2023-08-15T13:14:14-05:00 2022-09-30 135565207 KPMG LLP 500 W 5TH ST STE 800 WINSTONSALEM NC 27101 990 2021-10-01 560845796 CUMBERLAND COUNTY HOSPITAL SYSTEM INC CUMB 9106154829 PO BOX 2000 FAYETTEVILLE NC 283022000 BRET JOHNSON CFO 9106154829 2023-08-15 1 BRET JOHNSON 999009999 WHITNEY B HEBRON P01226647 3362753394 3 AAL1 IAL1 2021 2023-04-26 12:10:37Z MICHAEL NAGOWSKI CEO PO BOX 2000 FAYETTEVILLE NC 283022000 1261481133 0 X WWW.CAPEFEARVALLEY.COM X 1956 NC SEE SCHEDULE O 22 20 8417 149 226606 0 75418689 24345333 1111084328 1200502235 15810860 21160229 11527958 15355488 1213841835 1261363285 285000 382750 0 0 516866455 535516533 0 0 0 624721513 675021481 1141872968 1210920764 71968867 50442521 1474757677 1447981523 732954971 760660924 741802706 687320599 CUMBERLAND COUNTY HOSPITAL SYSTEM, INC. EXISTS TO MEET THE HEALTH CARE NEEDS OF THE RESIDENTS OF CUMBERLAND, BLADEN, AND HOKE COUNTIES, AND THE SURROUNDING AREA IN NORTH CAROLINA. 0 0 1100396956 382750 1200283746 AS PART OF MEETING THE HEALTH CARE NEEDS OF THE SERVICE AREA, CCHS, INC. ADMITTED 35,285 PATIENTS, PROVIDED 219,006 PATIENT DAYS OF CARE, HAD 185,170 EMERGENCY ROOM VISITS AND HAD OVER 599,000 OUTPATIENT VISITS FOR OTHER SERVICES. 1100396956 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 1 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 1 414 0 1 8417 1 1 1 1 CJ 0 0 0 0 0 0 0 0 1 0 X 22 20 0 0 0 0 0 1 0 1 1 0 0 1 1 1 1 1 1 1 1 1 0 X BRET JOHNSON 9106154829 PO BOX 2000 FAYETTEVILLE NC 283022000 CHUKWUEMEKA CHIMA MD CHIEF OF STAFF & PHYSICIAN 5.00 0.00 X X 56250 0 0 MYRON STICKLAND TRUSTEE 2.00 0.00 X 12800 0 0 GLENN ADAMS TRUSTEE 2.00 0.00 X 0 0 0 AFUA ARHIN TRUSTEE 2.00 0.00 X 0 0 0 SANJAY SHAH TRUSTEE 2.00 0.00 X 0 0 0 TONI STEWART TRUSTEE 2.00 0.00 X 0 0 0 TAMMY S THURMAN TRUSTEE 2.00 0.00 X 0 0 0 PAMELA S STORY TRUSTEE 2.00 0.00 X 0 0 0 SHANNON MATTHEWS TRUSTEE 2.00 0.00 X 0 0 0 ALICIA MARKS BOARD VICE CHAIR 2.00 0.00 X X 0 0 0 GENE LEWIS TRUSTEE 2.00 0.00 X 0 0 0 LARRY L LANCASTER TRUSTEE 2.00 0.00 X 0 0 0 JIMMY KEEFE TRUSTEE 2.00 0.00 X 0 0 0 MICHAEL JONES TRUSTEE 2.00 0.00 X 0 0 0 GIRUM FEYISSA MD VICE CHEIF OF STAFF 2.00 0.00 X X 0 0 0 MARSHALL FAIRCLOTH TRUSTEE 2.00 0.00 X 0 0 0 CHARLES EVANS TRUSTEE 2.00 0.00 X 0 0 0 JEANNETTE COUNCIL TRUSTEE 2.00 0.00 X 0 0 0 AMY CANNON TRUSTEE 2.00 0.00 X 0 0 0 BRADLEY BROUSSARD MD BOARD CHAIR & PHYSICIAN 2.00 0.00 X X 0 0 0 MICHAEL BOOSE TRUSTEE 2.00 0.00 X 0 0 0 RYAN AUL TRUSTEE 2.00 0.00 X 0 0 0 MICHAEL NAGOWSKI CEO 55.00 0.00 X 1518665 0 18594 DANIEL WEATHERLY COO 55.00 0.00 X 909932 0 17333 SAMUEL FLEISHMAN CMO 55.00 0.00 X 736972 0 14478 BRET JOHNSON CFO 55.00 0.00 X 368408 0 14573 MELISSA STAMATES PHYSICIAN 40.00 0.00 X 877982 0 14000 PRITHVI NARAYAN PHYSICIAN 40.00 0.00 X 834139 0 14619 MICHAEL ZAPPA MEDICAL DIRECTOR 55.00 0.00 X 834294 0 11228 ROBERT MAUGHAN MD PHYSICIAN 40.00 0.00 X 1221527 0 12889 CHARLES HAWORTH MD PHYSICIAN 40.00 0.00 X 1462258 0 19236 SANDRA WILLIAMS CFO 55.00 0.00 X 442921 0 4539 9276148 0 141489 843 1 1 0 AYA HEALTHCARE INC PO BOX 123519 DALLAS TX 75312 CONTRACT LABOR 24853973 AMN HEALTHCARE INC 4441 COLLECTIONS CENTER DR CHICAGO IL 60693 CONTRACT LABOR 21611943 MB KAHN CONSTRUCTION CO PO BOX 1179 COLUMBIA SC 29202 CONSTRUCTION 15776201 ARAMARK DALLAS LOCKBOX PO BOX 978839 DALLAS TX 75397 MANAGEMENT FEES 9888677 PROLINK HEALTHCARE LLC PO BOX 772516 DETROIT MI 482772516 CONTRACT LABOR 4192480 140 210110 20381917 3753306 24345333 PATIENT SERVICE REVENU 900099 1147745360 1147745360 ANCILLARY MEDICAL SERV 900099 52751249 52532760 218489 EDUCATION/OUTREACH 611710 5626 5626 1200502235 14259168 8117 14251051 313083 117848 195235 195235 195235 6901061 0 6901061 6901061 6901061 CAFETERIA AND PARKING 900099 3983510 3983510 PURCHASE REBATES, DISC 812900 1393424 1393424 9783319 9783319 15160253 1261363285 1200283746 226606 36507600 382750 382750 4115466 4115466 449286863 408663598 40623265 13078710 13078710 39433448 39397395 36053 29602046 26836061 2765985 10708246 10698547 9699 1993738 1993738 478423 478423 29599093 18713260 10885833 994816 986790 8026 4652983 4303103 349880 18920523 23826 18896697 9169059 9169059 522595 483434 39161 673989 384891 289098 10170712 9352211 818501 35450253 28996092 6454161 2067645 610135 1457510 MEDICAL & OTHER SUPPLIE 213261039 211566770 1694269 BAD DEBT EXPENSE 150802069 150802069 CONTRACT LABOR 104137934 100383497 3754437 REPAIRS & MAINTENANCE 17850069 14565593 3284476 63568295 50999165 12569130 1210920764 1100396956 110523808 0 270882682 159009111 20250854 251411 95221475 129366631 15785059 15322189 6804471 8624575 1005993326 529892339 439311078 476100987 477701598 395309680 148800460 263996939 1474757677 1447981523 150560537 82967262 7086730 4376547 152000000 293177000 188237317 179458904 235070387 200681211 732954971 760660924 X 0 0 0 0 741802706 687320599 741802706 687320599 1474757677 1447981523 50442521 -108924629 4000001 0 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 0 0 0 1 371106 0 0 371106 0 PART II-B, LINE 1: EMPLOYEES OF THE HEALTH SYSTEM AND NCHA MEET WITH LOCAL, STATE, AND FEDERAL LEGISLATORS AND REGULATORS REGARDING MATTERS OF INTEREST TO THE HOSPITAL. 27270736 27270736 579729944 290284487 289445457 6705487 2819878 3885609 309252581 221930316 87322265 83034578 14857658 68176920 476100987 OTHER RECEIVABLES 20190832 SELF INSURANCE TRUSTS 66788275 BOND FUND TRUSTS 134435819 OTHER ASSETS 12564732 DEFERRED OUTFLOW 30017281 263996939 ESTIMATED CLAIM 37764533 DUE TO PAYOR AGENCIES 92586101 OTHER LIABILITIES 55079082 DEFERRED INFLOWS 15251495 200681211 X 1001754434 -108924629 -108924629 1110679063 150684222 150684222 1261363285 1060236542 0 1060236542 150684222 150684222 1210920764 PART X, LINE 2: THE HEALTH SYSTEM AND THE FOUNDATION ARE EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME UNDER SECTION 501(A) OF THE INTERNAL REVENUE CODE AS ORGANIZATIONS DESCRIBED IN SECTION 501(C)(3). THE UNRELATED BUSINESS INCOME GENERATED BY THE HEALTH SYSTEM AND THE INCOME GENERATED BY THE HEALTH SYSTEM'S TAXABLE COMPONENT ARE NOT MATERIAL TO THE FINANCIAL STATEMENTS. ACCORDINGLY, NO PROVISION FOR INCOME TAXES IS REQUIRED IN THE ACCOMPANYING FINANCIAL STATEMENTS. PART XI, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 150,802,070. RENT EXPENSE -117,848. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 150,802,070. RENT EXPENSE -117,848. CENTRAL AMERICA AND THE CARIBBEAN - ANTIGUA & BARBUDA, ARUBA, BAHAMAS, INVESTMENTS CAPTIVE INSURANCE 60810393 0 0 0 0 0 0 60810393 0 60810393 1 0 1 0 0 0 PART I, LINE 3: THE ACCRUAL METHOD IS USED FOR INVESTMENTS. PART III ACCOUNTING METHOD: 1 1 X 1 X 1 X 500.000000000000 1 1 0 1 1 58480375 4150297 54330078 0.05120 183289450 148364419 34925031 0.03160 1030344 686840 343504 0.00030 242800169 153201556 89598613 0.08310 34413827 8172879 26240948 0.02380 42343181 15311381 27031800 0.02450 76757008 23484260 53272748 0.04830 319557177 176685816 142871361 0.13140 261308 261308 0.00020 55713 55713 0.00010 317021 317021 0.00030 0 150802069 157122795 150355898 6766897 X 1 1 4 1 CAPE FEAR VALLEY HEALTH SYSTEM 1638 OWEN DRIVE FAYETTEVILLE NC 28304 WWW.CAPEFEARVALLEY.COM X X X A 2 HIGHSMITH RAINEY HOSPITAL 150 ROBESON STREET FAYETTEVILLE NC 28301 WWW.CAPEFEARVALLEY.COM X LONG TERM ACUTE CARE HOSPITAL A 3 BLADEN COUNTY HOSPITAL 501 SOUTH POPLAR STREET ELIZABETHTOWN NC 28337 WWW.CAPEFEARVALLEY.COM X X X A 4 HOKE HOSPITAL 210 MEDICAL PAVILION DRIVE RAEFORD NC 28376 WWW.CAPEFEARVALLEY.COM X A FACILITY REPORTING GROUP - A 0 0 1 X X X X X X X X X 21 1 0 0 1 X HTTPS://WWW.CAPEFEARVALLEY.COM/DOWNLOADS/CHNA/CUMBERLAND-CHNA-2019.PDF X 1 21 0 0 0 1 X 200.000000000000 500.000000000000 X X 1 1 X X X 1 X HTTPS://WWW.CAPEFEARVALLEY.COM/PATIENTS/FINANCIAL-ASSISTANCE.HTML X HTTPS://WWW.CAPEFEARVALLEY.COM/PATIENTS/FINANCIAL-ASSISTANCE.HTML X HTTPS://WWW.CAPEFEARVALLEY.COM/PATIENTS/FINANCIAL-ASSISTANCE.HTML X X X X X X X 1 X 0 X X X X 1 X 0 0 CAPE FEAR VALLEY HEALTH SYSTEM PART V. SECTION B, LINE 3: CAPE FEAR VALLEY HEALTH SYSTEM (CFVHS) PERFORMED A NEW COMMUNITY HEALTH NEEDS ASSESSMENT FOR FY 2022. FOR OUR 2022 CHNA WE COLLABORATED WITH HEALTHENC AND CONDUENT HEALTHY COMMUNITIES INSTITUTE, A COLLABORATIVE OF 22 HOSPITALS AND 21 HEALTH DEPARTMENTS FROM ACROSS EASTERN NC, INCLUDING THE BLADEN, CUMBERLAND, HOKE, AND HARNETT COUNTY HEALTH DEPARTMENTS. COMMUNITY HEALTH ASSESSMENT TEAMS (CHAT) WERE DEVELOPED IN EACH OF THE RESPECTIVE COUNTIES. THE CHAT CONSISTED OF COMMUNITY MEMBERS, STAKEHOLDERS, AND THOSE WORKING IN PUBLIC HEALTH. THE CHATS WERE INSTRUMENTAL IN THE DISTRIBUTION OF OUR SURVEYS IN THE COMMUNITY IN ELECTRONIC AND PAPER FORMAT. UTILIZING THE SURVEYS (PRIMARY DATA) AND DATA FROM THE STATE PLUS FEDERAL SOURCES (SECONDARY DATA), AND CHAT LED FOCUSED GROUPS ASSISTED HEALTHENC IN CREATING A COMPREHENSIVE REPORT FOR EACH OF THE FOUR COUNTIES CAPE FEAR VALLEY HAS A HOSPITAL. THERE WERE A FEW CONTINUOUS THEMES DESPITE THE GEOGRAPHICAL DIFFERENCES IN THE COUNTIES. WORKING WITH THE RESPECTIVE HEALTH DEPARTMENTS IN EACH COUNTY, CAPE FEAR VALLEY HEALTH SYSTEM IDENTIFIED SUBSTANCE ABUSE/MENTAL HEALTH, ACCESS TO HEALTH SERVICES, AND CHRONIC DISEASE MANAGEMENT AS THE AREAS THAT NEEDED TO BE ADDRESSED. THESE AREAS ARE ALL AMONG THE MOST MENTIONED AREAS AMONGST OUR SURVEY RESPONDENTS AND FOCUS GROUP ATTENDEES.THE OUTPATIENT PHARMACIES AT CAPE FEAR VALLEY CONTINUED THE MISSION OF VACCINATING THE PUBLIC AGAINST COVID-19 AND INFLUENZA, WITH BOTH NEW VACCINATIONS AND BOOSTERS. THROUGHOUT THE PANDEMIC AND SINCE THE COVID VACCINE WAS MADE AVAILABLE, CFVHS HAS PROVIDED OVER 180,000 VACCINES TO MEMBERS OF THE COMMUNITY. SYSTEM-WIDE COVID-19 VACCINES IN 2022 AMOUNTED TO 6,961 AND INFLUENZA VACCINES TOTALED 25,198. THE EASE OF ONLINE SCHEDULING AND WALK-IN OPTIONS LED TO VERY SHORT WAIT TIMES AND INCREASED AVAILABILITY TO THESE LIFE-SAVING VACCINES. CAPE FEAR VALLEY NOT ONLY HOSTED REGULAR CLINICS AT OUR HOSPITAL, COMMUNITY PHARMACIES AND CLINICS, BUT ALSO HOSTED EVENTS AT LOCAL HIGH SCHOOLS FOR ADULTS AND STUDENTS, AS WELL AS MULTIPLE OTHER COMMUNITY EVENTS.PHARMACY HAS ALSO EXPANDED INTO THE OUTPATIENT CLINICS AS WELL. CLINICAL PHARMACIST PRACTITIONERS, OR CPPS, ARE NOW AVAILABLE IN FOUR CAPE FEAR VALLEY OUTPATIENT CLINICS INCLUDING FAYETTEVILLE FAMILY, SENIOR HEALTH SERVICES, THE DIABETES AND ENDOCRINE CLINIC, AND THE MEDICAL ONCOLOGY CLINIC AT THE MAIN CAMPUS. THESE ADVANCED PRACTICE PROVIDERS OFFER OUR PATIENTS IN-DEPTH MEDICATION COUNSELING TO IMPROVE OUTCOMES AND HELP EASE THE BURDEN OF HEAVY CASELOADS FOR OUR PROVIDERS. SINCE THE INTRODUCTION OF THE CPP IN THE DIABETES AND ENDOCRINE CENTER, PATIENT A1C LEVELS WERE DRAMATICALLY DECREASED IN PATIENTS RECEIVING MEDICATION COUNSELING FROM THE PHARMACIST. THE CPP POSITION WAS SO WELL RECEIVED THAT ANOTHER CPP WAS PLACED IN THE CLINIC IN 2022 TO FURTHER HELP PATIENTS GET TO THEIR DIABETES GOALS. THE CPP IN THE MEDICAL ONCOLOGY CLINIC CONTINUES TO OFFER CHEMOTHERAPY COUNSELING AND MEDICATION ADVERSE EVENT MANAGEMENT TO THE PATIENTS OF THE CANCER CENTER. THIS HAS ALLOWED FOR THE MEDICAL ONCOLOGISTS, PHYSICIAN ASSISTANTS, AND NURSE PRACTITIONERS TO SEE MORE PATIENTS IN THIS EVER-GROWING CLINIC AND IMPROVES PATIENT UNDERSTANDING OF THEIR REGIMENS AND HOW TO COPE WITH THE ADVERSE EFFECTS OF CHEMOTHERAPY.THE RESIDENCY PROGRAM AT CFVHS FOSTERS OUTREACH AMONGST OUR RESIDENTS AND RAISES AWARENESS OF OUR RESIDENCY PROGRAM AND ITS EXPECTED IMPACT. WE WILL CONTINUE OUR AGGRESSIVE OUTREACH EFFORTS TO HELP EDUCATE OUR PATIENTS ABOUT THE VARIOUS RISK FACTORS ASSOCIATED WITH ALL THE IDENTIFIED NEEDS. THE HEALTH SYSTEM ADDED TWO PRIMARY CARE PRACTICES, ONE IN A RURAL COMMUNITY AND THE OTHER TO SERVE TO THE PEDIATRIC POPULATION. ADDITIONALLY, THREE SPECIALTY CLINICS WERE OPENED IN CUMBERLAND AND HARNETT COUNTY TO PROVIDE GREATER ACCESS FOR OUR COMMUNITY TO SPECIALTY PROVIDERS. WE CONTINUE TO STRENGTHEN OUR RELATIONSHIPS WITH OUR LOCAL HEALTH DEPARTMENTS, AREA CHURCHES AND THE SCHOOL SYSTEMS TO BETTER IDENTIFY AREAS OF FUTURE COMMUNITY IMPACT.THE PROVIDER RESIDENCY PROGRAM AT CFVHS HAS GROWN TO INCLUDE ALMOST 250 DOCTORS IN TRAINING IN NUMEROUS PROGRAM AREAS INCLUDING TRADITIONAL ROTATING INTERNSHIP, CARDIOLOGY, EMERGENCY MEDICINE, INTERNAL MEDICINE, OB/GYN, PEDIATRICS, PSYCHIATRY, ORTHOPEDICS, PODIATRY, AND SURGERY. MORE THAN HALF OF ELIGIBLE RESIDENTS HAVE COMMITTED TO WORK AT CFVHS UPON COMPLETION OF THEIR RESIDENCY. IN JANUARY 2021, CFVHS BROKE GROUND ON A STATE-OF-THE-ART EDUCATION AND RESEARCH CENTER FOR MEDICAL RESIDENCY PROGRAMS THAT WILL BENEFIT MEDICAL STUDENTS FOR GENERATIONS TO COME. THE CENTER FOR MEDICAL EDUCATION & RESEARCH AND NEUROSCIENCE INSTITUTE SPANS FIVE FLOORS AND 120,000 SQUARE FEET AND INCLUDES LECTURE HALLS, CLASSROOMS, AND SIMULATION LABS TO PROVIDE RESIDENT MEDICAL STUDENTS WITH HANDS-ON, APPLIED LEARNING WITH SOPHISTICATED TECHNOLOGY. THE FACILITY OPENED JANUARY 2023. THE NEW CENTER FOR MEDICAL EDUCATION ALLOWS CFVMC TO EXPAND TO ITS FULL EDUCATIONAL CAPACITY, THUS, THE RESIDENCY PROGRAM IS POISED TO BRING HUNDREDS OF NEW DOCTORS TO THE REGION IN THE NEXT DECADE.CFVHS ENGAGED 3D CONSULTING TO PROVIDE A PHYSICIAN NEEDS ASSESSMENT BY EACH COUNTY IN OUR SERVICE AREA. THIS ASSESSMENT WAS COMPLETED ON NOVEMBER 9, 2022. BASED ON INTERVIEWS WITH CFVHS PROVIDERS AND EXECUTIVES, THE TOP AREAS WITH IDENTIFIED NEED BASED ON A SHORTAGE OF ALIGNED PROVIDERS, LONG WAIT TIMES, AND OLDER PHYSICIAN BASES WERE: GENERAL PRIMARY CARE, UROLOGY, NEUROLOGY, PEDIATRICS, PULMONOLOGY, VASCULAR SURGERY, GENERAL SURGERY, AND OBGYN. ADDITIONALLY, INTERVIEWS AND SURVEYS WERE CONDUCTED FOR OUR SERVICE AREA WHICH IDENTIFIED PROVIDER SHORTAGES NOTED MOST OFTEN IN NEUROLOGY, ENDOCRINOLOGY, UROLOGY, INTERNAL MEDICINE, AND VASCULAR SURGERY. AVERAGE WAIT TIMES FOR PROVIDERS IN OUR SERVICE AREA EXTENDED BEYOND 30 DAYS FOR SOME SPECIALTIES (NEPHROLOGY: 52 DAYS, SLEEP MEDICINE: 48 DAYS, GENERAL SURGERY: 38 DAYS, AND UROLOGY 34 DAYS). BASED ON CURRENT DEMAND AND SUPPLY IN OUR SERVICE AREA FOR 2022, THE FOLLOWING AREAS HAVE GREATER DEMAND THAN SUPPLY: GENERAL PRIMARY CARE, OBGYN, PEDIATRICS, PSYCHOLOGY, NEUROLOGY, PULMONOLOGY, AND PLASTIC SURGERY. TARGETED PRODUCTIVITY INCREASES AMONG CURRENT EMPLOYED PROVIDERS AND FOCUSED RECRUITMENT EFFORTS ARE EXPECTED TO CONTINUE ACROSS THE HEALTH SYSTEM TO MEET GROWING PATIENT DEMAND.CFVHS FRIENDS OF THE CANCER CENTER FUNDED OVER 161 SCREENING MAMMOGRAMS TO CATCH BREAST CANCER IN EARLIER STAGES. BREAST CANCER AWARENESS OUTREACH EVENTS WERE HELD DURING THE MONTH OF OCTOBER, EDUCATING OVER 900 MEMBERS OF THE COMMUNITY ABOUT BREAST CARE EDUCATION AND BREAST CANCER AWARENESS. HANDS-ONLY CPR INSTRUCTION AND BLOOD PRESSURE CHECKS ARE A SERVICE OFFERED AT MOST OUTREACH EVENTS - OVER 3,500 COMMUNITY MEMBERS ACROSS OUR FOUR COUNTIES WERE REACHED IN 2022. OVER 2,100 COMMUNITY MEMBERS PARTICIPATED IN HEALTH SYSTEM SPONSORED BLOOD DRIVES THAT OFFERED EDUCATION AND BLOOD DONATION TO OUR HOSPITALS. BARIATRIC PEER SUPPORT GROUPS AND PREVENTATIVE EDUCATION EVENTS WERE OFFERED TO APPROXIMATELY 200 MEMBERS OF THE COMMUNITY. STROKE EDUCATION EVENTS WERE HELD TO EDUCATE OVER 200 MEMBERS OF THE COMMUNITY ON IDENTIFYING AND PREVENTING STROKES AS WELL AS CARING FOR YOURSELF AND OTHERS AFTER A STROKE. FITNESS INSTRUCTION EVENTS WERE HELD FOR OVER 1,700 MEMBERS OF THE COMMUNITY TO ENCOURAGE STAYING ACTIVE AND TAKING CARE OF YOUR BODY THROUGH MOVEMENT.STEP UP 4 HEALTH & WELLNESS EXPO IS A PARTNERSHIP BETWEEN CAPE FEAR VALLEY HEALTH FOUNDATION AND METHODIST UNIVERSITY. APRIL 2022 WAS THE FIRST YEAR THIS EVENT TOOK PLACE IN FAYETTEVILLE, NC AND OVER 750 PARTICIPANTS AND 60 VENDORS WERE PRESENT. A 4K OR 1 MILE ROUTE WAS AVAILABLE FOR ATTENDEES TO PARTICIPATE IN WHICH REQUIRED A REGISTRATION FEE WHERE REGISTRANTS COULD CHOOSE THE BENEFICIARY (FRIENDS OF THE CANCER CENTER, CHILDREN'S SERVICES, ETC.). THIS HEALTH-RELATED EDUCATIONAL FESTIVAL FEATURED INFORMATIONAL BOOTHS FOR CFVHS SERVICES AS WELL AS FOOD TRUCKS, MUSIC, AND SPONSOR TABLES. PARTICIPANTS LEARNED ABOUT HANDS-ONLY CPR, RECEIVED FREE WELLNESS CHECKS, AND OTHER HEALTH-RELATED GOODIES.CFVHS CONTINUES TO UTILIZE AND EXPAND THE COMMUNITY PARAMEDIC PROGRAM TO AIDE IN HOME VISITS TO PATIENTS WITH CHRONIC CONDITIONS TO PREVENT READMISSIONS AND TO MAINTAIN STABLE HEALTH OUTCOMES. A GRANT WAS RECEIVED TO SUPPORT THE EXPANSION OF THIS PROGRAM. THIS PROGRAM PROVIDES PATIENTS AND FAMILIES WITH ADDITIONAL EDUCATION AND ROUTINE SUPPORT IN MANAGING THEIR CONDITION.CAPE FEAR VALLEY HEALTH SYSTEM HAS ESTABLISHED A SYSTEM-WIDE OPIOID STEWARDSHIP PROGRAM. WE HAVE ESTABLISHED SEVERAL COMMUNITY PARTNERSHIPS TO ADDRESS SUBSTANCE ABUSE ISSUES IN OUR AREA SUCH AS (FIGHTING ADDICTION THROUGH COMMUNITY EMPOWERMENT TEAMS WITH SOUTHEASTERN REGIONAL AREA HEALTH EDUCATION CENTER (SRAHEC) & CUMBERLAND-FAYETTEVILLE OPIOID RESPONSE TEAMS). CAPE FEAR VALLEY HEALTH SYSTEM (CONT.) THE OPIOID STEWARDSHIP PROGRAM EXISTS TO REDUCE OPIOID USE, DECREASE HARM RELATED TO OPIOID USE, AND IDENTIFY PATIENTS WITH POTENTIAL OPIOID USE DISORDERS. THESE GOALS ARE MET BY EDUCATING PATIENTS, IDENTIFYING, AND MONITORING HIGH RISK PATIENTS, SYSTEMIC SCREENING, AND PROVIDING ALTERNATIVE TREATMENT OPTIONS. ORDERING PRACTICES OF OUR PHYSICIANS ARE MONITORED REGULARLY AND ALTERNATIVES FOR PAIN CONTROL ARE OFFERED IN OUR EMERGENCY DEPARTMENTS. KITS ARE PROVIDED THROUGH THE OUTPATIENT PHARMACY TO DISPOSE OF OPIOIDS SAFELY. ADDITIONALLY, SAFE DRUG DISPOSALS ARE LOCATED AT OUR PHARMACIES FOR PRESCRIPTION TAKE-BACK DURING OPERATING HOURS. NARCAN IS AVAILABLE FOR USE ON OUR EMS TRANSPORT VEHICLES.CAPE FEAR VALLEY MEDICAL CENTER IN CUMBERLAND COUNTY HAS SEEN TREMENDOUS GROWTH WHICH HAS ALLOWED FOR ENHANCED CARE FOR OUR COMMUNITY. AN ADDITIONAL VASCULAR SURGEON WAS RECRUITED AND IS CURRENTLY SEEING PATIENTS AND PERFORMING SURGERIES AT CAPE FEAR VALLEY MEDICAL CENTER. THE REPLACEMENT OF OUR CARDIAC CATH & INTERVENTIONAL LAB WAS COMPLETED IN 2022. EXPANSION OF THE CATH LAB THROUGH THE SUPPORT OF ADDITIONAL CARDIOLOGISTS HAS PROVIDED INCREASED COVERAGE FOR OUR COMMUNITY. WE CURRENTLY HAVE TWO FULL TIME AND TWO PART TIME ELECTROPHYSIOLOGY PHYSICIANS SERVING OUR COMMUNITY; IMPROVING OUR ABILITY TO TREAT ATRIAL FIBRILLATION. LASTLY, INTERVENTIONAL HEART CATHETERIZATIONS ARE CONTINUING TO BE PERFORMED AT HARNETT HEALTH AND HAVE SEEN TREMENDOUS GROWTH OVER THE PAST 5 YEARS (287 PROCEDURES PERFORMED IN 2022). THE HEALTH SYSTEM IS OPENING A HEART & VASCULAR CLINIC IN HARNETT COUNTY WHICH IS EXPECTED IN OPEN IN MID-2023.WITH THE SUPPORT OF THE DOROTHEA DIX STATE ALLOCATED FUNDS, CAPE FEAR VALLEY MEDICAL CENTER, LOCATED IN CUMBERLAND COUNTY, BUILT, AND OPENED 16 ADDITIONAL ADOLESCENT BEHAVIORAL HEALTH BEDS DURING CALENDAR YEAR 2022. THESE BEDS ARE OPERATIONAL AND SUPPORTING OUR YOUTH IN NEED OF THESE SERVICES.CFVHS PROPOSES TO BUILD AND OPERATE AN ADOLESCENT INPATIENT PSYCHIATRIC FACILITY AT CENTRAL HARNETT HOSPITAL IN LILLINGTON, NORTH CAROLINA. THE DDPS UNIT IS PLANNED AS A 12-BED FACILITY DESIGNED SPECIFICALLY TO PROVIDE HELP TO ADOLESCENTS GENERALLY FROM AGES 13-17 AND THEIR FAMILIES DURING PERIODS OF ACUTELY EXACERBATED PSYCHIATRIC ILLNESS. THE DDPS UNIT WILL BE A STATE LICENSED PROGRAM DESIGNED TO TREAT PSYCHIATRIC ILLNESS IN ADOLESCENTS THAT ARE NOT SAFE TO BE MANAGED ON AN OUTPATIENT BASIS AND TO PROVIDE STABILIZATION SERVICES TO ALLOW FOR ONGOING TREATMENT UPON DISCHARGE ONCE STABILIZATION HAS OCCURRED. INCLUDED IN THIS SCOPE OF WORK IS THE LAND PURCHASE NEEDED TO PROVIDE SUITABLE SPACE FOR THE CONSTRUCTION OF THIS NEW FACILITY. CFVHS IS UTILIZING FUNDING PROVIDED TO PURCHASE APPROXIMATELY SIX ACRES TO EXPAND THE SIZE OF THE OVERALL CAMPUS WHICH WILL PROVIDE THE SITE FOR THE CONSTRUCTION OF THE ADOLESCENT PSYCHIATRIC UNIT, RECREATIONAL AREAS FOR THE UNIT, APPROPRIATE PARKING, AND EASY CONNECTIONS TO THE MAIN HOSPITAL FACILITY. IN ADDITION, THE FACILITY AT CENTRAL HARNETT HOSPITAL ALLOWS FOR FUTURE EXPANSION SHOULD THE NEED ARISE. CFVHS HAS SECURED $8 MILLION IN FUNDING FOR THIS PROJECT THROUGH DOROTHEA DIX AND THE STATE CAPITAL AND INFRASTRUCTURE FUND SCIF. GROUNDBREAKING FOR THIS PROJECT WILL BE SCHEDULED DURING THE EARLY SUMMER OF 2023, WITH A PROJECTED OPENING DATE OF THE FALL OF 2025.CAPE FEAR VALLEY HEALTH SYSTEM IS CONSTANTLY EVOLVING TO MEET THE NEEDS OF THE COMMUNITIES WE SERVE. THE INTEGRATION OF EPIC AT HARNETT HEALTH WAS SUCCESSFULLY COMPLETED ON OCTOBER 1, 2022. THIS INTEGRATION RESULTED IN A SMOOTH TRANSITION INTO THE HEALTH SYSTEM'S HEALTH INFORMATION RECORD WHICH HAS AIDED IN PROVIDING SEAMLESS CARE TO OUR PATIENTS ACROSS THE COUNTIES THAT WE SERVE. WE HAVE ALREADY BEGUN THE NEXT STEPS FOR OUR NEXT COMMUNITY NEEDS ASSESSMENT TO LEARN IF WE ARE HEADING IN THE RIGHT DIRECTION. OUR VISION IS TO IMPROVE THE QUALITY OF LIFE FOR EVERY LIFE WE TOUCH.CAPE FEAR VALLEY HEALTH SYSTEMPART V, SECTION B, LINE 4: CAPE FEAR VALLEY AND HIGHSMITH RAINEY WORKED COLLABORATIVELY WITH ONE ANOTHER.PART V, SECTION B, LINE 5: COMMUNITY HEALTH ASSESSMENT TEAMS (CHAT) WERE DEVELOPED IN EACH OF THE RESPECTIVE COUNTIES. THE CHAT CONSISTED OF COMMUNITY MEMBERS, STAKEHOLDERS, AND THOSE WORKING IN PUBLIC HEALTH. THE CHAT'S DEVELOPED COMMUNITY HEALTH ASSESSMENT SURVEYS AND DISTRIBUTED THEM IN THE COMMUNITY IN ELECTRONIC AND PAPER FORMAT. UTILIZING THE SURVEYS (PRIMARY DATA) AND DATA FROM THE STATE PLUS FEDERAL SOURCES (SECONDARY DATA), CFVHS WAS ABLE TO IDENTIFY THE MOST PRESSING NEEDS IN OUR COMMUNITIES.PART V, SECTION B, LINE 11: CFVHS WILL CONTINUE OUR AGGRESSIVE OUTREACH EFFORTS TO HELP EDUCATE OUR PATIENTS ABOUT THE VARIOUS RISK FACTORS ASSOCIATED WITH ALL THE IDENTIFIED NEEDS. WE ARE STRENGTHENING OUR RELATIONSHIPS WITH OUR LOCAL HEALTH DEPARTMENTS AND IDENTIFYING POTENTIAL COLLABORATIONS WITH COMMUNITY STAKEHOLDERS. GOING FORWARD THE HOSPITAL IS DEVELOPING AN ADDITIONAL CARDIAC CATHETERIZATION LAB. OUR LUNG NODULE CLINIC HAS MOVED TO THE MAIN CAMPUS FOR BETTER COVERAGE OF POTENTIAL LUNG CANCER PATIENTS. HIGHSMITH RAINEY HOSPITAL PART V, SECTION B, LINE 16I: SEE THE RESPONSE TO PART VI, LINE 3 BLADEN COUNTY HOSPITAL PART V, SECTION B, LINE 16I: SEE THE RESPONSE TO PART VI, LINE 3 HOKE HOSPITAL PART V, SECTION B, LINE 16I: SEE THE RESPONSE TO PART VI, LINE 3 CAPE FEAR VALLEY HEALTH SYSTEM PART V, SECTION B, LINE 16I: SEE THE RESPONSE TO PART VI, LINE 3 40 1 - CFV-REHABILITATION CENTER 1638 OWEN DRIVE FAYETTEVILLE NC 28304 REHABILITATION CENTER 2 - CUMBERLAND CTY EMS OF CFV 610 GILLESPIE STREET FAYETTEVILLE NC 28306 EMERGENCY MEDICAL SERVICES 3 - CFV BEHAVIOR HEALTH CENTER 3425 MELROSE ROAD FAYETTEVILLE NC 28304 BEHAVIOR HEALTH CENTER 4 - CFV DETOX CENTER 1724 ROXIE AVENUE FAYETTEVILLE NC 28304 DETOXICATION CENTER 5 - HEALTHPLEX WELLNESS CENTER 1930 SKIBO ROAD FAYETTEVILLE NC 28304 REHABILITATION CENTER 6 - HEALTH PAVILION NORTH 6387 RAMSEY STREET FAYETTEVILLE NC 28311 OUTPATIENT SERVICES 7 - HIGHSMITH-RAINEY EXPRESS CARE 150 ROBESON STREET FAYETTEVILLE NC 28311 EXPRESS CARE 8 - CAPE FEAR VALLEY EXPRESS CARE 1638 OWEN DRIVE FAYETTEVILLE NC 28304 EXPRESS CARE 9 - CAPE FEAR VALLEY OBGYN 1341 WALTHER REED ROAD FAYETTEVILLE NC 28304 OB/GYN SERVICES 10 - HEALTH PAVILION NORTH EXPRESS CARE 6387 RAMSEY STREET FAYETTEVILLE NC 28301 EXPRESS CARE 11 - CAPE FEAR VALLEY SLEEP MEDICINE 1213 WALTER REED ROAD FAYETTEVILLE NC 28304 SLEEP CENTER 12 - HEALTH PAVILION NORTH FAMILY CARE 6387 RAMSEY STREET FAYETTEVILLE NC 28311 FAMILY PRACTICE 13 - HOPE MILLS FAMILY CARE 4092 PROFESSIONAL DRIVE HOPE MILLS NC 28348 FAMILY PRACTICE 14 - CAPE FEAR VALLEY PERINATOLOGY 2109 VALLEYGATE DRIVE FAYETTEVILLE NC 28304 PERINATOLOGY 15 - BEHAVIORAL HEALTH CENTER 3425 MELROSE ROAD FAYETTEVILLE NC 28304 MENTAL HEALTH CLINIC INPATIENT 16 - VALLEY MEDICAL ASSOCIATES-HIGHSMITH 101 ROBESON STREET FAYETTEVILLE NC 28301 FAMILY PRACTICE 17 - CAPE FEAR VALLEY UROLOGY 2301 ROBESON STREET SUITE 203 FAYETTEVILLE NC 28305 UROLOGY 18 - HOKE FAMILY MEDICAL CENTER 405 SOUTH MAIN STREET RAEFORD NC 28376 FAMILY PRACTICE 19 - SENIOR HEALTH SERVICES 101 ROBESON STREET SUITE 202 FAYETTEVILLE NC 28310 GERIATRICS 20 - BLADEN MEDICAL ASSOC-ELIZABETHTOWN 300 A EAST MCKAY STREET ELIZABETHTOWN NC 28337 FAMILY PRACTICE 21 - STEDMAN MEDICAL CARE 114 FORTE ROAD STEDMAN NC 28391 FAMILY PRACTICE 22 - CAPE FEAR VALLEY NEUROSURGERY 3308 MELROSE ROAD FAYETTEVILLE NC 28304 NEUROSURGERY OUTPATIENT 23 - CAPE FEAR VALLEY WOUND CARE CENTER 101 ROBESON ST SUITE 210 FAYETTEVILLE NC 28301 WOUND CENTER 24 - CAPE FEAR VALLEY PEDIATRIC CARE 1262 OLIVER STREET FAYETTEVILLE NC 28304 PEDIATRIC CARE 25 - WESTSIDE MEDICAL CARE 1463 PAMALEE DRIVE FAYETTEVILLE NC 28303 FAMILY PRACTICE 26 - CAPE FEAR VALLEY INTERNAL MEDICINE 101 ROBESON STREET SUITE 100 FAYETTEVILLE NC 28301 INTERNAL MEDICINE 27 - WOMEN'S HEALTH SPECIALISTS 300 EAST MCKAY STREET SUITE F ELIZABETHTOWN NC 28337 OB/GYN 28 - THREE RIVERS MEDICAL CENTER 580 WEST MCLEAN STREET ST PAULS NC 28384 FAMILY PRACTICE 29 - BLADEN MEDICAL ASSOC - BLADENBORO 106 FOURTH STREET BLADENBORO NC 28302 FAMILY PRACTICE 30 - BLADEN MEDICAL ASSOCIATES-DUBLIN 106 FOURTH STREET DUBLIN NC 28332 FAMILY PRACTICE 31 - DIABETES & ENDOCRINE CENTER 101 ROBESON STREET SUITE 405 FAYETTEVILLE NC 28301 DIABETES & ENDOCRINOLOGY OUTPATIENT 32 - CFV PEDIATRIC ENDOCRINOLOGY 101 ROBESON STREET SUITE 410 FAYETTEVILLE NC 28301 DIABETES & ENDOCRINOLOGY OUTPATIENT 33 - BEHAVIORAL HEALTH CLINIC 3425 MELROSE ROAD FAYETTEVILLE NC 28304 MENTAL HEALTH OUTPATIENT CARE 34 - BLADEN SURGICAL SPECIALIST 107 EAST DUNHAM STREET ELIZABETHTOWN NC 28377 SURGICAL SPECIALIST 35 - HEALTH PAVILION NORTH PEDIATRIC CARE 6387 RAMSEY STREET SUITE 240 FAYETTEVILLE NC 28311 PEDIATRIC CARE 36 - HEALTH PAVILION HOKE PRIMARY CARE 300 MEDICAL PAVILION DRIVE SUITE 102 RAEFORD NC 28376 FAMILY PRACTICE 37 - HOKE OBGYN 300 MEDICAL PAVILION DRIVE SUITE 250 RAEFORD NC 28376 FAMILY PRACTICE 38 - HOKE EXPRESS CARE 300 MEDICAL PAVILION DRIVE SUIT 102 RAEFORD NC 28376 EXPRESS CARE 39 - CFV INFECTIOUS DISEASE CARE 101 ROBESON STREET SUITE 300 FAYETTEVILLE NC 28301 INFECTIOUS DISEASE 40 - CAPE FEAR VALLEY NEUROLOGY 3308 MELROSE ROAD FAYETTEVILLE NC 28304 NEUROLOGY PART I, LINE 6A: CUMBERLAND COUNTY HOSPITAL SYSTEM FILES A COMMUNITY BENEFIT REPORT ANNUALLY IN THE STATE OF NORTH CAROLINA TO THE NORTH CAROLINA HOSPITAL ASSOCIATION. PART I, LINE 7: EXCLUSIONS FROM PERCENT OF TOTAL EXPENSE $150,802,069 IN BAD DEBT DEDUCTIONS WERE OFFSET FROM REVENUES IN THE FINANCIAL STATEMENTS. THERE IS NO NEED TO ADJUST THE TOTAL EXPENSE USED TO CALCULATE THE PERCENTAGES IN PART I, LINE 7, COLUMN (F).LINE 7A - CHARITY CARE COSTS WERE CALCULATED USING A MEDICAID SPECIFIC COST-TO-CHARGE RATIO (CCR) FROM THE MEDICARE COST REPORT. A MEDICAID CCR WAS USED BECAUSE THE MEDICAID POPULATION BETTER REPRESENTS THE UTILIZATION AND ACUITY OF THE CHARITY POPULATION THAN THE USE OF AN OVERALL CCR AS CALCULATED IN WORKSHEET 2. A CCR WAS USED INSTEAD OF A COST ACCOUNTING SYSTEM BECAUSE CHARITY, AS WELL AS BAD DEBTS, REPRESENT ONLY A PORTION OF A PATIENT ACCOUNT THAT IS BEING WRITTEN OFF. PART I, LINE 7G: LINE 7B, 7C & 7G - A MEDICAID CCR WAS USED TO ESTIMATE THE MEDICAID