2011-11-14T07:19:15-06:00 2010-12-31 STOUT STUART MCGOWEN & KING LLP POST OFFICE BOX 1440 BURLINGTON NC 272161440 990 2010-01-01 560529994 ALAMANCE REGIONAL MEDICAL CENTER INC ALAM 3365387460 PO BOX 202 BURLINGTON NC 272160202 REX STREET 3365387460 2011-11-09 PATRICIA B RHODES 3362267343 2011-11-09 2010 2016-02-24 21:20:13Z REX STREET 1240 HUFFMAN MILL ROAD BURL NC 27215 256920179 0 X WWW.ARMC.COM X 1937 NC COMPREHENSIVE COMMUNITY HOSPITAL AND HEALTH CARE SERVICES 22 18 2165 630 0 0 78900 38320 212990281 220464972 -474562 4438674 446684 -5816 213041303 224936150 0 0 0 0 94812702 98169966 0 0 0 111096959 117051462 205909661 215221428 7131642 9714722 242832218 250436238 85833082 82764439 156999136 167671799 HEALTHCARE ORG. COMMITTED TO IMPROVE THE HEALTH OF THE CITIZENS OF ALAMANCE COUNTY AND ITS SURROUNDING COMMUNITIES THROUGH THE PROVISION OF A CONTINUUM OF HIGH QUALITY CLINICAL, EDUC., PREVENTIVE-WELLNESS, AND SUPPORT SERV. IN A SAFE AND FRIENDLY ENVIRONMENT. 0 0 169953959 220464972 ACUTE HOSPITAL CARE PROVIDED TO THE COMMUNITY 169953959 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 231 0 2165 1 1 1 1 CJ 0 0 0 0 0 0 0 0 X 22 18 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 NC CA IL X X REX STREET 3365387460 PO BOX 202 BURLINGTON NC 272160202 FD HORNADAY III X 0 0 0 THOMAS E CHANDLER X 0 0 0 DAVID JORDAN MD 2.00 X 17819 0 0 JAMES A BARNWELL JR X 0 0 0 ALLEN E GANT JR X 0 0 0 NANCY HEMRIC X 0 0 0 JAMES G MCCLURE X 0 0 0 ALAN J WHITE PHD X 0 0 0 ANDREW LAMB MD 5.00 X 36000 0 0 MICHAEL HOLT X 0 0 0 THOMAS E CHANDLER JR X 0 0 0 AARON P NOBLE JR PHD X 0 0 0 BARBARA TAPSCOTT PHD X 0 0 0 CARL STEINBICKER X 0 0 0 SHAWN SMITH X 0 0 0 PAUL H JUENGEL MD 2.00 X 9000 0 0 BILL SMITH X 0 0 0 CHAPMAN T MCQUEEN MD 3.00 X 20440 0 0 ALAN H NORTON X 0 0 0 JOHN A PETERSON JR X 0 0 0 JUAN SANCHIZ X 0 0 0 WILLIAM BRADLEY HAYES X 0 0 0 GLENN CHRYSTAL 40.00 X 896560 0 35569 JANAK CHOKSI 40.00 X 801070 0 34177 JOHN CURRIN JR 40.00 X 479427 0 313423 JANE YBANEZ 40.00 X 463441 0 17309 SANDEEP PANDIT 40.00 X 434398 0 22133 TIMOTHY FINNEGAN 40.00 X 389799 0 21114 REX A STREET 40.00 X 331991 0 165211 RICHARD DONAHEY 40.00 X 309784 0 194494 CAROL L HUDSON 40.00 X 295145 0 166975 ROBERT E BYRD 40.00 X 207707 0 105686 4692581 0 1076091 34 0 1 0 EMCARE INC 7032 NW COLLECTION CENTER DRIVE CHICAGO IL 60693 ER PHYSICIANS 6701176 SIEMENS FINANCIAL 2809 COLLECTION CENTER DRIVE CHICAGO IL 60693 MIS SUPPORT SERVICES 2520217 ECLIPSYS CORP LOCK BOX 077133 PHILADELPHIA PA 191710133 SOFTWARE MAINTENANCE 1221387 PRIMEDOC OF BURLINGTON PA PO BOX 7568 ASHEVILLE NC 28802 HOSPITALIST SERVICES 588333 PRIVATE DIAGNOSTIC CLINIC PO BOX 3179 DURHAM NC 27710 PHYSICIAN SERVICES 582823 5 38320 38320 OUTPATIENT REVENUES 173650876 173650876 INPATIENT REVENUES 40280308 40280308 OTHER OPERATING REVENU 4170242 4170242 OCCUPATIONAL HEALTH 1593149 1593149 CAFETERIA REVENUES 770397 770397 220464972 2002504 494617 1507887 31983108 2437091 29778808 2205221 2204300 231870 2436170 2436170 RENT REVENUE 498366 498366 OTHER NON-OP. REV. 541900 -504182 -504182 -5816 224936150 223395759 0 1502071 4955711 3331657 1624054 73950997 53592418 20358579 19263258 13869546 5393712 2288278 1402674 885604 2881624 1765328 1116296 11680893 8687080 2993813 MEDICAL SUPPLIES 37823503 37796429 27074 PURCHASED SERVICES 25071338 22783831 2287507 BAD DEBT EXPENSE 21067292 21067292 OTHER EXPENSES 5239344 765626 4473718 PROFESSIONAL FEES 