2011-08-15T15:57:14-05:00 2010-09-30 990 2009-10-01 560619367 Rutherford Hospital Inc RUTH 8282865000 288 South Ridgecrest Avenue Rutherfordton NC 28139 john domansky 8282865000 2011-08-15 2009 2016-02-24 21:20:13Z john domansky 288 South Ridgecrest Avenue Rutherfordton NC 28139 98461530 0 X www.rutherfordhosp.org X 1906 NC Provision of general acute care services. 15 15 956 326 401116 -321179 108117 0 90563677 95506482 -6087862 2955048 55277 0 84639209 98461530 6447 0 0 48438209 45524628 0 0 47796550 50189836 96241206 95714464 -11601997 2747066 99692935 99800759 24768081 22097538 74924854 77703221 to compassionately improve the health and well-being of our patients. 0 0 89486703 95506482 Rutherford Hospital is a general acute care hospital that provides traditional patient care to residents of its service area. Rutherford provides its services to all residents regardless of their ability to pay.# of ED Visits:40,193# of OP Visits:49,884# of Surgical cases: 34,85# of Volunteer Hours: 26,133 89486703 1 0 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 1 0 0 1 135 0 956 1 1 1 0 0 0 0 0 0 0 0 15 15 0 1 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 1 0 NC X X john domansky 8282865080 288 South Ridgecrest Avenue Rutherfordton NC 28139 Joseph L Carson JR 1.00 X 0 0 0 J Thomas Davis 1.00 X 0 0 0 Paul Deck 1.00 X 0 0 0 David Eaker 1.00 X 0 0 0 Diane Hamrick 1.00 X 0 0 0 E Thomas Hardin 1.00 X 0 0 0 J Larry Harrill 1.00 X 0 0 0 Lee Harrill 1.00 X 0 0 0 Thomas J Jaski MD 1.00 X 0 0 0 Matt Bright 1.00 X 0 0 0 Myra Johnson 1.00 X 0 0 0 Michael S Wheeler MD 40.00 X 770621 0 0 Terry Hines 1.00 X 0 0 0 Jerald Delagarza MD 1.00 X 0 0 0 David Bixler 40.00 X 0 0 0 Mary K Millington 40.00 X 104585 0 23678 Dean R Backstrom 40.00 X 222297 0 50328 Jimmy H Rowell 40.00 X 119796 0 27122 Nancy J Boffemmyer 40.00 X 125616 0 28440 William C Parke 40.00 X 114070 0 25825 James B Bross 40.00 X 181908 0 41184 Bill R Chapman 40.00 X 129951 0 29421 Marsha S Baker 40.00 X 121651 0 27542 Jill W Miracle 40.00 X 54995 0 12451 Michael W Roberts 40.00 X 754810 0 170889 Charles Dana Bond 40.00 X 712304 0 161266 Sharren Esther Wolff 40.00 X 403625 0 91381 Gregg Allen Drabek 40.00 X 390799 0 88477 Kirkpatrick James Leroy III 40.00 X 365507 0 82751 4572535 0 860755 41 0 1 0 Michael S Wheeler 288 s ridgecrest ave rutherfordton NC 28139 laboratory & pathology medical directors 770621 Quorum 105 Continental Place Brentwood TN 37027 Hospital Management 654797 Sodexo PO Box 536922 Atlanta GA 30353 Food & Nutrition Management 631180 Softscript Dept 3215 Los Angeles CA 90084 Transcription Services 412283 Diamond Healthcare Corp 700 E Main St Suite 900 Richmond VA 23218 Psychiatric Services Mgt Co. 407993 11 patient service 621110 93988953 93988953 1517529 1116413 401116 95506482 2955048 2955048 98461530 95105366 401116 2955048 2211480 2211480 34907783 32962561 1945222 8405365 8393643 11722 1986411 1161807 824604 187712 187712 19674684 18326246 1348438 381072 338127 42945 1943989 1943400 589 278041 258589 19452 348811 348811 5027574 5025293 2281 681028 1593 679435 Bad Debt 15193684 15177863 15821 medical fees 3038562 3038562 recruiting 412943 97062 315881 dues 228933 101352 127581 806392 449125 357267 95714464 89486703 6227761 0 3259763 5616549 11343444 11146959 2446327 2071898 1042950 801894 113960700 71220372 41328960 42740328 38355288 35636785 1916203 1786346 99692935 99800759 10068388 8971104 8880000 8140000 288811 979797 5530882 4006637 24768081 22097538 X 74921686 77703221 3168 0 74924854 77703221 99692935 99800759 X 0 1 1 X 0 X 1 9606 9606 0 Part II-B, Line 1i: Explanation of Other Lobbying Activities: $1,200 for home and hospice and $8,406 for NCHA. 2075217 2075217 60837687 28849634 31988053 47272517 41523205 5749312 3775279 847533 2927746 42740328 other liabilities 133243 estimated third party settlements 3873394 4006637 1 1 1 X 120.000000000000 1 X 1 1 1 0 1 1 2789620 2789620 0.02910 14802714 14802714 0.15470 17592334 17592334 0.18380 37830312 37830312 0.39520 37830312 37830312 0.39520 55422646 55422646 0.57900 1 5106035 0 1 1 Rutherford Hospital Inc

