CHATHAM HOSPITAL INC: Form 990, tax year 2009
View the entire original 990 at ProPublica ↗
- Organization
- CHATHAM HOSPITAL INC (EIN 56-0611546)
- Tax period
- 2009-07-01 to 2010-06-30
- Filed
- 2011-05-16
- IRS object ID
- 201131369349302563
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule H
- Schedule J
- Schedule K
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2011-05-16T10:34:10-05:00 | Timestamp |
| Tax Period End Date | 2010-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LarsonAllen LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 101 N Tryon Street Suite 1000 | AddressLine1 |
| City | Charlotte | City |
| State | NC | State |
| ZIP Code | 28246 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2009-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 560611546 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Chatham Hospital Inc | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | CHAT | NameControl |
| Phone | 9197994000 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 649 | AddressLine1 |
| City | Siler City | City |
| State | NC | State |
| ZIP Code | 27344 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Carol Straight | Name |
| Title | president | Title |
| Phone | 9197994000 | Phone |
| Date Signed | 2011-05-13 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7049985200 | Phone |
| 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 | Carol Straight | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 649 | AddressLine1 |
| City | Siler City | City |
| State | NC | State |
| ZIP Code | 27344 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 29238100 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c | X | Organization501c |
| Web Site | www.chathamhospital.org | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1939 | YearFormation |
| State Legal Domicile | NC | StateLegalDomicile |
| Activity Or Mission Description | Provides short-term medical care on an inpatient and outpatient basis. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 15 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 7 | NbrIndependentVotingMembers |
| Total Nbr Employees | 305 | TotalNbrEmployees |
| Total Nbr Volunteers | 40 | TotalNbrVolunteers |
| Total Gross UBI | 1072431 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 57734 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 197305 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 487591 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 18764495 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 28499121 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 117907 | InvestmentIncomePriorYear |
| Investment Income Current Year | 140114 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 85727 | OtherRevenuePriorYear |
| Other Revenue Current Year | 111274 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 19165434 | TotalRevenuePriorYear |
| Total Revenue Current Year | 29238100 | TotalRevenueCurrentYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 8029531 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 10630679 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 11340272 | OtherExpensePriorYear |
| Other Expenses Current Year | 19956326 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 19369803 | TotalExpensesPriorYear |
| Total Expenses Current Year | 30587005 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -204369 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -1348905 | RevenuesLessExpensesCY |
| Total Assets BOY | 44887818 | TotalAssetsBOY |
| Total Assets EOY | 50351188 | TotalAssetsEOY |
| Total Liabilities BOY | 38709406 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 36537635 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 6178412 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 13813553 | NetAssetsOrFundBalancesEOY |
| Mission Description | To participate in and promote the provision of patient care, facilitate the education of physicians and other health care providers, promote research in collaboration with the health sciences schools of the university of north carolina at chapel hill, and facilitate and promote the delivery of other services designed to promote the health and well-being of the citizens of north carolina. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 27401693 | Expense |
| Revenue | 28499121 | Revenue |
