Form990
Click to see attachment
Department of the Treasury
Internal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations)
MediumBullet Do not enter Social Security numbers on this form as it may be made public. By law, the IRS
generally cannot redact the information on the form.
MediumBullet Information about Form 990 and its instructions is at www.IRS.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
A For the 2013 calendar year, or tax year beginning 10-01-2013 , 2013, and ending 09-30-2014
BCheck if applicable:
CName of organization
LENOIR MEMORIAL HOSPITAL INC
 
Doing Business As
 
 
Number and street (or P.O. box if mail is not delivered to street address)
100 AIRPORT ROAD
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
KINSTON, NC28501
D Employer identification number

56-6000674
E Telephone number

G Gross receipts $ 129,542,995
F Name and address of principal officer:
GARY BLACK
100 AIRPORT ROAD
KINSTON,NC28501
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.LENOIRMEMORIAL.ORG
H(a)
Is this a group return for
subordinates?
H(b)
Are all subordinates
included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:
 
L Year of formation: 1950
M State of legal domicile: NC
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: PROVIDING EXCEPTIONAL HEALTHCARE AS AN OUTSTANDING COMMUNITY HOSPITAL
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 16
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 14
5 Total number of individuals employed in calendar year 2013 (Part V, line 2a) ...... 5 1,163
6 Total number of volunteers (estimate if necessary) ............. 6 276
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 421,838
b Net unrelated business taxable income from Form 990-T, line 34 ......... 7b 41,375
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 112,217 239,903
9 Program service revenue (Part VIII, line 2g) ......... 129,976,588 122,741,162
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 3,641,359 2,886,195
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 3,206,396 2,961,999
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 136,936,560 128,829,259
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 186,375 172,287
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) 61,246,580 56,443,186
16a Professional fundraising fees (Part IX, column (A), line 11e)..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet71,787    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 76,868,554 74,616,082
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 138,301,509 131,231,555
19 Revenue less expenses. Subtract line 18 from line 12....... -1,364,949 -2,402,296
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 185,415,041 180,872,103
21 Total liabilities (Part X, line 26)............. 46,940,935 40,185,676
22 Net assets or fund balances. Subtract line 21 from line 20..... 138,474,106 140,686,427
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title
Paid Preparer Use Only
Print/Type preparer's name
Preparer's signature
Date
PTIN
Firm's name MediumBullet

Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ............
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y
Form 990 (2013)
Form 990 (2013)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line in this Part III ..............
1
Briefly describe the organization’s mission: THE MISSION OF LENOIR MEMORIAL IS TO ENSURE EXCEPTIONAL HEALTHCARE FOR THE PEOPLE WE SERVE.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? ......................
If "Yes," describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program services? ............................
If "Yes," describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 113,266,085 including grants of $ 172,287 ) (Revenue $ 124,392,267 )
SEE SCHEDULE O FOR DESCRIPTION OF THE ORGANIZATIONS PROGRAM SERVICE ACCOMPLISHMENTS:
4b (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
SEE SCHEDULE O
4c (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4d Other program services (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet113,266,085
Form 990 (2013)
Form 990 (2013)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If "Yes," complete Schedule AClick to see attachment........................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors (see instructions)? Click to see attachment...
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If "Yes," complete Schedule C, Part IClick to see attachment..........
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part IIClick to see attachment........
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If "Yes," complete Schedule C,
Part IIIClick to see attachment............................
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If "Yes," complete Schedule D, Part IClick to see attachment........................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If "Yes," complete Schedule D, Part IIClick to see attachment...
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes," complete Schedule D, Part III Click to see attachment....................
8
 
No
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If "Yes," complete Schedule D, Part IVClick to see attachment..............
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi-endowments? If "Yes," complete Schedule D, Part VClick to see attachment......
10
 
No
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10?
If "Yes," complete Schedule D, Part VI.Click to see attachment...................
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIClick to see attachment.......
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIIClick to see attachment.......
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part IXClick to see attachment............
11d
 
No
e
Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, Part XClick to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If "Yes," complete Schedule D, Part XClick to see attachment.........................
11f
Yes
 
12a
Did the organization obtain separate, independent audited financial statements for the tax year?
If "Yes," complete Schedule D, Parts XI and XII Click to see attachment.................
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E....
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States?.....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If "Yes," complete Schedule F, Parts I and IV.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? If “Yes,” complete Schedule F, Parts II and IV
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? If “Yes,” complete Schedule F, Parts III and IV...
16
 
No
17
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If "Yes," complete Schedule G, Part I (see instructions)....
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If "Yes," complete Schedule G, Part II............
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If "Yes," complete Schedule G, Part III...................
19
 
No
20a
Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H.... Click to see attachment
20a
Yes
 
b
If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return?
20b
Yes
 
Form 990 (2013)
Form 990 (2013)
Page 4
Part IV
Checklist of Required Schedules (continued)
21
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or government on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II... Click to see attachment
21
 
No
22
Did the organization report more than $5,000 of grants or other assistance to individuals in the United States on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........ Click to see attachment
22
Yes
 
23
Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5 about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If "Yes," complete Schedule J....................... Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 25a................ Click to see attachment
24a
Yes
 
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
No
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds?......................
24c
 
No
d
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?...
24d
 
No
25a
Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes," complete Schedule L, Part I........
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If "Yes," complete Schedule L, Part I...................
25b
 
No
26
Did the organization report any amount on Part X, line 5, 6, or 22 for receivables from or payables to any current or former officers, directors, trustees, key employees, highest compensated employees, or disqualified persons? If so, complete Schedule L, Part II....................
26
 
No
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons? If "Yes," complete Schedule L, Part III.........
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If "Yes," complete Schedule L, Part IV ..........................
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If "Yes,"
complete Schedule L, Part IV.....................
28b
 
No
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or direct or indirect owner? If "Yes," complete Schedule L, Part IV...
28c
 
No
29
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M..
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M.............
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N,
Part I...........................
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete Schedule N, Part II......................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If "Yes," complete Schedule R, Part I........ Click to see attachment
33
Yes
 
34
Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, Part II, III, or IV, and Part V, line 1........................ Click to see attachment
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
Yes
 
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes," complete Schedule R, Part V, line 2... Click to see attachment
35b
 
No
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If "Yes," complete Schedule R, Part V, line 2............. Click to see attachment
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If "Yes," complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2013)
Form 990 (2013)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V ..............
Yes
No
1a
Enter the number reported in Box 3 of Form 1096 Enter -0- if not applicable ..
1a
135
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable .
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................
2a
1,163
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No” to line 3b, provide an explanation in Schedule O...
3b
Yes
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)?..........................
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts.
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If "Yes," to line 5a or 5b, did the organization file Form 8886-T? ............
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions?...
6a
 
No
b
If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?........................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?....................
7a
 
No
b
If "Yes," did the organization notify the donor of the value of the goods or services provided?.....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?...........................
7c
 
No
d
If "Yes," indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?............................
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?............................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?..........................
7h
 
 
8
Sponsoring organizations maintaining donor advised funds and section 509(a)(3) supporting organizations. Did the supporting organization, or a donor advised fund maintained by a sponsoring organization, have excess business holdings at any time during the year?............
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the organization make any taxable distributions under section 4966?..........
9a
 
 
b
Did the organization make a distribution to a donor, donor advisor, or related person?.......
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ..........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If "Yes," enter the amount of tax-exempt interest received or accrued during the year. ....................
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note. See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans ....
13b
 
c
Enter the amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If "No," provide an explanation in Schedule O..
14b
 
 
Form 990 (2013)
Form 990 (2013)
Page 6
Part VI
Governance, Management, and Disclosure For each "Yes" response to lines 2 through 7b below, and for a "No" response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response or note to any line in this Part VI ..............
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year .....................
1a
16
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent ...................
1b
14
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
 
No
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? ...........................
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
 
No
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
 
No
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
 
No
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .........................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If "Yes," provide the names and addresses in Schedule O.......
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
 
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If "No," go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe in Schedule O how this was done.......................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line 15a or 15b, describe the process in Schedule O (see instructions).
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
Yes
 
b
If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
Yes
 
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
18
Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, physical address, and telephone number of the person who possesses the books and records of the organization:
MediumBulletMICHELLE MITTEN CPA FINANCE DIR100 AIRPORT ROADKINSTONNC28501 (252) 522-7927
Form 990 (2013)
Form 990 (2013)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response or note to any line in this Part VII ..............
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

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

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

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

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
(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) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(1) GARY BLACK........................................................................
CEO
 40.00
.......................1.00 		X   X       457,821 0 19,662
(2) RAY COLLIER JR........................................................................
CHAIRPERSON
 3.00
.......................   		X   X       0 0 0
(3) MARY M CAULEY EDD........................................................................
VICE CHAIR
 3.00
.......................   		X           0 0 0
(4) CRAIG HILL........................................................................
BOARD MEMBER
 2.00
.......................   		X           0 0 0
(5) RALPH LEE COX MD........................................................................
BOARD MEMBER
 2.00
.......................   		X           0 0 0
(6) DEXTER FLOYD........................................................................
BOARD MEMBER
 2.00
.......................   		X           0 0 0
(7) OSCAR SKIP GREENE III........................................................................
BOARD MEMBER
 2.00
.......................   		X           0 0 0
(8) WAYNE JARMAN MD........................................................................
BOARD MEMBER
 40.00
.......................   		X           430,009 0 24,072
(9) CLIFTON HARRISON........................................................................
BOARD MEMBER
 2.00
.......................   		X           0 0 0
(10) AGNES HO........................................................................
BOARD MEMBER
 2.00
.......................   		X           0 0 0
(11) ADRIAN KING........................................................................
BOARD MEMBER
 2.00
.......................   		X           0 0 0
(12) WILLIAM ANTHONY LAWSON JR........................................................................
BOARD MEMBER
 2.00
.......................   		X           0 0 0
(13) DAPHNE POLLOCK........................................................................
BOARD MEMBER
 2.00
.......................   		X           0 0 0
(14) LADDIE M CRISP JR MD........................................................................
BOARD MEMBER
 2.00
.......................   		X           695 0 0
(15) ARMISTEAD MAUCK........................................................................
BOARD MEMBER
 2.00
.......................   		X           0 0 0
(16) CARLTON YOUNGER JR........................................................................
BOARD MEMBER
 2.00
.......................   		X           0 0 0
(17) JIM DOBBINS........................................................................
VP - HUMAN RESOUCES
 40.00
.......................   		    X       212,223 0 33,740
Form 990 (2013)
Form 990 (2013)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and Title 		(B)
Average hours per week (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) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(18) SARAH MAYO........................................................................
CFO
 40.00
.......................1.00 		    X       288,850 0 38,473
(19) ROSALAND MCDONALD........................................................................
VP - NURSING SERVICES
 40.00
.......................   		    X       221,610 0 16,580
(20) ALTON HARDY........................................................................
PHARMACY DIRECTOR
 40.00
.......................   		      X     181,338 0 15,775
(21) KARL LEONARD VANDERSTOUW........................................................................
SENIOR DIRECTOR ITS
 40.00
.......................   		      X     207,145 0 16,874
(22) SCOTT STEGBAUER MD........................................................................
ORTHOPEDIC SURGEON
 40.00
.......................   		        X   502,076 0 22,808
(23) CONNIE SUE MANGEL........................................................................
CRNA
 40.00
.......................   		        X   205,942 0 21,418
(24) MARK HENNING........................................................................
CRNA
 40.00
.......................   		        X   216,633 0 21,965
(25) ANGELA P WILLIAMS........................................................................
CRNA
 40.00
.......................   		        X   193,684 0 20,882
(26) JESSICA AMBER WOODCOCK........................................................................
ORTHOPEDIC SURGEON
 40.00
.......................   		        X   406,281 0 12,535








