2025-09-24T09:23:25-05:00 2024-09-30 410746749 CLIFTONLARSONALLEN LLP 227 WEST TRADE STREET SUITE 800 CHARLOTTE NC 28202 990 2023-10-01 264073395 GRANVILLE HEALTH INC GRAN 9196903402 PO BOX 947 OXFORD NC 27565 JAMIE PURVIS CHIEF FINANCIAL OFFICER 9196903402 2025-09-20 1 0 KATHRINE A WARLICK P02065266 7049985200 2025-09-08 2023 2025-03-06 01:10:19Z ADAM W MCCONNELL PO BOX 947 OXFORD NC 27565 9887940 0 1 X GHSHOSPITAL.ORG X 2008 NC TO PROVIDE MEDICAL SERVICES TO THE COMMUNITY OF GRANVILLE COUNTY NORTH CAROLINA. 7 3 34 3 0 0 0 0 8033458 9887940 0 0 0 0 8033458 9887940 0 0 0 0 8033458 9887940 0 0 0 0 0 8033458 9887940 0 0 14768 1999 343247 426744 -328479 -424745 THE PURPOSE OF THE CORPORATION IS TO ENGAGE IN CHARITABLE EFFORTS AND TO SUPPORT GRANVILLE HEALTH SYSTEM IN PROVIDING HEALTHCARE AND RELATED SERVICES TO THE CITIZENS AND RESIDENTS OF GRANVILLE COUNTY AND THE SURROUNDING COMMUNITY. 0 0 9887940 9887940 THE CORPORATION SUPPORTED GRANVILLE HEALTH SYSTEM IN PROVIDING HEALTHCARE AND RELATED SERVICES TO THE CITIZENS AND RESIDENTS OF GRANVILLE COUNTY, NORTH CAROLINA, AND THE SURROUNDING COMMUNITY. 9887940 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 34 1 0 0 0 0 0 0 0 0 0 0 X 7 3 0 0 0 0 1 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X JAMIE PURVIS 9196903237 PO BOX 947 OXFORD NC 27565 DAVID SMITH BOARD CHAIR 1.00 0.00 X X 0 0 0 TONY COZART BOARD MEMBER 1.00 0.00 X 0 0 0 RICHARD PACCA BOARD MEMBER 10.00 40.00 X 0 237898 15989 ADAM MCCONNELL BOARD MEMBER & CEO 1.00 49.00 X X 0 333622 51137 ANN MARIE HOLTZMAN-WHEELER CNO/SECRETARY 1.00 49.00 X X 0 167609 32152 JAMES W LUMPKINS BOARD MEMBER 1.00 0.00 X 0 0 0 JOHN SNOW CEO - 4/18/2023 10.00 40.00 X 0 188262 29449 JOSEPH ZOLA PHYSICIAN 0.00 40.00 X 920966 0 35478 ALBIN ABRAHAM PHYSICIAN 0.00 40.00 X 859958 0 36228 RICHARD ALEXANDER PHYSICIAN 0.00 40.00 X 441685 0 10674 SHANE HODGE SURGEON 0.00 40.00 X 457914 0 30795 NAVEEN KUMAR SURGEON 0.00 40.00 X 460051 0 10674 3140574 927391 252576 26 0 1 0 0 MEDICAL SERVICE REVENU 621110 9887940 9887940 9887940 9887940 9887940 0 0 9206649 9206649 251914 251914 429377 429377 9887940 9887940 0 0 3761 1999 11007 14768 1999 343247 426744 343247 426744 X -328479 -424745 -328479 -424745 14768 1999 X 0 -96266 X 0 1 X 0 0 X 0 0 0 0 0 0 0 0 0 JOSEPH ZOLA PHYSICIAN 574107 0 331859 0 15000 0 9150 0 26328 0 956444 0 0 0 ALBIN ABRAHAM PHYSICIAN 451568 0 408390 0 0 0 9900 0 26328 0 896186 0 0 0 SHANE HODGE SURGEON 442914 0 15000 0 0 0 9900 0 20895 0 488709 0 0 0 NAVEEN KUMAR SURGEON 445051 0 15000 0 0 0 9900 0 774 0 470725 0 0 0 RICHARD ALEXANDER PHYSICIAN 419181 0 22504 0 0 0 9900 0 774 0 452359 0 0 0 ADAM MCCONNELL BOARD MEMBER & CEO 0 332222 0 0 0 1400 0 41336 0 9801 0 384759 0 0 RICHARD PACCA BOARD MEMBER 0 199037 0 38861 0 0 0 5971 0 10018 0 253887 0 0 JOHN SNOW CEO - 4/18/2023 0 185546 0 0 0 2716 0 22687 0 6762 0 217711 0 0 ANN MARIE HOLTZMAN-WHEELER CNO/SECRETARY 0 167609 0 0 0 0 0 21164 0 10988 0 199761 0 0 PART I, LINE 3 THE BOARD OF GRANVILLE HEALTH SYSTEM REVIEWS AND APPROVES THE COMPENSATION FOR THE CEO, USING COMPARABLE DATA PROVIDED BY AN INDEPENDENT CONSULTANT AND THE USE OF COMPENSATION SURVEYS. THE TERMS OF THE CEO'S CONTRACT ARE SET OUT IN WRITTEN AGREEMENT. FORM 990, PART VI, SECTION A, LINE 6 MEMBERS OF THE COUNTY COMMISSION ARE MEMBERS OF THE BOARD OF TRUSTEEES. FORM 990, PART VI, SECTION B, LINE 11B PRIOR TO THE SIGNATURE AND FILING OF THE FORM 990, THE GOVERNING BOARD IS PROVIDED THE FORM 990 FOR REVIEW VIA EMAIL. FORM 990, PART VI, SECTION B, LINE 12C ON AN ANNUAL BASIS, MEMBERS OF THE GOVERNING BOARD ARE ASKED TO SIGN A CONFLICT-OF-INTEREST STATEMENT DISCLOSING ANY POTENTIAL CONFLICTS WITH THEIR RESPONSIBILITIES TO THE ORGANIZATION. ADDITIONALLY, MEMBERS OF STAFF ARE REQUIRED TO DISCLOSE ANY CONFLICTS OF INTEREST IF THEY HAVE ANY DIRECT DEALINGS WITH THE ORGANIZATION, VENDORS, DONORS, BOARD MEMBERS, ETC. ON AN ANNUAL BASIS, ALL EMPLOYEES ARE REQUIRED TO COMPLETE CODE OF CONDUCT TRAINING, WHICH REQUIRES THEM TO CERTIFY THEY HAVE REVIEWED THE CONFLICT-OF-INTEREST POLICY AND THEY HAVE NOT VIOLATED THE POLICY. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD FOR GRANVILLE HEALTH SYSTEM REVIEWS AND APPROVES THE COMPENSATION FOR THE CEO, USING COMPARABLE DATA PROVIDED BY AN INDEPENDENT CONSULTATION CONSULTANT AND THE USE OF A COMPENSATION SURVEY. THE TERMS OF THE CEO'S CONTRACT ARE SET OUT IN A WRITTEN AGREEMENT. THE PROCESS DESCRIBED HERE WAS LAST COMPLETED IN 2022. FORM 990, PART VI, SECTION C, LINE 18 THE ORGANIZATION PROVIDES COPIES OF ITS FORM 990 AND FORM 1023 UPON REQUEST. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, FINANCIAL STATEMENTS AND THE CONFLICT OF INTEREST POLICY ARE AVAILABLE TO REVIEW UPON REQUEST. FORM 990, PART XI, LINE 9: MISCELLANEOUS -96,266. GRANVILLE HEALTH SYSTEM 1010 COLLEGE ST OXFORD NC 27565 560593549 HOSPITAL/SKILLED NURSING NC SECTION 115 N/A GRANVILLE COUNTY NC 0 GRANVILLE HEALTH SYSTEM FOUNDATION 1010 COLLEGE ST OXFORD NC 27565 581573322 FUNDRAISING NC 501(C)(3) LINE 7 N/A 0 0 0 0 0 0 0 0 0 1 0 1 1 1 1 1 0 1 1 1