2021-11-12T15:42:54-06:00 2020-12-31 346565596 ERNST & YOUNG US LLP 100 NORTH TRYON STREET SUITE 3800 CHARLOTTE NC 28202 990 2020-01-01 560928089 FORSYTH MEMORIAL HOSPITAL INC FORS 3367182803 2085 FRONTIS PLAZA BLVD WINSTON SALEM NC 27103 FRED HARGETT EVP & CFO 3367182803 2021-11-12 1 FRED HARGETT 999009999 SCOTT TIDWELL P01729213 7043726300 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z NOVANT HEALTH FORSYTH MEDICAL CENTER CARL ARMATO 2085 FRONTIS PLAZA BLVD WINSTON SALEM NC 27103 1551533794 0 X WWW.NOVANTHEALTH.ORG X 1968 NC SEE SCHEDULE O 17 14 7981 154 0 0 1764533 49327067 1498133546 1496176082 -360296 409589 7574138 5460108 1507111921 1551372846 1103779 2835053 0 0 584808516 572676488 0 0 0 813508722 868336650 1399421017 1443848191 107690904 107524655 1827333103 2063331863 128402528 260050611 1698930575 1803281252 X SEE SCHEDULE O 1 0 1171909069 2835053 1496807506 FORSYTH MEMORIAL HOSPITAL, INC. (FMH), KERNERSVILLE MEDICAL CENTER (KMC), AND CLEMMONS MEDICAL CENTER (CMC) CARRY OUT THE PURPOSE OF THE FORSYTH COUNTY BOARD OF COMMISSIONERS BY ADVANCING AND SUPPORTING THE PROMOTION OF THE HEALTH OF THE INHABITANTS OF FORSYTH COUNTY AND THE KERNERSVILLE AREA OF NC. FMH, KMC, AND CMC MAINTAIN AN OPEN DOOR POLICY, ACCEPTING ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. FMH HAS 859 LICENSED BEDS. DURING 2020 THERE WERE 217,673 PATIENT DAYS WITH AN AVERAGE LENGTH OF STAY OF 6 DAYS, AN AVERAGE DAILY CENSUS OF 595, AND 34,304 DISCHARGES. THERE WERE 20,115 INPATIENT AND OUTPATIENT SURGERIES, A TOTAL OF 1,103,316 OUTPATIENT ENCOUNTERS AND 77,334 EMERGENCY DEPARTMENT VISITS.(CONTINUED ON SCHEDULE O) 1171909069 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 0 0 0 0 0 0 1 0 0 0 0 0 1 1 1 1 0 0 1 0 0 7981 1 0 0 0 0 0 0 0 0 0 0 1 0 X 17 14 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 1 1 NC X X KAREN DAUGHERTY 3367182803 2085 FRONTIS PLAZA BLVD WINSTON SALEM NC 27103 X BERGER WILLIAM MD TRUSTEE 0.20 45.00 X 0 574913 52090 EDWARDS JOEL MD TRUSTEE 45.20 0.00 X 233516 0 15110 BAREFOOT SAMUEL TRUSTEE 0.20 0.00 X 0 0 0 BROWN CANDICE TRUSTEE 0.20 0.00 X 0 0 0 FORIEST BRYANT TRUSTEE 0.20 0.00 X 0 0 0 HALL AVERY TRUSTEE 0.20 0.00 X 0 0 0 HARDING LARI VICE CHAIR 0.20 0.00 X X 0 0 0 HAUSER CHARLES TRUSTEE 0.20 0.00 X 0 0 0 HORN MIKE TRUSTEE 0.20 0.00 X 0 0 0 JOHNSON JOIA CHAIR 0.20 0.00 X X 0 0 0 LANDRY ROBERT TRUSTEE 0.20 0.00 X 0 0 0 LATHAM LINDA SEC/TREAS 0.20 0.00 X X 0 0 0 LEON CHRISTOPHER TRUSTEE 0.20 0.00 X 0 0 0 MARTIN TRACEY TRUSTEE 0.20 0.00 X 0 0 0 OWENS MARK TRUSTEE 0.20 0.00 X 0 0 0 WELTON CHARLES TRUSTEE 0.20 0.00 X 0 0 0 WOLFE III JOHN TRUSTEE 0.20 0.00 X 0 0 0 SMITH HARRY FMR SVP HOSP OPS (1/1/20-8/5/20) 0.00 50.00 X 0 1394920 46260 SETLIFF MICHAEL PRES & COO 50.00 0.00 X 788781 0 123544 HEALY JOAN ASST SEC 0.20 0.00 X 112678 0 0 NYCUM LAWRENCE MD FMR SVP & CCO (1/1/20-10/27/20) 50.00 0.00 X 1047567 0 40364 MANN JOHN PRESIDENT & COO 50.00 0.00 X 710866 0 130475 ROYSTER KIRSTEN PRES & COO KMC 50.00 0.00 X 589399 0 26493 ELLIOTT KATHLEEN ONCOLOGIST 45.00 0.00 X 796189 0 52194 FRIEDMAN ROLAND UROLOGIST 45.00 0.00 X 785317 0 47837 COLLINS TIMOTHY ONCOLOGIST 45.00 0.00 X 760643 0 52227 ZEYLIKMAN YURIY NEUROLOGIST 45.00 0.00 X 761976 0 50071 BAKER WILLIAM ONCOLOGIST 45.00 0.00 X 724799 0 49202 BRIGHT JANET FMR VP NURSING & MARKET CNO 0.00 0.00 X 155248 0 5610 7466979 1969833 691477 635 1 1 0 VANNOY CONSTRUCTION PO BOX 635 JEFFERSON NC 28640 CONSTRUCTION SERVICES 26737202 LABORATORY CORPORATION OF AMERICA HOLDIN PO BOX 12140 BURLINGTON NC 27216 LAB SERVICES 18603550 MORRISON HEALTHCARE PO BOX 102289 ATLANTA GA 30368 FOOD MANAGEMENT SERVICES 13109690 AYA HEALTHCARE INC PO BOX 123519 DALLAS TX 75312 TRAVEL NURSING SERVICES 9401444 TRIMEDX INC PO BOX 636129 CINCINNATI OH 45263 CLINICAL ENGINEERING SERVICES 8620309 102 2502429 46585535 239103 49327067 NET PATIENT REVENUE 622110 1411014463 1411014463 PHARMACY 446110 79758404 79758404 PASS-THRU PATIENT REVENUE 621111 3730398 3730398 VALUE BASED INCENTIVE 900099 1637777 1637777 PHYSICIAN SERVICES 621111 35040 35040 1496176082 230618 230618 606513 0 606513 606513 606513 313151 134180 178971 178971 178971 54901 26768 28133 28133 CAFETERIA MEALS 722514 2331962 2331962 CHILD DEVELOPMENT CENTER 624410 1169574 1169574 PARKING 812930 374833 374833 949093 631424 317669 4825462 1551372846 1496807506 0 5238273 1272280 1272280 1562773 1562773 3811857 3811857 202774 202774 455766390 437535734 18230656 17446950 16749072 697878 66047649 63405744 2641905 29400868 28224833 1176035 3658 3658 1180 1180 112547836 92955520 19592316 1067733 1032719 35014 4578255 3620718 957537 9520305 9305861 214444 27400518 26321608 1078910 569739 542115 27624 103084 98961 4123 18974472 18974472 28989093 26644969 2344124 5697197 5420136 277061 CORPORATE SUPPORT 203566506 203566506 PHARMACEUTICALS 158342043 158342043 0 MEDICAL SUPPLIES 149901059 149729305 171754 BAD DEBT 89104651 89104651 57969321 41064375 16904946 1443848191 1171909069 271939122 0 393328 139561 263760491 350938607 14921289 13494133 23973728 25883750 967602 537550 653275808 362834131 260551889 290441677 14422125 16986941 31015047 31015047 1217327604 1333894597 1827333103 2063331863 68765444 198690472 59637084 61360139 128402528 260050611 X 1698930125 1803280802 450 450 1698930575 1803281252 1827333103 2063331863 X 107524655 450 -3174428 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 1 0 0 0 0 1 344 0 1 77903 78247 0 PART II-B, LINE 1: LINE 1A THERE IS LIMITED ENGAGEMENT OF THE BOARD. LINE 1B THERE IS MINIMAL TIME OF SENIOR LEADERS. LINE 1G THERE IS LIMITED CONTACT MADE BY SENIOR LEADERS DURING LOBBYING ACTIVITIES. LINE 1I DUES PAID TO CERTAIN ORGANIZATIONS WHICH INCLUDE A PORTION RELATED TO LOBBYING ACTIVITIES. 450 450 363 87 450 363 363 0.00000 1.00000 0.00000 0 0 10727897 10727897 167326521 48012373 119314148 19464708 9432096 10032612 386326141 285866885 100459256 69430541 19522777 49907764 290441677 DUE FROM AFFILIATE 1310910354 OTHER ASSETS 331069 RIGHT OF USE ASSETS 22653174 1333894597 0 THIRD PARTY PAYMENT PAYABLE 16208503 NOTES PAYABLE 16543591 PATIENT REFUNDS 5162998 OPERATING LEASE 23445047 61360139 X PART V, LINE 4: THE ENDOWMENT FUNDS ARE HELD FOR COMMUNITY ENGAGEMENT. PART X, LINE 2: PART X, LINE 2: LIABILITY UNDER FIN 48 (ASC 740) FOOTNOTE THE AUDIT FOR NOVANT HEALTH AND ITS AFFILIATES IS PREPARED ON A CONSOLIDATED BASIS. THE COMPANY IS REQUIRED TO EVALUATE UNCERTAIN TAX POSITIONS. THIS EVALUATION INCLUDES A QUANTIFICATION OF TAX RISK IN AREAS SUCH AS UNRELATED BUSINESS TAXABLE INCOME AND THE TAXATION OF OUR FOR-PROFIT SUBSIDIARIES. THIS EVALUATION DID NOT HAVE A MATERIAL EFFECT ON THE COMPANY'S CONSOLIDATED STATEMENTS OF OPERATIONS AND CHANGES IN NET ASSETS FOR THE YEARS ENDED DECEMBER 31, 2020 AND 2019. 1 1 X 1 X 300.000000000000 0 0 1 1 0 1 1 56295918 0 56295918 0.04160 158640224 131328324 27311900 0.02020 3280787 2707345 573442 0.00040 218216929 134035669 84181260 0.06220 547969 8926 539043 0.00040 5104310 1015512 4088798 0.00300 21760408 13232926 8527482 0.00630 1387050 0 1387050 0.00100 219705 0 219705 0.00020 29019442 14257364 14762078 0.01090 247236371 148293033 98943338 0.07310 100 100 0.00000 35000 0 35000 0.00000 34000 0 34000 0.00000 25000 0 25000 0.00000 94100 94100 0.00000 1 89104651 0 207324665 225730629 -18405964 X 1 0 4 1 FMH DBA NOVANT HEALTH FORSYTH MEDICAL CENTER 3333 SILAS CREEK PARKWAY WINSTONSALEM NC 27103 WWW.NOVANTHEALTH.ORG H0209 X X X A 2 FMH DBA NOVANT HEALTH KERNERSVILLE MED CENTER 1750 KERNERSVILLE MEDICAL PARKWAY KERNERSVILLE NC 27284 WWW.NOVANTHEALTH.ORG H0209 X X X A 3 FMH DBA NOVANT HEALTH CLEMMONS MEDICAL CENTER 6915 VILLAGE MEDICAL CIRCLE CLEMMONS NC 27012 WWW.NOVANTHEALTH.ORG H0209 X X X A 4 NOVANT HEALTH REHABILITATION HOSPITAL 2475 HILLCREST CENTER CIRCLE WINSTONSALEM NC 27103 WWW.ENCOMPASSHEALTH.COM/LOCATIONS/NOVA H0291 X SPECIALTY - REHABILITATION B FORSYTH MEMORIAL HOSPITAL INC 0 0 1 X X X X X X X X 19 1 0 0 1 X SEE SECTION C X 1 19 1 SEE SECTION C 0 1 X 300.000000000000 0.000000000000 X X X X 1 1 X X X 1 X SEE SECTION C X SEE SECTION C X SEE SECTION C X X X X X X 1 X 0 X X X X 1 X 0 1 NOVANT HEALTH REHABILITATION HOSPITAL 0 0 1 X X X X X X X 20 1 0 0 1 X SEE SECTION C X 1 20 1 SEE SECTION C 0 1 X 300.000000000000 0.000000000000 X X 1 1 X X X 1 X SEE SECTION C X SEE SECTION C X SEE SECTION C X X X X X 1 X 0 X X X X 0 X X 0 0 PART V, SECTION B FACILITY REPORTING GROUP A FACILITY REPORTING GROUP A CONSISTS OF: - FACILITY 1: FMH DBA NOVANT HEALTH FORSYTH MEDICAL CENTER, - FACILITY 2: FMH DBA NOVANT HEALTH KERNERSVILLE MED CENTER, - FACILITY 3: FMH DBA NOVANT HEALTH CLEMMONS MEDICAL CENTER FORSYTH MEMORIAL HOSPITAL, INC. PART V, SECTION B, LINE 3J: FORSYTH MEMORIAL HOSPITAL, INC.PART V, SECTION B, LINE 3E:SEVERAL SOCIAL, BEHAVIORAL, AND CLINICAL HEALTH NEEDS WERE IDENTIFIED IN THE NEEDS ASSESSMENT. ONCE THE HEALTH NEEDS WERE IDENTIFIED, SURVEYS AND COMMUNITY MEETINGS WERE CONDUCTED IN WHICH THE VARIOUS COMMUNITY STAKEHOLDERS RANKED THE HEALTH ISSUES ACCORDING TO THE YEARS OF POTENTIAL LIFE LOST AND MAGNITUDE OF IMPACT. THE INFORMATION GATHERED WAS THEN MATRIXED AND SCORED IN ORDER TO RANK THE FOCUS AREAS AND PRIORITIZE THE IDENTIFIED HEALTH NEEDS. THE PRIORITIZED IDENTIFIED HEALTH NEEDS AND SUPPORTING DATA ARE THEN REVIEWED AND DELIBERATED UPON FURTHER BY THE BOARD. AN IMPLEMENTATION PLAN IS CREATED FOR CERTAIN OF THE PRIORITIZED, IDENTIFIED HEALTH NEEDS AND ASSESSED REGULARLY THROUGHOUT THE COMMUNITY HEALTH NEEDS ASSESSMENT LIFE CYCLE. COMMUNITY PARTNERS WHO ARE CURRENTLY DOING THE WORK ARE IDENTIFIED AS POTENTIAL PARTNERS FOR COLLABORATION ON THOSE IDENTIFIED NEEDS THAT ARE NOT PART OF THE IMPLEMENTATION PLAN. FORSYTH MEMORIAL HOSPITAL, INC. PART V, SECTION B, LINE 5: WHILE CONDUCTING THE CHNA, THE HOSPITAL FACILITY(IES) SOLICITED INPUT FROM, AND CONSULTED