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Nonprofiteer
← CAROMONT HEALTH SERVICES INC

Form 990 for tax year 2022

Filed by CAROMONT HEALTH SERVICES INC.

Totals

Total revenue
$19,864,973
Total expenses
$17,352,681
Contributions and grants received
$0
Grants paid
$0
Program service revenue
$19,863,320
Investment income
$4
Other revenue
$1,649
Total assets, end of year
$8,619,956
Total liabilities, end of year
$997,655
Net assets or fund balances, end of year
$7,622,301
Program services expenses (Part IX)
$15,885,875
Management and general expenses
$1,466,806
Fundraising expenses
$0
Program service expenses (Part III)
$15,885,875

Program services were 91.5% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Line items

Every line the filer filed in Parts VIII, IX and X, as filed and in filed order. Blank columns are left out, and the lines are not forced to add up to the totals above.

Revenue

Part VIII, the statement of revenue.

  • 2a · Program service revenue: OUTPATIENT SERVICES

    total $19,863,320 · related or exempt $19,863,320

  • 3 · Investment income

    total $4 · excluded $4

  • 11a · Other revenue: CAFETERIA

    total $1,640 · excluded $1,640

  • 11b · Other revenue: MISCELLANEOUS

    total $9 · excluded $9

  • 11e · Other revenue, total

    $1,649

Functional expenses

Part IX, the statement of functional expenses.

  • 7 · Other salaries and wages

    total $8,235,190 · program services $7,148,897 · management and general $1,086,293

  • 8 · Pension plan contributions

    total $256,539 · program services $222,699 · management and general $33,840

  • 9 · Other employee benefits

    total $1,192,245 · program services $1,034,978 · management and general $157,267

  • 10 · Payroll taxes

    total $543,480 · program services $471,790 · management and general $71,690

  • 11g · Fees: other

    total $2,164,024 · program services $2,146,669 · management and general $17,355

  • 13 · Office expenses

    total $130,090 · program services $107,164 · management and general $22,926

  • 14 · Information technology

    total $823 · management and general $823

  • 16 · Occupancy

    total $486,488 · program services $486,097 · management and general $391

  • 17 · Travel

    total $59,386 · program services $55,035 · management and general $4,351

  • 19 · Conferences, conventions and meetings

    total $1,892 · management and general $1,892

  • 20 · Interest

    total $1,509 · management and general $1,509

  • 22 · Depreciation, depletion and amortization

    total $959,438 · program services $959,438

  • 23 · Insurance

    total $64,519 · program services $13,979 · management and general $50,540

  • 24a · Other expenses: MEDICAL SUPPLIES

    total $3,296,660 · program services $3,296,660

  • 24b · Other expenses: EQUIPMENT RENTAL & MAIN

    total $145,847 · program services $145,809 · management and general $38

  • 24c · Other expenses: MISCELLANEOUS

    total $15,164 · program services $9,644 · management and general $5,520

  • 24d · Other expenses: RECRUITING

    total $12,371 · management and general $12,371

  • 24e · All other expenses

    total -$212,984 · program services -$212,984

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    beginning of year $3,599 · end of year $5,095

  • 4 · Accounts receivable

    beginning of year $872,358 · end of year $791,475

  • 8 · Inventories for sale or use

    beginning of year $206,900 · end of year $210,226

  • 10a · Land, buildings and equipment: cost or other basis

    $29,176,234

  • 10b · Land, buildings and equipment: accumulated depreciation

    $21,625,188

  • 10c · Land, buildings and equipment, net

    beginning of year $8,342,054 · end of year $7,551,046

  • 15 · Other assets

    beginning of year $58,101 · end of year $62,114

  • 17 · Accounts payable and accrued expenses

    beginning of year $734,621 · end of year $998,031

  • 25 · Other liabilities

    beginning of year -$376 · end of year -$376

  • 27 · Net assets without donor restrictions

    beginning of year $8,748,767 · end of year $7,622,301

Mission and programs · 2022

Mission

TO PROVIDE COMPASSIONATE, EXCEPTIONAL AND HIGHLY RELIABLE CARE.

