MEDICAL PARK HOSPITAL INC: Form 990, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- MEDICAL PARK HOSPITAL INC (EIN 56-1340424)
- Tax period
- 2020-01-01 to 2020-12-31
- Filed
- 2021-11-12
- IRS object ID
- 202113169349311711
- Schema version
- 2020v4.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2021-11-12T16:17:24-06:00 | ReturnTs |
| Tax Period End | 2020-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 346565596 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ERNST & YOUNG US LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 100 NORTH TRYON STREET SUITE 3800 | AddressLine1Txt |
| City | CHARLOTTE | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 28202 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2020-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 561340424 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MEDICAL PARK HOSPITAL INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | MEDI | BusinessNameControlTxt |
| Phone | 3367182803 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2085 FRONTIS PLAZA BLVD | AddressLine1Txt |
| City | WINSTON SALEM | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 27103 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | FRED HARGETT | PersonNm |
| Person Title | EVP & CFO | PersonTitleTxt |
| Phone | 3367182803 | PhoneNum |
| Signature | 2021-11-12 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | FRED | PersonFirstNm |
| Person Last | HARGETT | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | SCOTT TIDWELL | PreparerPersonNm |
| PTIN | P01729213 | PTIN |
| Phone | 7043726300 | PhoneNum |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 2 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2020 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NOVANT HEALTH MEDICAL PARK HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | CARL ARMATO | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2085 FRONTIS PLAZA BLVD | AddressLine1Txt |
| City | WINSTON SALEM | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 27103 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $95,860,703 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.NOVANTHEALTH.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1966 | FormationYr |
| Legal Domicile State | NC | LegalDomicileStateCd |
| Activity Or Mission | SEE SCHEDULE O | ActivityOrMissionDesc |
| Voting Members Governing Body | 8 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 6 | VotingMembersIndependentCnt |
| Total Employee | 327 | TotalEmployeeCnt |
| Total Volunteers | 21 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,527,650 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $84,909,173 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $94,091,627 | CYProgramServiceRevenueAmt |
| PY Investment Income | -$34,299 | PYInvestmentIncomeAmt |
| CY Investment Income | $71,302 | CYInvestmentIncomeAmt |
| PY Other Revenue | $155,686 | PYOtherRevenueAmt |
| CY Other Revenue | $170,124 | CYOtherRevenueAmt |
| PY Total Revenue | $85,030,560 | PYTotalRevenueAmt |
| CY Total Revenue | $95,860,703 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $1,170 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $49,646 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $18,499,407 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $22,743,466 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $47,491,452 | PYOtherExpensesAmt |
| CY Other Expenses | $48,888,084 | CYOtherExpensesAmt |
| PY Total Expenses | $65,992,029 | PYTotalExpensesAmt |
| CY Total Expenses | $71,681,196 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $19,038,531 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $24,179,507 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $368,238,691 | TotalAssetsBOYAmt |
| Total Assets EOY | $397,674,890 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $4,610,167 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $9,866,859 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $363,628,524 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $387,808,031 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | SEE SCHEDULE O | MissionDesc |
| Significant New Program Srvc | Yes (1) | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $53,578,941 | ExpenseAmt |
| Grant | $49,646 | GrantAmt |
| Revenue | $94,151,459 | RevenueAmt |
| Desc | MEDICAL PARK HOSPITAL CARRIES OUT THE PURPOSE OF THE FORSYTH COUNTY BOARD OF COMMISSIONERS THROUGH ADVANCING AND SUPPORTING THE PROMOTION OF HEALTH OF THE INHABITANTS OF FORSYTH COUNTY. MEDICAL PARK HOSPITAL HAS 22 LICENSED BEDS. DURING 2020, THERE WERE 2,970 PATIENT DAYS WITH AN AVERAGE LENGTH OF STAY OF 3 DAYS, AN AVERAGE DAILY CENSUS OF 8, AND 912 DISCHARGES. THERE WERE 9,981 INPATIENT AND OUTPATIENT SURGERIES, AND 25,643 OUTPATIENT ENCOUNTERS. | Desc |
| Total Program Service Expenses | $53,578,941 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | Yes (1) | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 327 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 8 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 6 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | NC | StatesWhereCopyOfReturnIsFldCd |
| Own Website | Yes (X) | OwnWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KAREN DAUGHERTY | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3367182803 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2085 FRONTIS PLAZA BLVD | AddressLine1Txt |
