Form990
Click to see attachment
Department of the Treasury
Internal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except black lung benefit trust or private foundation)

MediumBullet The organization may have to use a copy of this return to satisfy state reporting requirements.
OMB No. 1545-0047
2010
Open to Public Inspection
A For the calendar year, or tax year beginning 10-01-2010 and ending 09-30-2011
BCheck if applicable:
CName of organization
BLUE RIDGE REGIONAL HOSPITAL INC
 
Doing Business As
 
 
Number and street (or P.O. box if mail is not delivered to street address)
PO BOX 9
 
Room/suite
City or town, state or country, and ZIP + 4
SPRUCE PINE, NC287770009
D Employer identification number

56-1025032
E Telephone number

G Gross receipts $ 41,973,805
F Name and address of principal officer:
JONATHAN SMITH
PO BOX 9
SPRUCE PINE,NC287770009
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.SPCHOSPITAL.ORG
H(a)
Is this a group return for
affiliates?
H(b)
Are all affiliates included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:
 
L Year of formation: 1971
M State of legal domicile: NC
Part I
Summary
Activities  & Governance 1 Briefly describe the organization’s mission or most significant activities: PROVISION OF INPATIENT AND OUTPATIENT HOSPITAL SERVICES
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) .... 3 11
4 Number of independent voting members of the governing body (Part VI, line 1b) .... 4 6
5 Total number of individuals employed in calendar year 2010 (Part V, line 2a) ... 5 471
6 Total number of volunteers (estimate if necessary) .... 6 50
7a Total unrelated business revenue from Part VIII, column (C), line 12 .. 7a 0
b Net unrelated business taxable income from Form 990-T, line 34 .. 7b 0
Revenues; Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 566,487 481,696
9 Program service revenue (Part VIII, line 2g) ......... 39,102,622 39,982,286
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 389,945 263,690
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 851,809 1,229,675
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 40,910,863 41,957,347
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 0 0
14 Benefits paid to or for members (Part IX, column (A), line 4) .... 0 0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 20,527,069 21,347,134
16a Professional fundraising fees (Part IX, column (A), line 11e).... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24f).... 18,630,106 19,575,918
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 39,157,175 40,923,052
19 Revenue less expenses. Subtract line 18 from line 12...... 1,753,688 1,034,295
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............ 52,753,083 52,242,371
21 Total liabilities (Part X, line 26)............ 20,000,218 18,819,014
22 Net assets or fund balances. Subtract line 21 from line 20 ..... 32,752,865 33,423,357
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title.
Paid Preparer's Use Only Preparer's
signature
Big Right Arrow
Date
right pointing bullet image Preparer’s taxpayer identification number
(see instructions)
Firm’s name (or yours
if self-employed),
address, and ZIP + 4
Big Right Arrow




EIN right pointing bullet image
Phone no. right pointing bullet image
May the IRS discuss this return with the preparer shown above? (see instructions) .........
For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y
Form 990 (2010)
Form 990 (2010)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response to any question in this Part III . . . . . . . . . .
1
Briefly describe the organization’s mission: WE EXIST TO IDENTIFY AND RESPOND TO THE HEALTH AND WELLNESS NEEDS OF THE REGION, PARTNERING WITH PATIENTS, FAMILIES, AND FRIENDS THROUGH A COMPREHENSIVE APPROACH TO HEALING THAT MINISTERS TO THE MIND, BODY, AND SPIRIT.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? ....................
If “Yes,” describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program services? ..........................
If “Yes,” describe these changes on Schedule O.
4
Describe the exempt purpose achievements for each of the organization’s three largest program services by expenses.
Section 501(c)(3) and 501(c)(4) organizations and section 4947(a)(1) trusts are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 35,679,956 including grants of $   ) (Revenue $ 40,748,367 )
BLUE RIDGE REGIONAL HOSPITAL BELIEVES THAT PATIENT AND FAMILY-CENTERED CARE IS THE BEST APPROACH TO MEETING OUR PATIENTS' HEALTHCARE NEEDS. PATIENT AND FAMILY-CENTERED CARE MEANS PATIENTS, THEIR FAMILIES, DOCTORS, NURSES AND OTHER HEALTHCARE PROFESSIONALS FORM A PARTNERSHIP THAT BENEFITS EVERYONE.A "FAMILY MEMBER" IS RECOGNIZED AS ANYONE WHO PATIENTS REGARD AS SIGNIFICANT IN THEIR LIVES. FAMILIES ARE NOT CONSIDERED VISITORS, BUT ESSENTIAL PARTICIPANTS IN CARE AND DECISIONS THAT AFFECT THE TOTAL HEALING OF THE PATIENT. THE COMPONENTS OF FAMILY-CENTERED CARE ARE RESPECT AND DIGNITY; INFORMATION SHARING; AND PARTICIPATION AND COLLABORATION.THE GOAL IN CARING FOR PATIENTS AT BLUE RIDGE REGIONAL HOSPITAL IS THE SAME FOR THE PHYSICIANS, MEDICAL STAFF AND FAMILIES--TO PROVIDE THE BEST CARE AND OUTCOME FOR THE PATIENT. IT TAKES A COMBINATION OF MODERN MEDICINE, COMPASSIONATE CARE, ADVANCED TECHNOLOGY, DEDICATED STAFF, AS WELL AS CARE PROVIDED BY FAMILIES TO REACH THE BEST POSSIBLE OUTCOME.THE STAFF AT BLUE RIDGE REGIONAL HOSPITAL IS DEDICATED TO CREATING THIS TYPE OF EXPERIENCE FOR EVERY PATIENT AND FAMILY MEMBER WHO ENTERS OUR DOORS.BLUE RIDGE REGIONAL HOSPITAL HAD THE FOLLOWING AWARDS AND SERVICE ACCOMPLISHMENTS:BLUE RIDGE REGIONAL HOSPITAL RECEIVED 5-STAR AWARDIN 2011 BLUE RIDGE REGIONAL HOSPITAL WAS RECOGNIZED AS A COMMUNITY VALUE FIVE-STAR HOSPITAL BY CLEVERLEY + ASSOCIATES (COLUMBUS, OH) FOR THE 5TH YEAR. CLEVERLEY + ASSOCIATES IS A LEADING HEALTHCARE FINANCIAL CONSULTING FIRM SPECIALIZING IN OPERATIONAL BENCHMARKING AND PERFORMANCE ENHANCEMENT STRATEGIES. THE FIVE-STAR SURVEY EXAMINES TEN MEASURES IN FOUR KEY PERFORMANCE AREAS: FINANCIAL VIABILITY AND PLANT REINVESTMENT, HOSPITAL COST STRUCTURE, HOSPITAL CHARGE STRUCTURE AND HOSPITAL QUALITY PERFORMANCE. OUR DEDICATED STAFF STRIVES TO PROVIDE OUR PATIENTS WITH FIVE-STAR QUALITY CARE CLOSE TO HOME. BLUE RIDGE REGIONAL HOSPITAL HAS BEEN RECOGNIZED AS A TOP-RANKED COMMUNITY VALUE PROVIDER BY CLEVERLEY + ASSOCIATES IN 2006, 2007, 2008, 2010, AND 2011.BLUE RIDGE REGIONAL HOSPITAL PAVES THE WAY FOR WOMEN'S HEALTH IN THE REGIONTONYA STYLES, MAMMOGRAPHY TECHNOLOGIST IN THE WOMEN'S IMAGING CENTER AT BLUE RIDGE REGIONAL HOSPITAL RECEIVED HER CERTIFICATION FROM THE NATIONAL CONSORTIUM OF BREAST CENTERS AS A CLINICAL BREAST EXAMINER. TONYA IS CERTIFIED IN THE SKILLS REQUIRED TO PERFORM A CLINICAL BREAST EXAM INCLUDING THE DETECTION OF ANY DOMINANT BREAST MASS IN THE EARLY DETECTION OF BREAST CANCER. THIS CERTIFICATION IS AVAILABLE TO HEALTHCARE PROFESSIONALS ONLY AND TONYA IS ONE OF ONLY FOUR CERTIFIED PROFESSIONALS IN THE STATE OF NORTH CAROLINA. "I AM SO PLEASED TO BE ABLE TO PROVIDE CLINICAL BREAST EXAMS TO THE WOMEN WE SERVE", SAYS STYLES "THROUGH OUR WOMEN'S IMAGING CENTER WE CAN REALLY IMPACT THE HEALTH AND WELL-BEING OF WOMEN IN OUR REGION." THE WOMEN'S IMAGING CENTER AT BLUE RIDGE REGIONAL HOSPITAL OPENED IN AUGUST OF 2010 AND IS LOCATED WITHIN THE RADIOLOGY DEPARTMENT. THIS ADVANCED CENTER FEATURES DIGITAL MAMMOGRAPHY, A PRIVATE "WOMEN'S ONLY" WAITING AREA, PRIVATE CHANGING ROOMS AND AN EDUCATION RESOURCE ROOM IN A RELAXING, HEALING ENVIRONMENT. OUR EDUCATION RESOURCE ROOM INCLUDES DVDS AND EDUCATIONAL MATERIALS IN MULTIPLE LANGUAGES AS WELL AS MODELS AND BREAST FORMS THAT ALLOW WOMEN TO FEEL WHAT BREAST MASSES AND LUMPS OF DIFFERENT SIZES MIGHT FEEL LIKE. FUNDING FOR THE CERTIFICATION AS WELL AS RESOURCES FOR THE WOMEN'S IMAGING CENTER EDUCATIONAL RESOURCE ROOM WAS MADE POSSIBLE BY SUSAN G. KOMEN FOR THE CURE. "OUR GOAL IS TO PROVIDE A RELAXING EDUCATIONAL EXPERIENCE TO THE WOMEN IN OUR REGION TO HELP PROMOTE BREAST CANCER AWARENESS AS WELL AS BREAST CANCER PREVENTION" SAID ROBIN NICHOLS, DIRECTOR OF IMAGING SERVICES AT BLUE RIDGE REGIONAL HOSPITAL. "EARLY DETECTION IS THE BEST PROTECTION AND WE HOPE TO EDUCATE ALL WOMEN IN OUR AREA ON THE IMPORTANCE OF SELF BREAST EXAMS AS WELL AS REGULAR MAMMOGRAMS. HAVING A CERTIFIED CLINICAL BREAST EXAMINER IN THE DEPARTMENT WILL HELP US PROVIDE EDUCATION AND STATE-OF-THE-ART CARE TO THE WOMEN IN OUR REGION." BLUE RIDGE REGIONAL HOSPITAL OPENS CANCER RESOURCE ROOM BLUE RIDGE REGIONAL HOSPITAL PARTNERED WITH THE AMERICAN CANCER SOCIETY TO PROVIDE A CANCER RESOURCE ROOM FOR CANCER PATIENTS AND SURVIVORS. THIS ROOM IS LOCATED NEAR THE CHEMOTHERAPY DEPARTMENT AND PROVIDES FREE RESOURCES INCLUDING WIGS, PROSTHESIS, BRAS, TURBANS, HATS, AND EDUCATIONAL MATERIALS REGARDING DIFFERENT TYPES OF CANCER AND RESOURCES FOR CAREGIVERS. ALL RESOURCES ARE LOCATED IN A PRIVATE RELAXING ENVIRONMENT FOR PATIENTS, SURVIVORS AND FAMILY MEMBERS TO USE. ALL RESOURCES ARE PROVIDED TO PATIENTS AND SURVIVORS COURTESY OF THE AMERICAN CANCER SOCIETY. BLUE RIDGE REGIONAL HOSPITAL PROVIDED THE SPACE FOR THE RESOURCE ROOM AND THE FURNITURE AVAILABLE TO PATIENTS AND FAMILIES. BLUE RIDGE REGIONAL HOSPITAL LAB RECEIVES CAP ACCREDITATION THE ACCREDITATION COMMITTEE OF THE COLLEGE OF AMERICAN PATHOLOGISTS (CAP) AWARDED ACCREDITATION TO THE LABORATORY AT BLUE RIDGE REGIONAL HOSPITAL BASED ON THE RESULTS OF A RECENT ONSITE INSPECTION. DURING THE CAP ACCREDITATION PROCESS, INSPECTORS EXAMINE THE LABORATORY'S RECORDS AND QUALITY CONTROL OF PROCEDURES FOR THE PRECEDING TWO YEARS. CAP INSPECTORS ALSO EXAMINE LABORATORY STAFF QUALIFICATIONS, AS WELL AS THE LABORATORY'S EQUIPMENT, FACILITIES, SAFETY PROGRAM AND RECORD, IN ADDITION TO THE OVERALL MANAGEMENT OF THE LABORATORY. THIS STRINGENT INSPECTION PROGRAM IS DESIGNED TO SPECIFICALLY ENSURE THE HIGHEST STANDARD OF CARE FOR ALL LABORATORY PATIENTS. THE LABORATORY AT BLUE RIDGE REGIONAL HOSPITAL PROCESSES OVER 500,000 TESTS ANNUALLYCEO RECEIVES ACHE AWARDKEITH S. HOLTSCLAW (FELLOW IN THE AMERICAN COLLEGE OF HEALTHCARE EXECUTIVES), PRESIDENT AND CEO OF BLUE RIDGE REGIONAL HOSPITAL, RECEIVED THE AMERICAN COLLEGE OF HEALTHCARE EXECUTIVES (ACHE) SENIOR-LEVEL HEALTHCARE EXECUTIVE REGENT'S AWARD RECENTLY AT THE ANNUAL NORTH CAROLINA HOSPITAL ASSOCIATION MEETING IN RALEIGH. THE SENIOR-LEVEL HEALTHCARE AWARD RECOGNIZES ACHE MEMBERS WHO ARE EXPERIENCED IN THE FIELD AND HAVE MADE SIGNIFICANT CONTRIBUTIONS TO THE ADVANCEMENT OF HEALTHCARE MANAGEMENT. AWARD RECIPIENTS ARE EVALUATED ON LEADERSHIP ABILITY, INNOVATIVE AND CREATIVE MANAGEMENT, EXECUTIVE CAPABILITY IN DEVELOPING THEIR OWN ORGANIZATION AND PROMOTING ITS GROWTH AND STATURE IN THE COMMUNITY, CONTRIBUTIONS TO DEVELOPMENT OF OTHERS IN THE HEALTHCARE PROFESSION, LEADERSHIP IN LOCAL, STATE OR PROVINCIAL HOSPITAL AND HEALTH ASSOCIATION ACTIVITIES, PARTICIPATION IN CIVIC AND COMMUNITY ACTIVITIES AND PROJECTS, PARTICIPATION IN ACHE ACTIVITIES, AND INTEREST IN ASSISTING ACHE IN ACHIEVING ITS OBJECTIVES. THE AMERICAN COLLEGE OF HEALTH CARE EXECUTIVES IS AN INTERNATIONAL PROFESSIONAL SOCIETY OF MORE THAN 30,000 HEALTHCARE EXECUTIVES WHO LEAD HOSPITALS, HEALTHCARE SYSTEMS AND OTHER HEALTHCARE ORGANIZATIONSTOE RIVER PROJECT ACCESS RECOGNIZED BY AMERICAN HOSPITAL ASSOCIATIONTOE RIVER PROJECT ACCESS (TRPA), AN INITIATIVE OF THE BLUE RIDGE REGIONAL HOSPITAL FOUNDATION, WAS FEATURED IN THE 2011 EDITION OF THE AMERICAN HOSPITAL ASSOCIATION'S COMMUNITY CONNECTIONS: IDEAS AND INNOVATIONS FOR HOSPITAL LEADERS. THIS NATIONAL PUBLICATION HIGHLIGHTS HOSPITALS THAT MEET THEIR COMMUNITY'S SOCIAL AND BASIC NEEDS THROUGH PROMOTING COMMUNITY HEALTH, IMPROVING ACCESS AND COVERAGE AND ENHANCING THE QUALITY OF LIFE FOR THE PEOPLE THEY SERVE. TOE RIVER PROJECT ACCESS WAS FEATURED FOR THE ACCESS TO NEEDED MEDICAL CARE THAT THEY HAVE PROVIDED TO MITCHELL AND YANCEY COUNTY RESIDENTS SINCE THE PROGRAM'S LAUNCH IN 2003. TOE RIVER PROJECT ACCESS PROVIDES ACCESS TO MEDICAL, DENTAL AND VISION CARE AS WELL AS MEDICATION ASSISTANCE FOR LOW-INCOME, UNINSURED RESIDENTS OF MITCHELL AND YANCEY COUNTIES WHO DO NOT QUALIFY FOR OTHER PROGRAMS OR GOVERNMENTAL ASSISTANCE. "IT IS AN HONOR TO HAVE THIS PROGRAM RECOGNIZED FOR THE ACCESS TO CARE THAT IT PROVIDES", SAYS TRPA COORDINATOR AUBREY STEWART, "SINCE WE LAUNCHED IN 2003 WE HAVE BEEN ABLE TO PROVIDE ACCESS TO OVER $3.7 MILLION IN NEEDED COMPREHENSIVE HEALTH CARE TO MEMBERS OF OUR COMMUNITY." TOE RIVER PROJECT ACCESS PARTNERS WITH OVER 37 PRIMARY AND SPECIALTY CARE PROVIDERS WHO VOLUNTEER THEIR SERVICES AND HAVE PROVIDED CARE TO OVER 828 CLIENTS SINCE THE PROGRAM BEGAN. "THE SUCCESS OF THIS PROGRAM IS A DIRECT RESULT OF THE GENEROUS PROVIDERS THAT VOLUNTEER THEIR SERVICES AND THE COOPERATION OF BLUE RIDGE REGIONAL HOSPITAL", SAYS BRRH FOUNDATION EXECUTIVE DIRECTOR NANCY LINDEMAN, "TRPA WOULD NOT BE POSSIBLE WITHOUT OUR VOLUNTEERS, GRANT FUNDING AND PRIVATE DONATIONS."
4b (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4c (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4d Other program services. (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet$ 35,679,956
Form 990 (2010)
Form 990 (2010)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If “Yes,” complete Schedule AClick to see attachment.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors? Click to see attachment........
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If “Yes,” complete Schedule C, Part I..........
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities? If “Yes,” complete Schedule C,
Part II
.........................
4
 
