2024-11-14T13:27:37-06:00 2023-12-31 990 2023-01-01 560928089 FORSYTH MEMORIAL HOSPITAL INC FORS 3362772411 2085 FRONTIS PLAZA BLVD WINSTON SALEM NC 27103 ALICE POPE EVP & CFO 3362772411 2024-11-14 1 2023 2024-10-15 13:58:12Z NOVANT HEALTH FORSYTH MEDICAL CENTER CARL ARMATO 2085 FRONTIS PLAZA BLVD WINSTON SALEM NC 27103 1474101679 0 X WWW.NOVANTHEALTH.ORG X 1968 NC SEE SCHEDULE O 17 13 7947 427 0 0 22273285 2376136 1347574893 1430937885 945729 513788 7070517 8260661 1377864424 1442088470 2104271 3479419 0 0 590311344 626191213 0 0 0 817030092 815089941 1409445707 1444760573 -31581283 -2672103 2102000445 2056045743 196380928 160164353 1905619517 1895881390 X SEE SCHEDULE O 0 0 1159391979 3479419 1431674901 FORSYTH MEMORIAL HOSPITAL, INC. ("FMH") DBA NOVANT HEALTH FORSYTH MEDICAL CENTER ("NHFMC"), NOVANT HEALTH KERNERSVILLE MEDICAL CENTER ("NHKMC"), AND NOVANT HEALTH CLEMMONS MEDICAL CENTER ("NHCMC"), ALONG WITH THEIR PROVIDER BASED PHYSICIAN PRACTICES, EXISTS TO CARRY OUT THE PURPOSE OF THE FORSYTH COUNTY BOARD OF COMISSIONERS BY ADVANCING AND SUPPORTING THE PROMOTION OF HEALTH FOR MEMBERS OF MULTIPLE COMMUNITIES IN FORSYTH COUNTY NORTH CAROLINA, INCLUDING WINSTON-SALEM, KERNERSVILLE, AND CLEMMONS. THESE HOSPITAL FACLIITIES MAINTAIN AN OPEN DOOR POLICY, ACCEPTING ALL PATIENTS REGARDLESS OF A PATIENT'S ABILITY TO PAY. (CONTINUED ON SCHEDULE O) 1159391979 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 1 0 0 7947 1 0 0 0 0 0 0 0 0 0 0 1 0 X 17 13 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 1 1 X X WENDI STOCKSTILL 3362772411 2085 FRONTIS PLAZA BLVD WINSTON SALEM NC 27103 X ASHLEY PERROTT MD TRUSTEE, SR PHYS EXEC 45.20 0.00 X 567670 0 42591 AVERY HALL CHAIR 0.20 0.00 X X 0 0 0 CARL ARMATO TRUSTEE (FR 1/1/23)/PRES/CEO NH 0.20 50.00 X 0 5820530 1206191 CHARLES HAUSER TRUSTEE 0.20 0.00 X 0 0 0 CHARLES WELTON TRUSTEE 0.20 0.00 X 0 0 0 FRANKLIN CHEN MD TRUSTEE, CLIN PHYS EXEC 0.20 45.00 X 0 665459 56806 IMEN CLARK TRUSTEE (TO 12/31/23) 0.20 0.00 X 0 0 0 KRISTINE SIMS TRUSTEE 0.20 0.00 X 0 0 0 LARI HARDING TRUSTEE 0.20 0.00 X 0 0 0 LINDA LATHAM VICE CHAIR 0.20 0.00 X X 0 0 0 MARK OWENS TRUSTEE 0.20 0.00 X 0 0 0 MIKE HORN SECR/TREAS 0.20 0.00 X X 0 0 0 PHYLLIS CALDWELL-GEORGE TRUSTEE (FR 1/1/23) 0.20 0.00 X 0 0 0 ROBERT LANDRY TRUSTEE 0.20 0.00 X 0 0 0 SAMUEL BAREFOOT TRUSTEE 0.20 0.00 X 0 0 0 TRACEY MARTIN TRUSTEE 0.20 0.00 X 0 0 0 WILLIAM HALL TRUSTEE 0.20 0.00 X 0 0 0 FRED HARGETT EVP/CFO (TO 9/6/23) 0.20 50.00 X 0 2400670 50705 GEOFFREY GARDNER CFO (FR 9/6/23) 0.20 50.00 X 0 909106 128749 MICHAEL SETLIFF PRES NHFMC/GWM 50.00 0.00 X 1176474 0 159580 ALISHA HUTCHENS PRES, COO 50.00 0.00 X 492552 0 57272 JOHN MANN MD SVP NH INST 35.00 10.00 X 917005 202759 167716 JUDSON RACKLEY MD UROLOGIST 45.00 0.00 X 778934 0 59324 ROLAND FRIEDMAN MD UROLOGIST 45.00 0.00 X 986764 0 59868 STANLEY FULLER MD SVP CH CLIN OFFICER 45.00 0.20 X 947480 0 153328 SUSAN HINES MD ONCOLOGIST 45.00 0.00 X 778450 0 46439 KIRSTEN ROYSTER FMR KE (12/31/21) 45.00 0.00 X 749705 0 99102 7395034 9998524 2287671 951 1 1 0 VANNOY CONSTRUCTION PO BOX 635 JEFFERSON NC 28640 CONSTRUCTION SERVICES 109288378 AYA HEALTHCARE INC DEPT 3519 PO BOX 123519 DALLAS TX 75312 STAFFING SERVICES 62121557 MORRISON HEALTHCARE PO BOX 102289 ATLANTA GA 30368 FOOD MANAGEMENT SERVICES 18384160 LABORATORY CORPORATION OF AMERICA HOLDIN PO BOX 12140 BURLINGTON NC 27216 LAB SERVICES 16258478 CHRISTMAN DA EVERETT A J VENTURE 208 N CAPITOL AVENUE LANSING MI 48933 CONSTRUCTION SERVICES 12530163 115 1786210 402575 187351 2376136 NET PATIENT REVENUE 622110 1390415455 1390415455 PHARMACY 622110 33115270 33115270 PASS-THRU PATIENT REVENUE 621111 4179788 4179788 VALUE BASED INCENTIVE 900099 3152492 3152492 PHYSICIAN SERVICES 621111 74880 74880 1430937885 747909 747909 319790 0 319790 319790 319790 31741900 31976021 -234121 -234121 -234121 69998 37188 32810 32810 CAFETERIA MEALS 722514 4434187 4434187 CHILD DEVELOPMENT CENTER 624410 1813594 1813594 PARKING 812930 442646 442646 1217634 737016 480618 7908061 1442088470 1431674901 0 8037433 X 2845636 2845636 633783 633783 2496139 2496139 1809795 1809795 497532106 477630819 19901287 20374824 19559831 814993 72252587 69362484 2890103 31725762 30456732 1269030 4758 4758 115543945 104885466 10658479 598205 574283 23922 4788115 3745250 1042865 10122493 9875421 247072 31549422 30335875 1213547 749441 720365 29076 170211 163403 6808 18139574 18139574 32648855 29965884 2682971 8443448 7766838 676610 CORPORATE SUPPORT 223827888 223827888 MEDICAL SUPPLIES 166885659 166696715 188944 PHARMACEUTICALS 81830468 81830468 CONTRACT LABOR 75197939 72190021 3007918 44589520 32013131 12576389 1444760573 1159391979 285368594 0 95308 153443 216795688 243372959 11460024 11017276 30572456 28948254 974990 1378040 864740558 398345481 356616965 466395077 35543671 32555109 1559385 1559385 1448381958 1270666200 2102000445 2056045743 141893082 101354638 128664 10530 54359182 58799185 196380928 160164353 X 1905619067 1895880940 450 450 1905619517 1895881390 2102000445 2056045743 X -2672103 -7066024 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 1 0 0 0 0 1 536 0 1 66929 67465 0 PART II-B, LINE 1: LINE 1A THERE IS LIMITED ENGAGEMENT OF THE BOARD. LINE 1B THERE IS MINIMAL TIME OF SENIOR LEADERS. LINE 1G THERE IS LIMITED CONTACT MADE BY SENIOR LEADERS DURING LOBBYING ACTIVITIES. LINE 1I DUES PAID TO CERTAIN ORGANIZATIONS WHICH INCLUDE A PORTION RELATED TO LOBBYING ACTIVITIES. 450 450 450 450 450 450 450 450 363 87 450 0.00000 1.00000 0.00000 0 0 10727897 10727897 172290527 67682345 104608182 15318794 9436361 5882433 406088972 307402941 98686031 260314368 13823834 246490534 466395077 OTHER ASSETS 533226 DUE FROM AFFILIATE 1241418939 RIGHT OF USE ASSETS 28714035 1270666200 0 OTHER LIABILITIES 13243073 PATIENT REFUNDS 6182969 THIRD PARTY PAYMENT PAYABLE 9152283 OPERATING LEASE 30220860 58799185 X PART V, LINE 4: THE ENDOWMENT FUNDS ARE HELD FOR COMMUNITY ENGAGEMENT. PART X, LINE 2: PART X, LINE 2: LIABILITY UNDER FIN 48 (ASC 740) FOOTNOTE THE AUDIT FOR NOVANT HEALTH AND ITS AFFILIATES IS PREPARED ON A CONSOLIDATED BASIS. THE COMPANY IS REQUIRED TO EVALUATE UNCERTAIN TAX POSITIONS. THIS EVALUATION INCLUDES A QUANTIFICATION OF TAX RISK IN AREAS SUCH AS UNRELATED BUSINESS TAXABLE INCOME AND THE TAXATION OF OUR FOR-PROFIT SUBSIDIARIES. THIS EVALUATION DID NOT HAVE A MATERIAL EFFECT ON THE COMPANY'S CONSOLIDATED STATEMENTS OF OPERATIONS AND CHANGES IN NET ASSETS FOR THE YEARS ENDED DECEMBER 31, 2023 AND 2022. 1 1 X 1 X 300.000000000000 0 0 1 0 1 1 55234257 55234257 0.03820 210113828 182185588 27928240 0.01930 2514043 1815916 698127 0.00050 267862128 184001504 83860624 0.05800 1274640 79012 1195628 0.00080 7078007 536039 6541968 0.00450 31460686 16669336 14791350 0.01020 1524124 1524124 0.00110 1521265 1521265 0.00110 42858722 17284387 25574335 0.01770 310720850 201285891 109434959 0.07570 115 115 0.00000 25689 25689 0.00000 885835 885835 0.00060 5000 5000 0.00000 10977 10977 0.00000 30000 30000 0.00010 160339 160339 0.00010 1117955 1117955 0.00080 1 53458145 175888826 200123343 -24234517 X 1 0 4 1 FMH DBA NOVANT HEALTH FORSYTH MEDICAL CENTER 3333 SILAS CREEK PARKWAY WINSTONSALEM NC 27103 WWW.NOVANTHEALTH.ORG H0209 X X X A 2 FMH DBA NOVANT HEALTH KERNERSVILLE MED CENTER 1750 KERNERSVILLE MEDICAL PARKWAY KERNERSVILLE NC 27284 WWW.NOVANTHEALTH.ORG H0209 X X X A 3 FMH DBA NOVANT HEALTH CLEMMONS MEDICAL CENTER 6915 VILLAGE MEDICAL CIRCLE CLEMMONS NC 27012 WWW.NOVANTHEALTH.ORG H0209 X X X A 4 NOVANT HEALTH REHABILITATION HOSPITAL 2475 HILLCREST CENTER CIRCLE WINSTONSALEM NC 27103 WWW.ENCOMPASSHEALTH.COM/LOCATIONS/NOVA H0291 X SPECIALTY - REHABILITATION B FORSYTH MEMORIAL HOSPITAL INC 0 0 1 X X X X X X X X X 22 1 0 1 1 X SEE SECTION C X 1 22 1 SEE SECTION C 0 1 X 300.000000000000 0.000000000000 X X X X 1 1 X X X 1 X SEE SECTION C X SEE SECTION C X SEE SECTION C X X X X X X 1 X 0 X X X X 1 X 0 0 NOVANT HEALTH REHABILITATION HOSPITAL 0 0 1 X X X X X X X X X 22 1 0 1 1 X SEE SECTION C X 1 22 1 SEE SECTION C 0 1 X 300.000000000000 0.000000000000 X X 1 1 X X X 1 X SEE SECTION C X SEE SECTION C X SEE SECTION C X X X X X 1 X 0 X X X X 0 X X 0 0 PART V, SECTION B FACILITY REPORTING GROUP A FACILITY REPORTING GROUP A CONSISTS OF: - FACILITY 1: FMH DBA NOVANT HEALTH FORSYTH MEDICAL CENTER, - FACILITY 2: FMH DBA NOVANT HEALTH KERNERSVILLE MED CENTER, - FACILITY 3: FMH DBA NOVANT HEALTH CLEMMONS MEDICAL CENTER FORSYTH MEMORIAL HOSPITAL, INC. PART V, SECTION B, LINE 3J: FORSYTH MEMORIAL HOSPITAL, INC.PART V, SECTION B, LINE 3E:VARIOUS SOCIAL, BEHAVIORAL, AND CLINICAL HEALTH NEEDS WERE IDENTIFIED THROUGH PRIMARY AND SECONDARY DATA IN THE NEEDS ASSESSMENT. ONCE THE HEALTH NEEDS WERE IDENTIFIED, SURVEYS AND COMMUNITY MEETINGS WERE CONDUCTED IN WHICH THE VARIOUS COMMUNITY STAKEHOLDERS RANKED THE HEALTH ISSUES BASED ON AVAILABLE DATA INCLUDING SEVERITY OF NEED AND MAGNITUDE OF IMPACT. THE INFORMATION GATHERED WAS THEN MATRIXED AND SCORED IN ORDER TO RANK THE FOCUS AREAS AND PRIORITIZE THE IDENTIFIED HEALTH NEEDS, BASED ON CAREFUL CONSIDERATION OF ESTIMATED FEASIBILITY AND EFFECTIVENESS OF POSSIBLE INTERVENTIONS. THE PRIORITIZED IDENTIFIED HEALTH NEEDS AND SUPPORTING DATA ARE THEN REVIEWED AND DELIBERATED UPON FURTHER BY THE BOARD BEFORE FINAL APPROVAL. AN IMPLEMENTATION PLAN WAS CREATED FOR THE PRIORITIZED HEALTH NEEDS AND PROGRESS TOWARD MEETING IMPLEMENTATION PLAN GOALS IS ASSESSED REGULARLY THROUGHOUT THE COMMUNITY HEALTH NEEDS ASSESSMENT LIFE CYCLE. COMMUNITY PARTNERS WHO ARE CURRENTLY SERVING COMMUNITY NEEDS ARE IDENTIFIED AS POTENTIAL PARTNERS FOR COLLABORATION ON THOSE IDENTIFIED NEEDS THAT ARE NOT PART OF THE IMPLEMENTATION PLAN. FORSYTH MEMORIAL HOSPITAL, INC. PART V, SECTION B, LINE 5: WHILE CONDUCTING THE COMMUNITY HEALTH NEEDS ASSESSMENT ("CHNA"), NOVANT HEALTH HOSPITAL FACILITIES SOLICITED INPUT FROM AND CONSULTED WITH A VARIETY OF COMMUNITY MEMBERS AND REPRESENTATIVES INCLUDING, BUT NOT LIMITED TO, REPRESENTATIVES OF CITY AND COUNTY GOVERNMENT, COUNTY HEALTH DEPARTMENTS, COMMUNITY-BASED ORGANIZATIONS, FOUNDATIONS, CHURCHES, COLLEGES/UNIVERSITIES, COMMUNITY COALITIONS AND OTHER SOCIAL SERVICE AGENCIES. INPUT WAS GATHERED THROUGH A COMMUNITY SURVEY (DISTRIBUTED THROUGH A VARIETY OF PARTNERS, METHODS, AND CHANNELS), COMMUNITY MEETINGS AND/OR FOCUS GROUPS, AND STAKEHOLDER'S INTERVIEWS. INPUT WAS ALSO SOLICITED THROUGH WRITTEN COMMENTS THROUGHOUT THE SURVEY PERIOD UNTIL THE FINAL COMMUNITY PRIORITY SETTING MEETING(S) AND/OR SURVEY. THE SCOPE OF EXPERTISE WAS BROAD AND INCLUDED REPRESENTATIVES OF PUBLIC HEALTH, MINORITY POPULATIONS, HEALTH DISPARITIES, AND SOCIAL SERVICES. DATA DERIVED FROM THESE EXERCISES IS BOTH QUANTITATIVE AND QUALITATIVE IN SCOPE.FORSYTH MEMORIAL HOSPITAL (DBA NOVANT HEALTH FORSYTH MEDICAL CENTER, NOVANT HEALTH CLEMMONS MEDICAL CENTER, AND NOVANT HEALTH KERNERSVILLE MEDICAL CENTER), IN PARTNERSHIP WITH THE FORSYTH COUNTY DEPARTMENT OF PUBLIC HEALTH, AND FORSYTH COUNTY COMMUNITY PARTNERS, CONDUCTED A COMPREHENSIVE CHNA THAT WAS APPROVED BY THE BOARD OF TRUSTEES IN 2022. THIS CHNA PROCESS INCLUDED EXTENSIVE PRIMARY AND SECONDARY DATA COLLECTION, USING THE COMMUNITY HEALTH OPINION SURVEY, AND VARIOUS LOCAL, STATE AND FEDERAL DATA SOURCES. THE CHNA SURVEY WAS DISTRIBUTED FROM JULY 2021 TO OCTOBER 2021 TO COUNTY RESIDENTS WITH THE HELP OF MORE THAN 300 NON-PROFIT COMMUNITY PARTNER AGENCIES AND REDUCED COST COMMUNITY CLINICS THROUGHOUT FORSYTH COUNTY. THE SURVEY WAS AVAILABLE IN BOTH SPANISH AND ENGLISH. FROM NOVEMBER 2021 TO FEBRUARY 2022, VIRTUAL COMMUNITY MEETINGS WERE CONDUCTED WITH COMMUNITY PARTNERS WITH PARTICIPATION FROM KEY COMMUNITY STAKEHOLDERS ON THE STEERING COMMITTEE, INCLUDING BUT NOT LIMITED TO: FORSYTH COUNTY DEPARTMENT OF PUBLIC HEALTH, FORSYTH COUNTY SHERIFF'S OFFICE, UNION BAPTIST CHURCH, WINSTON-SALEM/FORSYTH COUNTY SCHOOLS, FORSYTH COUNTY EMERGENCY MEDICAL SERVICES, AND THE FORSYTH REGIONAL OPIOID & SUBSTANCE USE TEAM. THESE COMMUNITY PARTNERS SERVE VARIOUS COMMUNITIES, REPRESENTING THE INTERESTS OF MANY COUNTY RESIDENTS, INCLUDING MEDICALLY UNDERSERVED, LOW-INCOME AND MINORITY INDIVIDUALS, INDIVIDUALS WITH SUBSTANCE USE DISORDER DIAGNOSES, INDIVIDUALS WHO HAVE HAD INTERACTIONS WITH THE JUSTICE SYSTEM, AND INDIVIDUALS WITH GEOGRAPHIC OR FINANCIAL BARRIERS WITH ACCESSING PRIMARY CARE. ADDITIONALLY, COMMUNITY PARTNERS INVOLVED IN THE CHNA PROCESS SERVE INDIVIDUALS SPANNING ACROSS DIVERSE RACES, ETHNICITIES, AGES, SEXUAL ORIENTATIONS, PREFERRED LANGUAGES, AND GENDER IDENTITY DEMOGRAPHICS. SPECIFIC REFERENCES AND OTHER SUPPORTING INFORMATION CAN BE FOUND IN THE MOST RECENT CHNA LOCATED AT HTTPS://WWW.NOVANTHEALTH.ORG/ABOUT/OUR-IMPACT/COMMUNITY-HEALTH-NEEDS/. FORSYTH MEMORIAL HOSPITAL, INC. PART V, SECTION B, LINE 6B: FORSYTH COUNTY DEPARTMENT OF PUBLIC HEALTH FORSYTH MEMORIAL HOSPITAL, INC. PART V, SECTION B, LINE 7D: FORSYTH MEMORIAL HOSPITAL, INC.PART V, SECTION B, LINE 7BHTTPS://WWW.NOVANTHEALTH.ORG/ABOUT/COMMUNITY/COMMUNITY-HEALTH-NEEDS/FORSYTH MEMORIAL HOSPITAL, INC.PART V, SECTION B, LINE 10AHTTPS://WWW.NOVANTHEALTH.ORG/ABOUT/COMMUNITY/COMMUNITY-HEALTH-NEEDS/ FORSYTH MEMORIAL HOSPITAL, INC. PART V, SECTION B, LINE 11: THE FACILITY'S CHNA IDENTIFIED MULTIPLE NEEDS FOR THE COMMUNITY SERVED. THE NEEDS IDENTIFIED WERE REVIEWED AND PRIORITIZED BY THE CHNA RESOURCE GROUP AND SUBSEQUENTLY BY EACH FACILITY'S BOARD. THEY EVALUATED EACH DOCUMENTED NEED AND ITS INTERSECTION WITH THE ORGANIZATION'S VISION, COMMITMENTS, KEY STRENGTHS AND AVAILABLE RESOURCES BEFORE FURTHER PRIORITIZING THE HEALTH NEEDS AND AGREEING UPON THE TOP HEALTH PRIORITIES TO BE ADDRESSED. WHERE POSSIBLE, THE FACILITIES LEVERAGED THE SYSTEM'S STRENGTHS AND RESOURCES TO BEST ADDRESS THOSE NEEDS THAT ARE HIGHEST IN PRIORITY BASED ON SCOPE, SEVERITY, HEALTH DISPARITIES ASSOCIATED WITH THE NEED, AND THE ESTIMATED FEASIBILITY AND EFFECTIVENESS OF POSSIBLE INTERVENTIONS. EACH FACILITY HAS ADOPTED AND EXECUTED AN IMPLEMENTATION STRATEGY THAT ADDRESSES THE PRIORITIZED COMMUNITY HEALTH NEEDS FROM THE CHNAS. THE IMPLEMENTATION STRATEGIES OUTLINE THE PLAN THAT THE HOSPITAL FACILITIES UNDERTAKE TO MEET THOSE HEALTH NEEDS IN EACH COMMUNITY SERVED. CERTAIN NEEDS THAT WERE IDENTIFIED BY THE CHNA HAVE NOT BEEN ADDRESSED. CERTAIN OF THE NEEDS NOT ADDRESSED FALL OUTSIDE THE SCOPE OF TRADITIONAL HEALTHCARE (E.G., DENTAL WORK). OTHER NEEDS ARE ADDRESSED BY COLLABORATIVE WORK AND HAVE OTHER RESOURCES IN THE COMMUNITY THAT CAN MORE APPROPRIATELY MEET THESE NEEDS BASED ON SCOPE OF SERVICES AND EXPERTISE.FORSYTH MEMORIAL HOSPITAL (DBA NOVANT HEALTH FORSYTH MEDICAL CENTER, NOVANT HEALTH CLEMMONS MEDICAL CENTER, AND NOVANT HEALTH KERNERSVILLE MEDICAL CENTER) CONDUCTED A COMPREHENSIVE CHNA THAT WAS APPROVED BY THE BOARD OF TRUSTEES IN 2022. RESULTS FROM THIS CHNA PROCESS HELPED IDENTIFY THE FOLLOWING SIGNIFICANT HEALTH NEEDS FOR FORSYTH COUNTY: CHRONIC DISEASE, DRUG OVERDOSE (SUBSTANCE ABUSE), MATERNAL & INFANT HEALTH, INFANT MORTALITY (RACE/ETHNIC DISPARITY RATIO), MENTAL HEALTH, AND VIOLENCE-RELATED BEHAVIORS. AFTER THOROUGH EVALUATION OF EACH DOCUMENTED NEED AND ITS INTERSECTION WITH THE ORGANIZATION'S VISION, COMMITMENTS, KEY STRENGTHS AND AVAILABLE RESOURCES, THE FOLLOWING TOP THREE HEALTH NEEDS WERE IDENTIFIED AS PRIORITY AREAS FOR NOVANT HEALTH FORSYTH MEDICAL CENTER: ACCESS TO CARE AND RESOURCES, MATERNAL & INFANT HEALTH, AND CHRONIC DISEASES. THE FOLLOWING TOP TWO HEALTH NEEDS WERE IDENTIFIED AS PRIORITY AREAS FOR NOVANT HEALTH CLEMMONS MEDICAL CENTER AND NOVANT HEALTH KERNERSVILLE MEDICAL CENTER: ACCESS TO CARE & RESOURCES, AND CHRONIC DISEASES. NOVANT HEALTH HAS DEVELOPED STRATEGIC IMPLEMENTATION PLANS TO ADDRESS THESE PRIORITIZED AREAS OF NEED AND IS COMMITTED TO IMPROVING THE COMMUNITY'S HEALTH. SPECIFIC REFERENCES AND OTHER SUPPORTING INFORMATION CAN BE FOUND IN THE MOST RECENT CHNA LOCATED AT HTTPS://WWW.NOVANTHEALTH.ORG/ABOUT/OUR-IMPACT/COMMUNITY-HEALTH-NEEDS/. FORSYTH MEMORIAL HOSPITAL, INC. PART V, SECTION B, LINE 13H: OTHER ELIGIBILITY CRITERIA EXPLAINED IN THE FAP INCLUDE THE FOLLOWING: FREE CARE IS ONLY APPLICABLE TO MEDICALLY NECESSARY SERVICES; PROVIDER BASED PHYSICIAN CLINICS REQUIRE THAT PATIENTS MUST HAVE BEEN TREATED BY AN AFFILIATED MEDICAL GROUP PRIMARY CARE PHYSICIAN WITHIN THE PREVIOUS THREE YEARS; PATIENTS MUST BE UNABLE TO ACCESS ENTITLEMENT PROGRAMS; PATIENTS WITH SPECIAL CIRCUMSTANCES SUCH AS BANKRUPTCY MAY ALSO BE ELIGIBLE FOR CHARITY CARE. SCHEDULE H, PART V, SECTION B. FACILITY REPORTING GROUP APART V, LINE 16A, FAP WEBSITE:HTTPS://WWW.NOVANTHEALTH.ORG/FOR-PATIENTS/BILLING--INSURANCE/FINANCIAL-ASSISTANCE/SCHEDULE H, PART V, SECTION B. FACILITY REPORTING GROUP APART V, LINE 16B, FAP APPLICATION:HTTPS://WWW.NOVANTHEALTH.ORG/GLOBALASSETS/BUTTONS-AND-DOCUMENTS-CTASLINKS/DOCUMENTS-PDFS/FAA_APP_ENGLISH.PDFSCHEDULE H, PART V, SECTION B. FACILITY REPORTING GROUP APART V, LINE 16C, FAP PLAIN LANGUAGE SUMMARY:HTTPS://WWW.NOVANTHEALTH.ORG/GLOBALASSETS/BUTTONS-AND-DOCUMENTS-CTASLINKS/DOCUMENTS-PDFS/NOVANT-HEALTH-ACUTE-PLS-ENGLISH.PDF PART V, SECTION B FACILITY REPORTING GROUP B FACILITY REPORTING GROUP B CONSISTS OF: - FACILITY 4: NOVANT HEALTH REHABILITATION HOSPITAL NOVANT HEALTH REHABILITATION HOSPITAL PART V, SECTION B, LINE 3J: NOVANT HEALTH REHABILITATION HOSPITALPART V, SECTION B, LINE 3E:VARIOUS SOCIAL, BEHAVIORAL, AND CLINICAL HEALTH NEEDS WERE IDENTIFIED THROUGH PRIMARY AND SECONDARY DATA IN THE NEEDS ASSESSMENT. ONCE THE HEALTH NEEDS WERE IDENTIFIED, SURVEYS AND COMMUNITY MEETINGS WERE CONDUCTED IN WHICH THE VARIOUS COMMUNITY STAKEHOLDERS RANKED THE HEALTH ISSUES BASED ON AVAILABLE DATA INCLUDING SEVERITY OF NEED AND MAGNITUDE OF IMPACT. THE INFORMATION GATHERED WAS THEN MATRIXED AND SCORED IN ORDER TO RANK THE FOCUS AREAS AND PRIORITIZE THE IDENTIFIED HEALTH NEEDS, BASED ON CAREFUL CONSIDERATION OF ESTIMATED FEASIBILITY AND EFFECTIVENESS OF POSSIBLE INTERVENTIONS. THE PRIORITIZED IDENTIFIED HEALTH NEEDS AND SUPPORTING DATA ARE THEN REVIEWED AND DELIBERATED UPON FURTHER BY THE BOARD BEFORE FINAL APPROVAL. AN IMPLEMENTATION PLAN WAS CREATED FOR THE PRIORITIZED HEALTH NEEDS AND PROGRESS TOWARD MEETING IMPLEMENTATION PLAN GOALS IS ASSESSED REGULARLY THROUGHOUT THE COMMUNITY HEALTH NEEDS ASSESSMENT LIFE CYCLE. COMMUNITY PARTNERS WHO ARE CURRENTLY SERVING COMMUNITY NEEDS ARE IDENTIFIED AS POTENTIAL PARTNERS FOR COLLABORATION ON THOSE IDENTIFIED NEEDS THAT ARE NOT PART OF THE IMPLEMENTATION PLAN. NOVANT HEALTH REHABILITATION HOSPITAL PART V, SECTION B, LINE 5: WHILE CONDUCTING THE COMMUNITY HEALTH NEEDS ASSESSMENT ("CHNA"), NOVANT HEALTH HOSPITAL FACILITIES SOLICITED INPUT FROM AND CONSULTED WITH A VARIETY OF COMMUNITY MEMBERS AND REPRESENTATIVES INCLUDING, BUT NOT LIMITED TO, REPRESENTATIVES OF CITY AND COUNTY GOVERNMENT, COUNTY HEALTH DEPARTMENTS, COMMUNITY-BASED ORGANIZATIONS, FOUNDATIONS, CHURCHES, COLLEGES/UNIVERSITIES, COMMUNITY COALITIONS AND OTHER SOCIAL SERVICE AGENCIES. INPUT WAS GATHERED THROUGH A COMMUNITY SURVEY (DISTRIBUTED THROUGH A VARIETY OF PARTNERS, METHODS, AND CHANNELS), COMMUNITY MEETINGS AND/OR FOCUS GROUPS, AND STAKEHOLDER'S INTERVIEWS. INPUT WAS ALSO SOLICITED THROUGH WRITTEN COMMENTS THROUGHOUT THE SURVEY PERIOD UNTIL THE FINAL COMMUNITY PRIORITY SETTING MEETING(S) AND/OR SURVEY. THE SCOPE OF EXPERTISE WAS BROAD AND INCLUDED REPRESENTATIVES OF PUBLIC HEALTH, MINORITY POPULATIONS, HEALTH DISPARITIES, AND SOCIAL SERVICES. DATA DERIVED FROM THESE EXERCISES IS BOTH QUANTITATIVE AND QUALITATIVE IN SCOPE.NOVANT HEALTH REHABILITATION HOSPITAL, IN PARTNERSHIP WITH THE FORSYTH COUNTY DEPARTMENT OF PUBLIC HEALTH, AND FORSYTH COUNTY COMMUNITY PARTNERS, CONDUCTED A COMPREHENSIVE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) THAT WAS APPROVED BY THE BOARD OF TRUSTEES IN 2022. THIS CHNA PROCESS INCLUDED EXTENSIVE PRIMARY AND SECONDARY DATA COLLECTION, USING THE COMMUNITY HEALTH OPINION SURVEY, AND VARIOUS LOCAL, STATE, AND FEDERAL DATA SOURCES. THE CHNA SURVEY WAS DISTRIBUTED FROM JULY 2021 TO OCTOBER 2021 TO COUNTY RESIDENTS WITH THE HELP OF MORE THAN 300 NON-PROFIT COMMUNITY PARTNER AGENCIES AND REDUCED COST COMMUNITY CLINICS THROUGHOUT FORSYTH COUNTY. THE SURVEY WAS AVAILABLE IN BOTH SPANISH AND ENGLISH. FROM NOVEMBER 2021 TO FEBRUARY 2022, VIRTUAL COMMUNITY MEETINGS WERE CONDUCTED WITH COMMUNITY PARTNERS WITH PARTICIPATION FROM KEY COMMUNITY STAKEHOLDERS ON THE STEERING COMMITTEE, INCLUDING BUT NOT LIMITED TO: FORSYTH COUNTY DEPARTMENT OF PUBLIC HEALTH, FORSYTH COUNTY SHERIFF'S OFFICE, UNION BAPTIST CHURCH, WINSTON-SALEM/FORSYTH COUNTY SCHOOLS, FORSYTH COUNTY EMERGENCY MEDICAL SERVICES, AND THE FORSYTH REGIONAL OPIOID & SUBSTANCE USE TEAM. THESE COMMUNITY PARTNERS SERVE VARIOUS COMMUNITIES, REPRESENTING THE INTERESTS OF MANY COUNTY RESIDENTS, INCLUDING MEDICALLY UNDERSERVED, LOW-INCOME AND MINORITY INDIVIDUALS, INDIVIDUALS WITH SUBSTANCE USE DISORDER DIAGNOSES, INDIVIDUALS WHO HAVE HAD INTERACTIONS WITH THE JUSTICE SYSTEM, AND INDIVIDUALS WITH GEOGRAPHIC OR FINANCIAL BARRIERS WITH ACCESSING PRIMARY CARE. ADDITIONALLY, COMMUNITY PARTNERS INVOLVED IN THE CHNA PROCESS SERVE INDIVIDUALS SPANNING ACROSS DIVERSE RACES, ETHNICITIES, AGES, SEXUAL ORIENTATIONS, PREFERRED LANGUAGES, AND GENDER IDENTITY DEMOGRAPHICS.SPECIFIC REFERENCES AND OTHER SUPPORTING INFORMATION CAN BE FOUND IN THE MOST RECENT CHNA HERE: HTTPS://WWW.NOVANTHEALTH.ORG/ABOUT/OUR-IMPACT/COMMUNITY-HEALTH-NEEDS/ NOVANT HEALTH REHABILITATION HOSPITAL PART V, SECTION B, LINE 6B: FORSYTH COUNTY DEPARTMENT OF PUBLIC HEALTH NOVANT HEALTH REHABILITATION HOSPITAL PART V, SECTION B, LINE 7D: NOVANT HEALTH REHABILITATION HOSPITALPART V, SECTION B, LINE 7BHTTPS://ENCOMPASSHEALTH.COM/LOCATIONS/NOVANTHEALTHREHABNOVANT HEALTH REHABILITATION HOSPITALPART V, SECTION B, LINE 10AHTTPS://ENCOMPASSHEALTH.COM/LOCATIONS/NOVANTHEALTHREHAB NOVANT HEALTH REHABILITATION HOSPITAL PART V, SECTION B, LINE 11: THE FACILITIES' CHNAS IDENTIFIED MULTIPLE NEEDS FOR THE COMMUNITY SERVED. THE NEEDS IDENTIFIED WERE REVIEWED AND PRIORITIZED BY THE CHNA RESOURCE GROUP AND SUBSEQUENTLY BY EACH FACILITY'S BOARD. THEY EVALUATED EACH DOCUMENTED NEED AND ITS INTERSECTION WITH THE ORGANIZATION'S VISION, COMMITMENTS, KEY STRENGTHS AND AVAILABLE RESOURCES BEFORE FURTHER PRIORITIZING THE HEALTH NEEDS AND AGREEING UPON THE TOP HEALTH PRIORITIES TO BE ADDRESSED. WHERE POSSIBLE, THE FACILITIES LEVERAGED THE SYSTEM'S STRENGTHS AND RESOURCES TO BEST ADDRESS THOSE NEEDS THAT ARE HIGHEST IN PRIORITY BASED ON SCOPE, SEVERITY, HEALTH DISPARITIES ASSOCIATED WITH THE NEED, AND THE ESTIMATED FEASIBILITY AND EFFECTIVENESS OF POSSIBLE INTERVENTIONS. EACH FACILITY HAS ADOPTED AND EXECUTED AN IMPLEMENTATION STRATEGY THAT ADDRESSES THE PRIORITIZED COMMUNITY HEALTH NEEDS FROM THE CHNAS. THE IMPLEMENTATION STRATEGIES OUTLINE THE PLAN THAT THE HOSPITAL FACILITIES UNDERTAKE TO MEET THOSE HEALTH NEEDS IN EACH COMMUNITY SERVED. CERTAIN NEEDS THAT WERE IDENTIFIED BY THE CHNA HAVE NOT BEEN ADDRESSED. CERTAIN OF THE NEEDS NOT ADDRESSED FALL OUTSIDE THE SCOPE OF TRADITIONAL HEALTHCARE (E.G., DENTAL WORK). OTHER NEEDS ARE ADDRESSED BY COLLABORATIVE WORK AND HAVE OTHER RESOURCES IN THE COMMUNITY THAT CAN MORE APPROPRIATELY MEET THESE NEEDS BASED ON SCOPE OF SERVICES AND EXPERTISE.NOVANT HEALTH REHABILITATION HOSPITAL CONDUCTED A COMPREHENSIVE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) THAT WAS APPROVED BY THE BOARD OF TRUSTEES IN 2022. RESULTS FROM THIS COMPREHENSIVE CHNA PROCESS HELPED IDENTIFY THE FOLLOWING SIGNIFICANT HEALTH NEEDS: CHRONIC DISEASE, DRUG OVERDOSE (SUBSTANCE ABUSE), MATERNAL & INFANT HEALTH, INFANT MORTALITY (RACE/ETHNIC DISPARITY RATIO), MENTAL HEALTH AND VIOLENCE-RELATED BEHAVIORS. AFTER THOROUGH EVALUATION OF EACH DOCUMENTED NEED AND ITS INTERSECTION WITH THE ORGANIZATION'S VISION, COMMITMENTS, KEY STRENGTHS AND AVAILABLE RESOURCES, THE FOLLOWING TOP TWO HEALTH NEEDS WERE IDENTIFIED AS PRIORITY AREAS FOR NOVANT HEALTH REHABILITATION HOSPITAL: ACCESS TO CARE AND RESOURCES, AND CHRONIC DISEASES. NOVANT HEALTH HAS DEVELOPED STRATEGIC IMPLEMENTATION PLANS TO ADDRESS THESE PRIORITIZED AREAS OF NEED AND IS COMMITTED TO IMPROVING THE COMMUNITY'S HEALTH.SPECIFIC REFERENCES AND OTHER SUPPORTING INFORMATION CAN BE FOUND IN THE MOST RECENT CHNA HERE: HTTPS://WWW.NOVANTHEALTH.ORG/ABOUT/OUR-IMPACT/COMMUNITY-HEALTH-NEEDS/ NOVANT HEALTH REHABILITATION HOSPITAL PART V, SECTION B, LINE 13H: NOVANT HEALTH REHABILITATION HOSPITALSCHEDULE H, PART V, SECTION B. FACILITY REPORTING GROUP BPART V, LINE 16A, FAP WEBSITE:HTTPS://ENCOMPASSHEALTH.COM/LOCATIONS/NOVANTHEALTHREHAB/FINANCIAL-ASSISTANCESCHEDULE H, PART V, SECTION B. FACILITY REPORTING GROUP BPART V, LINE 16B, FAP APPLICATION:HTTPS://ENCOMPASSHEALTH.COM/-/MEDIA/HEALTHSOUTH/PROJECT/HEALTHSOUTH/FILES/FINANCIAL-ASSISTANCE/INSTRUCTIONS_APPLICATIONS/NOVANT-INSTRUCTIONS-AND-APPLICATION.PDFSCHEDULE H, PART V, SECTION B. FACILITY REPORTING GROUP BPART V, LINE 16C, FAP PLAIN LANGUAGE SUMMARY:HTTPS://ENCOMPASSHEALTH.COM/-/MEDIA/HEALTHSOUTH/PROJECT/HEALTHSOUTH/FILES/FINANCIAL-ASSISTANCE/PLAIN_LANGUAGE/NOVANT-PLAIN-LANGUAGE-SUMMARY.PDF?LA=EN&HASH=AD3A4F1C74510B86183F143C1D5087B438C5F627 NOVANT HEALTH REHABILITATION HOSPITAL PART V, SECTION B, LINE 21D: NOVANT HEALTH REHABILITATION HOSPITAL DOES NOT HAVE A DEDICATED EMERGENCY DEPARTMENT. THE HOSPITAL WILL APPRAISE EMERGENCIES, PROVIDE INITIAL TREATMENT, AND REFER OR TRANSFER AN INDIVIDUAL TO ANOTHER HOSPITAL/FACILITY, WHEN APPROPRIATE, WITHOUT DISCRIMINATION AND WITHOUT REGARD TO WHETHER THE INDIVIDUAL IS ELIGIBLE FOR FINANCIAL ASSISTANCE.NOVANT HEALTH REHABILITATION HOSPITAL WILL NOT ENGAGE IN ACTIONS THAT DISCOURAGE INDIVIDUALS FROM SEEKING EMERGENCY MEDICAL CARE, SUCH AS DEMANDING THAT AN INDIVIDUAL PAY BEFORE RECEIVING INITIAL TREATMENT FOR EMERGENCY MEDICAL CONDITIONS OR PERMITTING DEBT COLLECTION ACTIVITIES THAT INTERFERE WITH HOSPITAL'S APPRAISAL AND PROVISION, WITHOUT DISCRIMINATION, OF SUCH INITIAL TREATMENT. 46 1 - NH ADULT PRIMARY CARE MILLER STREET 50 MILLER ST STE G WINSTONSALEM NC 271044206 PHYSICIAN CLINIC 2 - NH ARCADIA FAMILY MEDICINE 12208 N NC HWY 150 WINSTONSALEM NC 271279730 PHYSICIAN CLINIC 3 - NH BREAST CENTER 2025 FRONTIS PLAZA BLVD SUITE 100 WINSTON SALEM NC 271035663 PHYSICIAN CLINIC 4 - NH BREAST CENTER 2025 FRONTIS PLAZA BLVD SUITE 300 WINSTON SALEM NC 271035663 PHYSICIAN CLINIC 5 - NH CANCER INSTITUTE - MT AIRY 1908 CAUDLE DR STE 200 MOUNT AIRY NC 270304322 CANCER CENTER 6 - NH CARDIOLOGY - CLEMMONS 7114 VILLAGE MEDICAL CIR CLEMMONS NC 270128004 PHYSICIAN CLINIC 7 - NH CARDIOLOGY - KERNERSVILLE 1710 KERNERSVILLE MEDICAL PKWY STE 205 KERNERSVILLE NC 272847156 PHYSICIAN CLINIC 8 - NH CARDIOLOGY - KIMEL PARK ANNEX 185 KIMEL PARK DR WINSTONSALEM NC 271036973 PHYSICIAN CLINIC 9 - NH CARDIOLOGY - KIMEL PARK MAIN 186 KIMEL PARK DR WINSTONSALEM NC 271036946 PHYSICIAN CLINIC 10 - NH CARDIOLOGY - MT AIRY 694 RIVERSIDE DR MOUNT AIRY NC 270303117 PHYSICIAN CLINIC 11 - NH CHAIR CITY FAMILY MEDICINE 903 RANDOLPH ST STE 1 THOMASVILLE NC 273605898 PHYSICIAN CLINIC 12 - NH CLEMMONS OUTPATIENT SURGERY 7210 VILLAGE MEDICAL CIRCLE STE 235 CLEMMONS NC 27012 AMBULATORY SURGERY CENTER 13 - NH DAVIE MEDICAL ASSOCIATES 485 VALLEY RD MOCKSVILLE NC 270282074 PHYSICIAN CLINIC 14 - NH FORSYTH BEHAVIORAL HEALTH OUTPATIENT 175 KIMEL PARK DR STE 100 WINSTONSALEM NC 271036951 PHYSICIAN CLINIC 15 - NH FORSYTH ENDOCRINE CONSULTANTS - HIGHLAN 755 HIGHLAND OAKS DR STE 201 WINSTONSALEM NC 271037106 PHYSICIAN CLINIC 16 - NH FORSYTH ENDOCRINE CONSULTANTS - THOMASV 903 RANDOLPH ST THOMASVILLE NC 273605898 PHYSICIAN CLINIC 17 - NH FORSYTH FAMILY MEDICINE 400 JONESTOWN RD WINSTONSALEM NC 271044623 PHYSICIAN CLINIC 18 - NH FORSYTH HEART & WELLNESS- HEART FAILURE 725 HIGHLAND OAKS DR STE 200 WINSTONSALEM NC 271037109 PHYSICIAN CLINIC 19 - NH FORSYTH INTERNAL MEDICINE 1381 WESTGATE CENTER DR WINSTONSALEM NC 271032934 PHYSICIAN CLINIC 20 - NH HAWTHORNE OUTPATIENT SURGERY 1999 SOUTH HAWTHORNE RD WINSTON SALEM NC 271033916 AMBULATORY SURGERY CENTER 21 - NH IMAGING KERNERSVILLE 445 PINEVIEW DRIVE SUITE 100 KERNERSVILLE NC 272843818 IMAGING CENTER 22 - NH IMAGING MAPLEWOOD 3155 MAPLEWOOD AVENUE WINSTON SALEM NC 271033903 IMAGING CENTER 23 - NH INFECTIOUS DISEASE SPECIALISTS - WINSTO 1381 WESTGATE CENTER DR WINSTONSALEM NC 271032934 PHYSICIAN CLINIC 24 - NH KERNERSVILLE FAMILY MEDICINE 291 BROAD ST KERNERSVILLE NC 272842932 PHYSICIAN CLINIC 25 - NH KERNERSVILLE OUTPATIENT SURGERY CENTER 1730 KERNERSVILLE MEDICAL PKWY STE 304 KERNERSVILLE NC 27284 AMBULATORY SURGERY CENTER 26 - NH MAPLEWOOD FAMILY MEDICINE 100 ROBINHOOD MEDICAL PLZ WINSTONSALEM NC 271065472 PHYSICIAN CLINIC 27 - NH MOUNTAINVIEW MEDICAL 216 MOORE RD KING NC 270218703 PHYSICIAN CLINIC 28 - NH NORTH POINT MEDICAL ASSOCIATES 1995 BETHABARA RD WINSTONSALEM NC 271063375 PHYSICIAN CLINIC 29 - NH PFAFFTOWN FAMILY MEDICINE 4611 YADKINVILLE RD PFAFFTOWN NC 270408622 PHYSICIAN CLINIC 30 - NH PILOT MOUNTAIN MEDICAL CARE 207 MEDICAL ST PILOT MOUNTAIN NC 270418656 PHYSICIAN CLINIC 31 - NH PREMIER MEDICAL ASSOCIATES 3333 BROOKVIEW HILLS BLVD STE 204 WINSTONSALEM NC 271035661 PHYSICIAN CLINIC 32 - NH PSYCHIATRIC MEDICINE - THOMASVILLE 309 PINEYWOOD RD THOMASVILLE NC 273603438 PHYSICIAN CLINIC 33 - NH PSYCHIATRY - FORSYTH 175 KIMEL PARK DR STE 100 WINSTONSALEM NC 271036951 PHYSICIAN CLINIC 34 - NH SALEM FAMILY MEDICINE 105 VEST MILL CIR WINSTONSALEM NC 271032943 PHYSICIAN CLINIC 35 - NH SURRY MEDICAL ASSOCIATES - WESTLAKE 865 WESTLAKE DR MOUNT AIRY NC 270302157 PHYSICIAN CLINIC 36 - NH THOMASVILLE MEDICAL ASSOCIATES 309 PINEYWOOD RD THOMASVILLE NC 273603438 PHYSICIAN CLINIC 37 - NH TRIAD ENDOCRINE - KERNERSVILLE 500 PINEVIEW DR STE 101 KERNERSVILLE NC 272843813 PHYSICIAN CLINIC 38 - NH UROLOGY - BALDWIN 2010 BALDWIN LN WINSTONSALEM NC 271035846 PHYSICIAN CLINIC 39 - NH UROLOGY - KERNERSVILLE 1730 KERNERSVILLE MEDICAL PKWY STE 303 KERNERSVILLE NC 272847198 PHYSICIAN CLINIC 40 - NH UROLOGY - KIMEL PARK 140 KIMEL PARK DR STE 100 WINSTONSALEM NC 271036160 PHYSICIAN CLINIC 41 - NH WEST FORSYTH INTERNAL MEDICINE & PEDIAT 105 STADIUM OAKS DR CLEMMONS NC 270128962 PHYSICIAN CLINIC 42 - NH WINSTON-SALEM HEALTH CARE 250 CHARLOIS BLVD WINSTONSALEM NC 271031508 PHYSICIAN CLINIC 43 - NH WINSTON-SALEM HEALTH CARE - DERMATOLOGY 175 KIMEL PARK DR WINSTONSALEM NC 271036951 PHYSICIAN CLINIC 44 - NH WOUND CARE - KERNERSVILLE 1710 KERNERSVILLE MEDICAL PKWY STE 220 KERNERSVILLE NC 272847156 PHYSICIAN CLINIC 45 - NH WOUND CARE & HYPERBARIC MEDICINE-WINSTO 1901 S HAWTHORNE RD STE 220 WINSTONSALEM NC 271033921 PHYSICIAN CLINIC 46 - NH YADKIN MEDICAL ASSOCIATES 305 EAST LEE AVE YADKINVILLE NC 270558132 PHYSICIAN CLINIC PART I, LINE 3C: OTHER CRITERIA BESIDES INCOME AND FPG USED IN DETERMINING ELIGIBILITY FOR FREE CARE INCLUDE: (1) RESIDENCY - PATIENTS MUST RESIDE WITHIN THE SERVICE AREA OF THE HOSPITAL; (2) THE KIND OF SERVICE PROVIDED - ONLY MEDICALLY NECESSARY SERVICES ARE COVERED; (3) PATIENT STATUS - IN PROVIDER BASED PHYSICIAN CLINICS, PATIENTS MUST HAVE BEEN TREATED BY AN AFFILIATED MEDICAL GROUP PRIMARY CARE PHYSICIAN WITHIN THE PREVIOUS THREE YEARS; AND (4) ACCESS TO HEALTH CARE COVERAGE - PATIENTS MUST BE UNABLE TO ACCESS EMPLOYER SPONSORED HEALTH PLANS OR ENTITLEMENT PROGRAMS. LASTLY, THE PATIENT MUST BE WITHOUT SUBSTANTIAL LIQUID ASSETS (I.E. CASH-ON-HAND). ASSETS SUCH AS HOUSES, CARS, PENALIZED RETIREMENT SAVINGS FUNDS, ETC. ARE NOT CONSIDERED LIQUID ASSETS. SUBSTANTIAL ASSETS ARE DEFINED AS ENOUGH CASH-ON-HAND TO COVER THE MEDICAL EXPENSES WITHOUT PLACING A HARDSHIP ON THE PATIENT. PATIENTS WITH SPECIAL CIRCUMSTANCES SUCH AS BANKRUPTCY MAY ALSO BE ELIGIBLE FOR CHARITY CARE; DETERMINATION IS MADE ON A CASE BY CASE BASIS UNDER THESE CIRCUMSTANCES. PART I, LINE 6A: PART I, LINE 6A:THE ORGANIZATION IS A PART OF NOVANT HEALTH, AN INTEGRATED NON-PROFIT HEALTH SYSTEM. THE SYSTEM-WIDE COMMUNITY BENEFIT REPORT, REFERRED TO AS THE "COMMUNITY IMPACT REPORT", IS PRODUCED BY NOVANT HEALTH, INC., A RELATED ORGANIZATION AND THE PARENT COMPANY OF THE HEALTHCARE SYSTEM. NOVANT HEALTH'S ANNUAL COMMUNITY IMPACT REPORT CAN BE FOUND AT HTTPS://WWW.NOVANTHEALTH.ORG/ABOUT/COMMUNITY/COMMUNITY-HEALTH-NEEDS/. PLEASE NOTE THAT THE NUMERIC DATA IN THE COMMUNITY IMPACT REPORT IS NOT BASED UPON CALCULATIONS ACCORDING TO FORM 990, SCHEDULE H INSTRUCTIONS, BUT RATHER THE AMOUNTS ARE PREPARED IN ACCORDANCE WITH THE NORTH CAROLINA HEALTHCARE ASSOCIATION REPORTING GUIDELINES. THEREFORE, THE REPORT SHOULD NOT BE RELIED UPON AS EQUIVALENT TO THE TOTAL OF ALL SYSTEM ORGANIZATIONS' FORM 990, SCHEDULE H PART I AMOUNTS OR BASED ON THE REQUIRED COMMUNITY HEALTH NEEDS ASSESSMENT OR COMMUNITY BENEFIT IMPLEMENTATION STRATEGY UNDER INTERNAL REVENUE CODE SECTION 501(R). PART I, LINE 7: COSTS REPORTED IN THE TABLE FOR FINANCIAL ASSISTANCE (I.E., CHARITY CARE) AND CERTAIN OTHER COMMUNITY BENEFITS AMOUNTS ARE CALCULATED USING A REPORTING ENTITY SPECIFIC COST-TO-CHARGE RATIO ("CCR") BASED ON FORM 990, SCHEDULE H, INSTRUCTIONS, WORKSHEET 2. PART I, LN 7 COL(F): PART I, LN 7 COL(F):THE AMOUNT OF BAD DEBT REMOVED FROM TOTAL EXPENSES IN THE DENOMINATOR WAS $0. PART I, LINE 4: NOVANT HEALTH HAS A CATASTROPHIC SETTLEMENT POLICY WHICH IS SEPARATE FROM THE FINANCIAL ASSISTANCE POLICY. THE PURPOSE OF THIS POLICY IS TO IDENTIFY CIRCUMSTANCES IN WHICH NOVANT HEALTH AFFILIATES MAY WORK WITH PATIENTS TO MEET THEIR FINANCIAL OBLIGATIONS WHEN THEY HAVE LARGE OUT-OF POCKET EXPENSES RELATED TO A VISIT THAT IS NOT COVERED BY FINANCIAL ASSISTANCE. PART II, COMMUNITY BUILDING ACTIVITIES: THE ORGANIZATION'S COMMUNITY BUILDING ACTIVITIES ADDRESS THE UNDERLYING CAUSES OF HEALTH PROBLEMS AND IMPACT THE HEALTH OF OUR COMMUNITY THROUGH PARTNERSHIPS WITH LOCAL AGENCIES DEDICATED TO IMPROVING THE LIVES OF ALL INDIVIDUALS. WE PROVIDE FINANCIAL SUPPORT AND OTHER RESOURCES TO ORGANIZATIONS SUCH AS LOCAL YMCA'S, UNITED WAY PARTNER AGENCIES, CHAMBERS OF COMMERCE, PARKS AND RECREATION DEPARTMENTS, AND OTHER LOCAL COMMUNITY ORGANIZATIONS, ASSISTING WITH COMMUNITY AND COUNTY COALITIONS, AND PROVIDING EDUCATION SEMINARS AND TRAINING FOR COMMUNITY MEMBERS AND GROUPS. THROUGH THESE PARTNERSHIPS AND OUTREACH METHODS WE ARE ABLE TO SUCCESSFULLY BRIDGE THE GAP OF NEED FOR RESOURCES BEYOND TRADITIONAL HEALTHCARE SERVICES WITHIN THE COMMUNITIES WE SERVE. PART III, LINE 2: IMPLICIT PRICE CONCESSIONS (FORMERLY KNOWN AS BAD DEBT EXPENSE) ARE DETERMINED BASED ON MANAGEMENT'S ASSESSMENT OF CONTRACTUAL AGREEMENTS, DISCOUNT POLICIES, AND HISTORICAL EXPERIENCE, AS WELL AS CURRENT AND EXPECTED FUTURE ECONOMIC CONDITIONS. PART III, LINE 4: THE ORGANIZATION'S IMPLICIT PRICE CONCESSIONS (FORMERLY KNOWN AS BAD DEBT EXPENSE, AT COST) ON LINE 2 IS CALCULATED USING THE SAME METHODOLOGY AS FINANCIAL ASSISTANCE AND OTHER COMMUNITY BENEFITS USING AN ENTITY SPECIFIC COST-TO-CHARGE RATIO (CCR). FOOTNOTE 2 (ACCOUNTS RECEIVABLE) ON PAGE 8 OF THE AUDITED FINANCIAL STATEMENTS DESCRIBES PRICE CONCESSIONS. PART III, LINE 8: THE METHODOLOGY USED TO DETERMINE THE MEDICARE ALLOWABLE COSTS REPORTED IN THE ORGANIZATION'S MEDICARE COST REPORT AS REFLECTED IN THE AMOUNT REPORTED IN PART III, LINE 6 IS DETERMINED BY FOLLOWING THE MEDICARE PRINCIPLES OF ALLOWABLE COSTS. COST FOR THE OVERHEAD DEPARTMENTS ARE STEPPED DOWN TO THE REMAINING COST CENTERS BASED ON STATISTICS FOR EACH OVERHEAD COST CENTER. ONCE THE STEP-DOWN PROCESS IS COMPLETE, A COST TO CHARGE RATIO ("CCR") IS DEVELOPED FOR EACH COST CENTER. THE CCR IS THEN APPLIED TO THE MEDICARE REVENUE BY COST CENTER AND TOTALED.IT SHOULD BE NOTED THAT THE MEDICARE COST REPORTS DO NOT ADDRESS ANY MANAGED CARE MEDICARE REVENUES, COSTS, OR RELATED SHORTFALL. THE TOTAL REVENUES REPORTED AS RECEIVED FROM MEDICARE IN LINE 5 OF SECTION B ARE ONLY REPRESENTATIVE OF MEDICARE FEE FOR SERVICE PAYMENTS RECEIVED. THE ALLOWABLE COSTS ON LINE 6 ARE SIGNIFICANTLY LOWER THAN THE ACTUAL EXPENDITURES. AS SUCH, THE SHORTFALL IS UNDERESTIMATED.EVERY HOSPITAL TREATS MEDICARE PATIENTS. SOME HOSPITALS ARE LOCATED IN HIGH MEDICARE POPULATION AREAS; OTHERS PROVIDE SERVICES DISPROPORTIONATELY USED BY MEDICARE PATIENTS. MEDICARE RATES AND NUMBERS OF MEDICARE PATIENTS ARE NOT NEGOTIATED. AS REIMBURSEMENT RATES DECLINE RELATIVE TO COSTS OF CARE, HOSPITALS CONTINUE TO SERVE THE MEDICARE POPULATION. WITHOUT THIS SERVICE THESE PATIENTS WOULD BECOME AN OBLIGATION ON THE GOVERNMENT. ANY UNREIMBURSED COSTS OF THIS CARE ARE A COMMUNITY BENEFIT PROVIDED BY THE HOSPITAL TO THE COMMUNITY AND GOVERNMENT. PART III, LINE 9B: THE ORGANIZATION'S BILLING AND COLLECTIONS POLICY DOES EXPLAIN ACTIONS AGAINST PATIENTS WHO HAVE OUTSTANDING DELINQUENT AMOUNTS, BUT THE POLICY DOES NOT CONTAIN PROVISIONS FOR COLLECTION PRACTICES AGAINST PATIENTS WHO ARE ELIGIBLE UNDER THE FINANCIAL ASSISTANCE POLICY (FAP) BECAUSE FAP ELIGIBLE PATIENTS RECEIVE 100% FREE CARE AND THEREFORE DO NOT RECEIVE BILLS ONCE FAP ELIGIBILITY HAS BEEN ESTABLISHED. PART VI, LINE 2: PART VI, LINE 2: NEEDS ASSESSMENTTHE ORGANIZATION IS PART OF NOVANT HEALTH, AN INTEGRATED NON-PROFIT HEALTHCARE SYSTEM, NOVANT EMPLOYS A COMMUNITY ENGAGEMENT DEPARTMENT THAT FACILITATES COMMUNITY BENEFIT ACROSS THE SYSTEM. THE COMMUNITY ENGAGEMENT DEPARTMENT IS RESPONSIBLE FOR COORDINATING THE PREPARATION OF THE COMMUNITY HEALTH NEEDS ASSESSMENTS (CHNA) FOR EACH HOSPITAL WITHIN THE SYSTEM, INCLUDING THE CHNAS REPORTED IN PART V, SECTION B. THE COMMUNITY ENGAGEMENT DEPARTMENT WORKS WITH EACH HOSPITAL FACILITY TO IDENTIFY ORGANIZATIONS AND RESOURCES WITHIN THEIR RESPECTIVE COMMUNITIES THAT PARTICIPATE IN ALLEVIATING SIGNIFICANT COMMUNITY HEALTH NEEDS. THESE ORGANIZATIONS AND RESOURCES INCLUDE PUBLIC HEALTH DEPARTMENTS, LOCAL COMMUNITY COALITIONS AND CLINICS REPRESENTING THE MEDICALLY UNDERSERVED, UNITED WAY, YMCAS, LOCAL UNIVERSITIES, AND MORE. COMMUNITY HEALTH ASSESSMENTS PREPARED BY OTHER ORGANIZATIONS ARE USED IN COMBINATION WITH INTERNAL HOSPITAL DATA AND INFORMATION COLLECTED FROM LOCAL AGENCIES TO PREPARE THE CHNAS FOR HOSPITAL FACILITIES. THROUGH DATA COLLECTION AND COMMUNITY PARTNERSHIPS, NOVANT HEALTH IS ABLE TO ASSESS UNMET NEEDS AND WORK TO DIRECTLY SUPPORT PARTNERS IN ADDRESSING THOSE NEEDS WITHIN ITS COMMUNITIES SERVED. ORGANIZATIONAL PARTNERSHIPS ESTABLISHED BY THE COMMUNITY ENGAGEMENT DEPARTMENT ARE OFTEN LEVERAGED TO ADDRESS NEEDS THAT WERE IDENTIFIED IN THE CHNAS, BUT WERE NOT PRIORITIZED BY THE FACILITY IMPLEMENTATION PLAN. IN ADDITION TO ADDRESSING HEALTH NEEDS IDENTIFIED THROUGH THE CHNA PROCESS, EACH HOSPITAL FACILITY RESPONDS TO REQUESTS FOR SPECIFIC COMMUNITY BENEFIT ACTIVITIES OR PROGRAMS FROM PUBLIC AGENCIES AND/OR COMMUNITY GROUPS. PART VI, LINE 3: PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCENOVANT HEALTH IS COMMITTED TO PROVIDING OUTSTANDING HEALTHCARE TO ALL MEMBERS OF THE COMMUNITIES SERVED, REGARDLESS OF THEIR ABILITY TO PAY. ITS FINANCIAL COUNSELING TEAMS ARE CONSTANTLY WORKING WITH THE PATIENTS WITHIN COMMUNITIES SERVED TO UNDERSTAND PATIENT NEEDS AND ENSURE THAT THEIR POLICIES AND PROCESSES ADDRESS THESE NEEDS. NOVANT HEALTH ALSO MAINTAINS CONTRACTS WITH MEDICAID ELIGIBILITY VENDORS. THESE TEAMS OFFER ADDITIONAL SUPPORT IN PROCESSING AND ASSESSING HOW THE HEALTHCARE SYSTEM SERVES THE FINANCIAL NEEDS OF ITS PATIENTS. BASED ON THE ASSESSMENTS OF COMMUNITIES SERVED, NOVANT HEALTH & AFFILIATES DEVELOPED FINANCIAL ASSISTANCE POLICIES AND PROGRAMS THAT ADDRESS THE FINANCIAL NEEDS OF ITS PATIENTS. THE HEALTHCARE SYSTEM PRIDES ITSELF ON THE TRANSPARENCY OF ITS FINANCIAL ASSISTANCE POLICY AND PROGRAMS, AND THE EDUCATION OFFERED TO PATIENTS REGARDING FINANCIAL ASSISTANCE. FINANCIAL ASSISTANCE PROGRAMS ARE DOCUMENTED ON THE NOVANT HEALTH WEBSITE, ALONG WITH CONTACT INFORMATION FOR ITS FINANCIAL COUNSELORS. ADDITIONALLY, FINANCIAL ASSISTANCE PROGRAMS ARE DOCUMENTED ON PATIENT FLYERS THROUGHOUT THE SYSTEM'S HOSPITAL FACILITIES, OUTPATIENT CENTERS, AND PHYSICIAN OFFICES. THE SYSTEM'S PATIENT ACCESS SPECIALISTS, FINANCIAL COUNSELORS AND BUSINESS OFFICE TEAMS WORK WITH ALL ELIGIBLE PATIENTS TO EDUCATE THEM ON THE VARIOUS OPTIONS AVAILABLE VIA FINANCIAL ASSISTANCE PROGRAMS OR GOVERNMENT SPONSORED CARE. THESE PATIENT FACING TEAM MEMBERS ALSO REFERENCE THE FINANCIAL ASSISTANCE POLICY IN ALL CONVERSATIONS RELATED TO PATIENTS BILLS. FINALLY, NOVANT HEALTH WORKS WITH LOCAL AREA FREE HEALTH CLINICS AND OTHER CHARITABLE ORGANIZATIONS TO PROVIDE CONTINUATION OF CARE FOR PATIENTS IN THE COMMUNITIES SERVED. IN ADDITION TO FINANCIAL COUNSELING PROCESSES USED TO IDENTIFY CHARITY CARE PATIENTS, NOVANT HEALTH'S COLLECTIONS PROCESS WITHIN OUR BUSINESS OFFICES HELPS IDENTIFY PATIENTS WHO ARE ALREADY ELIGIBLE FOR CHARITY OR WHO MAY BE ELIGIBLE BASED ON THEIR STATUS WITHIN THE FEDERAL POVERTY GUIDELINES ("FPG"). THE SYSTEM UTILIZES PREVIOUSLY SUBMITTED PATIENT DOCUMENTATION AND CREDIT AGENCY REPORTED FPG FOR FINANCIAL ASSISTANCE DETERMINATIONS. SUPPORTING DOCUMENTS ARE VALID 6 MONTHS FROM THE DATE OF SUBMISSION. NOVANT HEALTH REHABILITATION HOSPITAL HAS ADDITIONAL CRITERIA; PATIENTS ARE PRESUMED TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE, WITHOUT COMPLETING AN APPLICATION, IN THE FOLLOWING CIRCUMSTANCES: 1. HOMELESSNESS 2. DECEASED WITH NO ESTATE 3. MENTAL INCAPACITATION WITH NO ONE TO ACT ON PATIENT'S BEHALF 4. RECENT MEDICAID COVERAGE, I.E. COVERAGE WITHIN THREE (3) MONTHS OF ADMISSION OR DISCHARGE. FINANCIAL ASSISTANCE POLICIES ARE CONSIDERED FLUID AND ARE UPDATED FREQUENTLY BASED ON LOCAL AND NATIONAL MARKET STANDARDS AND NATIONAL ECONOMIC CONDITIONS. ANY UPDATES TO FINANCIAL ASSISTANCE POLICIES REQUIRE MULTI-LEVEL LEADERSHIP APPROVAL AND ARE ULTIMATELY APPROVED BY THE ORGANIZATION'S BOARD. PART VI, LINE 4: PART VI, LINE 4: COMMUNITY INFORMATIONTHE FORSYTH MEMORIAL HOSPITAL, INC.'S FORM 990 INCLUDES THE OPERATIONS OF TWO LICENSED HOSPITALS: FORSYTH MEMORIAL HOSPITAL, INC. (DBA NOVANT HEALTH FORSYTH MEDICAL CENTER) AND NOVANT HEALTH REHABILITATION HOSPITAL OF WINSTON-SALEM, LLC (DBA NOVANT HEALTH REHABILITATION HOSPITAL, A LICENSED HOSPITAL OPERATED THROUGH A JOINT VENTURE). FORSYTH MEMORIAL HOSPITAL, INC. HAS FACILITIES IN THREE LOCATIONS: 1. NOVANT HEALTH FORSYTH MEDICAL CENTER, 2. NOVANT HEALTH CLEMMONS MEDICAL CENTER, AND3. NOVANT HEALTH KERNERSVILLE MEDICAL CENTERTHE PRIMARY SERVICE AREA IS DEFINED BY THE ZIP CODES THAT REPRESENT AT LEAST 75% OF THE HOSPITAL'S IN-PATIENT POPULATION. NOVANT HEALTH FORSYTH MEDICAL CENTER THERE ARE 6 COUNTIES IN THE PRIMARY SERVICE AREA (PSA): DAVIDSON, DAVIE, FORSYTH, STOKES, SURRY AND YADKIN COUNTIES. 50% OF PATIENTS RESIDE IN THE PSA OF FORSYTH COUNTY AND 51% OF PATIENTS RESIDE IN THE PRIMARY AND SECONDARY SERVICE AREAS OF FORSYTH COUNTY. THE PSA DOES NOT INCLUDE MORE THAN 6.5% OF THE TOTAL IN-PATIENT POPULATION FROM ANY OTHER COUNTY. MOST PATIENTS RESIDE IN FORSYTH COUNTY, AND IT REPRESENTS THE HIGHEST POPULATION OF POTENTIALLY UNDERSERVED, LOW-INCOME AND MINORITY INDIVIDUALS FROM THE PSA. NOVANT HEALTH CLEMMONS MEDICAL CENTERNOVANT HEALTH CLEMMONS MEDICAL CENTER'S PSA INCLUDES DAVIDSON, DAVIE, FORSYTH, STOKES, SURRY AND YADKIN COUNTIES. 49.6% OF PATIENTS RESIDE IN THE PSA OF FORSYTH COUNTY AND 50.3% OF PATIENTS RESIDE IN THE PRIMARY AND SECONDARY SERVICE AREAS OF FORSYTH COUNTY. THE PSA DOES NOT INCLUDE MORE THAN 11.6% OF THE TOTAL IN-PATIENT POPULATION FROM ANY OTHER COUNTY. MOST PATIENTS RESIDE IN FORSYTH COUNTY, AND IT REPRESENTS THE HIGHEST POPULATION OF POTENTIALLY UNDERSERVED, LOW-INCOME AND MINORITY INDIVIDUALS FROM THE PSA.NOVANT HEALTH KERNERSVILLE MEDICAL CENTERNOVANT HEALTH KERNERSVILLE MEDICAL CENTER'S PSA INCLUDES FORSYTH, GUILFORD AND STOKES COUNTIES. 59% OF PATIENTS RESIDE IN THE PSA OF FORSYTH COUNTY, WHILE 62% OF PATIENTS RESIDE IN THE PRIMARY AND SECONDARY SERVICE AREAS OF FORSYTH COUNTY. MOST PATIENTS RESIDE IN FORSYTH COUNTY, AND IT REPRESENTS THE HIGHEST POPULATION OF POTENTIALLY UNDERSERVED, LOW-INCOME AND MINORITY INDIVIDUALS FROM THE PSA.NOVANT HEALTH REHABILITATION HOSPITALTHERE ARE 10 COUNTIES IN THE PSA: DAVIDSON, DAVIE, FORSYTH, GALAX CITY, GUILFORD, ROCKINGHAM, STOKES, SURRY, WILKES, AND YADKIN. 46.6% OF PATIENTS RESIDE IN THE PSA OF FORSYTH COUNTY AND 48% OF PATIENTS RESIDE IN THE PRIMARY AND SECONDARY SERVICES AREAS OF FORSYTH COUNTY. THE PSA DOES NOT INCLUDE MORE THAN 8% OF THE TOTAL IN-PATIENT POPULATION FROM ANY OTHER COUNTY. MOST PATIENTS RESIDE IN FORSYTH COUNTY AND IT REPRESENTS THE HIGHEST POPULATION OF POTENTIALLY UNDERSERVED, LOW-INCOME AND MINORITY INDIVIDUALS. NOVANT HEALTH FORSYTH MEDICAL CENTER SHARES MUCH OF THE SAME PSA AS NOVANT HEALTH REHABILITATION HOSPITAL, AND THEY ARE LOCATED WITHIN 5 MILES OF EACH OTHER.ALL HOSPITAL FACILITIESFORSYTH COUNTY INCLUDES WINSTON SALEM, THE MOST POPULATED CITY, AND THE COUNTY SEAT. IT HAS A POPULATION OF 385,523 COMPARED TO THE TOTAL NORTH CAROLINA POPULATION OF 10,551,162. ACCORDING TO THE VIZIENT VULNERABILITY INDEX RELEASED IN JANUARY 2022, PATIENTS ADMITTED TO FORSYTH MEDICAL CENTER EXPERIENCE THE MOST PROFOUND SOCIAL RISKS IF THEY LIVE IN 27105, 27101, 27110, 27030, 27292. THESE ZIP CODES EXPERIENCE DISPROPORTIONATELY HIGH SOCIAL RISKS WHEN COMPARED TO THEIR COUNTERPART NEIGHBORHOODS. AREAS OF PARTICULAR CONCERN INCLUDE ACCESS TO HEALTHCARE, POVERTY, ACCESS TO TRANSPORTATION, AND FOOD INSECURITY. IN FORSYTH COUNTY:- 65.9% OF THE POPULATION IS WHITE, 27.8% IS BLACK/AFRICAN AMERICAN, AND 13.9% IS HISPANIC- THE MEDIAN INCOME IS $53,583- THE POVERTY RATE IS 13%- THE LEADING CAUSES OF DEATH ARE CANCER AND HEART DISEASE- 12.2% OF THE POPULATION UNDER AGE 65 DOES NOT HAVE HEALTH INSURANCE - 18% OF THE POPULATION IS FACING FOOD HARDSHIP- THE DEMOGRAPHIC GROUPS FACING THE MOST SIGNIFICANT HOUSING HARDSHIP ARE HISPANIC AND BLACK POPULATIONS. MOST NOTABLY, 33% OF THE HISPANIC POPULATION IN FORSYTH COUNTY FACES A HOUSING HARDSHIP.ATRIUM HEALTH WAKE FOREST BAPTIST IS THE OTHER HEALTHCARE SYSTEM SERVING THIS PRIMARY SERVICE AREA, AND IS NOT AFFILIATED WITH NOVANT HEALTH. DATA FOR THE CHNA WAS GATHERED FROM VARIOUS STATE AND FEDERAL SOURCES, BUT PRIMARILY THE US CENSUS BUREAU. SPECIFIC REFERENCES AND OTHER SUPPORTING INFORMATION CAN BE FOUND IN THE MOST RECENT CHNA HERE: HTTPS://WWW.NOVANTHEALTH.ORG/ABOUT/OUR-IMPACT/COMMUNITY-HEALTH-NEEDS PART VI, LINE 5: PART VI, LINE 5: PROMOTION OF COMMUNITY HEALTHTHE ORGANIZATION FURTHERS ITS EXEMPT PURPOSES BY:1. ADOPTING A FINANCIAL ASSISTANCE POLICY;2. REMAINING CERTIFIED BY THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES TO PROVIDE SERVICES TO ALL BENEFICIARIES OF MEDICARE, MEDICAID, AND OTHER GOVERNMENT PAYMENT PROGRAMS, AND PROVIDING SERVICES IN A NONDISCRIMINATORY MANNER TO SUCH BENEFICIARIES;3. OPERATING A FULL-TIME EMERGENCY ROOM WHICH IS OPEN TO AND ACCEPTS ALL PERSONS, REGARDLESS OF THEIR ABILITY TO PAY;4. MAINTAINING AN OPEN MEDICAL STAFF, SUBJECT TO EXCLUSIVE CONTRACTS FOR HOSPITAL-BASED SERVICES SUCH AS ANESTHESIOLOGY, RADIOLOGY, PATHOLOGY, HOSPITALIST, AND EMERGENCY DEPARTMENT SERVICES, TO THE EXTENT AN EXCLUSIVE CONTRACT FOR THOSE SERVICES IS REQUIRED TO OBTAIN PROPER STAFFING COVERAGE OR TO PERMIT A MORE EFFICIENT DELIVERY OF THOSE SERVICES WITHIN HOSPITAL FACILITIES;5. MAINTAINING A GOVERNING BOARD CONSISTING PRIMARILY OF A BROAD CROSS-SECTION OF LEADERS IN THE COMMUNITY;6. ADOPTING AND APPLYING A CONFLICT-OF-INTEREST POLICY, WHICH APPLIES TO THE GOVERNING BOARD AND ORGANIZATION OFFICERS;7. PROVIDING HEALTH EDUCATION LECTURES AND WORKSHOPS;8. PROVIDING HEALTH FAIRS, EDUCATION ON SPECIFIC DISEASES OR CONDITIONS, AND HEALTH PROMOTION AND WELLNESS PROGRAMS TO COMMUNITIES SERVED;9. PROVIDING SUPPORT GROUPS AND SELF-HELP PROGRAMS TO COMMUNITIES SERVED;10. PROVIDING COMMUNITY-BASED CLINICAL SERVICES, INCLUDING WITHOUT LIMITATION, HEALTH SCREENINGS AND CLINICS FOR UNINSURED OR UNDERINSURED PERSONS TO COMMUNITIES SERVED;11. PROVIDING HEALTHCARE SUPPORT SERVICES, INCLUDING WITHOUT LIMITATION, INFORMATION AND REFERRAL TO COMMUNITY SERVICES, CASE MANAGEMENT OF UNDERINSURED AND UNINSURED PERSONS, TELEPHONE INFORMATION SERVICES AND ASSISTANCE TO ENROLL IN PUBLIC PROGRAMS, SUCH AS STATE CHILDREN'S HEALTH INSURANCE PROGRAM (SCHIP) AND MEDICAID TO COMMUNITIES SERVED;12. PROVIDING SUBSIDIZED HEALTH SERVICES AND CLINICAL PROGRAMS TO COMMUNITIES SERVED;13. PROVIDING CASH AND IN-KIND CONTRIBUTIONS TO NONPROFIT COMMUNITY HEALTHCARE ORGANIZATIONS IN COMMUNITIES SERVED; AND14. GENERALLY PROMOTING THE HEALTH, WELLNESS, AND WELFARE OF COMMUNITIES SERVED BY PROVIDING QUALITY HEALTHCARE SERVICES AT REASONABLE COST. PART VI, LINE 6: PART VI, LINE 6: AFFILIATED HEALTH CARE SYSTEMTHE ORGANIZATION IS AN INTEGRAL PART OF NOVANT HEALTH, A NON-PROFIT INTEGRATED GROUP OF HOSPITALS, PHYSICIAN CLINICS, OUTPATIENT CENTERS AND OTHER HEALTHCARE SERVICE PROVIDERS. NOVANT HEALTH IS RANKED AS ONE OF THE NATION'S TOP 20 INTEGRATED HEALTHCARE SYSTEMS - CARING FOR PATIENTS AND COMMUNITIES IN NORTH AND SOUTH CAROLINA. EACH HOSPITAL FACILITY PROVIDES SUBSTANTIAL COMMUNITY BENEFIT TO THE COMMUNITY SERVED, AS REPORTED INDIVIDUALLY ON EACH HOSPITAL ORGANIZATION'S FORM 990, SCHEDULE H. SYSTEM-WIDE COMMUNITY BENEFIT IS DOCUMENTED IN THE COMMUNITY BENEFIT REPORT, LOCATED AT HTTPS://WWW.NOVANTHEALTH.ORG/ABOUT/COMMUNITY/COMMUNITY-HEALTH-NEEDS/. PLEASE NOTE THAT THE NUMERIC INFORMATION IN THIS REPORT IS NOT BASED UPON THE FORM 990, SCHEDULE H INSTRUCTIONS, BUT RATHER IS PREPARED IN ACCORDANCE WITH THE NORTH CAROLINA HEALTHCARE ASSOCIATION REPORTING GUIDELINES. THIS COMMUNITY BENEFIT REPORT SHOULD NOT BE RELIED UPON AS THE SUM OF AFFILIATE ORGANIZATION'S FORM 990, SCHEDULE H COMMUNITY BENEFIT, OR IN ALIGNMENT WITH ITS COMMUNITY HEALTH NEEDS ASSESSMENT OR COMMUNITY BENEFIT IMPLEMENTATION STRATEGY. THERE ARE SIGNIFICANT COMMUNITY BENEFIT ACTIVITIES WITHIN NOVANT HEALTH WHICH MAY NOT BE REPORTABLE ON A FORM 990 SCHEDULE H BECAUSE THEY ARE NOT CONDUCTED BY A LEGAL ENTITY WHICH OWNS OR OPERATES A HOSPITAL.IN ADDITION TO HOSPITALS, THE NOVANT HEALTH INTEGRATED HEALTHCARE SYSTEM INCLUDES MULTIPLE PHYSICIAN ORGANIZATIONS WITH PRACTICES IN NORTH AND SOUTH CAROLINA, AND SIX HOSPITAL FOUNDATIONS WHICH SUPPORT AND ENHANCE THE ACTIVITIES IN THOSE HOSPITALS' COMMUNITIES. FURTHER, NOVANT HEALTH INCLUDES AMBULATORY SURGERY CENTERS, IMAGING CENTERS, REHABILITATION CENTERS, AND OTHER OUTPATIENT FACILITIES; ALL DEDICATED TO PROMOTING THE HEALTH OF THEIR RESPECTIVE COMMUNITIES. PART VI, LINE 7: STATE FILING OF COMMUNITY BENEFIT REPORT NOVANT HEALTH, INC. FILES A SYSTEM-WIDE COMMUNITY BENEFIT REPORT PREPARED IN ACCORDANCE WITH THE NORTH CAROLINA HEALTHCARE ASSOCIATION REPORTING GUIDELINES WITH THE NORTH CAROLINA MEDICAL CARE COMMISSION AS PART OF THE DOCUMENTATION REQUIRED FOR THE ISSUANCE OF TAX EXEMPT BOND FINANCING. 1 AMERICAN HEART ASSOCIATION INC 7272 GREENVILLE AVENUE DALLAS TX 75231 135613797 501(C)(3) 134400 0 COMMUNITY OUTREACH CANCER SERVICES INC 3175 MAPLEWOOD AVENUE WINSTONSALEM NC 27103 560656375 501(C)(3) 22000 0 COMMUNITY OUTREACH CRISIS CONTROL MINISTRY INC 200 EAST TENTH STREET WINSTONSALEM NC 27101 237348168 501(C)(3) 12500 0 COMMUNITY OUTREACH CROSBY SCHOLARS COMMUNITY PARTNERSHIP 2701 UNIVERSITY PARKWAY WINSTONSALEM NC 27105 311523230 501(C)(3) 24500 0 COMMUNITY OUTREACH DAVIE COMMUNITY FOUNDATION INC 107 N SALISBURY STREET MOCKSVILLE NC 27028 581850531 501(C)(3) 20000 0 COMMUNITY OUTREACH EXCHANGE CLUB CENTER FOR PREVENTION OF CHILD ABUSE OF NC INC 500 WEST NORTHWEST BLVD WINSTONSALEM NC 27105 581443692 501(C)(3) 15000 0 COMMUNITY OUTREACH FAMILY SERVICES INC 1200 SOUTH BROAD STREET WINSTONSALEM NC 27101 560689235 501(C)(3) 9500 0 COMMUNITY OUTREACH FORSYTH FUTURES 100 N CHERRY STREET WINSTONSALEM NC 27101 561092807 501(C)(3) 30000 0 COMMUNITY OUTREACH FORSYTH HEALTHCARE INC 515 N CLEVELAND AVE WINSTONSALEM NC 27101 320097975 501(C)(3) 150000 0 COMMUNITY OUTREACH GO FAR INC 2011 SANDY RIDGE ROAD COLFAX NC 27235 262059189 501(C)(3) 20000 0 COMMUNITY OUTREACH HOPE OF WINSTON-SALEM INC 844 GLEN ECHO TRAIL WINSTONSALEM NC 27106 463772491 501(C)(3) 6500 0 COMMUNITY OUTREACH LEAD GIRLS OF NC INC 500 W 4TH STREET WINSTONSALEM NC 27101 820984711 501(C)(3) 10000 0 COMMUNITY OUTREACH LEADERSHIP WINSTON-SALEM 624 W SIXTH STREET SUITE 110 WINSTONSALEM NC 27101 581574887 501(C)(3) 8000 0 COMMUNITY OUTREACH MARCH OF DIMES FOUNDATION 1275 MAMARONECK AVENUE WHITE PLAINS NY 10605 131846366 501(C)(3) 25000 0 COMMUNITY OUTREACH MEDASSIST OF MECKLENBURG DBA NC MEDASSIST 4428 TAGGART CREEK ROAD CHARLOTTE NC 28208 562018957 501(C)(3) 10000 0 COMMUNITY OUTREACH PIEDMONT TRIAD PARTNERSHIP PO BOX 2672 HIGH POINT NC 27261 561750279 501(C)(3) 25000 0 COMMUNITY OUTREACH RONALD MCDONALD HOUSE OF WINSTON-SALEM 419 S HAWTHORNE ROAD WINSTONSALEM NC 27103 581454715 501(C)(3) 12500 0 COMMUNITY OUTREACH SAMARITAN MINISTRIES 414 E NORTHWEST BLVD WINSTONSALEM NC 27105 561490019 501(C)(3) 15000 0 COMMUNITY OUTREACH SECOND HARVEST FOOD BANK OF NORTHWEST NC INC 3655 REED STREET WINSTONSALEM NC 27107 581457912 501(C)(3) 25000 0 COMMUNITY OUTREACH SENIOR SERVICES INC 2895 SHOREFAIR DRIVE WINSTONSALEM NC 27105 561085968 501(C)(3) 150000 0 COMMUNITY OUTREACH SHEPHERD'S CENTER OF GREATER WINSTON-SALEM INC 1700 EBERT STREET WINSTONSALEM NC 27103 561646960 501(C)(3) 20280 0 COMMUNITY OUTREACH THE CENTERS FOR EXCEPTIONAL CHILDREN INC 2315 COLISEUM DRIVE WINSTONSALEM NC 27106 560615188 501(C)(3) 10000 0 COMMUNITY OUTREACH THE LEUKEMIA & LYMPHOMA SOCIETY INC 3 INTERNATIONAL DR RYE BROOK NY 10573 135644916 501(C)(3) 102000 0 COMMUNITY OUTREACH THE SCIENCE CENTER AND ENVIRONMENTAL PARK OF FORSYTH COUNTY DBA SCIWORKS 400 W HANES MILL ROAD WINSTONSALEM NC 27105 560815746 501(C)(3) 209120 0 COMMUNITY OUTREACH UNITED WAY OF FORSYTH COUNTY INC 301 N MAIN STREET SUITE 1700 WINSTONSALEM NC 27101 237357234 501(C)(3) 47500 0 COMMUNITY OUTREACH WINSTON-SALEM ALLIANCE 100 N MAIN STREET WINSTONSALEM NC 27101 311726654 501(C)(6) 35000 0 COMMUNITY OUTREACH SMART START OF DAVIE COUNTY INC 1278 YADKINVILLE ROAD MOCKSVILLE NC 27028 311600557 501(C)(3) 8000 0 COMMUNITY OUTREACH YOUNG MEN'S CHRISTIAN ASSOCIATION OF NORTHWEST NORTH CAROLINA 301 N MAIN STREET SUITE 1900 WINSTONSALEM NC 27101 560530015 501(C)(3) 1250000 0 COMMUNITY OUTREACH GREATER WINSTON-SALEM INC FOUNDATION 525 VINE STREET SUITE 240 WINSTONSALEM NC 27101 510167887 501(C)(3) 30000 0 COMMUNITY OUTREACH PIEDMONT DOWN SYNDROME SUPPORT NETWORK 305 W 4TH ST SUITE B11 WINSTONSALEM NC 27101 203131948 501(C)(3) 6000 0 COMMUNITY OUTREACH JUNIOR ACHIEVEMENT OF THE TRIAD 3220 NORTHLINE AVENUE GREENSBORO NC 27408 560844838 501(C)(3) 13000 0 COMMUNITY OUTREACH REACH WOMENS NETWORK 2618 ARBOR PLACE COURT WINSTONSALEM NC 27104 831574715 501(C)(3) 5280 0 COMMUNITY OUTREACH GOLER DEPOT STREET RENAISSANCE CORPORATION 889 NORTH LIBERTY STREET WINSTONSALEM NC 27101 562118777 501(C)(3) 8000 0 COMMUNITY OUTREACH IMPRINTS CARES 711 COLISEUM PLAZA COURT WINSTONSALEM NC 27106 560949178 501(C)(3) 8000 0 COMMUNITY OUTREACH HOSPITALITY HOUSE OF WINSTON-SALEM 1970 BALDWIN LANE WINSTONSALEM NC 27103 203604576 501(C)(3) 10000 0 COMMUNITY OUTREACH SMART START OF FORSYTH COUNTY 7820 NORTH POINT BLVD SUITE 200 WINSTONSALEM NC 27106 561899564 501(C)(3) 10000 0 COMMUNITY OUTREACH AGE-FRIENDLY FORSYTH 110 OAKWOOD DRIVE SUITE 300 WINSTONSALEM NC 27103 873894106 501(C)(3) 15000 0 COMMUNITY OUTREACH FORSYTH BACKPACK PROGRAM BOX 402 380-H KNOLLWOOD STREET WINSTONSALEM NC 27103 461940233 501(C)(3) 25000 0 COMMUNITY OUTREACH YOUNG WOMEN'S CHRISTIAN ASSOCIATION OF HIGH POINT NC INC 155 W WESTWOOD AVE HIGH POINT NC 27262 560579600 501(C)(3) 45000 0 COMMUNITY OUTREACH THE SHEPHERD'S CENTER OF KERNERSVILLE INC PO BOX 2044 KERNERSVILLE NC 27285 561471510 501(C)(3) 20500 0 COMMUNITY OUTREACH FORSYTH COMMUNITY PCC LLC 650 N HIGHLAND AVENUE SUITE 120 WINSTONSALEM NC 27101 815300614 501(C)(3) 144816 0 COMMUNITY OUTREACH 40 1 PATIENT ASSISTANCE 80 12160 MEDICATION FOR INDIGENT PATIENTS 220 52772 FMV MEDICATION FOR INDIGENT PATIENTS PATIENT TRANSPORTATION 2175 537006 FMV CAB FARES FOR INDIGENT PATIENTS ZOLL LIFE VESTS 1 3250 FMV ZOLL LIFE VESTS FOR INDIGENT PATIENTS SCHOLARSHIPS 25 28595 PART I, LINE 2 : PROCEDURES FOR MONITORING THE USE OF THE GRANT FUNDS THE FILING ORGANIZATION IS PART OF THE INTEGRATED HEALTHCARE SYSTEM OPERATED BY NOVANT HEALTH, INC. ("NOVANT HEALTH"), THE PARENT ORGANIZATION. NOVANT HEALTH'S BYLAWS AUTHORIZE IT TO ESTABLISH CERTAIN POLICIES FOR ALL OF ITS SUBSIDIARIES WITHIN THE SYSTEM. NOVANT HEALTH HAS ESTABLISHED A SYSTEM-WIDE CORPORATE POLICY WITH STANDARDIZED GUIDELINES THAT ARE TO BE USED IN REVIEWING THE ELIGIBILITY AND SELECTION OF GRANTEES RECEIVING CERTAIN EXEMPT PURPOSE FUNDS. THE FILING ORGANIZATION MAINTAINS DOCUMENTATION OF THE ELIGIBILITY AND SELECTION CRITERIA AND RECORDS OF THE AMOUNTS ARE MAINTAINED VIA THE GENERAL LEDGER. FUNDS ARE GENERALLY NOT TRACKED AFTER BEING GRANTED, AS THE ORIGINAL ELIGIBILITY AND SELECTION CRITERIA HAVE ALREADY BEEN MET. X X X X 1 1 0 1 0 0 0 0 0 0 0 CARL ARMATO TRUSTEE (FR 1/1/23)/PRES/CEO NH 0 2316664 0 2052150 0 1451716 0 1169800 0 36391 0 7026721 0 0 FRED HARGETT EVP/CFO (TO 9/6/23) 0 886648 0 1074292 0 439730 0 19800 0 30905 0 2451375 0 0 MICHAEL SETLIFF PRES NHFMC/GWM 626622 0 436049 0 113803 0 118941 0 40639 0 1336054 0 68211 0 JOHN MANN MD SVP NH INST 422132 193743 418901 0 75972 9016 16595 101220 27388 22513 960988 326492 0 28813 STANLEY FULLER MD SVP CH CLIN OFFICER 535885 0 363476 0 48119 0 105764 0 47564 0 1100808 0 0 0 ROLAND FRIEDMAN MD UROLOGIST 319537 0 578635 0 88592 0 19800 0 40068 0 1046632 0 0 0 GEOFFREY GARDNER CFO (FR 9/6/23) 0 496309 0 343441 0 69356 0 98858 0 29891 0 1037855 0 25993 KIRSTEN ROYSTER FMR KE (12/31/21) 413718 0 293395 0 42592 0 83119 0 15983 0 848807 0 0 0 JUDSON RACKLEY MD UROLOGIST 470973 0 250361 0 57600 0 19800 0 39524 0 838258 0 0 0 SUSAN HINES MD ONCOLOGIST 424213 0 320376 0 33861 0 19800 0 26639 0 824889 0 0 0 FRANKLIN CHEN MD TRUSTEE, CLIN PHYS EXEC 0 592246 0 32000 0 41213 0 19800 0 37006 0 722265 0 0 ASHLEY PERROTT MD TRUSTEE, SR PHYS EXEC 420472 0 92250 0 54948 0 19800 0 22791 0 610261 0 0 0 ALISHA HUTCHENS PRES, COO 384542 0 91344 0 16666 0 19800 0 37472 0 549824 0 0 0 PART I, LINE 1A FRINGE OR EXPENSE EXPLANATION FIRST-CLASS OR CHARTER TRAVEL: FIRST-CLASS OR CHARTER TRAVEL IS NOT A COVERED TRAVEL EXPENSE FOR EXECUTIVES; THEY ARE LIMITED TO BUSINESS OR COACH CLASS FARES FOR COMMERCIAL FLIGHTS. HOWEVER, CHARTER TRAVEL IS AVAILABLE TO CERTAIN EXECUTIVES, BOARD MEMBERS, AND APPROVED BUSINESS PERSONNEL MEETING APPLICABLE POLICY CRITERIA. TRAVEL FOR COMPANIONS: COMPANIONS ARE ALLOWED ON CERTAIN CHARTER FLIGHTS PAID FOR BY THE ORGANIZATION. IN THAT CASE, THE VALUE OF THE COMPANION'S FLIGHT IS CALCULATED UNDER APPLICABLE TAX LAWS AND THAT AMOUNT IS INCLUDED IN THE EXECUTIVE'S TAXABLE INCOME AS PRESCRIBED BY THE APPLICABLE TAX LAWS. DISCRETIONARY SPENDING ACCOUNT: CERTAIN EXECUTIVES RECEIVE A DISCRETIONARY SPENDING ACCOUNT. THE DOLLAR AMOUNT IN THE ACCOUNT IS PRE-APPROVED BY THE COMPENSATION AND LEADERSHIP COMMITTEE OF THE NOVANT HEALTH BOARD OF TRUSTEES. THE EXECUTIVE MAY DEFER THE AMOUNT TO A RETIREMENT ACCOUNT OR THE AMOUNT IS TREATED AS COMPENSATION AND IS SPREAD OUT OVER THE COURSE OF THE YEAR IN THE EXECUTIVE'S PAYCHECKS AS TAXABLE INCOME. HOUSING ALLOWANCE OR RESIDENCE FOR PERSONAL USE: WE PROVIDE TEMPORARY HOUSING ALLOWANCES IN CERTAIN EXECUTIVE RECRUITMENT AND RELOCATION PACKAGES. THE VALUE IS CALCULATED UNDER APPLICABLE TAX LAWS AND THAT AMOUNT IS INCLUDED IN THE EXECUTIVE'S INCOME AS PRESCRIBED BY THE APPLICABLE TAX LAWS. PART I, LINE 3 THE FILING ORGANIZATION IS AN INTEGRAL PART OF NOVANT HEALTH, AN INTEGRATED HEALTHCARE SYSTEM AND RELIES UPON NOVANT HEALTH, INC., THE PARENT ORGANIZATION, TO USE THE PROCESS DESCRIBED IN PART VI, LINE 15A/15B OF THIS RETURN TO ESTABLISH COMPENSATION FOR CERTAIN EXECUTIVES. THIS PROCESS ADHERES TO THE REQUIREMENTS SET FORTH TO SECURE THE REBUTTABLE PRESUMPTION OF REASONABLENESS AND INCLUDES A REVIEW AND APPROVAL BY INDEPENDENT AND DISINTERESTED MEMBERS OF A COMPENSATION COMMITTEE, CONSULTATION WITH INDEPENDENT COMPENSATION CONSULTANTS, THE UTILIZATION OF THIRD-PARTY COMPARABILITY DATA SUCH AS PUBLISHED COMPENSATION SURVEYS, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. PART I, LINE 4B PART I, LINES 4A-C: SEVERANCE, NONQUALIFIED, AND EQUITY-BASED PAYMENTS SEVERANCE NONE NONQUALIFIED GEOFFREY GARDNER $25,993 JOHN MANN MD $35,792 MICHAEL SETLIFF $70,493 EQUITY-BASED NONE PART I, LINE 4B - SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANS: THE SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN ("SERP") IS INTENDED TO SUPPORT RETENTION OF KEY EXECUTIVES, AND TO OFFER COMPETITIVE TOTAL COMPENSATION. GENERALLY, ANNUAL CONTRIBUTIONS TO THE PLAN OR PAYMENTS TO PARTICIPANTS WILL BE BASED ON A PERCENTAGE OF THE PARTICIPANT'S BASE SALARY AS OF JANUARY 1ST OF THE PREVIOUS PLAN YEAR AND ARE REPORTED IN COLUMN (C) OF SCHEDULE J. PRIOR TO MAKING THE CONTRIBUTIONS OR PAYMENTS, THE NOVANT HEALTH COMPENSATION AND LEADERSHIP COMMITTEE ("COMMITTEE") WILL APPROVE THE AMOUNTS AS TO REASONABLENESS, WHEN COMBINED WITH ALL OTHER ANNUAL COMPENSATION. A 3 YEAR CLASS-YEAR VESTING PERIOD WILL APPLY UP TO AGE 62, WHEN ALL MONEY WOULD BE VESTED AND PAID OUT TO THE PARTICIPANT. OTHERWISE, VESTING WILL OCCUR ON JANUARY 1ST OF EACH YEAR FOR THE APPROPRIATE CLASS-YEAR VESTING PERIOD. THE COMMITTEE REVIEWS, APPROVES, AND OVERSEES ALL ASPECTS AND ALL ELEMENTS OF EXECUTIVE COMPENSATION AND BENEFITS, INCLUDING THE AMOUNTS AWARDED UNDER THIS SERP. FORM 990, PI, L1: ORGANIZATION'S MISSION OR MOST SIGNIFICANT ACTIVITIES NOVANT HEALTH IS A NON-PROFIT INTEGRATED HEALTHCARE SYSTEM OF 15 MEDICAL CENTERS WITH MORE THAN 35,000 EMPLOYEES AND 1,800 PHYSICIANS IN OVER 800 LOCATIONS, AS WELL AS NUMEROUS OUTPATIENT SURGERY CENTERS, MEDICAL PLAZAS, REHABILITATION PROGRAMS, DIAGNOSTIC IMAGING CENTERS AND COMMUNITY HEALTH OUTREACH PROGRAMS. HEADQUARTERED IN WINSTON-SALEM, NORTH CAROLINA, NOVANT HEALTH'S TEAM MEMBERS AND PHYSICIAN PARTNERS CARE FOR PATIENTS AND COMMUNITIES IN NORTH CAROLINA, SOUTH CAROLINA AND GEORGIA. THE NOVANT HEALTH INTEGRATED HEALTHCARE SYSTEM OPERATES TO CARRY OUT ITS CHARITABLE MISSION OF IMPROVING THE HEALTH OF COMMUNITIES IT SERVES AND MAKING HEALTHCARE REMARKABLE FOR PATIENTS. NOVANT HEALTH ACCOMPLISHES THAT MISSION BY PROVIDING AND SUPPORTING EXCELLENT HEALTHCARE FACILITIES AND PHYSICIAN PRACTICES AND BY MAKING A COMMITMENT TO COMMUNITY OUTREACH/SERVICE THROUGH THE PROVISION OF COMMUNITY BENEFIT PROGRAMS. BY BRINGING TOGETHER WORLD-CLASS TECHNOLOGY AND CLINICIANS TO PROVIDE QUALITY CARE, NOVANT HEALTH IS COMMITTED TO CREATING A HEALTHCARE EXPERIENCE THAT IS SIMPLER, MORE CONVENIENT, AND MORE AFFORDABLE SO PATIENTS CAN FOCUS ON GETTING BETTER AND STAYING HEALTHY. IN 2023, NOVANT HEALTH PROVIDED NEARLY 7 MILLION PATIENT VISITS AND OVER $1.5 BILLION OF COMMUNITY BENEFIT EXPENDITURES SYSTEM-WIDE. IN ADDITION TO PROVIDING A HIGH QUALITY, COMPREHENSIVE CATALOG OF HEALTHCARE SERVICES, NOVANT HEALTH OFFERS A ROBUST PATIENT FINANCIAL ASSISTANCE PROGRAM, WORKING WITH ITS PATIENTS TO ASSIST WITH ESTABLISHING REASONABLE PAYMENT PLANS, DISCOUNTING PATIENT BILLS, AND PROVIDING FREE CARE FOR THOSE THAT QUALIFY UNDER ITS FINANCIAL ASSISTANCE POLICY. FORSYTH MEMORIAL HOSPITAL, INC. IS AN INTEGRAL PART OF THE NOVANT HEALTH SYSTEM AND INCLUDES FOUR HOSPITAL FACILITIES AS FOLLOWS: NOVANT HEALTH FORSYTH MEDICAL CENTER ("NHFMC"), NOVANT HEALTH KERNERSVILLE MEDICAL CENTER ("NHKMC"), NOVANT HEALTH CLEMMONS MEDICAL CENTER ("NHCMC"), AND NOVANT HEALTH REHABILITATION HOSPITAL OF WINSTON-SALEM, LLC. - NHFMC IS AN 859-BED HOSPITAL IN WINSTON-SALEM, NC OFFERING A WIDE RANGE OF SERVICES IN EMERGENCY, MEDICAL, SURGERY, NEUROLOGY, CRITICAL CARE, ONCOLOGY, WOMEN'S HEALTH AND WELLNESS AND BEHAVIORAL HEALTH. CENTERS OF EXCELLENCE INCLUDE THE MAYA ANGELOU WOMEN'S HEALTH AND WELLNESS CENTER, HEART AND VASCULAR INSTITUTE, DERRICK L. DAVIS CANCER INSTITUTE, STROKE AND NEUROSCIENCES CENTER, ORTHOPEDIC CENTER AND BEHAVIORAL HEALTH. - NHKMC IS A 50-BED COMMUNITY HOSPITAL IN KERNERSVILLE, NC OFFERING A WIDE RANGE OF SERVICES IN EMERGENCY, SURGERY, CARDIOVASCULAR, DIAGNOSTIC AND CANCER CARE CLOSE TO HOME FOR LOCAL RESIDENTS. - NHCMC IS A 36-BED COMMUNITY HOSPITAL IN CLEMMONS, NC OFFERING EMERGENCY, IMAGING, LABORATORY, MEDICAL, SURGERY AND ORTHOPEDIC SERVICES. THE MEDICAL CENTER FIRST OPENED IN APRIL 2013 AND WAS EXPANDED TO A FULL-SERVICE HOSPITAL IN AUGUST 2017. - NH REHAB HOSPITAL OF WINSTON-SALEM, LLC IS A JOINT VENTURE HOSPITAL FACILITY OFFERING INPATIENT REHABILITATION FOR STROKE, BRAIN INJURY, HIP FRACTURE AND OTHER COMPLEX NEUROLOGICAL AND ORTHOPEDIC CONDITIONS. COMMUNITY OUTREACH COMMUNITY OUTREACH IS A CRITICAL COMPONENT TO THE MISSION OF NOVANT HEALTH. THE HEALTHCARE SYSTEM PROVIDES HUNDREDS OF PROGRAMS THAT SERVE PATIENTS, NEIGHBORS, AND SOME OF THE COMMUNITIES' MOST VULNERABLE CITIZENS. NOVANT HEALTH ALSO PROVIDES FINANCIAL ASSISTANCE (I.E., CHARITY CARE) FOR ITS QUALIFIED UNINSURED PATIENTS, CATASTROPHIC SETTLEMENTS AND LONG-TERM PAYMENT PLANS TO MEDICALLY INDIGENT PATIENTS, SERVICES TO PATIENTS WITH MEDICARE, MEDICAID, AND OTHER GOVERNMENT MEDICAL PROGRAM COVERAGE (REIMBURSED AT LESS THAN COST), COMMUNITY HEALTH EDUCATION, SUPPORT GROUPS, SUBSIDIZED OUTREACH SERVICES, AND COMMUNITY EVENTS/SCREENINGS. IN ADDITION, NOVANT HEALTH PARTICIPATES IN MEDICAL RESEARCH, AS WELL AS ACADEMIC HEALTH PROGRAMS AND PARTNERSHIPS WITH A DIVERSE GROUP OF ORGANIZATIONS TO PROVIDE OTHER COMMUNITY INITIATIVES. NOVANT HEALTH IS ALSO COMMITTED TO SUPPORTING THE COMMUNITIES IT SERVES THROUGH CHARITABLE CONTRIBUTIONS TO COMMUNITY-BASED PROGRAMS THAT IMPROVE HEALTH EQUITY AND UPWARD MOBILITY FOR THOSE WHO NEED IT MOST. TOWARD THAT GOAL, NOVANT HEALTH INVESTS IN COMMUNITY-BASED PROGRAMS THAT ALIGN WITH ITS TWO INVESTMENT PRIORITIES OF DEVELOPING HEALTHY COMMUNITIES AND EXPANDING OPPORTUNITIES FOR HEALTHCARE EDUCATION. THE ANNUAL NOVANT HEALTH COMMUNITY IMPACT REPORT, AVAILABLE AT HTTPS://WWW.NOVANTHEALTH.ORG/ABOUT/COMMUNITY/COMMUNITY-HEALTH-NEEDS/, INCLUDES QUALITATIVE AND QUANTITATIVE INFORMATION REGARDING THE HEALTHCARE SYSTEM'S COMMUNITY BENEFIT EFFORTS AND ACHIEVEMENTS. FOR 2023, NOVANT HEALTH'S SYSTEM-WIDE COMMUNITY BENEFIT EXPENDITURES TOTALED APPROXIMATELY $1.61 BILLION, INCLUDING $225 MILLION OF FINANCIAL ASSISTANCE. NOTE: NUMERIC DATA IN THIS REPORT IS NOT BASED UPON FORM 990, SCHEDULE H INSTRUCTIONS, BUT RATHER IN ACCORDANCE WITH NORTH CAROLINA HEALTHCARE ASSOCIATION COMMUNITY BENEFIT REPORTING GUIDELINES. NOVANT HEALTH COMMUNITY IMPACT REPORT SHOULD NOT BE RELIED UPON AS EQUIVALENT TO FORM 990, SCHEDULE H COMMUNITY BENEFIT, COMMUNITY HEALTH NEEDS ASSESSMENT OR COMMUNITY BENEFIT IMPLEMENTATION STRATEGY REPORTING. IN 2023, NOVANT HEALTH AND THE YMCA OF NORTHWEST NORTH CAROLINA ANNOUNCED A STRATEGIC PARTNERSHIP TO ENCOMPASS THE YMCA'S 17 BRANCH LOCATIONS ACROSS ALEXANDER, DAVIE, FORSYTH, IREDELL, STOKES, WILKES AND YADKIN COUNTIES. GUIDED BY THE LOCAL COMMUNITY HEALTH NEEDS ASSESSMENTS "CHNAS", THE TWO NON-PROFIT ORGANIZATIONS WILL EXPAND WELLNESS PROGRAMMING, SUPPORT YOUTH SPORTS, AND ESTABLISH PHYSICAL AND TELEHEALTH CLINIC LOCATIONS TO CREATE INTEGRATED HEALTHCARE ACCESS FOR THE REGION. NHFMC SUPPORTED THE COMMUNITY IN 2023 THROUGH RESOURCES, SCREENINGS/CLINICS, HEALTH EDUCATION INITIATIVES AND CLASSES, SOCIAL & ENVIRONMENTAL IMPROVEMENT ACTIVITIES, COMMUNITY BUILDING ACTIVITIES, IN-KIND DONATIONS, AND MORE. SOME EXAMPLES OF RESOURCES PROVIDED TO THE COMMUNITY INCLUDE: - MYCOMMUNITY ACCESS, WHICH ENABLED COMMUNITY MEMBERS TO SEARCH FOR FREE OR REDUCED COST RESOURCES LOCATED WITHIN THE COMMUNITY. NOVANT PAID THE ANNUAL FEES FOR THIS PLATFORM THAT COMMUNITY MEMBERS WOULD HAVE OTHERWISE HAD TO PAY. - PRINTED RESOURCE CARDS FOR ANYONE TO SEARCH FOR LOCAL FREE AND REDUCED COST SERVICES - 'ASK THE EDUCATOR IN ENGLISH AND SPANISH' - HISPANIC OUTREACH SPECIFICALLY FOR NAVIGATING HEALTHCARE. - SCREENINGS/CLINICS FOR BLOOD PRESSURE/HYPERTENSION, CHOLESTEROL, DIABETES, AND BREAST CANCER, IN BOTH STATIONARY AND MOBILE CLINIC SETTINGS. - MATERNAL & INFANT HEALTH INITIATIVES INCLUDED CHILDBIRTH PREPARATION, BREASTFEEDING, INFANT SAFETY & CPR, CAR SEAT SAFETY, NEWBORN CARE (IN ENGLISH AND SPANISH), SIBLING PREPARATION, DAD'S 411, FINANCIAL CHECKLIST FOR NEW PARENT CLASSES, AND INCREASING COMFORT IN LABOR, POSTPARTUM 101. - SUPPORT GROUPS ESTABLISHED WERE FOR POSTPARTUM, GI WELLNESS, GYN ONCOLOGY, AND NURSING MOTHERS (BABY CAFE). - NUTRITION, EXERCISE & WELLNESS PROGRAMS PROVIDED WERE PREGNANCY YOGA, MOMMY & BABY YOGA, CHAIR YOGA, TRADITIONAL YOGA, BREAST CANCER NUTRITION PREVENTION, AND SURVIVORSHIP CLASSES. - SOCIAL AND ENVIRONMENTAL IMPROVEMENT ACTIVITIES & COMMUNITY BUILDING WERE LEADERSHIP WINSTON SALEM HEALTHCARE DAY, SENIOR ACADEMY DAY DROPOUT PREVENTION PROGRAM, LEADERSHIP WINSTON SALEM MENTORSHIP, BRIDGES TO HEALTHCARE INTERN SUPPORT, TEAM MEMBER NON-PROFIT BOARD SERVICE, ADVISORY COUNCIL SERVICE, AND A COMMITTEE/COALITION SERVICE. - IN-KIND GIFTS CAME FOR FIRST-AID PERSONNEL AT COMMUNITY EVENTS. - OTHER COMMUNITY EDUCATIONAL PROGRAMS AND ACTIVITIES INCLUDED CANCER EDUCATION CLASSES, CPR/FIRST AID TRAINING, HEALTH FAIRS, HEART HEALTH TALKS, BARIATRIC SOLUTIONS FOR SENIOR'S HEALTH TALK, MONKEY POX VACCINE EDUCATION, AND VARIOUS WELLNESS WEBINARS. NHKMC PROVIDED MYCOMMUNITY ACCESS AND PRINTED RESOURCE CARDS FOR ANYONE TO SEARCH FOR LOCAL FREE AND REDUCED COST SERVICES. SCREENINGS/CLINICS PROVIDED WERE FOR BLOOD PRESSURE AND HYPERTENSION SCREENING. HEALTH EDUCATION INITIATIVES INCLUDED A WELLNESS WEBINAR, HEALTHY LIVING EXPO & OTHER HEART HEALTH PROGRAMMING, AND AN 'ASK AN EDUCATOR' EVENT. NHCMC PROVIDED MYCOMMUNITY ACCESS AND PRINTED RESOURCE CARDS FOR ANYONE TO SEARCH FOR LOCAL FREE AND REDUCED COST SERVICES. SCREENINGS/CLINICS PROVIDED WERE FOR BLOOD PRESSURE AND BODY FAT MEASUREMENTS. HEALTH EDUCATION INITIATIVES INCLUDED GENERAL WELLNESS HEALTH EDUCATION EVENTS, AND A HEALTHY AGING PROGRAM. IN-KIND DONATIONS WERE MADE AT FOOD DRIVES AND FOR PHYSICALS FOR PARTICIPATION IN SCHOOL-BASED SPORTS. FORM 990, PI, L1: CONTINUED NEW TECHNOLOGY & SERVICES NHFMC LAUNCHED ITS FIRST 2 PLUVICTO ADMINISTRATIONS IN OCTOBER 2023. PLUVICTO IS A THERAPEUTIC RADIOPHARMACEUTICAL USED TO TREAT METASTATIC CASTRATION-RESISTANT PROSTATE CANCER. DR. SHOGBESAN BECAME THE NEW MEDICAL DIRECTOR OF MOLECULAR IMAGING AND THERANOSTICS, JOINING TRIAD RADIOLOGY ASSOCIATES IN AUGUST OF 2023. DR. SHOGBESAN COMPLETED HIS NUCLEAR MEDICINE RESIDENCY AND A SPECIAL FELLOWSHIP IN PET/CT AND THERANOSTICS AT EMORY SCHOOL OF MEDICINE. IN AUGUST 2023, NHFMC OPENED ITS COMPLETELY RENOVATED MOTHER-BABY UNIT ON THE SIXTH AND SEVENTH FLOORS OF THE HOSPITAL. THIS UNIT, WHICH PROVIDES AROUND-THE-CLOCK CARE FOR NEWBORNS AND THEIR PARENTS, WAS THE FINAL STEP IN A MULTIPHASE CONSTRUCTION PROJECT SPECIFICALLY DESIGNED TO ENHANCE ALL ASPECTS OF MATERNITY CARE. NHFMC CELEBRATED THE STRUCTURAL COMPLETION OF ITS NEW CRITICAL CARE TOWER IN MAY 2023 WITH A "TOPPING OUT" CEREMONY. ONCE COMPLETE IN EARLY 2025, THE FIVE-STORY, 193,000-SQUARE-FOOT TOWER WILL BRING THE LATEST IN ADVANCED ACUTE CARE SERVICES TO THE GROWING POPULATION IN AND AROUND FORSYTH COUNTY. NHKMC OPENED ITS NEW HEART AND VASCULAR LAB IN APRIL 2023, BRINGING NEW CARDIOVASCULAR DIAGNOSTIC AND INTERVENTIONAL PROCEDURES TO THE HOSPITAL, IMPROVING ACCESS TO LIFESAVING CARE AND TREATMENT FOR PATIENTS IN KERNERSVILLE AND WEST GUILFORD COUNTY. THE MEDICAL CENTER'S NEWLY EXPANDED INTENSIVE CARE UNIT OPENED IN DECEMBER 2023. THE EXPANSION DOUBLED THE SIZE OF THE UNIT AND IS DESIGNED TO PROVIDE THE LATEST IN ADVANCED CARE FOR THE SICKEST PATIENTS IN THE AREA. BOTH PROJECTS ARE PART OF NHKMC'S ONGOING $55 MILLION EXPANSION PROJECT, WHICH WILL ALSO INCLUDE A BIRTH CENTER, SCHEDULED FOR COMPLETION IN EARLY 2024. AWARDS AND RECOGNITION & CERTIFICATIONS/RECERTIFICATIONS NOVANT HEALTH FORSYTH MEDICAL CENTER - "A" RATED HOSPITAL FOR SAFETY BY THE LEAPFROG GROUP (2023) - GOLD PLUS RATED HOSPITAL BY AMERICAN HEART ASSOCIATION (2020, 2021, 2022, 2023) - ADVANCED COMPREHENSIVE STROKE CERTIFICATION BY THE JOINT COMMISSION - "BABY-FRIENDLY" DESIGNATED HOSPITAL BY THE WORLD HEALTH ORGANIZATION AND THE UNITED NATIONS CHILDREN'S FUND - 5-STAR-RATED HOSPITAL FOR "BREASTFEEDING FRIENDLINESS" BY NORTH CAROLINA DEPARTMENT OF HEALTH AND HUMAN SERVICES - LEADER IN LGBTQ HEALTHCARE EQUALITY BY HUMAN RIGHTS CAMPAIGN (2017, 2018, 2019, 2020, 2022) - CLINICAL EXCELLENCE AWARD BY VIZIENT - MAGNET RECOGNITION PROGRAM DESIGNATED HOSPITAL BY THE AMERICAN NURSES CREDENTIALING CENTER - NORTH CAROLINA DIVISION OF MEDICAL ASSISTANCE - MEDICAID - TJC - COMPREHENSIVE STROKE CENTER CERTIFICATION - UNITED STATES DEPARTMENT OF HEALTH & HUMAN SERVICES - CLIA - UNITED STATES DEPARTMENT OF HEALTH & HUMAN SERVICES - MEDICARE NOVANT HEALTH KERNERSVILLE MEDICAL CENTER - "A" RATED HOSPITAL FOR SAFETY BY THE LEAPFROG GROUP (2023) - GOLD PLUS RATED HOSPITAL BY THE AMERICAN HEART ASSOCIATION (2020, 2021, 2022, 2023) - LEADER IN LGBTQ HEALTHCARE EQUALITY BY HUMAN RIGHTS CAMPAIGN (2017, 2018, 2019, 2020, 2022) - ANCC MAGNET RECOGNITION PROGRAM DESIGNATION - METABOLIC & BARIATRIC SURGERY ACCREDITATION AND QUALITY IMPROVEMENT PROGRAM - FDA MQSA CERTIFICATION - INTERNATIONAL ASSOCIATION FOR HEALTHCARE SECURITY AND SAFETY - NORTH CAROLINA DIVISION OF MEDICAL ASSISTANCE - MEDICAID - TJC - ACUTE STROKE READY HOSPITAL - UNITED STATES DEPARTMENT OF HEALTH & HUMAN SERVICES - CLIA - UNITED STATES DEPARTMENT OF HEALTH & HUMAN SERVICES - MEDICARE NOVANT HEALTH CLEMMONS MEDICAL CENTER - GOLD SAFETY AWARD BY NORTH CAROLINA DEPARTMENT OF LABOR - LEADER IN LGBTQ HEALTHCARE EQUALITY BY HUMAN RIGHTS CAMPAIGN (2017, 2018, 2019, 2020, 2022) - HIP AND KNEE JOINT REPLACEMENT CERTIFICATION BY THE JOINT COMMISSION - INTERNATIONAL ASSOCIATION FOR HEALTHCARE SECURITY AND SAFETY - NORTH CAROLINA DIVISION OF MEDICAL ASSISTANCE - MEDICAID - TJC - HIP JOINT REPLACEMENT CERTIFICATION - TJC - KNEE JOINT REPLACEMENT CERTIFICATION - UNITED STATES DEPARTMENT OF HEALTH & HUMAN SERVICES - CLIA - UNITED STATES DEPARTMENT OF HEALTH & HUMAN SERVICES - MEDICARE ACCREDITATION NHFMC, NHKMC, NHCMC HAVE BEEN FULLY ACCREDITED BY THE JOINT COMMISSION, AN INDEPENDENT ORGANIZATION THAT EVALUATES A HEALTHCARE ORGANIZATION'S PERFORMANCE IN AREAS THAT MOST AFFECT PATIENT HEALTH AND SAFETY. IN ADDITION, THESE HOSPITAL FACILITIES HAVE EARNED SOME OF THE NATION'S TOP HONORS IN QUALITY CARE, INCLUDING BREAST CENTER ACCREDITATION. NHKMC ALSO MEETS ALL CRITERIA AS A COMPREHENSIVE CENTER UNDER THE METABOLIC AND BARIATRIC SURGERY ACCREDITATION AND QUALITY IMPROVEMENT PROGRAM (MBSAQIP), A JOINT PROGRAM OF THE AMERICAN COLLEGE OF SURGEONS (ACS) AND THE AMERICAN SOCIETY FOR METABOLIC AND BARIATRIC SURGERY (ASMBS). THE MBSAQIP STANDARDS ENSURE THAT BARIATRIC SURGICAL PATIENTS RECEIVE A MULTIDISCIPLINARY PROGRAM, NOT JUST A SURGICAL PROCEDURE, WHICH IMPROVES PATIENT OUTCOMES AND LONG-TERM SUCCESS. NOVANT HEALTH FORSYTH MEDICAL CENTER - AMERICAN ASSOCIATION OF BLOOD BANKS - AMERICAN COLLEGE OF RADIOLOGY: RADIATION ONCOLOGY - AMERICAN NURSES CREDENTIALING CENTER - NURSE RESIDENCY PROGRAM - AMERICAN SOCIETY OF HEALTH SYSTEM PHARMACISTS - PHARMACY RESIDENCY PROGRAM - COLLEGE OF AMERICAN PATHOLOGY - INTERSOCIETAL ACCREDITATION COMMISSION ECHOCARDIOGRAPHY LABORATORIES - NOVANT HEALTH CANCER INSTITUTE - NATIONAL ACCREDITATION PROGRAM FOR BREAST CENTERS - NATIONAL ASSOCIATION EPILEPSY CENTERS NOVANT HEALTH CLEMMONS MEDICAL CENTER - AMERICAN ASSOCIATION OF BLOOD BANKS - AMERICAN NURSES CREDENTIALING CENTER - NURSE RESIDENCY PROGRAM - COLLEGE OF AMERICAN PATHOLOGY NOVANT HEALTH KERNERSVILLE MEDICAL CENTER - AMERICAN ASSOCIATION OF BLOOD BANKS - AMERICAN COLLEGE OF RADIOLOGY: MAMMOGRAPHY - AMERICAN COLLEGE OF RADIOLOGY: RADIATION ONCOLOGY - AMERICAN NURSES CREDENTIALING CENTER - NURSE RESIDENCY PROGRAM - COLLEGE OF AMERICAN PATHOLOGY - INTERSOCIETAL ACCREDITATION COMMISSION ECHOCARDIOGRAPHY LABORATORIES - NOVANT HEALTH CANCER INSTITUTE - NATIONAL ACCREDITATION PROGRAM FOR BREAST CENTERS FORM 990, PART III, LINE 1: OUR CAUSE (FKA MISSION, VISION AND VALUES) IN THE SPIRIT OF KEEPING OUR FOCUS ON PATIENT-CENTERED, EQUITABLE AND COMPASSIONATE CARE WHILE ENSURING OUR ORGANIZATION IS SUSTAINABLE FOR FUTURE GENERATIONS, WE HAVE RESTATED OUR MISSION, VISION AND VALUES AND ARE NOW GUIDED BY OUR CAUSE. OUR CAUSE WE CREATE A HEALTHIER FUTURE AND BRING REMARKABLE EXPERIENCES TO LIFE. DISCOVER WE CONSISTENTLY SEEK TO INNOVATE, COURAGEOUSLY TRANSFORM OURSELVES AND FIND NEW WAYS TO ADD VALUE FOR OUR PATIENTS, COMMUNITIES AND ONE ANOTHER. EMPOWER WE PROVIDE ONE ANOTHER, OUR PATIENTS, FAMILIES AND COMMUNITIES WITH THE RESOURCES AND ENVIRONMENT TO CREATE SHARED ACCOUNTABILITY AND ACTION. THRIVE WE DEMONSTRATE EQUITY, EMPATHY, SAFETY AND QUALITY TO HELP EACH OTHER, AND OUR COMMUNITIES GROW AND SUCCEED. TOGETHER WE WORK AS A TRUSTED TEAM WITH OUR UNIQUE PERSPECTIVES, LIFE EXPERIENCES AND EXPERTISE TO BRING REMARKABLE TO LIFE IN EVERY INTERACTION. WE ALL BELONG. FORM 990, PART III, LINE 4A: PROGRAM SERVICE ACCOMPLISHMENTS NHFMC HAS 859 LICENSED BEDS. IN 2023, THERE WERE 220,769 PATIENT DAYS WITH AN AVERAGE LENGTH OF STAY OF 6 DAYS, AN AVERAGE DAILY CENSUS OF 605, AND 36,034 DISCHARGES. THERE WERE 22,631 INPATIENT AND OUTPATIENT SURGERIES, A TOTAL OF 1,022,884 OUTPATIENT ENCOUNTERS AND 78,126 EMERGENCY DEPARTMENT VISITS. NHKMC HAS 50 LICENSED BEDS. IN 2023 THERE WERE 12,690 PATIENT DAYS WITH AN AVERAGE LENGTH OF STAY OF 4 DAYS, AN AVERAGE DAILY CENSUS OF 35, AND 3,074 DISCHARGES. THERE WERE 3,725 INPATIENT AND OUTPATIENT SURGERIES, A TOTAL OF 60,405 OUTPATIENT ENCOUNTERS AND 35,263 EMERGENCY DEPARTMENT VISITS. NHCMC HAS 36 LICENSED BEDS. IN 2023 THERE WERE 5,286 PATIENT DAYS WITH AN AVERAGE LENGTH OF STAY OF 3 DAYS, AN AVERAGE DAILY CENSUS OF 14, AND 1,899 DISCHARGES. THERE WERE 3,876 INPATIENT AND OUTPATIENT SURGERIES, A TOTAL OF 43,626 OUTPATIENT ENCOUNTERS AND 24,649 EMERGENCY DEPARTMENT VISITS. FORM 990, PART VI, SECTION A, LINE 6 FORM 990, PART VI, SECTION A, LINE 6: CLASSES OF MEMBERS OR STOCKHOLDERS THE CORPORATION IS A NONPROFIT CORPORATION WITH MEMBERS (OR A MEMBER). MEMBER HAS SOLE VOTING AUTHORITY OVER ALL MATTERS. IN ADDITION TO THESE POWERS, MEMBER HAS CERTAIN RIGHTS SUBJECT TO THE RESERVED POWERS OF NOVANT HEALTH, INC. FORM 990, PART VI, SECTION A, LINE 7A FORM 990, PART VI, SECTION A, LINE 7A: ELECTION OF MEMBERS AND THEIR RIGHTS NOVANT HEALTH, INC. ELECTS ALL MEMBERS OF THE GOVERNING BODY OF FORSYTH MEMORIAL HOSPITAL,INC. FORM 990, PART VI, SECTION A, LINE 7B FORM 990, PART VI, SECTION A, LINE 7B: DECISIONS SUBJECT TO APPROVAL OF MEMBERS NOVANT HEALTH, INC. HAS CERTAIN RESERVED POWERS, SUCH AS APPROVAL OF AMENDMENTS TO THE ARTICLES AND BYLAWS OF THE CORPORATION, AND TO ADOPT CERTAIN POLICIES WHICH SHALL BE IMPLEMENTED BY THE CORPORATION BOARD. FORM 990, PART VI, SECTION B, LINE 11B FORM 990, PART VI, SECTION B, LINE 11: ORGANIZATION'S PROCESS TO REVIEW FORM 990 THE BOARD DELEGATES REVIEW OF THE FORM 990 TO NOVANT HEALTH'S BOARD OF TRUSTEES' AUDIT AND COMPLIANCE COMMITTEE ("THE COMMITTEE"), WHICH OVERSEES TAX MATTERS FOR ENTITIES IN THE NOVANT HEALTH SYSTEM. THE COMMITTEE IS THE REVIEW BODY FOR ALL OF THE FORM 990S FILED FOR TAX-EXEMPT ORGANIZATIONS WITHIN THE NOVANT HEALTH SYSTEM. THE COMMITTEE IS PROVIDED A COPY OF FORM 990 AND MEETS TO ADDRESS ANY QUESTIONS AND SIGNIFICANT DISCLOSURES WITHIN THE FORM 990 PRIOR TO ITS FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C FORM 990, PART VI, SECTION B, LINE 12C: MONITORING AND ENFORCEMENT OF COI THE ORGANIZATION'S TRUSTEE CONFLICT OF INTEREST POLICY APPLIES TO ALL TRUSTEES, PRINCIPAL OFFICERS OR MEMBERS OF A COMMITTEE WITH BOARD DELEGATED POWERS INCLUDING ANY APPLICABLE DISREGARDED ENTITIES. ALL TRUSTEES ARE SENT AN ANNUAL DISCLOSURE QUESTIONNAIRE. THE TRUSTEE ANNUAL DISCLOSURE QUESTIONNAIRES ARE REVIEWED BY THE COMPLIANCE AND TAX DEPARTMENTS. WITH RESPECT TO PARTICULAR TRANSACTIONS THAT COME BEFORE THE BOARD, THE CONFLICT OF INTEREST POLICY WOULD BE FOLLOWED. THE POTENTIAL CONFLICT OF INTEREST WOULD BE DISCLOSED BY THE BOARD MEMBER BEFORE A VOTE ON THE TRANSACTION AND THE REST OF THE BOARD WOULD DETERMINE WHETHER A CONFLICT OF INTEREST EXISTS. IF THE REST OF THE BOARD DETERMINED THAT A CONFLICT OF INTEREST EXISTED THEN THE BOARD MEMBER WITH THE CONFLICT OF INTEREST WOULD NOT PARTICIPATE IN THE DELIBERATIONS AND VOTE. FORM 990, PART VI, SECTION B, LINE 15 FORM 990, PART VI, SECTION B, LINE 15A/15B: THE FILING ORGANIZATION IS AN INTEGRAL PART OF NOVANT HEALTH, AN INTEGRATED HEALTHCARE SYSTEM. INDEPENDENT AND DISINTERESTED BOARD MEMBERS OF THE PARENT ORGANIZATION, NOVANT HEALTH, INC. BOARD OF TRUSTEES (WHO COMPRISE THE COMPENSATION AND LEADERSHIP COMMITTEE OF THE BOARD), REVIEW, APPROVE, AND OVERSEE ALL ASPECTS OF COMPENSATION AND BENEFITS FOR CERTAIN LEADERS ("EXECUTIVES") SERVING AS OFFICERS, INCLUDING THE TOP MANAGEMENT & FINANCIAL OFFICIALS, OR KEY EMPLOYEES FOR NOVANT HEALTH ENTITIES. THE COMMITTEE WORKS WITH AN INDEPENDENT COMPENSATION CONSULTANT AND USES THIRD PARTY COMPARABILITY DATA FOR FUNCTIONALLY SIMILAR POSITIONS AT COMPARABLE ORGANIZATIONS TO ENSURE THAT TOTAL COMPENSATION AND BENEFITS FOR EACH EXECUTIVE IS REASONABLE. THE COMMITTEE REVIEWS AND APPROVES EXECUTIVE COMPENSATION AND BENEFITS ANNUALLY, CONSISTENT WITH THE WRITTEN EXECUTIVE COMPENSATION PHILOSOPHY OF NOVANT HEALTH, AND IN A MANNER THAT QUALIFIES FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS. FORM 990, PART VI, SECTION C, LINE 19 FORM 990, PART VI, SECTION C, LINE 19: GOVERNING DOCUMENTS DISCLOSURE THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS CONTAINING ALL ORGANIZATIONS IN THE NOVANT HEALTH SYSTEM ARE POSTED TO THE NOVANT HEALTH WEBSITE. THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT AVAILABLE TO THE PUBLIC. FORM 990, PART VII, SECTION B: INDEPENDENT CONTRACTORS NOVANT HEALTH, INC, A RELATED ORGANIZATION, IS RESPONSIBLE FOR CERTAIN CORPORATE SUPPORT FUNCTIONS OF THE FILING ORGANIZATION, INCLUDING ACCOUNTS PAYABLE AND ISSUANCE OF FORMS 1099. INFORMATION REPORTED IN PART VII, SECTION B REPRESENTS EXPENSES PAID BY NOVANT HEALTH, INC. ON BEHALF OF THE FILING ORGANIZATION TO INDEPENDENT CONTRACTORS OVER $100,000. FORM 990, PART IX, LINE 6: COMPENSATION OF DISQUALIFIED PERSONS THE AMOUNTS REPORTED HERE INCLUDE AMOUNTS ATTRIBUTABLE TO DISQUALIFIED PERSONS (DQP) AS DEFINED IN THE INSTRUCTIONS, BUT NOW ALSO INCLUDES AMOUNTS ATTRIBUTABLE TO INDIVIDUALS THAT MAY NOT DEFINITIVELY BE CONSIDERED DQPS UNDER THE 4958 RULES. WE HAVE OPTED TO TAKE A MORE EXPANSIVE APPROACH AS TO WHO MAY BE CONSIDERED A DQP AND REPORT THEM HERE AS WELL. FORM 990, PART XI, LINE 9: CONTRIBUTIONS: -1,149,202. AFFILIATE TRANSFERS: -312,228. INVESTMENT IN NORFOLK PARTNERSHIP: -2,943,370. MEMBER WITHDRAWAL: -2,661,224. 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