Attach to Form 990 or Form 990-EZ.
Go to
www.irs.gov/Form990 for instructions and the latest information.
| (i) Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 10 above (see instructions)) | (iv) Is the organization listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
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Total |
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Calendar year
(or fiscal year beginning in)
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(a) 2019 | (b) 2020 | (c) 2021 | (d) 2022 | (e) 2023 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") .. | ||||||
| 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. | ||||||
Calendar year
(or fiscal year beginning in)
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(a) 2019 | (b) 2020 | (c) 2021 | (d) 2022 | (e) 2023 | (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 VI.).. | ||||||
| 11 | Total support. Add lines 7 through 10 | ||||||
Calendar year (or fiscal
year beginning in) ![]() |
(a) 2019 | (b) 2020 | (c) 2021 | (d) 2022 | (e) 2023 | (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.) | ||||||
Calendar year
(or fiscal year beginning in)
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(a) 2019 | (b) 2020 | (c) 2021 | (d) 2022 | (e) 2023 | (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 on 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 VI.) .. | ||||||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | ||||||
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
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| 1 | Net short-term capital gain | 1 | ||||
| 2 | Recoveries of prior-year distributions | 2 | ||||
| 3 | Other gross income (see instructions) | 3 | ||||
| 4 | Add lines 1 through 3 | 4 | ||||
| 5 | Depreciation and depletion | 5 | ||||
| 6 | Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) | 6 | ||||
| 7 | Other expenses (see instructions) | 7 | ||||
| 8 | Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) | 8 | ||||
| Section B - Minimum Asset Amount | (A) Prior Year |
(B) Current Year (optional) |
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| 1 | Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): | 1 | ||||
| a | Average monthly value of securities | 1a | ||||
| b | Average monthly cash balances | 1b | ||||
| c | Fair market value of other non-exempt-use assets | 1c | ||||
| d | Total (add lines 1a, 1b, and 1c) | 1d | ||||
| e |
Discount claimed for blockage or other factors (explain in detail in Part VI): |
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| 2 | Acquisition indebtedness applicable to non-exempt use assets | 2 | ||||
| 3 | Subtract line 2 from line 1d | 3 | ||||
| 4 | Cash deemed held for exempt use. Enter 0.015 of line 3 (for greater amount, see instructions). | 4 | ||||
| 5 | Net value of non-exempt-use assets (subtract line 4 from line 3) | 5 | ||||
| 6 | Multiply line 5 by 0.035 | 6 | ||||
| 7 | Recoveries of prior-year distributions | 7 | ||||
| 8 | Minimum Asset Amount (add line 7 to line 6) | 8 | ||||
| Section C - Distributable Amount | Current Year | |||||
| 1 | Adjusted net income for prior year (from Section A, line 8, Column A) | 1 | ||||
| 2 | Enter 85% of line 1 | 2 | ||||
| 3 | Minimum asset amount for prior year (from Section B, line 8, Column A) | 3 | ||||
| 4 | Enter greater of line 2 or line 3 | 4 | ||||
| 5 | Income tax imposed in prior year | 5 | ||||
| 6 | Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) | 6 | ||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | 1 | |
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
2 | |
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | 3 | |
| 4 Amounts paid to acquire exempt-use assets | 4 | |
| 5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI) | 5 | |
| 6 Other distributions (describe in Part VI). See instructions | 6 | |
| 7Total annual distributions. Add lines 1 through 6. | 7 | |
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
8 | |
| 9 Distributable amount for 2023 from Section C, line 6 | 9 | |
| 10 Line 8 amount divided by Line 9 amount | 10 | |
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2023 |
(iii) Distributable Amount for 2023 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2023 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2023 (reasonable cause required-- explain in Part VI).
