TY 2013 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)	(F) Estimated amount of other compensation from the organization and related organizations
(1) Marcus Albernaz MD........................................................................ Board Member	2.00 .......................4.00	X			0	0	0
(2) Phillip Flowers........................................................................ Board Member	2.00 .......................2.00	X			0	0	0
(3) Bruce Gray........................................................................ Board Member	2.00 .......................2.00	X			0	0	0
(4) David Harris........................................................................ Board Member	2.00 .......................2.00	X			0	0	0
(5) Arthur Keeney........................................................................ Board Member	2.00 .......................6.00	X			0	0	0
(6) Thomasine Kennedy........................................................................ Board Member	2.00 .......................4.00	X			0	0	0
(7) Ray Rogers........................................................................ Board Member	2.00 .......................0.00	X			0	0	0
(8) Mary P Johnson MSN RN FAAN........................................................................ Board Member	2.00 .......................0.00	X			0	0	0
(9) David Herman........................................................................ Chief Executive	2.00 .......................50.00	X			0	1,273,732	96,302
(10) Roger Robertson........................................................................ President, ECH	2.00 .......................46.00		X		0	426,654	111,345
(11) Lynn Lanier........................................................................ Vice President, ECH	40.00 .......................4.00		X		0	238,793	78,857
(12) David S Hughes........................................................................ Chief Secretary/Treasurer	2.00 .......................50.00		X		0	440,003	138,991
(13) Jeff Sackrison........................................................................ President of Bertie/Chowan	40.00 .......................			X	314,365	0	51,284
(14) Jay Briley........................................................................ President of Duplin	40.00 .......................			X	0	208,796	57,040
(15) Wendell Baker Jr........................................................................ President of Heritage	40.00 .......................			X	300,797	0	71,658
(16) Sue Lassiter........................................................................ President of RCH	40.00 .......................			X	258,353	0	70,955
(17) William Case........................................................................ President of Beaufort/Pungo	40.00 .......................			X	0	255,448	88,433

(A) Name and business address	(B) Description of services	(C) Compensation
Horizon Mental Health ManagementPO Box 840839DallasTX75284	Behavioral Health Nurse Staffing	2,676,008
Sightpath Medical IncPO Box 204253DallasTX75284	Opthalmic Surgery Services	1,474,978
Diamond Healthcare CorpFederal Reserve Bank Building PORichmondVA23285	Behavioral Health Nurse Staffing	1,054,171
Executive Health Resources IncPO Box 822688PhiladelphiaPA19182	Medical Compliance Consulting	856,504
Timothy Brent Chafin, 522 Cabin Branch RoadTarboroNC27886	Anesthesiology Services	748,442
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 5

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	4,000	4,000
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 ....	2,430,178		2,430,178
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	113,357,709	109,361,824	3,995,885
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	5,872,876	5,618,947	253,929
9	Other employee benefits .......	20,725,367	19,076,432	1,648,935
10	Payroll taxes ...........	8,125,154	7,688,976	436,178
11	Fees for services (non-employees):
a	Management ......	42,863,980	26,994,178	15,869,802
b	Legal .........	233,237	135,396	97,841
c	Accounting ...........	280,845	22,784	258,061
d	Lobbying ...........	32,917		32,917
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) ........	24,286,853	19,195,816	5,091,037
12	Advertising and promotion ....	321,857	195,530	126,327
13	Office expenses .......	5,105,328	4,120,385	984,943
14	Information technology ......	1,511,903	467,422	1,044,481
15	Royalties ..
16	Occupancy ...........	6,888,086	5,510,469	1,377,617
17	Travel ............	766,068	612,854	153,214
18	Payments of travel or entertainment expenses for any federal, state, or local public officials ......
19	Conferences, conventions, and meetings ....
20	Interest ...........	3,824,257	304,768	3,519,489
21	Payments to affiliates .......	80,780		80,780
22	Depreciation, depletion, and amortization .....	15,403,209	15,403,209
23	Insurance ..............	6,379,544	603,304	5,776,240
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	Chargeable Patient Supp	45,156,949	40,498,300	4,658,649
b	Bad Debt Expense	43,844,402	43,844,402
c	Repairs	6,062,182	4,685,217	1,376,965
d	Patient Accommondations	3,784,122		3,784,122
e	All other expenses	4,026,785	2,790,245	1,236,540
25	Total functional expenses. Add lines 1 through 24e	361,368,588	307,134,458	54,234,130	0
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 or note to any line in this Part X ..............
	1	Cash–non-interest-bearing .............	33,558,488	1	31,012,754
2	Savings and temporary cash investments .........		2
3	Pledges and grants receivable, net ...........		3
4	Accounts receivable, net .............	48,525,674	4	46,116,507
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 .............		7
8	Inventories for sale or use ..............	10,150,265	8	10,801,633
9	Prepaid expenses and deferred charges ..........	16,129,472	9	18,893,236
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	286,781,948
b	Less: accumulated depreciation .....	10b	160,769,463	133,828,197	10c	126,012,485
11	Investments—publicly traded securities ..........		11
12	Investments—other securities. See Part IV, line 11 .....	3,972,333	12	3,634,025
13	Investments—program-related. See Part IV, line 11 .....		13
14	Intangible assets ...............	22,829,529	14	22,831,411
15	Other assets. See Part IV, line 11 ...........	10,341,589	15	8,538,411
16	Total assets. Add lines 1 through 15 (must equal line 34)......	279,335,547	16	267,840,462
	17	Accounts payable and accrued expenses .........	34,715,430	17	34,998,958
18	Grants payable .................		18
19	Deferred revenue ................		19
20	Tax-exempt bond liabilities .............		20
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 ..	2,168,159	23	1,383,446
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....................	127,115,096	25	124,367,053
26	Total liabilities. Add lines 17 through 25.........	163,998,685	26	160,749,457
		Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets ..............	112,495,894	27	104,252,918
28	Temporarily restricted net assets ...........	2,840,968	28	2,838,087
29	Permanently restricted net assets ...........		29
	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 ...........	115,336,862	33	107,091,005
34	Total liabilities and net assets/fund balances ........	279,335,547	34	267,840,462

- TIN:

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.
right arrow

Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public
Inspection

Name of the organization

East Carolina Health Inc

Employer identification number

91-1997979

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) 2013

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) 2009	(b) 2010	(c) 2011	(d) 2012	(e) 2013	(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) 2009	(b) 2010	(c) 2011	(d) 2012	(e) 2013	(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 2013 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2012 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2013. 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—2012. 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—2013. 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—2012. 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) 2013

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) 2009	(b) 2010	(c) 2011	(d) 2012	(e) 2013	(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) 2009	(b) 2010	(c) 2011	(d) 2012	(e) 2013	(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 2013 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2012 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2013 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2012 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests—2013. 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—2012. 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) 2013

Page 4

Part IV

Supplemental Information. 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) 2013

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.

Information about Schedule B (Form 990, 990-EZ, or 990-PF) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Name of the organization

East Carolina Health Inc

Employer identification number

91-1997979

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 for 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 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 its Form 990PF, Part I, line 2, 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) (2013)

Schedule B (Form 990, 990-EZ, or 990-PF) (2013)

Page 2

Name of organization East Carolina Health 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, RESTRICTEDRESTRICTED	$RESTRICTED	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2013)

Schedule B (Form 990, 990-EZ, or 990-PF) (2013)

Page 3

Name of organization East Carolina Health 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) (2013)

Schedule B (Form 990, 990-EZ, or 990-PF) (2013)

Page 4

Name of organization
East Carolina Health Inc

Employer identification number

91-1997979

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) (2013)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527
SchCMd Bullet

Complete if the organization is described below. SchCMd Bullet

Attach to Form 990 or Form 990-EZ.
SchCMd Bullet

See separate instructions. SchCMd Bullet

Information about Schedule C (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public
Inspection

If the organization answered "Yes" to Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet

Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet

Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet

Section 527 organizations: Complete Part I-A only.
If the organization answered "Yes" to Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet

Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet

Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered "Yes" to Form 990, Part IV, Line 5 (Proxy Tax) or Form 990-EZ, Part V, line 35c (Proxy Tax), then
Round Bullet

Section 501(c)(4), (5), or (6) organizations: Complete Part III.

Name of the organization

East Carolina Health Inc

Employer identification number

91-1997979

Part I-A

Complete if the organization is exempt under section 501(c) or is a section 527 organization.

Provide a description of the organization’s direct and indirect political campaign activities in Part IV.

Political expenditures .................................... SchCMd Bullet

Volunteer hours ........................................

Part I-B

Complete if the organization is exempt under section 501(c)(3).

Enter the amount of any excise tax incurred by the organization under section 4955 ......... SchCMd Bullet

Enter the amount of any excise tax incurred by organization managers under section 4955 ...... SchCMd Bullet

If the organization incurred a section 4955 tax, did it file Form 4720 for this year? ..............

Yes No

Was a correction made? .........................................

Yes No

If "Yes," describe in Part IV.

Part I-C

Complete if the organization is exempt under section 501(c), except section 501(c)(3).

Enter the amount directly expended by the filing organization for section 527 exempt function activities SchCMd Bullet

Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ................................... SchCMd Bullet

Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b.. SchCMd Bullet

Did the filing organization file Form 1120-POL for this year? ..........................

Yes No

Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.

(a) Name	(b) Address	(c) EIN	(d) Amount paid from filing organization's funds. If none, enter -0-.	(e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.

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

Cat. No. 50084S

Schedule C (Form 990 or 990-EZ) 2013

Page 2

Part II-A

Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).

A Check SchCMd Bullet

if the filing organization belongs to an affiliated group (and list in Part IV each affiliated group member's name, address, EIN, expenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet

if the filing organization checked box A and "limited control" provisions apply.

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(b) Affiliated group totals
1a	Total lobbying expenditures to influence public opinion (grass roots lobbying) ......
b	Total lobbying expenditures to influence a legislative body (direct lobbying) .......
c	Total lobbying expenditures (add lines 1a and 1b) ...................
d	Other exempt purpose expenditures ........................
e	Total exempt purpose expenditures (add lines 1c and 1d) ...............
f	Lobbying nontaxable amount. Enter the amount from the following table in both columns.
	If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
	Not over $500,00020% of the amount on line 1e.
	Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
	Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
	Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
	Over $17,000,000$1,000,000.

g	Grassroots nontaxable amount (enter 25% of line 1f) .................
h	Subtract line 1g from line 1a. If zero or less, enter -0-. ................
i	Subtract line 1f from line 1c. If zero or less, enter -0-. ................
j	If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting section 4911 tax for this year? ......................................	Yes No

4-Year Averaging Period Under Section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the instructions for lines 2a through 2f on page 4.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2010	(b) 2011	(c) 2012	(d) 2013	(e) Total

2a	Lobbying nontaxable amount

b	Lobbying ceiling amount (150% of line 2a, column(e))

c	Total lobbying expenditures

d	Grassroots nontaxable amount

e	Grassroots ceiling amount (150% of line 2d, column (e))

f	Grassroots lobbying expenditures

Schedule C (Form 990 or 990-EZ) 2013

Page 3

Part II-B

Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).

For each "Yes" response to lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.

(a)

Yes

(b)

Amount

During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:

Volunteers? .........................................

Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....

Media advertisements? ....................................

Mailings to members, legislators, or the public? .........................

Publications, or published or broadcast statements? .......................

Grants to other organizations for lobbying purposes? .......................

Direct contact with legislators, their staffs, government officials, or a legislative body? ........

Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......

Other activities? ..........................

Yes

32,917

Total. Add lines 1c through 1i ...............................

32,917

Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....

If "Yes," enter the amount of any tax incurred under section 4912 .................

If "Yes," enter the amount of any tax incurred by organization managers under section 4912 .....

If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? .......

Part III-A

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).

Yes

Were substantially all (90% or more) dues received nondeductible by members? ................

Did the organization make only in-house lobbying expenditures of $2,000 or less? ................

Did the organization agree to carry over lobbying and political expenditures from the prior year? ..........

Part III-B

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."

Dues, assessments and similar amounts from members .....................

Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political
expenses for which the section 527(f) tax was paid).

Current year .........................................

Carryover from last year ....................................

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

Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .

If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ................................

Taxable amount of lobbying and political expenditures (see instructions) ..............

Part IV

Supplemental Information

Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, line 2; and Part ll-B, line 1. Also, complete this part for any additional information.

Return Reference	Explanation
Part II-B, Line 1:	During the year, 27.14% of annual NCHA dues and 39.00% of annual AMRPA dues were allocated towards lobbying.

Schedule C (Form 990 or 990EZ) 2013

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. SchDMd Bullet

Information about Schedule D (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public Inspection

Name of the organization

East Carolina Health Inc

Employer identification number

91-1997979

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) 2013

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. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(b)Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value
1a	Land .................	4,977,228		4,977,228
b	Buildings ................	163,452,281	76,937,421	86,514,860
c	Leasehold improvements ............	3,116,484	3,116,484	0
d	Equipment ................	113,676,204	80,715,558	32,960,646
e	Other .................	1,559,751		1,559,751
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......				126,012,485

Schedule D (Form 990) 2013

Page 3

Part VII

InvestmentsOther Securities. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11b. 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. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

(a) Description of investment		(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. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11d. 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. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability		(b) Book value
Federal income taxes
Third Party Payable		4,401,787
Lease Obligation		9,220,704
Due to Affiliates		108,552,383
Other		1,889,794
Long Term Debt-Bank		72,115
Self-Insurance Reserve		230,270



Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)		124,367,053
2. Liability for uncertain tax positions 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) 2013

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......		1
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
e	Add lines 2a through 2d .....................		2e
3	Subtract line 2e from line 1.....................		3
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
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......		5

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........		1
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
e	Add lines 2a through 2d......................		2e
3	Subtract line 2e from line 1.....................		3
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
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......		5

Part XIII

Supplemental Information

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.

Return Reference	Explanation
Part X, Line 2:	East Carolina Health, Inc. has been determined to qualify as a tax-exempt organization under Section 501(c)(3) of the Internal Revenue Code. East Carolina Health, Inc. has reviewed its tax positions for all open years and has concluded that no material liabilities exist as of September 30, 2014 and 2013. East Carolina Health files tax returns with the U.S. federal and State of North Carolina jurisdictions. With few exceptions, East Carolina Health is no longer subject to U.S. federal examinations by tax authorities for years before 2010.

Return Reference

Explanation

Part X, Line 2:

East Carolina Health, Inc. has been determined to qualify as a tax-exempt organization under Section 501(c)(3) of the Internal Revenue Code. East Carolina Health, Inc. has reviewed its tax positions for all open years and has concluded that no material liabilities exist as of September 30, 2014 and 2013. East Carolina Health files tax returns with the U.S. federal and State of North Carolina jurisdictions. With few exceptions, East Carolina Health is no longer subject to U.S. federal examinations by tax authorities for years before 2010.

Schedule D (Form 990) 2013

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.
MediumBullet

Information about Schedule H (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public Inspection

Name of the organization

East Carolina Health Inc

Employer identification number

91-1997979

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		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) ..			16,476,536		16,476,536	4.560 %
b	Medicaid (from Worksheet 3, column a) ....
c	Costs of other means-tested government programs (from Worksheet 3, column b) .			53,896,542	43,774,801	10,121,741	2.800 %
d	Total Financial Assistance and Means-Tested Government Programs .			70,373,078	43,774,801	26,598,277	7.360 %
Other Benefits		88	33,908	3,061,984	857,498	2,204,486	0.610 %
e	Community health improvement services and community benefit operations (from Worksheet 4) ..	88	33,908	3,061,984	857,498	2,204,486	0.610 %
f	Health professions education (from Worksheet 5) ..	14	1,278	1,452,305	0	1,452,305	0.400 %
g	Subsidized health services (from Worksheet 6) ..
h	Research (from Worksheet 7)	1		141,314	12,553	128,761	0.040 %
i	Cash and in-kind contributions for community benefit (from Worksheet 8)	31	62,798	1,066,805	60,803	1,006,002	0.280 %
j	Total. Other Benefits ..	134	97,984	5,722,408	930,854	4,791,554	1.330 %
k	Total. Add lines 7d and 7j .	134	97,984	76,095,486	44,705,655	31,389,831	8.690 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2013

Schedule H (Form 990) 2013

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.

		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community building expense	(d) Direct offsetting revenue	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development	5	653	48,761	0	48,761	0.010 %
3	Community support	8	730	83,704	0	83,704	0.020 %
4	Environmental improvements
5	Leadership development and training for community members	1		3,124	0	3,124	0 %
6	Coalition building	4	114	13,200	0	13,200	0 %
7	Community health improvement advocacy
8	Workforce development	7	2,723	84,626	0	84,626	0.020 %
9	Other
10	Total	25	4,220	233,415		233,415	0.050 %

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. ......

15,470,330

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. ......

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).....

140,911,754

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

139,382,441

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

1,529,313

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 %
11 Heritage MRI LLC	Outpatient MRI Services	66.670 %	0 %	33.330 %
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2013

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?7 Name, address, primary website address, and state license number							Other (Describe)
1	East Carolina Health - Heritage Inc 111 Hospital Drive Tarboro,NC27886	X	X		X	X	Rehabilitation
2	East Carolina Health - Roanoke-Chowan 500 Academy Street Ahoskie,NC27910	X	X		X	X	Behavioral Health
3	East Carolina Health - Beaufort Inc 628 East Twelfth Street Washington,NC27889	X	X		X	X	Behavioral Health
4	East Carolina Health - Chowan Inc 211 Virginia Road Edenton,NC27932	X	X	X	X
5	Duplin General Hospital Inc 401 North Main Street Kenansville,NC28349	X	X		X	X	Behavioral Health
6	East Carolina Health - Bertie 1403 South King Street Windsor,NC27983	X	X	X	X
7	Pungo District Hospital Corporation 202 East Water Street Belhaven,NC27810	X	X	X	X

Schedule H (Form 990) 2013

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)

	East Carolina Health - Heritage Inc
Name of hospital facility or facility reporting group

If reporting on Part V, Section B for a single hospital facility 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 11

In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests 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 (list url): See Section C

Other website (list url):

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 as of the end of the tax year):

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 ........

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) 2013

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: 200.000000000000% 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	Residency
i	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 individual’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 Section C)
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 individual’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 Section C)

Schedule H (Form 990) 2013

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 individuals regarding the individuals’ bills

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

Other (describe in Section C)

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 individual 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 individual an amount equal to the gross charge for any service provided to that individual? .........................

If "Yes," explain in Part VI.

Schedule H (Form 990) 2013

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)

	East Carolina Health - Roanoke-Chowan
Name of hospital facility or facility reporting group

If reporting on Part V, Section B for a single hospital facility 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 11

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 (list url): See Section C

Other website (list url):

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 as of the end of the tax year):

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 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) 2013

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: 200.000000000000% 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	Residency
i	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 individual’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 Section C)
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 individual’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 Section C)

Schedule H (Form 990) 2013

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 individuals regarding the individuals’ bills

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

Other (describe in Section C)

Policy Relating to Emergency Medical Care

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)

If "Yes," explain in Part VI.

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

If "Yes," explain in Part VI.

Schedule H (Form 990) 2013

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)

	East Carolina Health - Beaufort Inc
Name of hospital facility or facility reporting group

If reporting on Part V, Section B for a single hospital facility 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 11

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 (list url): See Section C

Other website (list url):

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 as of the end of the tax year):

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 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) 2013

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: 200.000000000000% 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	Residency
i	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 individual’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 Section C)
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 individual’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 Section C)

Schedule H (Form 990) 2013

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 individuals regarding the individuals’ bills

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

Other (describe in Section C)

Policy Relating to Emergency Medical Care

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)

If "Yes," explain in Part VI.

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

If "Yes," explain in Part VI.

Schedule H (Form 990) 2013

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)

	East Carolina Health - Chowan Inc
Name of hospital facility or facility reporting group

If reporting on Part V, Section B for a single hospital facility 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 11

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 (list url): See Section C

Other website (list url):

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 as of the end of the tax year):

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 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) 2013

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: 200.000000000000% 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	Residency
i	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 individual’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 Section C)
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 individual’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 Section C)

Schedule H (Form 990) 2013

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 individuals regarding the individuals’ bills

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

Other (describe in Section C)

Policy Relating to Emergency Medical Care

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)

If "Yes," explain in Part VI.

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

If "Yes," explain in Part VI.

Schedule H (Form 990) 2013

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)

	Duplin General Hospital Inc
Name of hospital facility or facility reporting group

If reporting on Part V, Section B for a single hospital facility 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 11

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 (list url): See Section C

Other website (list url):

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 as of the end of the tax year):

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 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) 2013

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: 200.000000000000% 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	Residency
i	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 individual’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 Section C)
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 individual’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 Section C)

Schedule H (Form 990) 2013

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 individuals regarding the individuals’ bills

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

Other (describe in Section C)

Policy Relating to Emergency Medical Care

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)

If "Yes," explain in Part VI.

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

If "Yes," explain in Part VI.

Schedule H (Form 990) 2013

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)

	East Carolina Health - Bertie
Name of hospital facility or facility reporting group

If reporting on Part V, Section B for a single hospital facility 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 11

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 (list url): See Section C

Other website (list url):

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 as of the end of the tax year):

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 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) 2013

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: 200.000000000000% 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	Residency
i	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 individual’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 Section C)
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 individual’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 Section C)

Schedule H (Form 990) 2013

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 individuals regarding the individuals’ bills

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

Other (describe in Section C)

Policy Relating to Emergency Medical Care

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)

If "Yes," explain in Part VI.

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

If "Yes," explain in Part VI.

Schedule H (Form 990) 2013

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)

	Pungo District Hospital Corporation
Name of hospital facility or facility reporting group

If reporting on Part V, Section B for a single hospital facility 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 11

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 (list url): See Section C

Other website (list url):

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 as of the end of the tax year):

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 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) 2013

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: 200.000000000000% 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	Residency
i	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 individual’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 Section C)
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 individual’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 Section C)

Schedule H (Form 990) 2013

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 individuals regarding the individuals’ bills

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

Other (describe in Section C)

Policy Relating to Emergency Medical Care

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)

If "Yes," explain in Part VI.

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

If "Yes," explain in Part VI.

Schedule H (Form 990) 2013

Page

Part V

Facility Information (continued)

Section C. Supplemental Information for Part V, Section B.Provide descriptions required for Part V, Section B, lines 1j, 3, 4, 5d, 6i, 7, 10, 11, 12i, 14g, 16e, 17e, 18e, 19c, 19d, 20d, 21, and 22. If applicable, provide separate descriptions for each facility in a facility reporting group, designated by "Facility A," "Facility B," etc.
Form and Line Reference	Explanation
East Carolina Health - Heritage, Inc.	Part V, Section B, Line 3: Each of the Vidant Community Hospitals collaborate with local county health departments and other interested parties in the local communities to produce the Community Health Needs Assessment. These partners include schools, health-focused not-for-profits, community health initiatives, chambers of commerce, and other agencies dedicated to promoting the well-being of their communities. The partners represent a wide range of diverse constituencies including children, seniors, and underserved populations. The information created through this collaborative effort is then used to determine areas of health needs focus for the individual entities and also for creating partnerships to address needs where possible.
East Carolina Health - Roanoke-Chowan	Part V, Section B, Line 3: Each of the Vidant Community Hospitals collaborate with local county health departments and other interested parties in the local communities to produce the Community Health Needs Assessment. These partners include schools, health-focused not-for-profits, community health initiatives, chambers of commerce, and other agencies dedicated to promoting the well-being of their communities. The partners represent a wide range of diverse constituencies including children, seniors, and underserved populations. The information created through this collaborative effort is then used to determine areas of health needs focus for the individual entities and also for creating partnerships to address needs where possible.
East Carolina Health - Beaufort, Inc.	Part V, Section B, Line 3: Each of the Vidant Community Hospitals collaborate with local county health departments and other interested parties in the local communities to produce the Community Health Needs Assessment. These partners include schools, health-focused not-for-profits, community health initiatives, chambers of commerce, and other agencies dedicated to promoting the well-being of their communities. The partners represent a wide range of diverse constituencies including children, seniors, and underserved populations. The information created through this collaborative effort is then used to determine areas of health needs focus for the individual entities and also for creating partnerships to address needs where possible.
East Carolina Health - Chowan, Inc.	Part V, Section B, Line 3: Each of the Vidant Community Hospitals collaborate with local county health departments and other interested parties in the local communities to produce the Community Health Needs Assessment. These partners include schools, health-focused not-for-profits, community health initiatives, chambers of commerce, and other agencies dedicated to promoting the well-being of their communities. The partners represent a wide range of diverse constituencies including children, seniors, and underserved populations. The information created through this collaborative effort is then used to determine areas of health needs focus for the individual entities and also for creating partnerships to address needs where possible.
Duplin General Hospital, Inc.	Part V, Section B, Line 3: Each of the Vidant Community Hospitals collaborate with local county health departments and other interested parties in the local communities to produce the Community Health Needs Assessment. These partners include schools, health-focused not-for-profits, community health initiatives, chambers of commerce, and other agencies dedicated to promoting the well-being of their communities. The partners represent a wide range of diverse constituencies including children, seniors, and underserved populations. The information created through this collaborative effort is then used to determine areas of health needs focus for the individual entities and also for creating partnerships to address needs where possible.
East Carolina Health - Bertie	Part V, Section B, Line 3: Each of the Vidant Community Hospitals collaborate with local county health departments and other interested parties in the local communities to produce the Community Health Needs Assessment. These partners include schools, health-focused not-for-profits, community health initiatives, chambers of commerce, and other agencies dedicated to promoting the well-being of their communities. The partners represent a wide range of diverse constituencies including children, seniors, and underserved populations. The information created through this collaborative effort is then used to determine areas of health needs focus for the individual entities and also for creating partnerships to address needs where possible.
Pungo District Hospital Corporation	Part V, Section B, Line 3: Each of the Vidant Community Hospitals collaborate with local county health departments and other interested parties in the local communities to produce the Community Health Needs Assessment. These partners include schools, health-focused not-for-profits, community health initiatives, chambers of commerce, and other agencies dedicated to promoting the well-being of their communities. The partners represent a wide range of diverse constituencies including children, seniors, and underserved populations. The information created through this collaborative effort is then used to determine areas of health needs focus for the individual entities and also for creating partnerships to address needs where possible.
East Carolina Health - Heritage, Inc.	Part V, Section B, Line 4: The Community Health Needs Assessment was conducted with the following hospitals:- East Carolina Health - Heritage, Inc. DBA Vidant Edgecombe Hospital- East Carolina Health DBA Vidant Roanoke-Chowan Hospital- East Carolina Health - Beaufort, Inc. DBA Vidant Beaufort Hospital- East Carolina Health - Chowan, Inc. DBA Vidant Chowan Hospital- Duplin General Hospital, Inc. DBA Vidant Duplin Hospital- East Carolina Health - Bertie DBA Vidant Bertie Hospital- Pungo District Hospital Corporation DBA Vidant Pungo Hospital
East Carolina Health - Roanoke-Chowan	Part V, Section B, Line 4: The Community Health Needs Assessment was conducted with the following hospitals:- East Carolina Health - Heritage, Inc. DBA Vidant Edgecombe Hospital- East Carolina Health DBA Vidant Roanoke-Chowan Hospital- East Carolina Health - Beaufort, Inc. DBA Vidant Beaufort Hospital- East Carolina Health - Chowan, Inc. DBA Vidant Chowan Hospital- Duplin General Hospital, Inc. DBA Vidant Duplin Hospital- East Carolina Health - Bertie DBA Vidant Bertie Hospital- Pungo District Hospital Corporation DBA Vidant Pungo Hospital
East Carolina Health - Beaufort, Inc.	Part V, Section B, Line 4: The Community Health Needs Assessment was conducted with the following hospitals:- East Carolina Health - Heritage, Inc. DBA Vidant Edgecombe Hospital- East Carolina Health DBA Vidant Roanoke-Chowan Hospital- East Carolina Health - Beaufort, Inc. DBA Vidant Beaufort Hospital- East Carolina Health - Chowan, Inc. DBA Vidant Chowan Hospital- Duplin General Hospital, Inc. DBA Vidant Duplin Hospital- East Carolina Health - Bertie DBA Vidant Bertie Hospital- Pungo District Hospital Corporation DBA Vidant Pungo Hospital
East Carolina Health - Chowan, Inc.	Part V, Section B, Line 4: The Community Health Needs Assessment was conducted with the following hospitals:- East Carolina Health - Heritage, Inc. DBA Vidant Edgecombe Hospital- East Carolina Health DBA Vidant Roanoke-Chowan Hospital- East Carolina Health - Beaufort, Inc. DBA Vidant Beaufort Hospital- East Carolina Health - Chowan, Inc. DBA Vidant Chowan Hospital- Duplin General Hospital, Inc. DBA Vidant Duplin Hospital- East Carolina Health - Bertie DBA Vidant Bertie Hospital- Pungo District Hospital Corporation DBA Vidant Pungo Hospital
Duplin General Hospital, Inc.	Part V, Section B, Line 4: The Community Health Needs Assessment was conducted with the following hospitals:- East Carolina Health - Heritage, Inc. DBA Vidant Edgecombe Hospital- East Carolina Health DBA Vidant Roanoke-Chowan Hospital- East Carolina Health - Beaufort, Inc. DBA Vidant Beaufort Hospital- East Carolina Health - Chowan, Inc. DBA Vidant Chowan Hospital- Duplin General Hospital, Inc. DBA Vidant Duplin Hospital- East Carolina Health - Bertie DBA Vidant Bertie Hospital- Pungo District Hospital Corporation DBA Vidant Pungo Hospital
East Carolina Health - Bertie	Part V, Section B, Line 4: The Community Health Needs Assessment was conducted with the following hospitals:- East Carolina Health - Heritage, Inc. DBA Vidant Edgecombe Hospital- East Carolina Health DBA Vidant Roanoke-Chowan Hospital- East Carolina Health - Beaufort, Inc. DBA Vidant Beaufort Hospital- East Carolina Health - Chowan, Inc. DBA Vidant Chowan Hospital- Duplin General Hospital, Inc. DBA Vidant Duplin Hospital- East Carolina Health - Bertie DBA Vidant Bertie Hospital- Pungo District Hospital Corporation DBA Vidant Pungo Hospital
Pungo District Hospital Corporation	Part V, Section B, Line 4: The Community Health Needs Assessment was conducted with the following hospitals:- East Carolina Health - Heritage, Inc. DBA Vidant Edgecombe Hospital- East Carolina Health DBA Vidant Roanoke-Chowan Hospital- East Carolina Health - Beaufort, Inc. DBA Vidant Beaufort Hospital- East Carolina Health - Chowan, Inc. DBA Vidant Chowan Hospital- Duplin General Hospital, Inc. DBA Vidant Duplin Hospital- East Carolina Health - Bertie DBA Vidant Bertie Hospital- Pungo District Hospital Corporation DBA Vidant Pungo Hospital
East Carolina Health - Heritage, Inc.	Part V, Section B, Line 5d: https://www.vidanthealth.com/vidant/dynamic-detail.aspx?id=13673
East Carolina Health - Roanoke-Chowan	Part V, Section B, Line 5d: https://www.vidanthealth.com/vidant/dynamic-detail.aspx?id=13673
East Carolina Health - Beaufort, Inc.	Part V, Section B, Line 5d: https://www.vidanthealth.com/vidant/dynamic-detail.aspx?id=13673
East Carolina Health - Chowan, Inc.	Part V, Section B, Line 5d: https://www.vidanthealth.com/vidant/dynamic-detail.aspx?id=13673
Duplin General Hospital, Inc.	Part V, Section B, Line 5d: https://www.vidanthealth.com/vidant/dynamic-detail.aspx?id=13673
East Carolina Health - Bertie	Part V, Section B, Line 5d: https://www.vidanthealth.com/vidant/dynamic-detail.aspx?id=13673
Pungo District Hospital Corporation	Part V, Section B, Line 5d: https://www.vidanthealth.com/vidant/dynamic-detail.aspx?id=13673
East Carolina Health - Heritage, Inc.	Part V, Section B, Line 7: Certain community needs may not be fully documented or addressed in the Community Health Needs Assessment. These needs are generally those which other organizations share an overlap with East Carolina Health. Those other organizations are better equiped to address these specific needs, and are subsequently not considered as issues of East Carolina Health.
East Carolina Health - Roanoke-Chowan	Part V, Section B, Line 7: Certain community needs may not be fully documented or addressed in the Community Health Needs Assessment. These needs are generally those which other organizations share an overlap with East Carolina Health. Those other organizations are better equiped to address these specific needs, and are subsequently not considered as issues of East Carolina Health.
East Carolina Health - Beaufort, Inc.	Part V, Section B, Line 7: Certain community needs may not be fully documented or addressed in the Community Health Needs Assessment. These needs are generally those which other organizations share an overlap with East Carolina Health. Those other organizations are better equiped to address these specific needs, and are subsequently not considered as issues of East Carolina Health.
East Carolina Health - Chowan, Inc.	Part V, Section B, Line 7: Certain community needs may not be fully documented or addressed in the Community Health Needs Assessment. These needs are generally those which other organizations share an overlap with East Carolina Health. Those other organizations are better equiped to address these specific needs, and are subsequently not considered as issues of East Carolina Health.
Duplin General Hospital, Inc.	Part V, Section B, Line 7: Certain community needs may not be fully documented or addressed in the Community Health Needs Assessment. These needs are generally those which other organizations share an overlap with East Carolina Health. Those other organizations are better equiped to address these specific needs, and are subsequently not considered as issues of East Carolina Health.
East Carolina Health - Bertie	Part V, Section B, Line 7: Certain community needs may not be fully documented or addressed in the Community Health Needs Assessment. These needs are generally those which other organizations share an overlap with East Carolina Health. Those other organizations are better equiped to address these specific needs, and are subsequently not considered as issues of East Carolina Health.
Pungo District Hospital Corporation	Part V, Section B, Line 7: Certain community needs may not be fully documented or addressed in the Community Health Needs Assessment. These needs are generally those which other organizations share an overlap with East Carolina Health. Those other organizations are better equiped to address these specific needs, and are subsequently not considered as issues of East Carolina Health.
East Carolina Health - Heritage, Inc.	Part V, Section B, Line 14g: The full policy is not available on the facility website. In lieu of the policy, a concise summary is provided with pertinent details and phone numbers for additional information.
East Carolina Health - Roanoke-Chowan	Part V, Section B, Line 14g: The full policy is not available on the facility website. In lieu of the policy, a concise summary is provided with pertinent details and phone numbers for additional information.
East Carolina Health - Beaufort, Inc.	Part V, Section B, Line 14g: The full policy is not available on the facility website. In lieu of the policy, a concise summary is provided with pertinent details and phone numbers for additional information.
East Carolina Health - Chowan, Inc.	Part V, Section B, Line 14g: The full policy is not available on the facility website. In lieu of the policy, a concise summary is provided with pertinent details and phone numbers for additional information.
Duplin General Hospital, Inc.	Part V, Section B, Line 14g: The full policy is not available on the facility website. In lieu of the policy, a concise summary is provided with pertinent details and phone numbers for additional information.
East Carolina Health - Bertie	Part V, Section B, Line 14g: The full policy is not available on the facility website. In lieu of the policy, a concise summary is provided with pertinent details and phone numbers for additional information.
Pungo District Hospital Corporation	Part V, Section B, Line 14g: The full policy is not available on the facility website. In lieu of the policy, a concise summary is provided with pertinent details and phone numbers for additional information.

Schedule H (Form 990) 2013

Page

Part VFacility Information (continued)

Section D. 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?
Name and address		Type of Facility (describe)
1
2
3
4
5
6
7
8
9
10

Schedule H (Form 990) 2013

Page

Part VI

Supplemental Information

Provide the following information.

1	Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2	Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs 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.

Form and Line Reference	Explanation
East Carolina Health - Heritage, Inc.	Part V, Section B, Line 3: Each of the Vidant Community Hospitals collaborate with local county health departments and other interested parties in the local communities to produce the Community Health Needs Assessment. These partners include schools, health-focused not-for-profits, community health initiatives, chambers of commerce, and other agencies dedicated to promoting the well-being of their communities. The partners represent a wide range of diverse constituencies including children, seniors, and underserved populations. The information created through this collaborative effort is then used to determine areas of health needs focus for the individual entities and also for creating partnerships to address needs where possible.
East Carolina Health - Roanoke-Chowan	Part V, Section B, Line 3: Each of the Vidant Community Hospitals collaborate with local county health departments and other interested parties in the local communities to produce the Community Health Needs Assessment. These partners include schools, health-focused not-for-profits, community health initiatives, chambers of commerce, and other agencies dedicated to promoting the well-being of their communities. The partners represent a wide range of diverse constituencies including children, seniors, and underserved populations. The information created through this collaborative effort is then used to determine areas of health needs focus for the individual entities and also for creating partnerships to address needs where possible.
East Carolina Health - Beaufort, Inc.	Part V, Section B, Line 3: Each of the Vidant Community Hospitals collaborate with local county health departments and other interested parties in the local communities to produce the Community Health Needs Assessment. These partners include schools, health-focused not-for-profits, community health initiatives, chambers of commerce, and other agencies dedicated to promoting the well-being of their communities. The partners represent a wide range of diverse constituencies including children, seniors, and underserved populations. The information created through this collaborative effort is then used to determine areas of health needs focus for the individual entities and also for creating partnerships to address needs where possible.
East Carolina Health - Chowan, Inc.	Part V, Section B, Line 3: Each of the Vidant Community Hospitals collaborate with local county health departments and other interested parties in the local communities to produce the Community Health Needs Assessment. These partners include schools, health-focused not-for-profits, community health initiatives, chambers of commerce, and other agencies dedicated to promoting the well-being of their communities. The partners represent a wide range of diverse constituencies including children, seniors, and underserved populations. The information created through this collaborative effort is then used to determine areas of health needs focus for the individual entities and also for creating partnerships to address needs where possible.
Duplin General Hospital, Inc.	Part V, Section B, Line 3: Each of the Vidant Community Hospitals collaborate with local county health departments and other interested parties in the local communities to produce the Community Health Needs Assessment. These partners include schools, health-focused not-for-profits, community health initiatives, chambers of commerce, and other agencies dedicated to promoting the well-being of their communities. The partners represent a wide range of diverse constituencies including children, seniors, and underserved populations. The information created through this collaborative effort is then used to determine areas of health needs focus for the individual entities and also for creating partnerships to address needs where possible.
East Carolina Health - Bertie	Part V, Section B, Line 3: Each of the Vidant Community Hospitals collaborate with local county health departments and other interested parties in the local communities to produce the Community Health Needs Assessment. These partners include schools, health-focused not-for-profits, community health initiatives, chambers of commerce, and other agencies dedicated to promoting the well-being of their communities. The partners represent a wide range of diverse constituencies including children, seniors, and underserved populations. The information created through this collaborative effort is then used to determine areas of health needs focus for the individual entities and also for creating partnerships to address needs where possible.
Pungo District Hospital Corporation	Part V, Section B, Line 3: Each of the Vidant Community Hospitals collaborate with local county health departments and other interested parties in the local communities to produce the Community Health Needs Assessment. These partners include schools, health-focused not-for-profits, community health initiatives, chambers of commerce, and other agencies dedicated to promoting the well-being of their communities. The partners represent a wide range of diverse constituencies including children, seniors, and underserved populations. The information created through this collaborative effort is then used to determine areas of health needs focus for the individual entities and also for creating partnerships to address needs where possible.
East Carolina Health - Heritage, Inc.	Part V, Section B, Line 4: The Community Health Needs Assessment was conducted with the following hospitals:- East Carolina Health - Heritage, Inc. DBA Vidant Edgecombe Hospital- East Carolina Health DBA Vidant Roanoke-Chowan Hospital- East Carolina Health - Beaufort, Inc. DBA Vidant Beaufort Hospital- East Carolina Health - Chowan, Inc. DBA Vidant Chowan Hospital- Duplin General Hospital, Inc. DBA Vidant Duplin Hospital- East Carolina Health - Bertie DBA Vidant Bertie Hospital- Pungo District Hospital Corporation DBA Vidant Pungo Hospital
East Carolina Health - Roanoke-Chowan	Part V, Section B, Line 4: The Community Health Needs Assessment was conducted with the following hospitals:- East Carolina Health - Heritage, Inc. DBA Vidant Edgecombe Hospital- East Carolina Health DBA Vidant Roanoke-Chowan Hospital- East Carolina Health - Beaufort, Inc. DBA Vidant Beaufort Hospital- East Carolina Health - Chowan, Inc. DBA Vidant Chowan Hospital- Duplin General Hospital, Inc. DBA Vidant Duplin Hospital- East Carolina Health - Bertie DBA Vidant Bertie Hospital- Pungo District Hospital Corporation DBA Vidant Pungo Hospital
East Carolina Health - Beaufort, Inc.	Part V, Section B, Line 4: The Community Health Needs Assessment was conducted with the following hospitals:- East Carolina Health - Heritage, Inc. DBA Vidant Edgecombe Hospital- East Carolina Health DBA Vidant Roanoke-Chowan Hospital- East Carolina Health - Beaufort, Inc. DBA Vidant Beaufort Hospital- East Carolina Health - Chowan, Inc. DBA Vidant Chowan Hospital- Duplin General Hospital, Inc. DBA Vidant Duplin Hospital- East Carolina Health - Bertie DBA Vidant Bertie Hospital- Pungo District Hospital Corporation DBA Vidant Pungo Hospital
East Carolina Health - Chowan, Inc.	Part V, Section B, Line 4: The Community Health Needs Assessment was conducted with the following hospitals:- East Carolina Health - Heritage, Inc. DBA Vidant Edgecombe Hospital- East Carolina Health DBA Vidant Roanoke-Chowan Hospital- East Carolina Health - Beaufort, Inc. DBA Vidant Beaufort Hospital- East Carolina Health - Chowan, Inc. DBA Vidant Chowan Hospital- Duplin General Hospital, Inc. DBA Vidant Duplin Hospital- East Carolina Health - Bertie DBA Vidant Bertie Hospital- Pungo District Hospital Corporation DBA Vidant Pungo Hospital
Duplin General Hospital, Inc.	Part V, Section B, Line 4: The Community Health Needs Assessment was conducted with the following hospitals:- East Carolina Health - Heritage, Inc. DBA Vidant Edgecombe Hospital- East Carolina Health DBA Vidant Roanoke-Chowan Hospital- East Carolina Health - Beaufort, Inc. DBA Vidant Beaufort Hospital- East Carolina Health - Chowan, Inc. DBA Vidant Chowan Hospital- Duplin General Hospital, Inc. DBA Vidant Duplin Hospital- East Carolina Health - Bertie DBA Vidant Bertie Hospital- Pungo District Hospital Corporation DBA Vidant Pungo Hospital
East Carolina Health - Bertie	Part V, Section B, Line 4: The Community Health Needs Assessment was conducted with the following hospitals:- East Carolina Health - Heritage, Inc. DBA Vidant Edgecombe Hospital- East Carolina Health DBA Vidant Roanoke-Chowan Hospital- East Carolina Health - Beaufort, Inc. DBA Vidant Beaufort Hospital- East Carolina Health - Chowan, Inc. DBA Vidant Chowan Hospital- Duplin General Hospital, Inc. DBA Vidant Duplin Hospital- East Carolina Health - Bertie DBA Vidant Bertie Hospital- Pungo District Hospital Corporation DBA Vidant Pungo Hospital
Pungo District Hospital Corporation	Part V, Section B, Line 4: The Community Health Needs Assessment was conducted with the following hospitals:- East Carolina Health - Heritage, Inc. DBA Vidant Edgecombe Hospital- East Carolina Health DBA Vidant Roanoke-Chowan Hospital- East Carolina Health - Beaufort, Inc. DBA Vidant Beaufort Hospital- East Carolina Health - Chowan, Inc. DBA Vidant Chowan Hospital- Duplin General Hospital, Inc. DBA Vidant Duplin Hospital- East Carolina Health - Bertie DBA Vidant Bertie Hospital- Pungo District Hospital Corporation DBA Vidant Pungo Hospital
East Carolina Health - Heritage, Inc.	Part V, Section B, Line 5d: https://www.vidanthealth.com/vidant/dynamic-detail.aspx?id=13673
East Carolina Health - Roanoke-Chowan	Part V, Section B, Line 5d: https://www.vidanthealth.com/vidant/dynamic-detail.aspx?id=13673
East Carolina Health - Beaufort, Inc.	Part V, Section B, Line 5d: https://www.vidanthealth.com/vidant/dynamic-detail.aspx?id=13673
East Carolina Health - Chowan, Inc.	Part V, Section B, Line 5d: https://www.vidanthealth.com/vidant/dynamic-detail.aspx?id=13673
Duplin General Hospital, Inc.	Part V, Section B, Line 5d: https://www.vidanthealth.com/vidant/dynamic-detail.aspx?id=13673
East Carolina Health - Bertie	Part V, Section B, Line 5d: https://www.vidanthealth.com/vidant/dynamic-detail.aspx?id=13673
Pungo District Hospital Corporation	Part V, Section B, Line 5d: https://www.vidanthealth.com/vidant/dynamic-detail.aspx?id=13673
East Carolina Health - Heritage, Inc.	Part V, Section B, Line 7: Certain community needs may not be fully documented or addressed in the Community Health Needs Assessment. These needs are generally those which other organizations share an overlap with East Carolina Health. Those other organizations are better equiped to address these specific needs, and are subsequently not considered as issues of East Carolina Health.
East Carolina Health - Roanoke-Chowan	Part V, Section B, Line 7: Certain community needs may not be fully documented or addressed in the Community Health Needs Assessment. These needs are generally those which other organizations share an overlap with East Carolina Health. Those other organizations are better equiped to address these specific needs, and are subsequently not considered as issues of East Carolina Health.
East Carolina Health - Beaufort, Inc.	Part V, Section B, Line 7: Certain community needs may not be fully documented or addressed in the Community Health Needs Assessment. These needs are generally those which other organizations share an overlap with East Carolina Health. Those other organizations are better equiped to address these specific needs, and are subsequently not considered as issues of East Carolina Health.
East Carolina Health - Chowan, Inc.	Part V, Section B, Line 7: Certain community needs may not be fully documented or addressed in the Community Health Needs Assessment. These needs are generally those which other organizations share an overlap with East Carolina Health. Those other organizations are better equiped to address these specific needs, and are subsequently not considered as issues of East Carolina Health.
Duplin General Hospital, Inc.	Part V, Section B, Line 7: Certain community needs may not be fully documented or addressed in the Community Health Needs Assessment. These needs are generally those which other organizations share an overlap with East Carolina Health. Those other organizations are better equiped to address these specific needs, and are subsequently not considered as issues of East Carolina Health.
East Carolina Health - Bertie	Part V, Section B, Line 7: Certain community needs may not be fully documented or addressed in the Community Health Needs Assessment. These needs are generally those which other organizations share an overlap with East Carolina Health. Those other organizations are better equiped to address these specific needs, and are subsequently not considered as issues of East Carolina Health.
Pungo District Hospital Corporation	Part V, Section B, Line 7: Certain community needs may not be fully documented or addressed in the Community Health Needs Assessment. These needs are generally those which other organizations share an overlap with East Carolina Health. Those other organizations are better equiped to address these specific needs, and are subsequently not considered as issues of East Carolina Health.
East Carolina Health - Heritage, Inc.	Part V, Section B, Line 14g: The full policy is not available on the facility website. In lieu of the policy, a concise summary is provided with pertinent details and phone numbers for additional information.
East Carolina Health - Roanoke-Chowan	Part V, Section B, Line 14g: The full policy is not available on the facility website. In lieu of the policy, a concise summary is provided with pertinent details and phone numbers for additional information.
East Carolina Health - Beaufort, Inc.	Part V, Section B, Line 14g: The full policy is not available on the facility website. In lieu of the policy, a concise summary is provided with pertinent details and phone numbers for additional information.
East Carolina Health - Chowan, Inc.	Part V, Section B, Line 14g: The full policy is not available on the facility website. In lieu of the policy, a concise summary is provided with pertinent details and phone numbers for additional information.
Duplin General Hospital, Inc.	Part V, Section B, Line 14g: The full policy is not available on the facility website. In lieu of the policy, a concise summary is provided with pertinent details and phone numbers for additional information.
East Carolina Health - Bertie	Part V, Section B, Line 14g: The full policy is not available on the facility website. In lieu of the policy, a concise summary is provided with pertinent details and phone numbers for additional information.
Pungo District Hospital Corporation	Part V, Section B, Line 14g: The full policy is not available on the facility website. In lieu of the policy, a concise summary is provided with pertinent details and phone numbers for additional information.

Schedule H (Form 990) 2013

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, line 23.
SchJMediumBullet

Attach to Form 990. SchJMediumBullet

See separate instructions.
SchJMediumBullet

Information about Schedule J (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public Inspection

Name of the organization

East Carolina Health Inc

Employer identification number

91-1997979

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
directors, trustees, officers, including 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? .........

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) 2013

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)David HermanChief Executive	(i) (ii)	0 1,019,677	0 186,404	0 67,651	0 74,000	0 22,302	0 1,370,034	0 0
(2)Roger RobertsonPresident, ECH	(i) (ii)	0 382,629	0 41,994	0 2,031	0 74,172	0 37,173	0 537,999	0 0
(3)Lynn LanierVice President, ECH	(i) (ii)	0 223,507	0 14,630	0 656	0 48,402	0 30,455	0 317,650	0 0
(4)David S HughesChief Secretary/Treasurer	(i) (ii)	0 384,865	0 53,900	0 1,238	0 99,644	0 39,347	0 578,994	0 0
(5)Jeff SackrisonPresident of Bertie/Chowan	(i) (ii)	275,627 0	37,106 0	1,632 0	37,301 0	13,983 0	365,649 0	0 0
(6)Jay BrileyPresident of Duplin	(i) (ii)	0 182,790	0 26,006	0 0	0 26,593	0 30,447	0 265,836	0 0
(7)Wendell Baker JrPresident of Heritage	(i) (ii)	264,725 0	34,497 0	1,575 0	37,827 0	33,831 0	372,455 0	0 0
(8)Sue LassiterPresident of RCH	(i) (ii)	242,601 0	14,804 0	948 0	50,081 0	20,874 0	329,308 0	0 0
(9)William CasePresident of Beaufort/Pungo	(i) (ii)	0 222,784	0 32,068	0 596	0 47,971	0 40,462	0 343,881	0 0
(10)Susan MitchellVP, Patient Care Svcs RCH	(i) (ii)	150,984 0	3,750 0	0 0	15,463 0	2,010 0	172,207 0	0 0
(11)Jon GrahamVP, Finance/CFO RCH	(i) (ii)	157,233 0	3,795 0	0 0	18,112 0	13,380 0	192,520 0	0 0
(12)Patrick HeinsVP, Patient Care Services	(i) (ii)	157,275 0	4,058 0	0 0	18,792 0	14,252 0	194,377 0	0 0
(13)Tammi RoosAnesthesiologist - Duplin	(i) (ii)	369,064 0	0 0	0 0	4,002 0	19,577 0	392,643 0	0 0
(14)Debra AllenspachNurse Anesthetist - Chowan	(i) (ii)	249,718 0	500 0	0 0	3,253 0	32,543 0	286,014 0	0 0
(15)Betty MaciasManager, Anesthesia - Chowan	(i) (ii)	261,395 0	1,500 0	0 0	3,403 0	36,798 0	303,096 0	0 0
(16)Robert PostonNurse Anesthetist - Chowan	(i) (ii)	267,735 0	500 0	0 0	3,453 0	11,225 0	282,913 0	0 0
(17)Sharon VinsonManager, Anesthesia - Roanoke, Chowa	(i) (ii)	246,611 0	0 0	0 0	3,250 0	38,411 0	288,272 0	0 0

Schedule J (Form 990) 2013

Page 3

Part III

Supplemental Information

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.

Return Reference

Explanation

Part I, Line 3

The Top Management Official is the President who is an employee of East Carolina Health. The compensation is determined by the Compensation and Benefits Committee of the Vidant Health Board using comparative data from like organizations and input from consultants. This process is performed every two years, the last year being 2015. It will be performed again in fiscal year 2017. Compensation of other officers and key employees is also determined by the Compensation and Benefits Committee of the VH Board using comparative data from like organizations and input from consultants. This process is performed every two years, the last year being 2015. It will be performed again in fiscal year 2017. All compensation discussions and actions are documented and approved in the minutes of the Committee.

Part I, Line 4

As of January 1, 2013, the supplemental nonqualified retirement plan was frozen and no further amounts have accrued to its benefit. In lieu of the SERP, the comprehensive defined benefit pension plan will provide an equivalent benefit. The increase in the value of such plans is reflected in the sum of Part II, Column (C).

Schedule J (Form 990) 2013

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.
MediumBullet

Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public
Inspection

Name of the organization

East Carolina Health Inc

Employer identification number

91-1997979

Return Reference	Explanation
Form 990, Part III, Line 4a	Overview of University Health Systems of Eastern Carolina: Our mission at VH to enhance the quality of life for the people and communities we serve, touch and support drives us far beyond caring for patients within the confines of our hospital walls. It calls us to help make eastern North Carolina a better, healthier place to live. VH is a North Carolina non-profit corporation with headquarters in Greenville, North Carolina. VH and its affiliates operate an integrated health care delivery system that serves a total market of approximately 1.4 million people in 29 contiguous counties in eastern North Carolina. The Health System includes hospitals, physician practices, outpatient services, long-term care, home health, hospice, and wellness services. The Health System's owned hospitals are Vidant Medical Center ("VMC"), which is a tertiary care hospital and an academic medical center, and eight other acute care hospitals: Vidant Roanoke-Chowan Hospital, Vidant Edgecombe Hospital, Vidant Chowan Hospital, Vidant Bertie Hospital, Vidant Duplin Hospital, Vidant Beaufort Hospital, Vidant Pungo Hospital and The Outer Banks Hospital. VH also manages Albemarle Hospital. VMC serves as the teaching hospital for the Brody School of Medicine, East Carolina Schools of Nursing and Allied Health and Pitt Community College. The system also serves as a regional referral center for eastern North Carolina. The System's eight owned acute care hospitals are licensed to operate 1,439 beds. Each hospital is licensed by the Division of Facility Services of the North Carolina Department of Health and Human Services and approved as a provider by the Medicare and Medicaid programs. VH and its hospitals and affiliate organizations provide services to patients without regard to their ability to pay. In fiscal year 2014 VH's combined patient care statistics were: inpatient admissions, 63,891; inpatient days of care, 343,780; surgeries, 46,223; births, 5,819; and outpatient visits, 329,742. Our System's workforce included 11,950 employees. Each of VH's hospitals operates an emergency room, which is open 24 hours a day. VMC also offers a full spectrum of trauma services. Emergency and trauma services are provided to patients without regard to their ability to pay. In fiscal year 2014 VH provided care to 265,875 emergency room patients. VH's Board of Directors consists of 11 voting members, six of whom must be current or former Pitt County, North Carolina appointees of VMC's Board of Trustees and five of whom must be current of former Board of Governors of the University of North Carolina appointees of VMC's Board of Trustees. VMC, in affiliation with the Brody School of Medicine, which is owned by the State of North Carolina, operates 30 resident-training programs with over 400 medical residents. This relationship enables VMC and the Brody School of Medicine to combine their resources for the provision of quality patient care, medical education and research for the residents of eastern North Carolina. The Brody School of Medicine has three important goals: educating primary care physicians, making medical care more readily available to the people of eastern North Carolina, and providing opportunities to minority and disadvantaged students. As a non-profit organization, VH reinvests all excess of revenues over expenses in programs, services, and facilities that provide access to patient care and health services to the citizens of Eastern Carolina. Overview of Vidant Health Community Benefit Programs 1. Eastern North Carolina is comprised of 1.4 million people living in 14,000 square miles. Boundaries are from I-95 East to the coast, and from the Virginia line up to and including Onslow County. The area is largely rural and largely poor, with higher than state or national average rates for poverty and uninsured. Health status indicators show increased incidence of disease in the region, especially cancer, heart disease and stroke. VH determines priorities for target populations by working in concert with medical and community agency partners in ongoing assessment of the most pressing health care needs. Many efforts over the past decade have focused on diabetes, pediatric asthma, school health, injury prevention, access to care, nutrition enhancement, physical activities and chronic disease screenings. Also, special programs to manage the care of Medicaid enrollees, address access to both medical care and medications for the uninsured, and coordination of services for children with obesity have been undertaken. The populations that are served by addressing these issues are largely the poor, the underserved, and minorities. Determination of specific populations to address occurs when partners such as the North Carolina Department of Health and Human Services, local health departments, county Healthy Carolinian task forces, and physicians identify a quantifiable need, and community partners are engaged to work together with the health system. 2. Funding for community health programs is obtained from both the operating funds of VH entities and external grant-awarding organizations. The VH Board annually provides financial support for the Community Benefit Initiatives program of its foundation. These funds are then awarded to community agencies that successfully demonstrate both need and a well-designed plan to address one of the Foundation's priority categories. In addition, each VH hospital financially supports community health resources within its operating budget. Programs vary according to the hospital's financial ability and community need, but all include collaborative efforts with local health departments, including health screenings and education to targeted populations. VH also has a successful track record of obtaining community health program support from external agencies that award grant funding to approve projects. The VH Grants Office was established in 2008 and serves as the central point for grant mining, acquisition and management of grants awarded to VH hospitals for community-based programs. Grant funds are utilized to demonstrate the effectiveness of a proposed community program, measure the outcomes achieved, and garner long-term sustainability from either the health system, other community agencies or as a collaborative program. Many community health programs are collaborative in nature with local service agencies, and often a portion of the grant funds are used to support resources or services in these agencies. 3. Community health priorities are determined in several ways. In partnership with the local health departments, the results of state-mandated community health assessments are studied by each local Healthy Carolinians task force. Those task force groups then compile a list of the most pressing issues in their communities based on data from community input. Both established resources within various agencies and potential opportunities to garner new support are reviewed. 4. Community priorities are also established in response to a compelling need identified by health practitioners or community groups. Examples include the pediatric asthma program that has been in place for over 10 years in Pitt County, and expanded to other communities in the region. This major community-based program was established following a plea for assistance by pediatricians and pediatric clinical nurse specialists caring for children with asthma in the acute care setting. The Pitt County School System and local parents identified a lack of health care support in the schools, resulting in an award-winning school nurse program that has been replicated in several counties. Most recently, the focused attention on pediatric obesity and associated diseases has resulted in multiple community-based programs directed at improving nutrition, physical activity, and case management for that population. VH is fortunate to have a strong collaborative partnership with East Carolina University, and works closely with the schools within the Health Sciences Division, especially the Brody School of Medicine. BSOM is an active participant in almost every community health initiative, supporting the research and evaluation of these programs, and contributes to programs for the under and uninsured in multiple ways. ECU and other educational institutions whose students matriculate through VH facilities also provide opportunities for collaboration and participation in various community health initiatives. 5. Provided below are a few highlights of the community benefit and education activities:
Form 990, Schedule H, Part VI, Line 5:	5a. Community Health Improvement Services Community health improvement services are programs and services that meet an identified need and are offered to the community at little or no charge. VH hospitals sponsor programs that improve access to health care for the underserved and enhance the identification and management of chronic diseases, such as cancer, diabetes and heart disease. Here are a few examples of these programs: - Medical assistance programs for uninsured patients - The Pediatric Healthy Weight Program - Support for Health Carolinians collaboratives, including Pitt Partners for Health, the Hertford Partnership for Health and Three Rivers Healthy Carolinians. - School nurse programs - Support for the Community Care Plan of Eastern Carolina for Medicaid recipients and HealthAssist for the uninsured - Support of local Federally Qualified Health Center 5b. Health Professional Education Preparing future health care professionals is important to us. Our hospitals provide clinical settings for students of health professions, such as future physicians, nurses and other allied health professionals. We also support students through deferred forgivable loans and internships including resident training, nursing clinic sites, allied health professionals, and financial support of nursing programs. 5c. Research East Carolina University (ECU) conducts research to evaluate new treatments and protocols. These studies help health professionals everywhere provide quality care to patients. VH supports this through various means including supporting the Institutional Review Board at ECU and providing study sites. 5d. Financial and In-Kind Contributions VH donates money and in-kind services to community groups and activities that share our mission of improving health. They include Meals on Wheels, American Red Cross blood drives, medical supplies to emergency medical services, and free medications to qualifying patients. VH hospitals are key partners in fundraising for organizations such as the United Way, American Heart Association, Juvenile Diabetes Association and the American Cancer Society. VH contributed $1.0 million to the Community Benefits Grants Program which awards grants to local non-profits for health related programs. 5e. Community Building Community-building activities include programs that are not directly related to health care but address underlying issues that impact the health of communities. Poverty, crime, homelessness, workforce development and economic development all affect the overall health of communities. VH has provided support for our local Chambers of Commerce, financial support for road improvements, investments in communication infrastructure via information technology connections, support for the Teen Leadership Academy, recruitment of physicians to our rural communities, and programs that encourage students to pursue health careers.
Form 990, Part VI, Section B, line 11	The 990 is made available to Board Members by posting to a Board Member's website. Any Board Member who does not have the ability to access the return in this manner will receive a copy via electronic or regular mail. The return is also reviewed by the Chief Financial Officer, Chief General Counsel and the Chief Audit and Compliance Officer of University Health Systems prior to filing.
Form 990, Part VI, Section B, line 12	All Officers, Board Members and Key Employees are required to complete a yearly comprehensive conflict of interest questionnaire. These are reviewed by legal counsel and any potential or actual conflicts are brought to the Board for disposition. Board Members are instructed to report any potential conflicts arising during the year for review. Board Members are required to recuse themselves from voting on issues in which they are deemed to have a conflict.
Form 990, Part VI, Section B, line 15	The Top Management Official is the President who is an employee of East Carolina Health, Inc. The compensation is determined by the Compensation and Benefits Committee of the Vidant Health Board using comparative data from like organizations and input from consultants. This process is performed every two years, the last year being 2015. It will be performed again in fiscal year 2017. Compensation of other officers and key employees is also determined by the Compensation and Benefits Committee of the VH Board using comparative data from like organizations and input from consultants. This process is performed every two years, the last year being 2015. It will be performed again in fiscal year 2017. All compensation discussions and actions are documented and approved in the minutes of the Committee.
Form 990, Part VI, Section C, line 19	The Organization makes its governing documents, conflict of interest policy, and combined financial statements available upon request for the same period of disclosure as set forth in IRC Section 6104(d).
Form 990, Part XI, line 9:	Capital Contributions and Transfers with Affiliates -13,384,972.

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

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2013

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" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBullet

Attach to Form 990. MediumBullet

See separate instructions.
MediumBullet

Information about Schedule R (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public Inspection

Name of the organization

East Carolina Health Inc

Employer identification number

91-1997979

Part I

Identification of Disregarded Entities Complete if the organization answered "Yes" on 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" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled 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) University Health Systems of Eastern Carolina (DBA Vidant Health) 2100 Stantonsburg Road Greenville,NC27835 56-2141073	Healthcare	NC	501(c)(3)	Line 11c, III-FI	N/A		No
(2) Pitt County Memorial Hospital Inc (DBA Vidant Medical Center) 2100 Stantonsburg Road Greenville,NC27835 56-0585243	Hospital	NC	501(c)(3)	Line 3	Vidant Health		No
(3) Surgicenter Services of Pitt Inc 102 Bethesda Drive Greenville,NC27835 56-1690553	Healthcare	NC	501(c)(3)	Line 11b, II	Vidant Medical Center		No
(4) East Carolina Health Inc (DBA Vidant Community Hospitals - Central) 2100 Stantonsburg Road Greenville,NC27835 56-2003393	Hospital	NC	501(c)(3)	Line 3	Vidant Health		No
(5) PCMH Management Inc (DBA Vidant Properties) 2100 Stantonsburg Road Greenville,NC27835 56-1690740	Medical Property Management	NC	501(c)(2)		Vidant Health		No
(6) HealthAccess Inc 2100 Stantonsburg Road Greenville,NC27835 56-1396133	Healthcare	NC	501(c)(3)	Line 11b, II	Vidant Health		No
(7) The Outer Banks Hospital 2100 Stantonsburg Road Greenville,NC27835 56-2112733	Hospital	NC	501(c)(3)	Line 3	East Carolina Health		No

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

Cat. No. 50135Y

Schedule R (Form 990) 2013

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(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 V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Part IV

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(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

Schedule R (Form 990) 2013

Page 3

Part V

Transactions With Related Organizations Complete if the organization answered "Yes" on 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 . . . . . . . . . . . . . . . . . . . . . . .

Yes

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

Yes

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) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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

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

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

Yes

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

Yes

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

Yes

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

Yes

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

Yes

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

Yes

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 related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved

Schedule R (Form 990) 2013

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 37.

Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.

(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(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 V?UBI 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 V?UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Schedule R (Form 990) 2013

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R (see instructions).

Return Reference	Explanation

Schedule R (Form 990) 2013

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: To enhance the quality and management of non-profit hospitals and health care system services.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	7
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	6
5	Total number of individuals employed in calendar year 2013 (Part V, line 2a) ......	5	0
6	Total number of volunteers (estimate if necessary) .............	6	0
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	0
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	2,057,424	1,457,120
9	Program service revenue (Part VIII, line 2g) .........	365,126,887	359,218,104
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	248,072	-839,134
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	6,386,564	6,671,613
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)...................	373,818,947	366,507,703
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	53,007	4,000
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)	156,610,439	150,511,284
16a	Professional fundraising fees (Part IX, column (A), line 11e).....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	206,960,151	210,853,304
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	363,623,597	361,368,588
19	Revenue less expenses. Subtract line 18 from line 12.......	10,195,350	5,139,115
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	279,335,547	267,840,462
21	Total liabilities (Part X, line 26).............	163,998,685	160,749,457
22	Net assets or fund balances. Subtract line 21 from line 20.....	115,336,862	107,091,005

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 63,284,173 including grants of $ ) (Revenue $ 84,873,461 )
	Vidant Edgecombe HospitalVidant Edgecombe Hospital, formerly Heritage Hospital, is a 101-bed facility located in Tarboro, North Carolina, that is also licensed for 16 inpatient rehabilitation beds. Services at Vidant Edgecombe include acute care, inpatient and same-day surgery, emergency, critical care, obstetrics/gynecology, rehabilitation and oncology services. It also operates a rural health center, which provides general, pediatric, women's and occupational health services.

4b	(Code: ) (Expenses $ 74,839,353 including grants of $ ) (Revenue $ 79,048,672 )
	Vidant Roanoke-Chowan HospitalVidant Roanoke-Chowan Hospital is an 86-bed hospital located in Ahoskie, North Carolina, that is also licensed for 28 inpatient psychiatric beds. Services at Roanoke-Chowan Hospital include acute care, obstetrics/gynecology, emergency, sub-acute care, specialty clinics and behavioral health. The hospital also operates a wellness center for the community.

4c	(Code: ) (Expenses $ 59,075,586 including grants of $ ) (Revenue $ 65,468,218 )
	Vidant Beaufort HospitalVidant Beaufort Hospital is a 120-bed hospital located in Washington, North Carolina, that is also licensed for 22 inpatient psychiatric beds. Services at Vidant Beaufort Hospital include acute care, obstetrics/gynecology, emergency, sub-acute care, specialty clinics and behavioral health.

	(Code: ) (Expenses $ 109,935,346 including grants of $ 4,000 ) (Revenue $ 129,827,753 )


4d	Other program services (Describe in Schedule O.)
	(Expenses $ 109,935,346 including grants of $ 4,000 ) (Revenue $ 129,827,753 )
4e	Total program service expenses307,134,458

(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) Susan Mitchell........................................................................ VP, Patient Care Svcs RCH	40.00 .......................	X		154,734	0	17,473
(19) Jon Graham........................................................................ VP, Finance/CFO RCH	40.00 .......................	X		161,028	0	31,492
(20) Patrick Heins........................................................................ VP, Patient Care Services	40.00 .......................	X		161,333	0	33,044
(21) Tammi Roos........................................................................ Anesthesiologist - Duplin	40.00 .......................		X	369,064	0	23,579
(22) Debra Allenspach........................................................................ Nurse Anesthetist - Chowan	40.00 .......................		X	250,218	0	35,796
(23) Betty Macias........................................................................ Manager, Anesthesia - Chowan	40.00 .......................		X	262,895	0	40,201
(24) Robert Poston........................................................................ Nurse Anesthetist - Chowan	40.00 .......................		X	268,235	0	14,678
(25) Sharon Vinson........................................................................ Manager, Anesthesia - Roanoke, Chowan	40.00 .......................		X	246,611	0	41,661

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)............	2,747,633	2,843,426	1,002,789

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

f	All other contributions, gifts, grants, and similar amounts not included above1f		1,457,120

g	Noncash contributions included in lines 1a-1f:$		3,625
h	Total. Add lines 1a-1f.......			1,457,120
			Business Code
2a	Outpatient Revenue		621400	205,025,245	205,025,245
b	Inpatient Revenue		621110	150,786,125	150,786,125
c
d
e
f	All other program service revenue .			3,406,734	3,406,734
g	Total. Add lines 2a–2f........			359,218,104
3	Investment income (including dividends, interest, and other similar amounts).......			250,208			250,208
4	Income from investment of tax-exempt bond proceeds..
5	Royalties...........
		(i) Real	(ii) Personal
6a	Gross rents	105,121
b	Less: rental expenses	0
c	Rental income or (loss)	105,121
d	Net rental income or (loss).......			105,121			105,121
		(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory
b	Less: cost or other basis and sales expenses	1,089,342
c	Gain or (loss)	-1,089,342
d	Net gain or (loss)..........			-1,089,342			-1,089,342
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ..
	a
b	Less: direct expenses ...b
c	Net income or (loss) from fundraising events..
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	Cafeteria Services		722210	1,966,128			1,966,128
b	ViQuest Fitness		900099	1,377,634			1,377,634
c	Pharmacy		446110	1,184,973			1,184,973
d	All other revenue ....			2,037,757			2,037,757
e	Total. Add lines 11a–11d ......			6,566,492
12	Total revenue. See Instructions......			366,507,703	359,218,104	0	5,832,479


				(A) Beginning of year		(B) End of year
1	Cash–non-interest-bearing .............			33,558,488	1	31,012,754
2	Savings and temporary cash investments .........				2
3	Pledges and grants receivable, net ...........				3
4	Accounts receivable, net .............			48,525,674	4	46,116,507
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 .............				7
8	Inventories for sale or use ..............			10,150,265	8	10,801,633
9	Prepaid expenses and deferred charges ..........			16,129,472	9	18,893,236
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	286,781,948
b	Less: accumulated depreciation .....	10b	160,769,463	133,828,197	10c	126,012,485
11	Investments—publicly traded securities ..........				11
12	Investments—other securities. See Part IV, line 11 .....			3,972,333	12	3,634,025
13	Investments—program-related. See Part IV, line 11 .....				13
14	Intangible assets ...............			22,829,529	14	22,831,411
15	Other assets. See Part IV, line 11 ...........			10,341,589	15	8,538,411
16	Total assets. Add lines 1 through 15 (must equal line 34)......			279,335,547	16	267,840,462
17	Accounts payable and accrued expenses .........			34,715,430	17	34,998,958
18	Grants payable .................				18
19	Deferred revenue ................				19
20	Tax-exempt bond liabilities .............				20
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 ..			2,168,159	23	1,383,446
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....................			127,115,096	25	124,367,053
26	Total liabilities. Add lines 17 through 25.........			163,998,685	26	160,749,457
	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets ..............			112,495,894	27	104,252,918
28	Temporarily restricted net assets ...........			2,840,968	28	2,838,087
29	Permanently restricted net assets ...........				29
	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 ...........			115,336,862	33	107,091,005
34	Total liabilities and net assets/fund balances ........			279,335,547	34	267,840,462