4532443 1529672 3002771 6466747 3362406 3104341 215221428 169953959 45267469 0 26590523 28719425 27444408 25406459 6125997 9364258 4244098 5428004 1679635 1739099 225518500 119984102 110280801 105534398 61314774 68540223 5151982 5704372 242832218 250436238 20908380 22500653 46096979 43810663 13370365 9789207 5457358 6663916 85833082 82764439 X 156820249 167470529 178887 201270 156999136 167671799 242832218 250436238 X 9714722 957941 X 0 1 1 X 0 X 11073446 11073446 106315638 37128974 69186664 3598355 2499640 1098715 103622702 80355488 23267214 908359 908359 105534398 BOARD DESIGNATED/DONOR RESTRICTED 63556655 F HELD BY TRUSTEE 4983568 F 68540223 LIABILITY FOR PROJECTED BENEFIT OBLIGATION 6663916 6663916 224936150 215221428 9714722 3762060 -621712 -2182407 957941 10672663 228698210 3762060 3762060 224936150 0 224936150 217387899 2166471 2166471 215221428 0 215221428 PART XI, LINE 8 - OTHER ADJUSTMENTS: NET ASSETS RELEASED FROM RESTRICTION -15,936. TRANSFER TO AFFILIATE -2,166,471. PART XIII, LINE 2D - OTHER ADJUSTMENTS: TRANSFER TO AFFILIATE 2,166,471. THE ORGANIZATION HAD A FOOTNOTE DISCLOSURE IN THE FINANCIAL STATEMENTS THAT ADDRESSED FIN 48. AT 12/31/2010, THE ORGANIZATION DID NOT RECORD ANY LIABILITIES RELATED TO UNCERTAIN TAX POSITIONS. 1 1 1 X 1 X 1 1 1 0 1 1 15362 7029744 7029744 0.03620 1971 20501030 18830105 1670925 0.00860 406717 319724 86993 0.00040 17333 27937491 19149829 8787662 0.04520 69 81630 1845620 443570 1402050 0.00720 13 1880 2983101 10269 2972832 0.01530 2 10000 1001403 175686 825717 0.00430 3 0 304072 219817 84255 0.00040 20 5881 681002 675 680327 0.00350 107 99391 6815198 850017 5965181 0.03070 107 116724 34752689 19999846 14752843 0.07590 1 0 165 165 0.00000 2 130 15929 15929 0.00010 2 0 12323 12323 0.00010 0 0 0 0 0 0 4 849 52928 52928 0.00030 0 0 0 5 728 1203055 1203055 0.00620 0 0 0 14 1707 1284400 1284400 0.00670 1 9041202 4500000 83705298 93927627 -10222329 X 1 1 1 MEBANE MEDICAL INVESTORS LLC OWNERSHIP OF BUILDING HOUSING AMBULATORY SURGERY CENTER,PHYSICIANS' OFFICES 0.51000 0.13910 1 1 ALAMANCE REGIONAL MEDICAL CENTER INC

PO BOX 202 1240 HUFFMAN MILL ROAD BURLINGTON NC 27215

X X X ALAMANCE REGIONAL MEDICAL CENTER 1 PART I, LINE 7G: THE HOSPITAL REIMBURSES CERTAIN PHYSICIANS FOR TAKING EMERGENCY DEPARTMENT CALL FOR UNINSURED PATIENTS. THE COSTS ASSOCIATED WITH PHYSICIAN CALL INCLUDED IN PART 1, LINE 7G ARE $825,717. PART I, L7 COL(F): BAD DEBTS OF $21,067,292 WERE ELIMINATED FROM TOTAL EXPENSES REPORTED ON 990 PART IX, LINE 25 TO CALCULATE THE PERCENTAGES PER INSTRUCTIONS. PART II: ALAMANCE REGIONAL IS INVOLVED IN NUMEROUS ACTIVITIES DESIGNED TO PROMOTE BUILDING OUR COMMUNITY. THESE ARE NOT LISTED AS PART OF THE CHARITY CARE OR OTHER COMMUNITY BENEFITS, AND ARE NOT INCLUDED ELSEWHERE IN THE REPORT. THESE ACTIVITIES INCLUDE:PHYSICAL IMPROVEMENTS AND HOUSING: ALAMANCE REGIONAL PARTNERS WITH LOCAL MUNICIPALITIES, INCLUDING ELON AND THE CITY OF BURLINGTON ON THE DEVELOPMENT OF PARKS AND PLAYGROUNDS TO PROMOTE PHYSICAL RECREATION. WE HAVE DONATED SIGNIFICANT FUNDS TO DEVELOP WALKING TRAILS AND INSTALL FITNESS EQUIPMENT AT SEVERAL CITY PARKS.ECONOMIC DEVELOPMENT: WE WORK TO CREATE NEW EMPLOYMENT OPPORTUNITIES IN AN AREA THAT TRADITIONALLY HAS HIGH UNEMPLOYMENT RATES. THE ORGANIZATION IS HEAVILY INVOLVED WITH THE CHAMBER OF COMMERCE AND THE MEBANE BUSINESS ASSOCIATION, WITH STAFF MEMBERS SITTING ON SEVERAL BOARDS AND COMMITTEES DESIGNED TO PROMOTE ECONOMIC GROWTH.COMMUNITY SUPPORT: ALAMANCE REGIONAL PROVIDES SUPPORT FOR NUMEROUS COMMUNITY AGENCIES INCLUDING OUR LOCAL CITY FIRE AND POLICE DEPARTMENT. THE HOSPITALS CLINICAL ENGINEERING STAFF MAINTAINS ALL OF THE LIFESAVING EQUIPMENT FOUND IN THE CARS AND FIRE TRUCKS. THE HOSPITAL IS ALSO HEAVILY INVOLVED IN COUNTY-WIDE EMERGENCY PREPAREDNESS INITIATIVES. COALITION BUILDING: THE HOSPITAL PARTICIPATES IN NUMEROUS COMMUNITY COALITIONS AIMED AT ADDRESSING HEALTH AND SAFETY ISSUES. THESE INCLUDE, BUT ARE NOT LIMITED TO, HEALTHY MOTHERS, HEALTHY BABIES, THE ALAMANCE PARTNERSHIP FOR CHILDREN, THE SAFE KIDS COALITION, HEALTHY ALAMANCE.WORKFORCES DEVELOPMENT: ALAMANCE REGIONAL IS A MAJOR SUPPORTER OF ALAMANCE COMMUNITY COLLEGE, THE PIEDMONT TRIAD ALLIED HEALTH REGIONAL SKILLS PARTNERSHIP, THE RAD-TECH PROGRAM AND LOCAL SCHOOL CAREER FAIRS. COLLABORATION WITH THESE PROGRAMS AND INSTITUTIONS ALLOWS THE HOSPITAL TO HELP TRAIN AND RECRUIT HEALTH PROFESSIONALS WHICH ARE NEEDED IN OUR TRADITIONALLY UNDERSERVED AREA.PHYSICIAN RECRUITMENT: THE HOSPITAL PLACES SIGNIFICANT RESOURCES INTO THE RECRUITMENT OF PHYSICIANS TO SERVE OUR LOCAL COMMUNITY. OTHER: ALAMANCE REGIONAL DONATES EXPIRED EQUIPMENT AND SUPPLIES TO AREA MISSION PROGRAMS PART III, LINE 4: THE CORPORATION MAINTAINS RECORDS TO IDENTIFY AND MONITOR THE LEVEL OF CHARITY CARE IT PROVIDES. THESE RECORDS INCLUDE THE AMOUNT OF UNCOLLECTED CHARGES FOR SERVICES AND SUPPLIES FURNISHED BY THE HEALTHCARE FACILITIES UNDER THEIR FINANCIAL ASSISTANCE AND COLLECTIONS POLICY. THE CORPORATIONS FINANCIAL ASSISTANCE AND COLLECTIONS POLICY PROVIDES FOR UP TO 100% REDUCTION OF CHARGES FOR BOTH INDIGENT AND UNINSURED WHEN THE GUARANTOR SUPPLIES THE NECESSARY DOCUMENTATION. WHEN PROOF OF MEDICAL INDIGENCE IS NOT SUPPLIED, THE UNCOLLECTIBLE AMOUNT IS REFLECTED IN THE CORPORATIONS PROVISION FOR BAD DEBT. IN ADDITION TO IDENTIFYING SPECIFIC CHARITY ACCOUNTS IN ACCORDANCE WITH ITS FINANCIAL ASSISTANCE AND COLLECTION POLICY, THE CORPORATION DEEMED CERTAIN SPECIFIC PATIENT ACCOUNTS ELIGIBLE FOR FINANCIAL ASSISTANCE BASED ON FAMILY SIZE, INCOME AND CREDIT SCORE OBTAINED FROM A THIRD PARTY SERVICE. PART III, LINE 8: THE HOSPITAL IS REPORTING COSTS CALCULATED USING THE NORTH CAROLINA HOSPITAL ASSOCIATION ANDI COMMUNITY BENEFIT COST-TO-CHARGE RATIO DATED 9/2/2011. PART III, LINE 9B: THE HOSPITAL'S BAD DEBT POLICY REFERS TO THE FINANCIAL ASSISTANCE POLICY FOR HANDLING OF PATIENTS KNOWN TO QUALIFY FOR CHARITY OR FINANCIAL ASSISTANCE. PART VI, LINE 2: ALAMANCE REGIONAL MEDICAL CENTER SUBSIDIZES THE SALARY OF THE DIRECTOR OF HEALTHY ALAMANCE, A SUBSIDIARY OF HEALTHY CAROLINIANS. THROUGH THIS PARTNERSHIP, THE HOSPITAL HAS SUPPORTED HEALTHY ALAMANCE IN CONDUCTING A COMMUNITY HEALTH ASSESSMENT EVERY FOUR YEARS. THIS COMPREHENSIVE REPORT IS CONDUCTED IN CONJUNCTION WITH NUMEROUS LOCAL AGENCIES INCLUDING THE UNITED WAY AND THE ALAMANCE COUNTY HEALTH DEPARTMENT. IT ALLOWS THE HOSPITAL TO FOCUS ON HEALTH NEEDS IN THE COMMUNITY IN ORDER TO MEET ITS MISSION OF IMPROVING THE HEALTH OF THE COMMUNITY AND THE SURROUNDING AREAS. THE LAST ASSESSMENT WAS CONDUCTED IN 2007. THE ASSESSMENT DOCUMENT INCLUDES PRIMARY AND SECONDARY DATA FROM A VARIETY OF SOURCES. SECONDARY DATA SPECIFIC TO ALAMANCE COUNTY WAS COLLECTED AND ANALYZED FROM THE NC STATE CENTER FOR HEALTH STATISTICS, US CENSUS, AND THE BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS). PRIMARY