2024-05-15T17:10:20-04:00 2023-06-30 580914992 DRAFFIN & TUCKER LLP PO BOX 71309 ALBANY GA 317081309 990 2022-10-01 560529974 CHARLES A CANNON JR MEMORIAL HOSPITAL INC CHAR 8287377000 434 HOSPITAL DRIVE LINVILLE NC 28646 RICK CASSADY CFO 8287377000 2024-05-13 true RICK CASSADAY 999009999 false WILLIAM EDWARD PHILLIPS P00451499 2298837878 2024-05-15 2022 2023-04-26 12:10:37Z CHARLES MANTOOTH 434 HOSPITAL DRIVE LINVILLE NC 28646 18444261 false X HTTPS://APPRHS.ORG/CANNON/ X 1957 NC TO PROVIDE HEALTHCARE SERVICES TO ENHANCE THE QUALITY OF LIFE FOR THE CITIZENS OF AVERY COUNTY. 15 14 0 0 1098420 44653 20200136 15969402 30516 5529 2577447 2270490 23906519 18290074 0 0 13721953 9620007 0 0 11289507 10062639 25011460 19682646 -1104941 -1392572 34213790 30726386 30303428 28208596 3910362 2517790 TO PROVIDE HEALTHCARE SERVICES TO ENHANCE THE QUALITY OF LIFE FOR THE CITIZENS OF AVERY COUNTY. false false 16418755 17430510 CHARLES A. CANNON, JR MEMORIAL HOSPITAL IN LINVILLE IS A 23-BED CRITICAL ACCESS HOSPITAL. THE FULL-SERVICE EMERGENCY DEPARTMENT, IMAGING DEPARTMENT, LABORATORY, REHABILITATION CENTER OFFERING PHYSICAL AND OCCUPATIONAL THERAPIES, AND CARDIOPULMONARY REHABILITATION COMPLETE THE LIST OF SERVICES OFFERED. 16418755 true true false false false false false false false true true false false true true true false true false false false false false false false false true true false false true false false false false false false false false false false false false false true false false false true 0 0 0 false false false false false false false false false false false false X 15 14 false true false false true true false true true false false true true true true true true false false false X RICK CASSADY 8282624119 336 DEERFIELD RD BOONE NC 28607 CHARLES MANTOOTH CEO 1.00 40.00 X 0 718682 37627 PAUL DAGHER MD TRUSTEE/PHYS 1.00 40.00 X 0 499154 34653 MATT THOMAS CFO (LEFT 10 1.00 40.00 X 0 471974 34748 RICK CASSADY CFO 1.00 40.00 X 0 229316 39237 STEPHANIE GREER PRES AVERY H 1.00 40.00 X 0 195741 32548 CARMEN LACEY LEFT 122 PRES CMH 1.00 X 0 12949 1154 KENNETH WILCOX TERM 0123 TRUSTEE 1.00 X 0 0 0 BILLY KENNEDY TERM 1022 TRUSTEE 1.00 X 0 0 0 SAM ADAMS TRUSTEE 1.00 4.00 X 0 0 0 JONATHAN ALLEN TRUSTEE 1.00 3.00 X 0 0 0 JOHN BLACKBURN TRUSTEE 1.00 4.00 X 0 0 0 LISA COOPER TRUSTEE 1.00 4.00 X 0 0 0 TOM DALE VICE CHAIR 1.00 5.00 X X 0 0 0 JIM DEAL CHAIR 1.00 4.00 X X 0 0 0 BRETT LOFTIS TRUSTEE 1.00 3.00 X 0 0 0 CHARLES BAKER MD TRUSTEE 1.00 2.00 X 0 0 0 MEAGAN PHILLIPS TRUSTEE 1.00 5.00 X 0 0 0 MARK RICKS TRUSTEE 1.00 4.00 X X 0 0 0 MARY LOUISE ROBERTS TRUSTEE 1.00 4.00 X 0 0 0 RAY RUSSELL TRUSTEE 1.00 3.00 X 0 0 0 KENT TARBUTTON TRUSTEE 1.00 4.00 X 0 0 0 JAN WINKLER TRUSTEE 1.00 3.00 X 0 0 0 2127816 179967 false true false 44653 44653 NET PATIENT SERVICE REVENUE 621990 15969402 15969402 15969402 7124 7124 694511 138825 555686 555686 555686 1595 -1595 -1595 -1595 11716 13767 -2051 -2051 MANAGEMENT FEES RELATED PARTY 722210 1388738 1388738 CAFETERIA AND VENDING 621990 255747 255747 MISCELLANEOUS REVENUES 621990 66734 66734 5636 5636 1716855 18290074 17430510 814911 X 7876456 6802216 1074240 1243945 1074271 169674 499606 431460 68146 3317974 3022566 295408 679 679 2690853 1171564 1519289 524901 490835 34066 82165 72793 9372 14245 11701 2544 -90980 -90980 1641240 1534724 106516 108124 79000 29124 MEDICAL SUPPLIES 1338394 1338394 REPAIRS & MAINTENANCE 344329 344329 DUES & SUBSCRIPTIONS 57307 22910 34397 MISCELLANEOUS EXPENSE 20877 15982 4895 12531 5331 7200 19682646 16418755 