TY 2012 Form 990

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)
(1) JAN UNGER........................................................................ CHAIRPERSON	1.00 .......................	X	X	0	0	0
(2) KEN STONEBRAKER........................................................................ VICE-CHAIRPERSON	1.00 .......................	X	X	0	0	0
(3) JANE C KIMSEY........................................................................ TREASURER	1.00 .......................	X	X	0	0	0
(4) JOHNNY MIRA-KNIPPEL........................................................................ SECRETARY	1.00 .......................	X	X	0	0	0
(5) CHARLES BARRIER MD........................................................................ BOARD MEMBER	1.00 .......................	X		0	0	0
(6) DAVID FRANKS MD........................................................................ BOARD MEMBER	40.00 .......................	X		72,800	0	0
(7) CHUCK TRENTHAM MD........................................................................ BOARD MEMBER	40.00 .......................	X		353,635	0	0
(8) JANET J GREENE........................................................................ BOARD MEMBER	1.00 .......................	X		0	0	0
(9) MARLA ANN D'ASCOLI........................................................................ BOARD MEMBER	1.00 .......................	X		0	0	0
(10) JOHN J MAHER........................................................................ BOARD MEMBER	2.00 .......................58.00	X		0	321,703	77,140
(11) GEORGE RENFRO........................................................................ BOARD MEMBER	1.00 .......................1.00	X		0	0	0
(12) PAUL MARTIN........................................................................ BOARD MEMBER	1.00 .......................	X		0	0	0
(13) TRAVIS PETRICEK MD........................................................................ CHIEF OF STAFF	50.00 .......................	X		360,562	0	37,692
(14) JOE COLLINS........................................................................ BOARD MEMBER	1.00 .......................	X		0	0	0
(15) CONNIE HAIRE........................................................................ BOARD MEMBER	1.00 .......................	X		0	0	0
(16) DALE WEST........................................................................ BOARD MEMBER	1.00 .......................	X		0	0	0
(17) ROBERT BEDNAREK........................................................................ BOARD MEMBER	1.00 .......................40.00	X		0	302,355	52,735

(A) Name and business address	(B) Description of services	(C) Compensation
CHARLES TRENTHAM MD, 1948 FULTON ROADFRANKLINNC28734	ANESTHESIA COVERAGE	353,635
RONELL BERNARD MD, 40 OAKCREST LANEWAYNESVILLENC28786	ANESTHESIA COVERAGE	320,833
LORENA MCFADDEN COSENTINO, 6632 LOWER BURNINGTOWN ROADFRANKLINNC28734	CRNA COVERAGE	192,650
VALERIE CARVER, 131 STAYVESCENT ROADASHEVILLENC28803	CRNA COVERAGE	179,194
FISHER CREEK ANESTHESIA1977 FISHER CREEK ROADSYLVANC28779	CRNA COVERAGE	176,313
2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization 6

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 United States. See Part IV, line 21
2	Grants and other assistance to individuals in the United States. See Part IV, line 22
3	Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16
4	Benefits paid to or for members
5	Compensation of current officers, directors, trustees, and key employees ....	546,719	437,375	109,344
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	25,027,727	22,024,400	2,753,050	250,277
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	285,946	251,633	31,454	2,859
9	Other employee benefits .......	2,835,753	2,495,462	311,933	28,358
10	Payroll taxes ...........	1,825,845	1,606,744	200,843	18,258
11	Fees for services (non-employees):
a	Management ......
b	Legal .........	253,636		253,636
c	Accounting ...........	160,342		160,342
d	Lobbying ...........
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) ........	2,372,748	2,206,655	154,229	11,864
12	Advertising and promotion ....
13	Office expenses .......	2,955,822	2,808,031	133,012	14,779
14	Information technology ......	238,582	95,433	143,149
15	Royalties ..
16	Occupancy ...........	814,160	814,160
17	Travel ............	285,416	231,187	48,521	5,708
18	Payments of travel or entertainment expenses for any federal, state, or local public officials ......
19	Conferences, conventions, and meetings ....
20	Interest ...........	122,527	122,527
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization .....	2,136,009	2,136,009
23	Insurance ..............	572,523	572,523
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	MEDICAL SUPPLIES	4,694,625	3,990,431	704,194
b
c
d
e	All other expenses	3,912,663	3,325,763	586,900
25	Total functional expenses. Add lines 1 through 24e	49,041,043	43,118,333	5,590,607	332,103
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

Part X Balance Sheet Check if Schedule O contains a response to any question in this Part X ...............
	1	Cashnon-interest-bearing .............	1,258,507	1	2,524,129
2	Savings and temporary cash investments .........	23,916	2	23,944
3	Pledges and grants receivable, net ...........	38,000	3	27,500
4	Accounts receivable, net .............	5,946,441	4	9,148,520
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L ..................
			5
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
			6
7	Notes and loans receivable, net .............	140,014	7	119,384
8	Inventories for sale or use ..............	1,580,148	8	1,516,395
9	Prepaid expenses and deferred charges ..........	533,139	9	328,721
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	20,034,872
b	Less: accumulated depreciation .....	10b	221,123	18,648,527	10c	19,813,749
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 .....		13
14	Intangible assets ...............		14
15	Other assets. See Part IV, line 11 ...........	1,753,025	15	269,822
16	Total assets. Add lines 1 through 15 (must equal line 34)......	29,921,717	16	33,772,164
	17	Accounts payable and accrued expenses .........	3,294,226	17	4,299,676
18	Grants payable .................		18
19	Deferred revenue ................		19
20	Tax-exempt bond liabilities .............	12,450,000	20	12,170,000
21	Escrow or custodial account liability. Complete Part IV of Schedule D..		21
22	Loans and other 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 ..	134,527	23	71,805
24	Unsecured notes and loans payable to unrelated third parties ....		24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D....................	2,693,650	25	92,469
26	Total liabilities. Add lines 17 through 25.........	18,572,403	26	16,633,950
		Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets ..............	10,945,635	27	16,679,077
28	Temporarily restricted net assets ...........	301,671	28	459,137
29	Permanently restricted net assets ...........	102,008	29	0
	Organizations that do not follow SFAS 117 (ASC 958), check here 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 ...........	11,349,314	33	17,138,214
34	Total liabilities and net assets/fund balances ........	29,921,717	34	33,772,164

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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.

Attach to Form 990 or Form 990-EZ. right arrow

See separate instructions.

OMB No. 1545-0047

2012

Open to Public
Inspection

Name of the organization

ANGEL MEDICAL CENTER INC

Employer identification number

56-6000064

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.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E.)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in

section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross

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.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box that describes the type of supporting organization and complete lines 11e through 11h.

Type I

Type II

Type III - Functionally integrated

Type III - Non-functionally integrated

By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons other than foundation managers and other than one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2).

If the organization received a written determination from the IRS that it is a Type I, Type II, or Type III supporting organization, check this box ..................................................

Since August 17, 2006, has the organization accepted any gift or contribution from any of the
following persons?

(i) A person who directly or indirectly controls, either alone or together with persons described in (ii)

Yes

and (iii) below, the governing body of 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)

Provide the following information about the supported organization(s).

(i) Name of supported organization	(ii) EIN	(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 monetary support
(i) Name of supported organization	(ii) EIN	Yes	No	Yes	No	Yes	No	(vii) Amount of monetary support


Total

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990EZ.

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2012

Page 2

Part II

Support Schedule for Organizations Described in Sections 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) 2008	(b) 2009	(c) 2010	(d) 2011	(e) 2012	(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) 2008	(b) 2009	(c) 2010	(d) 2011	(e) 2012	(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. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)..
11	Total support (Add lines 7 through 10).

Gross receipts from related activities, etc. (see instructions) ..................

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization, check this box and stop here........................................ right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2012 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2011 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2012. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2011. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2012. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part IV how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2011. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part IV how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow

Schedule A (Form 990 or 990-EZ) 2012

Page 3

Part III

Support Schedule for Organizations Described in Section 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) 2008	(b) 2009	(c) 2010	(d) 2011	(e) 2012	(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) 2008	(b) 2009	(c) 2010	(d) 2011	(e) 2012	(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.)..

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here............................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2012 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2011 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2012 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2011 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests—2012. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ........ right arrow

33 1/3% support tests—2011. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ..... right arrow

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions ..... right arrow

Schedule A (Form 990 or 990-EZ) 2012

Page 4

Part IV

Supplemental Information. Complete this part to provide the explanations required by Part II, line 10; Part II, line 17a or 17b; and 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) 2012

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990, 990-EZ,
or 990-PF)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

OMB No. 1545-0047

2012

Name of the organization

ANGEL MEDICAL CENTER INC

Employer identification number

56-6000064

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

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

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, $5,000 or more (in money or
property) from any one contributor. Complete Parts I and II.

Special Rules

For a section 501(c)(3) organization filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi) and received from any one contributor, during the year, a contribution of the
greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For a section 501(c)(7), (8), or (10) organization filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 for use exclusively for religious, charitable,
scientific, literary, or educational purposes, or the prevention of cruelty to children or animals. Complete Parts I, II, and
III.

For a section 501(c)(7), (8), or (10) organization filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions for use exclusively for religious, charitable, etc., purposes, but these contributions did
not total to more than $1,000. If this box is checked, enter here the total contributions that were received during
the year for an exclusively religious, charitable, etc., purpose. Do not complete any of the parts unless the General Rule
applies to this organization because it received nonexclusively religious, charitable, etc., contributions of $5,000 or more
during the year ......................... 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 on line H of its
Form 990-EZ or on Part I, 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) (2012)

Schedule B (Form 990, 990-EZ, or 990-PF) (2012)

Page 2

Name of organization ANGEL MEDICAL CENTER INC

Part I	Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	RESTRICTED RESTRICTED RESTRICTED RESTRICTED, RESTRICTED RESTRICTED	$RESTRICTED	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2012)

Schedule B (Form 990, 990-EZ, or 990-PF) (2012)

Page 3

Name of organization ANGEL MEDICAL CENTER INC

Part II	Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(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) (2012)

Schedule B (Form 990, 990-EZ, or 990-PF) (2012)

Page 4

Name of organization
ANGEL MEDICAL CENTER INC

Employer identification number

56-6000064

Part III

Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
that total 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

$
Use duplicate copies of Part III if additional space is needed.