| Description | Chatham Hospital is a 25 bed critical access hospital and is part of UNC Health Care System. The Hospital has a 70 year history of providing quality health services. The hospital provides comprehensive care, including emergency, general surgery, lab, CT, MRI, nuclear medicine, pharmacy, cardio-pulmonary and intensive care on its campus. The Hospital reaches beyond the hospital setting to provide diabetes education, physical therapy, and cardiac rehabilitation in temporary leased space located in Siler City near the main hospital campus. The year ended June 30, 2010 continued to be a time of transition. There were changes in personnel, the start of construction on a medical office building, and an information system implementation that carries on into subsequent years. The hospital continued its focus on quality measures from the year before which resulted in significant improvements. During 2010 Chatham had 3,017 patient days and an average length of stay of 3.7 days. There were 815 discharges and 369 inpatient and outpatient surgeries as well as 528 endoscopic procedures. There were 13,877 emergency room visits. | Description |
| Total Program Service Expense | 27401693 | 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 | 1 | 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 | 1 | TaxExemptBonds |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBonds |
| Escrow Account | 0 | EscrowAccount |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 14 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 305 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 1 | UnrelatedBusinessIncome |
| Form990-T Filed | 1 | Form990-TFiled |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Nbr Voting Governing Body Members | 15 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 7 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 1 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | NC | StatesWhereCopyOfReturnIsFiled |
| Other Website | X | OtherWebsite |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Bob Blackwell | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 9197994000 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 649 | AddressLine1 |
| City | Siler City | City |
| State | NC | State |
| ZIP Code | 27344 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | X | NoListedPersonsCompensated |
Form990 Part VII Section A Form990PartVIISectionA (20 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| Laura Clapp | |||||||
| President | 1.00 | X | 0 | 0 | 0 | ||
| Barry Wilkie | |||||||
| Vice President | 1.00 | X | 0 | 0 | 0 | ||
| Mary Beck | |||||||
| Board Member | 1.00 | X | 0 | 244678 | 48297 | ||
| Warren Newton MD | |||||||
| Board Member | 1.00 | X | 0 | 0 | 0 | ||
| Barry Hayes | |||||||
| Board Member | 1.00 | X | 0 | 0 | 0 | ||
| Mel Hurston | |||||||
| Board Member | 1.00 | X | 0 | 208660 | 76683 | ||
| Charles Johnson | |||||||
| Board Member | 1.00 | X | 0 | 0 | 0 | ||
| John Lewis | |||||||
| Board Member | 1.00 | X | 0 | 387639 | 71727 | ||
| Todd Peterson | |||||||
| Board Member | 1.00 | X | 0 | 436719 | 99826 | ||
| magaraet pollard | |||||||
| board Member | 1.00 | X | 0 | 0 | 0 | ||
| gabriel soltren | |||||||
| board Member | 1.00 | X | 0 | 0 | 0 | ||
| tim weiner md | |||||||
| board Member | 1.00 | X | 0 | 0 | 0 | ||
| mark zeringue md | |||||||
| board Member | 1.00 | X | 0 | 0 | 0 | ||
| mark gwynne do | |||||||
| board Member | 1.00 | X | 0 | 0 | 0 | ||
| Carl thompson | |||||||
| board Member | 1.00 | X | 0 | 0 | 0 | ||
| carol straight | |||||||
| Board Member/President | 40.00 | X | 0 | 167587 | 45836 | X | |
| leslie gura | |||||||
| Interim CFO (7/1/09-2/15/10) | 40.00 | 0 | 98114 | 0 | X | ||
| Bob Blackwell | |||||||
| CFO | 40.00 | 0 | 164249 | 30105 | X | ||
| Rebecca W Quate | |||||||
| Chief Nursing Executive | 40.00 | 106244 | 0 | 9086 | X | ||
| Donna B Sessoms | |||||||
| HIS Project Manager | 40.00 | 100136 | 0 | 8661 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 206380 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 1707646 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 390221 | TotalOtherCompensation |
| Number Individuals GT100 K | 2 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| Rodgers Builders | |||||
| PO Box 18446 | Charlotte | NC | 28218 | Construction | 991531 |
| Labcorp | |||||
| 458 S Main | Burlington | NC | 27215 | Laboratory | 384185 |
| Alliance Imaging | |||||
| PO Box 96485 | Chicago | NC | 60693 | medical equipment | 181300 |
| Chatham Anesthesia | |||||
| 209 Glenhaven Drive | Chapel Hill | NC | 27516 | Medical Services | 166666 |
| Mcneary | |||||
| 6525 Morrison Blvd | Charlotte | NC | 28211 | medical equipment | 106779 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 5 | NumberOfContractorsGT100K |
| All Other Contributions | 487591 | AllOtherContributions |
| Total Contributions | 487591 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | patient revenue | Description |
| Business Code | 621110 | BusinessCode |
| Total Revenue Column | 27751843 | TotalRevenueColumn |
| Related Or Exempt Function Income | 26679412 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 1072431 | UnrelatedBusinessRevenue |
Total Oth Program Service Revenue TotalOthProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 747278 | TotalRevenueColumn |
| Related Or Exempt Function Income | 747278 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 28499121 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 140114 | TotalRevenueColumn |