3263891 0 1270 1270 4913324 979962 3063853 2628562 7639 41389 680532 651168 155030 256602 51171322 29516997 22612534 21654325 367278 367635 2412330 4145473 34213790 30726386 513491 564915 81000 81000 6371826 5515243 23337111 22047438 30303428 28208596 X 3000547 1607975 909815 909815 3910362 2517790 34213790 30726386 -1392572 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 909815 909815 909815 909815 909815 909815 909815 909815 909815 909815 1.00000 false false 1220002 1220002 36762271 19073421 17688850 1847482 1744100 103382 11193329 8699476 2493853 148238 148238 21654325 DUE FROM ARBH 4006569 OTHER RECEIVABLES 138904 4145473 DUE TO RELATED PARTIES 21991048 THIRD PARTY SETTLEMENTS 56390 22047438 X SCHEDULE D, PAGE 2, PART V, LINE 4 THE ASSETS HELD IN THE ENDOWMENT FUND ARE PARCELS OF LAND TO BE USED FOR THE PURPOSE OF PROMOTING THE HEALTH, CARE AND WELL-BEING OF THE CITIZENS AND RESIDENTS OF AVERY COUNTY AND SURROUNDING COUNTIES. UPON THE PROPERTY CEASING TO BE USED FOR THAT PURPOSE, THE PROPERTY IS TO REVERT TO THE GRANTOR, ITS HEIRS, SUCCESSORS AND ASSIGNS. SCHEDULE D, PAGE 3, PART X ARHS AND THE COMPANIES FOR WHICH IT SERVICES AS SOLE MEMBER ARE NOT-FOR- PROFIT CORPORATIONS AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND ARE EXEMPT FROM FEDERAL AND STATE INCOME TAXES ON RELATED INCOME. ACCORDINGLY, NO PROVISION FOR INCOME TAXES HAS BEEN CONSIDERED IN THE ACCOMPANYING FINANCIAL STATEMENTS. THE SYSTEM HAS DETERMINED IT DOES NOT HAVE ANY MATERIAL UNRECOGNIZED TAX BENEFITS OR OBLIGATIONS AS OF JUNE 30, 2023. true true X true X true X true true false true true 105125 105125 0.00500 341462 374321 446587 374321 105125 0.00500 1135423 444247 691176 0.03450 8706 8706 0.00040 1144129 444247 699882 0.03490 1590716 818568 805007 0.03990 false 2103395 105170 5036553 5052924 -16371 X true true 1 1 CHARLES A CANNON JR MEMORIAL HOSPITAL 434 HOSPITAL DRIVE LINVILLE NC 28646 HTTPS://APPRHS.ORG H0037 X X X X PSYCH, SWB SNF CHARLES A CANNON JR MEMORIAL HOSPITAL 1 false false true X X X X X X X X X X 22 true true true true X HTTPS://APPRHS.ORG X true 22 true HTTPS://APPRHS.ORG false false true X 200.000000000000 300.000000000000 X X true true X X X X true X HTTPS://APPRHS.ORG/FINANCIAL-ASSISTANC X HTTPS://APPRHS.ORG/FINANCIAL-ASSISTANC X HTTPS://APPRHS.ORG/FINANCIAL-ASSISTANC X X X X X X true X false X X X X true X false false FACILITY 1, CHARLES A CANNON JR MEMORIAL - PART V, LINE 3E THE 2022 CHNA AND RELATED IMPLEMENTATION STRATEGY REPORT IDENTIFIED THE FOLLOWING PRIORITY HEALTH NEEDS FOR THE COMMUNITY- 1) MENTAL/BEHAVIORAL HEALTH 2) HEART & VASCULAR CARE 3) CANCER FACILITY 1, CHARLES A CANNON JR MEMORIAL - PART V, LINE 5 ARHS REGULARLY COLLABORATES WITH APPALACHIAN DISTRICT HEALTH DEPARTMENT AND TOE RIVER HEALTH DISTRICT TO FACILITATE COMMUNITY EVENTS AND INITIATIVES. APPALACHIAN REGIONAL HEALTHCARE SYSTEM (ARHS) ANALYZED THE COMMUNITY HEALTH NEEDS ASSESSMENTS (CHNAS) CONDUCTED AND PUBLISHED BY APPALACHIAN DISTRICT HEALTH DEPARTMENT AND TOE RIVER HEALTH DISTRICT TO DETERMINE HOW ARHS HOSPITALS AND MEDICAL OFFICES CAN CONTRIBUTE TO ADDRESSING THE IDENTIFIED PRIORITY HEALTH ISSUES IN THE HIGH COUNTRY. CHNAS WERE CONDUCTED IN THREE COUNTIES: ASHE AND WATAUGA COUNTIES BY APPALACHIAN DISTRICT HEALTH DEPARTMENT AND AVERY COUNTY BY TOE RIVER HEALTH DISTRICT. PRIORITIZED NEEDS WERE SELECTED BASED ON JOINT ANALYSIS OF CONDUCTED COMMUNITY HEALTH OPINIONS SURVEYS (PRIMARY DATA) AND UTILIZING SECONDARY DATA ABOUT WATAUGA, ASHE, AND AVERY COUNTIES. ASHE COUNTY -HOUSING AND