BLUE RIDGE HEALTHCARE HOSPITALS INC: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
BLUE RIDGE HEALTHCARE HOSPITALS INC (EIN 56-0529976)
Tax period
2010-01-01 to 2010-12-31
Filed
2011-11-09
IRS object ID
201113139349300816
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 ReturnHeader

FieldValueIRS element (for citing)
Timestamp2011-11-09T15:46:11-06:00Timestamp
Tax Period End Date2010-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1LARSONALLEN LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1101 N TRYON STREET SUITE 1000AddressLine1
CityCHARLOTTECity
StateNCState
ZIP Code28246ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN560529976EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1GRACE HOSPITAL INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlGRACNameControl
Phone8285805000Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line12201 SOUTH STERLING STREETAddressLine1
CityMORGANTONCity
StateNCState
ZIP Code28655ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameROBERT G FRITTSName
TitleSENIOR VP FINANCE/CFOTitle
Phone8285805000Phone
Date Signed2011-11-09DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameGREGORY W JOHNSName
Phone7049985200Phone
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonKENNETH W WOODNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line12201 SOUTH STERLING STREETAddressLine1
CityMORGANTONCity
StateNCState
ZIP Code28655ZIPCode
FieldValueIRS element (for citing)
Gross Receipts132384083GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.BLUERIDGEHEALTH.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1906YearFormation
State Legal DomicileNCStateLegalDomicile
Activity Or Mission DescriptionIMPROVING THE HEALTH OF OUR COMMUNITIES BY PROVIDING EXCELLENT AND COMPASSIONATE CARE.ActivityOrMissionDescription
Nbr Voting Members Governing Body15NbrVotingMembersGoverningBody
Nbr Independent Voting Members13NbrIndependentVotingMembers
Total Nbr Employees1107TotalNbrEmployees
Total Nbr Volunteers86TotalNbrVolunteers
Total Gross UBI1498668TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year731347ContributionsGrantsPriorYear
Contributions Grants Current Year588840ContributionsGrantsCurrentYear
Program Service Revenue Prior Year103963451ProgramServiceRevenuePriorYear
Program Service Revenue CY106468654ProgramServiceRevenueCY
Investment Income Prior Year-2647539InvestmentIncomePriorYear
Investment Income Current Year3501698InvestmentIncomeCurrentYear
Other Revenue Prior Year2414308OtherRevenuePriorYear
Other Revenue Current Year2759811OtherRevenueCurrentYear
Total Revenue Prior Year104461567TotalRevenuePriorYear
Total Revenue Current Year113319003TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year55525GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY273479GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year43004100SalariesEtcPriorYear
Salaries Etc Current Year43680548SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year64564432OtherExpensePriorYear
Other Expenses Current Year65221334OtherExpensesCurrentYear
Total Expenses Prior Year107624057TotalExpensesPriorYear
Total Expenses Current Year109175361TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-3162490RevenuesLessExpensesPriorYear
Revenues Less Expenses CY4143642RevenuesLessExpensesCY
Total Assets BOY197138382TotalAssetsBOY
Total Assets EOY198574101TotalAssetsEOY
Total Liabilities BOY77262947TotalLiabilitiesBOY
Total Liabilities EOY69545712TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY119875435NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY129028389NetAssetsOrFundBalancesEOY
Mission DescriptionGRACE HOSPITAL IS COMMITTED TO IMPROVING THE HEALTH OF OUR COMMUNITIES BY PROVIDING EXCELLENT AND COMPASSIONATE CARE.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense15693863Expense
Revenue15296623Revenue
DescriptionGRACE HOSPITAL PROVIDED 24,026 DAYS OF CARE TO 6,223 PATIENTS ADMITTED. GRACE HOSPITAL HAS 184 BEDS AND OFFERS A BROAD SCOPE OF SERVICES.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense12669368Expense
Revenue20804247Revenue
DescriptionGRACE HOSPITAL'S SURGICAL SERVICES PERFORMED 1,450 INPATIENTS SURGERIES AND 3,911 OUTPATIENT SURGERIES. ORTHOPEDICS, GENERAL SURGERY, SPINE SURGERY, AND OB/GYN ARE THE MAJOR SURGICAL SPECIALITIES OFFERED.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense4847513Expense
Revenue13013816Revenue
DescriptionEMERGENCY ROOM SAW 38,226 PATIENTS DURING THE YEAR. THE ED IS OPEN 24 HOURS A DAY, 7 DAYS A WEEK AND IS ABLE TO TAKE CARE OF ANY TYPE OF EMERGENCY OR PROBLEM.Description