WITH, A VARIETY OF COMMUNITY REPRESENTATIVES INCLUDING, BUT NOT LIMITED TO, REPRESENTATIVES OF CITY AND COUNTY GOVERNMENT INCLUDING HEALTH DEPARTMENTS, COMMUNITY-BASED ORGANIZATIONS, FOUNDATIONS, CHURCHES, COLLEGES/UNIVERSITIES, COMMUNITY COALITIONS AND OTHER SOCIAL SERVICE AGENCIES. INPUT WAS GATHERED THROUGH COMMUNITY MEETINGS, STAKEHOLDER'S INTERVIEWS, AND SOLICITED THROUGH WRITTEN COMMENTS THROUGHOUT THE SURVEY PERIOD UNTIL THE FINAL COMMUNITY PRIORITY SETTING MEETING(S) AND/OR SURVEY. THE SCOPE OF EXPERTISE WAS BROAD AND INCLUDED SUCH AREAS AS PUBLIC HEALTH, MINORITY POPULATIONS, HEALTH DISPARITIES, AND SOCIAL SERVICES. DATA DERIVED FROM THESE EXERCISES IS BOTH QUANTITATIVE AND QUALITATIVE IN SCOPE. FORSYTH MEMORIAL HOSPITAL, INC. PART V, SECTION B, LINE 7D: FORSYTH MEMORIAL HOSPITAL, INC.PART V, SECTION B, LINE 7BHTTPS://WWW.NOVANTHEALTH.ORG/HOME/ABOUT-US/COMMUNITY-ENGAGEMENT/OUR-IMPACT.ASPXFORSYTH MEMORIAL HOSPITAL, INC.PART V, SECTION B, LINE 10AHTTPS://WWW.NOVANTHEALTH.ORG/HOME/ABOUT-US/COMMUNITY-ENGAGEMENT/OUR-IMPACT.ASPX FORSYTH MEMORIAL HOSPITAL, INC. PART V, SECTION B, LINE 11: THE HOSPITAL FACILITY(IES) IS/ARE A PART OF NOVANT HEALTH, AN INTEGRATED NOT-FOR-PROFIT HEALTH SYSTEM. AS SUCH, NOVANT HEALTH INCLUDES MULTIPLE HOSPITAL FACILITIES AND HAS ENGAGED IN CHNAS FOR ALL OF THE COMMUNITIES BEING SERVED. THE FACILITY'S CHNA IDENTIFIED MULTIPLE NEEDS FOR THE COMMUNITY SERVED. THE NEEDS IDENTIFIED WERE REVIEWED AND PRIORITIZED BY THE CHNA RESOURCE GROUP AND SUBSEQUENTLY BY EACH FACILITY'S BOARD. THEY EVALUATED EACH DOCUMENTED NEED AND ITS INTERSECTION WITH THE ORGANIZATION'S VISION, COMMITMENTS, AND KEY STRENGTHS BEFORE FURTHER PRIORITIZING THE HEALTH NEEDS AND AGREEING UPON THE TOP HEALTH PRIORITIES TO BE ADDRESSED. WHERE POSSIBLE, WE HAVE LEVERAGED THE SYSTEM'S STRENGTHS AND RESOURCES TO BEST ADDRESS THOSE NEEDS THAT ARE HIGHEST IN PRIORITY AND CONSISTENT ACROSS COMMUNITIES. NOVANT HEALTH AND EACH OF ITS HOSPITAL FACILITIES HAVE ADOPTED AND EXECUTED AN IMPLEMENTATION STRATEGY THAT ADDRESSES THE PRIORITIZED COMMUNITY HEALTH NEEDS FROM THE CHNAS. THE IMPLEMENTATION STRATEGIES OUTLINE THE PLAN THAT THE HOSPITAL FACILITY(IES) WILL UNDERTAKE TO MEET THOSE HEALTH NEEDS IN EACH OF ITS COMMUNITIES. CERTAIN NEEDS THAT WERE IDENTIFIED BY THE CHNA HAVE NOT BEEN ADDRESSED. CERTAIN OF THE NEEDS NOT ADDRESSED FALL OUTSIDE OF THE SCOPE OF TRADITIONAL HEALTHCARE (IE. DENTAL WORK) AND OTHERS ARE CANDIDATES FOR COLLABORATIVE WORK AND HAVE OTHER RESOURCES IN THE COMMUNITY THAT CAN MORE APPROPRIATELY ADDRESS THESE NEEDS BASED ON SCOPE OF SERVICES AND SKILL SET. FOR MORE DETAILED INFORMATION, REFER TO THE PUBLICLY AVAILABLE IMPLEMENTATION PLAN AVAILABLE ON THE WEBSITE; REFER TO THE URL GIVEN PREVIOUSLY FOR THE POSTING OF THE PLAN. FORSYTH MEMORIAL HOSPITAL, INC. PART V, SECTION B, LINE 13H: OTHER ELIGIBILITY CRITERIA EXPLAINED IN THE FAP INCLUDE THE FOLLOWING: FREE CARE IS ONLY APPLICABLE TO MEDICALLY NECESSARY SERVICES; PROVIDER BASED PHYSICIAN CLINICS REQUIRE THAT PATIENTS MUST HAVE BEEN TREATED BY AN AFFILIATED MEDICAL GROUP PRIMARY CARE PHYSICIAN WITHIN THE PREVIOUS THREE YEARS; PATIENTS MUST BE UNABLE TO ACCESS ENTITLEMENT PROGRAMS; PATIENTS WITH SPECIAL CIRCUMSTANCES SUCH AS BANKRUPTCY MAY ALSO BE ELIGIBLE FOR CHARITY CARE. SCHEDULE H, PART V, SECTION B. FACILITY REPORTING GROUP APART V, LINE 16A, FAP WEBSITE:HTTPS://WWW.NOVANTHEALTH.ORG/HOME/PATIENTS--VISITORS/YOUR-HEALTHCARE-COSTS/FINANCIAL-ASSISTANCE-FOR-THE-UNINSURED.ASPXSCHEDULE H, PART V, SECTION B. FACILITY REPORTING GROUP APART V, LINE 16B, FAP APPLICATION:HTTPS://WWW.NOVANTHEALTH.ORG/PORTALS/92/NOVANT_HEALTH/DOCUMENTS/PATIENTS_VISITORS/FINANCIAL_SERVICES/FINANCIAL%20ASSISTANCE%20APPLICATIONS/2019/FINANCIAL_ASSISTANCE/FAA_APP_ENGLISH.PDFSCHEDULE H, PART V, SECTION B. FACILITY REPORTING GROUP APART V, LINE 16C, FAP PLAIN LANGUAGE SUMMARY:HTTPS://WWW.NOVANTHEALTH.ORG/PORTALS/92/NOVANT_HEALTH/DOCUMENTS/PATIENTS_VISITORS/FINANCIAL_SERVICES/FINANCIAL%20ASSISTANCE%20APPLICATIONS/2019/PLAIN_LANGUAGE/NOVANT%20HEALTH%20ACUTE%20PLS%20ENGLISH.PDF FORSYTH MEMORIAL HOSPITAL, INC. PART V, SECTION B, LINE 24: IT IS POSSIBLE FOR A FINANCIAL ASSISTANCE POLICY (FAP) ELIGIBLE PATIENT TO BE CHARGED AN AMOUNT EQUAL TO THE GROSS CHARGE FOR A NON-EMERGENCY OR NON-MEDICALLY NECESSARY SERVICE. HOWEVER, IF THE SERVICE IS DEEMED AN EMERGENCY OR A MEDICAL NECESSITY, THEN THE FAP ELIGIBLE PATIENT WOULD NOT BE CHARGED FOR CARE AND WOULD NOT RECEIVE A BILL ONCE FAP ELIGIBILITY HAD BEEN ESTABLISHED. PART V, SECTION B FACILITY REPORTING GROUP B FACILITY REPORTING GROUP B CONSISTS OF: - FACILITY 4: NOVANT HEALTH REHABILITATION HOSPITAL NOVANT HEALTH REHABILITATION HOSPITAL PART V, SECTION B, LINE 3J: NOVANT HEALTH REHABILITATION HOSPITALPART V, SECTION B, LINE 3E:SEVERAL SOCIAL, BEHAVIORAL, AND CLINICAL HEALTH NEEDS WERE IDENTIFIED IN THE NEEDS ASSESSMENT. ONCE THE HEALTH NEEDS WERE IDENTIFIED, SURVEYS AND COMMUNITY MEETINGS WERE CONDUCTED IN WHICH THE VARIOUS COMMUNITY STAKEHOLDERS RANKED THE HEALTH ISSUES ACCORDING TO THE YEARS OF POTENTIAL LIFE LOST AND MAGNITUDE OF IMPACT. THE INFORMATION GATHERED WAS THEN MATRIXED AND SCORED IN ORDER TO RANK THE FOCUS AREAS AND PRIORITIZE THE IDENTIFIED HEALTH NEEDS. THE PRIORITIZED IDENTIFIED HEALTH NEEDS AND SUPPORTING DATA ARE THEN REVIEWED AND DELIBERATED UPON FURTHER BY THE BOARD. AN IMPLEMENTATION PLAN IS CREATED FOR CERTAIN OF THE PRIORITIZED, IDENTIFIED HEALTH NEEDS AND ASSESSED REGULARLY THROUGHOUT THE COMMUNITY HEALTH NEEDS ASSESSMENT LIFE CYCLE. COMMUNITY PARTNERS WHO ARE CURRENTLY DOING THE WORK ARE IDENTIFIED AS POTENTIAL PARTNERS FOR COLLABORATION ON THOSE IDENTIFIED NEEDS THAT ARE NOT PART OF THE IMPLEMENTATION PLAN. NOVANT HEALTH REHABILITATION HOSPITAL PART V, SECTION B, LINE 5: WHILE CONDUCTING THE CHNA, THE HOSPITAL FACILITY(IES) SOLICITED INPUT FROM, AND CONSULTED WITH, A VARIETY OF COMMUNITY REPRESENTATIVES INCLUDING, BUT NOT LIMITED TO, REPRESENTATIVES OF CITY AND COUNTY GOVERNMENT INCLUDING HEALTH DEPARTMENTS, COMMUNITY-BASED ORGANIZATIONS, FOUNDATIONS, CHURCHES, COLLEGES/UNIVERSITIES, COMMUNITY COALITIONS AND OTHER SOCIAL SERVICE AGENCIES. INPUT WAS GATHERED THROUGH COMMUNITY MEETINGS, STAKEHOLDER'S INTERVIEWS, AND SOLICITED THROUGH WRITTEN COMMENTS THROUGHOUT THE SURVEY PERIOD UNTIL THE FINAL COMMUNITY PRIORITY SETTING MEETING(S) AND/OR SURVEY. THE SCOPE OF EXPERTISE WAS BROAD AND INCLUDED SUCH AREAS AS PUBLIC HEALTH, MINORITY POPULATIONS, HEALTH DISPARITIES, AND SOCIAL SERVICES. DATA DERIVED FROM THESE EXERCISES IS BOTH QUANTITATIVE AND QUALITATIVE IN SCOPE. NOVANT HEALTH REHABILITATION HOSPITAL PART V, SECTION B, LINE 7D: NOVANT HEALTH REHABILITATION HOSPITALPART V, SECTION B, LINE 7BNOVANT HEALTH REHABILITATION HOSPITALPART V, SECTION B, LINE 10A NOVANT HEALTH REHABILITATION HOSPITAL PART V, SECTION B, LINE 11: THE FORSYTH MEMORIAL HOSPITAL, INC. INCLUDES THE OPERATIONS OF TWO LICENSED HOSPITALS; ONE WITH FACILITIES IN THREE LOCATIONS: FORSYTH MEMORIAL HOSPITAL, INC. DOING BUSINESS AS NOVANT HEALTH FORSYTH MEDICAL CENTER, AS NOVANT HEALTH KERNERSVILLE MEDICAL CENTER, AND AS NOVANT HEALTH CLEMMONS MEDICAL CENTER; AND NOVANT HEALTH REHABILITATION HOSPITAL, A LICENSED HOSPITAL OPERATED THROUGH A JOINT VENTURE. THE FACILITY'S CHNA IDENTIFIED MULTIPLE NEEDS FOR THE COMMUNITY SERVED. THE NEEDS IDENTIFIED WERE REVIEWED AND PRIORITIZED BY THE CHNA RESOURCE GROUP AND SUBSEQUENTLY BY EACH FACILITY'S BOARD. THEY EVALUATED EACH DOCUMENTED NEED AND ITS INTERSECTION WITH THE ORGANIZATION'S VISION, COMMITMENTS, AND KEY STRENGTHS BEFORE FURTHER PRIORITIZING THE HEALTH NEEDS AND AGREEING UPON THE TOP HEALTH PRIORITIES TO BE ADDRESSED. WHERE POSSIBLE, WE HAVE LEVERAGED THE SYSTEM'S STRENGTHS AND RESOURCES TO BEST ADDRESS THOSE NEEDS THAT ARE HIGHEST IN PRIORITY AND CONSISTENT ACROSS COMMUNITIES. NOVANT HEALTH AND EACH OF ITS HOSPITAL FACILITIES HAVE ADOPTED AND EXECUTED AN IMPLEMENTATION STRATEGY THAT ADDRESSES THE PRIORITIZED COMMUNITY HEALTH NEEDS FROM THE CHNAS. THE IMPLEMENTATION STRATEGIES OUTLINE THE PLAN THAT THE HOSPITAL FACILITY(IES) WILL UNDERTAKE TO MEET THOSE HEALTH NEEDS IN EACH OF ITS COMMUNITIES. CERTAIN NEEDS THAT WERE IDENTIFIED BY THE CHNA HAVE NOT BEEN ADDRESSED. CERTAIN OF THE NEEDS NOT ADDRESSED FALL OUTSIDE OF THE SCOPE OF TRADITIONAL HEALTHCARE (IE. DENTAL WORK) AND OTHERS ARE CANDIDATES FOR COLLABORATIVE WORK AND HAVE OTHER RESOURCES IN THE COMMUNITY THAT CAN MORE APPROPRIATELY ADDRESS THESE NEEDS BASED ON SCOPE OF SERVICES AND SKILL SET. FOR MORE DETAILED INFORMATION, REFER TO THE PUBLICLY AVAILABLE IMPLEMENTATION PLAN AVAILABLE ON THE WEBSITE; REFER TO THE URL GIVEN PREVIOUSLY FOR THE POSTING OF THE PLAN. NOVANT HEALTH REHABILITATION HOSPITAL PART V, SECTION B, LINE 13H: NOVANT HEALTH REHABILITATION HOSPITALSCHEDULE H, PART V, SECTION B. FACILITY REPORTING GROUP BPART V, LINE 16A, FAP WEBSITE:HTTPS://WWW.ENCOMPASSHEALTH.COM/-/MEDIA/HEALTHSOUTH/PROJECT/HEALTHSOUTH/FILES/FINANCIAL-ASSISTANCE/2019-FINANCIAL-POLICY/NOVANT_FA_POLICY.PDF?LA=EN&HASH=77C51099FE74B3549A26469D6B5C465479CC77FASCHEDULE H, PART V, SECTION B. FACILITY REPORTING GROUP BPART V, LINE 16B, FAP APPLICATION:HTTPS://WWW.ENCOMPASSHEALTH.COM/-/MEDIA/HEALTHSOUTH/PROJECT/HEALTHSOUTH/FILES/FINANCIAL-ASSISTANCE/2019_APPLICATION/NOVANT_FA_INST_APP.PDF?LA=EN&HASH=C17E842E930B98DF8A794D58BEF97AF1CA5C3310SCHEDULE H, PART V, SECTION B. FACILITY REPORTING GROUP BPART V, LINE 16C, FAP PLAIN LANGUAGE SUMMARY:HTTPS://WWW.ENCOMPASSHEALTH.COM/-/MEDIA/HEALTHSOUTH/PROJECT/HEALTHSOUTH/FILES/FINANCIAL-ASSISTANCE/2019_PLAIN_LANGUAGE/NOVANT_FA_PLAIN_LANG_2.PDF?LA=EN&HASH=4B1FC5F7C19BAE59694B321B07BCB4E4FB2AA6A1 NOVANT HEALTH REHABILITATION HOSPITAL PART V, SECTION B, LINE 21D: NOVANT HEALTH REHABILITATION HOSPITAL DOES NOT HAVE A DEDICATED EMERGENCY DEPARTMENT. THE HOSPITAL WILL APPRAISE EMERGENCIES, PROVIDE INITIAL TREATMENT, AND REFER OR TRANSFER AN INDIVIDUAL TO ANOTHER HOSPITAL/FACILITY, WHEN APPROPRIATE, WITHOUT DISCRIMINATION AND WITHOUT REGARD TO WHETHER THE INDIVIDUAL IS ELIGIBLE FOR FINANCIAL ASSISTANCE.NOVANT HEALTH REHABILITATION HOSPITAL WILL NOT ENGAGE IN ACTIONS THAT DISCOURAGE INDIVIDUALS FROM SEEKING EMERGENCY MEDICAL CARE, SUCH AS DEMANDING THAT AN INDIVIDUAL PAY BEFORE RECEIVING INITIAL TREATMENT FOR EMERGENCY MEDICAL CONDITIONS OR PERMITTING DEBT COLLECTION ACTIVITIES THAT INTERFERE WITH HOSPITAL'S APPRAISAL AND PROVISION, WITHOUT DISCRIMINATION, OF SUCH INITIAL TREATMENT. 49 1 - NH ARCADIA FAMILY MEDICINE 12208 NC HWY 150 NORTH WINSTONSALEM NC 27127 PHYSICIAN CLINIC 2 - NH BREAST CENTER 2025 FRONTIS PLAZA BLVD SUITE 123 WINSTONSALEM NC 27103 IMAGING CENTER 3 - NH CARDIOLOGY CLEMMONS 7114 VILLAGE MEDICAL CIRCLE CLEMMONS NC 27012 PHYSICIAN CLINIC 4 - NH CARDIOLOGY KERNERSVILLE 1710 KERNERSVILLE MEDICAL PKWY SUITE 205 KERNERSVILLE NC 27284 PHYSICIAN CLINIC 5 - NH CARDIOLOGY MT AIRY 694 RIVERSIDE DR MOUNT AIRY NC 27030 PHYSICIAN CLINIC 6 - NH CARDIOLOGY WINSTON-SALEM 186 KIMEL PARK DRIVE WINSTONSALEM NC 27103 PHYSICIAN CLINIC 7 - NH CHAIR CITY FAMILY MEDICINE 903 RANDOLPH ST THOMASVILLE NC 27360 PHYSICIAN CLINIC 8 - NH CLEMMONS FAMILY MEDICINE 6301 STADIUM DRIVE CLEMMONS NC 27012 PHYSICIAN CLINIC 9 - NH CLEMMONS OUTPATIENT SURGERY 7210 VILLAGE MEDICAL CIRCLE CLEMMONS NC 27012 AMBULATORY SURGERY CENTER 10 - NH DAVIE MEDICAL ASSOCIATES 485 VALLEY ROAD MOCKSVILLE NC 27028 PHYSICIAN CLINIC 11 - NH FORSYTH ENDOCRINE CONSULTANTS 755 HIGHLAND OAKS DRIVE SUITE 201 WINSTONSALEM NC 27103 PHYSICIAN CLINIC 12 - NH FORSYTH FAMILY MEDICINE 400 JONESTOWN ROAD WINSTONSALEM NC 27104 PHYSICIAN CLINIC 13 - NH FORSYTH INTERNAL MEDICINE 1381 WESTGATE CENTER DRIVE WINSTONSALEM NC 27103 PHYSICIAN CLINIC 14 - NH HAWTHORNE OUTPATIENT SURGERY 1999 S HAWTHORNE ROAD WINSTONSALEM NC 27103 AMBULATORY SURGERY CENTER 15 - NH IMAGING KERNERSVILLE 445 PINEVIEW DRIVE SUITE 100 KERNERSVILLE NC 27284 IMAGING CENTER 16 - NH IMAGING MAPLEWOOD 3155 MAPLEWOOD AVENUE WINSTONSALEM NC 27103 IMAGING CENTER 17 - NH INFECTIOUS DISEASE SPECIALISTS 1381 WESTGATE CENTER DRIVE WINSTONSALEM NC 27103 PHYSICIAN CLINIC 18 - NH INPATIENT CARE SPECIALISTS KERNERSVILLE 1750 KERNERSVILLE MEDICAL PKWY KERNERSVILLE NC 27284 PHYSICIAN CLINIC 19 - NH INTENSIVE DIABETES MANAGEMENT 1400 WESTGATE CENTER DRIVE STE 130 WINSTONSALEM NC 27103 PHYSICIAN CLINIC 20 - NH KERNERSVILLE FAMILY MEDICINE 291 BROAD STREET WINSTONSALEM NC 27284 PHYSICIAN CLINIC 21 - NH KERNERSVILLE OUTPATIENT SURGERY 1730 KERNERSVILLE MEDICAL PKWY STE 304 KERNERSVILLE NC 27284 AMBULATORY SURGERY CENTER 22 - NH LEWISVILLE FAMILY MEDICINE 1225 LEWISVILLE-CLEMMONS ROAD LEWISVILLE NC 27023 PHYSICIAN CLINIC 23 - NH LEXINGTON PRIMARY CARE 110 WEST MEDICAL PARK DRIVE LEXINGTON NC 27292 PHYSICIAN CLINIC 24 - NH MAPLEWOOD FAMILY MEDICINE ROBINHOOD MEDICAL PLAZA BLDG 100 WINSTONSALEM NC 27106 PHYSICIAN CLINIC 25 - NH MOUNTAINVIEW MEDICAL 216 MOORE ROAD KING NC 27021 PHYSICIAN CLINIC 26 - NH NORTH POINT MEDICAL ASSOCIATES 1995 BETHABARA ROAD WINSTONSALEM NC 27106 PHYSICIAN CLINIC 27 - NH ONCOLOGY SPECIALISTS 1213 LEXINGTON AVENUE STE B LEXINGTON NC 27360 PHYSICIAN CLINIC 28 - NH ONCOLOGY SPECIALISTS 1710 KERNERSVILLE MEDICAL PKWY STE 116 KERNERSVILLE NC 27284 PHYSICIAN CLINIC 29 - NH ONCOLOGY SPECIALISTS 276 OLD MOCKSVILLE ROAD SUITE 800 STATESVILLE NC 28625 PHYSICIAN CLINIC 30 - NH ONCOLOGY SPECIALISTS 865 WESTLAKE DRIVE MOUNT AIRY NC 27030 PHYSICIAN CLINIC 31 - NH PFAFFTOWN FAMILY MEDICINE 4611 YADKINVILLE ROAD PFAFFTOWN NC 27040 PHYSICIAN CLINIC 32 - NH PILOT MOUNTAIN MEDICAL CARE 207 MEDICAL STREET PILOT MOUNTAIN NC 27041 PHYSICIAN CLINIC 33 - NH PREMIER MEDICAL ASSOCIATES 3333 BROOKVIEW HILLS BLVD STES 202-204 WINSTONSALEM NC 27103 PHYSICIAN CLINIC 34 - NH PSYCHIATRIC MEDICINE 175 KIMEL PARK DRIVE SUITE 100 WINSTONSALEM NC 27103 PHYSICIAN CLINIC 35 - NH PSYCHIATRIC MEDICINE 309 PINEYWOOD ROAD THOMASVILLE NC 27360 PHYSICIAN CLINIC 36 - NH RHEUMATOLOGY AND ARTHRITIS 1551 WESTBROOK PLAZA DR SUITE 200 WINSTONSALEM NC 27106 PHYSICIAN CLINIC 37 - NH SALEM FAMILY MEDICINE 105 VEST MILL CIRCLE WINSTONSALEM NC 27103 PHYSICIAN CLINIC 38 - NH SURRY MEDICAL ASSOCIATES 2133 ROCKFORD ST SUITE 1400 MOUNT AIRY NC 27030 PHYSICIAN CLINIC 39 - NH SURRY MEDICAL ASSOCIATES 865 WESTLAKE DRIVE MOUNT AIRY NC 27030 PHYSICIAN CLINIC 40 - NH THOMASVILLE MEDICAL ASSOCIATES 309 PINEYWOOD ROAD THOMASVILLE NC 27360 PHYSICIAN CLINIC 41 - NH TRIAD ENDOCRINE 500 PINEVIEW DR SUITE 101 KERNERSVILLE NC 27284 PHYSICIAN CLINIC 42 - NH UROLOGY 140 KIMEL PARK DR SUITE 100 WINSTONSALEM NC 27103 PHYSICIAN CLINIC 43 - NH UROLOGY 1730 KERNERSVILLE MEDICAL PKWY STE 303 KERNERSVILLE NC 27284 PHYSICIAN CLINIC 44 - NH UROLOGY 2010 BALDWIN LANE WINSTONSALEM NC 27103 PHYSICIAN CLINIC 45 - NH WEST FORSYTH INTERNAL MED & PED 105 STADIUM OAKS DRIVE CLEMMONS NC 27012 PHYSICIAN CLINIC 46 - NH WINSTON-SALEM HEALTH CARE 175 KIMEL PARK DRIVE SUITE 250 WINSTONSALEM NC 27103 PHYSICIAN CLINIC 47 - NH WINSTON-SALEM HEALTH CARE 250 CHARLOIS BLVD WINSTONSALEM NC 27103 PHYSICIAN CLINIC 48 - NH WOUND CARE & HYPERBARIC MEDICINE 1901 S HAWTHORNE ROAD SUITE 220 WINSTONSALEM NC 27103 PHYSICIAN CLINIC 49 - NH YADKIN MEDICAL ASSOCIATES 305 EAST LEE AVENUE YADKINVILLE NC 27055 PHYSICIAN CLINIC PART I, LINE 3C: OTHER CRITERIA BESIDES INCOME AND FPG USED IN DETERMINING ELIGIBILITY FOR FREE CARE INCLUDE: (1) RESIDENCY - PATIENTS MUST RESIDE WITHIN THE SERVICE AREA OF THE HOSPITAL; (2) THE KIND OF SERVICE PROVIDED - ONLY MEDICALLY NECESSARY SERVICES ARE COVERED; (3) PATIENT STATUS - IN PROVIDER BASED PHYSICIAN CLINICS, PATIENTS MUST HAVE BEEN TREATED BY AN AFFILIATED MEDICAL GROUP PRIMARY CARE PHYSICIAN WITHIN THE PREVIOUS THREE YEARS; AND (4) ACCESS TO HEALTH CARE COVERAGE - PATIENTS MUST BE UNABLE TO ACCESS EMPLOYER SPONSORED HEALTH PLANS OR ENTITLEMENT PROGRAMS. LASTLY, THE PATIENT MUST BE WITHOUT SUBSTANTIAL LIQUID ASSETS (I.E. CASH-ON-HAND). ASSETS SUCH AS HOUSES, CARS, PENALIZED RETIREMENT SAVINGS FUNDS, ETC. ARE NOT CONSIDERED LIQUID ASSETS. SUBSTANTIAL ASSETS ARE DEFINED AS ENOUGH CASH-ON-HAND TO COVER THE MEDICAL EXPENSES WITHOUT PLACING A HARDSHIP ON THE PATIENT. PATIENTS WITH SPECIAL CIRCUMSTANCES SUCH AS BANKRUPTCY MAY ALSO BE ELIGIBLE FOR CHARITY CARE; DETERMINATION IS MADE ON A CASE BY CASE BASIS UNDER THESE CIRCUMSTANCES. PART I, LINE 6A: PART I, LINE 6A:THE ORGANIZATION IS A PART OF NOVANT HEALTH, AN INTEGRATED NOT-FOR-PROFIT HEALTH SYSTEM. THE COMMUNITY BENEFIT REPORT, REFERRED TO AS A COMMUNITY IMPACT REPORT, IS PREPARED BY A RELATED ORGANIZATION. NOVANT HEALTH, INC. IS THE PARENT COMPANY AND PRODUCES A COMMUNITY BENEFIT REPORT REPRESENTING THE HEALTH SYSTEM AS A WHOLE. THE REPORT CAN BE FOUND AT HTTPS://WWW.NOVANTHEALTH.ORG/HOME/ABOUT-US/COMMUNITY-ENGAGEMENT/OUR-IMPACT.ASPX.PLEASE NOTE THAT THE NUMERIC DATA IN THIS REPORT IS NOT BASED UPON THE FORM 990, SCHEDULE H CRITERIA, BUT RATHER IT HAS BEEN PREPARED IN ACCORDANCE WITH THE NORTH CAROLINA HOSPITAL ASSOCIATION REPORTING GUIDELINES. IT SHOULD NOT BE RELIED UPON AS THE ORGANIZATION'S FORM 990, SCHEDULE H COMMUNITY BENEFIT REPORT, ITS COMMUNITY HEALTH NEEDS ASSESSMENT OR COMMUNITY BENEFIT IMPLEMENTATION STRATEGY. PART I, LINE 7: COSTS REPORTED IN THE TABLE FOR CHARITY CARE AND CERTAIN OTHER COMMUNITY BENEFITS AMOUNTS ARE CALCULATED USING AN ENTITY SPECIFIC COST TO CHARGE RATIO BASED ON WORKSHEET 2 (CCR). PART I, LN 7 COL(F): PART I, LN 7 COL(F):THE AMOUNT OF BAD DEBT REMOVED FROM TOTAL EXPENSES (DENOMINATOR) WAS $89,104,651. PART II, COMMUNITY BUILDING ACTIVITIES: THE ORGANIZATION'S COMMUNITY BUILDING ACTIVITIES ADDRESS THE UNDERLYING CAUSES OF HEALTH PROBLEMS AND IMPACTS THE HEALTH OF OUR COMMUNITY THROUGH PARTNERSHIPS WITH LOCAL AGENCIES DEDICATED TO IMPROVING THE LIVES OF ALL INDIVIDUALS. OUTREACH INCLUDES PROVIDING SUPPORT TO ORGANIZATIONS SUCH AS LOCAL YMCA'S, UNITED WAY PARTNER AGENCIES, CHAMBERS OF COMMERCE AND OTHER LOCAL COMMUNITY ORGANIZATIONS, ASSISTING WITH COMMUNITY AND COUNTY COALITIONS, AND PROVIDING EDUCATION SEMINARS AND TRAINING FOR COMMUNITY WORKFORCES. THROUGH THESE OUTREACH METHODS WE ARE ABLE TO SUCCESSFULLY WORK TOWARDS BRIDGING THE GAP OF NEED WITHIN OUR IDENTIFIED IMPACTED COMMUNITIES. PART III, LINE 2: IMPLICIT PRICE CONCESSIONS (FORMERLY LABELED BAD DEBT EXPENSE) ARE DETERMINED BASED ON MANAGEMENT'S ASSESSMENT OF CONTRACTUAL AGREEMENTS, DISCOUNT POLICIES, AND HISTORICAL EXPERIENCE. PART III, LINE 4: THE ORGANIZATION'S IMPLICIT PRICE CONCESSIONS (FORMERLY LABELED BAD DEBT EXPENSE, AT COST) ON LINE 2 IS CALCULATED USING THE SAME METHODOLOGY AS CHARITY CARE AND OTHER COMMUNITY BENEFITS USING AN ENTITY SPECIFIC COST TO CHARGE RATIO (CCR). FOOTNOTE 2 (ACCOUNTS RECEIVABLE) ON PAGE 8 OF THE AUDITED FINANCIAL STATEMENTS DESCRIBES PRICE CONCESSIONS. PART III, LINE 8: THE METHODOLOGY USED TO DETERMINE THE MEDICARE ALLOWABLE COSTS REPORTED IN THE ORGANIZATION'S MEDICARE COST REPORT AS REFLECTED IN THE AMOUNT REPORTED IN PART III, LINE 6 IS DETERMINED BY FOLLOWING THE MEDICARE PRINCIPLES OF ALLOWABLE COSTS. COST FOR THE OVERHEAD DEPARTMENTS ARE STEPPED DOWN TO THE REMAINING COST CENTERS BASED ON STATISTICS FOR EACH OVERHEAD COST CENTER. ONCE THE STEP-DOWN PROCESS IS COMPLETE, A COST TO CHARGE RATIO ("CCR") IS DEVELOPED FOR EACH COST CENTER. THE CCR IS THEN APPLIED TO THE MEDICARE REVENUE BY COST CENTER AND TOTALED. IT SHOULD BE NOTED THAT THE MEDICARE COST REPORTS DO NOT ADDRESS ANY MANAGED CARE MEDICARE REVENUES, COSTS, OR RELATED SHORTFALL. THE TOTAL REVENUES REPORTED AS RECEIVED FROM MEDICARE IN LINE 5 OF SECTION B ARE ONLY REPRESENTATIVE OF MEDICARE FEE FOR SERVICE PAYMENTS RECEIVED. THE ALLOWABLE COSTS ON LINE 6 ARE SIGNIFICANTLY LOWER THAN THE ACTUAL EXPENDITURES. AS SUCH, THE SHORTFALL IS UNDERESTIMATED. EVERY HOSPITAL TREATS MEDICARE PATIENTS. SOME HOSPITALS ARE LOCATED IN HIGH MEDICARE POPULATION AREAS; OTHERS PROVIDE SERVICES DISPROPORTIONATELY USED BY MEDICARE PATIENTS. MEDICARE RATES AND NUMBERS OF MEDICARE PATIENTS ARE NOT NEGOTIATED. AS REIMBURSEMENT RATES DECLINE RELATIVE TO COSTS OF CARE, HOSPITALS CONTINUE TO SERVE THE MEDICARE POPULATION. WITHOUT THIS SERVICE THESE PATIENTS WOULD BECOME AN OBLIGATION ON THE GOVERNMENT. ANY UNREIMBURSED COSTS OF THIS CARE ARE A COMMUNITY BENEFIT PROVIDED BY THE HOSPITAL TO THE COMMUNITY AND GOVERNMENT. PART III, LINE 9B: THE ORGANIZATION'S BILLING AND COLLECTIONS POLICY DOES EXPLAIN ACTIONS AGAINST PATIENTS WHO HAVE OUTSTANDING DELINQUENT AMOUNTS, BUT THE POLICY DOES NOT CONTAIN PROVISIONS FOR COLLECTION PRACTICES AGAINST PATIENTS WHO ARE ELIGIBLE UNDER THE FINANCIAL ASSISTANCE POLICY (FAP) BECAUSE FAP ELIGIBLE PATIENTS RECEIVE 100% FREE CARE AND THEREFORE DO NOT RECEIVE BILLS ONCE FAP ELIGIBILITY HAS BEEN ESTABLISHED. PART VI, LINE 2: PART VI, LINE 2: NEEDS ASSESSMENTTHE ORGANIZATION IS PART OF NOVANT HEALTH, AN INTEGRATED NOT-FOR-PROFIT HEALTH SYSTEM, WHICH HAS A COMMUNITY ENGAGEMENT DEPARTMENT COMPRISED OF COMMUNITY BENEFIT PROFESSIONALS. THE COMMUNITY ENGAGEMENT DEPARTMENT IS RESPONSIBLE FOR COORDINATING THE PREPARATION OF THE COMMUNITY HEALTH NEEDS ASSESSMENTS (CHNA) FOR EACH HOSPITAL WITHIN THE SYSTEM, INCLUDING THE CHNAS REPORTED IN PART V, SECTION B. EACH HOSPITAL AND THE COMMUNITY ENGAGEMENT DEPARTMENT WORK TOGETHER TO IDENTIFY ORGANIZATIONS AND RESOURCES WITHIN ITS COMMUNITY THAT CONTRIBUTE TO THE PROCESS. THESE ORGANIZATIONS AND RESOURCES INCLUDE PUBLIC HEALTH DEPARTMENTS, LOCAL COMMUNITY COALITIONS REPRESENTING THE MEDICALLY UNDERSERVED, UNITED WAY, LOCAL UNIVERSITIES, ETC. COMMUNITY HEALTH ASSESSMENTS PREPARED BY OTHER ORGANIZATIONS IN THE COMMUNITY ARE USED IN COMBINATION WITH INTERNAL HOSPITAL DATA AND INFORMATION COLLECTED FROM LOCAL AGENCIES TO PREPARE THE HOSPITAL'S CHNA. THROUGH PARTNERSHIPS WITH OTHER COMMUNITY ORGANIZATIONS WE ARE ABLE TO DRAW INFERENCE OF THE NEEDS NOT MET WITHIN THE IMMEDIATE COMMUNITIES WE SERVE, AND MEET OR EXCEED THOSE COMMUNITY MEMBER'S NEEDS. IN ADDITION TO ADDRESSING NEEDS IDENTIFIED THROUGH THE CHNA, EACH HOSPITAL MAY RESPOND TO REQUESTS FOR SPECIFIC COMMUNITY BENEFIT ACTIVITIES OR PROGRAMS FROM PUBLIC AGENCIES OR COMMUNITY GROUPS. ORGANIZATIONAL PARTNERSHIPS ESTABLISHED BY THE COMMUNITY BENEFIT DEPARTMENT ARE OFTEN LEVERAGED TO ADDRESS NEEDS THAT WERE IDENTIFIED IN THE CHNA, BUT WERE UNADDRESSED BY THE FACILITY IMPLEMENTATION PLAN. PART VI, LINE 3: PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCETHE ORGANIZATION IS COMMITTED TO PROVIDING OUTSTANDING HEALTHCARE TO ALL MEMBERS OF OUR COMMUNITIES, REGARDLESS OF THEIR ABILITY TO PAY. OUR FINANCIAL COUNSELING TEAMS ARE CONSTANTLY WORKING WITH THE PATIENTS WITHIN OUR COMMUNITIES TO UNDERSTAND THEIR NEEDS AND ENSURE THAT OUR POLICIES AND PROCESSES ADDRESS THESE NEEDS. WE ALSO MAINTAIN CONTRACTS WITH MEDICAID ELIGIBILITY VENDORS AND THESE TEAMS OFFER ADDITIONAL SUPPORT IN PROCESSING AND ASSESSING HOW WE SERVE THE FINANCIAL NEEDS OF OUR PATIENTS. BASED ON THE ASSESSMENTS OF OUR COMMUNITIES, THE ORGANIZATION HAS DEVELOPED FINANCIAL ASSISTANCE POLICIES AND PROGRAMS THAT ADDRESS THE FINANCIAL NEEDS OF OUR PATIENTS. WE PRIDE OURSELVES ON THE TRANSPARENCY OF OUR PROGRAMS AND THE EDUCATION WE OFFER OUR PATIENTS AROUND OUR FINANCIAL ASSISTANCE POLICIES. OUR PROGRAMS ARE DOCUMENTED ON OUR WEBSITE, ALONG WITH CONTACT INFORMATION FOR OUR FINANCIAL COUNSELORS. ADDITIONALLY, OUR PROGRAMS ARE DOCUMENTED ON PATIENT FLYERS THROUGHOUT THE ORGANIZATION'S FACILITIES AND PHYSICIAN OFFICES. OUR PATIENT ACCESS SPECIALISTS, FINANCIAL COUNSELORS AND BUSINESS OFFICE TEAMS WORK WITH ALL ELIGIBLE PATIENTS TO EDUCATE THEM ON THE VARIOUS OPTIONS AVAILABLE VIA OUR FINANCIAL ASSISTANCE PROGRAMS OR GOVERNMENT SPONSORED CARE. THEY ALSO REFERENCE OUR FINANCIAL ASSISTANCE POLICY IN ALL CONVERSATIONS RELATED TO PATIENTS BILLS. FINALLY, WE WORK WITH LOCAL AREA FREE HEALTH CLINICS AND OTHER CHARITABLE ORGANIZATIONS TO PROVIDE CONTINUATION OF CARE FOR THEIR PATIENTS. IN ADDITION TO OUR FINANCIAL COUNSELING PROCESSES USED TO IDENTIFY CHARITY CARE PATIENTS, OUR COLLECTIONS PROCESSES WITHIN OUR BUSINESS OFFICES ALSO HELP IDENTIFY PATIENTS WHO ARE ALREADY ELIGIBLE FOR CHARITY OR WHO MAY BE ELIGIBLE BASED ON THEIR STATUS WITHIN THE FEDERAL POVERTY GUIDELINES ("FPG"). WE UTILIZE PREVIOUSLY SUBMITTED PATIENT DOCUMENTATION AND CREDIT AGENCY REPORTED FPG FOR DETERMINATION. SUPPORTING DOCUMENTS ARE VALID 6 MONTHS FROM THE DATE OF SUBMISSION. NOVANT HEALTH REHABILITATION HOSPITAL HAS ADDITIONAL CRITERIA; PATIENTS ARE PRESUMED TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE, WITHOUT COMPLETING AN APPLICATION, IN THE FOLLOWING CIRCUMSTANCES:1. HOMELESSNESS2. DECEASED WITH NO ESTATE3. MENTAL INCAPACITATION WITH NO ONE TO ACT ON PATIENT'S BEHALF4. RECENT MEDICAID COVERAGE, I.E. COVERAGE WITHIN THREE (3) MONTHS OF ADMISSION OR DISCHARGE.OUR POLICIES ARE CONSIDERED FLUID AND ARE UPDATED FREQUENTLY BASED ON LOCAL AND NATIONAL MARKET STANDARDS AND NATIONAL ECONOMIC CONDITIONS. ANY UPDATES TO OUR POLICIES REQUIRE MULTI-LEVEL LEADERSHIP APPROVAL AND ARE ULTIMATELY APPROVED BY THE ORGANIZATION'S BOARD. PART VI, LINE 4: PART VI, LINE 4: COMMUNITY INFORMATIONTHE FORSYTH MEMORIAL HOSPITAL, INC. FORM 990 INCLUDES THE OPERATIONS OF TWO LICENSED HOSPITALS; ONE WITH FACILITIES IN THREE LOCATIONS: FORSYTH MEMORIAL HOSPITAL, INC. DBA NOVANT HEALTH FORSYTH MEDICAL CENTER, AS NOVANT HEALTH KERNERSVILLE MEDICAL CENTER, AND AS NOVANT HEALTH CLEMMONS MEDICAL CENTER; AND NOVANT HEALTH REHABILITATION HOSPITAL, A LICENSED HOSPITAL OPERATED THROUGH A JOINT VENTURE.FORSYTH MEMORIAL HOSPITAL, INC. DBA NOVANT HEALTH FORSYTH MEDICAL CENTER AND NOVANT HEALTH REHABILITATION HOSPITALTHE ORGANIZATION DEFINES ITS COMMUNITY BY ITS PRIMARY SERVICE AREA. THE PRIMARY SERVICE AREA FOR NOVANT HEALTH FORSYTH MEDICAL CENTER AND NOVANT HEALTH REHABILITATION HOSPITAL IS DEFINED BY THE ZIP CODES THAT REPRESENT MORE THAN 75% OF THE HOSPITAL'S IN-PATIENT POPULATION. THIS INCLUDES THE CITY OF WINSTON-SALEM, THE TOWNS OF KERNERSVILLE, LEWISVILLE, RURAL HALL, WALNUT COVE, THE UNINCORPORATED COMMUNITY OF PFAFFTOWN, AND THE VILLAGE OF CLEMMONS, ALL OF WHICH ARE LOCATED IN FORSYTH COUNTY, NORTH CAROLINA. THE PRIMARY SERVICE AREA ALSO INCLUDES THE CITY OF LEXINGTON IN DAVIDSON COUNTY, THE TOWNS OF ADVANCE AND MOCKSVILLE, BOTH IN DAVIE COUNTY, THE CITY OF KING IN STOKES COUNTY, THE CITY OF MOUNT AIRY IN SURRY COUNTY, AND THE TOWN OF EAST BEND AND YADKINVILLE, BOTH IN YADKIN COUNTY. FORSYTH MEMORIAL HOSPITAL, INC. DBA NOVANT HEALTH CLEMMONS MEDICAL CENTERTHE ORGANIZATION DEFINES ITS COMMUNITY BY ITS PRIMARY SERVICE AREA. THE PRIMARY SERVICE AREA FOR NOVANT HEALTH CLEMMONS MEDICAL CENTER IS DEFINED BY THE ZIP CODES THAT REPRESENT MORE THAN 75% OF THE HOSPITAL'S IN-PATIENT POPULATION. THIS INCLUDES CITY OF WINSTON-SALEM, THE TOWN OF LEWISVILLE, AND THE VILLAGE OF CLEMMONS, ALL OF WHICH ARE LOCATED IN FORSYTH COUNTY, NORTH CAROLINA. THE PRIMARY SERVICE AREA ALSO INCLUDES THE TOWNS OF ADVANCE AND MOCKSVILLE, BOTH IN DAVIE COUNTY, NORTH CAROLINA, AND THE TOWNS OF EAST BEND AND YADKINVILLE, BOTH IN YADKIN COUNTY, NORTH CAROLINA.THE SECONDARY SERVICE AREA FOR NOVANT HEALTH CLEMMONS MEDICAL CENTER COVERS DAVIDSON AND STOKES COUNTIES. 66% OF THE PATIENTS IN THE PRIMARY SERVICE AREA RESIDE IN FORSYTH COUNTY AND 30% RESIDE IN DAVIE COUNTY, WHILE 66% OF THE PATIENTS IN THE PRIMARY AND SECONDARY SERVICE AREAS RESIDE IN FORSYTH COUNTY.FORSYTH MEMORIAL HOSPITAL, INC. DBA NOVANT HEALTH KERNERSVILLE MEDICAL CENTERTHE ORGANIZATION DEFINES ITS COMMUNITY BY ITS PRIMARY SERVICE AREA. THE PRIMARY SERVICE AREA FOR NOVANT HEALTH KERNERSVILLE MEDICAL CENTER IS DEFINED BY THE ZIP CODES THAT REPRESENT MORE THAN 75% OF THE HOSPITAL'S IN-PATIENT POPULATION. THIS INCLUDES CITY OF WINSTON-SALEM, THE TOWNS OF KERNERSVILLE, WALKERTOWN, WALNUT COVE, AND THE TOWNSHIP OF BELEWS CREEK, ALL OF WHICH ARE LOCATED IN FORSYTH COUNTY, NORTH CAROLINA. THE PRIMARY SERVICE AREA ALSO INCLUDES THE TOWN OF STOKESDALE IN GUILDFORD COUNTY, NORTH CAROLINA.THE SECONDARY SERVICE AREA FOR NOVANT HEALTH KERNERSVILLE MEDICAL CENTER COVERS DAVIDSON AND STOKES COUNTIES.FORSYTH COUNTY IS MOSTLY URBAN IN NATURE, WITH ONLY 7.4% OF THE POPULATION LIVING IN RURAL AREAS. THE COUNTY CONSISTS OF A LARGE URBAN CENTER SURROUNDED BY SMALLER, MORE RURAL COMMUNITIES. BASED ON 2018 ESTIMATES, FORSYTH COUNTY REMAINED THE FOURTH LARGEST COUNTY IN THE STATE OF NORTH CAROLINA WITH 379,099 RESIDENTS. FROM 2020 TO 2030, THE POPULATION OF FORSYTH COUNTY IS PROJECTED TO GROW BY 4.0% WHICH IS DOWN FROM 7.0% FOR THE 2010-2020 PERIOD. ADOLESCENTS (INDIVIDUALS 18 AND YOUNGER) MAKE UP AN ESTIMATED 22.9% OF THE POPULATION IN FORSYTH COUNTY, WHILE SENIORS (INDIVIDUALS 65 AND OLDER) MAKE UP 16.0% OF THE POPULATION. MEDIAN AGE CONTINUES TO INCREASE, AND WE CAN SEE A SHIFT IN THE POPULATION FROM ADOLESCENTS TO SENIORS AS OUR POPULATION CONTINUES TO AGE. THIS TREND MAY PUT A STRAIN ON HEALTHCARE SERVICES IN FORSYTH COUNTY BECAUSE HEALTH CARE FOR OLDER PERSONS IS DIFFERENT FROM THAT PROVIDED TO OTHER AGE GROUPS IN SEVERAL RESPECTS: GREATER RESOURCE DEMANDS, THE INTERTWINING OF PROFESSIONAL HEALTH SERVICES WITH SOCIAL SERVICES, THE FREQUENT OCCURRENCE OF IMPORTANT ETHICAL CONUNDRUMS, AND A HIGHER PREVALENCE OF PHYSICAL AND MENTAL DISABILITIES. NON-WHITE MINORITIES CURRENTLY MAKE UP ALMOST HALF (43.5%) OF THE RACIAL DEMOGRAPHIC IN FORSYTH COUNTY. THE SPECIFIC POPULATION GROUPS (ETHNIC AND CULTURAL) ARE AS FOLLOWS: WHITE NON-HISPANIC 56.5%; BLACK/AFRICAN-AMERICAN 27.5%; HISPANIC OR LATINO 13.0%; OTHER 