2020-05-08T11:02:22-05:00 2019-06-30 560574444 CHERRY BEKAERT LLP 3800 GLENWOOD AVE SUITE 200 RALEIGH NC 27612 990 2018-07-01 205408367 NORTH CAROLINA COMMUNITY CARE NETWORKS INC NORT 9197452442 2300 REXWOODS DRIVE NO 200 RALEIGH NC 27607 CHRISTOPHER C WOODFIN EXECUTIVE VP & CFO 9197452442 2020-04-29 1 AMANDA ADAMS P00748038 9197821040 76.105.106.201 2020-04-29 13:04:11 ED P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 18694F53AD11E15FFCEA276DE93F63B2E746D691 2018 2020-09-23 17:36:50Z CHRISTOPHER C WOODFIN 2300 REXWOODS DRIVE NO 200 RALEIGH NC 27607 84989218 0 X COMMUNITYCARENC.ORG X 2006 NC TO IMPROVE THE HEALTH AND QUALITY OF LIFE OF ALL NORTH CAROLINIANS BY BUILDING AND SUPPORTING BETTER COMMUNITY-BASED HEALTH CARE DELIVERY SYSTEMS. 7 5 0 6 0 0 52910142 18808 42624 84557613 -1732 412797 0 0 52951034 84989218 0 0 0 0 0 0 0 0 224315 37656168 88077786 37656168 88077786 15294866 -3088568 28454567 33889591 1876352 10349768 26578215 23539823 X THE PRIMARY EXEMPT PURPOSE IS TO IMPROVE THE HEALTH AND QUALITY OF LIFE OF ALL NORTH CAROLINIANS BY BUILDING AND SUPPORTING BETTER COMMUNITY-BASED HEALTH CARE DELIVERY SYSTEMS. 0 0 60170091 84557613 CLINICAL PROGRAMS: THE PURPOSE OF N3CN CLINICAL PROGRAMS IS TO PROVIDE HIGH VALUE SERVICES TO THE STATE OF NORTH CAROLINA TO IMPROVE THE HEALTH OF MEDICAID BENEFICIARIES AND IMPROVE QUALITY IN THE HEALTHCARE DELIVERY SYSTEM. THE PROGRAM DEVELOPS AND IMPLEMENTS POPULATION MANAGEMENT INITIATIVES THAT ARE SUPPORTED BY DATA ANALYTICS AND POPULATION HEALTH TOOLS. USING ANALYTICS, THE PROGRAM TARGETS INDIVIDUALS THAT WOULD BENEFIT MOST FROM CARE MANAGEMENT SERVICES TO HIGH NEED MEDICAID ENROLLEES. N3CN ALSO PROVIDES PRACTICE SUPPORT SERVICES THAT SUPPORT PRIMARY CARE PRACTICES AND OBSTETRIC PRACTICES IN THE MEDICAID PROGRAM. THESE SERVICES ALSO SUPPORT PRIMARY CARE AND MATERNITY QUALITY INITIATIVES AND HIGH VALUE CARE. 14751704 DATA ANALYTICS: PERFORMANCE MEASURES AND DATA ANALYTICS HAVE BEEN ESTABLISHED ON A STATEWIDE BASIS. THE PROCESS INCLUDES DEVELOPING SYSTEMS FOR COLLECTION AND ANALYZING DATA AND REPORTING PERFORMANCE MEASURE RESULTS. THESE REPORTS ARE CREATED AT THE PROGRAM, REGIONAL AND PRACTICE LEVEL AND PROVIDE THE BASIS FOR MEASURING IMPROVEMENT AND IMPACT ON THE ENROLLED POPULATION. 7390 GENERAL MISSIONS: THE ORGANIZATION WAS CREATED TO ALLOW THE BENEFITS OF NORTH CAROLINA'S UNIQUE APPROACH TO HEALTHCARE TO BE MADE AVAILABLE MORE BROADLY, INCLUDING TO NEW POPULATIONS BEYOND MEDICAID RECIPIENTS. THE OVERARCHING GOAL IS TO EDUCATE, SHOWCASE, AND SHARE THE ORGANIZATION'S MODEL OF PATIENT CENTRIC CARE BY DEMONSTRATING THE ORGANIZATION'S SUCCESS IN ESTABLISHING MEDICAL HOMES AND THE CARE MANAGEMENT PROGRAM. THE ORGANIZATION'S ABILITY TO DEMONSTRATE ITS INNOVATIVE THINKING AND SUCCESSFUL IMPLEMENTATION HAS RECEIVED NATIONAL ATTENTION. ORGANIZATIONS HAVE INVITED THE ORGANIZATION TO PRESENT ITS MODEL AND SERVICES TO LEADERSHIP, STAFF, LEGISLATURES, AND COMMUNITIES. ORGANIZATIONS INCLUDE GOVERNMENTAL AND NON-GOVERNMENTAL AGENCIES AS WELL AS SMALL AND LARGE COMPANIES THROUGHOUT THE COUNTRY. BY DEMONSTRATING THE ORGANIZATION'S ABILITY TO BRING ABOUT POSITIVE SOCIETAL CHANGE, THE ORGANIZATION IS BUILDING LONG-TERM RELATIONSHIPS WITH A NUMBER OF THESE ENTITIES. 74929185 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 15 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 7 5 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 NC X COLIN FELMET 9197452442 2300 REXWOODS DRIVE NO 200 RALEIGH NC 27607 THOMAS WROTH MD PRESIDENT 30.00 6.00 X X 0 369984 24790 TOM BACON DRPH BOARD MEMBER 0.50 0.00 X 0 0 0 MICHELLE BROOKS RN MSN BOARD MEMBER 0.50 0.00 X 0 0 0 ANITA SCHAMBACH BOARD MEMBER 0.50 0.00 X 0 0 0 JEFF SIMMS MSPH MDIV BOARD MEMBER 0.50 0.00 X 0 0 0 WILLIAM STEWART MD FAAP BOARD MEMBER 0.50 0.00 X 27862 0 0 DAVID TAYLOE MD BOARD MEMBER 0.50 0.00 X 0 0 0 TORLEN WADE EVP FOR BUSINESS & PROVIDER PARTNERSHIPS 1.00 33.00 X 0 262695 12871 CHRISTOPHER WOODFIN EVP OF CORPORATE SERVICES & CFO 1.00 39.00 X 0 419721 25497 RONALD SMITH EVP STRATEGIC INITIATIVES 1.00 35.00 X 0 370240 22738 DENISE HEWSON EVP CARE MANAGEMENT & PROVIDER SERVICES 9.00 31.00 X 0 359346 24802 CARLOS JACKSON CHIEF DATA & ANALYTICS OFFICER 1.00 39.00 X 0 248072 25286 GEORGE BAKOLIA SVP & CHIEF INFORMATION OFFICER 1.00 39.00 X 0 324385 15906 MICHELLE BUCKNOR CHIEF MEDICAL OFFICER 23.00 17.00 X 0 318373 14980 WILLIAM TAYLOR SVP BUSINESS DEVELOPMENT 1.00 39.00 X 0 287929 20376 SCOTT TREMAYNE SVP FINANCE 1.00 39.00 X 0 246687 25244 JUDITH O'NEAL SVP OF STRATEGIC PLANNING, COMMUNICATION & PR 1.00 39.00 X 0 246497 20179 27862 3453929 232669 0 0 1 0 NC HOSPITAL FOUNDATION INC 2401 WESTON PARKWAY SUITE 203 CARY NC 27513 CLINICAL SERVICES 267031 UNC DEPARTMENT OF OBGYN CAMPUS BOX 7570 OLD CLINIC BUILDIN CHAPEL HILL NC 27599 CLINICAL SERVICES 216264 UNC-CH DEPT OF FAMILY MEDICINE CB7595 590 MANNING DR CHAPEL HILL NC 27599 CLINICAL SERVICES 166820 HEALTHWISE INCORPORATED PO BOX 1689 BOISE ID 83701 CONSULTING SERVICES 108568 4 18808 18808 18808 CLINICAL PROGRAM FEES 621990 84399797 84399797 SERVICE FEES 900099 135073 135073 RENTAL INCOME 531120 22325 22325 ADMINISTRATIVE FEES 900099 418 418 84557613 357055 357055 55742 0 55742 55742 55742 84989218 84557613 0 412797 X 30160 30160 43341012 42739819 596326 4867 582371 294688 285552 2131 651821 419102 227868 4851 318302 278294 33519 6489 29023 29023 6734067 66631 6666503 933 1007 1007 SHARED SERVICES 22063565 16831237 5027429 204899 SPECIAL PROJECTS 14130494 14130494 EQUIPMENT 134504 118164 16195 145 61460 20726 40734 88077786 74929185 12924286 224315 20569183 6587327 152197 6414581 5045 15831 100932 2345433 252937 302724 6322940 6093144 334915 229796 15327222 6678131 0 361227 2666677 28454567 33889591 1556631 10060344 319721 289424 1876352 10349768 X 26578215 23539823 26578215 23539823 28454567 33889591 -3088568 50176 0 X 0 1 X 1 0 X 31593556 26089949 24895596 52910142 18808 135508051 31593556 26089949 24895596 52910142 18808 135508051 135508051 1141 932 357055 359128 135867179 92241130 0.99740 1.00000 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 88047626 88047626 1000000 250000 0 0 1000000 1000000 1000000 1000000 4000000 6000000 38984 38984 250000 250000 250000 250000 1000000 1500000 428371 412803 15568 3660147 3527125 133022 2234422 2153216 81206 229796 SECURITY DEPOSITS 33610 DUE FROM AFFILATE 2633067 2666677 DEFERRED RENT 289424 289424 X 87281576 50176 2272342 2322518 84959058 30160 30160 84989218 90319968 2272342 2272342 88047626 30160 30160 88077786 PART X, LINE 2: THE ORGANIZATION IS EXEMPT FROM FEDERAL INCOME TAXES UNDER INTERNAL REVENUE CODE SECTION 501(C)(3) OF THE U.S. INTERNAL REVENUE CODE AND THE APPLICABLE STATE TAX STATUTES. IN ADDITION, THE ORGANIZATION QUALIFIES FOR THE CHARITABLE CONTRIBUTIONS DEDUCTION UNDER SECTION 170(B)(1)(A) OF THE U.S. INTERNAL REVENUE CODE. MANAGEMENT HAS EVALUATED THE EFFECT OF THE GUIDANCE PROVIDED BY U.S. GENERALLY ACCEPTED ACCOUNTING PRINCIPLES. MANAGEMENT BELIEVES THAT THE ORGANIZATION CONTINUES TO SATISFY THE REQUIREMENTS OF A TAX-EXEMPT ORGANIZATION AT JUNE 30, 2019. MANAGEMENT HAS EVALUATED ALL OTHER TAX POSITIONS THAT COULD HAVE A SIGNIFICANT EFFECT ON THE CONSOLIDATED FINANCIAL STATEMENTS AND DETERMINED THAT THE ORGANIZATION HAD NO SIGNIFICANT UNCERTAIN INCOME TAX POSITIONS AT JUNE 30, 2019 AND 2018. PART XI, LINE 2D - OTHER ADJUSTMENTS: REIMBURSEMENT OF EXPENSES FROM RELATED ORGANIZATION 2,272,342. PART XII, LINE 2D - OTHER ADJUSTMENTS: EXPENSES REIMBURSED BY RELATED ORGANIZATION 2,272,342. 0 0 0 0 0 0 1 0 0 THOMAS WROTH MD PRESIDENT 0 310818 0 59166 0 0 0 13750 0 11040 0 394774 0 0 TORLEN WADE EVP FOR BUSINESS & PROVIDER PARTNERS 0 203525 0 37999 0 21171 0 11078 0 1793 0 275566 0 0 CHRISTOPHER WOODFIN EVP OF CORPORATE SERVICES & CFO 0 349236 0 70485 0 0 0 13750 0 11747 0 445218 0 0 RONALD SMITH EVP STRATEGIC INITIATIVES 0 307946 0 62294 0 0 0 13750 0 8988 0 392978 0 0 DENISE HEWSON EVP CARE MANAGEMENT & PROVIDER SERVI 0 314234 0 45112 0 0 0 13750 0 11052 0 384148 0 0 CARLOS JACKSON CHIEF DATA & ANALYTICS OFFICER 0 211322 0 36750 0 0 0 13037 0 12249 0 273358 0 0 GEORGE BAKOLIA SVP & CHIEF INFORMATION OFFICER 0 284730 0 39655 0 0 0 13306 0 2600 0 340291 0 0 MICHELLE BUCKNOR CHIEF MEDICAL OFFICER 0 283653 0 34720 0 0 0 13538 0 1442 0 333353 0 0 WILLIAM TAYLOR SVP BUSINESS DEVELOPMENT 0 245299 0 42630 0 0 0 11498 0 8878 0 308305 0 0 SCOTT TREMAYNE SVP FINANCE 0 203187 0 43500 0 0 0 13021 0 12223 0 271931 0 0 JUDITH O'NEAL SVP OF STRATEGIC PLANNING, COMMUNICA 0 205877 0 40620 0 0 0 12322 0 7857 0 266676 0 0 PART I, LINE 3 NORTH CAROLINA COMMUNITY CARE NETWORKS, INC. (N3CN) DOES NOT HAVE ANY EMPLOYEES. ALL INDIVIDUALS PERFORMING WORK FOR THE ORGANIZATION ARE EMPLOYED BY COMMUNITY CARE OF NORTH CAROLINA, INC., (CCNC) A RELATED ORGANIZATION. N3CN REIMBURSES CCNC UNDER A SHARED SERVICES AGREEMENT. CCNC USED THE FOLLOWING PROCEDURES TO ESTABLISH THE COMPENSATION OF THE ORGANIZATIONS' CEO/EXECUTIVE DIRECTOR: COMPENSATION COMMITTEE, WRITTEN EMPLOYMENT CONTRACT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. PART I, LINE 6 CCNC'S INCENTIVE COMPENSATION PLAN IS PARTIALLY BASED ON ACHIEVING CERTAIN NET INCOME GOALS ESTABLISHED BY THE BOARD OF DIRECTORS. TOTAL INCENTIVE PAYMENTS WERE CAPPED AT 15.00% OF TOTAL SALARY EXPENSE. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE CORPORATE MEMBER IS COMMUNITY CARE OF NORTH CAROLINA, INC. FORM 990, PART VI, SECTION A, LINE 7A ANY VACANCY OCCURRING ON THE BOARD OF DIRECTORS MAY BE FILLED BY THE AFFIRMATIVE VOTE OF A MAJORITY OF THE REMAINING DIRECTORS, SUBJECT TO THE APPROVAL OF THE CORPORATE MEMBER. FORM 990, PART VI, SECTION A, LINE 7B THE CORPORATE MEMBER HAS THE RIGHT TO APPROVE THE FOLLOWING ACTIONS, PROVIDED THOSE ACTIONS HAVE ALREADY BEEN APPROVED BY THE BOARD OF DIRECTORS OF THE CORPORATION: 1. APPROVAL OF ANNUAL OPERATING AND CAPITAL BUDGETS OF THE CORPORATION, AND ANY MATERIAL VARIANCES THEREFROM, AND APPROVAL OF LONG-RANGE FINANCIAL PLANS. 2. APPROVAL OF THE INCURRENCE OF ANY INDEBTEDNESS OF THE CORPORATION IN EXCESS OF AMOUNTS DETERMINED FROM TIME TO TOME BY RESOLUTION OF THIS CORPORATION'S CORPORATE MEMBER. 3. APPROVAL OF MERGERS OR CONSOLIDATIONS OF THE CORPORATION WITH ANY DOMESTIC OR FOREIGN CORPORATION. 4. THE SALE, TRANSFER, ENCUMBRANCE OR OTHER DISPOSITION OF ASSETS OF THE CORPORATION WITH A FAIR MARKET VALUE IN EXCESS OF AN AMOUNT DETERMINED FROM TIME TO TIME BY THIS CORPORATION'S CORPORATE MEMBER OTHER THAN IN THE ORDINARY COURSE OF BUSINESS. 5. APPOINTMENT OR REMOVAL OF THE PRESIDENT OF THE CORPORATION. 6. APPOINTMENT OR REMOVAL OF A DIRECTOR OF THE CORPORATION. 7. AMENDMENTS TO THE ARTICLES OF INCORPORATION AND/OR BYLAWS OF THE CORPORATION. 8. VOLUNTARY DISSOLUTION OF THE CORPORATION. 9. APPROVAL OF VENDOR AGREEMENTS INVOLVING 20% OR MORE OF THIS CORPORATION'S OPERATING EXPENSE OF THE CORPORATION. 10. ESTABLISHMENT OF LONG RANGE PLANS AND STRATEGIES FOR THIS CORPORATION, INCLUDING ISSUES RELATING TO MARKETING, STRATEGIC DIRECTION, AND ONGOING OPERATIONS. 11. DEVELOPMENT OF POLICIES REGARDING THE IMPLEMENTATION OF ANY OF THE RESERVED POWERS DESCRIBED ABOVE. FORM 990, PART VI, SECTION B, LINE 11B FORM 990 IS REVIEWED BY MANAGEMENT AND PROVIDED TO EACH VOTING MEMBER OF THE BOARD IN FULL BEFORE FILING WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C EACH DIRECTOR, PRINCIPAL OFFICER AND EMPLOYEE SIGNS A STATEMENT ANNUALLY. THE CORPORATION SHALL CONDUCT PERIODIC REVIEWS OF ITS ACTIVITIES TO ENSURE THAT IT IS OPERATING IN A MANNER CONSISTENT WITH ITS CHARITABLE PURPOSES AND THAT IT IS NOT ENGAGING IN ACTIVITIES THAT COULD JEOPARDIZE ITS STATUS AS AN ORGANIZATION EXEMPT FROM FEDERAL INCOME TAX. IN THE EVENT OF A CONFLICT, THE BOARD MEMBER WOULD RECUSE HIMSELF/HERSELF FROM THE DISCUSSION AND VOTING PROCESS. A CHANGE IN THE ORGANIZATIONS CONFLICT OF INTEREST POLICY DIRECTS STAFF TO "IDENTIFY POSSIBLE CLASSES OF BOARD MEMBERSHIP BASED ON CONTRACTUAL RELATIONSHIPS BETWEEN COMPANIES THAT EMPLOY THE BOARD MEMBER AND COMPANIES FOR WHICH THE MEMBER IS A BOARD MEMBER, AND TO RESEARCH BOARD POWERS THAT MIGHT BE RESERVED FOR BOARD MEMBERS OF PARTICULAR IDENTIFIED CLASSES." FORM 990, PART VI, SECTION B, LINE 15 NORTH CAROLINA COMMUNITY CARE NETWORKS, INC. DOES NOT HAVE ANY EMPLOYEES. ALL INDIVIDUALS PERFORMING WORK FOR THE ORGANIZATION ARE EMPLOYED BY CCNC, A RELATED ORGANIZATION. N3CN REIMBURSES CCNC UNDER A SHARED SERVICES AGREEMENT. CCNC'S EVALUATION AND COMPENSATION COMMITTEE RECOMMENDED, AND CCNC'S BOARD APPROVED, A CORPORATE COMPENSATION PHILOSOPHY ON JUNE 3, 2013. THE PHILOSOPHY INCLUDES: PAYING AT A LEVEL TO ATTRACT AND RETAIN QUALIFIED AND TALENTED EXECUTIVES; COMPENSATION BASED ON BENCHMARKS AND SIMILARLY SIZED NON-PROFITS WITH SIMILAR EXECUTIVE STRUCTURES; COMPENSATION AT OR SLIGHTLY ABOVE MEDIAN; BASE SALARY LINKED TO PERFORMANCE AND SKILLS. EXECUTIVE COMPENSATION IS EVALUATED AND APPROVED BY CCNC'S EVALUATION AND COMPENSATION COMMITTEE AND RATIFIED BY CCNC'S BOARD OF DIRECTORS. CEO COMPENSATION IS APPROVED BY CCNC'S BOARD OF DIRECTORS. FORM 990, PART VI, SECTION C, LINE 19 ALL GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON WRITTEN REQUEST AT THE OFFICE OF THE ORGANIZATION. FORM 990, PART IX, LINE 11G CONTRACT SERVICES: PROGRAM SERVICE EXPENSES 42,739,819. MANAGEMENT AND GENERAL EXPENSES 596,326. FUNDRAISING EXPENSES 4,867. TOTAL EXPENSES 43,341,012. COMMUNITY CARE OF NORTH CAROLINA INC 2300 REXWOODS DRIVE SUITE 140 RALEIGH NC 27607 463355510 FOSTER AND ENHANCE QUALITY, EFFICIENCY AND ACCESS TO HEALTH CARE NC 501(C)(3) LINE 7 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 1 1 1 0 0 COMMUNITY CARE OF NORTH CAROLINA INC J 774363 CASH COMMUNITY CARE OF NORTH CAROLINA INC M 14006444 CASH COMMUNITY CARE OF NORTH CAROLINA INC O 15809506 CASH COMMUNITY CARE OF NORTH CAROLINA INC P 25080457 CASH COMMUNITY CARE OF NORTH CAROLINA INC Q 2272341 CASH