No
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If “Yes,” complete Schedule C, Part III........................
5
 
 
6
Did the organization maintain any donor advised funds or any similar funds or accounts where donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If “Yes,” complete
Schedule D, Part I
Click to see attachment
.......................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas or historic structures? If “Yes,” complete Schedule D, Part IIClick to see attachment
...
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If “Yes,” complete Schedule D, Part III Click to see attachment....................
8
 
No
9
Did the organization report an amount in Part X, line 21; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If “Yes,”
complete Schedule D, Part IV
Click to see attachment
...................
9
 
No
10
Did the organization, directly or through a related organization, hold assets in term, permanent,or quasi-endowments? If “Yes,” complete Schedule D, Part VClick to see attachment
10
 
No
11
If the organization’s answer to any of the following questions is ‘Yes,’ then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable:
a
Did the organization report an amount for land, buildings, and equipment in Part X, line10? If “Yes,” complete Schedule D, Part VI.Click to see attachment
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VII.Click to see attachment
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VIII.Click to see attachment
11c
Yes
 
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part IX.Click to see attachment
11d
 
No
e
Did the organization report an amount for other liabilities in Part X, line 25? If “Yes,” complete Schedule D, Part X.Click to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If “Yes,” complete Schedule D, Part X.Click to see attachment
11f
Yes
 
12a
Did the organization obtain separate, independent audited financial statements for the tax year? If “Yes,” complete Schedule D, Parts XI, XII, and XIII Click to see attachment
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If “Yes,” and if the organization answered ‘No’ to line 12a, then completing Schedule D, Parts XI, XII, and XIII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If “Yes,” complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States?....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, and program service activities outside the United States? If “Yes,” complete Schedule F, Part I.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or assistance to any organization or entity located outside the U.S.? If “Yes,” complete Schedule F, Part II..
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or assistance to individuals located outside the U.S.? If “Yes,” complete Schedule F, Part III..
16
 
No
17
Did the organization report a total of more than $15,000, of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If “Yes,” complete Schedule G, Part I
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If “Yes,” complete Schedule G, Part II..........
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If “Yes,” complete Schedule G, Part III...................
19
 
No
Form 990 (2010)
Form 990 (2010)
Page 4
Part IV
Checklist of Required Schedules (continued)
20a
Did the organization operate one or more hospitals? If “Yes,” complete Schedule H..... Click to see attachment
20a
Yes
 
b
Did the organization attach its audited financial statement to this return? Note: All Form 990 filers that operate one or more hospitals must attach audited financial statements. ..... Click to see attachment
20b
Yes
 
21
Did the organization report more than $5,000 of grants and other assistance to governments and organizations in the United States on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II..
21
 
No
22
Did the organization report more than $5,000 of grants and other assistance to individuals in the United States on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III.....
22
 
No
23
Did the organization answer “Yes” to Part VII, Section A, questions 3, 4, or 5, about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If “Yes,” complete Schedule J................ Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer questions 24b–24d and complete Schedule K. If “No,” go to line 25................
24a
 
No
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
 
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds?
......................
24c
 
 
d
Did the organization act as an “on behalf of” issuer for bonds outstanding at any time during the year?...
24d
 
 
25a
Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If “Yes,” complete Schedule L, Part I...... Click to see attachment
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If “Yes,” complete Schedule L, Part I................ Click to see attachment
25b
 
No
26
Was a loan to or by a current or former officer, director, trustee, key employee, highly compensated employee, or disqualified person outstanding as of the end of the organization’s tax year? If “Yes,” complete Schedule L,
Part II
........................... Click to see attachment
26
 
No
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor, or a grant selection committee member, or to a person related to such an individual? If “Yes,” complete Schedule L, Part III............... Click to see attachment
27
 
No
28
Was the organization a party to a business transaction with one of the following parties? (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If “Yes,” complete Schedule L, Part IV ......................... Click to see attachment
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If “Yes,”
complete Schedule L, Part IV
................... Click to see attachment
28b
Yes
 
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or owner? If “Yes,” complete Schedule L, Part IV.. Click to see attachment
28c
 
No
29
Did the organization receive more than $25,000 in non-cash contributions? If “Yes,” complete Schedule M
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If “Yes,” complete Schedule M............
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If “Yes,” complete Schedule N,
Part I
...........................
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If “Yes,” complete Schedule N, Part II.......................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If “Yes,” complete Schedule R, Part I........ Click to see attachment
33
 
No
34
Was the organization related to any tax-exempt or taxable entity? If “Yes,” complete Schedule R, Parts II, III, IV, and V, line 1..................... Click to see attachment
34
Yes
 
35
Is any related organization a controlled entity within the meaning of section 512(b)(13)? .....
35
Yes
 
a
Did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If “Yes,” complete Schedule R, Part V, line 2... Click to see attachment
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If “Yes,” complete Schedule R, Part V, line 2........... Click to see attachment
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If “Yes,” complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11 and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2010)
Form 990 (2010)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response to any question in this Part V . . . . . . . . . .
Yes
No
1a
Enter the number reported in Box 3 of Form 1096. Enter -0- if not applicable. .......
1a
55
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable.
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and Tax Statements filed for the calendar year ending with or within the year covered by this return .....................
2a
471
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?

Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file. (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?.............................
3a
 
No
b
If “Yes,” has it filed a Form 990-T for this year? If “No,” provide an explanation in Schedule O.....
3b
 
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account or securities account)?.......................
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts.
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If “Yes” to line 5a or 5b, did the organization file Form 8886-T? ........
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible?..........
6a
 
No
b
If “Yes,” did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?........................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?....................
7a
 
No
b
If “Yes,” did the organization notify the donor of the value of the goods or services provided?.....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?...........................
7c
 
No
d
If “Yes,” indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?..........................
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?...................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?...............
7h
 
 
8
Sponsoring organizations maintaining donor advised funds and section 509(a)(3) supporting organizations. Did the supporting organization, or a donor advised fund maintained by a sponsoring organization, have excess business holdings at any time during the year?................
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the organization make any taxable distributions under section 4966?.........
9a
 
 
b
Did the organization make a distribution to a donor, donor advisor, or related person?......
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If “Yes,” enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note.
All 501(c)(29) organizations must list in Schedule O each state in which they are licensed to issue qualified health plans, the amount of reserves required by each state, and the amount of reserves the organization allocated to each state.
13a
 
 
b
Enter the aggregate amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans.
13b
 
c
Enter the aggregate amount of reserves on hand.
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
 
b
If "Yes," has it filed a Form 720 to report these payments? If “No,” provide an explanation in Schedule O..
14b
 
 
Form 990 (2010)
Form 990 (2010)
Page 6
Part VI
Governance, Management, and Disclosure For each “Yes” response to lines 2 through 7b below, and for a “No” response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response to any question in this Part VI . . . . . . . . . .
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year ..............
1a
11
b
Enter the number of voting members included in line 1a, above, who are independent .................
1b
6
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
 
No
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? ..
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed?
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Does the organization have members or stockholders? ................
6
Yes
 
7a
Does the organization have members, stockholders, or other persons who may elect one or more members of the governing body? .........................
7a
Yes
 
b
Are any decisions of the governing body subject to approval by members, stockholders, or other persons? ..
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .........................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If “Yes,” provide the names and addresses in Schedule O .....
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal
Revenue Code.)
Yes
No
10a
Does the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If “Yes,” does the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with those of the organization? ....
10b
 
 
11a
Has the organization provided a copy of this Form 990 to all members of its governing body before filing the form?
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review the Form 990. .....
12a
Does the organization have a written conflict of interest policy? If “No,” go to line 13.......
12a
Yes
 
b
Are officers, directors or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ...........................
12b
Yes
 
c
Does the organization regularly and consistently monitor and enforce compliance with the policy? If “Yes,” describe in Schedule O how this is done ....................
12c
Yes
 
13
Does the organization have a written whistleblower policy? ...............
13
Yes
 
14
Does the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line a or b, describe the process in Schedule O. (See instructions.)
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
Yes
 
b
If “Yes,” has the organization adopted a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and taken steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
Yes
 
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
NC
18
Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you make these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how), the organization makes its governing documents, conflict of interest policy, and financial statements available to the public.
20
State the name, physical address, and telephone number of the person who possesses the books and records of the organization: MediumBullet
JONATHAN SMITH
125 HOSPITAL DRIVE PO BOX 9
SPRUCE PINE,NC28777
(828) 766-1740
Form 990 (2010)
Form 990 (2010)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response to any question in this Part VII . . . . . . . . . .
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation, and current key employees. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the
organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organizations compensated any current or former officer, director, or trustee.
(A)
Name and Title
(B)
Average hours per week (describe hours for related organizations in Schedule O)
(C)
Position (check all that apply)
(D)
Reportable compensation from the organization (W- 2/1099-MISC)
(E)
Reportable compensation from related organizations (W- 2/1099-MISC)
(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(1) COURTNEY MAUZEY
CHAIRMAN
8.00 X   X       0 0 0
(2) KAY ROYER
VICE CHAIR
1.00 X   X       0 0 0
(3) RICHARD MONTAGUE
SECRETARY/TREASURER
2.00 X   X       0 0 0
(4) DAVID HOEPPNER MD
BOARD MEMBER
1.00 X           46,507 0 0
(5) JANICE BRUMIT
BOARD MEMBER
1.00 X           0 0 0
(6) JERRY CADE MD
BOARD MEMBER
.50 X           14,049 0 0
(7) CHARLES ALDRIDGE
BOARD MEMBER
1.50 X           0 0 0
(8) MARTHA TYNER
BOARD MEMBER
1.50 X           4,024 0 0
(9) BOB JONES
BOARD MEMBER
3.00 X           0 144,513 11,312
(10) BYRON PHILLIPS
BOARD MEMBER
2.00 X           0 0 0
(11) KEITH HOLTSCLAW
CEO: THROUGH AUG. 12, 2011
40.00 X   X       0 263,019 14,258
(12) OSCAR WEINMEISTER
CEO: BEGINNING AUG. 8, 2011
40.00 X   X       0 0 0
(13) JONATHAN SMITH
VP, OPERATIONS & FINANCE
40.00     X       103,463 0 10,066
(14) RUSSELL FLINT
STAFF PHYSICIAN
40.00         X   539,994 0 8,074
(15) SHEHLA KAHN
STAFF PHYSICIAN
40.00         X   317,738 0 15,403
(16) RICHARD RHEINBOLT
STAFF PHYSICIAN
40.00         X   247,830 0 12,581
(17) DAVID ROBINSON
STAFF PHYSICIAN
40.00         X   443,642 0 7,953
Form 990 (2010)
Form 990 (2010)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and Title
(B)
Average hours per week (describe hours for related organizations in Schedule O)
(C)
Position (check all that apply)
(D)
Reportable compensation from the organization (W- 2/1099-MISC)
(E)
Reportable compensation from related organizations (W- 2/1099-MISC)
(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(18) RYCKMAN CAPLAN
PHYSICIAN
40.00         X   285,824 0 7,905
























1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 2,003,071 407,532 87,552
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 in reportable compensation from the organizationMediumBullet23
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If “Yes,” complete Schedule J for such individual .............
3
 
No
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If “Yes,” complete Schedule J for such individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If “Yes,” complete Schedule J for such person .....
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization.
(A)
Name and business address
(B)
Description of services
(C)
Compensation
HARRY ERVINE JR MD
1048 BULLHEAD ROAD
SPARTA,NC28675
OBSTETRICIAN 302,843
MCCLURE CONSTRUCTION
PO BOX 1188
SPRUCE PINE,NC28777
LANDSCAPE & SNOW REMOVAL SERVICE 217,337
COMPREHENSIVE PAIN CONSULTANTS OF THE CA
26 GLEN COVE DR
ASHEVILLE,NC28704
PHYSICIAN 149,496
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 in compensation from the organization MediumBullet3
Form 990 (2010)
Form 990 (2010)
Page 9
Part VIII
Statement of Revenue
(A)
Total revenue
(B)
Related or
exempt
function
revenue
(C)
Unrelated
business
revenue
(D)
Revenue
excluded from
tax under sections
512, 513, or 514
Contributions, gifts, grants and other similar amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c  
d Related organizations...1d 381,762
e Government grants (contributions)1e 900
f All other contributions, gifts, grants, and
similar amounts not included above
1f
99,034
g Noncash contributions included in lines 1a-1f:$  
h Total. Add lines 1a-1f.......MediumBullet 481,696
 Program Service Revenue Business Code
2a PATIENT CARE REVENUE 621,400 39,960,668 39,960,668    
b ANCILLIARY REVENUES 900,099 21,618 21,618    
c
d
e
f All other program service revenue .        
g Total. Add lines 2a–2f........MediumBullet 39,982,286
 Other Revenue 3 Investment income (including dividends, interest
and other similar amounts).....MediumBullet 114,701     114,701
4 Income from investment of tax-exempt bond proceeds..MediumBullet        
5 Royalties............MediumBullet        
(i) Real (ii) Personal
6a Gross Rents 97,610 382,173
b Less: rental expenses 16,189  
c Rental income or (loss) 81,421 382,173
d Net rental income or (loss).......MediumBullet 463,594     463,594
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory 149,258  
b Less: cost or other basis and sales expenses   269
c Gain or (loss) 149,258 -269
d Net gain or (loss)..........MediumBullet 148,989     148,989
8a Gross income from fundraising events (not including
$  
of contributions reported on line 1c). See Part IV, line 18 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from fundraising events..MediumBullet      
9a Gross income from gaming activities.
See Part IV, line 19 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from gaming activities...MediumBullet        
10a Gross sales of inventory, less
returns and allowances .
a  
b Less: cost of goods sold ..b  
c Net income or (loss) from sales of inventory..MediumBullet        
Miscellaneous Revenue Business Code
11a MISCELLANEOUS INCOME 900,099 463,449 463,449    
b FOOD & VENDING 722,210 229,397 229,397    
c REBATES & DISCOUNTS 900,099 73,235 73,235    
d All other revenue ....        
e Total. Add lines 11a–11d ......MediumBullet 766,081
12 Total revenue. See Instructions....MediumBullet 41,957,347 40,748,367 0 727,284
Form 990 (2010)
Form 990 (2010)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A) but are not required to complete columns (B), (C), and (D).
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII.
(A)
Total expenses
(B)
Program service expenses
(C)
Management and general expenses
(D)
Fundraising expenses
1 Grants and other assistance to governments and organizations in the U.S. See Part IV, line 21    
2 Grants and other assistance to individuals in the U.S. See Part IV, line 22    
3 Grants and other assistance to governments, organizations, and individuals outside the U.S. See Part IV, lines 15 and 16    
4 Benefits paid to or for members    
5 Compensation of current officers, directors, trustees, and key employees .... 155,712 103,374 52,338  
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....        
7 Other salaries and wages 17,360,949 14,785,788 2,575,161  
8 Pension plan contributions (include section 401(k) and section 403(b) employer contributions) .... 317,442 269,826 47,616  
9 Other employee benefits ....... 2,209,071 1,877,710 331,361  
10 Payroll taxes ........... 1,303,960 1,108,366 195,594  
11 Fees for services (non-employees):        
a Management ......        
b Legal ......... 200,842   200,842  
c Accounting ........... 51,638   51,638  
d Lobbying ...........        
e Professional fundraising. See Part IV, line 17..    
f Investment management fees ......        
g Other .......... 2,725,211 2,316,429 408,782  
12 Advertising and promotion .... 78,560 66,776 11,784  
13 Office expenses ....... 6,075,262 5,163,996 911,266  
14 Information technology ...... 62,575 53,189 9,386  
15 Royalties ..        
16 Occupancy ........... 639,789 639,789    
17 Travel ............ 82,764 70,349 12,415  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ......        
19 Conferences, conventions, and meetings ....        
20 Interest ........... 690,130 690,130    
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization ..... 2,238,806 1,902,985 335,821  
23 Insurance .............. 660,613 561,521 99,092  
24 Other expenses. Itemize expenses not covered above. (Expenses grouped together and labeled miscellaneous may not exceed 5% of total expenses shown on line 25 below.)
a BAD DEBT EXPENSE 6,069,728 6,069,728    
b
c
d
e
f All other expenses        
25 Total functional expenses. Add lines 1 through 24f 40,923,052 35,679,956 5,243,096 0
26 Joint costs. Check here MediumBullet if following
SOP 98-2 (ASC 958-720). Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation
       