288 s ridgecrest avenue rutherfordton NC 28139

X X Carolina Community Care

212 allendale drive forest city NC 28043

X dsh Rutherford Orthopedics

139 dr henry norris drive rutherfordton NC 28139

X home health Rutherford Surgical Associates

330 nc 108 highway rutherfordton NC 28139

X Rutherford East Medical Services

605 nc 120 highway mooresboro NC 28139

X Insigts

317 s oak street spindale NC 28160

X England & Godfrey

124 groce street forest city NC 28043

X James Medical Clinic

1269 us highway 221-a forest city NC 28043

X Rutherford Plastic Surgery & SPA

128 dr henry norris drive rutherfordton NC 28139

X Onesource Rehab

2270 us highway 74 bypass 341 forest city NC 28043

X Rutherford Anesthesiolgoy

288 s ridgecrest avenue rutherfordton NC 28139

X NC X 1 0 X X 0 0 0 0 0 0 0 0 0 Michael S Wheeler MD 770621 0 0 0 0 0 0 0 0 0 770621 0 0 0 Dean R Backstrom 222297 0 0 0 0 0 0 0 50328 0 272625 0 0 0 Nancy J Boffemmyer 125616 0 0 0 0 0 0 0 28440 0 154056 0 0 0 James B Bross 181908 0 0 0 0 0 0 0 41184 0 223092 0 0 0 Bill R Chapman 129951 0 0 0 0 0 0 0 29421 0 159372 0 0 0 Michael W Roberts 754810 0 0 0 0 0 0 0 170889 0 925699 0 0 0 Charles Dana Bond 712304 0 0 0 0 0 0 0 161266 0 873570 0 0 0 Sharren Esther Wolff 403625 0 0 0 0 0 0 0 91381 0 495006 0 0 0 Gregg Allen Drabek 390799 0 0 0 0 0 0 0 88477 0 479276 0 0 0 Kirkpatrick James Leroy III 365507 0 0 0 0 0 0 0 82751 0 448258 0 0 0 Part I, Line 1a the organizaton's ceo receives an auto allowance of $605 a month. Part I, Line 1b the organizaton's ceo receives an auto allowance of $605 a month. the organization's ceo was compensated by an unrelated management company for his services performed for the organization. the ceo's compensation paid by the management company has been included on schedule j. Form 990, Part VI, Section A, line 3 The organization uses a management company, quorum, to delegate day to day management functions. Form 990, Part VI, Section B, line 11 the 990 is reviewed my certain officers before filing. Form 990, Part VI, Section B, line 12c the organization's compliance officer completes an annual compliance survey to ensure that the conflict of interest policy is being enforced effectively. Form 990, Part VI, Section B, line 15 the oranization's management company determines the ceo and other top management official compensation based upon comparative data and industry and market standards from a compensation review performed using hospital association data. Form 990, Part VI, Section C, line 18 the organization's governing documents, conflct of interest policy, and financial statements are made available to the public upon request. Form 990, Part VI, Section C, line 19 the organization makes its governing documents, conflict of interest policy, and financial statements available to the public upon request. Form 990, Part XI, line 2c: No changes for approving audited financial statements or selection of independent accountants have occurred from the prior year. Rutherford hospital Foundation inc 288 s ridgecrest ave rutherfordton NC 28139 561968736 healthcare NC 501(c)(3) Line 3 N/A 0 0 1 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 Rutherford hospital Foundation inc N 67446 Rutherford hospital Foundation inc C 24599