| City | WINSTON SALEM | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 27103 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (21 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|
| SETLIFF MICHAEL | |||||||||
| TRUSTEE | 0.20 | 50.00 | Yes (X) | $0 | $788,781 | $123,544 | |||
| CHRISTMAN JENNIFER | |||||||||
| TRUSTEE | 0.20 | 45.00 | Yes (X) | $0 | $529,187 | $47,476 | |||
| ALMENGUAL TERRENCE MD | |||||||||
| VICE CHAIR | 0.20 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| FORIEST BRYANT | |||||||||
| TRUSTEE | 0.20 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| INMAN JOSEPH MD | |||||||||
| TRUSTEE | 0.20 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| JOHNSON JOIA | |||||||||
| TRUSTEE | 0.20 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| LAWSON GEORGE MD | |||||||||
| CHAIR | 0.20 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| MCPHAIL ERNEST MD | |||||||||
| TRUSTEE | 0.20 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| WILLIS JOHN MD | |||||||||
| TRUSTEE | 0.20 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| SMITH HARRY | |||||||||
| FMR SVP HOSP OPS (1/1/20-8/5/20) | 0.00 | 50.00 | $0 | $1,394,920 | $46,260 | Yes (X) | |||
| BARRETT LESLIE | |||||||||
| PRESIDENT & COO | 50.00 | 0.00 | $0 | $445,521 | $27,973 | Yes (X) | |||
| COLEMAN TRISHA | |||||||||
| TREASURER | 0.20 | 45.00 | $0 | $344,100 | $47,139 | Yes (X) | |||
| MORRIS JOHN | |||||||||
| ASST SEC | 0.20 | 45.00 | $0 | $277,596 | $35,453 | Yes (X) | |||
| FRANCE BARBARA | |||||||||
| SEC | 0.20 | 45.00 | $51,686 | $0 | $33,000 | Yes (X) | |||
| SECHRIST ALICIA | |||||||||
| SUPV CRNA | 45.00 | 0.00 | $182,459 | $0 | $35,682 | Yes (X) | |||
| METCALF SUSAN | |||||||||
| CRNA II | 45.00 | 0.00 | $195,134 | $0 | $22,753 | Yes (X) | |||
| LYERLY RONALD | |||||||||
| PHARMACIST | 45.00 | 0.00 | $164,424 | $0 | $38,213 | Yes (X) | |||
| YOUENS MARK | |||||||||
| CRNA II | 45.00 | 0.00 | $171,242 | $0 | $28,153 | Yes (X) | |||
| SMITH CAROL | |||||||||
| DIR OPERATIONS/NURSING | 45.00 | 0.00 | $162,727 | $0 | $31,674 | Yes (X) | |||
| ROYSTER KIRSTEN | |||||||||
| FMR PRES | 0.20 | 50.00 | $0 | $589,399 | $26,493 | Yes (X) | |||
| BRIGHT JANET | |||||||||
| FMR CNO | 0.00 | 0.00 | $0 | $155,248 | $5,610 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $927,672 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $4,524,752 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $549,423 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 18 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| SALEM ELECTRIC CO | |||||
| PO BOX 26784 | WINSTON SALEM | NC | 27114 | ELECTRICIAN SERVICES | $1,116,354 |
| CHILLER SERVICES INC | |||||
| PO BOX 668165 | CHARLOTTE | NC | 28266 | HVAC CONTRACTOR/SERVICES | $756,968 |
| TRIMEDX INC | |||||
| PO BOX 636129 | CINCINNATI | OH | 45263 | CLINICAL ENGINEERING SERVICES | $731,216 |
| MORRISON HEALTHCARE | |||||
| PO BOX 102289 | ATLANTA | GA | 30368 | FOOD MANAGEMENT SERVICES | $599,618 |
| MODERN CONSTRUCTION SERVICES | |||||
| PO BOX 92 | CORNELIUS | NC | 28031 | CONSTRUCTION SERVICES | $366,404 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 12 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $1,527,650 | GovernmentGrantsAmt |
| Total Contributions | $1,527,650 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | NET PATIENT REVENUE | Desc |
| Business | 622110 | BusinessCd |
| Total Revenue Column | $94,091,627 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $94,091,627 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $94,091,627 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $56,302 | TotalRevenueColumnAmt |
| Exclusion | $56,302 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $15,000 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $0 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $15,000 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $15,000 | TotalRevenueColumnAmt |
| Exclusion | $15,000 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|---|
| CAFETERIA MEALS | 722514 | $101,254 | $101,254 | |
| MISCELLANEOUS | 900099 | $59,832 | $59,832 | |
| VENDING MACHINE INCOME | 900099 | $9,038 | $9,038 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $170,124 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $95,860,703 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $94,151,459 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $181,594 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $585 | TotalAmt |
| Program Services | $585 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $49,061 | TotalAmt |
| Program Services | $49,061 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $84,686 | TotalAmt |
| Management And General | $84,686 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,119,796 | TotalAmt |
| Program Services | $16,126,619 | ProgramServicesAmt |
| Management And General | $1,993,177 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $775,986 | TotalAmt |
| Program Services | $690,628 | ProgramServicesAmt |
| Management And General | $85,358 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,529,361 | TotalAmt |
| Program Services | $2,251,131 | ProgramServicesAmt |
| Management And General | $278,230 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,233,637 | TotalAmt |
| Program Services | $1,097,937 | ProgramServicesAmt |
| Management And General | $135,700 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,340,425 | TotalAmt |
| Program Services | $2,889,085 | ProgramServicesAmt |
| Management And General | $451,340 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,184 | TotalAmt |
