2020-08-14T08:01:47-05:00 2019-09-30 560747981 Dixon Hughes Goodman LLP 500 Ridgefield Court Asheville NC 28806 990 2018-10-01 383740839 Vidant Medical Group LLC VIDA 2528475129 2100 Stantonsburg Rd Greenville NC 27835 David S Hughes Treasurer 2528475129 2020-08-14 1 Amy Bibby P00445891 8282542254 2020-08-14 99.47.28.203 2020-08-14 07:19:10 ED P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 48FB394F9AA065459641371F168D9F2AFFFBB473 2018 2020-09-22 18:59:49Z David S Hughes 2100 Stantonsburg Rd Greenville NC 27835 242937006 0 X www.vidanthealth.com X 2006 NC To provide medical services in Eastern North Carolina. 6 0 619 0 0 0 15523 56806 210589455 242683340 28616 29449 95636 167411 210729230 242937006 0 2300 0 0 172199331 200097089 0 0 0 106401552 122796151 278600883 322895540 -67871653 -79958534 46341159 44945042 36189213 36550954 10151946 8394088 To enhance the quality of life for the people and communities we serve, touch and support. 0 0 307720908 2300 242850751 Vidant Health professionals provided evaluations, clinical care management and medically necessary procedures. 307720908 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 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 1 1 0 0 0 1 0 0 619 1 0 0 0 0 0 0 0 0 0 0 0 0 X 6 0 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X X Brian Dunn 2528477479 2100 Stantonsburg Rd Greenville NC 27835 Michael Waldrum MD CEO 2.00 50.00 X X 0 1155199 218911 Jay Briley President Of VCom 2.00 46.00 X 0 313931 111700 David Hughes Treasurer 2.00 50.00 X X 0 524535 1471416 William Floyd President Of VMC 2.00 42.00 X 0 532328 446999 Anthony Bartholomew VP, of Operations 40.00 X 219397 0 46042 Daniel Drake PHD President of VMG 40.00 2.00 X 252366 0 149417 Manjunath Markandaya Physician 40.00 X 1153081 0 33145 Richard Dalyai Physician 40.00 X 1094720 0 37045 Aaron Danison Physician 40.00 X 1029749 0 32570 Hilal Kanaan Physician 40.00 X 974299 0 40880 Kenneth Lee Physician 40.00 X 889957 0 34540 5613569 2525993 2622665 464 0 1 0 ECU School of Medicine PO Box 75514 Charlotte NC 282750514 Physician Services 10297286 Hayes Locums LLC 6700 North Andrews Ave Suite 600 Ft Lauderdale FL 33309 Physician Services 2157989 Bunn Medical Associates 606 Ashburton Drive Greenville NC 27858 Physician Services 2039078 Weatherby Locums Inc PO Box 972633 Dallas TX 753972633 Physician Services 1645511 Center for Neuropsychiatric Services PA 12417 Moriah Way Raleigh NC 27614 Physician Services 1189562 58 56806 56806 Patient Services 621110 184325487 184325487 Contract Management Fees 621110 58357853 58357853 242683340 27504 27504 167411 0 167411 167411 167411 1945 0 1945 1945 1945 242937006 242850751 0 29449 X 2300 2300 471763 471763 175467500 168444250 7023250 3645420 3490125 155295 11386016 10900972 485044 9126390 8737606 388784 66879 64030 2849 43646 41787 1859 58354676 55868767 2485909 699043 669264 29779 1043331 998885 44446 302113 289243 12870 7574106 7251449 322657 768356 499431 268925 2229390 2134418 94972 4611105 2074997 2536108 Bad Debt 27147607 27147607 Medical Supplies 18925769 18119531 806238 Other expenses 1030130 986246 43884 322895540 307720908 15174632 0 2184295 5500630 17924119 14601866 285855 144926 1746451 2047555 875970 945047 34759055 16975733 16276643 17783322 12046 12046 7035780 3909650 46341159 44945042 31090919 32437529 5098294 4113425 36189213 36550954 X 10151946 8394088 10151946 8394088 46341159 44945042 X -79958534 78200676 X X 0 1 X 1 0 X 15523 56806 72329 164114286 164870197 178081637 165014722 183916077 855996919 164114286 164870197 178081637 165030245 183972883 856069248 0 0 0 856069248 17182 17268 30567 30515 27504 123036 17182 17268 30567 30515 27504 123036 164131468 164887465 178112204 165060760 184000387 856192284 0.99990 0.99990 0.00010 0.00010 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1977315 1977315 14151283 7328116 6823167 18630457 9647617 8982840 17783322 Other Assets 2635694 Other Receivables 1244357 Deferred Pension Outflows 29599 3909650 Reserve for Professional Liability 4031405 Deferred Pension Inflows 35836 Other liability 46184 4113425 X Part X, Line 2: Vidant Medical Group has been determined to qualify as a tax-exempt organization under Section 501(c)(3) of the Internal Revenue Code. Vidant Medical Gruop has reviewed its tax positions for all open years and has concluded that no material liabilities exist as of September 30, 2019 and 2018. Vidant Medical Group files tax returns with the U.S. federal jurisdiction. With few exceptions, Vidant Medical Group is no longer subject to U.S. federal examinations by tax authorities for years before 2016. 0 0 0 0 0 0 0 0 0 Michael Waldrum MD CEO 0 1143540 0 0 0 11659 0 175115 0 43796 0 1374110 0 0 Jay Briley President Of VCom 0 313931 0 0 0 0 0 76017 0 35683 0 425631 0 0 David Hughes Treasurer 0 522510 0 0 0 2025 0 1433650 0 37766 0 1995951 0 0 William Floyd President Of VMC 0 531518 0 0 0 810 0 406335 0 40664 0 979327 0 0 Anthony Bartholomew VP, of Operations 219397 0 0 0 0 0 22342 0 23700 0 265439 0 0 0 Daniel Drake PHD President of VMG 252366 0 0 0 0 0 108733 0 40684 0 401783 0 0 0 Manjunath Markandaya Physician 1109581 0 43500 0 0 0 0 0 33145 0 1186226 0 0 0 Richard Dalyai Physician 1046758 0 47962 0 0 0 0 0 37045 0 1131765 0 0 0 Aaron Danison Physician 981923 0 47826 0 0 0 0 0 32570 0 1062319 0 0 0 Hilal Kanaan Physician 913876 0 60423 0 0 0 0 0 40880 0 1015179 0 0 0 Kenneth Lee Physician 842471 0 47486 0 0 0 0 0 34540 0 924497 0 0 0 Part I, Line 1a All compensation and reimbursement listed for such items are paid at the Vidant Health entity, and the written policy and adherence to the policy is maintained at VH. Part I, Line 3 The compensation is determined by the Compensation and Benefits Committee of the VH Board using comparative data from like organizations and input from consultants. All compensation discussions and actions are documented and approved in the minutes of the Committee. Part I, Line 4 As of January 1, 2013, the supplemental nonqualified retirement plan was frozen and no further amounts have accrued to its benefit. In lieu of the SERP, the comprehensive defined benefit pension plan will provide an equivalent benefit. The increase in the value of such plans is reflected in the sum of Part II, Column (C). On May 3, 2018 an amendment was adopted in the non-vesting supplemental executive retirement plan (SERP) that effectively transferred the frozen SERP benefits for the remaining 10 active participants to the qualified pension plan to the extent permitted by IRS limits. This resulted in an increase in the reported deferred compensation for these 10 executives. The deferred compensation reported for the two officers of the company, in part, represent the amounts transferred to their qualified pension plan that was earned over and related to their years of service to the Organization of 14 and 22 years. Form 990, Part VI, Section A, line 6 University Health Systems of Eastern Carolina, Inc. ("Vidant Health") is the sole corporate member of Vidant Medical Group, LLC. Form 990, Part VI, Section A, line 7a As the corporate member, Vidant Health shall have the responsibility to elect or appoint the seven individual voting members of Vidant Medical Group, LLC. Form 990, Part VI, Section A, line 7b The rights reserved to the corporate member include the rights of: a. Selling, leasing or otherwise disposing of, or agreeing to sell, lease or otherwise dispose of, all or substantially all of the assets of Vidant Medical Group, LLC; b. Winding up, dissolving, liquidating, reorganizing, or otherwise terminating the existence of Vidant Medical Group, LLC; c. Merging or consolidating Vidant Medical Group, LLC with or into any other entity or converting into any other type of entity; d. Amending the Articles of Organization or Operating Agreement, and; e. Admitting additional Members or issuing additional Membership Interests. Form 990, Part VI, Section B, line 11b The Board Member is provided a copy of the return for review prior to filing. The return is also reviewed by the Chief Financial Officer, Chief General Counsel and the Chief Audit and Compliance Officer of University Health Systems of Eastern Carolina, Inc. (D/B/A Vidant Health) prior to filing with the Internal Revenue Service. Form 990, Part VI, Section B, line 12c As described in the Conflict of Interest policy maintained by VH, all Officers, Board Members and Key Employees are required to complete a yearly comprehensive conflict of interest questionnaire. These are reviewed by legal counsel and any potential or actual conflicts are brought to the Board for disposition. Board Members are instructed to report any potential conflicts arising during the year for review. Board Members are required to recuse themselves from voting on issues in which they are deemed to have a conflict. Form 990, Part VI, Section B, line 15 The compensation is determined by the Compensation and Benefits Committee of the VH Board using comparative data from like organizations and input from consultants. This process is performed every year. Compensation of other officers and key employees is also determined by the Compensation and Benefits Committee of the VH Board using comparative data from like organizations and input from consultants. This process is performed every year. All compensation discussions and actions are documented and approved in the minutes of the Committee. Form 990, Part VI, Section C, line 19 The organization makes its governing documents, conflict of interest policy, and financial statements available to the public upon request for the same period of disclosure as set forth in IRC Section 6104(d). Form 990, Part IX, line 11g Purchased Services: Program service expenses 55,868,767. Management and general expenses 2,485,909. Fundraising expenses 0. Total expenses 58,354,676. Form 990, Part XI, line 9: Net Asset Transfer 78,200,676. Form 990, Part XII, Line 2C This process has not changed from the prior year. Vidant Medical Group Affiliates LLC 2100 Stantonsburg Rd Greenville NC 27835 472875992 Healthcare NC 0 0 Vidant Medical Group LLC Tarboro Endoscopy Center LLC 201 Clinic Dr Tarboro NC 27886 271345858 Healthcare NC 0 0 Vidant Medical Group LLC University Health Systems Of Eastern Carolina DBA Vidant Health 2100 Stantonsburg Rd Greenville NC 27835 562141073 Healthcare NC 501(c)(3) Line 12c, III-FI N/A 0 Pitt County Memorial Hospital Inc DBA Vidant Medical Center 2100 Stantonsburg Rd Greenville NC 27835 560585243 Hospital NC 501(c)(3) Line 3 Vidant Health 0 The Outer Banks Hospital Inc 2100 Stantonsburg Rd Greenville NC 27835 562112733 Hospital NC 501(c)(3) Line 3 East Carolina Health 0 PCMH Management Inc DBA Vidant Properties 2100 Stantonsburg Rd Greenville NC 27835 561690740 Medical Property Management NC 501(c)(2) Vidant Health 0 East Carolina Health Inc DBA Vidant Community Hospitals - Central 2100 Stantonsburg Rd Greenville NC 27835 562003393 Hospital NC 501(c)(3) Line 3 Vidant Health 0 HealthAccess Inc 2100 Stantonsburg Rd Greenville NC 27835 561396133 Healthcare NC 501(c)(3) Line 12b, II Vidant Health 0 East Carolina Health-Bertie DBA Vidant Bertie Hospital 2100 Stantonsburg Rd Greenville NC 27835 562072002 Hospital NC 501(c)(3) Line 3 Vidant Health 0 East Carolina Health-Chowan DBA Vidant Chowan Hospital 2100 Stantonsburg Rd Greenville NC 27835 562101090 Hospital NC 501(c)(3) Line 3 Vidant Health 0 East Carolina Health-Heritage DBA Vidant Edgecombe Hospital 2100 Stantonsburg Rd Greenville NC 27835 562093700 Hospital NC 501(c)(3) Line 3 Vidant Health 0 East Carolina Health-Beaufort DBA Vidant Beaufort Hospital 2100 Stantonsburg Rd Greenville NC 27835 452436270 Hospital NC 501(c)(3) Line 3 Vidant Health 0 Duplin General Hospital DBA Vidant Duplin Hospital 2100 Stantonsburg Rd Greenville NC 27835 566011594 Hospital NC 501(c)(3) Line 3 Vidant Health 0 East Carolina Health Inc DBA Vidant Roanoke-Chowan Hospital 2100 Stantonsburg Rd Greenville NC 27835 264634725 Hospital NC 501(c)(3) Line 3 Vidant Health 0 Pungo District Hospital Corporation DBA Vidant Pungo Hospital 2100 Stantonsburg Rd Greenville NC 27835 560518757 Hospital NC 501(c)(3) Line 3 Vidant Health 0 Access East Inc 2410 Stantonsburg Rd Stanton Square Greenville NC 27834 561949493 Healthcare NC 501(c)(3) Line 10 Vidant Health 0 Roanoke Valley Health Services Inc 2100 Stantonsburg Rd Greenville NC 27835 561925492 Healthcare NC 501(c)(3) Line 3 Vidant Health 0 Halifax Regional Medical Center Inc 2100 Stantonsburg Rd Greenville NC 27835 560989789 Hospital NC 501(c)(3) Line 3 Vidant Health 0 0 1 1 0 0 0 0 0 0 1 1 1 1 0 1 1 1 0 0