3.0%.ACCORDING TO THE US CENSUS BUREAU DATA (2018), THE MEDIAN HOUSEHOLD INCOME LEVEL WAS $48,369 IN FORSYTH COUNTY. THE POVERTY RATE FOR FORSYTH COUNTY IS 19.1%.THERE ARE FOUR LICENSED HOSPITAL FACILITIES IN THE COMMUNITY, TWO OF WHICH ARE PART OF THE NOVANT HEALTH SYSTEM AND ONE IS A SPECIALITY HOSPITAL OPERATED BY THE FILING ENTITY THROUGH A JOINT VENTURE. THERE IS ALSO ONE ACADEMIC TEACHING HOSPITAL. STATISTICAL INFORMATION WAS GATHERED FROM VARIOUS STATE AND FEDERAL SOURCES, BUT PRIMARILY THE US CENSUS BUREAU. SPECIFIC REFERENCES AND OTHER SUPPORTING INFORMATION CAN BE FOUND IN THE ORGANIZATION'S MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT AT:HTTPS://WWW.NOVANTHEALTH.ORG/HOME/ABOUT-US/COMMUNITY-ENGAGEMENT/OUR-IMPACT.ASPX PART VI, LINE 5: PART VI, LINE 5: PROMOTION OF COMMUNITY HEALTHTHE ORGANIZATION FURTHERS ITS EXEMPT PURPOSES BY DOING THE FOLLOWING:1. ADOPTING A FINANCIAL ASSISTANCE POLICY;2. REMAINING CERTIFIED BY THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES TO PROVIDE SERVICES TO ALL BENEFICIARIES OF MEDICARE, MEDICAID, AND OTHER GOVERNMENT PAYMENT PROGRAMS, AND PROVIDING SERVICES IN A NONDISCRIMINATORY MANNER TO SUCH BENEFICIARIES;3. OPERATING A FULL-TIME EMERGENCY ROOM WHICH IS OPEN TO AND ACCEPTS ALL PERSONS, REGARDLESS OF THEIR ABILITY TO PAY;4. MAINTAINING AN OPEN MEDICAL STAFF, SUBJECT TO EXCLUSIVE CONTRACTS FOR HOSPITAL-BASED SERVICES SUCH AS ANESTHESIOLOGY, RADIOLOGY, PATHOLOGY, HOSPITALIST, AND EMERGENCY DEPARTMENT SERVICES, TO THE EXTENT AN EXCLUSIVE CONTRACT FOR THOSE SERVICES IS REQUIRED TO OBTAIN PROPER STAFFING COVERAGE OR TO PERMIT A MORE EFFICIENT DELIVERY OF THOSE SERVICES WITHIN THE HOSPITAL FACILITY;5. MAINTAINING A GOVERNING BOARD CONSISTING PRIMARILY OF A BROAD CROSS-SECTION OF LEADERS IN THE COMMUNITY;6. ADOPTING AND APPLYING A CONFLICT OF INTEREST POLICY, WHICH APPLIES TO THE GOVERNING BOARD AND ORGANIZATION OFFICERS;7. PROVIDING HEALTH EDUCATION LECTURES AND WORKSHOPS;8. PROVIDING HEALTH FAIRS, EDUCATION ON SPECIFIC DISEASES OR CONDITIONS, AND HEALTH PROMOTION AND WELLNESS PROGRAMS TO THE COMMUNITIES IT SERVES;9. PROVIDING SUPPORT GROUPS AND SELF HELP PROGRAMS TO THE COMMUNITIES IT SERVES;10. PROVIDING COMMUNITY-BASED CLINICAL SERVICES, INCLUDING WITHOUT LIMITATION, HEALTH SCREENINGS AND CLINICS FOR UNINSURED OR UNDERINSURED PERSONS TO THE COMMUNITIES IT SERVES;11. PROVIDING HEALTHCARE SUPPORT SERVICES, INCLUDING WITHOUT LIMITATION, INFORMATION AND REFERRAL TO COMMUNITY SERVICES, CASE MANAGEMENT OF UNDERINSURED AND UNINSURED PERSONS, TELEPHONE INFORMATION SERVICES AND ASSISTANCE TO ENROLL IN PUBLIC PROGRAMS, SUCH AS STATE CHILDREN'S HEALTH INSURANCE PROGRAM (SCHIP) AND MEDICAID TO THE COMMUNITIES IT SERVES;12. PROVIDING SUBSIDIZED HEALTH SERVICES AND CLINICAL PROGRAMS TO THE COMMUNITIES IT SERVES;13. PROVIDING CASH AND IN-KIND CONTRIBUTIONS TO NONPROFIT COMMUNITY HEALTHCARE ORGANIZATIONS IN THE COMMUNITIES IT SERVES; AND14. GENERALLY PROMOTING THE HEALTH, WELLNESS, AND WELFARE OF THE COMMUNITIES IT SERVES BY PROVIDING QUALITY HEALTHCARE SERVICES AT REASONABLE COST.PLEASE SEE THE NOVANT HEALTH COMMUNITY BENEFIT REPORT, LOCATED AT HTTPS://WWW.NOVANTHEALTH.ORG/HOME/ABOUT-US/COMMUNITY-ENGAGEMENT/OUR-IMPACT.ASPXPLEASE NOTE THAT THE NUMERIC INFORMATION IN THIS REPORT IS NOT BASED UPON THE FORM 990, SCHEDULE H CRITERIA, BUT RATHER IT HAS BEEN PREPARED IN ACCORDANCE WITH THE NORTH CAROLINA HOSPITAL ASSOCIATION REPORTING GUIDELINES. PART VI, LINE 6: PART VI, LINE 6: AFFILIATED HEALTH CARE SYSTEMTHE ORGANIZATION IS AN INTEGRAL PART OF NOVANT HEALTH, A NOT-FOR-PROFIT INTEGRATED GROUP OF HOSPITALS, PHYSICIAN CLINICS, OUTPATIENT CENTERS AND OTHER HEALTHCARE SERVICE PROVIDERS. NOVANT HEALTH IS RANKED AS ONE OF OUR NATION'S TOP 20 INTEGRATED HEALTHCARE SYSTEMS - CARING FOR PATIENTS AND COMMUNITIES IN NORTH CAROLINA, SOUTH CAROLINA, AND VIRGINIA. EACH HOSPITAL PROVIDES SUBSTANTIAL COMMUNITY BENEFIT TO THE COMMUNITY IT SERVES, AS REPORTED INDIVIDUALLY ON EACH HOSPITAL'S FORM 990, SCHEDULE H. THE COMMUNITY BENEFIT OF THE SYSTEM AS A WHOLE IS DOCUMENTED IN A SYSTEM-WIDE COMMUNITY BENEFIT REPORT, LOCATED AT HTTPS://WWW.NOVANTHEALTH.ORG/HOME/ABOUT-US/COMMUNITY-ENGAGEMENT/OUR-IMPACT.ASPX. PLEASE NOTE THAT THE NUMERIC INFORMATION IN THIS REPORT IS NOT BASED UPON THE FORM 990, SCHEDULE H CRITERIA, BUT RATHER IT HAS BEEN PREPARED IN ACCORDANCE WITH THE NORTH CAROLINA HOSPITAL ASSOCIATION REPORTING GUIDELINES. IT SHOULD NOT BE RELIED UPON AS THE ORGANIZATION'S FORM 990, SCHEDULE H COMMUNITY BENEFIT REPORT, ITS COMMUNITY HEALTH NEEDS ASSESSMENT OR COMMUNITY BENEFIT IMPLEMENTATION STRATEGY. THERE ARE SIGNIFICANT COMMUNITY BENEFIT ACTIVITIES WITHIN NOVANT HEALTH WHICH MAY NOT BE REPORTABLE ON A SCHEDULE H BECAUSE THEY ARE NOT CONDUCTED BY AN ENTITY WHICH OWNS OR OPERATES A HOSPITAL.IN ADDITION TO HOSPITALS, NOVANT HEALTH INCLUDES A PHYSICIAN ORGANIZATION WITH PRACTICES IN NORTH CAROLINA, SOUTH CAROLINA, AND VIRGINIA AND FIVE HOSPITAL FOUNDATIONS WHICH SUPPORT AND ENHANCE THE ACTIVITIES IN THOSE HOSPITALS' COMMUNITIES. FURTHER, NOVANT HEALTH INCLUDES AMBULATORY SURGERY CENTERS, IMAGING CENTERS, REHABILITATION CENTERS, AND OTHER OUTPATIENT FACILITIES; ALL DEDICATED TO PROMOTING THE HEALTH OF THEIR RESPECTIVE COMMUNITIES. PART VI, LINE 7: STATE FILING OF COMMUNITY BENEFIT REPORT NOVANT HEALTH, INC. FILES A SYSTEM-WIDE COMMUNITY BENEFIT REPORT PREPARED IN ACCORDANCE WITH THE NORTH CAROLINA HOSPITAL ASSOCIATION REPORTING GUIDELINES WITH THE NORTH CAROLINA MEDICAL CARE COMMISSION AS PART OF THE DOCUMENTATION REQUIRED FOR THE ISSUANCE OF TAX EXEMPT BOND FINANCING. 1 THE SHALOM PROJECT INC 639 SOUTH GREEN STREET WINSTONSALEM NC 27101 202136431 501(C)(3) 12500 COMMUNITY OUTREACH HOSPITAL HOSPITALITY HOUSE OF WINSTON-SALEM 1970 BALDWIN LANE WINSTONSALEM NC 27103 203604576 501(C)(3) 17500 COMMUNITY OUTREACH CRISIS CONTROL MINISTRY INC 200 EAST TENTH STREET WINSTONSALEM NC 27101 237348168 501(C)(3) 25000 COMMUNITY OUTREACH LEADERSHIP WINSTON-SALEM 624 W SIXTH STREET SUITE 110 WINSTONSALEM NC 27101 581574887 501(C)(3) 10700 COMMUNITY OUTREACH UNITED WAY OF FORSYTH COUNTY INC 301 N MAIN STREET SUITE 1700 WINSTONSALEM NC 27101 237357234 501(C)(3) 40000 COMMUNITY OUTREACH AMERICAN HEART ASSOCIATION INC 7272 GREENVILLE AVENUE DALLAS TX 75231 135613797 501(C)(3) 92720 COMMUNITY OUTREACH YWCA OF WINSTON-SALEM AND FORSYTH COUNTY 313 INDERA MILLS COURT WINSTONSALEM NC 27101 560564345 501(C)(3) 32500 COMMUNITY OUTREACH WINSTON-SALEM ALLIANCE 100 N MAIN STREET WINSTONSALEM NC 27101 311726654 501(C)(6) 35000 COMMUNITY OUTREACH MARCH OF DIMES FOUNDATION 1275 MAMARONECK AVENUE WHITE PLAINS NY 10605 131846366 501(C)(3) 17500 COMMUNITY OUTREACH CANCER SERVICES INC 3175 MAPLEWOOD AVENUE WINSTONSALEM NC 27103 560656375 501(C)(3) 25000 COMMUNITY OUTREACH SENIOR SERVICES INC 2895 SHOREFAIR DRIVE WINSTONSALEM NC 27105 561085968 501(C)(3) 44000 COMMUNITY OUTREACH THE SHEPHERD'S CENTER OF KERNERSVILLE INC PO BOX 2044 KERNERSVILLE NC 27285 561471510 501(C)(3) 12500 COMMUNITY OUTREACH SHEPHERD'S CENTER OF GREATER WINSTON-SALEM INC 1700 EBERT STREET WINSTONSALEM NC 27103 561646960 501(C)(3) 10000 COMMUNITY OUTREACH PIEDMONT TRIAD PARTNERSHIP PO BOX 2672 HIGH POINT NC 27261 561750279 501(C)(3) 25000 COMMUNITY OUTREACH UNIVERSITY OF NORTH CAROLINA SCHOOL OF THE ARTS FOUNDATION INC 1533 SOUTH MAIN STREET WINSTONSALEM NC 27127 566064850 501(C)(3) 9700 COMMUNITY OUTREACH EXCHANGE CLUB CENTER FOR PREVENTION OF CHILD ABUSE OF NC INC 500 WEST NORTHWEST BLVD WINSTONSALEM NC 27105 581443692 501(C)(3) 11067 COMMUNITY OUTREACH RONALD MCDONALD HOUSE OF WINSTON-SALEM 419 S HAWTHORNE ROAD WINSTONSALEM NC 27103 581454715 501(C)(3) 12500 COMMUNITY OUTREACH THE SCIENCE CENTER AND ENVIRONMENTAL PARK OF FORSYTH COUNTY DBA SCIWORKS 400 W HANES MILL ROAD WINSTONSALEM NC 27105 560815746 501(C)(3) 210000 COMMUNITY OUTREACH MEDASSIST OF MECKLENBURG DBA NC MEDASSIST 4428 TAGGART CREEK ROAD CHARLOTTE NC 28208 562018957 501(C)(3) 7500 COMMUNITY OUTREACH TRELLIS SUPPORTIVE CARE ROWAN LLC 101 HOSPICE LANE WINSTONSALEM NC 27103 453013461 501(C)(3) 10000 COMMUNITY OUTREACH ABC OF NC CHILD DEVELOPMENT 905 FRIEDBERG CHURCH ROAD WINSTONSALEM NC 27127 300111894 501(C)(3) 24205 COMMUNITY OUTREACH THE LEUKEMIA & LYMPHOMA SOCIETY INC 3 INTERNATIONAL DR RYE BROOK NY 10573 135644916 501(C)(3) 9300 COMMUNITY OUTREACH FAMILY SERVICE OF HIGH POINT FOUNDATION INC 902 BONNER DRIVE JAMESTOWN NC 27282 560582016 501(C)(3) 7500 COMMUNITY OUTREACH FORSYTH MEDICAL CENTER FOUNDATION 2085 FRONTIS PLAZA BLVD WINSTONSALEM NC 27103 562120959 501(C)(3) 538943 GENERAL SUPPORT 23 1 PATIENT ASSISTANCE 35 12682 MEDICATION FOR INDIGENT PATIENTS 1997 119118 FMV MEDICATION FOR INDIGENT PATIENTS PATIENT TRANSPORTATION 3785 51698 FMV CAB FARES FOR INDIGENT PATIENTS DISASTER RELIEF ASSISTANCE 2519 1379275 PART I, LINE 2 : PROCEDURES FOR MONITORING THE USE OF THE GRANT FUNDS THE FILING ORGANIZATION IS PART OF THE INTEGRATED HEALTHCARE SYSTEM OPERATED BY NOVANT HEALTH, INC. ("NOVANT HEALTH"), THE PARENT ORGANIZATION. NOVANT HEALTH'S BYLAWS AUTHORIZE IT TO ESTABLISH CERTAIN POLICIES FOR ALL OF ITS SUBSIDIARIES WITHIN THE SYSTEM. NOVANT HEALTH HAS ESTABLISHED A SYSTEM-WIDE CORPORATE POLICY WITH STANDARDIZED GUIDELINES THAT ARE TO BE USED IN REVIEWING THE ELIGIBILITY AND SELECTION OF GRANTEES RECEIVING CERTAIN EXEMPT PURPOSE FUNDS. THE FILING ORGANIZATION MAINTAINS DOCUMENTATION OF THE ELIGIBILITY AND SELECTION CRITERIA AND RECORDS OF THE AMOUNTS ARE MAINTAINED VIA THE GENERAL LEDGER. FUNDS ARE GENERALLY NOT TRACKED AFTER BEING GRANTED, AS THE ORIGINAL ELIGIBILITY AND SELECTION CRITERIA HAVE ALREADY BEEN MET. X X X X 1 1 1 1 0 0 0 0 0 0 0 SMITH HARRY FMR SVP HOSP OPS (1/1/20-8/5/20) 0 381135 0 604330 0 409455 0 12156 0 34104 0 1441180 0 94406 NYCUM LAWRENCE MD FMR SVP & CCO (1/1/20-10/27/20) 397438 0 458000 0 192129 0 17100 0 23264 0 1087931 0 67176 0 SETLIFF MICHAEL PRES & COO 481211 0 265879 0 41691 0 92132 0 31412 0 912325 0 7500 0 ELLIOTT KATHLEEN ONCOLOGIST 491226 0 286554 0 18409 0 17100 0 35094 0 848383 0 7500 0 MANN JOHN PRESIDENT & COO 446212 0 211830 0 52824 0 88324 0 35215 6936 834405 6936 7500 0 FRIEDMAN ROLAND UROLOGIST 325466 0 374100 0 85751 0 17100 0 30737 0 833154 0 0 0 COLLINS TIMOTHY ONCOLOGIST 574122 0 155205 0 31316 0 17100 0 35127 0 812870 0 7500 0 ZEYLIKMAN YURIY NEUROLOGIST 388956 0 22653 0 350367 0 17100 0 32971 0 812047 0 7500 0 BAKER WILLIAM ONCOLOGIST 357083 0 345596 0 22120 0 16820 0 32382 0 774001 0 0 0 BERGER WILLIAM MD TRUSTEE 0 351673 0 195773 0 27467 0 17100 0 34990 0 627003 0 7500 ROYSTER KIRSTEN PRES & COO KMC 352018 0 198015 0 39366 0 14830 0 11663 0 615892 0 0 0 EDWARDS JOEL MD TRUSTEE 211109 0 1612 0 20795 0 12442 0 2668 0 248626 0 0 0 BRIGHT JANET FMR VP NURSING & MARKET CNO 0 0 0 0 155248 0 0 0 5610 0 160858 0 0 0 PART I, LINE 1A FRINGE OR EXPENSE EXPLANATION FIRST-CLASS OR CHARTER TRAVEL: FIRST-CLASS OR CHARTER TRAVEL IS NOT A COVERED TRAVEL EXPENSE FOR EXECUTIVES; THEY ARE LIMITED TO BUSINESS OR COACH CLASS FARES FOR COMMERCIAL FLIGHTS. HOWEVER, CHARTER TRAVEL IS AVAILABLE TO CERTAIN EXECUTIVES, BOARD MEMBERS, AND APPROVED BUSINESS PERSONNEL MEETING APPLICABLE POLICY CRITERIA. TRAVEL FOR COMPANIONS: COMPANIONS ARE ALLOWED ON CERTAIN CHARTER FLIGHTS PAID FOR BY THE ORGANIZATION. IN THAT CASE, THE VALUE OF THE COMPANION'S FLIGHT IS CALCULATED UNDER APPLICABLE TAX LAWS AND THAT AMOUNT IS INCLUDED IN THE EXECUTIVE'S TAXABLE INCOME AS PRESCRIBED BY THE APPLICABLE TAX LAWS. DISCRETIONARY SPENDING ACCOUNT: CERTAIN EXECUTIVES RECEIVE A DISCRETIONARY SPENDING ACCOUNT. THE DOLLAR AMOUNT IN THE ACCOUNT IS PRE-APPROVED BY THE COMPENSATION AND LEADERSHIP COMMITTEE OF THE NOVANT HEALTH BOARD OF TRUSTEES. THE ACCOUNT CAN BE USED ONLY FOR AN APPROVED LIST OF EXPENDITURES. ALL OPTIONS OTHER THAN A DEFERRED, AT-RISK, COMPENSATION OPTION ARE CONSIDERED TAXABLE AND ARE INCLUDED IN THE EXECUTIVE'S TAXABLE INCOME AS PRESCRIBED BY THE APPLICABLE TAX LAWS. HOUSING ALLOWANCE OR RESIDENCE FOR PERSONAL USE: WE PROVIDE TEMPORARY HOUSING ALLOWANCES IN CERTAIN EXECUTIVE RECRUITMENT AND RELOCATION PACKAGES. THE VALUE IS CALCULATED UNDER APPLICABLE TAX LAWS AND THAT AMOUNT IS INCLUDED IN THE EXECUTIVE'S INCOME AS PRESCRIBED BY THE APPLICABLE TAX LAWS. PART I, LINE 3 THE FILING ORGANIZATION IS AN INTEGRAL PART OF NOVANT HEALTH, AN INTEGRATED HEALTHCARE SYSTEM AND RELIES UPON NOVANT HEALTH, INC., THE PARENT ORGANIZATION, TO USE THE PROCESS DESCRIBED IN PART VI, LINE 15A/15B OF THIS RETURN TO ESTABLISH COMPENSATION FOR CERTAIN EXECUTIVES. THIS PROCESS ADHERES TO THE REQUIREMENTS SET FORTH TO SECURE THE REBUTTABLE PRESUMPTION OF REASONABLENESS AND INCLUDES A REVIEW AND APPROVAL BY INDEPENDENT AND DISINTERESTED MEMBERS OF A COMPENSATION COMMITTEE, CONSULTATION WITH INDEPENDENT COMPENSATION CONSULTANTS, THE UTILIZATION OF THIRD-PARTY COMPARABILITY DATA SUCH AS PUBLISHED COMPENSATION SURVEYS, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. PART I, LINES 4A-B PART I, LINES 4A-C: SEVERANCE, NONQUALIFIED, AND EQUITY-BASED PAYMENTS SEVERANCE BRIGHT, JANET $156,305 NYCUM, LAWRENCE $71,965 SMITH, HARRY $248,175 NONQUALIFIED NYCUM, LAWRENCE $59,676 SMITH, HARRY $86,906 EQUITY-BASED NONE PART I, LINE 4A - SEVERANCE PLAN: ELIGIBLE EXECUTIVES MAY RECEIVE SEVERANCE PAY THAT IS BASED ON ANNUAL COMPENSATION FOR A SPECIFIED PERIOD OF TIME. THE SEVERANCE PAY WOULD BE PAID ONLY IN THE EVENT OF CERTAIN TYPES OF EMPLOYMENT TERMINATION, AND IS FURTHER CONTINGENT ON THE SATISFACTION OF OTHER CONDITIONS SUCH AS COMPLIANCE WITH A NON-COMPETITION COVENANT. ANY CURRENT YEAR PAYMENTS HAVE BEEN INCLUDED IN THE COMPENSATION AMOUNTS REPORTED IN PART VII AND IN COLUMN (B)(III) OF SCHEDULE J. THE COMPENSATION AND LEADERSHIP COMMITTEE OF THE NOVANT HEALTH BOARD REVIEWS, APPROVES, AND OVERSEES ALL ASPECTS AND ALL ELEMENTS OF EXECUTIVE COMPENSATION AND BENEFITS, INCLUDING THE AMOUNTS AWARDED UNDER THIS SEVERANCE PLAN. PART I, LINE 4B - SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANS: THE SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN ("SERP") IS INTENDED TO SUPPORT RETENTION OF KEY EXECUTIVES, AND TO OFFER COMPETITIVE TOTAL COMPENSATION. ELIGIBLE EXECUTIVES WILL BE NOMINATED BY THE CEO AND APPROVED BY THE NOVANT HEALTH COMPENSATION AND LEADERSHIP COMMITTEE ("THE COMMITTEE") TO PARTICIPATE. GENERALLY, ANNUAL CONTRIBUTIONS TO THE PLAN OR PAYMENTS TO PARTICIPANTS WILL BE BASED ON A PERCENTAGE OF THE PARTICIPANT'S BASE SALARY AS OF JANUARY 1ST OF THE PREVIOUS PLAN YEAR AND ARE REPORTED IN COLUMN (C) OF SCHEDULE J. PRIOR TO MAKING THE CONTRIBUTIONS OR PAYMENTS, THE COMMITTEE WILL APPROVE THE AMOUNTS AS TO REASONABLENESS, WHEN COMBINED WITH ALL OTHER ANNUAL COMPENSATION. A 3 YEAR CLASS-YEAR VESTING PERIOD WILL APPLY UP TO AGE 62, WHEN ALL MONEY WOULD BE VESTED AND PAID OUT TO THE PARTICIPANT. OTHERWISE, VESTING WILL OCCUR ON JANUARY 1ST OF EACH YEAR FOR THE APPROPRIATE CLASS-YEAR VESTING PERIOD. THE COMMITTEE REVIEWS, APPROVES, AND OVERSEES ALL ASPECTS AND ALL ELEMENTS OF EXECUTIVE COMPENSATION AND BENEFITS. MURPHY TAYLOR WILLIAM FAMILY MEMBER OF TRACEY MARTIN, BOARD MEMBER 41916 COMPENSATION PAID BY THE FILING ORGANIZATION TO THE INTERESTED PERSON. 0 HEALY PATRICK FAMILY MEMBER OF JOAN HEALY, BOARD OFFICER 548567 COMPENSATION PAID BY THE FILING ORGANIZATION TO THE INTERESTED PERSON 0 FORM 990, PI, L1: ORGANIZATION'S MISSION OR MOST SIGNIFICANT ACTIVITIES FORSYTH MEMORIAL HOSPITAL, INC. DOING BUSINESS AS NOVANT HEALTH FORSYTH MEDICAL CENTER ("NHFMC") , NOVANT HEALTH CLEMMONS MEDICAL CENTER ("NHCMC"), AND NOVANT HEALTH KERNERSVILLE MEDICAL CENTER ("NHKMC") IS AN INTEGRAL PART OF THE NOVANT HEALTH SYSTEM (COLLECTIVELY KNOWN AS "NOVANT HEALTH"), A NOT-FOR-PROFIT INTEGRATED GROUP OF HOSPITALS, PHYSICIAN CLINICS, OUTPATIENT CENTERS AND OTHER HEALTHCARE SERVICE PROVIDERS. NOVANT HEALTH CONSISTS OF MORE THAN 1,600 PHYSICIANS AND OVER 29,000 EMPLOYEES WHO MAKE HEALTHCARE REMARKABLE AT NEARLY 700 LOCATIONS, INCLUDING 15 MEDICAL CENTERS AND HUNDREDS OF OUTPATIENT FACILITIES AND PHYSICIAN CLINICS. HEADQUARTERED IN WINSTON SALEM, NC, NOVANT HEALTH IS COMMITTED TO MAKING HEALTHCARE REMARKABLE FOR PATIENTS AND COMMUNITIES, SERVING MORE THAN FIVE MILLION PATIENTS ANNUALLY. IN 2020, NOVANT HEALTH WAS THE ONLY HEALTHCARE SYSTEM IN NORTH CAROLINA TO BE INCLUDED ON FORBES' BEST EMPLOYERS FOR DIVERSITY LIST. IN 2020, THE NOVANT HEALTH SYSTEM REPORTED $5.7 BILLION IN REVENUES. GENERAL INFORMATION NOVANT HEALTH FORSYTH MEDICAL CENTER, NOVANT HEALTH CLEMMONS MEDICAL CENTER, AND NOVANT HEALTH KERNERSVILLE MEDICAL CENTER EXIST TO IMPROVE THE HEALTH OF THE COMMUNITIES THEY SERVE WITH A VISION OF PROVIDING A REMARKABLE PATIENT EXPERIENCE IN EVERY DIMENSION, EVERY TIME. THEY ACCOMPLISH THAT MISSION BY PROVIDING HEALTHCARE SERVICES TO ALL WHO ENTRUST THEIR CARE TO THEM AND BY SUPPORTING THE GREATER WINSTON-SALEM AND KERNERSVILLE COMMUNITIES THROUGH PARTNERSHIPS AND OUTREACH. THE HOSPITALS SUPPORT ORGANIZATIONS THAT PROVIDE HEALTH SERVICES, EDUCATION AND ASSISTANCE TO THE UNINSURED AND THE OVERALL COMMUNITY. NOVANT HEALTH FORSYTH MEDICAL CENTER AFFILIATE HOSPITAL, NOVANT HEALTH KERNERSVILLE MEDICAL CENTER IN KERNERSVILLE, NORTH CAROLINA, FOCUSED ON PROVIDING A REMARKABLE PATIENT EXPERIENCE THROUGHOUT THE COVID-19 PANDEMIC VIA A FAST-ACCESS EMERGENCY DEPARTMENT, CONSISTENT QUALITY, AND EXCELLENT SERVICE TO RESIDENTS IN THE KERNERSVILLE AREA, WESTERN GUILFORD AND ROCKINGHAM COUNTIES OF NORTH CAROLINA, AS WELL AS EASTERN STOKES AND FORSYTH COUNTIES OF NORTH CAROLINA. NOVANT HEALTH FORSYTH MEDICAL CENTER'S AFFILIATE HOSPITAL, NOVANT HEALTH CLEMMONS MEDICAL CENTER IN CLEMMONS, NORTH CAROLINA FOCUSED ON PROVIDING A REMARKABLE PATIENT EXPERIENCE VIA A FAST-ACCESS EMERGENCY DEPARTMENT, GENERAL, ORTHOPEDIC, PODIATRIC, TRANSITIONAL/INFUSION SERVICES AND EAR, NOSE AND THROAT SURGICAL SERVICES, CONSISTENT QUALITY, AND EXCELLENT SERVICE TO RESIDENTS IN WESTERN FORSYTH COUNTY, DAVIE COUNTY AND YADKIN COUNTY. IN ADDITION TO OUR QUALITY OF SERVICES AND COMPREHENSIVE CATEGORIES OF SERVICES, WE'RE VERY PROUD OF OUR PATIENT FINANCIAL ASSISTANCE PROGRAM. WE WORK WITH PATIENTS TO HELP QUALIFY THEM FOR PUBLIC ASSISTANCE, ESTABLISH A REASONABLE PAYMENT PLAN, DISCOUNT THEIR BILL, OR PROVIDE FREE CARE FOR THOSE THAT QUALIFY FOR FINANCIAL ASSISTANCE. COMMUNITY OUTREACH COMMUNITY OUTREACH IS A CRITICAL COMPONENT TO THE MISSION OF NOVANT HEALTH FORSYTH MEDICAL CENTER, NOVANT HEALTH KERNERSVILLE MEDICAL CENTER, AND NOVANT HEALTH CLEMMONS MEDICAL CENTER. EACH YEAR, OUR PHYSICIANS, NURSES AND STAFF HOLD SCREENINGS, TEACH PROGRAMS, HOST SEMINARS AND VOLUNTEER COUNTLESS HOURS TO HELP IMPROVE THE LIVES OF THOSE IN OUR COMMUNITY. A FEW EXAMPLES OF THIS ARE AS FOLLOWS: SUPPORT GROUPS: - HEAD & NECK ONCOLOGY SUPPORT GROUP - GYN ONCOLOGY SUPPORT GROUP - GI WELLNESS SUPPORT GROUP - VIRTUAL BREAST CANCER NUTRITION SURVIVORSHIP CLASS - PROJECT CARE SCREENINGS: - GTS- A1C SCREENINGS - BREAST CANCER SCREENING - RY SCREENING AT RED H.E.A.R.R.T CLASSES AND TOURS: - BABY CAFE AND BREASTFEEDING CLASS - MATERNITY TOUR AT FORSYTH MEDICAL CENTER - NICU INFANT CPR AT FORSYTH MEDICAL CENTER - VIRTUAL NEWBORN CARE AT FORSYTH MEDICAL CENTER - VIRTUAL MEET OUR PEDIATRIC PROVIDER OTHER INITIATIVES INCLUDE: - GREATER WINSTON-SALEM MARKET SPANISH RADIO (EDUCATIONAL PROGRAM) - MASK DISTRIBUTION AND SCREENING SITES NEW TECHNOLOGY & SERVICES NOVANT HEALTH FORSYTH MEDICAL CENTER - NOVANT HEALTH LAUNCHED AN ARTIFICIAL INTELLIGENCE PROGRAM TO HELP SUPPORT STROKE CARE AT FIVE RURAL HOSPITALS IN NORTH CAROLINA - DAVIS REGIONAL MEDICAL CENTER (IN STATESVILLE), ASHE MEMORIAL HOSPITAL (IN