4A (Expenses $ 18182917 including grants of $ 50260) (Revenue $ 26276470)
THE ORGANIZATION FORMERLY KNOWN AS THE MCDOWELL HOSPITAL, INC. IS COMMITTED TO PROMOTING HEALTH IN THE COMMUNITY THROUGH DIVERSE AND INNOVATIVE PROGRAMS, DESIGNED TO REACH A BROAD-RANGE TARGET POPULATION AND CREATE THE HIGHEST IMPACT, WITH A SPECIAL EMPHASIS ON THE UNINSURED AND UNDERINSURED. THESE PROGRAMS INCLUDE SPORTS MEDICINE THROUGH THE LOCAL SCHOOL, NATIONAL CANCER SURVIVOR DAY CELEBRATION AND A QUARTERLY MAGAZINE PUBLICATION TO YOUR HEALTH. WHILE NOT AN EXHAUSTIVE LIST, THESE PROGRAMS PROVIDE AN EXAMPLE OF THE EFFORTS TO PROMOTE HEALTHY LIVING WITHIN THE COMMUNITY.

THE MCDOWELL HOSPITAL, INC.:
"PART V, SECTION B, LINE 4: CHNA Tax Year THE ORGANIZATIONS LAST CHNA WAS CONDUCTED IN TAX YEAR 2015. IN ACCORDANCE WITH IRC SECTION 501(R)(3)(D)(4), ""A HOSPITAL ORGANIZATION IS NOT REQUIRED TO MEET THE REQUIREMENTS OF SECTION 501(R)(3) WITH RESPECT TO A HOSPITAL FACILITY IN A TAXABLE YEAR IF, BEFORE THE END OF THAT TAXABLE YEAR, THE HOSPITAL ORGANIZATION TRANSFERS ALL OWNERSHIP OF THE HOSPITAL FACILITY TO ANOTHER ORGANIZATION OR OTHERWISE CEASES ITS OPERATION OF THE HOSPITAL FACILITY OR THE FACILITY CEASES TO BE LICENSED, REGISTERED, OR SIMILARLY RECOGNIZED AS A HOSPITAL BY A STATE."" DUE TO THE SALE OF THE HOSPITAL FACILITY DURING THE CURRENT 2018 TAX YEAR, THE ORGANIZATION DID NOT CONDUCT A NEW CHNA. THE MCDOWELL HOSPITAL, INC.: PART V, SECTION B, LINE 5: THE ORGANIZATION'S COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WAS CONDUCTED IN PARTNERSHIP WITH THE RUTHERFORD POLK MCDOWELL (RPM) HEALTH DISTRICT AND MCDOWELL HEALTH COALITION.THIS WRITTEN REPORT DESCRIBES: THE COMMUNITY SERVED BY THE HOSPITAL -COMMUNITY DEMOGRAPHICS -EXISTING HEALTH RESOURCES IN THE COMMUNITY AVAILABLE TO RESPOND TO NEEDS -HOW DATA WAS COLLECTED IN THE ASSESSMENT PROCESS -THE PRIORITY HEALTH NEEDS OF THE COMMUNITY -HEALTH NEEDS AND ISSUES OF UNINSURED, LOW-INCOME, AND MINORITY GROUPS -THE PROCESS FOR IDENTIFYING AND PRIORITIZING COMMUNITY NEEDS AND SERVICES TO MEET THE NEEDS -THE PROCESS FOR CONSULTING WITH PERSONS REPRESENTING THE COMMUNITY'S INTERESTS -INFORMATION GAPS THAT LIMIT THE HOSPITAL FACILITY'S ABILITY TO ASSESS THE COMMUNITY'S HEALTH NEEDS -INFORMATION GAPS THAT LIMIT THE HOSPITAL FACILITY'S ABILITY TO ASSESS THE COMMUNITY'S HEALTH NEEDS"

THE MCDOWELL HOSPITAL, INC.:
PART V, SECTION B, LINE 6A: THE ORGANIZATION'S COLLABORATIVE COMMUNITY HEALTH IMPROVEMENT EFFORT IS ALSO SUPPORTED BY A LARGER PARTNERSHIP WITH OTHER HOSPITAL FACILITIES AND HEALTH DEPARTMENT PARTNERS ACROSS A SIXTEEN COUNTY REGION IN WESTERN NORTH CAROLINA TO IMPROVE COMMUNITY HEALTH: WNC HEALTHY IMPACT. MORE INFORMATION ABOUT THIS INNOVATIVE REGIONAL COLLABORATION, COUNTY-WIDE COMMUNITY HEALTH ASSESSMENTS, AND OVERALL REGIONAL FINDINGS, ARE MADE WIDELY AVAILABLE TO THE PUBLIC AT WWW.WNCHEALTHYIMPACT.COM. THE MCDOWELL HOSPITAL, INC.: PART V, SECTION B, LINE 6B: MCDOWELL COUNTY HEALTH DEPARTMENT

THE MCDOWELL HOSPITAL, INC.:
PART V, SECTION B, LINE 7D: HTTPS://MISSIONHEALTH.ORG/ OUR-COMMITMENT-TO-YOU/ COMMUNITY-INVESTMENT/ OUR-COMMUNITYS-HEALTH-NEEDS/

THE MCDOWELL HOSPITAL, INC.:
PART V, SECTION B, LINE 11: IMPLEMENTED CAMPUS-WIDE EDUCATIONAL CAMPAIGN ABOUT TOBACCO-FREE CAMPUS POLICY, INCLUDING PERSONAL INSTRUCTION OF VISITORS, TABLE TENT NOTICES, ETC. PROVIDED SMOKING CESSATION EXHIBIT AT LOCAL COMMUNITY EVENTS,WITH HEALTHY VS. SMOKER'S LUNG GRAPHICS, INFORMATION CARDS WITH CESSATION RESOURCES, AND PROS AND CONS OF TOBACCO USE; PARTICIPATED IN MORE THAN 21 HEALTH FAIRS AND FESTIVALS. PARTNERED WITH LOCAL SCHOOLS TO STUDY THE SUSTAINABILITY OF SCHOOL-BASED HEALTH CLINIC TO EXPAND ACCESS TO HEALTHCARE FOR TEENAGERS AND HEALTH INFORMATION FOR HIGH SCHOOL STUDENTS. EXPANDED TELEMEDICINE STRATEGY FOR LOCAL SCHOOL SYSTEM, WITH ADDITIONAL ATHLETIC TRAINER ACCESS AT THE MIDDLE SCHOOL LEVEL. IMPLEMENTED CHRONIC PAIN CARE PROCESS MODEL (CPM) AT 100% OF MHM CLINICS. COMPLETED CONSTRUCTION OF GREENWAY CONNECTING THE HOSPITAL TO THE LOCAL YMCA. PARTNERED WITH CORPENING YMCA TO OFFER TAKING CONTROL OF TYPE 2 DIABETES PROGRAM, WITH SIGNIFICANT PROGRAMMATIC GROWTH SINCE 2017. SUPPORTED COMMUNITY EFFORTS TO ADDRESS ACCESS TO HEALTHY FOODS, INCLUDING FINAL PLANS TO OPEN A FOOD HUB THAT WILL OFFER FOOD, EDUCATION, AND RESOURCES TO THOSE WITH FOOD DISPARITIES; THE HOSPITAL DONATED SEVERAL KITCHEN ITEMS FOR UP-FIT OF THE FOOD HUB, INCLUDING STOVES AND STAINLESS STEEL TABLES. THERE ARE NO SIGNIFICANT NEEDS IDENTIFIED WHICH ARE NOT BEING ADDRESSED. SEE IMPLEMENTATION PLAN AT: HTTPS://MISSIONHEALTH.ORG/OUR-COMMITMENT-TO-YOU/COMMUNITY-INVESTMENT/OUR-C

THE MCDOWELL HOSPITAL, INC.:
PART V, SECTION B, LINE 15E: THE ORGANIZATION'S STAFF WORK IN COLLABORATION WITH THE PATIENT AND APPROPRIATE COMMUNITY HEALTH AND HUMAN SERVICES AGENCIES AND OTHER ORGANIZATIONS THAT ASSIST PEOPLE IN NEED OF HEALTH CARE SERVICES TO DETERMINE AVAILABLE FUNDING SOURCES. PART V, SECTION B, LINE 10A HTTPS://MISSIONHEALTH.ORG/OUR-COMMITMENT-TO-YOU/COMMUNITY-INVESTMENT/OU PART V, SECTION B, LINE 16A HTTPS://MISSIONHEALTH.ORG/WP-CONTENT/UPLOADS /2018/05/FINASSDISCOUNT_POLICY_04.PDF PART V, SECTION B, LINE 16B HTTPS://MISSIONHEALTH.ORG/WP-CONTENT/UPLOADS /2018/05/PATIENT_FINANCIAL_ASSISTANCE_PAGE.PDF PART V, SECTION B, LINE 16C HTTPS://MISSIONHEALTH.ORG/WP-CONTENT/UPLOADS /2018/03/FINASSISTPLAIN_LANGUAGE_SUMMARY_4.PDF

PART I, LINE 7:
THE ORGANIZATION USED THE NCHA ANDI REPORTS WHICH ARE BASED ON THE IRS GUIDELINES. FOR PHYSICIAN CLINICS, AS DESCRIBED IN SUBSIDIZED HEALTH SERVICES, DIRECT AND INDIRECT COSTS WERE USED. THE FINANCIALS INCLUDE ALL PATIENT SEGMENTS, INCLUDING INPATIENT, OUTPATIENT, EMERGENCY ROOM,PRIVATE INSURANCE, MEDICAID, MEDICARE, UNINSURED, AND SELF-PAY. A COST TO CHARGE RATIO WAS GENERATED USING THE IRS WORKSHEET 2 AND USED FOR ALL COMMUNITY BENEFITS REPORTED EXCEPT FOR SUBSIDIZED SERVICES WHICH USED DIRECT AND INDIRECT COSTS.

PART III, LINE 2:
THE ORGANIZATION USES A COST TO CHARGE RATIO TO ESTIMATE BAD DEBT.

PART III, LINE 3:
THE ORGANIZATION USES THE COST TO CHARGE RATIO APPLIED TO BAD DEBTS RECLASSIFIED TO CHARITY CARE AS OF THE MOST RECENT DATE AVAILABLE AFTER YEAR END.

PART III, LINE 8:
PER THE INSTRUCTIONS, THE MEDICARE COST REPORT IS THE BASIS FOR CALCULATING THE COSTS USING ALLOWABLE COSTS RELATED TO THE REVENUE REPORTED.

PART III, LINE 9B:
"PATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE AND OTHER CHARITY CARE ARE NOTIFIED USING THE PROCESS DESCRIBED IN THE EDUCATION OF PATIENTS' ELIGIBILITY IN PART VI, ON LINE 3. MISSION'S STATED POLICY WITH RESPECT TO FINANCIAL ASSISTANCE: ""MISSION HOSPITAL WILL MAKE EVERY EFFORT TO THOROUGHLY SCREEN ALL PATIENTS THAT ARE UNINSURED OR UNDERINSURED IN AN EFFORT TO IDENTIFY A SOURCE OF FINANCIAL SPONSORSHIP. ONLY AFTER A FINAL DETERMINATION IS MADE THAT THE PATIENT IS NOT ELIGIBLE FOR ANY SOURCE OF FUNDING TO COVER THE MEDICAL EXPENSES WILL THE ACCOUNT BE ELIGIBLE FOR CONSIDERATION OF FINANCIAL ASSISTANCE."" AFTER THE NOTIFICATIONS AND PROCESSES REFERENCED ABOVE HAVE BEEN COMPLETED,STANDARD DEBT COLLECTION POLICIES ARE IN EFFECT FOR THE PORTION OF THE BILL FOR WHICH THE PATIENT IS RESPONSIBLE."

PART VI, LINE 2:
"MCDOWELL COUNTY HAS A POPULATION OF 45,231 PEOPLE AND GEOGRAPHICALLY CONSISTS OF 442 SQUARE MILES LOCATED IN THE APPALACHIAN MOUNTAINS. MCDOWELL COUNTY RESIDENTS ARE 90.6% WHITE AND 9.4% NON-WHITE, COMPARED TO A NORTH CAROLINA AVERAGE OF 68.5% WHITE AND 31.5% NONWHITE. FIVE (5%) PERCENT OF THE POPULATION IDENTIFIES AS HISPANIC OR LATINO. APPROXIMATELY 70.3% OF THE POPULATION IN THIS COUNTY LIVE IN A RURAL AREA. SOME MAY EXPERIENCE TRANSPORTATION BARRIERS. UNEMPLOYMENT IS SLIGHTLY HIGHER IN MCDOWELL THAN IN THE REST OF NORTH CAROLINA, AT 5.8% IN THE COUNTY AS COMPARED TO 5.4% IN THE REST OF THE STATE. MCDOWELL COUNTY ALSO HAS A RELATIVELY LARGE ELDERLY POPULATION. MCDOWELL IS CONSISTENTLY RANKED IN THE LOWER HALF OF COUNTIES IN NORTH CAROLINA FOR HEALTH OUTCOMES: 22% OF MCDOWELL ADULTS(VS.18% OF NC RESIDENTS AND 16.9% OF US RESIDENTS OVERALL) REPORT THEY ARE IN POOR OR FAIR HEALTH; 23% ARE CURRENT SMOKERS(VS. 22% OF NC RESIDENTS AND 19.6% OF US RESIDENTS OVERALL); 33% OF ADULTS ARE OBESE (VS. 29% OF NC RESIDENTS AND 27.6% OF US RESIDENTS OVERALL); 31% OF ADULTS IN MCDOWELL COUNTY REPORT NO LEISURE TIME PHYSICAL ACTIVITY (VS. 25% OF NC RESIDENTS AND 22.9% OF US RESIDENTS OVERALL). MANY HEALTH INDICATORS IN MCDOWELL COUNTY HAVE SHOWN LITTLE IMPROVEMENT IN THE LAST THREE YEARS SINCE THE 2012 COMMUNITY HEALTH NEEDS ASSESSMENT. NOTABLE UNFAVORABLE CHANGES IN SOCIAL DETERMINANTS OF HEALTH THAT HAVE OCCURRED OVER THE PAST THREE YEARS INCLUDE: A REDUCTION IN THE MEDIAN FAMILY INCOME,AN INCREASE IN RESIDENTS LIVING BELOW THE POVERTY LEVEL AND CHILDHOOD POVERTY ALONG WITH INCREASES IN CRIME AND DOMESTIC VIOLENCE. FROM A HEALTH OUTCOMES STANDPOINT, MCDOWELL COUNTY HAS DEMONSTRATED INCREASES IN CANCER (LUNG, PROSTATE, BREAST AND COLORECTAL) ALONG WITH RATES OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) THAT ARE MORE THAN DOUBLE STATE RATES. FURTHER, THERE ARE CONTINUED HIGH RATES OF POISONING DEATHS DUE TO MEDICATION OR DRUG OVERDOSES AND CONTINUED HIGH RATES OF ADULT OBESITY. IN THE PAST THREE YEARS, AN ALARMING HIKE IN THE RATES OF CURRENT SMOKING, SMOKING DURING PREGNANCY AND USE OF E-CIGARETTES IS OF CONCERN. THE FOLLOWING SECTION DESCRIBES HOW DATA WAS OBTAINED, COMPILED AND ANALYZED IN OUR ASSESSMENT PROCESS. WNC HEALTHY IMPACT IS A PARTNERSHIP WHICH PROVIDES A COORDINATED PROCESS BETWEEN HOSPITALS AND HEALTH DEPARTMENTS IN WESTERN NORTH CAROLINA TO IMPROVE COMMUNITY HEALTH. AS PART OF A LARGER, AND CONTINUOUS, COMMUNITY HEALTH IMPROVEMENT PROCESS, THESE PARTNERS ARE COLLABORATING TO CONDUCT COMMUNITY HEALTH (NEEDS) ASSESSMENTS ACROSS WESTERN NORTH CAROLINA WWW.WNCHEALTHYIMPACT.COM. MCDOWELL HOSPITAL IS ALSO INVOLVED IN THIS REGIONAL/LOCAL VISION AND COLLABORATION. PARTICIPATING COUNTIES INCLUDE: BUNCOMBE, CHEROKEE, CLAY, GRAHAM, HAYWOOD, HENDERSON, JACKSON, MACON, MADISON, MCDOWELL, MITCHELL, POLK, RUTHERFORD, SWAIN, TRANSYLVANIA AND YANCEY. THE DATA REVIEWED AS PART OF OUR COMMUNITY'S HEALTH NEEDS ASSESSMENT CAME FROM THE WNC HEALTHY IMPACT REGIONAL CORE SET OF DATA. WNC HEALTHY IMPACT'S CORE REGIONAL DATASET INCLUDES SECONDARY (EXISTING) AND PRIMARY(NEWLY COLLECTED)DATA COMPILED TO REFLECT A COMPREHENSIVE LOOK AT HEALTH. THE FOLLOWING DATA SET ELEMENTS AND COLLECTION ARE SUPPORTED BY WNC HEALTHY IMPACT DATA CONSULTING TEAM, A SURVEY VENDOR, AND PARTNER DATA NEEDS AND INPUT: - A COMPREHENSIVE SET OF PUBLICALLY AVAILABLE SECONDARY DATA METRICS WITH OUR TARGET POPULATION COMPARED TO THE OTHER WNC REGIONS AS ""PEER"" - SET OF MAPS ACCESSED FROM COMMUNITY COMMONS AND NC CENTER FOR HEALTH STATISTICS - TELEPHONE SURVEY OF A RANDOM SAMPLE OF ADULTS IN THE COUNTY - EMAIL KEY-INFORMANT SURVEY SEE MCDOWELL COUNTY LOCAL COMMUNITY HEALTH ASSESSMENTS HTTP://WWW.RPMHD.ORG/INDEX.PHP/HEALTH-PROMOTION/COMMUNITY-HEALTH-ASSESSMEN FOR MORE DETAILS ON THE REGIONAL DATA COLLECTION METHODOLOGY. DURING THE DATA COLLECTION PROCESS, THE TEAM LOCALLY REVIEWED NC DETECT DATA AND HIGHWAY SAFETY DATA AS WELL AS PRIDE SURVEY DATA FOR 8TH GRADERS IN MCDOWELL TO LEARN MORE ABOUT SPECIFIC HEALTH CONCERNS. IN 2015, A COLLABORATION BETWEEN MCDOWELL COUNTY, UNC-CHAPEL HILL GILLINGS SCHOOL OF GLOBAL PUBLIC HEALTH AND THE CAROLINA COLLABORATIVE FOR RESEARCH ON WORK & HEALTH PRODUCED THE MCDOWELL COUNTY WORKSITE WELLNESS PROJECT REPORT. THIS REPORT PROVIDES A GREAT DEAL OF INFORMATION ABOUT CURRENT PRACTICES AT WORKSITES IN MCDOWELL AS WELL AS RECOMMENDATIONS TO IMPROVE EMPLOYEE HEALTH AND WELLNESS. THE FULL REPORT CAN BE FOUND IN THE APPENDIX A OF THE MCDOWELL COUNTY COMMUNITY NEEDS ASSESSMENT LOCATED AT HTTP://WWW.RPMHD.ORG/INDEX.PHP/HEALTH-PROMOTION/COMMUNITY-HEALTH-ASSESSMEN T"

PART VI, LINE 4:
MCDOWELL HOSPITAL IS THE ONLY HOSPITAL IN MCDOWELL COUNTY, PROVIDING SERVICES TO A COMMUNITY OF ALMOST 45,159 RESIDENTS. THERE ARE 20.1% OVER TEH AGE OF 65 AND 18.4% LIVING IN POVERTY. THE ORGIZATION'S MISSION IS TO SERVE THE HEALTHCARE NEEDS OF OUR COMMUNITY, GIVING COMPREHENSIVE, COST-EFFECTIVE QUALITY CARE WITHOUT REGARD TO RACE, COLOR, CREED OR ABILITY TO PAY. WE PROVIDE QUALITY CARE TO THE COMMUNITY OF MCDOWELL COUNTY, INCLUDING THE CITY OF MARION, AS WELL AS THE SURROUNDING COMMUNITIES OF OLD FORT, GLENWOOD, LITTLE SWITZERLAND, NEBO, PLEASANT GARDENS, AND NORTH COVE.

PART VI, LINE 5:
SEE PROGRAM SERVICE ACCOMPLISHMENTS ON PAGE 2 OF THE 990.

PART VI, LINE 3:
THE ORGANIZATION PROVIDES INFORMATION TO OUR PATIENTS REGARDING HOW TO APPLY FOR FINANCIAL ASSISTANCE/CHARITY CARE IN THE FOLLOWING WAYS: A PLAIN LANGUAGE DESCRIPTION OF THE FINANCIAL ASSISTANCE POLICY IS POSTED ON THE HOSPITAL FACILITY'S WEBSITE, ATTACHED TO BILLING INVOICES, POSTED IN THE EMERGENCY ROOMS OR WAITING ROOMS AND IN THE ADMISSIONS OFFICES. IT IS ALSO PROVIDED IN WRITING TO PATIENTS ON ADMISSION TO THE HOSPITAL FACILITY, AND UPON REQUEST. THE ORGANIZATION'S INTERNET WEBSITE AND BROCHURES CONTAIN INFORMATION ABOUT FINANCIAL ASSISTANCE THAT OFFER HELP IN OBTAINING FINANCIAL ASSISTANCE, OPTIONS FOR INSURANCE PROCESSING AND PAYMENT FOR SERVICES. IN ADDITION, ASSISTANCE IS OFFERED TO HELP IN DETERMINING IF A PATIENT QUALIFIES FOR STAGE AGENCY PROGRAMS AND MEDICAID BENEFITS AS WELL AS ASSISTANCE WITH THE APPLICATION PROCESS. THE WEBSITE AND BROCHURES EXPLAIN THAT THE HOSPITAL OFFERS DISCOUNTS BASED ON CERTAIN CRITERIA, AND NOTES THE RANGE OF DISCOUNTS AND HOW HOUSEHOLD INCOME GUIDELINES ARE USED TO DETERMINE DISCOUNT ELIGIBILITY. THE PATIENT IS DIRECTED TO CALL THE CUSTOMER SERVICE CENTER OR VISIT THE HOSPITAL'S BUSINESS OFFICE AND LISTS THE HOURS THE OFFICE AND CENTER ARE OPEN. THERE ARE ALSO MESSAGES ON PATIENT BILLS GIVING INFORMATION ON FINANCIAL ASSISTANCE AND HOW TO CONTACT THE HOSPITAL IF THEY HAVE QUESTIONS OR WANT TO APPLY.

PART VI, LINE 6:
THE MCDOWELL HOSPITAL IS PART OF AN AFFILIATED HEALTH CARE SYSTEM WITH THE RESPECTIVE ROLES OF THE ORGANIZATION AND ITS AFFILIATES DESCRIBED BELOW IN PROMOTING THE HEALTH OF THE COMMUNITIES SERVED. ANC HEALTHCARE, INC. (FKA MISSION HEALTH SYSTEM) IS THE PARENT ORGANIZATION FOR THE CHARITABLE ORGANIZATIONS OF MISSION HOSPITAL, INC.; MISSION HEALTH SYSTEM FOUNDATION, INC.; ANC MISSION MEDICAL ASSOCIATES, INC; ANC BLUE RIDGE HOSPITAL, INC.; ANC MCDOWELL HOSPITAL, INC.; ANC ANGEL MEDICAL CENTER,INC.; ANC TRANSYLVANIA COMMUNITY HOSPITAL, INC.; ANC HIGHLANDS-CASHIERS HOSPITAL, INC. AND MOUNTAIN CARE, INC. (FKA COMMUNITY CAREPARTNERS, INC.) THE SYSTEM'S MISSION IS TO OPERATE AN INTEGRATED HEALTH CARE SYSTEM FOR THE BENEFIT OF THE RESIDENTS OF WESTERN NORTH CAROLINA. MISSION HOSPITAL, INC. IS A REGIONAL INTEGRATED HEALTH FACILITY PROVIDING SUPERIOR CARE AND SERVICE TO PATIENTS AND THEIR FAMILIES THROUGH A FULL CONTINUUM OF INTEGRATED SERVICES, EDUCATION, AND RESEARCH. IT SERVES AS A TRAUMA CENTER TO PEOPLE OF WESTERN NORTH CAROLINA AND THE SURROUNDING COUNTIES. ANC MISSION MEDICAL ASSOCIATES' MISSION IS TO PROVIDE PHYSICIAN SERVICES IN PREDOMINANTLY RURAL AREAS THAT ARE INSUFFICIENTLY SERVED, THEREBY IMPROVING THE HEALTH CARE OF THE GENERAL PUBLIC. IN MANY CASES THIS INVOLVES RECRUITING AND PLACING PRIMARY CARE PHYSICIANS, AS WELL AS PEDIATRIC AND ADULT SPECIALTY SERVICES CLOSE TO WHERE PEOPLE LIVE AND WORK. ANC BLUE RIDGE HOSPITAL SERVES AS A COMMUNITY HOSPITAL IN MITCHELL, YANCEY AND SURROUNDING COUNTIES. ANC MCDOWELL HOSPITAL SERVES AS A COMMUNITY HOSPITAL IN MCDOWELL AND THE SURROUNDING COUNTIES. MISSION HEALTH SYSTEM FOUNDATION, INC. SUPPORTS THE MISSION AND PROGRAMS OF MISSION HOSPITAL, INC. AND ANC HEALTHCARE, INC. (MISSION HEALTH SYSTEM, INC.) AND OTHER ORGANIZATIONS THAT ARE TAX EXEMPT UNDER THE PROVISIONS OF SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND WORKS TO BENEFIT THE COMMUNITY AND REGION SERVED BY THE ENTITIES LISTED ABOVE. ANC ANGEL MEDICAL CENTER, INC. SERVES AS A COMMUNITY HOSPITAL IN MACON AND SURROUNDING COUNTIES. ANC TRANSYLVANIA COMMUNITY HOSPITAL, INC. SERVES AS A COMMUNITY HOSPITAL IN TRANSYLVANIA AND SURROUNDING COUNTIES. ANC HIGHLANDS-CASHIERS HOSPITAL, INC. SERVES AS A COMMUNITY HOSPITAL FOR JACKSON AND MACON AND SURROUNDING COUNTIES. MOUNTAINCARE, INC. OPERATES AN INPATIENT FACILITY FOR ACUTE REHABILITATION LOCATED IN ASHEVILLE, NORTH CAROLINA, AND PROVIDES A WIDE VARIETY OF POST-ACUTE CARE SERVICES TO RESIDENTS OF WESTERN NORTH CAROLINA, INCLUDING REHABILITATION, HOME HEALTH, ADULT CARE, AND HOSPICE AND PALLIATIVE CARE. MSJHS AND CCP JOINT DEVELOPMENT COMPANY DBA ASHEVILLE SPECIALTY HOSPITAL OPERATES AN INPATIENT FACILITY FOR LONG-TERM ACUTE CARE. PART VI, LINE 7, LIST OF STATES RECEIVING COMMUNITY BENEFIT REPORT: NC