325 | 194325 | |
| Miscellaneous | 145153 | 124223 | 20930 |
| Minor Equipment | 48908 | 48908 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 54648 | Total |
| Program Services | 54648 | ProgramServices |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 21155065 | Total |
| Program Services | 15931001 | ProgramServices |
| Management And General | 5224064 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2013578 | BOY |
| EOY | 3436102 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 768486 | BOY |
| EOY | 800177 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3220418 | BOY |
| EOY | 3084651 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 130992 | BOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 366978 | BOY |
| EOY | 415630 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 143509 | BOY |
| EOY | 146928 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 35497525 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 16884305 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 20018434 | BOY |
| EOY | 18613220 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2427907 | BOY |
| EOY | 2707029 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 29090302 | BOY |
| EOY | 29203737 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1653927 | BOY |
| EOY | 308273 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7615266 | BOY |
| EOY | 7892404 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1332027 | BOY |
| EOY | 1452869 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10601220 | BOY |
| EOY | 9653546 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 17150965 | BOY |
| EOY | 18212074 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 341202 | BOY |
| EOY | 341202 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 996915 | BOY |
| EOY | 996915 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 18489082 | BOY |
| EOY | 19550191 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 29090302 | BOY |
| EOY | 29203737 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1307101 | OtherCostOrOtherBasis |
| Book Value | 1307101 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 23275988 | OtherCostOrOtherBasis |
| Depreciation | 8256968 | Depreciation |
| Book Value | 15019020 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1675233 | OtherCostOrOtherBasis |
| Depreciation | 845467 | Depreciation |
| Book Value | 829766 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 9207303 | OtherCostOrOtherBasis |
| Depreciation | 7781870 | Depreciation |
| Book Value | 1425433 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 31900 | OtherCostOrOtherBasis |
| Book Value | 31900 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 18613220 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (2 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| Assets Whose use is limited | 2673930 |
| Other assets | 33099 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 2707029 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities (4 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| Capital lease obligation | $12,552 |
| Due to affiliate | $875,207 |
| Deferred Revenue | $263,000 |
| Estimated third-party settlements | $302,110 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 1452869 | TotalOfAmounts |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
Other Percentage OtherPercentage
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Free Other Percentage | 175.000000000000 | FreeOtherPercentage |
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | 458853 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 458853 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02170 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1917383 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2176553 | DirectOffsettingRevenue |
| Net Community Benefit Expense | -259170 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 2376236 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2176553 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 199683 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02170 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 68096 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 68096 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00320 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 95595 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 95595 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00450 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 163691 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 163691 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00770 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 2539927 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2176553 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 363374 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02940 | PercentOfTotalExpense |
Physical Improvements And Housing PhysicalImprovementsAndHousing
| Field | Value | IRS element (for citing) |
|---|---|---|
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Economic Development EconomicDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Community Support CommunitySupport
| Field | Value | IRS element (for citing) |
|---|---|---|
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Environmental Improvements EnvironmentalImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Leadership Development LeadershipDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Coalition Building CoalitionBuilding
| Field | Value | IRS element (for citing) |
|---|---|---|
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Health Improvement Advocacy HealthImprovementAdvocacy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Workforce Development WorkforceDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Other Other