| Exclusion | $140,114 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 69205 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 69205 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 69205 | TotalRevenueColumn |
| Exclusion | $69,205 | ExclusionAmount |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 42069 | TotalRevenueColumn |
| Exclusion | $42,069 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 42069 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 29238100 | TotalRevenueColumn |
| Related Or Exempt Function Income | 27426690 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 1072431 | UnrelatedBusinessRevenue |
| Exclusion | $251,388 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 331837 | Total |
| Management And General | 331837 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8231044 | Total |
| Program Services | 7271976 | ProgramServices |
| Management And General | 959068 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 93063 | Total |
| Program Services | 82219 | ProgramServices |
| Management And General | 10844 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1285349 | Total |
| Program Services | 1135582 | ProgramServices |
| Management And General | 149767 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 689386 | Total |
| Program Services | 609060 | ProgramServices |
| Management And General | 80326 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 158000 | Total |
| Management And General | 158000 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 49721 | Total |
| Management And General | 49721 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 89291 | Total |
| Management And General | 89291 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4261465 | Total |
| Program Services | 3444682 | ProgramServices |
| Management And General | 816783 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 44665 | Total |
| Management And General | 44665 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1836652 | Total |
| Program Services | 1634864 | ProgramServices |
| Management And General | 201788 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1938088 | Total |
| Program Services | 1938088 | ProgramServices |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 46543 | Total |
| Program Services | 34953 | ProgramServices |
| Management And General | 11590 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6139 | Total |
| Program Services | 6139 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2084101 | Total |
| Program Services | 2084101 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 389119 | Total |
| Program Services | 389119 | ProgramServices |
Other Expenses OtherExpenses (2 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices |
|---|---|---|
| bad debt expense | 8601164 | 8601164 |
| Food | 119518 | 119518 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 331860 | Total |
| Program Services | 50228 | ProgramServices |
| Management And General | 281632 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 30587005 | Total |
| Program Services | 27401693 | ProgramServices |
| Management And General | 3185312 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1000 | BOY |
| EOY | 1000 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2119363 | BOY |
| EOY | 2718595 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 220190 | BOY |
| EOY | 133190 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5214815 | BOY |
| EOY | 5795452 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 361467 | BOY |
| EOY | 408101 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 209796 | BOY |
| EOY | 77617 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 33768167 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 7769144 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 26346238 | BOY |
| EOY | 25999023 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8475961 | BOY |
| EOY | 12629686 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1938988 | BOY |
| EOY | 2588524 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 44887818 | BOY |
| EOY | 50351188 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4614799 | BOY |
| EOY | 3633399 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 32033797 | BOY |
| EOY | 30905236 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 13421 | BOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2047389 | BOY |
| EOY | 1999000 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 38709406 | BOY |
| EOY | 36537635 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5751432 | BOY |
| EOY | 13205277 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 426980 | BOY |
| EOY | 608276 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6178412 | BOY |
| EOY | 13813553 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 44887818 | BOY |