  • SEE SCHEDULE O.CAROMONT HEALTH IS A NOT-FOR-PROFIT HEALTH SYSTEM HEADQUARTERED IN GASTONIA, NC THAT PROVIDES INPATIENT AND OUTPATIENT MEDICAL SERVICES WITHIN FIVE COUNTIES AND TWO STATES. ANCHORED BY THE 476-BED, ACUTE CARE HOSPITAL, CAROMONT REGIONAL MEDICAL CENTER, THE HEALTH SYSTEM EMPLOYS NEARLY 4,500 HEALTHCARE PROFESSIONALS WITH A MEDICAL STAFF MEMBERSHIP OF MORE THAN 450.CAROMONT HEALTH SERVICES OWNS AND OPERATES CAROMONT SPECIALTY SURGERY, COURTLAND TERRACE AND CAROMONT ENDOSCOPY CENTER.CAROMONT SPECIALTY SURGERY IS A FREE-STANDING AMBULATORY SURGERY CENTER ON THE CAMPUS OF CAROMONT REGIONAL MEDICAL CENTER, WHICH PERFORMS OPHTHALMOLOGY, ENT, COSMETIC AND ORTHOPEDIC SURGICAL PROCEDURES. IN FISCAL YEAR 2023, THE CENTER PERFORMED APPROXIMATELY 4,160 SURGICAL PROCEDURES. COURTLAND TERRACE IS A SKILLED NURSING FACILITY LICENSED FOR 77 SKILLED NURSING BEDS AND 19 ASSISTED LIVING BEDS. SKILLED NURSING SERVICES PROVIDED AT COURTLAND TERRACE INCLUDE SHORT-TERM REHABILITATION, ALZHEIMER'S' SPECIAL CARE AND LONG-TERM CARE. IN FISCAL YEAR 2023, THE NURSING HOME PROVIDED CARE TO AN AVERAGE OF 84 PATIENTS EACH DAY. CAROMONT ENDOSCOPY CENTER IS A FREE-STANDING OUTPATIENT ENDOSCOPY CENTER, LOCATED IN BELMONT AND OPENED IN 2012. CAROMONT ENDOSCOPY CENTER PROVIDES OUTPATIENT ENDOSCOPIC PROCEDURES FOR UPPER ENDOSCOPY AND SCREENING COLONOSCOPY. IN FISCAL YEAR 2023, THE CENTER PERFORMED 5,789 PROCEDURES.

    Expenses $15,885,875 · Revenue $19,863,320

As filed on the 2022 return. The filer continues this part on Schedule O, which is not shown here.

Listed in Part VII

  • Rev Pearl Burris-Floyd

    CHAIR

    Total calculated
    $119,248
    From this org
    $0
    From related orgs
    $119,248
    Other
    $0
    Hours/week
    1 + 1 related

  • Ms Janie Peak

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • Mr Bob Hovis

    DIRECTOR

    Total calculated
    $30,589
    From this org
    $0
    From related orgs
    $30,589
    Other
    $0
    Hours/week
    1 + 2 related

  • Mr K Christopher Peek

    CEO

    Total calculated
    $1,844,813
    From this org
    $0
    From related orgs
    $1,558,081
    Other
    $286,732
    Hours/week
    1 + 54 related

    Schedule J breakdown matched by us

    Base
    $0 + $948,458 related
    Bonus
    $0 + $411,971 related
    Other
    $0 + $197,652 related
    Deferred
    $0 + $263,009 related
    Nontaxable benefits
    $0 + $23,723 related
    Filer's total
    $0 + $1,844,813 related

  • Mr David O'Connor

    EVP/CFO/ASST. TREASURER

    Total calculated
    $1,058,707
    From this org
    $0
    From related orgs
    $884,243
    Other
    $174,464
    Hours/week
    1 + 54 related

    Schedule J breakdown matched by us

    Base
    $0 + $580,745 related
    Bonus
    $0 + $194,511 related
    Other
    $0 + $108,987 related
    Deferred
    $0 + $150,741 related
    Nontaxable benefits
    $0 + $23,723 related
    Filer's total
    $0 + $1,058,707 related

  • Ms Leigh Hickman

    CLO/ASST. SEC.