1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 3,524,307 0 264,784
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organizationMediumBullet46
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If "Yes," complete Schedule J for such individual ..............
3
 
No
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If "Yes," complete Schedule J for such individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If "Yes," complete Schedule J for such person ........
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address 		(B)
Description of services 		(C)
Compensation
CA LEWIS CONSTRUCTION COMPANYPO BOX 5064GREENVILLENC27834 CONSTRUCTION CONTRACTOR 1,345,274
LENOIR HM SERVICESPO BOX 82368LAFAYETTELA705982368 HOSPITALIST STAFFING 1,182,369
SODEXO INC & AFFILIATESPO BOX 536922ATLANTAGA303536922 DIETARY SERVICES 811,600
SLEEP SERVICES OF AMERICA INCPO BOX 198320ATLANTAGA30384 SLEEP DIAGNOSIS AND TREATMENT 718,300
HALIFAX LINEN SERVICESPO BOX 129ROANOKE RAPIDSNC27870 LAUNDRY SERVICES 479,605
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet29
Form 990 (2013)
Form 990 (2013)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII .............
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512-514
Contributions, Gifts, GrantAmt and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c  
d Related organizations...1d 47,012
e Government grants (contributions)1e  
f All other contributions, gifts, grants, and
similar amounts not included above1f 		192,891
g Noncash contributions included in lines
1a-1f:$ 		 
h Total. Add lines 1a-1f.......MediumBullet 239,903
Program Service RevenueAmt Business Code
2a PATIENT SERVICES 621990 121,984,010 121,984,010    
b AUXILLARY SERVICE REVENUE 621990 377,888 377,888    
c MEANINGFUL USE REVENUE 900099 231,078 231,078    
d WELLNESS CENTER REVEUNE 713940 151,153 151,153    
e LAB REVENUE 541380 34,182 17,091 17,091  
f All other program service revenue . -37,149   -37,149  
g Total. Add lines 2a–2f........MediumBullet 122,741,162
OtherAmt RevenueAmt 3 Investment income (including dividends, interest, and other similar amounts).......MediumBullet 2,607,558   2,323 2,605,235
4 Income from investment of tax-exempt bond proceeds..MediumBullet        
5 Royalties...........MediumBullet        
(i) Real (ii) Personal
6a Gross rents   1,356,942
b Less: rental expenses   0
c Rental income or (loss)   1,356,942
d Net rental income or (loss).......MediumBullet 1,356,942 1,060,213 296,729  
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory 351,727  
b Less: cost or other basis and sales expenses 0 73,090
c Gain or (loss) 351,727 -73,090
d Net gain or (loss)..........MediumBullet 278,637     278,637
8a Gross income from fundraising events (not including
$  
of contributions reported on line 1c). See Part IV, line 18 ..
a  
b Less: direct expenses ...b  
c Net income or (loss) from fundraising events..MediumBullet      
9a Gross income from gaming activities.
See Part IV, line 19 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from gaming activities...MediumBullet        
10a Gross sales of inventory, less
returns and allowances .
a 1,354,324
b Less: cost of goods sold ..b 640,646
c Net income or (loss) from sales of inventory..MediumBullet 713,678 570,834 142,844  
Miscellaneous Revenue Business Code
11a DIETARY AND CAFETERIA 900099 849,210     849,210
b VENDING 900099 42,169     42,169
c            
d All other revenue ....        
e Total. Add lines 11a–11d ...... MediumBullet 891,379
12 Total revenue. See Instructions......MediumBullet 128,829,259 124,392,267 421,838 3,775,251
Form 990 (2013)
Form 990 (2013)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).Check if Schedule O contains a response or note to any line in this Part IX ...............
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 67,153 67,153
2 Grants and other assistance to individuals in the United States. See Part IV, line 22 105,134 105,134
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 .... 1,696,124 264,884 1,373,034 58,206
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 44,068,444 36,261,684 7,806,760  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 1,481,224 1,182,225 297,115 1,884
9 Other employee benefits ....... 5,987,681 4,779,013 1,201,053 7,615
10 Payroll taxes ........... 3,209,713 2,561,803 643,828 4,082
11 Fees for services (non-employees):        
a Management ...... 51,267   51,267  
b Legal ......... 206,242   206,242  
c Accounting ........... 100,900   100,900  
d Lobbying ...........        
e Professional fundraising services. See Part IV, line 17    
f Investment management fees ...... 268,692   268,692  
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) ........ 10,223,796 8,017,911 2,205,885  
12 Advertising and promotion .... 360,969 12,718 348,251  
13 Office expenses ....... 6,553,742 3,352,898 3,200,844  
14 Information technology ...... 1,788,725 1,788,725    
15 Royalties ..        
16 Occupancy ........... 2,849,967 2,785,934 64,033  
17 Travel ............ 79,425 52,876 26,549  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ......        
19 Conferences, conventions, and meetings .... 55,964 27,175 28,789  
20 Interest ........... 25,575   25,575  
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization ..... 7,072,064 7,072,064    
23 Insurance .............. 62,533 62,533    
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 BAD DEBT EXPENSE 29,431,737 29,431,737    
b MEDICAL SUPPLIES 14,832,823 14,832,823    
c RECRUITMENT 596,186 596,186    
d MISCELLANEOUS 55,475 10,609 44,866  
e All other expenses        
25 Total functional expenses. Add lines 1 through 24e 131,231,555 113,266,085 17,893,683 71,787
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 MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2013)
Form 990 (2013)
Page 11
Part X Balance Sheet Check if Schedule O contains a response or note to any line in this Part X ..............
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash–non-interest-bearing ............. 4,023,737 1 4,816,469
2 Savings and temporary cash investments ......... 14,030,756 2 10,867,002
3 Pledges and grants receivable, net ...........   3  
4 Accounts receivable, net ............. 11,626,291 4 9,438,819
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 .............. 3,572,953 8 3,127,956
9 Prepaid expenses and deferred charges .......... 1,719,576 9 1,737,270
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 144,807,887
b Less: accumulated depreciation ..... 10b 88,627,465 59,853,084 10c 56,180,422
11 Investments—publicly traded securities .......... 87,104,244 11 91,851,087
12 Investments—other securities. See Part IV, line 11 .....   12  
13 Investments—program-related. See Part IV, line 11 .....   13  
14 Intangible assets ...............   14  
15 Other assets. See Part IV, line 11 ........... 3,484,400 15 2,853,078
16 Total assets. Add lines 1 through 15 (must equal line 34)...... 185,415,041 16 180,872,103
Liabilities 17 Accounts payable and accrued expenses ......... 9,874,478 17 9,383,211
18 Grants payable .................   18  
19 Deferred revenue ................ 8,946,149 19 4,675,558
20 Tax-exempt bond liabilities ............. 18,485,000 20 18,010,000
21 Escrow or custodial account liability. Complete Part IV of Schedule D..   21  
22 Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
persons. Complete Part II of Schedule L..........   22  
23 Secured mortgages and notes payable to unrelated third parties .. 5,500,000 23 5,000,000
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.................... 4,135,308 25 3,116,907
26 Total liabilities. Add lines 17 through 25......... 46,940,935 26 40,185,676
Net Assets or Fund Balance Organizations that follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets .............. 103,596,311 27 107,658,664
28 Temporarily restricted net assets ........... 34,877,795 28 33,027,763
29 Permanently restricted net assets ...........   29  
Organizations that do not follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 30 through 34.
30 Capital stock or trust principal, or current funds ........   30  
31 Paid-in or capital surplus, or land, building or equipment fund .....   31  
32 Retained earnings, endowment, accumulated income, or other funds   32  
33 Total net assets or fund balances ........... 138,474,106 33 140,686,427
34 Total liabilities and net assets/fund balances ........ 185,415,041 34 180,872,103
Form 990 (2013)
Form 990 (2013)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response or note to any line in this Part XI ..............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
128,829,259
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
131,231,555
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
-2,402,296
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
138,474,106
5
Net unrealized gains (losses) on investments ...............
5
4,774,659
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
 
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
-160,042
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33, column (B))
10
140,686,427
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response or note to any line in this Part XII .............
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?
2a
 
No
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If "Yes," to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133?
3a
 
No
b
If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits.
3b
 
 
Form 990 (2013)
Form 990, Special Condition Description:
Special Condition Description
Additional Data


Software ID:  
Software Version:  
SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service
Public Charity Status and Public Support
Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow Attach to Form 990 or Form 990-EZ. right arrow See separate instructions.
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
LENOIR MEMORIAL HOSPITAL INC
 
Employer identification number

56-6000674
Part I
Reason for Public Charity Status (All organizations must complete this part.) See instructions.
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
f
g
(i) A person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the supported organization? ................
11g(i)
 
 
(ii) A family member of a person described in (i) above? ......................
11g(ii)
 
 
(iii) A 35% controlled entity of a person described in (i) or (ii) above? ................
11g(iii)
 
 
h
Provide the following information about the supported organization(s).
(i) Name of supported organization (ii) EIN (iii) Type of organization (described on lines 1- 9 above or IRC section (see instructions)) (iv) Is the organization in col. (i) listed in your governing document? (v) Did you notify the organization in col. (i) of your support? (vi) Is the organization in col. (i) organized in the U.S.? (vii) Amount of monetary support
Yes No Yes No Yes No
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
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) right arrow (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) right arrow (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).  
12
12
 
13
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
14
14
 
15
15
 
16a
b
17a
b
18
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
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) right arrow (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) right arrow (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.)..            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2013
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:  
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors
Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
Arrow Bullet 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
LENOIR MEMORIAL HOSPITAL INC
 
Employer identification number

56-6000674
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ





Form 990-PF




Check if your organization is covered by the General Rule or a Special Rule.  
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
General Rule
Special Rules
......................... Arrow Bullet $  
Caution. An organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box 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
LENOIR MEMORIAL HOSPITAL INC
  		Employer identification number

56-6000674
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


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

   
 
 

$  


(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
LENOIR MEMORIAL HOSPITAL INC
  		Employer identification number

56-6000674
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
LENOIR MEMORIAL HOSPITAL INC
  		Employer identification number

56-6000674
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 (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a) No.
from
Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a) No.
from
Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a) No.
from
Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
Schedule B (Form 990, 990-EZ, or 990-PF) (2013)

Additional Data


Software ID:  
Software Version:  
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
LENOIR MEMORIAL HOSPITAL INC
 
Employer identification number

56-6000674
Part I-A
Complete if the organization is exempt under section 501(c) or is a section 527 organization.

1
Provide a description of the organization’s direct and indirect political campaign activities in Part IV.
2
Political expenditures ....................................SchCMd Bullet
$  
3
Volunteer hours ........................................
 

Part I-B
Complete if the organization is exempt under section 501(c)(3).
1
Enter the amount of any excise tax incurred by the organization under section 4955 .........SchCMd Bullet
$  
2
Enter the amount of any excise tax incurred by organization managers under section 4955 ......SchCMd Bullet
$  
3
If the organization incurred a section 4955 tax, did it file Form 4720 for this year? ..............
4a
Was a correction made? .........................................
b
If "Yes," describe in Part IV.
Part I-C
Complete if the organization is exempt under section 501(c), except section 501(c)(3).
1
Enter the amount directly expended by the filing organization for section 527 exempt function activities SchCMd Bullet
$  
2
Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ...................................SchCMd Bullet

$  
3
Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b..SchCMd Bullet

$  
4
Did the filing organization file Form 1120-POL for this year? ..........................
5
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

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 Bulletexpenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet
Limits on Lobbying Expenditures
(The term "expenditures" means amounts paid or incurred.) 		(a) Filing
organization's
totals 		(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? ......................................