| EOY | 50351188 | 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 Separate | X | FinancialStatementSeparate |
| Federal Grant Audit Required | 1 | FederalGrantAuditRequired |
| Federal Grant Audit Performed | 1 | FederalGrantAuditPerformed |
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 | 444983 | OtherCostOrOtherBasis |
| Book Value | 444983 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 26975248 | OtherCostOrOtherBasis |
| Depreciation | 7534466 | Depreciation |
| Book Value | 19440782 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 6347936 | OtherCostOrOtherBasis |
| Depreciation | 234678 | Depreciation |
| Book Value | 6113258 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 25999023 | TotalOfBookValueLandBuildings |
Other Securities OtherSecurities (2 entries)
| DescriptionDescription | Book ValueBookValue | Method Of ValuationMethodOfValuation |
|---|---|---|
| investments | 2564155 | F |
| restricted assets | 10065531 | F |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Securities | 12629686 | TotalOfBookValueSecurities |
Other Assets OtherAssets (4 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| Deferred Financing Costs | 1113134 |
| Estimated Third-Party Payer Settlements | 1442337 |
| Siler City Country Club Bond | 2375 |
| RRG Consortium | 30678 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 2588524 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Note Payable to related entity | Description |
| Amount | $1,999,000 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 1999000 | TotalOfAmounts |
| Total Revenue | 29238100 | TotalRevenue |
| Total Expenses | 30587005 | TotalExpenses |
| Excess Or Deficit For Year | -1348905 | ExcessOrDeficitForYear |
| Other | $8,984,046 | OtherAmount |
| Total Adjustments | 8984046 | TotalAdjustments |
| Excess Or Deficit Per FS | 7635141 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 29620982 | TotRevenueEtcAuditedFinclStmt |
| Other Revenues | 382882 | OtherRevenues |
| Revenue Not Rptd F990 | 382882 | RevenueNotRptdF990 |
| Revenue Subtotal | 29238100 | RevenueSubtotal |
| Revenue Not Rptd On Fin Stmt | 0 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 29238100 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 21985841 | TotExpensesEtcAuditedFinclStmt |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 21985841 | ExpensesSubtotal |
| Other Expenses Not Included | 8601164 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | 8601164 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 30587005 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (3 entries)
| IdentifierIdentifier | ExplanationExplanation |
|---|---|
| Part XI, Line 8 - Other Adjustments: | capital contributed from sole member: 8984046. |
| Part XII, Line 2d - Other Adjustments: | capital contributed from sole member: 8984046. bad debt expense: -8601164. |
| Part XIII, Line 4b - Other Adjustments: | bad debt expense: 8601164. |
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 | 250.000000000000 | FreeOtherPercentage |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | 0 | FPGReferenceDiscountedCare |
| Free Disc Care Medically Indigent | 0 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 0 | ExpensesExceededBudget |
| Annual Community Benefit Report | 1 | AnnualCommunityBenefitReport |
| Report Publically Available | 1 | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 111827 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 111827 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00510 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 2634539 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2201671 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 432868 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01970 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 2746366 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2201671 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 544695 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02480 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 19 | NumberOfActivitiesOrPrograms |
| Total Community Benefit Expense | 2000 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 2000 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 10 | NumberOfActivitiesOrPrograms |
| Total Community Benefit Expense | 1000 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 1000 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Total Community Benefit Expense | 200 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 200 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 30 | NumberOfActivitiesOrPrograms |
| Total Community Benefit Expense | 3200 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 3200 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 30 | NumberOfActivitiesOrPrograms |