TRANSIT AN ESTIMATED 16% OF ASHE COUNTY HOUSEHOLDS HAVE AT LEAST ONE OF FOUR MAJOR HOUSING PROBLEMS (OVERCROWDING, HIGH HOUSING COSTS, LACK OF KITCHEN OR PLUMBING FACILITIES). IN ADDITION, AN ESTIMATED THREE PERCENT OF HOUSEHOLDS, OR 299 HOMES, IN ASHE COUNTY DO NOT HAVE TELEPHONE SERVICES AVAILABLE. AFFORDABLE HOUSING WAS ONE OF THE MOST COMMON RESPONSES TO AN OPEN-ENDED QUESTION ASKED IN THE COMMUNITY HEALTH OPINION SURVEY REGARDING RESOURCES NEEDED IN THE COMMUNITY. -MENTAL/BEHAVIORAL HEALTH ACCORDING TO THE YOUTH RISK BEHAVIOR SURVEY CONDUCTED IN 2017 AT ASHE COUNTY HIGH SCHOOL, DURING THE PAST 12 MONTHS, 27% OF STUDENTS FELT SO SAD OR HOPELESS ALMOST EVERY DAY FOR AT LEAST TWO WEEKS IN A ROW THAT THEY STOPPED DOING SOME OF THEIR USUAL ACTIVITIES. 17% OF ASHE COUNTY HIGH SCHOOL STUDENTS REPORTED HURT THEMSELVES ON PURPOSE WITHOUT INTENDING TO KILL THEMSELVES IN THE PAST 12 MONTHS. IN ADDITION, THE RATE OF SUICIDE IN ASHE COUNTY HAS INCREASED SINCE THE LAST COMMUNITY HEALTH ASSESSMENT FROM 17.8 PER 100,000 PEOPLE (2012-2016) TO 17.9 PER 100,000 PEOPLE (2014-2018). ACCESS TO COUNSELING, REFERRAL SERVICES, CASE MANAGEMENT AND CRISIS MANAGEMENT CONTINUES TO IMPROVE IN ASHE COUNTY. FOR INSTANCE, DAYMARK RECOVERY SERVICES OFFERS MOBILE CRISIS MANAGEMENT SERVICES THAT PROVIDE A COMPREHENSIVE CRISIS INTERVENTION IN THE LEAST RESTRICTIVE ENVIRONMENT WITH A TEAM PERSPECTIVE TO MEET ANY INDIVIDUALS NEEDS. HOWEVER, ACCESS TO PRIVATE MENTAL HEALTH IS EXTREMELY LIMITED IN ASHE COUNTY. -SUBSTANCE USE AND MISUSE PREVENTION SUBSTANCE USE INCLUDES ALCOHOL USE, TOBACCO USE AND OTHER DRUG USE, INCLUDING PRESCRIPTION DRUGS. SUBSTANCE MISUSE IS THE HARMFUL USE OF SUBSTANCES (LIKE DRUGS AND ALCOHOL) FOR NON-MEDICAL PURPOSES. BETWEEN 2014 -2018, ONE IN FOUR DRIVING DEATHS (23.5%) INVOLVED ALCOHOL IN ASHE COUNTY, COMPARED TO 28.2% OF ALL DRIVING DEATHS IN NORTH CAROLINA. AND APPROXIMATELY 17% OF ADULTS IN ASHE COUNTY ARE CURRENT SMOKERS, IN LINE WITH THE NORTH CAROLINA AVERAGE (17%). AVERY COUNTY -MENTAL HEALTH AMONG 2021 AVERY COUNTY COMMUNITY HEALTH SURVEY RESPONDENTS, 10.4% REPORTED FEELING DISSATISFIED OR VERY DISSATISFIED WITH LIFE, SLIGHTLY HIGHER COMPARED TO WESTERN NORTH CAROLINA. APPROXIMATELY, 20% REPORTED MORE THAN SEVEN DAYS OF POOR MENTAL HEALTH IN THE PAST MONTH, LOWER THAN THE REGIONAL AVERAGE. FOUR PERCENT OF AVERY COUNTY RESPONDENTS IN 2021 REPORTED HAVING CONSIDERED SUICIDE IN THE PAST YEAR. AMONG RESPONDENTS TO THE 2021 AVERY COUNTY STUDENT SURVEY, 37% OF HIGH SCHOOL STUDENTS REPORTED FEELING SO SAD OR HOPELESS EVERY DAY FOR TWO WEEKS THAT THEY STOPPED DOING THEIR USUAL ACTIVITIES; FEMALE STUDENTS WERE MORE LIKELY THAN OTHER GROUPS TO REPORT FEELING SAD OR HOPELESS. 12% OF STUDENT RESPONDENTS REPORTED HAVING CONSIDERED SUICIDE IN THE PAST YEAR AND 11% HAD PLANNED HOW THEY WOULD COMMIT SUICIDE. NEARLY FOUR PERCENT REPORTED THAT THEY HAD ATTEMPTED SUICIDE ONE OR MORE TIMES IN THE PAST YEAR (AVERY COUNTY SCHOOLS, 2021). -SUBSTANCE ABUSE SUBSTANCE ABUSE PREVENTION AND INCREASING AVAILABILITY/ACCESS TO MENTAL HEALTH SERVICES IS AN ONGOING ISSUE IN AVERY COUNTY AND ACROSS NORTH CAROLINA. SUBSTANCE ABUSE CAN INCLUDE, BUT IS NOT LIMITED TO, ALCOHOL, TOBACCO, PRESCRIPTION DRUGS AND ILLICIT DRUGS. IMPROVEMENTS HAVE BEEN MADE TO SUBSTANCE ABUSE PREVENTION AND INCREASED MENTAL HEALTH SERVICES, BUT MUCH MORE IS NEEDED. THIS WAS CHOSEN AS A HEALTH PRIORITY DUE TO THE CONCERN ABOUT ABUSE OF ILLEGAL DRUGS AMONG RESIDENTS AND MISUSE OF PRESCRIPTION DRUGS AMONG TEENS AND ADULTS AS WELL