Civic Intelligence

Appalachian Regional Healthcare System

EIN 20-1067022 • 501(c)3 • Boone, NC

Profile

To support the provision of high quality, compassionate healthcare for the mountain region of northwest carolina, northeast tennessee with a spirit of teamwork based on a set of operating values.

PO Box 2600Boone, NC 28607-2600

www.apprhs.org

Siviq Scores

Precomputed percentiles relative to similar nonprofits. These scores are descriptive rather than judgmental.

Liabilities / Assets

96th percentile

1.13x

Higher debt load relative to assets than 96% of similar nonprofits.

501(c)3 • $25M-$50M nonprofits • Source year 2024

Liabilities / Revenue

99th percentile

31.06x

Higher debt load relative to revenue than 99% of similar nonprofits.

501(c)3 • $25M-$50M nonprofits • Source year 2024

Net Margin

1st percentile

-5387%

Higher net margin than 1% of similar nonprofits.

501(c)3 • $25M-$50M nonprofits • Source year 2024

Top Officer Pay

97th percentile

$1,690,056

Higher top officer pay than 97% of similar nonprofits.

Top officer pay equals 136.2% of source-year revenue.

501(c)3 • $25M-$50M nonprofits • Source year 2024

Asset Growth

84th percentile

20%

Faster asset growth than 84% of similar nonprofits.

501(c)3 • $25M-$50M nonprofits • Annualized from 2023 to 2024

Revenue Growth

1st percentile

-96%

Faster revenue growth than 1% of similar nonprofits.

501(c)3 • $25M-$50M nonprofits • Annualized from 2023 to 2024

Assets

Up

$33,985,070

Up $5,683,520 (+20%) from 2023

Liabilities

Up

$38,551,196

Up $5,684,840 (+17%) from 2023

Net Assets

Down

-$4,566,126

Down $1,320 (-0.0%) from 2023

Revenue

Down

$1,241,276

Down $34,127,364 (-96%) from 2023

Expenses

Up

$68,103,139

Up $32,735,728 (+93%) from 2023

Net Income

Down

-$66,861,863

Down $66,863,092 (-5440447%) from 2023

Trend Graphs

Balance Sheet Trend

Grouped bars show assets, liabilities, and net assets across loaded filings.

$60M$40M$20M$0-$20MAssets 2011: $10,363,480Liabilities 2011: $15,685,871Net Assets 2011: -$5,322,3912011Assets 2012: $9,113,135Liabilities 2012: $14,435,526Net Assets 2012: -$5,322,3912012Assets 2013: $14,104,198Liabilities 2013: $19,426,586Net Assets 2013: -$5,322,3882013Assets 2014: $19,278,784Liabilities 2014: $21,140,624Net Assets 2014: -$1,861,8402014Assets 2015: $32,439,908Liabilities 2015: $30,356,799Net Assets 2015: $2,083,1092015Assets 2016: $42,757,903Liabilities 2016: $40,248,624Net Assets 2016: $2,509,2792016Assets 2017: $43,313,115Liabilities 2017: $40,159,748Net Assets 2017: $3,153,3672017Assets 2018: $45,976,464Liabilities 2018: $42,939,953Net Assets 2018: $3,036,5112018Assets 2019: $24,713,711Liabilities 2019: $30,036,100Net Assets 2019: -$5,322,3892019Assets 2020: $24,084,829Liabilities 2020: $29,407,217Net Assets 2020: -$5,322,3882020Assets 2021: $23,857,588Liabilities 2021: $28,809,622Net Assets 2021: -$4,952,0342021Assets 2022: $32,855,284Liabilities 2022: $37,421,319Net Assets 2022: -$4,566,0352022Assets 2023: $28,301,550Liabilities 2023: $32,866,356Net Assets 2023: -$4,564,8062023Assets 2024: $33,985,070Liabilities 2024: $38,551,196Net Assets 2024: -$4,566,1262024

Highlighted filing

2024

Assets$33,985,070
Liabilities$38,551,196
Net Assets-$4,566,126

Operations Trend

Revenue, expenses, and net income by year, with the latest filing highlighted.

$100M$50M$0-$50M-$100MExpenses 2011: $26,461,4712011Expenses 2012: $29,180,5842012Expenses 2013: $32,783,0462013Revenue 2014: $37,352,450Expenses 2014: $36,456,582Net Income 2014: $895,8682014Revenue 2015: $39,553,394Expenses 2015: $37,412,491Net Income 2015: $2,140,9032015Revenue 2016: $37,496,934Expenses 2016: $35,045,026Net Income 2016: $2,451,9082016Revenue 2017: $39,056,614Expenses 2017: $38,348,353Net Income 2017: $708,2612017Revenue 2018: $27,058,730Expenses 2018: $27,665,147Net Income 2018: -$606,4172018Revenue 2019: $20,595,985Expenses 2019: $28,949,349Net Income 2019: -$8,353,3642019Revenue 2020: $29,997,837Expenses 2020: $29,997,837Net Income 2020: $02020Revenue 2021: $47,007,711Expenses 2021: $47,007,709Net Income 2021: $22021Revenue 2022: $50,710,259Expenses 2022: $50,320,103Net Income 2022: $390,1562022Revenue 2023: $35,368,640Expenses 2023: $35,367,411Net Income 2023: $1,2292023Revenue 2024: $1,241,276Expenses 2024: $68,103,139Net Income 2024: -$66,861,8632024

Highlighted filing

2024

Revenue$1,241,276
Expenses$68,103,139
Net Income-$66,861,863

Filings

Balance SheetOperations
YearAssetsLiabilitiesNet AssetsRevenueExpensesNet Income
2024Facts available. Structured filing facts are available, but richer extracted sections are limited.$34.0$38.6$4.57$1.24$68.1$66.9
2023Summary only. Only limited summary data is available for this year.$28.3$32.9$4.56$35.4$35.4$0.00
2022Facts available. Structured filing facts are available, but richer extracted sections are limited.$32.9$37.4$4.57$50.7$50.3$0.39
2021Facts available. Structured filing facts are available, but richer extracted sections are limited.$23.9$28.8$4.95$47.0$47.0$0.00
2020XML pending. An XML filing is linked for this year, but detailed extraction is still pending.$24.1$29.4$5.32$30.0$30.0$0.00
2019Facts available. Structured filing facts are available, but richer extracted sections are limited.$24.7$30.0$5.32$20.6$28.9$8.35
2018Summary only. Only limited summary data is available for this year.$46.0$42.9$3.04$27.1$27.7$0.61
2017Facts available. Structured filing facts are available, but richer extracted sections are limited.$43.3$40.2$3.15$39.1$38.3$0.71
2016Detailed filing. Detailed filing data is available for this year.$42.8$40.2$2.51$37.5$35.0$2.45
2015Detailed filing. Detailed filing data is available for this year.$32.4$30.4$2.08$39.6$37.4$2.14
2014Detailed filing. Detailed filing data is available for this year.$19.3$21.1$1.86$37.4$36.5$0.90
2013Facts available. Structured filing facts are available, but richer extracted sections are limited.$14.1$19.4$5.32$32.8
2012Facts available. Structured filing facts are available, but richer extracted sections are limited.$9.11$14.4$5.32$29.2
2011Facts available. Structured filing facts are available, but richer extracted sections are limited.$10.4$15.7$5.32$26.5
Latest Filing Detail
Jump To
Filing Snapshot
Filing Period
Jul 1, 2023 to Jun 30, 2024
Signed
Sep 23, 2025
Return Version
2023v6.0
Gross Receipts
$1,241,276
Mission and Program Overview

Mission

To support the provision of high quality, compassionate healthcare for the mountain region of northwest carolina, northeast tennessee with a spirit of teamwork based on a set of operating values.

To provide, coordinate, and support the delivery of healthcare and healthcare-related services.

Balance Sheet Detail
LineBeginningEndChange
Assets
Prepaid Expenses and Deferred Charges$483,743$18,584,565▲ $18,100,822
Land, Buildings, and Equipment, Net$23,727,041$10,840,347▼ $12,886,694
Savings and Temporary Cash Investments$1,566,112$3,097,776▲ $1,531,664
Investments in Publicly Traded Securities$669,718$279,419▼ $390,299
Cash and Non-Interest-Bearing Accounts$20,217$26,781▲ $6,564
Accounts Receivable$0$0→ $0
Other Notes and Loans Receivable, Net$0$0→ $0
Pledges and Grants Receivable$0$0→ $0
Receivable From Disqualified Prsn$0$0→ $0
Receivables From Officers Etc$0$0→ $0
Investments Other Securities$0$0→ $0
Investments Program Related$0$0→ $0
Intangible Assets$0$0→ $0
Inventories for Sale or Use$0$0→ $0
Loans From Officers Directors$0$0→ $0
Total Assets$28,301,550$33,985,070▲ $5,683,520
Other Assets Total$1,834,719$1,156,182▼ $678,537
Liabilities
Accounts Payable and Accrued Expenses$9,281,119$28,287,751▲ $19,006,632
Mortgage Notes Payable Secured by Investment Property$6,580,772$5,913,559▼ $667,213
Other Liabilities$17,004,465$4,349,886▼ $12,654,579
Grants Payable$0$0→ $0
Unsecured Notes Loans Payable$0$0→ $0
Deferred Revenue$0$0→ $0
Escrow Account Liability$0$0→ $0
Tax Exempt Bond Liabilities$0$0→ $0
Total Liabilities$32,866,356$38,551,196▲ $5,684,840
Net Assets / Fund Balance
Net Assets With Donor Restrictions$0$0→ $0
Net Assets Without Donor Restrictions$-4,564,806$-4,566,126▼ $1,320
Total Net Assets Fund Balance$-4,564,806$-4,566,126▼ $1,320
Total Liabilities and Net Assets / Fund Balance$28,301,550$33,985,070▲ $5,683,520

Asset Categories

AssetBook ValueDepreciationBasis
Equipment$1,601,535$27,596,128$29,197,663
Land$9,125,815-$9,125,815
Other Land Buildings$112,997-$112,997
Compensation and Service Providers

Employees

NameTitleFull / Part TimeBaseOtherTotal
Steven Anderson MdPhysicianFT$1,618,207$71,849$1,690,056
Benjamin Parker MdPhysicianFT$1,461,168$41,907$1,503,075
Khurram TariqPhysicianFT$701,735$66,568$768,303
Douglas TratePhysicianFT$643,255$65,861$709,116
Gregory DiamontiPhysicianFT$624,373$45,258$669,631
Charles MantoothChief Executive OfficerFT$598,227$60,065$658,292
Paul Dagher MdTrustee/physician-$523,686$41,002$564,688
Lisa KaufmannChief Medical OfficerFT$404,478$31,483$435,961
David Nathan NipperChief Operating OfficerFT$369,055$37,095$406,150
Rick CassadyChief Financial OfficerFT$341,061$60,103$401,164
Deanna MoolChief Legal OfficerFT$306,190$21,699$327,889
Rob HudspethSVP DevelopmentFT$226,698$24,903$251,601
Greg MillerChief Nursing OfficerFT$211,156$28,357$239,513
Stephanie GreerPres Avery MarketFT$176,192$25,343$201,535
Charles Baker MdTrustee--$32,555$32,555

Board Members and Trustees

NameTitle
Jim DealChair
Tom DaleVice Chair
Brett LoftisTrustee
Cathy WilliamsonTrustee
Jan WinklerTrustee
John BlackburnTrustee
Jonathan AllenTrustee
Lisa CooperTrustee
Mark RicksTrustee
Mary Louise RobertsTrustee
Meagan PhillipsTrustee
Sam AdamsTrustee
Kent TarbuttonTrustee (thru 09/2023)
Ray RussellCounty Commissioner Rep.

Highest Paid Contractors

ContractorServicesLocationCompensation
Cardiosolution Phys CaliforniaInterven. Cardiology4675 CORNELL RD STE 100, Cincinnati, OH 45241$1,682,071
Mountain Area Health Education CentResident Pgm Ptrs.121 HENDERSONVILLE RD, Asheville, NC 28803$1,262,002
Chg Medical Staffing INCMedical staffingPO BOX 972670, Dallas, TX 75397-2670$1,250,283
Obhg North Carolina PCOb Hospitalist Svcs777 LOWNDES HILL ROAD BUILDING 1, Greenville, SC 29607$1,124,217
Wake Forest University Health ScienEd CoverageMEDICAL CENTER BLVD, Winston Salem, NC 27157$1,026,143
Revenue and Support

Revenue Composition

Contributions and Grants
$69,013
Program Service Revenue
$0
Investment Income
$171
Other Revenue
$1,172,092
All Other Contributions
$69,013
Change in Net Assets
$-66,861,863
Expenses and Functional Allocation

Major Expense Lines

Line ItemAmount
Other Expenses$38,720,024
Salaries, Compensation, and Employee Benefits$29,383,115
Grants and Similar Amounts Paid$0
Professional Fundraising Fees$0
Total Fundraising Expense$0

Functional Expense Allocation

Line ItemProgramManagementFundraisingTotal
Information Technology$21,332,916$419,188-$21,752,104
Other Employee Benefits$28,983$13,443,052-$13,472,035
Fees for Services Other$7,369,587$3,782,826$0$11,152,413
Other Salaries and Wages$45,120$9,632,393-$9,677,513
Depreciation Depletion$2,428,800$615,569-$3,044,369
Current Officers, Directors, Trustees, and Key Employees-$2,865,408-$2,865,408
Pension Plan Contributions$5,304$2,519,849-$2,525,153
Occupancy$208,763$823,696-$1,032,459
Payroll Taxes$1,770$841,236-$843,006
Advertising$362,729$58,727-$421,456
Fees for Services Legal-$249,513-$249,513
Interest$2,463$170,943-$173,406
Fees for Services Accounting-$172,833-$172,833
All Other Expenses$144,472$12-$144,484
Other Expenses$11,207$63,988-$75,195
Conferences and Meetings$21,800$22,428-$44,228
Travel-$8,703-$8,703
Insurance-$3,363-$3,363
Total Functional Expenses$32,298,767$35,804,372$0$68,103,139
Fundraising, Events, and Gaming
Fundraising activities
No
Gaming activities
No
Professional fundraiser used
No

Fundraising and Gaming Totals

Line ItemAmount
Fundraising Direct Expenses$0
Fundraising Gross Income$0
Gaming Direct Expenses$0
Gaming Gross Income$0
Professional Fundraising Fees$0
Political and Lobbying Activity
Political campaign activity
No
Lobbying activity
No
Subject to proxy tax
No
Insider Transactions and Loans

Loans and Receivables

Line ItemBeginningEndChange
Loans from Officers, Directors, Trustees, and Key Employees$0$0→ $0
Receivables from Disqualified Persons$0$0→ $0
Receivables from Officers, Directors, Trustees, and Key Employees$0$0→ $0
Debt and Bond Financing

Other Reported Liabilities

LiabilityAmount
Due to Related Parties$4,055,083
Other Liabilities$294,803
Governance and Compliance

Governance Checklist

Compiled or reviewed by an accountant
No
Annual disclosure for covered persons
Yes
Audit committee
Yes
Backup withholding compliance
Yes
Business relationship with 35% controlled entity
No
Business relationship with family members
No
Business relationship with organization members
No
Material changes to governing documents
No
Compensation from other sources disclosed
No
CEO compensation reviewed
Yes
Other officer compensation reviewed
No
Conflict-of-interest policy
Yes
Audited financial statements prepared
Yes
Key decisions subject to board approval
No
Management duties delegated
No

Governance Explanations

FORM 990, PART VI, LINE 11B - ORGANIZATION'S PROCESS TO REVIEW FORM 990

The system controller and the cfo review the 990 prior to filing with the internal revenue service. The return is made available to the board of trustees upon completion.

Form 990, Part VI, Line 12C - Enforcement of Conflicts Policy

The conflict of interest policy is reviewed annually and applies to all employees, officers and board members. Should a conflict exist, the individual is recused from discussion and decision-making process.

Form 990, Part VI, Line 15A - Compensation Process for Top Official

Arthur j. Gallagher & co. Conducted an independent compensation and benefit analysis for the ceo and executive team of arhs. Comparative data was used in this analysis from national and regional peer groups (health systems with comparable net revenue, structure, and organizational complexity). Benchmark data included integrated healthcare strategies.

Form 990, Part VI, Line 19 - Governing Documents Disclosure Explanation

Governing documents, conflict of interest policy, and financial statements are provided upon request.

Filing and Contact Details

Filer

Filer Name
Appalachian Regional Healthcare System Inc
EIN
20-1067022
In Care Of
% RICK CASSADY
Phone
8282624100
Address
PO BOX 2600, BOONE, NC 28607-2600

Signing Officer

Name
Rick Cassady
Title
CFO
Phone
8282624100
Signed
2025-09-23
Discuss with paid preparer
Yes

Organization Details

Principal Officer
David Nathan Nipper
Formed
2004
Legal Domicile
Nc
Voting Board Members
15
Independent Board Members
13
Employees
2,015
Volunteers
13

Preparer

Firm
Bdo USA
Address
421 Fayetteville Street Suite 300, Raleigh, NC 27601
Preparer
Sandra L Feinsmith
Phone
9192781936
Supplemental Narrative

Additional Explanations

FORM 990, PART XI, LINE 9 - OTHER CHANGES IN NET ASSETS:

Corporate allocations - $66,860,543

Form 990 Part IX Line 11G

Description:collection fees total fees:4726669

Form 990 Part IX Line 11G

Description:outside services total fees:3920501

Form 990 Part IX Line 11G

Description:consulting fees total fees:2396488

Form 990 Part IX Line 11G

Description:contract labor total fees:81895

Form 990 Part IX Line 11G

Description:professional services total fees:8294

Form 990 Part IX Line 11G

Description:freight in total fees:7440

Form 990 Part IX Line 11G

Description:maintenance services total fees:4138

Form 990 Part IX Line 11G

Description:physician fees total fees:3821

Form 990 Part IX Line 11G

Description:claim defense costs total fees:3075

Form 990 Part IX Line 11G

Description:medical waste disposal total fees:92

Financial Statement Notes

SCHEDULE D, PART X, LINE 2:

Arhs and its blended component units are not-for-profit corporations as described in section 501(c)(3) of the internal revenue code and are exempt from federal and state income taxes on related income. Accordingly, no provision for income taxes has been considered in the accompanying financial statements. The system has determined it does not have any material unrecognized tax benefits or obligations as of june 30, 2024.

Raw XML AppendixShowing 400 of 1,119 raw XML fields

This appendix keeps the raw XML leaves available for debugging and edge-case review. The human report above is the primary experience.

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