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


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)
No
Yes
(b)
Amount
1
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:
a
Volunteers? .........................................
 
No
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....
 
No
c
Media advertisements? ....................................
 
No
 
d
Mailings to members, legislators, or the public? .........................
 
No
 
e
Publications, or published or broadcast statements? .......................
 
No
 
f
Grants to other organizations for lobbying purposes? .......................
 
No
 
g
Direct contact with legislators, their staffs, government officials, or a legislative body? ........
 
No
 
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......
 
No
 
i
Other activities? ..........................
Yes
 
9,500
j
Total. Add lines 1c through 1i ...............................
9,500
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
No
b
If "Yes," enter the amount of any tax incurred under section 4912 .................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 .....
 
d
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
No
1
Were substantially all (90% or more) dues received nondeductible by members? ................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ................
2
 
 
3
Did the organization agree to carry over lobbying and political expenditures from the prior year? ..........
3
 
 
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."
1
Dues, assessments and similar amounts from members .....................
1
 
2
Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political
expenses for which the section 527(f) tax was paid).
a
Current year .........................................
2a
 
b
Carryover from last year ....................................
2b
 
c
Total ............................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
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? ................................
4
 
5
Taxable amount of lobbying and political expenditures (see instructions) ..............
5
 
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: THE ORGANIZATION IS A MEMBER OF THE NORTH CAROLINA HOSPITAL ASSOCIATION. A PORTION OF THE DUES PAID TO THE NCHA ARE ALLOCATED EACH YEAR TO LOBBYING EFFORTS ON BEHALF OF ITS MEMBERSHIP BODY. ACCORDING TO THE NCHA, 27.14% OF THE HOSPITAL'S ANNUAL DUES OF $35,000 CAN BE ALLOCATED TO LOBBYING EXPENSE, WHICH IS APPROXIMATELY $9,500.
Schedule C (Form 990 or 990EZ) 2013

Additional Data


Software ID:  
Software Version:  

SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 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
LENOIR MEMORIAL HOSPITAL INC
 
Employer identification number

56-6000674
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .........    
2 Aggregate contributions to (during year) ...    
3 Aggregate grants from (during year) .....    
4 Aggregate value at end of year ........    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds 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? ...................................
Part II
Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a 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.
Held at the End of the Year
a Total number of conservation easements ....................... 2a  
b Total acreage restricted by conservation easements .................. 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 8/17/06, and not on a historic structure listed in the National Register .................... 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................
6
Staff and volunteer hours devoted to monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .......................................
9
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.
1a
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.
b
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 $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958) relating to these items:
a
Revenues included in Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 52283D
Schedule D (Form 990) 2013

Schedule D (Form 990) 2013
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
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):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b
If "Yes," explain the arrangement in Part XIII and complete the following table:
Amount
c Beginning balance ................................. 1c  
d Additions during the year .............................. 1d  
e Distributions during the year ............................. 1e  
f Ending balance ................................... 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21? .....................
b
If "Yes," explain the arrangement in Part 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 ......          
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet  
b
Permanent endowment SchDMd Bullet  
c
Temporarily restricted endowment SchDMd Bullet  
The percentages in lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations ........................
3a(i)
 
 
(ii) related organizations ........................
3a(ii)
 
 
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
Describe in Part 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 (a) Cost or other basis (investment) (b)Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .................   425,406 425,406
b Buildings ................   60,673,408 24,890,548 35,782,860
c Leasehold improvements ............   8,112,508 4,035,465 4,077,043
d Equipment ................   75,178,725 59,701,452 15,477,273
e Other .................   417,840   417,840
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......SchDMdBullet 56,180,422
Schedule D (Form 990) 2013

Schedule D (Form 990) 2013
Page 3
Part VII
Investments—Other 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.)Small Bullet  
Part VIII
Investments—Program 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.)Small Bullet  
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.)...........Small Bullet  
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  
ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS 2,974,248
CAPITAL LEASE OBLIGATION 142,659







Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 3,116,907
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

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 ....... 1 104,812,827
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains on investments .......... 2a 4,774,659
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIII.) ............ 2d 640,646
e Add lines 2a through 2d ..................... 2e 5,415,305
3 Subtract line 2e from line 1..................... 3 99,397,522
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 29,431,737
c Add lines 4a and 4b....................... 4c 29,431,737
5 Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ...... 5 128,829,259
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 ........... 1 102,440,464
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 640,646
e Add lines 2a through 2d...................... 2e 640,646
3 Subtract line 2e from line 1..................... 3 101,799,818
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 29,431,737
c Add lines 4a and 4b....................... 4c 29,431,737
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ...... 5 131,231,555
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: THE HOSPITAL AND FOUNDATION ARE EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE; ACCORDINGLY, THE ACCOMPANYING FINANCIAL STATEMENTS DO NOT REFLECT A PROVISION OR LIABILITY FOR FEDERAL AND STATE INCOME TAXES. THE HOSPITAL AND THE FOUNDATION HAVE DETERMINED THAT THEY DO NOT HAVE ANY MATERIAL UNRECOGNIZED TAX BENEFITS OR OBLIGATIONS AS OF SEPTEMBER 30, 2014. THE HOSPITAL AND FOUNDATION BELIEVE THEY ARE NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO SEPTEMBER 30, 2011.
PART XI, LINE 2D - OTHER ADJUSTMENTS: COST OF GOODS SOLD 640,646.
PART XI, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBTS 29,431,737.
PART XII, LINE 2D - OTHER ADJUSTMENTS: COSTS OF GOODS SOLD 640,646.
PART XII, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBTS 29,431,737.
Schedule D (Form 990) 2013

Additional Data


Software ID:  
Software Version:  




SCHEDULE H (Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, question 20.
MediumBullet Attach to Form 990. MediumBullet See separate instructions.
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
LENOIR MEMORIAL HOSPITAL INC
 
Employer identification number

56-6000674
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a ...
1a
Yes
 
b
If "Yes," was it a written policy? .......................
1b
Yes
 
2
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.
3
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.
a
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:
3a
Yes
 
%
b
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: .........
3b
Yes
 
%
c
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.
4
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"? ..............

4

Yes

 
5a
Did the organization budget amounts for free or discounted care provided under its financial assistance policy during the tax year? ............................

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? ......
5b
Yes
 
c
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? ..............
5c
 
No
6a
Did the organization prepare a community benefit report during the tax year? ..........
6a
Yes
 
b
If "Yes," did the organization make it available to the public? ..............
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
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) .. 		    1,678,248 216,632 1,461,616 1.440 %
b Medicaid (from Worksheet 3,
column a) .... 		    17,906,777 16,879,912 1,026,865 1.010 %
c Costs of other means-tested
government programs (from
Worksheet 3, column b) . 		           
d Total Financial Assistance
and Means-Tested
Government Programs . 		    19,585,025 17,096,544 2,488,481 2.450 %
Other Benefits
     827,929 174,329 653,600 0.640 %
e Community health
improvement services and
community benefit operations
(from Worksheet 4) ..
f Health professions education
(from Worksheet 5) .. 		    281,049   281,049 0.280 %
g Subsidized health services
(from Worksheet 6) .. 		    7,948,214 6,964,846 983,368 0.970 %
h Research (from Worksheet 7)     24,881   24,881 0.020 %
i Cash and in-kind
contributions for community
benefit (from Worksheet 8) 		    192,528   192,528 0.190 %
j Total. Other Benefits ..     9,274,601 7,139,175 2,135,426 2.100 %
k Total. Add lines 7d and 7j .     28,859,626 24,235,719 4,623,907 4.550 %
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     1,128   1,128 0 %
3 Community support     64,007   64,007 0.060 %
4 Environmental improvements            
5 Leadership development and training for community members            
6 Coalition building            
7 Community health improvement advocacy            
8 Workforce development     690,462   690,462 0.680 %
9 Other            
10 Total     755,597   755,597 0.740 %
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................
1
 
No
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
29,431,737
3
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. ......
3
3,237,491
4
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
5
Enter total revenue received from Medicare (including DSH and IME).....
5
36,705,109
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
41,567,428
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-4,862,319
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
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.......................

9b

Yes

 
Part IV
Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)
(a) Name of entity (b) Description of primary
activity of entity 		(c) Organization's
profit % or stock
ownership % 		(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership % 		(e) Physicians'
profit % or stock
ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2013
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?1
Name, address, primary website address, and state license number 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital ResearchGrp Facility ER-24Hours ER-Other Other (Describe) Facility reporting group
1 LENOIR MEMORIAL HOSPITAL INC
100 AIRPORT ROAD
KINSTON,NC28501 		X X         X X DISPROPORTIONARE SHARE HOSPITAL  
Schedule H (Form 990) 2013
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)
LENOIR MEMORIAL 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) 		1
Yes No
Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)
1 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.................... 1 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
2 Indicate the tax year the hospital facility last conducted a CHNA: 20 11
3 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 .................... 3 Yes  
4 Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Part VI................................ 4   No
5 Did the hospital facility make its CHNA report widely available to the public? ............. 5 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
6 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):
a
b
c
d
e
f
g
h
i
7 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 ........ 7   No
8a 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)? ........................... 8a   No
b If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ...... 8b    
c 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
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: 100.000000000000%
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: 250.000000000000%
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
b
c
d
e
f
g
h
i
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
b
c
d
e
f
g
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
b
c
d
e
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
b
c
d
e
Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VFacility Information (continued)