| Total Community Benefit Expense | 2749566 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2201671 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 547895 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02490 | PercentOfTotalExpense |
Economic Development EconomicDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Total Community Building Expense | 6445 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 6445 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00030 | PercentOfTotalExpense |
Coalition Building CoalitionBuilding
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Total Community Building Expense | 1000 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 1000 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Health Improvement Advocacy HealthImprovementAdvocacy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Total Community Building Expense | 1200 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 1200 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 3 | NumberOfActivitiesOrPrograms |
| Total Community Building Expense | 8645 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 8645 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00040 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $4,300,582 | BadDebtExpenseAmount |
| Amount Attributable To | 2150291 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 5981687 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 6594519 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -612832 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
Form990 Schedule H Part V Form990ScheduleHPartV (2 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Licensed HospitalLicensedHospital | General Medical And SurgicalGeneralMedicalAndSurgical | Critical Access HospitalCriticalAccessHospital | Er24 HoursEr24Hours | OtherOther |
|---|---|---|---|---|---|---|---|---|
| chatham hospital | ||||||||
| 475 progress blvd | siler city | NC | 27344 | X | X | X | X | |
| chatham hospital off site clinic | ||||||||
| 128 village lake rd | siler city | NC | 27344 | Cardiac Rehabilitation, Diabetes Education, PT/OT | ||||
Form990 Schedule H Part VI Form990ScheduleHPartVI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Income Based Criteria | Part I, Line 3c: Persons who have no health insurance coverage or who obtain services not covered by their health insurance will be eligible for a 35% discount of their Chatham Hospital charges, except for Category 3 services in the Financial Assistance Exceptions Table (Appendix A). This discount will be given regardless of income or North Carolina residency. | IncomeBasedCriteria |
| Bad Debt Footnote | Part III, Line 4: Specific patient balances are written off at the time they are determined to be uncollectible. | BadDebtFootnote |
| Shortfall As Community Benefit | Part III, Line 8: As a Critical Access Hospital, the difference between revenue received from Medicare and the Medicare Allowable Cost is the amount due from the patients in the form of co-payments, co-insurance and deductibles. The patient amounts that are not collected end up as bad debts which are partially recoverable on future cost reports. | ShortfallAsCommunityBenefit |
| Debt Collection Policy | Part III, Line 9b: Policy does contain provisions on the collection practices to be followed for patients who are known to qualify for charity care | DebtCollectionPolicy |
| Needs Assessment | Part VI, Line 2: Less than 20% of our countys residents live in incorporated towns. The county has about 85 residents per square mile, which reflects its generally rural nature. a critical access hospital is essential for a rural community such as this.Chatham Hospital addresses the community's emergency health needs by providing around-the-clock emergency services to more than 1,000 patients each month. Our 5,500-square foot emergency room is newly renovated and equipped with the advanced diagnostic and monitoring equipment required to deliver excellent care.Chatham hospital strives to improve emergency care for kids by increasing medication safety. Also, the hospital has a diabetes self-management program for individuals with diabetes within the community. | NeedsAssessment |
| Patient Education Assistance | Part VI, Line 3: patient financial services is available to patients who wish to discuss payment options. | PatientEducationAssistance |
