WAYNE MEMORIAL HOSPITAL INC: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- WAYNE MEMORIAL HOSPITAL INC (EIN 56-1484844)
- Tax period
- 2016-07-01 to 2017-06-30
- Filed
- 2018-05-15
- IRS object ID
- 201831359349309503
- Schema version
- 2016v3.0
- 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 K
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2018-05-15T14:47:48-05:00 | ReturnTs |
| Tax Period End | 2017-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 410746749 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLIFTONLARSONALLEN LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 227 WEST TRADE STREET SUITE 800 | AddressLine1Txt |
| City | CHARLOTTE | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 28202 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2016-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 561484844 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WAYNE MEMORIAL HOSPITAL INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | WAYN | BusinessNameControlTxt |
| Phone | 9197316142 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 8001 | AddressLine1Txt |
| City | GOLDSBORO | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 27533 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | REBECCA CRAIG | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 9197316142 | PhoneNum |
| Signature | 2018-05-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | JOHN NORMAN | PreparerPersonNm |
| PTIN | P01506766 | PTIN |
| Phone | 7049985200 | PhoneNum |
| Preparation | 2018-05-15 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | JANIE JABERG | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 8001 | AddressLine1Txt |
| City | GOLDSBORO | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 27533 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $282,657,299 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.WAYNEHEALTH.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1896 | FormationYr |
| Legal Domicile State | NC | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE THE COMMUNITY QUALITY HEALTHCARE SERVICES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 12 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 11 | VotingMembersIndependentCnt |
| Total Employee | 1908 | TotalEmployeeCnt |
| Total Volunteers | 100 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $55,808 | PYContributionsGrantsAmt |
| CY Contributions Grants | $902,137 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $196,972,399 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $276,676,044 | CYProgramServiceRevenueAmt |
| PY Investment Income | $3,967,662 | PYInvestmentIncomeAmt |
| CY Investment Income | $4,265,088 | CYInvestmentIncomeAmt |
| PY Other Revenue | $282,420 | PYOtherRevenueAmt |
| CY Other Revenue | $369,228 | CYOtherRevenueAmt |
| PY Total Revenue | $201,278,289 | PYTotalRevenueAmt |
| CY Total Revenue | $282,212,497 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $417,615 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $91,887,024 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $124,495,874 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $89,346,891 | PYOtherExpensesAmt |
| CY Other Expenses | $133,516,545 | CYOtherExpensesAmt |
| PY Total Expenses | $181,233,915 | PYTotalExpensesAmt |
| CY Total Expenses | $258,430,034 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $20,044,374 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $23,782,463 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $327,118,395 | TotalAssetsBOYAmt |
| Total Assets EOY | $373,312,144 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $167,374,573 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $149,552,979 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $159,743,822 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $223,759,165 | NetAssetsOrFundBalancesEOYAmt |
| Mission | THE MISSION OF WAYNE MEMORIAL HOSPITAL IS TO PROVIDE THE COMMUNITY QUALITY HEALTHCARE SERVICES THROUGH THE COMPASSIONATE HANDS OF WELL-TRAINED STAFF IN A TECHNOLOGICALLY ADVANCED, COST-EFFECTIVE MANNER. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $240,999,046 | ExpenseAmt |
| Grant | $417,615 | GrantAmt |
| Revenue | $277,045,272 | RevenueAmt |
| Desc | PROVIDING COMPASSIONATE PROGRESSIVE HEALTHCARE INCLUDING INPATIENT, OUTPATIENT, INTENSIVE CARE, AND EMERGENCY CARE. | Desc |
| Total Program Service Expenses | $240,999,046 | 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 |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | Yes (1) | 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 | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | Yes (1) | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| 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 With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | Yes (1) | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | 0 | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 137 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 1908 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| 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 |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 12 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 11 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (1) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | 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 | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | Yes (1) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | Yes (1) | WrittenPolicyOrProcedureInd |
| States Where Copy Of Return Is Fld | NC | StatesWhereCopyOfReturnIsFldCd |
| Other Website | Yes (X) | OtherWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | REBECCA CRAIG CFO | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 9197316142 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 8001 | AddressLine1Txt |
| City | GOLDSBORO | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 27533 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (23 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|
| SHIRLEY HARKEY | |||||||||
| CHIEF OPERATIONS OFFICER | 40.00 | Yes (X) | Yes (X) | $343,957 | $0 | $53,364 | |||
| DONNA WIMBERLY | |||||||||
| CHIEF NURSING OFFICER | 40.00 | Yes (X) | Yes (X) | $249,727 | $0 | $42,726 | |||
| RICHARD ROGERS | |||||||||
| VICE-PRESIDENT HUMAN RESOURCES | 40.00 | Yes (X) | $262,740 | $0 | $47,283 | 1.00 | |||
| C MUNROE BEST JR | |||||||||
| CHAIRMAN | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | 2.00 | ||
| ELLEN BRUBECK MD | |||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | 1.00 | |||
| FREEMAN HARDISON | |||||||||
| BOARD MEMBER | 0.00 | Yes (X) | $0 | $0 | $0 | 1.00 | |||
| SAMER KASBARI MD | |||||||||
| BOARD MEMBER | 0.00 | Yes (X) | $0 | $0 | $0 | 1.00 | |||
| STEPHEN C LIES MD | |||||||||
| BOARD MEMBER | 0.00 | Yes (X) | $0 | $0 | $0 | 1.00 | |||
| DIMITRIOS LINTZERIS MD | |||||||||
| BOARD MEMBER | 0.00 | Yes (X) | $0 | $0 | $0 | 1.00 | |||
| SUSAN H MCCALL | |||||||||
| BOARD MEMBER | 0.00 | Yes (X) | $0 | $0 | $0 | 2.00 | |||
| BILL PATE | |||||||||
| BOARD MEMBER | 0.00 | Yes (X) | $0 | $0 | $0 | 2.00 | |||
| JAMES C PARKER | |||||||||
| BOARD MEMBER | 0.00 | Yes (X) | $0 | $0 | $0 | 1.00 | |||
| ANITA SHREENATH | |||||||||
| BOARD MEMBER | 0.00 | Yes (X) | $0 | $0 | $0 | 2.00 | |||
| ROBERT WALKER JR | |||||||||
| VICE CHAIRMAN | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | 1.00 | ||
| JANIE JABERG | |||||||||
| CHIEF EXECUTIVE OFFICER | 40.00 | Yes (X) | $0 | $0 | $0 | 1.00 | |||
| REBECCA W CRAIG | |||||||||
| CHIEF FINANCIAL OFFICER | 40.00 | Yes (X) | $318,583 | $0 | $64,255 | 1.00 | |||
| DANIEL BROCK | |||||||||
| CRNA | 40.00 | $254,000 | $0 | $13,910 | Yes (X) | ||||
| RICHARD MIDDLETON | |||||||||
| CRNA | 40.00 | $229,200 | $0 | $37,546 | Yes (X) | ||||
| BETTY ROUSE | |||||||||
| CRNA | 40.00 | $227,267 | $0 | $24,267 | Yes (X) | ||||
| JAMIE RICHARDS | |||||||||
| CRNA | 40.00 | $222,001 | $0 | $43,036 | Yes (X) | ||||
| AMY WILLOUGHBY | |||||||||
| CRNA | 40.00 | $219,970 | $0 | $32,513 | Yes (X) | ||||
| J WILLIAM PAUGH | |||||||||
| CEO (RETIRED) | 0.00 | $650,775 | $0 | $10,656 | Yes (X) | ||||
| THOMAS W BRADSHAW | |||||||||
| COO (RETIRED) | 0.00 | $439,056 | $0 | $37,265 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $3,417,276 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $406,821 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 69 | 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 |
|---|---|---|---|---|---|
| DANIS CONSTRUCTION CO | |||||
| 5511 CAPITAL CENTER DRIVE | RALEIGH | NC | 27606 | CONSTRUCTION | $3,529,314 |
| EASTERN MEDICAL ASSOCIATES | |||||
| 2609 MEDICAL OFFICE PLACE | GOLDSBORO | NC | 27534 | HOSPITALISTS | $2,114,651 |
| T A LOVING | |||||
| P O DRAWER 919 | GOLDSBORO | NC | 27533 | CONSTRUCTION | $1,042,316 |
| SODEXO INC | |||||
| P O BOX 360170 | PITTSBURGH | PA | 15213 | CONTRACT MGMT | $846,157 |
| GOLDSBORO EMERGENCY MEDICAL | |||||
| P O BOX K | GOLDSBORO | NC | 27533 | EMERGENCY MEDICINE | $510,901 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $902,137 | AllOtherContributionsAmt |
| Total Contributions | $902,137 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PATIENT REVENUE | Desc |
| Business | 621110 | BusinessCd |
| Total Revenue Column | $264,939,474 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $264,939,474 | RelatedOrExemptFuncIncomeAmt |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $11,736,570 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $11,736,570 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $276,676,044 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,709,890 | TotalRevenueColumnAmt |
| Exclusion | $4,709,890 | ExclusionAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $387,666 | SecuritiesAmt |
| Other | $57,136 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -$387,666 | SecuritiesAmt |
| Other | -$57,136 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$444,802 | TotalRevenueColumnAmt |
| Exclusion | -$444,802 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MRI INCOME | Desc |
| Business | 621500 | BusinessCd |
| Total Revenue Column | $369,228 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $369,228 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $369,228 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $282,212,497 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $277,045,272 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $4,265,088 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $150,000 | TotalAmt |
| Program Services | $150,000 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $267,615 | TotalAmt |
| Program Services | $267,615 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,016,000 | TotalAmt |
| Management And General | $1,016,000 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $76,744,094 | TotalAmt |
| Program Services | $71,966,987 | ProgramServicesAmt |
| Management And General | $4,777,107 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,186,058 | TotalAmt |
| Program Services | $10,171,348 | ProgramServicesAmt |
| Management And General | $1,014,710 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $29,354,878 | TotalAmt |
| Program Services | $26,660,285 | ProgramServicesAmt |
| Management And General | $2,694,593 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,194,844 | TotalAmt |
| Program Services | $5,606,334 | ProgramServicesAmt |
| Management And General | $588,510 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,179,137 | TotalAmt |
| Management And General | $1,179,137 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $409,226 | TotalAmt |
| Management And General | $409,226 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $123,500 | TotalAmt |
| Management And General | $123,500 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,988,552 | TotalAmt |
| Management And General | $3,988,552 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $420,046 | TotalAmt |
| Management And General | $420,046 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,130,596 | TotalAmt |
| Program Services | $512,278 | ProgramServicesAmt |
| Management And General | $618,318 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,288,117 | TotalAmt |
| Program Services | $4,785,747 | ProgramServicesAmt |
| Management And General | $502,370 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $72,397 | TotalAmt |
| Program Services | $67,814 | ProgramServicesAmt |
| Management And General | $4,583 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $332,721 | TotalAmt |
| Program Services | $255,176 | ProgramServicesAmt |
| Management And General | $77,545 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,147,452 | TotalAmt |
| Program Services | $2,147,452 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,683,768 | TotalAmt |
| Program Services | $11,666,977 | ProgramServicesAmt |
| Management And General | $16,791 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,374,491 | TotalAmt |
| Program Services | $2,374,491 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| MEDICAL SUPPLIES | $50,272,622 | $50,272,622 |
| BAD DEBT EXPENSE | $22,750,114 | $22,750,114 |
| PURCHASED SERVICES | $19,403,987 | $19,403,987 |
| ALL OTHER EXPENSE | $7,799,652 | $7,799,652 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,140,167 | TotalAmt |
| Program Services | $4,140,167 | ProgramServicesAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $258,430,034 | TotalAmt |
| Program Services | $240,999,046 | ProgramServicesAmt |
| Management And General | $17,430,988 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,558,686 | BOYAmt |
| EOY | $1,653,920 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,001,455 | BOYAmt |
| EOY | $23,446,609 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,547,251 | BOYAmt |
| EOY | $5,719,205 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,714,958 | BOYAmt |
| EOY | $2,684,137 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $263,365,526 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $143,048,022 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $114,278,645 | BOYAmt |
| EOY | $120,317,504 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $126,499,152 | BOYAmt |
| EOY | $168,706,507 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $38,518,248 | BOYAmt |
| EOY | $50,784,262 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $327,118,395 | BOYAmt |
| EOY | $373,312,144 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $36,389,025 | BOYAmt |
| EOY | $45,723,206 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $49,383,396 | BOYAmt |
| EOY | $48,960,544 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $81,602,152 | BOYAmt |
| EOY | $54,869,229 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $167,374,573 | BOYAmt |
| EOY | $149,552,979 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $159,254,566 | BOYAmt |
| EOY | $223,270,230 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $489,256 | BOYAmt |
| EOY | $488,935 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $159,743,822 | BOYAmt |
| EOY | $223,759,165 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $327,118,395 | BOYAmt |
| EOY | $373,312,144 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $23,782,463 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $11,715,203 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $28,517,677 | 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 |
| Total Lobbying Expenditures | $0 | TotalLobbyingExpendituresAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | A PORTION OF THE DUES THE HOSPITAL PAYS TO THE NORTH CAROLINA HOSPITAL ASSOCIATION ARE ATTRIBUTABLE TO LOBBYING ACTIVITIES. | ExplanationTxt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Endowments Held Unrelated Org | Yes (1) | EndowmentsHeldUnrelatedOrgInd |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $130,321,861 | OtherCostOrOtherBasisAmt |
| Depreciation | $59,302,055 | DepreciationAmt |
| Book Value | $71,019,806 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $7,780,109 | OtherCostOrOtherBasisAmt |
| Depreciation | $5,861,764 | DepreciationAmt |
| Book Value | $1,918,345 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $114,336,323 | OtherCostOrOtherBasisAmt |
| Depreciation | $77,884,203 | DepreciationAmt |
| Book Value | $36,452,120 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $10,927,233 | OtherCostOrOtherBasisAmt |
| Book Value | $10,927,233 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $120,317,504 | TotalBookValueLandBuildingsAmt |
Invst Program Related Org InvstProgramRelatedOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | INVESTMENTS | Desc |
| Book Value | $168,706,507 | BookValueAmt |
| Method Valuation | F | MethodValuationCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Program Rltd | $168,706,507 | TotalBookValueProgramRltdAmt |
Other Assets Org OtherAssetsOrgGrp (5 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| OTHER ISSUANCE COSTS, NET | $546,039 |
| INVESTMENT IN AFFILIATE | $2,662,438 |
| OTHER RECEIVABLES | $5,235,476 |
| DUE FROM AFFILIATE | $40,030,974 |
| LONG-TERM RECEIVABLES | $2,309,335 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $50,784,262 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)
| DescDesc | AmtAmt |
|---|---|
| OTHER LIABILITIES | $15,287,735 |
| MINIMUM PENSION LIABILITY | $33,184,119 |
| ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS | $5,856,611 |
| CAPITAL LEASE OBLIGATIONS | $540,764 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $54,869,229 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, LINE 4: | ALL ENDOWMENT FUNDS HELD BY WELLS FARGO ARE USED FOR THE CHARITABLE PURPOSES OF WAYNE MEMORIAL HOSPITAL. |
| PART X, LINE 2: | WAYNE MEMORIAL HOSPITAL ("WMH") IS A NOT-FOR-PROFIT CORPORATION AND HAS BEEN RECOGNIZED AS TAX-EXEMPT PURSUANT TO SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. WMH ADOPTED THE PROVISIONS OF THE INCOME TAX STANDARD THAT CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN AN ORGANIZATION'S FINANCIAL STATEMENTS. THIS GUIDANCE PRESCRIBES A RECOGNITION AND MEASUREMENT OF TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN ON A TAX RETURN THAT ARE NOT CERTAIN TO BE REALIZED. WMH HAS DETERMINED THAT THERE ARE NO UNCERTAIN TAX POSITIONS AS OF JUNE 30, 2017. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent350 | Yes (X) | Percent350Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | 0 | AnnualCommunityBnftReportInd |
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
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 | Yes (1) | FinancialAssistancePrvsnInd |
Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp
Entity Name EntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 1 WAYNE MRI LLC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Primary Activities | MRI | PrimaryActivitiesTxt |
| Org Profit Or Ownership | 0.66700 | OrgProfitOrOwnershipPct |
| Physicians Profit Or Ownership | 0.33300 | PhysiciansProfitOrOwnershipPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | WAYNE MEMORIAL HOSPITAL INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2700 WAYNE MEMORIAL DRIVE | AddressLine1Txt |
| City | GOLDSBORO | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 27533 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WAYNE MEMORIAL HOSPITAL INC | 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 |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 15 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (1) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Own Website URL | SEE PART V, SECTION C | OwnWebsiteURLTxt |
| Other Website | Yes (X) | OtherWebsiteInd |
| Other Website URL | SEE PART V, SECTION C | OtherWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 15 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | SEE PART V, 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 | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 350.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Income Level Criteria | Yes (X) | IncomeLevelCriteriaInd |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| 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 |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | SEE PART V, SECTION C | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | SEE PART V, SECTION C | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | SEE PART V, 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 |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicaid Medcr Prvt | Yes (X) | LookBackMedicaidMedcrPrvtInd |
| Amounts Generally Billed | Yes (1) | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| WAYNE MEMORIAL HOSPITAL, INC. | PART V, SECTION B, LINE 5: THE CHNA WAS CONDUCTED IN CONJUCTION WITH WAYNE COUNTY DEPARTMENT OF HEALTH. THE CHNA TEAM ELICITED FEEDBACK FROM KEY STAKEHOLDER GROUPS BY CONDUCTING FOCUS GROUPS IN UNDER REPRESENTED GROUPS, AS WELL AS CONDUCTING A HEALTH OPINION SURVEY. THE HEALTH OPINION SURVEY WAS ADAPTED FROM THE COMMUNITY HEALTH ASSESSMENT GUDEBOOK, NC DIVISION OF PUBLIC HEALTH AND WAS SIMILAR TO THE 2012 SURVEY. MORE THAN 500 PEOPLE SUBMITTED THEIR OPINIONS.THE STAKEHOLDER GROUPS MET PERIODICALLY AND SCHEDULED EXTRA MEETINGS, IN EARLY 2016, TO COMPLETE THE PROCESS. SIX FOCUS GROUPS WERE HELD IN SPECIFIC LOCATIONS TO DISCOVER THE COMMUNITY MEMBERS' PERCEPTION AND SUGGESTIONS FOR IMPROVING HEALTH WITHIN THE COMMUNITY. THERE WERE A TOTAL OF 53 FOCUS GROUP PARTICIPANTS. |
| WAYNE MEMORIAL HOSPITAL, INC. | PART V, SECTION B, LINE 6B: REPRESENTATIVES FROM THE WAYNE COUNTY HEALTH DEPARTMENT, WAYNE MEMORIAL HOSPITAL, WAYNE COUNTY BOARD OF HEALTH, WATCH AND ECU COOPERATIVELY CONDUCTED THE COMMUNITY HEALTH ASSESSMENT. THE COLLABORATION IDENTIFIED THE TYPES AND SOURCES OF DATA TO BE COLLECTED, DETERMINED THE METHODS FOR COLLECTING INPUT FROM THE COMMUNITY AND KEY STAKEHOLDERS CONCERNING HEALTH RELATED ISSUES AS WELL AS COMMUNICATING THIS INFORMATION TO THE VARIOUS STAKEHOLDERS IN ORDER TO PRIORITIZE COMMUNITY HEALTH CONCERNS. |
| WAYNE MEMORIAL HOSPITAL, INC. | PART V, SECTION B, LINE 11: WAYNE MEMORIAL HOSPITAL PARTNERS WITH OUR COMMUNITY IN MANY WAYS. WE BELIEVE HEALTH AND WELLNESS ARE THE FOUNDATION TO LIVING WELL. IN 2016-17, OUR STRATEGY TO ADDRESS SOME OF THE NEEDS IDENTIFIED IN THE 2015 COMMUNITY HEALTH NEEDS ASSESSMENT INCLUDED SEVERAL PROGRAMS AND INITIATIVES DESIGNED TO HELP IMPROVE THE HEALTH OF THOSE IN OUR COMMUNITY WITH THE GREATEST NEED, AS FOLLOWS:GOAL 1: IMPROVE ACCESS TO HEALTHCARE FOR THE UNDERSERVED AND YOUTH -- WAYNE ACTION TEAMS FOR COMMUNITY HEALTH (WATCH) HEALTHCARE PROGRAM: THIS PROGRAM OPERATES ONE MOBILE AND TWO STATIONARY CLINICAL SITES, PROVIDING A FREE MEDICAL HOME TO THE COUNTY'S UNINSURED. WAYNE MEMORIAL HOSPITAL PARTICIPATES WITH OTHER COMMUNITY ORGANIZATIONS IN THE WAYNE INITIATIVE FOR SCHOOL BASED HEALTH (WISH), A NONPROFIT THAT PROVIDES COMPREHENSIVE HEALTH SERVICES FOR MIDDLE AND HIGH SCHOOL STUDENTS IN SIX SCHOOL-BASED HEALTH CENTERS, WITH PARENTAL CONSENT. ALL WISH CENTERS ARE STAFFED BY NURSE PRACTITIONERS, REGISTERED NURSES AND CLERICAL STAFF, WITH A LOCAL PEDIATRICIAN SERVING AS THE WISH MEDICAL DIRECTOR.WAYNE MEMORIAL HOSPITAL PARTNERS WITH WAYNE COUNTY PUBLIC SCHOOLS TO PROVIDE SCHOOL HEALTH NURSING SERVICES. ON AVERAGE WAYNE COUNTY HAS ONE SCHOOL NURSE FOR EVERY 1,074 STUDENTS. THE NATIONAL SCHOOL NURSE-TO-STUDENT RECOMMENDED RATIO IS 1 NURSE FOR 750 STUDENTS.GOAL 2: PROVIDE COMMUNITY-BASED HEALTH EDUCATION -- WATCH HEALTH EDUCATORS WORK WITH YOUTH IN LOCAL HIGH SCHOOLS, HELPING TO DECREASE THE INCIDENCE OF TEEN PREGNANCY.GOWAYNEGO: THIS GRASSROOTS GROUP IS DEDICATED TO EDUCATING THE COMMUNITY ABOUT HEALTHY EATING AND INCREASED PHYSICAL ACTIVITY. THE PROGRAM ASSISTS WITH IMPLEMENTING RELATED PROGRAMS AT LOCAL CHURCHES AND FACILITATING DEVELOPMENT OF WORKSITE WELLNESS PROGRAMS FOR EMPLOYEES. THE GROUP ALSO BEGAN THE GOWAYNEGO WALKING SERIES AND DEVELOPED A HEALTHY RESTAURANT EATING GUIDE AND PHYSICAL ACTIVITY RESOURCE GUIDE.LIVEWELL COMMUNITY EDUCATION: WAYNE MEMORIAL HOSPITAL HOSTS WAYNE COUNTY RESIDENTS AT A SERIES OF FREE COMMUNITY HEALTH EDUCATION EVENTS AND ACTIVITIES.GOAL 3: IMPROVE CHRONIC DISEASE MANAGEMENT -- WATCH INITIATIVE FOR LIFE: MEMBERS WORK WITH A HEALTH EDUCATOR/TRAINER TO DEVELOP A SELF-MANAGEMENT PLAN TO DECREASE THE INCIDENCE OF OBESITY THROUGH EXERCISE AND HEALTHY EATING.SUPPORT GROUPS: WAYNE MEMORIAL HOSPITAL HOSTS VARIOUS CHRONIC DISEASE SUPPORT GROUPS.THE CENTER FOR NUTRITION AND DIABETES HEALTH: OFFERS OUTPATIENT EDUCATION TO HELP PATIENTS MANAGE THEIR DIABETES. THE CENTER ALSO PROVIDES NUTRITION COUNSELING TO ASSIST PATIENTS WITH CHRONIC DISEASE MANAGEMENT, TOBACCO CESSATION, A DIABETES SUPPORT GROUP AND WEIGHT LOSS. |
| WAYNE MEMORIAL HOSPITAL, INC. | PART V, SECTION B, LINE 16J: ALL SELF PAY INPATIENTS RECEIVE VISITS FROM FINANCIAL COUNSELORS, AND THE CHARITY POLICY IS REVIEWED AT THAT TIME. SELF PAY OUTPATIENTS ARE SENT LETTERS OFFERING FINANCIAL ASSISTANCE. IF WE CAN IDENTIFY CHARITY STATUS AT TIME OF VISIT (BASED ON PATIENT) NO BILL IS SENT. |
| WAYNE MEMORIAL HOSPITAL, INC. | PART V, SECTION B, LINE 23: THE ORGANIZATION DETERMINED THAT DURING FISCAL YEAR 2017, CERTAIN PATIENTS THAT RECEIVED PATIENT CARE AND WERE ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY WERE BILLED MORE THAN THE AMOUNTS GENERALLY BILLED TO INDIVIDUALS WHO HAD INSURANCE COVERING SUCH CARE. INDIVIDUAL REFUNDS ARE BEING CALCULATED AND WILL BE MADE ONCE CALCULATIONS ARE COMPLETE. THE ORGANIZATION EXPECTS THAT TOTAL REFUNDS WILL BE LESS THAN $50,000. |
| PART V, SECTION B, LINE 7A | WWW.WAYNEHEALTH.ORG/ABOUT/COMMUNITY-OUTREACH/REPORTS-ASSESSMENTS |
| PART V, SECTION B, LINE 7B | WWW.WAYNEGOV.COM/249/COMMUNITY-HEALTH-ASSESSMENT |
| PART V, SECTION B, LINE 10A | WWW.WAYNEHEALTH.ORG/ABOUT/COMMUNITY-OUTREACH/REPORTS-ASSESSMENTS |
| PART V, SECTION B, LINES 16A-C | RECENTLY, DURING AN INTERNAL COMPLIANCE REVIEW, THE ORGANIZATION DETERMINED THAT CERTAIN ASPECTS OF ITS WRITTEN FINANCIAL ASSISTANCE POLICY, BILLING/COLLECTIONS POLICY, AND BILLING STATEMENTS NEEDED TO BE ENHANCED AND/OR CLARIFIED. ADDITIONALLY, THE FOLLOWING ITEMS WERE ADDED: - CHANGE IN DISCOUNT GIVEN TO PATIENTS QUALIFYING FOR CHARITY CARE, BASED ON THE LOOKBACK METHOD TO CALCULATE AMOUNTS GENERALLY BILLED; - APPENDIX ADDED TO INCLUDE A LIST OF PROVIDERS NOT COVERED BY THE FAP; - FAP PLAIN LANGUAGE SUMMARY UPDATED AND POSTED ONLINE AND OFFERED TO PATIENTS AT DISCHARGE OR INTAKE; - FAP UPDATED AND POSTED ONLINE; - SPANISH TRANSLATIONS OF ALL FAP DOCUMENTS UPDATED AND POSTED ONLINE.THE ORGANIZATION BELIEVES THAT THESE CHANGES MEET THE REQUIREMENTS OF SECTION 501(R) AND WILL PROVIDE MORE CLARITY TO BOTH PATIENTS ELIGIBLE UNDER THE FINANCIAL ASSISTANCE POLICY AND THE ORGANIZATION'S BILLING STAFF. AS A RESULT, THE ORGANIZATION REVISED ITS FINANCIAL ASSISTANCE POLICY TO MAKE SURE THAT IT MEETS ALL THE REQUIREMENTS OF SECTION 501(R). PLEASE SEE THE UPDATED FAP AT HTTP://WWW.WAYNEHEALTH.ORG/PATIENTS/PATIENT-FINANCIAL-SERVICES/FINANCIAL-ASSISTANCE-POLICY. |
| PART V, SECTION B, LINE 4 | THE ORGANIZATION'S COMMUNITY HEALTH NEEDS ASSESSMENT ("CHNA") FOR TAX YEAR 2015 (FISCAL YEAR JUNE 30, 2016) WAS COMPLETED BY JUNE 23, 2016 AND WAS ADOPTED BY THE WAYNE BOARD OF DIRECTORS ON AUGUST 10, 2016 (WITH THE ADOPTION REFLECTED IN THE BOARD MINUTES FOR THAT MEETING). AT THIS SAME BOARD MEETING, THE WAYNE BOARD APPROVED A CHNA PROGRESS REPORT THAT EVALUATED THE RESOURCES AND IMPACT OF STRATEGIES USED TO COMBAT THE NEEDS IDENTIFIED IN WAYNE'S 2012 CHNA. BECAUSE THE NEEDS IDENTIFIED IN THE 2012 CHNA PROGRESS REPORT ARE SUBSTANTIALLY SIMILAR TO THE NEEDS IDENTIFIED IN THE 2015 CHNA, APPROVAL OF THIS PROGRESS REPORT FUNCTIONED AS THE BOARD'S APPROVAL OF CONTINUATION OF THE STRATEGIES PUT IN PLACE AFTER THE 2012 CHNA. AFTER THE CHNA WAS CONDUCTED, THE BOARD ALSO ACTIVELY MONITORED IMPLEMENTATION STRATEGY PROGRESS BY RECEIVING QUARTERLY REPORTS ON ACTIONS TO IMPROVE ACCESS TO HEALTHCARE AND REDUCE OBESITY, WHICH WERE TOP PRIORITIES IN THE 2015 CHNA. THE 2015 TAX YEAR WAS A SHORT TAX YEAR BECAUSE THE ORGANIZATION ENTERED INTO AN AFFILIATION AND MANAGEMENT AGREEMENT WITH UNC HEALTH CARE SYSTEM ("UNCHCS") ON JANUARY 1, 2016, AND THE ORGANIZATION CHANGED ITS FISCAL YEAR END FROM SEPTEMBER 30 TO JUNE 30 TO BE CONSISTENT WITH UNC HEALTH CARE'S YEAR END. HAD THE ORGANIZATION OPERATED WITHIN A NORMAL 12-MONTH TAX YEAR LIKE IT HAD ALWAYS DONE, THE ORGANIZATION'S BOARD WOULD HAVE ACTED WELL WITHIN THE TAX YEAR. APPROVAL ONLY OCCURRED AFTER THE END OF THE 2015 TAX YEAR BECAUSE THE 2015 TAX YEAR WAS 3 MONTHS SHORTER THAN NORMAL.THE FINAL TREASURY REGULATIONS BECAME EFFECTIVE FOR TAX YEARS BEGINNING AFTER DECEMBER 29, 2015 AND, THEREFORE, WERE NOT IN EFFECT FOR THE 2015 TAX YEAR (WHICH BEGAN ON OCTOBER 1, 2015). FURTHER, TREAS. REG. 1.501(R)-7(B) PROVIDES, IN PART, THAT "[F]OR TAXABLE YEARS BEGINNING ON OR BEFORE DECEMBER 29, 2015, A HOSPITAL FACILITY MAY RELY ON A REASONABLE, GOOD FAITH INTERPRETATION OF SECTION 501(R)." EVEN IF THE FINAL TREASURY REGULATIONS HAD BEEN EFFECTIVE FOR THE 2015 TAX YEAR, THE ORGANIZATION CONSIDERS THE BOARD'S APPROVAL OF THE CHNA AFTER THE CLOSE OF THE SHORT TAX YEAR TO BE A MINOR ERROR PURSUANT TO REG. 1.501(R)-2(B) BECAUSE IT WAS DUE TO REASONABLE CAUSE. THE ORGANIZATION HAD NEVER HAD A SHORT NINE-MONTH TAX YEAR, AND THE BOARD CLEARLY WOULD HAVE ADOPTED THE CHNA PRIOR TO THE END OF A NORMAL 12-MONTH TAX YEAR. A MINOR ERROR IS NOT CONSIDERED TO BE A FAILURE TO MEET AN IRC 501(R)(3) REQUIREMENT. FINALLY, SUBSEQUENT TO ADOPTING THE MOST RECENT CHNA AND IMPLEMENTATION STRATEGY, THE ORGANIZATION, THROUGH MOVING THE CHNA PROCESS TO A ROLE NEW AT WAYNE, CALLED VICE PRESIDENT OF STRATEGY AND BUSINESS DEVELOPMENT, HAS CEMENTED THE STRATEGIC IMPORTANCE OF MEETING IDENTIFIED COMMUNITY NEEDS. WAYNE HAS ENTERED INTO A REGIONAL APPROACH WITH OTHER RURAL EASTERN NORTH CAROLINA COUNTIES TO SURVEY THE PUBLIC AND UPDATE DEMOGRAPHIC AND HEALTH DATA, LEADING TO IMPROVED LINKAGES BETWEEN COMMUNITY HEALTH DATA AND HOSPITAL AND COMMUNITY STRATEGIES TO IMPROVE HEALTH. THE NEW PROCESS WILL INCLUDE TRACKING ALL MILESTONES REQUIRED UNDER THE FINAL TREASURY REGULATIONS, WHICH THE ORGANIZATION IS COMMITTED TO MEETING. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 5 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - WAYNE MRI LLC | ||||
| 2700 WAYNE MEMORIAL DRIVE | GOLDSBORO | NC | 27533 | MRI |
| 2 - GOLDSBORO WOUND CARE CENTER | ||||
| 2700 WAYNE MEMORIAL DRIVE | GOLDSBORO | NC | 27533 | WOUND CARE |
| 3 - KINSTON WOUND CARE CENTER | ||||
| 204 AIRPORT ROAD | KINSTON | NC | 28504 | WOUND CARE |
| 4 - WAYNE MEMORIAL HOSPITAL PHYSICAL THERAPY | ||||
| 2808 MCLAMB PLACE | GOLDSBORO | NC | 27534 | PHYSICAL THERAPY |
| 5 - CENTER FOR NUTRITION AND DIABETES HEALTH | ||||
| 208 COX BLVD STE 101 | GOLDSBORO | NC | 27534 | DIABETES CENTER |
Supplemental Information Detail SupplementalInformationDetail (14 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3C: | WAYNE MEMORIAL MANAGEMENT USES 200% OF FEDERAL POVERTY GUIDELINES TO DETERMINE ELIGIBILITY FOR PATIENTS WHO PROVIDES INFOMRATION TO US. WE ALSO USE A PROPRIETARY CREDIT SCORING TOOL TO FURTHER DETERMINE ELIGIBILITY AND FOR NON-COMPLIANT PATIENTS. THIS PROPRIETARY TOOL USES ALGORITHMS, CONSUMER DATA, AND OTHER INFORMATION TO ASSIST WITH UNDERSTANDING PATIENT'S ABILITY TO PAY. |
| PART I, LINE 7: | AMOUNTS SHOWN IN PART I, LINE 7, COLUMN C WERE COMPUTED USING THE COST-TO-CHARGE RATIO WORKSHEET (WORKSHEET 2) FROM THE IRS INSTRUCTIONS FOR SCHEDULE H. |
| PART I, LN 7 COL(F): | FOR PURPOSES OF CALCULATING THE COMMUNITY BENEFIT PERCENTAGE IN PART I, COLUMN (F), THE ORGANIZATION SUBTRACTED $22,750,114 (WHICH WAS REPORTED ON FORM 990, PART IX, LINE 25) AS BAD DEBT EXPENSE. |
| PART II, COMMUNITY BUILDING ACTIVITIES: | THE HOSPITAL SURVEYS THE NEEDS OF THE MEDICAL COMMUNITY (PROVIDERS) TO ENABLE THE BOARD OF DIRECTORS TO ADOPT A MEDICAL STAFF DEVELOPMENT PLAN, FROM WHICH THEY DETERMINE RECRUITMENT TARGETS. IN THE CURRENT ENVIRONMENT, HOSPITALS ARE WORKING WITH MEDICAL STAFFS TO MEET THE NEED FOR PRIMARY CARE, AS WELL AS SPECIALTY CARE. THE HOSPITAL HAS PROVIDED SUPPORT IN THE FORM OF LOANS TO DOCTORS NEW TO THE AREA FOR THE FIRST YEAR OF PRACTICE, WHICH ARE FORGIVEN AS THESE PHYSICIANS STAY AND MEET COMMUNITY NEEDS.WAYNE MEMORIAL HOSPITAL EMPLOYS MORE THAN 700 REGISTERED NURSES, PLUS OTHER LICENSED HEALTH PROVIDERS (LAB TECHNOLOGISTS, IMAGING TECHNOLOGISTS, PHARMACISTS, PHARMACY TECHNOLOGISTS) TO CARE FOR RESIDENTS OF WAYNE COUNTY WHO NEED HOSPITAL SERVICES. IN SUPPORT OF THIS MISSION, THE HOSPITAL HAS CONTRIBUTED SCHOLARSHIP FUNDS TO ENABLE STUDENTS AT WAYNE COMMUNITY COLLEGE TO PURSUE DEGREES IN HEALTH SCIENCES. NURSES FROM WAYNE MEMORIAL ARE A VITAL PART OF SCHOOL-BASED HEALTH, AND ARE ALSO PART OF MANY LOCAL BUSINESSES WHICH SEE THE VALUE OF HAVING ON-SITE HEALTH EXPERTISE IN KEEPING THEIR EMPLOYEES PRODUCTIVE AND WELL. EDUCATING OUR LOCAL WORKFORCE IS A PRIORITY OF THIS HOSPITAL, IN TERMS OF CARE OF PATIENTS, AND CREATING A CULTURE OF WELLNESS WITHIN OUR COMMUNITY, BOTH AT SCHOOLS, IN BUSINESSES AND IN HOMES. |
| PART III, LINE 2: | BAD DEBT EXPENSES WAS CALCULATED BY APPLYING THE COST-TO-CHARGE RATIO DETERMINED BY THE HOSPITAL TO THE GROSS BAD DEBT CHARGES FOR THE YEAR, INCLUDING ANY UN-DISCOUNTED SELF-PAY BAD DEBT CHARGES. |
| PART III, LINE 4: | THE HOSPITAL USES HISTORICAL COLLECTION EXPERIENCE AND A REVIEW OF CURRENT RECEIVABLES TO PROVIDE AN ESTIMATE OF THE ALLOWANCE FOR UNCOLLECTIBLES AND THE BAD DEBT EXPENSE. ACCOUNTS PAST DUE FOR MORE THAN 90 DAYS ARE INDIVIDUALLY ANALYZED FOR COLLECTIBILITY. IF DEEMED UNCOLLECTIBLE, ACCOUNTS ARE REFERRED TO ONE OF TWO OUTSIDE COLLECTION AGENCIES UNLESS THE ACCOUNT IS BEING REVIEWED UNDER THE HOSPITAL'S CHARITY POLICY. THE HOSPITAL PROVIDES SERVICES TO PATIENTS REGARDLESS OF ABILITY TO PAY. AS A RESULT, THE HOSPITAL HAS INCURRED LOSSES FROM BAD DEBT EXPENSE. THESE UNREIMBURSED SERVICES ARE CONSIDERED A COMMUNITY BENEFIT SINCE THE HEALTHCARE NEEDS OF THE COMMUNITY WOULD OTHERWISE BE UNMET. NOTE 2 ON PAGE 19 OF THE AUDITED FINANCIAL STATEMENTS DISCUSSES BAD DEBTS.PART III, SECTION A, LINE 2:THE AMOUNT ON LINE 2 WAS DERIVED BY TAKING THE BAD DEBT EXPENSE PER THE AUDITED FINANCIAL STATEMENTS AND MULTIPLYING IT BY THE RATIO OF PATIENT CARE COST TO CHARGES DERIVED USING WORKSHEET 2 OF THE IRS INSTRUCTIONS FOR SCHEDULE H.PART III, SECTION A, LINE 3:THE HOSPITAL DOES NOT HAVE A PROCESS IN PLACE THAT ESTIMATES THE AMOUNT OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER A FINANCIAL ASSISTANCE POLICY. |
| PART III, LINE 8: | THE HOSPITAL PROVIDES SERVICES TO PATIENTS REGARDLESS OF ABILITY TO PAY. AS A RESULT, THE HOSPITAL HAS INCURRED LOSSES BY SERVING MEDICARE PATIENTS. THE UNREIMBURSED SERVICES THE HOSPITAL PROVIDES TO PATIENTS COVERED BY MEDICARE SHOULD BE CONSIDERED A COMMUNITY BENEFIT SINCE THE HEALTHCARE NEEDS OF THE COMMUNITY WOULD OTHERWISE BE UNMET.PART III, SECTION B, LINE 8:THE COST TO CHARGE RATIO AS CALCULATED BY THE MOST RECENTLY FILED COST REPORT WAS USED TO DETERMINE MEDICARE ALLOWABLE COSTS. |
| PART III, LINE 9B: | OUR COLLECTION POLICY INDICATES OUR USE OF A CREDIT SCORING TOOL WHICH ASSISTS OUR COLLECTION STAFF IN THE IDENTIFICATION OF PATIENTS THAT QUALIFY FOR UNCOMPENSATED CARE. |
| PART VI, LINE 2: | WAYNE MEMORIAL HOSPITAL ROUTINELY CONDUCTS A JOINT COMMUNITY HEALTH NEEDS ASSESSMENT WITH THE WAYNE COUNTY HEALTH DEPARTMENT. IN 2015, A JOINT CHNA WAS BEGUN, WHICH CONCLUDED IN THE FALL OF 2015, AND WAS REPORTED TO THE COMMUNITY IN SUMMER 2016, PART OF THE HOSPITAL'S FYE 9/30/2016. AS PART OF THIS CHNA, AN ELECTRONIC AND PAPER SURVEY WAS CONDUCTED, WITH MORE THAN 500 RESPONSES. FOCUS GROUPS WERE CONVENED IN 6 DIFFERENT SETTINGS (DIVERSE IN GEOGRAPHY AND CULTURE) TO ADD MORE UNDERSTANDING. ACTIONS ARE BEING COORDINATED AND TAKEN BY KEY CONSTITUENTS FROM WAYNE COUNTY, IN PARTNERSHIP WITH THE WAYNE COUNTY HEALTH DEPARTMENT, THE CITY OF GOLDSBORO, THE HOSPITAL AND OTHER AGENCIES TO ENCOURAGE GOOD HEALTH COUNTY-WIDE.FINDINGS FROM THE 2015 COMMUNITY HEALTH NEEDS ASSESSMENT SHOWED SIGNIFICANT OVERLAP WITH THOSE FROM THE 2012 COMMUNITY HEALTH NEEDS ASSESSMENT. OBESITY CONTINUES TO BE THE SINGLE MOST PERVASIVE HEALTH ISSUE IN WAYNE COUNTY, FOLLOWED BY CHRONIC DISEASES. TOGETHER, THESE ARE TAKING A HEAVY TOLL ON WAYNE COUNTYS HEALTH. MORE THAN 12% OF WAYNE COUNTY ADULTS ARE DIAGNOSED WITH DIABETES. OBESITY HAS BEEN SHOWN TO CONTRIBUTE TO THE LEADING CAUSES OF DEATH INCLUDING HEART DISEASE, SOME CANCERS, AND DIABETES. THE PERCENTAGE OF OVERWEIGHT AND OBESE ADULTS IN WAYNE COUNTY HAS INCREASED TO MORE THAN 70% - MORE THAN 65,000 PEOPLE. IN RESPONSE TO THIS ISSUE, COMMUNITY PARTNERS HAVE COME TOGETHER TO FORM THE "HEALTHY WAYNE TASK FORCE", WHICH HAS PLACE HEALTHY LIVING AT ITS CENTER. ITS FIRST INITIATIVE, BEGUN IN THE SUMMER OF 2013, IS CALLED GOWAYNEGO. INITIAL EFFORTS HAVE BEEN TO CENTRALIZE COMMUNICATIONS TO LOCAL CITIZENS ABOUT THE IMPORTANCE OF INCREASING DAILY MOVEMENT, AND EDUCATING CITIZENS ABOUT FREE AND LOW-COST WAYS TO GET MORE ACTIVE IN WAYNE COUNTY. MORE THAN 3,000 T-SHIRTS WITH THE GOWAYNEGO LOGO HAVE BEEN DISTRIBUTED TO WAYNE COUNTY RESIDENTS, AND A WEBSITE HAS BEEN SET UP TO ENCOURAGE GETTING ROUTINE EXERCISE. PARTNERS IN THE HEALTHY WAYNE TASK FORCE INCLUDE WAYNE COUNTY HEALTH DEPARTMENT, WAYNE HEALTH FOUNDATION (DBA WATCH), GOLDSBORO FAMILY YMCA, CITY OF GOLDSBORO PARKS & RECREATION DEPARTMENT, UNITED WAY OF WAYNE COUNTY, SEYMOUR JOHNSON AIR FORCE BASE, GOLDSBORO PEDIATRICS, PARTNERSHIP FOR CHILDREN OF WAYNE COUNTY, WAYNE INITIATIVE FOR SCHOOL HEALTH, AND OTHERS. HEALTH LITERACY AND MENTAL HEALTH WERE THE OTHER MOST SIGNIFICANT ISSUES COMING OUT OF THE 2015 COMMUNITY HEALTH ASSESSMENT. A SUMMARY OF ALL INITIATIVES SELECTED, RESOURCES, USED, AND EVALUATION OF RESULTS IS INCLUDED AT WWW.WAYNEHEALTH.ORG.HEALTH LITERACY IS AN ISSUE IN RURAL AREAS LIKE EASTERN NORTH CAROLINA. IN WAYNE COUNTY, 10% OF ADULTS ARE NON-READERS, AND 26% STRUGGLE WITH BASIC LITERACY. WAYNE MEMORIAL HOSPITAL HAS A TEAM OF NURSES AND TRAINERS WORKING TO IMPROVE DISCHARGE INSTRUCTIONS FOR PATIENTS AND FAMILIES, TO REDUCE THE NUMBERS OF PATIENTS WHO MUST RETURN TO THE HOSPITAL SOON AFTER DISCHARGE FOR PROBLEMS THAT MIGHT NOT HAVE ARISEN IF THERE WERE BETTER UNDERSTANDING OF FOLLOW UP CARE. THIS TEAM IS USING RESOURCES DEVELOPED FROM AROUND THE COUNTRY TO TRY TO GET IMPROVED RESULTS (LOWER READMISSIONS). WITH RESPECT TO TEACHING READING SKILLS, IN WAYNE COUNTY, LITERACY CONNECTIONS OF WAYNE COUNTY IS A NON-PROFIT AGENCY CREATED TO IMPROVE ADULT LITERACY. LITERACY CONNECTIONS PROVIDES FREE, CONFIDENTIAL, ONE-ON-ONE TUTORING FOR ADULTS TO IMPROVE THEIR READING SKILLS. IT IS SUPPORTED BY WAYNE COUNTY GOVERNMENT, AND UNITED WAY OF WAYNE COUNTY. MENTAL HEALTH IS AN ISSUE THAT CONTINUES TO IMPACT HEALTH CARE IN OUR COMMUNITY, OUR STATE AND THE ENTIRE COUNTRY. IN RECOGNITION OF THE SPECIAL NEEDS OF PATIENTS WITH BEHAVIORAL HEALTH ISSUES, THE HOSPITAL DESIGNED ITS NEW EMERGENCY DEPARTMENT (OPENED IN 2012) TO ENABLE SEPARATION OF PATIENTS WITH MENTAL ISSUES FROM PATIENTS WITH PHYSICAL HEALTH ISSUES. THE OBJECTIVE WAS TO GIVE THESE PATIENTS AN AREA WHERE THEY CAN BE CARED FOR IN A CALM CONTROLLED ENVIRONMENT, WHERE THEY AND THOSE THAT ARE CARING FOR THEM CAN BE SAFE. IN ADDITION, THE HOSPITAL'S PARENT ORGANIZATION, WAYNE HEALTH CORPORATION, RECOGNIZING THE NEED TO REPLACE PSYCHIATRISTS WHO WERE APPROACHING RETIREMENT, RECRUITED THREE ADDITIONAL PSYCHIATRISTS, EMPLOYED BY HOSPITAL'S SISTER ORGANIZATION, WAYNE HEALTH PHYSICIANS, TO SEE PATIENTS IN OFFICES AS OUTPATIENTS, PLUS TREAT PATIENTS ADMITTED TO THE INPATIENT UNIT. A SUMMARY OF ALL INITIATIVES SELECTED, RESOURCES USED, AND EVALUATION OF RESULTS IS INCLUDED AT WWW.WAYNEHEALTH.ORG. |
| PART VI, LINE 3: | WE HAVE FINANCIAL COUNSELORS THAT ASSIST WHILE THEY ARE PATIENTS. WE ALSO SEND FINANCIAL ASSISTANCE LETTERS TO PATIENTS THAT WE ARE UNABLE TO SEE WHILE THEY ARE IN-HOUSE. WE ALSO PROVIDE INFORMATIONAL PAMPHLETS AND HAVE INFORMATION AVAILABLE ON THE HOSPITAL WEBSITE. |
| PART VI, LINE 4: | WAYNE MEMORIAL HOSPITAL SERVES PRIMARILY WAYNE COUNTY,NORTH CAROLINA, WITH AN ESTIMATED POPULATION WAS 124,000 IN 2015, ACCORDING TO THE US CENSUS QUICKFACTS. THE POPULATION IS SLIGHTLY YOUNGER THAN THE AVERAGE IN NORTH CAROLINA, LIKELY DUE TO THE PRESENCE OF SEYMOUR JOHNSON AIR FORCE BASE, WITH ABOUT 6,000 ACTIVE DUTY AND RESERVISTS PLUS THEIR FAMILIES. AVERAGE HOUSEHOLD INCOME IN WAYNE COUNTY IS LOWER, AT $41,172, THAN NORTH CAROLINA'S AVERAGE OF $46,693. CHILDREN LIVING IN POVERTY IN WAYNE COUNTY, (AVERAGE 2010-2014) IS HIGHER, AT 35%, COMPARED TO NORTH CAROLINA'S AVERAGE OF 26%. WAYNE COUNTY'S POPULATION IS 51.1% WHITE, 32% BLACK, AND 11.2% HISPANIC. THE COUNTY IS LARGE, AT 553 SQUARE MILES, AND IT IS THE 4TH LARGEST AGRICULTURAL PRODUCER IN THE STATE. POVERTY IMPACTS ACCESS TO CARE, WITH EMERGENCY DEPARTMENT USE HIGHER IN AREAS WITH HIGHER PROVERTY, AND SHORTER LIVES ON AVERAGE. |
| PART VI, LINE 5: | WAYNE MEMORIAL HOSPITAL HAS AN OPEN MEDICAL STAFF, WHICH MEANS THAT ANY PHYSICIAN WHO MEETS QUALITY STANDARDS SET BY A COMMITTEE OF THE HOSPITAL (WHICH INCLUDES BOARD MEMBERS) IS WELCOME TO JOIN THE STAFF, IN RETURN FOR CERTAIN RESPONSIBILITIES RELATED TO PROVIDING CARE TO PATIENTS SEEN IN THE EMERGENCY DEPARTMENT WHO NEED INPATIENT CARE. THE BOARD OF DIRECTORS IS COMPRISED ON 12 CITIZENS OF WAYNE COUNTY, INCLUDING THE CEO, WHO ARE CHARGED WITH ENSURING THAT QUALITY, EFFICIENT CARE IS PROVIDED AT THE HOSPITAL, AND FOR ENSURING PLANNING, WITH COMMUNITY PARTNERS, FOR FUTURE HEALTH NEEDS. |
| PART VI, LINE 6: | AS THE PROVIDER OF CARE WITHIN THE COMMUNITY WITH THE MOST DIVERSE AND SOPHISTICATED EQUIPMENT, THE BOARD, MANAGEMENT AND STAFF OF WAYNE MEMORIAL HOSPITAL SEES ITS ROLE AS BOTH COORDINATOR OF CARE FOR THOSE WHO ARE THE SICKEST IN OUR COMMUNITY AS WELL AS PROMOTER OF HEALTHY LIVING FOR ALL RESIDENTS, IN COORDINATION WITH OUR PARTNERS IN HEALTH THROUGHOUT WAYNE COUNTY. THE HOSPITAL HAS TWO PRIMARY AFFILIATES THAT ARE INTEGRAL TO COMMUNITY HEALTH. ONE IS WAYNE HEALTH FOUNDATION,DBA "WATCH", WHICH HAS OPERATED A MOBILE VAN FOR UNINSURED SINCE THE 1990'S, ADDED TWO FIXED CLINICS SINCE 2009, AND WHOSE OTHER PRIMARY FOCUS HAS BEEN ADDRESSING COMMUNITY NEEDS IDENTIFIED IN FREQUENT HEALTH NEEDS ASSESSMENTS SINCE THAT TIME. THE SECOND SISTER CORPORATION, WAYNE HEALTH PHYSICIANS, WAS ORGANIZED IN 2009 TO HELP MEET THE NEEDS FOR PRIMARY AND SPECIALTY PHYSICIAN CARE IN WAYNE COUNTY. THIS WAS IN RESPONSE TO NATIONAL TRENDS THAT SHOWED PHYSICIANS SEEKING EMPLOYMENT IN SYSTEM ENVIRONMENTS TO ALLOW THEM MORE FOCUS ON PATIENT CARE, AND LESS ON THE BUSINESS ASPECTS OF MEDICAL PRACTICES. THIS COMPANY IS PROVIDING AN AVENUE TO WORK TOWARD LOWER OVERALL HEALTH CARE COSTS THROUGH BETTER COORDINATION OF CARE, WITH THE OBJECTIVE OF PROVIDING SERVICES TO PATIENTS IN THE LOWEST COST SETTING. |
| PART VI, LINE 7, REPORTS FILED WITH STATES | NC |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt | Valuation Method UsedValuationMethodUsedDesc |
|---|---|---|---|---|---|---|---|---|
| THE FOUNDATION OF WAYNE COMMUNITY COLLEGE | ||||||||
| PO BOX 8002 | GOLDSBORO | NC | 27533 | 561556512 | 501(C)(3) | $100,000 | NURSING SCHOLARSHIPS | |
| UNIVERSITY OF MOUNT OLIVE | ||||||||
| 634 HENDERSON ST | MOUNT OLIVE | NC | 28365 | 560623936 | 501(C)(3) | $50,000 | SCHOLARSHIP | BOOK |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp (2 entries)
| Grant TypeGrantTypeTxt | RecipientRecipientCnt | Cash GrantCashGrantAmt | Valuation Method UsedValuationMethodUsedDesc | Non Cash AssistanceNonCashAssistanceDesc |
|---|---|---|---|---|
| EDUCATIONAL ASSISTANCE | 61 | $99,274 | BOOK | ADDITIONAL COURSE STUDY |
| SCHOLARSHIPS | 47 | $168,341 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | WAYNE MEMORIAL HOSPITAL, INC. MAKES GRANTS TO SUPPORT THE ACTIVITIES OF ITS RELATED ORGANIZATIONS AND TO PROMOTE GOOD COMMUNITY RELATIONS. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Club Dues Or Fees | Yes (X) | ClubDuesOrFeesInd |
| Written Policy Ref T And E Expnss | Yes (1) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (1) | SubstantiationRequiredInd |
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | 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 (11 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| SHIRLEY HARKEY | ||||||||||||||
| CHIEF OPERATIONS OFFICER | $220,032 | $0 | $91,918 | $0 | $32,007 | $0 | $26,130 | $0 | $27,234 | $0 | $397,321 | $0 | $28,461 | $0 |
| DONNA WIMBERLY | ||||||||||||||
| CHIEF NURSING OFFICER | $176,417 | $0 | $72,165 | $0 | $1,145 | $0 | $15,073 | $0 | $27,653 | $0 | $292,453 | $0 | $0 | $0 |
| RICHARD ROGERS | ||||||||||||||
| VICE-PRESIDENT HUMAN RESOURCES | $193,333 | $0 | $49,098 | $0 | $20,309 | $0 | $24,707 | $0 | $22,576 | $0 | $310,023 | $0 | $0 | $0 |
| REBECCA W CRAIG | ||||||||||||||
| CHIEF FINANCIAL OFFICER | $258,611 | $0 | $28,983 | $0 | $30,989 | $0 | $39,136 | $0 | $25,119 | $0 | $382,838 | $0 | $26,898 | $0 |
| DANIEL BROCK | ||||||||||||||
| CRNA | $165,364 | $0 | $23,271 | $0 | $65,365 | $0 | $13,324 | $0 | $586 | $0 | $267,910 | $0 | $0 | $0 |
| RICHARD MIDDLETON | ||||||||||||||
| CRNA | $161,586 | $0 | $22,399 | $0 | $45,215 | $0 | $9,416 | $0 | $28,130 | $0 | $266,746 | $0 | $0 | $0 |
| BETTY ROUSE | ||||||||||||||
| CRNA | $171,681 | $0 | $12,180 | $0 | $43,406 | $0 | $14,796 | $0 | $9,471 | $0 | $251,534 | $0 | $0 | $0 |
| JAMIE RICHARDS | ||||||||||||||
| CRNA | $149,513 | $0 | $29,660 | $0 | $42,828 | $0 | $14,770 | $0 | $28,266 | $0 | $265,037 | $0 | $0 | $0 |
| AMY WILLOUGHBY | ||||||||||||||
| CRNA | $171,211 | $0 | $8,380 | $0 | $40,379 | $0 | $23,267 | $0 | $9,246 | $0 | $252,483 | $0 | $0 | $0 |
| J WILLIAM PAUGH | ||||||||||||||
| CEO (RETIRED) | $266,927 | $0 | $149,974 | $0 | $233,874 | $0 | $1,505 | $0 | $9,151 | $0 | $661,431 | $0 | $227,166 | $0 |
| THOMAS W BRADSHAW | ||||||||||||||
| COO (RETIRED) | $96,569 | $0 | $0 | $0 | $342,487 | $0 | $11,666 | $0 | $25,599 | $0 | $476,321 | $0 | $82,343 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 1A | LESS THAN $300 PAID ANNUALLY. |
| PART I, LINE 1B | CERTAIN DUES AND FEES AND COMPANION TRAVEL ARE REIMBURSED BY THE ORGANIZATION. |
| PART I, LINE 4B | REBECCA CRAIG PARTICIPATED IN A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN AND RECEIVED $26,898 IN PAYMENTS FROM THE PLAN DURING THE YEAR. WILLIAM PAUGH, A FORMER OFFICER, RECEIVED $227,166 IN PAYMENTS FROM THE SUPPLEMENTAL NON-QUALIFED RETIREMENT PLAN DURING THE YEAR. THOMAS BRADSHAW, A FORMER KEY EMPLOYEE, RECEIVED $82,343 IN PAYMENTS FROM THE SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN DURING THE YEAR. HE ALSO RECEIVED SEVERANCE PAYMENTS TOTALING $258,488 DURING THE YEAR. SHIRLEY HARKEY PARTICIPATED IN A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN AND RECEIVED $28,461 IN PAYMENTS FROM THE PLAN DURING THE YEAR. |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (2 entries)
| Bond ReferenceBondReferenceCd | Bond Issuer EINBondIssuerEIN | CUSIPCUSIPNum | Bond IssuedBondIssuedDt | Issue PriceIssuePriceAmt | DefeasedDefeasedInd | On Behalf Of IssuerOnBehalfOfIssuerInd | Pool FinancingPoolFinancingInd | PurposePurposeDesc |
|---|---|---|---|---|---|---|---|---|
| NORTH CAROLINA MEDICAL CARE COMMISSION | ||||||||
| A | 521309402 | NONEAVAIL | 2015-07-21 | $17,455,000 | 0 | 0 | 0 | |
| NORTH CAROLINA MEDICAL CARE COMMISSION | ||||||||
| B | 521309402 | NONEAVAIL | 2017-05-25 | $77,245,000 | 0 | 0 | 0 | SURGICAL CENTER/AIR HANDLER UNITS/REFUND PRIOR BONDS |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)
| Bond ReferenceBondReferenceCd | RetiredRetiredAmt | Total ProceedsTotalProceedsAmt | Other Spent ProceedsOtherSpentProceedsAmt | Current RefundingCurrentRefundingInd | Advance RefundingAdvanceRefundingInd | Final Allocation MadeFinalAllocationMadeInd | Adequate Books And Rec MaintAdequateBooksAndRecMaintInd | Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt | UnspentUnspentAmt |
|---|---|---|---|---|---|---|---|---|---|
| A | $4,400,000 | $17,455,000 | $17,455,000 | Yes (1) | 0 | Yes (1) | Yes (1) | ||
| B | $77,245,000 | $33,956,989 | Yes (1) | 0 | 0 | Yes (1) | $482,133 | $42,805,878 |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (2 entries)
| Bond ReferenceBondReferenceCd | Owning Bond Financed PropertyOwningBondFinancedPropertyInd | Any Lease ArrangementsAnyLeaseArrangementsInd | Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd | Engage Bond Counsel ContractsEngageBondCounselContractsInd | Any Research AgreementsAnyResearchAgreementsInd | Private Bus Concerning UBIPrivateBusConcerningUBIPct | Total Private Business UseTotalPrivateBusinessUsePct | Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd | Change In Use Bond Financed PropChangeInUseBondFinancedPropInd | Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd | Private Bus Use By OthersPrivateBusUseByOthersPct |
|---|---|---|---|---|---|---|---|---|---|---|---|
| A | 0 | Yes (1) | Yes (1) | Yes (1) | 0 | 0.02590 | 0.02590 | 0 | 0 | Yes (1) | |
| B | 0 | 0 | Yes (1) | Yes (1) | 0 | 0.01100 | 0 | 0 | Yes (1) | 0.01100 |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (2 entries)
| Bond ReferenceBondReferenceCd | Form8038 T FiledForm8038TFiledInd | Rebate Not Due YetRebateNotDueYetInd | Exception To RebateExceptionToRebateInd | No Rebate DueNoRebateDueInd | Variable Rate IssueVariableRateIssueInd | Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd | Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd | Gross Proceeds InvestedGrossProceedsInvestedInd | Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd |
|---|---|---|---|---|---|---|---|---|---|
| A | 0 | 0 | Yes (1) | 0 | 0 | 0 | 0 | 0 | Yes (1) |
| B | 0 | 0 | 0 | Yes (1) | 0 | 0 | 0 | 0 | Yes (1) |
Procedures Corrective Action ProceduresCorrectiveActionGrp (2 entries)
| Bond ReferenceBondReferenceCd | Procedures Corrective ActionProceduresCorrectiveActionInd |
|---|---|
| A | 0 |
| B | Yes (1) |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 3 | IN DECEMBER 2015, IN CONJUNCTION WITH THE HOSPITAL'S AFFILIATION WITH UNC HEALTH CARE SYSTEM ("UNCHCS"), THE HOSPITAL ENTERED INTO A TEN-YEAR MANAGEMENT AGREEMENT WITH UNCHCS, EFFECTIVE JANUARY 1, 2016. THE CONTRACT GIVES UNCHCS THE RESPONSIBILITY FOR THE DAY-TO-DAY OPERATIONS OF THE HOSPITAL. UNDER THIS AGREEMENT, UNCHCS EMPLOYS AND PROVIDES THE HOSPITAL WITH A CHIEF EXECUTIVE OFFICER (CEO). |
| FORM 990, PART VI, SECTION B, LINE 11B | A DRAFT OF FORM 990 IS MADE AVAILABLE TO THE GOVERNING BODY FOR REVIEW BEFORE IT IS FILED WITH THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | ALL PERSONNEL ARE RESPONSIBLE FOR ADHERING TO THE CORPORATE COMPLIANCE PLAN. THIS PLAN REQUIRES PERSONNEL TO DISCLOSE CONFLICTS AS THEY ARISE. VOTING MEMBERS OF THE GOVERNING BODY ARE RECUSED FROM VOTING WHEN A CONFLICT ARISES. |
| FORM 990, PART VI, SECTION B, LINE 15 | COMPENSATION IS REVIEWED AGAINST COMPARABILITY DATA AND APPROVED BY THE BOARD. WRITTEN COMPENSATION AGREEMENTS ARE KEPT UP-TO-DATE. OFFICER AND KEY EMPLOYEE COMPENSATION IS REVIEWED ANNUALLY. |
| FORM 990, PART VI, SECTION C, LINE 19 | THESE DOCUMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. THE CORPORATE COMPLIANCE POLICY IS AVAILABLE ON THE HOSPITAL'S WEBSITE. ADDITIONALLY, THE AUDITED FINANCIAL STATEMENTS ARE AVAILABLE ON WWW.DACBOND.COM AND WWW.GUIDESTAR.ORG. |
| FORM 990, PART XI, LINE 9: | NET ASSETS RELEASED FROM RESTRICTIONS -902,458. CHANGE IN MINIMUM PENSION LIABILITY 23,862,449. CHANGE IN VALUE OF DERIVATIVE FINANCIAL INSTRUMENT 3,817,453. DISTRIBUTIONS FROM MEMBERS 1,740,233. |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | AMERICAN MANAGEMENT ASSOCIATES LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2719 GRAVES DRIVE | AddressLine1Txt |
| City | GOLDSBORO | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 27534 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 561622637 | EIN |
| Primary Activities | COLLECTIONS | PrimaryActivitiesTxt |
| Legal Domicile State | NC | LegalDomicileStateCd |
| Direct Controlling NA | N/A | DirectControllingNACd |
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (4 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| WAYNE HEALTH FOUNDATION INC | ||||||||||
| 2700 WAYNE MEMORIAL DRIVE | GOLDSBORO | NC | 27533 | 581881912 | SUPPORT | NC | 501(C)(3) | LINE 10 | N/A | 0 |
| WAYNE HEALTH CORPORATION | ||||||||||
| PO BOX 8001 | GOLDSBORO | NC | 27534 | 561479733 | HEALTHCARE | NC | 501(C)(3) | LINE 12A, I | N/A | 0 |
| WAYNE HEALTH PHYSICIANS | ||||||||||
| 2700 WAYNE MEMORIAL DRIVE | GOLDSBORO | NC | 27533 | 264291056 | HEALTHCARE | NC | 501(C)(3) | LINE 10 | N/A | 0 |
| WAYNE MEMORIAL HOSPITAL FOUNDATION | ||||||||||
| 2700 WAYNE MEMORIAL DRIVE | GOLDSBORO | NC | 27533 | 814132398 | SUPPORT | NC | 501(C)(3) | LINE 10 | N/A | 0 |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WAYNE MRI LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2700 WAYNE MEMORIAL DRIVE | AddressLine1Txt |
| City | GOLDSBORO | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 27533 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 342043934 | EIN |
| Primary Activities | MRI SERVICES | PrimaryActivitiesTxt |
| Legal Domicile State | NC | LegalDomicileStateCd |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Predominant Income Type | RELATED | PredominantIncomeTypeTxt |
| Disproportionate Allocations | 0 | DisproportionateAllocationsInd |
| General Or Managing Partner | Yes (1) | GeneralOrManagingPartnerInd |
| Ownership | 0.66670 | OwnershipPct |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|
| WAYNE HEALTH ENTERPRISES INC | ||||||||
| PO BOX 8001 | GOLDSBORO | NC | 27533 | 561622624 | NC | WAYNE HEALTH CORPORATION | C | Yes (1) |
| WAYNE HEALTH PROPERTIES | ||||||||
| PO BOX 8001 | GOLDSBORO | NC | 27533 | 561756076 | NC | WAYNE HEALTH ENTERPRISES | C | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | Yes (1) | 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 | Yes (1) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | 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 | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (2 entries)
| Transaction TypeTransactionTypeTxt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|
| WAYNE HEALTH CORPORATION | |
| K | ACTUAL CASH TRANSFER |
| WAYNE HEALTH PHYSICIANS | |
| D | ACTUAL CASH TRANSFER |