| Form 990, page 5, line 1a |
The Organization's payments which would otherwise be reported on forms 1099 are paid and reported to the IRS on form 1096 by the Organization's parent organization Mission Health System, Inc., however the expenses related to those payments are recorded on the financial statements of the Organization to which they relate. Therefore, there are professional services reported on page 8, but not 1099's filed by the Organization. |
| Form 990, Part VI, Section A, line 6 |
Mission Health System, Inc, a 501(c)(3) is the parent company of Mission Hospital, Inc. It is the sole member of Mission Hospital, Inc. |
| Form 990, Part VI, Section A, line 7a |
Mission Health System, the sole member of Mission Hospital, Inc has reserved powers relating to the governing body of Mission Hospital as follows: Appointment of members of the Board of Directors of the Hospital, including the power to fill any vacancies on the Hospital Board of Directors. Removal, with or without cause, and at any time, of members of the Board of Directors of the Hospital. Appointment and/or removal of the President of the Hospital. |
| Form 990, Part VI, Section A, line 7b |
Mission Health System as sole member of Mission Hospital has reserve powers as follows: Approval of any plan of dissolution, consolidation or merger of the Hospital. Approval of the acquisition, purchase, sale or disposition of assets of the Hospital with a value in excess of $5,000,000. Approval of the incurrence of long-term debt. Development and implementation of strategies for contracting with managed care providers and other payors, including the development of a physician-hospital organization. Approval of strategic and financial plans of the Hospital. Approval of capital and operating budgets of the Hospital. Approval of any material expansion or elimination of any clinical service or non-clinical service at the Hospital. |
| Form 990, Part VI, Section B, line 11b |
Form 990 is prepared by the tax finance staff at Mission Health System. Form 990 is reviewed by the organization's senior leadership team. An outside accounting firm is engaged to review and sign the 990 for final filing with the IRS. A draft of the 990 is provided to the Mission Health System board of directors for review. Highlights of the 990 are presented to the board and they have the opportunity to ask questions and suggest improvements or provide corrections. If there are changes as a result of board review, a corrected Form 990 will be provided for final approval before filing. After final approval, the final Form 990 is provided to the board before filing with the IRS. |
| Form 990, Part VI, Section B, line 12c |
The Organization's Conflict of Interest Policy is reviewed and updated annually. Education about the policy and the responsibilities of a board member including conflicts of interest is provided during orientation for new board members. Board meetings begin with a comment summarizing the conflict of interest policy and the duty to disclose conflicts. If a conflict of interest is identified, the interested person does not participate in any decision relating to the transaction issue. A conflict of interest is a particular relationship or arrangement that would reasonably be expected to exert an influence on the individual's judgment and preclude the individual from being an Independent Director or being independent with respect to the transaction under consideration. In addition to board members, the organization's conflict of interest policy applies to members of senior leadership, medical staff, clinical service line leaders, elected medical staff leaders, departmental directors, staff members working in the purchasing department, and all other staff members with purchasing authority, as well as immediate family members of such interested persons and entities in which interested persons have a material financial interest. The organization's policy is for all interested persons to disclose any and all conflicts of interest in accordance with the IRS guidelines for tax-exempt entities as well as any other applicable state or federal law. Upon initial assumption of duties, interested persons are provided with a copy of the conflict of interest policy and submit a conflict of interest disclosure statement. Thereafter, the statements will be completed annually. Periodically all staff members are asked to complete a conflict of interest disclosure statement. Internal and external auditors, General Counsel or outside counsel will periodically conduct a review of the disclosure process to determine whether the organization is in compliance with the policy. |
| Form 990, Part VI, Section B, line 15 |
The Organization draws wage comparison data from outside executive compensation consultants to ensure compensation levels are at fair market value. The Human Resources and Compensation Committee (Committee) reviews this data and recommends to the Board any revisions to the overall philosophy and policy to guide the determination of compensation and benefit packages for executives which includes the CEO, the CFO, and President as well as all other executives, which would include all key employees. The Committee keeps and distributes minutes of all its meetings to its members. Items of a sensitive nature are referenced in the minutes with detailed, supporting documentation retained on file. The Committee also discloses any potential conflicts of interest situations to the Committee Chairman that may affect their independent directors' status as soon as they arise, and maintains complete documentation of all matters discussed by the Committee. The Committee obtains education and training to exercise all responsibilities effectively and keeps abreast of significant developments in executive compensation practices and regulations, and ensures that all aspects of Mission Health System and Hospital executive compensation adhere to all relevant regulatory requirements, and reviews the Committee charter annually revising as appropriate and conducts an annual evaluation of the Committee's performance. |
| Form 990, Part VI, Section C, line 19 |
Mission Hospital prepares an annual report to the community and makes its significant accomplishments available through this report on the Mission Hospital website. Audited Financials are attached to the 990. The articles of incorporation are available to the public through the North Carolina Secretary of State website. Conflict of interest policy and by-laws are available upon request. |
| Form 990, Part IX, line 11g |
Other Purchased Services: Program service expenses 57,793,144. Management and general expenses 6,421,460. Fundraising expenses 0. Total expenses 64,214,604. Medical Purchased Services: Program service expenses 118,924,257. Management and general expenses 0. Fundraising expenses 0. Total expenses 118,924,257. |
Attach to Form 990 or 990-EZ.