18 Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):
a
b
c
d
e
Policy Relating to Emergency Medical Care
Yes No
19 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?.......... 19 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)
20 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.
a
b
c
d
21 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? ............................ 21   No
If "Yes," explain in Part VI.
22 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? ......................... 22   No
If "Yes," explain in Part VI.
Schedule H (Form 990) 2013
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
LENOIR MEMORIAL HOSPITAL, INC. PART V, SECTION B, LINE 3: THE 2011 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS WAS LED BY REPRESENTATIVES OF THE LEADERSHIP TEAM AT THE LENOIR COUNTY HEALTH DEPARTMENT AND BY THE DIRECTOR OF COMMUNITY PROGRAMMING AND DEVELOPMENT AT OUR HOSPITAL. THESE STAFF WORK IN THE AREA OF COMMUNITY HEALTH IN THEIR EMPLOYED POSITIONS AND ATTEND EDUCATIONAL SESSIONS ANNUALLY IN THE AREA OF COMMUNITY HEALTH ASSESSMENT PROCESS. ADDITIONALLY, THE LENOIR COUNTY ALLIANCE FOR A HEALTHY COMMUNITY TASK FORCE, REPRESENTING OVER 30 LENOIR COUNTY COMMUNITY ORGANIZATIONS AND AGENCY LEADERS FROM DIVERSE COMMUNITY PERSPECTIVES, WERE COMMITTED TO THE ASSESSMENT PROCESS, AND DISTRIBUTED SURVEYS AND STAYED INFORMED ON THE TIMELINE AT MONTHLY MEETINGS. THEY OFFERED VALUABLE INPUT AND RECOMMENDATIONS IN THE PRIORITIZATION PROCESS ONCE SURVEY RESULTS WERE IN. THIS HELPED TO ENSURE THAT INPUT FROM PERSONS WITH BROAD KNOWLEDGE OF THE COMMUNITY WERE REPORTED.
LENOIR MEMORIAL HOSPITAL, INC. PART V, SECTION B, LINE 4: THE CHNA WAS MAILED OUT TO COMMUNITY LEADERS
LENOIR MEMORIAL HOSPITAL, INC. PART V, SECTION B, LINE 7: LENOIR MEMORIAL IS NOT CURRENTLY INVOLVED IN THE ILLEGAL DRUGS AND DRUG ABUSE/SUBSTANCE AND YOUTH VIOLENCE/GANGS ISSUE BUT A GROUP OF COMMUNITY ORGANIZATIONS LED BY KINSTON PUBLIC SAFETY HAS FORMED A TASK FORCE TO WORK ON THIS ISSUE. LENOIR MEMORIAL HOSTED MEETING SPACE AND A BREAKFAST FOR LEADERS IN THIS REGARD TO GET THE INITIATIVE STARTED. YOUTH ACCESS AND USE OF GUNS MAY ALSO BE CLOSELY RELATED TO THIS ISSUE AND SAFE KIDS ENC WORKS TO PROVIDE THE COMMUNITY WITH GUN LOCKS AND GUN SAFETY EDUCATION.JOB OPPORTUNITIES WERE IDENTIFIED AS A TOP ISSUE IN THE COMMUNITY AND EVEN THOUGH LENOIR MEMORIAL RECEIVED A WORKFORCE DEVELOPMENT GRANT FROM THE GOLDEN LEAF FOUNDATION IN 2010 AND TRAINED 20 CERTIFIED NURSING ASSISTANTS FOR THE LOCAL WORKFORCE, LENOIR MEMORIAL DOES NOT HAVE ANY CURRENT PLANS IN THIS AREA OTHER THAN SERVING AS A TRAINING SITE FOR STUDENTS WHO MAY JOIN THE WORKFORCE ONCE THEY COMPLETE THEIR PROGRAMS. LENOIR MEMORIAL IS A MAJOR EMPLOYER IN LENOIR COUNTY AND WILL HIRE AS VACANT POSITIONS NECESSITATE. HOSPITAL LEADERSHIP PARTICIPATES IN A VARIETY OF ECONOMIC DEVELOPMENT COMMITTEES AND PROJECTS THROUGHOUT THE YEAR.DRINKING AND DRIVING CONTINUES TO BE SEEN AS A PRIORITY ISSUE IN THE 2011 CHNA. LOCAL LAW ENFORCEMENT AND STATEWIDE PROGRAMS HAVE INITIATED PROGRAMS IN OUR COMMUNITY SUCH AS BOOZE IT AND LOSE IT AND OTHER ROAD STOP PROGRAMS IN AN EFFORT TO ADDRESS THE PROBLEM.LENOIR MEMORIAL OFFERS SMOKING CESSATION PROGRAMMING THROUGH THE MINGES WELLNESS CENTER AND DOES NOT LIMIT THE PROGRAMS TO ADULTS ONLY. THE ISSUE OF CIGARETTE SMOKING AMONG PEOPLE UNDER AGE 18 HAS BEEN A DISCUSSION AT THE LENOIR COUNTY SCHOOL HEALTH ADVISORY COMMITTEE ON WHICH LENOIR MEMORIAL SERVES. IT WILL NOT BE A PRIORITY FOR LENOIR MEMORIAL SINCE SERVICES FOR CESSATION EXIST AND THE HOSPITAL SERVES AS AN ORGANIZATIONAL ROLE MODEL AS A TOBACCO-FREE CAMPUS.
LENOIR MEMORIAL HOSPITAL, INC. PART V, SECTION B, LINE 12I: SLIDING SCALE BASED ON PERCENTAGE OF FPG
LENOIR MEMORIAL HOSPITAL, INC. PART V, SECTION B, LINE 14G: SIGNS ARE POSTED NOTIFYING PATIENTS OF THE AVAILABILITY OF FINANCIAL ASSISTANCE AND INCLUDED ON PATIENT'S STATEMENTS. BROCHURES ARE ALSO PROVIDED NOTIFYING OF PATIENTS FINANCIAL ASSISTANCE AVAILABILITY.
LENOIR MEMORIAL HOSPITAL, INC. PART V, SECTION B, LINE 20D: THE MAXIMUM AMOUNT CHARGED IS BASED ON A SLIDING SCALE OF 250% OF FPG. PATIENT WOULD BE BILLED 75%.
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2013
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?2
Name and address Type of Facility (describe)
1 LENOIR ORTHOPEDICS
701 DOCTORS DRIVE
KINSTON,NC28501 		ORTHOPEDIC CENTER
2 LENOIR SURGICAL
701 DOCTORS DRIVE
KINSTON,NC28501 		SURGERY CENTER
3
4
5
6
7
8
9
10
Schedule H (Form 990) 2013
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
LENOIR MEMORIAL HOSPITAL, INC. PART V, SECTION B, LINE 3: THE 2011 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS WAS LED BY REPRESENTATIVES OF THE LEADERSHIP TEAM AT THE LENOIR COUNTY HEALTH DEPARTMENT AND BY THE DIRECTOR OF COMMUNITY PROGRAMMING AND DEVELOPMENT AT OUR HOSPITAL. THESE STAFF WORK IN THE AREA OF COMMUNITY HEALTH IN THEIR EMPLOYED POSITIONS AND ATTEND EDUCATIONAL SESSIONS ANNUALLY IN THE AREA OF COMMUNITY HEALTH ASSESSMENT PROCESS. ADDITIONALLY, THE LENOIR COUNTY ALLIANCE FOR A HEALTHY COMMUNITY TASK FORCE, REPRESENTING OVER 30 LENOIR COUNTY COMMUNITY ORGANIZATIONS AND AGENCY LEADERS FROM DIVERSE COMMUNITY PERSPECTIVES, WERE COMMITTED TO THE ASSESSMENT PROCESS, AND DISTRIBUTED SURVEYS AND STAYED INFORMED ON THE TIMELINE AT MONTHLY MEETINGS. THEY OFFERED VALUABLE INPUT AND RECOMMENDATIONS IN THE PRIORITIZATION PROCESS ONCE SURVEY RESULTS WERE IN. THIS HELPED TO ENSURE THAT INPUT FROM PERSONS WITH BROAD KNOWLEDGE OF THE COMMUNITY WERE REPORTED.
LENOIR MEMORIAL HOSPITAL, INC. PART V, SECTION B, LINE 4: THE CHNA WAS MAILED OUT TO COMMUNITY LEADERS
LENOIR MEMORIAL HOSPITAL, INC. PART V, SECTION B, LINE 7: LENOIR MEMORIAL IS NOT CURRENTLY INVOLVED IN THE ILLEGAL DRUGS AND DRUG ABUSE/SUBSTANCE AND YOUTH VIOLENCE/GANGS ISSUE BUT A GROUP OF COMMUNITY ORGANIZATIONS LED BY KINSTON PUBLIC SAFETY HAS FORMED A TASK FORCE TO WORK ON THIS ISSUE. LENOIR MEMORIAL HOSTED MEETING SPACE AND A BREAKFAST FOR LEADERS IN THIS REGARD TO GET THE INITIATIVE STARTED. YOUTH ACCESS AND USE OF GUNS MAY ALSO BE CLOSELY RELATED TO THIS ISSUE AND SAFE KIDS ENC WORKS TO PROVIDE THE COMMUNITY WITH GUN LOCKS AND GUN SAFETY EDUCATION.JOB OPPORTUNITIES WERE IDENTIFIED AS A TOP ISSUE IN THE COMMUNITY AND EVEN THOUGH LENOIR MEMORIAL RECEIVED A WORKFORCE DEVELOPMENT GRANT FROM THE GOLDEN LEAF FOUNDATION IN 2010 AND TRAINED 20 CERTIFIED NURSING ASSISTANTS FOR THE LOCAL WORKFORCE, LENOIR MEMORIAL DOES NOT HAVE ANY CURRENT PLANS IN THIS AREA OTHER THAN SERVING AS A TRAINING SITE FOR STUDENTS WHO MAY JOIN THE WORKFORCE ONCE THEY COMPLETE THEIR PROGRAMS. LENOIR MEMORIAL IS A MAJOR EMPLOYER IN LENOIR COUNTY AND WILL HIRE AS VACANT POSITIONS NECESSITATE. HOSPITAL LEADERSHIP PARTICIPATES IN A VARIETY OF ECONOMIC DEVELOPMENT COMMITTEES AND PROJECTS THROUGHOUT THE YEAR.DRINKING AND DRIVING CONTINUES TO BE SEEN AS A PRIORITY ISSUE IN THE 2011 CHNA. LOCAL LAW ENFORCEMENT AND STATEWIDE PROGRAMS HAVE INITIATED PROGRAMS IN OUR COMMUNITY SUCH AS BOOZE IT AND LOSE IT AND OTHER ROAD STOP PROGRAMS IN AN EFFORT TO ADDRESS THE PROBLEM.LENOIR MEMORIAL OFFERS SMOKING CESSATION PROGRAMMING THROUGH THE MINGES WELLNESS CENTER AND DOES NOT LIMIT THE PROGRAMS TO ADULTS ONLY. THE ISSUE OF CIGARETTE SMOKING AMONG PEOPLE UNDER AGE 18 HAS BEEN A DISCUSSION AT THE LENOIR COUNTY SCHOOL HEALTH ADVISORY COMMITTEE ON WHICH LENOIR MEMORIAL SERVES. IT WILL NOT BE A PRIORITY FOR LENOIR MEMORIAL SINCE SERVICES FOR CESSATION EXIST AND THE HOSPITAL SERVES AS AN ORGANIZATIONAL ROLE MODEL AS A TOBACCO-FREE CAMPUS.
LENOIR MEMORIAL HOSPITAL, INC. PART V, SECTION B, LINE 12I: SLIDING SCALE BASED ON PERCENTAGE OF FPG
LENOIR MEMORIAL HOSPITAL, INC. PART V, SECTION B, LINE 14G: SIGNS ARE POSTED NOTIFYING PATIENTS OF THE AVAILABILITY OF FINANCIAL ASSISTANCE AND INCLUDED ON PATIENT'S STATEMENTS. BROCHURES ARE ALSO PROVIDED NOTIFYING OF PATIENTS FINANCIAL ASSISTANCE AVAILABILITY.
LENOIR MEMORIAL HOSPITAL, INC. PART V, SECTION B, LINE 20D: THE MAXIMUM AMOUNT CHARGED IS BASED ON A SLIDING SCALE OF 250% OF FPG. PATIENT WOULD BE BILLED 75%.
Schedule H (Form 990) 2013
Additional Data


Software ID:  
Software Version:  
Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," to Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990
lBullet Information about Schedule I (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public
Inspection
Name of the organization
LENOIR MEMORIAL HOSPITAL INC
 
Employer identification number
56-6000674
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ....................................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Governments and Organizations in the United States. Complete if the organization answered "Yes" to
Form 990, Part IV, line 21, for any recipient that received more than $5,000. Part II can be duplicated if additional space is needed.
(a) Name and address of organization
or government		 (b) EIN (c) IRC Code section
if applicable		 (d) Amount of cash grant (e) Amount of non-cash
assistance		 (f) Method of valuation
(book, FMV, appraisal,
other)		 (g) Description of
non-cash assistance		 (h) Purpose of grant
or assistance






















2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................ Bullet Image
 