| Community Information | Part VI, Line 4: Population Information: The official 2010 Census places our 2010 population at 63,505, an increase of 28.74% since 2000. The state average growth for this decade was 18.5%. Less than 20% of our county's residents live in incorporated towns. The county has about 85 residents per square mile, which reflects its generally rural nature. Ethnic/Racial Diversity: The overall, racial/ethnic composition of Chatham County is: 71% white, 13% African American, 12% Hispanic, 2% Asian and 2% other.Age: The 2009 estimated median age for Chatham County residents is 42, up from 38.7 in 2007 and above the state average. The greatest percentage of our population (54%) is in the range of 20 to 60 years old, and 21.9% are age 60 or older. Income and Poverty: The estimated median household income for Chatham County in 2008 was $46,574, a significant drop from $51,794 in 2007, but still ranks us 8th in the state Per capita income for 2008 was $43,894, which ranks third out of the 100 counties. The percentage of individuals living in poverty in 2008 was estimated at 10.3%, lower than the state average of 14.6%, but still significant. This points out the challenges of a county with residents at extreme ends of the income spectrum. | CommunityInformation |
| Community Building Activities | Part VI, Line 5: Chatham hospital strives to improve emergency care for kids by increasing medication safety. Also, the hospital has a diabetes self-management program for individuals with diabetes within the community. | CommunityBuildingActivities |
| Other Information | Part VI, Line 6: Chatham Hospital and UNC Health Care are partnering to bring nationally-recognized health care to Chatham County. Our partnership means you'll continue to have access to advanced health care close to home, with the personal touch you've come to expect from us. | OtherInformation |
| Reports Filed With States | NC | ReportsFiledWithStates |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (6 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Mary Beck | |||||||||||||
| 0 | 225253 | 0 | 15304 | 0 | 4121 | 0 | 23633 | 0 | 24664 | 0 | 292975 | 0 | 0 |
| Mel Hurston | |||||||||||||
| 0 | 193373 | 0 | 13138 | 0 | 2149 | 0 | 54891 | 0 | 21792 | 0 | 285343 | 0 | 0 |
| John Lewis | |||||||||||||
| 0 | 386640 | 0 | 0 | 0 | 999 | 0 | 47583 | 0 | 24144 | 0 | 459366 | 0 | 0 |
| Todd Peterson | |||||||||||||
| 0 | 401094 | 0 | 27250 | 0 | 8375 | 0 | 65478 | 0 | 34348 | 0 | 536545 | 0 | 0 |
| carol straight | |||||||||||||
| 0 | 149249 | 0 | 10140 | 0 | 8198 | 0 | 28019 | 0 | 17817 | 0 | 213423 | 0 | 0 |
| Bob Blackwell | |||||||||||||
| 0 | 152637 | 0 | 9971 | 0 | 1641 | 0 | 11828 | 0 | 18277 | 0 | 194354 | 0 | 0 |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | North Carolina Medical Care Commission | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Issuer EIN | 521309402 | IssuerEIN |
| CUSIP Number | 657905ES0 | CUSIPNumber |
| Date Issued | 2007-02-08 | DateIssued |
| Issue Price | 30540000 | IssuePrice |
| Description Of Purpose | FHA Insured Mortgage Revenue Bonds | DescriptionOfPurpose |
| Defeased | 0 | Defeased |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
Form990 Schedule K Part II Form990ScheduleKPartII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Proceeds | 30540000 | TotalProceeds |
| Amount In Reserve Fund | 639326 | AmountInReserveFund |
| Issuance Costs From Proceeds | 1370283 | IssuanceCostsFromProceeds |
| Capital Expenditures | 29976186 | CapitalExpenditures |
| Year Of Subst Completion | 2008 | YearOfSubstCompletion |
| Current Refunding | 0 | CurrentRefunding |
| Advance Refunding | 0 | AdvanceRefunding |
| Final Allocation Made | 1 | FinalAllocationMade |
| Adequate Books And Recds Maintaind | 1 | AdequateBooksAndRecdsMaintaind |
Form990 Schedule K Part III Form990ScheduleKPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Owning Bond Financed Property | 0 | OwningBondFinancedProperty |
| Any Lease Arrangements | 0 | AnyLeaseArrangements |
| Mngment Cntrct Bond Financd Prprty | 0 | MngmentCntrctBondFinancdPrprty |
| Any Research Agreements | 0 | AnyResearchAgreements |
| Bond Counsel Routinely Engaged | 1 | BondCounselRoutinelyEngaged |
| Post Issuance Compliance Procdrs | 1 | PostIssuanceComplianceProcdrs |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (9 entries)
| IdentifierIdentifier | ExplanationExplanation |
|---|---|
| Form 990, Part VI, Section A, line 4 | Effective August 1, 2006, the hospital entered into a five-year contract with UNCH to provide a CEO and a CFO to manage the day-to-day operations of the hospital. In addition to the salaries of the ceo and cfo, the hospital paid unch a management fee of $150,000 for the first-year term of the contract. this fee will increase each subsequent year by a percentage equal to the increase in the consumer price index as published by the bureau of labor statistics. |
| Form 990, Part VI, Section A, line 6 | See response to question 7a. |
| Form 990, Part VI, Section A, line 7a | In addition to such powers and rights as are vested in it by law, the amended and restated articles of incorporation of the corporation or the amended and restated bylaws, the member ("unchcs") shall have the following powers: (a) the power to appoint the chairman of the board, vice chairman, president, executive vice presidents, secretary/treasurer and other corporate officers of the corporation; (b) the power to appoint individual members of the corporation's board of trustees; (c) the power to establish and maintain quality, service delivery, and financial standards to be observed by all members of unchcs, including the corporation; (d) the power to establish a schedule of cost-based assessments payable by provider components of unchcs for the support of that portion of its operating budget attributable to unchcs-wide administration and initiatives and reflecting operating entity performance; (e) the power to negotiate, develop, and approve all managed care products and contracts for the corporation; (f) the power to approve (i) the corporation's name, (ii) capital and operating budgets of the corporation, and (iii) non-budgeted material expenditures of the corporation (as "material" is established by the member from time to time), provided that only the board of trustees shall have the authority to initiate a change in the name of the corporation of the hospital, which shall be subject to final approval by unchcs; and (g) other powers mutually agreed to by unchcs and the corporation. |
| Form 990, Part VI, Section A, line 7b | See response to question 7a. |
| Form 990, Part VI, Section B, line 11 | Form 990, Part VI, Section A,line 10: The form 990 was reviewed prior to filing by the president and cfo of the hospital. In addition, it was made available to every member of the governing body before it was filed with the IRS. |
| Form 990, Part VI, Section B, line 12c | The conflict of interest statements are completed by the board members annually to be reviewed by the hospital president. the chatham hospital conflict of interest policy outlines the process to be followed in determining the existence of a potential conflict, and how to address the situation when decisions face a fha insured mortgage revenue bonds. |
| Form 990, Part VI, Section B, line 15 | Effective August 1, 2006, the hospital enetered into a five-year contract with unch to provide a CEO and a CFO to manage the day-to-day operations of the hospital. the president of chatham hospital reports monthly to the president of unc hospitals, discussing surveys of compensation data and planned ranges of salary offers for employees of chatham. Target levels are based on level of education and experience. with input from the management of unc hospitals, the president of chatham hospital makes the final decision on salaries, with the exception of his/her own, which is set by the president of unch with input from the unc hospitals management team. |
| Form 990, Part VI, Section C, line 19 | Photocopies of the form 1023 and recent copies of the form 990 are available upon request at the organization's administrative office. in additon, recent copies of form 990 are available online at www.guidestar.org. |
| form 990, part xi, line 2c: | This process has not changed from the prior year. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (8 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection |
|---|---|---|---|---|---|---|---|
| University of North Carolina Healthcare System | |||||||
| 211 Friday Center Drive | Chapel Hill | NC | 27517 | 562206970 | Healthcare | NC | 501(c)(3) |
| Rex Hospital Inc | |||||||
| 4420 Lake Boone Trail | Raleigh | NC | 27607 | 561509260 | Healthcare | NC | 501(c)(3) |
| University of North Carolina Hospitals | |||||||
| 101 Manning Drive | Chapel Hill | NC | 27514 | 561118388 | Healthcare | NC | 501(c)(3) |
| Rex Healthcare Inc | |||||||
| 4420 Lake Boone Trail | Raleigh | NC | 27607 | 561509129 | healthcare | NC | 501(c)(3) |
| Rex Healthcare Foundation Inc | |||||||
| 4420 Lake Boone Trail | Raleigh | NC | 27607 | 566052117 | HEalthcare | NC | 501(c)(3) |
| Rex Home Services Inc | |||||||
| 4420 Lake Boone Trail | Raleigh | NC | 27607 | 561636242 | Healthcare | NC | 501(c)(3) |
| Triangle Physician Network | |||||||
| 211 Friday Center Drive | Chapel Hill | NC | 27517 | 271081647 | Healthcare | NC | 501(c)(3) |
| UNC Department of Family Medicine | |||||||
| 590 Manning Drive | Chapel Hill | NC | 27599 | 566001393 | Healthcare | NC | 501(c)(3) |
Form990 Schedule R Part IV Form990ScheduleRPartIV
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Rex Enterprises Company Inc | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4420 Lake Boone Trail | AddressLine1 |
| City | Raleigh | City |
| State | NC | State |
| ZIP Code | 27607 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Primary Activity | Holding Company | PrimaryActivity |
| Legal Domicile State | NC | LegalDomicileState |
| Type Of Entity | C | TypeOfEntity |
| 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 | 1 | 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 | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | 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 (3 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved |
|---|---|
| University of North Carolina Hospitals | |
| L | 124498 |
| Triangle Physician Network | |
| L | 1433775 |
| University of North Carolina Healthcare System | |
| C | 8984046 |