    Total calculated
    $568,958
    From this org
    $0
    From related orgs
    $465,494
    Other
    $103,464
    Hours/week
    1 + 54 related

    Schedule J breakdown matched by us

    Base
    $0 + $362,901 related
    Bonus
    $0 + $101,731 related
    Other
    $0 + $862 related
    Deferred
    $0 + $87,394 related
    Nontaxable benefits
    $0 + $16,070 related
    Filer's total
    $0 + $568,958 related

  • Ms Melva Ramirez

    CNA II COURTLAND

    Total calculated
    $181,291
    From this org
    $150,317
    From related orgs
    $0
    Other
    $30,974
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $144,367
    Bonus
    $5,950
    Other
    $0
    Deferred
    $20,195
    Nontaxable benefits
    $10,779
    Filer's total
    $181,291

  • Ms Jessica Williams

    ASSISTANT CLINICAL MANAGER

    Total calculated
    $126,929
    From this org
    $111,278
    From related orgs
    $0
    Other
    $15,651
    Hours/week
    40

  • Ms Aimee Callahan

    LPN

    Total calculated
    $120,849
    From this org
    $114,637
    From related orgs
    $0
    Other
    $6,212
    Hours/week
    40

  • Ms Kimberly Long

    ADMINISTRATOR

    Total calculated
    $118,006
    From this org
    $107,435
    From related orgs
    $0
    Other
    $10,571
    Hours/week
    40

  • Ms Comfort Hodasi

    CNA I COURTLAND

    Total calculated
    $136,466
    From this org
    $108,877
    From related orgs
    $0
    Other
    $27,589
    Hours/week
    40

Compensation is as filed in Part VII: reportable pay from this organization and from related organizations, other compensation, and hours per week. The total, marked calculated, is our sum of the three dollar columns, with a blank column counted as $0; the form itself has no total. On a Form 990-EZ the columns are Part IV's instead, and on a Form 990-PF Part VIII's — compensation, contributions to benefit plans, and expense account — and the total sums those. A Schedule J breakdown is as filed: base pay, bonus, other, deferred compensation and nontaxable benefits from this organization, with any from related organizations beside each, and the filer's own total. It is shown with the Part VII listing of the same name on the same return. The form gives no key between the two, so that pairing is ours, and is marked matched by us.

Schedule J

Answered yes

  • 4b · Supplemental nonqualified retirement plan
  • 6a · Pay contingent on this organization's net earnings
  • 6b · Pay contingent on a related organization's net earnings

Answered no

  • 4a · Severance or change-of-control payment
  • 4c · Equity-based compensation arrangement
  • 5a · Pay contingent on this organization's revenues
  • 5b · Pay contingent on a related organization's revenues
  • 7 · Other non-fixed payments
  • 8 · Paid under the initial-contract exception

The filer's explanations (Part III)

PART I, LINE 3
COMPENSATION PAID TO CEO OF CAROMONT HEALTH, INC. WAS PAID BY CAROMONT REGIONAL MEDICAL CENTER, A RELATED ORGANIZATION. CAROMONT REGIONAL MEDICAL CENTER UTILIZED THE FOLLOWING METHODS TO DETERMINE APPROPRIATE COMPENSATION FOR CEO THAT HAD INFLUENCE OVER THE ORGANIZATION'S ACTIVITIES: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - WRITTEN EMPLOYMENT CONTRACTS - COMPENSATION SURVEY OR STUDY - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE
PART I, LINE 4B
THE FOLLOWING INDIVIDUALS RECEIVED DEFERRED COMPENSATION ALLOCATIONS BY RELATED ORGANIZATION CAROMONT REGIONAL MEDICAL CENTER FROM A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP): DAVID O'CONNOR - $ 111,541 K. CHRISTOPHER PEEK - $ 223,809 LEIGH HICKMAN - $ 55,268
PART I, LINE 6
THE EXECUTIVE INCENTIVE COMPENSATION PLAN FOR ALL KEY EMPLOYEES IS BASED ON THE ACHIEVEMENT OF ANNUAL BUSINESS OBJECTIVES WHICH INCLUDE A FINANCIAL GOAL ATTRIBUTABLE TO OPERATING MARGIN. THE MANAGER INCENTIVE PLAN IS BASED ON CONSOLIDATED CORPORATE AND INDIVIDUAL PERFORMANCE GOALS.

Part I's answers as filed. A line not listed was left unanswered; on lines 1a and 3 that means the box was not checked.

Grants on this return

No itemized grants to organizations on this return.

Related organizations on this return

Schedule R Part II: tax-exempt organizations related to the filer by control. It does not record shared board members or money.

Provenance

Return type
form_990
Tax year
2022
Filed
29 April 2024
IRS schema version
2022v5.0
Source object
202441209349300639

Check it against the return as filed: the GivingTuesday Data Lake hosts a public copy of the original XML.

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