2021-05-11T15:37:24-05:00 2020-06-30 BDO USA LLP 421 Fayetteville Street Suite 300 Raleigh NC 27601 990 2019-07-01 560554202 Caldwell Memorial Hospital % MICHAEL BUNCH CALD 8287575100 321 Mulberry Street SW Lenoir NC 28645 MICHAEL BUNCH CFO 8287575100 2021-04-26 true SANDRA L FEINSMITH P01064157 9192781936 2019 2022-09-23 18:48:47Z Laura J Easton 321 Mulberry Street SW Lenoir NC 28645 140717562 false X www.caldwellmemorial.org X 1945 NC To provide safe, effective, compassionate care and to promote healthy lifestyles to our community. 15 13 1113 97 589790 -466704 15872415 7800860 136176010 130287669 1107109 -409266 889495 3038299 154045029 140717562 0 0 0 0 68105030 66402178 0 0 0 74247037 75474577 142352067 141876755 11692962 -1159193 97819298 106154351 28653005 38147251 69166293 68007100 X TO PROVIDE SAFE, EFFECTIVE, COMPASSIONATE CARE AND TO PROMOTE HEALTHY LIFESTYLES TO OUR COMMUNITY. false false 118802611 0 132271311 SINCE OPENING IN 1951, CALDWELL MEMORIAL HOSPITAL HAS CONTINUED TO GROW AND CHANGE IN ORDER TO BETTER MEET THE NEEDS OF OUR COMMUNITY. THE MISSION OF CALDWELL MEMORIAL HOSPITAL IS TO PROVIDE SAFE, EFFECTIVE, COMPASSIONATE CARE AND TO PROMOTE HEALTHY LIFESTYLES TO OUR COMMUNITY. ANCHORED BY A 110-BED ACUTE CARE FACILITY, CALDWELL MEMORIAL HOSPITAL'S SERVICES INCLUDE A VAST ARRAY OF MEDICAL AND SURGICAL SERVICES. AMONG SERVICES OFFERED, BUT BY NO MEANS A COMPLETE LIST, ARE CAROTID ARTERY STENTING; CARDIOVASCULAR AND ENDOVASCULAR CARE; RADIATION ONCOLOGY; COMPUTER-ASSISTED ORTHOPEDIC SURGERY; NEUROLOGY AND MEMORY CARE; PAIN MANAGEMENT; A FULLY STAFFED 24-HOUR EMERGENCY DEPARTMENT; CALDWELL PHYSICIANS CLINICS CONVENIENTLY LOCATED COUNTY-WIDE; DIAGNOSTIC SERVICES; OUTPATIENT SURGERY; PLUS URGENT CARE; AND THE QUEST 4 LIFE WELLNESS CENTER. MULTIPLE EDUCATIONAL AND COUNSELING PROGRAMS ARE AVAILABLE FOR A WIDE ARRAY OF HEALTHCARE NEEDS INCLUDING CANCER, DIABETES, NUTRITION, JOINT CARE, PRE-NATAL CLASSES AND PARENTING SKILLS. IN LATE DECEMBER 2019, CALDWELL STARTED A 2 CHAMBER HYPERBARIC SERVICE AS PART OF THE WOUND CARE PROGRAM. CALDWELL PHYSICIANS IS A DIVISION OF CALDWELL MEMORIAL HOSPITAL. WITH PRACTICES IN COMMUNITIES COUNTYWIDE, CALDWELL PHYSICIANS PROVIDES THE PRIMARY AND SPECIALTY HEALTHCARE, DIAGNOSTICS AND TREATMENTS THAT OUR COMMUNITY NEEDS IN CONVENIENT LOCATIONS NEAR THEIR HOMES. CALDWELL PHYSICIANS INCLUDES: ANDERSON MEDICAL PARK, ANDERSON PLUS URGENT CARE, BLOWING ROCK MEDICAL, BLOWING ROCK PLUS URGENT CARE, LAUREL PARK WOMEN'S HEALTH - LENOIR, LAUREL PARK WOMEN'S HEALTH - GRANITE FALLS, MULBERRY PEDIATRICS, ROBBINS MEDICAL PARK, ROBBINS PULMONOLOGY, ROBBINS EAR, NOSE, THROAT AND ALLERGY, ROBBINS PLUS URGENT CARE, ROBBINS CARDIOLOGY, ROBBINS SURGICAL, SOUTHFORK MEDICAL PARK, RIVERCREST MEDICAL PARK, RIVERCREST PLUS URGENT CARE, THE FALLS PEDIATRICS, WESTPOINTE MEDICAL PRACTICE, CALDWELL UROLOGY ASSOCIATES, CALDWELL FOOT & ANKLE, AND THE FALLS PEDIATRICS PLUS URGENT CARE. IN SPRING 2000, CALDWELL EMPLOYED AN ORTHOPEDIST TO JOIN CALDWELL PHYSICIAN NETWORK IN THE PODIATRY CLINIC KNOWN AS UNC ORTHO. THE ORTHOPEDIST OFFERS GENERAL ORTHOPEDICS WITH FOCUS ON HANDS. IN RESPONSE TO THE 2020 GLOBAL PANDEMIC, CALDWELL OPENED TWO RESPiratory DIAGNOSTIC CENTERS (RDC) IN THE COUNTY FOR COVID-19 TESTING. ONE CENTER IN LENoir AND THE OTHER IN GRANITE FALLS. 