See instructions. |
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| 3 Excess distributions carryover, if any, to 2023: | ||||
| a From 2018....... | ||||
| b From 2019....... | ||||
| c From 2020....... | ||||
| d From 2021....... | ||||
| e From 2022....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2023 distributable amount | ||||
|
i
Carryover from 2018 not applied (see instructions) |
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| j Remainder. Subtract lines 3g, 3h, and 3i from line 3f. | ||||
| 4Distributions for 2023 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2023 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from line 4. | ||||
|
5
Remaining underdistributions for years prior to 2023, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions. |
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6
Remaining underdistributions for 2023. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions. |
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7 Excess distributions carryover to 2024. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a Excess from 2019..... | ||||
| b Excess from 2020..... | ||||
| c Excess from 2021..... | ||||
| d Excess from 2022..... | ||||
| e Excess from 2023..... | ||||
| Facts And Circumstances Test |
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| Return Reference | Explanation |
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| Software ID: | 23017437 |
| Software Version: | 2023v6.0 |
| Return Reference | Explanation |
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| Form 990, Part III, Line 4a | FirstHealth of the Carolinas, Inc. ("FirstHealth") provides a comprehensive community benefits program in its primary and secondary service areas. FirstHealth plays a pivotal role in delivering health care in the mid-Carolinas and is both the infrastructure and safety net for health care in its communities. FirstHealth operates two hospitals: FirstHealth Moore Regional Hospital and FirstHealth Montgomery Memorial Hospital. FirstHealth Moore Regional Hospital has licensed beds in three locations: the main campus in Pinehurst, North Carolina and remote locations in Rockingham and Raeford, North Carolina. Hospital care is the cornerstone of health care in most communities, but FirstHealth goes beyond the walls of these facilities to enhance the health and wellness of the residents of its service areas. FirstHealth provides low-cost and, in many cases, free programs to our most vulnerable patient populations. One of FirstHealth's most important financial contributions is bridging the gap created by underpayments from Medicare and Medicaid and other government programs, while continuing to provide access to free or low-cost health screenings and diagnostic services, as well as health/wellness educational programs in the communities FirstHealth serves. Free and Discounted Charity Care to Eligible Patients Served Anyone who visits a FirstHealth hospital for medical care is treated regardless of his or her ability to pay for the treatment provided. When patients are unable to help with their medical expenses, FirstHealth absorbs some or all the cost of care for those that meet designated financial criteria, depending on family income. Patients with family incomes at or below 200 percent of the federal poverty guideline qualify for 100 percent financial assistance under FirstHealth's Financial Assistance Program. FirstHealth's net cost of free care (treating patients that qualified for 100% financial assistance) was $12,075,751 in fiscal 2024. Through its Financial Assistance Program, FirstHealth also offers varying levels of discounted care to patients who are poor and/or meet certain income guidelines. Patients with family incomes between 201 and 360 percent of the federal poverty guideline qualify for discounts against FirstHealth's list price for services rendered. FirstHealth also incurs bad debt expense each year for patients who have been determined to have the financial capacity to pay for healthcare services provided but are unwilling/financially unable to settle the claim. FirstHealth continues to provide all necessary healthcare services to this patient population. In fiscal 2024, the cost to FirstHealth for these services was $15,223,804. FirstHealth's Financial Counselors work closely with patients and families to help determine eligibility for assistance or qualification for public programs. FirstHealth requests that patients provide appropriate documentation, such as tax returns, current pay stubs, or other relevant information, that is used to demonstrate financial need. FirstHealth also offers interest-free extended payment plans that will vary in length, depending on the