Activity Other ActivityOther

FieldValueIRS element (for citing)
Expense58281478Expense
Revenue58127461Revenue
FieldValueIRS element (for citing)
Total Of Other Program Service Exp58281478TotalOfOtherProgramServiceExp
Total Of Other Program Service Rev58127461TotalOfOtherProgramServiceRev
Total Program Service Expense91492222TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities1LobbyingActivities
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities1ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets1ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Financial Stmt Attached0FinancialStmtAttached
Grants To Organizations1GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp1OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With10961NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees1107NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income1UnrelatedBusinessIncome
Form990-T Filed1Form990-TFiled
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members15NbrVotingGoverningBodyMembers
Number Independent Voting Members13NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties1DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters1LocalChapters
Policies Reference Chapters1PoliciesReferenceChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture1InvestmentInJointVenture
Written Policy Or Procedure1WrittenPolicyOrProcedure
States Where Copy Of Return Is FiledNCStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1PATRICIA MOLLBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number8285805000TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line12201 SOUTH STERLING STREETAddressLine1
CityMORGANTONCity
StateNCState
ZIP Code28655ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (25 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
KENNETH W WOOD
PRESIDENT / CEO40.00XX000
J MICHAEL BRIDGES
CHAIRMAN1.00X000
MH MCCRARY
VICE CHAIRMAN1.00X000
JAMES ROSTAN
SECRETARY1.00X000
JEFF CARSWELL
TREASURER1.00X000
PHILIP TATE
BOARD MEMBER1.00X000
CLAY RICHARDSON MD
BOARD MEMBER1.00X000
KENNETH BONFIELD MD
BOARD MEMBER1.00X04060
S ANDREWS DEEKENS MD
BOARD MEMBER1.00X000
LISA BUFF
BOARD MEMBER1.00X000
JOHN BRANSTROM
BOARD MEMBER1.00X000
DORIS FULLWOOD
BOARD MEMBER1.00X000
SHERROD SALSBURY III
BOARD MEMBER1.00X000
ALAN GRIFFIN
BOARD MEMBER1.00X000
ALLEN VANNOPPEN
BOARD MEMBER1.00X000
JAY STOCK
BOARD MEMBER1.00X000
CRAIG RICHARDVILLE
BOARD MEMBER1.00X000
JOHN YOUNG
BOARD MEMBER1.00X000
ROBERT G FRITTS
SENIOR VICE PRESIDENT FINANCE/CFO40.00X000
KATHY BAILEY
EXECUTIVE VP/COO40.00X000
LAURA LAMBETH
SR. VICE PRESIDENT40.00240736030260X
THOMAS EURE
CORPORATE COMPLIANCE OFFICER40.00180521053257X
ANTHONY FRASCA MD
PSYCHIATRIST40.00240385040760X
BYRON STROTHER MD
PSYCHIATRIST40.00250000045517X
KENNETH GALLOWAY
HOSPITALIST40.00246320041845X
FieldValueIRS element (for citing)
Total Reportable Comp From Org1157962TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs406TotalReportableCompFrmRltdOrgs
Total Other Compensation211639TotalOtherCompensation
Number Individuals GT100 K21NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
NURSE ANESTHESIA OF NORTH CAROLINA
PO BOX 6633HIGH POINTNC28277CRNA STAFFING2162918
DAVID E LOOPER & COMPANY
320 15TH STREET SOUTHEASTHICKORYNC28602GENERAL CONTRACTORS1286655
ARAMARK CTS
12483 COLLECTIONS CENTER DRCHICAGOIL60693FACILITIES SERVICE MANAGEMENT1201636
ENDURACARE THERAPY MANAGEMENT
DEPT AT 952922 GEMINO HCATLANTAGA31192REHABILITATION THERAPY SERVICES1169318
ARAMARK FACILITIES
22506 NETWORK PLACECHICAGOIL60673FACILITIES SERVICES MANAGEMENT675716
FieldValueIRS element (for citing)
Number Of Contractors GT100 K17NumberOfContractorsGT100K
All Other Contributions588840AllOtherContributions
Total Contributions588840TotalContributions

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
PATIENT REVENUE621400100745767100745767
INTER-FACILITY REVENUE62140093513599351359
INTEGRATION OPERATING900099-4968463-4968463

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

FieldValueIRS element (for citing)
Total Revenue Column1339991TotalRevenueColumn
Related Or Exempt Function Income1339991RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue106468654TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column2359885TotalRevenueColumn
Exclusion$2,359,885ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real486128Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real486128Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column486128TotalRevenueColumn
Exclusion$486,128ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities20206893Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities19065080Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities1141813Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column1141813TotalRevenueColumn
Exclusion$1,141,813ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnUnrelated Business RevenueUnrelatedBusinessRevenueRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
UNRELATED BUSINESS INC62411014986681498668
GUILD9000996601266012
INTEGRATION CAPITAL900099-7970-7970

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column716973TotalRevenueColumn
Related Or Exempt Function Income716973RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue2273683TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column113319003TotalRevenueColumn
Related Or Exempt Function Income107243669RelatedOrExemptFunctionIncome
Unrelated Business Revenue1498668UnrelatedBusinessRevenue
Exclusion$3,987,826ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total273479Total
Program Services273479ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total271121Total
Program Services271121ProgramServices

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total37128734Total
Program Services26628261ProgramServices
Management And General10500473ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total281744Total
Program Services203070ProgramServices
Management And General78674ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total3689866Total
Program Services2652050ProgramServices
Management And General1037816ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total2309083Total
Program Services1664295ProgramServices
Management And General644788ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total179714Total
Management And General179714ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total82800Total
Management And General82800ManagementAndGeneral

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total179931Total
Management And General179931ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total13380238Total
Program Services12283009ProgramServices
Management And General1097229ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total962124Total
Management And General962124ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total180270Total
Management And General180270ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total1861836Total
Program Services1861836ProgramServices