(a) No.
from
Part I

(b) Purpose 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

(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

(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

(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) (2012)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b
SchDMd Bullet

Attach to Form 990. SchDMd Bullet

See separate instructions.

OMB No. 1545-0047

2012

Open to Public Inspection

Name of the organization

ANGEL MEDICAL CENTER INC

Employer identification number

56-6000064

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 ........

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? ............

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can 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? ...................................

Yes No

Part II

Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax 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, and not on a historic structure listed in the National Register ....................	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the tax year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet

Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .......................................

Yes No

In Part XIII, 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.

If the organization elected, as permitted under SFAS 116 (ASC 958), 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 XIII, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under SFAS 116 (ASC 958), 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

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 (ASC 958) relating to these items:

Revenues included in Form 990, Part VIII, line 1 .......................... SchDMd Bullet

Assets included in Form 990, Part X ............................... SchDMd Bullet

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 52283D

Schedule D (Form 990) 2012

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

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?........

Yes No

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.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No

If "Yes," explain the arrangement in Part XIII and complete the following table:


c	Beginning balance .................................	1c
d	Additions during the year ..............................	1d
e	Distributions during the year .............................	1e
f	Ending balance ...................................	1f

Did the organization include an amount on Form 990, Part X, line 21? .....................

Yes No

If “Yes,” explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ........

Part V

Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.

		(a)Current year	(b)Prior year	b (c)Two years back	(d)Three years back	(e)Four years back
1a	Beginning of year balance ....
b	Contributions ........
c	Net investment earnings, gains, and losses
d	Grants or scholarships .....
e	Other expenditures for facilities and programs ........
f	Administrative expenses ....
g	End of year balance ......

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

Temporarily restricted endowment SchDMd Bullet

The percentages in lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) unrelated organizations ........................

3a(i)

(ii) related organizations ........................

3a(ii)

If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........

Describe in Part XIII the intended uses of the organization's endowment funds.

Part VI

Land, Buildings, and Equipment. See Form 990, Part X, line 10.

Description of property		(b)Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value
1a	Land .................	3,480,000		3,480,000
b	Buildings ................	11,331,093	101,810	11,229,283
c	Leasehold improvements ............	48,881	239	48,642
d	Equipment ................	4,640,330	119,074	4,521,256
e	Other .................	534,568		534,568
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......				19,813,749

Schedule D (Form 990) 2012

Page 3

Part VII

InvestmentsOther 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) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

InvestmentsProgram 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









Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets. See Form 990, Part X, line 15.

(a) Description				(b) Book value









Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........

Part X

Other Liabilities. See Form 990, Part X, line 25.

1.(a) Description of liability		(b) Book value
Federal income taxes
NOTE PAYABLE TO MISSION		92,469








Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)		92,469
2. Fin 48 (ASC 740) Footnote. In Part XIII, 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 (ASC 740). Check here if the text of the footnote has been provided in Part XIII .....................................................

Schedule D (Form 990) 2012

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return
1	Total revenue, gains, and other support per audited financial statements .......			1	49,584,722
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains on investments ..........	2a
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d	200,857
e	Add lines 2a through 2d .....................			2e	200,857
3	Subtract line 2e from line 1.....................			3	49,383,865
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 XIII.) ...........	4b
c	Add lines 4a and 4b.......................			4c	0
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......			5	49,383,865

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
1	Total expenses and losses per audited financial statements ...........			1	49,241,900
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 XIII.) ............	2d	200,857
e	Add lines 2a through 2d......................			2e	200,857
3	Subtract line 2e from line 1.....................			3	49,041,043
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 XIII.) ............	4b
c	Add lines 4a and 4b.......................			4c	0
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......			5	49,041,043

Part XIII

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, line 2; Part XI, lines 2d and 4b; and Part XII, 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, LINE 2:	THE HOSPITAL HAS BEEN RECOGNIZED AS EXEMPT FROM FEDERAL INCOME TAX UNDER INTERNAL REVENUE CODE SECTION 501(A) AS AN ORGANIZATION DESCRIBED IN SECTION 501(C)(3), AND THEREFORE, RELATED INCOME IN GENERALLY NOT SUBJECT TO FEDERAL AND STATE INCOME TAXES. THE ORGANIZATION HAS DETERMINED THAT IT DOES NOT HAVE ANY MATERIAL UNRECOGNIZED TAX BENEFITS OR OBLIGATIONS AS OF SEPTEMBER 30, 2012. THE ORGANIZATION APPLIES THE PROVISIONS OF FASB ASC 740, INCOME TAXES, IN ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES. ASC 740 PROVIDES GUIDANCE ON WHEN TAX POSITIONS ARE RECOGNIZED IN AN ENTITY'S FINANCIAL STATEMENTS AND HOW THE VALUES OF THESE POSITIONS ARE DETERMINED. THERE IS CURRENTLY NO IMPACT ON THE ORGANIZATION'S CONSOLIDATED FINANCIAL STATEMENTS AS A RESULT OF THE APPLICATION OF ASC 740.
PART XI, LINE 2D - OTHER ADJUSTMENTS:		FUND RAISING EXPENSES RENTAL EXPENSES
PART XII, LINE 2D - OTHER ADJUSTMENTS:		FUND RAISING EXPENSES RENTAL EXPENSES
		ANGEL MEDICAL CENTER, INC. BECAME A FULL MEMBER OF MISSION HEALTH SYSTEM, INC. IN JUNE 2013. AS PART OF THIS BUSINESS COMBINATION, ASSETS' BOOK VALUES WERE REVALUED AND DEPRECIATION WAS STARTED AS OF JUNE 1, 2013. THE NEW AMOUNTS WERE CALCULATED BY AN INDEPEDENT ACCOUNTING FIRM. SCHEDULE D, PART XII & XIII, LINE 2D FUND RAISING EXPENSES $10,121 RENTAL EXPENSES $190,736

Schedule D (Form 990) 2012

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE G (Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information Regarding
Fundraising or Gaming Activities

Complete if the organization answered "Yes" to Form 990, Part IV, lines 17, 18, or 19, or if the organization entered more than $15,000 on Form 990-EZ, line 6a. Form 990-EZ filers are not required to complete this part. right arrow

Attach to Form 990 or Form 990-EZ. right arrow

See separate instructions.

OMB No. 1545-0047

2012

Open to Public Inspection

Name of the organization
ANGEL MEDICAL CENTER INC

Employer identification number

56-6000064

Part I

Fundraising Activities. Complete if the organization answered "Yes" to Form 990, Part IV, line 17.

Indicate whether the organization raised funds through any of the following activities. Check all that apply.

a	Mail solicitations	e	Solicitation of non-government grants
b	Internet and email solicitations	f	Solicitation of government grants
c	Phone solicitations	g	Special fundraising events
d	In-person solicitations

Did the organization have a written or oral agreement with any individual (including officers, directors, trustees

or key employees listed in Form 990, Part VII) or entity in connection with professional fundraising services?

Yes

If “Yes,” list the ten highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is
to be compensated at least $5,000 by the organization.

(i) Name and address of individual or entity (fundraiser)	(iii) Did fundraiser have custody or control of contributions?
	Yes	No










Total .................

List all states in which the organization is registered or licensed to solicit funds or has been notified it is exempt from registration or licensing.

For Paperwork Reduction Act Notice, see the Instructions for Form 990or 990-EZ.

Cat. No. 50083H

Schedule G (Form 990 or 990-EZ) 2012

Page 2

Part II

Fundraising Events. Complete if the organization answered "Yes" to Form 990, Part IV, line 18, or reported more than $15,000 of fundraising event contributions and gross income on Form 990-EZ, lines 1 and 6b. List events with gross receipts greater than $5,000.

		(a) Event #1 OKTOBERFEST (event type)	(b) Event #2 MACON YOUR HEART BEAT (MARATHON) (event type)	(c) Other events 1 (total number)	(d) Total events (add col. (a) through col. (c))
1	Gross receipts . . .	28,691	11,885	5,013	45,589
2	Less: Contributions . .	19,441	4,835	5,013	29,289
3	Gross income (line 1 minus line 2) . . .	9,250	7,050		16,300
4	Cash prizes . . .
5	Noncash prizes . .
6	Rent/facility costs . .	585			585
7	Food and beverages .	4,560			4,560
8	Entertainment . . .	500			500
9	Other direct expenses .	1,550	2,925		4,475
10	Direct expense summary. Add lines 4 through 9 in column (d) ...........				10,120
11	Net income summary. Combine line 3, column (d), and line 10. ..........				6,180

Part III

Gaming. Complete if the organization answered "Yes" to Form 990, Part IV, line 19, or reported more than $15,000 on Form 990-EZ, line 6a.

(a) Bingo

(b) Pull tabs/Instant
bingo/progressive bingo

(c) Other gaming

(d) Total gaming (add col.(a) through col.(c))

Gross revenue . . . .

Cash prizes . . . .

Non-cash prizes . . .

Rent/facility costs . . .

Other direct expenses . .

Volunteer labor . . .

	Yes
	No

	Yes
	No

	Yes
	No

Direct expense summary. Add lines 2 through 5 in column (d) ........... right arrow

Net gaming income summary. Combine lines 1 and 7 in column (d) .......... right arrow

Enter the state(s) in which the organization operates gaming activities:

Is the organization licensed to operate gaming activities in each of these states? ............

YesNo

If "No," explain:

10a

Were any of the organization's gaming licenses revoked, suspended or terminated during the tax year? .....

YesNo

If "Yes," explain:

Schedule G (Form 990 or 990-EZ) 2012

Page 3

Does the organization operate gaming activities with nonmembers? .................

YesNo

Is the organization a grantor, beneficiary or trustee of a trust or a member of a partnership or other entity

formed to administer charitable gaming? ..........................

YesNo

Indicate the percentage of gaming activity operated in:

The organization's facility ......................

13a

An outside facility ........................

13b

Enter the name and address of the person who prepares the organization's gaming/special events books and records:

Name

Address

15a

Does the organization have a contract with a third party from whom the organization receives gaming

revenue? ......................................

