2011-02-15T15:31:02-06:00 2010-09-30 GOODMAN & COMPANY L L P 111 FRANKLIN RD SE SUITE 501 ROANOKE VA 240112114 990 2009-10-01 560529974 CHARLES A CANNON JR MEMORIAL HOSPITAL INC CHAR 8282624119 434 hospital drive LINVILLE NC 28646 kevin b may 8282624119 2011-02-14 1 Michael P Norton 5409896144 2011-02-14 2009 2016-02-24 21:20:13Z KEVIN b MAY 434 hospital drive LINVILLE NC 28646 21676445 0 X WWW.APPRHS.ORG X 1957 NC 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. 15 15 0 94 0 0 401265 605360 24625049 20795236 172234 -127794 6150 216833 25204698 21489635 0 0 9148154 12095784 0 0 16735064 9059281 25883218 21155065 -678520 334570 29090302 29203737 10601220 9653546 18489082 19550191 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. 0 0 15931001 0 20884275 HEALTHCARE SERVICES PROVIDED FOR THE COMMUNITY OF LINVILLE, NORTH CAROLINA, CONSISTED OF THE FOLLOWING:ER VISITS 9,457DISCHARGES 2,370DAYS OF CARE 10,083 15931001 1 1 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 15 15 0 1 0 0 0 0 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X CORPORATE FINANCE 8282624100 336 DEERFIELD ROAD boone NC 28607 X KENNETH WILCOX 1.00 X 0 0 0 PAUL MILLER JR 1.00 X 0 0 0 SAM ADAMS 1.00 X 0 0 0 WILLIAM ATKINS MD 1.00 X 0 0 0 John Blackburn 1.00 X 0 0 0 CHARLES BAKER MD 1.00 X 0 0 0 JIM DEAL 1.00 X 0 0 0 DALE GREENE 1.00 X 0 0 0 MARGARET HAYDEN 1.00 X 0 0 0 JACK HOWARD 1.00 X 0 0 0 JOE MILLER 1.00 X 0 0 0 SUSAN ROGGENKAMP 1.00 X 0 0 0 KEITH TESTER 1.00 X 0 0 0 PAttie TENNILLE 1.00 X 0 0 0 JAN WINKLER 1.00 X 0 0 0 richard sparks 40.00 X 0 304397 109466 john barrett 40.00 X 0 229509 23854 kevin may 40.00 X 0 223341 18873 charles mantooth 40.00 X 0 155820 15377 0 913067 167570 0 0 1 0 0 605360 605360 Prog.serv.revenue-Rela 900099 20795236 20795236 20795236 45466 45466 28278 28278 28278 28278 13550 186810 -173260 -173260 -173260 Miscellaneous 900099 122001 122001 cafeteria revenues 900099 66554 66554 188555 21489635 20884275 0 0 9769976 8421835 1348141 1725708 1484109 241599 600100 585381 14719 19011 19011 1956867 1548198 408669 596 596 2184146 2034769 149377 666919 189025 477894 25320 23963 1357 1170 1170 531277 531277 1756708 803763 952945 262353 262353 Equipment rental and ma 607887 348060 259827 Corp. allocations 603993 603993 Debt forgiveness 194325 194325 Miscellaneous 145153 124223 20930 Minor Equipment 48908 48908 54648 54648 21155065 15931001 5224064 0 2013578 3436102 768486 800177 3220418 3084651 130992 366978 415630 143509 146928 35497525 16884305 20018434 18613220 2427907 2707029 29090302 29203737 1653927 308273 7615266 7892404 1332027 1452869 10601220 9653546 X 17150965 18212074 341202 341202 996915 996915 18489082 19550191 29090302 29203737 X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1307101 1307101 23275988 8256968 15019020 1675233 845467 829766 9207303 7781870 1425433 31900 31900 18613220 Assets Whose use is limited 2673930 Other assets 33099 2707029 Capital lease obligation 12552 Due to affiliate 875207 Deferred Revenue 263000 Estimated third-party settlements 302110 1452869 1 1 1 X 175.000000000000 1 X 1 1 1 0 1 1 458853 458853 0.02170 1917383 2176553 -259170 0.00000 2376236 2176553 199683 0.02170 68096 68096 0.00320 95595 95595 0.00450 163691 163691 0.00770 2539927 2176553 363374 0.02940 0.00000 0.00000 0.00000 0.00000 0.00000 0.00000 0.00000 0.00000 0.00000 1 1142696 57135 8062000 8062000 X 1 1 APPALACHIAN REGIONAL HEALTHCARE SYSTEM SOLE MEMBER OF CHARLES A. CANNON JR., MEMORIAL HOSPITAL, INC. 1.00000 charles a cannon jr memorial hospital

434 hospital drive linville NC 28646

X X X X 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. 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. 0 0 0 0 0 0 0 0 0 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 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. 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 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 Appalachian Regional Healthcare Foundation C 595569