WAKE FOREST UNIVERSITY HEALTH SCIENCES GROUP RETURN: Form 990, tax year 2021
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- Organization
- WAKE FOREST UNIVERSITY HEALTH SCIENCES GROUP RETURN (EIN 90-0222618)
- Tax period
- 2021-07-01 to 2021-12-31
- Filed
- 2022-11-14
- IRS object ID
- 202243189349300949
- Schema version
- 2021v4.2
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-11-14T07:27:46-06:00 | ReturnTs |
| Tax Period End | 2021-12-31 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 900222618 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WAKE FOREST UNIVERSITY HEALTH SCIENCES | BusinessNameLine1Txt |
| Business Name Line2 | GROUP RETURN | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | WAKE | BusinessNameControlTxt |
| Phone | 3367164445 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | MEDICAL CENTER BOULEVARD | AddressLine1Txt |
| City | WINSTONSALEM | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 27157 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | STEPHAN LILLIE | PersonNm |
| Person Title | TREASURER | PersonTitleTxt |
| Phone | 3367164445 | PhoneNum |
| Signature | 2022-11-14 | SignatureDt |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | STEPHAN | PersonFirstNm |
| Person Last | LILLIE | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 3 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | JULIE A FREISCHLAG MD | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | MEDICAL CENTER BOULEVARD | AddressLine1Txt |
| City | WINSTONSALEM | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 27157 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $56,430,791 | GrossReceiptsAmt |
| Group Return For Affiliates | Yes (1) | GroupReturnForAffiliatesInd |
| All Affiliates Included | Yes (1) | AllAffiliatesIncludedInd |
| Group Exemption | 3884 | GroupExemptionNum |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.WAKEHEALTH.EDU | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2003 | FormationYr |
| Legal Domicile State | NC | LegalDomicileStateCd |
| Activity Or Mission | OUTPATIENT MEDICAL CLINICS FOR THE PROMOTION OF HEALTH FOR THE BENEFIT OF THE COMMUNITY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 5 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 1 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 5 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $951,791 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $110,447,000 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $56,430,791 | CYProgramServiceRevenueAmt |
| PY Investment Income | $0 | PYInvestmentIncomeAmt |
| CY Investment Income | $0 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $111,398,791 | PYTotalRevenueAmt |
| CY Total Revenue | $56,430,791 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $1,363,605 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $789,374 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $0 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $0 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $88,757,302 | PYOtherExpensesAmt |
| CY Other Expenses | $44,551,875 | CYOtherExpensesAmt |
| PY Total Expenses | $90,120,907 | PYTotalExpensesAmt |
| CY Total Expenses | $45,341,249 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $21,277,884 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $11,089,542 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $282,624,081 | TotalAssetsBOYAmt |
| Total Assets EOY | $294,523,544 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $9,397,858 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $10,207,779 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $273,226,223 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $284,315,765 | NetAssetsOrFundBalancesEOYAmt |
| Mission | OUTPATIENT MEDICAL CLINICS FOR THE PROMOTION OF HEALTH FOR THE BENEFIT OF THE COMMUNITY AND AS A SUPPORTING ORGANIZATION EXCLUSIVELY FOR THE BENEFIT OF WAKE FOREST UNIVERSITY AND WAKE FOREST UNIVERSITY HEALTH SCIENCES. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $40,393,477 | ExpenseAmt |
| Grant | $789,374 | GrantAmt |
| Revenue | $56,430,791 | RevenueAmt |
| Desc | HEMODIALYSIS: THE CLINICS SERVE THE TEACHING AND RESEARCH PROGRAMS OF WAKE FOREST UNIVERSITY HEALTH SCIENCES AND WAKE FOREST UNIVERSITY BY PROVIDING DIALYSIS TREATMENTS TO END STAGE RENAL DISEASE PATIENTS (1,828 IN-CENTER AND 301 HOME DIALYSIS PATIENTS), OR BY TRAINING PATIENTS IN SELF-ADMINISTRATION OF AT-HOME DIALYSIS TREATMENTS. | Desc |
| Total Program Service Expenses | $40,393,477 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | 0 | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 108 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 0 | EmployeeCnt |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 5 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 1 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | Yes (1) | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HEALTH SYSTEMS MANAGEMENT INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 2293865505 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 7710 | AddressLine1Txt |
| City | TIFTON | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 317937710 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (8 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|
| JULIE A FREISCHLAG MD | ||||||||
| CHAIR & PRESIDENT | 0.50 | 39.50 | Yes (X) | Yes (X) | $0 | $3,375,350 | $555,809 | |
| KEVIN P HIGH MD | ||||||||
| DIRECTOR & VP | 0.50 | 39.50 | Yes (X) | Yes (X) | $0 | $1,442,392 | $263,970 | |
| TERRY L HALES JR | ||||||||
| DIRECTOR & ASST TREAS | 0.50 | 39.50 | Yes (X) | Yes (X) | $0 | $775,775 | $153,934 | |
| TERRY G WILLIAMS | ||||||||
| DIRECTOR | 0.10 | 39.90 | Yes (X) | $0 | $0 | $0 | ||
| RUSSELL M HOWERTON MD | ||||||||
| DIRECTOR (FROM 10/30/20) | 0.50 | 39.50 | Yes (X) | $0 | $983,499 | $181,343 | ||
| J REID MORGAN | ||||||||
| SECRETARY | 0.50 | 39.50 | Yes (X) | $0 | $1,218,034 | $102,296 | ||
| BRADLEY A CLARK | ||||||||
| TREASURER | 0.10 | 39.90 | Yes (X) | $0 | $0 | $0 | ||
| JOHN D MCCONNELL MD | ||||||||
| FORMER OFF (4/26/17) | 0.00 | 40.00 | $0 | $456,795 | $45,242 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $8,251,845 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $1,302,594 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| HSM DIALYSIS CENTERS LLC | |||||
| PO BOX 7710 | TIFTON | GA | 31793 | MANAGEMENT SERVICES | $8,866,762 |
| NEPHROLOGY ASSOCIATES | |||||
| 730 HIGHLAND OAKS DRIVE | WINSTONSALEM | NC | 27103 | MEDICAL DIRECTOR | $534,623 |
| HIGH POINT NEPHROLOGY ASSOCIATES | |||||
| 404 WESTWOOD AVE 105 | HIGH POINT | NC | 27262 | MEDICAL DIRECTOR | $143,530 |
| IREDELL NEPHROLOGY | |||||
| 2117 SIMONTON ROAD 102 | STATESVILLE | NC | 28625 | MEDICAL DIRECTOR | $125,932 |
| SCHEDULEWISE LLC | |||||
| 1730 E NORTHERN AVENUE SUITE 124 | PHOENIX | AZ | 85020 | CONSULTING SERVICES | $122,400 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PATIENT SERVICE REVENUE | Desc |
| Business | 621300 | BusinessCd |
| Total Revenue Column | $56,430,791 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $56,430,791 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $56,430,791 | TotalProgramServiceRevenueAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $56,430,791 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $56,430,791 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $789,374 | TotalAmt |
| Program Services | $789,374 | ProgramServicesAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,505,875 | TotalAmt |
| Management And General | $4,505,875 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,517 | TotalAmt |
| Program Services | $2,517 | ProgramServicesAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $42,131 | TotalAmt |
| Program Services | $28,296 | ProgramServicesAmt |
| Management And General | $13,835 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,402,724 | TotalAmt |
| Program Services | $21,329,135 | ProgramServicesAmt |
| Management And General | $73,589 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $240,711 | TotalAmt |
| Program Services | $202,568 | ProgramServicesAmt |
| Management And General | $38,143 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $337,405 | TotalAmt |
| Program Services | $283,939 | ProgramServicesAmt |
| Management And General | $53,466 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,891,860 | TotalAmt |
| Program Services | $1,679,273 | ProgramServicesAmt |
| Management And General | $212,587 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $76,652 | TotalAmt |
| Program Services | $64,506 | ProgramServicesAmt |
| Management And General | $12,146 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $20,907 | TotalAmt |
| Program Services | $17,594 | ProgramServicesAmt |
| Management And General | $3,313 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $195,950 | TotalAmt |
| Program Services | $179,216 | ProgramServicesAmt |
| Management And General | $16,734 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $12,398,171 | $12,398,171 | |
| BAD DEBT | $3,322,850 | $3,322,850 | |
| OTHER SUPPLIES | $114,122 | $96,038 | $18,084 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $45,341,249 | TotalAmt |
| Program Services | $40,393,477 | ProgramServicesAmt |
| Management And General | $4,947,772 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,349,834 | BOYAmt |
| EOY | $5,671,699 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,768,953 | BOYAmt |
| EOY | $10,382,388 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,944,308 | BOYAmt |
| EOY | $2,386,605 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $31,919 | BOYAmt |
