2021-11-09T13:28:43-06:00 2020-12-31 410746749 CLIFTONLARSONALLEN LLP 227 WEST TRADE STREET SUITE 800 CHARLOTTE NC 28202 990 2020-01-01 560773039 NORTH CAROLINA HEALTHCARE FOUNDATION INC NORT 9196772400 PO BOX 4449 CARY NC 27519 STEPHEN J LAWLER PRESIDENT 9196772400 2021-11-05 1 STEPHEN LAWLER 999009999 JOHN NORMAN P01506766 7049985200 2021-11-05 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z STEPHEN J LAWLER PO BOX 4449 CARY NC 27519 37557291 0 X NCHA.ORG X 1961 NC SEE SCHEDULE OTO FOSTER AND ACCELERATE THE COLLECTIVE IMPACT OF HOSPITALS, HEALTH SYSTEMS AND COMMUNITY PARTNERS TO IMPROVE THE HEALTH OF NORTH CAROLINIANS. 10 10 55 0 0 0 5008294 37148805 721413 401430 143416 -103343 0 0 5873123 37446892 1817387 8726370 0 0 1782823 1984281 0 0 0 1903075 25118059 5503285 35828710 369838 1618182 6804352 11910378 1577357 4608124 5226995 7302254 X TO FOSTER AND ACCELERATE THE COLLECTIVE IMPACT OF HOSPITALS, HEALTH SYSTEMS AND COMMUNITY PARTNERS TO IMPROVE THE HEALTH OF NORTH CAROLINIANS. 1 0 12494593 8726370 401430 THE NORTH CAROLINA HOSPITAL FOUNDATION CARRIES OUT ACTIVITIES THAT FOSTER AND ACCELERATE THE COLLECTIVE IMPACT OF HOSPITALS, HEALTH SYSTEMS AND COMMUNITY PARTNERS TO IMPROVE THE HEALTH OF NORTH CAROLINIANS.IN 2020 NCHF PARTNERED WITH PRIVATE PHILANTHROPY, CORPORATE PARTNERS, AND MAJOR GIFT DONORS TO DEPLOY RESOURCES TO ORGANIZATIONS RESPONDING TO THE COVID-19 CRISIS TO ADDRESS EMERGING, ACUTE, AND LONG-TERM NEEDS. NCHF DISTRIBUTED FUNDS TO 39 ORGANIZATIONS 23224851 THE STATE OF NORTH CAROLINA ALLOCATED FUNDS TO NCHF USED TO PURCHASE SUPPLIES AND EQUIPMENT NECESSARY FOR LIFE SAFETY, HEALTH, AND SANITATION, INCLUDING PERSONAL PROTECTIVE EQUIPMENT TO SUPPORT NORTH CAROLINA'S RESPONSE TO THE COVID-19 CRISIS. THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES AWARDED FUNDS TO SUPPORT THE URGENT PREPAREDNESS AND RESPONSE NEEDS OF HOSPITALS, HEALTH SYSTEMS, AND HEALTH CARE WORKERS ON THE FRONT LINES OF THE COVID-19 OUTBREAK. FUNDS SUPPORTED ACTIVITIES TO PREPARE HEALTH CARE SYSTEMS AND PROVIDERS TO IDENTIFY, ISOLATE, ASSESS, TRANSPORT AND TREAT PATIENTS WITH COVID-19 OR OTHER ILLNESSES 35719444 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 34 0 55 1 0 0 0 0 0 0 0 0 0 0 0 0 X 10 10 0 0 0 0 0 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 NC X JEFFREY WEEGAR 9196774231 2400 WESTON PARKWAY CARY NC 27513 STEPHEN J LAWLER PRESIDENT 7.50 30.00 X X 0 822662 50008 JULIA WACKER EXECUTIVE DIRECTOR 37.50 X 0 182814 15125 JEFFREY WEEGAR CFO 6.00 31.50 X 0 184868 21179 PAUL CUNNINGHAM MD BOARD MEMBER 1.00 X 0 0 0 VANESSA ERVIN BOARD MEMBER 1.00 X 0 0 0 GREG GOMBAR BOARD MEMBER 1.00 X 0 0 0 LIN HOLLOWELL BOARD MEMBER 1.00 X 0 0 0 CHUCK MANTOOTH BOARD MEMBER 1.00 X 0 0 0 LEAH MCCALL DEVLIN DDS BOARD MEMBER 1.00 X 0 0 0 ALLEN SMART BOARD MEMBER 1.00 X 0 0 0 CASSIUS WILLIAMS BOARD MEMBER 1.00 X 0 0 0 PHYLLIS WINGATE BOARD MEMBER 2.00 X 0 0 0 0 1190344 86312 0 0 1 0 IBM CORPORATION 3039 CORNWALLIS ROAD RESEARCH TRIANGLE PARK NC 27709 INFORMATION TECHNOLOGY SERVICES 277500 TSNE MISSIONWORKS 88 SOUTH STREET STUIE 700 BOSTON MA 02111 CONSULTING SERVICES 241943 2 27311389 9837416 37148805 MEETING REGISTRATION 621300 401430 401430 401430 7056 7056 110399 -110399 -110399 -110399 37446892 401430 