Travel Travel

FieldValueIRS element (for citing)
Total353680Total
Program Services353680ProgramServices

Interest Interest

FieldValueIRS element (for citing)
Total2430592Total
Program Services2430592ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total7921209Total
Program Services7921209ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total2344520Total
Management And General2344520ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServices
BAD DEBT1799042617990426
SUPPLIES96748989674898
DIETARY COSTS31465083146508
INTERCOMPANY18077041807704
EQUIP/MAINT11117291111729

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total1613155Total
Program Services1218355ProgramServices
Management And General394800ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total109175361Total
Program Services91492222ProgramServices
Management And General17683139ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY1385997BOY
EOY597214EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY3662251BOY
EOY3484324EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY16784978BOY
EOY15260567EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY16812718BOY
EOY15247732EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY1293628BOY
EOY1701514EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY680109BOY
EOY435877EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis173354218LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec93995736LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY83756175BOY
EOY79358482EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY13041742BOY
EOY15961988EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY59720784BOY
EOY66526403EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY197138382BOY
EOY198574101EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY6468868BOY
EOY7897960EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY354753BOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY13455000BOY
EOY32257290EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY4778762BOY
EOY1628670EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY52205564BOY
EOY27761792EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY77262947BOY
EOY69545712EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY119790000BOY
EOY128998053EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY85435BOY
EOY30336EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY119875435BOY
EOY129028389EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY197138382BOY
EOY198574101EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses4143642ReconcilationRevenueExpenses
Reconcilation Other Changes5009312ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0Volunteers
Paid Staff Or Management0PaidStaffOrManagement
Media Advertisements0MediaAdvertisements
Mailings Members0MailingsMembers
Publications Or Broadcast0PublicationsOrBroadcast
Grants Other Organizations0GrantsOtherOrganizations
Direct Contact Legislators0DirectContactLegislators
Rallies Demonstrations0RalliesDemonstrations
Other Activities1OtherActivities
Other Activities$9,937OtherActivitiesAmount
Total Lobbying Expenditures IIB9937TotalLobbyingExpendituresIIB
Not Described In501c30NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierEXPLANATION OF OTHER LOBBYING ACTIVITIES:Identifier
Return ReferencePART II-B, LINE 1I:ReturnReference
ExplanationMEMBERSHIP DUES TO AMERICAN HOSPITAL ASSOCIATION ($1,722) AND NORTH CAROLINA HEALTH CARE FACILITIES ASSOCIATION ($8,215).Explanation

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis977206OtherCostOrOtherBasis
Book Value977206BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis102267652OtherCostOrOtherBasis
Depreciation55765691Depreciation
Book Value46501961BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis65701838OtherCostOrOtherBasis
Depreciation35826660Depreciation
Book Value29875178BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis4407522OtherCostOrOtherBasis
Depreciation2403385Depreciation
Book Value2004137BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings79358482TotalOfBookValueLandBuildings

Other Securities OtherSecurities

FieldValueIRS element (for citing)
DescriptionINVESTMENTSDescription
Book Value15961988BookValue
Method Of ValuationFMethodOfValuation
FieldValueIRS element (for citing)
Total Of Book Value Securities15961988TotalOfBookValueSecurities

Other Assets OtherAssets (4 entries)

DescriptionDescriptionBook ValueBookValue
OTHER ASSETS1229135
BOARD DESIGNATED FOR SCHOLARSHIPS129338
BOARD DESIGNATED AS FUNDED DEPRECIATION65058704
GUILD109226
FieldValueIRS element (for citing)
Total Book Value Other Assets66526403TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (3 entries)

