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
2014
Open to Public
Inspection
Name of the organization
Mission Hospital Inc
 
Employer identification number
56-0532141
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 Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on 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 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
(1) Asheville Buncombe Community Christian Ministry
155 Livingston St
Asheville,NC28801 		56-1987021 501(c)(3) 430,000       Support for Access to Primary and Mental Care - laboratory and other clinical services at the free clinic.
(2) All Souls Counseling Ctr
9 Swan Street
Asheville,NC28803 		56-2200862 501(c)(3) 100,000       Support for Access to Primary and Mental Health Care - mental health counseling for uninsured, underinsured and homebound individuals.
(3) Council on Aging
1617 Hendersonville Road
Asheville,NC28803 		23-7410586 501(c)(3) 30,000       Support for Access to Primary and Mental Health Care - care management for 60 and older population after hospital discharge.
(4) Community Care of WNC
53 S French Broad Suite 300
Asheville,NC28801 		56-2097503 501(c)(3) 45,000       Support for Access to Primary and Mental Health Care - coordination for patients who are high utilizers in emergency care department.
(5) MAHEC
121 Hendersonville Road
Asheville,NC28803 		56-1071426 501(c)(3) 150,000       Support for Access to Primary and Mental Health Care - homeless outreach program.
(6) Memory Care
100 Far Horizons Lane
Asheville,NC28803 		56-2178294 501(c)(3) 55,000       Support for Access to Primary and Mental Health Care - for older adults with cognitive impairment as well as support for caregivers.
(7) Buncombe County Health Department
35 Woodfin St
Asheville,NC28801 		56-6000279 Buncombe County 175,000       Support for Children's Health and School Readiness - through Buncombe County's school health programs.
(8) Pisgah Legal Services
89 Montford Avenue
Asheville,NC28802 		56-1191115 501(c)(3) 160,000       Support for Women's Preconception Health- health education and legal support
(9) YWCA
185 South French Broad Avenue
Asheville,NC28801 		56-0547476 501(c)(3) 38,000       Support for Healthy Weight and Healthy Living/Chronic Disease Prevention and Treatment programs - for diabetes, wellness and prevention programs for low-wealth persons.
(10) Manna Food Bank
627 Swannanoa River Road
Asheville,NC28805 		58-1514800 501(c)(3) 25,000       Support for Children's Health and School Readiness programs - through weekend backpacks of food for children who qualify for free lunch.
(11) YMCA
53 Ashland Avenue Suite 105
Asheville,NC28801 		56-0530013 501(c)(3) 125,000       Support for Healthy Weight and Healthy Living/Chronic Disease Prevention and Treatment programs - providing access to diabetes prevention programs and for capital commitment to Swain County camp medical facility.
(12) Western Carolina University
230 HFR Admin Building
Cullowhee,NC28723 		24-5150850 Governmental 50,000       Assistance to nonprofit for nursing education scholarship programs.
(13) Homeward Bound of Asheville
35 Grove St
Asheville,NC28801 		56-1560917 501(c)(3) 100,000       Support for Access to Primary and Mental Health Care and Women's Preconception Health programs - moving most vulnerable chronically homeless into housing and for provision of case management.
(14) Child Abuse Prevention Services Inc
50 S FrenchBroadAve Ste 152
Asheville,NC28801 		58-1828408 501(c)(3) 30,000       Support Access to Primary and Mental Health Care programs - for services for crisis intervention, counseling for child survivors of abuse and their families.
(15) Caring for Children Inc
PO Box 19113
Asheville,NC28115 		56-1182686 501(c)(3) 15,000       Support for Access to Primary and Mental Health Care programs - outpatient psychotherapy and psychiatric services for children and families in Buncombe and Madison counties.
(16) Children First of Buncombe County
50 S FrenchBroadAve Ste 246
Asheville,NC28801 		59-1721943 501(c)(3) 10,000       Support for programs for Children's Health and School Readiness.
(17) Haywood Street Congregation
PO Box 2982
ASheville,NC28802 		45-5301549 501(c)(3) 30,000       Support for Access to Primary and Mental Health Care programs - respite care for homeless adults following hospital discharge.
(18) The Madison County Health Department
140 Health Care Lane
Marshall,NC28753 		56-6000316 Governmental 25,000       Support for Healthy Weight and Healthy Living/Chronic Disease Prevention and Treatment programs - tobacco prevention, education and treatment targeting pregnant women and their families.
(19) Verner Center for Early Education
Family Center Inc 2586 Riceville Rd
Rd
Asheville,NC28805 		56-2040462 501(c)(3) 15,000       Support for Children's Health and School Readiness programs - Rainbow in my Tummy program to improve children's healthy eating.
(20) Community Foundation of WNC
4 Vanderbilt Park Drive Suite 300
Asheville,NC28803 		56-1223384 501(c)(3) 25,000       Support for Local NonProfit for charitable programs.
(21) Smoky Mountain LMEMCO
44 Bonnie Lane
Sylva,NC28779 		56-1012965 501(c)(3) 500,000       Support for Access to Behavioral Health Programs.
(22) UNCA Foundation
Owen Hall CPO 1800 1 University
Heights
Asheville,NC28804 		56-6002370 501(c)(3) 25,000       Support for Healthy Living programs - promote healthy congregational living in African-American churches.
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
22
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
0
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2014
Page 2

Schedule I (Form 990) 2014
Page 2
Part III
Grants and Other Assistance to Domestic Individuals. 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)
(2)
(3)
(4)
(5)
(6)
(7)
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 Hospital donates funds to various local and national non-profits in furtherance of its charitable mission. For grants to organizations, Mission makes grants to governmental and 501(c)(3) entities. These entities have demonstrated their mission through their qualification as exempt organizations. A special committee reviews grant requests received through the application process and allocates donations each year.
Schedule I (Form 990) 2014



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