2024-11-15T01:09:19-06:00 2023-12-31 990 2023-01-01 850548753 ATRIUM HEALTH EMPLOYEE ASSISTANCE INC ATRI 7046310487 PO BOX 32861 CHARLOTTE NC 283232861 JOE FORQUER BOARD CHAIRMAN AND PRESIDENT 7046310487 2024-11-14 0 0 2023 2024-10-15 13:58:12Z JOE FORQUER PO BOX 32861 CHARLOTTE NC 283232861 678004 0 X N/A X 2020 NC TO ELEVATE HOPE - FOR ALL ATRIUM HEALTH TEAMMATE HEROES - BY PROVIDING EMERGENCY FINANCIAL ASSISTANCE TO TEAMMATES FOR QUALIFYING NEEDS 5 1 0 5 0 0 823738 631959 0 0 7765 46045 0 0 831503 678004 660809 977628 0 0 0 0 0 0 0 4651 34010 665460 1011638 166043 -333634 3210420 2876786 0 0 3210420 2876786 X TO ELEVATE HOPE - FOR ALL ATRIUM HEALTH TEAMMATE HEROES - BY PROVIDING EMERGENCY FINANCIAL ASSISTANCE TO TEAMMATES FOR QUALIFYING NEEDS 0 0 1011638 977628 THE ORGANIZATION WAS CREATED TO OPERATE A CHARITABLE DISASTER RELIEF PROGRAM FOR CURRENT AND FUTURE EMPLOYEES OF THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY ("CMHA", DBA ATRIUM HEALTH) AND ANY OF ITS AFFILIATES, AS DESIGNATED BY CMHA (AFFILIATE), AND TO PROVIDE FINANCIAL ASSISTANCE WHEN SUCH TEAMMATES HAVE SUFFERED A HARDSHIP CAUSED BY CATASTROPHIC EVENTS BEYOND THEIR CONTROL.DURING CALENDAR YEAR 2023, THE ORGANIZATION PROVIDED EMERGENCY FINANCIAL ASSISTANCE TO 475 TEAMMATES OF CMHA AND ITS AFFILIATES.DURING CALENDAR YEAR 2023, CMHA DONATED SERVICES TO THE ORGANIZATION TOTALING $49,428. SERVICES DONATED INCLUDE IN-KIND SALARIES AND BENEFITS, AS WELL AS LEGAL, ACCOUNTING, AND BANK FEES TO ASSIST WITH THE ADMINISTRATION OF THE ORGANIZATION. THESE IN-KIND SERVICES ARE NOT INCLUDED IN PART VII OR PART IX IN ACCORDANCE WITH FORM 990 INSTRUCTIONS. 1011638 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 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 5 1 0 0 1 0 1 1 1 1 0 0 0 1 1 1 1 1 1 0 0 0 GA SC X DAVID THOMAS 7046310487 PO BOX 32861 CHARLOTTE NC 283232861 LUCY DEAN CHAIR & PRES (TO 5/31/23) 5.00 35.00 X X 0 326919 22055 LUTETIA BAILEY DIRECTOR 2.50 37.50 X 0 0 0 WENDY RUTH PAXTON DIRECTOR, SECRETARY 2.00 38.00 X X 0 132604 33017 BILL MERRITT DIRECTOR (TO 1/31/23) 4.00 36.00 X 0 0 0 JOE FORQUER CHAIR & PRESIDENT (FR 6/1/23) 2.00 38.00 X X 0 180397 28156 FRANK MCCREE DIRECTOR (FR 1/1/23) 2.00 38.00 X 0 263971 41334 ALINA MOCAN DIRECTOR, ASST TREASURER (FR 1/16/23) 2.00 38.00 X X 0 63473 30392 ELECTA MCPHERSON TREASURER 4.00 36.00 X 0 291220 55887 0 1258584 210841 0 0 1 0 0 631959 631959 46045 46045 678004 0 0 46045 977628 977628 34010 34010 1011638 1011638 0 0 3210420 2876786 3210420 2876786 0 0 X 3210420 2876786 3210420 2876786 3210420 2876786 -333634 0 X 1 X 0 0 0 X 2968626 904916 823738 631959 5329239 2968626 904916 823738 631959 5329239 717339 4611900 15 7765 46045 53825 5383064 X PART II, SHORT YEAR EXPLANATION: PUBLIC SUPPORT IS MEASURED USING A 5 YEAR COMPUTATIONAL PERIOD THAT INCLUDES THE CURRENT YEAR AND THREE PRIOR PERIODS, CALENDAR YEARS 2022 AND 2021 AND THE SHORT YEAR ENDED DECEMBER 31, 2020. THE ORGANIZATION BEGAN OPERATING ON MARCH 25, 2020. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 DIRECT EMPLOYEE ASSISTANCE 475 977628 PART I, LINE 2: THE ORGANIZATION'S BYLAWS, AS ADOPTED BY THE ORGANIZATION'S BOARD OF DIRECTORS ON APRIL 2, 2020, GOVERN THE SELECTION OF GRANTEES/RECIPIENTS. GRANTEES/RECIPIENTS OF ASSISTANCE ARE SELECTED FROM ALL CURRENT AND FUTURE EMPLOYEES OF THE SOLE MEMBER AND ITS AFFILIATE ENTITIES, AS DETERMINED BY THE SOLE MEMBER. THE ELIGIBILITY, OBJECTIVE CRITERIA, AND POLICIES FOR THE ASSISTANCE PROGRAM ARE ESTABLISHED BY THE BOARD OF DIRECTORS. GRANTEES/RECIPIENTS ARE SELECTED BY THE INDEPENDENT DIRECTORS (AS DESCRIBED IN THE ORGANIZATION'S BYLAWS) OR A COMMITTEE APPROVED BY THE BOARD OF DIRECTORS COMPRISED EXCLUSIVELY OF INDIVIDUALS, WHO ARE NOT IN A POSITION TO EXERCISE SUBSTANTIAL INFLUENCE OVER THE AFFAIRS OF THE SOLE MEMBER, SUBJECT TO FINAL APPROVAL OF THE BOARD OF DIRECTORS. NO OFFICER, DIRECTOR, MEMBER OF THE SELECTION COMMITTE, OR ANY FAMILY MEMBER THEREOF, IS ELIGIBLE TO RECEIVE ASSISTANCE. 1 0 0 0 0 0 0 0 0 LUCY DEAN CHAIR & PRES (TO 5/31/23) 0 94472 0 86242 0 146205 0 7080 0 14975 0 348974 0 0 ELECTA MCPHERSON TREASURER 0 210745 0 78484 0 1991 0 20604 0 35283 0 347107 0 0 FRANK MCCREE DIRECTOR (FR 1/1/23) 0 199509 0 41345 0 23117 0 21593 0 19741 0 305305 0 0 JOE FORQUER CHAIR & PRESIDENT (FR 6/1/23) 0 147748 0 20079 0 12570 0 12058 0 16098 0 208553 0 0 WENDY RUTH PAXTON DIRECTOR, SECRETARY 0 124258 0 750 0 7596 0 11282 0 21735 0 165621 0 0 PART I, LINE 4A CERTAIN OFFICERS, KEY EMPLOYEES, AND HIGHLY COMPENSATED EMPLOYEES OF THE FILING ORGANIZATION RECEIVED PAYMENTS FOR SEVERANCE. THE FOLLOWING DIRECTORS, OFFICERS, KEY EMPLOYEES, AND HIGHLY COMPENSATED EMPLOYEES RECEIVED PAYMENTS FOR SEVERANCE DURING THE CURRENT TAX YEAR: SEVERANCE: LUCY DEAN 128,572 FORM 990, PART VI, SECTION A, LINE 4 THE BYLAWS WERE AMENDED TO CHANGE THE SIZE OF THE BOARD OF DIRECTORS.THE BYLAWS PREVIOUSLY SPECIFIED THAT THE BOARD OF DIRECTORS CONSISTED OF FIVE DIRECTORS, THREE OF WHOM MUST BE "INDEPENDENT DIRECTORS" (AS DEFINED IN THE BYLAWS).THE BYLAWS WERE AMENDED TO CREATE A VARIABLE RANGE FOR THE SIZE OF THE BOARD OF DIRECTORS, WITH NO FEWER THAN FIVE AND NO GREATER THAN ELEVEN DIRECTORS, AS ESTABLISHED FROM TIME TO TIME, WITHIN THE MINIMUM AND THE MAXIMUM, BY THE CORPORATION'S SOLE MEMBER, AND A MAJORITY OF THE DIRECTORS MUST BE "INDEPENDENT DIRECTORS" (AS DEFINED IN THE BYLAWS; THE DEFINITION OF "INDEPENDENT DIRECTORS" WAS NOT CHANGED). FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF THE ORGANIZATION IS THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY ("CMHA", DBA ATRIUM HEALTH). FORM 990, PART VI, SECTION A, LINE 7A THE DIRECTORS OF THE FILING ORGANIZATION ARE APPOINTED BY THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY ("CMHA", DBA ATRIUM HEALTH), THE ORGANIZATION'S SOLE MEMBER. FORM 990, PART VI, SECTION A, LINE 7B CMHA, THE SOLE MEMBER OF THE FILING ORGANIZATION, HAS VOTING AND OTHER RIGHTS EXPRESSLY SET FORTH IN THE FILING ORGANIZATION'S BYLAWS, OR AS REQUIRED BY LAW. EXPRESS RIGHTS OF THE SOLE MEMBER PROVIDED IN THE BYLAWS INCLUDE: 1. AMENDING, MODIFYING, OR REPEALING THE ARTICLES OF INCORPORATION; 2. AMENDING, MODIFYING, OR REPEALING ANY PROVISION OF THE BYLAWS THAT AFFECTS ANY RIGHT OR POWER OF THE SOLE MEMBER; AND 3. THE DISSOLUTION OR MERGER OF THE FILING ORGANIZATION, OR THE SALE, PLEDGE, OR TRANSFER OF ALL OR SUBSTANTIALLY ALL OF THE ORGANIZATION'S ASSETS. ADDITIONALLY, CMHA, AS THE SOLE MEMBER, MAY ASSIGN ITS MEMBERSHIP IN THE FILING ORGANIZATION TO ANOTHER PERSON WITHOUT CONSIDERATION IN A WRITING SIGNED BY AN EXECUTIVE OFFICER OF THE SOLE MEMBER AND PROVIDED TO THE SECRETARY OR PRESIDENT OF THE FILING ORGANIZATION. ALL DIRECTORS, OTHER THAN AN INDEPENDENT DIRECTOR (AS DESCRIBED IN THE ORGANIZATION'S BYLAWS), MAY BE REMOVED WITH OR WITHOUT CAUSE BY CMHA AS THE SOLE MEMBER. FORM 990, PART VI, SECTION A, LINE 8B THE FILING ORGANIZATION DOES NOT HAVE COMMITTEES THAT HAVE AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B THE FILING ORGANIZATION'S BOARD OF DIRECTORS RECEIVES A COPY OF THE FORM 990 WITH SUFFICIENT TIME TO PERMIT REVIEW, COMMENT, AND QUESTIONS PRIOR TO ITS FILING. IF MODIFICATIONS ARE REQUIRED FOLLOWING SUCH REVIEW AND COMMENT, THE REVISED FORM 990 IS REDISTRIBUTED TO ALL DIRECTORS PRIOR TO ITS FILING WITH THE IRS, ALONG WITH A REPORT NOTING THE MODIFICATIONS. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST ("COI") POLICY IS APPLICABLE TO ALL "COVERED PERSONS AND APPLIES TO TRANSACTIONS OR OTHER ARRANGEMENTS IN WHICH THE PERSONAL OR FINANCIAL INTERESTS OF A COVERED PERSON MAY APPEAR TO BE ADVANCED BY AN ACTION OF THE ORGANIZATION, OR OTHERWISE WHENEVER A COVERED PERSON'S PERSONAL OR FINANCIAL INTERESTS COULD BE REASONABLY VIEWED AS AFFECTING HIS OR HER OBJECTIVITY OR INDEPENDENCE IN FULFILLING HIS OR HER DUTIES TO THE ORGANIZATION (SUCH TRANSACTION OR ARRANGEMENT, A "COVERED TRANSACTION"). COVERED PERSONS INCLUDES CURRENT OFFICERS, DIRECTORS, SELECTION COMMITTEE MEMBERS, AND EMPLOYEES OF THE ORGANIZATION, AS WELL AS "FAMILY MEMBERS AND "AFFILIATED ENTITIES". "FAMILY MEMBER" INCLUDES ANY SPOUSE (INCLUDING FORMER SPOUSES WITHIN LAST FIVE YEARS), ANCESTOR, SIBLING, CHILD, GRANDCHILD, GREAT-GRANDCHILD, OR THE SPOUSE (OR FORMER SPOUSE WITHIN FIVE YEARS) OF SUCH PERSONS. "AFFILIATED ENTITY" INCLUDES AN ENTITY IN WHICH THE COVERED PERSON IS AN OFFICER, DIRECTOR, TRUSTEE, EMPLOYEE, OR HAS A MORE THAN 10% BENEFICIAL INTEREST (DIRECTLY OR WITH ONE OR MORE FAMILY MEMBERS OR OTHER AFFILIATED ENTITIES). WHEN A COVERED PERSON BECOMES AWARE OF A POSSIBLE COVERED TRANSACTION, HE/SHE HAS A DUTY TO TAKE THE FOLLOWING ACTIONS: IMMEDIATELY DISCLOSE TO THE PRESIDENT OR CHAIR OF THE BOARD OF DIRECTORS; REFRAIN FROM USING HIS/HER PERSONAL INFLUENCE TO ENCOURAGE ENTERING INTO THE COVERED TRANSACTION; AND PHYSICALLY EXCUSE HIMSELF/HERSELF FROM PARTICIPATION IN ANY DISCUSSIONS REGARDING THE COVERED TRANSACTION. THE ORGANIZATION MAY ENTER INTO A COVERED TRANSACTION IF THE BOARD (OR COMMITTEE THEREOF) ACTING IN EITHER CASE WITHOUT THE PARTICIPATION OF THE CONFLICTED PARTY, DETERMINES THAT SUCH TRANSACTION IS FAIR AND REASONABLE TO THE ORGANIZATION. IN ORDER TO ASSIST THE ORGANIZATION IN IDENTIFYING POTENTIAL COVERED TRANSACTIONS, EACH COVERED PERSON WHO SERVES AS A CURRENT OFFICER, DIRECTOR OR KEY EMPLOYEE ANNUALLY COMPLETES AND SIGNS A CONFLICT OF INTEREST DECLARATION ("DECLARATION") PROVIDED BY THE ORGANIZATION, AND UPDATES SUCH DECLARATION AS NECESSARY TO REFLECT CHANGES DURING THE COURSE OF THE YEAR. COMPLETED DECLARATIONS ARE AVAILABLE FOR INSPECTION BY THE BOARD OF DIRECTORS AND THE OFFICERS OF THE ORGANIZATION, AND BY SUCH OTHER PERSONS AS THE PRESIDENT DEEMS APPROPRIATE. THE BOARD (OR COMMITTEE THEREOF) IS RESPONSIBLE FOR REVIEWING ANNUAL DECLARATIONS, RECEIVING DISCLOSURE OF POSSIBLE COVERED TRANSACTIONS, REVIEWING COVERED TRANSACTIONS, MAINTAINING DOCUMENTATION OF REVIEW OF COVERED TRANSACTIONS (INCLUDING NATURE AND RESOLUTION), AND REPORTING TO THE BOARD ALL FINDINGS AND ACTIONS (IF PROCEDURES ARE ADMINISTERED BY A COMMITTEE OF THE BOARD). THE BOARD HAS AUTHORITY TO REVIEW THE OPERATION OF THE COI POLICY AND MAKE CHANGES FROM TIME TO TIME AS IT DEEMS APPROPRIATE. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S ARTICLES OF INCORPORATION ARE AVAILABLE TO THE PUBLIC ON REQUEST AND ARE AVAILABLE ON THE WEBSITE OF THE NORTH CAROLINA SECRETARY OF STATE. THE ORGANIZATION'S BYLAWS ARE NOT PUBLISHED, BUT PROVISIONS FROM THE BYLAWS ARE INCLUDED AS NECESSARY IN THE ORGANIZATION'S POLICIES, AND ARE ATTACHED TO THE FORM 1023 FILED FOR THE ORGANIZATION WITH THE IRS, WHICH IS PUBLICLY AVAILABLE. THE CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC ON REQUEST. AH GEORGIA INC PO BOX 32861 CHARLOTTE NC 282322861 831707383 HEALTHCARE MANAGEMENT NC 501(C)(3) LINE 10 CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY 0 AHSNF INC PO BOX 32861 CHARLOTTE NC 282322861 842727303 HEALTHCARE NC 501(C)(3) LINE 7 CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY 0 1717 GARDEN TERRACE LLC PO BOX 32861 CHARLOTTE NC 282322861 260897680 REAL ESTATE NC NC POLITICAL SUBDIVI CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY 0 3021 NESBITT LLC PO BOX 32861 CHARLOTTE NC 282322861 853018530 REAL ESTATE DE NC POLITICAL SUBDIVI CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY 0 ABC PARKWAY LLC PO BOX 32861 CHARLOTTE NC 282322861 REAL ESTATE NC NC POLITICAL SUBDIVI CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY 0 ATRIUM HEALTH HUNTERSVILLE ASC LLC PO BOX 32861 CHARLOTTE NC 282322861 863426328 HEALTHCARE NC NC POLITICAL SUBDIVI CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY 0 AV INSURANCE LLC PO BOX 32861 CHARLOTTE NC 282322861 205608253 INSURANCE NC NC POLITICAL SUBDIVI CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY 0 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