| Field | Value | IRS element (for citing) |
|---|---|---|
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $1,142,696 | BadDebtExpenseAmount |
| Amount Attributable To | 57135 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 8062000 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 8062000 | CostOfCareReimbursedByMedicare |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost Accounting System | X | CostAccountingSystem |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
Form990 Schedule H Part IV Form990ScheduleHPartIV
Name Of Entity NameOfEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | APPALACHIAN REGIONAL HEALTHCARE SYSTEM | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Ent Primary Activity | SOLE MEMBER OF CHARLES A. CANNON JR., MEMORIAL HOSPITAL, INC. | DescriptionEntPrimaryActivity |
| Organization Profit Or Ownership | 1.00000 | OrganizationProfitOrOwnership |
Form990 Schedule H Part V Form990ScheduleHPartV
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | charles a cannon jr memorial hospital | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 434 hospital drive | AddressLine1 |
| City | linville | City |
| State | NC | State |
| ZIP Code | 28646 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Critical Access Hospital | X | CriticalAccessHospital |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part VI Form990ScheduleHPartVI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Footnote | Part III, Line 4: AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IS RECORDED BASED ON HISTORICAL BAD DEBT EXPERIENCE AND MANAGEMENT'S EVALUATION OF THE ACCOUNTS RECEIVABLE. BALANCES ARE WRITTEN OFF AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN MADE.WE ESTIMATE 5% OF CHARITY COSTS FAIRLY ESTIMATE AMOUNTS INCLUDED AS BAD DEBT THAT WOULD BE ELIGIBLE FOR CHARITY CARE BUT FAILED TO APPLY. | BadDebtFootnote |
| Debt Collection Policy | Part III, Line 9b: CHARITY WRITE-OFFS ARE SEGREGATED FROM NORMAL BAD DEBTS THROUGH A SEPARATE TRANSACTION CODE. FAMILY INCOME BELOW 175% OF FPG ARE ELIGIBLE FOR 100% WRITE-OFF. PARTIAL WRITE-OFF IS AVAILABLE BETWEEN FAMILY INCOME BETWEEN 175% AND 250% OF FPG. | DebtCollectionPolicy |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 (4 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| richard sparks | |||||||||||||
| 0 | 304397 | 0 | 0 | 0 | 0 | 0 | 97176 | 0 | 12290 | 0 | 413863 | 0 | 0 |
| john barrett | |||||||||||||
| 0 | 229509 | 0 | 0 | 0 | 0 | 0 | 11206 | 0 | 12648 | 0 | 253363 | 0 | 0 |
| kevin may | |||||||||||||
| 0 | 223341 | 0 | 0 | 0 | 0 | 0 | 10500 | 0 | 8373 | 0 | 242214 | 0 | 0 |
| charles mantooth | |||||||||||||
| 0 | 155820 | 0 | 0 | 0 | 0 | 0 | 7453 | 0 | 7924 | 0 | 171197 | 0 | 0 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (6 entries)
| IdentifierIdentifier | ExplanationExplanation |
|---|---|
| Form 990, Part VI, Section A, line 3 | Parent company, Appalachian Regional Health Care System (ARHS) oversees CMH operations. also note that salaries and other common expenses incurred by ARHS are allocated appropriately to cmh and the other entites supported by arhs. this is why salaries expenses is reported even though no employees are listed. All wages and payments to vendors are paid out through ARHS. |
| Form 990, Part VI, Section A, line 7b | Approval may be needed by the parent company, Appalachian Regional Health Care System. |
| Form 990, Part VI, Section B, line 11 | The svp/cfo and the system director of finance review the 990 and then it is made available to the board upon completion. |
| Form 990, Part VI, Section B, line 12c | review of policy statement each year. |
| Form 990, Part VI, Section B, line 15 | Independent compensation and benefit analysis was performed by Findley Davies in late 2009. The Executive Committee (Compensation Committee) reviewed this information in January, 2010 to establish appropriateness of total compensation, comply with Intermediate Sanction regulations, and determine excutive compensation for CEO, COO, and CFO positions. Organization's officers and key employees are compensated through ARHS. No W-2s are paid out through Charles A. Cannon Jr., Memorial Hospital. |
| Form 990, Part VI, Section C, line 19 | provided upon request. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (6 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus |
|---|---|---|---|---|---|---|---|---|
| appalachian regional healthcare system | ||||||||
| po box 2600 | boone | NC | 28607 | 201067022 | parent company | NC | 501(c)(3) | 11c |
| blowing rock hospital inc | ||||||||
| po box 148 | blowing rock | NC | 28605 | 560513181 | hospital | NC | 501(c)(3) | 3 |
| watauga medical center inc | ||||||||
| 336 deerfield rd | boone | NC | 28607 | 560510824 | hospital | NC | 501(c)(3) | 3 |
| appalachian regional healthcare foundation | ||||||||
| 336 deerfield rd | boone | NC | 28607 | 204625618 | philanthropic organization for the system | NC | 501(c)(3) | 7 |
| appalachian regional medical associates inc | ||||||||
| po box 2600 | boone | NC | 28607 | 205755130 | employment alternative to both new and established physician practices | NC | 501(c)(3) | 9 |
| ARHS PROPERTIES INC | ||||||||
| 336 deerfield rd | boone | NC | 28607 | 203470765 | hold future purchase of non-profit land acquisitions | NC | 501(c)(3) | 9 |
| 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 | 1 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 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 | Appalachian Regional Healthcare Foundation | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | C | TransactionType |
| Amount Involved | 595569 | AmountInvolved |
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