2023-05-02T09:33:39-05:00 2022-06-30 410746749 CLIFTONLARSONALLEN LLP 227 WEST TRADE STREET SUITE 800 CHARLOTTE NC 28202 990 2022-01-01 020777195 BLUE RIDGE HEALTHCARE MEDICAL GROUP INC BLUE 8285805000 2201 SOUTH STERLING STREET MORGANTON NC 28655 PATRICIA A MOLL CHIEF FINANCIAL OFFICER 8285805000 2023-04-26 1 PATRICIA MOLL 999009999 0 JOHN NORMAN P01506766 7049985200 2023-04-26 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z KATHY BAILEY 2201 SOUTH STERLING STREET MORGANTON NC 28655 26058504 0 X WWW.BLUERIDGEHEALTHCAREMEDICALGROUP.ORG X 2006 NC TO PROVIDE MEDICAL CARE AND TO PROMOTE THE GENERAL HEALTH OF THE COMMUNITY. 3 1 0 0 0 0 408783 0 61681901 26058504 0 0 0 0 62090684 26058504 0 0 0 0 51665264 26075333 0 0 0 15089831 7331882 66755095 33407215 -4664411 -7348711 29518541 28294730 139764342 145889242 -110245801 -117594512 BLUE RIDGE MEDICAL GROUP IS COMMITTED TO IMPROVING THE HEALTH OF OUR COMMUNITIES BY PROVIDING EXCELLENT AND COMPASSIONATE CARE. 0 0 29362932 26058504 PHYSICIAN PRACTICE GROUPGENERAL AND SPECIALTY PRACTICES FOR THE COMMUNITY TO RECEIVE CARE, TREATMENT FROM ILLNESS, AND PROMOTE GENERAL HEALTH. THE PHYSICIAN GROUP COMPLIMENTS THE OTHER SERVICES OF BLUE RIDGE HEALTHCARE'S ACUTE CARE FACILITIES AND LONG TERM CARE FACILITIES. 29362932 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 3 1 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X PATRICIA MOLL 8285805003 2201 SOUTH STERLING STREET MORGANTON NC 28655 X X KATHY BAILEY PRESIDENT & CEO 1.00 50.00 X X 0 0 0 ALAN GRIFFIN BOARD MEMBER 1.00 X 0 0 0 GANDHARI LOOMIS BOARD MEMBER 50.00 1.00 X 0 0 0 PATRICIA MOLL CFO 1.00 50.00 X 0 0 0 0 0 0 0 0 0 0 0 PHYSICIAN PRACTICE 621110 19654476 19654476 INTER-FACILITY REVENUE 621110 5752179 5752179 651849 651849 26058504 26058504 26058504 0 0 24108792 20974649 3134143 492726 428672 64054 436377 379648 56729 1037438 902571 134867 1773412 1418730 354682 3036 3036 68687 68687 7418 7418 702966 702966 100057 100057 515723 515723 204387 204387 MED & GEN SUPPLIES 2113115 2113115 INTERCOMPANY 1767060 1767060 LEASE EXPENSE 21753 21753 54268 37988 16280 33407215 29362932 4044283 0 4021039 3365016 7889450 7904641 669 187978 221040 25990998 11637090 15070091 14353908 2033454 2033454 316529 416002 29518541 28294730 3520433 3316654 136243909 142572588 139764342 145889242 X -110245801 -117594512 -110245801 -117594512 29518541 28294730 -7348711 0 X X 0 1 X 1 1 1 X 13086 51469 824190 408783 1297528 32033090 37173630 35487862 44735056 19654476 169084114 32046176 37225099 36312052 45143839 19654476 170381642 0 0 0 170381642 202 202 202 202 13090453 12940121 11944632 17024057 6404028 61403291 45136629 50165220 48256886 62167896 26058504 231785135 0.73510 0.73090 0.00000 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: OTHER REVENUE - 2018 AMOUNT: $ 882,593. 2019 AMOUNT: $ 1,757,516. 2020 AMOUNT: $ 1,462,423. 2021 AMOUNT: $ 6,119,896. 2022 AMOUNT: $ 651,849. INTER-FACILITY REVENUE - 2018 AMOUNT: $ 12,207,860. 2019 AMOUNT: $ 11,182,605. 2020 AMOUNT: $ 10,482,209. 2021 AMOUNT: $ 10,904,161. 2022 AMOUNT: $ 5,752,179. SCHEDULE A, PART III - SHORT YEAR THE SUPPORT TEST INCLUDES A SHORT YEAR FROM 1/1/2022 THROUGH 6/30/22. 7145187 1488627 5656560 2339812 1467975 871837 9797573 8471204 1326369 6708426 209284 6499142 14353908 INTERCOMPANY PAYABLES 137986605 CURRENT PORTION OF OPERATING LEASE LIABILITY 901901 OPERATING LEASE LIABILITY 3096725 ESTIMATED THIRD-PARTY RESERVES 587357 142572588 X PART X, LINE 2: 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 JUNE 30, 2022 OR DECEMBER 31, 2021. FORM 990, PART VI, SECTION A, LINE 3 IN 2021, THE ORGANIZATION TERMINATED THE MANAGEMENT SERVICES CONTRACT WITH ATRIUM HEALTH AND ENTERED INTO A MANAGEMENT SERVICES CONTRACT WITH UNC HEALTH. THE TERMS OF THE CONTRACT CALL FOR THE ORGANIZATION TO PAY UNC HEALTH AN ANNUAL MANAGEMENT FEE BASED UPON THE ORGANIZATION'S NET OPERATING REVENUES. FORM 990, PART VI, SECTION B, LINE 11B THE CHIEF FINANCIAL OFFICER, THE BOARD AND THE EXECUTIVE COMMITTEE WILL REVIEW THE PREPARED FORM 990 BEFORE IT IS FILED WITH THE IRS. A DRAFT OF FORM 990 WAS POSTED FOR ACCESS BY THE GOVERNING BODY BEFORE IT WAS FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C 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 15 THE ORGANIZATION COMPENSATION COMMITTEE REVIEWED AND APPROVED THE COMPENSATION PACKAGE DURING 2022. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. PART VII DESCRIPTION OF HOURS -- FOR RELATED ORGANIZATIONS, OFFICERS LISTED ON PART VII WORK AN AVERAGE OF 40 TO 50 HOURS PER WEEK. THEIR TIME IS SHARED BETWEEN THE FILING ORGANIZATION AND OTHER RELATED ENTITIES LISTED ON SCHEDULE R. ALSO, BECAUSE THE ORGANIZATION IS FILING A SIX MONTH SHORT PERIOD RETURN ENDING JUNE 30, 2022, THE ORGANIZATION DID NOT HAVE ANY 1099 OR W-2 YEAR END INFORMATION TO USE FOR THIS RETURN. CONSEQUENTLY, SECTIONS A AND B DO NOT CONTAIN ANY PAYMENT INFORMATION FOR EMPLOYEES OR SERVICE PROVIDERS, AS MANDATED BY THE FORM 990 FILING INSTRUCTIONS. FORM 990, PART XII, LINE 2C NO CHANGES FOR APPROVING AUDITED FINANCIAL STATEMENTS OR SELECTION OF INDEPENDENT ACCOUNTANTS HAVE OCCURRED FROM THE PRIOR YEAR. BLUE RIDGE HEALTHCARE HOSPITALS INC 2201 SOUTH STERLING STREET MORGANTON NC 28655 560529976 HEALTHCARE NC 501(C)(3) 170(B)(1)(A) N/A 0 VALDESE NURSING HOME INC 95 LOCUST STREET CONNELLY SPRINGS NC 28612 581978560 HEALTHCARE NC 501(C)(3) 509(A)(2) N/A 0 GRACE NURSING CENTER INC 109 FOOTHILLS DRIVE MORGANTON NC 28655 561838369 HEALTHCARE NC 501(C)(3) 509(A)(2) N/A 0 GRACE LIFECARE INC 500 LENOIR ROAD MORGANTON NC 28655 561722754 HEALTHCARE NC 501(C)(3) 509(A)(2) N/A 0 GRACE PROPERTIES INC 500 LENOIR ROAD MORGANTON NC 28655 561727514 HEALTHCARE NC 501(C)(3) 509(A)(3) N/A 0 BLUE RIDGE FOUNDATION INC 2201 SOUTH STERLING STREET MORGANTON NC 28655 582063920 HEALTHCARE NC 501(C)(3) 509(A)(1) N/A 0 BLUE RIDGE HEALTHCARE SYSTEM INC 2201 SOUTH STERLING STREET MORGANTON NC 28655 562150313 HEALTHCARE NC 501(C)(3) 509(A)(3) N/A 0 GRACE HEALTH VENTURES INC 2201 SOUTH STERLING STRET MORGANTON NC 28655 561581317 RELATED NC BLUE RIDGE HEALTHCARE SYSTEM C 0 0 0 0 0 0 0 0 0 0 0 1 0 1 1 1 1 1 0 0