AS INCREASED ALCOHOL ABUSE AND THE AMOUNT OF OPIOID RELATED POLICE CALLS IN RECENT YEARS. IN 2021, 47.5% OF AVERY COUNTY RESPONDENTS TO THE COMMUNITY HEALTH SURVEY INDICATED THAT THEIR LIFE HAS BEEN NEGATIVELY AFFECTED BY SUBSTANCE ABUSE, AND APPROXIMATELY 13% OF THE COUNTYS RESPONDENTS REPORTED USING OPIATES/OPIOIDS, WITH OR WITHOUT A PRESCRIPTION, IN THE PAST YEAR. BETWEEN 2015 AND 2020, THE WERE A TOTAL OF 49 EMERGENCY DEPARTMENT VISITS WITH AN OPIOID OVERDOSE DIAGNOSIS AMONG AVERY COUNTY RESIDENTS, AN AVERAGE OF EIGHT PER YEAR. WHILE MUCH ATTENTION HAS FOCUSED ON THE OPIOID CRISIS IN RECENT YEARS, ALCOHOL CONTINUES TO BE A SUBSTANCE WHOSE MISUSE IMPACTS OUR COMMUNITIES. APPROXIMATELY 49% OF AVERY COUNTY COMMUNITY HEALTH SURVEY RESPONDENTS REPORTED CURRENT CONSUMPTION OF ALCOHOL, HIGHER THAN NC DATA AND LOWER THAN THE UNITED STATES. THE PERCENTAGE OF RESPONDENTS ENGAGING IN BINGE DRINKING WAS HIGHER IN AVERY COUNTY (24.4%) THAN ANY OF THE SURROUNDING COMPARATORS. BINGE DRINKING IS DEFINED AS MEN CONSUMING MORE THAN FIVE ALCOHOLIC DRINKS ON ANY ONE OCCASION IN THE PAST MONTH OR WOMEN CONSUMING FOUR OR MORE ALCOHOLIC DRINKS ON ANY ONE OCCASION IN THE PAST MONTH. -FOOD AND NUTRITION IN NOVEMBER 2021, HEALTHY CAROLINIANS OF AVERY COUNTY MEMBERS IDENTIFIED FOOD INSECURITY AS A CHIEF HEALTH CONCERN FOR THE COUNTY. ACCORDING TO FEEDING AMERICA, 16% OF THE AVERY COUNTY POPULATION WAS FOOD INSECURE IN 2019 AND 19.5% OF CHILDREN IN AVERY COUNTY WERE FOOD INSECURE. PARTICIPANTS IN THE 2021 COMMUNITY HEALTH SURVEYS WERE ASKED IF THEY RAN OUT OF FOOD AT LEAST ONCE IN THE PAST YEAR AND IF THEY WERE WORRIED ABOUT RUNNING OUT OF FOOD IN THE PAST YEAR. THOSE WHO SAID YES TO EITHER QUESTION WERE CLASSIFIED AS FOOD INSECURE. AVERY COUNTY DEMONSTRATED A HIGHER PERCENTAGE OF FOOD INSECURITY COMPARED TO WESTERN NORTH CAROLINA. THE NUMBER OF GROCERY STORES DECREASED FROM FIVE IN 2011 TO FOUR IN 2016: THERE ARE THREE LARGE-CHAIN GROCERY STORES IN AVERY COUNTY (AN INGLES IN NEWLAND, A FOOD LION AND A LOWES FOODS IN BANNER ELK). AS OF 2015, NEARLY FOUR PERCENT OF AVERY COUNTY HOUSEHOLDS HAD NO CAR AND LOW ACCESS (MORE THAN ONE MILE DISTANT) TO A GROCERY STORE. IN CONTRAST TO THE GROCERY STORES, FAST FOOD RESTAURANTS APPEAR MORE ABUNDANT IN AVERY COUNTY: THERE WERE 12 FAST FOOD ESTABLISHMENTS IN 2011 AND IN 2016. THERE WERE NO RECREATIONAL OR FITNESS FACILITIES IN AVERY COUNTY IN 2011 AND 2016. WATAUGA COUNTY -MENTAL/BEHAVIORAL HEALTH BEHAVIORAL HEALTH DESCRIBES THE CONNECTION BETWEEN BEHAVIORS AND THE WELL- BEING OF THE BODY, MIND, AND SPIRIT. BEHAVIORAL HEALTH INCLUDES NOT ONLY OUR MENTAL HEALTH, BUT HOW OUR BEHAVIORSSUCH AS EATING HABITS OR USE OF ALCOHOLIMPACT OUR WELL-BEING. ONE IN FIVE ADULTS (18.77%) IN NORTH CAROLINA HAS A MENTAL HEALTH CONDITION. MORE THAN HALF OF ADULTS IN NORTH CAROLINA (54.6%) WITH ANY MENTAL ILLNESS REPORT NOT RECEIVING MENTAL HEALTH TREATMENT OR COUNSELING OF ANY KIND. ONE OUT OF EVERY THREE ADULTS IN NORTH CAROLINA WITH MENTAL ILLNESS ARE UNINSURED. INDIVIDUALS LIVING IN POVERTY EXPERIENCE MENTAL ILLNESS AND MENTAL DISTRESS MORE FREQUENTLY THAN THOSE WHO ARE NOT BURDENED BY POVERTY. IT IS IMPORTANT TO CONSIDER THIS HEALTH DISPARITY WHEN ADDRESSING MENTAL HEALTH IN OUR RURAL COMMUNITY, WHERE 25.3% OF PEOPLE IN WATAUGA COUNTY WERE LIVING IN POVERTY IN 2019. ACCORDING TO THE YOUTH RISK BEHAVIOR SURVEY CONDUCTED IN 2018 AT WATAUGA COUNTY HIGH SCHOOL, DURING THE PAST 12 MONTHS, 30.1% OF WATAUGA HIGH SCHOOL STUDENT RESPONDENTS FELT SO SAD OR HOPELESS ALMOST EVERY DAY FOR AT LEAST TWO WEEKS IN A ROW THAT THEY STOPPED DOING THEIR USUAL ACTIVITIES. APPROXIMATELY 15.4% OF STUDENTS SERIOUSLY CONSIDERED ATTEMPTING SUICIDE IN THE PAST 12 MONTHS. SEEKING PRIMARY HEALTHCARE IS OFTEN THE FIRST STEP TO ACCESSING BEHAVIORAL HEALTHCARE. PRIMARY CARE PROVIDERS ARE NOW MOVING TOWARD A SYSTEM OF INTEGRATED CARE WHERE BOTH GENERAL AND BEHAVIORAL HEALTHCARE ARE PROVIDED. INTEGRATING MENTAL HEALTH, SUBSTANCE MISUSE, AND PRIMARY CARE SERVICES HAS BEEN SHOWN TO PRODUCE THE BEST OUTCOMES FOR PEOPLE WITH MULTIPLE HEALTHCARE NEEDS. -HOUSING AND TRANSIT HOUSING IS AN IMPORTANT SOCIAL DETERMINANT OF PHYSICAL AND MENTAL HEALTH AND WELLBEING. THE QUALITY AND COST OF HOUSING CAN IMPROVE OR WORSEN OUR HEALTH IN MANY WAYS: I. AFFORDABLE HOUSING MAKES MORE RESOURCES AVAILABLE TO PAY FOR HEALTHCARE AND HEALTHY FOOD, WHICH LEADS TO BETTER HEALTH OUTCOMES. II. AFFORDABLE, QUALITY HOUSING ALLEVIATES OVERCROWDING AND LIMITS OUR EXPOSURE TO ENVIRONMENTAL TOXINS. III. STABLE AND AFFORDABLE HOUSING SUPPORTS MENTAL HEALTH BY LIMITING STRESSORS RELATED TO FINANCIAL B FACILITY 1, CHARLES A CANNON JR MEMORIAL - PART V, LINE 6A WATAUGA MEDICAL CENTER, A RELATED ORGANIZATION LOCATED AT 336 DEERFIELD ROAD, BOONE, NC, ASSISTED IN CONDUCTING THE 2022 CHNA. FACILITY 1, CHARLES A CANNON JR MEMORIAL - PART V, LINE 6B ARHS ANALYZED CHNAS PUBLISHED BY APPALACHIAN DISTRICT HEALTH DEPARTMENT AND TOE RIVER HEALTH DISTRICT TO DETERMINE HOW ARHS HOSPITALS CAN CONTRIBUTE TO ADDRESSING THE DEFINED HEALTH PRIORITIES. THIS REPORT WILL FOCUS ON THE NEEDS OF OUR THREE MAIN SERVICE AREAS: ASHE, AVERY AND WATAUGA. CHNAS WERE CONDUCTED IN EACH COUNTY; ASHE AND WATAUGA BY APPALACHIAN DISTRICT HEALTH DEPARTMENT AND AVERY BY TOE RIVER HEALTH DISTRICT. FACILITY 1, CHARLES A CANNON JR MEMORIAL - PART V, LINE 11 SEVERAL NEEDS OUTLINED IN THE CHNA PROCESS SUCH AS CHILD ABUSE/NEGLECT, DENTAL PROBLEMS, ALCOHOL AND/OR DRUG USE, SEXUALLY TRANSMITTED DISEASE, TRANSPORTATION, AND FAMILY AND SOCIAL CONNECTIONS HAVE NOT BEEN ADDRESSED IN THIS PLAN. IN INITIAL DISCUSSION AND SUBSEQUENT PRIORITIZATION, ARHS CONSIDERED THE LEVELS TO WHICH SOME NEEDS WERE ALREADY BEING ADDRESSED IN THE SERVICE AREA. ADDITIONALLY, SOME COMMUNITY NEEDS FALL OUT OF THE SCOPE OF EXPERTISE AND RESOURCES OF THE HOSPITAL. SCHEDULE H, PART I, LINE 7 THE DATA REPORTED IN THIS AREA IS REPORTED AS INSTRUCTED BY CATHOLIC HEALTH ASSOCIATION'S "A GUIDE FOR PLANNING AND REPORTING COMMUNITY BENEFITS, 2008". SEE ALSO THE DESCRIPTION FOR PART III, LINE 2. SCHEDULE H, PART III, LINE 2 AMOUNTS INCLUDED ON PART III LINE 2 REPRESENT THE AMOUNT OF CHARGES CONSIDERED UNCOLLECTIBLE AFTER REASONABLE ATTEMPTS TO COLLECT, AND WRITTEN OFF TO BAD DEBT EXPENSE. SCHEDULE H, PART III, LINE 3 THE FIGURE ON PART III LINE 3 REPRESENTS MANAGEMENT'S ESTIMATE (APPROXIMATELY 5%) BASED ON AN ANALYSIS OF SELF PAY PATIENTS' ABILITY TO PAY THEIR OUTSTANDING ACCOUNT. THIS ANALYSIS INCLUDES REVIEWING THE PATIENT'S CREDIT HISTORY, INCOME LEVELS AND OVERALL COLLECTIBILITY OF THE ACCOUNT. SCHEDULE H, PART III, LINE 4 THE SYSTEM PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED ON AN EVALUATION OF THE OVERALL COLLECTABILITY OF THE ACCOUNTS RECEIVABLE. AS ACCOUNTS ARE KNOWN TO BE UNCOLLECTIBLE, THE ACCOUNTS ARE CHARGED AGAINST THE ALLOWANCE. SCHEDULE H, PART III, LINE 8 MEDICARE ALLOWABLE COSTS ARE COMPUTED IN ACCORDANCE WITH COST REPORTING METHODOLOGIES UTILIZED ON THE MEDICARE COST REPORT AND IN ACCORDANCE WITH RELATED REGULATIONS. INDIRECT COSTS ARE ALLOCATED TO DIRECT SERVICE AREAS USING THE MOST APPROPRIATE STATISTICAL BASIS. SCHEDULE H, PART III, LINE 9B CHARITY WRITE-OFFS ARE SEGREGATED FROM NORMAL BAD DEBTS THROUGH A SEPARATE TRANSACTION CODE. FAMILY INCOME BELOW 200% OF FEDERAL POVERTY GUIDELINES (FPG) ARE ELIGIBLE FOR 100% WRITE-OFF. PARTIAL WRITE-OFF IS AVAILABLE FOR FAMILY INCOME BETWEEN 200% AND 300% OF FPG. SCHEDULE H, PART VI, LINE 2 APPLACHIAN REGIONAL HEALTHCARE SYSTEM (ARHS) STAYS COMMITTED TO PROMOTING HEALTH IN THE HIGH COUNTRY, ENHANCING QUALITY OF LIFE AND SIMPLY MAKING LIFE BETTER. THE HEALTHCARE SYSTEM OFFERS A VARIETY OF HEALTH EDUCATION PROGRAMS, PREVENTION PROGRAMS AND HEALTH SCREENINGS TO ENCOURAGE HEALTHY LIFESTYLES FOR RESIDENTS AND VISITORS. IN ADDITION TO PARTNERING WITH LOCAL HEALTH DEPARTMENTS TO CONDUCT HEALTH NEEDS ASSESSMENTS, ARHS HOSTS ANNUAL HEALTH FAIRS IN OUR PRIMARY SERVICE AREA, WATAUGA AND AVERY COUNTIES. WE ALSO ATTEMPT TO ADDRESS THE NEEDS OF LOW INCOME, UNINSURED RESIDENTS THROUGH TWO PROGRAMS - APPLACHIAN HEALTHCARE PROJECT AND THE LATINO HEALTH PROGRAM WHICH ARE DISCUSSED FURTHER BELOW. SCHEDULE H, PART VI, LINE 3 PATIENTS ARE EDUCATED ABOUT THEIR ELIGIBILITY FOR ASSISTANCE UNDER FEDERAL, STATE OR LOCAL GOVERNMENT PROGRAMS OR UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY (FAP). DURING PRE-REGISTRATION AND REGISTRATION, PATIENTS CAN BE INTERVIEWED BY A PATIENT FINANCIAL ADVOCATE TO DETERMINE WHETHER THE PATIENT HAS A NEED FOR FINANCIAL ASSISTANCE OR POTENTIAL ELIGIBILITY UNDER GOVERNMENT PROGRAMS. SCHEDULE H, PART VI, LINE 4 THE COMMUNITY CONSISTS OF ASHE, AVERY, AND WATAUGA COUNTIES, A POPULATION OF APPROXIMATELY 98,000 PEOPLE IN NORTHWESTERN NORTH CAROLINA. PLEASE REFER TO THE RECENT COMMUNITY HEALTH NEEDS ASSESSMENT FOR AN IN-DEPTH LOOK AT THE DEMOGRAPHICS. BOTH THE 2019 AND 2022 CHNAS ARE AVAILABLE AT HTTPS://AAPRHS.ORG/COMMUNITY-HEALTH-NEEDS-ASSESSMENT. SCHEDULE H, PART VI, LINE 5 APPLACHIAN REGIONAL HEALTHCARE SYSTEM (ARHS) STAYS COMMITTED TO PROMOTING HEALTH IN THE HIGH COUNTRY, ENHANCING QUALITY OF LIFE AND SIMPLY MAKING LIFE BETTER. THE HEALTHCARE SYSTEM OFFERS A VARIETY OF HEALTH EDUCATION PROGRAMS, PREVENTION PROGRAMS AND HEALTH SCREENINGS TO ENCOURAGE HEALTHY LIFESTYLES FOR RESIDENTS AND VISITORS. IN ADDITION TO PARTNERING WITH LOCAL HEALTH DEPARTMENTS TO CONDUCT HEALTH NEEDS ASSESSMENTS, ARHS HOSTS ANNUAL HEALTH FAIRS IN OUR PRIMARY SERVICE AREA, WATAUGA AND AVERY COUNTIES. WE ALSO ATTEMPT TO ADDRESS THE NEEDS OF LOW INCOME, UNINSURED RESIDENTS THROUGH TWO PROGRAMS - APPLACHIAN HEALTHCARE PROJECT AND THE LATINO HEALTH PROGRAM. APPALACHIAN HEALTHCARE PROJECT IS A COLLABORATIVE EFFORT AMONG THE MEDICAL COMMUNITY TO PROVIDE HEALTHCARE FOR LOW INCOME, UNINSURED RESIDENTS OF WATAUGA AND AVERY COUNTIES. THE PROJECT ENROLLS PERSONS WHO MEET PROGRAM GUIDELINES AND COORDINATES HEALTH CARE ON THE INDIVIDUAL'S BEHALF. COORDINATION OF HEALTH CARE INCLUDES MANAGING REFERRALS TO SPECIALISTS, HELPING PATIENTS GET ACCESS TO MEDICATIONS, AND PATIENT CASE MANAGEMENT. MEDICAL PROVIDERS DONATE MUCH NEEDED CARE TO INDIVIDUALS WHO QUALIFY. THE LATINO HEALTH PROGRAM OF ARHS SEEKS TO IMPROVE THE HEALTH AND WELL-BEING OF LATINOS IN WATAUGA AND AVERY COUNTIES THROUGH INCREASED ACCESS TO CARE, HEALTH EDUCATION, AND OTHER ENABLING SERVICES. BOTH PROVIDE SUBSTANTIAL MEDICAL ASISTANCE TO APPROXIMATELY 500 LOW INCOME, UNINSURED RESIDENTS ANNUALLY. THE GOVERNING BODY OF THE HOSPITAL FACILITY IS PRIMARILY COMPRISED OF PERSONS WHO ARE NOT EMPLOYEES OR CONTRACTORS (NOR FAMILY MEMBERS THEREOF) AND WHO REPRESENT A BROAD SPECTRUM OF THE COMMUNITY. THE HOSPITAL'S MEDICAL STAFF IS OPEN TO ALL QUALIFIED PHYSICIANS IN THE REGION. SURPLUS FUNDS ARE REINVESTED IN THE FACILITIES AND OPERATIONS. THE HOSPITAL PARTICIPATES IN THE MEDICARE AND MEDICAID PROGRAMS, AND OFFER FINANCIAL ASSISTANCE TO INDIVIDUALS SATISFYING ELIGIBILITY REQUIREMENTS. SCHEDULE H, PART VI, LINE 6 APPALACHIAN REGIONAL HEALTHCARE SYSTEM (ARHS) IS A NOT-FOR-PROFIT ORGANIZATION PROVIDING HEALTH CARE SERVICES TO THE RESIDENTS OF THE MOUNTAIN REGIONS ON NORTHWEST NORTH CAROLINA AND NORTHEAST TENNESSEE. ARHS SERVES AS THE PARENT ORGANIZATION OF A MULTI-ENTITY HEALTHCARE SYSTEM. ARHS IS THE SOLE MEMBER OF WATAUGA MEDICAL CENTER, INC. (WMC), CHARLES A. CANNON, JR. MEMORIAL HOSPITAL (CANNON), INC., APPALACHIAN REGIONAL HEALTHCARE FOUNDATION, INC., ARHS PROPERTIES, INC., APPALACHIAN REGIONAL MEDICAL ASSOCIATES, INC., AND APPALACHIAN REGIONAL BEHAVIORAL HEALTH, INC. WATAUGA MEDICAL CENTER IS A 117-BED REGIONAL REFERRAL MEDICAL COMPLEX, OFFERING BOTH PRIMARY AND SECONDARY ACUTE AND SPECIALTY CARE. WATAUGA MEDICAL CENTER ALSO INCLUDES MANY OUTPATIENT CLINICS AND A DIAGNOSTICS CENTER. CHARLES A. CANNON, JR. MEMORIAL HOSPITAL IS AN ACUTE CARE HOSPITAL WITH A FULL-SERVICE EMERGENCY DEPARTMENT, IMAGING DEPARTMENT, LABORATORY, OUTPATIENT BEHAVIORAL HEALTH, AND THE REHABILITATION CENTERS PHYSICAL AND OCCUPATIONAL THERAPIES. APPALACHIAN REGIONAL HEALTHCARE FOUNDATION, INC. IS THE FUNDRAISING ORGANIZATION FOR THE SYSTEM. APPALACHIAN REGIONAL BEHAVIORAL HEALTH, INC. IS A 37-BED LICENSED INPATIENT MENTAL HEALTH HOSPITAL THAT BEGAN OPERATIONS DURING THE FISCAL YEAR. IT ALSO OPERATES THE OUPATIENT MENTAL HEALTH DEPARTMENT THAT WAS FORMERLY PART OF CANNON. APPALACHIAN REGIONAL MEDICAL ASSOCIATES, INC. (ARMA) PROVIDES PRIMARY CARE, ALONG WITH A WIDE ARRAY OF SPECIALTIES TO SERVE THE NEEDS OF AREA RESIDENTS. SPECIALTIES INCLUDE CARDIOLOGY, ORTHOPAEDICS, OB/GYN, GENERAL SURGERY, UROLOGY, RHEUMATOLOGY, PULMONOLOGY, AND URGENT CARE. ARMA ALSO PROVIDES ADMINISTRATIVE SERVICES, ELECTRONIC MEDICAL RECORDS SYSTEMS, PHYSICIAN RECRUITMENT, AND PHYSICIAN OFFICE MANAGEMENT SERVICES. ARHS PROPERTIES, INC. WAS FORMED TO MANAGE AND MAINTAIN PROPERTIES FOR THE USE OF WATAUGA MEDICAL CENTER, INC. AND CHARLES A. CANNON, JR. MEMORIAL HOSPITAL. false true false false false false false false false CHARLES MANTOOTH CEO 577293 124323 17066 18800 18827 756309 PAUL DAGHER MD TRUSTEE/PHYSICIAN 496832 2322 8700 25953 533807 MATT THOMAS CFO (LEFT 10/22) 370380 48650 52944 16463 18285 506722 RICK CASSADY CFO 229316 39237 268553 STEPHANIE GREER PRES AVERY HC MARKET 186012 9226 503 13130 19418 228289 SCHEDULE J, PAGE 1, PART I, LINE 3 NONE OF THE INDIVIDUAL BOARD MEMBERS OR OFFICERS ARE COMPENSATED BY THE FILING ORGANIZATION AND THE ORGANIZATION MUST RELY ON THE METHODS EMPLOYED BY THE RELATED ORGANIZATION, ARHS, TO DETERMINE REASONABLE COMPENSATION FOR THE INDIVIDUALS. COMPENSATION DETERMINATION BY ARHS INCLUDES AN INDEPENDENT COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT AND SURVEYS, AND BOARD APPROVAL. THESE METHODS ARE WELL DOCUMENTED. SCHEDULE J, PAGE 1, PART I, LINE 4 CHARLES MANTOOTH 0 10,250 0 MATT THOMAS 0 10,250 0 STEPHANIE GREER 0 7,193 0 SCHEDULE J, PART III NONQUALIFIED DEFERRED COMPENSATION PLAN: THE SYSTEM HAS A NONQUALIFIED DEFERRED COMPENSATION PLAN FOR CERTAIN MEMBERS OF MANAGEMENT AND PHYSICIANS TO DEFER A PORTION OF THEIR COMPENSATION UNTIL RETIREMENT. FORM 990, PAGE 6, PART VI, LINE 1A THE EXECUTIVE COMMITTEE SHALL CONSIST OF THE CHAIRMAN OF THE BOARD OF TRUSTEES, THE VICE CHAIRMAN OF THE BOARD OF TRUSTEES, THE IMMEDIATE PAST CHAIRMAN OF THE BOARD OF TRUSTEES (IF STILL A MEMBER OF THE BOARD OF TRUSTEES), AND THREE OTHER TRUSTEES. THE CHAIRMAN SHALL APPOINT THE MEMBERS OF THE EXECUTIVE COMMITTEE AND SHALL SERVE AS ITS CHAIRMAN. IN THE ABSENCE OF A QUORUM OF THE ENTIRE BOARD OF TRUSTEES, THE EXECUTIVE COMMITTEE OR A MAJORITY THEREOF SHALL HAVE FULL AUTHORITY TO ACT IN ALL MATTERS RELATING TO CANNON MEMORIAL HOSPITAL BUSINESS, INCLUDING, BUT NOT LIMITED TO ALL THINGS DEEMED NECESSARY AND EXPEDIENT IN THE GOVERNANCE, MANAGEMENT, AND CONTROL OF THE BUSINESS AND AFFAIRS OF THE CORPORATION, INCLUDING MATTERS RELATING TO EXECUTIVE COMPENSATION, AND SHALL HAVE AND EXERCISE THE POWER AND AUTHORITY OF THE BOARD OF TRUSTEES TO TRANSACT ALL REGULAR BUSINESS OF THE CORPORATION WHEN THE BOARD OF TRUSTEES IS NOT IN SESSION, EXCEPT FOR CERTAIN PROHIBITED ACTIONS (ARTICLE V, SECTION 3 OF THE BYLAWS). FURTHER, THE EXECUTIVE COMMITTEE OR A MAJORITY THEREOF SHALL HAVE FULL AUTHORITY TO ACT ON BEHALF OF CANNON MEMORIAL HOSPITAL AT ANY CALLED OR SPECIAL MEETING. WHEN THE EXECUTIVE COMMITTEE EXERCISES THE POWER AND AUTHORITY OF THE BOARD OF TRUSTEES, SUCH ACTION IS SUBJECT TO RATIFICATION BY THE BOARD OF TRUSTEES. FORM 990, PAGE 6, PART VI, LINE 3 THE PARENT COMPANY AND SOLE MEMBER, APPALACHIAN REGIONAL HEALTHCARE SYSTEM (ARHS) OVERSEES THE ORGANIZATION'S OPERATIONS. ALSO SALARIES AND OTHER COMMON EXPENSES INCURRED BY ARHS ARE ALLOCATED APPROPRIATELY TO THE FILING ORGANIZATION. ALL PAYROLL RETURNS, INCLUDING W-2S, ARE ISSUED BY ARHS. PAYMENTS TO VENDORS ARE MADE THROUGH ARHS AND ALL 1099S ARE ISSUED BY ARHS. FORM 990, PAGE 6, PART VI, LINE 6 THE SOLE MEMBER IS APPALACHIAN REGIONAL HEALTHCARE SYSTEM, INC. FORM 990, PAGE 6, PART VI, LINE 7A THE TRUSTEES OF THE SOLE MEMBER SHALL ALSO SERVE AS THE TRUSTEES OF THE FILING ORGANIZATION. FORM 990, PAGE 6, PART VI, LINE 11B THE SYSTEM CONTROLLER AND THE CFO REVIEW THE 990 PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. THE RETURN IS MADE AVAILABLE TO THE BOARD OF TRUSTEES UPON COMPLETION. FORM 990, PAGE 6, PART VI, LINE 12C THE CONFLICT OF INTEREST POLICY IS REVIEWED ANNUALLY AND APPLIES TO ALL EMPLOYEES, OFFICERS AND BOARD MEMBERS. SHOULD A CONFLICT EXIST, THE INDIVIDUAL IS RECUSED FROM DISCUSSION AND DECISION-MAKING PROCESS. FORM 990, PAGE 6, PART VI, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE PROVIDED UPON REQUEST. FORM 990, PART IX, LINE 11G CONTRACT LABOR 694,478 10,189 0 PHYSICIAN FEES 1,468,472 0 0 PURCHASED SERVICES 647,219 285,219 0 OUTSIDE SERVICES 212,352 0 0 CONSULTING 45 0 0 TOTAL 3,022,566 295,408 0 APPALACHIAN REGIONAL HEALTHCARE SYS PO BOX 2600 BOONE NC 28607 201067022 PARENT NC 501C3 12B N/A false WATAUGA MEDICAL CENTER INC 336 DEERFIELD RD BOONE NC 28607 560510824 HOSPITAL NC 501C3 3 ARHS false APPALACHIAN REGIONAL HEALTHCARE FDN 336 DEERFIELD RD BOONE NC 28607 204625618 FOUNDATION NC 501C3 7 ARHS false APPALACHIAN REGIONAL MED ASSOC PO BOX 2600 BOONE NC 28607 205755130 PHYSICIANS NC 501C3 10 ARHS false ARHS PROPERTIES INC 336 DEERFIELD RD BOONE NC 28607 203470765 PROPERTY NC 501C3 12B ARHS false APPALACHIAN REGIONAL BEHAVIORAL HLT 432 HOSPITAL DRIVE LINVILLE NC 28646 851313265 HOSPITAL NC 501C3 3 ARHS false SLOOP MED OFC PLAZA CONDO ASSOC 434 HOSPITAL DRIVE LINVILLE NC 28646 593761777 RENTAL NC N/A false false false false false true false false false false true false true true true true true true false false