YesNo

If "Yes," enter the amount of gaming revenue received by the organization right arrow

$ and the

amount of gaming revenue retained by the third party right arrow

$ .

If "Yes," enter name and address of the third party:

Name

Address

Gaming manager information:

Name

Gaming manager compensation right arrow

Description of services provided right arrow

Director/officer Employee Independent contractor

Mandatory distributions:

Is the organization required under state law to make charitable distributions from the gaming proceeds to

retain the state gaming license? ............................

YesNo

Enter the amount of distributions required under state law distributed to other exempt organizations or spent

in the organization's own exempt activities during the tax year right arrow

Part IV

Supplemental Information. Complete this part to provide the explanations required by Part I, line 2b, columns (iii) and (v), and Part III, lines 9, 9b, 10b, 15b, 15c, 16, and 17b, as applicable. Also complete this part to provide any additional information (see instructions).

Identifier	Return Reference	Explanation

Schedule G (Form 990 or 990-EZ) 2012

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H (Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

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

2012

Open to Public Inspection

Name of the organization

ANGEL MEDICAL CENTER INC

Employer identification number

56-6000064

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a ...

Yes

If "Yes," was it a written policy? .......................

Yes

If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.

Applied uniformly to all hospital facilities Applied uniformly to most hospital facilities Generally tailored to individual hospital facilities

Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.

Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?

If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:

Yes

100% 150% 200% Other %

Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate

which of the following was the family income limit for eligibility for discounted care: .........

Yes

200% 250% 300% 350% 400% Other %

If the organization used factors other than FPG in determining eligibility, describe in Part VI the income based criteria for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.

Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? ..............

Yes

Did the organization budget amounts for free or discounted care provided under its financial assistance policy during the tax year? ............................

Yes

If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? ......

Yes

If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? ..............

Did the organization prepare a community benefit report during the tax year? ..........

Yes

If "Yes," did the organization make it available to the public? ..............

Yes

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) ..	959,324		959,324	1.960 %
b	Medicaid (from Worksheet 3, column a) ....	6,803,254	5,832,102	971,152	1.980 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) .
d	Total Financial Assistance and Means-Tested Government Programs .	7,762,578	5,832,102	1,930,476	3.940 %
Other Benefits		58,652		58,652	0.120 %
e	Community health improvement services and community benefit operations (from Worksheet 4) ..	58,652		58,652	0.120 %
f	Health professions education (from Worksheet 5) ..	262,301		262,301	0.530 %
g	Subsidized health services (from Worksheet 6) ..
h	Research (from Worksheet 7)
i	Cash and in-kind contributions for community benefit (from Worksheet 8)	13,104		13,104	0.030 %
j	Total. Other Benefits ..	334,057		334,057	0.680 %
k	Total. Add lines 7d and 7j .	8,096,635	5,832,102	2,264,533	4.620 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2012

Schedule H (Form 990) 2012

Page

Part II

Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.

		(c) Total community building expense	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development
3	Community support	57,216	57,216	0.120 %
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy	3,116	3,116	0.010 %
8	Workforce development	36,454	36,454	0.070 %
9	Other
10	Total	96,786	96,786	0.200 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................

Yes

Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......

3,595,286

Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......

1,572,478

Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.

Section B. Medicare

Enter total revenue received from Medicare (including DSH and IME).....

18,365,096

Enter Medicare allowable costs of care relating to payments on line 5.....

17,488,408

Subtract line 6 from line 5. This is the surplus (or shortfall)........

876,688

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:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Did the organization have a written debt collection policy during the tax year? ..........

Yes

If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI.......................

Yes

Part IV

Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)

(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) 2012

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest—see instructions) How many hospital facilities did the organization operate during the tax year?1 Name, address, and primary website address
1	ANGEL MEDICAL CENTER INC 120 RIVERVIEW STREET FRANKLIN,NC28734	X	X	X

Schedule H (Form 990) 2012

Page

Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)

	ANGEL MEDICAL CENTER INC
Name of hospital facility or facility reporting group

For single facility filers only: line Number of Hospital Facility (from Schedule H, Part V, Section A)

Yes

Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 9....................

Yes

If “Yes,” indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

Information gaps that limit the hospital facility’s ability to assess the community’s health needs

Other (describe in Part VI)

Indicate the tax year the hospital facility last conducted a CHNA: 20 12

In conducting its most recent CHNA, did the hospital facility take into account input from representatives of the community served by the hospital facility, including those with special knowledge of or expertise in public health? 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 ....................

Yes

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI................................

Yes

Did the hospital facility make its CHNA report widely available to the public? .............

Yes

If “Yes,” indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website

Available upon request from the hospital facility

Other (describe in Part VI)

If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply to date):

Adoption of an implementation strategy that addresses each of the community health needs identified through the CHNA

Execution of the implementation strategy

Participation in the development of a community-wide plan

Participation in the execution of a community-wide plan

Inclusion of a community benefit section in operational plans

Adoption of a budget for provision of services that address the needs identified in the CHNA

Prioritization of health needs in its community

Prioritization of services that the hospital facility will undertake to meet health needs in its community

Other (describe in Part VI)

Did the hospital facility address all of the needs identified in its most recently conducted CHNA? If “No,” explain in Part VI which needs it has not addressed and the reasons why it has not addressed such needs ........

Yes

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)? ...........................

If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ......

If "Yes" to line 8b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2012

Page

Part VFacility Information (continued)

Financial Assistance Policy			Yes	No
9	Did the hospital facility have in place during the tax year a written financial assistance policy that:
	Explained eligibility criteria for financial assistance, and whether such assistance includes free or discounted care?	9	Yes
10	Used federal poverty guidelines (FPG) to determine eligibility for providing free care?...........	10	Yes
	If "Yes," indicate the FPG family income limit for eligibility for free care: 200.000000000000% If "No," explain in Part VI the criteria the hospital facility used.
11	Used FPG to determine eligibility for providing discounted care?.................	11	Yes
	If “Yes,” indicate the FPG family income limit for eligibility for discounted care: 300.000000000000% If "No," explain in Part VI the criteria the hospital facility used.
12	Explained the basis for calculating amounts charged to patients?.................	12	Yes
	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)
13	Explained the method for applying for financial assistance?...................	13	Yes
14	Included measures to publicize the policy within the community served by the hospital facility?.......	14	Yes
	If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
a	The policy was posted on the hospital facility’s website
b	The policy was attached to 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 on admission to the hospital facility
f	The policy was available upon request
g	Other (describe in Part VI)
Billing and Collections
15	Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained actions the hospital facility may take upon non-payment?.......	15	Yes
16	Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP:
a	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Part VI)
17	Did the hospital facility or an authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP?..........	17		No
	If “Yes,” check all actions in which the hospital facility or a third party engaged:
a	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Part VI)

Schedule H (Form 990) 2012

Page

Part VFacility Information (continued)

Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):

Notified individuals of the financial assistance policy on admission

Notified individuals of the financial assistance policy prior to discharge

Notified individuals of the financial assistance policy in communications with the patients regarding the patients’ bills

Documented its determination of whether patients were eligible for financial assistance under the hospital facility’s financial assistance policy

Other (describe in Part VI)

Policy Relating to Emergency Medical Care

Yes

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?..........

Yes

If “No,” indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)

Other (describe in Part VI)

Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that can be charged

The hospital facility used the average of its three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged

The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged

Other (describe in Part VI)

During the tax year, did the hospital facility charge any FAP-eligible individuals 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? ............................

If “Yes,” explain in Part VI.

During the tax year, did the hospital facility charge any FAP-eligible individuals an amount equal to the gross charge for any service provided to that individual? .........................

If “Yes,” explain in Part VI.

Schedule H (Form 990) 2012

Page

Part VFacility Information (continued)

Section C. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, from largest to smallest) How many non-hospital health care facilities did the organization operate during the tax year?3
Name and address		Type of Facility (describe)
1	ANGEL URGENT CARE 195 FRANKLIN PLAZA DRIVE FRANKLIN,NC28734	RURAL HEALTH CLINIC
2	ANGEL HOME HEALTH AND HOSPICE 170 CHURCH STREET FRANKLIN,NC28734	HOME HEALTH; SKILLED NURSING
3	ANGEL PHYSICIAN PRACTICES MEDICAL PARK DRIVE FRANKLIN,NC28734	PHYSICIAN OFFICES
4
5
6
7
8
9
10

Schedule H (Form 990) 2012

Page

Part VI

Supplemental Information

Complete this part to provide the following information.

1	Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II; Part III, lines 4, 8, and 9b; Part V, Section A; and Part V, Section B, lines 1j, 3, 4, 5c, 6i, 7, 10, 11, 12h, 14g, 16e, 17e, 18e, 19c, 19d, 20d, 21, and 22.
2	Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any 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.
8	Facility reporting group(s). If applicable, for each hospital facility in a facility reporting group provide the descriptions required for Part V, Section B, lines 1j, 3, 4, 5c, 6i, 7, 10, 11, 12h, 14g, 16e, 17e, 18e, 19c, 19d, 20d, 21, and 22.