FFS & MEDICAID MANAGED CARE AMOUNTS REPORTED ON LN 7B, THE NC HEALTHCHOICE (NC SCHIP PROGRAM) REPORTED ON LN 7C AND THE SUBSIDIZED HEALTH SERVICES REPORTED ON LN 7G. THE COST ACCOUNTING SYSTEM DATA USED DID INCLUDE INFORMATION FROM ALL PATIENT SEGMENTS REGARDLESS OF PAYOR. LN 7G INCLUDES SUBSIDIZED SERVICES FOR FREESTANDING CLINICS AS WELL. PART II, COMMUNITY BUILDING ACTIVITIES: CUMBERLAND COUNTY HOSPITAL SYSTEM, INC. ("CCHS") CONTINUES TO ENGAGE IN COALITION BUILDING AND WORKFORCE DEVELOPMENT ACTIVITIES IN THE COMMUNITY. COALITION BUILDING PROMOTES THE HEALTH OF THE COMMUNITIES IT SERVES BY NETWORKING WITH OTHER COMMUNITY AGENCIES TO ADDRESS THE HEALTH AND SAFETY ISSUES OF THE COMMUNITY. THE EMPLOYEES OF CCHS UTILIZE THEIR CLINICAL EXPERTISE TO COLLABORATE WITH OTHER COMMUNITY AGENCIES AND COUNTY AND STATE HEALTH DEPARTMENTS TO PROVIDE EDUCATION AND OTHER INITIATIVES THAT BENEFIT THE HEALTH OF PEOPLE IN THE COMMUNITY. WORKFORCE DEVELOPMENT ACTIVITIES INCLUDE THE RECRUITMENT OF PHYSICIANS AND OTHER HEALTH PROFESSIONALS TO MEDICAL SHORTAGE AREAS. PART III, LINE 2: IN THE CURRENT YEAR, BAD DEBTS ARE REPORTED AT CHARGES WRITTEN OFF IN THE PERIOD PLUS AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED ON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS. SEE THE LINE 4 NOTE BELOW FOR A MORE DETAILED DESCRIPTION OF THE METHODOLOGY USED IN DETERMINING THE AMOUNT REPORTED ON LINE 2 PER THE FINANCIAL STATEMENT FOOTNOTE RELATED TO "PROVISION FOR UNCOLLECTIBLE ACCOUNTS". DISCOUNTS AND PAYMENTS ON PATIENT ACCOUNTS ARE REFLECTED IN THE PATIENT BALANCE PRIOR TO ACCOUNTS BEING WRITTEN OFF TO BAD DEBT. PART III, LINE 4: AUDITED FINANCIAL STATEMENT FOOTNOTE -THE HEALTH SYSTEM'S PATIENT ACCOUNTS RECEIVABLE IS RECORDED NET OF ALLOWANCES FOR UNCOLLECTIBLE ACCOUNTS OF $252,725,000 AT SEPTEMBER 30, 2022. THE HEALTH SYSTEM'S NET PATIENT SERVICE REVENUE IS PRESENTED NET OF PROVISION OF UNCOLLECTIBLE ACCOUNTS OF $185,780,000 FOR THE YEAR ENDED SEPTEMBER 30, 2022. PART III, LINE 8: THE COST REPORTED ON LINE 6 ARE PER THE MEDICARE COST REPORT AND WERE CALCULATED BASED ON COST-TO-CHARGE RATIOS. SINCE THE AMOUNTS REPORTED ON LINES 5 & 6 ONLY INCLUDE MEDICARE PART A COSTS AND PAYMENTS, THE OTHER MEDICARE (I.E. - MEDICARE PT C, PHYSICIAN SERVICES, FEE SCHEDULE, NON-ALLOWABLE) COSTS AND PAYMENTS ARE INCLUDED IN THE ATTACHED MEDICARE RECONCILIATION. 0 OF THE MEDICARE SHORTFALL, IF APPLICABLE, REPORTED ON LINE 7 SHOULD BE TREATED AS COMMUNITY BENEFIT SINCE THAT PORTION OF THE SHORTFALL WAS RELATED TO THOSE PATIENTS THAT HAD MEDICAID AS A SECONDARY PAYOR AND THEREFORE DEEMED INDIGENT FOR MEDICARE BAD DEBT PURPOSES. PART III, LINE 9B: IF PATIENTS ARE DETERMINED TO QUALIFY FOR CHARITY, THEN THE ACCOUNT IS TREATED AS CHARITY RATHER THAN BAD DEBT. PART VI, LINE 2: THE MISSION OF CAPE FEAR VALLEY HEALTH SYSTEM IS TO STRENGTHEN THE HEALTH AND WELL-BEING OF THE GREATER CAPE FEAR VALLEY REGION THROUGH HIGH-QUALITY, COMPASSIONATE CARE PROVIDED TO ALL WHO NEED IT. AS A COMMUNITY NOT-FOR-PROFIT ORGANIZATION, WE TAKE SERIOUSLY OUR RESPONSIBILITY TO INVEST OUR RESOURCES AND ENERGIES INTO UNDERSTANDING AND MEETING THE DIVERSE HEALTH CARE NEEDS OF ALL, AND ENSURE THAT EVERYONE, REGARDLESS OF THEIR ABILITY TO PAY, RECEIVES THE CARE THEY NEED. THE SENIOR ADMINISTRATIVE TEAM SERVES IN VARIOUS CAPACITIES ON SEVERAL LOCAL COMMUNITY BOARDS AND GROUPS. AS MEMBERS OF THESE VARIOUS GROUPS, THEY ARE ABLE TO GAIN INSIGHT TO NEEDS OF THE COMMUNITY. OUR COMMUNITY PARTNERS ARE CRITICAL TO HELPING US IMPROVE THE HEALTH AND WELL-BEING OF THE CAPE FEAR VALLEY REGION. TOGETHER, WE CAN COMBINE RESOURCES AND STRENGTHS, POSITIVELY IMPACTING THE GREATEST NUMBER OF PEOPLE. BY WORKING CLOSELY WITH THE COMMUNITY LEADERS, WE ALSO BUILD A GREATER SENSE OF COMMUNITY AND A SHARED COMMITMENT TOWARD OUR COMMON GOAL OF IMPROVING THE COMMUNITY'S HEALTH. THE RESULTS HELP US TO DETERMINE OUR SHORT AND LONG TERM PRIORITIES AS WELL AS STRATEGIES FOR IMPROVING COMMUNITY HEALTH. THOSE COMMUNITY GROUPS AND PARTNERS CCCC, SRAHEC, CCMAP, CHAMBER OF COMMERCE, FAYETTEVILLE AREA PR ALLIANCE, CUMBERLAND FCOUNTY EDUCATION FOUNDATION, COMMUNITIES IN SCHOOLS OF NC, FORT BRAGG REGIONAL ALLIANCE, CARE CLINIC, AND THE METHODIST UNIVERSITY PHYSICIAN ASSISTANT PROGRAM. PART VI, LINE 3: UNINSURED PATIENTS ARE SCREENED AT THE TIME OF REGISTRATION FOR THEIR ABILITY TO PAY FOR THEIR HEALTH CARE SERVICES. IF THE PATIENT HAS NO ABILITY TO PAY AND IS DEEMED INELIGIBLE FOR GOVERNMENT PROGRAMS (MEDICARE, MEDICAID, ETC.) THEN THEY ARE INFORMED OF THE HOSPITAL CHARITY PROGRAM. THEY ARE PROVIDED WITH AN APPLICATION AND A LISTING OF THE APPROPRIATE DOCUMENTS NECESSARY TO ESTABLISH ELIGIBILITY FOR THE HOSPITAL CHARITY PROGRAM. ALL PATIENTS RECEIVE A COPY OF OUR CHARITY CARE APPLICATION ACCOMPANYING THE FIRST BILLING STATEMENT. PART VI, LINE 4: CUMBERLAND COUNTY HOSPITAL SYSTEM, INC. ("CCHS") DOING BUSINESS AS CAPE FEAR VALLEY MEDICAL CENTER ("CFVMC") IS THE FLAGSHIP OF CAPE FEAR VALLEY HEALTH SYSTEM ("CFVHS"). CFVHS OPERATES A VARIETY OF THE HEALTHCARE FACILITIES FROM ITS HEADQUARTERS IN FAYETTEVILLE, NORTH CAROLINA INCLUDING A TERTIARY ACUTE CARE HOSPITAL, A LONG-TERM ACUTE CARE HOSPITAL, A CRITICAL ACCESS HOSPITAL, AN INPATIENT REHABILITATION FACILITY, COUNTY EMERGENCY MEDICAL SERVICES, AN OUTPATIENT PSYCHIATRIC FACILITY, A DETOXIFICATION FACILITY, A WELLNESS CENTER, 14 PRIMARY CARE CLINICS, 16 SPECIALTY CARE CLINICS, 4 WALK-IN CLINICS, AND HEALTH PAVILION NORTH, AN OUTPATIENT COMPLEX. CAPE FEAR VALLEY HEALTH SYSTEM SERVES A SIX-COUNTY SERVICE AREA MADE UP OF THE FIVE COUNTIES CONTIGUOUS TO CUMBERLAND COUNTY, NC, WHICH IS ITS PRIMARY SERVICE AREA. PER INFORMATION FROM THE 2012 ESTIMATED CENSUS DATA, CUMBERLAND HAS A POPULATION OF OVER 326,000 RESIDENTS; THIS WAS A GROWTH OF 6.9% FROM THE 2000 CENSUS DATA. APPROXIMATELY 54.2% OF THE 326,000 RESIDENTS IN OUR PRIMARY SERVICE AREA ARE MINORITIES, COMPARED TO 35.6% FOR THE STATE. PART VI, LINE 5: CHRONIC DISEASES LIKE DIABETES AND OBESITY ARE INCREASING WITHIN OUR COMMUNITY. OUR FACILITY HAS OPENED A DIABETES AND ENDOCRINE CLINIC TO HELP THOSE PATIENTS DIAGNOSED WITH DIABETES. OUR HEALTHPLEX PROVIDES BOTH NUTRITIONAL AND EXERCISE PROGRAMS TO HELP THOSE IN THE COMMUNITY ADDRESS THE PROBLEM OF OBESITY. THE GOAL IS TO HELP ALL RESIDENTS LEARN TO MANAGE THEIR CONDITIONS AND LIVE HEALTHIER LIVES BY ADDRESSING THE CHALLENGES ASSOCIATED WITH THESE CONDITIONS. EXAMPLE OF PROGRAM AT CAPE FEAR VALLEY: CAPE FEAR VALLEY HEALTH SYSTEM'S "TAKE CHARGE OF YOUR HEALTH" PROGRAM BEGAN AS AN INITIATIVE TO CLOSE THE HEALTHCARE GAP BETWEEN AFRICAN-AMERICANS AND NON-HISPANIC WHITES IN CUMBERLAND COUNTY THROUGH PUBLIC SERVICE ANNOUNCEMENTS, HEALTH FAIRS, SCREENINGS AND SPEAKING ENGAGEMENTS. IT HAS SINCE BROADENED ITS FOCUS TO ALL OF CUMBERLAND COUNTY. DARVIN JONES IS THE COORDINATOR OF THE "TAKE CHARGE OF YOUR HEALTH" PROGRAM. HE SERVES ON THE BOARD OF DIRECTORS OF COMMUNITY HEALTH INTERVENTIONS & SICKLE CELL AGENCY, A NON-PROFIT THAT WORKS WITH INDIVIDUALS WITH SICKLE CELL DISEASE, HYPERTENSION AND DIABETES. DARVIN IS ALSO A MEMBER OF THE CUMBERLAND COUNTY COUNCIL FOR HEALTHY LIVING, A GROUP ASSEMBLED BY THE HEALTH DEPARTMENT, AND THE CUMBERLAND COUNTY SCHOOLS SCHOOL HEALTH ADVISORY COUNCIL. TAKE CHARGE OF YOUR HEALTH IS AFFILIATED WITH EAT SMART, MOVE MORE NORTH CAROLINA, A STATEWIDE INITIATIVE. AT CAPE FEAR VALLEY HEALTH SYSTEM, IT IS IMPORTANT TO US TO GIVE BACK TO OUR COMMUNITY. IN ADDITION TO EMPLOYEE UNITED WAY DONATIONS AND VOLUNTEER TIME, OUR EMPLOYEES PARTICIPATE IN A VARIETY OF COMMUNITY SERVICE INITIATIVES, TO INCLUDE THE HABITAT FOR HUMANITY AND THE FRIENDS OF CANCER RIVER WALK. LAST YEAR OUR EMPLOYEES GAVE OVER $250,000 IN DONATIONS TO VARIOUS COMMUNITY ORGANIZATIONS. PART VI, LINE 6: CUMBERLAND COUNTY HOSPITAL SYSTEM IS A STAND-ALONE HEALTH CARE ORGANIZATION AND IS NOT A PART OF AN AFFILIATED HEALTH CARE SYSTEM. PART VI, LINE 7, REPORTS FILED WITH STATES NC 1 CAPE FEAR VALLEY MEDICAL FOUNDATION PO BOX 87526 FAYETTEVILLE NC 28304 561947017 501(C)(3) 382750 0 GENERAL SUPPORT 1 PART I, LINE 2: CUMBERLAND COUNTY HOSPITAL SYSTEM AWARDS GRANTS TO THE CAPE FEAR VALLEY MEDICAL FOUNDATION FOR THE PURPOSE OF ASSISTING PATIENTS IN PAYING VARIOUS BILLS AND OTHER EXPENSES WHICH PATIENTS CANNOT PAY DUE TO THEIR EXCESSIVE MEDICAL EXPENSES REQUIRED FOR TREATING ILLNESS. PATIENTS APPLY AND APPLICATIONS ARE REVIEWED BY HOSPITAL SOCIAL WORKERS. ANY FUNDS GRANTED ARE PAID DIRECTLY TO THE ORGANIZATION FOR WHICH PATIENT OWES THE BILL AND/OR EXPENSE. ALL GRANT FUNDING REQUESTS MUST BE MADE IN WRITING. MEETINGS ARE HELD TO ENSURE THE GOALS OF THE HEALTH SYSTEM ARE MAINTAINED. X X X X X 0 0 0 0 0 0 0 1 0 MICHAEL NAGOWSKI CEO 1038831 0 476954 0 2880 0 8700 0 9894 0 1537259 0 0 0 CHARLES HAWORTH MD PHYSICIAN 896534 0 482112 0 83612 0 8700 0 10536 0 1481494 0 0 0 ROBERT MAUGHAN MD PHYSICIAN 770000 0 408442 0 43085 0 8700 0 4189 0 1234416 0 0 0 DANIEL WEATHERLY COO 595077 0 313634 0 1221 0 8700 0 8633 0 927265 0 0 0 MELISSA STAMATES PHYSICIAN 826808 0 512 0 50662 0 8700 0 5300 0 891982 0 0 0 PRITHVI NARAYAN PHYSICIAN 750000 0 512 0 83627 0 6058 0 8561 0 848758 0 0 0 MICHAEL ZAPPA MEDICAL DIRECTOR 625923 0 119325 0 89046 0 8700 0 2528 0 845522 0 0 0 SAMUEL FLEISHMAN CMO 498869 0 124668 0 113435 0 8700 0 5778 0 751450 0 0 0 SANDRA WILLIAMS CFO 162846 0 190820 0 89255 0 3865 0 674 0 447460 0 0 0 BRET JOHNSON CFO 359615 0 8793 0 0 0 8700 0 5873 0 382981 0 0 0 PART I, LINE 7 THE HOSPITAL PROVIDES INCENTIVE COMPENSATION TO ITS EXECUTIVES, WHICH IS BASED ON THE QUANTITATIVE AND QUALITATIVE PERFORMANCE OF THE HOSPITAL. THE DETERMINATION OF INCENTIVE COMPENSATION FOLLOWS THE HOSPITAL'S COMPENSATION PROCEDURES AS OUTLINED IN FORM 990, PART VI, SECTION B, LINE 15. A PUBLIC FINANCE AUTHORITY 273866124 000000000 2020-12-10 152000000 SEE DETAIL 0 0 0 B PUBLIC FINANCE AUTHORITY 273866124 000000000 2022-06-09 87500000 SEE DETAIL 0 0 0 C PUBLIC FINANCE AUTHORITY 273866124 000000000 2022-07-01 93400000 SEE DETAIL 0 0 0 A 50000000 152000000 152000000 2017 1 0 1 1 B 87500000 440000 4111290 82948710 0 0 1 1 C 93400000 290000 965650 42144350 50000000 2020 1 0 1 1 A 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 1 B 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 1 C 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 1 A 0 1 0 0 1 0 0 0 1 B 0 1 0 0 0 0 0 0 1 C 0 1 0 0 0 0 0 0 1 A 1 B 1 C 1 SCHEDULE K, PART I, COLUMN F - DESCRIPTION OF PURPOSE: BOND A ISSUED 12/10/2020 - $50,000,000 ISSUED TO REFUND A PORTION OF THE $152,000,000 BONDS ISSUED IN 2017 TO PARTIALLY REFUND BONDS ISSUED 9/23/2008, AND $102,000,000 DEEMED TO CURRENTLY REFUND A PORTION OF THOSE 2017 BONDS UPON CONVERSION TO A NEW MODE AND REISSUED, BECOMING ONE ISSUE FOR FEDERAL INCOME TAX PURPOSES. BOND B ISSUED 6/9/2022 - TO FUND A PORTION OF (1) THE ACQUISITION, CONSTRUCTION, EQUIPPING AND FURNISHING OF (A) A 100-BED EXPANSION OF THE VALLEY PAVILION TOWER AT CAPE FEAR VALLEY MEDICAL CENTER AND (B) A NEW MEDICAL OFFICE CANCER CENTER BUILDING LOCATED AT CENTRAL HARNETT HOSPITAL AND (2) ACQUIRING AND INSTALLING MEDICAL, COMPUTER, OFFICE AND CAPITAL EQUIPMENT FOR USE AT BOTH LOCATIONS (COLLECTIVELY, THE PROJECT). BOND C ISSUED 7/1/2022 - $43,400,000 TO FUND A PORTION OF THE PROJECT AND $50,000,000 TO REFUND THE SERIES 2020 BONDS. SCHEDULE K, SUPPLEMENTAL INFORMATION: PART IV, LINE 6, COLUMN A: THIS QUESTION IS BEING ANSWERED WITHOUT REGARD TO A YIELD-RESTRICTED ADVANCE REFUNDING ESCROW FINANCED WITH PROCEEDS OF THE BONDS. SCHEDULE K, PART IV, ARBITRAGE, LINE 7: INVESTMENT OF BOND PROCEEDS ARE BEING MONITORED THROUGH THE WRITTEN PROCEDURE REQUIREMENTS OF SECTION 148. FORM 990, PART I, LINE 1 CUMBERLAND COUNTY HOSPITAL SYSTEM, INC. EXISTS TO MEET THE HEALTH CARE NEEDS OF THE RESIDENTS OF CUMBERLAND AND BLADEN COUNTIES, AND THE SURROUNDING AREA IN NORTH CAROLINA. FORM 990, PART VI, SECTION A, LINE 7A THE CUMBERLAND COUNTY BOARD OF COMMISSIONERS, WHICH IS A GOVERNMENTAL UNIT, APPOINTS THE MAJORITY OF THE CUMBERLAND COUNTY HOSPITAL SYSTEM. THE BOARD OF TRUSTEES OF CUMBERLAND COUNTY HOSPITAL SYSTEM IS COMPRISED OF SEVEN TRUSTEES WHO ARE THE SEVEN MEMBERS OF THE BOARD OF COMMISSIONERS. THE BOARD OF TRUSTEES WILL ALSO HAVE EIGHT AT LARGE TRUSTEES WHO ARE APPOINTED BY THE BOARD OF COMMISSIONERS. THE REMAINING FIVE AT LARGE MEMBERS ARE APPOINTED BY THE BOARD OF TRUSTEES. FORM 990, PART VI, SECTION B, LINE 11B THE ORGANIZATION'S FORM 990 IS PREPARED BY KPMG, THEN IT IS REVIEWED BY THE FINANCE DEPARTMENT OF CUMBERLAND COUNTY HOSPITAL SYSTEM, INC. UPON COMPLETION OF THE FORM 990, IT IS PROVIDED TO THE BOARD OF TRUSTEES PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C CUMBERLAND COUNTY HOSPITAL SYSTEM, INC. REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY IN THAT ANY DIRECTOR, PRINCIPAL OFFICER, OR MEMBER OF A COMMITTEE WITH GOVERNING BOARD DELEGATE POWERS, WHO HAS A DIRECT OR INDIRECT FINANCIAL INTEREST, MUST DISCLOSE THE EXISTENCE OF THE FINANCIAL INTEREST AND BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS TO THE DIRECTORS AND MEMBERS OF THE COMMITTEES WITH GOVERNING BOARD DELEGATED POWERS CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT. THE REMAINING INDIVIDUALS ON THE GOVERNING BOARD OR COMMITTEE MEETING WILL DECIDE IF CONFLICTS OF INTEREST EXIST. EACH DIRECTOR, PRINCIPAL OFFICER AND MEMBER OF A COMMITTEE WITH GOVERNING BOARD DELEGATED POWERS ANNUALLY SIGNS A STATEMENT WHICH AFFIRMS SUCH PERSON HAS RECEIVED A COPY OF THE CONFICTS OF INTEREST POLICY, HAS READ AND UNDERSTANDS THE POLICY, HAS AGREED TO COMPLY WITH THE POLICY, AND UNDERSTANDS THAT THE ORGANIZATION IS CHARITABLE AND IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION IT MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ITS TAX-EXEMPT PURPOSE. FORM 990, PART VI, SECTION B, LINE 15 A HUMAN RESOURCES CONSULTING FIRM IS RETAINED BY CUMBERLAND COUNTY HOSPITAL SYSTEMS, INC. TO REVIEW THE COMPETITIVENESS AND REASONABLENESS OF THE COMPENSATION PROVIDED TO THE CEO AND OTHER TOP MANAGEMENT PERSONNEL. FORM 990, PART VI, SECTION B, LINE 16B: HOSPITAL REGULARLY EVALUATES THE JOINT VENTURES IN WHICH IT PARTICIPATES. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE NOT AVAILABLE TO THE PUBLIC UPON REQUEST. ORGANIZATION'S FORM 990 IS OPEN FOR PUBLIC INSPECTION, PROVIDES FINANCIAL INFORMATION, AND ADDRESSES ISSUES OF GOVERNANCE SUCH AS THE ORGANIZATION'S CONFLICT OF INTEREST POLICY AND GOVERNANCE DOCUMENTS. BLADEN COUNTY HEALTHCARE LLC PO BOX 2000 FAYETTEVILLE NC 28302 800164702 HEALTH SERVICES NC 41607273 28107046 CCHS CUMBERLAND HEALTH AFF LLC (INACTIVE) PO BOX 2000 FAYETTEVILLE NC 28302 562275588 HEALTH SERVICES NC 0 0 CCHS VALLEY HEALTH FACILITIES LLC (INACTIVE) PO BOX 2000 FAYETTEVILLE NC 28302 204268819 HEALTH SERVICES NC 0 0 CCHS HOKE HEALTHCARE LLC PO BOX 2000 FAYETTEVILLE NC 28302 272763125 HEALTH SERVICES NC 75745870 137114708 CCHS CAPE FEAR VALLEY MEDICAL FOUNDATION PO BOX 87526 FAYETTEVILLE NC 28304 561947017 FUNDRAISING NC 501(C)(3) 7 CCHS 1 BLADEN COUNTY HOSPITAL FOUNDATION INC PO BOX 398 ELIZABETHTOWN NC 28337 561833893 FUNDRAISING NC 501(C)(3) 7 CCHS 1 HARNETT HEALTH SYSTEM INC PO BOX 1706 DUNN NC 28335 560603898 HEALTH SERVICES NC 501(C)(3) 3 CCHS 1 HARNETT HEALTH SYSTEM FOUNDATION 800 TILGMAN DRIVE DUNN NC 28334 201929953 FUNDRAISING NC 501(C)(3) 7 N/A 0 FAYETTEVILLE AMB SURGERY CENTER 1781 METROMEDICAL DRIVE FAYETTEVILLE NC 28304 561754482 HEALTHCARE NC CCHS RELATED 904166 7527204 0 1 0.68320 THE MED IMAGING CENTER LLC 3186 VILLAGE DRIVE STE 101 FAYETTEVILLE NC 28304 264473832 HEALTHCARE NC CCHS RELATED 191162 579726 0 0 0.56830 HIGHSMITH-RAINEY MED ARTS CENTER ASSOC PO BOX 2000 FAYETTEVILLE NC 28302 561747424 RENTAL ASSOC. NC CCHS C 105883 1532578 1.00000 1 CUMBERLAND HLTH PARTNERS INC (INACTIVE) PO BOX 2000 FAYETTEVILLE NC 28302 562043978 BEHAVIORAL HEALTH NC CCHS C 1.00000 1 CAPE FEAR INSURANCE LTD PO BOX 30600 SMB WEST BAY RD GRAND CAYMAN CJ 980449284 INSURANCE CJ CCHS C 967639 60810393 1.00000 1 0 1 1 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 CAPE FEAR VALLEY MEDICAL FOUNDATION B 240000 CASH CAPE FEAR VALLEY MEDICAL FOUNDATION C 210110 CASH CAPE FEAR VALLEY MEDICAL FOUNDATION N 7798 CASH CAPE FEAR VALLEY MEDICAL FOUNDATION O 355009 CASH