balance of the patient's account. FirstHealth assists patients with finding available governmental programs that match patients' needs, such as Medicaid, Vocational Rehabilitation, Crime Victim Assistance, etc. FirstHealth also posts detailed information about its Financial Assistance Program on its website (www.firsthealth.org) so the public can be aware of its availability. Medicaid Shortfall FirstHealth provides Medicaid services in its two hospitals, as well as through its home care, hospice and palliative care, dental care, and other health care services in its primary and secondary service areas. Approximately 11.5% of FirstHealth's fiscal 2024 net patient revenue for acute care services came from the Medicaid program. The Medicaid program, which provides health care coverage for low-income families and individuals, is funded by the state and federal governments. In North Carolina, as in many states, Medicaid payments are well below the provider's actual cost of treating Medicaid patients and the reimbursement level is predicted to decline as financial pressures on the federal and state government operating budgets mount. In fiscal 2024, FirstHealth's unpaid costs from Medicaid totaled $22,898,724. Medicare Shortfall FirstHealth provides services to Medicare beneficiaries in its two hospitals. In addition, Medicare beneficiaries are served by FirstHealth's home care, hospice and palliative care and other health care programs and services. The Medicare shortfall represents the difference between the actual cost of care rendered and the reimbursement received for delivering that care to patients. Approximately 57.6% of FirstHealth's fiscal 2024 net patient revenue for acute care services came from the Medicare program. The cost of delivering care includes, but is not limited to, personnel costs, technology, supplies, pharmaceuticals, medical devices, facility operating costs, etc. FirstHealth's financial shortfall from providing these Medicare services in fiscal 2024 was $22,524,569. Subsidized Medically Essential Services As a rural health care provider, FirstHealth is many times the provider of last resort for our patients. In order to offer a full spectrum of health care services, FirstHealth provides services and programs that yield negative operating margins. However, because these services are essential to the overall health of the communities served, FirstHealth continues to provide them. Subsidized medically necessary hospital services provided by FirstHealth include, but are not limited to: inpatient psychiatry unit and outpatient mental health services; inpatient physical rehabilitation unit; neonatal intensive care unit; emergency departments (approximately 128,808 patient encounters in fiscal 2024); women's and children's services; inpatient medical and radiation oncology services; renal dialysis services; diabetes care; and a number of other outpatient services. In addition, FirstHealth, through its Regional Emergency Medical Services business line, provided 25,313 emergency 911 transports to residents of Chatham, Lee, Montgomery and Richmond counties in fiscal 2024. FirstHealth received $8,704,017 in fiscal 2024 operating subsidies from these counties to help offset the unreimbursed operating costs of providing these essential transport services. FirstHealth also provided $3,165,586 in direct financial subsidies to offset the unfunded operating costs of the Regional Emergency Medical Services business line in fiscal 2024. FirstHealth Community Health Services Initiatives (FHCS) Health Programs - Tobacco Cessation, Diabetes and Disease Prevention, Health Coaching The Health Program team addresses the health needs of residents based on current health system data and county-based community health needs assessments. The Community Health Programs team provides classes and one-on-one programs to address chronic disease and health behavior modification such as Pre-Diabetes (Prevent T2), Tobacco/Vaping Cessation (FirstQuit), Cardiovascular Health (Million Hearts), Health Coaching and access to Health Foods (Food Pantries). FirstQuit, an outpatient program, includes a combination of counseling and nicotine replacement therapies to assist residents in the service area to quit nicotine use. For fiscal 2024, 422 people enrolled in the outpatient program. The conservative six-month quit rate was 22%. 70 community education programs/health screenings to address chronic disease and physical activity were provided, with 76% targeted to low-income and underserved populations in the five-county primary service area of Moore, Montgomery, Hoke, Richmond and Lee counties. In addition, there were 706 health coaching encounters, with 77% of the participants showing improved blood pressure and/or weight status and 50 participants enrolled in Prevent T2 classes with 60% of the participants completing the program reporting 5-7% weight loss from the start of the class. Participants reported an overall 100% satisfaction rating. In total, FirstHealth leveraged $1.89 in grant funds for every $1 provided by FirstHealth. School-Based Health Centers FirstHealth offers on-site medical care at three clinic sites within the Montgomery County Schools (East Middle School, West Middle School and Central High School).. Hundreds of school children in Montgomery County have access to acute and preventive medical care on the school campus just steps away from the classroom doors. |