118802611 true true false true false false false false false false true true false false true true false true false false false false false false false false true true false false true false false false false false false false false false false false false false true true false false false true 135 0 true 1113 true true true false false false false false false false false false false false X 15 13 false false false false true true true true true false false true true true true true true true true false X MICHAEL BUNCH 8287575100 321 MULBERRY STREET SW Lenoir NC 28645 X Chris Ellington Director 2.0 58.0 X 0 1084690 184123 Ralph Duckett Medical Practice Physician 60.0 0.0 X 615533 0 11592 Thomas Young Medical Practice Physician 60.0 0.0 X 462886 0 33773 Philip Jenkins Medical Practice Physician 60.0 0.0 X 446409 0 26645 David Cook Medical Practice Physician 60.0 0.0 X 439178 0 14807 Timothy Clenney Medical Practice Physician 60.0 0.0 X 428780 0 0 Laura Easton Director/President & CEO 60.0 0.0 X X 360506 0 40408 David Lowery MD CMO 60.0 0.0 X 341680 0 40645 John Powell MD Director 2.0 0.0 X 254912 0 37360 Rebecca Smith COO & CNO 60.0 0.0 X 248515 0 21846 Michael Bunch CFO 60.0 0.0 X 238604 0 17086 Donita Damron VP Physician Services 60.0 0.0 X 173372 0 14872 Michael Chamberlain Director 2.0 0.0 X 0 0 0 Jerry Church Director 2.0 0.0 X 0 0 0 Richard Coffey Director 2.0 0.0 X 0 0 0 Joseph Gibbons Director 2.0 0.0 X 0 0 0 William Howard III Director 2.0 0.0 X 0 0 0 Doug Johnson Director 2.0 0.0 X 0 0 0 Jeffrey Keverline MD Director 2.0 0.0 X 0 0 0 Diana McClinton MD Director 2.0 0.0 X 0 0 0 Edward Pearce MD Director 2.0 0.0 X 0 0 0 David Smith Director 2.0 0.0 X 0 0 0 Alan Stiles Director 2.0 0.0 X 0 0 0 Crystal Thomas Director 2.0 0.0 X 0 0 0 Boyd Wilson Jr Director 2.0 0.0 X 0 0 0 Janet Aiken Director 2.0 0.0 X 0 0 0 4010375 1084690 443157 91 false true false David E Looper Company Inc 320 15th Street SE HICKORY NC 28602 Construction 4490895 Enduracare Acute Care Services 381 Riverside Drive Suite 440 FRANKLIN TN 37064 Therapy Program Mgmt 1081052 DLP Cardiac Partners LLC 3700 Arco Corp Office Suite 450 CHARLOTTE NC 27273 Cath Lab 1059407 Mountain Emergency Physicians 319 Springwood Drive NE VALDESE NC 28690 Physician Services 854926 Keach Construction Inc 10200 Industrial Drive PINEVILLE NC 28134 Construction 492606 20 3300860 4500000 7800860 PATIENT SERVICES 621500 125488254 125488254 QUEST4LIFE WELLNESS CENTER REVENUE 713990 589790 589790 OTHER PROGRAM SERVICES REVENUE 900099 4209625 3857101 352524 130287669 -409266 -409266 0 0 702133 702133 0 702133 702133 0 0 0 0 0 0 0 0 0 0 OTHER REVENUE 900099 49512 49512 CARES ACT STIMULUS 900099 2286654 2286654 2336166 140717562 131681521 589790 645391 0 0 0 0 1828439 1828439 0 52133388 43270711 8862677 935547 779385 156162 7918092 7224566 693526 3586712 3272562 314150 0 452034 452034 40141 40141 17721 17721 0 0 13691258 8912988 4778270 152749 152749 978906 978906 1226 1226 0 4478762 4478762 537376 322424 214952 0 3235 3235 40924 40924 1282548 1282548 7140272 7140272 831396 831396 PATIENT CARE SUPPLIES & SERV 15881080 15881080 BAD DEBT EXPENSE 12022583 12022583 MINOR EQUIPMENT AND R&M 1822149 1767485 54664 HOME OFFICE ALLOCATION 13832616 9682832 4149784 2267601 2194509 73092 141876755 118802611 23074144 0 10959818 14845403 0 0 0 0 15572996 16451810 0 0 0 0 0 0 4026377 4015105 1846651 2345904 156722655 96398497 56012364 60324158 1578594 1500831 7051223 6429589 771275 241551 0 0 0 0 97819298 106154351 24325859 22430646 0 0 0 12557406 0 0 0 0 0 0 1401725 1033781 0 0 2925421 2125418 28653005 38147251 X 69166293 68007100 0 0 69166293 68007100 97819298 106154351 -1159193 X X false true X true true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 17721 17721 false PART II-B, LINE 1, LOBBYING ACTIVITIES Annual dues were paid to the American Hospital Association and North Carolina Hospital Association. A percentage, determined by the organizations, was estimated to be expenditures used in lobbying activities by these organizations. 2754303 2754303 78107589 39503585 38604004 65095346 55478734 9616612 10765417 1416178 9349239 60324158 OTHER ASSETS 6429589 C 6429589 0 THIRD PARTY 701596 DEFERRED FEE PLAN LIABILITY 455023 THIRD PARTY 425193 RAC SETTLEMENT 543606 2125418 X PART X, LINE 2 THE HOSPITAL AND FOUNDATION ARE NONPROFIT CORPORATIONS AND HAVE BEEN RECOGNIZED AS TAX-EXEMPT, PURSUANT TO SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. NO PROVISION FOR INCOME TAXES HAS BEEN MADE IN THE ACCOMPANYING COMBINED FINANCIAL STATEMENTS. true true X true X 250. false true true false true false 6086169 6086169 0.04690 20793359 20113244 680115 0.00520 26879528 20113244 6766284 0.05210 149745 149745 0.00120 149745 149745 0.00120 27029273 20113244 6916029 0.05330 true 12022583 8320849 50619012 64322647 -13703635 X true true AMERICAN HOME PATIEN HEALTHCARE 0.25 0.75 LAUREL PARK MOB MEDICAL OFFICE BUILDING 0.149 0.851 PRIME SURGICAL SUITE AMBULATORY SURGERY CENTER 0.57 0.43 1 1 CALDWELL MEMORIAL HOSPITAL 321 MULBERRY STREET SW Lenoir NC 28645 WWW.CALDWELLMEMORIAL.ORG H0061 X X X DISPROPORTIONATE SHARE HOSPITAL CALDWELL MEMORIAL HOSPITAL 1 false false true X X X X X X X X 19 true false false true X See Part V X true 19 true See Part V false true X 250. 0. false true X X X true X SEE PART V X SEE PART V X SEE PART V X X X X X X true X false X X X X true X false false PART V, SECTION B, LINE 5 Caldwell Memorial Hospital (CMH) developed a broad online survey for the community to participate in. This survey was readily available on several platforms, including CMH's website and Facebook page and provided to CMH employees. A hard copy of the survey was distributed to local pharmacies, businesses, community centers, urgent cares/clinics and Physician practices, with over 800 responses received. After deploying the survey and identifying the significant needs of the community, CMH met with a select diverse group of community members to discuss the initial findings of the survey and CMH's previous CHNA. PART V, SECTION B, LINE 7a https://www.caldwellmemorial.org/about-us/-community-health-needs- assessment/ Part V, SECTION B, LINE 10a https://www.caldwellmemorial.org/about-us/-community-health-needs- assessment/ PART V, SECTION B, LINE 11 CMH has identified the following three areas as representing the most significant health needs for Caldwell County: Substance Abuse Caldwell services, programs and resources available to respond to this need: - Caldwell will provide lockboxes for patients and family members so that they can secure home medications to prevent misuse or diversion - Caldwell launched an Opioid Stewardship Program in August 2019, which will limit the number of oral opiates dispensed following surgical procedures by an estimated 30% - Caldwell's emergency department is participating in a UNC HCS opioid stewardship program to reduce the number of opioids dispensed following emergency department visits - Caldwell is participating in a UNC HCS initiative to improve the inpatient treatment of inpatients undergoing acute ethanol withdrawal - All licensed medical providers on staff at Caldwell are required to complete training in opioid prescribing per the North Carolina STOP Act Additionally, Caldwell constructed Jonas Hill Behavioral Health Pavilion which opened in the summer of 2020. Jonas Hill will provide inpatient and outpatient behavioral health services but will also treat patients with dual diagnoses of behavioral health illness and substance abuse. Approximately 30% or more of behavioral health patients carry dual diagnoses of behavioral illness and substance abuse. Mental Illness Caldwell services, programs and resources available to respond to this need: - Employee Assistance Program available to employees and family members - five counseling sessions - Outpatient depression screenings available at all clinics; including PHQ2 and PHQ9 screenings - Collaboration with state - Medicaid funded local management entity (LME), Vaya Health, to provide mental health screens in Emergency Department - Crisis Collaborative Team, consisting of various community health stake holders, that meets every other month - Mental Health resource guide available at all clinics - Emergency Department renovation for 5 psychiatric rooms; including one adolescent room - Qualified case management professional who assists with mental health screenings - Partnering with Project Lazarus, to battle prescription drug abuse - Caldwell promotes the use of 'black boxes' to dispose of prescription medications and controlled substances - System wide protocol for the use of Narcan Additionally, Caldwell is firmly positioned and committed to creating an innovative rural behavioral health program for Western NC. Working collaboratively with local mental health partners, Caldwell will achieve the goal of making mental healthcare as routine, accessible and understandable as physical healthcare. The newly opened Jonas Hill Hospital & Clinic will meet a critical need for increased rural inpatient psychiatric hospital beds and new psychiatric outpatient services in our community and region. Chronic Disease Caldwell services, programs and resources available to respond to this need: - Perform numerous screenings and track metrics in clinics to measure and address when statistics are above certain levels - CHAMP program, which evaluates patients fall risk - Provide smoking cessation assessment/counseling for inpatients and referring out patients to Quest for Life - Employee Track Clinic, clinic provided to employees and family members, providers monitor chronic illness - Diabetes and Nutrition services provided through the Quest for Life - Annual Cancer screening day provided by McCreary Cancer Center - CT screenings for Lung Cancer - Providing free high school EKG Screenings and physicals - Provide reduced cost mammography and chest X-Ray interpretations for the health department Additionally, Caldwell will assess population demographics and facilitate specific steps to address top chronic disease outliers in the County. Community outreach and education will be imperative to address this need. Caldwell will implement lean performance improvement initiatives for team to improve population metrics with chronic disease. The remaining top health issues that Caldwell will not be addressing include the following: Obesity, Cancer, Smoking and Tobacco Use, Child Abuse, Domestic Abuse, Violent Behavior, Abusive/Violent Behavior and Suicide. While Caldwell recognizes these health needs, their resources are better used in addressing the top three health priorities listed above. PART V, LINEs 16A-C https://www.caldwellmemorial.org/patients-visitors/billing-financial-servi ces/ 10 JONAS HILL HOSPITAL AND CLINIC 407 MULBERRY STREET SW LENOIR NC 28645 BEHAVIORAL HEALTH COMMUNITY PHARMACY 321 MULBERRY STREET SW LENOIR NC 28645 RETAIL/EMPLOYEE PHARMACY QUEST 4 LIFE WELLNESS CENTER 1031 MORGANTON BLVD LENOIR NC 28645 WELLNESS CENTER CALDWELL PHYSICIANS NETWORK 321 MULBERRY STREET SW LENOIR NC 28645 PHYSICIAN PRACTICE CALDWELL MEMORIAL SLEEP CENTER 270 PINE MOUNTAIN ROAD HUDSON NC 28638 SLEEP CENTER THE CENTER FOR WOUND MANAGEMENT 401 MULBERRY STREET LENOIR NC 28645 WOUND CARE CENTER GEORGE M HANCOCK SURGERY CENTER 1031 MORGANTON BLVD LENOIR NC 28645 OP SURGERY CENTER CENTER FOR DIABETES HEALTH 1031 MORGANTON BLVD LENOIR NC 28645 DIABETES EDUCATION AND SUPPORT PAIN MANAGEMENT CENTER 1031 MORGANTON BLVD LENOIR NC 28645 PAIN MANAGEMENT LAUREL PARK BREAST CENTER COLLEGE AVENUE LENOIR NC 28645 BREAST HEALTH PART I, LN 7 COL(F) The bad debt expense included on Form 990, Part IX, Line 25(a) but subtracted for purposes of calculating the percentages in this column, is $12,022,583. PART III, LINE 2 The Cost for bad debt expenses was calculated by applying the cost-to-charge ratio for the year to the gross bad debt charges for the year. Part III, Line 3 THE ESTIMATE FOR BAD DEBT EXPENSES ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE FINANCIAL ASSISTANCE POLICY WAS CALCULATED BY APPLYING THE COST-TO-CHARGE RATIO FOR THE YEAR TO THE GROSS BAD DEBT CHARGES ATTRIBUTABLE TO UNINSURED PATIENTS DURING THE YEAR. Part III, Line 3 PART III, LINE 4 Net patient service revenue is reported at the estimated net realizable amounts from patients, third-party payors, and others for services rendered, including estimated retroactive adjustments due to future audits, reviews, and investigations. Retroactive adjustments are accrued on an estimated basis in the period the related services are rendered, and such amounts are adjusted in future periods as adjustments become known or as years are no longer subject to such audits, reviews, and investigations. PART III, Line 9b THE HOSPITAL DOES NOT SUBJECT ANY PATIENTS TO A COLLECTION AGENCY WHO HAS QUALIFIED FOR FINANCIAL ASSISTANCE GUIDELINES. PART VI, LINE 2 Federal regulations surrounding CHNA require local input from representatives of particular demographic sectors. For this reason, Caldwell Memorial Hospital (CMH) developed a standard process of gathering community input. Caldwell Memorial Hospital (CMH) developed a broad online survey for the community to participate in. This survey was readily available on several platforms, including CMH's website and Facebook page and provided to CMH employees. A hard copy of the survey was distributed to local pharmacies, businesses, community centers, urgent cares/clinics and Physician practices, with over 800 responses received. After deploying the survey and identifying the significant needs of the community, CMH met with a select diverse group of community members to discuss the initial findings of the survey and CMH's previous CHNA. PART VI, LINE 3 CALDWELL MEMORIAL HOSPITAL (CMH) PROVIDES NEEDED HEALTHCARE SERVICES TO ANYONE REGARDLESS OF THAT PERSON'S ABILITY TO PAY. CMH'S FINANCIAL ASSISTANCE POLICY IS DESIGNED TO ASSIST PATIENTS WHO ARE FINANCIALLY UNABLE TO PAY FOR HEALTHCARE SERVICES. a link to the POLICY CAN BE FOUND ON THE CMH PUBLIC website. CMH DISPLAYS INFORMATION REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE IN ITS EMERGENCY ROOM, REGISTRATION AREAS IN THE HOSPITAL AND CLINICS, and FINANCIAL COUNSELOR OFFICES. A LINK IS ALSO PROVIDED ON THE HOSPITAL'S WEBSITE TO THE AVAILABILITY OF FINANCIAL ASSISTANCE AND ITS FINANCIAL ASSISTANCE POLICY, ALONG WITH AN ON-LINE APPLICATION. INPATIENT CASE MANAGERS ALSO PROVIDE INFORMATION TO THE PATIENTS REGARDING AVAILABLE PROGRAMS AND THE ORGANIZation's FINANCIAL POLICY. CONSULTATION WITH FINANCIAL COUNSELORS IS ALSO AVAILABLE TO ALL PATIENTS AS NEEDED. PART VI, LINE 4 The primary service area for Caldwell Memorial Hospital is Caldwell County with a limited number of patients from the surrounding counties of Burke, Watauga and Catawba. Of the multiple incorporated municipalities in Caldwell County, CMH received 90.03% of its patients from Collettsville, Granite Falls, Hudson and Lenoir. Caldwell County is in the NW section of NC in the foothills of the Blue Ridge mountains and is bounded on the NW by Watauga County, on the NE by Wilkes County, on the East by Alexander County, on the South by Catawba and Burke Counties and on the West by Burke and Avery Counties. The population is just under 80,000 with 51% Female and 49% Male. The population makeup is 87.1% White, 5.4% Hispanic, 4.9% Black or African American and 2.6% Other. The largest income group is $25-50K and largest age group is 35-54 years old. PART VI, LINE 5 CALDWELL MEMORIAL HOSPITAL PROVIDES FINANCIAL SUPPORT TO 2 COMMUNITY AGENCIES: THE HELPING HANDS CLINIC (PROVIDING CARE TO THE UNINSURED) AND THE SATIE AND JE BROYHILL CALDWELL SENIOR CENTER (FOCUS ON THE LIVES AND ADVOCACY OF SENIORS). OTHER COMMUNITY INVOLVEMENT INCLUDES BUT NOT LIMITED TO: ANNUAL PROSTATE SCREENING, HEALTH FAIRS, SUPPORT AND INVOLVEMENT IN THE CALDWELL COMMUNITY GARDEN WHICH HELPS FOSTER COMMUNITY GARDENING, REPRESENTATION BY ORGANIZATION REPRESENTATIVES ON LOCAL HEALTH CARE RELATED BOARDS (BOARD OF HEALTH, HOSPICE, AND CHILD PROTECTION TEAM.) CALDWELL MEMORIAL HEALTHWORKS WHICH IS OCCUPATIONAL, INDUSTRIAL AND WORKER'S COMP MEDICINE DESIGNED TO ASSIST EMPLOYERS TOWARD IMPROVING QUALITY OF HEALTHCARE. PART VI, LINE 6 CALDWELL MEMORIAL HOSPITAL IS PART OF THE UNC HEALTH CARE SYSTEM. UNC HEALTH CARE IS A NOT-FOR-PROFIT INTEGRATED HEALTH CARE SYSTEM OWNED BY THE STATE OF NORTH CAROLINA AND BASED IN CHAPEL HILL. ORIGINALLY ESTABLISHED NOV. 1, 1998, UNC HEALTH CARE CURRENTLY COMPRISES UNC HOSPITALS AND ITS PROVIDER NETWORK, THE CLINICAL PROGRAMS OF THE UNC SCHOOL OF MEDICINE, AND TEN AFFILIATE HOSPITALS AND HOSPITAL SYSTEMS ACROSS THE STATE. COLLECTIVELY, THIS GROUP OF HEALTH CARE PROVIDERS WORKS TOGETHER TO MAKE SURE THAT ALL OF THE COMMUNITIES SERVED RECEIVED THE HIGHEST QUALITY OF CARE. true X X X X X false true false false false true true false false Chris Ellington Director 0 714017 212800 157873 0 162812 0 21311 0 1268813 0 52405 John Powell MD Director 232943 21607 362 10715 0 26645 0 292272 0 0 0 Laura Easton Director/President & CEO 325881 24315 10310 13763 0 26645 0 400914 0 0 0 Rebecca Smith COO & CNO 212374 16126 20015 13264 0 8582 0 270361 0 0 0 Michael Bunch CFO 221856 16478 270 2084 0 15002 0 255690 0 0 0 David Lowery MD CMO 317126 23780 774 14000 0 26645 0 382325 0 0 0 Donita Damron VP Physician Services 161217 11950 205 6543 0 8329 0 188244 0 0 0 Philip Jenkins Medical Practice Physician 443667 2248 494 0 0 26645 0 473054 0 0 0 Thomas Young Medical Practice Physician 449764 12914 208 7128 0 26645 0 496659 0 0 0 Ralph Duckett Medical Practice Physician 503745 110600 1188 0 0 11592 0 627125 0 0 0 David Cook Medical Practice Physician 404500 28077 6601 0 0 14807 0 453985 0 0 0 Timothy Clenney Medical Practice Physician 399294 28712 774 0 0 0 0 428780 0 0 0 PART I, LINE 4B DURING THE CALENDAR YEAR 2019, THE FOLLOWING INDIVIDUALS RECEIVED DISTRIBUTIONS FROM A NON-QUALIFIED SUPPLEMENTAL RETIREMENT PLAN (457(F)): CHRIS ELLINGTON (DIRECTOR) $52,405 LAURA EASTON (CEO) HAS A SECURED BENEFIT PLAN WHICH IS INCLUDED IN THE STUDY COMPLETED BY THE INDEPENDENT COMPENSATION CONSULTANT; THE LOAN UNDER THIS ARRANGEMENT IS RECORDED ON THE FINANCIAL STATEMENTS AND FULLY SECURED BY LIFE INSURANCE ON THE LIFE OF THE CEO. PART I, LINE 6 Senior management has an incentive program which is partially earned based on profit margin and days cash on hand. The earned incentive is reviewed by the HR Committee of the Board and approved annually. Employed Physicians are paid on a productivity basis based on RVU's generated in their practice operations and these are tied to MGMA benchmarks. FORM 990, PART VI, SECTION A, LINE 1: THE EXECUTIVE/FINANCE COMMITTEE SHALL HAVE THE POWER TO TRANSACT ALL REGULAR BUSINESS OF THE HOSPITAL DURING THE PERIOD BETWEEN THE MEETINGS OF THE BOARD OF DIRECTORS, SUBJECT TO ANY PRIOR LIMITATION IMPOSED BY THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 6: THE UNIVERSITY OF NORTH CAROLINA HEALTH CARE SYSTEM IS A MEMBER. FORM 990, PART VI, SECTION A, LINE 7A: THE UNIVERSITY OF NORTH CAROLINA HEALTH CARE SYSTEM IS A MEMBER AND THEY HAVE THE POWER TO APPOINT BOARD MEMBERS AND APPROVE GOVERNANCE DECISIONS. FORM 990, PART VI, SECTION A, LINE 7B: THE UNIVERSITY OF NORTH CAROLINA HEALTH CARE SYSTEM AS A MEMBER HAS APPROVAL RIGHTS TO ALL GOVERNANCE DECISIONS. FORM 990, PART VI, SECTION B, LINE 11B: THE FORM 990 WAS PREPARED BY AN INDEPENDENT ACCOUNTANT WITH ASSISTANCE AND OVERSIGHT BY MANAGEMENT. THE FULL BOARD RECEIVED A COPY OF THE FORM 990 FOR THEIR REVIEW AND FOR ANY QUESTIONS. THE FULL BOARD VOTED FOR A FINAL APPROVAL OF THE FORM 990. FORM 990, PART VI, SECTION B, LINE 12C: THE AUDIT AND COMPLIANCE COMMITTEE OF THE BOARD ANNUALLY REVIEWS THE CONFLICT OF INTEREST STATEMENTS. MINUTES OF BOARD MEETINGS REFLECT ANY DECLARED CONFLICT OF INTEREST. FORM 990, PART VI, SECTION B, LINE 15: THE ORGANIZATION COMPLETES THE REBUTTABLE PRESUMPTION OF REASONABLENESS AS DESCRIBED IN TREASURY REGULATION 4958(6)(C) FOR EACH OFFICER AND KEY EMPLOYEE. THIS PROCESS IS PERFORMED BY AN OUTSIDE INDEPENDENT COMPENSATION SPECIALIST. THE CONSULTANT'S FINDINGS ARE PRESENTED TO THE HR COMMITTEE OF THE BOARD AND ARE ULTIMATELY APPROVED BY THE FULL BOARD. FORM 990, PART VI, SECTION C, LINE 18: PHOTOCOPIES OF THE FORM 990 ARE AVAILABLE UPON REQUEST AT THE ORGANIZATIONS ADMINISTRATIVE OFFICE. IN ADDITION, RECENT FILINGS OF THE FORM 990 ARE AVAILABLE ON GUIDESTAR.ORG. FORM 990, PART VI, SECTION C, LINE 19: THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, FINANCIAL STATEMENTS, AND CONFLICT OF INTEREST POLICY AVAILABLE UPON REQUEST. PLEASE USE THE ORGANIZATIONS "CONTACT US" LINK ON ITS WEBSITE FOR REQUESTS. FORM 990, PART VII, LINE 1B AVERAGE HOURS PER WEEK BOARD MEMBERS AND OFFICERS CONTRIBUTE THEIR TIME AND SERVICES UPON REQUEST AND ON AN AS-NEEDED BASIS, WHICH, THROUGHOUT THE YEAR, MAY DIFFER FROM THE AVERAGE NUMBER OF HOURS PER WEEK REPORTED ON PART VII, LINE 1B. FORM 990, PART XII, LINE 2C: NO CHANGE FROM PRIOR YEAR. Form 990, Part XII, Line 3B: The Organization and auditors were waiting on final guidance from the various federal agencies with respect to funding received under the CARES Act and other government sources. Once the final guidance was released, the Organization and auditors have begun the process of having the Single Audit completed. UNC ROCKINGHAM HEALTH CARE INC 117 E KINGS HWY EDEN NC 27288 823745228 HEALTHCARE NC 501(C)(3) LINE 3 UNC HEALTH C false UNC HEALTH CARE SYSTEM 101 MANNING DRIVE Chapel Hill NC 27514 562206970 HEALTHCARE NC SECTION 115 UNC HEALTH C false UNC HOSPITALS 101 Manning Drive CHAPEL HILL NC 27514 561118388 HEALTHCARE NC SECTION 115 UNC HEALTH C false THE REX HEALTHCARE FOUNDATION INC 4420 LAKE BOONE TRAIL RALEIGH NC 27607 566052117 support rex h NC 501(C)(3) LINE 12B ii UNC HEALTH C false CALDWELL MEMORIAL HOSPITAL FOUNDATION PO BOX 1890 LENOIR NC 28645 581935514 SUPPORT OF CA NC 501(C)(3) LINE 7 CALDWELL MEM false CHATHAM HOSPITAL INC PO BOX 649 SILER CITY NC 27344 560611546 HEALTHCARE NC 501(C)(3) LINE 3 UNC HEALTH C false PIEDMONT TRIAD HEALTH SERVICES 101 MANNING DR MED WING E 2ND FLO CHAPEL HILL NC 27514 561497163 HEALTHCARE NC 501(C)(3) LINE 12B II UNC HEALTH C false REX HEALTHCARE INC 4420 LAKE BOONE TRAIL RALEIGH NC 27607 561509129 HEALTHCARE NC 501(C)(3) LINE 12A, I UNC HEALTH C false REX HOSPITAL INC 4420 LAKE BOONE TRAIL RALEIGH NC 27607 561509260 HEALTHCARE NC 501(C)(3) LINE 3 UNC HEALTH C false UNC PHYSICIANS NETWORK 1600 PERIMETER PARK DR STE 225 MORRISVILLE NC 27560 271081647 HEALTHCARE NC 501(C)(3) LINE 10 UNC HEALTH C false UNC PHYSICIANS NETWORK GROUP PRACTICES 1600 PERIMETER PARK DRIVE Ste 225 MORRISVILLE NC 27560 461416986 HEALTHCARE NC NA C CORP 0 0 false false false true false false false false false false false false false true true false false false false false Caldwell Memorial Hospital Foundation C 3300860 CASH