DATA WAS GATHERED FROM A COMMUNITY WIDE SURVEY, FOCUS GROUPS, AND KEY INFORMANT INTERVIEWS. ALL OF THESE METHODS WERE UTILIZED IN ORDER TO RECOGNIZE GAPS IN SERVICES ALONG WITH THE PERCEIVED AND ACTUAL NEEDS IN ALAMANCE COUNTY. IT WAS FOUND THAT CHRONIC DISEASES SHOULD BE A MAIN AREA OF FOCUS FOR IMPROVING THE OVERALL HEALTH OF THE COMMUNITY. SEVERAL HOSPITAL REPRESENTATIVES SERVE ON HEALTHY ALAMANCES CHRONIC DISEASE COALITION, WHICH WORKS TO DEVELOP PLANS TO MEET THESE SPECIFIED NEEDS. THE NEXT COUNTY-WIDE ASSESSMENT IS PLANNED FOR 2011/2012. ALAMANCE REGIONAL MEDICAL CENTER IS HEAVILY INVOLVED IN THE PLANNING OF THIS UPCOMING ASSESSMENT. PART VI, LINE 3: FINANCIAL ASSISTANCE INFORMATION IS PROVIDED BY REGISTRATION STAFF, ED DISCHARGE STAFF, BILLING STATEMENT MESSAGES, ADMISSION BOOKLETS, AND IN FINANCIAL COUNSELING APPOINTMENTS. FINANCIAL ASSISTANCE INFORMATION IS ALSO POSTED ON THE HOSPITALS WEBSITE WWW.ARMC.COM. THE HOSPITALS CHARITY APPLICATION IS AVAILABLE IN BOTH ENGLISH AND SPANISH WITH INTERPRETER SERVICES AVAILABLE FOR PATIENTS NEEDING INFORMATION IN LANGUAGES OTHER THAN ENGLISH AND SPANISH.PATIENTS ARE GIVEN FINANCIAL ASSISTANCE CONTACT INFORMATION AT VARIOUS POINTS OF THE HOSPITAL TO INCLUDE REGISTRATION, CASHIER AND THE DEPARTMENT IN WHICH THEY ARE RECEIVING SERVICES. ALL SELF-PAY IN-PATIENTS /OBSERVATION PATIENTS ARE VISITED BY A HOSPITAL FINANCIAL COUNSELOR TO DISCUSS POSSIBLE FINANCIAL ASSISTANCE. SELF-PAY PATIENTS SCHEDULING OUTPATIENT PROCEDURES ARE INFORMED OF THE OPTION TO CONTACT FINANCIAL COUNSELORS TO DISCUSS FINANCIAL ASSISTANCE. PART VI, LINE 4: ALAMANCE COUNTY IS IN THE CENTRAL REGION OF NORTH CAROLINA AND IS CONVENIENTLY LOCATED BETWEEN TWO METROPOLITAN AREAS, THE RESEARCH TRIANGLE TO THE EAST AND THE TRIAD TO THE WEST. THE POPULATION HAS GROWN ABOUT 15% SINCE THE 2000 CENSUS, AND THERE ARE APPROXIMATELY 151,131 PEOPLE LIVING IN ALAMANCE COUNTY. WHITES COMPRISE 71% OF THE TOTAL POPULATION, AFRICAN AMERICANS 19% AND LATINOS 11.5%. ACCORDING TO US CENSUS BUREAU 2010 DATA, THE GROWTH OF TEH HISPANIC POPULATION FROM 2000 TO 2010 IS 53%. THE MEDIAN AGE OF RESIDENTS IN ALAMANCE COUNTY IS 37.9 YEARS. TWENTY FOUR PERCENT OF THE POPULATION IS UNDER THE AGE OF 18 AND 14% ARE OVER THE AGE OF 65.IN 2010, THE COUNTY AVERAGED AN 11% UNEMPLOYMENT RATE, WHILE THE STATE SHOWED 10%. SEVENTEEN PERCENT OF THE COUNTY RESIDENTS ARE UNINSURED AND 17% LIVE AT THE POVERTY LEVEL. THE AVERAGE HOUSEHOLD INCOME FOR ALAMANCE COUNTY IS $54,772, WHICH IS 12% BELOW THE STATE AVERAGE.ALAMANCE COUNTY HAS MANY ASSETS THAT HELP PROVIDE FOR THE QUALITY OF LIFE AND HEALTH OF ITS RESIDENTS. LABCORP (LABORATORY CORPORATION OF AMERICA) IS THE LARGEST PRIVATE EMPLOYER IN THE COUNTY AND ALAMANCE-BURLINGTON SCHOOL SYSTEM IS THE LARGEST PUBLIC EMPLOYER. ELON UNIVERSITY, A NATIONALLY RECOGNIZED FOUR-YEAR LIBERAL ARTS COLLEGE IS ALSO WITHIN ALAMANCE COUNTY, AS IS ALAMANCE COMMUNITY COLLEGE, WHICH OFFERS A VARIETY OF EDUCATIONAL AND TRAINING PROGRAM FOR MORE THAN 18,000 STUDENTS. PART VI, LINE 6: MEDICAL STAFF PRIVILEGES ARE OFFERED TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY.ALAMANCE REGIONALS BOARD OF DIRECTORS IS COMPRISED OF 22 LOCAL COMMUNITY LEADERS, BUSINESS AND MEDICAL PROFESSIONALS, ALL OF WHOM RESIDE IN THE HOSPITALS PRIMARY SERVICE AREA. THESE LEADERS PROVIDE COUNTLESS HOURS OF VOLUNTEER SERVICE AND PROVIDE VALUABLE OVERSIGHT TO THE ORGANIZATIONS OVERALL OPERATION. THEY ARE INVOLVED IN THE COMMUNITY NEEDS ASSESSMENT, FUNDRAISING AS WELL AS GENERAL STEWARDSHIP FOR THE ORGANIZATION IN THE COMMUNITY.SURPLUS FUNDS FROM ALAMANCE REGIONAL ARE REINVESTED IN OUR COMMUNITY. THEY HELP THE HOSPITAL MAINTAIN ACCESS TO PATIENT SERVICES, BUT ARE ALSO USED TO IMPROVE ACCESS. FUNDS HELP THE ORGANIZATION PURCHASE NEW EQUIPMENT, AS WELL AS EXPAND EDUCATIONAL OPPORTUNITIES ON IMPORTANT HEALTH RELATED TOPICS. X 1 1 X X X X X X 0 1 0 0 0 0 0 0 0 GLENN CHRYSTAL 729561 0 163464 0 3535 0 26300 0 9269 0 932129 0 0 0 JANAK CHOKSI 769547 0 27772 0 3751 0 26300 0 7877 0 835247 0 0 0 JOHN CURRIN JR 415800 0 60000 0 3627 0 307514 0 5909 0 792850 0 0 0 JANE YBANEZ 297524 0 165617 0 300 0 11304 0 6005 0 480750 0 0 0 SANDEEP PANDIT 347480 0 86558 0 360 0 13150 0 8983 0 456531 0 0 0 TIMOTHY FINNEGAN 297896 0 91633 0 270 0 12757 0 8357 0 410913 0 0 0 REX A STREET 286133 0 45000 0 858 0 156785 0 8426 0 497202 0 0 0 RICHARD DONAHEY 262962 0 45000 0 1822 0 187697 0 6797 0 504278 0 0 0 CAROL L HUDSON 248558 0 45000 0 1587 0 162271 0 4704 0 462120 0 0 0 ROBERT E BYRD 186600 0 20000 0 1107 0 99448 0 6238 0 313393 0 0 0 PART I, LINE 1A THE ORGANIZATION PAYS THE BUSINESS PORTION OF THE COUNTRY CLUB DUES FOR ONE OF ITS OFFICERS. THE ORGANIZATION HAS A WRITTEN POLICY ON HOW THIS AMOUNT IS PAID AND REPORTED AS COMPENSATION. PART I, LINE 4B PART I, LINE 4B: NONQUALIFIED DEFERRED COMPENSATION PLAN - AMOUNT SHOWN IS CURRENT YEAR ACCRUAL OF PROJECTED BENEFIT OBLIGATION JOHN G. CURRIN, JR $283,582 CAROL HUDSON $145,554 RICHARD DONAHEY $170,281 ROBERT BYRD $86,863 REX STREET $138,441 FORM 990, PART VI, SECTION A, LINE 2 THERE ARE FOUR MEMBERS ON THE BOARD OF DIRECTORS WHO ARE RELATED. FORM 990, PART VI, SECTION B, LINE 11 THE BOARD OF DIRECTORS DELEGATES TO THE AUDIT/CORPORATE COMPLIANCE COMMITTEE THE RESPONSIBILITY OF REVIEWING FORM 990 IN DETAIL WITH THE HOSPITAL'S EXTERNAL AUDITORS (THE PREPARER) PRIOR TO ITS FILING. ON 10/3/2011, PRIOR TO THE FILING, THE AUDIT/CORPORATE COMPLIANCE COMMITTEE MET, REVIEWED AND RECEIVED A COPY OF FORM 990 AND VOTED TO ACCEPT THE FORM 990 AS PRESENTED. ON 11/1/2011, PRIOR TO THE FILING, THE BOARD OF DIRECTORS MET AND ACCEPTED THE AUDIT/CORPORATE COMPLIANCE COMMITTEE RECOMMENDATION. AT THIS MEETING, EVERY BOARD MEMBER WAS GIVEN THE OPPORTUNITY TO REVIEW AND RECEIVE A COPY OF THE FORM 990. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION HAS A CONFLICT OF INTEREST POLICY WHICH IS REVIEWED, ACCEPTED, AND SIGNED BY EACH OFFICER AND VOTING BOARD MEMBER ON AN ANNUAL BASIS. PURSUANT TO THIS POLICY, EACH OFFICER AND BOARD MEMBER WILL RECUSE THEMSELVES FROM ANY DISCUSSION AND VOTE FOR WHICH A CONFLICT EXIST FOR THEMSELVES OR THEIR FAMILY. DETERMINATIONS OF WHETHER A CONFLICT EXISTS ARE MADE AT A MANAGEMENT, BOARD MEMBER, OFFICER AND INDIVIDUAL LEVEL. ACTUAL CONFLICTS ARE REVIEWED BY THE BOARD WITHOUT PRESENCE OF THE INTERESTED PARTY. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD OF DIRECTORS APPOINTS A COMPENSATION COMMITTEE WHICH RETAINS THE SERVICES OF AN INDEPENDENT COMPENSATION CONSULTANT TO GATHER COMPARATIVE DATA WITH WHICH TO MAKE RECOMMENDATIONS TO THE BOARD ON MATTERS OF EXECUTIVE COMPENSATION. SPECIFIC GROUP AND INDIVIDUAL PERFORMANCE INDICATORS ARE ESTABLISHED AND FACTORED IN ALONG WITH COMPARISONS OF COMPARABLE EXTERNAL FACTORS SUCH AS THE SIZE OF THE ORGANIZATION, THE GEOGRAPHIC LOCATION OF THE ORGANIZATION, AND THE EXECUTIVE'S TENURE. THIS PROCESS IS CONDUCTED ANNUALLY FOR THE CEO, CFO, SENIOR VICE PRESIDENTS AND OFFICERS OF THE ORGANIZATION. THE ORGANIZATION FOLLOWS THE PROCESS DESCRIBED IN THE TREASURY REGULATION 4958(6)(C) FOR ESTABLISHING THE REBUTTABLE PRESUMPTION OF REASONABLENESS IN THE REVIEW, APPROVAL, AND DOCUMENTATION OF OFFICER AND SENIOR EXECUTIVE COMPENSATION. FORM 990, PART VI, SECTION C, LINE 18 THE ORGANIZATION'S FORM 990 IS AVAILABLE FOR PUBLIC INSPECTION AT GUIDESTAR.COM OR IN THE ADMINISTRATIVE OFFICES AT ALAMANCE REGIONAL MEDICAL CENTER, INC. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES THESE DOCUMENTS AVAILABLE UPON REQUEST AT THE ADMINISTRATIVE OFFICES. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED GAINS ON INVESTMENTS: 3,762,060. PRIOR PERIOD ADJUSTMENTS: -621,712. NET ASSETS RELEASED FROM RESTRICTION -15,936. TRANSFER TO AFFILIATE -2,166,471. TOTAL TO FORM 990, PART XI, LINE 5: 957,941. FORM 990, PART V, LINE 4B ALAMANCE REGIONAL MEDICAL CENTER, INC. INVESTS LONG TERM SAVINGS FUNDS IN MANY DIFFERENT INVESTMENTS. ONE OF THESE INVESTMENTS IS AS A LIMITED PARTNER IN AN INVESTMENT PARTNERSHIP MANAGED BY A NORTH CAROLINA INVESTMENT FIRM. ONE OF THE INVESTMENTS INSIDE THIS LIMITED PARTNERSHIP IS IN A CAYMAN ISLANDS INVESTMENT FUND. THE INVESTMENT COMMITTEE OF THE BOARD SETS POLICY GOVERNING INVESTMENTS AND REVIEWS ALL INVESTMENTS ON A REGULAR BASIS. SCHEDULE H, LINE 7 ALAMANCE REGIONAL 2010 COMMUNITY BENEFIT INVENTORY TRADITIONAL CHARITY CARE AND OTHER FINANCIAL ASSISTANCE ON BEHALF OF UNINSURED AND LOW-INCOME PERSONS MEANS-TESTED PUBLIC PROGRAMS WITH UNPAID COSTS COMMUNITY HEALTH IMPROVEMENT SERVICES: HEALTH EDUCATION ( CLASSES OR LECTURES, SUPPORT GROUPS, SELF HELP PROGRAMS) HEALTH FAIRS HEALTH SMART AD HEALTHY WOMAN ASK THE DOCTOR UNDERSTANDING CANCER NUTRITION MATTERS BOOT CAMP FOR NEW DADS INFANT CPR AND CHILD SAFETY BREASTFEEDING AND INFANT NUTRITION BIG BROTHER/BIG SISTER CLASSES BREAST CANCER SPA DAY HEART SMART WOMEN PRENATAL EDUCATION PROGRAM STROKE SUPPORT GROUP BREAST CANCER SUPPORT GROUP WINGS TO RECOVERY CANCER SUPPORT GROUP CALENDARS FOR ALL SUPPORT GROUPS SENIOR ADVANTAGE ARTHRITIS SUPPORT GROUP KIDS CAN! FRESHSTART SMOKING CESSATION CLASS PEDIATRIC ORIENTATION PROGRAM (POP) MANY EVENTS SURROUNDING BREAST HEALTH COMMUNITY BASED CLINICAL SERVICES (SCREENINGS, CLINICS, FREE CLINICS, MOBILE UNITS) PROSTATE CANCER SCREENING CARE FOR YOUR HEART SCREENING NEEDLE FREE HIV TESTING (ALAMANCE CARES CLINIC AND COMMUNITY SCREENINGS) OPEN DOOR CLINIC ALAMAP ALAMANCE ELDER CARE BCCCP- BREAST AND CERVICAL CANCER AWARENESS PROGRAM CARE QUEST CONGESTIVE HEART FAILURE CLINIC PEDIATRIC ASTHMA CENTER FREE PHONE LACTATION CONSULTATIONS ADVANCE DIRECTIVES ALAMANCE MINORITY CANCER AWARENESS PROGRAM ASSISTANCE TO ENROLLMENT IN PUBLIC PROGRAMS BACK TO SCHOOL HEALTH & SAFETY FAIR BONE DENSITY SCREENINGS CARE GIVER RESOURCES FAIR CARE PROGRAM COMMUNITY EVENT ADVERTISING CONSUMER HEALTH LIBRARY DIABETES EDUCATION GENETIC RISK ASSESSMENTS LEGS FOR LIFE 5K LEGS FOR LIFE VASCULAR SCREENING LIFELINE PATRICIA BYNUM FUND PHYSICIAN REFERRAL PINK IN THE CITY PINK RIBBON FUND PRESS RELEASES FOR SUPPORT GROUPS RED CROSS BLOOD DRIVES SEXUAL ASSAULT NURSE EXAMINER PROGRAM (SANE) SPEAKERS BUREAU SPECIAL CARE NURSERY REUNION SPORTS MEDICINE SYMPOSIUM STROKE CARE TEAM ADVISORY TRANSPORTATION PROGRAMS WELL NOW WORKSITE HEALTH EDUCATION PROGRAMS YOUR HEALTH HEALTH CARE SUPPORT SERVICES (ENROLLMENT ASSISTANCE FOR GOVERNMENT-FUNDED HEALTH PROGRAM, INFORMATION AND REFERRAL, TRANSPORTATION TO IMPROVE ACCESS) ONCOLOGY TRANSPORTATION REHABILITATION TRANSPORTATION TAXI AND GAS VOUCHERS FOR LOW-INCOME PERSONS OTHER: LIFELINE RED CROSS BLOOD DRIVES SUPPLIES FOR BOY SCOUT CAMP AND RED CROSS DISASTER PROGRAM C. R. BYRD FUND PATRICIA BYNUM FUND EARL PARDUE CARDIOLOGY FUND INFANTS AND CHILDRENS FUND ONCOLOGY ANGELS FUND PINK RIBBON FUND CHILDHOOD ASTHMA FUND SEXUAL ASSAULT NURSE EXAMINER PROGRAM HEALTH PROFESSIONS EDUCATION HELPING TO PREPARE FUTURE HEALTH CARE PROFESSIONALS. NUMEROUS INTERNSHIP PROGRAMS NURSE SHADOWING PROGRAMS PHYSICAL THERAPY GRADUATE PROGRAM UNC STUDENTS IN NUCLEAR MEDICINE RAD-TECH PROGRAM UNC SCHOOL OF SOCIAL WORK PROGRAMS AND FINANCIAL ASSISTANCE FOR PHYSICIANS AND MEDICAL STUDENTS, NURSES AND NURSING STUDENTS, PASTORAL CARE RESIDENTS AND INTERNS AND OTHER HEALTH PROFESSIONALS. COMMUNITY HEALTH EDUCATION SCHOLARSHIP PROGRAM FREE IMMUNIZATION FOR ALAMANCE COUNTY NURSING STUDENTS EFFORTS TO GENERATE INTEREST IN THE HEALTH PROFESSIONS, SUCH AS MENTORING PROGRAMS JCCRP- JOINT COMMUNITY CLINICAL RESOURCE PLANNING HIGH SCHOOL STUDENT OBSERVATIONAL EXPERIENCES LOCAL SCHOOL CAREER FAIRS VISITATION PROGRAMS FOR NON-COMMUNITY AND FOREIGN PHYSICIANS SUBSIDIZED HEALTH SERVICES (MUST BE A DISTINCT SERVICE, NOT A SUBSET OF A SERVICE) EXAMPLES: EMERGENCY AND TRAUMA OUTPATIENT SERVICES OUTPATIENT HOSPICE AND PALLIATIVE CARE SERVICES PALLIATIVE CARE ON THE INPATIENT UNIT BEHAVIORAL HEALTH INPATIENT BEHAVIORAL HEALTH RESEARCH ACTIVITIES CLINICAL RESEARCH PHYSICAL THERAPY RESEARCH CANCER CENTER CLINICAL TRIALS COMMUNITY HEALTH RESEARCH HEALTHY ALAMANCE COMMUNITY ASSESSMENT RESEARCH ON INNOVATIVE HEALTH CARE DELIVERY FINANCIAL AND IN-KIND CONTRIBUTIONS CASH DONATIONS TO TAX EXEMPT ENTITIES: ACMCPD ADVANCED HOME CARE, GREENSBORO ALAMANCE BURLINGTON SCHOOL SYSTEM ALAMANCE CITIZENS FOR EDUCATION ALAMANCE COMMUNITY COLLEGE FOUNDATION ALAMANCE COUNTY ARTS COUNCIL ALAMANCE COUNTY CHAMBER OF COMMERCE ALAMANCE COUNTY CROP WALK ALAMANCE COUNTY MAYOR'S COMMITTEE ALAMANCE ELDERCARE ALAMANCE JR. TENNIS FOUNDATION ALAMANCE PARTNERSHIP FOR CHILDREN ALAMANCE REGIONAL FOUNDATION ALAMANCE ROTARY CLUB ALLIED CHURCHES OF ALAMANCE COUNTY AMERICAN DIABETES ASSOCIATION AMERICAN RED CROSS- PIEDMONT CHAPTER AMCAP ASSOCIATION FOR HOME AND HOSPICE CARE OF NORTH CAROLINA BARTLETT YANCEY HIGH SCHOOL BOY SCOUTS OF AMERICA BURLINGTON BOYS CHOIR BURLINGTON CHRISTIAN ACADEMY BURLINGTON PARKS AND RECREATION BURLINGTON VELO CLUB CASWELL COUNCIL CHAMBER OF COMMERCE CHILDREN'S FLIGHT OF HOPE CHRISTMAS CHEER OF ALAMANCE COUNTY COMMUNITY YMCA OF ALAMANCE COUNTY, INC DARE OF BURLINGTON, INC. EASTERN ALAMANCE HIGH SCHOOL TENNIS PROGRAM EGHS FRIENDS OF THE LIBRARY ELON UNIVERSITY FAMILY ABUSE SERVICES OF ALAMANCE COUNTY, INC. FRONT STREET UNITED METHODIST CHURCH GRAHAM AREA BUSINESS ASSOCIATION GREAT 100 GREENSBORO SYMPHONY HEALTHY CAROLINIANS, INC. HEAT FROM THE HEART HOSPICE LEAGUE OF ALAMANCE-CASWELL J&L BICYCLE CO. JUNIOR ACHIEVEMENT JUVENILE DIABETES RESEARCH FOUNDATION KIWANIS CLUB OF BURLINGTON LOAVES AND FISHES MINISTRY MARCH OF DIMES MAY MEMORIAL LIBRARY MEBANE BUSINESS ASSOCIATION MEBANE PARKS AND RECREATION MEBANE WOMEN'S CLUB MUSCULAR DYSTROPHY ASSOCIATION NAMI ALA/CASWELL/ROCKINGHAM NATIONAL FIRE SAFETY COUNCIL NEW LEAF SOCIETY NCPHP/NC PHYSICAL HEALTH PROGRAM, INC. NORTH CAROLINA PREVENTION PARTNERS NORTH PARK EXERCISE EQUIPMENT OLD NORTH STATE COUNCIL PAT CAMBE-CHILDREN'S AND FAMILY ENTERTAINER PIEDMONT HEALTH COALITION, INC. PIEDMONT RESCUE MISSION, INC. PIEDMONT TRIAD PARTNERSHIP POSITIVE ATTITUDE YOUTH CENTER RESIDENTIAL TREATMENT SERVICES, INC ROYAL AMBASSADORS SHRINE CIRCUS FUND SPECIAL OLYMPICS OF ALAMANCE COUNTY UNC-CH DEPT/ALLIED HEALTH SCI UNITED WAY OF ALAMANCE COUNTY WESTERN HIGH SCHOOL ACADEMICS BOOSTERS WOMEN'S RESOURCE CENTER OF ALAMANCE COUNTY YMCA GYM SPONSORSHIP GRANTS TO OTHER NOT-FOR-PROFIT ORGANIZATIONS ENDOWED NURSING CHAIR FOR ALAMANCE COMMUNITY COLLEGE IN-KIND DONATIONS SUCH AS MEETING ROOMS, SUPPLIES AND PARKING VOUCHERS FREE CLASSROOM SPACE FOR HEALTH CARE RELATED GROUPS USED COMPUTER EQUIPMENT DONATED TO HOSPICE COMMUNITY BUILDING AND LEADERSHIP ACTIVITIES (SHOULD BE RELATED TO COMMUNITY NEED) PROGRAMS THAT ADDRESS THE UNDERLYING CAUSES OF HEALTH PROBLEMS TO IMPROVE HEALTH STATUS AND QUALITY OF LIFE (POVERTY, HOMELESSNESS AND ENVIRONMENTAL PROBLEMS) PHYSICAL IMPROVEMENTS NEW LEAF SOCIETY HOUSING PROGRAMS EMERGENCY PREPAREDNESS MEETINGS AND PLANNING AT HOSPITAL, COUNTY, REGIONAL AND STATEWIDE LEVELS ECONOMIC DEVELOPMENT PROGRAMS CHAMBER BOARD ALAMANCE COUNTY ARTS COUNCIL ALAMANCE COUNTY ECONOMIC DEVELOPMENT COMMITTEE CLASSROOM COLLECTION CAMPAIGN SPONSOR ENVIRONMENTAL IMPROVEMENTS LEADERSHIP DEVELOPMENT AND TRAINING FOR COMMUNITY MEMBERS COALITION BUILDING HEALTHY ALAMANCE LOCAL EMERGENCY PLANNING COMMITTEE SAFE KIDS COALITION ADVOCACY FOR COMMUNITY HEALTH IMPROVEMENT SALVATION ARMY BOARD NCHA WORKFORCE DEVELOPMENT WORKSITE PLACEMENT FOR THE ALAMANCE FRIENDS OF YOUTH JUVENILE WORK RESTITUTION PROGRAM COMMUNITY COLLABORATIVE ORGANIZED TO IMPROVE THE HEALTH OF THE COMMUNITY EQUIPMENT SERVICE, PREVENTATIVE MAINTENANCE AND FOR EMS, BURLINGTON FIRE AND COUNTY FIRE DEPARTMENTS, SPONSORING THE SATELLITE STATION FOR EMS OPERATIONAL SUPPLIES AND BUILDING AND GROUNDS MAINTAINNCE FOR CHARLES DREW CENTER MARCH OF DIMES SPONSOR JDRF SPONSOR HEALTHY MOTHERS, HEALTHY BABIES ALAMANCE PARTNERSHIP FOR CHILDREN COMMUNITY BENEFIT OPERATIONS ACTIVITIES ASSIGNED STAFF. COMMUNITY HEALTH ASSESSMENT. EVALUATION OF PROGRAMS AND ACTIVITIES SOFTWARE THAT SUPPORTS THE COMMUNITY BENEFIT PROGRAM (CBISA) DUES AND PROGRAM EXPENSES FOR ORGANIZATIONS THAT SPECIFICALLY SUPPORT THE COMMUNITY BENEFIT PROGRAM, SUCH AS THE ASSOCIATION FOR COMMUNITY HEALTH IMPROVEMENT. PAGE 5, PART V QUESTION 3B A 990-T IS BEING FILED FOR THE ORGANIZATION BUT THERE IS NO UNRELATED BUSINESS INCOME FOR 2010. ALAMANCE REGIONAL MEDICAL CENTER FOUNDATION INC 144 LAKEWOOD COURT BURLINGTON NC 27215 581681560 RAISE FUNDS TO ENHANCE HEALTH SERVICES IN COMMUNITY NC 501(C)(3) 0 ARMC PHYSICIANS CARE INC 3940 LAKEWOOD BOULEVARD MEBANE NC 27302 562095382 PRIMARY CARE PHYSICIAN OFFICE NC 501(C)(3) 0 ALAMANCE EXTENDED CARE INC 1860 BROOKWOOD AVENUE BURLINGTON NC 27215 561681364 LONG-TERM CARE FACILITY NC 501(C)(3) 0 MEBANE ASC INVESTORS LLC 3940 ARROWHEAD BOULEVARD MEBANE NC 27302 203932019 AMBULATORY SURGERY CENTER NC -259221 0 0 1.00000 MEBANE MEDICAL INVESTORS LLC 4401 BARCLAY DOWNS DRIVE CHARLOTTE NC 28209 203931873 OWNERSHIP OF BUILDING HOUSING URGENT CARE CENTER, MEDICAL OFFICES AND ASC NC 203631 9208420 0 0 0.55131 0 1 0 1 0 0 0 0 0 0 0 0 0 1 0 0 1 1 ALAMANCE REGIONAL MEDICAL CENTER FOUNDATION INC B 166471 CASH ARMC PHYSICIANS CARE INC B 2000000 CASH