2026-08-12T12:18:29-05:00 2025-09-30 410746749 CLIFTONLARSONALLEN LLP 14815 BALLANTYNE VILLAGE WAY SUITE 300 CHARLOTTE NC 28277 990 2024-10-01 581573322 GRANVILLE HEALTH SYSTEM FOUNDATION INC GRAN 9196903402 PO BOX 947 OXFORD NC 27565 JAMIE PURVIS CHIEF FINANCIAL OFFICER 9196903402 2026-08-12 1 1 KATHRINE A WARLICK P02065266 7049985200 2026-08-12 2024 2025-03-06 01:10:19Z JAMIE PURVIS PO BOX 947 OXFORD NC 27565 202683 0 X GHSFOUNDATION.ORG X 2024 NC SERVE AS A CHARITABLE RESOURCE FOR GRANVILLE HEALTH SYSTEM 14 14 0 14 0 0 0 60634 0 0 0 661 0 92254 0 153549 0 15133 0 0 0 0 0 0 0 0 1274 0 16407 0 137142 240198 369481 0 0 240198 369481 X THE FOUNDATION SERVES AS A CHARITABLE RESOURCE FOR GRANVILLE HEALTH SYSTEM, SUPPORTING ITS COMMITMENT TO PROVIDE QUALITY HEALTH CARE TO ALL CITIZENS OF THE COMMUNITY, WHERE THEY WORK AND LIVE. (CONTINUED ON SCHEDULE O)THE FOUNDATION BUILDS SUPPORT FOR GHS AND PROVIDES FINANCIAL RESOURCES TO PURCHASE NEW EQUIPMENT, DEVELOP NEW SERVICES, MAINTAIN AND IMPROVE FACILITIES, AND RECRUIT NEW HEALTH PROFESSIONALS TO GRANVILLE COUNTY. 0 0 16407 15133 DURING THE YEAR, THE FOUNDATION RAISED FUNDS FOR THE GENERAL SUPPORT OF HEALTHCARE ACTIVITIES OF ITS RELATED ORGANIZATION, GRANVILLE HEALTH SYSTEM. 16407 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 14 14 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 X JAMIE PURVIS 9196903237 PO BOX 947 OXFORD NC 27565 XAVIER WORTHAM PRESIDENT 1.00 0.00 X 0 0 0 JOHN BURNS VICE-PRESIDENT 1.00 0.00 X 0 0 0 JAMES CRAWFORD BOARD MEMBER 1.00 0.00 X 0 0 0 LAUREN CURRIN BOARD MEMBER 1.00 0.00 X 0 0 0 HARRY MILLS BOARD MEMBER 1.00 0.00 X 0 0 0 RONNIE MORTON BOARD MEMBER 1.00 0.00 X 0 0 0 JILL PIKE BOARD MEMBER 1.00 0.00 X 0 0 0 BOBBY TALLEY JR BOARD MEMBER 1.00 0.00 X 0 0 0 MARSHALL TANNER BOARD MEMBER 1.00 0.00 X 0 0 0 CHANCE WILKINSON BOARD MEMBER 1.00 0.00 X 0 0 0 JEFF TINGEN BOARD MEMBER 1.00 0.00 X 0 0 0 GARY WILLIAMS BOARD MEMBER 1.00 0.00 X 0 0 0 MARTHA WRENN BOARD MEMBER 1.00 0.00 X 0 0 0 JOHNNY YOUNT BOARD MEMBER 1.00 0.00 X 0 0 0 ADAM MCCONNELL CEO 1.00 49.00 X 0 420504 78015 JAMIE PURVIS CFO 1.00 49.00 X 0 189201 58645 LAUREN ROBERSON MARKETING & FOUNDATION DIRECTOR 1.00 49.00 X 0 63865 27887 0 673570 164547 0 0 1 0 0 55107 5527 60634 661 661 131773 55107 49109 82664 82664 2110 25 2085 2085 VENDING 900099 7505 7505 7505 153549 0 0 92915 15133 15133 BANK FES 1274 1274 16407 16407 0 0 216296 292174 7830 61150 16072 16157 240198 369481 0 0 X 232368 361628 7830 7853 240198 369481 240198 369481 X 137142 -7859 X 0 0 0 X 128516 79729 24603 68498 192387 493733 128516 79729 24603 68498 192387 493733 493733 1101 661 1762 6539 9656 8807 10177 7505 42684 538179 2110 0.91740 0.89320 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: OTHER INCOME - 2020 AMOUNT: $ 6,539. 2021 AMOUNT: $ 9,656. 2022 AMOUNT: $ 8,807. 2023 AMOUNT: $ 10,177. 2024 AMOUNT: $ 7,505. SCHEDULE A, PART II, LINE 1, COLUMN D THE AMOUNT OF GIFTS, GRANTS, CONTRIBUTIONS, AND MEMBERSHIP FEES RECEIVED REPORTED FOR 2023 HAS BEEN ADJUSTED FROM $24,203 TO $68,498. THIS CHANGE IS THE RESULT OF ADDING IN CONTRIBUTIONS FROM FUNDRAISING EVENTS THAT WERE OMITTED ON THE PRIOR YEAR RETURN. THIS CORRECTION DOES NOT AFFECT THE ORGANIZATION'S ABILITY TO PASS THE PUBLIC SUPPORT TEST REQUIRED UNDER 170(B)(1)(A)(VI). RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED AMBULANCE CHASE 46904 10356 36548 7838 728 1902 4672 GALA 139976 44751 95225 717 26310 4431 2511 186880 55107 131773 8555 728 26310 6333 7183 49109 82664 0 GRANVILLE HEALTH SYSTEM 1010 COLLEGE ST OXFORD NC 27565 560593547 12984 0 GENERAL SUPPORT OF HOSPITAL ACTIVITIES 1 0 0 0 0 0 0 0 0 0 0 ADAM MCCONNELL CEO 0 377098 0 43400 0 6 0 0 0 78015 0 498519 0 0 JAMIE PURVIS CFO 0 174335 0 14776 0 90 0 0 0 58645 0 247846 0 0 PART I, LINE 3 THE BOARD FOR GRANVILLE HEALTH SYSTEM, A RELATED ORGANIZATION, 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 B, LINE 11B THE IRS FORM 990 WILL BE DISTRIBUTED TO THE BOARD OF DIRECTORS FOR THEIR REVIEW AHEAD OF FORMAL FILING. 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 15A THE BOARD FOR GRANVILLE HEALTH SYSTEM, A RELATED ENTITY, 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 19 GOVERNING DOCUMENTS, FINANCIAL STATEMENTS AND THE CONFLICT OF INTEREST POLICY ARE AVAILABLE TO REVIEW UPON REQUEST. FORM 990, PART XI, LINE 9: OTHER CHANGES IN NET ASSETS -7,859. GRANVILLE HEALTH SYSTEM 1010 COLLEGE ST OXFORD NC 27565 560593547 HOSPITAL/SKILLED NURSING NC SECTION 115 N/A GRANVILLE COUNTY NORTH CAROLINA 0 GRANVILLE HEALTH INC PO BOX 947 OXFORD NC 27565 264073395 MEDICAL SERVICES NC 501(C)(3) LINE 4 N/A 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0