DescriptionDescriptionAmountAmount
DUE TO BLUE RIDGE HEALTH SYSTEMS, INC.$24,523,974
THIRD PARTY SETTLEMENTS$3,236,961
GUILD$857
FieldValueIRS element (for citing)
Total Of Amounts27761792TotalOfAmounts
Total Revenue113319003TotalRevenue
Total Expenses109175361TotalExpenses
Excess Or Deficit For Year4143642ExcessOrDeficitForYear
Net Unrealized GL On Investments5010396NetUnrealizedGLOnInvestments
Other-$1,084OtherAmount
Total Adjustments5009312TotalAdjustments
Excess Or Deficit Per FS9152954ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt116930577TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments5010396NetUnrealizedGainsInvestments
Other Revenues-950451OtherRevenues
Revenue Not Rptd F9904059945RevenueNotRptdF990
Revenue Subtotal112870632RevenueSubtotal
Other Revenues Not Included448371OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt448371RevenueNotRptdOnFinStmt
Total Revenue Per Form990113319003TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt107763729TotExpensesEtcAuditedFinclStmt
Other Expenses Included-382359OtherExpensesIncluded
Expenses Not Rptd F990-382359ExpensesNotRptdF990
Expenses Subtotal108146088ExpensesSubtotal
Other Expenses Not Included1029273OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt1029273ExpensesNotRptdOnFinStmt
Total Expenses Per Form990109175361TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (6 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:PART X:THE FILING ORGANIZATION IS A TAX-EXEMPT ORGANIZATION AS DEFINED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE FILING ORGANIZATION'S INCOME TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL AND STATE AUTHORITIES. THE FILING ORGANIZATION IS NOT AWARE OF ANY ACTIVITIES THAT WOULD JEOPARDIZE ITS TAX-EXEMPT STATUS. THE FILING ORGANIZATION IS NOT AWARE OF ANY ACTIVITIES THAT ARE SUBJECT TO TAX ON UNRELATED BUSINESS INCOME OR EXCISE OR OTHER TAXES. THE FILING ORGANIZATION ADOPTED THE INCOME TAX STANDARD FOR UNCERTAIN TAX POSITIONS. THIS STANDARD CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN AN ORGANIZATION'S FINANCIAL STATEMENTS IN ACCORDANCE WITH THE INCOME TAX STANDARD. THIS STANDARD PRESCRIBES RECOGNITION AND MEASUREMENT OF TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN ON A TAX RETURN THAT ARE NOT CERTAIN TO BE REALIZED. THIS STANDARD HAD NO IMPACT ON THE FILING ORGANIZATION'S FINANCIAL STATEMENTS FOR THE YEARS ENDED DECEMBER 31, 2010 OR DECEMBER 31, 2009.
PART XI, LINE 8 - OTHER ADJUSTMENTS:MISCELLANEOUS -1,084.
PART XII, LINE 2D - OTHER ADJUSTMENTS:INVESTMENT FEES -179,931. RECLASSED EXPENSES -825,619. RELEASES FROM RESTRICTION 55,099.
PART XII, LINE 4B - OTHER ADJUSTMENTS:GUILD 66,012. DISTRIBUTIONS-PARTNERSHIPS 382,359. RENTAL EXPENSES
PART XIII, LINE 2D - OTHER ADJUSTMENTS:RENTAL EXPENSES DISTRIBUTIONS-PARTNERSHIPS -382,359.
PART XIII, LINE 4B - OTHER ADJUSTMENTS:RECLASSED EXPENSES 825,619. INVESTMENT FEES 179,931. GUILD 23,723.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free Care1FPGReferenceFreeCare
Pcent100XPcent100
FPG Reference Discounted Care1FPGReferenceDiscountedCare

Discounted Other DiscountedOther

FieldValueIRS element (for citing)
OtherXOther
Discounted Other Percentage180.000000000000DiscountedOtherPercentage
FieldValueIRS element (for citing)
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget1ExpensesExceededBudget
Unable To Provide Care0UnableToProvideCare
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available1ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense2321811TotalCommunityBenefitExpense
Direct Offsetting Revenue1918839DirectOffsettingRevenue
Net Community Benefit Expense402972NetCommunityBenefitExpense
Percent Of Total Expense0.00440PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense16384118TotalCommunityBenefitExpense
Direct Offsetting Revenue11188230DirectOffsettingRevenue
Net Community Benefit Expense5195888NetCommunityBenefitExpense
Percent Of Total Expense0.05700PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

FieldValueIRS element (for citing)
Total Community Benefit Expense430536TotalCommunityBenefitExpense
Direct Offsetting Revenue313479DirectOffsettingRevenue
Net Community Benefit Expense117057NetCommunityBenefitExpense
Percent Of Total Expense0.00130PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense19136465TotalCommunityBenefitExpense
Direct Offsetting Revenue13420548DirectOffsettingRevenue
Net Community Benefit Expense5715917NetCommunityBenefitExpense
Percent Of Total Expense0.06270PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense129626TotalCommunityBenefitExpense
Net Community Benefit Expense129626NetCommunityBenefitExpense
Percent Of Total Expense0.00140PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense41298TotalCommunityBenefitExpense
Net Community Benefit Expense41298NetCommunityBenefitExpense
Percent Of Total Expense0.00050PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense236282TotalCommunityBenefitExpense
Net Community Benefit Expense236282NetCommunityBenefitExpense
Percent Of Total Expense0.00260PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense407206TotalCommunityBenefitExpense
Net Community Benefit Expense407206NetCommunityBenefitExpense
Percent Of Total Expense0.00450PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense19543671TotalCommunityBenefitExpense
Direct Offsetting Revenue13420548DirectOffsettingRevenue
Net Community Benefit Expense6123123NetCommunityBenefitExpense
Percent Of Total Expense0.06720PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported0BadDebtExpenseReported
Bad Debt Expense$5,710,712BadDebtExpenseAmount
Amount Attributable To1097516AmountAttributableTo
Amount Reimbursed By Medicare25734431AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare27464449CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-1730018MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care1ProvisionForCharityCare

Form990 Schedule H Part IV Form990ScheduleHPartIV (3 entries)

Description Ent Primary ActivityDescriptionEntPrimaryActivityOrganization Profit Or OwnershipOrganizationProfitOrOwnership
1 BLUE RIDGE CARDIOLOGY
HEART CATH SVCS0.50000
3 CAROLINAS HEALTHCARE SYSTEM
MANAGEMENT SERVICES0.00000
4 CHS - HEALTHY HOME
HOME NURSING & THERAPY0.18000
FieldValueIRS element (for citing)
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1GRACE HOSPITAL INCBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line12201 SOUTH STERLING STREETAddressLine1
CityMORGANTONCity
StateNCState
ZIP Code28655ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1NOT REQUIREDBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
Eligibility Criteria Explained0EligibilityCriteriaExplained
Uses FPG Free0UsesFPGFree
Uses FPG Discounted0UsesFPGDiscounted
Explains Basis0ExplainsBasis
Explains Application Method0ExplainsApplicationMethod
Includes Publicity Measures0IncludesPublicityMeasures
Actions On Nonpayment0ActionsOnNonpayment
Collection Activities0CollectionActivities
Nondiscrim Emergency Care Policy0NondiscrimEmergencyCarePolicy
Amounts Generally Billed0AmountsGenerallyBilled
Gross Charges0GrossCharges

Form990 Schedule H Part VI Form990ScheduleHPartVI (13 entries)

ExplanationExplanationIdentifierIdentifierReturn ReferenceReturnReference
PART I, LINE 3C: GRACE HOSPITAL USES THE SLIDING SCALE PROVIDED IN THE FEDERAL POVERTY INCOME GUIDELINES PUBLISHED ANNUALLY BY THE DEPARTMENT OF HEALTH AND HUMAN SERVICES TO DETERMINE ELIGIBILITY. AN ASSET TEST IS USED TO DETERMINE ELIGIBILITY FOR FREE OR DISCOUNTED CARE.
PART I, LINE 6A: COMMUNITY BENEFIT REPORT IS PREPARED FOR BLUE RIDGE HEALTHCARE SYSTEM (BRHS) WHICH INCLUDES GRACE HOSPITAL AND VALDESE GENERAL HOSPITAL.
PART I, L7 COL(F): BAD DEBT COST FROM LINE 2 IS BASED ON TOTAL BAD DEBT EXPENSE MULTIPLIED BY THE COST-TO-CHARGE RATIO. CHARITY INCLUDED ON LINE 3 IS CALCULATED BASED ON A STATISTICAL SAMPLE OF SELF PAY PATIENTS THAT QUALIFY FOR CHARITY CARE FROM THE OUTPATIENT SETTING. PER NOTE 8 OF BLUE RIDGE'S AUDITED FINANCIAL STATEMENTS, "UNINSURED DISCOUNTS AND BAD DEBTS - INCLUDES THE COST OF SERVICES PROVIDED TO UNINSURED OR UNDERINSURED PATIENTS AND TO PATIENTS WHO OTHERWISE DO NOT PAY FOR THEIR HEALTHCARE SERVICES."
PART II: NOT APPLICABLE FOR GRACE HOSPITAL.
PART III, LINE 4: THE MISSION OF BRHS IS TO CREATE AND OPERATE A HEALTH SYSTEM TO PROVIDE HOSPITAL, ACUTE AND EMERGENCY CARE, INPATIENT PSYCHIATRIC SERVICES, PHYSICIAN SERVICES, LONG-TERM CARE AND HOME HEALTH SERVICES FOR THE BENEFIT OF THE COMMUNITY IT SERVES. COMMITMENT TO THIS MISSION REQUIRES BOTH AN INVESTMENT IN AND A PARTNERSHIP WITH THE COMMUNITY WITHIN WHICH BRHS OPERATES. BRHS DEFINES AND MEASURES THIS INVESTMENT IN AND PARTNERSHIP WITH THE COMMUNITY USING THE FOLLOWING CATEGORIES OF COMMUNITY BENEFIT:CHARITY CARE - INCLUDES THE COST OF SERVICES PROVIDED TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER BRHS CHARITY CARE POLICY. KEY ELEMENTS USED TO DETERMINE ELIGIBILITY FOR CHARITY CARE INCLUDE A PATIENTS DEMONSTRATED ABILITY TO PAY BASED ON FAMILY SIZE AND HOUSEHOLD INCOME RELATIVE TO FEDERAL INCOME POVERTY GUIDELINES. UNINSURED DISCOUNTS AND BAD DEBTS INCLUDES THE COST OF SERVICES PROVIDED TO UNINSURED OR UNDERINSURED PATIENTS AND TO PATIENTS WHO OTHERWISE DO NOT PAY FOR THEIR HEALTHCARE SERVICES.UNFUNDED MEDICARE AND MEDICAID REPRESENTS THE UN-REIMBURSED COST OF SERVICES PROVIDED TO PATIENTS WHO QUALIFY FOR FEDERAL AND-OR STATE GOVERNMENT HEALTHCARE BENEFITS. COMMUNITY BENEFIT PROGRAMS INCLUDES THE UN-REIMBURSED COST OF VARIOUS EDUCATION AND RESEARCH PROGRAMS, NON-BILLED MEDICAL SERVICES, IN-KIND DONATIONS, AND OTHER SERVICES THAT MEET A STRONG COMMUNITY NEED, BUT DO NOT PAY FOR THEMSELVES. EXAMPLES OF THESE COMMUNITY BENEFIT PROGRAMS INCLUDE ACTIVITIES THAT PROMOTE DISEASE DETECTION AND PREVENTION (FREE HEALTH SCREENINGS, EDUCATION AND INFORMATION), WORK FORCE TRAINING (PARTNERSHIPS WITH AREA COMMUNITY COLLEGES AND UNIVERSITIES), ECONOMIC DEVELOPMENT AND DONATIONS TO COMMUNITY-BASED HEALTH AND HUMAN SERVICES ORGANIZATIONS WHOSE MISSIONS COMPLEMENT THE MISSION OF BRHS.
PART III, LINE 8: THE MEDICARE COST REPORT IS PREPARED USING THE AUDITED TRIAL BALANCE FOR GRACE HOSPITAL. THE COST REPORT IS PREPARED IN ACCORDANCE WITH ALL APPLICABLE RULES AND REGULATIONS. AS A 501(C)(3) ORGANIZATION, GRACE HOSPITAL ACCEPTS ALL PATIENTS WITHOUT REGARD TO THE INSURANCE OR LACK OF INSURANCE.
PART III, LINE 9B: ALL SELF PAY E.D. PATIENTS ARE SCREENED FOR CHARITY AND-OR FINANCIAL ASSISTANCE IN THE E.D. AREA. PATIENT SEEN IN OUTPATIENT SURGERY AND INPATIENT SETTINGS ARE SCREENED DURING OR PRIOR TO SERVICES. MONTHLY STATEMENTS REFERENCE THE PHONE NUMBERS TO CALL FOR FINANCIAL ASSISTANCE.
PART VI, LINE 2: GRACE HOSPITAL PERFORMS OUTREACH SERVICES AND HEALTH EDUCATION OPPORTUNITIES FOR THE COMMUNITY SERVED. FEEDBACK FROM THESE EFFORTS ALONG WITH THE EVALUATION OF THE PATIENTS SERVED ARE CONSIDERED IN ASSESSING THE COMMUNITIES HEALTH CARE NEEDS. IN ADDITION, THE ORGANIZATION HAS CONDUCTED EXTENSIVE RESEARCH INTO THE AREAS MOST SERIOUS HEALTH THREATS AND DEVELOPED A PLAN TO FOCUS ATTENTION ON THESE ISSUES.
PART VI, LINE 3: ALL SELF PAY ED PATIENTS ARE SCREENED FOR CHARITY AND-OR FINANCIAL ASSISTANCE IN THE ED AREA. PATIENT SEEN IN OUTPATIENT SURGERY AND INPATIENT SETTINGS ARE SCREENED DURING OR PRIOR TO SERVICES. MONTHLY STATEMENTS REFERENCE THE PHONE NUMBERS TO CALL FOR FINANCIAL ASSISTANCE.
PART VI, LINE 4: BRHCS PRIMARY SERVICE AREA INCLUDES THREE COUNTIES (BURKE, MCDOWELL, CALDWELL); PATIENTS FROM A NUMBER OF OTHER OUTLYING COUNTIES ARE ALSO SERVED BY BRHC. THE POPULATION IS PREDOMINANTLY CAUCASIAN. SIGNIFICANT MINORITIES INCLUDE HMONG, AFRICAN-AMERICAN AND HISPANIC RESIDENTS. THE AREA IS ECONOMICALLY DEPRESSED DUE TO THE LOSS OF TRADITIONAL FURNITURE AND TEXTILE INDUSTRIES.
PART VI, LINE 6: BRHC IS GOVERNED BY A VOLUNTEER COMMUNITY BOARD OF DIRECTORS. BRHC SYSTEM IS SERVED BY OPEN MEDICAL STAFFS. THE SYSTEM IS ALSO SUPPORTED BY A GROWING BRHC VOLUNTEERS CORPS WHO CONTRIBUTE THOUSANDS OF HOURS IN SERVICE ANNUALLY. BRHC ACTIVELY RECRUITS PRIMARY CARE PHYSICIANS AND PHYSICIAN SPECIALISTS TO MEET SPECIFIC MEDICAL NEEDS IN THE COMMUNITY.
PART VI, LINE 7: GRACE HOSPITAL IS PART OF BLUE RIDGE HEALTHCARE SYSTEM. BLUE RIDGE SERVES BURKE COUNTY, NC AND SURROUNDING COUNTIES. BLUE RIDGE IS AFFILIATED WITH CAROLINAS HEALTHCARE SYSTEM BASED IN CHARLOTTE, NC.
NCREPORTS FILED WITH STATESPART VI, LINE 7

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Recipient Table RecipientTable (5 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantPurpose Of GrantPurposeOfGrantAmount Of Non Cash AssistanceAmountOfNonCashAssistanceMethod Of ValuationMethodOfValuation
BLUE RIDGE HEALTHCARE FOUNDATION INC
2201 SOUTH STERLING STREETMORGANTONNC28655582063920501(C)(3)24300MEMORIAL DONATIONS AND HEALTHCARE EQUIPMENT
BURKE CO - FOOTHILLS ALLIED HEALTH
PO BOX 219MORGANTONNC28655566000280501(C)(3)37800DONATION FOR HEALTHCARE EDUCATION CENTER
GOOD SAMARITAN CLINIC
305 W UNION STMORGANTONNC28655561939030501(C)(3)DONATED PHARMACEUTICALS50000RETAIL VALUE
BURKE COUNTY COMMITTEE OF 100 INC
PO BOX 1489MORGANTONNC28655208831851501(C)(3)5000COMMUNITY BENEFIT
BURKE COUNTY PUBLIC SCHOOLS
PO BOX 889MORGANTONNC28655560935935GOVERNMENTAL156379SCHOOL NURSES AND ATHLETIC TRAINERS
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants4TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations0TotalNbrOfOtherOrganizations

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierPROCEDURE FOR MONITORING GRANTS IN THE U.S.:Identifier
Return ReferencePART I, LINE 2:ReturnReference
ExplanationSCHEDULE I, PART I, LINE 2: BLUE RIDGE HEALTHCARE SYSTEM EMPLOYEES AND THEIR FAMILY MEMBERS ARE FIRST CONSIDERED FOR FINANCIAL ASSISTANCE THROUGH SCHOLARSHIPS AND GRANTS IN AID. APPLICANTS PREPARING FOR WORK IN HEALTHCARE RELATED AREAS ARE CONSIDERED NEXT. GENERALLY, THIS DOES NOT INCLUDE AREAS OF STUDY SUCH AS ACCOUNTING OR INFORMATION SYSTEMS. FINANCIAL ASSISTANCE IS BASED ON THE INDIVIDUAL'S QUALIFICATIONS AND DEMONSTRATED FINANCIAL NEEDS. A GRADE POINT AVERAGE OF AT LEAST 2.5 ON A 4.0 SCALE IS REQUIRED. THE SCHOLARSHIP COMMITTEE MEETS TWICE A YEAR OR AS OFTEN AS NEEDED TO DECIDE ON RECIPIENTS. IF ALL APPLICATIONS SATISFY SELECTION CRITERIA, THEN MONIES ARE AWARDED BASED ON OTHER FINANCIAL ASSISTANCE AWARDED, DEMONSTRATED FINANCIAL NEED, AREA OF STUDY, AND GRADE POINT AVERAGE. ALL SELECTED APPLICATIONS INTERVIEWED BY THE SCHOLARSHIP COMMITTEE CHAIRPERSON.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Club Dues Or FeesXClubDuesOrFees
Written Policy Re T And E Expenses1WrittenPolicyReTAndEExpenses
Substantiation Required1SubstantiationRequired
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org1CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs1CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (5 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
LAURA LAMBETH
184682056054000113900188700270996000
THOMAS EURE
153185025581017550124970407600233778000
ANTHONY FRASCA MD
2403850000000407600281145000
BYRON STROTHER MD
2500000000046170409000295517000
KENNETH GALLOWAY
245551000769010100408350288165000

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
PART I, LINE 6BONUSES ARE PAID IF THE ORGANIZATION'S RESULTS MEET CERTAIN PERFORMANCE INDICATORS.
PART IIIPART II: COMPENSATION FOR KENNETH WOOD, KATHY BAILEY, AND ROBERT FRITTS IS PAID BY CAROLINA HEALTH SYSTEMS THROUGH A MANAGEMENT SERVICE CONTRACT.SUPPLEMENTAL INFORMATION

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV

Name Of Interested Person NameOfInterestedPerson

FieldValueIRS element (for citing)
Name PersonKENNETH WOODNamePerson
FieldValueIRS element (for citing)
RelationshipVOTING BOARD MEMBER AND CEORelationship
Description Of TransactionHIS COMPENSATION IS PAID BY CAROLINA HEALTH SYSTEMDescriptionOfTransaction
Sharing Of Revenues0SharingOfRevenues

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (8 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
FORM 990, PART VI, SECTION A, LINE 3IN 1999, THE ORGANIZATION ENTERED INTO A MANAGEMENT SERVICES CONTRACT WITH CAROLINAS HEALTHCARE SYSTEM. THE TERMS OF THE CONTRACT CALL FOR THE ORGANIZATION TO PAY CAROLINAS HEALTHCARE SYSTEM AN ANNUAL MANAGEMENT FEE BASED UPON THE ORGANIZATION'S NET OPERATING REVENUES. IN ADDITION, CAROLINAS HEALTHCARE SYSTEM IS REQUIRED TO FURNISH THE ORGANIZATION WITH A CHIEF EXECUTIVE OFFICER, CHIEF OPERATING OFFICER, AND CHIEF FINANCIAL OFFICER. THE ORGANIZATION REIMBURSES CAROLINAS HEALTHCARE SYSTEM FOR THE SALARY AND BENEFITS' COST OF THESE INDIVIDUALS. SEE SCHEDULE J PART III FOR DETAILS OF THE SALARY AND BENEFITS.
FORM 990, PART VI, SECTION B, LINE 11THE CHIEF FINANCIAL OFFICER AND THE EXECUTIVE COMMITTEE WILL REVIEW THE PREPARED FORM 990 BEFORE IT IS FILED WITH THE IRS. A DRAFT OF FORM 990 WILL BE EMAILED TO EACH MEMBER OF THE GOVERNING BODY BEFORE IT IS FILED WITH THE IRS.
CORPORATE COUNSEL, WHO REVIEWS ALL ANNUAL CONFLICT OF INTEREST DISCLOSURES, IS PRESENT AT EVERY BOARD MEETING TO ENSURE THAT ANY POTENTIAL CONFLICTS ARE APPROPRIATELY HANDLED BY MEMBERS ABSTAINING FROM VOTES AS APPROPRIATE.FORM 990, PART VI, SECTION B, LINE 12C
SUCH A PROCESS WAS PERFORMED FOR DETERMINING THE COMPENSATION OF THE ORGANIZATION'S PRESIDENT/CEO, CFO AND AND COO DURING 2010 AND KEY EMPLOYEE DURING 2010.FORM 990, PART VI, SECTION B, LINE 15
BY-LAWS ARE AVAILABLE UPON REQUEST THROUGH CORPORATE COUNSEL. ARTICLES OF INCORPORATION ARE FILED WITH NC STATE AND ARE AVAILABLE ON THEIR WEBSITE. FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST.FORM 990, PART VI, SECTION C, LINE 19
OFFICERS AND KEY EMPLOYEES LISTED ON PART VII WORK AN AVERAGE OF 40 HOURS PER WEEK. THEIR TIME IS SHARED BETWEEN THE FILING ORGANIZATION AND OTHER RELATED ENTITIES LISTED ON SCHEDULE R.FORM 990, PART VII, DESCRIPTION OF HOURS FOR RELATED ORGANIZATIONS:
CHANGES IN NET ASSETS OR FUND BALANCES:NET UNREALIZED GAINS ON INVESTMENTS: 5,010,396. MISCELLANEOUS -1,084. TOTAL TO FORM 990, PART XI, LINE 5: 5,009,312.FORM 990, PART XI, LINE 5:
NO CHANGES FOR APPROVING AUDITED FINANCIAL STATEMENTS OR SELECTION OF INDEPENDENT ACCOUNTANTS HAVE OCCURRED FROM THE PRIOR YEAR.FORM 990, PART XII, LINE 2C:

Schedule R IRS990ScheduleR

Form990 Schedule R Part I Form990ScheduleRPartI

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1GRACE HEALTH VENTURES INCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line12201 SOUTH STERLING STREETAddressLine1
CityMORGANTONCity
StateNCState
ZIP Code28655ZIPCode
FieldValueIRS element (for citing)
EIN561581317EIN
Primary ActivitiesRELATEDPrimaryActivities
Legal Domicile StateNCLegalDomicileState
Total Income-869TotalIncome
EOY Assets35797EOYAssets

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1BLUE RIDGE HEALTHCARE SYSTEMS INCBusinessNameLine1

Form990 Schedule R Part II Form990ScheduleRPartII (9 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNAControlled OrgControlledOrg
VALDESE GENERAL HOSPITAL INC
720 MALCOLM BOULEVARDVALDESENC28690560634510HEALTHCARENC501 (C)(3)N/AN/A0
VALDESE NURSING HOME INC
95 LOCUST STREETRUTHERFORD COLLEGENC28671561978560HEALTHCARENC501 (C)(3)509(A)(2)N/A0
GRACE LIFECARE INC
500 LENOIR ROADMORGANTONNC28655561722754HEALTHCARENC501 (C)(3)509(A)(2)N/A0
GRACE NURSING CENTER INC
109 FOOTHILLS DRIVEMORGANTONNC28655561838369HEALTHCARENC501 (C)(3)509(A)(2)N/A0
GRACE PROPERTIES INC
500 LENOIR ROADMORGANTONNC28655561727514HEALTHCARENC501 (C)(3)509(A)(3)N/A0
BLUE RIDGE FOUNDATION INC
2201 SOUTH STERLING STREETMORGANTONNC28655582063920HEALTHCARENC501 (C)(3)509(A)(1)N/A0
BLUE RIDGE MEDICAL GROUP INC
2201 SOUTH STERLING STREETMORGANTONNC28655020777195HEALTHCARENC501 (C)(3)509(A)(2)N/A0
BLUE RIDGE HEALTHCARE SYSTEMS INC
2201 SOUTH STERLING STREETMORGANTONNC28655562150313HEALTHCARENC501 (C)(3)509(A)(3)N/A0
BLUE RIDGE MOBILE IMAGING LLC
2201 SOUTH STERLING STREETMORGANTONNC28655020777199HEALTHCARENC501 (C)(3)N/AN/A0

Form990 Schedule R Part III Form990ScheduleRPartIII (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Predominant Income TypePredominantIncomeTypeShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsDisproportionate AllocationsDisproportionateAllocationsGeneral Or Managing PartnerGeneralOrManagingPartnerPercentage OwnershipPercentageOwnership
BLUE RIDGE CARDIOLOGY
2201 SOUTH STERLING STREETMORGANTONNC28655753158601CARDIAC CATHETERIZATION SERVICESNCBRHC & MEDCATHRELATED-16581364134000.50000
HEALTHY HOME LLC
4425 GOLF ACRES DRCHARLOTTENC29202261451047HOME HEALTH SERVICESNCTHE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITYRELATED3121051608000.18000
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties1ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs1RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs1PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities1SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (5 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
GRACE LIFECARE INC
P348636INTERCOMPANY ACTIVITY
BLUE RIDGE MEDICAL GROUP INC
P220373INTERCOMPANY ACTIVITY
BLUE RIDGE MEDICAL GROUP INC
J489573INTERCOMPANY ACTIVITY
BLUE RIDGE CARDIOLOGY
L1779357INTERCOMPANY ACTIVITY
BLUE RIDGE HEALTHCARE SYSTEMS INC
O3432297INTERCOMPANY ACTIVITY

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