0 -103343 8726370 8726370 1585261 1511899 73362 53692 51207 2485 226286 215814 10472 119042 113533 5509 607526 607526 534415 534415 2275 2275 13874 13668 206 158750 154526 4224 58734 56943 1791 16793 16622 171 359070 351587 7483 88 88 COVID-19 RELATED EXPENS 23224851 23224851 DUES, SUBSCRIPTIONS, ET 138208 138208 GENERAL & ADMIN 3475 3475 35828710 35719444 109266 0 2512953 6700792 434383 990761 8500 49557 49557 0 0 3857016 4210325 6804352 11910378 379568 3201177 165984 32400 1031805 1374547 1577357 4608124 X 1047409 2874279 4179586 4427975 5226995 7302254 6804352 11910378 1618182 457077 0 X 0 1 X 1 1 1 X 4834711 3595190 4299952 5008294 37148805 54886952 721413 401430 1122843 4834711 3595190 4299952 5729707 37550235 56009795 0 0 0 56009795 131529 133417 137147 141742 7056 550891 131529 133417 137147 141742 7056 550891 4966240 3728607 4437099 5871449 37557291 56560686 0.99030 0.97490 0.00970 0.02510 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 49557 49557 0 0 DUE TO AFFILIATE 1309341 ACCRUED COMPENSATION 65206 1374547 X 10592580 457077 457077 10135503 27311389 27311389 37446892 8517321 0 8517321 27311389 27311389 35828710 PART X, LINE 2: THE FOUNDATION IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. ACCORDINGLY, THE ACCOMPANYING FINANCIAL STATEMENTS DO NOT REFLECT A LIABILITY FOR FEDERAL AND STATE INCOME TAXES. THE FOUNDATION FOLLOWS THE INCOME TAX STANDARD REGARDING THE RECOGNITION AND MEASUREMENT OF UNCERTAIN TAX POSITIONS, WHICH CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN AN ENTITY'S FINANCIAL STATEMENTS AND PRESCRIBES A RECOGNITION THRESHOLD AND MEASUREMENT PRINCIPLES FOR THE FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN ON A TAX RETURN THAT ARE NOT CERTAIN TO BE REALIZED. MANAGEMENT HAS DETERMINED THAT IT DOES NOT HAVE ANY MATERIAL UNCERTAIN TAX POSITIONS AS OF DECEMBER 31, 2020. PART XI, LINE 4B - OTHER ADJUSTMENTS: GOVERNMENT GRANT REVENUE 27,311,389. PART XII, LINE 4B - OTHER ADJUSTMENTS: GOVERNMENT GRANT EXPENSES 27,311,389. 1 ALCOHOL DRUG COUNCIL OF NC 1121 SITUS CT SUITE 360 RALEIGH NC 27606 560771084 501(C)(3) 149897 SUPPORTING UNDERSERVED POPULATIONS DISPROPORTIONATELY AFFECTED BY COVID-19. ALLEGHANY COUNTY MEMORIAL HOSPITAL INC PO BOX 947 SPARTA NC 28675 560525657 501(C)(3) 10400 SMALL RURAL HEALTH IMPROVEMENT GRANT PROGRAM. ASPR - NORTH CAROLINA COVID-19 HOSPITAL PREPAREDNESS PROGRAM APPALACHIAN REGIONAL HEALTHCARE SYSTEM PO BOX 2600 BOONE NC 28607 201067022 501(C)(3) 150000 ASPR - NORTH CAROLINA COVID-19 HOSPITAL PREPAREDNESS PROGRAM ASHE MEMORIAL HOSPITAL (F) 200 HOSPITAL AVENUE JEFFERSON NC 28640 560603900 501(C)(3) 264825 SMALL RURAL HEALTH IMPROVEMENT GRANT PROGRAM. ASPR - NORTH CAROLINA COVID-19 HOSPITAL PREPAREDNESS PROGRAM BENSON AREA MEDICAL CENTER INC 3333 NC HWY 242 N BENSON NC 275047844 561181412 501(C)(3) 35455 SUPPORTING UNDERSERVED POPULATIONS DISPROPORTIONATELY AFFECTED BY COVID-19. BLACK RIVER HEALTH SERVICES INC 301 S CAMPBELL ST BURGAW NC 28425 237356223 501(C)(3) 25383 SUPPORTING UNDERSERVED POPULATIONS DISPROPORTIONATELY AFFECTED BY COVID-19. BOYS & GIRLS CLUB OF HENDERSON COUNTY PO BOX 1460 HENDERSONVILLE NC 28793 561803125 501(C)(3) 50000 SUPPORTING UNDERSERVED POPULATIONS DISPROPORTIONATELY AFFECTED BY COVID-19. BOYS & GIRLS CLUB OF NORTH CENTRAL NC 105 WEST ST OXFORD NC 27565 562525793 501(C)(3) 25300 SUPPORTING UNDERSERVED POPULATIONS DISPROPORTIONATELY AFFECTED BY COVID-19. BOYS & GIRLS CLUBS OF THE ALBEMARLE INC 131 MORRISTOWN RD EDENTON NC 27932 611546080 501(C)(3) 25003 SUPPORTING UNDERSERVED POPULATIONS DISPROPORTIONATELY AFFECTED BY COVID-19. BRYNN MARR HOSPITAL 192 VILLAGE DRIVE JACKSONVILLE NC 28548 561317433 C-CORP 143000 ASPR - NORTH CAROLINA COVID-19 HOSPITAL PREPAREDNESS PROGRAM CALDWELL MEMORIAL HOSPITAL INCORPORATED 321 MULBERRY STREET LENOIR NC 28645 560554202 501(C)(3) 149318 ASPR - NORTH CAROLINA COVID-19 HOSPITAL PREPAREDNESS PROGRAM CAMINO COMMUNITY DEVELOPMENT CORP 133 STETSON DR CHARLOTTE NC 28262 562015959 501(C)(3) 93500 SUPPORTING UNDERSERVED POPULATIONS DISPROPORTIONATELY AFFECTED BY COVID-19. CAPE FEAR VALLEY - BLADEN HEALTHCARE 501 S POPLAR ST ELIZABETHTOWN NC 28337 800164702 501(C)(3) 72193 ASPR - NORTH CAROLINA COVID-19 HOSPITAL PREPAREDNESS PROGRAM CATAWBA VALLEY MEDICAL CENTER 810 FAIRGROVE CHURCH RD SE HICKORY NC 28602 560789196 509(A)(1) 75717 ASPR - NORTH CAROLINA COVID-19 HOSPITAL PREPAREDNESS PROGRAM CHARLES A CANNON JR MEMORIAL HOSPITAL (F) PO BOX 767 LINVILLE NC 28646 560529974 501(C)(3) 67893 SMALL RURAL HEALTH IMPROVEMENT GRANT PROGRAM. ASPR - NORTH CAROLINA COVID-19 HOSPITAL PREPAREDNESS PROGRAM CHATHAM HOSPITAL (F) PO BOX 649 SILER CITY NC 27344 560611546 501(C)(3) 67893 ASPR - NORTH CAROLINA COVID-19 HOSPITAL PREPAREDNESS PROGRAM CHEROKEE INDIAN HOSPITAL AUTHORITY (F) 1 HOSPITAL RDNCALLER BOX C-268 CHEROKEE NC 28719 050524222 7871 25556 ASPR - NORTH CAROLINA COVID-19 HOSPITAL PREPAREDNESS PROGRAM CHOWAN INC (VIDANT CHOWAN HOSPITAL) 211 VIRGINIA ROAD EDENTON NC 27932 562101090 501(C)(3) 73643 SMALL RURAL HEALTH IMPROVEMENT GRANT PROGRAM. ASPR - NORTH CAROLINA COVID-19 HOSPITAL PREPAREDNESS PROGRAM CLAY COUNTY NC EMERGENCY MEDICAL SERVICES PO BOX 118 HAYESVILLE NC 28904 566000287 509(A)(1) 147093 SUPPORTING UNDERSERVED POPULATIONS DISPROPORTIONATELY AFFECTED BY COVID-19. COLUMBUS REGIONAL HEALTHCARE SYSTEM 500 JEFFERSON ST WHITEVILLE NC 28472 560538020 501(C)(3) 149900 ASPR - NORTH CAROLINA COVID-19 HOSPITAL PREPAREDNESS PROGRAM CONE HEALTH 1200 NORTH ELM STREET GREENSBORO NC 27401 581588823 501(C)(3) 148198 NC EMERGENCY DEPARTMENT PEER SUPPORT PILOT PROGRAM. ASPR - NORTH CAROLINA COVID-19 HOSPITAL PREPAREDNESS PROGRAM CONE HEALTH BEHAVIORAL HEALTH HOSPITAL 1200 N ELM STREET GREENSBORO NC 27401 530532302 501(C)(3) 78739 ASPR - NORTH CAROLINA COVID-19 HOSPITAL PREPAREDNESS PROGRAM CROSSNORE SCHOOL & CHILDREN'S HOME PO BOX 249 CROSSNORE NC 28616 560567980 501(C)(3) 25000 SUPPORTING UNDERSERVED POPULATIONS DISPROPORTIONATELY AFFECTED BY COVID-19. CUMBERLAND COUNTY HOSPITAL SYSTEM INC 1638 OWEN DR FAYETTEVILLE NC 28304 560845796 501(C)(3) 200859 ASPR - NORTH CAROLINA COVID-19 HOSPITAL PREPAREDNESS PROGRAM CURAMERICAS GLOBAL INC 318 W MILLBROOK RD 105 RALEIGH NC 27609 561400098 501(C)(3) 249996 SUPPORTING UNDERSERVED POPULATIONS DISPROPORTIONATELY AFFECTED BY COVID-19. DAVIE MEDICAL CENTER 329 NC HWY 801N BERMUDA RUN NC 27006 562276994 501(C)(3) 25556 ASPR - NORTH CAROLINA COVID-19 HOSPITAL PREPAREDNESS PROGRAM DLP PERSON MEMORIAL HOSPITAL 615 RIDGE ROAD ROXBORO NC 27573 560543247 C-CORP 33556 SMALL RURAL HEALTH IMPROVEMENT GRANT PROGRAM. ASPR - NORTH CAROLINA COVID-19 HOSPITAL PREPAREDNESS PROGRAM EAGLE MARKET STREETS DEVELOPMENT CORPORATION CDC 70 SOUTH MARKET ST ASHEVILLE NC 28801 582140995 501(C)(3) 50022 SUPPORTING UNDERSERVED POPULATIONS DISPROPORTIONATELY AFFECTED BY COVID-19. ELIZABETH CITY STATE UNIVERSITY 1704 WEEKSVILLE RD ELIZABETH CITY NC 27909 561047680 501(C)(3) 131841 SUPPORTING UNDERSERVED POPULATIONS DISPROPORTIONATELY AFFECTED BY COVID-19. EPISCOPAL FARMWORKER MINISTRY 2989 EASY STREET DUNN NC 28334 204942554 N/A - RELIGIOUS ORGA 56225 SUPPORTING UNDERSERVED POPULATIONS DISPROPORTIONATELY AFFECTED BY COVID-19. ERLANGER WESTERN CAROLINA HOSPITAL (F) 3990 E HWY 64 ALT MURPHY NC 28906 561844262 509(A)(1) 189412 SMALL RURAL HEALTH IMPROVEMENT GRANT PROGRAM. ASPR - NORTH CAROLINA COVID-19 HOSPITAL PREPAREDNESS PROGRAM FIRSTHEALTH MONTGOMERY MEMORIAL HOSPITAL (F) 520 ALLEN STREET TROY NC 27932 561936354 501(C)(3) 57493 SMALL RURAL HEALTH IMPROVEMENT GRANT PROGRAM. ASPR - NORTH CAROLINA COVID-19 HOSPITAL PREPAREDNESS PROGRAM FIRSTHEALTH MOORE REGIONAL HOSPITAL - HOKE CAMPUS 6408 FAYETTEVILLE RD RAEFORD RAEFORD NC 28376 561936354 501(C)(3) 25556 ASPR - NORTH CAROLINA COVID-19 HOSPITAL PREPAREDNESS PROGRAM FIRSTHEALTH OF THE CAROLINAS INC PO BOX 3000 155 MEMORIAL DR PINEHURST NC 28374 561936354 501(C)(3) 150000 ASPR - NORTH CAROLINA COVID-19 HOSPITAL PREPAREDNESS PROGRAM FORSYTH MEDICAL CENTER FOUNDATION DBA NOVANT HEALTH FORSYTH MEDICAL CENTE 220 HAWTHORNE LANE CHARLOTTE NC 28204 581413074 501(C)(3) 149975 ASPR - NORTH CAROLINA COVID-19 HOSPITAL PREPAREDNESS PROGRAM GRANVILLE HEALTH SYSTEM (F) PO BOX 947 OXFORD NC 27565 264073395 509(A)(1) 167956 SMALL RURAL HEALTH IMPROVEMENT GRANT PROGRAM. ASPR - NORTH CAROLINA COVID-19 HOSPITAL PREPAREDNESS PROGRAM HARNETT HEALTH SYSTEM 1638 OWEN DR FAYETTEVILLE NC 28304 560603898 501(C)(3) 10400 ASPR - NORTH CAROLINA COVID-19 HOSPITAL PREPAREDNESS PROGRAM HEALTH EDUCATION FOUNDATION OF EASTERN NC INC 1631 SOUTH WESLEYAN BOULEVARD ROCKY MOUNT NC 278040368 237338802 501(C)(3) 500000 SUPPORTING UNDERSERVED POPULATIONS DISPROPORTIONATELY AFFECTED BY COVID-19. HEARTWOOD REFUGE & RETREAT CENTER 1020 STATE STREET HENDERSONVILLE NC 28739 820983637 501(C)(3) 27790 SUPPORTING UNDERSERVED POPULATIONS DISPROPORTIONATELY AFFECTED BY COVID-19. HINTON RURAL LIFE CENTER INC 2330 HINTON CENTER ROAD HAYESVILLE NC 289044862 560842073 501(C)(3) 142385 SUPPORTING UNDERSERVED POPULATIONS DISPROPORTIONATELY AFFECTED BY COVID-19. HISPANIC LIAISON OF CHATHAM COUNTY 200 N CHATHAM AVENUE SILER CITY NC 27344 561974043 501(C)(3) 98480 SUPPORTING UNDERSERVED POPULATIONS DISPROPORTIONATELY AFFECTED BY COVID-19. HOUSE OF MERCY INC PO BOX 808 BELMONT NC 28012 561733055 501(C)(3) 55000 SUPPORTING UNDERSERVED POPULATIONS DISPROPORTIONATELY AFFECTED BY COVID-19. IREDELL MEMORIAL HOSPITAL INC 557 BROOKDALE DR STATESVILLE NC 28677 560591303 509(A)(1) 149563 ASPR - NORTH CAROLINA COVID-19 HOSPITAL PREPAREDNESS PROGRAM J ARTHUR DOSHER MEMORIAL HOSPITAL FOUNDATION INC 924 N HOWE ST SOUTHPORT NC 28461 560845824 501(C)(3) 107893 SMALL RURAL HEALTH IMPROVEMENT GRANT PROGRAM. ASPR - NORTH CAROLINA COVID-19 HOSPITAL PREPAREDNESS PROGRAM JORDAN PEER RECOVERY INC 14623 ARGOS PL UPPER MARLBORO MD 20774 842396823 501(C)(3) 148418 SUPPORTING UNDERSERVED POPULATIONS DISPROPORTIONATELY AFFECTED BY COVID-19. LIFEBRITE COMMUNITY HOSPITAL OF STOKES (F) 1570 NC 8 89 HWY NORTH DANBURY NC 27016 561793620 501(C)(3) 57493 SMALL RURAL HEALTH IMPROVEMENT GRANT PROGRAM. ASPR - NORTH CAROLINA COVID-19 HOSPITAL PREPAREDNESS PROGRAM LINCOLN COMMUNITY HEALTH CENTER INCORPORATED 1301 FAYETTEVILLE STREET DURHAM NC 27707 561031244 501(C)(3) 90530 SUPPORTING UNDERSERVED POPULATIONS DISPROPORTIONATELY AFFECTED BY COVID-19. LUTHERAN SERVICES CAROLINAS 1416 S MARTIN LUTHER KING JR AVE SALISBURY NC 28145 201457236 501(C)(3) 148500 SUPPORTING UNDERSERVED POPULATIONS DISPROPORTIONATELY AFFECTED BY COVID-19. MH MISSION HOSPITAL LLLP 509 BILTMORE AVE ASHEVILLE NC 28801 832048706 C-CORP 39005 ASPR - NORTH CAROLINA COVID-19 HOSPITAL PREPAREDNESS PROGRAM NC ASSOCIATION OF FREE AND CHARITABLE CLINICS 1399 ASHLEYBROOK LN SUITE 110 WINSTONSALEM NC 27103 562062170 501(C)(3) 262500 SUPPORTING UNDERSERVED POPULATIONS DISPROPORTIONATELY AFFECTED BY COVID-19. NC COMMUNITY HEALTH CENTER ASSOCIATION 4917 WATERS EDGE DR 165 RALEIGH NC 27606 561240332 501(C)(3) 262500 SUPPORTING UNDERSERVED POPULATIONS DISPROPORTIONATELY AFFECTED BY COVID-19. NEIGHBORS IN MINISTRY INC PO BOX 1036 BREVARD NC 28712 562032133 501(C)(3) 28600 SUPPORTING UNDERSERVED POPULATIONS DISPROPORTIONATELY AFFECTED BY COVID-19. NORTH CAROLINA COALITION AGAINST DOMESTIC VIOLENCE INC 3710 UNIVERSITY DRIVE STE 140 DURHAM NC 27707 611077481 501(C)(3) 149881 SUPPORTING UNDERSERVED POPULATIONS DISPROPORTIONATELY AFFECTED BY COVID-19. NORTH CAROLINA FARMWORKERS PROJECT INC PO BOX 352 BENSON NC 27504 561870955 501(C)(3) 37840 SUPPORTING UNDERSERVED POPULATIONS DISPROPORTIONATELY AFFECTED BY COVID-19. NOVANT HEALTH PRESBYTERIAN MEDICAL CENTER FOUNDATION 200 HAWTHORNE LANE BELK HOUSE CHARLOTTE NC 27401 581413074 501(C)(3) 63158 NC EMERGENCY DEPARTMENT PEER SUPPORT PILOT PROGRAM. ASPR - NORTH CAROLINA COVID-19 HOSPITAL PREPAREDNESS PROGRAM ONSLOW MEMORIAL HOSPITAL 317 WESTERN BLVD JACKSONVILLE NC 28546 562014989 509(A)(1) 162157 ASPR - NORTH CAROLINA COVID-19 HOSPITAL PREPAREDNESS PROGRAM PARDEE HOSPITAL FOUNDATION 561 FLEMING STREET HENDERSONVILLE NC 28739 561930028 509(A)(1) 145618 ASPR - NORTH CAROLINA COVID-19 HOSPITAL PREPAREDNESS PROGRAM PELETAH MINISTRIES PO BOX 14253 NEW BERN NC 28561 611662965 501(C)(3) 91960 SUPPORTING UNDERSERVED POPULATIONS DISPROPORTIONATELY AFFECTED BY COVID-19. PENDER MEMORIAL HOSPITAL 507 E FREMONT ST BURGAW BURGAW NC 28425 560653348 509(A)(1) 77325 ASPR - NORTH CAROLINA COVID-19 HOSPITAL PREPAREDNESS PROGRAM PISGAH LEGAL SERVICES 62A CHARLOTTE STREET ASHEVILLE NC 28801 561191115 501(C)(3) 85800 SUPPORTING UNDERSERVED POPULATIONS DISPROPORTIONATELY AFFECTED BY COVID-19. REFUGEE COMMUNITY PARTNERSHIP PO BOX 461 CARRBORO NC 27510 263608741 501(C)(3) 116050 SUPPORTING UNDERSERVED POPULATIONS DISPROPORTIONATELY AFFECTED BY COVID-19. SAMPSON REGIONAL MEDICAL CENTER INC PO BOX 260 CLINTON NC 28328 560562304 509(A)(1) 132927 ASPR - NORTH CAROLINA COVID-19 HOSPITAL PREPAREDNESS PROGRAM SOUTHEASTERN HEALTH PO BOX 1408 LUMBERTON NC 28359 560530233 501(C)(3) 382839 SUPPORTING UNDERSERVED POPULATIONS DISPROPORTIONATELY AFFECTED BY COVID-19. ST LUKE'S HOSPITAL 101 HOSPITAL DR COLUMBUS NC 28722 560554222 501(C)(3) 209818 ASPR - NORTH CAROLINA COVID-19 HOSPITAL PREPAREDNESS PROGRAM SURRY MEDICAL MINISTRIES FOUNDATION PO BOX 349 MOUNT AIRY NC 27030 561829347 501(C)(3) 60000 SUPPORTING UNDERSERVED POPULATIONS DISPROPORTIONATELY AFFECTED BY COVID-19. SWAIN COMMUNITY HOSPITAL 45 PLATEAU ST BRYSON NC 28713 320441929 C-CORP 57493 ASPR - NORTH CAROLINA COVID-19 HOSPITAL PREPAREDNESS PROGRAM THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY DBA ATRIUM HEALTH DIVISION 1000 BLYTHE BLVD CHARLOTTE NC 28203 560529945 509(A)(1) 39189 ASPR - NORTH CAROLINA COVID-19 HOSPITAL PREPAREDNESS PROGRAM THE OUTER BANKS HOSPITAL (F) 4800 S CROATAN HWY NAGS HEAD NC 279599704 562112733 501(C)(3) 57493 ASPR - NORTH CAROLINA COVID-19 HOSPITAL PREPAREDNESS PROGRAM THE UNIVERSITY OF NORTH CAROLINA AT GREENSBORO 1111 SPRING GARDEN ST ROOM 2511 GREENSBORO NC 274125013 566001468 501(C)(3) 60483 SUPPORTING UNDERSERVED POPULATIONS DISPROPORTIONATELY AFFECTED BY COVID-19. THE YOUNG MEN'S CHRISTIAN ASSOCIATION OF THE TRIANGLE AREA INC 801 CORPORATE CENTER DRIVE SUITE 200 RALEIGH NC 27607 560591307 501(C)(3) 169050 SUPPORTING UNDERSERVED POPULATIONS DISPROPORTIONATELY AFFECTED BY COVID-19. UNC HEALTH CARE SYSTEM 211 FRIDAY CENTER DRIVE SUITE 2108 CHAPEL HILL NC 27517 562206970 501(C)(3) 67119 NC EMERGENCY DEPARTMENT PEER SUPPORT PILOT PROGRAM. ASPR - NORTH CAROLINA COVID-19 HOSPITAL PREPAREDNESS PROGRAM UNIVERSITY HEALTH SYSTEMS OF EASTERN CAROLINA FOUNDATION INC DBA VIDANT H PO BOX 8489 GREENVILLE NC 278358489 200777374 501(C)(3) 55391 ASPR - NORTH CAROLINA COVID-19 HOSPITAL PREPAREDNESS PROGRAM VIDANT BERTIE HOSPITAL 1403 S KING STREET WINDSOR NC 27983 562003393 501(C)(3) 58326 SMALL RURAL HEALTH IMPROVEMENT GRANT PROGRAM. ASPR - NORTH CAROLINA COVID-19 HOSPITAL PREPAREDNESS PROGRAM VIDANT DUPLIN HOSPITAL PO BOX 278 KENANSVILLE NC 28349 566011594 501(C)(3) 25556 ASPR - NORTH CAROLINA COVID-19 HOSPITAL PREPAREDNESS PROGRAM WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER MEDICAL CENTER BLVD WINSTONSALEM NC 27157 510190238 501(C)(3) 220188 NC EMERGENCY DEPARTMENT PEER SUPPORT PILOT PROGRAM. ASPR - NORTH CAROLINA COVID-19 HOSPITAL PREPAREDNESS PROGRAM WAKEMED 3000 NEW BERN AVENUE RALEIGH NC 27610 566017737 501(C)(3) 150000 ASPR - NORTH CAROLINA COVID-19 HOSPITAL PREPAREDNESS PROGRAM WASHINGTON COUNTY HOSPITAL 958 US-64 PLYMOUTH NC 27962 426037892 501(C)(3) 203743 ASPR - NORTH CAROLINA COVID-19 HOSPITAL PREPAREDNESS PROGRAM WESTERN CAROLINA MEDICAL SOCIETY FOUNDATION INC 304 SUMMIT ST ASHEVILLE NC 28803 455586998 501(C)(3) 150000 SUPPORTING UNDERSERVED POPULATIONS DISPROPORTIONATELY AFFECTED BY COVID-19. WILLIAMSTON HOSPITAL CORPORATION 310 S MCCASKEY RD WILLIAMSTON NC 27892 621749107 501(C)(3) 25556 ASPR - NORTH CAROLINA COVID-19 HOSPITAL PREPAREDNESS PROGRAM 63 16 PART I, LINE 2: ALL GRANTS RECEIVED BY NCHF ARE GOVERNED BY CONTRACTS WITH THE GRANTOR WHICH OUTLINE GRANT TERMS AND CONDITIONS INCLUDING DETAILED MONITORING, REPORTING, PERFORMANCE AND PAYMENT REQUIREMENTS. FOR ANY GRANT THAT INVOLVES A SUB-AWARD, OR RE-GRANTING OF FUNDS TO ANOTHER ORGANIZATION TO PERFORM A BODY OF WORK UNDER THE PRIMARY GRANT, NCHF COLLECTS APPLICATIONS AND EXECUTES DETAILED CONTRACTS WITH SUB-AWARD RECIPIENTS. EACH NCHF GRANT HAS AN ASSIGNED PROGRAM LEAD WHO IS RESPONSIBLE FOR PROVIDING PROGRAM OVERSIGHT TO ENSURE THAT ALL CONTRACT EXPECTATIONS ARE MET AND THAT ALL SUB-AWARD RECIPIENTS ARE ALSO MEETING THEIR CONTRACT OBLIGATIONS. NCHF DIRECTOR OF OPERATIONS ALSO HAS BUDGET OVERSIGHT OF ALL GRANT CONTRACTS AND ENSURES COMPLIANCE WITH CONTRACT TERMS AND CONDITIONS. GRANT SUB-AWARD RECIPIENTS MUST PRODUCE PERFORMANCE REPORTS AND DETAILED INVOICES, WITH SUPPORTING DOCUMENTATION, IN ORDER TO RECEIVE GRANT FUNDS. 0 1 0 0 0 0 0 0 0 STEPHEN J LAWLER PRESIDENT 0 635250 0 187412 0 0 0 38000 0 12008 0 872670 0 0 JULIA WACKER EXECUTIVE DIRECTOR 0 162225 0 20589 0 0 0 3774 0 11351 0 197939 0 0 JEFFREY WEEGAR CFO 0 184868 0 0 0 0 0 9750 0 11429 0 206047 0 0 PART I, LINE 3 THE EXECUTIVE COMPENSATION COMMITTEE OF THE NCHA, INC., A RELATED ORGANIZATION, REVIEWS THE COMPENSATION OF THE PRESIDENT AND OTHER KEY EXECUTIVES. IN ESTABLISHING THE REBUTTABLE PRESUMPTION OF REASONABLENESS, THE EXECUTIVE COMPENSATION COMMITTEE MAY ENGAGE THE PROFESSIONAL SERVICES OF INDEPENDENT LEGAL COUNSEL, COMPENSATION EXPERTS, ACCOUNTANTS, AND OTHER EXPERTS AND ADVISORS. PART I, LINE 4B A RELATED ORGANIZATION MAINTAINS A NON-QUALIFIED RETENTION BENEFIT PLAN UNDER SECTION 457(F) COVERING FIVE KEY EMPLOYEES. THE COVERED EMPLOYEES RECEIVE AN ANNUAL BENEFIT EQUAL TO A CERTAIN PERCENTAGE OF THEIR ORDINARY SALARY. THE PARTICIPANTS CAN ELECT TO INVEST THEIR ANNUAL BENEFIT IN A CAPITAL ACCUMULATION ACCOUNT OR CHOOSE OTHER FRINGE BENEFITS. FOR THE CURRENT YEAR, THE ORGANIZATION ACCRUED $25,000 TO THE PLAN FOR STEPHEN J. LAWLER. THIS AMOUNT IS INCLUDED IN SCHEDULE J, PART II. FORM 990, PART III, LINE 2 NCHF PARTNERED WITH PRIVATE PHILANTHROPY, CORPORATE PARTNERS, AND MAJOR GIFT DONORS TO DEPLOY RESOURCES TO ORGANIZATIONS RESPONDING TO THE COVID-19 CRISIS TO ADDRESS EMERGING, ACUTE, AND LONG-TERM NEEDS. THE STATE OF NORTH CAROLINA ALLOCATED FUNDS TO NCHF USED TO PURCHASE SUPPLIES AND EQUIPMENT NECESSARY FOR LIFE SAFETY, HEALTH, AND SANITATION, INCLUDING PERSONAL PROTECTIVE EQUIPMENT TO SUPPORT NORTH CAROLINA'S RESPONSE TO THE COVID-19 CRISIS. THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES AWARDED FUNDS TO SUPPORT THE URGENT PREPAREDNESS AND RESPONSE NEEDS OF HOSPITALS, HEALTH SYSTEMS, AND HEALTH CARE WORKERS ON THE FRONT LINES OF THE COVID-19 OUTBREAK. FUNDS SUPPORTED ACTIVITIES TO PREPARE HEALTH CARE SYSTEMS AND PROVIDERS TO IDENTIFY, ISOLATE, ASSESS, TRANSPORT AND TREAT PATIENTS WITH COVID-19 OR OTHER ILLNESSES FORM 990, PART VI, SECTION A, LINE 7A THE POWER AND AUTHORITY OF THE CORPORATION SHALL BE VESTED IN ITS BOARD OF TRUSTEES WHICH SHALL HAVE NOT LESS THAN TEN MEMBERS, CONSISTING OF HEALTHCARE, COMMUNITY, PHILANTHROPIC, FINANCIAL, AND CORPORATE LEADERS. ALL MEMBERS SHALL BE APPOINTED BY THE BOARD OF TRUSTEES OF NCHA, INC. AT LEAST TWO MEMBERS WILL ALSO SERVE ON THE BOARD OF TRUSTEES OF NCHA, INC. EACH MEMBER SHALL SERVE A THREE-YEAR TERM. A MEMBER MAY SERVE NO MORE THAN TWO FULL CONSECUTIVE TERMS. THE INITIAL TERMS BEGINNING IN 2019 SHALL BE STAGGERED SO THAT APPROXIMATELY ONE-THIRD OF THE TERMS EXPIRE IN 2020, ONE THIRD IN 2021, AND ONE-THIRD IN 2022. THE BOARD OF TRUSTEES OF NCHA, INC. SHALL ALSO FILL ANY VACANCY FOR THE UNEXPIRED TERM. FORM 990, PART VI, SECTION B, LINE 11B A DRAFT COPY OF THE 990 WAS SUBMITTED TO THE FOUNDATION BOARD FOR REVIEW PRIOR TO THE FORM 990 BEING FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS AND KEY EMPLOYEES SIGN A CONFLICT OF INTEREST POLICY ANNUALLY DISCLOSING ANY POSSIBLE CONFLICTS. FORM 990, PART VI, SECTION B, LINE 15 THE EXECUTIVE COMPENSATION COMMITTEE OF NCHA, INC., A RELATED ORGANIZATION, WILL ANNUALLY MONITOR AND REVIEW EXECUTIVE COMPENSATION AND BENEFIT PROGRAMS, IN AGGREGATE, TO ENSURE CONSISTENCY WITH THE OVERALL COMPENSATION PHILOSOPHY AND GUIDING PRINCIPLES AND OBJECTIVES. AT ITS DISCRETION, THE EXECUTIVE COMPENSATION COMMITTEE MAY DELEGATE "DAY TO DAY" RESPONSIBILITY TO ADMINISTER COMPENSATION AND BENEFIT PROGRAMS TO NCHA'S PRESIDENT FOR ALL OTHER EXECUTIVE OR ADMINISTRATIVE POSITIONS NOT COVERED UNDER THIS POLICY, I.E., ALL POSITIONS BELOW VICE PRESIDENT. THE EXECUTIVE COMPENSATION POLICY WILL BE ANNUALLY REVIEWED AND ANY PROPOSED MODIFICATIONS, PRESENTED FOR APPROVAL TO THE FULL BOARD. IN SETTING AN EXAMPLE FOR ITS MEMBER ORGANIZATIONS, THE EXECUTIVE COMPENSATION COMMITTEE WILL ALSO UNDERTAKE THE RESPONSIBILITY FOR COMPLIANCE WITH THE 1996 TAXPAYER BILLS OF RIGHTS 2 AND THE ESTABLISHMENT OF THE "REBUTTABLE PRESUMPTION OF REASONABLENESS" THAT IS DEFINED IN SECTION 4958 OF THE INTERNAL REVENUE CODE. IN ESTABLISHING THE REBUTTABLE PRESUMPTION OF REASONABLENESS, THE EXECUTIVE COMPENSATION COMMITTEE MAY ENGAGE THE PROFESSIONAL SERVICES OF INDEPENDENT LEGAL COUNSEL, COMPENSATION EXPERTS, ACCOUNTANTS, AND OTHER EXPERTS AND ADVISORS. FOR EXTERNAL COMPARISON PURPOSES, COMPENSATION IS REVIEWED AGAINST THE COMPENSATION PACKAGES OF OTHER STATE ASSOCIATIONS THAT FAIRLY REPRESENT THE MARKET FOR EXECUTIVE TALENT, AND MAY INCLUDE SOME OR ALL OF THE FOLLOWING CHARACTERISTICS: -- SIMILAR INDUSTRY AND/OR ANNUAL REVENUES SIZE -- SIMILAR STATE SIZE (POPULATION) AND MEMBERSHIP SIZE -- EMPLOYERS THAT ARE PRIMARILY FOCUSED ON THE SOUTHEAST REGION OF THE UNITED STATES -- ORGANIZATIONS WITH WHICH WE COMPETE FOR TALENT INDIVIDUAL SALARIES WILL BE BASED UPON SUCH FACTORS AS COMPETENCIES, CREDENTIALS, EXPERIENCE, PERFORMANCE, RELEVANT PRIOR EARNINGS HISTORY, AND MARKETABILITY. ANNUAL SALARY INCREASES WILL REFLECT SUCH FACTORS AS MARKET MOVEMENT OR INFLATION, INDIVIDUAL PERFORMANCE, COMPANY PERFORMANCE, GENERAL ECONOMIC CONDITIONS, AND THE AVAILABILITY OF FUNDS. IF A SALARY EXCEEDS THE RANGE MAXIMUM OR 75TH PERCENTILE, THE EXECUTIVE COMPENSATION COMMITTEE MUST APPROVE AND DOCUMENT ITS RATIONALE. FORM 990, PART VI, SECTION C, LINE 18 THE ORGANIZATION PROVIDES COPIES UPON REQUEST AND ALLOWS INSPECTION AT THE ADMINISTRATIVE OFFICE OF THE ORGANIZATION. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION PROVIDES COPIES UPON REQUEST AND ALLOWS INSPECTION AT THE ADMINISTRATIVE OFFICE OF THE ORGANIZATION. NCHA INC PO BOX 4449 CARY NC 27519 560641290 PROVIDES LEADERSHIP TO HOSPITALS IN NC & PROMOTES QUALITY HEALTHCARE NC 501(C)(6) 0 NORTH CAROLINA HEALTHCARE ENTERPRISES INC PO BOX 4449 CARY NC 27519 561653026 SUPPORT SERVICES RELATED TO FOR-PROFIT ACTIVITIES. NC C 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 NCHA INC K 58734 NCHA INC O 607526