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2013

Schedule I (Form 990) 2013
Page 2
Part III
Grants and Other Assistance to Individuals in the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.
(a)Type of grant or assistance (b)Number of
recipients		 (c)Amount of
cash grant		 (d)Amount of
non-cash assistance		 (e)Method of valuation (book,
FMV, appraisal, other)		 (f)Description of non-cash assistance
(1) SCHOLARSHIPS 36 36,329   N/A N/A












Part IV
Supplemental Information. Provide the information required in Part I, line 2, Part III, column (b), and any other additional information.
Return Reference Explanation
PART I, LINE 2: THE ORGANIZATION PROVIDES PRE-APPROVED FUNDS TO SELECTED ORGANIZATIONS AND INDIVIDUALS BASED UPON APPROVED CRITERIA. THE FUNDS ARE ONLY DISBURSED FOR THE APPROVED ACTIVITIES.
Schedule I (Form 990) 2013


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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
LENOIR MEMORIAL HOSPITAL INC
 
Employer identification number

56-6000674
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain....
1b
Yes
 
2
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? ..
2
Yes
 
3
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.
4
During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? ................
4a
 
No
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? .........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3) and 501(c)(4) organizations only must complete lines 5-9.
5
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ...........................
5a
 
No
b
Any related organization? .........................
5b
 
No
If "Yes," to line 5a or 5b, describe in Part III.
6
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization? ...........................
6a
 
No
b
Any related organization? .........................
6b
 
No
If "Yes," to line 6a or 6b, describe in Part III.
7
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
Yes
 
8
Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................
8
 
No
9
If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2013

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
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
(1)GARY BLACKCEO (i)
(ii)		 356,283
0 		20,932
0 		80,606
0 		10,200
0 		9,462
0 		477,483
0 		0
0
(2)WAYNE JARMAN MDBOARD MEMBER (i)
(ii)		 326,042
0 		56,804
0 		47,163
0 		10,200
0 		13,872
0 		454,081
0 		0
0
(3)JIM DOBBINSVP - HUMAN RESOUCES (i)
(ii)		 177,507
0 		10,429
0 		24,287
0 		25,401
0 		8,339
0 		245,963
0 		0
0
(4)SARAH MAYOCFO (i)
(ii)		 245,003
0 		14,394
0 		29,453
0 		29,639
0 		8,834
0 		327,323
0 		0
0
(5)ROSALAND MCDONALDVP - NURSING SERVICES (i)
(ii)		 175,011
0 		10,282
0 		36,317
0 		7,950
0 		8,630
0 		238,190
0 		0
0
(6)ALTON HARDYPHARMACY DIRECTOR (i)
(ii)		 156,376
0 		8,000
0 		16,962
0 		7,060
0 		8,715
0 		197,113
0 		0
0
(7)KARL LEONARD VANDERSTOUWSENIOR DIRECTOR ITS (i)
(ii)		 162,779
0 		40,000
0 		4,366
0 		8,111
0 		8,763
0 		224,019
0 		0
0
(8)SCOTT STEGBAUER MDORTHOPEDIC SURGEON (i)
(ii)		 475,010
0 		12,830
0 		14,236
0 		10,200
0 		12,608
0 		524,884
0 		0
0
(9)CONNIE SUE MANGELCRNA (i)
(ii)		 151,672
0 		4,000
0 		50,270
0 		8,449
0 		12,969
0 		227,360
0 		0
0
(10)MARK HENNINGCRNA (i)
(ii)		 166,699
0 		4,000
0 		45,934
0 		8,829
0 		13,136
0 		238,598
0 		0
0
(11)ANGELA P WILLIAMSCRNA (i)
(ii)		 137,610
0 		4,000
0 		52,074
0 		7,998
0 		12,884
0 		214,566
0 		0
0
(12)JESSICA AMBER WOODCOCKORTHOPEDIC SURGEON (i)
(ii)		 380,566
0 		25,000
0 		715
0 		10,200
0 		2,335
0 		418,816
0 		0
0
Schedule J (Form 990) 2013

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 4B THE FOLLOWING INDIVIDUALS RECEIVED AMOUNTS FROM A 457F PLAN: GARY BLACK, CEO, $49,880; SARAH MAYO, CFO, $16,733; JAMES CLINE DOBBINS, VP HUMAN RESOURCES, $13,287; ROSALIND MCDONALD, CNO $12,251
PART I, LINE 7 A PORTION OF THE SALARIES OF THE CEO AND VICE PRESIDENTS IS VARIABLE AND IS BASED UPON ATTAINMENT OF ANNUAL GOALS RELATED TO QUALITY, PATIENT SAFETY, STAFF ENGAGEMENT, PATIENT SATISFACTION, AND FINANCIAL STEWARDSHIP.
Schedule J (Form 990) 2013

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Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Part VI.
SchKMediumBullet Attach to Form 990. SchKMediumBullet See separate instructions.
SchKMediumBulletInformation about Schedule K (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public
Inspection
Name of the organization
LENOIR MEMORIAL HOSPITAL INC
 
Employer identification number
56-6000674
Part I
Bond Issues
(a) Issuer name (b) Issuer EIN (c) CUSIP # (d) Date issued (e) Issue price (f) Description of purpose (g) Defeased (h) On
behalf of
issuer 		(i) Pool
financing
Yes No Yes No Yes No
A NORTH CAROLINA MEDICAL CARE COMMISSION
  		52-1309402 657902Y63 09-22-2005 22,000,000 CAPITAL PROJECTS   X   X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired . . . . . . . . . . . . . . 3,990,000      
2 Amount of bonds legally defeased . . . . . . . . . . . 22,021,552      
3 Total proceeds of issue . . . . . . . . . . . . . .        
4 Gross proceeds in reserve funds . . . . . . . . . . . .        
5 Capitalized interest from proceeds . . . . . . . . . . .        
6 Proceeds in refunding escrows . . . . . . . . . . . .        
7 Issuance costs from proceeds . . . . . . . . . . . . 178,646      
8 Credit enhancement from proceeds . . . . . . . . . . . 20,213      
9 Working capital expenditures from proceeds . . . . . . . . .        
10 Capital expenditures from proceeds . . . . . . . . . . . 9,657,270      
11 Other spent proceeds . . . . . . . . . . . . . . 12,165,423      
12 Other unspent proceeds . . . . . . . . . . . . . .        
13 Year of substantial completion . . . . . . . . . . . . 2005
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue? . . . . . X              
15 Were the bonds issued as part of an advance refunding issue? . . . . .   X            
16 Has the final allocation of proceeds been made? . . . . . . . . X              
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . . . X              
Part III
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . . . . . .   X            
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . .   X            
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2013
Schedule K (Form 990) 2013
Page 2
Part III
Private Business Use (Continued)
A B C D
Yes No Yes No Yes No Yes No
3a Are there any management or service contracts that may result in private business use of bond-financed property? . . . . . . . . . . . . X              
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property? X              
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . . . . . . . . . .   X            
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?                
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . . SchKMediumBullet        
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . . . . . . . SchKMediumBullet 0.420 %      
6 Total of lines 4 and 5 . . . . . . . . . . . . . 0.420 %      
7 Does the bond issue meet the private security or payment test? . . . . .   X            
8a Has there been a sale or disposition of any of the bond financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?. . . . . . . . . . . . . . . . .   X            
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of.        
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? . . . . . . . . . . . . .                
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2? . . . . . . . 		X              
Part IV
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has the issuer filed Form 8038-T? . . . . .   X            
2 If "No" to line 1, did the following apply? . . . .
a Rebate not due yet? . . . . . . . .   X            
b Exception to rebate? . . . . . . . . X              
c No rebate due? . . . . . . . . X              
If you checked "No rebate due" in line 2c, provide in
Part VI the date the rebate computation was performed
3 Is the bond issue a variable rate issue? . . . . X              
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?   X            
b Name of provider . . . . . . . . .  
  		 
  		 
  		 
 
c Term of hedge . . . . . . . . . .        
d Was the hedge superintegrated? . . . .                
e Was the hedge terminated? . . . . . .                
Schedule K (Form 990) 2013
Schedule K (Form 990) 2013
Page 3
Part IV
Arbitrage (Continued)
A B C D
Yes No Yes No Yes No Yes No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)? . . . . . . . . .   X            
b Name of provider . . . . . . . . .  
  		 
  		 
  		 
 
c Term of GIC . . . . . . . . . .        
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . .                
6 Were any gross proceeds invested beyond an available temporary period? . . . . . . . .   X            
7 Has the organization established written procedures to monitor the requirements of section 148? . . . X              
Part V
Procedures To Undertake Corrective Action
A B C D
Yes No Yes No Yes No Yes No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations? X              
Part VI
Supplemental Information. Provide additional information for responses to questions on Schedule K (see instructions).
Return Reference Explanation
SCHEDULE K SUPPLENTAL INFORMATION THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I (E) AND THE TOTAL PROCEEDS IN PART II (3) IS DUE TO INTEREST EARNINGS THAT HAVE ACCRUED ON INVESTED BOND PROCEEDS. ISSUE DATES OF BONDS REFUNDED BY THE SERIES 2005 BONDS LISTED IN COLUMN A: NOVEMBER 16, 1995 AND MARCH 19,1998. PART IV, LN 2C - THE REBATE COMPUTATION WAS PERFORMED AS OF MARCH 22, 2006. PART III, LN 7 - AS PROVIDED IN TREASURY REGULATION SECTION 1.141-4(C)(2)(I)(B), THE AMOUNT OF PRIVATE PAYMENTS TAKEN INTO ACCOUNT UNDER THE PRIVATE PAYMENT TEST MAY NOT EXCEED THE AMOUNT OF PRIVATE BUSINESS USE AND/OR UNRELATED TRADE OR BUSINESS USE. ACCORDINGLY, THE AMOUNT OF PRIVATE PAYMENTS FOR THE REPORTING PERIOD DOES NOT EXCEED THE AMOUNT STATED IN PART III, LINE 6. THE ORGANIZATION HAS NOT UNDERTAKEN AN ANALYSIS OF THE PRIVATE SECURITY TEST WITH RESPECT TO THE BONDS, AS THE LEVEL OF PRIVATE BUSINESS USE AND/OR UNRELATED TRADE OR BUSINESS REPORTED IN PART III, LINE 6 IS NOT IN EXCESS OF THE AMOUNTS PERMITTED UNDER SECTION 145 OF THE CODE.
Schedule K (Form 990) 2013

Additional Data


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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
LENOIR MEMORIAL HOSPITAL INC
 