Identifier	ReturnReference	Explanation
	PART I, LINE 7:	ANGEL MEDICAL CENTER USED THE NCHA ANDI REPORTS WHICH ARE BASED ON THE IRS GUIDELINES TO DERIVE A COST-TO-CHARGE RATIO USED IN THE CALCULATION OF COMMUNITY BENEFIT EXPENSE AT COST.
	PART II:	COMMUNITY SUPPORT: AMC IS VERY INVOLVED WITH HEALTH PROMOTION IN THE SURROUNDING AREA. IN 2013, 185 VOLUNTEER HOURS WERE SPENT SERVING ON BOARDS AND COMMITTEES THAT HELP IMPROVE THE OVERALL HEALTH IN MACON COUNTY. ORGANIZATIONS SERVED INCLUDED THOSE HELPING BATTERED WOMEN AND CHILDREN, MENTAL HEALTH PROVIDERS, AND THE MACON COUNTY PUBLIC HEALTH DEPARTMENT AS WELL AS OTHERS. AMC ALSO ORGANIZES MULTIPLE BLOOD DRIVES EACH YEAR AND WILL CONTINUE TO BE A RED CROSS DONOR SITE. COALITION BUILDING: ANGEL MEDICAL CENTER HAS AN ACTIVE COMMUNITY RELATIONS BOARD THAT MEETS REGULARLY TO DISCUSS THE HOSPITAL AND ITS RELATIONSHIP TO THE COMMUNITY. EMPLOYEES PARTICIPATE IN VARIOUS POLICY COUNCILS IN THE COUNTY SUCH AS MACON PROGRAM FOR PROGRESS THAT ADDRESSES THE NEEDS OF UNDERPRIVILEGED CHILDREN. OVER 77 VOLUNTEER HOURS WERE RECORDED IN 2013.COMMUNITY HEALTH IMPROVEMENT ADVOCACY: REPRESENTATIVES FROM PUBLIC RELATIONS AND COMMUNITY EDUCATION SERVED 51 HOURS ON PLANNING BOARDS AND COMMITTEES TO PROMOTE HEALTHY LIVING IN MACON COUNTY. SUCH PROGRAMS INCLUDED LIGHTEN UP FOR LIFE, COMMUNITY HEALTH PLANNING AND AN AMERICAN CANCER SOCIETY STUDY, ALL OF WHICH PROMOTE A HEALTHIER LIFESTYLE TO HELP PREVENT POTENTIAL HEALTH PROBLEMS IN HIGH RISK INDIVIDUALS. WORKFORCE DEVELOPMENT: VOLUNTEERS FROM NURSING AND ALLIED HEALTH DEPARTMENTS PARTICIPATE ANNUALLY IN A PROGRAM WITH THE LOCAL HIGH SCHOOL AND COMMUNITY COLLEGE THAT ALLOWS STUDENTS FROM HEALTH OCCUPATIONS CLASSES TO OBSERVE AND LEARN FROM ACTUAL EXPERIENCE RATHER THAN JUST CLASS ROOM ACTIVITIES. OVER 1,300 VOLUNTEER HOURS WERE SPENT WITH THESE STUDENTS, THE MAJORITY OF WHICH GO ON TO PURSUE A DEGREE IN HEALTHCARE.
	PART III, LINE 3	APPROXIMATELY 81% OF AMC'S BAD DEBT WRITE OFFS ARE SELF-PAY PATIENTS. APPROXIMATELY 51% OF THOSE ARE UNEMPLOYED. THESE PERCENTAGES MULTIPLIED BY THE BAD DEBT COST OF $3.6 MILLION EQUALS THE ESTIMATED AMOUNT OF BAD DEBT ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE FINANCIAL ASSISTANCE POLICY.
		PART III, LINE 4: ANGEL MEDICAL CENTER DOES NOT DISCLOSE THE COST OF BAD DEBT SPECIFICALLY IN THE FOOTNOTES OF THE FINANCIALS; HOWEVER IT REPORTS THE COST OF BAD DEBT AS PART OF A REPORT TO THE NORTH CAROLINA HOSPITAL ASSOCIATION'S DATA INITIATIVE. THE FINANCIAL STATEMENTS NET BAD DEBT AGAINST PATIENT REVENUES TO ARRIVE AT "NET PATIENT REVENUE LESS PROVISION FOR BAD DEBTS".
		PART III, LINE 8: PER THE INSTRUCTIONS, THE MEDICARE COST REPORT IS THE BASIS FOR CALCULATING THE COSTS USING COSTS RELATED TO THE REVENUE REPORTED.
		PART III, LINE 9B: PATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE AND OTHER CHARITY CARE ARE NOTIFIED USING THE PROCESS DESCRIBED IN THE EDUCATION OF PATIENTS' ELIGIBILITY IN PART VI, ON LINE 3.
ANGEL MEDICAL CENTER, INC.		PART V, SECTION B, LINE 3: IN THE RANDOM-SAMPLE SURVEY THAT WAS ADMINISTERED IN OUR COUNTY AS PART OF THIS REGIONAL COMMUNITY HEALTH ASSESSMENT, 200 COMMUNITY MEMBERS COMPLETED A QUESTIONNAIRE REGARDING THEIR HEALTH STATUS, HEALTH BEHAVIORS, INTERACTIONS WITH CLINICAL CARE SERVICES, SUPPORT FOR CERTAIN HEALTH-RELATED POLICIES, AND FACTORS THAT IMPACT THEIR QUALITY OF LIFE. IN ADDITION, IN OUR COUNTY, COMMUNITY MEMBERS AND PARTNERS WERE INVOLVED IN: - A COLLECTION AND REVIEW OF KEY HEALTH STATISTICS, COMPARING MACON COUNTY RESULTS WITH PEER COUNTIES AND NC RESULTS. IN ADDITION, TRENDS IN MACON COUNTY RESULTS WERE REVIEWED. - A QUANTITATIVE RESEARCH STUDY OF 401 MACON COUNTY ADULTS, SELECTED AT RANDOM, AND INTERVIEWED USING A COMPREHENSIVE HEALTH QUESTIONNAIRE. - A SERIES OF EIGHT COMMUNITY FOCUS GROUPS. THESE DISCUSSION GROUPS CONSISTED OF MACON RESIDENTS REPRESENTING IMPORTANT COMMUNITY PERSPECTIVES, SUCH AS SENIOR CITIZENS, STUDENTS, THE LATINO COMMUNITY, HIGHLANDS RESIDENTS, AND PRIVATE BUSINESSES. - INTERVIEWS WITH SELECTED COMMUNITY LEADERS WITH PERSPECTIVES ON HEALTH. - ASSESSMENT RESULTS WERE ALSO COMPARED TO A PREVIOUS HCMC ASSESSMENT COMPLETED IN 2007. BASED ON THE RESEARCH RESULTS, HCMC LEADERS AND VOLUNTEERS SET PRIORITIES THEY HOPE TO PROMOTE AND PURSUE OVER THE NEXT FEW YEARS.
ANGEL MEDICAL CENTER, INC.		PART V, SECTION B, LINE 4: REGIONAL PARTNERSHIP:ANGEL MEDICAL CENTER'S COLLABORATIVE COMMUNITY HEALTH IMPROVEMENT EFFORT IS ALSO SUPPORTED BY A COMPREHENSIVE PARTNERSHIP WITH OTHER REGIONAL HOSPITALS AND LOCAL HEALTH DEPARTMENTS. THIS INITIATIVE, KNOWN AS WNC HEALTHY IMPACT, REPRESENTS 16 COUNTIES ACROSS THE WESTERN NORTH CAROLINAREGION WORKING COLLABORATIVELY TO IMPROVE COMMUNITY HEALTH. INFORMATION ABOUT THIS INNOVATIVE REGIONAL COLLABORATION, COUNTY-WIDE COMMUNITY HEALTH ASSESSMENTS, AND OVERALL REGIONAL FINDINGS, ARE MADE WIDELY AVAILABLE TO THE PUBLIC AT WWW.WNCHEALTHYIMPACT.COM.
ANGEL MEDICAL CENTER, INC.		PART V, SECTION B, LINE 5C: THE COMMUNITY HEALTH NEEDS ASSESSMENT CAN BE VIEWED AT WWW.WNCHEALTHYIMPACT.COM BY NAVIGATING TO "LOCAL STORIES" AND THEN TO "MACON". THIS INFORMATION CAN ALSO BE FOUND WITHIN THE MISSION HEALTH SYSTEM WEBSITE: HTTP://WWW.MISSION-HEALTH.ORG/ABOUT-US/VISION-VALUES/COMMUNITY-BENEFIT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT.
ANGEL MEDICAL CENTER, INC.		PART V, SECTION B, LINE 12H: THE ASSET LEVEL FACTOR IN DETERMINING THE BASIS FOR CHARGING PATIENTS IS BASED UPON CASH LEVEL ONLY.
ANGEL MEDICAL CENTER, INC.		PART V, SECTION B, LINE 18E: ANGEL PERFORMS THESE ACTIONS BEFORE INITIATING ANY COLLECTION ACTIONS.
ANGEL MEDICAL CENTER, INC.		PART V, SECTION B, LINE 20D: IT IS THE INTENT OF THIS POLICY THAT ALL UNINSURED PATIENTS QUALIFYING UNDER THE POLICY WILL RECEIVE A DISCOUNT EQUIVALENT TO THE DISCOUNT RECEIVED BY MEDICARE AND COMMERCIALLY INSURED PATIENTS. THIS MINIMUM DISCOUNT LEVEL FOR UNINSURED PATIENTS IS CALCULATED AT LEAST ANNUALLY BY DIVIDING THE SUM OF ALL MEDICARE AND COMMERCIAL INSURANCE PAYMENTS FOR EMERGENCY AND OTHER MEDICALLY NECESSARY CARE FROM CLAIMS THAT HAVE BEEN PAID IN FULL, BY THE SUM OF THE ASSOCIATED GROSS CHARGES FOR THOSE CLAIMS.
	PART V, SECTION B, LINE 14G:	INFORMATION REGARDING ANGEL'S FINANCIAL ASSISTANCE AND CHARITY POLICY IS AVAILABLE VIA THE MISSION HEALTH SYSTEM'S WEB SITE, WHICH APPLIES TO ALL FACILITY LOCATIONS, POSTED THROUGHOUT EACH FACILITY, PATIENT FRIENDLY MATERIALS, DURING FINANCIAL DISCUSSION WITH HOSPITAL STAFF AND UPON REQUEST.
		PART VI, LINE 2: ANGEL MEDICAL CENTER ASSESSES THE HEALTH CARE NEEDS OF THE COMMUNITY BY CONDUCTING A STRATEGIC PLANNING PROCESS THAT LOOKS AT A NUMBER OF INDICATORS THAT PROVIDE INPUT FOR PROVISION OF SERVICE FOR THE COMMUNITY. THE PROCESS INCLUDES BUT IS NOT LIMITED TO THE FOLLOWING: PARTICIPATION IN THE HEALTHY CAROLINIANS OF MACON COUNTY'S HEALTH ASSESSMENT, WHICH INCLUDES PHONE SURVEYS, FOCUS GROUPS AND INTERVIEWS WITH LOCAL BUSINESS, COMMUNITY AND HEALTH CARE LEADERS. AMC HAS AN ACTIVE COMMUNITY RELATIONS BOARD THAT MEETS REGULARLY TO DISCUSS THE HOSPITAL AND ITS RELATIONSHIP TO THE COMMUNITY. AMC'S BOARD OF DIRECTORS MEETS MONTHLY TO DISCUSS HOSPITAL OPERATIONS, QUALITY, PATIENT SAFETY AND THE NEEDS OF THE COMMUNITY. THE BOARD HAS AN ACTIVE PLANNING AND DEVELOPMENT COMMITTEE THAT ALSO MEETS MONTHLY TO WORK ON THE PLANNING PROCESS FOR THE HOSPITAL AND ROUTINELY ASSESS THE PROVISION OF SERVICES FOR THE COMMUNITY. THE HOSPITAL CEO AND THE DIRECTOR OF THE MACON COUNTY HEALTH DEPARTMENT MEET REGULARLY TO DISCUSS VARIOUS HEALTH CARE INITIATIVES, PROCESSES AND PROGRAMS. A NUMBER OF HOSPITAL EMPLOYEES ARE INVOLVED IN VARIOUS COMMUNITY ORGANIZATIONS THAT MEET THE NEEDS OF MACON COUNTY RESIDENTS. THESE INCLUDE BUT ARE NOT LIMITED TO "REACH", THE COUNTY'S DOMESTIC VIOLENCE AND SEXUAL ASSAULT AGENCY; "KIDS PLACE", AN ADVOCACY AGENCY FOR ABUSED CHILDREN; "CARENET", AN AGENCY THAT PROVIDES FOOD AND OTHER ESSENTIALS TO THOSE IN NEED; AND "THE COMMUNITY CARE CLINIC OF FRANKLIN", A FREE CLINIC OFFERING MINOR HEATH CARE SERVICES TO THE RESIDENTS OF MACON COUNTY. ADDITIONALLY, AMC ADMINISTRATION PARTICIPATES ON A NUMBER OF REGIONAL AND STATE BOARDS AND ORGANIZATIONS THAT PROVIDE INPUT INTO TRENDS AND CHANGES THAT MAY IMPACT THE PROVISION OF HEALTH CARE IN OUR COMMUNITY.
		PART VI, LINE 3: THE CURRENT INDIGENT CARE POLICY IS POSTED AT THE REGISTRATION AREAS. PATIENT'S ARE ENCOURAGED TO SPEAK WITH A PATIENT COUNSELOR TO SEEK FINANCIAL ASSISTANCE.
		PART VI, LINE 4: ANGEL MEDICAL CENTER SERVES MACON COUNTY, NC WITH A POPULATION OF APPROXIMATELY 34,000, 25.2% OF WHICH ARE OVER THE AGE 65, 19.6% OF WHICH ARE BELOW POVERTY LEVEL AND 7.5% OF WHICH ARE UNEMPLOYED. THE AVERAGE ANNUAL HOUSEHOLD INCOME IS ROUGHLY $38,000. THE ETHNIC DEMOGRAPHICS OF THE AREA IS WIDE-SPREAD INCLUDING A 6.6% HISPANIC POPULATION, A 1.7% AFRICAN AMERICAN POPULATION AND OTHER MINORITY POPULATIONS TOTALING 1.4%. THESE STATISTICS ARE ACCORDING TO THE US CENSUS BUREAU AND THE EMPLOYMENT SECURITIES COMMISSION OF NC.
		PART VI, LINE 5: SEE PROGRAM SERVICES ACCOMPLISHMENTS ON PAGE 2 OF THE 990.
		PART VI, LINE 6: ANGEL MEDICAL CENTER IS PART OF AN AFFILIATED HEALTH CARE SYSTEM WITH THE RESPECTIVE ROLES OF THE ORGANIZATION AND ITS AFFILIATES DESCRIBED BELOW IN PROMOTING THE HEALTH OF THE COMMUNITIES SERVED.MISSION HEALTH SYSTEM, INC. IS THE PARENT ORGANIZATION FOR THE CHARITABLE ORGANIZATIONS OF MISSION HOSPITAL, INC.; MISSION HEALTHCARE FOUNDATION, INC.; MISSION MEDICAL ASSOCIATES, INC; BLUE RIDGE REGIONAL HOSPITAL, INC.; AND THE MCDOWELL HOSPITAL, INC.MISSION HOSPITAL, INC. IS A REGIONAL INTEGRATED HEALTH SYSTEM PROVIDING SUPERIOR CARE AND SERVICE TO PATIENTS AND THEIR FAMILIES THROUGH A FULL CONTINUUM OF INTEGRATED SERVICES, EDUCATION, AND RESEARCH. IT SERVES AS A TRAUMA CENTER TO PEOPLE OF WESTERN NORTH CAROLINA AND THE SURROUNDING COUNTIES. MISSION MEDICAL ASSOCIATES MISSION IS TO PROVIDE PHYSICIAN SERVICES IN PREDOMINANTLY RURAL AREAS THAT ARE INSUFFICIENTLY SERVED, THEREBY IMPROVING THE HEALTH CARE OF THE GENERAL PUBLIC. IN MANY CASES THIS INVOLVES RECRUITING AND PLACING PRIMARY CARE PHYSICIANS, AS WELL AS PEDIATRIC AND ADULT SPECIALTY SERVICES CLOSE TO WHERE PEOPLE LIVE AND WORK.BLUE RIDGE REGIONAL HOSPITAL SERVES AS A COMMUNITY HOSPITAL IN MITCHELL, YANCEY AND SURROUNDING COUNTIES.ANGEL MEDICAL CENTER, INC. SERVES AS A COMMUNITY HOSPITAL IN MACON AND SURROUNDING COUNTIES.TRANSYLVANIA COMMUNITY HOSPITAL, INC.SERVES AS A COMMUNITY HOSPITAL IN TRANSYLVANIA AND SURROUNDING COUNTIES.THE MCDOWELL HOSPITAL SERVES AS A COMMUNITY HOSPITAL IN MCDOWELL AND THE SURROUNDING COUNTIES.MISSION HEALTHCARE FOUNDATION, INC. SUPPORTS THE MISSION AND PROGRAMS OF MISSION HOSPITAL, INC. AND MISSION HEALTH SYSTEM, INC. AND OF OTHER ORGANIZATIONS THAT ARE TAX EXEMPT UNDER THE PROVISIONS OF SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND WORKS TO BENEFIT THE COMMUNITY AND REGION SERVED BY THE ENTITIES LISTED ABOVE.
	PART VI LINE 5	AMC'S BOARD OF DIRECTORS IS MADE UP OF A CROSS SECTION OF THE COMMUNITY ALONG WITH REPRESENTATIVES OF MISSION HEALTH SYSTEM AFFILIATES DEDICATED TO ITS IMPROVEMENT. STAFF PRIVILEGES ARE EXTENDED TO AREA PHYSICIANS WHO ARE BOARD CERTIFIED, ALLOWING CERTAIN SPECIALTY SERVICES TO PATIENTS WHO WOULD OTHERWISE HAVE TO TRAVEL FOR TREATMENT. THE NUMBER OF CANCER PATIENTS IN MACON COUNTY IS CONTINUALLY RISING. AMC IS IN THE PROCESS OF ENHANCING ITS CHEMOTHERAPY SERVICES WITHIN THE YEAR BY OPENING A NEW OUTPATIENT INFUSION CENTER. AMC OFFERS FREE SCREENINGS DURING CANCER AWARENESS MONTHS.
	PART VI LINE 6	ANGEL MEDICAL CENTER IS PART OF THE MISSION HEALTH SYSTEM, BASED IN ASHEVILLE, NC, MHS IS THE STATE'S SIXTH LARGEST HEALTH SYSTEM AND THE REGION'S ONLY NOT-FOR-PROFIT, INDEPENDENT COMMUNITY HOSPITAL SYSTEM GOVERNED AND MANAGED EXCLUSIVELY IN WESTERN NORTH CAROLINA. LOCATED IN FRANKLIN, NC, AMC SERVES MACON AND SURROUNDING COUNTIES WITH BOTH INPATIENT AND OUTPATIENT SERVICES, INCLUDING AN URGENT CARE CENTER AND HOME HEALTH SERVICES.
LIST OF STATES RECEIVING COMMUNITY BENEFIT REPORT:	PART VI, LINE 7	NC

Schedule H (Form 990) 2012

Additional Data

Software ID:
Software Version:

- TIN:

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

2012

Open to Public Inspection

Name of the organization

ANGEL MEDICAL CENTER INC

Employer identification number

56-6000064

Part I

Questions Regarding Compensation

Yes

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.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain....

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? .......

Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

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:

Receive a severance payment or change-of-control payment? ................

Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........

Yes

Participate in, or receive payment from, an equity-based compensation arrangement? .........

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.

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:

The organization? ...........................

Any related organization? .........................

If "Yes," to line 5a or 5b, describe in Part III.

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:

The organization? ...........................

Any related organization? .........................

If "Yes," to line 6a or 6b, describe in Part III.

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 ............

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 Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................

If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50053T

Schedule J (Form 990) 2012

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is 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) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.

(A) Name and Title		(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 as deferred in prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation reported as deferred in prior Form 990
(1)CHUCK TRENTHAM MDBOARD MEMBER	(i) (ii)	353,635 0	0 0	0 0	0 0	0 0	353,635 0	0 0
(2)JOHN J MAHERBOARD MEMBER	(i) (ii)	0 260,635	0 58,433	0 2,635	0 56,048	0 21,092	0 398,843	0 0
(3)TRAVIS PETRICEK MDCHIEF OF STAFF	(i) (ii)	355,089 0	5,473 0	0 0	16,500 0	21,192 0	398,254 0	0 0
(4)ROBERT BEDNAREKBOARD MEMBER	(i) (ii)	0 236,337	0 49,687	0 16,331	0 39,276	0 13,459	0 355,090	0 0
(5)MARTIN WADEWITZCOO	(i) (ii)	84,986 0	19,500 0	6,512 0	16,500 0	34,841 0	162,339 0	0 0
(6)JEFF RUSHCFO	(i) (ii)	157,500 0	0 0	0 0	0 0	0 0	157,500 0	0 0
(7)VICTOR ADAN MDPHYSICIAN	(i) (ii)	242,068 0	21,684 0	2,409 0	16,500 0	27,101 0	309,762 0	0 0
(8)GILBERTO ROBLES MDPHYSICIAN	(i) (ii)	350,791 0	52,282 0	36,924 0	8,344 0	0 0	448,341 0	0 0
(9)NELSON P DAVIS MDPHYSICIAN	(i) (ii)	274,822 0	0 0	0 0	11,001 0	0 0	285,823 0	0 0
(10)MICHAEL D SHEAFFER MDPHYSICIAN	(i) (ii)	270,535 0	3,573 0	750 0	22,500 0	23,617 0	320,975 0	0 0
(11)PATRICK KESSLER MDPHYSICIAN	(i) (ii)	209,246 0	0 0	28,700 0	22,000 0	12,398 0	272,344 0	0 0

Schedule J (Form 990) 2012

Page 3

Part III

Supplemental Information

Complete this part to provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II.
Also complete this part for any additional information.

Identifier	Return Reference	Explanation
	PART I, LINE 4B	PART I, LINE 4B: THE FOLLOWING RECEIVED SUPPLEMENTAL NON-QUALIFIED PLAN PAYMENTS FROM THE FILING ORGANIZATION: JIM BROSS: $6,663 THE FOLLOWING RECEIVED SUPPLEMENTAL NON-QUALIFIED PLAN PAYMENTS FROM A RELATED ORGANIZATION: ROBERT BEDNAREK: $31,970 JOHN MAHER: $11,512

Schedule J (Form 990) 2012

Additional Data

Software ID:
Software Version:

- TIN:

Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Part VI.
SchKMediumBullet

Attach to Form 990. SchKMediumBullet

See separate instructions.

OMB No. 1545-0047

2012

Open to Public
Inspection

Name of the organization
ANGEL MEDICAL CENTER INC

Employer identification number
56-6000064

Part I

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	NORTH CAROLINA MEDICAL CARE COMMISSION	52-1309402		08-17-2011	14,485,000	SEE PART VI		X		X		X

Part II

Proceeds

	A		B		C		D
	1 Amount of bonds retired . . . . . . . . . . . . . .	2,315,000
2 Amount of bonds legally defeased . . . . . . . . . . .
3 Total proceeds of issue . . . . . . . . . . . . . .	14,485,000
4 Gross proceeds in reserve funds . . . . . . . . . . . .
5 Capitalized interest from proceeds . . . . . . . . . . .
6 Proceeds in refunding escrows . . . . . . . . . . . .
7 Issuance costs from proceeds . . . . . . . . . . . .
8 Credit enhancement from proceeds . . . . . . . . . . .
9 Working capital expenditures from proceeds . . . . . . . . .
10 Capital expenditures from proceeds . . . . . . . . . . .
11 Other spent proceeds . . . . . . . . . . . . . .	14,485,000
12 Other unspent proceeds . . . . . . . . . . . . . .
13 Year of substantial completion . . . . . . . . . . . .	2010
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue? . . . . .	X
15 Were the bonds issued as part of an advance refunding issue? . . . . .		X
16 Has the final allocation of proceeds been made? . . . . . . . .	X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . . .	X

Part III

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . . . . . .		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . .		X

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50193E

Schedule K (Form 990) 2012

Page 2

Part III

Private Business Use (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
3a Are there any management or service contracts that may result in private business use of bond-financed property? . . . . . . . . . . . .		X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property? . . . . . . . . . . . . . . . .
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . . . . . . . . . .		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property? .
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . .	%		%		%		%
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . . . . . . .	%		%		%		%
6 Total of lines 4 and 5 . . . . . . . . . . . . . . .	%		%		%		%
7 Does the bond issue meet the private security or payment test? . . . . .		X
8a Has there been a sale or disposition of any of the bond financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?. . . . . . . . . . . . . . . . .		X
b If “Yes” to line 8a, enter the percentage of bond-financed property sold or disposed of.	%		%		%		%
c If “Yes” to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? . . . . . . . . . . . . .
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2?	X

Part IV

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T? . . . . .		X
2 If "No" to line 1, did the following apply? . . . .
a Rebate not due yet? . . . . . . . .		X
b Exception to rebate? . . . . . . . .	X
c No rebate due? . . . . . . . . . .		X
If you checked "No rebate due" in line 2c, provide in Part VI the date the rebate computation was performed
3 Is the bond issue a variable rate issue? . . . .	X
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X
b Name of provider . . . . . . . . .
c Term of hedge . . . . . . . . . .
d Was the hedge superintegrated? . . . . . .
e Was a hedge terminated? . . . . . . .

Schedule K (Form 990) 2012

Page 3

Part IV

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)? . . . . . . . . .		X
b Name of provider . . . . . . . . .
c Term of GIC . . . . . . . . . .
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . .
6 Were any gross proceeds invested beyond an available temporary period? . . . . . . . .		X
7 Has the organization established written procedures to monitor the requirements of section 148? . . .		X

Part V

Procedures To Undertake Corrective Action

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?

Part VI

Supplemental Information. Complete this part to provide additional information for responses to questions on Schedule K (see instructions).

Identifier	Return Reference	Explanation
PART I, LINE A	COLUMN (F)	REFUND ALL OF THE OUTSTANDING NORTH CAROLINA MEDICAL CARE COMMISSION HEALTH CARE FACILITIES REVENUE BONDS (ANGEL MEDICAL CENTER), SERIES 2007 ORIGINALLY ISSUED ON MARCH 22, 2007 (DEEMED REISSUANCE).
PART II, LINE 11	COLUMN A	AMOUNT USED TO CURRENT REFUND PRIOR BOND ON ISSUE DATE.
PART II, LINE 13	COLUMN (A)	THE PROJECT WAS SUBSTANTIALLY COMPLETED IN 2010, THESE BONDS REFINANCED BONDS PREVIOUSLY ISSUED.

Schedule K (Form 990) 2012

Additional Data

Software ID:
Software Version:

- TIN:

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

2012

Open to Public
Inspection

Name of the organization

ANGEL MEDICAL CENTER INC

Employer identification number

56-6000064

Identifier	Return Reference	Explanation
	FORM 990, PART VI, SECTION A, LINE 3	THE ORGANIZATION EXECUTED A MANAGEMENT AGREEMENT WITH MISSION HEALTH SYSTEM, INC., A NORTH CAROLINA NONPROFIT CORPORATION. THE TERM OF THE AGREEMENT IS TEN YEARS. THE AGREEMENT PROVIDES FOR A RANGE OF ADMINISTRATIVE MANAGEMENT SERVICES FOR THE ORGANIZATION INCLUDING BUT NOT LIMITED TO: 1) STRATEGIES FOR DEVELOPING AND MAINTAINING PRIMARY CARE, SURGICAL AND MEDICAL SECONDARY CARE, TERTIARY CARE AND OUTREACH CLINICS 2) RECRUITMENT AND CONTRACTING FOR CERTAIN MEDICAL SERVICES 3) IMPROVING FINANCIAL VIABILITY OF PHYSICIAN CONTRACTS 4) STAFF EDUCATION AND TRAINING 5) CREDENTIALING 6) MAINTAINING AN APPROPRIATE MANAGEMENT TEAM 7) CORPORATE COMPLIANCE MISSION HEALTH SYSTEM, INC. ALSO RESERVES THE RIGHT TO REQUIRE THE CEO OF THE ORGANIZATION TO BECOME A MISSION EMPLOYEE, WHO WOULD BE REPORTABLE TO BOTH THE BOARDS OF MISSION HEALTH SYSTEM AND THE ORGANIZATION.
	FORM 990, PART VI, SECTION A, LINE 7A	MISSION HEALTH SYSTEM, INC. A NORTH CAROLINA NONPROFIT CORPORATION, HAS THE RIGHT TO APPOINT UP TO SEVEN MEMBERS OF THE GOVERNING BODY.
	FORM 990, PART VI, SECTION A, LINE 7B	PER THE MANAGEMENT AGREEMENT DISCUSSED IN LINE 3 ABOVE, DURING THE TERM OF THE AGREEMENT THE FOLLOWING ACTIONS REQUIRE THE JOINT APPROVAL OF BOTH THE ORGANIZATION'S BOARD OF DIRECTORS AND THE BOARD OF MISSION HEALTH SYSTEM, INC. 1) MATERIAL REDUCTION OR ELIMINATION OF MAJOR SERVICE LINES 2) CHANGE IN CERTAIN PHYSICIAN GROUPS PROVIDING HOSPITAL-BASED PHYSICIAN SERVICES 3) CHANGE IN NAME OF ORGANIZATION 4) AMENDMENT OF ARTICLES OF INCORPORATION AND/OR BYLAWS 5) ADOPTION OR MODIFICATION OF ANY STATEMENTS OR EXPRESSIONS OF MISSION, VALUESS, AND VISIONS OF THE ORGANIZATION 6) SALE, LEASE, OR OTHER TRANSFER OF A MATERIAL PORTION OF THE ORGANIZATION'S ASSETS 7) ENCUMBRANCE ON A MATERIAL PORTION OF THE ORGANIZATION'S ASSETS 8) PURCHASE, SALE, LEASE OR PLEDGE OF REAL PROPERTY OUTSIDE THE ORDINARY COURSE OF BUSINESS 9) DISSOLUTION, MERGER, OR CORPORATE BUSINESS COMBINATIONS 10) FORMATION OF NEW CORPORATIONS, PARTNERSHIPS, OR CONTRACTUAL JOINT VENTURES 11) HIRING OR REPLACEMENT OF THE ORGANIZATION'S CEO (MISSION RESERVIES THE SOLE RIGHT TO REMOVE THE ORGANIZATION'S CEO) 12) TO ISSUE, REFINANCE, OR RETIRE DEBT 13) APPROVAL, ADOPTION OR MODIFICATION OF CAPITAL OR OPERATING BUDGETS 14) APPROVAL, ADOPTION OR MODIFICATION OF A STRATEGIC OR FINANCIAL PLAN 15) SELECTION OR RETENTION OF EXTERNAL AUDITORS AND LEGAL COUNSEL (WITH CERTAIN EXCEPTIONS) 16) FILING OF CERTAIN VOLUNTARY PETITIONS CONCERNING BANKRUPTCY, DEBT RELIEF, INSOLVENCY PLEASE, ETC 17) MATERIAL MODIFICATION OF OFFICERS' INSURANCE CURRENTLY MAINTAINED
	FORM 990, PART VI, SECTION B, LINE 11	THE ORGANIZATION PROVIDES DATA TO THE SENIOR TREASURY ANALYST OF TAX SERVICES FOR MISSION HEALTH SYSTEM, INC. THE 990 IS PREPARED AND REVIEWED BY MANAGEMENT PRIOR TO THE REVIEW BY THE ANGEL MEDICAL CENTER FINANCE COMMITTEE. AN INDEPENDENT ACCOUNTING FIRM REVIEWS SCHEDULE H AND SCHEDULE R. AFTER REVIEW BY THE BOARD OF DIRECTORS, AND REVISIONS FOR ANY CLARIFICATIONS OR CORRECTIONS, THE FULL COPY OF THE 990 IS PROVIDED TO THE BOARD PRIOR TO FILING THE 990.
	FORM 990, PART VI, SECTION B, LINE 12C	THE BOARD OF DIRECTORS CIRCULATES A CONFLICT OF INTEREST POLICY ANNUALLY, REQUIRING ALL VOTING BOARD MEMBERS TO REVIEW, SIGN, AND RETURN. MEMBERS PRESENTING A POTENTIAL CONFLICT OF INTEREST RECUSE THEMSELVES BEEFORE ANY DISCUSSION OR VOTE ON A TOPIC THAT INCLUDES AN INTERESTED PARTY OR TRANSACTION.
	FORM 990, PART VI, SECTION B, LINE 15A	THE COMPENSATION PLAN FOR THE CEO INCLUDES A YEARLY REVIEW OF THE CEO'S ANNUAL BASE SALARY, A REVIEW OF PRE-APPROVED CRITERIA TO DETERMINE ANY INCENTIVE/BONUS, AND A GENERAL EVALUATION CONDUCTED BY THE EXECUTIVE COMMITTEE OF THE BOARD. THE REVIEW OF PERFORMANCE AND COMPENSATION ANALYSIS OF OTHER INDUSTRY CEOS' SALARIES INCLUDES BUT IS NOT LIMITED TO A REVIEW OF COMPILED DATA FROM PERRY AND ASSOCIATES FOR THE NC HEALTHCARE HUMAN RESOURCES ASSOCIATION, YAFFE & COMPANY FOR NC HOSPITAL ASSOCIATION, AND SELECT WESTERN NORTH CAROLINA HOSPITALS IN THE IMMEDIATE AREA. THE CEO PRESENTS A CURRENT SELF-EVALUATION ALONG WITH THE NEXT FISCAL YEAR'S RECOMMENDED OBJECTIVES WITH WEIGHTED VALUES TO THE BOARD CHAIR. SALARIES FOR OTHER OFFICERS AND KEY EMPLOYEES ARE REVIEWED ANNUALLY BY LOOKING AT COMPARABLE MARKET DATA BY THE HR MANAGER, CEO, AND VP OF FINANCE.
	FORM 990, PART VI, SECTION C, LINE 19	THE ORGANIZATION'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST AT THE ORGANIZATION'S ADMINISTRATIVE OFFICE. ANGEL MEDICAL CENTER'S FY 2012 AUDITED FINANCIAL STATEMENTS ARE ATTACHED TO THIS RETURN.
CHANGES IN NET ASSETS OR FUND BALANCES:	FORM 990, PART XI, LINE 9:	TRANSFER FROM MISSION HEALTH SYSTEM 3,009,000. NET EFFECT FROM BUSINESS COMBINATION 2,437,078.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2012

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" to Form 990, Part IV, line 33, 34, 35, 36, or 37.
MediumBullet

Attach to Form 990. MediumBullet

See separate instructions.

OMB No. 1545-0047

2012

Open to Public Inspection

Name of the organization

ANGEL MEDICAL CENTER INC

Employer identification number

56-6000064

Part I

Identification of Disregarded Entities (Complete if the organization answered "Yes" to Form 990, Part IV, line 33.)

(a) Name, address, and EIN (if applicable) 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" to 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 entity?
(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	Yes	No
(1) ANGEL MEDICAL CENTER AUXILIARY PO BOX 1209 FRANKLIN,NC28744 56-2133719	SUPPORTING ORGANIZATION	NC	501(C)(3)	LINE 11A, I	ANGEL MEDICAL CENTER INC		No
(2) MISSION HEALTH SYSTEM INC 400 RIDGEFIELD COURT SUITE 100 ASHEVILLE,NC28806 58-1450888	PARENT COMPANY SUPPORT SERVICES	NC	501(C)(3)	LINE 11A, I	N/A		No
(3) MISSION MEDICAL ASSOCIATES INC 866 HENDERSONVILLE ROAD ASHEVILLE,NC28803 26-3627231	EMPLOYED PHYSICIAN GROUP	NC	501(C)(3)	LINE 9	MISSION HEALTH SYSTEM INC		No
(4) THE MCDOWELL HOSPITAL INC 430 RANKIN AVENUE MARION,NC28742 56-0623938	COMMUNITY HOSPITAL	NC	501(C)(3)	LINE 3	MISSION HEALTH SYSTEM INC		No
(5) MISSION HEALTHCARE FOUNDATION INC 980 HENDERSONVILLE ROAD ASHEVILLE,NC28803 56-1025032	FOUNDATION	NC	501(C)(3)	LINE 7	MISSION HEALTH SYSTEM INC		No
(6) MISSION HOSPITAL INC 400 RIDGEFIELD COURT SUITE 100 ASHEVILLE,NC28806 56-0532141	COMMUNITY HOSPITAL	NC	501(C)(3)	LINE 3	MISSION HEALTH SYSTEM INC		No
(7) BLUE RIDGE REGIONAL HOSPITAL INC P O BOX 9 SPRUCE PINE,NC28777 56-1025032	COMMUNITY HOSPITAL	NC	501(C)(3)	LINE 3	MISSION HEALTH SYSTEM INC		No
(8) BLUE RIDGE REGIONAL HOSPITAL FOUNDATION PO BOX 247 SPRUCE PINE,NC28777 58-2172660	FOUNDATION	NC	501(C)(3)	LINE 11A, I	BLUE RIDGE REGIONAL HOSPITAL INC		No
(9) TRANSYLVANIA COMMUNITY HOSPITAL INC 260 HOSPITAL DRIVE BREVARD,NC28712 56-0562293	COMMUNITY HOSPITAL	NC	501(C)(3)	LINE 3	MISSION HEALTH SYSTEM INC		No
(10) TRANSYLVANIA REGIONAL HOSPITAL FOUNDATION INC PO BOX 2440 BREVARD,NC28712 56-1458024	FOUNDATION	NC	501(C)(3)	LINE 11A, I	TRANSYLVANIA COMMUNITY HOSPITAL INC		No
(11) TRANSYLVANIA PHYSICIAN SERVICES INC 260 HOSPITAL DRIVE BREVARD,NC28712 56-1920816	HEALTHCARE	NC	501(C)(3)	LINE 3	TRANSYLVANIA COMMUNITY HOSPITAL INC		No
(12) TRANSYLVANIA HEALTH SYSTEM INC 260 HOSPITAL DRIVE BREVARD,NC28712 56-1456987	MERGED WITH TRANSYLVANIA COMMUNITY HOSPITAL, JUNE 2013	NC	501(C)(3)	LINE 11B, II	DISSOLVED		No
(13) MCDOWELL HEALTHCARE FOUNDATION INC 430 RANKIN AVENUE MARION,NC28752 46-3395393	FOUNDATION	NC	501(C)(3)	LINE 11A, I	THE MCDOWELL HOSPITAL INC		No

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2012

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership (Complete if the organization answered "Yes" to 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	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No
(1) ASHEVILLE IMAGING LLP 534 BILTMORE AVENUE ASHEVILLE,NC28801 56-1907201	OUTPATIENT IMAGING SERVICES	NC	N/A
(2) IMAGING REALTY LLP 534 BILTMORE AVENUE ASHEVILLE,NC28801 56-1907203	MEDICAL OFFICE BUILDING	NC	N/A
(3) MSJHS AND CCP JOINT DEVELOPMENT COMPANY LLC 428 BILTMORE AVENUE ASHEVILLE,NC28801 56-2250464	LONG TERM ACUTE CARE HOSPITAL	NC	N/A
(4) BLUE RIDGE DME LLC 125 HOPSITAL DRIVE SPRUCE PINE,NC28777 26-3570174	HOME MEDICAL EQUIPMENT AND SUPPLIES SALES	NC	N/A
(5) MCDOWELL MRI LLC 414 RANKING AVENUE MARION,NC28752 75-3046378	MEDICAL IMAGING	NC	N/A
(6) BREVARD MRI AT TRANSYLVANIA REGIONAL HOSPITALLLC 260 HOSPITAL DRIVE BREVARD,NC28712 20-3281110	MEDICAL	NC	N/A
(7) TRANSYLVANIA HEALTHCARE II LIMITED PARTNERSHIP 2 MEDICAL PARK DRIVE BREVARD,NC28712 20-0333230	RENTAL	NC	N/A
(8) HEALTHCARE III LIMITED PARTNERSHIP 260 HOSPITAL DRIVE BREVARD,NC28712 56-1599696	RENTAL	NC	N/A
(9) HEALTHCARE LIMITED LIABILITY COMPANY VII 260 HOSPITAL DRIVE BREVARD,NC28712 20-0343455	RENTAL	NC	N/A
(10) WESTERN NC HEALTHCARE INNOVATORS LLC 5935 CARNEGIE BLVD CHARLOTTE,NC28209 80-0787882	REAL ESTATE RENTAL	NC	N/A
(11) WESTERN REGIONAL RADIATION THERAPY CENTER 68 HOSPITAL DRIVE SYLVA,NC28779 56-1849395	RADIATION THERAPY	NC	N/A
(12) ASHEVILLE MRI PO BOX 2959 ASHEVILLE,NC28802 56-1665863	IMAGING SERVICES	NC	N/A
(13) WNC STONE CENTER 509 BILTMORE AVENUE ASHEVILLE,NC28801 27-2152974	LITHOTRIPSY RENTAL	NC	N/A

Part IV

Identification of Related Organizations Taxable as a Corporation or Trust (Complete if the organization answered "Yes" to 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	(i) Section 512(b)(13) controlled entity?
(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	Yes	No
(1) HORIZON HEALTH CORP 213 RIDGEFIELD COURT ASHEVILLE,NC28806 56-1341621	HOLDING COMPANY	NC	N/A	C				No
(2) HORIZON MANAGEMENT SERVICES INC 213 RIDGEFIELD COURT ASHEVILLE,NC28806 56-1341624	PATIENT BILLING AND COLLECTION SERVICES, MEDICAL PROPERTY RENTAL	NC	N/A	C				No
(3) DOGWOOD INSURANCE COMPANY LTD THEGRANDPAVILIONCOMMERCIALCENTREPOB CAYMAN ISLANDS CJ	CAPTIVE INSURANCE ENTITY	CJ	N/A	C				No
(4) TRANSYLVANIA SERVICES INC 260 HOSPITAL DRIVE BREVARD,NC28712 56-1448199	REAL ESTATE	NC	N/A	C				No

Schedule R (Form 990) 2012

Page 3

Part V

Transactions With Related Organizations (Complete if the organization answered "Yes" to Form 990, Part IV, line 34, 35b, or 36.)

Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.

Yes

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 or (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .

b Gift, grant, or capital contribution to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

c Gift, grant, or capital contribution from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

d Loans or loan guarantees to or for related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

e Loans or loan guarantees by related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

f Dividends from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

g Sale of assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

h Purchase of assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

i Exchange of assets with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

j Lease of facilities, equipment, or other assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .

k Lease of facilities, equipment, or other assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .

l Performance of services or membership or fundraising solicitations for related organization(s) . . . . . . . . . . . . . . . . . . . .

m Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .

Yes

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .

Yes

o Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

p Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

q Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

r Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

s Other transfer of cash or property from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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-s)	(c) Amount involved	(d) Method of determining amount involved

Schedule R (Form 990) 2012

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership (Complete if the organization answered "Yes" to 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)	(e) Are all partners section 501(c)(3) organizations?		(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Schedule R (Form 990) 2012

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:

1	Briefly describe the organization’s mission or most significant activities: PROVISION OF HEALTHCARE SERVICES
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	17
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	12
5	Total number of individuals employed in calendar year 2011 (Part V, line 2a) ......	5	541
6	Total number of volunteers (estimate if necessary) .............	6	150
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	543,605
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b	-87,532

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	320,901	209,007
9	Program service revenue (Part VIII, line 2g) .........	42,393,650	49,091,493
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	156,713	17,443
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	903,136	65,922
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)...................	43,774,400	49,383,865
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)	21,949,731	30,521,990
16a	Professional fundraising fees (Part IX, column (A), line 11e).....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 332,103
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	22,091,146	18,519,053
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	44,040,877	49,041,043
19	Revenue less expenses. Subtract line 18 from line 12.......	-266,477	342,822
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	29,921,717	33,772,164
21	Total liabilities (Part X, line 26).............	18,572,403	16,633,950
22	Net assets or fund balances. Subtract line 21 from line 20.....	11,349,314	17,138,214

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 43,118,333 including grants of $ ) (Revenue $ 48,311,246 )
	ANGEL MEDICAL CENTER, INC. (AMC) PROVIDES QUALITY MEDICAL HEALTHCARE SERVICES TO PEOPLE IN ITS SERVICE AREA REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE, OR ABILITY TO PAY. ALTHOUGH REIMBURSMENT FOR SERVICES RENDERED IS CRITICAL TO THE OPERATION AND STABILITY OF AMC, IT IS RECOGNIZED THAT NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PAY FOR ESSENTIAL MEDICAL SERVICES. AMC FURTHER RECOGNIZES THAT ITS MISSION IS TO SERVE THE COMMUNITY WITH RESPECT TO PROVIDING HEALTHCARE SERVICES AND EDUCATION. TO THIS END, AMC PROVIDES FREE CARE, SUBSIDIZED CARE, AND CARE AT BELOW COST TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS. HEALTHCARE ACTIVITIES AND SCREENINGS, PROGRAMS AND EDUCATION TO SUPPORT THE COMMUNITY'S HEALTH ARE ALSO PROVIDED EACH YEAR. DURING FISCAL YEAR ENDED SEPTEMBER 30, 2013, AMC PROVIDED HEALTHCARE SERVICE TO 1,681 INPATIENTS WITH A TOTAL OF 5,875 PATIET DAYS, 16,527 EMERGENCY PATIENTS AND 26,388 VISITS TO AMC PHYSICIAN OFFICES.

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 expenses43,118,333

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)			(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
(A) Name and Title
(18) JIM BROSS........................................................................ CEO	50.00 .......................	X		102,873	0	14,904
(19) MARTIN WADEWITZ........................................................................ COO	50.00 .......................	X		110,998	0	51,341
(20) SHEILA PRICE........................................................................ CNO	50.00 .......................	X		124,424	0	21,413
(21) JEFF RUSH........................................................................ CFO	50.00 .......................	X		157,500	0	0
(22) GEORGE KIMBRO........................................................................ CFO THROUGH STARTING AUG 2013	50.00 .......................	X		0	0	0
(23) CYNTHIA GREENE........................................................................ CFO THROUGH AUG 2013	50.00 .......................	X		4,690	0	0
(24) VICTOR ADAN MD........................................................................ PHYSICIAN	50.00 .......................		X	266,161	0	43,601
(25) GILBERTO ROBLES MD........................................................................ PHYSICIAN	50.00 .......................		X	439,997	0	8,344
(26) NELSON P DAVIS MD........................................................................ PHYSICIAN	50.00 .......................		X	274,822	0	11,001
(27) MICHAEL D SHEAFFER MD........................................................................ PHYSICIAN	50.00 .......................		X	274,858	0	46,117
(28) PATRICK KESSLER MD........................................................................ PHYSICIAN	50.00 .......................		X	237,946	0	34,398

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)............	2,781,266	624,058	398,686

				(A) Total revenue	(B) Related or exempt function revenue	(C) Unrelated business revenue	(D) Revenue excluded from tax under sections 512, 513, or 514
1a	Federated campaigns..1a
b	Membership dues....1b
c	Fundraising events....1c		29,289
d	Related organizations...1d		20,000
e	Government grants (contributions)1e

f	All other contributions, gifts, grants, and similar amounts not included above1f		159,718

g	Noncash contributions included in lines 1a-1f:$
h	Total. Add lines 1a-1f.......			209,007
			Business Code
2a	NET PATIENT SERVICES REVENUE		900099	45,748,851	45,748,851
b	OTHER OPERATING REVENUE		900099	2,562,395	2,562,395
c	CATERING/MEAL SERVICE		722320	543,605		543,605
d	CAFETERIA & VENDING		722210	235,999			235,999
e
f	All other program service revenue .			643			643
g	Total. Add lines 2a–2f........			49,091,493
3	Investment income (including dividends, interest, and other similar amounts).......			5,924			5,924
4	Income from investment of tax-exempt bond proceeds..
5	Royalties...........
		(i) Real	(ii) Personal
6a	Gross rents	250,478
b	Less: rental expenses	190,736
c	Rental income or (loss)	59,742
d	Net rental income or (loss).......			59,742			59,742
		(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory		11,519
b	Less: cost or other basis and sales expenses		0
c	Gain or (loss)		11,519
d	Net gain or (loss)..........			11,519			11,519
8a	Gross income from fundraising events (not including $ 29,289 of contributions reported on line 1c). See Part IV, line 18 ..
	a		16,300
b	Less: direct expenses ...b		10,120
c	Net income or (loss) from fundraising events..			6,180			6,180
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...
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..
Miscellaneous Revenue			Business Code
11a
b
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......
12	Total revenue. See Instructions......			49,383,865	48,311,246	543,605	320,007


				(A) Beginning of year		(B) End of year
1	Cashnon-interest-bearing .............			1,258,507	1	2,524,129
2	Savings and temporary cash investments .........			23,916	2	23,944
3	Pledges and grants receivable, net ...........			38,000	3	27,500
4	Accounts receivable, net .............			5,946,441	4	9,148,520
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L ..................
					5
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
					6
7	Notes and loans receivable, net .............			140,014	7	119,384
8	Inventories for sale or use ..............			1,580,148	8	1,516,395
9	Prepaid expenses and deferred charges ..........			533,139	9	328,721
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	20,034,872
b	Less: accumulated depreciation .....	10b	221,123	18,648,527	10c	19,813,749
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 .....				13
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........			1,753,025	15	269,822
16	Total assets. Add lines 1 through 15 (must equal line 34)......			29,921,717	16	33,772,164
17	Accounts payable and accrued expenses .........			3,294,226	17	4,299,676
18	Grants payable .................				18
19	Deferred revenue ................				19
20	Tax-exempt bond liabilities .............			12,450,000	20	12,170,000
21	Escrow or custodial account liability. Complete Part IV of Schedule D..				21
22	Loans and other 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 ..			134,527	23	71,805
24	Unsecured notes and loans payable to unrelated third parties ....				24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D....................			2,693,650	25	92,469
26	Total liabilities. Add lines 17 through 25.........			18,572,403	26	16,633,950
	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets ..............			10,945,635	27	16,679,077
28	Temporarily restricted net assets ...........			301,671	28	459,137
29	Permanently restricted net assets ...........			102,008	29	0
	Organizations that do not follow SFAS 117 (ASC 958), check here 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 ...........			11,349,314	33	17,138,214
34	Total liabilities and net assets/fund balances ........			29,921,717	34	33,772,164