Form 990 (2010)
Form 990 (2010)
Page 11
Part X Balance Sheet
(A)
Beginning of year
(B)
End of year
Assets 1 Cash—non-interest-bearing .......... 9,025,018 1 8,663,067
2 Savings and temporary cash investments .......   2  
3 Pledges and grants receivable, net .........   3  
4 Accounts receivable, net ......... 4,797,425 4 5,046,548
5 Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L ..........   5  
6 Receivables from other disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B). Complete Part II of
Schedule L ..........   6  
7 Notes and loans receivable, net .............   7  
8 Inventories for sale or use .............. 693,232 8 706,202
9 Prepaid expenses and deferred charges ............ 166,482 9 134,590
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 57,488,605
b Less: accumulated depreciation. ..... 10b 26,956,865 31,391,460 10c 30,531,740
11 Investments—publicly traded securities ..........   11  
12 Investments—other securities. See Part IV, line 11 ......   12  
13 Investments—program-related. See Part IV, line 11 .. 6,286,587 13 6,263,254
14 Intangible assets .........   14  
15 Other assets. See Part IV, line 11 ........... 392,879 15 896,970
16 Total assets. Add lines 1 through 15 (must equal line 34)... 52,753,083 16 52,242,371
Liabilities 17 Accounts payable and accrued expenses . 2,458,111 17 2,144,927
18 Grants payable ..........   18  
19 Deferred revenue ..........   19  
20 Tax-exempt bond liabilities .......... 1,335,000 20 935,000
21 Escrow or custodial account liability. Complete Part IV of Schedule D..   21  
22 Payables to current and former officers, directors, trustees, key
employees, highest compensated employees, and disqualified
persons. Complete Part II of Schedule L..........   22  
23 Secured mortgages and notes payable to unrelated third parties .. 14,580,473 23 13,577,914
24 Unsecured notes and loans payable to unrelated third parties ....   24  
25 Other liabilities. Complete Part X of Schedule D..... 1,626,634 25 2,161,173
26 Total liabilities. Add lines 17 through 25..... 20,000,218 26 18,819,014
Net Assets or Fund Balance Organizations that follow SFAS 117, check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets ..... 32,752,865 27 33,423,357
28 Temporarily restricted net assets .....   28  
29 Permanently restricted net assets .....   29  
Organizations that do not follow SFAS 117, check here MediumBullet and complete lines 30 through 34.
30 Capital stock or trust principal, or current funds .....   30  
31 Paid-in or capital surplus, or land, building or equipment fund .....   31  
32 Retained earnings, endowment, accumulated income, or other funds   32  
33 Total net assets or fund balances ..... 32,752,865 33 33,423,357
34 Total liabilities and net assets/fund balances ..... 52,753,083 34 52,242,371
Form 990 (2010)
Form 990 (2010)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response to any question in this Part XI . . . . . . . . . .
1
Total revenue (must equal Part VIII, column (A), line 12) . . .
1
41,957,347
2
Total expenses (must equal Part IX, column (A), line 25) . . . . .
2
40,923,052
3
Revenue less expenses. Subtract line 2 from line 1 . . . .
3
1,034,295
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) . .
4
32,752,865
5
Other changes in net assets or fund balances (explain in Schedule O) . . . .
5
-363,803
6
Net assets or fund balances at end of year. Combine lines 3, 4, and 5 (must equal Part X, line 33, column (B)) . . . . . .
6
33,423,357
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response to any question in this Part XII . . . . . . . . . .
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?..
2a
 
No
b
Were the organization’s financial statements audited by an independent accountant?........
2b
Yes
 
c
If “Yes,” to 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
...........................
2c
Yes
 
d
If “Yes” to line 2a or 2b, check a box below to indicate whether the financial statements for the year were issued on a separate basis, consolidated basis, or both:
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133? ................
3a
 
No
b
If “Yes,” did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits. ..
3b
 
 
Form 990 (2010)
Additional Data


Software ID:  
Software Version:  
Form 990, Special Condition Description:
Special Condition Description
SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service
Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.
right arrow Attach to Form 990 or Form 990-EZ. right arrow See separate instructions.
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
BLUE RIDGE REGIONAL HOSPITAL INC
 
Employer identification number

56-1025032
Part I
Reason for Public Charity Status (All organizations must complete this part.) See instructions
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
f
g
(i) a person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the the supported organization? ................
11g(i)
 
 
(ii) a family member of a person described in (i) above? ......................
11g(ii)
 
 
(iii) a 35% controlled entity of a person described in (i) or (ii) above? ................
11g(iii)
 
 
h
(i)
Name of supported organization
(ii)
EIN
(iii)
Type of organization (described on lines 1- 9 above or IRC section (see instructions))
(iv)
Is the organization in col. (i) listed in your governing document?
(v)
Did you notify the organization in col. (i) of your support?
(vi)
Is the organization in col. (i) organized in the U.S.?
(vii)
Amount of support?
Yes No Yes No Yes No
Total                  

For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 2
Part II
Support Schedule for Organizations Described in IRC 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year(or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....            
2 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......            
3 The value of services or facilities furnished by a governmental unit to the organization without charge..            
4 Total. Add lines 1 through 3..            
5 The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..            
6 Public Support. Subtract line 5 from line 4.            
Section B. Total Support
Calendar year(or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
7 Amounts from line 4..            
8 Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
9 Net income from unrelated business activities, whether or not the business is regularly carried on..            
10 Other income. (Explain in Part IV.) Do not include gain or loss from the sale of capital assets..            
11 Total support (Add lines 7 through 10).            
12
12
 
13
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
18
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 3
Part III
Support Schedule for Organizations Described in IRC 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year(or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .            
2 Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......            
3 Gross receipts from activities that are not an unrelated trade or business under section 513..            
4 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...            
5 The value of services or facilities furnished by a governmental unit to the organization without charge..            
6 Total. Add lines 1 through 5.            
7a Amounts included on lines 1, 2, and 3 received from disqualified persons...            
b Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.            
c Add lines 7a and 7b..            
8 Public Support (Subtract line 7c from line 6.)            
Section B. Total Support
Calendar year (or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
9 Amounts from line 6...            
10a Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
b Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.            
c Add lines 10a and 10b.            
11 Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.            
12 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)            
13 Total support (Add lines 9, 10c, 11 and 12.).            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 4
Part IV
Supplemental Information. Supplemental Information. Complete this part to provide the explanation required by Part II, line 10; Part II, line 17a or 17b; or Part III, line 12. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
 
Explanation
 
 
 
 
Schedule A (Form 990 or 990-EZ) 2010

Additional Data


Software ID:  
Software Version:  
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors
Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
OMB No. 1545-0047
2010
Name of organization
BLUE RIDGE REGIONAL HOSPITAL INC
 
Employer identification number

56-1025032
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ





Form 990-PF




Check if your organization is covered by the General Rule or a Special Rule.  
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
General Rule—
Special Rules
......................... Arrow Bullet   $    
Caution. An Organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2 of its Form 990, or check the box in the heading of its
Form 990-EZ, or on line 2 of its Form 990-PF, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).
For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.
Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2010)

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)
Page 1 of 1 of Part I
Name of organization
BLUE RIDGE REGIONAL HOSPITAL INC
 
Employer identification number

56-1025032
Part I
Contributors (see Instructions)
     
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Aggregate contributions
(d)
Type of contribution
RESTRICTED
RESTRICTED
 

     
RESTRICTED
RESTRICTED  
RESTRICTED, RESTRICTED   RESTRICTED

$RESTRICTED




(Complete Part II if there is
a noncash contribution.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Aggregate contributions
(d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Aggregate contributions
(d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Aggregate contributions
(d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Aggregate contributions
(d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Aggregate contributions
(d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)
Page 1 of 1 of Part II
Name of organization
BLUE RIDGE REGIONAL HOSPITAL INC
 
Employer identification number

56-1025032
Part II
Noncash Property (see Instructions)
     
(a) No.
from
Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(see instructions)
(d)
Date received
 
$    
(a) No.
from
Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(see instructions)
(d)
Date received
 
$    
(a) No.
from
Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(see instructions)
(d)
Date received
 
$    
(a) No.
from
Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(see instructions)
(d)
Date received
 
$    
(a) No.
from
Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(see instructions)
(d)
Date received
 
$    
(a) No.
from
Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(see instructions)
(d)
Date received
 
$    
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)
Page 1 of 1 of Part III
Name of organization
BLUE RIDGE REGIONAL HOSPITAL INC
 
Employer identification number

56-1025032
Part III
Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
aggregating more than $1,000 for the year. (Complete columns (a) through (e) and the following line entry.)
For organizations completing Part III, enter the total of exclusively religious, charitable, etc.,
contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet $  
(a) No.
from
Part I
(b)
Purpose of gift
(c)
Use of gift
(d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I
(b)
Purpose of gift
(c)
Use of gift
(d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I
(b)
Purpose of gift
(c)
Use of gift
(d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I
(b)
Purpose of gift
(c)
Use of gift
(d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Additional Data


Software ID:  
Software Version:  
SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11, or 12.
SchDMd Bullet Attach to Form 990. SchDMd Bullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
BLUE RIDGE REGIONAL HOSPITAL INC
 
Employer identification number

56-1025032
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .......    
2 Aggregate contributions to (during year) ...    
3 Aggregate grants from (during year) ...    
4 Aggregate value at end of year .......    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds may be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit. ...................................
Part II
Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a–2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ....................... 2a  
b Total acreage restricted by conservation easements .................. 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 8/17/06 ........ 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the taxable year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................
6
Staff and volunteer hours devoted to monitoring, inspecting and enforcing conservation easements during the year SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section
170(h)(4)(B)(i) and 170(h)(4)(B)(ii)? ....................................
9
In Part XIV, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under SFAS 116, not to report in its revenue statement and balance sheet works of
art, historical treasures, or other similar assets held for public exhibition, education or research in furtherance of public service,
provide, in Part XIV, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under SFAS 116, to report in its revenue statement and balance sheet works of art,
historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service,
provide the following amounts relating to these items:
(i)
Revenues included in Form 990, Part VIII, line 1 ........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ..............................SchDMd Bullet $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 relating to these items:
a
Revenues included in Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990
Cat. No. 52283D
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s accession and other records, check any of the following that are a significant use of its collection
items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIV.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b
If "Yes," explain the arrangement in Part XIV and complete the following table:
Amount
c Beginning balance ................................. 1c  
d Additions during the year .............................. 1d  
e Distributions during the year ............................. 1e  
f Ending balance ................................... 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21? .....................
b
If “Yes,” explain the arrangement in Part XIV.
Part V
Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.
(a)Current Year (b)Prior Year (c)Two Years Back (d)Three Years Back (e)Four Years Back
1a Beginning of year balance ....      
b Contributions ........      
c Investment earnings or losses ...      
d Grants or scholarships .....      
e Other expenditures for facilities
and programs ........
     
f Administrative expenses ....      
g End of year balance ......      
2
Provide the estimated percentage of the year end balance held as:
a
Board designated or quasi-endowment: SchDMd Bullet  
b
Permanent endowment: SchDMd Bullet  
c
Term endowment: SchDMd Bullet  
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations ........................
3a(i)
 
 
(ii) related organizations ........................
3a(ii)
 
 
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
Describe in Part XIV the intended uses of the organization's endowment funds.
Part VI
Investments—Land, Buildings, and Equipment. See Form 990, Part X, line 10.
Description of investment (a) Cost or other basis (investment) (b)Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .................   2,498,577 2,498,577
b Buildings ................   30,709,659 8,584,808 22,124,851
c Leasehold improvements ............   340,405 216,372 124,033
d Equipment ................   23,315,558 18,155,685 5,159,873
e Other .................   624,406   624,406
Total. Add lines 1a-1e. (Column (d) should equal Form 990, Part X, column (B), line 10(c).)........SchDMdBullet 30,531,740
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 3
Part VII
Investments—Other Securities. See Form 990, Part X, line 12.
(a) Description of security or category
(including name of security)
(b)Book value (c) Method of valuation:
Cost or end-of-year market value
(1)Financial derivatives    
(2)Closely-held equity interests    
Other








Total. (Column (b) should equal Form 990, Part X, col.(B) line 12.)Small Bullet  
Part VIII
Investments—Program Related. See Form 990, Part X, line 13.
(a) Description of investment type (b) Book value (c) Method of valuation:
Cost or end-of-year market value
(1) INVESTMENT IN DME 918,841 C
(2) INVESTMENT HELD BY MISSION ST. JOSEPH 5,344,413 C







Total. (Column (b) should equal Form 990, Part X, col.(B) line 13.)Small Bullet 6,263,254
Part IX
Other Assets. See Form 990, Part X, line 15.
(a) Description (b) Book value








Total. (Column (b) should equal Form 990, Part X, col.(B) line 15.)...........Small Bullet  
Part X
Other Liabilities. See Form 990, Part X, line 25.
1.(a) Description of Liability (b) Amount
Federal Income Taxes  
ESTIMATED THIRD PARTY PAYABLES 1,198,209
CAPITAL LEASES 962,964







Total. (Column (b) should equal Form 990, Part X, col.(B) line 25.)Small Bullet 2,161,173
2. Fin 48 (ASC 740) Footnote. In Part XIV, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC740).
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 4
Part XI Reconciliation of Change in Net Assets from Form 990 to Financial Statements
1 Total revenue (Form 990, Part VIII, column (A), line 12) .................... 1 41,957,347
2 Total expenses (Form 990, Part IX, column (A), line 25) ..................... 2 40,923,052
3 Excess or (deficit) for the year. Subtract line 2 from line 1 ............. 3 1,034,295
4 Net unrealized gains (losses) on investments .......................... 4 -260,572
5 Donated services and use of facilities ............................. 5  
6 Investment expenses ................................... 6  
7 Prior period adjustments .................................. 7  
8 Other (Describe in Part XIV) ................................. 8 -103,231
9 Total adjustments (net). Add lines 4 - 8 ............................. 9 -363,803
10 Excess or (deficit) for the year per financial statements. Combine lines 3 and 9 ......... 10 670,492
Part XII Reconciliation of Revenue per Audited Financial Statements With Revenue per Return
1 Total revenue, gains, and other support per audited financial statements ....... 1 41,517,052
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains on investments .......... 2a -260,572
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIV): ............ 2d 19,608
e Add lines 2a through 2d ..................... 2e -240,964
3 Subtract line 2e from line 1..................... 3 41,758,016
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b . 4a  
b Other (Describe in Part XIV): ........... 4b 199,331
c Add lines 4a and 4b....................... 4c 199,331
5 Total Revenue. Add lines 3 and 4c. (This should equal Form 990, Part I, line 12.) ...... 5 41,957,347
Part XIII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
1 Total expenses and losses per audited financial statements ............. 1 40,846,560
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities .......... 2a  
b Prior year adjustments .............. 2b  
c Other losses ................ 2c  
d Other (Describe in Part XIV): ............ 2d 122,839
e Add lines 2a through 2d...................... 2e 122,839
3 Subtract line 2e from line 1..................... 3 40,723,721
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b .. 4a  
b Other (Describe in Part XIV): ............ 4b 199,331
c Add lines 4a and 4b....................... 4c 199,331
5 Total expenses. Add lines 3 and 4c. (This should equal Form 990, Part I, line 18.) ...... 5 40,923,052
Part XIV
Supplemental Information
Complete this part to provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X; Part XI, line 8; Part XII, lines 2d and 4b; and Part XIII, lines 2d and 4b. Also complete this part to provide any additional information.
Identifier Return Reference Explanation
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: INCOME TAXES- THE HOSPITAL AND THE FOUNDATION HAVE BEEN RECOGNIZED AS ORGANIZATIONS EXEMPT FROM FEDERAL INCOME TAX UNDER INTERNAL REVENUE CODE SECTION 501(A) AS ORGANIZATIONS DESCRIBED IN SECTION 501(C)(3) AND, THEREFORE, RELATED INCOME IS GENERALLY NOT SUBJECT TO FEDERAL OR STATE INCOME TAXES. THE HOSPITAL INCURS "UNRELATED BUSINESS INCOME TAX" ON THE INVESTMENT IN BLUE RIDGE HOME CARE UNDER THE INTERNAL REVENUE CODE. FISCAL YEARS ENDING ON OR AFTER SEPTEMBER 30, 2008 REMAIN SUBJECT TO EXAMINATION BY FEDERAL AND STATE TAX AUTHORITIES.
PART XI, LINE 8 - OTHER ADJUSTMENTS:   NET OF CONSOLIDATED ORGANIZATION -103,231.
PART XII, LINE 2D - OTHER ADJUSTMENTS:   REVENUES OF CONSOLIDATED ORGANIZATION 19,608.
PART XII, LINE 4B - OTHER ADJUSTMENTS:   TAXES AND OTHER EXPENSES NETTED W/ REVENUES 199,331.
PART XIII, LINE 2D - OTHER ADJUSTMENTS:   EXPENSES OF CONSOLIDATED ORGANIZATION 122,839.
PART XIII, LINE 4B - OTHER ADJUSTMENTS:   TAXES AND OTHER EXPENSES NETTED W/ REVENUES 199,331.
Schedule D (Form 990) 2010

Additional Data


Software ID:  
Software Version:  




SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, question 20.
MediumBullet Attach to Form 990. MediumBullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
BLUE RIDGE REGIONAL HOSPITAL INC
 
Employer identification number

56-1025032
Part I
Charity Care and Certain Other Community Benefits at Cost
Yes
No
1a
Does the organization have a charity care policy? If "No," skip to question 6a...........
1a
Yes
 
b
If "Yes," is it a written policy? .......................
1b
Yes
 
2
If the organization has multiple hospitals, indicate which of the following best describes application of the charity care policy to the various hospitals.
3
Answer the following based on the charity care eligibility criteria that applies to the largest number of the organization's patients.
a
Does the organization use Federal Poverty Guidelines (FPG) to determine eligibility for providing free care to low
income individuals? If "Yes," indicate which of the following is the FPG family income limit for eligibility for free care:
3a
Yes
 
b
Does the organization use FPG to determine eligibility for providing discounted care to low income individuals? If
"Yes," indicate which of the following is the family income limit for eligibility for discounted care: .....
3b
Yes
 
c
If the organization does not use FPG to determine eligibility, describe in Part VI the income based criteria for determining eligibility for free or discounted care. Include in the description whether the organization uses an asset test or other threshold, regardless of income, to determine eligibility for free or discounted care.
4
Does the organization's policy provide free or discounted care to the "medically indigent"? ......
4
Yes
 
5a
Does the organization budget amounts for free or discounted care provided under its charity care policy? ...
5a
Yes
 
b
If "Yes," did the organization's charity care expenses exceed the budgeted amount?.........
5b
 
No
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discounted
care to a patient who was eligibile for free or discounted care?...............
5c
 
 
6a
Does the organization prepare an annual community benefit report?.............
6a
Yes
 
6b
If "Yes," does the organization make it available to the public? ..............
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Charity Care and Certain Other Community Benefits at Cost
Charity Care and
Means-Tested Government Programs
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Charity care at cost (from
Worksheets 1 and 2) ..
    349,468   349,468 1.000 %
b Unreimbursed Medicaid (from
Worksheet 3, column a) .
    4,268,477 3,387,981 880,496 2.530 %
c Unreimbursed costs—other means-tested government programs (from Worksheet 3, column b) ....            
dTotal Charity Care and
Means-Tested Government Programs .....
    4,617,945 3,387,981 1,229,964 3.530 %
Other Benefits
e Community health improvement
services and community
benefit operations (from
(Worksheet 4) ....
    883,847 558,203 325,644 0.930 %
f Health professions education
(from Worksheet 5) ..
    2,289,100   2,289,100 6.570 %
g Subsidized health services
(from Worksheet 6) ..
           
h Research (from Worksheet 7)            
i Cash and in-kind contributions
to community groups
(from Worksheet 8) ..
    502,000 107,300 394,700 1.130 %
jTotal Other Benefits ...     3,674,947 665,503 3,009,444 8.630 %
kTotal. Add lines 7d and 7j. ..     8,292,892 4,053,484 4,239,408 12.160 %
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 2
Part II
Community Building Activities Complete this table if the organization conducted any community building activities.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue
(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing            
2 Economic development     35,000   35,000 0.100 %
3 Community support            
4 Environmental improvements            
5 Leadership development and training for community members            
6 Coalition building            
7 Community health improvement advocacy     11,840   11,840 0.030 %
8 Workforce development     134,000   134,000 0.380 %
9 Other            
10 Total     180,840   180,840 0.510 %
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Does the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense (at cost).....
2
2,603,939
3
Enter the estimated amount of the organization's bad debt expense (at cost) attributable to patients eligible under the organization's charity care policy ..
3
849,275
4
Provide in Part VI the text of the footnote to the organization's financial statements that describes bad debt expense. In addition, describe the costing methodology used in determining the amounts reported on lines 2 and 3, and rationale for including a portion of bad debt amounts as community benefit.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
12,161,729
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
10,017,716
7
Subtract line 6 from line 5. This is the surplus or (shortfall)........
7
2,144,013
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.
Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.
Check the box that describes the method used:
Section C. Collection Practices
9a
Does the organization have a written debt collection policy? ...............
9a
Yes
 
b
If "Yes," does the organization's collection policy contain provisions on the collection practices to be followed for patients who are known to qualify for charity care or financial assistance? Describe in Part VI......
9b
Yes
 
Part IV
Management Companies and Joint Ventures
(a) Name of entity (b) Description of primary
activity of entity
(c) Organization's
profit % or stock
ownership %
(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership%
(e) Physicians'
profit % or stock
ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 3
Part VFacility Information
Section A. Hospital Facilities
(list in order of size, measured by total revenue per facility, from largest to smallest)
How many hospital facilities did the organization operate during the tax year?1
Name and address
Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital Research Facility ER-24Hours ER-Other Other (Describe)
1 BLUE RIDGE REGIONAL HOSPITAL
125 HOSPITAL DRIVE
SPRUCE PINE,NC28777
X X         X    
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices.

(Complete a separate Section B for each of the hospital facilities listed in Part V, Section A)
Name of Hospital Facility:NA FOR 2010
Line Number of Hospital Facility (from Schedule H, Part V, Section A):1

Yes No
Community Health Needs Assessment (Lines 1 through 7 are optional for 2010)
1 During the tax year or any prior tax year, did the hospital facility conduct a community health needs assessment (“Needs Assessment”)? If “No,” skip to question 8. ..................... 1    
If “Yes,” indicate what the Needs Assessment describes (check all that apply):
a A definition of the community served by the hospital facility
b Demographics of the community
c Existing health care facilities and resources within the community that are available to respond to the health needs of the community
d How data was obtained
e The health needs of the community
f Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups
g The process for identifying and prioritizing community health needs and services to meet those needs
h The process for consulting with persons representing the community’s interests
i Information gaps that limit the hospital facility’s ability to assess all of the community’s health needs
j Other (describe in Part VI)
2 Indicate the tax year the hospital facility last conducted a Needs Assessment: 20  
3 In conducting its most recent Needs Assessment, did the hospital facility take into account input from persons who represent the community served by the hospital facility? If “Yes,” describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted. 3    
4 Was the hospital facility’s Needs Assessment conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI............................ 4    
5 Did the hospital facility make its Needs Assessment widely available to the public? ........... 5    
If “Yes,” indicate how the Needs Assessment was made widely available (check all that apply):
a Hospital facility’s website
b Available upon request from the hospital facility
c Other (describe in Part VI)
6 If the hospital facility addressed needs identified in its most recently conducted Needs Assessment, indicate how (check all that apply):
a Adoption of an implementation strategy to address the health needs of the hospital facility’s community
b Execution of the implementation strategy
c Development of a community benefit plan for the facility
d Participation in community-wide community benefit plan
e Inclusion of a community benefit section in operational plans
f Adoption of a budget for provision of services that address the needs identified in the CHNA
g Prioritization of health needs in the community
h Prioritization of services that the hospital facility will undertake to meet health needs in its community
i Other (describe in Part VI)
7 Did the hospital facility address all of the needs identified in its most recently conducted Needs Assessment? If “No,” explain in Part VI which needs it has not addressed together with the reasons why it has not addressed such needs. 7    
Financial Assistance Policy
Did the hospital facility have in place during the tax year a written financial assistance policy that:
8 Explains eligibility criteria for financial assistance, and whether such assistance includes free or discounted care? 8    
9 Used federal poverty guidelines (FPG) to determine eligibility for providing free care to low incomeindividuals?.. 9    
If “Yes,” indicate the FPG family income limit for eligibility for free care:   %
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 5
Part VFacility Information (continued)

Yes No
10 Used FPG to determine eligibility for providing discounted care to low income individuals?......... 10    
If “Yes,” indicate the FPG family income limit for eligibility for discounted care:   %
11 Explained the basis for calculating amounts charged to patients?................. 11    
If “Yes,” indicate the factors used in determining such amounts (check all that apply):
a Income level
b Asset level
c Medical indigency
d Insurance status
e Uninsured discount
f Medicaid/Medicare
g State regulation
h Other (describe in Part VI)
12 Explained the method for applying for financial assistance?................... 12    
13 Included measures to publicize the policy within the community served by the hospital facility?....... 13    
If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
a The policy was posted at all times on the hospital facility’s web site
b The policy was attached to all billing invoices
c The policy was posted in the hospital facility’s emergency rooms or waiting rooms
d The policy was posted in the hospital facility’s admissions offices
e The policy was provided, in writing, to patients upon admission to the hospital facility
f The policy was available upon request
g Other (describe in Part VI)
Billing and Collections
14 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy that explained actions the hospital facility may take upon non-payment?........ 14    
15 Check all of the following collection actions against a patient that were permitted under the hospital facility's policies at any time during the tax year:
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments or arrests
e Other (describe in Part VI)
16 Did the hospital facility engage in or authorize a third party to engage in any of the following collection actions during the tax year?................................... 16    
If “Yes,” check all collection actions in which the hospital facility or a third party engaged (check all that apply):
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments
e Other (describe in Part VI)
17 Indicate which actions the hospital facility took before initiating any of the collection actions checked in question 16 (check all that apply):
a Notified patients of the financial assistance policy upon admission
b Notified patients of the financial assistance policy prior to discharge
c Notified patients of the financial assistance policy in communications with the patients regarding the patients’ bills
d Documented its determination of whether a patient who applied for financial assistance under the financial assistance policy qualified for financial assistance
e Other (describe in Part VI)
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 6
Part VFacility Information (continued)

Policy Relating to Emergency Medical Care
Yes No
18 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.......... 18    
If “No,” indicate the reasons why (check all that apply):
a The hospital facility did not provide care for any emergency medical conditions
b The hospital facility did not have a policy relating to emergency medical care
c The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)
d Other (describe in Part VI)
Charges for Medical Care
19 Indicate how the hospital facility determined the amounts generally billed to individuals who had insurance covering emergency or other medically necessary care (check all that apply):
a The hospital facility used the lowest negotiated commercial insurance rate for those services at the hospital facility
b The hospital facility used the average of the three lowest negotiated commercial insurance rates for those services at the hospital facility
c The hospital facility used the Medicare rate for those services
d Other (describe in Part VI)
20 Did the hospital facility charge any of its patients who were eligible for assistance under the hospital facility’s financial assistance policy, and to whom the hospital facility provided emergency or other medically necessary services, more than the amounts generally billed to individuals who had insurance covering such care?......... 20    
If “Yes,” explain in Part VI.
21 Did the hospital facility charge any of its patients an amount equal to the gross charge for services provided to that patient?................................... 21    
If “Yes,” explain in Part VI.
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 7
Part VFacility Information (continued)

Section C. Other Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, measured by total revenue per facility, from largest to smallest)
How many non-hospital facilities did the organization operate during the tax year?  
Name and address Type of Facility (Describe)
1
2
3
4
5
6
7
8
9
10
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 8
Part VI
Supplemental Information
Complete this part to provide the following information.
1 Required descriptions. Provide the description required for Part I, lines 3c, 6a, and 7; Part II; Part III, lines 4, 8, and 9b; and Part V, Section B, lines 1j, 2, 4c, 6i, 7, 11i, 13i, 17l, 18l, 19e, 21d, 25, and 26.
2 Community health needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any community health needs assessments reported in Part V, Section B.
3 Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4 Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5 Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6 Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7 State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
Identifier ReturnReference Explanation
    PART I, LINE 7: THE ORGANIZATION USED AN INTERNAL COST ACCOUNTING PERCENTAGE TO DETERMINE THE COST-TO-CHARGE RATIO.
    PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 6069728.
    PART II: SERVING THE COMMUNITY FOR OVER 55 YEARS, BLUE RIDGE REGIONAL HOSPITAL PLAYS A VITAL ROLE IN THE DEVELOPMENT AND SUPPORT OF THE REGION IT SERVES. BLUE RIDGE REGIONAL HOSPITAL PROVIDES FACILITY SPACE FOR MEETINGS AND RESOURCES THROUGH THE AMERICAN CANCER SOCIETY INCLUDING A PATIENT RESOURCE ROOM AND BI-MONTHLY LOOK GOOD FEEL BETTER CLASSES. BLUE RIDGE REGIONAL HOSPITAL PROVIDES PRIVILEGES AND SPACES FOR VISITING SPECIALTY PHYSICIANS ON A REGULAR BASIS. THIS ARRANGEMENT ALLOWS COMMUNITY RESIDENTS TO RECEIVE NEEDED SPECIALTY CARE WITHOUT HAVING TO TRAVEL 50 OR MORE MILES ONE WAY. THIS SPACE IS PROVIDED AT MINIMAL COST TO THE VISITING PHYSICIANS TO PROVIDE COMFORT AND CONVENIENCE TO PATIENTS IN THE COMMUNITY. EMPLOYEES AT BLUE RIDGE REGIONAL HOSPITAL PARTICIPATE AND ARE MEMBERS OF MULTIPLE AGENCIES THAT SERVE THE COMMUNITY INCLUDING LOCAL CHAMBER OF COMMERCE BOARDS, HEALTH PARTNERSHIP BOARDS, RELAY FOR LIFE, LOCAL NON-PROFIT BOARDS INCLUDING THE CENTER FOR RURAL HEALTH INNOVATION, LOCAL CHAPTERS OF THE COMMUNITY FOUNDATION OF WESTERN NORTH CAROLINA, GRAHAMS CHILDREN HEALTH AND MANY OTHER AGENCIES.ECONOMIC DEVELOPMENT - A MEMBER OF THE EXECUTIVE TEAM WHO SERVES AS CHAIRMAN OF THE LOCAL ECONOMIC DEVELOPMENT COMMISSION AND FOUNDING CHAIRMAN OF THE LOCAL PARTNERSHIP FOR CHILDREN, WORKS DILIGENTLY TO FIND OPPORTUNITIES TO BRING MORE BUSINESS & JOBS TO THE PEOPLE OF OUR COMMUNITY, THUS PROVIDING A GREATER LIFE POTENTIAL FOR THOSE IN NEED.COMMUNITY HEALTH IMPROVEMENT ADVOCACY - BLUE RIDGE REGIONAL HOSPITAL PROMOTES COMMUNITY HEALTH IMPROVEMENT BY ORGANIZING THE OPERATION MEDICINE CABINET, WHICH SERVES TO INFORM MEMBERS OF THE LOCAL AND SURROUNDING REGIONS ABOUT AVAILABLE HEALTH CARE PROGRAMS IN OUR COMMUNITY.WORKFORCE DEVELOPMENT - AS AN UNDERSERVED COMMUNITY WITH EVIDENT MEDICAL SHORTAGE IN ALL AREAS OF GENERAL AND SPECALITY HEATHCARE, BLUE RIDGE STRIVES TO RECRUIT, OBTAIN AND RETAIN PHYSICIANS AND OTHER HEATHCARE PROVIDERS TO PROVIDE SERVICES FOR MEMBERS OF THE SURROUNDING COMMUNITIES. THIS YEAR, WE RECRUITED FOR AN OBGYN, HOME HEALTH THERAPIST, OTHOPEDIC SURGEON, GENERAL SURGEON, AND MULTIPLE GENERAL PRACTITIONERS. FOR THE GROWING NEED OF PHYSICAL THERAPY, WE ALSO PROVIDED EMPLOYMENT OPPORTUNITIES FOR PHYSICIAL THERAPY INTERNS.
    PART III, LINE 4: WORKSHEET 2 OF THE 2010 SCHEDULE H INSTRUCTIONS WAS USED TO COMPUTE A COST-TO-CHARGES RATIO USED TO CALCULATE BAD DEBT AT COST FOR PURPOSES OF PART III, LINE 2.THE ORGANIZATION'S CHARITY CARE OPERATES ON A SLIDING SCALE, THE ORGANIZATION ESTIMATES THAT 50% OF THE SELF-PAY WRITTEN OFF COULD BE ATTRIBUTABLE TO CHARITY CARE.
    PART III, LINE 8: THE COSTING METHOLODOLY USED WAS IN ACCORDANCE OF MEDICARE COST REPORTING.
    PART III, LINE 9B: PATIENTS MUST APPLY FOR CHARITY CARE FOR EACH HOSPITAL VISIT. SERVICES MUST ALREADY BE RENDERED FOR THEM TO APPLY FOR CHARTIY CARE. IF THEY QUALIFY FOR LESS THAN 100% OF THE WRITE-OFF, WE EITHER COLLECT FROM THE PATIENT OR SET THEM UP ON A PAYMENT PLAN.
    PART VI, LINE 2: BLUE RIDGE REGIONAL HOSPITAL STRIVES TO PROVIDE RELEVANT AND NEEDED SERVICES TO THE PATIENTS IN OUR REGION. THROUGH A DUAL SURVEY PROCESS OF SPEAKING WITH PATIENTS SERVED, BLUE RIDGE REGIONAL HOSPITAL CAN ASSESS PATIENTS NEEDS AND ENHANCE OR CREATE A SERVICE LINE FOR THE COMMUNITY.
    PART VI, LINE 3: BLUE RIDGE REGIONAL HOSPITAL STRIVES TO INFORM PATIENTS OF POTENTIAL ELIGIBILITY FOR ASSISTANCE AT EVERY POINT OF PATIENT CONTACT INCLUDING: PATIENT REGISTRATION, THROUGH PATIENT COUNSELORS, AND THROUGH ADVERTISEMENTS IN LOCAL MEDIA OUTLETS INCLUDING PAPERS. ALSO, BLUE RIDGE REGIONAL HOSPITAL MAKES THE ENTIRE CHARITY CARE POLICY VISIBLE ON OUR WEBSITE AT WWW.BLUERIDGEHOSPITAL.ORG.
    PART VI, LINE 4: BLUE RIDGE REGIONAL HOSPITAL SERVES THE RURAL MOUNTAINOUS AREA OF MITCHELL, YANCEY, LOWER AVERY AND UPPER MCDOWELL COUNTIES IN WESTERN NORTH CAROLINA. THE POPULATION WE SERVE IS A LARGELY INDIGENT POPULATION AND AN EVER-INCREASING ELDERLY POPULATION. IN 2011 BLUE RIDGE REGIONAL HOSPITAL PROVIDED $18.74 MILLION IN UNCOMPENSATED CARE TO THE COMMUNITY IT SERVES. IN 2011 MORE THAN 69% OF THE PATIENT POPULATION WAS MEDICAID, MEDICARE OR SELF-PAY PATIENTS.
    PART VI, LINE 6: THE MAJORITY OF BLUE RIDGE REGIONAL HOSPITAL'S GOVERNING BODY IS COMPRISED OF PERSONS WHO RESIDE IN THE ORGANIZATION'S PRIMARY SERVICE AREA AND WHO ARE NEITHER EMPLOYEES OR INDEPENDENT CONTRACTORS OF THE ORGANIZATION NOR FAMILY MEMBERS THEREOF. BLUE RIDGE REGIONAL HOSPITAL EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY FOR SOME OR ALL OF ITS DEPARTMENTS. IN 2011, WE PROVIDED OVER $17.9 MILLION IN UNCOMPENSATED CARE AND EXPECT THAT NUMBER TO INCREASE THIS YEAR. IN 2012 WE PLAN A 5K EVENT, MULTIPLE HEALTHY LECTURES AND SCREENING EVENTS, FURTHER SUPPORT OF ORGANIZATIONS SUCH AS THE AMERICAN CANCER SOCIETY AND THE RED CROSS AS WELL AS CONTINUED SPONSORSHIPS MEETING COMMUNITY NEEDS.
    PART VI, LINE 7: BLUE RIDGE REGIONAL HOSPITAL IS A SINGLE MEMBER HOSPITAL WITHIN THE MISSION HEALTH SYSTEM, SERVING WESTERN NORTH CAROLINA FOR MORE THAN 125 YEARS.
REPORTS FILED WITH STATES PART VI, LINE 7 NC
Schedule H (Form 990) 2010
Additional Data


Software ID:  
Software Version:  
Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet Complete if the organization answered "Yes" to Form 990,
Part IV, question 23.
SchJMediumBullet Attach to Form 990. SchJMediumBullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
BLUE RIDGE REGIONAL HOSPITAL INC
 
Employer identification number

56-1025032
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement orprovision of all the expenses described above? If "No," complete Part III to explain....
1b
 
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
officers, directors, trustees, and the CEO/Executive Director, regarding the items checked in line 1a? ....
2
 
 
3
Indicate which, if any, of the following the organization uses to establish the compensation of the
organization's CEO/Executive Director. Check all that apply.
4
During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? ...............
4a
 
No
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? ........
4b
 
No
c
Participate in, or receive payment from, an equity-based compensation arrangement? ........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3) and 501(c)(4) organizations only must complete lines 5-9.
5
For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ...........................
5a
 
No
b
Any related organization? .........................
5b
 
No
If "Yes," to line 5a or 5b, describe in Part III.
6
For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization? ...........................
6a
 
No
b
Any related organization? .........................
6b
 
No
If "Yes," to line 6a or 6b, describe in Part III.
7
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
 
No
8
Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regs. section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................
8
 
No
9
If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990
Cat. No. 50053T
Schedule J (Form 990) 2010

Schedule J (Form 990) 2010
Page 2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use Schedule J-1 if additional space needed.
For each individual whose compensation must be reported in Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.

Note. The sum of columns (B)(i)-(iii) must equal the applicable column (D) or column (E) amounts on Form 990, Part VII, line 1a.
(A) Name (B) Breakdown of W-2 and/or 1099-MISC compensation (C) Retirement and other deferred compensation (D) Nontaxable
benefits
(E) Total of columns
(B)(i)-(D)
(F) Compensation
reported in prior
Form 990 or
Form 990-EZ
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
(1) BOB JONES (i)
(ii)
0
129,210
0
15,303
0
0
0
0
0
11,312
0
155,825
0
0
(2) KEITH HOLTSCLAW (i)
(ii)
0
213,024
0
49,995
0
0
0
6,482
0
7,776
0
277,277
0
0
(3) RUSSELL FLINT (i)
(ii)
369,959
0
170,035
0
0
0
0
0
8,074
0
548,068
0
0
0
(4) SHEHLA KAHN (i)
(ii)
227,370
0
90,368
0
0
0
7,572
0
7,831
0
333,141
0
0
0
(5) RICHARD RHEINBOLT (i)
(ii)
220,657
0
27,173
0
0
0
4,779
0
7,802
0
260,411
0
0
0
(6) DAVID ROBINSON (i)
(ii)
300,494
0
143,148
0
0
0
0
0
7,953
0
451,595
0
0
0
(7) RYCKMAN CAPLAN (i)
(ii)
285,224
0
600
0
0
0
0
0
7,905
0
293,729
0
0
0









Schedule J (Form 990) 2010

Schedule J (Form 990) 2010
Page 3
Part III
Supplemental Information
Complete this part to provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 4c, 5a, 5b, 6a, 6b, 7, and 8. Also complete this part for any additional information.
Identifier Return Reference Explanation
Schedule J (Form 990) 2010

Additional Data


Software ID:  
Software Version:  
Schedule L
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Transactions with Interested Persons
MediumBullet Complete if the organization answered
"Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c,
or Form 990-EZ, Part V lines 38a or 40b.
MediumBullet Attach to Form 990 or Form 990-EZ. MediumBulletSee separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
BLUE RIDGE REGIONAL HOSPITAL INC
 
Employer identification number

56-1025032
Part I
Excess Benefit Transactions (section 501(c)(3) and section 501 (c)(4) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.
1(a) Name of disqualified person (b) Description of transaction (c) Corrected?
Yes No





2
Enter the amount of tax imposed on the organization managers or disqualified persons during the year under section 4958. ......................... Bullet Image$
 
3
Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ....... Bullet Image$
 

Part II
Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 26, or Form 990-EZ, Part V, line 38a.
(a) Name of interested person and purpose (b) Loan to or from the organization? (c)Original principal amount (d)Balance due (e) In default? (f) Approved by board or committee? (g)Written agreement?
To From Yes No Yes No Yes No
Total ...............Small Bullet $  
Part III
Grants or Assistance Benefitting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.
(a) Name of interested person (b)Relationship between interested person and the organization (c)Amount of grant or type of assistance
For Privacy Act and Paperwork Reduction Act Notice, see the
Instructions for Form 990 or 990-EZ.
Cat. No. 50056A
Schedule L (Form 990 or 990-EZ) 2010
Schedule L (Form 990 or 990-EZ) 2010
Page 2
Part IV
Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of transaction (d) Description of transaction (e) Sharing of organization's revenues?
Yes No
(1) MELISSA SMITH FAMILY RELATIONSHIP WITH OFFICER OF ORGANIZATION 52,656 COMPENSATION RECEIVED AS EMPLOYEE   No
Part V
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule L (see instructions).
Identifier Return Reference Explanation
Schedule L (Form 990 or 990-EZ) 2010

Additional Data


Software ID:  
Software Version:  




SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
BLUE RIDGE REGIONAL HOSPITAL INC
 
Employer identification number

56-1025032
Identifier Return Reference Explanation
    BLUE RIDGE REGIONAL HOSPITAL TO WORK WITH ASHEVILLE RADIOLOGY ASSOCIATES BLUE RIDGE REGIONAL HOSPITAL IS PLEASED TO ANNOUNCE A NEW PARTNERSHIP WITH ASHEVILLE RADIOLOGY ASSOCIATES. RADIOLOGISTS FROM ASHEVILLE RADIOLOGY ASSOCIATES WILL BEGIN PROVIDING IMAGING READINGS FOR BLUE RIDGE REGIONAL HOSPITAL PATIENTS ON MARCH 21, 2011. "THIS PARTNERSHIP IS A BENEFIT FOR THE PATIENTS AS WELL AS BOTH ORGANIZATIONS" SAYS ROBIN NICHOLS, DIRECTOR OF IMAGING SERVICES AT BLUE RIDGE REGIONAL HOSPITAL. "OUR USE OF THE NEW PICTURE ARCHIVING SYSTEM (PACS) AND OUR PARTNERSHIP WITH ASHEVILLE RADIOLOGY ASSOCIATES MEANS OUR PATIENTS NOW HAVE ACCESS TO ADVANCED IMAGING SERVICES AS WELL AS SPECIALIZED IMAGING READINGS WITHOUT HAVING TO LEAVE OUR AREA." THE NEW PARTNERSHIP ALLOWS BLUE RIDGE REGIONAL HOSPITAL PATIENTS TO RECEIVE A NEW LEVEL OF IMAGING SERVICES AND READINGS. USING SOPHISTICATED AND SECURE TECHNOLOGY, THE IMAGING DEPARTMENT AT BLUE RIDGE REGIONAL HOSPITAL IS NOW ABLE TO SHARE AND CONSULT WITH LEADING IMAGING EXPERTS IN ASHEVILLE. FOR EXAMPLE, A MAMMOGRAM STUDY CAN BE SENT TO A MAMMOGRAPHY SPECIALIST IN ASHEVILLE DIGITALLY THROUGH THE USE OF THE PICTURE ARCHIVING SYSTEM ON A SECURE NETWORK. "FOR OUR PATIENTS, THIS COLLABORATION MEANS HAVING TWO EXPERIENCED TEAMS WORKING CLOSELY TOGETHER EVERY DAY TO PROVIDE ADVANCED IMAGING AND DIAGNOSTIC SERVICES", SAYS NICHOLS "WE ARE PLEASED TO OFFER EVERYTHING FROM HEART CARE AND NEUROLOGY TO BREAST IMAGING AND BONE HEALTH TO OUR COMMUNITY." CAR SEAT CERTIFICATION BLUE RIDGE REGIONAL HOSPITAL IS PLEASED TO ANNOUNCE THAT HEATHER GREENE, WELLNESS COORDINATOR IN THE DISEASE MANAGEMENT DEPARTMENT, ACHIEVED ANOTHER STEP IN CHILD PASSENGER SAFETY. GREENE BECAME A CERTIFIED CHILD PASSENGER SAFETY TECHNICIAN IN MAY 2005 AND A CERTIFIED CHILD PASSENGER SAFETY TECHNICIAN INSTRUCTOR IN APRIL 2009. THIS CERTIFICATION MEANS THAT GREENE CAN CHECK THE SAFETY OF CAR SEATS, PROPERLY INSTALL CAR SEATS AND TRAIN OTHERS TO PROPERLY INSTALL CAR SEATS. TO RECEIVE HER CERTIFICATION, GREENE COMPLETED AN EXTENSIVE COURSE DEVELOPED BY THE NATIONAL HIGHWAY TRAFFIC SAFETY ADMINISTRATION, MONITORED BY THE CHILD PASSENGER SAFETY BOARD AND CERTIFIED THROUGH THE SAFE KIDS WORLDWIDE. IN ADDITION TO THE NATIONAL CERTIFICATION, HEATHER RECENTLY EARNED HER SENIOR CHECKER CERTIFICATION THROUGH THE SAFE KIDS BUCKLE UP PROGRAM. ACHIEVING SENIOR CHECKER STATUS MEANS THAT GREENE IS CERTIFIED TO NOT ONLY CHECK THE INSTALLATION AND SAFETY OF CAR SEATS, BUT THE SKILLS AND ABILITIES OF OTHER CHILD PASSENGER SAFETY TECHNICIANS. HEATHER IS THE ONLY NATIONALLY CERTIFIED CHILD PASSENGER SAFETY TECHNICIAN INSTRUCTOR/SENIOR CHECKER IN MITCHELL, AVERY, YANCEY, AND MCDOWELL COUNTIES. "IT IS AN HONOR TO BE A SENIOR CHECKER AS WELL AS A NATIONALLY CERTIFIED CHILD PASSENGER SAFETY TECHNICIAN INSTRUCTOR" SAYS HEATHER, "I CAN HELP PARENTS AND CAREGIVERS PROPERLY SECURE THEIR CHILDREN IN THE CORRECT RESTRAINTS AS WELL AS HELP OTHER CHILD PASSENGER SAFETY TECHNICIANS IN OUR AREA." WORKING AT BLUE RIDGE REGIONAL HOSPITAL, GREENE IS ABLE TO PROVIDE CAR SEAT SAFETY SERVICES TO THE COMMUNITY. "WORKING HERE AT THE HOSPITAL, I CHECK SEATS FOR NEWBORNS AND THEIR FAMILIES BEFORE THEY LEAVE THE HOSPITAL", SAYS GREENE "I CAN ALSO CHECK ALL OTHER SEATS AND RESTRAINTS. ALL PARENTS HAVE TO DO IS COME TO THE HOSPITAL."
FORM 990, PART VI, SECTION A, LINE 6   THE SOLE MEMBER OF THE CORPORATION IS MISSION-ST. JOSEPH HEALTH SYSTEM, INC.
FORM 990, PART VI, SECTION A, LINE 7A   THE DIRECTORS OF THE CORPORATION SHALL BE APPOINTED AT THE ANNUAL MEETING OF THE MEMBER OF THE CORPORATION (SEE ABOVE). THE TWO EX-OFFICIO DIRECTORS SHALL BE EX-OFFICIO BOARD MEMBERS WHO SERVE IN THE POSITIONS OF CHIEF EXECUTIVE OFFICER OF THE CORPORATION AND CHIEF OF STAFF OF THE HOSPITAL. THE BOARD OF DIRECTORS OF THE CORPORATION SHALL ELECT THE SEVEN INDIVIDUALS TO SERVE AS COMMUNITY DIRECTORS AS SOON AS REASONABLY PRACTICABLE SUBSEQUENT TO THE APPOINTMENT OF THE SOLE MEMBER'S DIRECTORS. THE COMMUNITY DIRECTORS ELECTED MUST BE APPROVED BY THE MEMBER OF THE CORPORATION; HOWEVER, SAID APPROVAL SHALL NOT BE ARBITRARILY AND CAPRICIOUSLY WITHHELD.
FORM 990, PART VI, SECTION A, LINE 7B   THE SOLE MEMBER HAS THE FOLLOWING RIGHTS WITH RESPECT TO THE CORPORATION: (A) APPROVAL OF THE GOVERNING INSTRUMENTS OF THE CORPORATION, (B) APPROVAL OF THE MISSION, VISION, AND VALUES STATEMENT, (C) ELECTION AND REMOVAL OF THE BOARD OF DIRECTORS, (D) APPROVAL OF THE PLEDGE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION, THE PURCHASE OR SALE OF PROPERTY, AND LONG-TERM BORROWING, (E) APPROVAL OF DISSOLUTION, MERGER, SALE, OR CONSOLIDATION, (F) APPROVAL OF THE FORMATION AND GOVERNANCE OF NEW CORPORATIONS, PARTNERSHIPS, OR JOINT VENTURES (ABOVE FINANCIAL AND OTHER LIMITS), (G) APPROVAL OF THE CAPITAL AND OPERATING BUDGET, (H) APPROVAL OF THE CONSOLIDATION, MATERIAL EXPANSION, OR ELIMINATION OF ANY CLINICAL SERVICE, (I) APPROVAL OF THE ELECTION OF THE PRESIDENT/CEO, (J) THE OPTION TO REMOVE THE PRESIDENT/CEO UPON THE HAPPENING OF ANY OF THE EVENTS LISTED IN THE BYLAWS AT SECTION 3.4(J).
FORM 990, PART VI, SECTION B, LINE 11   THE RETURN WAS PREPARED BY AN INDEPENDENT ACCOUNTANT WITH THE OVERSIGHT AND ASSISTANCE OF MANAGEMENT. UPON COMPLETION, THE RETURN WAS REVIEWED BY MANAGEMENT AND PRESENTED TO THE FINANCE COMMITTEE OF THE BOARD OF DIRECTORS. PRIOR TO FILING WITH THE IRS, THE FINANCE COMMITTEE PRESENTED THE RETURN TO THE FULL VOTING BOARD AT A SCHEDULED MEETING, AND A PERIOD OF TIME WAS ALLOWED FOR QUESTIONS AND DISCUSSION.
  FORM 990, PART VI, SECTION B, LINE 12C IN ALL BOARD MEETINGS, THE CHAIRMAN OF THE BOARD REVIEWS THE POLICY BEFORE VOTES, INQUIRING IF ANY MEMBER HAS A POTENTIAL CONFLICT. POTENTIALLY INTERESTED PARTIES ARE EXCUSED FROM DISCUSSIONS AND VOTES.
  FORM 990, PART VI, SECTION B, LINE 15 ANNUALLY THE FINANCE COMMITTEE OF THE BOARD REVIEWS AND COMPARES COMPENSATION DATA FOR THE TOP EXECUTIVE AND OTHER KEY POSITIONS WITH DATA FROM FOUR DIFFERENT COMPARABLE SOURCES, INCLUDING THE FORMS 990 OF OTHER ORGANIZATIONS, TWO NATIONAL SALARY SURVEYS, AND ONE STATE SALARY SURVEY. COMPENSATION PACKAGES ARE THEN APPROVED BY THE FINANCE COMMITTEE. IN ADDITION TO THE CEO, THE BOARD REVIEWS THE COMPENSATION FOR THE CFO, VP OF NURSING, VP OF PHYSICIAN PRACTICES, AND THE VP OF OUTREACH.
  FORM 990, PART VI, SECTION C, LINE 18 PHOTOCOPIES OF THE ORGANIZATION'S FORM 990 ARE AVAILABLE UPON REQUEST AT THE ORGANIZATION'S ADMINISTRATIVE OFFICE. IN ADDITION, RECENT FILINGS OF THE FORM 990 ARE AVAILABLE ONLINE AT GUIDESTAR.ORG, A NON-PROFIT ORGANIZATION.
  FORM 990, PART VI, SECTION C, LINE 19 PHOTOCOPIES OF THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST AT THE ORGANIZATION'S ADMINISTRATIVE OFFICE. IN ADDITION, DETAILS FROM THE ORGANIZATION'S FINANCIAL STATEMENTS ARE WIDELY DISTRIBUTED IN THE HOSPITAL'S REPORT TO THE COMMUNITY.
CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED LOSSES ON INVESTMENTS: -260,572. NET OF CONSOLIDATED ORGANIZATION -103,231. TOTAL TO FORM 990, PART XI, LINE 5: -363,803.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2010

Additional Data


Software ID:  
Software Version:  
SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" to Form 990, Part IV, line 33, 34, 35, 36, or 37.
MediumBulletAttach to Form 990. MediumBullet See separate instructions.

OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
BLUE RIDGE REGIONAL HOSPITAL INC
 
Employer identification number

56-1025032
Part I
Identification of Disregarded Entities (Complete if the organization answered "Yes" on Form 990, Part IV, line 33.)
(a)
Name, address, and EIN of disregarded entity


(b)
Primary activity


(c)
Legal domicile (state
or foreign country)

(d)
Total income



(e)
End-of-year assets


(f)
Direct controlling
entity



















Part II
Identification of Related Tax-Exempt Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.)
(a)
Name, address, and EIN of related organization


(b)
Primary activity


(c)
Legal domicile (state
or foreign country)

(d)
Exempt Code section



(e)
Public charity status
(if section 501(c)(3))

(f)
Direct controlling
entity

(g)
Section 512(b)(13) controlled organization
Yes No
(1) BLUE RIDGE REGIONAL HOSPITAL FOUNDATION

PO BOX 247

SPRUCE PINE,NC28777
58-2172660
SUPPORTING ORGANIZATION/FUNDRAISING NC 501(C)(3) LINE 11A, I BLUE RIDGE REGIONAL HOSPITAL INC
 
 
No
(2) MISSION HEALTH SYSTEM INC

400 RIDGEFIELD COURT

ASHEVILLE,NC28806
58-1450888
SUPPORTING ORGANIZATION NC 501(C)(3) LINE 11A, I N/A
 
No
(3) MISSION HOSPITAL INC

509 BILTMORE AVENUE

ASHEVILLE,NC28801
56-0532141
HEALTHCARE NC 501(C)(3) LINE 3 N/A
 
No
(4) MISSION HEALTHCARE FOUNDATION INC

908 HENDERSONVILLE ROAD

ASHEVILLE,NC28803
56-1881331
FUNDRAISING NC 501(C)(3) LINE 7 N/A
 
No
(5) MISSION MEDICAL ASSOCIATES

12 ARDMORE STREET

ASHEVILLE,NC28803
26-3627231
HEALTHCARE NC 501(C)(3) LINE 9 N/A
 
No
(6) THE MCDOWELL HOSPITAL

430 RANKIN DRIVE

MARION,NC28752
56-0623938
HEALTHCARE NC 501(C)(3) 3 N/A
 
No


For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.)
(a)
Name, address, and EIN of
related organization



(b)
Primary activity




(c)
Legal
domicile
(state or foreign
country)


(d)
Direct controlling
entity



(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(f)
Share of total income




(g)
Share of end-of-year
assets



(h)
Disproprtionate allocations?




(i)
Code V—UBI
amount in box 20 of
Schedule K-1
(Form 1065)
(j)
General or
managing
partner?



(k)
Percentage
ownership


Yes No Yes No
(1) BLUE RIDGE DME LLC

125 HOSPITAL DRIVE
SPRUCE PINE,NC28777
26-3570174
HOME MEDICAL EQUIPMENT & SUPPLIES SALES NC N/A
UNRELATED       No   Yes    
(2) IMAGING REALITY LLP

534 BILTMORE AVENUE
ASHEVILLE,NC28801
56-1907203
REAL ESTATE HOLDING NC N/A
                 
(3) MSJHS AND CCP JOINT DEVELOPMENT COMPANY LLC

428 BILTMORE AVENUE
ASHEVILLE,NC28801
56-2250464
HEALTHCARE NC N/A
                 








Part IV
Identification of Related Organizations Taxable as a Corporation or Trust (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.)
(a)
Name, address, and EIN of related organization



(b)
Primary activity



(c)
Legal domicile
(state or
foreign
country)
(d)
Direct controlling
entity


(e)
Type of entity
(C corp, S corp,
or trust)

(f)
Share of total income



(g)
Share of
end-of-year
assets

(h)
Percentage
ownership


(1) HORIZON HEALTH CORP
213 RIDGEFIELD COURT
ASHEVILLE,NC28806
56-1341621
HOLDING COMPANY NC N/A
C      
(2) HORIZON MANAGEMENT SERVICES INC
213 RIDGEFIELD COURT
ASHEVILLE,NC28806
56-1341624
COLLECTIONS, BILLING, MEDICAL PROPERTY NC N/A
C      










Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 3
Part V
Transactions With Related Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35, 35A, or 36.)
Note. Complete line 1 if any entity is listed in Parts II, III or IV.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest (ii) annuities (iii) royalties (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .
1a
Yes
 
b Gift, grant, or capital contribution to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
 
No
c Gift, grant, or capital contribution from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
Yes
 
d Loans or loan guarantees to or for other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
 
No
e Loans or loan guarantees by other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
Yes
 
f Sale of assets to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
 
No
g Purchase of assets from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1g
 
No
h Exchange of assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1h
 
No
i Lease of facilities, equipment, or other assets to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1i
 
No
j Lease of facilities, equipment, or other assets from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1j
 
No
k Performance of services or membership or fundraising solicitations for other organization(s) . . . . . . . . . . . . . . . . . . . . . .
1k
 
No
l Performance of services or membership or fundraising solicitations by other organization(s) . . . . . . . . . . . . . . . . . . . . . .
1l
Yes
 
m Sharing of facilities, equipment, mailing lists, or other assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1m
Yes
 
n Sharing of paid employees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1n
Yes
 
o Reimbursement paid to other organization for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
Yes
 
p Reimbursement paid by other organization for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
 
No
q Other transfer of cash or property to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
 
No
r Other transfer of cash or property from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
 
No
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of other organization
(b)
Transaction
type(a-r)
(c)
Amount involved
(d)
Method of determining amount involved
(1) BLUE RIDGE REGIONAL HOSPITAL FOUNDATION

C 381,762 FMV
(2) BLUE RIDGE HOME CARE

A 382,173 FMV
(3)

(4)

(5)

(6)

Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 37.)
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity
(b)
Primary activity
(c)
Legal domicile
(state or foreign
country)
(d)
Are all
partners
section
501(c)(3)
organizations?
(e)
Share of
end-of-year
assets
(f)
Disproprtionate allocations?
(g)
Code V—UBI
amount in box
20 of Schedule K-1
(Form 1065)
(h)
General or
managing
partner?
Yes No Yes No Yes No






























Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 5
Part VII
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule R (see instructions).
Identifier Return Reference Explanation
Additional Data


Software ID:  
Software Version: