2021-08-11T16:59:44-05:00 2020-09-30 KPMG LLP 300 North Greene Street Suite 400 Greensboro NC 27401 990 2019-10-01 560845796 CUMBERLAND COUNTY HOSPITAL SYSTEM INC % JAMES DUPE CUMB 9106154829 PO Box 2000 FAYETTEVILLE NC 283022000 BRET JOHNSON CFO 9106154829 2021-08-10 true WHITNEY B HEBRON P01226647 3362753394 2021-08-10 2019 2022-09-23 18:48:47Z Michael Nagowski ceo PO BOX 2000 FAYETTEVILLE NC 283022000 1353706180 false X www.capefearvalley.com X 1956 NC Cumberland County Hospital System, Inc. exists to meet the Health Care needs of the residents. 21 18 8312 201 177713 0 4746162 4971041 1107956072 1132178813 25189570 16818108 11507800 12555271 1149399604 1166523233 341158 620833 0 0 494518407 484409556 0 0 0 624046166 630299793 1118905731 1115330182 30493873 51193051 1159079000 1384134000 602061431 769734123 557017569 614399877 CUMBERLAND COUNTY HOSPITAL SYSTEM, INC. EXISTS TO MEET THE HEALTH CARE NEEDS OF THE RESIDENTS OF CUMBERLAND, BLADEN, AND HOKE COUNTIES, AND THE SURROUNDING AREA IN NORTH CAROLINA. false false 1005748445 620833 1140046428 As part of meeting the Health Care needs of the service area, CCHS, Inc. admitted 37,775 patients, provided 216,226 patient days of care, had 176,498 emergency room visits and had over 545,000 outpatient visits for other services. 1005748445 true true false true false false false false false false true false false true true false false true false false true false false false false false true true true false true true false false false false false false false false false true false false false false true true true false false false true 396 0 true 8312 true true true true CJ false false false false false false false false true false X 21 18 false false false false false true false true true false false true true true true true true true true true false X JAMES DUPE 9106154829 PO BOX 2000 FAYETTEVILLE NC 283022000 X Michael Nagowski CEO 55.0 0.0 X 1482334 0 16935 Charles Haworth MD Physician 40.0 0.0 X 1190756 0 16556 Robert Maughan MD Medical Director 40.0 0.0 X 1006524 0 12259 Michael Zappa Medical Director 40.0 0.0 X 824778 0 10990 Sandra Williams CFO 55.0 0.0 X 761535 0 8877 STUART SHELTON PHYSICIAN 40.0 0.0 X 694086 0 14569 MARK EATON PHYSICIAN 40.0 0.0 X 672235 0 14147 Samuel Fleischman CMO 55.0 0.0 X 668692 0 15360 DANIEL WEATHERLY COO 55.0 0.0 X 629379 0 17345 William B Pryor Former CHRO 55.0 0.0 X 84979 0 2257 CHUKWUEMEKA CHIMA MD TRUSTEE & PHYSICIAN 5.0 0.0 X 55000 0 0 BRADLEY J BROUSSARD TRUSTEE & PHYSICIAN 5.0 0.0 X 34000 0 0 NITIN DESAI MD TRUSTEE & CHIEF OF STAFF 5.0 0.0 X 6250 0 0 SANDRA CARR JOHNSON MD TRUSTEE 2.0 0.0 X 0 0 0 LARRY LANCASTER TRUSTEE 2.0 0.0 X 0 0 0 GLENN ADAMS TRUSTEE 2.0 0.0 X 0 0 0 SANDY AMMONS Trustee 2.0 0.0 X 0 0 0 JEANNETTE COUNCIL Trustee 2.0 0.0 X 0 0 0 CHARLES EVANS Trustee 2.0 0.0 X 0 0 0 JIMMY KEEFE Trustee 2.0 0.0 X 0 0 0 WARREN MCDONALD PHD TRUSTEE 2.0 0.0 X 0 0 0 SANJAY SHAH MD Trustee 2.0 0.0 X 0 0 0 MURTIS WORTH TRUSTEE 2.0 0.0 X 0 0 0 MICHAEL BOOSE TRUSTEE 2.0 0.0 X 0 0 0 ALICIA MARKS TRUSTEE 2.0 0.0 X 0 0 0 PAMELA S STORY TRUSTEE 2.0 0.0 X 0 0 0 TAMMY S THURMAN TRUSTEE 2.0 0.0 X 0 0 0 GIRUM FEYISSA MD TRUSTEE 2.0 0.0 X 0 0 0 TONI STEWART TRUSTEE 2.0 0.0 X 0 0 0 AMY CANNON TRUSTEE 2.0 0.0 X 0 0 0 EMILY SCHAEFER TRUSTEE 2.0 0.0 X 0 0 0 8110548 0 129295 786 true true false AMN HEALTHCARE INC 4441 COLLECTIONS CENTER DR CHICAGO IL 60693 Contract Labor 18120244 ARAMARK DALLAS LOCKBOX PO BOX 978839 DALLAS TX 75397 Management Fees 8164087 ALLIED UNIVERSAL SECURITY PO Box 534265 ATLANTA GA 30353 SECURITY SERVICES 3969012 FRESENIUS MEDICAL CARE - BMA 16343 COLLECTIONS CENTER DR CHICAGO IL 60693 CONTRACT LABOR 3609144 APOGEE MEDICAL MANAGEMENT 15059 N SCOTTSDALE RD SUITE 600 SCOTTSDALE AZ 85254 CONTRACT LABOR 3106044 123 392085 1215998 3362958 4971041 PATIENT SERVICE REVENUE 900099 1092410601 1092410601 ANCILLARY MEDICAL SERVICES 900099 39764571 39764571 EDUCATION/OUTREACH 611710 3641 3641 1132178813 13724051 97696 13626355 0 0 253433 51121 202312 0 202312 202312 190225883 187131826 3094057 3094057 3094057 0 0 0 0 0 0 0 0 0 PURCHASE REBATES, DISC. AND OTHER 812900 1803666 1803666 CAFETERIA AND PARKING REVENUE 900099 3533812 3533812 BUILDING CONVEYANCE 900099 4485344 4485344 2530137 80017 2450120 12352959 1166523233 1132178813 177713 29195666 620833 620833 0 0 0 3782943 3782943 0 396458834 359002970 37455864 16940013 16940013 41175841 41153021 22820 26051925 23508008 2543917 5965527 5965294 233 5428364 4000000 1428364 180000 180000 182530 142568 39962 0 0 0 895859 895219 640 4104097 3854686 249411 21146872 44942 21101930 0 8847350 8059273 788077 331649 315604 16045 0 666581 468803 197778 12125243 12005149 120094 0 34691617 27753224 6938393 12025273 647108 11378165 MEDICAL & OTHER SUPPLIES 170226037 165998254 4227783 BAD DEBT EXPENSE 243266866 243266866 CONTRACT LABOR 21082229 20455660 626569 PURCHASED SERVICES 27768232 16444190 11324042 61365467 54206760 7158707 1115330182 1005748445 109581737 0 57742423 228193159 95128 20095128 0 0 108178854 97208614 0 0 0 0 0 0 11991223 14197514 4884794 5153255 1014271533 584542402 433029788 429729131 384582240 411963685 0 0 0 0 0 0 158574550 177593514 1159079000 1384134000 75126173 176464814 0 0 4263308 43534310 226635338 217525441 0 0 0 0 89526849 87865019 0 0 206509763 244344539 602061431 769734123 X 0 0 0 0 557017569 614399877 557017569 614399877 1159079000 1384134000 X 51193051 6582596 -393339 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false true false false false false true 182530 false false 182530 false Part II-B, Line 1g Employees of the Health System and NCHA meet with Local, State, and Federal Legislators and Regulators regarding matters of interest to the hospital. 27216942 27216942 569351321 271546519 297804802 5308784 1921552 3387232 388867765 299616286 89251479 23526721 11458044 12068676 429729131 OTHER RECEIVABLES 2855430 SELF INSURANCE TRUSTS 64289109 TRUSTS-BOND FUNDS 6506876 OTHER ASSETS 14472000 DERIVATIVE INSTRUMENT 89470099 177593514 0 COMP COSTS 36048324 DUE TO PAYOR AGENCIES 89546360 DERIVATIVE INSTRUMENT 46498260 OTHER LIABILITIES 70474951 DEFERRED INFLOWS OF RESOURCES 1776644 244344539 X 933111838 6582596 6582596 926529242 239993991 239993991 1166523233 875336191 875336191 239993991 239993991 1115330182 Part X, Line 2 The Health System and the Foundation are exempt from federal income taxes on related income under Section 501(a) of the Internal Revenue Code as organizations described in Section 501(c)(3). The unrelated business income generated by the Health System and the income generated by the Health System's taxable component are not material to the financial statements. Accordingly, no provision for income taxes is required in the accompanying financial statements. Part XI, Line 4b BAD DEBT EXPENSE RECLASSIFIED $243,266,866 RENT EXPENSE RECLASSIFIED ($51,121) Reclass eliminations of other revenue and net investment income ($4,009,000) Reclass of other negative expenses to revenue $787,246 Part XII, Line 4b BAD DEBT EXPENSE RECLASSIFIED $243,266,866 RENT EXPENSE RECLASSIFIED ($51,121) Reclass eliminations of other revenue and net investment income ($4,009,000) Reclass of other negative expenses to revenue $787,246 Central America and the Caribbean Investments CAPTIVE INSURANCE 55916832 55916832 55916832 true false true false false false SCHEDULE F, PART I, LINE 3 The accrual method is used for investments. true true X true X true X 500. true true false true true 28432485 2160946 26271539 0.03010 183853200 169440282 14412918 0.01650 1040766 507464 533302 0.00060 213326451 172108692 41217759 0.04720 26635696 2734279 23901417 0.02740 20489113 13673473 6815640 0.00780 47124809 16407752 30717057 0.03520 260451260 188516444 71934816 0.08240 210000 210000 0.00020 55000 55000 0.00010 265000 265000 0.00030 false 243266866 164640847 159706406 4934441 X true true 4 1 Cape Fear Valley Health System 1638 Owen Drive Fayetteville NC 28304 www.capefearvalley.com X X X A 2 Highsmith Rainey Hospital 150 Robeson Street Fayetteville NC 28301 www.capefearvalley.com X Long Term Acute Care Hospital A 3 Bladen County Hospital 501 South Poplar Street Elizabethtown NC 28337 www.capefearvalley.com X X X A 4 Hoke Hospital 210 Medical Pavilion Drive Raeford NC 28376 www.capefearvalley.com X A A true false true X X X X X X X X X 18 true false false true X SEE PART V, SECTION C X true 18 true SEE PART V, SECTION C false true X 200. 500. X X true true X X X true X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE PART V, SECTION C X X X X X X X true X false X X X X true X false false Cape Fear Valley Health System PART V, SECTION B, LINE 3: Cape Fear Valley Health System performed a new Community Health Needs Assessment for FY 2019. For our 2019 CHNA we collaborated with HealthENC, a collaborative of 22 hospitals and 21 health departments from across Eastern NC, including the Bladen, Cumberland and Hoke County Health Departments. Community Health Assessment Teams (CHAT) were developed in each of the respective counties. The CHAT consisted of community members, stakeholders, and those working in public health. The CHATs were instrumental in the distribution of our surveys in the community in electronic and paper format. Utilizing the surveys (primary data) and data from the state plus federal sources (secondary data), and CHAT led focused groups HealthENC created a comprehensive report for each of the three counties Cape Fear Valley has a hospital. There were a few continuous themes despite the geographical differences in the counties. Working with the respective health departments in each county, Cape Fear Valley Health System identified Community Outreach & Screening for Early Intervention, Access to Health Services, and Substance Abuse as the areas that needed to be addressed. These areas are all among the most mentioned areas amongst our survey respondents and focus group attendees. CFVHS hosted almost 200 outreach events in the community in 2020 to address the issues in our service area. Preventive education, screening, and support groups were just a few of the ways we address our community needs. During the Pandemic and since the COVID vaccine was made available, CFVHS has provided over 141,000 vaccines. We operated 2 mass vaccination sites for several months as well as several smaller sites. We partnered with Cumberland County schools to vaccinate 50% of their 8,000 workforce the first week they were eligible and provided five separate outreach events at historically minority high schools to create and improve access. We are currently planning summer events for school age children aged 12 and above. CFVHS has administered over 200 doses to shut-ins through our CAP program via a mobile home deliver method. We worked with the WoodPeckers minor league baseball team to vaccinate the players and staff so the season could begin on time. We partnered with multiple organizations in multiple counties to host or staff vaccine events. Other health systems and military operations were so impressed with our efficient operations and delivery they came onsite to observe and to take back our best practice to their sites. The CFVHS Friends of the Cancer Center funded over 186 screening mammograms to catch breast cancer in earlier stages. CPR instruction and Blood Pressure checks are a service we offer at most outreach events. Our Residency program fosters outreach amongst our residents and raise awareness of our residency program and its expected impact. We will continue our aggressive outreach efforts to help educate our patients about the various risk factors associated with all the identified needs. The health system has added new access points in the forms of urgent care and primary care practices, so patients have greater access to physicians. We continue to strengthen our relationships with our local health departments and identifying potential collaborations with community stakeholders. Cape Fear Valley Health System has established a system-wide Opioid Stewardship Program. We have established several Community Partnerships to address substance abuse issues in our area (Fighting addiction through Community Empowerment Teams with SRAHEC & Cumberland-Fayetteville Opioid Response Teams) Cape Fear Valley Health System is constantly evolving to meet the needs of the communities we serve. We have already begun the next steps for our next Community Needs Assessment to learn if we are heading in the right direction. Our vision is to improve the quality of life of every life we touch. Cape Fear Valley Health System Part V, Section B, Line 4: Cape Fear Valley and Highsmith Rainey worked collaboratively with one another. Part V, Section B, Line 5: Community Health Assessment Teams (CHAT) were developed in each of the respective counties. The CHAT consisted of community members, stakeholders, and those working in public health. The CHAT's developed community health assessment surveys and distributed them in the community in electronic and paper format. Utilizing the surveys (primary data) and data from the state plus federal sources (secondary data), CFVHS was able to identify the most pressing needs in our communities. Part V, Section B, Line 7a and 10a: https://www.capefearvalley.com/downloads/CHNA/Cumberland-CHNA-2019.pdf Part V, Section B, Line 11: CFVHS will continue our aggressive outreach efforts to help educate our patients about the various risk factors associated with all the identified needs. We are strengthening our relationships with our local health departments and identifying potential collaborations with community stakeholders. Going forward the hospital is developing an additional cardiac catheterization lab. Our Lung Nodule Clinic has moved to the main campus for better coverage of potential lung cancer patients. Part V, Section B, Line 16a-c: https://www.capefearvalley.com/patients/financial-assistance.html Cape Fear Valley Health System Part V, Section B, Line 16I: See the response to Part VI, Line 3 Highsmith Rainey Hospital Part V, Section B, Line 16I: See the response to Part VI, Line 3 Bladen County Hospital Part V, Section B, Line 16I: See the response to Part VI, Line 3 Hoke Hospital Part V, Section B, Line 16I: See the Response to part VI, Line 3 40 CFV-Rehabilitation Center 1638 Owen Drive Fayetteville NC 28304 Rehabilitation Center Cumberland Cty EMS of CFV 610 Gillespie Street Fayetteville NC 28306 Emergency Medical Services CFV Behavior Health Center 3425 Melrose Road Fayetteville NC 28304 Behavior Health Center CFV Detox Center 1724 Roxie Avenue Fayetteville NC 28304 Detoxication Center Healthplex Wellness Center 1930 Skibo Road Fayetteville NC 28304 Rehabilitation Center Health Pavilion North 6387 Ramsey Street Fayetteville NC 28311 Outpatient Services Highsmith-Rainey Express Care 150 Robeson Street Fayetteville NC 28311 Express Care Cape Fear Valley Express Care 1638 Owen Drive Fayetteville NC 28304 Express Care Cape Fear Valley OBGYN 1341 Walther Reed Road Fayetteville NC 28304 OB/Gyn Services Health Pavilion North Express Care 6287 Ramsey Street Fayetteville NC 28301 Express Care Cape Fear Valley Sleep Medicine 1213 Walter Reed Road Fayetteville NC 28304 Sleep Center Health Pavilion North Family Care 6387 Ramsey Street Fayetteville NC 28311 Family Practice Hope Mills Family Care 4092 Professional Drive Hope Mills NC 28348 Family Practice Cape Fear Valley Perinatology 2109 Valleygate Drive Fayetteville NC 28304 Perinatology Behavioral Health Center 3425 Melrose Road Fayetteville NC 28304 Mental Health Clinic Inpatient Valley Medical Associates-Highsmith 101 Robeson Street Fayetteville NC 28301 Family Practice Cape Fear Valley Urology 2301 Robeson Street Suite 203 Fayetteville NC 28305 Urology Hoke Family Medical Center 405 South Main Street Raeford NC 28376 Family Practice Senior Health Services 101 Robeson Street Suite 202 Fayetteville NC 28310 Geriatrics Bladen Medical Assoc-Elizabethtown 300 A East McKay Street Elizabethtown NC 28337 Family Practice Stedman Medical Care 114 Forte Road Stedman NC 28391 Family Practice Cape Fear Valley Neurosurgery 3308 Melrose Road Fayetteville NC 28304 Neurosurgery Outpatient Cape Fear Valley Wound Care Center 101 Robeson St Suite 210 Fayetteville NC 28301 Wound Center Cape Fear Valley Pediatric Care 1262 Oliver Street Fayetteville NC 28304 Pediatric Care Westside Medical Care 1463 Pamalee Drive Fayetteville NC 28303 Family Practice Cape Fear Valley Internal Medicine 101 Robeson Street Suite 100 Fayetteville NC 28301 Internal Medicine Women's Health Specialists 300 East McKay Street Suite F Elizabethtown NC 28337 OB/GYN Three Rivers Medical Center 580 West McLean Street St Pauls NC 28384 Family Practice Bladen Medical Assoc - Bladenboro 106 Fourth Street Bladenboro NC 28302 Family Practice Bladen Medical Associates-Dublin 16 3rd Street Dublin NC 28332 Family Practice Diabetes & Endocrine Center 101 Robeson Street Suite 405 Fayetteville NC 28301 Diabetes & Endocrinology Outpatient CFV Pediatric Endocrinology 101 Robeson Street Suite 410 Fayetteville NC 28301 Diabetes & Endocrinology Outpatient Behavioral Health Clinic 3425 Melrose Road Fayetteville NC 28304 Mental Health Outpatient Care Bladen Surgical Specialist 107 East Dunham Street Elizabethtown NC 28377 Surgical Specialist Health Pavilion North Pediatric Care 6387 Ramsey Street Suite 240 Fayetteville NC 28311 Pediatric Care Health Pavilion Hoke Primay Care 300 Medical Pavilion Drive Suite 1 Raeford NC 28376 Family Practice Hoke OBGYN 300 Medical Pavilion Drive Suite 2 Raeford NC 28376 Family Practice Hoke Express Care 300 Medical Pavilion Drive Suit 10 Raeford NC 28376 Express Care CFV Infectious Disease Care 101 Robeson Street Suite 300 Fayetteville NC 28301 Infectious Disease Cape Fear Valley Neurology 3308 Melrose Road Fayetteville NC 28304 Neurology Part I, Line 6a Cumberland County Hospital System files a community benefit report annually in the state of North Carolina to the North Carolina Hospital Association. Part I, Line 7, column (f) Exclusions from Percent of Total Expense $243,266,866 in bad debt deductions were offset from revenues in the financial statements. There is no need to adjust the total expense used to calculate the percentages in Part I, Line 7, Column (f). Part I, Line 7 Charity care costs were calculated using a Medicaid specific cost-to-charge ratio (CCR) from the Medicare cost report. A Medicaid CCR was used because the Medicaid population better represents the utilization and acuity of the Charity population than the use of an overall CCR as calculated in Worksheet 2. A CCR was used instead of a cost accounting system because charity, as well as bad debts, represent only a portion of a patient account that is being written off. Part I, Line 7b, 7c, & 7g A Medicaid CCR was used to estimate the Medicaid FFS & Medicaid Managed Care amounts reported on Ln 7b, the NC Healthchoice (NC SCHIP program) reported on Ln 7c and the Subsidized Health Services reported on Ln 7g. The cost accounting system data used did include information from all patient segments regardless of payor. Part II, Community Building Activities Cumberland County Hospital System, Inc. ("CCHS") continues to engage in coalition building and workforce development activities in the Community. Coalition building promotes the health of the communities it serves by networking with other community agencies to address the health and safety issues of the community. The employees of CCHS utilize their clinical expertise to collaborate with other community agencies and county and state health departments to provide education and other initiatives that benefit the health of people in the community. Workforce development activities include the recruitment of physicians and other health professionals to medical shortage areas. Part III, Line 2 In the current year, Bad Debts are reported at charges written off in the period plus an allowance for uncollectible accounts based on management's assessment of historical and expected net collections. See the line 4 note below for a more detailed description of the methodology used in determining the amount reported on line 2 per the financial statement footnote related to "provision for uncollectible accounts". Discounts and payments on patient accounts are reflected in the patient balance prior to accounts being written off to bad debt. Part III, Line 4 Audited Financial Statement Footnote -The Health system's patient accounts receivable is recorded net of allowances for uncollectible accounts of $179,503,000 at September 30, 2020. The Health System's net patient service revenue is presented net of provision of uncollectible accounts of $211,977,000 for the year ended September 30, 2020. Part III, Line 8 The cost reported on line 6 are per the Medicare cost report and were calculated based on cost-to-charge ratios. Since the amounts reported on lines 5 & 6 only include Medicare Part A costs and payments, the other Medicare (i.e. - Medicare Pt C, physician services, fee schedule, non-allowable) costs and payments are included in the attached Medicare Reconciliation. $8,722,345 of the Medicare shortfall reported on line 7 should be treated as community benefit since that portion of the shortfall was related to those patients that had Medicaid as a secondary payor and therefore deemed indigent for Medicare bad debt purposes. Part III, Line 9b If patients are determined to qualify for charity, then the account is treated as charity rather than bad debt. Part VI, Line 2 The mission of Cape Fear Valley Health System is to strengthen the health and well-being of the greater Cape Fear Valley region through high-quality, compassionate care provided to all who need it. As a community not-for-profit organization, we take seriously our responsibility to invest our resources and energies into understanding and meeting the diverse health care needs of all, and ensure that everyone, regardless of their ability to pay, receives the care they need. The Senior Administrative team serves in various capacities on several local community boards and groups. As members of these various groups, they are able to gain insight to needs of the community. Our community partners are critical to helping us improve the health and well-being of the Cape Fear Valley region. Together, we can combine resources and strengths, positively impacting the greatest number of people. By working closely with the community leaders, we also build a greater sense of community and a shared commitment toward our common goal of improving the community's health. The results help us to determine our short and long term priorities as well as strategies for improving community health. Those community groups and partners CCCC, SRAHEC, CCMAP, Chamber of Commerce, Fayetteville Area PR Alliance, Cumberland County Education Foundation, Communities in Schools of NC, Fort Bragg Regional Alliance, Care Clinic, and the Methodist University Physician Assistant program. Part VI, Line 3 Uninsured patients are screened at the time of registration for their ability to pay for their health care services. If the patient has no ability to pay and is deemed ineligible for government programs (Medicare, Medicaid, etc.) then they are informed of the Hospital Charity program. They are provided with an application and a listing of the appropriate documents necessary to establish eligibility for the Hospital Charity program. All patients receive a copy of our Charity Care Application accompanying the first billing statement. Part VI, Line 4 Cumberland County Hospital System, Inc. ("CCHS") doing business as Cape Fear Valley Medical Center ("CFVMC") is the flagship of Cape Fear Valley Health System ("CFVHS"). CFVHS operates a variety of the healthcare facilities from its headquarters in Fayetteville, North Carolina including a tertiary acute care hospital, a long-term acute care hospital, a critical access hospital, an inpatient rehabilitation facility, county emergency medical services, an outpatient psychiatric facility, a detoxification facility, a wellness center, 14 primary care clinics, 16 specialty care clinics, 4 walk-in clinics, and Health Pavilion North, an outpatient complex. Cape Fear Valley Health System serves a six-county service area made up of the five counties contiguous to Cumberland County, NC, which is its Primary Service Area. Per information from the 2012 Estimated Census Data, Cumberland has a population of over 326,000 residents; this was a growth of 6.9% from the 2000 Census Data. Approximately 54.2% of the 326,000 residents in our primary service area are minorities, compared to 35.6% for the state. Part VI, Line 5 Chronic diseases like diabetes and obesity are increasing within our community. Our facility has opened a diabetes and endocrine clinic to help those patients diagnosed with diabetes. Our healthplex provides both nutritional and exercise programs to help those in the community address the problem of obesity. The goal is to help all residents learn to manage their conditions and live healthier lives by addressing the challenges associated with these conditions. Example of Program at Cape Fear Valley: Cape Fear Valley Health System's "Take Charge of Your Health" Program began as an initiative to close the healthcare gap between African-Americans and non-Hispanic Whites in Cumberland County through public service announcements, health fairs, screenings and speaking engagements. It has since broadened its focus to all of Cumberland County. Darvin Jones is the Coordinator of the "Take Charge of Your Health" Program. He serves on the Board of Directors of Community Health Interventions & Sickle Cell Agency, a non-profit that works with individuals with sickle cell disease, hypertension and diabetes. Darvin is also a member of the Cumberland County Council for Healthy Living, a group assembled by the Health Department, and the Cumberland County Schools School Health Advisory Council. Take Charge of Your Health is affiliated with Eat Smart, Move More North Carolina, a statewide initiative. At Cape Fear Valley Health System, it is important to us to give back to our community. In addition to employee United Way donations and volunteer time, our employees participate in a variety of community service initiatives, to include the Habitat for Humanity and the Friends of Cancer River Walk. Last year our employees gave over $150,000 in donations to various community organizations. Part VI, Line 6 Cumberland County Hospital System is a stand-alone health care organization and is not a part of an affiliated health care system. Part VI, Line 7, List of States Receiving Community Benefit Report NC true Cape Fear Valley Health Foundation PO Box 87526 Fayetteville NC 28304 561947017 501(c)(3) 467833 GENERAL SUPPORT Cape Fear Regional Theatre 1209 Hay St Fayetteville NC 28305 560856992 501(c)(3) 48000 General Support Community Concerts of Fayetteville Incorporated PO BOX 53932 FAYETTEVILLE NC 28305 561449568 501(c)(3) 30000 GENERAL SUPPORT Cape Fear Botanical Garden 536 N Eastern Blvd Fayetteville NC 28301 561673281 501(c)(3) 20000 GENERAL SUPPORT PARTNERSHIP FOR CHILDREN OF CUMBERLAND COUNTY 351 Wagoner Drive Fayetteville NC 28303 561845926 501(c)(3) 20000 GENERAL SUPPORT FAYETTEVILLE TECHNICAL COMMUNITY COLLEGE 2201 HULL ROAD FAYETTEVILLE NC 28303 581640133 GOVT 15000 GENERAL SUPPORT FAYETTEVILLE SYMPHONY ORCHESTRA INC PO BOX 302 FAYETTEVILLE NC 28302 581393271 501(c)(3) 10000 GENERAL SUPPORT GREATER FAYETTEVILLE CHAMBER 225 RAY AVE SUITE 165 FAYETTEVILLE NC 28301 800058724 501(c)(6) 10000 GENERAL SUPPORT 7 1 Part I, Line 2 Cumberland County Hospital System awards grants to the Cape Fear Valley MedicaY Foundation for the purpose of assisting patients in paying various bills and other expenses which patients cannot pay due to their excessive medical expenses required for treating illness. Patients apply and applications are reviewed by hospital social workers. Any funds granted are paid directly to the organization for which patient owes the bill and/or expense. X X X X X false false false false false false false true false Michael Nagowski CEO 1017693 0 460020 0 4621 0 8400 0 8535 0 1499269 0 0 0 Sandra Williams CFO 557617 0 182875 0 21043 0 8400 0 477 0 770412 0 0 0 William B Pryor Former CHRO 40615 0 0 0 44364 0 1232 0 1025 0 87236 0 0 0 Charles Haworth MD Physician 946281 0 244475 0 0 0 7098 0 9458 0 1207312 0 0 0 Robert Maughan MD Medical Director 814214 0 192310 0 0 0 8400 0 3859 0 1018783 0 0 0 Michael Zappa Medical Director 639500 0 133945 0 51333 0 8750 0 2240 0 835768 0 0 0 DANIEL WEATHERLY COO 506926 0 122453 0 0 0 8400 0 8945 0 646724 0 0 0 Samuel Fleischman CMO 455000 0 201658 0 12034 0 8400 0 6960 0 684052 0 0 0 STUART SHELTON PHYSICIAN 495388 0 172616 0 26082 0 8400 0 6169 0 708655 0 0 0 MARK EATON PHYSICIAN 300000 0 372235 0 0 0 6161 0 7986 0 686382 0 0 0 Part I, Line 7 The hospital provides incentive compensation to its executives, which is based on the quantitative and qualitative performance of the hospital. The determination of incentive compensation follows the hospital's compensation procedures as outlined in Form 990, Part VI, Section B, Line 15. A North Carolina Medical Care Commission 521309402 65821DPP0 2012-12-19 124978739 SEE DETAIL false false false B PUBLIC FINANCE AUTHORITY 273866124 000000000 2017-11-29 152000000 SEE DETAIL false false false A 45870000 0 124978739 0 0 0 1630191 0 0 0 123348548 0 2012 false true true true B 0 0 152000000 0 0 0 0 0 0 0 152000000 0 2017 true false true true A false false true true false 0.00360 0.00360 false false false true B false false true true false 0.00360 0.00360 false false false true A false false false true false false 0 false 0 false true B false true false false true false 0 false 0 false true A true B true SCHEDULE K, PART I, COLUMN F - DESCRIPTION OF PURPOSE BOND A ISSUED 12/19/2012 - TO PARTIALLY REFUND BONDS ISSUED 9/23/2008 BOND B ISSUED 11/29/2017 - TO PARTIALLY REFUND BONDS ISSUED 9/23/2008 Schedule K, Part IV, Arbitrage, Line 2c: (a) Issuer Name: North Carolina Medical Care Commission Date the Rebate Computation was Performed: 02/19/2018 Schedule K, Supplemental Information: Part IV, Line 6, column A This question is being answered without regard to a yield-restricted advance refunding escrow financed with proceeds of the bonds. Schedule K, Part IV, Arbitrage, Line 7: Investment of bond proceeds are being monitored through the written procedure requirements of section 148. Cape Fear Cardiology BOARD MEMBER 243246 INDEPENDENT CONTRACTOR false FORM SCH L PART IV (A) NAME OF PERSON: CAPE FEAR CARDIOLOGY (B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: BOARD MEMBER IS PRESIDENT IN COMPANY. (C) AMOUNT OF TRANSACTION: $243,246 (D) DESCRIPTION OF TRANSACTION: ARMS' LENGTH INDEPENDENT CONTRACTOR ARRANGEMENT WITH CAPE FEAR CARDIOLOGY, BOARD MEMBER IS PRESIDENT. (E) SHARING OF ORGANIZATION REVENUES?: NO FORM 990, PART I, LINE 1, DESCRIPTION OF ORGANIZATION MISSION OF CUMBERLAND AND BLADEN COUNTIES, AND THE SURROUNDING AREA IN NORTH CAROLINA. Form 990, Part VI, Section A, line 7a The Cumberland County Board of Commissioners, which is a governmental unit, appoints the majority of the Cumberland County Hospital System. The Board of Trustees of Cumberland County Hospital System is comprised of seven trustees who are the seven members of the Board of Commissioners. The Board of Trustees will also have eight at large trustees who are appointed by the Board of Commissioners. The remaining five at large members are appointed by the Board of Trustees. Form 990, Part VI, Section B, line 11 The Organization's Form 990 is prepared by KPMG, then it is reviewed by the Finance Department of Cumberland County Hospital System, Inc. Upon completion of the Form 990, it is provided to the board of trustees prior to filing. Form 990, Part VI, Section B, Line 12c Cumberland County Hospital System, Inc. regularly and consistently monitors and enforces compliance with the conflict of interest policy in that any director, principal officer, or member of a committee with governing board delegate powers, who has a direct or indirect financial interest, must disclose the existence of the financial interest and be given the opportunity to disclose all material facts to the directors and members of the committees with governing board delegated powers considering the proposed transaction or arrangement. The remaining individuals on the governing board or committee meeting will decide if conflicts of interest exist. Each director, principal officer and member of a committee with governing board delegated powers annually signs a statement which affirms such person has received a copy of the conficts of interest policy, has read and understands the policy, has agreed to comply with the policy, and understands that the organization is charitable and in order to maintain its federal tax exemption it must engage primarily in activities which accomplish its tax-exempt purpose. Form 990, Part VI, Section B, Line 15 A human resources consulting firm is retained by Cumberland County Hospital Systems, Inc. to review the competitiveness and reasonableness of the compensation provided to the CEO and other top management personnel. FORM 990, PART VI, LINE 16b Hospital regularly evaluates the joint ventures in which it participates. Form 990, Part VI, Section C, Line 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE NOT AVAILABLE TO THE PUBLIC UPON REQUEST. ORGANIZATION'S FORM 990 IS OPEN FOR PUBLIC INSPECTION, PROVIDES FINANCIAL INFORMATION, AND ADDRESSES ISSUES OF GOVERNANCE SUCH AS THE ORGANIZATION'S CONFLICT OF INTEREST POLICY AND GOVERNANCE DOCUMENTS. Form 990, Part XI, Line 9 Eliminations from Fayetteville Ambulatory Surgery Center -393,339 Bladen County Healthcare LLC PO Box 2000 Fayetteville NC 28302 800164702 Health Srvcs NC 27557343 33451780 CCHS Cumberland Health Aff LLC (INACTIVE) PO Box 2000 Fayetteville NC 28302 562275588 Health SRVCS NC 0 0 CCHS Valley Health Facilities LLC (INACTIVE) PO Box 2000 Fayetteville NC 28302 204268819 Health SRVCS NC 0 0 CCHS Hoke Healthcare LLC PO Box 2000 Fayetteville NC 28302 272763125 Health SRVCS NC 46175037 115154112 CCHS CAPE FEAR VALLEY MEDICAL FOUNDATION PO BOX 87526 FAYETTEVILLE NC 28304 561947017 FUNDRAISING NC 501(C)(3) 7 CCHS true BLADEN COUNTY HOSPITAL FOUNDATION INC PO BOX 398 ELIZABETHTOWN NC 28337 561833893 FUNDRAISING NC 501(C)(3) 7 CCHS true Fayetteville Amb Surgery Center LP 569 Brookwood Village Ste 901 Birmingham AL 35209 561754482 healthcare NC CCHS RELATED 572346 4350072 false 0 false 0.68315 THE MED IMAGING CENTER LLC 3186 Village Drive STE 101 Fayetteville NC 28304 264473832 healthcare NC CCHS RELATED -274690 628085 false 0 false 0.68894 Highsmith-Rainey Med Arts Center Assoc PO Box 2000 Fayetteville NC 28302 561747424 Rental Assoc. NC CCHS C CORP 164536 1300663 1.00000 true Cumberland Hlth Partners Inc (inactive) PO Box 2000 Fayetteville NC 28302 562043978 Behavioral He NC CCHS C CORP 0 0 1.00000 true CAPE FEAR INSURANCE LTD PO BOX 30600 SMB WEST BAY RD GRAND CAYMAN CJ 980449284 INSURANCE CJ CCHS C CORP -2632038 55916832 1.00000 true false true true false false false false false false false false false false true true false false false false Cape Fear Valley Medical Foundation b 465230 Cash Cape Fear Valley Medical Foundation c 480389 Cash Cape Fear Valley Medical Foundation n 15231 Cash Cape Fear Valley Medical Foundation o 278239 Cash