| EOY | $118,579 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $261,529,067 | BOYAmt |
| EOY | $275,964,273 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $282,624,081 | BOYAmt |
| EOY | $294,523,544 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,397,858 | BOYAmt |
| EOY | $10,207,779 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,397,858 | BOYAmt |
| EOY | $10,207,779 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $273,226,223 | BOYAmt |
| EOY | $284,315,765 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $273,226,223 | BOYAmt |
| EOY | $284,315,765 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $282,624,081 | BOYAmt |
| EOY | $294,523,544 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $11,089,542 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | Yes (X) | SupportingOrganization509a3Ind |
| Supporting Org Type1 | Yes (X) | SupportingOrgType1Ind |
| Supported Organizations | 2 | SupportedOrganizationsCnt |
Supported Org Information SupportedOrgInformationGrp (2 entries)
| EINEIN | Organization TypeOrganizationTypeCd | Governing Document ListedGoverningDocumentListedInd | SupportSupportAmt | Other SupportOtherSupportAmt |
|---|---|---|---|---|
| WAKE FOREST UNIVERSITY | ||||
| 560532138 | 2 | Yes (1) | $0 | $0 |
| WAKE FOREST UNIVERSITY HEALTH SCIENCES | ||||
| 223849199 | 2 | Yes (1) | $0 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supported Organizations Total | 2 | SupportedOrganizationsTotalCnt |
| Support Sum | $0 | SupportSumAmt |
| Other Support Sum | $0 | OtherSupportSumAmt |
Form990 Sch A Supporting Org Form990SchASupportingOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Listed By Name Governing Doc | Yes (1) | ListedByNameGoverningDocInd |
| Suprt Org No IRS Determination | 0 | SuprtOrgNoIRSDeterminationInd |
| Supported Org Section C456 | 0 | SupportedOrgSectionC456Ind |
| Supported Org Not Organized US | 0 | SupportedOrgNotOrganizedUSInd |
| Organization Change Suprt Org | 0 | OrganizationChangeSuprtOrgInd |
| Support Non Supported Org | Yes (1) | SupportNonSupportedOrgInd |
| Payment Substantial Contribtr | 0 | PaymentSubstantialContribtrInd |
| Loan Disqualified Person | 0 | LoanDisqualifiedPersonInd |
| Controlled Disqualified Prsn | 0 | ControlledDisqualifiedPrsnInd |
| Disqualified Prsn Controll Int | 0 | DisqualifiedPrsnControllIntInd |
| Disqualified Prsn Ownr Int | 0 | DisqualifiedPrsnOwnrIntInd |
| Excess Business Holdings Rules | 0 | ExcessBusinessHoldingsRulesInd |
| Contribution Controller | 0 | ContributionControllerInd |
| Contribution Family | 0 | ContributionFamilyInd |
| Contribution35 Controlled | 0 | Contribution35ControlledInd |
Form990 Sch A Type1 Suprt Org Form990SchAType1SuprtOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Power Appoint Majority Dir Trst | Yes (1) | PowerAppointMajorityDirTrstInd |
| Operate Benefit Non Suprt Org | 0 | OperateBenefitNonSuprtOrgInd |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART IV, LINE 6 EXPLANATION | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION PROVIDED SUPPORT TO AMERICAN KIDNEY FUND AND UNITED WAY OF FORSYTH COUNTY, BOTH OF WHICH ARE 501(C)(3) ORGANIZATIONS. AMERICAN KIDNEY FUND PROVIDES FINANCIAL ASSISTANCE FOR QUALIFIED KIDNEY PATIENTS AND DIRECTLY BENEFITS INDIVIDUALS BENEFITTED BY THE ORGANIZATION'S SUPPORTED ORGANIZATION, WAKE FOREST UNIVERSITY HEALTH SCIENCES. SIMILARLY, UNITED WAY OF FORSYTH COUNTY PROVIDES HEALTH, FINANCIAL, AND OTHER ASSISTANCE TO INDIVIDUALS AND FAMILIES IN NEED IN FORSYTH COUNTY, NC, DIRECTLY BENEFITTING INDIVIDUALS BENEFITTED BY THE ORGANIZATION'S SUPPORTED ORGANIZATION, WAKE FOREST UNIVERSITY HEALTH SCIENCES. | ExplanationTxt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $0 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | WFUHS CAPITAL CONTRIBUTION | Desc |
| Book Value | $275,964,273 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $275,964,273 | TotalBookValueOtherAssetsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | ALL DIALYSIS CENTER ORGANIZATIONS REPRESENTED IN THIS GROUP RETURN HAVE EVALUATED UNCERTAIN TAX POSITIONS FOR THEIR SHORT PERIOD ENDED DECEMBER 31, 2021 AND FISCAL YEAR ENDED JUNE 30, 2021, INCLUDING A QUANTIFICATION OF TAX RISK IN AREAS SUCH AS UNRELATED BUSINESS TAXABLE INCOME AND THE TAXATION OF ITS JOINT VENTURES. THIS EVALUATION DID NOT HAVE A MATERIAL EFFECT ON THE ORGANIZATION'S FINANCIAL STATEMENTS FOR THE SHORT PERIOD ENDED DECEMBER 31, 2021 AND FISCAL YEAR ENDED JUNE 30, 2021. | ExplanationTxt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Non Cash AssistanceNonCashAssistanceAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|---|
| AMERICAN KIDNEY FUND | ||||||||
| 11921 ROCKVILLE PIKE | ROCKVILLE | MD | 20852 | 237124261 | 501(C)(3) | $779,374 | $0 | FINANCIAL ASSISTANCE PROGRAM FOR QUALIFIED KIDNEY PATIENTS |
| UNITED WAY OF FORSYTH COUNTY | ||||||||
| 301 N MAIN STREET | WINSTON SALEM | NC | 27101 | 237357234 | 501(C)(3) | $10,000 | $0 | COMMUNITY SUPPORT |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 2 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | ALL ORGANIZATIONS REPRESENTED IN THIS GROUP EXEMPTION RETURN FOLLOW THE CORPORATE POLICY USED BY WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER (TO WHICH ENTITY THE OPERATION OF THE SUBSIDIARIES OF WAKE FOREST UNIVERSITY HEALTH SCIENCES "WFUHS AND NORTH CAROLINA BAPTIST HOSPITAL "NCBH" (INCLUDING THE FILING ORGANIZATION) HAS BEEN DELEGATED) IN REVIEWING ELIGIBILITY AND SELECTION OF GRANTEES RECEIVING CERTAIN EXEMPT PURPOSE FUNDS. THE ORGANIZATIONS MAINTAIN DOCUMENTATION OF THE ELIGIBILITY AND SELECTION CRITERIA AND RECORDS OF AMOUNTS DISBURSED. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (6 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JULIE A FREISCHLAG MD | ||||||||||||||
| CHAIR & PRESIDENT | $0 | $1,899,767 | $0 | $1,003,777 | $0 | $471,806 | $0 | $529,516 | $0 | $26,293 | $0 | $3,931,159 | $0 | $396,368 |
| KEVIN P HIGH MD | ||||||||||||||
| DIRECTOR & VP | $0 | $817,598 | $0 | $438,008 | $0 | $186,786 | $0 | $242,047 | $0 | $21,923 | $0 | $1,706,362 | $0 | $143,317 |
| J REID MORGAN | ||||||||||||||
| SECRETARY | $0 | $576,981 | $0 | $135,000 | $0 | $506,053 | $0 | $66,500 | $0 | $35,796 | $0 | $1,320,330 | $0 | $351,061 |
| RUSSELL M HOWERTON MD | ||||||||||||||
| DIRECTOR (FROM 10/30/20) | $0 | $552,828 | $0 | $258,000 | $0 | $172,671 | $0 | $150,916 | $0 | $30,427 | $0 | $1,164,842 | $0 | $12,005 |
| TERRY L HALES JR | ||||||||||||||
| DIRECTOR & ASST TREAS | $0 | $476,886 | $0 | $202,500 | $0 | $96,389 | $0 | $126,257 | $0 | $27,677 | $0 | $929,709 | $0 | $3,830 |
| JOHN D MCCONNELL MD | ||||||||||||||
| FORMER OFF (4/26/17) | $0 | $418,681 | $0 | $0 | $0 | $38,114 | $0 | $21,816 | $0 | $23,426 | $0 | $502,037 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 4B | FormAndLineReferenceDesc |
| Explanation | CERTAIN OFFICERS AND DIRECTORS OF THE ORGANIZATIONS INCLUDED IN THIS GROUP RETURN PARTICIPATED IN AND/OR RECEIVED PAYMENTS FROM SUPPLEMENTAL NON QUALIFIED RETIREMENT PLANS (SERP) AND EXECUTIVE INCENTIVE COMPENSATION PLANS (ALL OF WHICH WAS PAID BY RELATED ORGANIZATIONS, WAKE FOREST UNIVERSITY HEALTH SCIENCES OR WAKE FOREST UNIVERSITY, AS PART OF THE INDIVIDUAL'S COMPENSATION FROM THE RELATED ORGANIZATIONS). THE FOLLOWING CURRENT DIRECTORS AND OFFICERS RECEIVED SERP PAYMENTS IN THEIR CALENDAR YEAR 2021 COMPENSATION: JULIE A. FREISCHLAG, M.D. $396,368 KEVIN P. HIGH, M.D. $161,346 RUSSELL M. HOWERTON, M.D. $123,000 TERRY L. HALES, JR. $72,896 J. REID MORGAN $485,452 THE COMPENSATION OF J. REID MORGAN, SENIOR VICE PRESIDENT AND GENERAL COUNSEL OF RELATED ORGANIZATION WAKE FOREST UNIVERSITY, INCLUDES A PAYOUT OF $485,452 WHICH IS INCLUDED IN HIS 2021 FORM W-2 AND IN COLUMN BIII. $351,061 IS SHOWN IN SCHEDULE J, PART II, COLUMN F AND HAS BEEN PREVIOUSLY REPORTED ON PRIOR YEARS' FORMS 990. HIS COMPENSATION ALSO INCLUDES $37,500 SHOWN IN SCHEDULE J, PART II, COLUMN C, FROM HIS PARTICIPATION IN A DEFERRED COMPENSATION ARRANGEMENT WITH THAT RELATED ORGANIZATION. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 4 | THE BYLAWS OF ALL ORGANIZATIONS INCLUDED IN THIS GROUP RETURN WERE AMENDED EFFECTIVE JULY 1, 2021 TO CHANGE EACH ORGANIZATION'S FISCAL YEAR FROM ONE ENDING JUNE 30 TO ONE ENDING DECEMBER 31. |
| FORM 990, PART VI, SECTION A, LINE 6 | THE SOLE MEMBER OF ALL ORGANIZATIONS INCLUDED IN THIS GROUP RETURN IS WAKE FOREST UNIVERSITY HEALTH SCIENCES. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE MEMBERS OF THE BOARD OF DIRECTORS OF THE ORGANIZATIONS INCLUDED IN THIS GROUP RETURN ARE APPOINTED BY THE GOVERNING BODY OF WAKE FOREST UNIVERSITY HEALTH SCIENCES OR BY A MEMBER OF THE GOVERNING BODY OR BY AN OFFICER OF WAKE FOREST UNIVERSITY HEALTH SCIENCES ACTING IN THEIR OFFICIAL CAPACITY, IN ACCORDANCE WITH PROCEDURES PRESCRIBED BY THE BOARD OF DIRECTORS OF WAKE FOREST UNIVERSITY HEALTH SCIENCES. |
| FORM 990, PART VI, SECTION A, LINE 7B | DECISIONS OF THE ORGANIZATIONS' GOVERNING BODIES WHICH REQUIRE APPROVAL BY THE PARENT ORGANIZATION, WAKE FOREST UNIVERSITY HEALTH SCIENCES, INCLUDE AMENDMENTS TO THE ORGANIZATIONS' GOVERNANCE DOCUMENTS (ARTICLES OF INCORPORATION AND BYLAWS), AND THE ELECTION AND REMOVAL OF DIRECTORS. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE BOARDS OF DIRECTORS OF ALL ORGANIZATIONS REPRESENTED ON THIS GROUP RETURN RECEIVE A COPY OF THE FORM 990 WITH SUFFICIENT TIME TO PERMIT REVIEW, COMMENT, AND QUESTIONS PRIOR TO ITS FILING. IF MODIFICATIONS ARE REQUIRED FOLLOWING SUCH REVIEW, THE REVISED FORM 990 IS REDISTRIBUTED PRIOR TO ITS FILING WITH THE IRS, ALONG WITH A SUMMARY OF THE MODIFICATIONS. |
| FORM 990, PART VI, SECTION B, LINE 12C | ALL ORGANIZATIONS INCLUDED IN THIS GROUP RETURN REQUIRE OFFICERS AND DIRECTORS TO DISCLOSE CONFLICTS OF INTEREST ANNUALLY, AND AS THEY ARISE. ANY ITEMS DISCLOSED ARE REVIEWED AND MANAGED IN ACCORDANCE WITH THE ORGANIZATIONS' POLICY ON CONFLICTS OF INTEREST. |
| FORM 990, PART VI, SECTION B, LINE 15 | NO ORGANIZATIONS INCLUDED IN THIS GROUP RETURN PAY COMPENSATION TO OFFICERS OR DIRECTORS. ALL COMPENSATION PAID TO OFFICERS AND DIRECTORS AND FORMER OFFICERS OR DIRECTORS IS PAID BY RELATED ORGANIZATIONS. THE GOVERNANCE & COMPENSATION COMMITTEE OF THE WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER BOARD IS RESPONSIBLE FOR REVIEWING AND APPROVING MOST OFFICERS' COMPENSATION. THE COMMITTEE UTILIZES INDEPENDENT COMPENSATION CONSULTANTS, COMPENSATION SURVEYS AND STUDIES TO DETERMINE THE APPROPRIATENESS OF EACH SUCH OFFICERS' COMPENSATION. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ARTICLES OF INCORPORATION OF EACH OF THE SEPARATE DIALYSIS CENTER ORGANIZATIONS INCLUDED IN THIS GROUP EXEMPTION RETURN ARE AVAILABLE TO THE PUBLIC ON REQUEST AND ARE AVAILABLE ON THE WEBSITE OF THE NORTH CAROLINA SECRETARY OF STATE. SUCH ORGANIZATIONS' BYLAWS ARE NOT PUBLISHED, BUT PROVISIONS FROM THEIR BYLAWS ARE INCLUDED AS NECESSARY IN SUCH ORGANIZATIONS' POLICIES, AND ARE ATTACHED TO THE FORMS 1023 FILED FOR THE ORGANIZATION WITH THE IRS, WHICH IS PUBLICLY AVAILABLE. THE CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS OF SUCH ORGANIZATIONS ARE AVAILABLE TO THE PUBLIC ON REQUEST. |
| PART VII, SECTION A, COLUMN B, HOURS | JOHN D. MCCONNELL, MD FILING ORG 0.0 RELATED ORG 0.0 UNRELATED ORG 40.0 JULIE A. FREISCHLAG, MD FILING ORG 0.5 RELATED ORG 17.7 UNRELATED ORG 21.8 TERRY L. HALES, JR. FILING ORG 0.5 RELATED ORG 39.5 TERRY G. WILLIAMS FILING ORG 0.1 RELATED ORG 1.1 UNRELATED ORG 38.8 KEVIN P. HIGH, MD FILING ORG 0.5 RELATED ORG 5.8 UNRELATED ORG 33.7 J. REID MORGAN FILING ORG 0.5 RELATED ORG 30.5 UNRELATED ORG 9.0 BRADLEY A. CLARK FILING ORG 0.1 RELATED ORG 1.1 UNRELATED ORG 38.8 RUSSELL M. HOWERTON, MD FILING ORG 0.5 RELATED ORG 16.6 UNRELATED ORG 22.9 A MEDICAL CENTER INTEGRATION AGREEMENT ("MCIA") WAS ORIGINALLY ENTERED INTO IN 2010 AMONG FOUR PARTIES: WAKE FOREST UNIVERSITY ("WFU"), WAKE FOREST UNIVERSITY HEALTH SCIENCES ("WFUHS"), WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER ("WFUBMC") AND NORTH CAROLINA BAPTIST HOSPITAL ("NCBH"). PURSUANT TO THE TERMS OF THE ORIGINAL MCIA, THE OPERATION OF WFUHS AND NCBH, AND ALL OF THE RESPECTIVE SUBSIDIARIES OF EACH, IS DELEGATED TO WFUBMC. ADDITIONALLY, THE CORPORATE OFFICERS OF WFUBMC GENERALLY SERVE AS THE CORPORATE OFFICERS OF WFUHS AND NCBH. THE MCIA WAS REVISED AND RESTATED IN 2020 TO DELEGATE OVERSIGHT AND MANAGEMENT AUTHORITY OVER WFUBMC TO ATRIUM HEALTH, INC. ("AHI"). CERTAIN DIRECTORS AND/OR CORPORATE OFFICERS OF WFUHS, NCBH, & WFUBMC ALSO SERVE AS DIRECTORS OR CORPORATE OFFICERS OF AHI. WFU AND WFUHS ARE ORGANIZATIONS RELATED TO THE SEPARATE DIALYSIS CENTER ORGANIZATIONS INCLUDED IN THIS GROUP RETURN. NCBH, WFUBMC, AND AHI ARE ORGANIZATIONS UNRELATED TO THE ORGANIZATIONS INCLUDED IN THIS GROUP RETURN. THUS, CERTAIN DIRECTORS AND OFFICERS OF THE ORGANIZATIONS INCLUDED IN THIS GROUP RETURN DEVOTE HOURS TO RELATED ORGANIZATIONS (WFU & WFUHS) AND UNRELATED ORGANIZATIONS (WFUBMC, NCBH, AND AHI) AS SHOWN IN THE BREAKDOWN OF HOURS ABOVE. |
| FORM 990, PART IX, LINE 11G | CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 19,679,218. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 19,679,218. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 1,649,917. MANAGEMENT AND GENERAL EXPENSES 73,589. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,723,506. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (8 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| WAKE FOREST EMERGENCY PROVIDERS | |||||||||||
| MEDICAL CENTER BLVD | WINSTON SALEM | NC | 27157 | 561903275 | HEALTHCARE | NC | 501(C)(3) | LINE 3 | WAKE FOREST UNIVERSITY HEALTH SCIENCES | 0 | |
| WAKE FOREST UNIVERSITY HEALTH SCIENCES | |||||||||||
| MEDICAL CENTER BLVD | WINSTON SALEM | NC | 27157 | 223849199 | HEALTHCARE, EDUCATION, RESEARCH | NC | 501(C)(3) | LINE 2 | WAKE FOREST UNIVERSITY | 0 | |
| WAKE FOREST UNIVERSITY | |||||||||||
| BOX 7201 | WINSTON SALEM | NC | 27109 | 560532138 | EDUCATION | NC | 501(C)(3) | LINE 2 | 0 | N/A | |
| WAKE FOREST INNOVATION QUARTER MANAGEMENT CO | |||||||||||
| MEDICAL CENTER BLVD | WINSTON SALEM | NC | 27157 | 061818498 | RESEARCH PARK DEVELOPMENT | NC | 501(C)(3) | LINE 12A, I | WAKE FOREST UNIVERSITY HEALTH SCIENCES | 0 | |
| WAKE FOREST INNOVATION QUARTER CDC | |||||||||||
| MEDICAL CENTER BLVD | WINSTON SALEM | NC | 27157 | 200177581 | RESEARCH PARK DEVELOPMENT | NC | 501(C)(3) | LINE 12A, I | WAKE FOREST UNIVERSITY HEALTH SCIENCES | 0 | |
| WAKE FOREST INNOVATION QUARTER DEVELOPMENT CO | |||||||||||
| MEDICAL CENTER BLVD | WINSTON SALEM | NC | 27157 | 562094067 | RESEARCH PARK DEVELOPMENT | NC | 501(C)(6) | WAKE FOREST UNIVERSITY HEALTH SCIENCES | 0 | ||
| CHILDRESS INSTITUTE FOR PEDIATRIC TRAUMA | |||||||||||
| MEDICAL CENTER BLVD | WINSTON SALEM | NC | 27157 | 463674691 | HEALTHCARE RESEARCH | NC | 501(C)(3) | LINE 7 | WAKE FOREST UNIVERSITY HEALTH SCIENCES | 0 | |
| REGENMED DEVELOPMENT ORGANIZATION | |||||||||||
| MEDICAL CENTER BLVD | WINSTON SALEM | NC | 27157 | 202710571 | HEALTHCARE RESEARCH | NC | 501(C)(3) | LINE 7 | WAKE FOREST UNIVERSITY HEALTH SCIENCES | 0 | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd |
|---|---|---|---|---|---|---|---|---|---|
| VERGER FUND II LLC | |||||||||
| 751 W FOURTH STREET SUITE 410 | WINSTON SALEM | NC | 27101 | 352514227 | INVESTMENT | NC | N/A | 0 | 0 |
| WAKE FOREST TECHNOLOGY DEVELOPMENT PROGRAM LP | |||||||||
| 2520 MERIDIAN PARKWAY | DURHAM | NC | 27713 | 475437596 | INVESTMENT | NC | N/A | 0 | 0 |
| WAKE FOREST AMBULATORY VENTURES LLC | |||||||||
| MEDICAL CENTER BOULEVARD | WINSTON SALEM | NC | 27157 | 820777206 | HEALTHCARE | NC | N/A | 0 | 0 |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NORTH DISTRICT OWNERS ASSOCIATION | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | MEDICAL CENTER BLVD | AddressLine1Txt |
| City | WINSTON SALEM | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 27157 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 471128865 | EIN |
| Primary Activities | PROPERTY OWNERS ASSOCIATION | PrimaryActivitiesTxt |
| Legal Domicile State | NC | LegalDomicileStateCd |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Entity Type | C | EntityTypeTxt |
| Controlled Organization | 0 | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |