2022-12-15T12:12:53-06:00 2020-12-31 990 2020-01-01 560636250 NOVANT HEALTH THOMASVILLE MEDICAL CENTER LLC NOVA 3367182803 2085 FRONTIS PLAZA BLVD WINSTON SALEM NC 27103 FRED HARGETT EVP & CFO 3367182803 2022-12-15 FRED HARGETT XXX-XX-XXXX 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z X FKA COMMUNITY GENERAL HEALTH PARTNERS INC CARL ARMATO 2085 FRONTIS PLAZA BLVD WINSTON SALEM NC 27103 115030282 0 X WWW.NOVANTHEALTH.ORG X 1929 NC SEE SCHEDULE O 18 14 730 51 0 0 8866 4694781 112147445 109296702 42360 19414 1223449 996050 113422120 115006947 116539 235112 0 0 42393737 42517302 0 0 0 64400984 66324477 106911260 109076891 6510860 5930056 83404744 97078773 7383991 15373430 76020753 81705343 X SEE SCHEDULE O 1 0 85691693 235112 109342023 CONSISTENT WITH THE ORGANIZATION'S EXEMPT PURPOSE, COMMUNITY GENERAL HEALTH PARTNERS, INC (CGHP) PROMOTES THE HEALTH AND WELL-BEING OF THE INHABITANTS OF THE COMMUNITY IN WHICH THE ORGANIZATION OPERATES, SERVING ALL MEMBERS OF THE COMMUNITY REGARDLESS OF THEIR ABILITY TO PAY. DURING 2020, CGHP HAD 146 LICENSED BEDS. THERE WERE 24,259 PATIENT DAYS WITH AN AVERAGE LENGTH OF STAY OF 6 DAYS AND AN AVERAGE DAILY CENSUS OF 66. THERE WERE 4,260 DISCHARGES; 4,773 INPATIENT AND OUTPATIENT SURGERIES; 54,121 OUTPATIENT ENCOUNTERS AND 28,725 EMERGENCY DEPARTMENT VISITS. 85691693 1 1 0 1 0 0 0 0 0 0 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 1 0 0 0 0 0 0 1 1 1 0 0 1 0 0 730 1 0 0 0 0 0 0 0 0 0 0 0 0 X 18 14 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 NC X X KAREN DAUGHERTY 3367182803 2085 FRONTIS PLAZA BLVD WINSTON SALEM NC 27103 X MARKS PHILLIP MD TRUSTEE 0.20 45.00 X 0 513468 42297 CAILLAT ALEXANDRE MD TRUSTEE 0.20 45.00 X 0 489688 46745 BAREFOOT SAMUEL CHAIR 0.20 0.00 X X 0 0 0 BRODY JEFFREY MD TRUSTEE 0.20 0.00 X 0 3733 0 CLIFTON DAVID TRUSTEE 0.20 0.00 X 0 0 0 CRAVER KELLY SECRETARY 0.20 0.00 X X 0 0 0 DAVIS MARK DDS TRUSTEE 0.20 0.00 X 0 0 0 FORIEST BRYANT TRUSTEE 0.20 0.00 X 0 0 0 HOLT DONNIE VICE CHAIR 0.20 0.00 X X 0 0 0 LEONARD THOMAS TRUSTEE 0.20 0.00 X 0 0 0 MCCLURE FRED TREASURER 0.20 0.00 X X 0 0 0 MORRIS PAULINE TRUSTEE 0.20 0.00 X 0 0 0 ORMAN JED TRUSTEE 0.20 0.00 X 0 0 0 OWEN LAURA TRUSTEE 0.20 0.00 X 0 0 0 PERDUE LARRY TRUSTEE 0.20 0.00 X 0 0 0 PIOTTI WILLIAM TRUSTEE 0.20 0.00 X 0 0 0 RAMSAY DAVID MD TRUSTEE 0.20 0.00 X 0 10000 0 WARD LARRY TRUSTEE 0.20 0.00 X 0 0 0 SMITH HARRY FMR SVP HOSP OPS (1/1/20-8/5/20) 0.00 50.00 X 0 1394920 46260 APPLEBAUM JONATHAN CGHP PRES 50.00 0.00 X 456032 0 38888 MORRIS JOHN ASST SEC 0.20 45.00 X 0 277596 35453 HEATH SHANNON ASST SECRETARY 45.20 0.00 X 52318 0 22699 WEEMS II LARRY SVP CHIEF CLINICAL OFFICER 12.50 38.50 X 0 703994 97541 TRAHEY THOMAS VP MED AFFAIRS 0.00 50.00 X 0 522989 21716 PEARSON NANCY DIR NURSING 45.00 0.00 X 151675 0 43297 ANDERSON JENNIFER PHARMACIST 45.00 0.00 X 157531 0 32328 BOGER MARTHA CLINICAL PHARMACIST 45.00 0.00 X 138775 12015 33124 HUDSON NATHAN MGR PHARMACY 45.00 0.00 X 145659 0 29865 HILL ALEASE REGISTERED NURSE 45.00 0.00 X 151210 0 23873 GREEAR ALLISON FMR INTERIM CGHP PRES 0.00 50.00 X 0 420508 49625 1253200 4348911 563711 17 1 1 0 MORRISON HEALTHCARE PO BOX 102289 ATLANTA GA 30368 FOOD MANAGEMENT SERVICES 1446363 LABORATORY CORPORATION OF AMERICA HOLDIN PO BOX 12140 BURLINGTON NC 27216 LAB SERVICES 1400383 DAVIDSON ANESTHESIA CONSULTANTS PA 270 OLD LEXINGTON RD THOMASVILLE NC 27360 HEALTH SERVICES 1109688 TRIMEDX INC PO BOX 636129 CINCINNATI OH 45263 CLINICAL ENGINEERING SERVICES 791517 AYA HEALTHCARE INC DEPT 3519 PO BOX 123519 DALLAS TX 75312 TRAVEL NURSING SERVICES 586527 15 20636 4674145 4694781 NET PATIENT REVENUE 622110 109252835 109252835 PHARMACY 446110 43867 43867 109296702 17175 17175 12320 0 12320 12320 12320 5205 2966 2239 2239 2239 52123 20369 31754 31754 CHILD DEVELOPMENT CENTER 624410 605875 605875 CAFETERIA MEALS 722514 274502 274502 VENDING MACHINE INCOME 900099 26278 26278 45321 45321 951976 115006947 109342023 0 970143 X 95797 95797 139315 139315 569937 569937 32925 32925 32535860 30583709 1952151 1182320 1111380 70940 6012963 5652184 360779 2183297 2052299 130998 2444 2444 11764899 11446942 317957 166472 165659 813 333546 249671 83875 1131483 1113381 18102 2081973 1937101 144872 15262 14346 916 2216 2083 133 1023451 1023451 3168853 2889507 279346 403595 378249 25346 CORPORATE SUPPORT 19154042 19154042 BAD DEBT 12047633 12047633 MEDICAL SUPPLIES 8791149 8791008 141 PHARMACEUTICALS 2924539 2924539 0 3312920 3073439 239481 109076891 85691693 23385198 0 -1760 5777 14890333 18624596 1746035 1669143 2497607 2566919 82500 71000 81689036 56551439 24442028 25137597 1105505 1107523 38642496 47896218 83404744 97078773 3977631 11980554 3406360 3392876 7383991 15373430 X 76020753 81705343 76020753 81705343 83404744 97078773 X 5930056 -245466 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 7390 7390 0 PART II-B, LINE 1: LINE 1I DUES PAID TO CERTAIN ORGANIZATIONS WHICH INCLUDE A PORTION RELATED TO LOBBYING ACTIVITIES. 184862 184862 39966425 25915420 14051005 37859914 28533595 9326319 3677835 2102424 1575411 25137597 DUE FROM AFFILIATE 47896218 47896218 0 THIRD PARTY PAYMENT PAYABLE 1016101 OTHER LIABILITIES 2096472 PATIENT REFUNDS 280303 3392876 X 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, 2020 AND 2019. 1 1 X 1 X 300.000000000000 0 0 1 1 0 1 1 9511780 9511780 0.09800 18013344 14951926 3061418 0.03160 144385 64953 79432 0.00080 27669509 15016879 12652630 0.13040 65038 74 64964 0.00070 454935 454935 0.00470 14389889 7346918 7042971 0.07260 58212 0 58212 0.00060 14968074 7346992 7621082 0.07860 42637583 22363871 20273712 0.20900 2500 0 2500 0.00000 538 0 538 0.00000 20000 0 20000 0.00020 23038 23038 0.00020 1 12047633 0 16659225 9648556 7010669 X 1 0 1 1 CGHP DBA NH THOMASVILLE MEDICAL CENTER 207 OLD LEXINGTON ROAD THOMASVILLE NC 27360 WWW.NOVANTHEALTH.ORG H0112 X X X NOVANT HEALTH THOMASVILLE MEDICAL CENTER 1 0 0 1 X X X X X X X X 19 1 0 0 1 X SEE SECTION C X 1 19 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 1 NOVANT HEALTH THOMASVILLE MEDICAL CENTER PART V, SECTION B, LINE 3J: NOVANT HEALTH THOMASVILLE MEDICAL CENTER:PART V, SECTION B, LINE 3E:SEVERAL SOCIAL, BEHAVIORAL, AND CLINICAL HEALTH NEEDS WERE IDENTIFIED 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 ACCORDING TO THE YEARS OF POTENTIAL LIFE LOST 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. THE PRIORITIZED IDENTIFIED HEALTH NEEDS AND SUPPORTING DATA ARE THEN REVIEWED AND DELIBERATED UPON FURTHER BY THE BOARD. AN IMPLEMENTATION PLAN IS CREATED FOR CERTAIN OF THE PRIORITIZED, IDENTIFIED HEALTH NEEDS AND ASSESSED REGULARLY THROUGHOUT THE COMMUNITY HEALTH NEEDS ASSESSMENT LIFE CYCLE. COMMUNITY PARTNERS WHO ARE CURRENTLY DOING THE WORK ARE IDENTIFIED AS POTENTIAL PARTNERS FOR COLLABORATION ON THOSE IDENTIFIED NEEDS THAT ARE NOT PART OF THE IMPLEMENTATION PLAN. NOVANT HEALTH THOMASVILLE MEDICAL CENTER PART V, SECTION B, LINE 5: WHILE CONDUCTING THE CHNA, THE HOSPITAL FACILITY(IES) SOLICITED INPUT FROM, AND CONSULTED WITH, A VARIETY OF COMMUNITY REPRESENTATIVES INCLUDING, BUT NOT LIMITED TO, REPRESENTATIVES OF CITY AND COUNTY GOVERNMENT INCLUDING HEALTH DEPARTMENTS, COMMUNITY-BASED ORGANIZATIONS, FOUNDATIONS, CHURCHES, COLLEGES/UNIVERSITIES, COMMUNITY COALITIONS AND OTHER SOCIAL SERVICE AGENCIES. INPUT WAS GATHERED THROUGH COMMUNITY MEETINGS, STAKEHOLDER'S INTERVIEWS, AND 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 SUCH AREAS AS PUBLIC HEALTH, MINORITY POPULATIONS, HEALTH DISPARITIES, AND SOCIAL SERVICES. DATA DERIVED FROM THESE EXERCISES IS BOTH QUANTITATIVE AND QUALITATIVE IN SCOPE. NOVANT HEALTH THOMASVILLE MEDICAL CENTER PART V, SECTION B, LINE 7D: NOVANT HEALTH THOMASVILLE MEDICAL CENTERPART V, SECTION B, LINE 7BHTTPS://WWW.NOVANTHEALTH.ORG/HOME/ABOUT-US/COMMUNITY-ENGAGEMENT/OUR-IMPACT.ASPXNOVANT HEALTH THOMASVILLE MEDICAL CENTERPART V, SECTION B, LINE 10AHTTPS://WWW.NOVANTHEALTH.ORG/HOME/ABOUT-US/COMMUNITY-ENGAGEMENT/OUR-IMPACT.ASPX NOVANT HEALTH THOMASVILLE MEDICAL CENTER PART V, SECTION B, LINE 11: THE HOSPITAL FACILITY(IES) IS/ARE A PART OF NOVANT HEALTH, AN INTEGRATED NOT-FOR-PROFIT HEALTH SYSTEM. AS SUCH, NOVANT HEALTH INCLUDES MULTIPLE HOSPITAL FACILITIES AND HAS ENGAGED IN CHNAS FOR ALL OF THE COMMUNITIES BEING SERVED. 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, AND KEY STRENGTHS BEFORE FURTHER PRIORITIZING THE HEALTH NEEDS AND AGREEING UPON THE TOP HEALTH PRIORITIES TO BE ADDRESSED. WHERE POSSIBLE, WE HAVE LEVERAGED THE SYSTEM'S STRENGTHS AND RESOURCES TO BEST ADDRESS THOSE NEEDS THAT ARE HIGHEST IN PRIORITY AND CONSISTENT ACROSS COMMUNITIES. NOVANT HEALTH AND EACH OF ITS HOSPITAL FACILITIES HAVE 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 FACILITY(IES) WILL UNDERTAKE TO MEET THOSE HEALTH NEEDS IN EACH OF ITS COMMUNITIES. CERTAIN NEEDS THAT WERE IDENTIFIED BY THE CHNA HAVE NOT BEEN ADDRESSED. IT WAS DETERMINED THAT THERE ARE OTHER RESOURCES IN THE COMMUNITY THAT CAN MORE APPROPRIATELY ADDRESS THESE NEEDS BASED ON SCOPE OF SERVICES AND SKILL SET. FOR MORE DETAILED INFORMATION, REFER TO THE PUBLICLY AVAILABLE IMPLEMENTATION PLAN AVAILABLE ON THE WEBSITE; REFER TO THE URL GIVEN PREVIOUSLY FOR THE POSTING OF THE PLAN. NOVANT HEALTH THOMASVILLE MEDICAL CENTER 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. NOVANT HEALTH THOMASVILLE MEDICAL CENTER:PART V, LINE 16A, FAP WEBSITE: HTTPS://WWW.NOVANTHEALTH.ORG/HOME/PATIENTS--VISITORS/YOUR-HEALTHCARE-COSTS/FINANCIAL-ASSISTANCE-FOR-THE-UNINSURED.ASPXNOVANT HEALTH THOMASVILLE MEDICAL CENTER:PART V, LINE 16B, FAP APPLICATION: HTTPS://WWW.NOVANTHEALTH.ORG/PORTALS/92/NOVANT_HEALTH/DOCUMENTS/PATIENTS_VISITORS/FINANCIAL_SERVICES/FINANCIAL%20ASSISTANCE%20APPLICATIONS/2019/FINANCIAL_ASSISTANCE/FAA_APP_ENGLISH.PDFNOVANT HEALTH THOMASVILLE MEDICAL CENTER:PART V, LINE 16C, FAP PLAIN LANGUAGE SUMMARY: HTTPS://WWW.NOVANTHEALTH.ORG/PORTALS/92/NOVANT_HEALTH/DOCUMENTS/PATIENTS_VISITORS/FINANCIAL_SERVICES/FINANCIAL%20ASSISTANCE%20APPLICATIONS/2019/PLAIN_LANGUAGE/NOVANT%20HEALTH%20ACUTE%20PLS%20ENGLISH.PDF NOVANT HEALTH THOMASVILLE MEDICAL CENTER PART V, SECTION B, LINE 24: IT IS POSSIBLE FOR A FINANCIAL ASSISTANCE POLICY (FAP) ELIGIBLE PATIENT TO BE CHARGED AN AMOUNT EQUAL TO THE GROSS CHARGE FOR A NON-EMERGENCY OR NON-MEDICALLY NECESSARY SERVICE. HOWEVER, IF THE SERVICE IS DEEMED AN EMERGENCY OR A MEDICAL NECESSITY, THEN THE FAP ELIGIBLE PATIENT WOULD NOT BE CHARGED FOR CARE AND WOULD NOT RECEIVE A BILL ONCE FAP ELIGIBILITY HAD BEEN ESTABLISHED. 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 NOT-FOR-PROFIT HEALTH SYSTEM. THE COMMUNITY BENEFIT REPORT, REFERRED TO AS A COMMUNITY IMPACT REPORT, IS PREPARED BY A RELATED ORGANIZATION. NOVANT HEALTH, INC. IS THE PARENT COMPANY AND PRODUCES A COMMUNITY BENEFIT REPORT REPRESENTING THE HEALTH SYSTEM AS A WHOLE. THE REPORT CAN BE FOUND AT HTTPS://WWW.NOVANTHEALTH.ORG/HOME/ABOUT-US/COMMUNITY-ENGAGEMENT/OUR-IMPACT.ASPX.PLEASE NOTE THAT THE NUMERIC DATA IN THIS REPORT IS NOT BASED UPON THE FORM 990, SCHEDULE H CRITERIA, BUT RATHER IT HAS BEEN PREPARED IN ACCORDANCE WITH THE NORTH CAROLINA HOSPITAL ASSOCIATION REPORTING GUIDELINES. IT SHOULD NOT BE RELIED UPON AS THE ORGANIZATION'S FORM 990, SCHEDULE H COMMUNITY BENEFIT REPORT, ITS COMMUNITY HEALTH NEEDS ASSESSMENT OR COMMUNITY BENEFIT IMPLEMENTATION STRATEGY. PART I, LINE 7: COSTS REPORTED IN THE TABLE FOR CHARITY CARE AND CERTAIN OTHER COMMUNITY BENEFITS AMOUNTS ARE CALCULATED USING AN ENTITY SPECIFIC COST TO CHARGE RATIO BASED ON WORKSHEET 2 (CCR). PART I, LN 7 COL(F): PART I, LN 7 COL(F):THE AMOUNT OF BAD DEBT REMOVED FROM TOTAL EXPENSES (DENOMINATOR) WAS $12,047,633. PART II, COMMUNITY BUILDING ACTIVITIES: THE ORGANIZATION'S COMMUNITY BUILDING ACTIVITIES ADDRESSES THE UNDERLYING CAUSES OF HEALTH PROBLEMS AND IMPACTS THE HEALTH OF OUR COMMUNITY THROUGH PARTNERSHIPS WITH LOCAL AGENCIES DEDICATED TO IMPROVING THE LIVES OF ALL INDIVIDUALS. OUTREACH INCLUDES PROVIDING SUPPORT TO ORGANIZATIONS SUCH AS LOCAL YMCA'S, UNITED WAY PARTNER AGENCIES, CHAMBERS OF COMMERCE AND OTHER LOCAL COMMUNITY ORGANIZATIONS, ASSISTING WITH COMMUNITY AND COUNTY COALITIONS, AND PROVIDING EDUCATION SEMINARS AND TRAINING FOR COMMUNITY WORKFORCES. THROUGH THESE OUTREACH METHODS WE ARE ABLE TO SUCCESSFULLY WORK TOWARDS BRIDGING THE GAP OF NEED WITHIN OUR IDENTIFIED IMPACTED COMMUNITIES. PART III, LINE 2: IMPLICIT PRICE CONCESSIONS (ANALOGOUS TO BAD DEBT EXPENSE) ARE DETERMINED BASED ON MANAGEMENT'S ASSESSMENT OF CONTRACTUAL AGREEMENTS, DISCOUNT POLICIES, AND HISTORICAL EXPERIENCE. PART III, LINE 4: THE ORGANIZATION'S IMPLICIT PRICE CONCESSIONS (FORMERLY LABELED BAD DEBT EXPENSE, AT COST) ON LINE 2 IS CALCULATED USING THE SAME METHODOLOGY AS CHARITY CARE 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 NOT-FOR-PROFIT HEALTH SYSTEM, WHICH HAS A COMMUNITY ENGAGEMENT DEPARTMENT COMPRISED OF COMMUNITY BENEFIT PROFESSIONALS. 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. EACH HOSPITAL AND THE COMMUNITY ENGAGEMENT DEPARTMENT WORK TOGETHER TO IDENTIFY ORGANIZATIONS AND RESOURCES WITHIN ITS COMMUNITY THAT CONTRIBUTE TO THE PROCESS. THESE ORGANIZATIONS AND RESOURCES INCLUDE PUBLIC HEALTH DEPARTMENTS, LOCAL COMMUNITY COALITIONS REPRESENTING THE MEDICALLY UNDERSERVED, UNITED WAY, LOCAL UNIVERSITIES, ETC. COMMUNITY HEALTH ASSESSMENTS PREPARED BY OTHER ORGANIZATIONS IN THE COMMUNITY ARE USED IN COMBINATION WITH INTERNAL HOSPITAL DATA AND INFORMATION COLLECTED FROM LOCAL AGENCIES TO PREPARE THE HOSPITAL'S CHNA. THROUGH PARTNERSHIPS WITH OTHER COMMUNITY ORGANIZATIONS WE ARE ABLE TO DRAW INFERENCE OF THE NEEDS NOT MET WITHIN THE IMMEDIATE COMMUNITIES WE SERVE, AND MEET OR EXCEED THOSE COMMUNITY MEMBER'S NEEDS. IN ADDITION TO ADDRESSING NEEDS IDENTIFIED THROUGH THE CHNA, EACH HOSPITAL MAY RESPOND TO REQUESTS FOR SPECIFIC COMMUNITY BENEFIT ACTIVITIES OR PROGRAMS FROM PUBLIC AGENCIES OR COMMUNITY GROUPS. ORGANIZATIONAL PARTNERSHIPS ESTABLISHED BY THE COMMUNITY BENEFIT DEPARTMENT ARE OFTEN LEVERAGED TO ADDRESS NEEDS THAT WERE IDENTIFIED IN THE CHNA, BUT WERE UNADDRESSED BY THE FACILITY IMPLEMENTATION PLAN. PART VI, LINE 3: PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCETHE ORGANIZATION IS COMMITTED TO PROVIDING OUTSTANDING HEALTHCARE TO ALL MEMBERS OF OUR COMMUNITIES, REGARDLESS OF THEIR ABILITY TO PAY. OUR FINANCIAL COUNSELING TEAMS ARE CONSTANTLY WORKING WITH THE PATIENTS WITHIN OUR COMMUNITIES TO UNDERSTAND THEIR NEEDS AND ENSURE THAT OUR POLICIES AND PROCESSES ADDRESS THESE NEEDS. WE ALSO MAINTAIN CONTRACTS WITH MEDICAID ELIGIBILITY VENDORS AND THESE TEAMS OFFER ADDITIONAL SUPPORT IN PROCESSING AND ASSESSING HOW WE SERVE THE FINANCIAL NEEDS OF OUR PATIENTS. BASED ON THE ASSESSMENTS OF OUR COMMUNITIES, THE ORGANIZATION HAS DEVELOPED FINANCIAL ASSISTANCE POLICIES AND PROGRAMS THAT ADDRESS THE FINANCIAL NEEDS OF OUR PATIENTS. WE PRIDE OURSELVES ON THE TRANSPARENCY OF OUR PROGRAMS AND THE EDUCATION WE OFFER OUR PATIENTS AROUND OUR FINANCIAL ASSISTANCE POLICIES. OUR PROGRAMS ARE DOCUMENTED ON OUR WEBSITE, ALONG WITH CONTACT INFORMATION FOR OUR FINANCIAL COUNSELORS. ADDITIONALLY, OUR PROGRAMS ARE DOCUMENTED ON PATIENT FLYERS THROUGHOUT THE ORGANIZATION'S FACILITIES AND PHYSICIAN OFFICES. OUR PATIENT ACCESS SPECIALISTS, FINANCIAL COUNSELORS AND BUSINESS OFFICE TEAMS WORK WITH ALL ELIGIBLE PATIENTS TO EDUCATE THEM ON THE VARIOUS OPTIONS AVAILABLE VIA OUR FINANCIAL ASSISTANCE PROGRAMS OR GOVERNMENT SPONSORED CARE. THEY ALSO REFERENCE OUR FINANCIAL ASSISTANCE POLICY IN ALL CONVERSATIONS RELATED TO PATIENTS BILLS. FINALLY, WE WORK WITH LOCAL AREA FREE HEALTH CLINICS AND OTHER CHARITABLE ORGANIZATIONS TO PROVIDE CONTINUATION OF CARE FOR THEIR PATIENTS. IN ADDITION TO OUR FINANCIAL COUNSELING PROCESSES USED TO IDENTIFY CHARITY CARE PATIENTS, OUR COLLECTIONS PROCESSES WITHIN OUR BUSINESS OFFICES ALSO HELP IDENTIFY PATIENTS WHO ARE ALREADY ELIGIBLE FOR CHARITY OR WHO MAY BE ELIGIBLE BASED ON THEIR STATUS WITHIN THE FEDERAL POVERTY GUIDELINES ("FPG"). WE UTILIZE PREVIOUSLY SUBMITTED PATIENT DOCUMENTATION AND CREDIT AGENCY REPORTED FPG FOR DETERMINATION. SUPPORTING DOCUMENTS ARE VALID 6 MONTHS FROM THE DATE OF SUBMISSION. OUR POLICIES ARE CONSIDERED FLUID AND ARE UPDATED FREQUENTLY BASED ON LOCAL AND NATIONAL MARKET STANDARDS AND NATIONAL ECONOMIC CONDITIONS. ANY UPDATES TO OUR POLICIES REQUIRE MULTI-LEVEL LEADERSHIP APPROVAL AND ARE ULTIMATELY APPROVED BY THE ORGANIZATION'S BOARD. PART VI, LINE 4: PART VI, LINE 4: COMMUNITY INFORMATIONCOMMUNITY GENERAL HEALTH PARTNERS, INC. DBA NOVANT HEALTH THOMASVILLE MEDICAL CENTERTHE ORGANIZATION DEFINES ITS COMMUNITY BY ITS PRIMARY SERVICE AREA. THE PRIMARY SERVICE AREA FOR NOVANT HEALTH THOMASVILLE MEDICAL CENTER IS DEFINED BY THE ZIP CODES THAT REPRESENT MORE THAN 75% OF THE HOSPITAL'S IN-PATIENT POPULATION. THIS INCLUDES THE CITIES OF LEXINGTON AND THOMASVILLE, BOTH IN DAVIDSON COUNTY, NORTH CAROLINA, AND THE CITY OF TRINITY IN RANDOLPH COUNTY, NORTH CAROLINA. THE SECONDARY SERVICE AREA OF NOVANT HEALTH THOMASVILLE MEDICAL CENTER COVERS THE SAME GEOGRAPHIC AREA, ENCOMPASSING DAVIDSON AND RANDOLPH COUNTIES. THOUGH THERE TWO COUNTIES IN THE NOVANT HEALTH THOMASVILLE MEDICAL CENTER PRIMARY SERVICE AREAS, 93% OF THE PATIENTS IN THE PRIMARY SERVICE AREA RESIDE IN DAVIDSON COUNTY, WHILE 89% OF THE PATIENTS IN THE PRIMARY AND SECONDARY SERVICE AREAS RESIDE IN DAVIDSON COUNTY.DAVIDSON COUNTY IS MORE RURAL IN NATURE. IT HAS 18 MUNICIPALITIES, INCLUDING THOMASVILLE, THE MOST POPULATED CITY, AND LEXINGTON, THE COUNTY SEAT. BASED ON 2018 ESTIMATES, DAVIDSON COUNTY HAD 166,614 RESIDENTS, WHICH IS A 2.3% INCREASE SINCE THE 2010 U.S. CENSUS. DAVIDSON COUNTY'S RATE OF GROWTH WAS SMALLER THAN THE NORTH CAROLINA'S GROWTH RATE IN COMPARISON TO 2017 AND REMAINS SMALLER IN 2010-2020 AND 2020-2030 GROWTH PROJECTIONS. CHILDREN UNDER 18 MAKE UP 21.9% OF THE POPULATION IN DAVIDSON COUNTY, WHILE SENIORS MAKE UP 18.2% OF THE POPULATION. OVER THE NEXT 15 YEARS, THE SENIOR POPULATION IN DAVIDSON COUNTY IS PROJECTED TO STEADILY INCREASE. THIS TREND MAY PUT A STRAIN ON HEALTHCARE SERVICES IN DAVIDSON COUNTY BECAUSE HEALTH CARE FOR OLDER PERSONS IS DIFFERENT FROM THAT PROVIDED TO OTHER AGE GROUPS IN SEVERAL RESPECTS: GREATER RESOURCE DEMANDS, THE INTERTWINING OF PROFESSIONAL HEALTH SERVICES WITH SOCIAL SERVICES, THE FREQUENT OCCURRENCE OF IMPORTANT ETHICAL CONUNDRUMS, AND A HIGHER PREVALENCE OF PHYSICAL AND MENTAL DISABILITIES. NONWHITE MINORITIES CURRENTLY MAKE UP 20.0% OF THE RACIAL DEMOGRAPHIC IN DAVIDSON COUNTY. THE SPECIFIC POPULATION GROUPS (ETHNIC AND CULTURAL) ARE AS FOLLOWS: WHITE NON-HISPANIC 79.7%; BLACK/AFRICAN-AMERICAN 9.9%; HISPANIC OR LATINO 7.3%; OTHER 3.1%.ACCORDING TO THE US CENSUS BUREAU DATA, THE MEDIAN HOUSEHOLD INCOME LEVEL WAS $45,806. THE POVERTY RATE FOR DAVIDSON COUNTY IS 15.8%.THERE ARE TWO NONPROFIT ACUTE CARE HOSPITALS IN THE COMMUNITY, ONE OF WHICH IS THE ORGANIZATION.STATISTICAL INFORMATION 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 ORGANIZATION'S MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT AT:HTTPS://WWW.NOVANTHEALTH.ORG/HOME/ABOUT-US/COMMUNITY-ENGAGEMENT/OUR-IMPACT.ASPX. PART VI, LINE 5: PART VI, LINE 5: PROMOTION OF COMMUNITY HEALTHTHE ORGANIZATION FURTHERS ITS EXEMPT PURPOSES BY DOING THE FOLLOWING: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 THE HOSPITAL FACILITY;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 THE COMMUNITIES IT SERVES;9. PROVIDING SUPPORT GROUPS AND SELF HELP PROGRAMS TO THE COMMUNITIES IT SERVES;10. PROVIDING COMMUNITY-BASED CLINICAL SERVICES, INCLUDING WITHOUT LIMITATION, HEALTH SCREENINGS AND CLINICS FOR UNINSURED OR UNDERINSURED PERSONS TO THE COMMUNITIES IT SERVES;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 THE COMMUNITIES IT SERVES;12. PROVIDING SUBSIDIZED HEALTH SERVICES AND CLINICAL PROGRAMS TO THE COMMUNITIES IT SERVES;13. PROVIDING CASH AND IN-KIND CONTRIBUTIONS TO NONPROFIT COMMUNITY HEALTHCARE ORGANIZATIONS IN THE COMMUNITIES IT SERVES; AND14. GENERALLY PROMOTING THE HEALTH, WELLNESS, AND WELFARE OF THE COMMUNITIES IT SERVES BY PROVIDING QUALITY HEALTHCARE SERVICES AT REASONABLE COST.PLEASE SEE THE NOVANT HEALTH COMMUNITY BENEFIT REPORT, LOCATED AT HTTPS://WWW.NOVANTHEALTH.ORG/HOME/ABOUT-US/COMMUNITY-ENGAGEMENT/OUR-IMPACT.ASPX.PLEASE NOTE THAT THE NUMERIC INFORMATION IN THIS REPORT IS NOT BASED UPON THE FORM 990, SCHEDULE H CRITERIA, BUT RATHER IT HAS BEEN PREPARED IN ACCORDANCE WITH THE NORTH CAROLINA HOSPITAL ASSOCIATION REPORTING GUIDELINES. PART VI, LINE 6: PART VI, LINE 6: AFFILIATED HEALTH CARE SYSTEMTHE ORGANIZATION IS AN INTEGRAL PART OF NOVANT HEALTH, A NOT-FOR-PROFIT INTEGRATED GROUP OF HOSPITALS, PHYSICIAN CLINICS, OUTPATIENT CENTERS AND OTHER HEALTHCARE SERVICE PROVIDERS. NOVANT HEALTH IS RANKED AS ONE OF OUR NATION'S TOP 20 INTEGRATED HEALTHCARE SYSTEMS - CARING FOR PATIENTS AND COMMUNITIES IN NORTH CAROLINA, SOUTH CAROLINA, AND VIRGINIA. EACH HOSPITAL PROVIDES SUBSTANTIAL COMMUNITY BENEFIT TO THE COMMUNITY IT SERVES, AS REPORTED INDIVIDUALLY ON EACH HOSPITAL'S FORM 990, SCHEDULE H. THE COMMUNITY BENEFIT OF THE SYSTEM AS A WHOLE IS DOCUMENTED IN A SYSTEM-WIDE COMMUNITY BENEFIT REPORT, LOCATED AT HTTPS://WWW.NOVANTHEALTH.ORG/HOME/ABOUT-US/COMMUNITY-ENGAGEMENT/OUR-IMPACT.ASPX. PLEASE NOTE THAT THE NUMERIC INFORMATION IN THIS REPORT IS NOT BASED UPON THE FORM 990, SCHEDULE H CRITERIA, BUT RATHER IT HAS BEEN PREPARED IN ACCORDANCE WITH THE NORTH CAROLINA HOSPITAL ASSOCIATION REPORTING GUIDELINES. IT SHOULD NOT BE RELIED UPON AS THE ORGANIZATION'S FORM 990, SCHEDULE H COMMUNITY BENEFIT REPORT, 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 SCHEDULE H BECAUSE THEY ARE NOT CONDUCTED BY AN ENTITY WHICH OWNS OR OPERATES A HOSPITAL.IN ADDITION TO HOSPITALS, NOVANT HEALTH INCLUDES A PHYSICIAN ORGANIZATION WITH PRACTICES IN NORTH CAROLINA, SOUTH CAROLINA, AND VIRGINIA AND FIVE 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 HOSPITAL 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 DAVIDSON COLLEGE PO BOX 7162 DAVIDSON NC 28035 560529961 501(C)(3) 20000 COMMUNITY OUTREACH TOM A FINCH COMMUNITY YMCA INC 1010 MENDENHALL STREET THOMASVILLE NC 27360 561004370 501(C)(3) 40712 COMMUNITY OUTREACH CANCER SERVICES OF DAVIDSON COUNTY INC 25 WEST 6TH AVENUE LEXINGTON NC 27292 561974878 501(C)(3) 7500 COMMUNITY OUTREACH DAVIDSON COUNTY DEPARTMENT OF SENIOR SERVICES 555 B WEST CENTER STREET EXT LEXINGTON NC 27295 566000294 DAVIDSON COUNTY 6000 COMMUNITY OUTREACH THE LIFE CENTER OF DAVIDSON COUNTY INC 601 WEST CENTER STREET LEXINGTON NC 27292 581781761 501(C)(3) 10000 COMMUNITY OUTREACH 5 0 DISASTER RELIEF ASSISTANCE 207 137180 PATIENT ASSISTANCE 1 1785 PATIENT TRANSPORTATION 1 350 FMV CAB FARES FOR INDIGENT PATIENTS PART I, LINE 2: PROCEDURES FOR MONITORING THE USE OF 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 1 1 0 0 0 0 0 0 0 SMITH HARRY FMR SVP HOSP OPS (1/1/20-8/5/20) 0 381135 0 604330 0 409455 0 12156 0 34104 0 1441180 0 94406 WEEMS II LARRY SVP CHIEF CLINICAL OFFICER 0 405753 0 244572 0 53669 0 80966 0 16575 0 801535 0 7500 MARKS PHILLIP MD TRUSTEE 0 405091 0 23856 0 84521 0 15475 0 26822 0 555765 0 0 TRAHEY THOMAS VP MED AFFAIRS 0 219955 0 259186 0 43848 0 5506 0 16210 0 544705 0 7500 CAILLAT ALEXANDRE MD TRUSTEE 0 366344 0 61002 0 62342 0 17100 0 29645 0 536433 0 7500 APPLEBAUM JONATHAN CGHP PRES 255813 0 169549 0 30670 0 16725 0 22163 0 494920 0 0 0 GREEAR ALLISON FMR INTERIM CGHP PRES 0 221603 0 168851 0 30054 0 14700 0 34925 0 470133 0 0 MORRIS JOHN ASST SEC 0 206012 0 6069 0 65515 0 12720 0 22733 0 313049 0 7500 PEARSON NANCY DIR NURSING 139194 0 12206 0 275 0 8972 0 34325 0 194972 0 0 0 ANDERSON JENNIFER PHARMACIST 154702 0 2555 0 274 0 9624 0 22704 0 189859 0 0 0 BOGER MARTHA CLINICAL PHARMACIST 135920 0 2033 0 822 12015 8129 0 23342 1653 170246 13668 0 0 HUDSON NATHAN MGR PHARMACY 127069 0 6708 0 11882 0 8582 0 21283 0 175524 0 0 0 HILL ALEASE REGISTERED NURSE 145612 0 5133 0 465 0 0 0 23873 0 175083 0 0 0 PART I, LINE 1A 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 ACCOUNT CAN BE USED ONLY FOR AN APPROVED LIST OF EXPENDITURES. ALL OPTIONS OTHER THAN A DEFERRED, AT-RISK, COMPENSATION OPTION ARE CONSIDERED TAXABLE AND ARE INCLUDED IN THE EXECUTIVE'S TAXABLE INCOME AS PRESCRIBED BY THE APPLICABLE TAX LAWS. 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 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, LINES 4A-B PART I, LINES 4A-C: SEVERANCE, NONQUALIFIED, AND EQUITY-BASED PAYMENTS SEVERANCE BOGER, MARTHA $12,451 SMITH, HARRY $248,175 NONQUALIFIED SMITH, HARRY $86,906 EQUITY-BASED NONE PART I, LINE 4A - SEVERANCE PLAN: ELIGIBLE EXECUTIVES MAY RECEIVE SEVERANCE PAY THAT IS BASED ON ANNUAL COMPENSATION FOR A SPECIFIED PERIOD OF TIME. THE SEVERANCE PAY WOULD BE PAID ONLY IN THE EVENT OF CERTAIN TYPES OF EMPLOYMENT TERMINATION, AND IS FURTHER CONTINGENT ON THE SATISFACTION OF OTHER CONDITIONS SUCH AS COMPLIANCE WITH A NON-COMPETITION COVENANT. ANY CURRENT YEAR PAYMENTS HAVE BEEN INCLUDED IN THE COMPENSATION AMOUNTS REPORTED IN PART VII AND IN COLUMN (B)(III) OF SCHEDULE J. THE COMPENSATION AND LEADERSHIP COMMITTEE OF THE NOVANT HEALTH BOARD REVIEWS, APPROVES, AND OVERSEES ALL ASPECTS AND ALL ELEMENTS OF EXECUTIVE COMPENSATION AND BENEFITS, INCLUDING THE AMOUNTS AWARDED UNDER THIS SEVERANCE PLAN. 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. ELIGIBLE EXECUTIVES WILL BE NOMINATED BY THE CEO AND APPROVED BY THE NOVANT HEALTH COMPENSATION AND LEADERSHIP COMMITTEE ("THE COMMITTEE") TO PARTICIPATE. 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 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. MARY PERDUE FAMILY MEMBER OF LARRY PERDUE, BOARD MEMBER 32925 COMPENSATION PAID BY THE FILING ORGANIZATION TO THE INTERESTED PERSON. 0 FORM 990, PI, L1: ORGANIZATION'S MISSION OR MOST SIGNIFICANT ACTIVITIES COMMUNITY GENERAL HEALTH PARTNERS INC., DOING BUSINESS AS NOVANT HEALTH THOMASVILLE MEDICAL CENTER ("NHTMC"), IS AN INTEGRAL PART OF THE NOVANT HEALTH SYSTEM (COLLECTIVELY KNOWN AS "NOVANT HEALTH"), A NOT-FOR-PROFIT INTEGRATED GROUP OF HOSPITALS, PHYSICIAN CLINICS, OUTPATIENT CENTERS AND OTHER HEALTHCARE SERVICE PROVIDERS. NOVANT HEALTH CONSISTS OF MORE THAN 1,600 PHYSICIANS AND OVER 29,000 EMPLOYEES WHO MAKE HEALTHCARE REMARKABLE AT NEARLY 700 LOCATIONS, INCLUDING 15 MEDICAL CENTERS AND HUNDREDS OF OUTPATIENT FACILITIES AND PHYSICIAN CLINICS. HEADQUARTERED IN WINSTON SALEM, NC, NOVANT HEALTH IS COMMITTED TO MAKING HEALTHCARE REMARKABLE FOR PATIENTS AND COMMUNITIES, SERVING MORE THAN FIVE MILLION PATIENTS ANNUALLY. IN 2020, NOVANT HEALTH WAS THE ONLY HEALTHCARE SYSTEM IN NORTH CAROLINA TO BE INCLUDED ON FORBES' BEST EMPLOYERS FOR DIVERSITY LIST. IN 2020, THE NOVANT HEALTH SYSTEM REPORTED $5.7 BILLION IN REVENUES. GENERAL INFORMATION NOVANT HEALTH THOMASVILLE MEDICAL CENTER IS A 146-BED HOSPITAL OFFERING A WIDE RANGE OF INPATIENT AND OUTPATIENT SERVICES, BIRTHING ROOMS AND AN EMERGENCY DEPARTMENT. THE HOSPITAL FIRST OPENED AS CITY MEMORIAL HOSPITAL OF THOMASVILLE IN JULY 1930 WITH 31 BEDS. NOW, MORE THAN 90 YEARS LATER, IT IS A STATE-OF-THE-ART MEDICAL CENTER THAT OFFERS RESIDENTS OF DAVIDSON COUNTY QUALITY CARE. IN 1997, IT BECAME THE FIRST HOSPITAL OF ITS KIND TO JOIN NOVANT HEALTH. IN ADDITION TO OUR QUALITY OF SERVICES AND COMPREHENSIVE CATEGORIES OF SERVICES, WE'RE VERY PROUD OF OUR PATIENT FINANCIAL ASSISTANCE PROGRAM. WE WORK WITH CUSTOMERS TO HELP QUALIFY THEM FOR PUBLIC ASSISTANCE, ESTABLISH A REASONABLE PAYMENT PLAN, DISCOUNT THEIR BILL, OR PROVIDE FREE CARE FOR THOSE THAT QUALIFY FOR FINANCIAL ASSISTANCE. COMMUNITY OUTREACH COMMUNITY OUTREACH IS A CRITICAL COMPONENT TO THE MISSION OF NOVANT HEALTH THOMASVILLE MEDICAL CENTER. EACH YEAR, OUR PHYSICIANS, NURSES AND STAFF HOLD SCREENINGS, TEACH PROGRAMS, HOST SEMINARS AND VOLUNTEER COUNTLESS HOURS TO HELP IMPROVE THE LIVES OF THOSE IN OUR COMMUNITY. THE COVID-19 PANDEMIC LED TO AN INCREASE IN COMMUNITY OUTREACH: SOME VIRTUAL AND SOME IN PERSON. A FEW EXAMPLES OF THIS ARE AS FOLLOWS: CLASSES: - NEWBORN CARE AND CPR - WELLNESS COACHING - BABY CAFE OTHER INITIATIVES INCLUDE: - CHECK-IN CALLS TO CONNECTION LINK SENIOR MEMBERS - MARTIN LUTHER KING JR. HEALTH FAIR - CAREER DAY FOR THOMASVILLE PRIMARY SCHOOL - ADVANCE DIRECTIVES FOR COMMUNITY - COMMUNITY MASKING AND EDUCATION AT VARIETY OF LOCATIONS INCLUDING THOMASVILLE CITY SCHOOLS FOOD DISTRIBUTION SITE, DCCC COMMUNITY COLLEGE, CRISIS MINISTRIES, LIGHT OF THE WORLD MINISTRIES - OUTREACH TO INDIVIDUALS WHO UTILIZED EMERGENCY DEPARTMENT IN 2019 WITH MEDICAL ISSUES RELATED TO DIABETES PROVIDING TIPS TO HELP CONTROL DIABETES - PARTNERSHIP WITH DAVIDSON COUNTY TRANSPORTATION TO FUND THE ADDITION OF A 25 FOOT BUS WITH WHEELCHAIR LIFT TO COUNTY FLEET INCREASING ACCESS TO FREE PUBLIC TRANSPORTATION. PROVIDED MASKS AND EDUCATION FOR RIDERS. NEW TECHNOLOGY & SERVICES TO HELP ADDRESS THE PHYSICIAN AND NURSING SHORTAGE IN ACUTE CARE SETTINGS ACROSS THE UNITED STATES, NOVANT HEALTH LAUNCHED A NEW TELE-ICU PROGRAM TO EXPAND ACCESS TO CRITICAL CARE SERVICES AT COMMUNITY HOSPITALS, INCLUDING NOVANT HEALTH THOMASVILLE MEDICAL CENTER. THE TELE-ICU PROGRAM ENABLES 24/7 REMOTE MONITORING AND TREATMENT OF INTENSIVE CARE PATIENTS AT THE HOSPITAL. NOT ONLY DOES THIS NEW TECHNOLOGY IMPROVE ACCESS TO CRITICAL CARE SERVICES, BUT IT IS ALSO DESIGNED TO HELP REDUCE THE TRANSFER RATE TO TERTIARY HOSPITALS, SO PATIENTS CAN RECEIVE CARE CLOSER TO HOME. TO EXPAND ACCESS TO STATE-OF-THE-ART SURGICAL CAPABILITIES FOR WOMEN IN AND AROUND DAVIDSON COUNTY, DR. MEAGHAN AALTO AT NOVANT HEALTH CITY LAKE OB/GYN IS NOW TRAINED TO PERFORM GYNECOLOGICAL PROCEDURES WITH THE DA VINCI SURGICAL SYSTEM AT NOVANT HEALTH THOMASVILLE MEDICAL CENTER. THE ROBOTIC-ASSISTED SURGICAL SYSTEM IS DESIGNED TO ENHANCE THE SURGEON'S SKILLSET BY IMPROVING PRECISION AND STEADINESS. THE DA VINCI SURGICAL SYSTEM WAS ADDED TO THE HOSPITAL IN 2015, AND HAS BEEN UTILIZED TO ASSIST WITH A VARIETY OF UROLOGIC AND GENERAL SURGERY PROCEDURES. TO ENHANCE NEWBORN CARE, NEONATAL NURSE PRACTITIONERS (NNP) WERE RECENTLY ADDED AT NOVANT HEALTH THOMASVILLE MEDICAL CENTER. THESE SPECIALIZED PROVIDERS WORK ONSITE 24/7 TO HELP WITH ANY NEWBORN COMPLICATIONS THAT MAY ARISE, THUS DECREASING THE FREQUENCY IN WHICH HIGH-RISK TRANSFERS ARE SENT TO THE NEONATAL INTENSIVE CARE UNIT (NICU) AT NOVANT HEALTH FORSYTH MEDICAL CENTER. NOVANT HEALTH THOMASVILLE MEDICAL CENTER'S HISPANIC LATINO ADVISORY COUNCIL RESPONDED QUICKLY TO THE COVID-19 PANDEMIC BY OFFERING NEW OPPORTUNITIES TO REACH AND SUPPORT THE SPANISH-SPEAKING COMMUNITY. ESTABLISHED IN 2018, THE ADVISORY COUNCIL ASSISTED NOVANT HEALTH'S COMMUNITY ENGAGEMENT TEAM AS THEY PARTNERED WITH CHURCHES AND GROCERY STORES TO DISTRIBUTE MASKS AND IMPORTANT HEALTH INFORMATION TO THE HISPANIC AND LATINO COMMUNITY MEMBERS OF DAVIDSON COUNTY. TRANSLATORS WERE ALSO ADDED TO ALL OF THE NOVANT HEALTH COVID-19 SCREENING LOCATIONS, INCLUDING THE ONE THAT WAS OPENED IN DAVIDSON COUNTY. AWARDS, RECOGNITIONS & CERTIFICATIONS/RECERTIFICATIONS - 2020 CIRCLE OF LIFE AWARD FROM THE AMERICAN HOSPITAL ASSOCIATION (AHA) - BABY FRIENDLY DESIGNATION BY THE WORLD HEALTH ORGANIZATION AND THE UNITED NATIONS CHILDREN'S FUND - BREAST CARE CENTER ACCREDITED BY NATIONAL ACCREDITATION PROGRAM FOR BREAST CENTERS (NAPBC) - CLINICAL EXCELLENCE AWARD FOR THE REDUCTION OF PREVENTABLE HEART FAILURE READMISSIONS BY THE VHA, INC. - GET WITH THE GUIDELINES GOLD PLUS BY THE AMERICAN HEART ASSOCIATION/AMERICAN STROKE ASSOCIATION (2020) - GET WITH THE GUIDELINES SILVER PLUS AWARD FOR STROKE - AMERICAN HEART ASSOCIATION - GOLD SAFETY AWARD BY THE NORTH CAROLINA DEPARTMENT OF LABOR - HEALTHCARE DISEASE SPECIFIC CERTIFICATION FOR CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) BY THE JOINT COMMISSION - LEADER IN LGBTQ HEALTHCARE EQUALITY BY THE HUMAN RIGHTS CAMPAIGN FOUNDATION (2020, 2019, 2018, 2017) - LEAPFROG SAFETY LETTER GRADE "A" - NEWSWEEK 2020 BEST MATERNITY HOSPITAL - NURSING IMPROVING CARE FOR HEALTH SYSTEM ELDERS (NICHE) CERTIFICATION FOR GERIATRIC BEHAVIORAL HEALTH UNIT - PRIMARY STROKE CENTER CERTIFICATION BY THE JOINT COMMISSION - SLEEP CENTER ACCREDITED BY THE ACCREDITATION COMMISSION FOR HEALTH CARE - STAGE 7 EMRAM AWARD BY HIMSS ANALYTICS. THIS RECOGNITION REPRESENTS NOVANT HEALTH'S ACHIEVEMENT OF THE HIGHEST LEVEL ON THE ELECTRONIC MEDICAL RECORD ADOPTION MODEL (EMRAM), WHICH MEANS THE HOSPITALS ARE USING ELECTRONIC MEDICAL RECORD TECHNOLOGY TO ITS FULLEST POTENTIAL TO PROVIDE ACCESS AND CARE TO OUR PATIENTS. (2018) - TOP TEACHING HOSPITAL BY THE LEAPFROG GROUP (2019) - FDA MQSA CERTIFICATION - INTERNATIONAL ASSOCIATION FOR HEALTHCARE SECURITY AND SAFETY - TJC- CHRONIC OBSTRUCTIVE PULMONARY DISEASE - TJC- PRIMARY STROKE CENTER CERTIFICATION - NORTH CAROLINA DIVISION OF MEDICAL ASSISTANCE - MEDICAID - UNITED STATES DEPARTMENT OF HEALTH AND HUMAN SERVICES - CLIA - UNITED STATES DEPARTMENT OF HEALTH & HUMAN SERVICES - MEDICARE FORM 990, PART III, LINE 1: MISSION, VISION, AND VALUES MISSION NOVANT HEALTH EXISTS TO IMPROVE THE HEALTH OF COMMUNITIES, ONE PERSON AT A TIME. VISION WE, THE NOVANT HEALTH TEAM, WILL DELIVER THE MOST REMARKABLE PATIENT EXPERIENCE, IN EVERY DIMENSION, EVERY TIME. VALUES -COMPASSION: WE TREAT OUR CUSTOMERS AND THEIR FAMILIES, STAFF AND OTHER HEALTHCARE PROVIDERS AS FAMILY MEMBERS BY SHOWING THEM KINDNESS, PATIENCE, EMPATHY AND RESPECT. -DIVERSITY AND INCLUSION: WE RECOGNIZE THAT EVERY PERSON IS DIFFERENT, EACH SHAPED BY UNIQUE LIFE EXPERIENCES. THIS ENABLES US TO BETTER UNDERSTAND EACH OTHER AND OUR CUSTOMERS. -PERSONAL EXCELLENCE: WE STRIVE TO GROW PERSONALLY AND PROFESSIONALLY, AND WE APPROACH EACH SERVICE OPPORTUNITY WITH A POSITIVE, FLEXIBLE ATTITUDE. HONESTY AND PERSONAL INTEGRITY GUIDE ALL THAT WE DO. -TEAMWORK: THE NEEDS AND EXPECTATIONS OF ANY ONE CUSTOMER ARE GREATER THAN WHAT ONE PERSON'S SERVICE EFFORTS CAN SATISFY. WE SUPPORT EACH OTHER SO THAT TOGETHER AS A TEAM, WE CAN BE SUCCESSFUL IN THE EYE OF THE CUSTOMER AS A QUALITY SERVICE PROVIDER. -COURAGE: WE ACT BOLDLY IN MAKING THE CHANGES NECESSARY TO ACHIEVE OUR MISSION, VISION AND PROMISE OF DELIVERING REMARKABLE HEALTHCARE. OUR PEOPLE AT NOVANT HEALTH, PEOPLE ARE OUR BUSINESS. WE TREAT EACH OTHER WITH RESPECT AND COMPASSION. WE EMBRACE THE DIFFERENCES IN OUR STRENGTHS WHILE FOSTERING AN ENVIRONMENT OF INCLUSION, EMPOWERMENT, INSPIRATION AND COURAGE. WE ALWAYS REMEMBER, OUR BUSINESS IS THE CARE OF ALL PEOPLE, STARTING WITH OUR TEAM MEMBERS. OUR PROMISE TO PATIENTS WE ARE MAKING YOUR HEALTHCARE EXPERIENCE REMARKABLE. WE WILL BRING YOU WORLD-CLASS CLINICIANS, CARE AND TECHNOLOGY - WHEN AND WHERE YOU NEED THEM. WE ARE REINVENTING THE HEALTHCARE EXPERIENCE TO BE SIMPLER, MORE CONVENIENT AND MORE AFFORDABLE, SO THAT YOU CAN FOCUS ON GETTING BETTER AND STAYING HEALTHY. FORM 990, PI, L1: CONTINUED ACCREDITATION NOVANT HEALTH THOMASVILLE MEDICAL CENTER HAS 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. ADDITIONAL ACCREDITATIONS FOR NOVANT HEALTH THOMASVILLE MEDICAL CENTER INCLUDE: - ACCREDITATION COMMISSION FOR HEALTH CARE (SLEEP LAB ACCREDITATION) - AMERICAN ASSOCIATION OF BLOOD BANKS - AMERICAN COLLEGE OF RADIOLOGY: MAMMOGRAPHY - AMERICAN NURSES CREDENTIALING CENTER - NURSES RESIDENCY PROGRAM - COLLEGE OF AMERICAN PATHOLOGY - INTERSOCIETAL ACCREDITATION COMMISSION NONINVASIVE VASCULAR LABORATORIES - INTERSOCIETAL ACCREDITATION COMMISSION ECHOCARDIOGRAPHY LABORATORIES - NOVANT HEALTH CANCER INSTITUTE - NATIONAL ACCREDITATION PROGRAM FOR BREAST CENTERS COMMUNITY BENEFIT REPORT HTTPS://WWW.NOVANTHEALTH.ORG/HOME/ABOUT-US/COMMUNITY-ENGAGEMENT/OUR-IMPA CT.ASPX THE COMMUNITY BENEFIT REPORT, REFERRED TO AS A COMMUNITY IMPACT REPORT, PREPARED BY NOVANT HEALTH IS A SYSTEM-WIDE REPORT THAT INCLUDES QUALITATIVE AND QUANTITATIVE INFORMATION. PLEASE NOTE THAT THE NUMERIC DATA IN THIS REPORT IS NOT BASED UPON THE FORM 990, SCHEDULE H CRITERIA, BUT RATHER IT HAS BEEN PREPARED IN ACCORDANCE WITH THE NORTH CAROLINA HOSPITAL ASSOCIATION REPORTING GUIDELINES. IT SHOULD NOT BE RELIED UPON AS THE ORGANIZATION'S FORM 990, SCHEDULE H COMMUNITY BENEFIT REPORT, ITS COMMUNITY HEALTH NEEDS ASSESSMENT OR COMMUNITY BENEFIT IMPLEMENTATION STRATEGY. IN THIS REPORT, THE NOVANT HEALTH SYSTEM'S COMMUNITY BENEFIT WAS APPROXIMATELY $1,018,000,000, INCLUDING $179,000,000 IN FINANCIAL ASSISTANCE FOR 2020. FORM 990, PART III, LINE 2 LEARN ABOUT HOW WE ARE SERVING OUR COMMUNITIES IN THE PANDEMIC BY VISITING HTTPS://WWW.NOVANTHEALTH.ORG/PORTALS/92/ASSETS/DOCUMENTS/ANNUAL-FINANCIA L-INFORMATION/NOVANT-HEALTH-2020-ANNUAL-REPORT_RISING-UP.PDF. 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 IN ALL MATTERS, AND RESERVES CERTAIN POWERS TO 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 THE BOARD MEMBERS OF COMMUNITY GENERAL HEALTH PARTNERS. 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 HAS DELEGATED 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 ORGANIZATIONS WITHIN THE NOVANT HEALTH SYSTEM. THE COMMITTEE MEETS BEFORE THE FORM 990S ARE FILED WITH THE IRS AND AFTER ALL BOARD MEMBERS HAVE BEEN PROVIDED A PAPER OR ELECTRONIC COPY OF THE FORM 990 AND A SUMMARY OF ITS CONTENTS. THE VICE PRESIDENT OF TAX AND LEGAL COUNSEL FOR NOVANT HEALTH ATTEND THE MEETING TO ANSWER ANY QUESTIONS AND ADDRESS ANY SIGNIFICANT DISCLOSURES WITHIN THE FORM 990. 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 DEPARTMENT. 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 COLLECTIVELY REFERRED TO AS "NOVANT HEALTH." NOVANT HEALTH, INC. IS THE PARENT ORGANIZATION AND INDEPENDENT AND DISINTERESTED MEMBERS OF THE 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 AND EXECUTIVES ("EXECUTIVES") SERVING AS OFFICERS, INCLUDING THE TOP MANAGEMENT OFFICIAL, 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 SIMILARLY SITUATED ORGANIZATIONS TO ENSURE THAT TOTAL COMPENSATION AND BENEFITS FOR EACH EXECUTIVE IS REASONABLE FOR THAT EXECUTIVE'S POSITION. 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, THEREBY ASSURING THAT TOTAL COMPENSATION AND BENEFITS PROVIDED TO EACH EXECUTIVE IS REASONABLE. 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 THE FILING ENTITY IS PART OF THE NOT-FOR-PROFIT INTEGRATED HEALTHCARE SYSTEM KNOWN AS NOVANT HEALTH. NOVANT HEALTH, INC., THE PARENT ORGANIZATION, IS RESPONSIBLE FOR CERTAIN CORPORATE SUPPORT FUNCTIONS INCLUDING ACCOUNTS PAYABLE AND ISSUES FORMS 1099 FOR CERTAIN ENTITIES IN THE SYSTEM INCLUDING THE FILING ENTITY. INFORMATION REPORTED IN PART VII, SECTION B REPRESENTS THE EXPENSES PAID ON BEHALF OF THE FILING ENTITY TO INDEPENDENT CONTRACTORS OVER $100,000. FORM 990, PART IX, LINE 11G OUTSIDE SERVICES: PROGRAM SERVICE EXPENSES 2,515,888. MANAGEMENT AND GENERAL EXPENSES 139,188. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,655,076. CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 806,369. MANAGEMENT AND GENERAL EXPENSES 81,228. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 887,597. COLLECTION SERVICE: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 92,126. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 92,126. CREDENTIALING FEES: PROGRAM SERVICE EXPENSES 13,659. MANAGEMENT AND GENERAL EXPENSES 872. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 14,531. RECRUITMENT: PROGRAM SERVICE EXPENSES 68,295. MANAGEMENT AND GENERAL EXPENSES 4,359. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 72,654. REFERRALS: PROGRAM SERVICE EXPENSES 2,881. MANAGEMENT AND GENERAL EXPENSES 184. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,065. PROFESSIONAL PHYSICIAN SERVICES: PROGRAM SERVICE EXPENSES 6,570,505. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,570,505. FOOD SERVICE: PROGRAM SERVICE EXPENSES 1,469,345. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,469,345. 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: AFFILIATE TRANSFERS: -247,484. EQUITY IN EARNINGS: 2,018. AUXILIARY OF FORSYTH MEMORIAL HOSPITAL 2085 FRONTIS PLAZA BLVD WINSTON SALEM NC 27103 560862112 HEALTHCARE NC 501(C)(3) LINE 10 FORSYTH MEMORIAL HOSPITAL INC 0 BRUNSWICK NOVANT MEDICAL CENTER FOUNDATION 2085 FRONTIS PLAZA BLVD WINSTON SALEM NC 27103 274616751 HEALTHCARE NC 501(C)(3) LINE 7 BRUNSWICK COMMUNITY HOSPITAL LLC 0 CAROLINA MEDICORP ENTERPRISES INC 2085 FRONTIS PLAZA BLVD WINSTON SALEM NC 27103 581466368 HEALTHCARE NC 501(C)(3) LINE 10 NOVANT MEDICAL GROUP INC 0 COMMUNITY GENERAL HOSPITAL FOUNDATION INC 2085 FRONTIS PLAZA BLVD WINSTON SALEM NC 27103 561828629 HEALTHCARE NC 501(C)(3) LINE 7 COMMUNITY GENERAL HEALTH PARTNERS INC 1 FORSYTH MEDICAL CENTER FOUNDATION 2085 FRONTIS PLAZA BLVD WINSTON SALEM NC 27103 562120959 HEALTHCARE NC 501(C)(3) LINE 7 FORSYTH MEMORIAL HOSPITAL INC 0 FORSYTH MEMORIAL HOSPITAL INC 2085 FRONTIS PLAZA BLVD WINSTON SALEM NC 27103 560928089 HEALTHCARE NC 501(C)(3) LINE 3 NOVANT HEALTH TRIAD REGION LLC 0 FOUNDATION HEALTH SYSTEMS CORP 2085 FRONTIS PLAZA BLVD WINSTON SALEM NC 27103 561373175 HEALTHCARE NC 501(C)(3) LINE 10 NOVANT HEALTH INC 0 MEDICAL PARK HOSPITAL INC 2085 FRONTIS PLAZA BLVD WINSTON SALEM NC 27103 561340424 HEALTHCARE NC 501(C)(3) LINE 3 NOVANT HEALTH TRIAD REGION LLC 0 NOVANT HEALTH INC 2085 FRONTIS PLAZA BLVD WINSTON SALEM NC 27103 561376950 HEALTHCARE NC 501(C)(3) LINE 3 N/A 0 NOVANT MEDICAL GROUP INC 2085 FRONTIS PLAZA BLVD WINSTON SALEM NC 27103 581728803 HEALTHCARE NC 501(C)(3) LINE 3 NMG SERVICES LLC 0 PERSONAL CARE SERVICES 2085 FRONTIS PLAZA BLVD WINSTON SALEM NC 27103 541291284 HEALTHCARE VA 501(C)(3) LINE 10 PRINCE WILLIAM HEALTH SYSTEM 0 PRESBYTERIAN HOSPITAL FOUNDATION 2085 FRONTIS PLAZA BLVD WINSTON SALEM NC 27103 581413074 HEALTHCARE NC 501(C)(3) LINE 7 NOVANT HEALTH SOUTHERN PIEDMONT REGION LLC 0 PRESBYTERIAN MEDICAL CARE CORPORATION 2085 FRONTIS PLAZA BLVD WINSTON SALEM NC 27103 561376368 HEALTHCARE NC 501(C)(3) LINE 3 NOVANT HEALTH SOUTHERN PIEDMONT REGION LLC 0 PRINCE WILLIAM HEALTH SYSTEM 2085 FRONTIS PLAZA BLVD WINSTON SALEM NC 27103 541278944 HEALTHCARE VA 501(C)(3) LINE 12C, III-FI NOVANT HEALTH UVA HEALTH SYSTEM 0 PRINCE WILLIAM HOSPITAL 2085 FRONTIS PLAZA BLVD WINSTON SALEM NC 27103 540696355 HEALTHCARE VA 501(C)(3) LINE 3 PRINCE WILLIAM HEALTH SYSTEM 0 PWHS FOUNDATION 2085 FRONTIS PLAZA BLVD WINSTON SALEM NC 27103 541307595 HEALTHCARE VA 501(C)(3) LINE 7 PRINCE WILLIAM HEALTH SYSTEM 0 ROWAN HEALTH SERVICES CORPORATION 2085 FRONTIS PLAZA BLVD WINSTON SALEM NC 27103 561424814 HEALTHCARE NC 501(C)(3) LINE 12C, III-FI NOVANT HEALTH INC 0 ROWAN REGIONAL MEDICAL CENTER AUXILIARY 2085 FRONTIS PLAZA BLVD WINSTON SALEM NC 27103 237022472 HEALTHCARE NC 501(C)(3) LINE 10 ROWAN REGIONAL MEDICAL CENTER INC 0 ROWAN REGIONAL MEDICAL CENTER FOUNDATION INC 2085 FRONTIS PLAZA BLVD WINSTON SALEM NC 27103 561424818 HEALTHCARE NC 501(C)(3) LINE 7 ROWAN REGIONAL MEDICAL CENTER INC 0 ROWAN REGIONAL MEDICAL CENTER INC 2085 FRONTIS PLAZA BLVD WINSTON SALEM NC 27103 560547479 HEALTHCARE NC 501(C)(3) LINE 3 ROWAN HEALTH SERVICES CORPORATION 0 SELF INSURANCE FUND - NOVANT HEALTH INC 2085 FRONTIS PLAZA BLVD WINSTON SALEM NC 27103 581867242 HEALTHCARE NC 501(C)(3) LINE 12C, III-FI NOVANT HEALTH INC 0 THE PRESBYTERIAN HOSPITAL 2085 FRONTIS PLAZA BLVD WINSTON SALEM NC 27103 560554230 HEALTHCARE NC 501(C)(3) LINE 3 NOVANT HEALTH SOUTHERN PIEDMONT REGION LLC 0 CULPEPER MEMORIAL HOSPITAL INC 2085 FRONTIS PLAZA BLVD WINSTON SALEM NC 27103 540622371 HEALTHCARE VA 501(C)(3) LINE 3 NOVANT HEALTH UVA HEALTH SYSTEM 0 NOVANT HEALTH UVA HEALTH SYSTEM 2085 FRONTIS PLAZA BLVD WINSTON SALEM NC 27103 810868533 HEALTHCARE VA 501(C)(3) LINE 12A, I NOVANT HEALTH INC 0 ADEPT HEALTH INC 2085 FRONTIS PLAZA BLVD WINSTON SALEM NC 27103 562226937 ADMIN SERVICES NC N/A C 0 CHOICEHEALTH INC 2085 FRONTIS PLAZA BLVD WINSTON SALEM NC 27103 561896065 MANAGED CARE NC N/A C 0 COMMUNICARE INC 2085 FRONTIS PLAZA BLVD WINSTON SALEM NC 27103 561952950 RENTAL REAL ESTATE NC COMMUNITY GENERAL HEALTH PARTNERS INC C -2018 982927 1.00000 1 KERNERSVILLE MEDICAL CENTER PARK OWNERS' ASSOCIATION 2085 FRONTIS PLAZA BLVD WINSTON SALEM NC 27103 471511401 RENTAL REAL ESTATE NC N/A C 0 MEDQUEST INC & SUBSIDIARIES 3480 PRESTON RIDGE RD STE 600 ALPHARETTA GA 30005 223860764 DIAGNOSTIC IMAGING DE N/A C 0 NOVANT HEALTH TRINOVA INSURANCE PROTECTED CELL INC 2085 FRONTIS PLAZA BLVD WINSTON SALEM NC 27103 812963143 INSURANCE NC N/A C 0 SALEM DIAGNOSTICS INC 2085 FRONTIS PLAZA BLVD WINSTON SALEM NC 27103 561513621 HEALTH RELATED NC N/A C 0 SALEM HEALTH SERVICES INC 2085 FRONTIS PLAZA BLVD WINSTON SALEM NC 27103 561342654 HEALTH RELATED NC N/A C 0 THE PARK AT MONROE PROPERTY OWNERS ASSOCIATION INC 2085 FRONTIS PLAZA BLVD WINSTON SALEM NC 27103 463910256 RENTAL REAL ESTATE NC N/A C 0 0 0 1 0 0 0 0 0 0 0 0 0 1 1 1 1 0 1 0 COMMUNITY GENERAL HOSPITAL FOUNDATION R 247484 CASH