| Form 990, Part III, Line 4a | New in FY 2024 was the addition of behavioral health support for students and family members through a program supported financially by the North Carolina Office of Rural Health. The School-Based Health Centers provide on-site medical care that was easily accessible, valuable, and open to any child in the Montgomery County School System. FirstHealth provided $282,309 in financial subsidies to offset the unfunded operating costs of the School-Based Health Centers in fiscal 2024. FirstHealth Medication Assistance Program FirstHealth Cares assists low-income individuals in Moore, Montgomery, Hoke and Richmond counties in securing free or low-cost prescription medications through pharmaceutical companies' indigent care programs. Financially needy adults are eligible for assistance based on medication needs, lack of eligibility for prescription drug coverage, and individual pharmaceutical company program guidelines (typically less than 150 % to 200% of Federal Poverty Level). In fiscal 2024, 1,843 unique individuals were assisted through the FirstHealth CARES program with obtaining prescription medications. 88% of medication requests were filled, resulting in an Average Wholesale Value of over $19 million in medications dispensed. Dental Care Centers FirstHealth operates three Dental Care Centers: one site in Southern Pines (Moore County) and two sites at East Middle School and West Middle School (Montgomery County). Each Dental Care Center provides comprehensive dental care services to Medicaid and HealthChoice-eligible children and young adults up to age 21. Since few dentists in these counties participate in Medicaid's Dental program, the FirstHealth Dental Care Centers provides a tremendous unmet need in the region. When the Dental Care Centers opened in 1997, nearly half of the children of low-income families in FirstHealth's service area were getting little to no dental care services. During fiscal 2024, the Dental Care Centers provided 6,349 dental care visits to 2,872 children and young adults residing in the counties served. The Dental Care Centers recognized $375,998 in FirstHealth financial subsidies and external grant funding to offset the unfunded operating costs in fiscal 2024. Diabetes & Nutrition Education Center This group of clinical professionals provides services for both diabetes education and outpatient nutrition, serving all ages. Both programs help educate patients on how to better manage their diabetes diagnosis and/or make dietary and lifestyle changes to reduce health risk. Services are provided in-person in Moore, Richmond, Montgomery and Hoke counties, with the option of utilizing a telehealth platform. 61% of patients who completed a diabetes self-management workshop scheduled an individual session or group follow-up class. 37% of patients demonstrated a reduction of hemoglobin A1c at a post-program follow-up session or phone call. By offering both in-person and telehealth appointments to maintain continuity of treatment, the program has been able to improve patient access. Task Force Support and Policy Work FirstHealth Community Health Services supports county-based, disease-specific and grassroots task forces to collaborate on needs identification, resource acquisition and program implementation. Groups supported include MooreHealth, Safe Kids Mid-Carolinas Region, the Richmond Health Impact Team, Better Together Montgomery and Sandhills Opioid Response Consortium (SORC). Through work on task forces and those referenced below under "Corporate Initiatives," relationships and partnerships were built to promote healthy lifestyle policy at the local and state level. Support in the Community - Cash and In-Kind Contributions During fiscal 2024, FirstHealth supported health education events, distributed equipment and promoted community-based health initiatives. Through these initiatives, FirstHealth served an estimated 11,393 people at a cost of $558,767. Workforce Development and Community Building Activities FirstHealth provides assistance to the community in the areas of leadership development, planning, resource identification, and Board leadership. FirstHealth participated in and provided administrative support to county-based multi-agency groups including MooreHealth, Richmond County Chamber of Commerce, Moore County United Way, Boys and Girls Club of the Sandhills, and Richmond Healthy Carolinians. Also, FirstHealth coordinates the regional coalition, Safe Kids Mid-Carolinas, in Hoke, Montgomery, Moore, Richmond and Scotland counties as part of the statewide initiative to reduce childhood injuries. FirstHealth also provided financial resources to recruit providers to rural, low-income counties in the region. Family Assistance and Clara McLean House FirstHealth's Pastoral Care Services provided 363 free meals to family members staying with loved ones in the hospital who could not afford meals. The cost to FirstHealth for these free meals provided in fiscal 2024 totaled $2,181. The Clara McLean House ("Clara's House") has served over 13,500 guests since its inception in 2012. This encompasses 24,700 room nights with guests visiting from 48 states and 8 countries. In addition, over 7,500 visits were made to the on-site Healing Garden by guests and the Pinehurst community at-large. In fiscal year 2024, Clara's House focused in on the cancer patient population as its main housing market. With the cancer center entering its second year of operation, the number of room nights for cancer patients staying at Clara's increased by 17%. Thanks to the generous philanthropic support of the community through The Foundation of FirstHealth, Clara's House offered 1,172 nights to more than 240 cancer patients at no charge, equating to an approximate value of $244,340 in accommodations. Many patients and their support person stayed for up to 6 weeks during treatment regimens, which has required staff to step into a more refined skill set to accompany folks through this varied and often arduous portion of their medical and healing journey. Volunteers still come every Monday and make a hot lunch which is a welcome relief as many guests are not only transportation but food insecure as well. From the overall lodging standpoint, 947 guests stayed a total of 1,753 room nights, with 567 of those guests being first time visitors. Guests traveled a mean distance of 80 miles and stayed an average of 2.2 nights. Top diagnostic groups remain oncology, orthopedic and heart patients with the top three counties being served from Cumberland, Robeson and Richmond. Over 115 of those nights were dedicated to provider recruitment, retention and those in service to FirstHealth. Clara's House remains a central hub for community navigation, outreach and advocacy, hosting over 10 different support groups. Over 1,400 visits have been made to Parkinson's, Dementia, Traumatic Brain Injury, Stroke Recovery and Chronic Kidney Disease groups. Music and Art therapy as well as Centering Prayer and Book Club are still going strong after being in service more than a decade from this location. Additionally, four FirstHealth departments currently operate out of Clara's House, including FirstFutures. Nearly 500 meetings have taken place both in Shadowlawn and the House at large, requiring turning the children's playroom into a multi-purpose space to accommodate the influx of activities. Volunteers have provided more than 5,000 brownies/baked goods/healthy snacks to be deployed across FirstHealth entities as a morale booster to ultimately enhance patient care and employee satisfaction. $578,697 of the FY 2024 operating costs of Clara's House were reimbursed to FirstHealth by The Foundation of FirstHealth, Inc. Moore Free and Charitable Clinic The Moore Free and Charitable Clinic ("MFCC") is a private, volunteer-based, non-profit organization that provides primary health care services at no cost to the limited-income residents of Moore County that lack health care insurance coverage. FirstHealth provided direct financial support totaling $75,000 in fiscal 2024 to MFCC in furtherance of its mission. Patients of MFCC that required inpatient/outpatient acute care services were referred to FirstHealth Moore Regional and FirstHealth Montgomery Hospitals for care, resulting in a total of 9,471patient encounters in fiscal 2024. The $2,338,592 cost of providing these services in fiscal 2024 was absorbed by FirstHealth. |
| Form 990, Part III, Line 4a | Medical Staff Development / Physician Recruitment Assistance FirstHealth provides financial assistance to area physician practices and individual physicians for the recruitment of physicians to practice in the geographic areas served by the FirstHealth hospitals discussed previously. Under FirstHealth's Medical Staff Development Plan, recruitment assistance is appropriate to: (1) add physicians in an under-served geographic location; (2) add or enhance a service of the hospital or community; and (3) increase physician coverage where there is an existing shortage During fiscal 2024, FirstHealth participated in searches for specialists in cardiology, interventional pain, neurology, palliative care, primary care, psychiatry, hematology/oncology, OB/GYN, radiation oncology, orthopedics and URO/GYN. FirstHealth also forgave approximately $293,053 in payments made in prior years toward the recruitment of specialists to practices in FirstHealth's service area (Moore, Montgomery, Richmond, Hoke, Lee, Cumberland and Scotland counties) when the forgiveness criteria were met, and the physician had provided patient care in the community over that forgiveness period. In addition to recruitment assistance provided to the area physician practices, FirstHealth recruited a total of three (3) physicians and three (3) mid-level practitioners into its hospitalist programs in fiscal 2024. Research and Clinical Trials Initiatives FirstHealth Moore Regional Hospital, drawing on its state-of-the-art radiation oncology and medical oncology services, participates in several research and clinical trials with staff physicians. At any point in time, there were 40-45 trials open to accrual (actively enrolling new patients). The trials covered a variety of cancer types including but not limited to lung, breast, kidney, colon, prostate, and gynecology. Additionally, several cancer prevention and quality of life studies begun in prior years continued in fiscal 2024. The trials were chosen to match the population of cancer patients seen through the FirstHealth Cancer Center and provide them with the best research treatment opportunities. Providing clinical trials for cancer care is a requirement for the FirstHealth Cancer Center to maintain its ACOS Comprehensive Cancer Center designation. Outside of oncology, there are trials open in uro-gynecology, obstetrics gynecology, vascular medicine, pulmonology, medical diagnostic, and orthopedics. A total of $556,587 in external grant funding covered the operating costs of the research and clinical trials initiatives in fiscal 2024. FirstHealth Hospice & Palliative Care FirstHealth Hospice & Palliative Care provides compassionate, quality care for persons with life-limiting illnesses and support to their families. * FirstHealth Hospice cares for people who seek comfort over aggressive treatment and have an estimated six-month life expectancy. Hospice services include pain and symptom management, personal hygiene care, spiritual and volunteer services, and counseling for patients and families. Most hospice patients receive care in their homes, but patients with uncontrolled pain and other symptoms can be treated in the FirstHealth Hospice House, an 11-bed acute care facility. Grief counseling from master's level counselors is available to anyone who lost a loved one, regardless if the loved one was a FirstHealth Hospice patient. * FirstHealth Palliative Care supports people with life-impacting conditions while they seek aggressive care. Palliative care patients' life expectancy is greater than six months. Palliative care services include pain and symptom management, health care navigation, goals of care and advance directive support, counseling, and connection to community resources. People can receive palliative care in their homes, the hospital, by telehealth, or at palliative care clinics in Pinehurst and Rockingham. During fiscal 2024, FirstHealth Hospice maintained an average daily census of 168 patients in service, down from 193.6 in fiscal 2023. Competition from for-profit providers has impacted referrals. FirstHealth Palliative Care completed over 2100 new consults between inpatient and outpatient services and referred 576 patients to FirstHealth Hospice. |
| Form 990, Part VI, Line 15 | FirstHealth's Board of Directors determines compensation for the CEO through its Compensation Committee ("Committee"). The Committee is composed of Board members who are independent of FirstHealth management, have no personal interest in the compensation arrangements, are not related to or under the control of any individual whose compensation arrangement is being reviewed, have no material business relationship with FirstHealth, and are not paid for their services as a Board member. The Committee retains an independent consultant to conduct periodic compensation analyses to help ensure FirstHealth's compensation practices and compensation levels are reasonable. This consultant provides only advisory services related to compensation matters to FirstHealth. To attract and retain the highest caliber of healthcare professionals needed to sustain the quality of the healthcare FirstHealth provides to the communities that it serves, compensation must be competitive with that provided by other competing organizations in the area job market. When executive positions are filled, FirstHealth typically conducts national searches. FirstHealth benchmarks against organizations of comparable size and mission, across the region and the nation. Market data is assembled for all elements of executive compensation (i.e. cash compensation, benefits and perquisites). Compensation levels reflect the scope of the CEO's responsibilities, educational background, experience and industry standing, as well as individual and organization performance. The most recent review was performed during fiscal year 2024. A similar process to that for the CEO is affected for determining the compensation of the other corporate officers or key employees of FirstHealth (i.e. use of independent consultant, comparable industry data, etc.). The Committee reviews and approves the CEO's performance assessments and compensation recommendations for other corporate officer and key employees. All compensation decisions are made in a manner that is consistent with FirstHealth's Board-approved compensation philosophy. The most recent year review was performed during fiscal year 2024. |
| Form 990, Part VI, Line 18 | THE ORGANIZATION MAKES ITS FORM 990 AVAILABLE TO THE PUBLIC UPON REQUEST AND ON WWW.GUIDESTAR.ORG. |
| Form 990, Part VI, Line 11b Review of form 990 by governing body | FirstHealth's Form 990 is initially reviewed by qualified members of Administration, including the corporate CEO and CFO, and Compliance departments. The entire return is reviewed by the Board's Compensation Committee and the FirstHealth Board of Directors prior to filing with the IRS. FirstHealth's independent tax preparer, FORVIS MAZARS, LLP, also conducts a review of the return during their preparation process. Once the return is successfully e-filed with the IRS, a copy of the return is made available to all members of the FirstHealth Board of Directors. In addition to the posting of the FirstHealth return on GuideStar, a public inspection copy of the Form 990 is made available for review. |
| Form 990, Part VI, Line 12c Conflict of interest policy | FIRSTHEALTH STRIVES TO MAINTAIN THE HIGHEST ETHICAL STANDARDS AND HAS ADOPTED A CONFLICT OF INTEREST/DUALITY OF INTEREST POLICY THAT APPLIES TO ANY DIRECTOR, TRUSTEE, OFFICER OR MEMBER OF A BOARD COMMITTEE, OR ANY EMPLOYEE WHO HAS A DIRECT OR INDIRECT FINANCIAL INTEREST OR DUALITY OF INTEREST WITH ANY ORGANIZATION SEEKING TO DO BUSINESS WITH OR IS IN AN ACTUAL OR POTENTIAL ADVERSARIAL RELATIONSHIP WITH FIRSTHEALTH. ANY COVERED INDIVIDUAL WITH AN ACTUAL OR POSSIBLE CONFLICT MUST DISCLOSE THE EXISTENCE OF THE CONFLICT TO THE DIRECTORS, TRUSTEES AND MEMBERS OF BOARD COMMITTEES WITH BOARD-DELEGATED POWERS CONSIDERING THE PROPOSED TRANSACTION, ARRANGEMENT OR ISSUE. EACH TRUSTEE, OFFICER OR MEMBER OF A BOARD COMMITTEE WITH BOARD-DELEGATED POWERS COMPLETES AN ANNUAL CONFLICT OF INTEREST DISCLOSURE STATEMENT, AND ALL REPORTED CONFLICTS ARE REPORTED TO AND REVIEWED BY THE FIRSTHEALTH BOARD OF DIRECTORS. ALL MANAGEMENT EMPLOYEES ALSO COMPLETE ANNUAL CONFLICT OF INTEREST DISCLOSURE STATEMENTS, WHICH ARE SUMMARIZED AND REVIEWED WITH SENIOR MANAGEMENT. |
| Form 990, Part VI, Line 19 Required documents available to the public | THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. In addition, quarterly and annual financial statements are posted to the Digital Assurance Certification (DAC) website and filed with the North Carolina Medical Care Commission in accordance with existing debt covenants. |
| Form 990, Part IX, Line 11g Other Fees | PROFESSIONAL FEES - Total Expense: 60025582, Program Service Expense: 59178834, Management and General Expenses: 846748, Fundraising Expenses: ; CONTRACT LABOR - Total Expense: 30094524, Program Service Expense: 28963788, Management and General Expenses: 1130736, Fundraising Expenses: ; CONSULTANT FEES - Total Expense: 2268135, Program Service Expense: , Management and General Expenses: 2268135, Fundraising Expenses: ; PURCHASED SERVICES - Total Expense: 85693031, Program Service Expense: 56454136, Management and General Expenses: 29238895, Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; |
| Form 990, Part XI, Line 9 Other changes in net assets or fund balances | GAIN ON SWAP MARKET ADJUSTMENT - 9686946; TRANSFER OF EQUITY - -1902000; |
| Form 990, Part XII, Line 2c Change of oversight process or selection process | THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. |
| Software ID: | 23017437 |
| Software Version: | 2023v6.0 |