2025-02-03T16:31:07-06:00 2023-09-30 135565207 KPMG LLP 500 W 5TH ST STE 800 WINSTONSALEM NC 27101 990 2022-10-01 561833893 THE BLADEN COUNTY HOSPITAL FOUNDATION INC BLAD 9108621206 PO BOX 398 ELIZABETHTOWN NC 28337 SABRINA BROOKS EXECUTIVE DIRECTOR 9108621206 2025-02-03 1 0 WHITNEY B HEBRON P01226647 3362753394 2022 2025-03-06 01:10:19Z SABRINA BROOKS PO BOX 398 ELIZABETHTOWN NC 28337 16930 0 X WWW.CAPEFEARVALLEY.COM/BLADEN/FOUNDATION X 1992 NC TO ADVANCE HEALTHCARE IN AND AROUND BLADEN COUNTY, NC. 12 12 0 0 0 0 3698 2767 0 0 0 14007 0 0 3698 16774 0 10000 0 0 0 0 0 0 0 2129 1541 2129 11541 1569 5233 493272 519968 10380 0 482892 519968 THE MISSION OF THE BLADEN COUNTY HOSPITAL FOUNDATION IS TO SERVE THE COMMUNITY BY BUILDING AWARENESS AND PHILANTHROPIC SUPPORT FOR BLADEN COUNTY HOSPITAL AS IT PROVIDES COMPASSIONATE, QUALITY HEALTHCARE FOR ALL ITS PATIENTS. 0 0 11541 10000 BLADEN COUNTY HOSPITAL FOUNDATION IS THE PHILANTHROPIC ARM OF BLADEN COUNTY HOSPITAL. ALL FUNDS DONATED TO BLADEN COUNTY HOSPITAL FOUNDATION ARE DEDICATED TO PROGRAMS AND SERVICES AT BLADEN COUNTY HOSPITAL. OUR FOUNDATION HAS A SINGLE GENERAL FUND. THE FOUNDATION SUPPORTS BLADEN COUNTY HOSPITAL THROUGH EQUIPMENT PURCHASES, COMMUNITY BENEFITS AND PATIENT AND FAMILY SUPPORT. 11541 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 1 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 12 12 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 0 0 0 0 0 X ASHLEY DOWLESS 9108621206 PO BOX 398 ELIZABETHTOWN NC 28337 X LEON MARTIN CHAIRMAN 0.10 0.00 X X 0 0 0 BRIAN CAMPBELL VICE CHAIRMAN 0.10 0.00 X X 0 0 0 SHIRLEY VANN SECRETARY/TREASURER 0.10 0.00 X X 0 0 0 RICH GLENN DIRECTOR 0.10 0.00 X 0 0 0 TERRY NANCE DIRECTOR 0.10 0.00 X 0 0 0 ERIC MATTHEWS DIRECTOR 0.10 0.00 X 0 0 0 MAURICE WILLIAMS DIRECTOR 0.10 0.00 X 0 0 0 MARK GILLESPIE DIRECTOR 0.10 0.00 X 0 0 0 ANNE GREENE DIRECTOR 0.10 0.00 X 0 0 0 GENA ANDERSON PEED DIRECTOR 0.10 0.00 X 0 0 0 SHAUN HINES MD DIRECTOR 0.10 0.00 X 0 0 0 SABRINA BROOKS DIRECTOR 0.10 0.00 X 0 0 0 0 0 0 0 0 0 0 0 2767 2767 14163 14163 156 -156 -156 -156 16774 0 0 14007 10000 10000 689 689 OTHER COSTS 739 739 PROGRAM EXPENSES 113 113 11541 11541 0 0 73600 63364 2676 0 416996 456604 493272 519968 10380 0 10380 0 X 482892 519968 482892 519968 493272 519968 5233 21461 10382 0 X 0 1 X 1 0 X 28955 20996 10929 3697 2767 67344 28955 20996 10929 3697 2767 67344 67344 6109 7066 8279 0 14163 35617 102961 0.65410 0.77230 X 0 X 38235 21461 21461 16774 0 16774 11541 0 11541 0 11541 PART X, LINE 2: THE HEALTH SYSTEM AND THE FOUNDATION ARE EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME UNDER SECTION 501(A) OF THE INTERNAL REVENUE CODE AS ORGANIZATIONS DESCRIBED IN SECTION 501(C)(3). THE UNRELATED BUSINESS INCOME GENERATED BY THE HEALTH SYSTEM AND THE INCOME GENERATED BY THE HEALTH SYSTEM'S TAXABLE COMPONENT ARE NOT MATERIAL TO THE FINANCIAL STATEMENTS. ACCORDINGLY, NO PROVISION FOR INCOME TAXES IS REQUIRED IN THE ACCOMPANYING FINANCIAL STATEMENTS. 1 CUMBERLAND COUNTY HOSPITAL SYSTEM INC PO BOX 2000 FAYETTEVILLE NC 28302 560845796 501(C)(3) 10000 0 MAMMOGRAPHY ROOM 1 PART 1, LINE 2 BLADEN HOSPITAL FOUNDATION FUNDS A CARE ENHANCEMENT GRANT PROGRAM TO SUPPORT THE HIGHEST PRIORITY AND GREATEST NEED AREAS OF CAPE FEAR VALLEY HEALTH. ALL GRANT REQUESTS RECEIVED MUST BE GENERATED BY A HEALTH SYSTEM EMPLOYEE AND MUST BE FOR THE BENEFIT OF A HOSPITAL DEPARTMENT, ENTITY, SERVICE, OR PROGRAM. NO GRANT REQUEST CAN BE USED FOR GENERAL OPERATIONS OR BUDGET/OPERATING DEFICITS OF THE HEALTH SYSTEM. FORM 990, PART VI, SECTION B, LINE 11B THE FOUNDATION'S FORM 990 IS PREPARED BY KPMG, THEN IT IS REVIEWED BY THE FINANCE DEPARTMENT OF THE FOUNDATION'S PARENT, CUMBERLAND COUNTY HOSPITAL SYSTEM, INC. UPON COMPLETION OF THE FORM 990, IT IS PROVIDED TO THE FOUNDATION'S BOARD OF DIRECTORS PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C THE BLADEN COUNTY HOSPITAL FOUNDATION REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY IN THAT ANY DIRECTOR, PRINCIPAL OFFICER, OR MEMBER OF A COMMITTEE WITH GOVERNING BOARD DELEGATED POWERS, WHO HAS A DIRECT OR INDIRECT FINANCIAL INTEREST, MUST DISCLOSE THE EXISTENCE OF THE FINANCIAL INTEREST AND BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS TO THE DIRECTORS AND MEMBERS OF THE COMMITTEES WITH GOVERNING BOARD DELEGATED POWERS CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT. THE REMAINING INDIVIDUALS ON THE GOVERNING BOARD OR COMMITTEE MEETING WILL DECIDE IF CONFLICTS OF INTEREST EXIST. EACH DIRECTOR, PRINCIPAL OFFICER AND MEMBER OF A COMMITTEE WITH GOVERNING BOARD DELEGATED POWERS ANNUALLY SIGNS A STATEMENT WHICH AFFIRMS SUCH PERSON HAS RECEIVED A COPY OF THE CONFLICTS OF INTEREST POLICY, HAS READ AND UNDERSTANDS THE POLICY, HAS AGREED TO COMPLY WITH THE POLICY, AND UNDERSTANDS THAT THE ORGANIZATION IS CHARITABLE AND IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION IT MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ITS TAX-EXEMPT PURPOSE. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE NOT AVAILABLE TO THE PUBLIC UPON REQUEST. ORGANIZATION'S FORM 990 IS OPEN FOR PUBLIC INSPECTION, PROVIDES FINANCIAL INFORMATION, AND ADDRESSES ISSUES OF GOVERNANCE SUCH AS THE ORGANIZATION'S CONFLICT OF INTEREST POLICY AND GOVERNANCE DOCUMENTS. CUMBERLAND COUNTY HOSPITAL SYSTEM INC PO BOX 2000 FAYETTEVILLE NC 28302 560845796 HEALTH SERVICES NC 501(C)(3) LINE 3 N/A 0 CAPE FEAR VALLEY MEDICAL FOUNDATION INC PO BOX 87526 FAYETTEVILLE NC 28304 561947017 FUNDRAISING NC 501(C)(3) LINE 7 CCHS 0 HARNETT HEALTH SYSTEM INC PO BOX 1706 DUNN NC 28335 560603898 HEALTH SERVICES NC 501(C)(3) LINE 3 CCHS 0 HARNETT HEALTH SYSTEM FOUNDATION 800 TILGMAN DRIVE DUNN NC 28334 201929953 FUNDRAISING NC 501(C)(3) LINE 7 N/A 0 FAYETTEVILLE AMB SURGERY CENTER 1781 METROMEDICAL DRIVE FAYETTEVILLE NC 28304 561754482 HEALTHCARE NC CCHS RELATED 0 0 THE MED IMAGING CENTER LLC 3186 VILLAGE DRIVE STE 101 FAYETTEVILLE NC 28304 264473832 HEALTHCARE NC CCHS RELATED 0 0 HIGHSMITH-RAINEY MED ARTS CENTER ASSOC PO BOX 2000 FAYETTEVILLE NC 28302 561747424 RENTAL ASSOC. NC CCHS C 0 CUMBERLAND HLTH PARTNERS INC (INACTIVE) PO BOX 2000 FAYETTEVILLE NC 28302 562043978 BEHAVIORAL HEALTH NC CCHS C 0 CAPE FEAR INSURANCE LTD PO BOX 30600 SMB WEST BAY RD GRAND CAYMAN CJ 980449284 INSURANCE CJ CCHS C 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 1 0 0 0 0