Civic Intelligence

Northern Surry Foundation for Better Health Inc

EIN 38-3669834 • 501(c)3 • Mount Airy, NC

Profile

The foundation's main purpose is to support northern hospital of surry county.

PO Box 1101 830 Rockford StreetMount Airy, NC 27030

www.northernhospital.org

Siviq Scores

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

Liabilities / Assets

5th percentile

0.00x

Tied with the lowest-debt nonprofits in its peer group.

501(c)3 • $10M-$25M nonprofits • Source year 2024

Liabilities / Revenue

6th percentile

0.00x

Tied with the lowest-debt nonprofits in its peer group.

501(c)3 • $10M-$25M nonprofits • Source year 2024

Net Margin

94th percentile

69%

Higher net margin than 94% of similar nonprofits.

501(c)3 • $10M-$25M nonprofits • Source year 2024

Top Officer Pay

26th percentile

$0

Higher top officer pay than 26% of similar nonprofits.

Top officer pay equals 0.0% of source-year revenue.

501(c)3 • $10M-$25M nonprofits • Source year 2022

Asset Growth

43rd percentile

3.2%

Faster asset growth than 43% of similar nonprofits.

501(c)3 • $10M-$25M nonprofits • Annualized from 2023 to 2024

Revenue Growth

1st percentile

-98%

Faster revenue growth than 1% of similar nonprofits.

501(c)3 • $10M-$25M nonprofits • Annualized from 2023 to 2024

Balance Sheet
Liabilities / Assets5th percentile

Assets

Up

$23,714,092

Up $728,372 (+3.2%) from 2023

Liabilities

Down

$0

Down $104,394 (-100%) from 2023

Net Assets

Up

$23,714,092

Up $832,766 (+3.6%) from 2023

Operations
Liabilities / Revenue6th percentileNet Margin94th percentile

Revenue

Down

$326,429

Down $20,012,930 (-98%) from 2023

Expenses

Down

$102,638

Down $4,946,516 (-98%) from 2023

Net Income

Down

$223,791

Down $15,066,414 (-99%) from 2023

Trend Graphs

Balance Sheet Trend

Asset Growth43rd percentile

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

$30M$20M$10M$0-$10MAssets 2011: $1,088,061Liabilities 2011: $0Net Assets 2011: $1,088,0612011Assets 2013: $1,445,305Liabilities 2013: $0Net Assets 2013: $1,445,3052013Assets 2014: $1,537,084Liabilities 2014: $0Net Assets 2014: $1,537,0842014Assets 2015: $1,484,484Liabilities 2015: $0Net Assets 2015: $1,484,4842015Assets 2016: $1,594,176Liabilities 2016: -$81,690Net Assets 2016: $1,675,8662016Assets 2017: $1,778,826Liabilities 2017: -$109,813Net Assets 2017: $1,888,6392017Assets 2018: $2,142,410Liabilities 2018: -$20,414Net Assets 2018: $2,162,8242018Assets 2019: $2,229,097Liabilities 2019: -$54,295Net Assets 2019: $2,283,3922019Assets 2020: $2,512,832Liabilities 2020: -$26,124Net Assets 2020: $2,538,9562020Assets 2021: $3,094,567Liabilities 2021: $0Net Assets 2021: $3,094,5672021Assets 2022: $7,403,607Liabilities 2022: $33,616Net Assets 2022: $7,369,9912022Assets 2023: $22,985,720Liabilities 2023: $104,394Net Assets 2023: $22,881,3262023Assets 2024: $23,714,092Liabilities 2024: $0Net Assets 2024: $23,714,0922024

Highlighted filing

2024

Assets$23,714,092
Liabilities$0
Net Assets$23,714,092
Open 2024 Filing

Operations Trend

Revenue Growth1st percentile

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

$30M$20M$10M$0Expenses 2011: $02011Revenue 2013: $324,143Expenses 2013: $3,430Net Income 2013: $320,7132013Revenue 2014: $96,041Expenses 2014: $4,262Net Income 2014: $91,7792014Revenue 2015: $86,021Expenses 2015: $4,940Net Income 2015: $81,0812015Revenue 2016: $210,836Expenses 2016: $91,039Net Income 2016: $119,7972016Revenue 2017: $164,181Expenses 2017: $93,138Net Income 2017: $71,0432017Revenue 2018: $236,447Expenses 2018: $70,608Net Income 2018: $165,8392018Revenue 2019: $116,590Expenses 2019: $11,134Net Income 2019: $105,4562019Revenue 2020: $157,085Expenses 2020: $42,172Net Income 2020: $114,9132020Revenue 2021: $186,449Expenses 2021: $44,516Net Income 2021: $141,9332021Revenue 2022: $5,008,125Expenses 2022: $131,013Net Income 2022: $4,877,1122022Revenue 2023: $20,339,359Expenses 2023: $5,049,154Net Income 2023: $15,290,2052023Revenue 2024: $326,429Expenses 2024: $102,638Net Income 2024: $223,7912024

Highlighted filing

2024

Revenue$326,429
Expenses$102,638
Net Income$223,791
Open 2024 Filing

Filings

Most recent year

2024 • Form 990XML pending. An XML filing is linked for this year, but detailed extraction is still pending.

Open filing
Assets
$23,714,092
Liabilities
$0
Net assets
$23,714,092
Revenue
$326,429
Expenses
$102,638
Net income
$223,791
Balance SheetOperations
YearAssetsLiabilitiesNet AssetsRevenueExpensesNet Income
2024XML pending. An XML filing is linked for this year, but detailed extraction is still pending.$23.7$0.00$23.7$0.33$0.10$0.22
2023XML pending. An XML filing is linked for this year, but detailed extraction is still pending.$23.0$0.10$22.9$20.3$5.05$15.3
2022Facts available. Structured filing facts are available, but richer extracted sections are limited.$7.40$0.03$7.37$5.01$0.13$4.88
2021Facts available. Structured filing facts are available, but richer extracted sections are limited.$3.09$0.00$3.09$0.19$0.04$0.14
2020XML pending. An XML filing is linked for this year, but detailed extraction is still pending.$2.51$0.03$2.54$0.16$0.04$0.11
2019Import issue. A filing source exists for this year, but detailed import did not complete cleanly.$2.23$0.05$2.28$0.12$0.01$0.11
2018Facts available. Structured filing facts are available, but richer extracted sections are limited.$2.14$0.02$2.16$0.24$0.07$0.17
2017XML pending. An XML filing is linked for this year, but detailed extraction is still pending.$1.78$0.11$1.89$0.16$0.09$0.07
2016Detailed filing. Detailed filing data is available for this year.$1.59$0.08$1.68$0.21$0.09$0.12
2015XML pending. An XML filing is linked for this year, but detailed extraction is still pending.$1.48$0.00$1.48$0.09$0.00$0.08
2014XML pending. An XML filing is linked for this year, but detailed extraction is still pending.$1.54$0.00$1.54$0.10$0.00$0.09
2013Import issue. A filing source exists for this year, but detailed import did not complete cleanly.$1.45$0.00$1.45$0.32$0.00$0.32
2011Facts available. Structured filing facts are available, but richer extracted sections are limited.$1.09$0.00$1.09$0.00
Latest Detailed Filing

The latest 2024 filing currently has linked XML that has not been fully parsed yet. Showing the latest detailed filing from 2022 below.

Jump To
Filing Snapshot
Filing Period
Oct 1, 2021 to Sep 30, 2022
Signed
Aug 14, 2023
Return Version
2021v4.2
Gross Receipts
$5,008,125
Mission and Program Overview

Mission

The foundation's main purpose is to support northern hospital of surry county.

The foundation's main purpose is to support northern regional hospital.

Balance Sheet Detail
LineBeginningEndChange
Assets
Pledges and Grants Receivable-$4,825,000-
Investments Other Securities$2,977,171$2,545,694▼ $431,477
Savings and Temporary Cash Investments$8,290$32,913▲ $24,623
Total Assets$3,094,567$7,403,607▲ $4,309,040
Other Assets Total$109,106$0▼ $109,106
Liabilities
Other Liabilities$0$33,616▲ $33,616
Total Liabilities$0$33,616▲ $33,616
Net Assets / Fund Balance
Net Assets Without Donor Restrictions$3,094,567$7,369,991▲ $4,275,424
Total Net Assets Fund Balance$3,094,567$7,369,991▲ $4,275,424
Total Liabilities and Net Assets / Fund Balance$3,094,567$7,403,607▲ $4,309,040

Asset Categories

AssetBook ValueDepreciationBasis
Other Securities$2,545,694--
Compensation and Service Providers
Top Officer Pay26th percentile

Board Members and Trustees

NameTitle
William K Woltz JrChairman
Monty K VenableVice Chairman
Andy GillespieTrustee
Ann VaughnTrustee
Bill GoinsTrustee
Brian JohnsonTrustee
David ShockleyTrustee
Doug CookTrustee
Michael Gentry MdTrustee
Paul PattersonTrustee
Philip SnowTrustee
Teresa D LewisTrustee
Tom RiggsTrustee
Revenue and Support

Revenue Composition

Contributions and Grants
$4,923,842
Program Service Revenue
$5,204
Investment Income
$79,079
Other Revenue
$0
All Other Contributions
$98,842
Change in Net Assets
$4,877,112
Expenses and Functional Allocation

Major Expense Lines

Line ItemAmount
Other Expenses$76,944
Salaries, Compensation, and Employee Benefits$28,664
Grants and Similar Amounts Paid$25,405
Professional Fundraising Fees$0
Total Fundraising Expense$0

Functional Expense Allocation

Line ItemProgramManagementFundraisingTotal
Other Expenses-$72,596-$72,596
Grants to Domestic Individuals$25,405--$25,405
Other Salaries and Wages-$23,432-$23,432
Other Employee Benefits-$5,232-$5,232
Fees for Services Accounting-$2,473-$2,473
Fees for Services Management-$1,838-$1,838
Travel-$37-$37
Total Functional Expenses$25,405$105,608$0$131,013
Fundraising, Events, and Gaming
Fundraising activities
No
Gaming activities
No
Professional fundraiser used
No

Fundraising and Gaming Totals

Line ItemAmount
Professional Fundraising Fees$0
Political and Lobbying Activity
Political campaign activity
No
Lobbying activity
No
Subject to proxy tax
No
Debt and Bond Financing

Other Reported Liabilities

LiabilityAmount
Due to Related Party$33,616
Governance and Compliance

Governance Checklist

Compiled or reviewed by an accountant
No
Annual disclosure for covered persons
Yes
Audit committee
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
No
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, Section B, Line 11B

“The tax return will first be reviewed by internal management. Then management will review the tax return with the chairman before signing. Any significant issues will be brought up for discussion to the full board at the discretion of the chairman.”

Form 990, Part VI, Section B, Line 12C

“Annual questionnaires are required to be signed by each trustee. Financial activities are monitored by management for potential conflicts of interest.”

Form 990, Part VI, Section C, Line 19

“The organization makes its governing documents, conflict of interest policy, and financial statements available to the public upon request.”

Filing and Contact Details

Filer

Filer Name
Northern Surry Foundation for Better
EIN
38-3669834
Phone
3367197000
Address
PO BOX 1101 830 ROCKFORD STREET, MOUNT AIRY, NC 27030

Signing Officer

Name
William K Woltz Jr
Title
Chairman
Phone
3367197000
Signed
2023-08-14
Discuss with paid preparer
Yes

Organization Details

Principal Officer
William K Woltz Jr
Formed
1984
Legal Domicile
Nc
Voting Board Members
13
Independent Board Members
13
Employees
0
Volunteers
13

Preparer

Firm
Cliftonlarsonallen Llp
Address
227 WEST TRADE STREET SUITE 800, CHARLOTTE, NC 28202
Preparer
John Norman
Phone
7049985200
Supplemental Narrative

Additional Explanations

Form 990, Part III, Line 2

“The foundation received a grant from the nc house of representatives budget to help fund capital improvements or equipment for northern regional hospital.”

Raw XML AppendixShowing 400 of 458 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.

Path#Value
IRS990/AccountantCompileOrReviewInd00
IRS990/ActivitiesConductedPrtshpInd00
IRS990/ActivityOrMissionDesc0THE FOUNDATION'S MAIN PURPOSE IS TO SUPPORT NORTHERN REGIONAL HOSPITAL.
IRS990/AllOtherContributionsAmt098842
IRS990/AnnualDisclosureCoveredPrsnInd01
IRS990/AuditCommitteeInd01
IRS990/BooksInCareOfDetail/BusinessName/BusinessNameLine1Txt0DEREK G WHITE
IRS990/BooksInCareOfDetail/PhoneNum03367197283
IRS990/BooksInCareOfDetail/USAddress/AddressLine1Txt0830 ROCKFORD STREET
IRS990/BooksInCareOfDetail/USAddress/CityNm0MOUNT AIRY
IRS990/BooksInCareOfDetail/USAddress/StateAbbreviationCd0NC
IRS990/BooksInCareOfDetail/USAddress/ZIPCd027030
IRS990/BusinessRlnWith35CtrlEntInd00
IRS990/BusinessRlnWithFamMemInd00
IRS990/BusinessRlnWithOrgMemInd00
IRS990/ChangeToOrgDocumentsInd00
IRS990/CntrctRcvdGreaterThan100KCnt00
IRS990/CollectionsOfArtInd00
IRS990/CompensationFromOtherSrcsInd00
IRS990/CompensationProcessCEOInd00
IRS990/CompensationProcessOtherInd00
IRS990/ConflictOfInterestPolicyInd01
IRS990/ConservationEasementsInd00
IRS990/ConsolidatedAuditFinclStmtInd01
IRS990/CreditCounselingInd00
IRS990/CYBenefitsPaidToMembersAmt00
IRS990/CYContributionsGrantsAmt04923842
IRS990/CYGrantsAndSimilarPaidAmt025405
IRS990/CYInvestmentIncomeAmt079079
IRS990/CYOtherExpensesAmt076944
IRS990/CYOtherRevenueAmt00
IRS990/CYProgramServiceRevenueAmt05204
IRS990/CYRevenuesLessExpensesAmt04877112
IRS990/CYSalariesCompEmpBnftPaidAmt028664
IRS990/CYTotalExpensesAmt0131013
IRS990/CYTotalFundraisingExpenseAmt00
IRS990/CYTotalProfFndrsngExpnsAmt00
IRS990/CYTotalRevenueAmt05008125
IRS990/DecisionsSubjectToApprovaInd00
IRS990/DeductibleArtContributionInd00
IRS990/DeductibleNonCashContriInd00
IRS990/DelegationOfMgmtDutiesInd00
IRS990/Desc0THE FOUNDATION RAISED FUNDS TO PURCHASE CLOTHING FOR PATIENTS AND THEIR FAMILIES THAT WERE IN NEED.
IRS990/DescribedInSection501c3Ind01
IRS990/DisregardedEntityInd00
IRS990/DocumentRetentionPolicyInd01
IRS990/DonorAdvisedFundInd00
IRS990/DonorRstrOrQuasiEndowmentsInd00
IRS990/ElectionOfBoardMembersInd00
IRS990/EmployeeCnt00
IRS990/EngagedInExcessBenefitTransInd00
IRS990/ExpenseAmt02474
IRS990/FamilyOrBusinessRlnInd00
IRS990/FederalGrantAuditRequiredInd00
IRS990/FeesForServicesAccountingGrp/ManagementAndGeneralAmt02473
IRS990/FeesForServicesAccountingGrp/TotalAmt02473
IRS990/FeesForServicesManagementGrp/ManagementAndGeneralAmt01838
IRS990/FeesForServicesManagementGrp/TotalAmt01838
IRS990/ForeignActivitiesInd00
IRS990/ForeignFinancialAccountInd00
IRS990/ForeignOfficeInd00
IRS990/Form8282PropertyDisposedOfInd00
IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt01.00
IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt11.00
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IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt71.00
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IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt111.00
IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt121.00
IRS990/Form990PartVIISectionAGrp/IndividualTrusteeOrDirectorInd0X
IRS990/Form990PartVIISectionAGrp/IndividualTrusteeOrDirectorInd1X
IRS990/Form990PartVIISectionAGrp/IndividualTrusteeOrDirectorInd2X
IRS990/Form990PartVIISectionAGrp/IndividualTrusteeOrDirectorInd3X
IRS990/Form990PartVIISectionAGrp/IndividualTrusteeOrDirectorInd4X
IRS990/Form990PartVIISectionAGrp/IndividualTrusteeOrDirectorInd5X
IRS990/Form990PartVIISectionAGrp/IndividualTrusteeOrDirectorInd6X
IRS990/Form990PartVIISectionAGrp/IndividualTrusteeOrDirectorInd7X
IRS990/Form990PartVIISectionAGrp/IndividualTrusteeOrDirectorInd8X
IRS990/Form990PartVIISectionAGrp/IndividualTrusteeOrDirectorInd9X
IRS990/Form990PartVIISectionAGrp/IndividualTrusteeOrDirectorInd10X
IRS990/Form990PartVIISectionAGrp/IndividualTrusteeOrDirectorInd11X
IRS990/Form990PartVIISectionAGrp/IndividualTrusteeOrDirectorInd12X
IRS990/Form990PartVIISectionAGrp/OfficerInd0X
IRS990/Form990PartVIISectionAGrp/OfficerInd1X
IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt00
IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt10
IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt20
IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt30
IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt40
IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt50
IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt60
IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt70
IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt80
IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt90
IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt100
IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt110
IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt120
IRS990/Form990PartVIISectionAGrp/PersonNm0WILLIAM K WOLTZ JR
IRS990/Form990PartVIISectionAGrp/PersonNm1MONTY K VENABLE
IRS990/Form990PartVIISectionAGrp/PersonNm2DOUG COOK
IRS990/Form990PartVIISectionAGrp/PersonNm3ANDY GILLESPIE
IRS990/Form990PartVIISectionAGrp/PersonNm4BILL GOINS
IRS990/Form990PartVIISectionAGrp/PersonNm5BRIAN JOHNSON
IRS990/Form990PartVIISectionAGrp/PersonNm6TERESA D LEWIS
IRS990/Form990PartVIISectionAGrp/PersonNm7PAUL PATTERSON
IRS990/Form990PartVIISectionAGrp/PersonNm8TOM RIGGS
IRS990/Form990PartVIISectionAGrp/PersonNm9DAVID SHOCKLEY
IRS990/Form990PartVIISectionAGrp/PersonNm10PHILIP SNOW
IRS990/Form990PartVIISectionAGrp/PersonNm11ANN VAUGHN
IRS990/Form990PartVIISectionAGrp/PersonNm12MICHAEL GENTRY MD
IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt00
IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt10
IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt20
IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt30
IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt40
IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt50
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IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt00
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IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt110
IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt120
IRS990/Form990PartVIISectionAGrp/TitleTxt0CHAIRMAN
IRS990/Form990PartVIISectionAGrp/TitleTxt1VICE CHAIRMAN
IRS990/Form990PartVIISectionAGrp/TitleTxt2TRUSTEE
IRS990/Form990PartVIISectionAGrp/TitleTxt3TRUSTEE
IRS990/Form990PartVIISectionAGrp/TitleTxt4TRUSTEE
IRS990/Form990PartVIISectionAGrp/TitleTxt5TRUSTEE
IRS990/Form990PartVIISectionAGrp/TitleTxt6TRUSTEE
IRS990/Form990PartVIISectionAGrp/TitleTxt7TRUSTEE
IRS990/Form990PartVIISectionAGrp/TitleTxt8TRUSTEE
IRS990/Form990PartVIISectionAGrp/TitleTxt9TRUSTEE
IRS990/Form990PartVIISectionAGrp/TitleTxt10TRUSTEE
IRS990/Form990PartVIISectionAGrp/TitleTxt11TRUSTEE
IRS990/Form990PartVIISectionAGrp/TitleTxt12TRUSTEE
IRS990/Form990ProvidedToGvrnBodyInd01
IRS990/FormationYr01984
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IRS990/FSAuditedInd01
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IRS990/GamingActivitiesInd00
IRS990/GoverningBodyVotingMembersCnt013
IRS990/GrantAmt02474
IRS990/GrantsToDomesticIndividualsGrp/ProgramServicesAmt025405
IRS990/GrantsToDomesticIndividualsGrp/TotalAmt025405
IRS990/GrantsToIndividualsInd01
IRS990/GrantsToOrganizationsInd00
IRS990/GrantToRelatedPersonInd00
IRS990/GrossReceiptsAmt05008125
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IRS990/IRPDocumentCnt00
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IRS990/LoanOutstandingInd00
IRS990/LobbyingActivitiesInd00
IRS990/LocalChaptersInd00
IRS990/MaterialDiversionOrMisuseInd00
IRS990/MembersOrStockholdersInd00
IRS990/MethodOfAccountingAccrualInd0X
IRS990/MinutesOfCommitteesInd01
IRS990/MinutesOfGoverningBodyInd01
IRS990/MissionDesc0THE FOUNDATION'S MAIN PURPOSE IS TO SUPPORT NORTHERN REGIONAL HOSPITAL.
IRS990/MoreThan5000KToIndividualsInd00
IRS990/MoreThan5000KToOrgInd00
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IRS990/NetAssetsOrFundBalancesEOYAmt07369991
IRS990/NetUnrelatedBusTxblIncmAmt00
IRS990/NetUnrlzdGainsLossesInvstAmt0-601688
IRS990/NoDonorRestrictionNetAssetsGrp/BOYAmt03094567
IRS990/NoDonorRestrictionNetAssetsGrp/EOYAmt07369991
IRS990/NoListedPersonsCompensatedInd0X
IRS990/NondeductibleContributionsInd00
IRS990/OfficerMailingAddressInd00
IRS990/OperateHospitalInd00
IRS990/Organization501c3Ind0X
IRS990/OrganizationFollowsFASB117Ind0X
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IRS990/OtherAssetsTotalGrp/EOYAmt00
IRS990/OtherChangesInNetAssetsAmt00
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IRS990/OtherEmployeeBenefitsGrp/TotalAmt05232
IRS990/OtherExpensesGrp/Desc0MISCELLANEOUS
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IRS990/OtherLiabilitiesGrp/BOYAmt00
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IRS990/OtherSalariesAndWagesGrp/TotalAmt023432
IRS990/OwnWebsiteInd0X
IRS990/PartialLiquidationInd00
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IRS990/PoliticalCampaignActyInd00
IRS990/PrincipalOfficerNm0WILLIAM K WOLTZ JR
IRS990/ProfessionalFundraisingInd00
IRS990/ProgramServiceRevenueGrp/BusinessCd0448000
IRS990/ProgramServiceRevenueGrp/Desc0MISCELLANEOUS
IRS990/ProgramServiceRevenueGrp/ExclusionAmt05204
IRS990/ProgramServiceRevenueGrp/TotalRevenueColumnAmt05204
IRS990/ProgSrvcAccomActy2Grp/Desc0THE FOUNDATION RAISED FUNDS TO ASSIST EMPLOYEES IN NEED AT NORTHERN REGIONAL HOSPITAL.
IRS990/ProgSrvcAccomActy2Grp/ExpenseAmt011971
IRS990/ProgSrvcAccomActy2Grp/GrantAmt011971
IRS990/ProgSrvcAccomActy3Grp/Desc0THE FOUNDATION RAISED FUNDS TO PROVIDE SCHOLARSHIPS TO NURSING STUDENTS.
IRS990/ProgSrvcAccomActy3Grp/ExpenseAmt010500
IRS990/ProgSrvcAccomActy3Grp/GrantAmt010500
IRS990/ProgSrvcAccomActyOtherGrp/Desc0THE FOUNDATION RAISED FUNDS TO PROVIDE ASSISTANCE TO CANCER PATIENTS.
IRS990/ProgSrvcAccomActyOtherGrp/Desc1THE FOUNDATION RAISED FUNDS TO BUILD A PEACEFUL QUIET GARDEN FOR PATIENTS, FAMILIES AND VISITORS TO ENJOY.
IRS990/ProgSrvcAccomActyOtherGrp/Desc2THE FOUNDATION RECEIVED A GRANT FROM THE NC HOUSE OF REPRESENTATIVES BUDGET TO HELP FUND CAPITAL IMPROVEMENTS OR EQUIPMENT FOR NORTHERN REGIONAL HOSPITAL.
IRS990/ProgSrvcAccomActyOtherGrp/ExpenseAmt0460
IRS990/ProgSrvcAccomActyOtherGrp/GrantAmt0460
IRS990/ProgSrvcAccomActyOtherGrp/RevenueAmt00
IRS990/ProhibitedTaxShelterTransInd00
IRS990/PYBenefitsPaidToMembersAmt00
IRS990/PYContributionsGrantsAmt0118900
IRS990/PYExcessBenefitTransInd00
IRS990/PYGrantsAndSimilarPaidAmt021757
IRS990/PYInvestmentIncomeAmt067549
IRS990/PYOtherExpensesAmt022759
IRS990/PYOtherRevenueAmt00
IRS990/PYProgramServiceRevenueAmt00
IRS990/PYRevenuesLessExpensesAmt0141933
IRS990/PYSalariesCompEmpBnftPaidAmt00
IRS990/PYTotalExpensesAmt044516
IRS990/PYTotalProfFndrsngExpnsAmt00
IRS990/PYTotalRevenueAmt0186449
IRS990/QuidProQuoContributionsInd00
IRS990/ReconcilationRevenueExpnssAmt04877112
IRS990/RegularMonitoringEnfrcInd01
IRS990/RelatedEntityInd01
IRS990/RelatedOrganizationCtrlEntInd00
IRS990/RelatedOrganizationsAmt04825000
IRS990/ReportInvestmentsOtherSecInd01
IRS990/ReportLandBuildingEquipmentInd00
IRS990/ReportOtherAssetsInd00
IRS990/ReportOtherLiabilitiesInd01
IRS990/ReportProgramRelatedInvstInd00
IRS990/SavingsAndTempCashInvstGrp/BOYAmt08290
IRS990/SavingsAndTempCashInvstGrp/EOYAmt032913
IRS990ScheduleA/Form990SchASupportingOrgGrp/Contribution35ControlledInd00
IRS990ScheduleA/Form990SchASupportingOrgGrp/ContributionControllerInd00
IRS990ScheduleA/Form990SchASupportingOrgGrp/ContributionFamilyInd00
IRS990ScheduleA/Form990SchASupportingOrgGrp/ControlledDisqualifiedPrsnInd00
IRS990ScheduleA/Form990SchASupportingOrgGrp/DisqualifiedPrsnControllIntInd00
IRS990ScheduleA/Form990SchASupportingOrgGrp/DisqualifiedPrsnOwnrIntInd00
IRS990ScheduleA/Form990SchASupportingOrgGrp/ExcessBusinessHoldingsRulesInd00
IRS990ScheduleA/Form990SchASupportingOrgGrp/ListedByNameGoverningDocInd01
IRS990ScheduleA/Form990SchASupportingOrgGrp/LoanDisqualifiedPersonInd00
IRS990ScheduleA/Form990SchASupportingOrgGrp/OrganizationChangeSuprtOrgInd00
IRS990ScheduleA/Form990SchASupportingOrgGrp/PaymentSubstantialContribtrInd00
IRS990ScheduleA/Form990SchASupportingOrgGrp/SupportedOrgNotOrganizedUSInd00
IRS990ScheduleA/Form990SchASupportingOrgGrp/SupportedOrgSectionC456Ind00
IRS990ScheduleA/Form990SchASupportingOrgGrp/SupportNonSupportedOrgInd00
IRS990ScheduleA/Form990SchASupportingOrgGrp/SuprtOrgNoIRSDeterminationInd00
IRS990ScheduleA/MajorityDirTrstSupportedOrgInd01
IRS990ScheduleA/OtherSupportSumAmt00
IRS990ScheduleA/SupportedOrganizationsCnt01
IRS990ScheduleA/SupportedOrganizationsTotalCnt01
IRS990ScheduleA/SupportedOrgInformationGrp/EIN0566015416
IRS990ScheduleA/SupportedOrgInformationGrp/GoverningDocumentListedInd01
IRS990ScheduleA/SupportedOrgInformationGrp/OrganizationTypeCd03
IRS990ScheduleA/SupportedOrgInformationGrp/OtherSupportAmt00
IRS990ScheduleA/SupportedOrgInformationGrp/SupportAmt00
IRS990ScheduleA/SupportedOrgInformationGrp/SupportedOrganizationName/BusinessNameLine1Txt0NORTHERN REGIONAL HOSPITAL
IRS990ScheduleA/SupportingOrganization509a3Ind0X
IRS990ScheduleA/SupportingOrgType2Ind0X
IRS990ScheduleA/SupportSumAmt00
IRS990ScheduleB/ContributorInformationGrp/ContributorBusinessName/BusinessNameLine10RESTRICTED
IRS990ScheduleB/ContributorInformationGrp/ContributorNum0RESTRICTED
IRS990ScheduleB/ContributorInformationGrp/ContributorUSAddress/AddressLine10RESTRICTED
IRS990ScheduleB/ContributorInformationGrp/ContributorUSAddress/AddressLine20RESTRICTED
IRS990ScheduleB/ContributorInformationGrp/ContributorUSAddress/City0RESTRICTED
IRS990ScheduleB/ContributorInformationGrp/ContributorUSAddress/State0RESTRICTED
IRS990ScheduleB/ContributorInformationGrp/ContributorUSAddress/ZIPCode0RESTRICTED
IRS990ScheduleB/ContributorInformationGrp/TotalContributionsAmt0RESTRICTED
IRS990/ScheduleBRequiredInd01
IRS990ScheduleD/OtherLiabilitiesOrgGrp/Amt033616
IRS990ScheduleD/OtherLiabilitiesOrgGrp/Desc0DUE TO RELATED PARTY
IRS990ScheduleD/OtherSecuritiesGrp/BookValueAmt02545694
IRS990ScheduleD/OtherSecuritiesGrp/Desc0INVESTMENTS
IRS990ScheduleD/OtherSecuritiesGrp/MethodValuationCd0F
IRS990ScheduleD/TotalBookValueLandBuildingsAmt00
IRS990ScheduleD/TotalBookValueSecuritiesAmt02545694
IRS990ScheduleD/TotalLiabilityAmt033616
IRS990ScheduleI/GrantRecordsMaintainedInd01
IRS990ScheduleI/GrantsOtherAsstToIndivInUSGrp/CashGrantAmt010500
IRS990ScheduleI/GrantsOtherAsstToIndivInUSGrp/CashGrantAmt111371
IRS990ScheduleI/GrantsOtherAsstToIndivInUSGrp/CashGrantAmt22474
IRS990ScheduleI/GrantsOtherAsstToIndivInUSGrp/CashGrantAmt3460
IRS990ScheduleI/GrantsOtherAsstToIndivInUSGrp/GrantTypeTxt0SCHOLARSHIPS TO NURSING STUDENTS
IRS990ScheduleI/GrantsOtherAsstToIndivInUSGrp/GrantTypeTxt1EMPLOYEE ASSISTANCE
IRS990ScheduleI/GrantsOtherAsstToIndivInUSGrp/GrantTypeTxt2CLOTHING FUNDS
IRS990ScheduleI/GrantsOtherAsstToIndivInUSGrp/GrantTypeTxt3CANCER PATIENT SUPPORT
IRS990ScheduleI/GrantsOtherAsstToIndivInUSGrp/RecipientCnt010
IRS990ScheduleI/GrantsOtherAsstToIndivInUSGrp/RecipientCnt111
IRS990ScheduleI/GrantsOtherAsstToIndivInUSGrp/RecipientCnt22
IRS990ScheduleI/GrantsOtherAsstToIndivInUSGrp/RecipientCnt31
IRS990/ScheduleJRequiredInd00
IRS990/ScheduleORequiredInd01
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt0THE FOUNDATION RECEIVED A GRANT FROM THE NC HOUSE OF REPRESENTATIVES BUDGET TO HELP FUND CAPITAL IMPROVEMENTS OR EQUIPMENT FOR NORTHERN REGIONAL HOSPITAL.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt1THE TAX RETURN WILL FIRST BE REVIEWED BY INTERNAL MANAGEMENT. THEN MANAGEMENT WILL REVIEW THE TAX RETURN WITH THE CHAIRMAN BEFORE SIGNING. ANY SIGNIFICANT ISSUES WILL BE BROUGHT UP FOR DISCUSSION TO THE FULL BOARD AT THE DISCRETION OF THE CHAIRMAN.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt2ANNUAL QUESTIONNAIRES ARE REQUIRED TO BE SIGNED BY EACH TRUSTEE. FINANCIAL ACTIVITIES ARE MONITORED BY MANAGEMENT FOR POTENTIAL CONFLICTS OF INTEREST.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt3THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc0FORM 990, PART III, LINE 2
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc1FORM 990, PART VI, SECTION B, LINE 11B
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc2FORM 990, PART VI, SECTION B, LINE 12C
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc3FORM 990, PART VI, SECTION C, LINE 19
IRS990ScheduleR/AssetExchangeInd00
IRS990ScheduleR/AssetPurchaseFromOtherOrgInd00
IRS990ScheduleR/AssetSaleToOtherOrgInd00
IRS990ScheduleR/DivRelatedOrganizationInd00
IRS990ScheduleR/GiftGrntCapContriFromOthOrgInd00
IRS990ScheduleR/GiftGrntOrCapContriToOthOrgInd01
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/ControlledOrganizationInd00
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/DisregardedEntityName/BusinessNameLine1Txt0NORTHERN REGIONAL HOSPITAL
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/EIN0566015416
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/ExemptCodeSectionTxt0115/501(C)(3)
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/LegalDomicileStateCd0NC
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/PrimaryActivitiesTxt0HOSPITAL
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/PublicCharityStatusTxt0LINE 3
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/USAddress/AddressLine1Txt0830 ROCKFORD STREET
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/USAddress/CityNm0MOUNT AIRY
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/USAddress/StateAbbreviationCd0NC
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/USAddress/ZIPCd027030
IRS990ScheduleR/LoansOrGuaranteesFromOthOrgInd00
IRS990ScheduleR/LoansOrGuaranteesToOtherOrgInd00
IRS990ScheduleR/PaidEmployeesSharingInd00
IRS990ScheduleR/PerformOfServicesByOtherOrgInd00
IRS990ScheduleR/PerformOfServicesForOthOrgInd00
IRS990ScheduleR/ReceiptOfIntAnntsRntsRyltsInd00
IRS990ScheduleR/ReimbursementPaidByOtherOrgInd00
IRS990ScheduleR/ReimbursementPaidToOtherOrgInd00
IRS990ScheduleR/RentalOfFacilitiesToOthOrgInd00
IRS990ScheduleR/RentalOfFcltsFromOthOrgInd00
IRS990ScheduleR/SharingOfFacilitiesInd01
IRS990ScheduleR/TransferFromOtherOrgInd00
IRS990ScheduleR/TransferToOtherOrgInd00
IRS990/SchoolOperatingInd00
IRS990/SignificantChangeInd00
IRS990/SignificantNewProgramSrvcInd01
IRS990/SubjectToExcsTaxNetInvstIncInd00
IRS990/SubjectToProxyTaxInd00
IRS990/SubjToTaxRmnrtnExPrchtPymtInd00
IRS990/TaxablePartyNotificationInd00
IRS990/TaxExemptBondsInd00
IRS990/TerminateOperationsInd00
IRS990/TotalAssetsBOYAmt03094567
IRS990/TotalAssetsEOYAmt07403607
IRS990/TotalAssetsGrp/BOYAmt03094567
IRS990/TotalAssetsGrp/EOYAmt07403607
IRS990/TotalCompGreaterThan150KInd00
IRS990/TotalContributionsAmt04923842
IRS990/TotalEmployeeCnt00
IRS990/TotalFunctionalExpensesGrp/FundraisingAmt00
IRS990/TotalFunctionalExpensesGrp/ManagementAndGeneralAmt0105608
IRS990/TotalFunctionalExpensesGrp/ProgramServicesAmt025405
IRS990/TotalFunctionalExpensesGrp/TotalAmt0131013
IRS990/TotalGrossUBIAmt00
IRS990/TotalLiabilitiesBOYAmt00
IRS990/TotalLiabilitiesEOYAmt033616
IRS990/TotalLiabilitiesGrp/BOYAmt00
IRS990/TotalLiabilitiesGrp/EOYAmt033616
IRS990/TotalNetAssetsFundBalanceGrp/BOYAmt03094567
IRS990/TotalNetAssetsFundBalanceGrp/EOYAmt07369991
IRS990/TotalOtherCompensationAmt00
IRS990/TotalOtherProgSrvcExpenseAmt0460
IRS990/TotalOtherProgSrvcGrantAmt0460
IRS990/TotalOtherProgSrvcRevenueAmt00
IRS990/TotalProgramServiceExpensesAmt025405

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