Employer identification number

56-6000674
Return Reference Explanation
FORM 990, PART III, LINE 4A: STRATEGIC PRIORITIES FOCUS ON DELIVERING HEALTHCARE SERVICES CONSISTENT WITH COMMUNITY NEED. SERVICES ARE PROVIDED TO INDIVIDUALS REGARDLESS OF THE RACE, CREED, SEX, NATURAL ORIGIN AND/OR AN INDIVIDUAL'S INABILITY TO PAY. THE ORGANIZATION'S MOST RECENT COMMUNITY HEALTH REPORT IS LOCATED ON THE HOSPITAL WEBSITE AT WWW.LENOIRMEMORIAL.ORG. LMH PROVIDES LEADERSHIP AND EMPLOYEE EXPERTISE TO THE COMMUNITY ON AND OFF SITE. COMMUNITY BENEFIT OPERATIONS INCLUDED IN THIS AREA. HIGHLIGHTS INCLUDE BUT NOT LIMITED TO: STROKE PREVENTION AND CARE LENOIR MEMORIAL HOSPITAL IMPLEMENTED THE FIRST YEAR PLAN FOR DEVELOPING A PRIMARY STROKE CENTER USING GRANT FUNDS FROM THE DUKE ENDOWMENT FOR A THREE YEAR PROJECT THAT INCLUDES INITIATING TELESTROKE SERVICES. A COMMUNITY STROKE TEAM HAS CONVENED INVOLVING STAKEHOLDERS: LENOIR COUNTY EMS, LMH LEADERS AND A STROKE VICTIM TO MEET REGULARLY TO PLAN AWARENESS PROGRAMMING TREATMENT PROTOCOLS, POST-STROKE EDUCATION AND COMPREHENSIVE STAFF TRAINING. STROKE AWARENESS MESSAGING INCLUDES BILLBOARDS, TWELVE LENOIR COUNTY TRANSIT VANS, AND DIRECT MAIL TO LENOIR COUNTY RESIDENTS. ECONOMIC DEVELOPMENT CASH DONATIONS INCLUDED SUPPORT FOR STEMEAST, THE PINK HILL ROSE FESTIVAL 5K, PRIDE OF KINSTON DOWNTOWN PARK CONCERT SERIES, AND THE KINSTON RUN FOR THE RIVER. DONATIONS WERE ALSO MADE TO SUPPORT REGIONAL KINSTON/LENOIR COUNTY CHAMBER OF COMMERCE SIGNATURE EVENTS: FESTIVAL ON THE NEUSE AND THE LIVING WELL IN EASTERN NC SHOW. COMMUNITY DONATIONS CASH DONATIONS INCLUDE SUPPORT FOR THE LENOIR COUNTY RED CROSS, SAFE KIDS ENC, TEEN FEST, KINSTON COMMUNITY HEALTH CENTER ANNUAL HEALTH FAIR, MARY'S KITCHEN, AND BOYS AND GIRLS CLUB. GREENE COUNTY FARMERS MARKET LENOIR MEMORIAL ASSISTED THE EXPANSION OF THE FARMER'S MARKET WITH FUNDS IN A TWO YEAR PLEDGE TOWARDS A NEW REFRIGERATOR AT THE SNOW HILL SITE IN ORDER TO INCREASE ACCESS TO FRUITS AND VEGETABLES. COMMUNITY HEALTH NEEDS ASSESSMENT THE LAST THREE YEAR CYCLE PROCESS ( 2011/12) IDENTIFIED FOUR PRIORITY ISSUES FOR THE COMMUNITY: OBESITY (PHYSICAL ACTIVITY AND NUTRITION), DIABETES, HIGH BLOOD PRESSURE, AND RESPONSIBLE PARENTING. COMMUNITY EFFORTS TO ADDRESS THESE ISSUES HAVE BEEN ONGOING. THE 2014/15 CYCLE HAS BEEN INITIATED BY LENOIR MEMORIAL HOSPITAL AND THE LENOIR COUNTY HEALTH DEPARTMENT WITH COMMUNITY HEALTH PERCEPTION SURVEYS PROVIDED TO THE COMMUNITY AND THE FULL ASSESSMENT AND PRIORITIES TO BE DEVELOPED IN 2015. HEALTHY COMMUNITIES INSTITUTE THE HEALTHY COMMUNITIES INSTITUTE, A COMPREHENSIVE HEALTH STATUS DATABASE AT WWW.LENOIRMEMORIAL.ORG, PROVIDES THE LATEST LENOIR COUNTY DEMOGRAPHICS AND LEADING HEALTH INDICATORS. IT ALLOWS THE USER TO SEARCH AND REPORT ON OVER 50 SPECIFIC HEALTH INDICATORS, DEMOGRAPHICS, AND COMPARISONS WITH NC AND NATIONAL BENCHMARKS. THE DATABASE PROVIDES PROMISING PRACTICES FOR COMMUNITY HEALTH INTERVENTIONS AND ALLOWS THE COMMUNITY TO ADD LOCAL REPORTS FOR A ONE STOP INSPECTION FOR LOCAL COMMUNITY HEALTH ASSESSMENT. COMMUNITY LEADERS HAVE BEEN INFORMED OF THE FREE RESOURCE. THE RESOURCE IS PROVIDED THROUGH A JOINT EFFORT OF LENOIR MEMORIAL AND THE LENOIR MEMORIAL FOUNDATION. LENOIR COUNTY CHILDHOOD OBESITY PREVENTION TASK FORCE LENOIR MEMORIAL IS AN ACTIVE PARTNER IN THE LENOIR COUNTY CHILDHOOD OBESITY PREVENTION TASK FORCE THAT HAS REPRESENTATIVES FROM THE LOCAL SCHOOLS, COUNTY GOVERNMENT, AND OTHER KEY COMMUNITY AGENCIES. A SECOND SCHOOL-WIDE HEALTHY WATER BEVERAGE INITIATIVE WAS DONE AT NORTH EAST ELEMENTARY SCHOOL THIS YEAR. MORE INFORMATION ABOUT THE ACTIVITIES OF THE TASK FORCE CAN BE FOUND AT HTTP://WWW.LENOIRCOUNTYNCHEALTHYKIDS.COM/. PROJECT FIT AMERICA PROJECT FIT AMERICA HAS BEEN IMPLEMENTED FOR SOUTH EAST ELEMENTARY AS A JOINT PROJECT FUNDED BY LENOIR MEMORIAL AND THE LENOIR MEMORIAL FOUNDATION. AS THE FIRST PROJECT FIT AMERICA SCHOOL PROJECT IN NC, EAST OF GREENSBORO, THE PROJECT PROVIDED A FITNESS PLAYGROUND, SCHOOL FITNESS CURRICULUM, AND PE TEACHER TRAINING. PRE-TEST FALL 2013 VS POST-TEST FALL 2014 AGGREGATE PERFORMANCE DATA REVEALED SIGNIFICANT IMPROVEMENTS IN EVERY FITNESS TESTING AREA FOR 2ND- 5TH GRADERS. PLANS ARE UNDERWAY TO SUPPORT A SECOND SCHOOL IMPLEMENTATION IN 2015 DUE TO SUCCESSFUL OUTCOMES. COMMUNITY COALITION ACTIVITIES LENOIR MEMORIAL PROVIDES LEADERSHIP AND ADMINISTRATIVE SUPPORT FOR COMMUNITY HEALTH COALITIONS. THE LENOIR COUNTY ALLIANCE FOR A HEALTHY COMMUNITY MEETS ON A MONTHLY BASIS FOR COMMUNITY NETWORKING AND INFORMATION SHARING. ALMOST 20 DIFFERENT COMMUNITY ORGANIZATIONS PARTICIPATE IN THE MEETINGS. THE LENOIR COUNTY CRISIS COLLABORATIVE BRINGS EASTPOINTE MENTAL HEALTH, EASTER SEALS MOBILE CRISIS, LENOIR MEMORIAL, LOCAL LAW ENFORCEMENT, EMS, AND OTHER AGENCIES TOGETHER QUARTERLY. THE GROUP FOCUSES ON THE COMMUNITY MENTAL HEALTH CRISIS NEEDS TO IDENTIFY SOLUTIONS AND MEET CHALLENGES TO PROBLEMS IN LENOIR COUNTY. MATERNAL/CHILD HEALTH INITIATIVES - "BABY FRIENDLY" PRACTICES SUCH AS "ROOMING IN" AND "SKIN TO SKIN " FOR MOM AND BABY ARE A FOCUS. - BREASTFEEDING SUPPORT IS PROVIDED FOR THOSE MOMS WHO WANT TO BREASTFEED AND PROPER BOTTLE FEEDING TECHNIQUES FOR THOSE THAT CHOOSE TO FORMULA FEED. - EDUCATION WAS PROVIDED TO LOCAL DAY CARE CENTER EMPLOYEES ON THE PROPER USE AND STORAGE OF BREAST MILK AND THE SUPPORT FOR THE BREASTFEEDING MOTHER. - PARTICIPATING IN A COLLABORATIVE WITH THE NORTH CAROLINA HOSPITAL ASSOCIATION TO PREVENT ELECTIVE DELIVERIES PRIOR TO 39 WEEKS. 100% COMPLIANT WITH THIS STANDARD. - IMPLEMENTED A SCREENING TEST FOR ALL NEWBORNS TO RULE OUT CRITICAL CONGENITAL HEART DEFECTS PRIOR TO DISCHARGE. APPROXIMATELY 18 OUT OF EVERY 10,000 BABIES ARE BORN WITH A CRITICAL CONGENITAL HEART DEFECT (CCHD). CCHD IS LIFE THREATENING AND REQUIRES INTERVENTION IN INFANCY. CCHD IS NOT ALWAYS DETECTED PRENATALLY OR UPON EXAM IN THE NURSERY, AS A RESULT, SOME INFANTS WITH CCHD ARE DISCHARGED FROM THE NURSERY TO HOME, WHERE THEY QUICKLY DECOMPENSATE. TO IMPROVE THE EARLY DETECTION OF CCHD, THE SECRETARY OF HEALTH AND HUMAN SERVICES (HHS) RECOMMENDED THAT CCHD SCREENING BE ADDED TO THE UNIFORM NEWBORN SCREENING PANEL. - IMPLEMENTED A NEONATAL ABSTINENCE PROGRAM TO SCREEN ALL NEWBORNS THAT HAVE A HISTORY OF EXPOSURE TO ILLEGAL SUBSTANCES IN UTERO. NEONATAL ABSTINENCE SYNDROME (NAS) IS A GROUP OF PROBLEMS THAT OCCUR IN A NEWBORN WHO WAS EXPOSED TO ADDICTIVE OPIATE DRUGS WHILE IN THE MOTHER'S WOMB. SUPPORT GROUPS COORDINATED 14 HOSPITAL BASED GROUPS, ATTENDED BY 1446 PARTICIPANTS. FOUR COMMUNITY BLOOD PRESSURE MACHINES PROVIDED 38,556 SCREENING BLOOD PRESSURES AT SITES FOR BLOOD PRESSURE MACHINES AT VERNON PARK MALL, HOSPITAL, AND A MACHINE THAT TRAVELS TO VARIOUS COMMUNITY CHURCHES EACH MONTH. A FREE COMMUNITY BLOOD PRESSURE MANAGEMENT CLASS WAS OFFERED TO THE COMMUNITY TWICE MONTHLY STARTING IN 2014. EMERGENCY PREPAREDNESS LENOIR MEMORIAL PARTICIPATES IN THE LOCAL EMERGENCY PLANNING COMMITTEE, AND AS A MEMBER OF THE LENOIR COUNTY TEAM IN THE EASTERN REGIONAL ADVISORY COUNCIL FOR 29 COUNTIES TO PLAN, COORDINATE, AND EXECUTE DISASTER READINESS AND DRILLS. LENOIR MEMORIAL PARTICIPATES IN THE NORTH CAROLINA EMERGENCY MANAGEMENT DOMESTIC PREPAREDNESS REGION 2 (DPR2) EMERGENCY PREPAREDNESS COMMITTEE FOR 10 COUNTIES TO DEVELOP AND EXPAND REGIONAL PREVENTION, PREPAREDNESS, RESPONSE, AND RECOVERY CAPABILITIES FOR ALL HAZARDS, BOTH MAN-MADE AND NATURAL. MINGES WELLNESS CENTER THE ON-SITE MEDICALLY BASED FITNESS CENTER FOR THE COMMUNITY HAS 75 PIECES OF STATIONARY EXERCISE EQUIPMENT WITH 25 GROUP EXERCISE CLASSES WEEKLY. A TOTAL OF 959 INDIVIDUAL MEMBERS PARTICIPATED IN 2014, INCLUDING 60 INDIVIDUALS WHO WERE PROVIDED INCENTIVE SCHOLARSHIPS FOR DIABETES SELF MANAGEMENT. MONTHLY MEMBERSHIP RATES OF $20 PER MONTH ASSIST AN UNDERSERVED COMMUNITY TO INITIATE EXERCISE PLANS. SCREENING EVENTS PROVIDED EARLY DETECTION SCREENING EVENTS OF DISEASES/ DISORDERS/RISKS INCLUDING COLORECTAL, MAMMOGRAM, CHOLESTEROL, AND BLOOD PRESSURES. A SKIN CANCER AWARENESS EVENT WAS HELD IN MAY. COMMUNITY AIR QUALITY PROGRAM THROUGH NC AIR, DIFFERENT COLORED PENNANT FLAGS FLY AT LENOIR MEMORIAL HOSPITAL TO SIGNIFY THE OUTDOOR AIR QUALITY FOR EASTERN NC AS TESTED DAILY BY THE EPA IN ROCKY MOUNT, NC. CANCER RESOURCE CENTER- THE CANCER RESOURCE CENTER (CRC) IS A VISIBLE COLLABORATION BETWEEN LMH AND THE AMERICAN CANCER SOCIETY. THE CRC PROVIDES RESOURCES FOR INDIVIDUALS AND FAMILIES WHO HAVE RECEIVED A CANCER DIAGNOSIS AND NEED SERVICES TO SUPPORT THEIR MYRIAD OF NEEDS DURING TREATMENT AND CARE. 65 PATIENTS AND FAMILIES RECEIVED FORMAL SUPPORT THROUGH THE CENTER DURING FY14. DOZENS MORE INTERACTED WITH STAFF INFORMALLY. A STAFF OF TRAINED VOLUNTEERS ARE AVAILABLE TO ASSIST IN IDENTIFYING CANCER RESOURCES FROM 8-12 EACH WEEKDAY.
FORM 990, PART III, LINE 4B: CONTINUATION OF COMMUNITY BENEFITS LENOIR MEMORIAL COMMUNITY WALKING TRACK AVERAGES OVER 700 WALKERS PER MONTH. ALLOWED TWO EXTERNAL NOT-FOR-PROFIT GROUPS TO HOST WALK CAMPAIGNS ON THE TRACK ON TWO SEPARATE SATURDAY MORNINGS DURING FY14. CORPORATE HEALTH SERVICES SERVICES INCLUDED 79 CORPORATE CLIENTS, 239 WORKSITE WELLNESS VISITS WITH 2276 EMPLOYEE CONTACTS. FLU SHOTS, CPR TRAINING, AND TARGETED HEALTH EDUCATION FOR RISK FACTOR REDUCTION WAS PROVIDED. WORKHEALTHY AMERICA WORKING WITH PREVENTION PARTNERS IN CHAPEL HILL, NC, LENOIR MEMORIAL SUPPORTED A GRANT FUNDED WORKSITE WELLNESS ASSESSMENTS WITH TWELVE LENOIR COUNTY ORGANIZATIONS. THIS FACILITATED THE EVALUATION AND REPORT CARD OF CURRENT PRACTICES AND POLICY SUPPORT FOR WELLNESS CULTURE, ENVIRONMENT AND POLICY FOR 18.7% OF THE LOCAL WORKFORCE IMPACTING 5171 EMPLOYEES. LIVING THE GOOD LIFE IN EASTERN NC SPONSOR FOR THE KINSTON/LENOIR COUNTY CHAMBER OF COMMERCE EVENT WHICH FOCUSED ON REGIONAL HEALTHY LIVING ISSUES. OVER 2000 PARTICIPANTS AT VERNON PARK MALL RECEIVED MYLMH PORTAL EDUCATION AND HEALTHY FOOD SAMPLES. HEART HEALTHY LENOIR COLLABORATION WITH UNC CENTER FOR POPULATION HEALTH AND HEALTH DISPARITIES CONTINUES IN A 5 YEAR NIH GRANT TO REDUCE STROKE AND HEART DISEASE IN LENOIR COUNTY. THE PROJECT IS OVERSEEN BY RESEARCHERS AT UNC AND ECU, ASSISTING IN THE COORDINATION OF PROCESSES TO IMPLEMENT A BLOOD PRESSURE STUDY WITH 600 LOCAL PARTICIPANTS. THIS PROJECT INCLUDES SIX PHYSICIAN PRACTICES AND THE IMPLEMENTATION OF STANDARDIZED HYPERTENSION GUIDELINES, HOME BLOOD PRESSURE MONITORING AND TELEPHONE COACHING AS AN EVIDENCE-BASED APPROACH FOR BETTER HYPERTENSION MANAGEMENT. THE PROJECT PARTNERSHIP INCLUDES A LOCAL ADVISORY COMMITTEE ON WHICH SEVERAL HOSPITAL LEADERS SERVE AND ALSO FOCUSES ON HEALTHY LIFESTYLE AND GENETICS STUDY AREAS. DURING FY 14, AREA RESTAURANTS WERE INVITED TO PARTICIPATE IN A PILOT HEALTHY FOOD CHOICES PROGRAM FOR DINING OUT WITH THREE AREA RESTAURANTS PARTICIPATING IN THE FIRST PHASE. HEALTHY EATING FLIERS, TABLE TENTS AND 1564 COUPONS REDEEMED WITH PLANS FOR A LARGER ROLL OUT IN 2014/15. DIABETES WELLNESS PROGRAM LOCATED IN THE MINNIE P. STACKHOUSE DIABETES CENTER, THE AADE ACCREDITED DIABETES WELLNESS PROGRAM PROVIDED FREE DIABETES SELF-MANAGEMENT EDUCATION AND FOLLOW UP MANAGEMENT TO 206 INDIVIDUALS LIVING WITH DIABETES. OUTREACH EDUCATION AND OFF-SITE SCREENINGS WERE PROVIDED MONTHLY REACHING 399 COMMUNITY MEMBERS. ADDITIONALLY, A REGISTERED DIETITIAN/DIABETES EDUCATOR PROVIDED 158 MEDICAL NUTRITION COUNSELING SESSIONS DURING THIS YEAR. ADDITIONALLY, A GRANT WAS SUBMITTED TO KATE B. REYNOLDS TO EXPAND THE DSME/T PROGRAM INTO KINSTON COMMUNITY HEALTH CENTER. COMMUNITY HEALTH EDUCATION PROGRAMMING PROVIDED 2261 PARTICIPANTS ON AND OFF-SITE HEALTH AND WELLNESS PROGRAMMING. PROGRAMMING INCLUDED INFANT CPR, TOBACCO CESSATION, EXERCISE, NUTRITION AND OTHER HEALTH EDUCATION OFFERINGS. THREE SPECIAL PHYSICIAN-LED EDUCATIONAL SERIES WERE OFFERED THIS YEAR. PARENTING EDUCATION SERIES A THREE PART COMMUNITY EDUCATION SERIES WAS OFFERED TO SUPPORT PARENTING AND CONSTRUCTIVE DISCIPLINE NEEDS IN DIFFERENT AGE GROUPS BY A PARENTING EXPERT FOR RESIDENTS. ADVANCED DIRECTIVES PROVIDED 83 COMMUNITY RESIDENTS WITH SUPPORT IN COMPLETING ADVANCED DIRECTIVES. SHREDDING EVENT THE FALL 2014 EVENT ALLOWED AREA RESIDENTS TO SAFELY AND CONFIDENTIALLY DISPOSE OF OLD PERSONAL RECORDS AND DOCUMENTS BY PARTNERING WITH CINTAS FOR THE FREE EVENT. OVER 100 RESIDENTS UTILIZED THE EVENT. FAMILY BIRTH CENTER COMMUNITY EDUCATION LAMAZE/SIBLING/EARLY PRENATAL CLASSES INCLUDED 60 ATTENDEES. PATIENT ADVISORY COMMITTEE DURING 2014, THE PATIENT ADVISORY COUNCIL MET SIX TIMES AND WAS MADE UP OF 23 REPRESENTATIVES FROM THROUGHOUT THE COMMUNITY, MEDICAL STAFF, BOARD, VOLUNTEERS, AND HOSPITAL STAFF TO SOLICIT INPUT ON HOW WE MIGHT IMPROVE OUR PATIENT CARE PROCESS. THIS FOSTERS A CONTINUING OPPORTUNITY FOR US TO LISTEN TO OUR CUSTOMERS AND USE THE INFORMATION TO HELP US IMPROVE OUR SYSTEMS AND PROCESSES. THE FOCUS OF THIS GROUP IS TO FEED INFORMATION BACK TO THE ORGANIZATION FROM THE COMMUNITY IN ORDER TO DELIVER CARE THAT IS PATIENT CENTERED AND COMMUNITY PERSPECTIVE DRIVEN. TOPICS FOR MEETINGS INCLUDED PATIENT EXPERIENCE UPDATES, TELE-PSYCHIATRY PROGRAM, ED MINOR CARE, 2014 GOALS AND OBJECTIVES, LEAN ED RIE UPDATE, 2013 COMMUNITY BENEFITS, PATIENT PORTAL, PARTNERSHIP/AFFILIATION, HOSPITAL SECURITY, TELE-STROKE PROGRAM, EBOLA UPDATE, TJC UPDATE AND "SEASON OF GIVING" UPDATE - UNITED WAY, FOOD DRIVE, SECRET SANTA AND LIGHTS OF LOVE. EMPLOYEE OUTREACH LENOIR MEMORIAL EMPLOYEES SHOW GOOD COMMUNITY STEWARDSHIP BY PARTICIPATING IN FUNDRAISING TO SUPPORT THE AMERICAN CANCER SOCIETY RELAY FOR LIFE, LENOIR MEMORIAL FOUNDATION OUTREACH, AND LENOIR- GREENE UNITED WAY. EMPLOYEES WORKED TOGETHER TO GIVE TIME, TALENT AND PERSONAL DONATIONS OF OVER $75,000 DURING FY14 TOWARDS GREAT CAUSES IN THE COMMUNITY. EMPLOYEES ALSO FED 26 LOCAL FAMILIES FOR THANKSGIVING AND PROVIDED FOOD TO FRIENDS OF THE HOMELESS AND GREENE COUNTY INTERFAITH. EMPLOYEES KEPT THE LONG TRADITION OF PLAYING SECRET SANTA TO 26 NEEDY CHILDREN AT NORTHEAST ELEMENTARY SCHOOL WITH GIFTS FROM THEIR OWN POCKETS. COMMUNITY HEALTHCARE SCHOLARSHIPS NURSING LEADERSHIP, HIGH SCHOOL HEALTH OCCUPATION STUDENTS AND TEEN VOLUNTEERS RECEIVE SCHOLARSHIP AWARDS TO SUPPORT ONGOING HIGH SCHOOL AND COLLEGE HEALTH CAREER EDUCATION. HOSPITAL VOLUNTEER PROGRAM DURING FY 14, 269 VOLUNTEERS INCLUDING 55 YOUTH VOLUNTEERS PROVIDED 35,034 VOLUNTEER HOURS IN A VARIETY OF HOSPITAL SETTINGS ENRICHING THE PATIENT EXPERIENCE AND PERFORMING THE WORK OF 17 UNPAID FTES. LIGHTS OF LOVE HOLIDAY TREE LIGHTING CAMPAIGN COMMUNITY DONATIONS FUND A NUMBER OF HOSPITAL PROGRAMS AND PROJECTS EACH YEAR. PHYSICIAN RECRUITMENT LENOIR MEMORIAL PROVIDED PHYSICIAN RECRUITMENT SERVICES TO MEET COMMUNITY NEEDS FOR PROVIDERS IN THE PRIORITY AREAS OF GENERAL SURGERY AND NEUROLOGY. TWO PROVIDERS WERE SUCCESSFULLY RECRUITED TO AREA PRACTICES. IN 2014, WE SUCCESSFULLY RECRUITED TWO PHYSICIANS AND ONE MIDLEVEL TO LENOIR PHYSICIAN NETWORK PRACTICES. THEY ARE : CHARLES MOORE - GENERAL SURGERY AND MANASI GAHLOT - NEUROLOGY, AND JOY SMITH, ORTHOPEDIC PA . IN ADDITION, DR. VIKRAM GAHLOT, AN INVASIVE NON-INTERVENTIONAL CARDIOLOGIST WAS RECRUITED FOR KINSTON CARDIOLOGY. MY LMH PORTAL LENOIR MEMORIAL IMPLEMENTED AN ONLINE PATIENT PORTAL IN JULY, 2014 TO PROVIDE PATIENTS A SECURE ONLINE ACCESS TO PERSONAL HEALTH INFORMATION BY USING AN INTERNET CONNECTION WITH A SECURE USER NAME AND PASSWORD. COMMUNITY PRESENTATIONS AND STRATEGIES HAVE BEEN USED TO INFORM THE PUBLIC OF THIS FREE FEATURE. THE ADDITIONAL FEATURES PROVIDED ALLOW RESIDENTS TO ADD INFORMATION TO THEIR PERSONAL PROFILE AND MANAGE MORE COMPLETE HEALTH INFORMATION IN ONE LOCATION. STEM OUTREACH LENOIR MEMORIAL WORKED WITH THE LENOIR COUNTY MANUFACTURING ASSOCIATION TO REWARD LENOIR COUNTY PROJECT LEAD THE WAY PROGRAMS WITH SCIENCE, TECHNOLOGY, ENGINEERING AND MATH (STEM) PROGRAMMING IN AREA HIGH SCHOOLS THROUGH SUPPORT FOR CREATIVE STUDENT PROJECT COMPETITION AND SCHOLARSHIP AWARDS. LENOIR MEMORIAL ALSO SERVED AS A SITE FOR A LENOIR COUNTY PUBLIC SCHOOLS STEM PARTNERSHIP WITH ECU SHOWCASING CAREERS IN STEM BASED AREAS. ADDITIONALLY, LMH PROVIDED SUPPORT FOR STEMEAST THROUGH THE LENOIR COMMITTEE OF 100. KINSTON/LENOIR COUNTY FARMER'S MARKET LENOIR MEMORIAL PARTNERED WITH THE FARMERS MARKET TO PROVIDE ONSITE VENDING FOR EMPLOYEES AND LOCAL COMMUNITY AS AN ADDITIONAL SITE FOR ACCESS TO FRESH FRUITS AND VEGETABLES.
FORM 990, PART VI, SECTION A, LINE 1 THE CHAIRMAN OF THE BOARD, VICE CHAIRMAN, SECRETARY, PRESIDENT, AND OTHERS AS APPOINTED BY THE CHAIRMAN SHALL CONSTITUTE THE EXECUTIVE COMMITTEE. THE CHAIRMAN OF THE BOARD OF DIRECTORS SHALL SERVE AS CHAIRMAN OF THE EXECUTIVE COMMITTEE AND THE VICE CHAIRMAN OF THE BOARD OF DIRECTORS SHALL SERVE AS VICE CHAIRMAN OF THE EXECUTIVE COMMITTEE. THE EXECUTIVE COMMITTEE SHALL HAVE FULL AUTHORITY TO TRANSACT ALL REGULAR BUSINESS OF THE HOSPITAL DURING THE INTERIM BETWEEN THE REGULAR MEETINGS OF THE BOARD OF DIRECTORS, PROVIDED THAT ANY ACTION WHICH IT MAY TAKE SHALL NOT CONFLICT WITH THESE BYLAWS, RULES AND REGULATIONS OR ARTICLES OF INCORPORATION OR WITH THE POLICIES AND DECISIONS OF THE BOARD OF DIRECTORS. SHOULD ANY MATTERS OF EXTREME URGENCY ARISE BETWEEN REGULAR MEETINGS OF THE BOARD OF DIRECTORS, A MAJORITY OF THE MEMBERS OF THE COMMITTEE SHALL CONSTITUTE A QUORUM.
FORM 990, PART VI, SECTION B, LINE 11 THE FINANCE DIRECTOR FOR THE HOSPITAL WILL ATTEND A SCHEDULED MEETING OF THE BOARD OF DIRECTORS AND PRESENT THE FORM 990 BEFORE IT IS FILED WITH THE IRS.
FORM 990, PART VI, SECTION B, LINE 12C UPON THEIR APPOINTMENT TO THE BOARD, AND BEFORE ACTUALLY PARTICIPATING IN MEETINGS, MEMBERS MUST READ THE CONFLICTS OF INTEREST POLICY AND DISCLOSE ANY FINANCIAL INTERESTS THAT COULD CREATE A CONFLICT OF INTEREST. AS LONG AS THEY CONTINUE TO SERVE ON THE BOARD, MEMBERS THEN COMPLETE THESE FINANCIAL RELATIONSHIP DISCLOSURE STATEMENTS ON AN ANNUAL BASIS. IF SUCH INTERESTS ARE NOT DISCLOSED, THE CEO, BOARD CHAIR, OR ANY OTHER BOARD MEMBER MAY BRING THE FINANCIAL INTEREST OR ACTUAL/POSSIBLE CONFLICT TO THE ATTENTION OF THE BOARD; THUS THE ENTIRE BOARD IS RESPONSIBLE FOR ONGOING MONITORING OF POTENTIAL CONFLICTS AND THEIR DISCLOSURE. INTENTIONAL FAILURE TO DISCLOSE SUCH FINANCIAL INTERESTS WILL, BY POLICY, RESULT IN APPROPRIATE CORRECTIVE ACTION BY THE BOARD. SHOULD A CONFLICT OF INTEREST ARISE IN CONDUCTING THE BUSINESS OF THE HOSPITAL, THE AFFECTED MEMBER(S) MAY NOT PARTICIPATE IN DISCUSSION REGARDING THE RELEVANT TRANSACTION, AND DEPENDING UPON THE SPECIFIC NATURE OF THE MATTER, THE BOARD CAN TAKE A RANGE OF ACTIONS, SUCH AS APPOINTING A DISINTERESTED PERSON TO INVESTIGATE POSSIBLE ALTERNATIVES, REQUIRING THE INTERESTED PERSON TO REFRAIN FROM PERFORMING ANY FUNCTIONS RELATED TO THE INTEREST CREATING THE CONFLICT, OR REQUIRING THE INTERESTED PERSON TO DIVEST HIMSELF OF THE CONFLICT-CREATING INTEREST IN ORDER TO REMAIN ON THE BOARD. EDUCATION AND COMPLIANCE FORMS ARE UPDATED ANNUALLY BY THE HOSPITAL'S CORPORATE COMPLIANCE OFFICER.
FORM 990, PART VI, SECTION B, LINE 15 THE EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS CONTRACTS YEARLY WITH AN OUTSIDE, INDEPENDENT, PROFESSIONAL FIRM TO EXAMINE AND REVIEW THE WAGES AND BENEFITS OF THE CEO AND TOP MANAGEMENT OFFICALS OF THE HOSPITAL.
FORM 990, PART VI, SECTION C, LINE 18 PHOTOCOPIES OF THE FORM 990 ARE AVAILABLE UPON REQUEST AT THE ORGANIZATION'S ADMINISTRATIVE OFFICE. ADDITIONALLY, RECENT FILINGS OF THE FORM 990 ARE AVAILABLE ONLINE AT WWW.GUIDESTAR.ORG.
FORM 990, PART VI, SECTION C, LINE 19 THE HOSPITAL MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART XI, LINE 9: RESTATING BEGINNING NET POSITION PER GASB 65 -160,042.
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:  
SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBulletAttach 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
LENOIR MEMORIAL HOSPITAL INC
 
Employer identification number

56-6000674
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
(1) LENOIR PHYSICIANS NETWORK LLC
100 AIRPORT RD
KINSTON,NC28501
46-0687300 		PHYSICIANS SERVICES NC 2,204,127 1,803,135 LENOIR MEMORIAL HOSPITAL
 










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?
Yes No
(1) LENOIR MEMORIAL HOSPITAL FOUNDATION INC

100 AIRPORT ROAD

KINSTON,NC28501
58-1584139 		SUPPORT THE CHARITABLE, EDUCATIONAL, AND SCIENTIFIC PURPOSES OF LMH, INC. NC 501(C)(3) LINE 11A, I LENOIR MEMORIAL HOSPITAL
 
Yes
 
(2) LENOIR HEALTH SERVICES INC

100 AIRPORT ROAD

KINSTON,NC28501
58-1705689 		SUPPORT CHARITABLE, EDUCATIONAL, AND SCIENTIFIC PURPOSES OF LMH, INC. NC 501(C)(3) LINE 11A, I LENOIR MEMORIAL HOSPITAL
 
Yes
 










For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2013
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



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

(f)
Share of total income




 		(g)
Share of end-of-year
assets



 		(h)
Disproprtionate allocations?




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



 		(k)
Percentage
ownership
Yes No Yes No
(1) PAMLICO MEDICAL EQUIPMENT LLC

628 EAST TWELFTH STREET
WASHINGTON,NC27889
56-2101748 		RENTAL/SALES OF MEDICAL EQUIPMENT NC N/A
 UNRELATED -41,598 -2   No -41,613 Yes    
(2) SPRING ARBOR OF KINSTON LP

800 HETHWOOD BOULEVARD
BLACKSBURG,VA24060
52-2118245 		RENTAL REAL ESTATE VA N/A
 RELATED 192,815     No     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
 		(h)
Percentage
ownership
 		(i)
Section 512(b)(13) controlled entity?
Yes No












Schedule R (Form 990) 2013
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
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest (ii) annuities (iii) royalties or (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .
1a
 
No
b Gift, grant, or capital contribution to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
Yes
 
c Gift, grant, or capital contribution from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
Yes
 
d Loans or loan guarantees to or for related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
 
No
e Loans or loan guarantees by related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
 
No
f Dividends from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
 
No
g Sale of assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1g
Yes
 
h Purchase of assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1h
 
No
i Exchange of assets with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1j
 
No
k Lease of facilities, equipment, or other assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1k
 
No
l Performance of services or membership or fundraising solicitations for related organization(s) . . . . . . . . . . . . . . . . . . . .
1l
 
No
m Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .
1m
 
No
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .
1n
Yes
 
o Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
Yes
 
p Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
Yes
 
q Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
Yes
 
r Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
 
No
s Other transfer of cash or property from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1s
Yes
 
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of related organization 		(b)
Transaction
type (a-s) 		(c)
Amount involved 		(d)
Method of determining amount involved
(1) LENOIR MEMORIAL HOSPITAL FOUNDATION

 O 62,736 FMV





Schedule R (Form 990) 2013
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) 		(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)

(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? 		(k)
Percentage
ownership
Yes No Yes No Yes No






























Schedule R (Form 990) 2013
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


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