| Program Services | $8,184 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $229,589 | TotalAmt |
| Program Services | $138,467 | ProgramServicesAmt |
| Management And General | $91,122 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $329,620 | TotalAmt |
| Program Services | $318,171 | ProgramServicesAmt |
| Management And General | $11,449 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,127,019 | TotalAmt |
| Program Services | $990,459 | ProgramServicesAmt |
| Management And General | $136,560 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,522 | TotalAmt |
| Program Services | $5,754 | ProgramServicesAmt |
| Management And General | $768 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,986 | TotalAmt |
| Program Services | $3,548 | ProgramServicesAmt |
| Management And General | $438 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $853,371 | TotalAmt |
| Program Services | $853,371 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,725,210 | TotalAmt |
| Program Services | $2,420,347 | ProgramServicesAmt |
| Management And General | $304,863 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $98,414 | TotalAmt |
| Program Services | $83,379 | ProgramServicesAmt |
| Management And General | $15,035 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $19,539,907 | $19,528,547 | $11,360 |
| CORPORATE SUPPORT | $14,389,447 | $14,389,447 | |
| BAD DEBT | $2,860,632 | $2,860,632 | |
| REPAIRS AND MAINTENANCE | $1,381,185 | $1,361,872 | $19,313 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,994,573 | TotalAmt |
| Program Services | $1,901,164 | ProgramServicesAmt |
| Management And General | $93,409 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $71,681,196 | TotalAmt |
| Program Services | $53,578,941 | ProgramServicesAmt |
| Management And General | $18,102,255 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,363 | BOYAmt |
| EOY | $5,312 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,470,690 | BOYAmt |
| EOY | $12,682,905 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,857,999 | BOYAmt |
| EOY | $1,828,232 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,692,738 | BOYAmt |
| EOY | $3,867,701 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $167,739 | BOYAmt |
| EOY | $303,083 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $65,836,901 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $47,063,146 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,500,205 | BOYAmt |
| EOY | $18,773,755 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $336,539,957 | BOYAmt |
| EOY | $360,213,902 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $368,238,691 | BOYAmt |
| EOY | $397,674,890 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,516,153 | BOYAmt |
| EOY | $6,498,606 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,094,014 | BOYAmt |
| EOY | $3,368,253 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,610,167 | BOYAmt |
| EOY | $9,866,859 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $363,628,524 | BOYAmt |
| EOY | $387,808,031 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $363,628,524 | BOYAmt |
| EOY | $387,808,031 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $368,238,691 | BOYAmt |
| EOY | $397,674,890 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $24,179,507 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $5,677 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $5,677 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | LINE 1I DUES PAID TO CERTAIN ORGANIZATIONS WHICH INCLUDE A PORTION RELATED TO LOBBYING ACTIVITIES. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,200,000 | OtherCostOrOtherBasisAmt |
| Book Value | $2,200,000 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $25,113,149 | OtherCostOrOtherBasisAmt |
| Depreciation | $19,501,350 | DepreciationAmt |
| Book Value | $5,611,799 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $35,195,842 | OtherCostOrOtherBasisAmt |
| Depreciation | $26,966,299 | DepreciationAmt |
| Book Value | $8,229,543 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,327,910 | OtherCostOrOtherBasisAmt |
| Depreciation | $595,497 | DepreciationAmt |
| Book Value | $2,732,413 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $18,773,755 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (2 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| DUE FROM AFFILIATE | $359,949,994 |
| RIGHT OF USE ASSETS | $263,908 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $360,213,902 | TotalBookValueOtherAssetsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)
| DescDesc | AmtAmt |
|---|---|
| NOTES PAYABLE | $2,284,048 |
| PATIENT REFUNDS | $170,760 |
| THIRD PARTY PAYMENT PAYABLE | $648,320 |
| OPERATING LEASE | $265,125 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $3,368,253 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | 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. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 300.000000000000 | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | 0 | FPGReferenceDiscountedCareInd |