JEFFERSON), UNC ROCKINGHAM HEALTH CARE (IN EDEN), HUGH CHATMAN MEMORIAL (IN ELKIN) AND NORTHERN REGIONAL HOSPITAL (IN MOUNT AIRY). THE PROGRAM IS CALLED VIZ.AI, AND IS DESIGNED TO REDUCE DELAYS IN CARE AND TRAVEL TIME TO FORSYTH MEDICAL CENTER - AN ADVANCED CERTIFIED COMPREHENSIVE STROKE CENTER. IN A RURAL HOSPITAL SETTING, IT OFTEN TAKES AT LEAST AN HOUR TO RECEIVE THE RESULTS FROM DIAGNOSTIC SCANS, BUT VIZ.AI SENDS THE SCAN RESULTS IMMEDIATELY TO THE "CLOUD" TO BE READ BY ARTIFICIAL INTELLIGENCE. IF THE PROGRAM DETECTS A LARGE BLOOD CLOT, IT SENDS AN ALERT TO THE RURAL EMERGENCY PHYSICIAN AS WELL AS THE INTERVENTIONAL NEUROLOGIST AT FORSYTH MEDICAL CENTER. THE ON-SITE CARE TEAM CAN THEN CONNECT VIA VIDEO WITH THE STROKE SPECIALIST AT NOVANT HEALTH FOR IMMEDIATE CONSULT SUPPORT. AS A RESULT, THE 60-MINUTE WAIT TIME HAS BEEN REDUCED TO UNDER 10 MINUTES IN MOST CASES, THUS DECREASING THE FREQUENCY OF TRANSFERS TO TERTIARY HOSPITALS. - NOVANT HEALTH PARTNERED WITH JVION, A LEADER IN ARTIFICIAL INTELLIGENCE, TO LAUNCH A CONGESTIVE HEART FAILURE READMISSION REDUCTION PROGRAM THAT WAS IMPLEMENTED AT FORSYTH MEDICAL CENTER. THE PROGRAM'S GOAL IS TO REDUCE READMISSIONS FOR CONGESTIVE HEART FAILURE PATIENTS BY 5%. JVION'S AI MACHINE LEARNING ALGORITHMS ARE DESIGNED TO HELP PREVENT PATIENT HARM AND REDUCE ASSOCIATED COSTS BY ENABLING CLINICAL STAFF TO FOCUS ATTENTION, RESOURCES AND INDIVIDUALIZED INTERVENTIONS ON PATIENTS WHOSE OUTCOMES CAN BE IMPROVED. UNLIKE TRADITIONAL AI AND PREDICTIVE ANALYTIC SOLUTIONS THAT MERELY IDENTIFY HIGH-RISK PATIENTS AND CAUSE ALARM FATIGUE, JVION'S MODEL PINPOINTS THE SPECIFIC PATIENTS WHO ARE ON A RISK TRAJECTORY THAT CAN BE CHANGED AND PROVIDES THE INDIVIDUAL PATIENT WITH RECOMMENDATIONS THAT WILL DRIVE BETTER OUTCOMES. - TO IMPROVE ACCESS TO SURGICAL SERVICES, NOVANT HEALTH PARTNERED WITH LEANTAAS, INC., A HEALTHCARE ANALYTICS SOFTWARE COMPANY, TO DEPLOY IQUEUE FOR OPERATING ROOMS ACROSS THE HEALTHCARE SYSTEM. THE NEW SOFTWARE PROGRAM IS DESIGNED TO IMPROVE SCHEDULING ACCESS FOR PATIENTS, OPTIMIZE OPERATING ROOM UTILIZATION, AND ENSURE NO SURGICAL BLOCK TIME IS WASTED. THE PROGRAM ALSO PROVIDES HOSPITAL LEADERSHIP WITH VALUABLE REAL-TIME DATA TO HAVE A BETTER UNDERSTANDING OF TRUE SURGICAL CAPACITY. - THROUGHOUT THE COVID-19 PANDEMIC, NOVANT HEALTH FORSYTH MEDICAL CENTER CONTINUED CONSTRUCTION ON ITS MULTIYEAR, MULTIPHASE PROJECT TO ENHANCE THE DELIVERY OF CARE AT THE HOSPITAL. FORSYTH MEDICAL CENTER'S $184.4 MILLION CAPITAL INVESTMENT INCLUDES RENOVATING 25 PERCENT OF PATIENT ROOMS, FORTIFYING FACILITY INFRASTRUCTURE, AND COMPLETING A MAJOR ENHANCEMENT FOR THE WOMEN'S AND CHILDREN'S CENTER. FORM 990, PI, L1: CONTINUED NOVANT HEALTH CLEMMONS MEDICAL CENTER - TO ENHANCE ITS IMAGING SERVICES, NOVANT HEALTH CLEMMONS MEDICAL CENTER RECENTLY REPLACED ITS 20 SLICE CT SCANNER WITH A NEW 64 SLICE SCANNER AND A 128 SLICE SCANNER. THE 64 SLICE SCANNER IS EQUIPPED WITH A FLUOROSCOPY PLATFORM WHICH ENABLES IMAGE GUIDED INTERVENTIONAL PROCEDURES, WHERE REAL TIME IMAGING IS USED TO TARGET AND TREAT SPECIFIC PARTS OF THE ANATOMY. THE 128 SLICE SCANNER IS PRIMARILY UTILIZED TO SUPPORT PATIENTS IN THE EMERGENCY ROOM BY PROVIDING SHORTER SCAN TIMES WITH SUPERIOR IMAGE QUALITY. BOTH SCANNERS ARE EQUIPPED WITH LOW DOSE RADIATION SOFTWARE PLATFORMS, ALLOWING FOR EXCELLENT IMAGE QUALITY WHILE ALSO ENSURING LOW DOSE RADIATION LEVELS FOR PATIENTS. - ROBOTIC-ASSISTED SURGERY IS NOW AVAILABLE FOR PATIENTS AT NOVANT HEALTH CLEMMONS MEDICAL CENTER. THE DA VINCI SURGICAL SYSTEM WAS ADDED TO THE HOSPITAL IN 2020, AND PROVIDES SURGEONS WITH AN ALTERNATIVE TO OPEN SURGERY AND CONVENTIONAL LAPAROSCOPY. THE ROBOTIC-ASSISTED SURGICAL PLATFORM ALLOWS SURGEONS TO COMPLETE COMPLEX AND DELICATE PROCEDURES TO BE PERFORMED THROUGH TINY INCISIONS WITH UNMATCHED PRECISION, MEANING LESS PAIN AND SHORTER RECOVERY TIMES FOR PATIENTS. THE SURGICAL SYSTEM HAS BEEN UTILIZED TO ASSIST WITH A VARIETY OF GENERAL SURGERIES, AND WILL BEGIN TO ASSIST WITH COLORECTAL SURGERY IN 2021. - TO DELIVER ON OUR PROMISE ON CONTINUE TO EXPAND SERVICES OFFERED TO THE CLEMMONS AND SURROUNDING COMMUNITY, CLEMMONS HAS PARTNERED WITH CARDIOLOGY TO OFFER OUTPATIENT CARDIAC SERVICES TO INCLUDE CARDIOVERSION AND TRANSESOPHAGEAL ECHOCARDIOGRAM (TEE). A TEE CAN DETECT BLOOD CLOTS, MASSES AND TUMORS LOCATED INSIDE THE HEART. IT CAN ALSO GAUGE THE SEVERITY OF CERTAIN VALVE PROBLEMS AND DETECT CONGENITAL HEART DISEASE. CARDIOVERSION IS A MEDICAL PROCEDURE THAT CAN ASSIST IN RESTORING NORMAL HEART RHYTHM IN PEOPLE WITH CERTAIN TYPES OF ABNORMAL HEARTBEATS. NOVANT HEALTH KERNERSVILLE MEDICAL CENTER - TO HELP ADDRESS THE PHYSICIAN AND NURSING SHORTAGE IN ACUTE CARE SETTINGS ACROSS THE UNITED STATES, NOVANT HEALTH LAUNCHED A NEW TELE-ICU PROGRAM TO EXPANDED ACCESS TO CRITICAL CARE SERVICES AT COMMUNITY HOSPITALS, INCLUDING NOVANT HEALTH KERNERSVILLE MEDICAL CENTER. THE TELE-ICU PROGRAM ENABLES 24/7 REMOTE MONITORING AND TREATMENT OF INTENSIVE CARE PATIENTS AT THE HOSPITAL. NOT ONLY DOES THIS NEW TECHNOLOGY IMPROVE ACCESS TO CRITICAL CARE SERVICES, BUT IT IS ALSO DESIGNED TO HELP REDUCE THE TRANSFER RATE TO TERTIARY HOSPITALS, SO PATIENTS CAN RECEIVE CARE CLOSER TO HOME. - TO ENHANCE IMAGING SERVICES, NOVANT HEALTH KERNERSVILLE MEDICAL CENTER ADDED A 128-SLICE CT IN 2020. THE NEW SCANNER NOT ONLY IMPROVES IMAGE QUALITY AND ACCESS FOR PATIENTS, BUT WILL ALSO BE UTILIZED TO ASSIST WITH HEARTFLOW STUDIES IN 2021. THESE NON-INVASIVE IMAGING STUDIES WILL HELP PROVIDERS VISUALIZE BLOCKAGES IN THE CORONARY ARTERIES, AND DEVELOP A MORE EFFECTIVE TREATMENT PLAN FOR THEIR PATIENTS. - ROBOTIC-ASSISTED SURGERY IS NOW AVAILABLE FOR PATIENTS AT NOVANT HEALTH KERNERSVILLE MEDICAL CENTER. THE DA VINCI SURGICAL SYSTEM WAS ADDED TO THE HOSPITAL IN 2020, AND IS DESIGNED TO ENHANCE THE SURGEON'S SKILLSET BY IMPROVING PRECISION, WHILE ALSO IMPROVING THE EXPECTED RECOVERY TIME FOR PATIENTS. THE STATE-OF-THE-ART SURGICAL SYSTEM HAS BEEN UTILIZED TO ASSIST WITH A VARIETY OF MINIMALLY INVASIVE GENERAL SURGERY, GYNECOLOGIC AND COLORECTAL PROCEDURES. AWARDS, RECOGNITIONS & CERTIFICATIONS/RECERTIFICATIONS FORSYTH MEDICAL CENTER - CLINICAL EXCELLENCE AWARD BY VIZIENT - GET WITH THE GUIDELINES GOLD PLUS BY THE AMERICAN HEART ASSOCIATION/AMERICAN STROKE ASSOCIATION (2020) - MISSION LIFELINE - STEMI RECEIVING GOLD PLUS ACHIEVEMENT AWARD BY THE AMERICAN HEART ASSOCIATION - ADVANCED COMPREHENSIVE STROKE CERTIFICATION BY THE JOINT COMMISSION - BABY-FRIENDLY DESIGNATION BY THE WORLD HEALTH ORGANIZATION AND THE UNITED NATIONS CHILDREN'S FUND - LEADER IN LGBTQ HEALTHCARE EQUALITY BY THE HUMAN RIGHTS CAMPAIGN FOUNDATION (2020, 2019, 2018, 2017) - MAGNET RECOGNITION PROGRAM DESIGNATION BY THE AMERICAN NURSES CREDENTIALING CENTER ADDITIONAL CERTIFICATIONS FOR FORSYTH MEDICAL CENTER INCLUDE: - BABY FRIENDLY DESIGNATION - INTERNATIONAL ASSOCIATION FOR HEALTHCARE SECURITY AND SAFETY - NORTH CAROLINA DIVISION OF MEDICAL ASSISTANCE - MEDICAID - TJC - COMPREHENSIVE STROKE CENTER CERTIFICATION - UNITED STATES DEPARTMENT OF HEALTH & HUMAN SERVICES - CLIA - UNITED STATES DEPARTMENT OF HEALTH & HUMAN SERVICES - MEDICARE KERNERSVILLE MEDICAL CENTER - LEADER IN LGBTQ HEALTHCARE EQUALITY BY THE HUMAN RIGHTS CAMPAIGN FOUNDATION (2020, 2019, 2018, 2017) - STAGE 7 EMRAM AWARD BY HIMSS ANALYTICS. THIS RECOGNITION REPRESENTS NOVANT HEALTH'S ACHIEVEMENT OF THE HIGHEST LEVEL ON THE ELECTRONIC MEDICAL RECORD ADOPTION MODEL (EMRAM), WHICH MEANS THE HOSPITALS ARE USING ELECTRONIC MEDICAL RECORD TECHNOLOGY TO ITS FULLEST POTENTIAL TO PROVIDE ACCESS AND CARE TO OUR PATIENTS. (2018) - MAGNET RECOGNITION PROGRAM DESIGNATION BY THE AMERICAN NURSES CREDENTIALING CENTER ADDITIONAL CERTIFICATIONS FOR KERNERSVILLE MEDICAL CENTER INCLUDE: - METABOLIC & BARIATRIC SURGERY ACCREDITATION AND QUALITY IMPROVEMENT PROGRAM - FDA MQSA CERTIFICATION - INTERNATIONAL ASSOCIATION FOR HEALTHCARE SECURITY AND SAFETY - NORTH CAROLINA DIVISION OF MEDICAL ASSISTANCE - MEDICAID - UNITED STATES DEPARTMENT OF HEALTH & HUMAN SERVICES - CLIA - UNITED STATES DEPARTMENT OF HEALTH & HUMAN SERVICES - MEDICARE CLEMMONS MEDICAL CENTER - GOLD SAFETY AWARD BY THE NORTH CAROLINA DEPARTMENT OF LABOR - LEADER IN LGBTQ HEALTHCARE EQUALITY BY THE HUMAN RIGHTS CAMPAIGN FOUNDATION (2020, 2019, 2018) - 2018 AND 2019 GUARDIAN OF EXCELLENCE AWARD BY PRESS GANEY ASSOCIATES - HIP AND KNEE JOINT REPLACEMENT CERTIFICATION BY THE JOINT COMMISSION - MAGNET RECOGNITION PROGRAM DESIGNATION BY THE AMERICAN NURSES CREDENTIALING CENTER ADDITIONAL CERTIFICATIONS FOR CLEMMONS MEDICAL CENTER INCLUDE: - INTERNATIONAL ASSOCIATION FOR HEALTHCARE SECURITY AND SAFETY - NORTH CAROLINA DIVISION OF MEDICAL ASSISTANCE - MEDICAID - TJC - HIP JOINT REPLACEMENT CERTIFICATION - TJC - KNEE JOINT REPLACEMENT CERTIFICATION - UNITED STATES DEPARTMENT OF HEALTH & HUMAN SERVICES - CLIA - UNITED STATES DEPARTMENT OF HEALTH & HUMAN SERVICES - MEDICARE ACCREDITATION NOVANT HEALTH FORSYTH MEDICAL CENTER, NOVANT HEALTH CLEMMONS MEDICAL CENTER AND NOVANT HEALTH KERNERSVILLE MEDICAL CENTER HAVE BEEN FULLY ACCREDITED BY THE JOINT COMMISSION, AN INDEPENDENT ORGANIZATION THAT EVALUATES A HEALTHCARE ORGANIZATION'S PERFORMANCE IN AREAS THAT MOST AFFECT PATIENT HEALTH AND SAFETY. IN ADDITION, WE HAVE EARNED SOME OF THE NATION'S TOP HONORS IN QUALITY CARE, INCLUDING BREAST CENTER ACCREDITATION. NOVANT HEALTH KERNERSVILLE MEDICAL CENTER ALSO MEETS ALL CRITERIA AS A COMPREHENSIVE CENTER UNDER THE METABOLIC AND BARIATRIC SURGERY ACCREDITATION AND QUALITY IMPROVEMENT PROGRAM (MBSAQIP), A JOINT PROGRAM OF THE AMERICAN COLLEGE OF SURGEONS (ACS) AND THE AMERICAN SOCIETY FOR METABOLIC AND BARIATRIC SURGERY (ASMBS). THE MBSAQIP STANDARDS ENSURE THAT BARIATRIC SURGICAL PATIENTS RECEIVE A MULTIDISCIPLINARY PROGRAM, NOT JUST A SURGICAL PROCEDURE, WHICH IMPROVES PATIENT OUTCOMES AND LONG-TERM SUCCESS. FORM 990, PI, L1: CONTINUED ADDITIONAL ACCREDITATIONS FOR NOVANT HEALTH FORSYTH MEDICAL CENTER: - AMERICAN ASSOCIATION OF BLOOD BANKS - AMERICAN COLLEGE OF RADIOLOGY: RADIATION ONCOLOGY - AMERICAN NURSES CREDENTIALING CENTER - NURSE RESIDENCY PROGRAM - AMERICAN SOCIETY OF HEALTH SYSTEM PHARMACISTS - PHARMACY RESIDENCY PROGRAM - COLLEGE OF AMERICAN PATHOLOGY - INTERSOCIETAL ACCREDITATION COMMISSION ECHOCARDIOGRAPHY LABORATORIES - NOVANT HEALTH CANCER INSTITUTE - NATIONAL ACCREDITATION PROGRAM FOR BREAST CENTERS - NATIONAL ASSOCIATION EPILEPSY CENTERS ADDITIONAL ACCREDITATIONS FOR NOVANT HEALTH CLEMMONS MEDICAL CENTER - AMERICAN ASSOCIATION OF BLOOD BANKS - AMERICAN NURSES CREDENTIALING CENTER - NURSE RESIDENCY PROGRAM - COLLEGE OF AMERICAN PATHOLOGY ADDITIONAL ACCREDITATIONS FOR NOVANT HEALTH KERNERSVILLE MEDICAL CENTER - AMERICAN ASSOCIATION OF BLOOD BANKS - AMERICAN COLLEGE OF RADIOLOGY: MAMMOGRAPHY - AMERICAN COLLEGE OF RADIOLOGY: RADIATION ONCOLOGY - AMERICAN NURSES CREDENTIALING CENTER - NURSE RESIDENCY PROGRAM - COLLEGE OF AMERICAN PATHOLOGY - INTERSOCIETAL ACCREDITATION COMMISSION ECHOCARDIOGRAPHY LABORATORIES - NOVANT HEALTH CANCER INSTITUTE - NATIONAL ACCREDITATION PROGRAM FOR BREAST CENTERS COMMUNITY BENEFIT REPORT HTTPS://WWW.NOVANTHEALTH.ORG/HOME/ABOUT-US/COMMUNITY-ENGAGEMENT/OUR-IMPA CT.ASPX THE COMMUNITY BENEFIT REPORT, REFERRED TO AS A COMMUNITY IMPACT REPORT, PREPARED BY NOVANT HEALTH IS A SYSTEM-WIDE REPORT THAT INCLUDES QUALITATIVE AND QUANTITATIVE INFORMATION. PLEASE NOTE THAT THE NUMERIC DATA IN THIS REPORT IS NOT BASED UPON THE FORM 990, SCHEDULE H CRITERIA, BUT RATHER IT HAS BEEN PREPARED IN ACCORDANCE WITH THE NORTH CAROLINA HOSPITAL ASSOCIATION REPORTING GUIDELINES. IT SHOULD NOT BE RELIED UPON AS THE ORGANIZATION'S FORM 990, SCHEDULE H COMMUNITY BENEFIT REPORT, ITS COMMUNITY HEALTH NEEDS ASSESSMENT OR COMMUNITY BENEFIT IMPLEMENTATION STRATEGY. IN THIS REPORT, THE NOVANT HEALTH SYSTEM'S COMMUNITY BENEFIT WAS APPROXIMATELY $1,018,000,000, INCLUDING $179,000,000 IN FINANCIAL ASSISTANCE FOR 2020. FORM 990, PART III, LINE 1: MISSION, VISION, AND VALUES MISSION NOVANT HEALTH EXISTS TO IMPROVE THE HEALTH OF COMMUNITIES, ONE PERSON AT A TIME. VISION WE, THE NOVANT HEALTH TEAM, WILL DELIVER THE MOST REMARKABLE PATIENT EXPERIENCE, IN EVERY DIMENSION, EVERY TIME. VALUES -COMPASSION: WE TREAT OUR CUSTOMERS AND THEIR FAMILIES, STAFF AND OTHER HEALTHCARE PROVIDERS AS FAMILY MEMBERS BY SHOWING THEM KINDNESS, PATIENCE, EMPATHY AND RESPECT. -DIVERSITY AND INCLUSION: WE RECOGNIZE THAT EVERY PERSON IS DIFFERENT, EACH SHAPED BY UNIQUE LIFE EXPERIENCES. THIS ENABLES US TO BETTER UNDERSTAND EACH OTHER AND OUR CUSTOMERS. -PERSONAL EXCELLENCE: WE STRIVE TO GROW PERSONALLY AND PROFESSIONALLY, AND WE APPROACH EACH SERVICE OPPORTUNITY WITH A POSITIVE, FLEXIBLE ATTITUDE. HONESTY AND PERSONAL INTEGRITY GUIDE ALL THAT WE DO. -TEAMWORK: THE NEEDS AND EXPECTATIONS OF ANY ONE CUSTOMER ARE GREATER THAN WHAT ONE PERSON'S SERVICE EFFORTS CAN SATISFY. WE SUPPORT EACH OTHER SO THAT TOGETHER AS A TEAM, WE CAN BE SUCCESSFUL IN THE EYE OF THE CUSTOMER AS A QUALITY SERVICE PROVIDER. -COURAGE: WE ACT BOLDLY IN MAKING THE CHANGES NECESSARY TO ACHIEVE OUR MISSION, VISION AND PROMISE OF DELIVERING REMARKABLE HEALTHCARE. OUR PEOPLE AT NOVANT HEALTH, PEOPLE ARE OUR BUSINESS. WE TREAT EACH OTHER WITH RESPECT AND COMPASSION. WE EMBRACE THE DIFFERENCES IN OUR STRENGTHS WHILE FOSTERING AN ENVIRONMENT OF INCLUSION, EMPOWERMENT, INSPIRATION AND COURAGE. WE ALWAYS REMEMBER, OUR BUSINESS IS THE CARE OF ALL PEOPLE, STARTING WITH OUR TEAM MEMBERS. OUR PROMISE TO PATIENTS WE ARE MAKING YOUR HEALTHCARE EXPERIENCE REMARKABLE. WE WILL BRING YOU WORLD-CLASS CLINICIANS, CARE AND TECHNOLOGY - WHEN AND WHERE YOU NEED THEM. WE ARE REINVENTING THE HEALTHCARE EXPERIENCE TO BE SIMPLER, MORE CONVENIENT AND MORE AFFORDABLE, SO THAT YOU CAN FOCUS ON GETTING BETTER AND STAYING HEALTHY. FORM 990, PART III, LINE 2 LEARN ABOUT HOW WE ARE SERVING OUR COMMUNITIES IN THE PANDEMIC BY VISITING HTTPS://WWW.NOVANTHEALTH.ORG/PORTALS/92/ASSETS/DOCUMENTS/ANNUAL-FINANCIA L-INFORMATION/NOVANT-HEALTH-2020-ANNUAL-REPORT_RISING-UP.PDF FORM 990, PART III, LINE 4A: PROGRAM SERVICE ACCOMPLISHMENTS KMC HAS 50 LICENSED BEDS. DURING 2020 THERE WERE 11,749 PATIENT DAYS WITH AN AVERAGE LENGTH OF STAY OF 4 DAYS, AN AVERAGE DAILY CENSUS OF 32, AND 2,942 DISCHARGES. THERE WERE 3,010 INPATIENT AND OUTPATIENT SURGERIES, A TOTAL OF 51,475 OUTPATIENT ENCOUNTERS AND 32,327 EMERGENCY DEPARTMENT VISITS. CMC HAS 36 LICENSED BEDS. DURING 2020 THERE WERE 4,597 PATIENT DAYS WITH AN AVERAGE LENGTH OF STAY OF 2 DAYS, AN AVERAGE DAILY CENSUS OF 13, AND 2,377 DISCHARGES. THERE WERE 5,639 INPATIENT AND OUTPATIENT SURGERIES, A TOTAL OF 32,752 OUTPATIENT ENCOUNTERS AND 17,840 EMERGENCY DEPARTMENT VISITS. FORM 990, PART VI, SECTION A, LINE 6 FORM 990, PART VI, SECTION A, LINE 6: CLASSES OF MEMBERS OR STOCKHOLDERS THE CORPORATION IS A NONPROFIT CORPORATION WITH MEMBERS (OR A MEMBER). MEMBER HAS SOLE VOTING AUTHORITY OVER ALL MATTERS. IN ADDITION TO THESE POWERS, MEMBER HAS CETAIN RIGHTS SUBJECT TO THE RESERVED POWERS OF NOVANT HEALTH, INC. FORM 990, PART VI, SECTION A, LINE 7A FORM 990, PART VI, SECTION A, LINE 7A: ELECTION OF MEMBERS AND THEIR RIGHTS NOVANT HEALTH, INC. ELECTS ALL MEMBERS OF THE GOVERNING BODY OF FORSYTH MEMORIAL HOSPITAL,INC. FORM 990, PART VI, SECTION A, LINE 7B FORM 990, PART VI, SECTION A, LINE 7B: DECISIONS SUBJECT TO APPROVAL OF MEMBERS NOVANT HEALTH, INC. HAS CERTAIN RESERVED POWERS, SUCH AS APPROVAL OF AMENDMENTS TO THE ARTICLES AND BYLAWS OF THE CORPORATION, AND TO ADOPT CERTAIN POLICIES WHICH SHALL BE IMPLEMENTED BY THE CORPORATION BOARD. FORM 990, PART VI, SECTION B, LINE 11B FORM 990, PART VI, SECTION B, LINE 11: ORGANIZATION'S PROCESS TO REVIEW FORM 990 THE BOARD HAS DELEGATED REVIEW OF THE FORM 990 TO NOVANT HEALTH'S BOARD OF TRUSTEES' AUDIT AND COMPLIANCE COMMITTEE ("THE COMMITTEE"), WHICH OVERSEES TAX MATTERS FOR ENTITIES IN THE NOVANT HEALTH SYSTEM. THE COMMITTEE IS THE REVIEW BODY FOR ALL OF THE FORM 990S FILED FOR ORGANIZATIONS WITHIN THE NOVANT HEALTH SYSTEM. THE COMMITTEE MEETS BEFORE THE FORM 990S ARE FILED WITH THE IRS AND AFTER ALL BOARD MEMBERS HAVE BEEN PROVIDED A PAPER OR ELECTRONIC COPY OF THE FORM 990 AND A SUMMARY OF ITS CONTENTS. THE VICE PRESIDENT OF TAX AND LEGAL COUNSEL FOR NOVANT HEALTH ATTEND THE MEETING TO ANSWER ANY QUESTIONS AND ADDRESS ANY SIGNIFICANT DISCLOSURES WITHIN THE FORM 990. FORM 990, PART VI, SECTION B, LINE 12C FORM 990, PART VI, SECTION B, LINE 12C: MONITORING AND ENFORCEMENT OF COI THE ORGANIZATION'S TRUSTEE CONFLICT OF INTEREST POLICY APPLIES TO ALL TRUSTEES, PRINCIPAL OFFICERS OR MEMBERS OF A COMMITTEE WITH BOARD DELEGATED POWERS INCLUDING ANY APPLICABLE DISREGARDED ENTITIES. ALL TRUSTEES ARE SENT AN ANNUAL DISCLOSURE QUESTIONNAIRE. THE TRUSTEE ANNUAL DISCLOSURE QUESTIONNAIRES ARE REVIEWED BY THE COMPLIANCE DEPARTMENT. WITH RESPECT TO PARTICULAR TRANSACTIONS THAT COME BEFORE THE BOARD, THE CONFLICT OF INTEREST POLICY WOULD BE FOLLOWED. THE POTENTIAL CONFLICT OF INTEREST WOULD BE DISCLOSED BY THE BOARD MEMBER BEFORE A VOTE ON THE TRANSACTION AND THE REST OF THE BOARD WOULD DETERMINE WHETHER A CONFLICT OF INTEREST EXISTS. IF THE REST OF THE BOARD DETERMINED THAT A CONFLICT OF INTEREST EXISTED THEN THE BOARD MEMBER WITH THE CONFLICT OF INTEREST WOULD NOT PARTICIPATE IN THE DELIBERATIONS AND VOTE. FORM 990, PART VI, SECTION B, LINE 15 FORM 990, PART VI, SECTION B, LINE 15A/15B: THE FILING ORGANIZATION IS AN INTEGRAL PART OF NOVANT HEALTH, AN INTEGRATED HEALTHCARE SYSTEM COLLECTIVELY REFERRED TO AS "NOVANT HEALTH." NOVANT HEALTH, INC. IS THE PARENT ORGANIZATION AND INDEPENDENT AND DISINTERESTED MEMBERS OF THE NOVANT HEALTH, INC. BOARD OF TRUSTEES (WHO COMPRISE THE COMPENSATION AND LEADERSHIP COMMITTEE OF THE BOARD) REVIEW, APPROVE, AND OVERSEE ALL ASPECTS OF COMPENSATION AND BENEFITS FOR CERTAIN LEADERS AND EXECUTIVES ("EXECUTIVES") SERVING AS OFFICERS, INCLUDING THE TOP MANAGEMENT OFFICIAL, OR KEY EMPLOYEES FOR NOVANT HEALTH ENTITIES. THE COMMITTEE WORKS WITH AN INDEPENDENT COMPENSATION CONSULTANT AND USES THIRD PARTY COMPARABILITY DATA FOR FUNCTIONALLY SIMILAR POSITIONS AT SIMILARLY SITUATED ORGANIZATIONS TO ENSURE THAT TOTAL COMPENSATION AND BENEFITS FOR EACH EXECUTIVE IS REASONABLE FOR THAT EXECUTIVE'S POSITION. THE COMMITTEE REVIEWS AND APPROVES EXECUTIVE COMPENSATION AND BENEFITS ANNUALLY, CONSISTENT WITH THE WRITTEN EXECUTIVE COMPENSATION PHILOSOPHY OF NOVANT HEALTH, AND IN A MANNER THAT QUALIFIES FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS, THEREBY ASSURING THAT TOTAL COMPENSATION AND BENEFITS PROVIDED TO EACH EXECUTIVE IS REASONABLE. FORM 990, PART VI, SECTION C, LINE 19 FORM 990, PART VI, SECTION C, LINE 19: GOVERNING DOCUMENTS DISCLOSURE THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS CONTAINING ALL ORGANIZATIONS IN THE NOVANT HEALTH SYSTEM ARE POSTED TO THE NOVANT HEALTH WEBSITE. THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT AVAILABLE TO THE PUBLIC. FORM 990, PART VII, SECTION B: INDEPENDENT CONTRACTORS THE FILING ENTITY IS PART OF THE NOT-FOR-PROFIT INTEGRATED HEALTHCARE SYSTEM KNOWN AS NOVANT HEALTH. NOVANT HEALTH, INC., THE PARENT ORGANIZATION, IS RESPONSIBLE FOR CERTAIN CORPORATE SUPPORT FUNCTIONS INCLUDING ACCOUNTS PAYABLE AND ISSUES FORMS 1099 FOR CERTAIN ENTITIES IN THE SYSTEM INCLUDING THE FILING ENTITY. INFORMATION REPORTED IN PART VII, SECTION B REPRESENTS THE EXPENSES PAID ON BEHALF OF THE FILING ENTITY TO INDEPENDENT CONTRACTORS OVER $100,000. FORM 990, PART XI, LINE 9: CONTRIBUTIONS: -1,022,725. PARTNERSHIP ADJUSTMENT: -1,520,488. AFFILIATE TRANSFERS: -631,215. 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