| Free Care Medically Indigent | 0 | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,649,754 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,649,754 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02400 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,016,591 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,904,065 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,112,526 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03070 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $6,666,345 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,904,065 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,762,280 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05470 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $515 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $515 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $47,147 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $47,147 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00070 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $47,662 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $47,662 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00070 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $6,714,007 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,904,065 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,809,942 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05540 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $2,860,632 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $0 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $9,723,893 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $9,618,919 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $104,974 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | 0 | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MPH DBA NH MEDICAL PARK HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1950 SOUTH HAWTHORNE ROAD | AddressLine1Txt |
| City | WINSTON SALEM | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 27103 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.NOVANTHEALTH.ORG | WebsiteAddressTxt |
| State License | H0229 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NH MEDICAL PARK HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 19 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | 0 | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Other Website | Yes (X) | OtherWebsiteInd |
| Other Website URL | SEE SECTION C | OtherWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 19 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | SEE SECTION C | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 300.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 0.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Residency Criteria | Yes (X) | ResidencyCriteriaInd |
| Other Criteria | Yes (X) | OtherCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | SEE SECTION C | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | SEE SECTION C | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | SEE SECTION C | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Prospective Medicare Medicaid | Yes (X) | ProspectiveMedicareMedicaidInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | Yes (1) | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| NH MEDICAL PARK HOSPITAL | PART V, SECTION B, LINE 3J: NH MEDICAL PARK 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. |
| NH MEDICAL PARK 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. |
| NH MEDICAL PARK HOSPITAL | PART V, SECTION B, LINE 7D: MEDICAL PARK HOSPITALPART V, SECTION B, LINE 7BHTTPS://WWW.NOVANTHEALTH.ORG/HOME/ABOUT-US/COMMUNITY-ENGAGEMENT/OUR-IMPACT.ASPXMEDICAL PARK HOSPITALPART V, SECTION B, LINE 10AHTTPS://WWW.NOVANTHEALTH.ORG/HOME/ABOUT-US/COMMUNITY-ENGAGEMENT/OUR-IMPACT.ASPX |
| NH MEDICAL PARK HOSPITAL | 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. |
| NH MEDICAL PARK HOSPITAL | PART V, SECTION B, LINE 13H: OTHER ELIGIBILITY CRITERIA EXPLAINED IN THE FAP INCLUDE THE FOLLOWING: FREE CARE IS ONLY APPLICABLE TO MEDICALLY NECESSARY SERVICES; PROVIDER BASED PHYSICIAN CLINICS REQUIRE THAT PATIENTS MUST HAVE BEEN TREATED BY AN AFFILIATED MEDICAL GROUP PRIMARY CARE PHYSICIAN WITHIN THE PREVIOUS THREE YEARS; PATIENTS MUST BE UNABLE TO ACCESS ENTITLEMENT PROGRAMS; PATIENTS WITH SPECIAL CIRCUMSTANCES SUCH AS BANKRUPTCY MAY ALSO BE ELIGIBLE FOR CHARITY CARE. NOVANT HEALTH MEDICAL PARK HOSPITAL:PART V, LINE 16A, FAP WEBSITE: HTTPS://WWW.NOVANTHEALTH.ORG/HOME/PATIENTS--VISITORS/YOUR-HEALTHCARE-COSTS/FINANCIAL-ASSISTANCE-FOR-THE-UNINSURED.ASPXPART 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.PDFPART 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 |
| NH MEDICAL PARK HOSPITAL | 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. |
Supplemental Information Detail SupplementalInformationDetail (15 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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 $2,860,632. |
| 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. 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 INFORMATIONMEDICAL PARK HOSPITAL DBA NOVANT HEALTH MEDICAL PARK HOSPITALTHE ORGANIZATION DEFINES ITS COMMUNITY BY ITS PRIMARY SERVICE AREA. THE PRIMARY SERVICE AREA FOR NOVANT HEALTH MEDICAL PARK 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, WALKERTOWN, 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 CITIES OF LEXINGTON AND THOMASVILLE, BOTH IN DAVIDSON COUNTY, THE TOWNS OF ADVANCE AND MOCKSVILLE, BOTH IN DAVIE COUNTY, THE CITY OF KING AND THE TOWN OF PINNACLE, BOTH IN STOKES COUNTY, THE CITY OF MOUNT AIRY AND THE TOWN OF PILOT MOUNTAIN, BOTH IN SURRY COUNTY, THE TOWN OF NORTH WILKESBORO IN WILKES COUNTY, AND THE TOWN OF EAST BEND AND YADKINVILLE, BOTH IN YADKIN COUNTY. THE SECONDARY SERVICE AREA FOR NOVANT HEALTH MEDICAL PARK HOSPITAL COVERS ALLEGHANY, CARROLL VA, GUILFORD, IREDELL, RANDOLPH AND ROCKINGHAM COUNTIES. 66% OF THE PATIENTS IN THE PRIMARY SERVICE AREA RESIDE IN FORSYTH COUNTY, WHILE 57% OF THE PATIENTS IN THE PRIMARY AND SECONDARY SERVICE AREAS RESIDE IN FORSYTH COUNTYFORSYTH 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 NONPROFIT ACUTE CARE HOSPITAL FACILITIES IN THE COMMUNITY, THREE OF WHICH ARE PART OF THE NOVANT HEALTH SYSTEM. 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. MAINTAINING AN OPEN MEDICAL STAFF, SUBJECT TO EXCLUSIVE CONTRACTS FOR HOSPITAL-BASED SERVICES SUCH AS ANESTHESIOLOGY, RADIOLOGY, PATHOLOGY, AND HOSPITALIST 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;4. ADOPTING AND APPLYING A CONFLICT OF INTEREST POLICY, WHICH APPLIES TO THE GOVERNING BOARD AND ORGANIZATION OFFICERS;5. PROVIDING HEALTH EDUCATION LECTURES AND WORKSHOPS;6. PROVIDING COMMUNITY-BASED CLINICAL SERVICES, INCLUDING WITHOUT LIMITATION, HEALTH SCREENINGS AND CLINICS FOR UNINSURED OR UNDERINSURED PERSONS TO THE COMMUNITIES IT SERVES;7. 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;8. PROVIDING SUBSIDIZED HEALTH SERVICES AND CLINICAL PROGRAMS TO THE COMMUNITIES IT SERVES;9. PROVIDING CASH AND IN-KIND CONTRIBUTIONS TO NONPROFIT COMMUNITY HEALTHCARE ORGANIZATIONS IN THE COMMUNITIES IT SERVES; AND10. GENERALLY PROMOTING THE HEALTH, WELLNESS, AND WELFARE OF THE COMMUNITIES IT SERVES BY PROVIDING QUALITY HEALTHCARE SERVICES AT REASONABLE COST.PLEASE SEE THE NOVANT HEALTH COMMUNITY BENEFIT REPORT, LOCATED AT HTTPS://WWW.NOVANTHEALTH.ORG/HOME/ABOUT-US/COMMUNITY-ENGAGEMENT/OUR-IMPACT.ASPX.PLEASE NOTE THAT THE NUMERIC INFORMATION IN THIS REPORT IS NOT BASED UPON THE FORM 990, SCHEDULE H CRITERIA, BUT RATHER IT HAS BEEN PREPARED IN ACCORDANCE WITH THE NORTH CAROLINA HOSPITAL ASSOCIATION REPORTING GUIDELINES. |
| PART VI, LINE 6: | PART VI, LINE 6: AFFILIATED HEALTH CARE SYSTEMTHE ORGANIZATION IS AN INTEGRAL PART OF NOVANT HEALTH, A NOT-FOR-PROFIT INTEGRATED GROUP OF HOSPITALS, PHYSICIAN CLINICS, OUTPATIENT CENTERS AND OTHER HEALTHCARE SERVICE PROVIDERS. NOVANT HEALTH IS RANKED AS ONE OF OUR NATION'S TOP 20 INTEGRATED HEALTHCARE SYSTEMS - CARING FOR PATIENTS AND COMMUNITIES IN NORTH CAROLINA, SOUTH CAROLINA, AND VIRGINIA. EACH HOSPITAL PROVIDES SUBSTANTIAL COMMUNITY BENEFIT TO THE COMMUNITY IT SERVES, AS REPORTED INDIVIDUALLY ON EACH HOSPITAL'S FORM 990, SCHEDULE H. THE COMMUNITY BENEFIT OF THE SYSTEM AS A WHOLE IS DOCUMENTED IN A SYSTEM-WIDE COMMUNITY BENEFIT REPORT, LOCATED AT HTTPS://WWW.NOVANTHEALTH.ORG/HOME/ABOUT-US/COMMUNITY-ENGAGEMENT/OUR-IMPACT.ASPX. PLEASE NOTE THAT THE NUMERIC INFORMATION IN THIS REPORT IS NOT BASED UPON THE FORM 990, SCHEDULE H CRITERIA, BUT RATHER IT HAS BEEN PREPARED IN ACCORDANCE WITH THE NORTH CAROLINA HOSPITAL ASSOCIATION REPORTING GUIDELINES. IT SHOULD NOT BE RELIED UPON AS THE ORGANIZATION'S FORM 990, SCHEDULE H COMMUNITY BENEFIT REPORT, ITS COMMUNITY HEALTH NEEDS ASSESSMENT OR COMMUNITY BENEFIT IMPLEMENTATION STRATEGY. THERE ARE SIGNIFICANT COMMUNITY BENEFIT ACTIVITIES WITHIN NOVANT HEALTH WHICH MAY NOT BE REPORTABLE ON A SCHEDULE H BECAUSE THEY ARE NOT CONDUCTED BY AN ENTITY WHICH OWNS OR OPERATES A HOSPITAL.IN ADDITION TO HOSPITALS, NOVANT HEALTH INCLUDES A PHYSICIAN ORGANIZATION WITH PRACTICES IN NORTH CAROLINA, SOUTH CAROLINA, AND VIRGINIA AND FIVE HOSPITAL FOUNDATIONS WHICH SUPPORT AND ENHANCE THE ACTIVITIES IN THOSE HOSPITALS' COMMUNITIES. FURTHER, NOVANT HEALTH INCLUDES AMBULATORY SURGERY CENTERS, IMAGING CENTERS, REHABILITATION CENTERS, AND OTHER OUTPATIENT FACILITIES; ALL DEDICATED TO PROMOTING THE HEALTH OF THEIR RESPECTIVE COMMUNITIES. |
| PART VI, LINE 7: STATE FILING OF COMMUNITY BENEFIT REPORT | NOVANT HEALTH, INC. FILES A SYSTEM-WIDE COMMUNITY BENEFIT REPORT PREPARED IN ACCORDANCE WITH THE NORTH CAROLINA HOSPITAL ASSOCIATION REPORTING GUIDELINES WITH THE NORTH CAROLINA MEDICAL CARE COMMISSION AS PART OF THE DOCUMENTATION REQUIRED FOR THE ISSUANCE OF TAX EXEMPT BOND FINANCING. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Type | DISASTER RELIEF ASSISTANCE | GrantTypeTxt |
| Recipient | 92 | RecipientCnt |
| Cash Grant | $49,061 | CashGrantAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS | FormAndLineReferenceDesc |
| Explanation | 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. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| First Class Or Charter Travel | Yes (X) | FirstClassOrCharterTravelInd |
| Travel For Companions | Yes (X) | TravelForCompanionsInd |
| Discretionary Spending Acct | Yes (X) | DiscretionarySpendingAcctInd |
| Housing Allowance Or Residence | Yes (X) | HousingAllowanceOrResidenceInd |
| Written Policy Ref T And E Expnss | Yes (1) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (1) | SubstantiationRequiredInd |
| Severance Payment | Yes (1) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (13 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| SMITH HARRY | ||||||||||||||
| FMR SVP HOSP OPS (1/1/20-8/5/20) | $0 | $381,135 | $0 | $604,330 | $0 | $409,455 | $0 | $12,156 | $0 | $34,104 | $0 | $1,441,180 | $0 | $94,406 |
| SETLIFF MICHAEL | ||||||||||||||
| TRUSTEE | $0 | $481,211 | $0 | $265,879 | $0 | $41,691 | $0 | $92,132 | $0 | $31,412 | $0 | $912,325 | $0 | $7,500 |
| ROYSTER KIRSTEN | ||||||||||||||
| FMR PRES | $0 | $352,018 | $0 | $198,015 | $0 | $39,366 | $0 | $14,830 | $0 | $11,663 | $0 | $615,892 | $0 | $0 |
| CHRISTMAN JENNIFER | ||||||||||||||
| TRUSTEE | $0 | $341,820 | $0 | $166,354 | $0 | $21,013 | $0 | $17,100 | $0 | $30,376 | $0 | $576,663 | $0 | $0 |
| BARRETT LESLIE | ||||||||||||||
| PRESIDENT & COO | $0 | $280,934 | $0 | $114,928 | $0 | $49,659 | $0 | $14,692 | $0 | $13,281 | $0 | $473,494 | $0 | $7,500 |
| COLEMAN TRISHA | ||||||||||||||
| TREASURER | $0 | $270,914 | $0 | $54,390 | $0 | $18,796 | $0 | $17,098 | $0 | $30,041 | $0 | $391,239 | $0 | $0 |
| MORRIS JOHN | ||||||||||||||
| ASST SEC | $0 | $206,012 | $0 | $6,069 | $0 | $65,515 | $0 | $12,720 | $0 | $22,733 | $0 | $313,049 | $0 | $7,500 |
| SECHRIST ALICIA | ||||||||||||||
| SUPV CRNA | $181,015 | $0 | $1,290 | $0 | $154 | $0 | $10,954 | $0 | $24,728 | $0 | $218,141 | $0 | $0 | $0 |
| METCALF SUSAN | ||||||||||||||
| CRNA II | $192,581 | $0 | $1,225 | $0 | $1,328 | $0 | $11,662 | $0 | $11,091 | $0 | $217,887 | $0 | $0 | $0 |
| LYERLY RONALD | ||||||||||||||
| PHARMACIST | $160,207 | $0 | $2,612 | $0 | $1,605 | $0 | $9,192 | $0 | $29,021 | $0 | $202,637 | $0 | $0 | $0 |
| YOUENS MARK | ||||||||||||||
| CRNA II | $169,807 | $0 | $1,290 | $0 | $145 | $0 | $10,347 | $0 | $17,806 | $0 | $199,395 | $0 | $0 | $0 |
| SMITH CAROL | ||||||||||||||
| DIR OPERATIONS/NURSING | $146,647 | $0 | $14,768 | $0 | $1,312 | $0 | $9,148 | $0 | $22,526 | $0 | $194,401 | $0 | $0 | $0 |
| BRIGHT JANET | ||||||||||||||
| FMR CNO | $0 | $0 | $0 | $0 | $0 | $155,248 | $0 | $0 | $0 | $5,610 | $0 | $160,858 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 1A | PART I, LINE 1A: FRINGE OR EXPENSE EXPLANATION FIRST-CLASS OR CHARTER TRAVEL: FIRST-CLASS OR CHARTER TRAVEL IS NOT A COVERED TRAVEL EXPENSE FOR EXECUTIVES; THEY ARE LIMITED TO BUSINESS OR COACH CLASS FARES FOR COMMERCIAL FLIGHTS. HOWEVER, CHARTER TRAVEL IS AVAILABLE TO CERTAIN EXECUTIVES, BOARD MEMBERS, AND APPROVED BUSINESS PERSONNEL MEETING APPLICABLE POLICY CRITERIA. TRAVEL FOR COMPANIONS: COMPANIONS ARE ALLOWED ON CERTAIN CHARTER FLIGHTS PAID FOR BY THE ORGANIZATION. IN THAT CASE, THE VALUE OF THE COMPANION'S FLIGHT IS CALCULATED UNDER APPLICABLE TAX LAWS AND THAT AMOUNT IS INCLUDED IN THE EXECUTIVE'S TAXABLE INCOME AS PRESCRIBED BY THE APPLICABLE TAX LAWS. DISCRETIONARY SPENDING ACCOUNT: CERTAIN EXECUTIVES RECEIVE A DISCRETIONARY SPENDING ACCOUNT. THE DOLLAR AMOUNT IN THE ACCOUNT IS PRE-APPROVED BY THE COMPENSATION AND LEADERSHIP COMMITTEE OF THE NOVANT HEALTH BOARD OF TRUSTEES. THE ACCOUNT CAN BE USED ONLY FOR AN APPROVED LIST OF EXPENDITURES. ALL OPTIONS OTHER THAN A DEFERRED, AT-RISK, COMPENSATION OPTION ARE CONSIDERED TAXABLE AND ARE INCLUDED IN THE EXECUTIVE'S TAXABLE INCOME AS PRESCRIBED BY THE APPLICABLE TAX LAWS. HOUSING ALLOWANCE OR RESIDENCE FOR PERSONAL USE: WE PROVIDE TEMPORARY HOUSING ALLOWANCES IN CERTAIN EXECUTIVE RECRUITMENT AND RELOCATION PACKAGES. THE VALUE IS CALCULATED UNDER APPLICABLE TAX LAWS AND THAT AMOUNT IS INCLUDED IN THE EXECUTIVE'S INCOME AS PRESCRIBED BY THE APPLICABLE TAX LAWS. |
| PART I, LINE 3 | PART I, LINE 3: THE FILING ORGANIZATION IS AN INTEGRAL PART OF NOVANT HEALTH, AN INTEGRATED HEALTHCARE SYSTEM AND RELIES UPON NOVANT HEALTH, INC., THE PARENT ORGANIZATION, TO USE THE PROCESS DESCRIBED IN PART VI, LINE 15A/15B OF THIS RETURN TO ESTABLISH COMPENSATION FOR CERTAIN EXECUTIVES. THIS PROCESS ADHERES TO THE REQUIREMENTS SET FORTH TO SECURE THE REBUTTABLE PRESUMPTION OF REASONABLENESS AND INCLUDES A REVIEW AND APPROVAL BY INDEPENDENT AND DISINTERESTED MEMBERS OF A COMPENSATION COMMITTEE, CONSULTATION WITH INDEPENDENT COMPENSATION CONSULTANTS, THE UTILIZATION OF THIRD-PARTY COMPARABILITY DATA SUCH AS PUBLISHED COMPENSATION SURVEYS, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. |
| PART I, LINES 4A-B | PART I, LINES 4A-C: SEVERANCE, NONQUALIFIED, AND EQUITY-BASED PAYMENTS SEVERANCE BRIGHT, JANET $156,305 SMITH, HARRY $248,175 NONQUALIFIED SMITH, HARRY $86,906 EQUITY-BASED NONE |
| PART I, LINE 4A - SEVERANCE PLAN: | ELIGIBLE EXECUTIVES MAY RECEIVE SEVERANCE PAY THAT IS BASED ON ANNUAL COMPENSATION FOR A SPECIFIED PERIOD OF TIME. THE SEVERANCE PAY WOULD BE PAID ONLY IN THE EVENT OF CERTAIN TYPES OF EMPLOYMENT TERMINATION, AND IS FURTHER CONTINGENT ON THE SATISFACTION OF OTHER CONDITIONS SUCH AS COMPLIANCE WITH A NON-COMPETITION COVENANT. ANY CURRENT YEAR PAYMENTS HAVE BEEN INCLUDED IN THE COMPENSATION AMOUNTS REPORTED IN PART VII AND IN COLUMN (B)(III) OF SCHEDULE J. THE COMPENSATION AND LEADERSHIP COMMITTEE OF THE NOVANT HEALTH BOARD REVIEWS, APPROVES, AND OVERSEES ALL ASPECTS AND ALL ELEMENTS OF EXECUTIVE COMPENSATION AND BENEFITS, INCLUDING THE AMOUNTS AWARDED UNDER THIS SEVERANCE PLAN. |
| PART I, LINE 4B - SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANS: | THE SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN ("SERP") IS INTENDED TO SUPPORT RETENTION OF KEY EXECUTIVES, AND TO OFFER COMPETITIVE TOTAL COMPENSATION. ELIGIBLE EXECUTIVES WILL BE NOMINATED BY THE CEO AND APPROVED BY THE NOVANT HEALTH COMPENSATION AND LEADERSHIP COMMITTEE ("THE COMMITTEE") TO PARTICIPATE. GENERALLY, ANNUAL CONTRIBUTIONS TO THE PLAN OR PAYMENTS TO PARTICIPANTS WILL BE BASED ON A PERCENTAGE OF THE PARTICIPANT'S BASE SALARY AS OF JANUARY 1ST OF THE PREVIOUS PLAN YEAR AND ARE REPORTED IN COLUMN (C) OF SCHEDULE J. PRIOR TO MAKING THE CONTRIBUTIONS OR PAYMENTS, THE COMMITTEE WILL APPROVE THE AMOUNTS AS TO REASONABLENESS, WHEN COMBINED WITH ALL OTHER ANNUAL COMPENSATION. A 3 YEAR CLASS-YEAR VESTING PERIOD WILL APPLY UP TO AGE 62, WHEN ALL MONEY WOULD BE VESTED AND PAID OUT TO THE PARTICIPANT. OTHERWISE, VESTING WILL OCCUR ON JANUARY 1ST OF EACH YEAR FOR THE APPROPRIATE CLASS-YEAR VESTING PERIOD. THE COMMITTEE REVIEWS, APPROVES, AND OVERSEES ALL ASPECTS AND ALL ELEMENTS OF EXECUTIVE COMPENSATION AND BENEFITS. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PI, L1: ORGANIZATION'S MISSION OR MOST SIGNIFICANT ACTIVITIES | MEDICAL PARK HOSPITAL, DOING BUSINESS AS NOVANT HEALTH MEDICAL PARK HOSPITAL ("NHMPH") 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 MORE THAN 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 MEDICAL PARK HOSPITAL IS A 22-BED, NOT-FOR-PROFIT SURGICAL HOSPITAL THAT SPECIALIZES IN ELECTIVE INPATIENT AND OUTPATIENT SURGERIES. OUR TEAM OF HIGHLY SKILLED SURGEONS, ANESTHESIOLOGISTS, NURSES AND TECHNICIANS PERFORMED 9,981 ELECTIVE SURGICAL PROCEDURES IN 2020. IN 2020, THE HOSPITAL FOCUSED ON PROVIDING COMMUNITY SUPPORT, CONSISTENT QUALITY AND OUTCOMES, EXCELLENT SERVICE AND A REMARKABLE WORK ENVIRONMENT FOR STAFF. OUR HOSPITAL IS COMMITTED TO MEETING THE HEALTHCARE NEEDS OF RESIDENTS IN THE TRIAD AREA OF NORTH CAROLINA. THE HOSPITAL SPECIALIZES IN SURGICAL CARE INCLUSIVE OF ORTHOPEDIC, GENERAL, COLORECTAL, GYNECOLOGY, UROLOGY, ONCOLOGY, OPHTHALMOLOGY, NEUROSURGERY, EAR, NOSE, AND THROAT, AND PLASTIC SURGERIES. TRADITIONAL AND MINIMALLY INVASIVE/ROBOTIC SURGERIES ARE PERFORMED. IN ADDITION, BLOOD SERVICES INCLUDING TRANSFUSIONS AND DONATIONS, IMAGING, AND PAIN MANAGEMENT PROCEDURES ARE AVAILABLE. THE HOSPITAL'S INTERPRETER SERVICES HELP PATIENTS AND THEIR FAMILY MEMBERS WHO HAVE SPECIAL COMMUNICATION NEEDS. FOREIGN-LANGUAGE INTERPRETERS ARE AVAILABLE FOR INDIVIDUALS WHO ARE LIMITED ENGLISH-PROFICIENT. FREE SIGN LANGUAGE AND ORAL INTERPRETERS, TTYS AND OTHER SERVICES ARE AVAILABLE TO DEAF AND HARD-OF-HEARING PERSONS. 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 MEDICAL PARK HOSPITAL. 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. IN 2020, NOVANT HEALTH MEDICAL PARK HOSPITAL DEVELOPED FIVE SERVICE PROJECTS IN PARTNERSHIP WITH THE NORTH CAROLINA STATE EMPLOYEE'S CREDIT UNION (NCSECU) SERVICES & FACILITIES COMMITTEE. NEW TECHNOLOGY & SERVICES THE DA VINCI SURGICAL SYSTEM AT NOVANT HEALTH MEDICAL PARK HOSPITAL WAS RECENTLY UPGRADED TO OFFER TWO ADVANCED XI SYSTEMS. THE USE OF THE XI SYSTEM OFFERS BETTER VISUALIZATION TO INCREASE THE NUMBER OF PATIENTS THAT CAN RECEIVE MINIMALLY INVASIVE TECHNIQUES. THESE PROCEDURES SPREAD ACROSS VARIOUS SERVICE LINES AND INCLUDE HYSTERECTOMIES, CANCER STAGING, NEPHRECTOMIES, PARTIAL NEPHRECTOMIES, BOWEL RESECTIONS, VENTRAL AND HIATAL HERNIAS. THE SURGICAL SYSTEM WAS ADDED TO THE HOSPITAL IN 2005, AND PROVIDES SURGEONS WITH A STATE-OF-THE-ART ALTERNATIVE TO OPEN SURGERY AND CONVENTIONAL LAPAROSCOPY. THE ROBOTIC-ASSISTED SURGICAL PLATFORM ALLOWS SURGEONS TO COMPLETE COMPLEX AND DELICATE PROCEDURES THAT ARE PERFORMED THROUGH TINY INCISIONS WITH UNMATCHED PRECISION, MEANING LESS PAIN AND SHORTER RECOVERY TIMES FOR PATIENTS. TO OPTIMIZE SURGICAL PRECISION UTILIZING TECHNOLOGY NOVANT HEALTH MEDICAL PARK HOSPITAL, BEGAN OFFERING ADVANCED IMAGING MODALITIES (AIM) 4K PLATFORM IN 2020. THE PLATFORM ASSISTS WITH A VARIETY OF MINIMALLY INVASIVE LAPAROSCOPIC SURGICAL PROCEDURES BY UTILIZING ENHANCED IMAGING TECHNOLOGY TO VISUALIZE BLOOD FLOW AND RELATED TISSUE PERFUSION. THIS TECHNOLOGY PROVIDES SEAMLESS CONNECTIVITY TO IMAGES AND DATA DURING THE SURGICAL PROCEDURE, THUS PROVIDING IMPROVED IMAGE CLARITY AND ENHANCED LIGHT. THIS NEW TECHNOLOGY ALSO PROVIDES ICG INDUCED IMAGES OF BLOOD FLOW OF INVOLVED TISSUES TO ENSURE VIABILITY AND BETTER PATIENT OUTCOMES. NOVANT HEALTH MEDICAL PARK HOSPITAL LAUNCHED A NEW OUTPATIENT VASCULAR SURGICAL PROGRAM IN 2020. THIS PROGRAM HAS IMPROVED ACCESS TO A VARIETY OF DIAGNOSTIC AND OUTPATIENT VASCULAR PROCEDURES INCLUDING: EVALUATION AND CARE OF ARTERIOVENOUS (AV) FISTULA/GRAFTS, TEMPORAL ARTERY BIOPSY, INSERTION AND REMOVAL OF PERITONEAL DIALYSIS CATHETER, INTERVENTIONAL ANGIOGRAM, REMOVAL OF BLOOD CLOTS, AND VARICOSE VEIN REMOVAL. AWARDS, RECOGNITIONS & CERTIFICATIONS/RECERTIFICATIONS - TOP GENERAL HOSPITAL BY THE LEAPFROG GROUP (2019) - 2020 AMERICA'S BEST HOSPITAL AWARD FOR OUTPATIENT EXPERIENCE FROM WOMEN'S CHOICE ORGANIZATION - 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 - AMERICAN COLLEGE OF SURGEONS COMMISSION CANCER ACCREDITATION - NATIONAL ACCREDITATION PROGRAM FOR BREAST CENTERS ADDITIONAL CERTIFICATIONS FOR NHMPH INCLUDE: - NORTH CAROLINA DIVISION OF MEDICAL ASSISTANCE - MEDICAID - UNITED STATES DEPARTMENT OF HEALTH & HUMAN SERVICES - CLIA - UNITED STATES DEPARTMENT OF HEALTH & HUMAN SERVICES - MEDICARE ACCREDITATION NHMPH HAS BEEN FULLY ACCREDITED BY THE JOINT COMMISSION, AN INDEPENDENT ORGANIZATION THAT EVALUATES A HEALTHCARE ORGANIZATION'S PERFORMANCE IN AREAS THAT MOST AFFECT PATIENT HEALTH AND SAFETY. ADDITIONAL ACCREDITATIONS FOR NHMPH INCLUDE: - ACCREDITATION COMMISSION FOR HEALTH CARE (SLEEP LAB ACCREDITATION) - AMERICAN NURSES CREDENTIALING CENTER - NURSE RESIDENCY PROGRAM - COLLEGE OF AMERICAN PATHOLOGY - 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 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). IN ADDITION TO POWERS ELSEWHERE RESERVED, NOVANT HEALTH, INC. RESERVES THE FOLLOWING POWERS: AMENDMENTS OF ARTICLES, BYLAWS, MERGERS, ACQUISITIONS, ETC., ELECT TRUSTEES CONSISTENT WITH TERMS AND CONDITIONS IN ARTICLE III, SECTION 3. |
| 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 MEDICAL PARK 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. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (24 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| AUXILIARY OF FORSYTH MEMORIAL HOSPITAL | |||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 560862112 | HEALTHCARE | NC | 501(C)(3) | LINE 10 | FORSYTH MEMORIAL HOSPITAL INC | 0 | |
| BRUNSWICK NOVANT MEDICAL CENTER FOUNDATION | |||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 274616751 | HEALTHCARE | NC | 501(C)(3) | LINE 7 | BRUNSWICK COMMUNITY HOSPITAL LLC | 0 | |
| CAROLINA MEDICORP ENTERPRISES INC | |||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 581466368 | HEALTHCARE | NC | 501(C)(3) | LINE 10 | NOVANT MEDICAL GROUP INC | 0 | |
| COMMUNITY GENERAL HEALTH PARTNERS INC | |||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 560636250 | HEALTHCARE | NC | 501(C)(3) | LINE 3 | NOVANT HEALTH TRIAD REGION LLC | 0 | |
| COMMUNITY GENERAL HOSPITAL FOUNDATION INC | |||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 561828629 | HEALTHCARE | NC | 501(C)(3) | LINE 7 | COMMUNITY GENERAL HEALTH PARTNERS INC | 0 | |
| FORSYTH MEDICAL CENTER FOUNDATION | |||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 562120959 | HEALTHCARE | NC | 501(C)(3) | LINE 7 | FORSYTH MEMORIAL HOSPITAL INC | 0 | |
| FORSYTH MEMORIAL HOSPITAL INC | |||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 560928089 | HEALTHCARE | NC | 501(C)(3) | LINE 3 | NOVANT HEALTH TRIAD REGION LLC | 0 | |
| FOUNDATION HEALTH SYSTEMS CORP | |||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 561373175 | HEALTHCARE | NC | 501(C)(3) | LINE 10 | NOVANT HEALTH INC | 0 | |
| NOVANT HEALTH INC | |||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 561376950 | HEALTHCARE | NC | 501(C)(3) | LINE 3 | 0 | N/A | |
| NOVANT MEDICAL GROUP INC | |||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 581728803 | HEALTHCARE | NC | 501(C)(3) | LINE 3 | NMG SERVICES LLC | 0 | |
| PERSONAL CARE SERVICES | |||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 541291284 | HEALTHCARE | VA | 501(C)(3) | LINE 10 | PRINCE WILLIAM HEALTH SYSTEM | 0 | |
| PRESBYTERIAN HOSPITAL FOUNDATION | |||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 581413074 | HEALTHCARE | NC | 501(C)(3) | LINE 7 | NOVANT HEALTH SOUTHERN PIEDMONT REGION LLC | 0 | |
| PRESBYTERIAN MEDICAL CARE CORPORATION | |||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 561376368 | HEALTHCARE | NC | 501(C)(3) | LINE 3 | NOVANT HEALTH SOUTHERN PIEDMONT REGION LLC | 0 | |
| PRINCE WILLIAM HEALTH SYSTEM | |||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 541278944 | HEALTHCARE | VA | 501(C)(3) | LINE 12C, III-FI | NOVANT HEALTH UVA HEALTH SYSTEM | 0 | |
| PRINCE WILLIAM HOSPITAL | |||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 540696355 | HEALTHCARE | VA | 501(C)(3) | LINE 3 | PRINCE WILLIAM HEALTH SYSTEM | 0 | |
| PWHS FOUNDATION | |||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 541307595 | HEALTHCARE | VA | 501(C)(3) | LINE 7 | PRINCE WILLIAM HEALTH SYSTEM | 0 | |
| ROWAN HEALTH SERVICES CORPORATION | |||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 561424814 | HEALTHCARE | NC | 501(C)(3) | LINE 12C, III-FI | NOVANT HEALTH INC | 0 | |
| ROWAN REGIONAL MEDICAL CENTER AUXILIARY | |||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 237022472 | HEALTHCARE | NC | 501(C)(3) | LINE 10 | ROWAN REGIONAL MEDICAL CENTER INC | 0 | |
| ROWAN REGIONAL MEDICAL CENTER FOUNDATION INC | |||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 561424818 | HEALTHCARE | NC | 501(C)(3) | LINE 7 | ROWAN REGIONAL MEDICAL CENTER INC | 0 | |
| ROWAN REGIONAL MEDICAL CENTER INC | |||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 560547479 | HEALTHCARE | NC | 501(C)(3) | LINE 3 | ROWAN HEALTH SERVICES CORPORATION | 0 | |
| SELF INSURANCE FUND - NOVANT HEALTH INC | |||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 581867242 | HEALTHCARE | NC | 501(C)(3) | LINE 12C, III-FI | NOVANT HEALTH INC | 0 | |
| THE PRESBYTERIAN HOSPITAL | |||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 560554230 | HEALTHCARE | NC | 501(C)(3) | LINE 3 | NOVANT HEALTH SOUTHERN PIEDMONT REGION LLC | 0 | |
| CULPEPER MEMORIAL HOSPITAL INC | |||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 540622371 | HEALTHCARE | VA | 501(C)(3) | LINE 3 | NOVANT HEALTH UVA HEALTH SYSTEM | 0 | |
| NOVANT HEALTH UVA HEALTH SYSTEM | |||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 810868533 | HEALTHCARE | VA | 501(C)(3) | LINE 12A, I | NOVANT HEALTH INC | 0 | |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (9 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| ADEPT HEALTH INC | |||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 562226937 | ADMIN SERVICES | NC | N/A | C | 0 |
| CHOICEHEALTH INC | |||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 561896065 | MANAGED CARE | NC | N/A | C | 0 |
| COMMUNICARE INC | |||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 561952950 | RENTAL REAL ESTATE | NC | N/A | C | 0 |
| KERNERSVILLE MEDICAL CENTER PARK OWNERS' ASSOCIATION | |||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 471511401 | RENTAL REAL ESTATE | NC | N/A | C | 0 |
| MEDQUEST INC & SUBSIDIARIES | |||||||||
| 3480 PRESTON RIDGE RD STE 600 | ALPHARETTA | GA | 30005 | 223860764 | DIAGNOSTIC IMAGING | DE | N/A | C | 0 |
| NOVANT HEALTH TRINOVA INSURANCE PROTECTED CELL INC | |||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 812963143 | INSURANCE | NC | N/A | C | 0 |
| SALEM DIAGNOSTICS INC | |||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 561513621 | HEALTH RELATED | NC | N/A | C | 0 |
| SALEM HEALTH SERVICES INC | |||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 561342654 | HEALTH RELATED | NC | N/A | C | 0 |
| THE PARK AT MONROE PROPERTY OWNERS ASSOCIATION INC | |||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 463910256 | RENTAL REAL ESTATE | NC | N/A | C | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |