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DUKE UNIVERSITY HEALTH SYSTEM INC: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization
DUKE UNIVERSITY HEALTH SYSTEM INC (EIN 56-2070036)
Tax period
2016-07-01 to 2017-06-30
Filed
2018-05-15
IRS object ID
201831359349312558
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 ReturnHeader

FieldValueIRS element (for citing)
Return2018-05-15T17:19:12-05:00ReturnTs
Tax Period End2017-06-30TaxPeriodEndDt
Return Type990ReturnTypeCd
Tax Period Begin2016-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN562070036EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1DUKE UNIVERSITY HEALTH SYSTEM INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlDUKEBusinessNameControlTxt
Phone9196842006PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1324 BLACKWELL ST WASHIN BLDG NO 850AddressLine1Txt
CityDURHAMCityNm
State AbbreviationNCStateAbbreviationCd
ZIP27701ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonKENNETH C MORRISPersonNm
Person TitleSVP, CFO, TREASURERPersonTitleTxt
Phone9196842006PhoneNum
Signature2018-05-15SignatureDt
Discuss With Paid Preparer0DiscussWithPaidPreparerInd
FieldValueIRS element (for citing)
Tax2016TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerA EUGENE WASHINGTON MDPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1615 DOUGLAS ST STE 700AddressLine1Txt
CityDURHAMCityNm
State AbbreviationNCStateAbbreviationCd
ZIP27705ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$4,888,194,157GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.DUKEHEALTH.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1998FormationYr
Legal Domicile StateNCLegalDomicileStateCd
Activity Or MissionSEE SCHEDULE O FOR ORGANIZATION'S MISSION STATEMENTActivityOrMissionDesc
Voting Members Governing Body22VotingMembersGoverningBodyCnt
Voting Members Independent14VotingMembersIndependentCnt
Total Employee19362TotalEmployeeCnt
Total Volunteers1211TotalVolunteersCnt
Total Gross UBI$205,127TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm-$882,276NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$8,218,130PYContributionsGrantsAmt
CY Contributions Grants$2,882,117CYContributionsGrantsAmt
PY Program Service Revenue$2,936,916,539PYProgramServiceRevenueAmt
CY Program Service Revenue$3,118,023,960CYProgramServiceRevenueAmt
PY Investment Income$97,734,118PYInvestmentIncomeAmt
CY Investment Income$136,108,446CYInvestmentIncomeAmt
PY Other Revenue$90,308,683PYOtherRevenueAmt
CY Other Revenue$74,659,951CYOtherRevenueAmt
PY Total Revenue$3,133,177,470PYTotalRevenueAmt
CY Total Revenue$3,331,674,474CYTotalRevenueAmt
PY Grants And Similar Paid$1,823,541PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$1,615,585CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$1,271,861,355PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$1,392,576,407CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$145,661CYTotalFundraisingExpenseAmt
PY Other Expenses$1,472,089,701PYOtherExpensesAmt
CY Other Expenses$1,544,991,410CYOtherExpensesAmt
PY Total Expenses$2,745,774,597PYTotalExpensesAmt
CY Total Expenses$2,939,183,402CYTotalExpensesAmt
PY Revenues Less Expenses$387,402,873PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$392,491,072CYRevenuesLessExpensesAmt
Total Assets BOY$4,933,202,039TotalAssetsBOYAmt
Total Assets EOY$5,374,830,842TotalAssetsEOYAmt
Total Liabilities BOY$2,714,201,164TotalLiabilitiesBOYAmt
Total Liabilities EOY$2,654,271,874TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$2,219,000,875NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$2,720,558,968NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionSEE SCHEDULE OMissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$2,181,427,021ExpenseAmt
Grant$1,615,585GrantAmt
Revenue$3,175,020,562RevenueAmt
DescSEE SCHEDULE ODesc
Total Program Service Expenses$2,181,427,021TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent EndowmentsYes (1)TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other SecYes (1)ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 Footnote0IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign ActivitiesYes (1)ForeignActivitiesInd
More Than5000 K To OrgYes (1)MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising ActivitiesYes (1)FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To IndividualsYes (1)GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt BondsYes (1)TaxExemptBondsInd
Invest Tax Exempt Bonds0InvestTaxExemptBondsInd
Escrow Account0EscrowAccountInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org MemYes (1)BusinessRlnWithOrgMemInd
Business Rln With Fam MemYes (1)BusinessRlnWithFamMemInd
Business Rln With Officer EntYes (1)BusinessRlnWithOfficerEntInd
Deductible Non Cash ContriYes (1)DeductibleNonCashContriInd
Deductible Art ContributionYes (1)DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded EntityYes (1)DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (1)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
Info In Schedule O Part VYes (X)InfoInScheduleOPartVInd
IRP Document559IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee19362EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (1)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (1)Form990TFiledInd
Foreign Financial AccountYes (1)ForeignFinancialAccountInd
Foreign CountryBRForeignCountryCd
Foreign CountryCIForeignCountryCd
Foreign CountryCHForeignCountryCd
Foreign CountryCOForeignCountryCd
Foreign CountryEZForeignCountryCd
Foreign CountryDAForeignCountryCd
Foreign CountryGRForeignCountryCd
Foreign CountryHUForeignCountryCd
Foreign CountryIDForeignCountryCd
Foreign CountryEIForeignCountryCd
Foreign CountryJAForeignCountryCd
Foreign CountryKUForeignCountryCd
Foreign CountryMYForeignCountryCd
Foreign CountryNIForeignCountryCd
Foreign CountryNOForeignCountryCd
Foreign CountryPEForeignCountryCd
Foreign CountryPLForeignCountryCd
Foreign CountryPOForeignCountryCd
Foreign CountryROForeignCountryCd
Foreign CountryKSForeignCountryCd
Foreign CountrySWForeignCountryCd
Foreign CountryTUForeignCountryCd
Foreign CountryUKForeignCountryCd
Foreign CountryBDForeignCountryCd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo ContributionsYes (1)QuidProQuoContributionsInd
Quid Pro Quo Contri DisclYes (1)QuidProQuoContriDisclInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members22GoverningBodyVotingMembersCnt
Independent Voting Member14IndependentVotingMemberCnt
Family Or Business RlnYes (1)FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesYes (1)DelegationOfMgmtDutiesInd
Change To Org DocumentsYes (1)ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldAKStatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is FldFLStatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is FldGAStatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is FldHIStatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is FldILStatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is FldKSStatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is FldKYStatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is FldMDStatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is FldMAStatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is FldMIStatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is FldMNStatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is FldMSStatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is FldNHStatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is FldNJStatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is FldNYStatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is FldOKStatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is FldORStatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is FldPAStatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is FldSCStatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is FldTNStatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is FldUTStatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is FldWIStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd
OtherYes (X)OtherInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1LAURA ALVISBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone9196138993PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1DUHS INC 615 DOUGLAS STREET SUITEAddressLine1Txt
CityDURHAMCityNm
State AbbreviationNCStateAbbreviationCd
ZIP27705ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (34 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
FARAD ALI
DIRECTOR2.000.00Yes (X)$0$0$0
NANCY ANDREWS MD
DIRECTOR3.0056.20Yes (X)$0$959,361$90,625
LESLIE E BAINS
DIRECTOR1.000.00Yes (X)$0$0$0
GAIL BELVETT MD DDS
DIRECTOR1.000.10Yes (X)$0$0$0
JACK O BOVENDER JR
DIRECTOR3.008.00Yes (X)$0$0$0
RICHARD H BRODHEAD
DIRECTOR10.0050.30Yes (X)$0$1,258,009$166,091
JAMES F GOODMON
DIRECTOR2.000.00Yes (X)$0$0$0
THOMAS M GORRIE
DIRECTOR3.009.10Yes (X)$0$0$0
WILLIAM HAWKINS
DIRECTOR6.006.00Yes (X)$0$0$0
JOHN M KANE
DIRECTOR1.000.00Yes (X)$0$0$0
MARY E KLOTMAN MD
DIRECTOR25.0040.20Yes (X)$0$404,841$45,474
MICHAEL MARSICANO
DIRECTOR1.004.00Yes (X)$0$0$0
LLOYD B MORGAN
DIRECTOR2.000.00Yes (X)$0$0$0
MARK F NEWMAN
DIRECTOR1.0050.20Yes (X)$0$213,689$46,916
DAVID M RUBENSTEIN
DIRECTOR1.0016.10Yes (X)$0$0$0
NANCY M SCHLICHTING
DIRECTOR6.000.00Yes (X)$0$0$0
STEVEN M SCOTT MD
DIRECTOR4.002.00Yes (X)$0$0$0
SUSAN STALNECKER
DIRECTOR2.000.00Yes (X)$0$0$0
GEORGE RICHARD WAGONER JR
DIRECTOR2.000.00Yes (X)$0$0$0
A EUGENE WASHINGTON MD
PRESIDENT & CEO DUHS/DIRECTOR33.0033.10Yes (X)$0$2,090,109$144,548Yes (X)
JIM WHITEHURST
DIRECTOR1.000.00Yes (X)$0$0$0
MONTE D BROWN MD
VP FOR ADMINISTRATION/SECRETARY60.000.10$669,947$0$50,232Yes (X)
WILLIAM J FULKERSON MD
EXECUTIVE VP, DUHS60.000.60$1,425,996$0$37,490Yes (X)
KENNETH C MORRIS
SVP, CFO, TREASURER40.000.90$1,271,288$0$41,825Yes (X)
MARY ANN FUCHS
VP-PATIENT CARE/CHIEF NURSE EXEC60.000.00$458,734$0$38,606Yes (X)
KATHLEEN GALBRAITH
PRESIDENT, DUKE REGIONAL HOSPITAL60.000.50$514,452$0$48,845Yes (X)
KEVIN SOWERS
PRESIDENT, DUKE UNIVERSITY HOSPITAL64.000.00$721,326$0$43,183Yes (X)
DAVID ZAAS MD
PRESIDENT, DUKE RALEIGH HOSPITAL60.000.00$539,594$0$42,104Yes (X)
RHONDA BRANDON
CHIEF HUMAN RESOURCES OFFICER40.000.00$545,021$0$55,204Yes (X)
MARC CALABRESE
PHYSICIAN40.000.00$439,903$0$55,060Yes (X)
CAROLYN C CARPENTER
CHIEF OPERATING OFFICER DUH40.000.00$444,483$0$49,464Yes (X)
JEFFREY M FERRANTI
VP, CIO, DHTS ADMINISTRATION44.505.50$622,660$102,220$53,244Yes (X)
THOMAS A OWENS MD
CHIEF MEDICAL OFFICER60.000.20$711,274$0$44,421Yes (X)
VICTOR J DZAU MD
FORMER DIRECTOR/OFFICER0.000.00$0$143,032$18,666Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$8,364,678TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$5,171,261TotReportableCompRltdOrgAmt
Total Other Compensation$1,071,998TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K1721IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (1)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
PRIVATE DIAGNOSTIC CLINIC PLLC
DUMC 3070DURHAMNC27710PHYSICIAN SERVICES$127,722,651
SKANSKA USA BUILDING INC
4309 EMPEROR BLVD STE 200DURHAMNC27703CONSTRUCTION SERVICES$15,367,938
PRISM HEALTHCARE PARTNERS LTD
190 SOUTH LA SALLE ST 2900CHICAGOIL60603CONSULTING SERVICES$13,930,118
ROBINS & MORTON GROUP
400 SHADES CREEK PKWBIRMINGHAMAL35209CONSTRUCTION SERVICES$13,011,582
KILPATRICK TOWNSEND & STOCKTON LLP
4208 SIX FORKS RD STE 1400RALEIGHNC27609CONSULTING SERVICES$12,226,640
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K335CntrctRcvdGreaterThan100KCnt
Fundraising$43,858FundraisingAmt
Government Grants$459,127GovernmentGrantsAmt
All Other Contributions$2,379,132AllOtherContributionsAmt
Noncash Contributions$75,443NoncashContributionsAmt
Total Contributions$2,882,117TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
PATIENT REVENUE621990$3,085,205,739$3,085,205,739
ANCILLARY MEDICAL SVCS621990$30,094,891$30,094,891
MEDICAL SERVICES621990$2,723,330$2,723,330
FieldValueIRS element (for citing)
Total Program Service Revenue$3,118,023,960TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$12,810,879TotalRevenueColumnAmt
Unrelated Business Revenue$205,127UnrelatedBusinessRevenueAmt
Exclusion$12,605,752ExclusionAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$10,575,729TotalRevenueColumnAmt
Exclusion$10,575,729ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$13,106,145RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$11,481,278RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$1,624,867RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,624,867TotalRevenueColumnAmt
Exclusion$1,624,867ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$1,667,524,469SecuritiesAmt
Other$750,696OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$1,544,130,166SecuritiesAmt
Other$847,432OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$123,394,303SecuritiesAmt
Other-$96,736OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$123,297,567TotalRevenueColumnAmt
Exclusion$123,297,567ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$78,103FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event$43,858ContriRptFundraisingEventAmt
Fundraising Direct Expenses$60,807FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$17,296TotalRevenueColumnAmt
Exclusion$17,296ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
BILLING FEES621990$40,328,325$40,328,325
LAB SERVICES621990$3,213,662$3,213,662
TUITION REVENUE611600$2,316,203$2,316,203

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$16,583,869TotalRevenueColumnAmt
Related Or Exempt Func Income$11,138,412RelatedOrExemptFuncIncomeAmt
Exclusion$5,445,457ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$62,442,059OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$3,331,674,474TotalRevenueColumnAmt
Related Or Exempt Func Income$3,175,020,562RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$205,127UnrelatedBusinessRevenueAmt
Exclusion$153,566,668ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$1,527,135TotalAmt
Program Services$1,527,135ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$56,000TotalAmt
Program Services$56,000ProgramServicesAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$32,450TotalAmt
Program Services$32,450ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$5,906,714TotalAmt
Program Services$576,165ProgramServicesAmt
Management And General$5,282,116ManagementAndGeneralAmt
Fundraising$48,433FundraisingAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$886,073TotalAmt
Program Services$92,530ProgramServicesAmt
Management And General$793,543ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$1,095,650,750TotalAmt
Program Services$753,375,773ProgramServicesAmt
Management And General$342,222,218ManagementAndGeneralAmt
Fundraising$52,759FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$54,444,666TotalAmt
Program Services$34,297,905ProgramServicesAmt
Management And General$20,143,185ManagementAndGeneralAmt
Fundraising$3,576FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$160,209,236TotalAmt
Program Services$84,997,028ProgramServicesAmt
Management And General$75,207,186ManagementAndGeneralAmt
Fundraising$5,022FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$75,478,968TotalAmt
Program Services$51,639,136ProgramServicesAmt
Management And General$23,836,219ManagementAndGeneralAmt
Fundraising$3,613FundraisingAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$10,388,991TotalAmt
Program Services$9,720,430ProgramServicesAmt
Management And General$668,561ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$1,949,436TotalAmt
Program Services$79,997ProgramServicesAmt
Management And General$1,869,439ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$533,100TotalAmt
Management And General$533,100ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$4,031,053TotalAmt
Management And General$4,031,053ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$246,401,602TotalAmt
Program Services$144,499,956ProgramServicesAmt
Management And General$101,901,236ManagementAndGeneralAmt
Fundraising$410FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$7,959,089TotalAmt
Program Services$521,209ProgramServicesAmt
Management And General$7,437,880ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$35,184,444TotalAmt
Program Services$21,917,672ProgramServicesAmt
Management And General$13,237,825ManagementAndGeneralAmt
Fundraising$28,947FundraisingAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$48,380,253TotalAmt
Program Services$2,879,325ProgramServicesAmt
Management And General$45,500,928ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$64,906,382TotalAmt
Program Services$42,943,318ProgramServicesAmt
Management And General$21,963,046ManagementAndGeneralAmt
Fundraising$18FundraisingAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$5,899,563TotalAmt
Program Services$2,980,432ProgramServicesAmt
Management And General$2,917,798ManagementAndGeneralAmt
Fundraising$1,333FundraisingAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$1,250TotalAmt
Fundraising$1,250FundraisingAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$5,698,714TotalAmt
Management And General$5,698,714ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$36,791,534TotalAmt
Program Services$244,927ProgramServicesAmt
Management And General$36,546,607ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$152,589,324TotalAmt
Program Services$112,894,532ProgramServicesAmt
Management And General$39,694,792ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$5,778,207TotalAmt
Program Services$5,778,207ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES$749,913,845$749,913,845
EQUIPMENT RENTAL & MAIN$73,447,696$47,459,793$25,987,903
MEDICAID ASSESSMENT$72,412,084$72,412,084
LOSS - DEBT EXTINGUISH.$18,328,491$18,328,491

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$4,396,352TotalAmt
Program Services$40,587,172ProgramServicesAmt
Management And General-$36,191,120ManagementAndGeneralAmt
Fundraising$300FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$2,939,183,402TotalAmt
Program Services$2,181,427,021ProgramServicesAmt
Management And General$757,610,720ManagementAndGeneralAmt
Fundraising$145,661FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$87,611BOYAmt
EOY$89,587EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$329,162,546BOYAmt
EOY$224,797,612EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$2,033,882BOYAmt
EOY$1,036,024EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$385,991,772BOYAmt
EOY$382,630,005EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$708,155BOYAmt
EOY$569,286EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$80,843,829BOYAmt
EOY$84,835,939EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$18,726,721BOYAmt
EOY$23,117,570EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$3,122,582,679LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$1,671,657,533LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$1,433,156,774BOYAmt
EOY$1,450,925,146EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$249,703,654BOYAmt
EOY$660,358,948EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$2,396,723,865BOYAmt
EOY$2,505,806,356EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$21,109,824BOYAmt
EOY$21,109,823EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$14,953,406BOYAmt
EOY$19,554,546EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$4,933,202,039BOYAmt
EOY$5,374,830,842EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$310,640,992BOYAmt
EOY$303,899,724EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$8,442,833BOYAmt
EOY$6,965,255EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$1,078,059,351BOYAmt
EOY$1,069,719,707EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$1,317,057,988BOYAmt
EOY$1,273,687,188EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$2,714,201,164BOYAmt
EOY$2,654,271,874EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$2,161,184,588BOYAmt
EOY$2,663,381,238EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$44,116,648BOYAmt
EOY$43,472,884EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$13,699,639BOYAmt
EOY$13,704,846EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$2,219,000,875BOYAmt
EOY$2,720,558,968EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$4,933,202,039BOYAmt
EOY$5,374,830,842EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$392,491,072ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$114,585,878NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$5,518,857OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or ManagementYes (1)PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other Organizations0GrantsOtherOrganizationsInd
Direct Contact LegislatorsYes (1)DirectContactLegislatorsInd
Direct Contact Legislators$184,812DirectContactLegislatorsAmt
Rallies Demonstrations0RalliesDemonstrationsInd
Other ActivitiesYes (1)OtherActivitiesInd
Other Activities$125,060OtherActivitiesAmt
Total Lobbying Expenditures$309,872TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART II-B, LINE 1:FormAndLineReferenceDesc
ExplanationDUKE UNIVERSITY HEALTH SYSTEM, INC. EMPLOYS STAFF WHO PERFORM SOME LOBBYING ACTIVITIES AS PART OF THEIR JOB RESPONSIBILITIES. THESE SAME EMPLOYEES HAVE AND SOME SENIOR LEADERS MAY HAVE DIRECT CONTACT WITH LEGISLATORS, THEIR STAFFS, AND GOVERNMENT OFFICIALS. DUKE UNIVERSITY HEALTH SYSTEM, INC. PAYS MEMBERSHIP DUES TO OTHER ORGANIZATIONS. PER THE MEMBERSHIP DUES INVOICES, SOME OF THESE ORGANIZATIONS PROVIDE A DISCLOSURE OF LOBBYING PERCENTAGE OF THE DUES RECEIVED.ExplanationTxt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$57,816,285BeginningYearBalanceAmt
Contributions$2,312,345ContributionsAmt
Investment Earnings Or Losses$1,810,497InvestmentEarningsOrLossesAmt
Other Expenditures$4,761,397OtherExpendituresAmt
End Year Balance$57,177,730EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$57,578,816BeginningYearBalanceAmt
Contributions$7,276,856ContributionsAmt
Investment Earnings Or Losses-$1,590,780InvestmentEarningsOrLossesAmt
Other Expenditures$5,448,607OtherExpendituresAmt
End Year Balance$57,816,285EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$59,083,195BeginningYearBalanceAmt
Contributions$4,849,436ContributionsAmt
Investment Earnings Or Losses-$29,888InvestmentEarningsOrLossesAmt
Other Expenditures$6,323,927OtherExpendituresAmt
End Year Balance$57,578,816EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$46,947,089BeginningYearBalanceAmt
Contributions$13,413,723ContributionsAmt
Investment Earnings Or Losses$2,988,057InvestmentEarningsOrLossesAmt
Other Expenditures$4,265,674OtherExpendituresAmt
End Year Balance$59,083,195EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$50,036,781BeginningYearBalanceAmt
Contributions$8,190,873ContributionsAmt
Investment Earnings Or Losses$1,409,233InvestmentEarningsOrLossesAmt
Other Expenditures$12,689,798OtherExpendituresAmt
End Year Balance$46,947,089EndYearBalanceAmt
FieldValueIRS element (for citing)
Prmnnt Endowment Balance EOY0.47120PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0.52880TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org0EndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgYes (1)EndowmentsHeldRelatedOrgInd
Related Org List Sch RYes (1)RelatedOrgListSchRInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$57,155,782OtherCostOrOtherBasisAmt
Book Value$57,155,782BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,850,343,316OtherCostOrOtherBasisAmt
Depreciation$813,967,218DepreciationAmt
Book Value$1,036,376,098BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$761,474,712OtherCostOrOtherBasisAmt
Depreciation$548,550,179DepreciationAmt
Book Value$212,924,533BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$453,608,869OtherCostOrOtherBasisAmt
Depreciation$309,140,136DepreciationAmt
Book Value$144,468,733BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$1,450,925,146TotalBookValueLandBuildingsAmt

Other Securities OtherSecuritiesGrp (7 entries)

DescDescBook ValueBookValueAmtMethod ValuationMethodValuationCd
HEDGED STRATEGIES$798,349,352F
SHORT-TERM INVESTMENTS$463,232,809F
PRIVATE CAPITAL$458,455,695F
REAL ASSETS$334,713,521F
FIXED INCOME$236,503,134F
EQUITIES$157,047,909F
OTHER INVESTMENTS$57,503,936F
FieldValueIRS element (for citing)
Total Book Value Securities$2,505,806,356TotalBookValueSecuritiesAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (8 entries)

DescDescAmtAmt
INTERCOMPANY PAYABLE$11,019,963
INTEREST PAYABLE$12,029,537
PROFESSIONAL LIABILITY COSTS$6,588,052
POST RETIREMENT BENEFIT OBLIGATION$416,631,000
CAPITAL LEASE OBLIGATION$127,571,016
DERIVATIVE INSTRUMENTS$80,650,994
TAXABLE BOND LIABILITY$586,511,737
OTHER NON-CURRENT LIABILITIES$32,684,889
FieldValueIRS element (for citing)
Total Liability$1,273,687,188TotalLiabilityAmt

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART V, LINE 4:THE INTENDED USE FOR THE ORGANIZATION'S ENDOWMENT: FUNDS SUPPORT CAPITAL PURCHASES, OFFSET OPERATING COSTS, IMPROVE PATIENT SAFETY, AND SUPPORT THE NEEDS OF PATIENTS AND FAMILIES.
PART X, LINE 2:DUKE UNIVERSITY HEALTH SYSTEM, INC. ADOPTED THE REQUIREMENTS OF FIN 48 AND CONSIDERED ITS TAX POSITIONS. BASED ON THAT ANALYSIS, THE PROVISIONS OF FIN 48 ARE DEEMED IMMATERIAL TO THE DUKE UNIVERSITY HEALTH SYSTEM, INC. FINANCIAL STATEMENTS AND THEREFORE NO FIN 48 SPECIFIC DISCLOSURES ARE MADE IN THE AUDITED FINANCIAL STATEMENTS OF DUKE UNIVERSITY HEALTH SYSTEM, INC. AND ITS AFFILIATES FOR FISCAL YEAR ENDED JUNE 30, 2017.

Schedule F IRS990ScheduleF

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Account Activities Outside US AccountActivitiesOutsideUSGrp (14 entries)

RegionRegionTxtOfficesOfficesCntEmployeeEmployeeCntType Of Activities ConductedTypeOfActivitiesConductedTxtRegion Total ExpendituresRegionTotalExpendituresAmtSpecific Services ProvidedSpecificServicesProvidedTxt
CENTRAL AMERICA AND THE CARIBBEAN00SEMINAR$7,838
EAST ASIA AND THE PACIFIC00SEMINAR$13,497
EUROPE (INCLUDING ICELAND & GREENLAND)00SEMINAR$27,586
EAST ASIA AND THE PACIFIC00PROGRAM SERVICES$13,567EDUCATION
SUB-SAHARAN AFRICA00SEMINAR$2,500
NORTH AMERICA00SEMINAR$12,381
SOUTH AMERICA00SEMINAR$1,326
CENTRAL AMERICA AND THE CARIBBEAN00INVESTMENTS$211,773,945
CENTRAL AMERICA AND THE CARIBBEAN00PROGRAM SERVICES$123,301EDUCATION
NORTH AMERICA00PROGRAM SERVICES$5,250EDUCATION
SUB-SAHARAN AFRICA00GRANTMAKING$32,450
EUROPE (INCLUDING ICELAND & GREENLAND)00PROGRAM SERVICES$3,639EDUCATION
RUSSIA AND NEIGHBORING STATES00PROGRAM SERVICES$1,462RESEARCH
SUB-SAHARAN AFRICA00PROGRAM SERVICES$7,999EDUCATION
FieldValueIRS element (for citing)
Subtotal Offices0SubtotalOfficesCnt
Subtotal Employees0SubtotalEmployeesCnt
Continutation Total Office0ContinutationTotalOfficeCnt
Continutation Total Employee0ContinutationTotalEmployeeCnt
Total Office0TotalOfficeCnt
Total Employee0TotalEmployeeCnt
Subtotal Spent$211,852,640SubtotalSpentAmt
Continuation Spent$174,101ContinuationSpentAmt
Total Spent$212,026,741TotalSpentAmt

Grants To Org Outside US GrantsToOrgOutsideUSGrp

FieldValueIRS element (for citing)
RegionSUB-SAHARAN AFRICARegionTxt
Purpose Of GrantGENERAL SUPPORTPurposeOfGrantTxt
Non Cash Assistance$32,450NonCashAssistanceAmt
Description Of Non Cash AsstMEDICAL EQUIPMENTDescriptionOfNonCashAsstTxt
Valuation Method UsedFMVValuationMethodUsedDesc
FieldValueIRS element (for citing)
Total501c3 Org1Total501c3OrgCnt
Total Other Org0TotalOtherOrgCnt
Transfer To Foreign Corp0TransferToForeignCorpInd
Interest In Foreign Trust0InterestInForeignTrustInd
Foreign Corp OwnershipYes (1)ForeignCorpOwnershipInd
Passive Foreign Investmest Co0PassiveForeignInvestmestCoInd
Foreign Partnership0ForeignPartnershipInd
Boycott Countries0BoycottCountriesInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 2:FormAndLineReferenceDesc
ExplanationDUKE UNIVERSITY HEALTH SYSTEM, INC. PERIODICALLY APPROVES NONCASH ASSISTANCE AND TRANSFERS MEDICAL EQUIPMENT AND SUPPLIES TO ORGANIZATIONS OUTSIDE THE UNITED STATES, USUALLY IN RESPONSE TO NATURAL DISASTERS. THE ORGANIZATIONS AWARDED THE ASSISTANCE MUST MONITOR THE APPROPRIATE USE OF THE ASSISTANCE IN THE ORDINARY COURSE OF BUSINESS.ExplanationTxt

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Event1GALAEvent1Nm
Gross Receipts Event1$121,961GrossReceiptsEvent1Amt
Charitable Contri Event1$43,858CharitableContriEvent1Amt
Gross Revenue Event1$78,103GrossRevenueEvent1Amt
Non Cash Prizes Event1$24,789NonCashPrizesEvent1Amt
Food And Beverage Event1$20,518FoodAndBeverageEvent1Amt
Entertainment Event1$5,986EntertainmentEvent1Amt
Other Direct Expenses Event1$9,514OtherDirectExpensesEvent1Amt
Gross Receipts Total$121,961GrossReceiptsTotalAmt
Charitable Contributions Tot$43,858CharitableContributionsTotAmt
Gross Revenue Total Events$78,103GrossRevenueTotalEventsAmt
Non Cash Prizes Total Events$24,789NonCashPrizesTotalEventsAmt
Food And Beverage Total Events$20,518FoodAndBeverageTotalEventsAmt
Entertainment Total Events$5,986EntertainmentTotalEventsAmt
Oth Direct Expnss Total Events$9,514OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events$60,807DirectExpenseSummaryEventsAmt
Net Income Summary$17,296NetIncomeSummaryAmt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceFORM 990, SCHEDULE G, PART I, LINE 2BFormAndLineReferenceDesc
ExplanationDUKE UNIVERSITY HEALTH SYSTEM, INC. SUPPORTS THE FUNDRAISING ACTIVITIES PERFORMED BY EMPLOYEES OF DUKE UNIVERSITY. SUCH ACTIVITIES ARE DESIGNED TO DEVELOP SUPPORT FOR BOTH THE UNIVERSITY AND THE DUKE UNIVERSITY HEALTH SYSTEM, INC.'S EDUCATIONAL, RESEARCH AND HEALTHCARE PURPOSES. DUKE UNIVERSITY RECEIVES AND DIRECTS THE CONTRIBUTIONS AS APPROPRIATE TO DUKE UNIVERSITY HEALTH SYSTEM, INC. THE AGREEMENT BETWEEN DUKE UNIVERSITY AND DUKE UNIVERSITY HEALTH SYSTEM, INC. DOES NOT DISTINGUISH BETWEEN PAYMENTS FOR PROFESSIONAL FUNDRAISING SERVICES AND EXPENSE PAYMENTS OR REIMBURSEMENTS.ExplanationTxt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd
Percent200Yes (X)Percent200Ind
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd
Percent300Yes (X)Percent300Ind
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed Budget0ExpensesExceedBudgetInd
Annual Community Bnft ReportYes (1)AnnualCommunityBnftReportInd
Report Publically AvailableYes (1)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$96,710,397TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$96,710,397NetCommunityBenefitExpnsAmt
Total Expense0.03290TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$109,018,730TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$109,018,730NetCommunityBenefitExpnsAmt
Total Expense0.03710TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$205,729,127TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$205,729,127NetCommunityBenefitExpnsAmt
Total Expense0.07000TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$80,124,798TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$14,847,505DirectOffsettingRevenueAmt
Net Community Benefit Expns$65,277,293NetCommunityBenefitExpnsAmt
Total Expense0.02220TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$12,000,255TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$12,000,255NetCommunityBenefitExpnsAmt
Total Expense0.00410TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$92,125,053TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$14,847,505DirectOffsettingRevenueAmt
Net Community Benefit Expns$77,277,548NetCommunityBenefitExpnsAmt
Total Expense0.02630TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$297,854,180TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$14,847,505DirectOffsettingRevenueAmt
Net Community Benefit Expns$283,006,675NetCommunityBenefitExpnsAmt
Total Expense0.09630TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$12,619,125BadDebtExpenseAmt
Bad Debt Expense Attributable$0BadDebtExpenseAttributableAmt
Reimbursed By Medicare$547,314,073ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$646,276,788CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$98,962,715MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (1)FinancialAssistancePrvsnInd
Hospital Facilities3HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp (3 entries)

FacilityFacilityNumAddress Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdWebsite AddressWebsiteAddressTxtState LicenseStateLicenseNumLicensed HospitalLicensedHospitalIndGeneral Medical And SurgicalGeneralMedicalAndSurgicalIndChildrens HospitalChildrensHospitalIndTeaching HospitalTeachingHospitalIndResearch FacilityResearchFacilityIndEmergency Room24 HrsEmergencyRoom24HrsIndFacility Reporting GroupFacilityReportingGroupCdAddress Line2USAddress/AddressLine2Txt
DUKE UNIVERSITY HOSPITAL
12301 ERWIN ROAD PRIMARY CAMPUSDURHAMNC27710HTTP://WWW.DUKEHEALTH.ORGH0015Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)A
DUKE RALEIGH HOSPITAL
23400 WAKE FOREST ROAD PRIMARYRALEIGHNC27609HTTP://WWW.DUKEHEALTH.ORGH0238Yes (X)Yes (X)Yes (X)CAMPUS
DUKE REGIONAL HOSPITAL
33643 ROXBORO ROADDURHAMNC27704HTTP://WWW.DUKEHEALTH.ORGH0233Yes (X)Yes (X)Yes (X)A

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp (2 entries)

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DUKE UNIVERSITYDUKE REGIONAL HOSPITALS
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DUKE RALEIGH HOSPITAL
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Supplemental Information SupplementalInformationGrp (18 entries)

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NOTE: THIS SCHEDULE H CONTAINS REFERENCES TO DUKE AND DUKE HEALTH WHICH AREMEANT TO ENCOMPASS FOR THE PURPOSES OF THIS SCHEDULE DUKE UNIVERSITY HEALTH SYSTEM (DUHS), DUKE UNIVERSITY SCHOOL OF MEDICINE, AND DUKE UNIVERSITY SCHOOL OF NURSING. PART V, SECTION B:GROUP A - FACILITY 1 - DUKE UNIVERSITY HOSPITALPART V, SECTION B, LINE 5: DUKE UNIVERSITY HOSPITAL ("DUH") DUH COLLABORATES WITH THE PARTNERSHIP FOR A HEALTHY DURHAM (THE STATE CERTIFIED HEALTHY CAROLINIANS GROUP) AND THE DURHAM COUNTY HEALTH DEPARTMENT TO CONDUCT THE DURHAM COUNTY COMMUNITY HEALTH ASSESSMENT AND DEVELOPS STRATEGIES TO ADDRESS IDENTIFIED NEEDS. FACULTY AND STAFF OF THE DUKE DIVISION OF COMMUNITY HEALTH AND APPOINTED MEMBERS OF THE DUH SENIOR LEADERSHIP TEAM OFFICIALLY SERVE ON PARTNERSHIP FOR A HEALTHY DURHAM COMMITTEES.THE MOST RECENT ASSESSMENT PROCESS CONDUCTED IN CALENDAR YEAR 2014 COMPILED VALID AND RELIABLE INFORMATION ABOUT THE HEALTH OF DURHAM. IT INCLUDED 354 CITIZEN SURVEYS FROM RANDOMLY SELECTED HOUSEHOLDS AND 8 COMMUNITY LISTENING SESSIONS WITH 205 COMMUNITY MEMBERS. THE COMMUNITY HEALTH ASSESSMENT TEAM - COMPRISED OF MORE THAN 89 MEMBERS REPRESENTING, DUKE UNIVERSITY HOSPITAL AND DUKE REGIONAL HOSPITAL (FORMERLY DURHAM REGIONAL HOSPITAL), UNIVERSITIES, LOCAL GOVERNMENT, SCHOOLS, NON-PROFIT ORGANIZATIONS AND BUSINESSES - WORKED TO DIRECT THE ACTIVITIES OF THE ASSESSMENT AND PROVIDE WRITTEN CONTENT AND EXPERTISE ON ISSUES OF INTEREST. THIS JOINT CHNA AND RELATED IMPLEMENTATION PLAN WAS ADOPTED BY THE DUHS BOARD OF DIRECTORS AND PUBLISHED ON THE DUKE HEALTH WEBSITE IN FISCAL YEAR 2016 (TAX YEAR 2015).GROUP A - FACILITY 1 - DUKE UNIVERSITY HOSPITALPART V, SECTION B, LINE 6A: DUKE REGIONAL HOSPITAL ("DRH")GROUP A - FACILITY 1 - DUKE UNIVERSITY HOSPITALPART V, SECTION B, LINE 6B: THE PARTNERSHIP FOR A HEALTHY DURHAM AND THE DURHAM COUNTY HEALTH DEPARTMENTGROUP A - FACILITY 1 - DUKE UNIVERSITY HOSPITALPART V, SECTION B, LINE 11: THE ASSESSMENT IDENTIFIED SIX HEALTH PRIORITIES FOR 2015 - 2017: 1. ACCESS TO MEDICAL AND DENTAL CARE 2. MENTAL HEALTH AND SUBSTANCE ABUSE3. OBESITY AND CHRONIC ILLNESS 4. HIV AND SEXUALLY TRANSMITTED INFECTIONS 5. POVERTY 6. EDUCATION ALL OF THE PROGRAMS DESCRIBED IN THE FOLLOWING IMPLEMENTATION PLAN ARE ALIGNED WITH THE SIX HEALTH PRIORITIES WITH MANY OF THE PROGRAMS ADDRESSING COMBINATIONS OF THE SIX HEALTH PRIORITIES. A BRIEF EXCERPT FROM THE COMMUNITY HEALTH NEEDS ASSESSMENT DESCRIBING EACH PRIORITY IS INCLUDED IN THIS IMPLEMENTATION PLAN. DUH CONSIDERS THIS DOCUMENT TO BE A "WORKING PLAN" THAT WILL CONTINUE TO EVOLVE OVER THIS THREE YEAR PERIOD IN ORDER TO ENSURE THE EFFICACY OF STRATEGIES INTENDED TO MEET EXPRESSED COMMUNITY HEALTH NEEDS. THIS IMPLEMENTATION PLAN DOES NOT CONTAIN DESCRIPTIONS OF THE COMMUNITY HEALTH IMPROVEMENT WORK CARRIED OUT BY OTHER COMPONENTS OF THE LARGER DUKE HEALTH SYSTEM OR DUKE UNIVERSITY. THIS IMPLEMENTATION PLAN ONLY REPRESENTS DUKE HOSPITAL'S CONTINUALLY EVOLVING ACTIVITIES AND SUPPORT TO IMPROVE HEALTH WITH THE DURHAM COMMUNITY.IMPLEMENTATION PLANTOGETHER, WITH ITS PARTNERS, DUH ASKS ABOUT AND LISTENS TO CONCERNS, EXPLORES BARRIERS TO CARE, ANALYZES HEALTHCARE UTILIZATION AND COSTS, IDENTIFIES PARTNER NEEDS AND RESOURCES, PLANS/REDESIGNS SERVICES, TRACKS OUTCOMES, AND SHARES ACCOUNTABILITY IN ORDER TO DEVELOP EFFECTIVE PROGRAMS TO IMPROVE THE HEALTH OF THE DURHAM COMMUNITY. AS SUCH THIS IMPLEMENTATION PLAN INCLUDES NEW AND LONG-STANDING PROGRAMS. 1. ACCESS TO MEDICAL AND DENTAL CARE INITIATIVES:ACCESS TO HEALTH CARE IN A COMMUNITY REFERS TO THE ABILITY OF RESIDENTS TO FIND A CONSISTENT MEDICAL PROVIDER FOR THEIR PRIMARY CARE NEEDS, TO FIND A SPECIALTY PROVIDER WHEN NEEDED AND TO BE ABLE TO RECEIVE THAT CARE WITHOUT ENCOUNTERING SIGNIFICANT BARRIERS. ALTHOUGH THERE ARE MANY MEDICAL PROVIDERS, DURHAM COUNTY IS PARTICULARLY HAMPERED BY A LACK OF HEALTH INSURANCE COVERAGE (WHETHER PRIVATE OR PUBLIC, SUCH AS MEDICAID) FOR MANY OF ITS RESIDENTS. IN DURHAM COUNTY, 19% OF ADULTS LESS THAN 65 YEARS ARE UNINSURED. PROJECT ACCESS OF DURHAM COUNTY (PADC) LINKS ELIGIBLE LOW-INCOME, UNINSURED, DURHAM COUNTY RESIDENTS TO SPECIALTY MEDICAL CARE FULLY DONATED TO THE PATIENTS BY THE PHYSICIANS, HOSPITALS INCLUDING DUH, LABS, CLINICS AND OTHER PROVIDERS PARTICIPATING IN THE PADC NETWORK. IN FY15, PADC PROVIDED SERVICES TO MORE THAN 1,000 PATIENTS.PLANS FOR FY16: ENROLL AND CARE MANAGE AT LEAST 1,000 PATIENTS; RE-ESTABLISH THE MEDICAL DIRECTOR COMMITTEE TO REVIEW AND FINALIZE OUTCOME METRICS; CONTINUE CARE MANAGEMENT ASSISTANCE OF MEDICAL RESPITE PROGRAM.PROGRESS IN FY16: PADC ENROLLED 1117 PATIENTS AND EXPANDED ITS MEDICAL RESPITE PROGRAM SERVING A DOZEN PATIENTS. IN ADDITION TO EXCEEDING THOSE FY 16 GOALS, PADC IMPROVED OPERATIONS BY LAUNCHING A DIGITAL ENROLLMENT SYSTEM IN THE COACH WEB-BASED INFORMATION AND COMMUNICATION SYSTEM.PLANS FOR FY17: CONTINUE TO FUNCTION AND SERVE ITS DONATED NUMBER OF BUNDLED SERVICES (2500/YEAR). MAKE THE NECESSARY PROTOCOL AND OPERATIONAL ADJUSTMENTS TO THE MEDICAL RESPITE PROGRAM TO ALLOW PATIENTS TO STAY MORE THAN 30 DAYS WHILE HOUSING IS BEING ARRANGED.PROGRESS IN FY17: PADC CONTINUED TO MEET SERVICE GOALS IN FY17. EARLY EVALUATION RESULTS OF THE MEDICAL RESPITE PROGRAM DEMONSTRATED POSITIVE IMPACTS FOR PATIENTS SERVED INCLUDING A: 37% REDUCTION IN INPATIENT ADMISSIONS, 70% REDUCTION IN INPATIENT DAYS, AND 192% INCREASE IN OUTPATIENT VISITS. BENEFITS AND SERVICES OBTAINED FOR PARTICIPANTS THROUGH THE MEDICAL RESPITE PROGRAM INCLUDED CONNECTIONS TO PRIMARY CARE SERVICES, MENTAL HEALTH AND/OR SUBSTANCE ABUSE SERVICES, AND ASSISTANCE IN TRANSITIONING TO STABLE HOUSING. LOCAL ACCESS TO COORDINATED HEALTHCARE (LATCH) WAS INITIATED IN 2002 WITH HEALTHY COMMUNITIES ACCESS PROGRAM (HCAP) FUNDING FROM THE US HEALTH RESOURCES AND SERVICES ADMINISTRATION (HRSA) TO DUKE'S DIVISION OF COMMUNITY HEALTH, DEPARTMENT OF COMMUNITY AND FAMILY MEDICINE. THE FOUNDING AND SUSTAINING LATCH PARTNERSHIP INCLUDES DUH (WHICH NOW PROVIDES THE MAJORITY OF OPERATING FUNDS), LINCOLN COMMUNITY HEALTH CENTER, THE DURHAM COUNTY DEPARTMENTS OF HEALTH AND SOCIAL SERVICES, EL CENTRO HISPANO, AND A NUMBER OF COMMUNITY-BASED ORGANIZATIONS (CBOS). THROUGH COMMUNITY-BASED, LINGUISTICALLY AND CULTURALLY-RELEVANT CARE MANAGEMENT, LATCH AIMS TO IMPROVE HEALTH KNOWLEDGE AND SELF-CARE, ACCESS TO HEALTH CARE AND HEALTH SERVICES UTILIZATION OUTCOMES AMONG DURHAM COUNTY'S UNINSURED. CARE MANAGEMENT SERVICES INCLUDE: HEALTH SERVICES COORDINATION AND NAVIGATION (MEDICAL, SOCIAL, BEHAVIORAL); POST-HOSPITALIZATION FOLLOW-UP; PATIENT EDUCATION; CHRONIC DISEASE MANAGEMENT; PSYCHO-SOCIAL SUPPORT; ACCESS TO BENEFITS (MEDICAID/SSI/SSDI); BILLS ASSISTANCE; INTERPRETATION/TRANSLATION; AND, TRANSPORTATION COORDINATION. IN PARTNERSHIP WITH OTHER COMMUNITY STAKEHOLDERS-HEALTH CARE AND SOCIAL SERVICE PROVIDERS, LOCAL GOVERNMENT AND COMMUNITY-BASED ORGANIZATIONS-LATCH MONITORS HEALTH CARE TRENDS, IDENTIFIES BARRIERS FACING UNINSURED PATIENTS, AND, WORKING AS A CONSORTIUM, ADDRESSES AND ELIMINATES BARRIERS. IN FY15 LATCH PROVIDED MORE THAN 6,000 CARE MANAGEMENT SERVICE ENCOUNTERS WITH PATIENTS. PRE- AND POST- ANALYSIS OF PATIENTS SERVED BY LATCH SHOWS A 17% DECREASE IN HOSPITALIZATIONS.PLANS FOR FY16: REACH OUT AND ENROLL NEW REFUGEE/IMMIGRANT POPULATIONS ARRIVING IN DURHAM FROM NUMEROUS AREAS OF THE WORLD, INCLUDING EAST ASIA, MIDDLE EAST, EAST AFRICA, AND BURMA; CONTINUE ENGAGEMENT WITH EL CENTRO HISPANO AND THE LATINO ROUNDTABLE; CONTINUE ENROLLING UNINSURED IN THE HEALTH INSURANCE EXCHANGE PROMOTING THE UNITED WAY "SPECIAL DISCOUNT" FOR DURHAM RESIDENTS; CONTINUE ENROLLING UNINSURED AND UNDERINSURED IN LATCH CASE MANAGEMENT SERVICES.
PROGRESS IN FY16: LATCH WORKED WITH THE GROWING REFUGEE COMMUNITYAND THE LOCAL OFFICES OF NATIONAL REFUGEE RESETTLEMENT PROGRAMS. LATCH CONTINUED TO PERFORM AWARENESS OUTREACH IN THE COMMUNITY TO ENCOURAGE RESIDENTS TO ENROLL IN THE HEALTH INSURANCE EXCHANGE; AND BEGAN ASSISTING MOTHERS WITH CHILDREN AGES 0 -2 IN ENROLLING IN MEDICAID DUE TO LAPSES IN THE NC FAST ELIGIBILITY SYSTEM.PLANS FOR FY17: CONTINUE PROVIDING MEDICAID AND CHARITY CARE ASSISTANCE, TRANSLATION AND INTERPRETATION SERVICES, EXPAND MEDICAL RESPITE WITH A DAILY CENSUS MINIMUM OF A DOZEN PATIENTS; AND CONTINUE CASE MANAGEMENT OF UNINSURED AND UNDERINSURED PATIENTS WHO HAVE AN EMERGENCY DEPARTMENT (ED) ENCOUNTER. PROGRESS IN FY17: LATCH CONTINUED TO PERFORM AWARENESS OUTREACH IN THE COMMUNITY TO ENCOURAGE RESIDENTS TO ENROLL IN THE HEALTH INSURANCE EXCHANGE. LATCH PARTICIPATED IN THE RIDES TO WELLNESS INITIATIVE TO ADDRESS TRANSPORTATION BARRIERS. LATCH PROVIDED DISABILITY, MEDICAID AND CHARITY CARE ASSISTANCE, TRANSLATION AND INTERPRETATION SERVICES, AND CONTINUED CASE MANAGEMENT OF UNINSURED AND UNDERINSURED PATIENTS WHO HAVE AN ED ENCOUNTER. LATCH INCREASED ITS OWN COMMUNITY OUTREACH EFFORTS, ENROLLING UNINSURED INDIVIDUALS IN NEED OF ASSISTANCE AT VARIOUS CHURCHES AND COMMUNITY EVENTS. THE COMPLEX CHILD PROGRAM (CCP) PROVIDES THE COORDINATION OF MEDICAL AND CO-MANAGEMENT OF MEDICAL CARE FOR CHILDREN WITH MULTIPLE MEDICALLY COMPLEX ISSUES THAT REQUIRE THE INTERACTION WITH MULTIPLE SPECIALISTS. ON AVERAGE THESE CHILDREN WORK WITH 13 SPECIALISTS. BEFORE THE COMPLEX CHILD PROGRAM, CARE COULD SEEM FRAGMENTED AS PATIENTS/FAMILIES HAD NO CENTRAL "QUARTERBACK" HELPING TO OVERSEE THE BIG PICTURE.THROUGH THE CCP PARENTS NOW HAVE DIRECT PHONE ACCESS TO A COMPLEX CARE SERVICE (CCS) PROVIDER OR RN 24/7. THE CCP TEAM WORKS WITH PARENTS TO CREATE A COMPREHENSIVE "COMPLEX CARE PLAN" THAT IS PLACED IN THE CHILD'S MEDICAL RECORD AND GIVEN TO THE PARENTS. IN ADDITION, THE CCP TEAM COORDINATES INPATIENT INTENSIVE CARE TRANSITIONS PRIOR TO DISCHARGE AND CONDUCTS INTENSIVE OUTPATIENT "BETWEEN-VISIT" CONTACTS (PHONE, CLINIC VISITS, AND IN SOME CASES, HOME VISITS). IN FY15, CCP SERVED 22 CHILDREN AND THEIR FAMILIES.
PLANS FOR FY16: DEVELOPMENT OF A COMPLEX CARE CLINIC AND ENROLL 50 NEWCHILDREN IN THE SERVICE.PROGRESS IN FY16: CCP IS NOW NAMED THE DUKE CHILDREN'S COMPLEX CARE SERVICE (CCS) AND IN FY 16, CCS ESTABLISHED A LONGITUDINAL CLINICAL FOLLOW UP CONTINUUM THAT CONSISTS OF THE COMPLEX CARE CLINIC, INPATIENT ROUNDS, AND DIRECT COMMUNICATION WITH PCP, SPECIALIST AND PATIENT'S GUARDIAN. THE CCS PROVIDES 24/7 AVAILABILITY. IN FY16 DUKE HOSPITAL FUNDED 1.0 MD FTE (DIVIDED AMONGST 3 MDS); 1.0 RN CLINICIAN AND 1.0 PROGRAM COORDINATOR (IN COLLABORATION WITH DUKE-NPCC). IN FY 16, CCS EXPANDED TO A STATEWIDE REPRESENTATION (WITH SIGNIFICANT REACH TOWARD CENTRAL AND EASTERN NC). CCS HAS EXPERIENCED A REDUCTION IN ED VISITS AND SUBSTANTIAL HOSPITAL STAY REDUCTION. THE PATIENT EXPERIENCE INCLUDED HOME VISITS, CONCURRENT AND PALLIATIVE CARE AND FAMILY CARE CONFERENCES. PLANS FOR FY17: PLANS INCLUDE NEW PATIENT SERVICES, A MOBILE APP FOR COMPLEX CARE PLANS, TELEHEALTH, AND PROGRAM EXPANSION WITH A TARGET OF SERVING 100 PATIENTS IN FY17.PROGRESS IN FY17: THE CCS PROGRAM CONTINUED TO DEVELOP ADDITIONAL RESOURCES FOR THE CHILDREN, FAMILIES, AND PROVIDERS SERVED BY THE PROGRAM AND CONTINUED TO WORK ON EXPANSION PLANS FOR THE PROGRAM.
DUKE - DURHAM FOSTER CARE CLINIC PROGRAM IS A HIGHLY EFFECTIVE PARTNERSHIPBETWEEN DUKE AND DURHAM COUNTY. IN SEPTEMBER OF 2013 THE DUKE CHILD ABUSE AND NEGLECT MEDICAL EVALUATION CLINIC (CANMEC) PARTNERED WITH DURHAM COUNTY DEPARTMENT OF SOCIAL SERVICES (DSS) TO FORMALIZE A FOSTER CARE CLINIC. THIS CLINIC PROVIDES THE INITIAL SCREENING AND COMPREHENSIVE HEALTH ASSESSMENT ACCORDING TO THE AAP STANDARDS FOR CHILDREN IN FOSTER CARE IN DURHAM. CHILDREN RECEIVE A COMPREHENSIVE MEDICAL EVALUATION INCLUDING COMPLETE PHYSICAL EXAM, MEDICAL RECORD REVIEW AS WELL AS SCREENING FOR DENTAL, DEVELOPMENTAL, MENTAL HEALTH, AND SOCIAL CONCERNS. UNMET MEDICAL NEEDS ARE IDENTIFIED AND THE CLINIC IDENTIFIES A MEDICAL HOME; ARRANGES MEDICAL, MENTAL HEALTH, AND SOCIAL REFERRALS; PROVIDES FOLLOW UP CARE UNTIL A MEDICAL HOME IS ESTABLISHED; AND SUPPORTS SOCIAL WORKERS WITH NAVIGATING THE COMPLEX HEALTH SYSTEM.CHILDREN IN DURHAM COUNTY FOSTER CARE WHO HAVE COMPLETED A COMPREHENSIVE ASSESSMENT AT THE DUKE FOSTER CARE CLINIC ARE CURRENT ON IMMUNIZATIONS, ARE ENROLLED IN A MEDICAL HOME, ARE REFERRED FOR MENTAL HEALTH TREATMENT IF NEEDED, AND ARE HAVING THEIR ONGOING MEDICAL, DEVELOPMENTAL AND SOCIAL NEEDS ADDRESSED. THE DUKE-DURHAM FOSTER CARE CLINIC SERVES ALL CHILDREN IN THE FOSTER CARE SYSTEM IN DURHAM COUNTY. UNFORTUNATELY, THE NEED FOR THIS CLINIC CONTINUES TO GROW EACH YEAR.PLANS FOR FY16: ENABLE DSS SOCIAL WORKER TO BE ABLE TO CONTACT FOSTER PARENT(S) REGARDING UPCOMING MEDICAL APPOINTMENTS, AND FOLLOW UP WITH FOSTER PARENT(S) IN THE EVENT OF A CANCELATION AND TO RESCHEDULE THE CHILD FOR PRIMARY CARE AND SPECIALTY VISITS; ASSIST CANMEC AND PCP EXCHANGE MEDICAL AND PSYCH-SOCIAL PATIENT INFORMATION; PROVIDE PCP WITH A TOOL BOX FOR ASSESSING AT RISK KIDS.PROGRESS IN FY16: THE DURHAM DEPARTMENT OF SOCIAL SERVICES UTILIZED DUKE'S CLINICAL DECISION SUPPORT AND ELECTRONIC ALERT SYSTEM (COACH) TO MANAGE OVER 300 CHILDREN'S MEDICAL APPOINTMENTS. THROUGH THE USE OF COACHS' TARGETED MESSAGING SOCIAL SERVICE WORKERS WERE ABLE TO RECEIVE ADVANCE NOTIFICATION OF EACH CHILD'S MEDICAL APPOINTMENT AND ASSIST THE FOSTER PARENT IN GETTING TO THE APPOINTMENT. PLANS FOR FY17: ESTABLISH A REGISTRY FOR AGES 0-2 TO ASSIST PCP AND FOSTER PARENT IN SCHEDULING AND ATTENDING WELL CHILD VISITS AND IMMUNIZATIONS.
PROGRESS IN FY17: CONTINUED TO PROVIDE LINKAGES FOR DURHAMCOUNTY DEPARTMENT OF SOCIAL SERVICES TO MANAGE HEALTHCARE SERVICES FOR CHILDREN IN THE FOSTER CARE SYSTEM.
SOUTHERN HIGH SCHOOL WELLNESS CENTER PROVIDES COMPREHENSIVE PRIMARY CAREAND MENTAL HEALTH SERVICES AT SOUTHERN HIGH SCHOOL TO STUDENTS AT THE SCHOOL AND IS OPEN TO ALL STUDENTS AND STAFF OF DURHAM PUBLIC SCHOOLS. OPERATED BY DUKE'S DIVISION OF COMMUNITY HEALTH ON BEHALF OF DUH, THE SOUTHERN HIGH SCHOOL WELLNESS CENTER WILL CELEBRATE ITS 20TH ANNIVERSARY IN 2016. IN FY15 THE SOUTHERN HIGH SCHOOL WELLNESS CENTER HAD TO SCALE BACK HOURS DUE TO STAFFING ISSUES, BUT STILL COMPLETED 188 PATIENT VISITS.PLANS FOR FY16: CONTINUE PRIMARY CARE AND MENTAL HEALTH SERVICES; CONTINUE NUTRITIONAL COUNSELING; ENROLL 520 NEW STUDENTS. ADD SERVICES FOR FACULTY AND STAFF OF THE SCHOOL AND EMPLOYEES OF DURHAM PUBLIC SCHOOLS.PROGRESS IN FY16: THE SOUTHERN HIGH SCHOOL (SHS) WELLNESS CENTER CELEBRATED ITS 20TH ANNIVERSARY IN APRIL OF 2016. THE CENTER CONTINUED TO STRUGGLE WITH STAFFING ISSUES IN EARLY FY16 BUT, CONTINUED TO INCREASE ITS ENROLLMENT AND BEGAN OUTREACH TO SERVE SCHOOL STAFF AND EMPLOYEES OF DURHAM PUBLIC SCHOOLS.PLANS FOR FY17: SECURE FULL-TIME CLINICIAN AND RESTORE PATIENT CARE SCHEDULE TO FIVE DAYS A WEEK. ROLL OUT THE SPARCS (STRUCTURED PSYCHOTHERAPY FOR ADOLESCENTS RESPONDING TO CHRONIC STRESS) PROGRAM TO INCLUDE ADDITIONAL GROUPS AND EXPAND THE PROGRAM TO SERVE NORTHERN HIGH SCHOOL. PARTNER WITH THE DURHAM COUNTY DEPARTMENT OF PUBLIC HEALTH TO EXPLORE THE FEASIBILITY OF PLACING A REGISTERED DIETICIAN IN THE CLINIC.PROGRESS IN FY17: EXPANDED SPARCS PROGRAM TO NORTHERN HIGH SCHOOL AND DEVELOPED A PLAN TO PLACE A DURHAM COUNTY DEPARTMENT OF PUBLIC HEALTH REGISTERED DIETICIAN IN THE SHS WELLNESS CENTER TO SEE CLIENTS. KEY FINDINGS OF THE 2-YEAR STUDENT SATISFACTION SURVEY RESULTS SHOW 62% OF THE RESPONDENTS REPORTED HAVING NO USUAL SOURCE OF CARE OUTSIDE OF THE SHS WELLNESS CENTER, 71% OF THE VISITS TO THE CENTER INVOLVED SICK CARE OR INJURY CARE, 14% SAID THEY WOULD HAVE NOT RECEIVED CARE WITHOUT THE CENTER, 9% SAID THEY WOULD HAVE GONE TO THE EMERGENCY DEPARTMENT. THE MEAN OVERALL SATISFACTION WITH THE CENTER WAS 4.9 OUT OF A POSSIBLE 5.DURHAM CHILD HEALTH ASSESSMENT AND PREVENTION PROGRAM (CHAPP) WAS CREATED TO CLOSE GAPS IN ACCESS FOR CHILDREN WHO HAVE MISSED PREVENTIVE VISITS. IN ADDITION, THE PROGRAM SEEKS TO RECONNECT THESE CHILDREN AND THEIR FAMILIES TO SUPPORTIVE MEDICAL HOMES. TOGETHER, DUH THROUGH THE DUKE DIVISION OF COMMUNITY HEALTH, THE DURHAM COUNTY DEPARTMENT OF PUBLIC HEALTH, AND DURHAM PUBLIC SCHOOLS CONVERTED THREE DUH ELEMENTARY SCHOOL BASED HEALTH CENTERS AND OPENED TWO ADDITIONAL ONES UTILIZING ENHANCED ROLE REGISTERED NURSES (ERRNS) TO DELIVER WELL-CHILD CARE TO CHILDREN WHO ARE OVERDUE FOR THEIR WELL-CHILD CHECKUPS. THE FIVE SCHOOLS ARE IN AREAS OF THE COUNTY THAT DEMONSTRATE SIGNIFICANT GAPS IN PEDIATRIC CARE AND THE CHAPP CLINICS OPERATE AS SATELLITES OF THE DURHAM COUNTY DEPARTMENT OF PUBLIC HEALTH. DUH CONTINUES TO SUPPORT MENTAL HEALTH SERVICES AT ALL FIVE OF THE SITES AND PROVIDES MEDICAL BACK UP.PLANS FOR FY16: FY16 WILL BE THE FIRST FULL YEAR OF OPERATION FOR CHAAP. IT IS ANTICIPATED THAT THE PROGRAM WILL REDUCE THE COST OF WELL-CHILD VISITS WHILE EXPANDING ACCESS TO PHYSICIANS FOR COMPLEX ACUTE AND CHRONIC NEEDS BY ENSURING THAT BOTH ENHANCED ROLE NURSES AND PRIMARY CARE PHYSICIANS ARE WORKING AT THE TOP OF THEIR LICENSES. CHAPP EVALUATION METRICS WILL INCLUDE: NUMBER OF WELL CHILD CARE VISITS; NUMBER OF CHILDREN REFERRED TO A MEDICAL HOME; NUMBER OF VACCINATIONS ADMINISTRATED; NUMBER OF DENTAL, HEARING, VISION REFERRALS; AND FINANCIAL INPUTS AND OUTPUTS TO DETERMINE FISCAL EFFICACY, SUSTAINABILITY, AND IDEALLY, EXPANSION OPPORTUNITIES.PROGRESS IN FY16: CHAAP WAS RENAMED HEALTHY FUTURES. IN THE FOURTH QUARTER OF FY 16, HEALTHY FUTURES WAS FULLY STAFFED AND OPERATIONAL. THREE ENHANCED ROLE NURSES STAFFED FIVE DURHAM ELEMENTARY SCHOOL CLINICS AND PROVIDED THREE HUNDRED WELL CHILD VISITS OF WHICH 50% OF THE CHILDREN DID NOT HAVE A MEDICAL HOME PRIOR TO THEIR HEALTHY FUTURES VISIT. OTHER NOTABLE RESULTS INCLUDE:- 57% OF CHILDREN RECEIVED A VACCINE DURING THEIR VISIT AND 90% OF THOSE VACCINATIONS WERE A REQUIRED VACCINE TO CATCH UP TO THE AGE APPROPRIATE VACCINE SCHEDULE- 30% OF CLIENTS SAID THEIR MAIN REASON FOR CONTACTING HEALTHY FUTURES WAS THAT THEY WERE UNABLE TO GET AN APPOINTMENT WITH THEIR PEDIATRICIAN AND 15% STATED APPOINTMENT WAIT TIME WAS TOO LONG- REASON FOR REFERRAL: 33% ACUTE CONCERN, 29% CHRONIC CARE, 14% DENTAL CONCERN, 10% FAILED VISION SCREEN, 9% BEHAVIORAL CONCERN- REASON FOR CHRONIC CARE REFERRAL: OBESITY 20%, BLOOD PRESSURE 33%, DIABETES 7%, ASTHMA 7%PLANS FOR FY17: CONTINUE OUTREACH EFFORTS TO INCREASE THE NUMBER OF CHILDREN SERVED.PROGRESS IN FY17: HEALTHY FUTURES CONTINUED OUTREACH EFFORTS AND PROVIDED WELL-CHILD VISITS AND CONNECTIONS TO MEDICAL HOMES FOR CHILDREN THAT DID NOT HAVE A CONSISTENT CONNECTION TO A MEDICAL HOME.
JUST FOR US (JFU) PROVIDES IN-HOME CARE PROGRAM FOR LOW-INCOME,FRAIL ELDERLY AND DISABLED. JFU WAS LAUNCHED IN 2002 AS A COLLABORATION OF DUKE, LINCOLN COMMUNITY HEALTH CENTER, DURHAM DEPARTMENT OF SOCIAL SERVICES (DSS), THE LOCAL AREA MENTAL HEALTH ENTITY, AND THE DURHAM HOUSING AUTHORITY. DUH PROVIDES THE MAJORITY OF ONGOING SUPPORT FOR THE PROGRAM. THROUGH JUST FOR US, AN INTERDISCIPLINARY TEAM OF PROVIDERS SERVES CLIENTS IN THEIR HOMES, PROVIDING MEDICAL CARE, MANAGEMENT OF CHRONIC ILLNESSES, AND CASE MANAGEMENT. EACH PARTICIPANT RECEIVES A HOME VISIT EVERY 5 WEEKS UNLESS THERE IS AN ACUTE EPISODE OR A HOSPITAL DISCHARGE, FOR WHICH A VISIT IS SCHEDULED IMMEDIATELY. VISITS INCLUDE MEDICATION RECONCILIATION, SOCIAL ISSUES, SUPPORT SERVICES, CHRONIC DISEASE MANAGEMENT, AND POST-HOSPITAL CARE. THE HEALTH CARE TEAM CONSISTS OF A CLINICAL PROVIDER (PA, NP OR MD), OCCUPATIONAL THERAPIST, REGISTERED DIETITIAN, SOCIAL WORKER, PHLEBOTOMIST, AND COMMUNITY HEALTH WORKER. IN FY15, JUST FOR US TRANSITIONED TO EPIC (ELECTRONIC MEDICAL RECORD SYSTEM) AND EXPERIENCED THE TYPICAL DECREASE IN PRODUCTIVITY ASSOCIATED WITH SUCH TRANSITIONS. IN ADDITION, JUST FOR US LOST ONE OF ITS TEAM MEMBERS CAUSING A FURTHER REDUCTION IN THE ABILITY TO PROVIDE SERVICES. IN FY15 JUST FOR US COMPLETED 841 PATIENT ENCOUNTERS.PLANS FOR FY16: ENROLL 112 NEW PATIENTS; EXPAND GEOGRAPHY OF SERVICE TO OUTSIDE OF THE EXISTING SERVICE SITES BUILDINGS; ESTABLISH PROVIDER LINKAGE AND SUPPORT TO PATIENTS OF THE HOMELESS SHELTER AND THE DUKE CONGESTIVE HEART FAILURE (CHF) CLINIC.PROGRESS IN FY16: CONTINUED CHRONIC CARE AND TRANSITIONAL CARE HOME VISITS TO DISABLED AND LOW INCOME PATIENTS; MONTHLY ENROLLMENT AVERAGED 275 PATIENTS AND OVER 1200 ENCOUNTERS. JFU UTILIZES A CO-MANAGEMENT PROTOCOL WITH DURHAM PRIMARY CARE PRACTICES. PLANS FOR FY17: EXPAND THIS MODEL BY IMPLEMENTING A CO-MANAGEMENT PROTOCOL WITH DUKE'S CHF CLINIC. HIRE A FULL-TIME CLINICIAN AND DEVELOP CHRONIC CARE MANAGEMENT AND TRANSITIONAL CARE MANAGEMENT PROTOCOLS WITH THE JFU REGISTERED NURSE.PROGRESS IN FY17: JFU EXPERIENCED SIGNIFICANT STAFFING SHORTFALLS AS RECRUITING AND HIRING A DEDICATED CLINICIAN TOOK MUCH LONGER THAN ANTICIPATED.
NEIGHBORHOOD/COMMUNITY CLINICS: DUH IN PARTNERSHIP WITH LINCOLN COMMUNITYHEALTH CENTER COLLABORATIVELY OPERATES THREE COMMUNITY HEALTH CLINICS; THE LYON PARK COMMUNITY CLINIC, THE WALLTOWN NEIGHBORHOOD CLINIC AND THE HOLTON WELLNESS CENTER. THE CLINICS WERE DESIGNED TO PROVIDE PRIMARY CARE, HEALTH EDUCATION, AND DISEASE PREVENTION TO THE UNDERSERVED POPULATIONS OF DURHAM. THE CLINICS PROVIDE MEDICAL CARE FOR PERSONS WITH AND WITHOUT HEALTH INSURANCE. THOSE WITHOUT INSURANCE ARE SEEN BASED ON A SLIDING FEE SCALE. NO PATIENT IS DENIED CARE BASED ON INABILITY TO PAY FOR SERVICES. THE LYON PARK CLINIC WAS THE FIRST OF THE COLLABORATIVE NEIGHBORHOOD CLINICS, OPENING ITS DOORS FOR PATIENT CARE IN APRIL 2003. THE WALLTOWN CLINIC OPENED IN JANUARY 2005 AND THE HOLTON CLINIC OPENED IN AUGUST 2009. EACH CLINIC RECEIVED START-UP FUNDS THROUGH A DUKE ENDOWMENT GRANT. CLINICS GENERATE REVENUE THROUGH A CONTRACT WITH LINCOLN COMMUNITY HEALTH CENTER AND RECEIVE SIGNIFICANT SUPPORT FROM DUH. THE CLINICS OPERATE AS FAMILY MEDICINE PRACTICES AND ARE OPEN 5 DAYS A WEEK. STAFFING INCLUDES PHYSICIAN ASSISTANTS, NURSE PRACTITIONERS AND FAMILY PHYSICIANS, WHO SERVE AS SUPERVISING DOCTORS. EACH CLINIC IS SUPPORTED BY NURSING STAFF: CERTIFIED NURSING ASSISTANTS, LICENSED PRACTICAL NURSES, OR CERTIFIED MEDICAL ASSISTANTS AND A STAFF ASSISTANT. THE STAFF ASSISTANT PERFORMS ALL ADMINISTRATIVE TASKS FOR THE CLINIC INCLUDING ANSWERING INCOMING PHONE CALLS, REGISTRATION, SCHEDULING, ETC. IN FY2015, THE COMMUNITY CLINICS TRANSITIONED TO EPIC (ELECTRONIC MEDICAL RECORD SYSTEM) AND EXPERIENCED THE TYPICAL DECREASE IN PRODUCTIVITY ASSOCIATED WITH SUCH TRANSITIONS. IN FY15, THE CLINICS COMPLETED 11,000 PATIENT VISITS. PLANS FOR FY16: PROVIDE 15,000 PATIENT ENCOUNTERS; CONTINUE THE BREAST AND CERVICAL CANCER PREVENTION PROGRAM FOR UNINSURED WOMAN; CONTINUE HEALTH DEPARTMENT HIV/STD SCREENING PROGRAM; CONTINUE EVENING CLINIC HOURS.PROGRESS IN FY16: THE CLINICS EXPERIENCED SOME STAFFING ISSUES THROUGHOUT FY16, BUT WERE ABLE TO PROVIDE PRIMARY CARE TO 5,404 UNIQUE PATIENTS WITH 12,000 ENCOUNTERS. THE COMMUNITY CLINICS CONTINUE TO HOUSE A DURHAM HEALTH DEPARTMENT HIV/STD SCREENING PROGRAM. IN ADDITION, A PEDIATRIC/ADOLESCENT CLINIC WAS LAUNCHED AT HOLTON AND LYON PARK TWO DAYS A WEEK. THE CLINICS TRANSITIONED THE BREAST AND CERVICAL CANCER CONTROL PROGRAM TO LINCOLN COMMUNITY HEALTH CENTER TO STREAMLINE THE SERVICE FOR PATIENTS. PLANS FOR FY17: EXPAND ADOLESCENT CLINIC AND MENTAL HEALTH SERVICES BY PROVIDING 16,000 PRIMARY CARE VISITS; CONTINUE HIV/STD SCREENING PROGRAM AND LAUNCH ON-DEMAND TELE-BEHAVIORAL HEALTH CONSULT SERVICE WITH LINCOLN COMMUNITY HEALTH CENTER.PROGRESS IN FY17: THE CLINICS CONTINUED TO EXPERIENCE STAFFING SHORTFALLS THROUGHOUT FY17, BUT WERE ABLE TO CONDUCT 12,078 PRIMARY CARE VISITS. THE STAFFING SHORTFALLS HAMPERED PLANNED EFFORTS TO EXPAND CLINIC OFFERINGS.
2. MENTAL HEALTH AND SUBSTANCE ABUSE INITIATIVESAN ESTIMATED 17,000 RESIDENTS OF DURHAM COUNTY NEED MENTAL HEALTH TREATMENT AND 19,000 NEED SUBSTANCE USE TREATMENT. ALCOHOL IS THE PRIMARY SUBSTANCE ABUSED BY DURHAM COUNTY RESIDENTS SEEKING CRISIS DETOXIFICATION SERVICES AND BY ADOLESCENTS IN DURHAM'S MIDDLE AND HIGH SCHOOLS. RESPONDENTS IN THE COMMUNITY HEALTH OPINION SURVEY IDENTIFIED ADDICTION TO ALCOHOL, DRUGS OR PRESCRIPTION PILLS AS THE NUMBER ONE COMMUNITY HEALTH PROBLEM. DUH HAS PARTNERED WITH AND SUPPORTS A NUMBER OF COLLABORATIVE INITIATIVES TO IMPROVE ACCESS TO MENTAL HEALTH SERVICES AND REDUCE SUBSTANCE ABUSE.PROJECT LAZARUS, IN CONJUNCTION WITH COMMUNITY CARE OF NORTH CAROLINA (CCNC) AND DUH, SEEKS TO REDUCE OPIOID-RELATED OVERDOSES; OPTIMIZE TREATMENT OF CHRONIC PAIN; AND MANAGE SUBSTANCE ABUSE ISSUES RELATED TO OPIOIDS. THE CORE COMPONENTS OF THE PROJECT LAZARUS MODEL ARE: 1) PUBLIC AWARENESS, 2) COALITION ACTION, AND 3) DATA & EVALUATION. STRATEGIES OF THE MODEL INCLUDE: COMMUNITY EDUCATION; PROVIDER EDUCATION; HOSPITAL ED POLICIES; DIVERSION CONTROL; PAIN PATIENT SUPPORT; HARM REDUCTION; ADDICTION TREATMENT. DUH IS A KEY PARTNER IN SUPPORTING THE FOLLOWING ACTIVITIES:- COMMUNITY COALITIONS: DURHAM CRISIS COLLABORATIVE; PARTNERSHIP FOR A HEALTHY DURHAM SUBSTANCE USE/ AND MENTAL HEALTH COMMITTEE AND DURHAM TOGETHER FOR RESILIENT YOUTH.- NALOXONE OUTREACH: PHARMACIES (DUKE SOUTH, CLINIC PHARMACY, MAIN STREET, GURLEY'S, JOSEF'S, & DUKE CANCER SPECIALTY); DURHAM COUNTY DEPARTMENT OF PUBLIC HEALTH; DURHAM MOBILE CRISIS UNIT. - PROVIDER EDUCATION: PROVIDER TOOLKITS AND CME EDUCATION; USE OF PAIN AGREEMENTS; USE OF CONTROLLED SUBSTANCE REPORTING SYSTEM (CSRS); CHRONIC PAIN PROVIDER CONSULTATION CALLS. - DIVERSION CONTROL: PERMANENT DROP BOXES IN 5 OF 6 COUNTIES (DURHAM, FRANKLIN, PERSON, GRANVILLE, & VANCE).- CHRONIC PAIN PATIENT SUPPORT: CHRONIC PAIN SELF-MANAGEMENT WORKSHOPS; CHRONIC PAIN MANAGEMENT RESOURCES; KEY COMMUNITY PRESENTATIONS. FY15 ACCOMPLISHMENTS INCLUDE:
- 62 NALOXONE KITS PROVIDED TO PHARMACIES- 7 CLINICS WITH PROVIDERS PRESCRIBING NALOXONE- 35 PROVIDERS RECEIVED CME TRAINING FOR PROJECT LAZARUS- 6 MONTHLY CHRONIC PAIN TELEPHONE CONSULTATIONS FOR PRIMARY CARE PROVIDERS HELD REACHING 20 PROVIDERS- 20 PATIENTS RECEIVED CHRONIC DISEASE SELF-MANAGEMENT EDUCATION (STANFORD MODEL)- 120 PHARMACIES RECEIVED ANNOUNCEMENT FOR CME TRAINING OPPORTUNITIES- 50 PROVIDERS RECEIVED INFORMATION ON CHRONIC PAIN RESOURCES AND TELEPHONE CONSULTATION AT NORTHERN PIEDMONT COMMUNITY CARE (NPCC) BI-ANNUAL MEETING SESSION- 180 PROVIDER EDUCATIONAL HANDOUTS DISSEMINATED- 70 REFERRALS FOR CHRONIC PAIN RESOURCES- 60 PATIENT REMINDER CALLS FOR DUH -DOC PAIN CLASSES- 5 PATIENTS TO COMPLETE 8 WEEK DUH - DOC PAIN CLASSPLANS FOR FY16: LAUNCH AN INTEGRATED CARE ASSESSMENT AND SCREENING PROGRAM FOR MEDICAID AND UNINSURED ADULT PATIENTS IN A DURHAM HIGH VOLUME ADULT CLINIC THAT SCREENS FOR DEPRESSION, ANXIETY, SUBSTANCE ABUSE AND CHRONIC TRAUMA; CONTINUE PROJECT LAZARUS AND DISTRIBUTION OF NALOXONE KITS THROUGH PRIMARY CARE PHYSICIANS (PCPS), PHARMACIES, COMMUNITY PARTNERS AND COMMUNITY MENTAL HEALTH/SUBSTANCE ABUSE PROVIDERS; CONTINUE PROVIDER EDUCATION, DIVERSION CONTROL, COMMUNITY COALITIONS AND CHRONIC PAIN SUPPORT.PROGRESS IN FY16: - NALOXONE NALOXONE DISTRIBUTION EFFORTS CONTINUE WITHIN THE COMMUNITY AND LOCAL PHARMACIES. IN JUNE 2016, THE STATE HEALTH DIRECTOR SIGNED A STATEWIDE STANDING ORDER FOR NALOXONE DISPENSING. NC DHHS HAS SET UP A WEBSITE WHERE PHARMACIST AND THE PUBLIC CAN ACCESS MORE INFORMATION ABOUT THE STANDING ORDER. THE WEBSITE IS WWW.NALOXONESAVES.ORG. PHARMACIES CAN GO TO THE WEBSITE AND SIGN ON TO DISPENSE UNDER STATEWIDE STANDING ORDER. THE DUKE- NPCC CHRONIC PAIN COORDINATOR WORKED WITH NPCC'S PHARMACY PROGRAM SPECIALIST TO REACH OUT TO LOCAL PHARMACIES IN THE NETWORK. APPROXIMATELY NINETY FIVE (95) PHARMACIES RECEIVED THE FAX THAT INCLUDED A COPY OF THE STANDING ORDER, A ONE-PAGER EXPLAINING THE STANDING ORDER FOR MEDICAID PHARMACIST AND PROVIDERS, AND THE CHRONIC PAIN COORDINATOR'S CONTACT INFORMATION. OUT OF THE 95 PHARMACIES 78 WERE LISTED IN DURHAM. DUKE - NPCC IN PARTNERSHIP WITH THE SUBSTANCE USE/ MENTAL HEALTH SUBCOMMITTEE OF THE PARTNERSHIP FOR A HEALTHY DURHAM WILL CONDUCT OUTREACH TO THE 78 PHARMACIES TO ASSIST THEM WITH REGISTERING ON WWW.NALOXONESAVES.ORG.
- SUBSTANCE USE AND MENTAL HEALTH COMMITTEE (SUMH)OF THE PARTNERSHIP FOR A HEALTHY DURHAMIN ADDITION TO WORKING ON NALOXONE OUTREACH TO PHARMACIES, SUMH IS ALSO WORKING ON A PROVIDER RESOURCE MANUAL TO BE IN LINE WITH THE NETWORK OF CARE WEBSITE RESOURCES AS WELL AS A USER-FRIENDLY HARD COPY VERSION TO DISSEMINATE THROUGHOUT THE DUHS.- PROJECT LAZARUS (PL) KITS CONTINUE TO BE DISSEMINATED IN THE COMMUNITY AT LOCAL PHARMACIES. TO DATE APPROXIMATELY 60 KITS WERE PROVIDED TO PHARMACIES UPON REQUEST. NUMBERS MAY VARY GOING FORWARD AS A RESULT OF THE STATEWIDE NALOXONE STANDING ORDER IN PLACE AND LOCAL PHARMACIES DISPENSING FDA APPROVED NASAL NARCAN 4MG INTRANASAL SPRAY. - CHRONIC PAIN SELF-MANAGEMENT (CPSMP) WORKSHOPSTHE CPSMP WORKSHOPS CONTINUE TO TAKE PLACE AT LINCOLN COMMUNITY HEALTH CENTER AND CONTINUE TO BE SUCCESSFUL. NINE SIX WEEK WORKSHOPS WERE HELD IN FY16, WITH APPROXIMATELY 130 PEOPLE REACHED IN THE WORKSHOPS. IN ADDITION TO THE WORKSHOPS, A CPSMP LEADER TRAINING WAS CONDUCTED OCTOBER 2016. AS A RESULT OF THE TRAINING, SIX NEWLY TRAINED LEADERS WILL IMPLEMENT WORKSHOPS UNDER THE DUKE NORTHERN PIEDMONT COMMUNITY CARE LICENSE. THE DUKE-NPCC CHRONIC PAIN COORDINATOR WILL OVERSEE THE CPSMP LEADERS EFFORTS AND PROVIDE SUPPORT AND INSTRUCTION ON STANFORD'S MODEL FOR CPSMP. - COMMUNITY CARE OF NORTH CAROLINA CHRONIC PAIN INITIATIVE TASK FORCE THROUGH THE WORK OF THE CCNC CHRONIC PAIN INITIATIVE (CPI) TASK FORCE (DUKE), THE COMMUNITY CARE OF NORTH CAROLINA PROVIDER TOOLKIT HAS BEEN UPDATED WITH MORE RESOURCES AND TOOLS. IN ADDITION, THE TASK FORCE IS WORKING ON THE DEVELOPMENT OF A CME ON SAFE OPIOID PRESCRIBING FOR OUR PROVIDERS TO EDUCATE ON THE LATEST GUIDELINES FROM THE NC MEDICAL BOARD AND THE CENTERS FOR DISEASE CONTROL AND PREVENTIONS RELATING TO OPIOID SAFETY AND CHRONIC PAIN MANAGEMENT.- CHRONIC PAIN TELEPHONE CONSULTATIONS WITH PAIN SPECIALIST PAIN CONSULTS ARE CONTINUING WITH OUTREACH AND AWARENESS EFFORTS TO INFORM PROVIDERS OF THIS RESOURCE. TO DATE THERE HAVE BEEN APPROXIMATELY 15 OF 17 PHONE CONSULTS WITH 32 PROVIDERS PARTICIPATING ON THE CALLS. PCPS, NPS, AND BEHAVIORAL HEALTH PROVIDERS PARTICIPATE.PLANS FOR FY17:
IN COLLABORATION WITH THE PARTNERSHIP OF A HEALTHY DURHAM'S SUBSTANCE USEAND MENTAL HEALTH COMMITTEE, PHARMACY OUTREACH WILL BE IMPLEMENTED IN THE COMMUNITY TO INCREASE AWARENESS OF THE STATEWIDE NALOXONE STANDING ORDER AS WELL AS ASSISTANCE WITH REGISTERING AT WWW.NALOXONESAVES.ORG. TO PARTICIPATE UNDER THE STANDING ORDER AND FOR THOSE WHO REGISTER, SIGNAGE WILL BE OFFERED TO PUT UP IN THEIR PHARMACY TO SHOW THAT NALOXONE IS AVAILABLE IN THAT PARTICULAR PHARMACY. WORK WITH THE CPI TASK FORCE WILL RESULT IN MORE RESOURCES BEING MADE AVAILABLE IN THE PROVIDER TOOLKIT AND A CME FOR PROVIDERS TO LEARN MORE ABOUT SAFE OPIOID PRESCRIBING. THE PROVIDER TOOLKIT WILL BE MADE AVAILABLE ONLINE. CHRONIC PAIN CONSULT CALLS WILL CONTINUE WITH EXPANDED OUTREACH TO ENGAGE BEHAVIORAL HEALTH PROVIDERS WHO ARE TREATING CHRONIC PAIN PATIENTS.PROGRESS IN FY17: COORDINATED AND CO-HOSTED A SYMPOSIUM FOR MORE THAN 150 PROVIDERS ON SAFE OPIOID PRESCRIBING WITH THE NORTH CAROLINA MEDICAL BOARD AND THE GOVERNOR'S INSTITUTE ON SUBSTANCE ABUSE. COLLABORATED ON THE CREATION OF THE MENTAL HEALTH AND SUBSTANCE USE TREATMENT RESOURCES IN DURHAM AND SURROUNDING COUNTIES GUIDE. SIX HUNDRED AND FIFTY COPIES OF THE GUIDE WERE PROVIDED TO MEDICAL PRACTICES, HOSPITAL DEPARTMENTS AND COMMUNITY-BASED ORGANIZATIONS. A WEB-BASED VERSION OF THE GUIDE WILL BE MADE AVAILABLE IN LATE FY18. CONDUCTED FIVE 6-WEEK CHRONIC PAIN SELF-MANAGEMENT COURSES (STANFORD MODEL) AT LINCOLN COMMUNITY HEALTH CENTER. CONTINUED CHRONIC PAIN CONSULT CALLS.HOMEBASE: IS AN INTEGRATED MODEL OF PRIMARY CARE AND MENTAL HEALTH DELIVERED BY A DUALLY-TRAINED PA AND SUPPORTED BY THE DUH OUTPATIENT CLINIC (DOC). THE GOALS OF THE PROGRAM ARE TO IMPROVE CARE AND OUTCOMES FOR DOC PATIENTS WITH CO-MORBID MENTAL HEALTH CONDITIONS; ENCOURAGE AND ENABLE PATIENTS TO SEEK SERVICES AT THE DOC FIRST AND NOT THE ED; REINVENT A CARE TEAM MODEL AT DOC TO INCREASE PATIENT-PROVIDER CONTINUITY, PROVIDER ACCOUNTABILITY FOR PATIENT OUTCOMES, USE OF BEST PRACTICE; AND IMPROVE TRANSITIONS OF CARE FROM HOSPITAL AND ED SETTINGS TO CLINIC AND HOME, PARTICULARLY FOR HIGH UTILIZER (HU) PATIENTS. DURING ITS LAST TWO PILOT YEARS, HOMEBASE SERVED 44 PATIENTS DECREASING THEIR EMERGENCY DEPARTMENT USE BY 53% AND THEIR HOSPITALIZATIONS BY 36%.PLANS FOR FY16: CONTINUE ENROLLMENT OF HIGH RISK PATIENTS WITH A GOAL OF 100 CARE PLANS.PROGRESS IN FY16: IN FY 16 HOMEBASE CONTINUED SERVING AN EXTREMELY MEDICALLY COMPLEX PANEL OF DUKE MEDICAL OUTPATIENT CLINIC (DOC) PATIENTS SERVING OVER 150 WITH INTENSIVE COMPLEX CARE MANAGEMENT. IN THE SECOND HALF OF FY 16 AN INTEGRATED CARE SCREENING AND BRIEF COUNSELING PROGRAM WAS LAUNCHED WITH 2 FTE LICENSED CLINICAL SOCIAL WORKERS FUNDED BY DUKE-NPCC. EVERY PATIENT WHO SCREENS POSITIVE ON PHQ 9 (DEPRESSION SCREEN) WILL NOW RECEIVE ANXIETY, SUBSTANCE ABUSE AND TRAUMA SCREENS AND COUNSELING. PLANS FOR FY17: PLANS FOR FY 17 ARE TO CONTINUE HOMEBASE, THE DOC CLINIC WIDE BEHAVIORAL HEALTH SCREENING AND ADD PEER TO PEER SUPPORT TO THE INTEGRATED BEHAVIORAL HEALTH TEAM. PROGRESS IN FY17: IN ADDITION TO CONTINUING SUPPORT FOR THE HOMEBASE PROGRAM, DUH IS NOW SUPPORTING AN EXPANSION (HOMEBASE PLUS) OF CLINIC-BASED CARE MANAGEMENT AND INCREASED WALK-IN CAPACITY TO PROVIDE ON-SITE ACUTE ILLNESS AND OTHER CARE FOR HIGH-NEED PATIENTS WITH CHRONIC ILLNESSES WHO EXPERIENCE FREQUENT EXACERBATIONS SO THAT THE CLINIC CAN SERVE AS A CAPABLE AND APPROPRIATE ALTERNATIVE TO THE ED FOR SOME OF THE MOST COMMON PRESENTING COMPLAINTS.DUHS SAFE OPIOID TASK FORCE WAS CREATED TO IMPROVE THE SAFETY OF PAIN MANAGEMENT BY ENCOURAGING CLINICAL PRACTICE STANDARDIZATION, WHERE CLINICALLY APPROPRIATE, WHEN OPIOID THERAPY IS DESIGNATED FOR TREATMENT. THE OPIOID SAFETY TASK FORCE PROVIDES RECOMMENDATIONS FOR THE INITIATION AND MANAGEMENT OF OPIOID THERAPY ACROSS DUKE UNIVERSITY HEALTH SYSTEM (DUHS) TO IMPROVE PERSONAL AND COMMUNITY SAFETY AND REDUCE HARM ASSOCIATED WITH THE HIGH RISK TREATMENTS WHILE ENGAGING PATIENTS IN THEIR OWN CARE. DUH ALONG WITH DUKE REGIONAL AND DUKE RALEIGH HOSPITALS SERVES AS A PIVOTAL PLAYER IN ALL ASPECTS OF THE WORK OF THE TASK FORCE. OVER THE LAST TWO YEARS, ALL THREE HOSPITALS ENGAGED IN THE STANDARDIZATION OF NC MEDICAL BOARD GUIDELINES; HELPED TO DEVELOP 12 SMARTPHRASES DEVELOPED IN EPIC; CREATED 12 PATIENT EDUCATION VIDEOS; AND PROVIDED 35 ADVANCED PRACTITIONERS EDUCATION ON PAIN MANAGEMENT & SAFE OPIOID PRESCRIBING.PLANS FOR FY16: CONDUCT PROVIDER EDUCATION WITH EVERY PRIMARY CARE, SPECIALTY CARE AND HOSPITAL SERVICE UNIT ADOPTING AND PRACTICING THE POLICY; OPERATIONALIZE SYSTEM TO TRACK AND MONITOR PROVIDERS ADHERENCE TO POLICY; CONTINUE MONTHLY PROVIDER LEARNING COLLABORATIVE WITH PAIN CLINIC. PROGRESS IN FY16: THE OPIOID TASK FORCE IS CONTINUING TO UPDATE THE INTAKE AND CHRONIC PAIN FOLLOW UP FORMS IN DUKE'S ELECTRONIC HEALTH RECORD (EHR) AND THE TASK FORCE LIAISONS ARE CONTINUING OUTREACH TO CLINICS. PLANS FOR FY17: DEVELOP AN OPIOID NOTE AND SMARTSET AS AN ADDITIONAL OPTION TO EXISTING FLOWSHEETS AND AS A METHOD TO ELIMINATE DUPLICATE DOCUMENTATION. PLAN AND PILOT IMPROVEMENTS TO NORTH CAROLINA CONTROLLED SUBSTANCE REPORTING SYSTEM (NCCSRS). CONTINUE TO PROVIDE OUTREACH AND OFFER TECHNICAL ASSISTANCE TO CLINICS.PROGRESS IN FY17: WORKED WITH THE NC PRESCRIPTION DRUG MONITORING PROGRAM LEADERSHIP TO INTEGRATE THE SUBSTANCE ABUSE REPORTING SYSTEM INTO DUKE'S EHR. CREATED AND DISTRIBUTED ROUTINE ELECTRONIC COMMUNICATIONS FROM HOSPITAL LEADERSHIP, AS WELL AS AN OPIOID SAFETY NEWSLETTER THAT COVERS A RANGE OF TOPICS FROM REGULATORY ISSUES TO HOW-TO GUIDES FOR INTERPRETING A URINE DRUG SCREEN AND LOCATING PATIENT EDUCATION RESOURCES.3. OBESITY AND CHRONIC ILLNESS INITIATIVESFOUR OF THE 10 LEADING CAUSES OF DEATH IN NORTH CAROLINA ARE RELATED TO OBESITY: HEART DISEASE, TYPE 2 DIABETES, STROKE AND SOME KINDS OF CANCER. OVERWEIGHT AND OBESITY WERE THE SECOND LEADING CAUSES OF PREVENTABLE DEATH IN NORTH CAROLINA IN 2010. OBESITY RATES CONTINUE TO RISE ACROSS ALL AGES, GENDERS AND RACIAL/ETHNIC GROUPS IN DURHAM COUNTY. THE MOST RECENT COMBINED OBESITY AND OVERWEIGHT RATES ARE: ADULTS, 65%; DURHAM PUBLIC SCHOOL HIGH SCHOOL STUDENTS, 32%, AND ENTERING KINDERGARTENERS, 19%. DIABETES IS THE 7TH LEADING CAUSE OF DEATH IN DURHAM COUNTY AND 8% OF ADULTS HAVE DIABETES.BULL CITY FIT IS A COMMUNITY-BASED WELLNESS PROGRAM AND IS PART OF THE LARGER DUKE CHILDREN'S HEALTHY LIFESTYLES PROGRAM. THE HEALTHY LIFESTYLES PROGRAM SEEKS TO ADDRESS WEIGHT-RELATED HEALTH PROBLEMS FOR CHILDREN BY OFFERING CARING PROVIDERS, FAMILY-CENTERED TREATMENT PROGRAMS, HIGHLY TRAINED EDUCATORS AND RESEARCHERS, AND STRONG COMMUNITY PARTNERSHIPS. BULL CITY FIT HELPS IN THIS EFFORT BY OFFERING FREE EVENING AND WEEKEND ACTIVITY SESSIONS FOR THE LARGER COMMUNITY. THESE SESSIONS COVER VARIOUS THEMES THAT ENCOURAGE AND PROMOTE ACTIVE LIVING, SUCH AS FITNESS GAMES, SPORT LESSONS, EXERCISE ROUTINES, SWIMMING, COOKING, AND GARDENING. EACH ACTIVITY IS FACILITATED WITH THE SUPPORT OF ENERGETIC STAFF AND VOLUNTEERS TO CREATE A POSITIVE AND FUN ENVIRONMENT FOR ALL. BULL CITY FIT EMPOWERS THE WHOLE FAMILY TO INCREASE KNOWLEDGE AND PRACTICE OF PHYSICAL ACTIVITY AND HEALTHY EATING; ADDRESS CURRENT WEIGHT-RELATED ILLNESS AND PREVENT CHRONIC DISEASE THROUGH INCREASED ACTIVITY LEVELS; IMPROVE QUALITY OF LIFE BY PROMOTING HEALTHY BEHAVIORS; INCREASE CONFIDENCE, SUPPORT POSITIVE CHANGE, AND BUILD A LIFELONG COMMITMENT TO A HEALTHY LIFESTYLE.PARTNERS INCLUDE: DURHAM PARKS AND RECREATION; DURHAM CITY GOVERNMENT; DURHAM COUNTY DEPARTMENT OF PUBLIC HEALTH; EAST DURHAM CHILDREN'S INITIATIVE; LINCOLN COMMUNITY HEALTH CENTER; COMMUNITY NUTRITION PARTNERSHIP; VEGGIE VAN; BLUE POINTE YOGA; DURHAM PUBLIC SCHOOLS; PARTNERSHIP FOR A HEALTHY DURHAM; DUKE SERVICE LEARNING; DUKE FAMILY MEDICINE; DUKE CHILDREN'S HOSPITAL AND THE UNC SCHOOL OF SOCIAL WORK.DUH ALSO SUPPORTS INITIATIVES THROUGH THE NEIGHBORHOOD CLINICS, SCHOOL-BASED HEALTH CENTERS, JFU AND THE DUKE OUTPATIENT CLINIC (ALL DESCRIBED EARLIER IN THIS DOCUMENT) THAT TARGET CHRONIC ILLNESS.PLANS FOR FY16: CONTINUE TO COLLABORATE AND LOOK FOR OPPORTUNITIES TO EXPAND THE PROGRAMS.PROGRESS IN FY16: IDENTIFIED INCREASING RATES OF NON ALCOHOLIC FATTY LIVER (NAFL) DISEASE DUE PRIMARILY TO AN INCREASE IN- OBESITY, SUGARY DIET, SEDENTARY LIFESTYLE. PLANS FOR FY17: ORGANIZE AND LAUNCH A DURHAM-WIDE EDUCATION CAMPAIGN TO INFORM COMMUNITY OF NAFL DISEASE AND ITS LONG TERM HEALTH REPERCUSSIONS. CONTINUE TO EXPAND THE BULL CITY FIT PROGRAM.
PROGRESS IN FY17: BULL CITY FIT CONTINUED TO GROW AS AN INTEGRATEDMODEL OF CHILD OBESITY TREATMENT, LEVERAGING THE STRENGTHS OF DUKE'S HIGH-QUALITY HEALTH CARE AND DURHAM'S EXTENSIVE PARKS SYSTEM AND RECREATION CENTERS. KEY SUPPORT FOR THE PROGRAM IS PROVIDED BY THE DUKE ENDOWMENT, THE DURHAM DEPARTMENT OF PARKS AND RECREATION, THE DEPARTMENT OF PEDIATRICS, THE DUKE CLINICAL RESEARCH INSTITUTE, AND THE DUKE CENTER FOR CHILDHOOD OBESITY RESEARCH. PRELIMINARY EVALUATION DATA HAS SHOWN HIGH LEVELS OF ENGAGEMENT WITH RACIALLY-DIVERSE AND LOW-INCOME FAMILIES, AND A RECENTLY PUBLISHED PROSPECTIVE TRIAL HAS DEMONSTRATED IMPROVEMENTS IN CHILD PHYSICAL ACTIVITY, FITNESS, AND QUALITY OF LIFE. BULL CITY FIT HAS TWO ONGOING STUDIES FUNDED BY THE DUKE ENDOWMENT AND AMERICAN HEART ASSOCIATION TO TEST IMPLEMENTATION AND OUTCOMES EFFECTIVENESS.4. HIV AND SEXUALLY TRANSMITTED INFECTIONSSEXUALLY TRANSMITTED INFECTIONS MAY LEAD TO PREMATURE DEATH AND DISABILITY AND CAN RESULT IN SIGNIFICANT HEALTH CARE COSTS. CHLAMYDIA, GONORRHEA, AND SYPHILIS ARE THE THREE MOST COMMON SEXUALLY TRANSMITTED INFECTIONS (STIS) IN NORTH CAROLINA AND DURHAM COUNTY. ALTHOUGH HIV IS NOT AS COMMON, DURHAM RANKS FOURTH HIGHEST IN NORTH CAROLINA, WITH AN AVERAGE RATE OF HIV DISEASE (29.9 PER 100,000) WELL ABOVE THE STATE RATE (16.4 PER 100,000).WHILE DUH THROUGH THE PROGRAMS DESCRIBED IN THIS DOCUMENT SUPPORTS MECHANISMS TO ADDRESS HIV AND SEXUALLY TRANSMITTED INFECTIONS, IT DOES NOT INCLUDE SPECIFIC STRATEGIES IN THIS PLAN TO ADDRESS THE RATE OF HIV AND SEXUALLY TRANSMITTED INFECTIONS, BECAUSE CONSIDERABLE WORK IS ALREADY BEING DONE THROUGH ORGANIZATIONS WITHIN THE COMMUNITY. THROUGH THE PARTNERSHIP FOR A HEALTHY DURHAM, THE HIV/STI ADVISORY COUNCIL BRINGS TOGETHER COMMUNITY MEMBERS AND AGENCIES TO FOCUS ON STRATEGIES TO PREVENT THE SPREAD OF SYPHILIS AND HIV/AIDS. IN ADDITION, LINCOLN COMMUNITY HEALTH CENTER OPERATES AN EARLY INTERVENTION CLINIC FOR PATIENTS WITH HIV/AIDS AT THE DURHAM COUNTY HEALTH DEPARTMENT. PLANS FOR FY16: DUH WILL CONTINUE TO PARTNER WITH THE MANY ORGANIZATIONS WORKING ON ADDRESSING HIV AND SEXUALLY TRANSMITTED INFECTIONS. DUH WILL ALSO BE A KEY PARTNER IN THE SOON TO LAUNCH DURHAM KNOWS PUBLIC HEALTH CAMPAIGN DESIGNED TO INCREASE ROUTINE HIV TESTING; INCREASE EARLY DIAGNOSIS OF HIV-INFECTED PERSONS AND ENHANCE LINKAGES TO CARE FOR INDIVIDUALS WHO ARE HIV POSITIVE.PROGRESS IN FY16: DUH CONTINUED TO WORK WITH THE MANY ORGANIZATIONS WORKING ON ADDRESSING HIV AND SEXUALLY TRANSMITTED INFECTIONS AND INTRODUCED HIV SCREENING INTO THE COMMUNITY CLINICS AS NOTED EARLIER IN THIS DOCUMENT.PLANS FOR FY17: CONTINUE HIV SCREENING IN THE COMMUNITY CLINICS AND CONTINUE TO SUPPORT THE EFFORTS OF THE DURHAM KNOWS CAMPAIGN.PROGRESS IN FY17: DUH, THROUGH THE DUKE DIVISION OF COMMUNITY HEALTH, CONTINUED TO SUPPORT THE COMMUNITY CLINICS AND THE EFFORTS OF THE DURHAM KNOWS CAMPAIGN. 5. POVERTYPEOPLE WITH HIGHER INCOMES, MORE YEARS OF EDUCATION, AND A HEALTHY AND SAFE ENVIRONMENT TO LIVE IN HAVE BETTER HEALTH OUTCOMES AND GENERALLY HAVE LONGER LIFE EXPECTANCIES. IN DURHAM COUNTY, 16.6% OF INDIVIDUALS LIVE IN POVERTY. FEMALE SINGLE-PARENT FAMILIES ARE DISPROPORTIONATELY AT RISK FOR POVERTY THAN MARRIED COUPLE FAMILIES (41.5% TO 8.7%) AND 40.6% OF FEMALE SINGLE-PARENT FAMILIES WITH RELATED CHILDREN UNDER 18 YEARS ARE LIVING IN POVERTY. NEARLY ONE-HALF OF DURHAM'S RENTERS ARE PAYING 30% OR MORE OF THEIR INCOME FOR HOUSING.DURHAM'S BULL CITY CONNECTOR IS A FARE-FREE CONNECTOR BUS SERVICE THAT CONTINUOUSLY LOOPS THROUGH STOPS FROM DOWNTOWN DURHAM ALL THE WAY TO THE DUKE HOSPITAL, DUKE CLINICS, AND DUKE EYE CENTER CAMPUSES. ON AVERAGE, BULL CITY CONNECTOR BUSES ACCUMULATE 1,500 RIDERS EVERY WEEKDAY AND COMPLETE THEIR LOOPS IN 17 MINUTE INTERVALS. SAFE AND EFFECTIVE TRANSPORTATION IS A KEY CORRELATE IN HEALTH AND ECONOMIC WELL-BEING. THE BULL CITY CONNECTOR HAS PROVEN TO BE AN ASSET FOR DUKE EMPLOYEES, STUDENTS, AND PATIENTS.SSI/SSDI OUTREACH, ACCESS AND RECOVERY (SOAR): HELPS PATIENTS WHO ARE CHRONICALLY HOMELESS, OR AT RISK OF HOMELESSNESS ACCESS HEALTH INSURANCE, A STABLE INCOME, AND MEDICAL CARE BY ASSISTING THESE INDIVIDUALS IN APPLYING FOR SUPPLEMENTAL SECURITY INCOME (SSI) AND SOCIAL SECURITY DISABILITY INSURANCE (SSDI). THE HOMELESS POPULATION AND THOSE REENTERING THE COMMUNITY FROM AN INSTITUTION FACE NUMEROUS CHALLENGES IN ACCESSING SERVICES. APPROVAL ON INITIAL SSI AND SSDI APPLICATIONS FOR THESE AT-RISK POPULATIONS, WHO HAVE NO ONE TO ASSIST, IS ABOUT 10-15 PERCENT. FOR THOSE WITH MENTAL ILLNESS, SUBSTANCE ABUSE ISSUES, AND/OR CO-COGNITIVE IMPAIRMENT, THE APPLICATION PROCESS IS EVEN MORE DIFFICULT. EVEN WITH ASSISTANCE, THE APPLICATION PROCESS CAN TAKE UP TO SIX MONTHS. THROUGH SOAR, THESE INDIVIDUALS WITH COMPLEX NEEDS ARE PROVIDED CASE MANAGEMENT FOR HOME, HOSPITAL, AND CLINIC VISITS; PROVIDED WITH A STEP BY STEP EXPLANATION AND COMPLETION OF ALL APPLICATIONS FOR FEDERAL DISABILITY BENEFITS; RECEIVE EXPEDITED APPLICATIONS FOR MONTHLY INCOME AND MEDICAID/MEDICARE; AND LINKED TO COMMUNITY RESOURCES. DUH CURRENTLY FUNDS TWO SOAR CASE MANAGERS WHO HAVE SUCCESSFULLY HELPED MORE THAN 100 PATIENTS IN THE LAST 3 YEARS. PLANS FOR FY16: CONTINUE AND EXPAND THE SOAR PROGRAMPROGRESS IN FY16: 152 INDIVIDUALS WERE ENROLLED IN SSI/SSDI OUTREACH, ACCESS AND RECOVERY SOAR. LATCH RURAL HEALTH WAS ADDED AS A GRANT FUNDED PROGRAM WHICH EXPANDED THE DURHAM SOAR PROGRAM AND ASSISTED IN COMPLETING SOAR APPLICATIONS FOR RESIDENTS IN TIER-1 COUNTIES SURROUNDING DURHAM. PLANS FOR FY17: CONTINUE SOAR PROGRAMPROGRESS IN FY17: 264 INDIVIDUALS WERE ENROLLED IN THE SOAR PROGRAM AND SCREENED FOR ELIGIBILITY. THE TEAM MAINTAINED A WAITLIST LIST AVERAGING AROUND 60 INDIVIDUALS WHO WOULD MOST LIKELY MEET FEDERAL DISABILITY CRITERIA AND THUS ELIGIBLE FOR DUH SOAR SERVICES. THE TWO PERSON TEAM AVERAGED 5 APPLICATIONS PER MONTH AND MAINTAINED A 90% APPROVAL RATE FOR THE YEAR WHICH EXCEEDS THE STATEWIDE SOAR APPROVAL RATE OF 79%. BENEFITS ENROLLMENT COUNSELING (BEC). IN FY 16 THE DIVISION OF COMMUNITY HEALTH LAUNCHED THE BENEFITS ENROLLMENT COUNSELING PROGRAM (BEC) WITH GRANT FUNDING THROUGH THE NATIONAL COUNCIL ON AGING TO HELP SENIORS AND THOSE WITH DISABILITIES AND A LIMITED INCOME, FIND AND ENROLL IN ALL THE BENEFITS PROGRAMS FOR WHICH THEY ARE ELIGIBLE. THE GOAL OF THE SERVICE IS TO ENABLE OLDER ADULTS TO ENJOY LIFE AND LIVE INDEPENDENTLY IN THEIR HOMES AND COMMUNITIES FOR AS LONG AS POSSIBLE. FOR THOSE WITH LIMITED INCOME AND RESOURCES, ADDITIONAL SUPPORT CAN BE CRITICAL IN MAINTAINING THEIR HEALTH AND AVOIDING COSTLY HOSPITALIZATIONS. THE BENEFITS PROVIDE CLIENTS SERVED WITH ACCESS TO HEALTHY FOOD, NEEDED MEDICAL CARE AND PRESCRIPTIONS, AS WELL AS OTHER SUPPORTIVE SERVICES. THE BENEFITS ALSO PROVIDE A COMMUNITY ECONOMIC STIMULUS, AS BENEFITS ARE SPENT LOCALLY IN PHARMACIES, GROCERY STORES, UTILITY COMPANIES, AND HEALTH CARE PROVIDERS. TO INCREASE THE REACH OF THE PROGRAM BEYOND GRANT FUNDING, BEC STAFF TRAIN VOLUNTEERS (FROM PARTNER COMMUNITY BASED ORGANIZATIONS AND DUKE) TO ASSIST CLIENTS IN DURHAM, GRANVILLE AND PERSON COUNTIES. PROGRESS IN FY17: BEC SCREENED 1,340 INDIVIDUALS. 1,199 OF THOSE INDIVIDUALS WERE ELIGIBLE TO RECEIVE ASSISTANCE FROM BEC TO FIND AND APPLY TO SUPPORTIVE BENEFITS PROGRAMS. BEC ASSISTED THESE INDIVIDUALS IN COMPLETING 4,773 BENEFIT APPLICATIONS.DURHAM MEDICAL RESPITE PROGRAM IS A PILOT PROGRAM FOR HOMELESS PATIENTS THAT EMANATED OUT OF THE WORK OF PADC (NOTED EARLIER IN THIS PLAN) IN 2014. THE MEDICAL RESPITE PILOT PROGRAM OPERATES 24/7 AND PROVIDES PARTICIPANTS WITH CLEAN AND SAFE HOUSING WHICH WILL MEET THE STANDARDS THAT HOSPITALS USE WHEN PLANNING FOR DISCHARGE TO HOME. DEPENDING ON PARTICIPANT NEEDS AND DEMOGRAPHICS, POTENTIAL SITES INCLUDE TRANSITIONAL HOUSING (JUST A CLEAN HOUSE), MOTELS, OR HEALING WITH CAARE, INC. PER DIEM HOUSING. ROOM AND BOARD IS FUNDED BY DURHAM COUNTY DEPARTMENT OF PUBLIC HEALTH THROUGH A CONTRACT WITH PROJECT ACCESS OF DURHAM COUNTY (PADC), ALONG WITH PRIVATE DONATIONS. AS THE PROGRAM BECOMES FULLY OPERATIONAL, EACH PROGRAM PARTICIPANT WILL WORK WITH A TRANSITIONAL NURSE CARE MANAGER (PROVIDED BY DUKE'S DIVISION OF COMMUNITY HEALTH) TO MAXIMIZE THEIR HEALTH AND CONNECT WITH APPROPRIATE COMMUNITY RESOURCES AND SERVICES.
PLANS FOR FY16: ACHIEVE FULL OPERATIONAL STATUS FOR THE PROGRAM ANDCONTINUE TO COLLABORATE ON POTENTIAL EXPANSION OPPORTUNITIES.PROGRESS IN FY16: THE PROGRAM RECEIVED A GRANT FROM THE HILLMAN FOUNDATION TO COVER THE COST OF AN RN CARE MANAGER AND COMMUNITY HEALTH WORKERS. THE PROGRAM SERVED 29 PATIENTS IN FY16. PRIOR TO MEDICAL RESPITE 10 LIVED IN SHELTERS AND 13 WERE UNSHELTERED AND POST-MEDICAL RESPITE 9 RECEIVED TRANSITIONAL HOUSING. SEVENTY FIVE PERCENT OF REFERRALS ORIGINATED FROM DUKE HOSPITAL, DUKE REGIONAL HOSPITAL AND DUKE OUTPATIENT CLINIC. PLANS FOR FY17: CONTINUE THE PROGRAM AND EXPAND REFERRAL SOURCES. PROGRESS IN FY17: EARLY EVALUATION RESULTS OF THE MEDICAL RESPITE PROGRAM DEMONSTRATED POSITIVE IMPACTS FOR PATIENTS SERVED INCLUDING A: 37% REDUCTION IN INPATIENT ADMISSIONS, 70% REDUCTION IN INPATIENT DAYS, AND 192% INCREASE IN OUTPATIENT VISITS. BENEFITS AND SERVICES OBTAINED FOR PARTICIPANTS THROUGH THE MEDICAL RESPITE PROGRAM INCLUDED CONNECTIONS TO PRIMARY CARE SERVICES, MENTAL HEALTH AND/OR SUBSTANCE ABUSE SERVICES, AND ASSISTANCE IN TRANSITIONING TO STABLE HOUSING. 6. EDUCATION QUALITY CHILD CARE AND EARLY EDUCATION PREDICT A CHILD'S FUTURE SUCCESS AND THE ACADEMIC SUCCESS OF YOUNG ADULTS IS STRONGLY LINKED WITH THEIR HEALTH THROUGHOUT THEIR LIFETIME. THE IMPORTANCE OF A HIGH SCHOOL DIPLOMA AND HIGHER EDUCATION CANNOT BE OVERSTATED. COLLEGE GRADUATES AGE 25 AND OVER EARN NEARLY TWICE AS MUCH AS WORKERS WHO ONLY HAVE A HIGH SCHOOL DIPLOMA. THE UNEMPLOYMENT RATE FOR WORKERS WHO DROPPED OUT OF HIGH SCHOOL IS NEARLY FOUR TIMES THE RATE FOR COLLEGE GRADUATES. IN DURHAM COUNTY, THE FOUR-YEAR HIGH SCHOOL GRADUATION RATE IS 79.6% COMPARED TO NORTH CAROLINA'S RATE OF 82.5%. THE OVERALL 4-YEAR COHORT GRADUATION RATE HAS INCREASED BY NEARLY 10% SINCE 2010-11, BUT THERE IS STILL A DISPARITY IN THE PERCENTAGES OF WHITE VERSUS MINORITY STUDENTS WHO ARE GRADUATING FROM HIGH SCHOOL. FOR EXAMPLE, 84.7% OF WHITES GRADUATED IN 2011-2012 COMPARED TO 74.7% OF BLACKS AND 73% OF HISPANIC STUDENTS.LEARNING TOGETHER PROVIDES TRAINING AND OPPORTUNITIES FOR DUKE STUDENTS (LEARNERS) TO PARTICIPATE IN HEALTH-RELATED COMMUNITY SERVICE ACTIVITIES. SERVICE OPPORTUNITIES MAY INCLUDE PROVIDING HEALTH EDUCATION TO ELEMENTARY SCHOOL CHILDREN, HELPING FRAIL SENIORS COMPLETE THE APPLICATION PROCESS FOR FOOD STAMPS, AND CONDUCTING WORKSHOPS TO TEACH PATIENTS HOW TO EFFECTIVELY COMMUNICATE WITH THEIR DOCTOR. THROUGH LEARNING TOGETHER, LEARNERS WORK WITH A VARIETY OF POPULATIONS, EXPERIENCE THE INTERDISCIPLINARY NATURE OF COMMUNITY WORK, AND DEVELOP COMPETENCE FOR WORKING WITH DIVERSE COMMUNITIES AND CULTURES. LEARNERS WHO PARTICIPATE GAIN SKILLS THEY CAN USE TO WORK EFFECTIVELY WITH ANY COMMUNITY. IN FY15 LEARNING TOGETHER TRAINED 126 DUKE LEARNERS WHO IN TURN VOLUNTEERED FOR COMMUNITY SERVICES ACTIVITIES WHICH PROVIDED ASSISTANCE FOR 300 ADULTS AND 1,125 CHILDREN.PLANS FOR FY16: CONTINUE TO OPERATE THE LEARNING TOGETHER PROGRAM WITH A SPECIAL FOCUS ON PARTNERING WITH DURHAM PUBLIC SCHOOLS AND OTHER EDUCATION AND HEALTH AND HUMAN SERVICES ENTITIES.PROGRESS IN FY16: THE LEARNING TOGETHER PROGRAM TRAINED 92 DUKE LEARNERS WHO IN TURN VOLUNTEERED FOR COMMUNITY SERVICES ACTIVITIES WHICH PROVIDED ASSISTANCE FOR 350 ADULTS AND 1200 CHILDREN.PLANS FOR FY17: CONTINUE THE SUCCESSFUL SERVICE-LEANING PARTNERSHIPS WITH DURHAM PUBLIC SCHOOLS AND OTHER EDUCATION AND HEALTH AND HUMAN SERVICE ENTITIES.PROGRESS IN FY17: THE LEARNING TOGETHER PROGRAM PREPARED AND/OR TRAINED 158 DUKE LEARNERS WHO IN TURN VOLUNTEERED FOR COMMUNITY SERVICE ACTIVITIES, PROVIDING HEALTH EDUCATION FOR 400 ADULTS AND 1200 CHILDREN. ADDITIONALLY, LEARNING TOGETHER STAFF CONDUCTED 10 VOCATIONAL/PERSONAL GROWTH SESSIONS FOR DUKE INTERNS AND FACILITATED A TOTAL OF 43 PSYCHOEDUCATIONAL GROUPS (SELF-ESTEEM, STRESS MANAGEMENT, AND COMMUNICATING WITH CONFIDENCE) FOR APPROXIMATELY 381 UNDERSERVED ELEMENTARY AND MIDDLE SCHOOL CHILDREN THROUGHOUT THE DURHAM COMMUNITY.GROUP A - FACILITY 1 - DUKE UNIVERSITY HOSPITALPART V, SECTION B, LINE 16J: DUHS PROVIDES A BROCHURE TO ALL ADMISSIONS THAT INCLUDES A BRIEF SUMMARY OF DUHS FINANCIAL ASSISTANCE POLICIES. DUHS ALSO COMMENTS ON THE BACK OF ITS BILLING INVOICES THAT PATIENTS SHOULD CONTACT PATIENT ACCOUNT REPRESENTATIVES TO HELP THEM IF THEY CANNOT PAY THEIR BILL IN FULL. THIS COMMENT REFERENCES GOVERNMENT-SPONSORED PROGRAMS, MONTHLY PAYMENT PROGRAMS, AND OTHER FINANCIAL ASSISTANCE PROGRAMS AVAILABLE FOR PATIENTS WHO MEET CERTAIN FINANCIAL CRITERIA. DUHS ALSO PUBLICIZED ITS FINANCIAL ASSISTANCE POLICY VERBALLY THROUGH ITS FINANCIAL CARE COUNSELORS.GROUP A - FACILITY 1 - DUKE UNIVERSITY HOSPITALPART V, SECTION B, LINE 24: CERTAIN ELECTIVE COSMETIC/AESTHETICSERVICES, AND OTHER SERVICES NOT COVERED BY INSURANCE, WILL BE BILLEDAT AN AMOUNT EQUAL TO GROSS CHARGES.DUKE RALEIGH HOSPITAL:PART V, SECTION B, LINE 5: DUKE RALEIGH HOSPITAL ("DRAH") COLLABORATEDWITH WAKE COUNTY HUMAN SERVICES, WAKEMED HEALTH AND HOSPITALS, UNC REX HEALTHCARE, ADVANCE COMMUNITY HEALTH, UNITED WAY OF THE GREATER TRIANGLE, AND THE WAKE COUNTY MEDICAL SOCIETY COMMUNITY HEALTH FOUNDATION IN CONDUCTING THE 2016 WAKE COUNTY COMMUNITY HEALTH NEEDSASSESSMENT (CHNA). THE PROCESS OF DETERMINING THE PRIORITY HEALTH NEEDS FOR THE 2016 WAKE COUNTY CHNA BEGAN WITH THE COLLECTION AND ANALYSIS OF HUNDREDS OF DATA POINTS. ALL INDIVIDUAL DATA MEASURES FROM BOTH PRIMARY (NEW) AND SECONDARY (EXISTING) SOURCES WERE GATHERED, ANALYZED, AND INTERPRETED. IN ORDER TO COMBINE DATA POINTS INTO MORE EASILY DISCUSSABLE CATEGORIES, DATA MEASURES WERE SORTED BY COMMON THEMES AND DEVELOPED INTO TWENTY-ONE DATA CATEGORIES.PRIMARY (NEW) DATA COLLECTION: COMMUNITY MEMBERS PROVIDED INPUT FOR THE STUDY THROUGH INTERNET-BASED AND TELEPHONE SURVEYS, FOCUS GROUPS, AND PRIORITIZATION MEETINGS THAT WERE HELD THROUGHOUT THE COUNTY. ADDITIONALLY, KEY LEADERS OF ORGANIZATIONS REPRESENTING BROAD INTERESTS OF THE COMMUNITY PROVIDED INPUT THROUGH AN INTERNET-BASED SURVEY, PARTICIPATION ON THE STEERING COMMITTEE, AND A PRIORITIZATION SURVEY. THE PROCESS ALSO HAD SIGNIFICANT INPUT AND DIRECTION FROM THE COMMUNITY HEALTH ASSESSMENT TEAM. CONSIDERING ALL OF THESE SOURCES, INPUT FROM MORE THAN 1,500 WAKE COUNTY RESIDENTS AND ORGANIZATIONAL LEADERS IS INCLUDED IN THIS COMMUNITY HEALTH NEEDS ASSESSMENT.SECONDARY (EXISTING) DATA: KEY SOURCES FOR EXISTING DATA ON WAKE COUNTY INCLUDED NUMEROUS PUBLIC DATA SOURCES RELATED TO DEMOGRAPHICS, SOCIAL AND ECONOMIC DETERMINANTS OF HEALTH, ENVIRONMENTAL HEALTH, HEALTH STATUS AND DISEASE TRENDS, MENTAL/BEHAVIORAL HEALTH TRENDS, AND MODIFIABLE HEALTH RISKS. FURTHER, SOME LOCAL ORGANIZATIONS PROVIDED INTERNAL DATA THAT WERE ALSO INCORPORATED INTO THE ANALYSIS PROCESS.IN AN EFFORT TO IDENTIFY THE TOP PRIORITIES FOR THE COUNTY, A PRIORITIZATION MATRIX WAS DEVELOPED. THE PRIORITIZATION MATRIX INCLUDED THE FINDINGS FROM THE ANALYSIS OF THE PRIMARY (NEW) AND SECONDARY (EXISTING) DATA, WHICH WERE PRESENTED TO THE STEERING COMMITTEE IN FEBRUARY 2016 AND TO COMMUNITY MEMBERS DURING THE PRIORITIZATION MEETINGS HELD ON MARCH 8, 2016. ADDITIONALLY, STEERING COMMITTEE MEMBERS WERE PROVIDED THE OPPORTUNITY TO COMPLETE AN INTERNET-BASED SURVEY IN WHICH THEY WERE ASKED TO IDENTIFY THE SIGNIFICANCE OF THE NEED FOR EACH OF THE TWENTY-ONE CATEGORIES AS HIGH, MEDIUM, OR LOW. COMMUNITY MEMBERS WERE ASKED TO PROVIDE THE SAME INFORMATION AT THE COMMUNITY PRIORITIZATION MEETINGS. THESE VARIOUS DATA COMPONENTS WERE THEN ANALYZED AND THE RESULTS WERE WEIGHTED AS FOLLOWS:SECONDARY (EXISTING) DATA - WEIGHTED 50 PERCENT; PRIMARY (NEW) DATA - WEIGHTED 50 PERCENT IN TOTAL, AS FOLLOWS: FOCUS GROUP FINDINGS, TELEPHONE SURVEY RESULTS, AND INTERNET-BASED COMMUNITY SURVEY RESULTS - WEIGHTED 20 PERCENT; COMMUNITY PRIORITIZATION MEETING RESULTS - WEIGHTED 20 PERCENT; AND, STEERING COMMITTEE PRIORITIZATION SURVEY RESULTS - WEIGHTED 10 PERCENT.THIS JOINT CHNA AND RELATED IMPLEMENTATION PLAN WERE ADOPTED BY THE DUHS BOARD OF DIRECTORS AND PUBLISHED ON THE DUKE HEALTH WEBSITE IN FISCAL YEAR 2017 (TAX YEAR 2016).DUKE RALEIGH HOSPITAL:PART V, SECTION B, LINE 6A: UNC REX HEALTHCARE, WAKEMED HEALTH AND HOSPITALSDUKE RALEIGH HOSPITAL:PART V, SECTION B, LINE 6B: UNITED WAY OF THE GREATER TRIANGLE, WAKE COUNTY HUMAN SERVICES, ADVANCE COMMUNITY HEALTH AND THE WAKE COUNTY MEDICAL SOCIETY COMMUNITY HEALTH FOUNDATION.DUKE RALEIGH HOSPITAL:PART V, SECTION B, LINE 11: THE FOLLOWING CATEGORIES WERE IDENTIFIED AS THE FOUR PRIORITY AREAS FOR WAKE COUNTY THAT WILL BE ADDRESSED OVER THE NEXT THREE YEARS:
1. HEALTH INSURANCE COVERAGE2. TRANSPORTATION3. ACCESS TO HEALTH SERVICES4. MENTAL HEALTH AND SUBSTANCE ABUSE1. HEALTH INSURANCE COVERAGEACCESS TO HEALTH INSURANCE COVERAGE WAS IDENTIFIED AS ONE OF THE MOST IMPORTANT ISSUES IMPACTING THE QUALITY OF LIFE OF WAKE COUNTY RESIDENTS. THIS ISSUE NOT ONLY ENCOMPASSES THOSE WHO LACK INSURANCE, BUT ALSO THOSE THAT ARE UNDERINSURED AS WELL AS THOSE UNDER GOVERNMENT PROGRAMS SUCH AS MEDICARE AND MEDICAID. CONCERNS WERE ALSO EXPRESSED REGARDING THE COMPLEXITY OF THE HEALTH CARE SYSTEM AND CONFUSION REGARDING HOW HEALTH INSURANCE WORKS. TO ADDRESS THIS PRIORITY DUKE RALEIGH WILL EMPLOY THE FOLLOWING STRATEGY ALONG WITH OUTLINED ACTION ITEMS:CONTINUE TO PROVIDE FINANCIAL ASSISTANCE VIA DUKE UNIVERSITY HEALTH SYSTEM'S CHARITY AND DISCOUNTED CARE POLICIES. THESE POLICIES PROVIDE ELIGIBLE CARE AT A DISCOUNT OR WITHOUT CHARGE TO ALL QUALIFYING PATIENTS WHO DO NOT HAVE HEALTH INSURANCE, OR BECAUSE OF FINANCIAL HARDSHIP CANNOT PAY FOR THE CARE THEY RECEIVE FOR MEDICALLY NECESSARY SERVICES.CONTINUE TO UTILIZE FINANCIAL CARE COUNSELORS TO HELP PATIENTS UNDERSTAND THEIR FINANCIAL RESPONSIBILITIES AND CONNECT PATIENTS WITH COMMUNITY RESOURCES.CONTINUE TO HELP PATIENTS NAVIGATE THROUGH GOVERNMENT SPONSORED FINANCIAL ASSISTANCE PROGRAMS FOR WHICH THEY MAY QUALIFY. CONTINUE TO PROVIDE SUPPORT TO ORGANIZATIONS SUCH AS ALLIANCE MEDICAL MINISTRY AND URBAN MINISTRIES OPEN DOOR CLINIC, WHICH PROVIDES AFFORDABLE HEALTHCARE TO UNINSURED ADULTS IN WAKE COUNTY.CONTINUE TO PROVIDE IN KIND SUPPORT TO PROJECT ACCESS OF WAKE COUNTY, A PRIVATE, NONPROFIT PROGRAM THAT CONNECTS ELIGIBLE UNINSURED CLIENTS TO HIGH QUALITY MEDICAL SERVICES DONATED BY PHYSICIANS. IN FY2017, DUKE RALEIGH HOSPITAL PROVIDED $2.8M OF IN KIND SUPPORT UP FROM $2.2M IN FY2016 TO PROJECT ACCESS OF WAKE COUNTY CLIENTS.CONTINUE TO PROVIDE HEALTH LITERACY COURSE THROUGH OUR CLINICAL EDUCATION DEPARTMENT WHICH EDUCATED OVER 40 CLINICIANS IN FY17. 2. TRANSPORTATIONACCESS TO AND COST OF TRANSPORTATION HAS IMPLICATIONS ON ONE'S HEALTH AS LACK OF TIMELY TRANSPORTATION CAN IMPACT THE ABILITY TO MAKE PHYSICIAN APPOINTMENTS AND OBTAIN PRESCRIPTIONS PARTICULARLY FOR OUR ELDERLY AND MOST DISADVANTAGED RESIDENTS. TO ADDRESS THIS PRIORITY DUKE RALEIGH WILL EMPLOY THE FOLLOWING STRATEGY ALONG WITH THE OUTLINED ACTION ITEMS:CONTINUE TO EMPLOY MULTIDISCIPLINARY APPROACHES WITHIN THE CANCER CENTER TO FACILITATE MULTIPLE APPOINTMENTS IN THE SAME DAY THEREBY REDUCING TRANSPORTATION NEEDS.CONTINUE TO EMPLOY THE DUHS RESOURCE CENTER IN ASSESSING AND ADDRESSING ANY BARRIERS, INCLUDING TRANSPORTATION THAT MAY IMPACT A PATIENT'S ABILITY TO GET TO THEIR FOLLOWUP APPOINTMENT.CONTINUE TO SUPPORT ORGANIZATIONS SUCH AS THE GREATER RALEIGH CHAMBER OF COMMERCE AND MIDTOWN RALEIGH ALLIANCE, WHICH ADVOCATES FOR AN ENHANCED TRANSIT SYSTEM FOR ALL RESIDENTS.CONTINUE TO SUPPORT ORGANIZATIONS SUCH AS THE LUNG CANCER INITIATIVE OF NC, WHICH FUNDS A GAS CARD PROGRAM TO LESSEN THE FINANCIAL BURDEN OF LUNG CANCER PATIENTS SEEKING TREATMENT WHO NEED ASSISTANCE.3. ACCESS TO HEALTH SERVICESACCESS TO HEALTH SERVICES IS KEY TO IMPROVING COMMUNITY HEALTH AND RESIDENTS HEALTH STATUS. THIS PRIORITY RELATES TO THE UTILIZATION OF EXISTING HEALTH FACILITIES, THE EASE OF ACCESSING HEALTH RESOURCES, AND PRIMARY AND PREVENTIVE CARE/SCREENINGS. THIS WAS IDENTIFIED AS A TOP PRIORITY BASED ON FEEDBACK FROM FOCUS GROUPS AND SURVEYS AS WELL AS THE RATE OF PREVENTABLE HOSPITAL STAYS FOR CONDITIONS SUCH AS DIABETES, COPD, ASTHMA, HEART FAILURE, BACTERIAL PNEUMONIA, UTI, AND DEHYDRATION. ALSO, THE COMPLEXITY OF NAVIGATING THE HEALTH CARE SYSTEM, AFFORDABILITY OF HEALTH SERVICES, AND PROVIDER AVAILABILITY AROSE AS KEY CONCERNS RELATED TO ACCESS TO HEALTH SERVICES. DUKE RALEIGH AS WELL AS DUKE HEALTH IS ACTIVELY ENGAGED IN IMPROVING ACCESS TO HEALTH SERVICES FOR ALL RESIDENTS THROUGH STRATEGIC INITIATIVES AS WELL AS THROUGH STRATEGIC COMMUNITY PARTNERSHIPS.DUKE PRIMARY CARE, AN ENTITY OF DUKE UNIVERSITY HEALTH SYSTEM, CONTINUES TO EVALUATE OPPORTUNITIES TO EXPAND ACCESS TO THE GROWING WAKE COUNTY POPULATION, ADDING TWO PRACTICES AND RELOCATING ONE PRACTICE IN FY17.CONTINUE TO IMPROVE THE DISCHARGE PROCESS TO ENSURE THAT DISCHARGED PATIENTS ARE CONNECTED WITH PRIMARY CARE RESOURCES.CONTINUE WORK OF THE DUHS RESOURCE CENTER IN FOLLOWING UP WITH DISCHARGED PATIENTS TO ENSURE THEY ARE SCHEDULED FOR THE APPROPRIATE FOLLOW UP TO REDUCE LIKELIHOOD OF UNNECESSARY READMISSIONS. THIS INCLUDES CONNECTING HOMEBOUND PATIENTS WITHOUT PRIMARY CARE TO ORGANIZATIONS THAT PERFORM HOME VISITS.CONTINUE PARTNERSHIP WITH WAKE EMS AND AREA HOSPITALS ON TRIAGE AND DESTINATION PLAN FOR STROKE PATIENTS.CONTINUE TO PROVIDE IN-KIND LAB SERVICES TO URBAN MINISTRIES OPEN DOOR CLINIC TO FACILITATE THE CARE FOR THOSE WHO LACK ADEQUATE INCOME, INSURANCE COVERAGE, AND OTHER MEANS TO HEALTH SERVICES. IN FY17, THIS IN-KIND DONATION WAS VALUED AT $1.8M.CONTINUE TO PROVIDE DIABETES EDUCATION TO ALLIANCE MEDICAL MINISTRY PATIENTS. THIS EDUCATION IS OFFERED BY CERTIFIED DIABETES EDUCATORS THROUGH DUKE SPECIALTY REHAB SERVICES MIDTOWN. STRENGTHEN SUPPORT OF ALLIANCE MEDICAL MINISTRY AND URBAN MINISTRIES THROUGH INCREASED EMPLOYEE VOLUNTEERISM IN EFFORTS TO EXPAND THEIR CAPACITY AND ABILITY TO SERVE PATIENTS. IN FY17, DUKE RALEIGH HOSTED A DAY OF SERVICE WHERE OVER 30 EMPLOYEES VOLUNTEERED THEIR TIME TO PACK 1,000 LBS OF RICE AND BEANS FOR URBAN MINISTRIES' CLIENT CHOICE FOOD PANTRY. FOR THE PAST TWO YEARS, DUKE RALEIGH EMPLOYEES VOLUNTEERED AT ALLIANCE MEDICAL MINISTRY AS PART OF THE TRIANGLE-WIDE MLK DAY OF SERVICE. DUKE RALEIGH CONTINUES TO EVALUATE OPPORTUNITIES FOR ONE-TIME AND ON-GOING SERVICE OPPORTUNITIES FOR THESE AND OTHER COMMUNITY PARTNERS. CONTINUE PROGRAMS THROUGH THE DUKE SPECIALTY REHAB SERVICES MIDTOWN, WHICH OFFERS A VARIETY OF PROGRAMS DESIGNED TO HELP PEOPLE LOSE WEIGHT AND MAKE HEALTHY LIFESTYLE CHANGES. SERVICES OFFERED INCLUDE PULMONARY REHABILITATION PROGRAMS, PERSONALIZED DIABETES MANAGEMENT PLANS, MULTIDISCIPLINARY THERAPY FOR NEUROLOGICAL DISORDERS, PHYSICAL THERAPY, OCCUPATIONAL THERAPY, SPEECH THERAPY AS WELL AS CARDIOVASCULAR AND STRENGTH TRAINING EQUIPMENT.CONTINUE COMMUNITY EDUCATION, HEALTHY FOCUS SEMINARS WITH EFFORTS TO EXPAND ATTENDANCE TO INCLUDE POPULATIONS THROUGHOUT WAKE COUNTY AS WELL AS A FOCUS ON TOPICS ALIGNED WITH THE NEEDS ASSESSMENT. IN FY2017, WE LAUNCHED THE 11TH YEAR OF THE HEALTH FOCUS EDUCATION SERIES WITH TOPICS INCLUDING, BUT NOT LIMITED TO CANCER, CARDIOVASCULAR DISEASE, AND STROKE.IN FY17, DUKE RALEIGH CONTINUED TO SPONSOR MIDTOWN FARMERS MARKET, WHICH PROMOTES A HEALTHY LIFESTYLE AS WELL AS PROVIDES A VENUE FOR DUKE RALEIGH TO SHARE HEALTHY EDUCATION.EXPAND AND STRENGTHEN COMMUNITY OUTREACH EFFORTS AROUND STROKE, CARDIOVASCULAR DISEASE, DIABETES, CANCER, ORTHOPEDICS AND SPORTS MEDICINE ALONG WITH OUR COMMUNITY PARTNERS. IN FY2017, WE PARTICIPATED AGAIN IN THE 4TH CONGRESSIONAL DISTRICT HEALTH FAIR WHERE OUR STROKE CHAMPIONS PROVIDED HEALTH EDUCATION. 4.MENTAL HEALTH AND SUBSTANCE ABUSEWAKE COUNTY HAS EXPERIENCED AN INCREASE IN THE PREVALENCE AND SEVERITY OF MENTAL HEALTH AND SUBSTANCE USE PROBLEMS. THIS PRIORITY RELATES TO TOBACCO USE/EXPOSURE, ILLEGAL DRUG USE, EXCESSIVE DRINKING, ALCOHOL-IMPAIRED DRIVING DEATHS, SUICIDE RATES, MENTAL HEALTH EMERGENCY DEPARTMENT UTILIZATION AND THE AVAILABILITY OF RESOURCES TO MEET THIS GROWING DEMAND. DUE TO THE SCOPE AND COMPLEXITY OF MENTAL HEALTH AND SUBSTANCE USE ISSUES, A COLLECTIVE AND COLLABORATIVE APPROACH IS NEEDED. BELOW IS A LISTING OF A NUMBER OF INITIATIVES AND COLLABORATIONS THAT DUKE RALEIGH HOSPITAL IS ENGAGED WITH TO HAVE THE GREATEST IMPACT TO ADDRESS THIS ISSUE:CONTINUE TO PARTICIPATE IN THE WAKE COUNTY CRISIS HOSPITAL COLLABORATIVE, WHICH INCLUDES ALL WAKE COUNTY HOSPITALS, REPRESENTATIVES FROM MENTAL HEALTH, LAW ENFORCEMENT AND OTHER STAKEHOLDERS IN CRISIS RESPONSE IN WAKE COUNTY.CONTINUE TO CONVENE TREATMENT TEAM MEETINGS FOR INPATIENTS WHO ALSO HAVE SUBSTANCE USE AND CHRONIC PERSISTENT MENTAL ILLNESS WITH COMPLEX NEEDS. THE TREATMENT TEAM INCLUDES CARE COORDINATORS FROM MENTAL HEALTH AGENCIES, ALLIANCE BEHAVIORAL HEALTH AND OTHER PROVIDERS INVOLVED IN THE PATIENT'S CARE.CONTINUE REGULAR MEETINGS WITH DUKE RALEIGH HOSPITAL CASE MANAGEMENT, ALLIANCE BEHAVIORAL HEALTH, CASE MANAGER WITH COMMUNITY CARE OF WAKE AND JOHNSTON COUNTIES (CCWJC), AND EMS TO ADDRESS BARRIERS TO CARE FOR HIGH RISK PATIENTS AND REDUCE NON-EMERGENT VISITS TO HOSPITALS.CONTINUE TO UTILIZE COMMUNITY CARE OF JOHNSTON & WAKE COUNTIES PORTAL AND THE NORTH CAROLINA CONTROLLED SUBSTANCES REPORTING SYSTEM (CSRS) TO REDUCE NARCOTIC DEPENDENCY AND PREVENT OVERPRESCRIBING.
CONTINUE SUPPORT OF ORGANIZATIONS SUCH AS NATIONAL ALLIANCE ON MENTALILLNESS (NAMI) WAKE COUNTY, WHICH PROVIDES SUPPORT, EDUCATION, AND ADVOCACY FOR PEOPLE WITH MENTAL ILLNESS ALONG WITH THEIR FAMILIES AND FRIENDS.STRENGTHEN SUPPORT OF TRIANGLE FAMILY SERVICES, WHICH FOCUSES ON BUILDING A STRONGER COMMUNITY BY STRENGTHENING THE FAMILY THROUGH FAMILY SAFETY, FINANCIAL STABILITY, AND MENTAL HEALTH. CONTINUE TOBACCO CESSATION SUPPORT FOR EMPLOYEES AND DEPENDENTS THROUGH LIVE FOR LIFE'S STEPS TO HEALTH TOBACCO CESSATION PROGRAM. THIS 12-MONTH COACHING PROGRAM INVOLVES AN INITIAL CONSULTATION TO DEVELOP A QUIT PLAN, THEN FOLLOW-UP CALLS AT ONE, THREE, SIX, AND 12 MONTHS. COACHES PROVIDE ADDITIONAL RESOURCES AND MOTIVATION TO HELP PARTICIPANTS QUIT. ENROLLMENT ALSO INCLUDES ACCESS TO THREE MONTHS OF LOW-COST TREATMENT AT PARTICIPATING DUKE HOSPITAL OUTPATIENT PHARMACIES.DUKE RALEIGH HOSPITAL:PART V, SECTION B, LINE 16J: DUHS PROVIDES A BROCHURE TO ALL ADMISSIONS THAT INCLUDES A BRIEF SUMMARY OF DUHS FINANCIAL ASSISTANCE POLICIES. DUHS ALSO COMMENTS ON THE BACK OF ITS BILLING INVOICES THAT PATIENTS SHOULD CONTACT PATIENT ACCOUNT REPRESENTATIVES TO HELP THEM IF THEY CANNOT PAY THEIR BILL IN FULL. THIS COMMENT REFERENCES GOVERNMENT-SPONSORED PROGRAMS, MONTHLY PAYMENT PROGRAMS, AND OTHER FINANCIAL ASSISTANCE PROGRAMS AVAILABLE FOR PATIENTS WHO MEET CERTAIN FINANCIAL CRITERIA. DUHS ALSO PUBLICIZED ITS FINANCIAL ASSISTANCE POLICY VERBALLY THROUGH ITS FINANCIAL CARE COUNSELORS.DUKE RALEIGH HOSPITAL:PART V, SECTION B, LINE 24: CERTAIN ELECTIVE COSMETIC/AESTHETIC SERVICES, AND OTHER SERVICES NOT COVERED BY INSURANCE, WILL BE BILLED AT AN AMOUNT EQUAL TO GROSS CHARGES.SCHEDULE H, PART V, SECTION BGROUP A - FACILITY 3 - DUKE REGIONAL HOSPITAL:PART V, SECTION B, LINE 5: DUKE REGIONAL HOSPITAL ("DRH") WAS A PARTICIPANT IN THE 2014 DURHAM COMMUNITY HEALTH ASSESSMENT, LED BY PARTNERSHIP FOR A HEALTHY DURHAM. THE ASSESSMENT PROCESS INCLUDED 354 CITIZEN SURVEYS FROM RANDOMLY SELECTED HOUSEHOLDS AND 8 COMMUNITY LISTENING SESSIONS WITH 205 COMMUNITY MEMBERS. REPRESENTATIVES FROM DUKE UNIVERSITY HOSPITAL (DUH) AND DRH PARTICIPATED AS MEMBERS ON THE COMMUNITY HEALTH ASSESSMENT TEAM ALONG WITH REPRESENTATIVES FROM OTHER UNIVERSITIES, LOCAL GOVERNMENT, SCHOOLS, NON-PROFIT ORGANIZATIONS, AND BUSINESSES. THE COMMUNITY HEALTH ASSESSMENT TEAM WORKED TO DIRECT THE ACTIVITIES OF THE ASSESSMENT AND PROVIDE WRITTEN CONTENT AND EXPERTISE ON ISSUES OF INTEREST. THIS JOINT CHNA AND RELATED IMPLEMENTATION PLAN WAS ADOPTED BY THE DUHS BOARD OF DIRECTORS AND PUBLISHED ON THE DUKE HEALTH WEBSITE IN FISCAL YEAR 2016 (TAX YEAR 2015).GROUP A - FACILITY 3 - DUKE REGIONAL HOSPITAL:PART V, SECTION B, LINE 6A: DUKE UNIVERSITY HOSPITALGROUP A - FACILITY 3 - DUKE REGIONAL HOSPITAL:PART V, SECTION B, LINE 6B: THE PARTNERSHIP FOR A HEALTHY DURHAM AND THE DURHAM COUNTY HEALTH DEPARTMENTGROUP A - FACILITY 3 - DUKE REGIONAL HOSPITAL:PART V, SECTION B, LINE 11: THE ASSESSMENT IDENTIFIED SIX HEALTH PRIORITIES FOR 2015-2017:1. OBESITY AND CHRONIC ILLNESS2. POVERTY3. EDUCATION4. ACCESS TO MEDICAL AND DENTAL CARE5. MENTAL HEALTH AND SUBSTANCE ABUSE6. HIV AND SEXUALLY TRANSMITTED INFECTIONSDUKE REGIONAL HOSPITAL CONSIDERS THIS DOCUMENT TO BE A "WORKING PLAN" THAT WILL CONTINUE TO EVOLVE OVER THIS THREE-YEAR PERIOD IN ORDER TO ENSURE THE EFFICACY OF STRATEGIES INTENDED TO MEET EXPRESSED COMMUNITY HEALTH NEEDS. THIS IMPLEMENTATION PLAN DOES NOT CONTAIN DESCRIPTIONS OF THE COMMUNITY HEALTH IMPROVEMENT WORK CARRIED OUT BY OTHER COMPONENTS OF DUKE HEALTH OR DUKE UNIVERSITY. THIS IMPLEMENTATION PLAN REPRESENTS ONLY DUKE REGIONAL HOSPITAL'S CONTINUALLY EVOLVING VARIETY OF PROGRAMS AND ACTIVITIES IN THE SIX PRIORITY AREAS TO IMPROVE HEALTH WITH THE DURHAM COMMUNITY. 1. OBESITY AND CHRONIC ILLNESSLOOK GOOD FEEL BETTER THE AMERICAN CANCER SOCIETY'S LOOK GOOD FEEL BETTER PROGRAM PROVIDES SUPPORT FOR FEMALE CANCER TREATMENT PATIENTS WHO HAVE EXPERIENCED HAIR LOSS OR OTHER PHYSICAL APPEARANCE CHANGES DUE TO CHEMOTHERAPY OR RADIATION TREATMENTS. IN FY 2014, THIS MONTHLY SUPPORT PROGRAM HELPED 58 WOMEN. 2016 GOAL: DUKE REGIONAL WILL CONTINUE TO SUPPORT THE PROGRAM IN 2016 WITH A GOAL OF REACHING 65 PATIENTS. 2016 PROGRESS: 45 WOMEN PARTICIPATED IN THE LOOK GOOD FEEL BETTER PROGRAM HOSTED AT DUKE REGIONAL.2017 GOAL: DUKE REGIONAL WILL CONTINUE TO HOST THE MONTHLY PROGRAM. 2017 PROGRESS: 50 WOMEN PARTICIPATED IN THE LOOK GOOD FEEL BETTER PROGRAM HOSTED AT DUKE REGIONAL.STROKE AWARENESSDUKE REGIONAL OFFERS A MONTHLY STROKE SUPPORT GROUP TO EDUCATE STROKE SURVIVORS, CARE GIVERS AND PEOPLE IN THE COMMUNITY ABOUT STROKE PREVENTION AND STROKE DISABILITIES. APPROXIMATELY, 25 PEOPLE ATTEND THE GROUP EACH MONTH. 2016 GOAL: DUKE REGIONAL WILL CONTINUE TO OFFER A MONTHLY STROKE SUPPORT GROUP. 2016 PROGRESS: DUKE REGIONAL OFFERED A PEER-LED MONTHLY STROKE SUPPORT GROUP WITH APPROXIMATELY 25 PEOPLE PARTICIPATING. 2017 GOAL: CONTINUE TO OFFER A MONTHLY STROKE SUPPORT GROUP WITH A GOAL OF 25 PARTICIPANTS. 2017 PROGRESS: DUKE REGIONAL OFFERED A PEER-LED MONTHLY STROKE SUPPORT GROUP WITH APPROXIMATELY 20 PEOPLE PARTICIPATING. 2. POVERTYFILL THAT BUSEMPLOYEES DONATED BINS OF SCHOOL SUPPLIES TO FILL THAT BUS IN AUGUST 2015 TO SUPPORT DURHAM PUBLIC SCHOOLS. TEACHERS FROM THE HIGHEST POVERTY SCHOOLS WERE INVITED TO PICK OUT SUPPLIES NEEDED IN THEIR CLASSROOMS.SALVATION ARMY ANGEL TREEEACH DECEMBER, EMPLOYEES "ADOPT" 100 CHILDREN FROM DUKE REGIONAL'S SALVATION ARMY ANGEL TREE. CHILDREN IN DURHAM HAVE RECEIVED BIKES, CLOTHING, DOLLS AND TOYS THANKS TO THE GENEROUS DONATIONS. EXTRA GIFTS ARE ALSO DONATED TO THE SALVATION ARMY FOR OTHER NEEDY FAMILIES IN THE AREA.2016 GOAL: DUKE REGIONAL WILL HOST A DRIVE TO BENEFIT UNDERSERVED CHILDREN OR FAMILIES IN OUR COMMUNITY. 2016 PROGRESS: IN AUGUST 2015, DRH DONATED 25 BINS OF CRAYONS, GLUE STICKS, MARKERS, PAPER, PENCILS AND MORE TO THE FILL THAT BUS! CAMPAIGN FOR DURHAM PUBLIC SCHOOLS CLASSROOMS. THE HOSPITAL ALSO "ADOPTED" 100 CHILDREN THROUGH THE SALVATION ARMY ANGEL TREE PROGRAM IN DECEMBER 2015.2017 GOAL: DUKE REGIONAL WILL AGAIN HOST AT LEAST ONE DRIVE TO BENEFIT UNDERSERVED CHILDREN OR FAMILIES IN OUR COMMUNITY. 2017 PROGRESS: DUKE REGIONAL DONATED 40 BINS OF CRAYONS, GLUE STICKS, MARKERS, PAPER, PENCILS AND MORE TO THE CRAYONS2CALCULATORS FILL THAT BUS! CAMPAIGN FOR DURHAM PUBLIC SCHOOLS TEACHERS IN HIGH-NEED AND HIGH-POVERTY AREAS. THE HOSPITAL ALSO GRANTED 100 HOLIDAY WISHES THROUGH THE SALVATION ARMY ANGEL TREE PROGRAM. 3. EDUCATIONHEALTH PROFESSIONS EDUCATIONDUKE REGIONAL IS COMMITTED TO HELPING TRAIN THE HEALTHCARE WORKERS OF THE FUTURE. IN FY 2015, DRH CONTRIBUTED OVER $3 MILLION TOWARD THE TRAINING AND TEACHING OF TOMORROW'S HEALTHCARE PROFESSIONALS. 2016 GOAL: DUKE REGIONAL WILL CONTINUE THAT LEVEL OF SUPPORT IN FY 2016. 2016 PROGRESS: DRH INVESTED $3.4 MILLION IN TEACHING AND TRAINING HEALTHCARE PROFESSIONALS. DRH ALSO PROVIDED OPPORTUNITIES FOR PRE-HEALTH UNDERGRADUATE STUDENTS FROM LOCAL COLLEGES AND UNIVERSITIES TO SHADOW AND VOLUNTEER ALONGSIDE CLINICAL AND CUSTOMER SERVICE STAFF AS AMBASSADORS IN THE EMERGENCY DEPARTMENT, OPERATING ROOM AND WOMEN'S SERVICES.2017 GOAL: DUKE REGIONAL WILL CONTINUE THAT LEVEL OF SUPPORT IN FY 17. 2017 PROGRESS: DRH INVESTED $3.5 MILLION IN TEACHING AND TRAINING HEALTHCARE PROFESSIONALS. DRH ALSO PROVIDED OPPORTUNITIES FOR 70 PRE-HEALTH UNDERGRADUATE STUDENTS FROM LOCAL COLLEGES AND UNIVERSITIES TO SHADOW AND VOLUNTEER ALONGSIDE CLINICAL AND CUSTOMER SERVICE STAFF AS AMBASSADORS IN THE EMERGENCY DEPARTMENT. DRH ALSO PROVIDED AN EIGHT-WEEK JUNIOR VOLUNTEER PROGRAM FOR AREA HIGH SCHOOL STUDENTS TO GAIN CLERICAL AND CUSTOMER SERVICES WORK EXPERIENCES IN A HEALTH CARE SETTING.PROJECT SEARCHDUKE REGIONAL IS THE HOST BUSINESS FOR PROJECT SEARCH, A PARTNERSHIP WITH DURHAM PUBLIC SCHOOLS, OE ENTERPRISES, VOCATIONAL REHAB AND DURHAM CENTER ACCESS THAT PROVIDES CAREER DEVELOPMENT EXPERIENCES TO SENIOR HIGH SCHOOL STUDENTS WITH DEVELOPMENTAL DISABILITIES. THE STUDENTS, ACCOMPANIED BY A TEACHER, TEACHER'S ASSISTANT AND JOB COACHES, COMPLETE INTERNSHIPS IN SEVERAL HOSPITAL DEPARTMENTS DURING THE ACADEMIC YEAR. SIX STUDENTS GRADUATED IN MAY 2015, AND FIVE WERE EMPLOYED IN THE COMMUNITY BY THE END OF THE SUMMER.
2016 GOAL: DUKE REGIONAL WILL CONTINUE TO SERVE AS A HOSTSITE FOR PROJECT SEARCH FOR THE 2015-16 ACADEMIC YEAR. 2016 PROGRESS: MORE THAN 40 STUDENTS HAVE GRADUATED FROM THE PROJECT SEARCH PROGRAM SINCE ITS INCEPTION IN 2011 AND MORE THAN HALF ARE CURRENTLY EMPLOYED IN THE COMMUNITY. 2017 GOAL: DUKE REGIONAL WILL CONTINUE TO SERVE AS A HOST SITE FOR THE 2016-2017 ACADEMIC YEAR. 2017 PROGRESS: DUKE REGIONAL CONTINUED TO SERVE AS A HOST SITE FOR PROJECT SEARCH ADDING 8 NEW GRADUATES BRINGING THE TOTAL NUMBER OF GRADUATES TO 48 SINCE 2011.CITY OF MEDICINE ACADEMYDUKE REGIONAL HAS BEEN A PARTNER WITH CITY OF MEDICINE ACADEMY (CMA) AND DURHAM PUBLIC SCHOOLS SINCE THE PROGRAM'S INCEPTION AT SOUTHERN HIGH SCHOOL IN THE 1990S. IN AUGUST 2011, CMA MOVED TO A NEW FACILITY LOCATED ON THE DUKE REGIONAL CAMPUS. AS PART OF OUR PARTNERSHIP, DUKE REGIONAL HOSTS STUDENTS FOR CLINICAL ROTATIONS AND INTERNSHIPS, PROVIDES CPR TRAINING AND HOSTS THE ANNUAL SENIOR AWARDS NIGHT. 2016 GOAL: DUKE REGIONAL WILL CONTINUE THIS PARTNERSHIP WITH CMA IN FY 2016.2016 PROGRESS: DUKE REGIONAL CONTINUED TO PARTNER WITH CMA, HOSTING STUDENTS THROUGHOUT THE YEAR AND HOSTING THE ANNUAL SENIOR AWARDS NIGHT IN THE HOSPITAL AUDITORIUM. 2017 GOAL: DUKE REGIONAL WILL CONTINUE ITS PARTNERSHIP WITH CMA IN FY 2017. 2017 PROGRESS: DUKE REGIONAL CONTINUED TO PARTNER WITH CMA, PROVIDING VARIOUS LEARNING EXPERIENCES FOR STUDENTS THROUGHOUT THE YEAR.4. ACCESS TO MEDICAL AND DENTAL CARELINCOLN COMMUNITY HEALTH CENTERLINCOLN COMMUNITY HEALTH CENTER (LCHC) IS A FEDERALLY QUALIFIED COMMUNITY HEALTH CENTER THAT PROVIDES PRIMARY CARE SERVICES FOR ABOUT 40,000 PATIENTS EACH YEAR. APPROXIMATELY 80 PERCENT OF LCHC PATIENTS ARE UNINSURED AND LIVING AT OR BELOW THE POVERTY LEVEL. IN ADDITION TO GENEROUS FINANCIAL SUPPORT, DUKE REGIONAL PROVIDES ENGINEERING, ENVIRONMENTAL, LABORATORY, PHARMACY AND RADIOLOGY SERVICES. THE TOTAL DUKE REGIONAL HOSPITAL CONTRIBUTION TO LCHC IN FISCAL YEAR (FY) 2015, INCLUDING MONETARY AND IN-KIND SERVICES, WAS MORE THAN $7.5 MILLION. 2016 GOAL: DUKE REGIONAL WILL CONTINUE THAT LEVEL OF SUPPORT IN FY 2016. 2016 PROGRESS: DUKE REGIONAL CONTRIBUTED $7.4 MILLION IN MONETARY DONATIONS AND IN-KIND SERVICES TO LCHC.2017 GOAL: DUKE REGIONAL WILL CONTINUE THAT LEVEL OF SUPPORT IN FY 17. 2017 PROGRESS: DUKE REGIONAL CONTRIBUTED $7.9 MILLION IN MONETARY DONATIONS AND IN-KIND SERVICES TO LCHC.DURHAM COUNTY EMERGENCY MEDICAL SERVICESDURHAM COUNTY EMERGENCY MEDICAL SERVICES (EMS) SERVES AS THE PRIMARY PROVIDER OF EMERGENCY AMBULANCE SERVICES AND ALTERNATIVE MEDICAL TRANSPORTATION IN DURHAM COUNTY. IN FY 2015, DUKE REGIONAL PAID THE COUNTY MORE THAN $2.3 MILLION TO SUPPORT DURHAM EMS. 2016 GOAL: DUKE REGIONAL WILL CONTINUE THAT LEVEL OF SUPPORT IN FY 2016. 2016 PROGRESS: DRH PAID $2.4 MILLION TO SUPPORT DURHAM COUNTY EMS.2017 GOAL: DRH WILL CONTINUE THAT LEVEL OF SUPPORT IN FY 17. 2017 PROGRESS: DRH PAID $2.4 MILLION TO SUPPORT DURHAM COUNTY EMS.PROJECT ACCESS DURHAM COUNTYPROJECT ACCESS OF DURHAM COUNTY (PADC) COORDINATES SPECIALTY CARE AT NO CHARGE TO UNINSURED AND UNDERINSURED DURHAM RESIDENTS LIVING AT OR BELOW 200 PERCENT OF THE FEDERAL POVERTY LEVEL. THESE RESIDENTS HAVE ACCESS TO PRIMARY HEALTH CARE THROUGH LINCOLN COMMUNITY HEALTH CENTER. 2016 GOAL: DUKE REGIONAL WILL CONTINUE TO PROVIDE OFFICE SPACE AS WELL AS TECHNOLOGICAL SUPPORT FOR PADC IN FY 2016. 2016 PROGRESS: DUKE REGIONAL PROVIDED OFFICE SPACE AND TECHNOLOGICAL SUPPORT TO PROJECT ACCESS DURHAM COUNTY. 2017 GOAL: DUKE REGIONAL WILL CONTINUE THIS LEVEL OF SUPPORT IN FY 17. 2017 PROGRESS: DUKE REGIONAL PROVIDED OFFICE SPACE AND TECH SUPPORT TO PADC IN FY17. CHARITY CAREEACH YEAR DUKE REGIONAL PROVIDES NO-COST OR DISCOUNTED URGENT OR EMERGENT HEALTH CARE SERVICES TO PATIENTS WHO WERE UNABLE TO PAY. IN FY 2015 DUKE REGIONAL PROVIDED $16.7 MILLION IN CHARITY CARE. 2016 GOAL: DUKE REGIONAL WILL CONTINUE TO PROVIDE CHARITY CARE AT A SIMILAR LEVEL IN FY 2016. 2016 PROGRESS: DRH PROVIDED $21.4 MILLION IN CHARITY CARE.2017 GOAL: DUKE REGIONAL WILL CONTINUE TO PROVIDE CHARITY CARE AT A SIMILAR LEVEL IN FY 17. 2017 PROGRESS: DUKE REGIONAL PROVIDED $21.9 MILLION IN CHARITY CARE.5. MENTAL HEALTH AND SUBSTANCE ABUSEDURHAM CENTER ACCESS (OAKLEIGH)EACH YEAR DUKE REGIONAL PROVIDES $100,000 TO SUPPORT DURHAM CENTER ACCESS, AN INPATIENT TREATMENT FACILITY FOR MENTAL HEALTH, DEVELOPMENTAL DISABILITY AND SUBSTANCE ABUSE SERVICES. 2016 GOAL: DUKE REGIONAL WILL CONTINUE THAT LEVEL OF SUPPORT IN FY 2016. 2016 PROGRESS: DRH PROVIDED $100,000 TO DURHAM CENTER ACCESS.2017 GOAL: DRH WILL CONTINUE THAT LEVEL OF SUPPORT IN FY 17. 2017 PROGRESS: DRH PROVIDED $100,000 TO DURHAM CENTER ACCESS.6. HIV AND SEXUALLY TRANSMITTED INFECTIONSDUKE REGIONAL DOES NOT HAVE A SPECIFIC GOAL TO ADDRESS THE RATE OF HIV AND SEXUALLY TRANSMITTED INFECTIONS BECAUSE CONSIDERABLE WORK IS ALREADY BEING DONE THROUGH ORGANIZATIONS WITHIN THE COMMUNITY. THROUGH THE PARTNERSHIP FOR A HEALTHY DURHAM, THE HIV/STI ADVISORY COUNCIL BRINGS TOGETHER COMMUNITY MEMBERS AND AGENCIES TO FOCUS ON STRATEGIES TO PREVENT THE SPREAD OF SYPHILIS AND HIV/AIDS. IN ADDITION, LINCOLN COMMUNITY HEALTH CENTER, WHICH DUKE REGIONAL SUPPORTS, OPERATES AN EARLY INTERVENTION CLINIC FOR PATIENTS WITH HIV/AIDS AT THE DURHAM COUNTY HEALTH DEPARTMENT. FUNDRAISING AND OUTREACHIN ADDITION TO THE ACTIVITIES DESCRIBED IN THE PREVIOUS SECTIONS, DUKE REGIONAL CONDUCTS A NUMBER OF FUNDRAISING AND OUTREACH ACTIVITIES IN THE DURHAM COMMUNITY AND BEYOND. DUKE REGIONAL EMPLOYEES RAISED $31,763 FOR THE FOLLOWING CHARITABLE ORGANIZATIONS IN FY 2015: - DUKE COMMUNITY GIVING $20,906 (INCLUDES UNITED WAY)- UNITED WAY OF THE GREATER TRIANGLE (SEE ABOVE)- AMERICAN HEART ASSOCIATION HEART WALK $10,8572016 GOAL: DUKE REGIONAL WILL RAISE AT LEAST $35,000 FOR LOCAL CHARITIES, INCLUDING DUKE COMMUNITY GIVING/ UNITED WAY OF THE GREATER TRIANGLE, THE AMERICAN HEART ASSOCIATION HEART WALK AND AT LEAST ONE ADDITIONAL COMMUNITY-WIDE FUNDRAISING EFFORT.2016 PROGRESS: DRH RAISED $18,665 THROUGH DUKE'S DOING GOOD IN THE NEIGHBORHOOD CAMPAIGN, WHICH INCLUDES DUKE COMMUNITY GIVING AND UNITED WAY OF THE GREATER TRIANGLE; $8,173 FOR THE AMERICAN HEART ASSOCIATION TRIANGLE HEART WALK; AND $14,316 FOR THE MARCH OF DIMES MARCH FOR BABIES.2017 GOAL: DUKE REGIONAL WILL RAISE AT LEAST $35,000 FOR LOCAL CHARITIES. 2017 PROGRESS: DRH RAISED $15,066 THROUGH DUKE'S DOING GOOD IN THE NEIGHBORHOOD CAMPAIGN, WHICH INCLUDES DUKE COMMUNITY GIVING AND UNITED WAY OF THE GREATER TRIANGLE; $15,333 FOR THE AMERICAN HEART ASSOCIATION TRIANGLE HEART WALK; AND $7,840 FOR THE MARCH OF DIMES MARCH FOR BABIES.THE HOSPITAL CONTINUES TO PARTNER WITH LOCAL NONPROFITS ON ENDEAVORS THAT EDUCATE OUR COMMUNITY ON HEALTH INITIATIVES AND DISPARITIES, AND PROVIDES MEETING SPACE FOR DURHAM AND ORANGE COUNTY'S DOMESTIC VIOLENCE AND SEXUAL ASSAULT PROGRAM, COMMUNITY HEALTH COALITION, AMERICAN CANCER SOCIETY'S LOOK GOOD FEEL BETTER PROGRAM, AND PROJECT ACCESS. IN ADDITION, THE HOSPITAL:-PARTNERED WITH THE AMERICAN RED CROSS TO HOST BLOOD DRIVES, COLLECTING 84 UNITS OF BLOOD FROM 252 DONORS.-MARCHED IN THE NORTH CAROLINA PRIDEFEST PARADE IN SUPPORT OF THE LESBIAN, GAY, BISEXUAL, TRANSGENDER, AND QUEER/QUESTIONING (LGBTQ) COMMUNITY AND SURVEYED ATTENDEES TO IDENTIFY SERVICE GAPS.-DONATED 1,028 POUNDS OF NONPERISHABLE FOOD, CLEANING SUPPLIES, PERSONAL CARE ITEMS AND MORE FOR FAMILIES AFFECTED BY HURRICANE MATTHEW.
GROUP A - FACILITY 3 - DUKE REGIONAL HOSPITALPART V, SECTION B, LINE 16J: DUHS PROVIDES A BROCHURE TO ALL ADMISSIONS THAT INCLUDES A BRIEF SUMMARY OF DUHS FINANCIAL ASSISTANCE POLICIES. DUHS ALSO COMMENTS ON THE BACK OF ITS BILLING INVOICES THAT PATIENTS SHOULD CONTACT PATIENT ACCOUNT REPRESENTATIVES TO HELP THEM IF THEY CANNOT PAY THEIR BILL IN FULL. THIS COMMENT REFERENCES GOVERNMENT-SPONSORED PROGRAMS, MONTHLY PAYMENT PROGRAMS, AND OTHER FINANCIAL ASSISTANCE PROGRAMS AVAILABLE FOR PATIENTS WHO MEET CERTAIN FINANCIAL CRITERIA. DUHS ALSO PUBLICIZED ITS FINANCIAL ASSISTANCE POLICY VERBALLY THROUGH ITS FINANCIAL CARE COUNSELORS.PART V, SECTION B, LINE 24: CERTAIN ELECTIVE COSMETIC/AESTHETIC SERVICES, AND OTHER SERVICES NOT COVERED BY INSURANCE, WILL BE BILLED AT AN AMOUNT EQUAL TO GROSS CHARGES.
FieldValueIRS element (for citing)
Facility3FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (3 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
1 - HOSPICE OF MEADOWLANDS
1001 CORPORATE DRIVEHILLSBOROUGHNC27278HOSPICE
2 - HOCK FAMILY PAVILION
4023 NORTH ROXBORO ROADDURHAMNC27704HOSPICE
3 - DUKE IMAGING SERVICES
3700 NW CARY PARKWAY SUITE 120CARYNC27513INDEPENDENT DIAGNOSTIC TESTING FACILITY

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 3C:NOT APPLICABLEPART I, LINE 6A:NOT APPLICABLEPART I, LINE 7, COLUMN F:TOTAL GROSS COMMUNITY BENEFIT EXPENSE AS A PERCENT OF TOTAL EXPENSES IS 10.14%.PART I, LINE 7:CHARITY CARE AT COST IS DETERMINED USING THE COST-TO-CHARGE CALCULATION FROM WORKSHEET 2, IN ORDER TO CALCULATE THE AMOUNTS REPORTED ON THE TABLE. UNREIMBURSED MEDICAID IS DETERMINED USING A COST ACCOUNTING SYSTEM THAT ADDRESSES ALL PATIENT SEGMENTS.PART II, COMMUNITY BUILDING ACTIVITIES:THESE ACTIVITIES ARE INCLUDED IN DUKE UNIVERSITY HEALTH SYSTEM, INC.'S (DUHS) OPERATING EXPENSES AND ARE NOT TRACKED SEPARATELY FOR COMMUNITY BENEFIT REPORTING PURPOSES.PART III, LINE 2:BAD DEBT AT COST IS DETERMINED USING THE COST-TO-CHARGE RATIO CALCULATION FROM WORKSHEET 2.PART III, LINE 3:A PORTION OF BAD DEBT EXPENSE SHOULD BE INCLUDED AS A COMMUNITY BENEFIT, BUT THE PORTION THAT IS ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER OUR FINANCIAL ASSISTANCE POLICY IS INDETERMINABLE BECAUSE THOSE PATIENTS FAIL TO APPLY FOR OR PROVIDE INFORMATION NEEDED TO DETERMINE THEIR ELIGIBILITY UNDER THE DUHS FAP. DUHS, INC. FOLLOWS ITS MISSION TO THE COMMUNITY AND PROVIDES EMERGENT SERVICES TO PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. BAD DEBT IS FURTHER COMPLICATED BY DOCUMENTATION REQUIRED BY THE CENTERS FOR MEDICARE AND MEDICAID SERVICES (CMS) FOR REPORTING CHARITY CARE. THEREFORE, PATIENTS WHO MAY QUALIFY FOR CHARITY CARE ARE REPORTED AS BAD DEBT EXPENSE INSTEAD BECAUSE OF THOSE PATIENTS' INABILITY OR UNWILLINGNESS TO PROVIDE THE NECESSARY DOCUMENTATION REQUIRED TO DETERMINE CHARITY CARE CLASSIFICATION.PART III, LINE 4:PAGES 16-18 IN THE FY2017 AUDITED FINANCIAL STATEMENT FOOTNOTES DESCRIBE BAD DEBT EXPENSE.PART III, LINE 7:TOTAL UNREIMBURSED COSTS ATTRIBUTABLE TO PROVIDING SERVICES UNDER MEDICARE AS REPORTED IN THE JUNE 30, 2017 DUHS CONSOLIDATED FINANCIAL STATEMENTS ARE $212,922,000 AS COMPARED TO $98,962,712 AS REPORTED IN SECTION B, LINE 7 OF SCHEDULE H. THE DUHS TOTAL MEDICARE SHORTFALL OF $212,922,000 IS DERIVED FROM THE COST ACCOUNTING SYSTEM WHICH INCLUDES ALL PAYMENTS AND COSTS ASSOCIATED WITH MEDICARE PATIENTS, WHEREAS THE AMOUNT REPORTED IN SECTION B OF SCHEDULE H IS DERIVED BASED ON IRS INSTRUCTIONS. IRS INSTRUCTIONS SPECIFY THAT ONLY A PORTION OF COSTS ASSOCIATED WITH MEDICARE BENEFICIARIES BE REPORTED ON SCHEDULE H. SIGNIFICANT MEDICARE COSTS EXCLUDED FROM SCHEDULE H DATA INCLUDE THOSE ASSOCIATED WITH MEDICARE PATIENTS COVERED UNDER MANAGED CARE PLANS AND COSTS REIMBURSED THROUGH MEANS NOT REPORTED ON THE COST REPORT.PART III, LINE 8:MEDICARE RATES AND THE NUMBER OF MEDICARE PATIENTS DUHS TREATS ARE NOT NEGOTIATED. MEDICARE DOES NOT FULLY COMPENSATE DUHS FOR THE COST OF PROVIDING CARE TO MEDICARE BENEFICIARIES. DUHS CONTINUES TO SERVE THE MEDICARE POPULATION AS MEDICARE REIMBURSEMENT RATES DECLINE RELATIVE TO THE COST OF CARE. THEREFORE, ANY LOSS RELATED TO PROVIDING CARE FOR MEDICARE PATIENTS SHOULD BE CLASSIFIED AS A COMMUNITY BENEFIT. DUHS FOLLOWED THE MEDICARE COST REPORT RULES AND GUIDELINES IN DETERMINING THE COSTS REPORTED ON LINE 6. THESE RULES USE A VARIETY OF DIFFERENT METHODOLOGIES BASED ON THE TYPE OF SERVICE.PART III, LINE 9B:COLLECTION EFFORTS ARE IMMEDIATELY STOPPED FOR PATIENTS WHO SUBMIT A FINANCIAL ASSISTANCE APPLICATION. PATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE ARE NOT PURSUED USING ANY DEBT COLLECTION PRACTICES.
NEEDS ASSESSMENT:PART VI, LINE 2:DUHS USES SEVERAL MECHANISMS TO ASSESS AND ADDRESS THE HEALTH CARE NEEDS OF THE COMMUNITIES IT SERVES. IN DURHAM COUNTY, DUHS AND THE DUKE UNIVERSITY SCHOOL OF MEDICINE FACULTY ARE ACTIVELY INVOLVED IN THE PARTNERSHIP FOR A HEALTHY DURHAM. THE PARTNERSHIP IS A COALITION OF LOCAL ORGANIZATIONS AND COMMUNITY MEMBERS WITH THE GOAL OF COLLABORATIVELY IMPROVING THE PHYSICAL, MENTAL, SOCIAL, HEALTH, AND WELL-BEING OF DURHAM COUNTY'S RESIDENTS. THE NETWORK IS A CERTIFIED HEALTH CAROLINIAN'S WORKGROUP. THE PARTNERSHIP EVALUATES COMMUNITY HEALTH CARE INFORMATION, THEN IDENTIFIES AND PRIORITIZES COMMUNITY-IDENTIFIED HEALTH CARE NEEDS AMONG SUBCOMMITTEES THAT FOCUS ON A DURHAM COUNTY HEALTH PRIORITY. SINCE 2002, DUHS' OFFICE OF COMMUNITY RELATIONS HAS PLAYED A CENTRAL ROLE IN CONDUCTING A DURHAM HEALTH SUMMIT. THIS IS AN EVENT THAT ATTRACTS HUNDREDS OF COMMUNITY MEMBERS, HEALTH OFFICIALS, ELECTED OFFICIALS, AND DUHS EXECUTIVES AND PHYSICIANS TO RAISE AWARENESS OF KEY HEALTH ISSUES IN THE COMMUNITY AND SEEK COLLABORATIVE SOLUTIONS TO THESE ISSUES. THE SUMMIT HAS PRODUCED A NUMBER OF COMMUNITY-DRIVEN HEALTH CARE PROGRAMS AND INITIATIVES, INCLUDING SPECIALTY PROJECT ACCESS, IN WHICH PHYSICIANS WHO PRACTICE AT DUHS FACILITIES AND OTHER DURHAM COUNTY PHYSICIANS OFFER FREE SPECIALTY CARE SERVICES TO RESIDENTS WHO OTHERWISE COULD NOT AFFORD SPECIALTY CARE. DUHS ALSO PLAYS A CENTRAL ROLE IN REGIONAL AND STATE HEALTH CARE SUMMITS USING THE SUMMITS' INFORMATION AND DATA TO ADDRESS THE HEALTH CARE NEEDS OF THOSE BROADER COMMUNITIES.PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE:PART VI, LINE 3:DUHS EMPLOYS NUMEROUS MEANS TO EDUCATE PATIENTS ABOUT THEIR ELIGIBILITY FOR ASSISTANCE UNDER FEDERAL, STATE, OR LOCAL GOVERNMENT PROGRAMS OR UNDER THE DUHS CHARITY CARE POLICY. DETAILED INFORMATION IS POSTED ON WWW.DUKEHEALTH.ORG (DUHS' WEBSITE) ALONG WITH HARDCOPY BROCHURES THAT ARE AVAILABLE IN ENGLISH OR SPANISH AT ALL OF OUR PATIENT REGISTRATION LOCATIONS. ALL INPATIENTS AND EMERGENCY DEPARTMENT PATIENTS ARE ALSO PROVIDED WITH A HARDCOPY, ONE-PAGE SUMMARY OF THE WAYS DUHS CAN ASSIST PATIENTS FINANCIALLY. FOR OUTPATIENTS, THIS SAME ONE-PAGE SUMMARY IS PROVIDED ON THEIR FIRST VISIT TO THE INSTITUTION. IN ADDITION, DUHS EMPLOYS FINANCIAL CARE COUNSELORS WHO MEET INDIVIDUALLY WITH PATIENTS WHO HAVE QUESTIONS REGARDING PAYMENT FOR THEIR CARE. DUHS ALSO EMPLOYS MEDICAID ASSISTANCE COUNSELORS WHO SPECIALIZE IN ASSISTING PATIENTS TO APPLY FOR MEDICAID, DISABILITY, AND OTHER FEDERAL, STATE, AND LOCAL PROGRAMS. DUHS ASSISTS BETWEEN 12,000-15,000 PATIENTS IN APPLYING AND BECOMING ELIGIBLE FOR THESE PROGRAMS ANNUALLY. FINALLY, PATIENTS MAY ALWAYS CONTACT DUHS' TOLL FREE CUSTOMER SERVICE NUMBER TO REQUEST INFORMATION ABOUT THEIR BILL OR OBTAIN A CHARITY CARE APPLICATION.
COMMUNITY INFORMATION:PART VI, LINE 4:DUHS SERVES A BROAD, CULTURALLY, RACIALLY AND SOCIALLY DIVERSE GEOGRAPHIC AND DEMOGRAPHIC REGION. DUHS' HOME CITY OF DURHAM IS THE CORE, BUT DUHS' REACH EXTENDS INTO THE SURROUNDING RESEARCH TRIANGLE AREA OF NORTH CAROLINA AND THE STATE'S LARGER NORTHERN PIEDMONT REGION, AS WELL AS STATEWIDE, NATIONALLY AND GLOBALLY. DUHS PRIMARY SERVICE AREA IS A 7-COUNTY REGION IN NC THAT INCLUDES ALAMANCE, DURHAM, GRANVILLE, ORANGE, PERSON, VANCE AND WAKE COUNTIES. THIS 7-COUNTY REGION REPRESENTS APPROXIMATELY 18% OF NC'S POPULATION BASED ON FEDERAL FISCAL YEAR (FFY) 2015 DATA. APPROXIMATELY 70% OF INPATIENT DISCHARGES FROM DUHS FACILITIES IN FFY 2015 WERE PATIENTS FROM ITS PRIMARY SERVICE AREA. DUHS' SECONDARY SERVICE AREA COVERS 15 COUNTIES IN NORTH CAROLINA AND SOUTHERN VIRGINIA WITH A POPULATION OF APPROXIMATELY 2 MILLION. PROMOTION OF COMMUNITY HEALTH:PART VI, LINE 5:DUHS PROMOTES THE HEALTH OF THE COMMUNITIES IT SERVES THROUGH A NUMBER OF COMMUNITY BUILDING ACTIVITIES. CENTRAL TO MANY OF THE EFFORTS IS DUHS' OFFICE OF COMMUNITY RELATIONS, WHOSE ASSOCIATE VICE PRESIDENT REPORTS DIRECTLY TO DUHS' CEO AND SERVES AS A FULL-TIME LIAISON WITH THE DURHAM COMMUNITY. THE OFFICE SPONSORS AND FACILITATES COMMUNITY EVENTS SUCH AS THE ANNUAL DURHAM HEALTH SUMMIT AND SIMILAR REGIONAL AND STATE HEALTH SUMMITS THAT RAISE AWARENESS OF COMMUNITY HEALTH NEEDS, PROMOTE PREVENTION AND WELLNESS, AND CHART A COURSE FOR SOLVING HEALTH ISSUES AND DISPARITIES. IN ADDITION, THE OFFICE PROVIDES A POINT OF DIRECT CONTACT FOR COMMUNITY MEMBERS WHO HAVE QUESTIONS OR CONCERNS ABOUT COMMUNITY ISSUES OR ABOUT ACCESS TO HEALTH CARE SERVICES. THE OFFICE ALSO PROVIDES DIRECT FINANCIAL SUPPORT TO A VARIETY OF COMMUNITY GROUPS THROUGH THE CHARITABLE GRANTS AND GOODWILL GRANTS PROGRAM. THE ASSOCIATE VICE-PRESIDENT AND STAFF SERVE ON A NUMBER OF HEALTH CARE-RELATED COMMUNITY BOARDS AND HEALTH-RELATED COMMITTEES. STAFF FROM THE OFFICE OF COMMUNITY RELATIONS AND MEMBERS OF THE DUHS COMMUNITY HEALTH PLANNING GROUP CREATED A FORMAL PRINCIPLES OF COMMUNITY ENGAGEMENT POLICY THAT COMMITS DUHS AND ITS COMMUNITY COLLABORATES TO DEVELOPING PROPOSED PROJECTS AND INITIATIVES ON TRUST, RESPECT, DIVERSITY, SAFETY AND COMMUNITY-IDENTIFIED NEEDS. THESE PRINCIPLES HAVE BEEN INCORPORATED INTO COMMUNITY-BASED HEALTH CARE PROJECTS SUCH AS THE DEVELOPMENT OF THE HOLTON WELLNESS CENTER AND DURHAM HEALTH INNOVATIONS, A MULTIDISCIPLINARY COMMUNITY BASED JOINT EFFORT BETWEEN DUHS AND THE DURHAM COMMUNITY THAT FOCUSES ON IMPROVING HEALTH OUTCOMES THROUGH NEW AND CREATIVE APPROACHES TO HEALTH CARE DELIVERY.IN ADDITION TO COMMUNITY BUILDING ACTIVITIES, DUHS PROMOTES THE HEALTH OF ITS COMMUNITIES IN A NUMBER OF IMPORTANT WAYS. ONE OF DUHS' THREE CONSTITUENT HOSPITALS, DUKE REGIONAL, HAS AN OPEN MEDICAL STAFF AND A HOSPITAL CORPORATION BOARD, WHICH IS A COUNTY APPOINTED BOARD RESPONSIBLE FOR HOSPITAL OVERSIGHT. IN ADDITION, APPROXIMATELY 50 LOCAL LEADERS IN THE DURHAM FAITH COMMUNITY ARE WORKING WITH DUKE HEALTH TO LOOK AT HOW TO ADDRESS THE NEEDS OF THEIR CONGREGATIONS AND COMMUNITIES BY COMBINING THE TRADITIONS OF THE FAITH COMMUNITY WITH THE KNOWLEDGE OF MODERN MEDICINE. MEETINGS ARE HELD TO DETERMINE HOW DUKE HEALTH CAN ASSIST THE FAITH COMMUNITY TO SUPPORT HEALTH MINISTRY ACTIVITIES IN THEIR COMMUNITY AND PLACES OF WORSHIP.DUHS' CEO ALSO HAS A CHANCELLOR'S COMMUNITY HEALTH ADVISORY BOARD TO PROVIDE FEEDBACK ON A VARIETY OF ISSUES, INCLUDING USE OF DUHS RESOURCES, HEALTH SERVICE DELIVERY SYSTEMS AND LONG-RANGE GOALS TO REDUCE HEALTH RISKS AND DISPARITIES IN DURHAM COUNTY. THE BOARD INCLUDES STATE AND LOCAL ELECTED OFFICIALS, NEIGHBORHOOD COUNCILS AND OTHER GRASSROOTS ORGANIZATIONS, POLITICAL GROUPS, LOCAL PHYSICIANS, THE DURHAM PUBLIC SCHOOLS, AMONG OTHERS. DUHS MAINTAINS A CHARITABLE GRANTS COMMITTEE TO REVIEW COMMUNITY REQUESTS FOR PHILANTHROPIC ASSISTANCE THAT PROMOTE HEALTH AND WELLNESS. DUKE HEALTH PROVIDES VARIOUS OPPORTUNITIES FOR STUDENTS TO INTERACT WITH DIFFERENT HEALTH CARE PROFESSIONALS ACROSS THE SYSTEM. THE OFFICE OF COMMUNITY RELATIONS, DRH, AND OTHER KEY COMMUNITY PARTICIPANTS ARE ACTIVE IN A WORKFORCE DEVELOPMENT PROJECT CALLED PROJECT SEARCH. THIS PROGRAM, MODELED AFTER THE PROGRAM AT CINCINNATI CHILDREN'S HOSPITAL, PROVIDES YOUTH WITH DISABILITIES EMPLOYMENT TRAINING AND CAREER OPPORTUNITIES IN THE HEALTHCARE FIELD. THE OFFICE OF COMMUNITY RELATIONS WORKS WITH THE DURHAM-ORANGE MEDICAL SOCIETY AND THE DURHAM ACADEMY OF MEDICINE, DENTISTRY AND PHARMACY (AN ASSOCIATION FOR AFRICAN-AMERICAN MEDICAL PROFESSIONALS) TO PROMOTE THE SUCCESS OF THE CITY OF MEDICINE ACADEMY (CMA). THE CMA IS A PUBLIC MAGNET HIGH SCHOOL DESIGNED FOR STUDENTS INTERESTED IN HEALTH CARE CAREERS. FACULTY ARE INVOLVED WITH MENTORING STUDENTS AND CLASSROOM LECTURES. IN ADDITION, THE HEALTH SYSTEM CEO IS WORKING TO HELP THE CMA BECOME THE PREMIER HEALTH SCIENCE HIGH SCHOOL IN NORTH CAROLINA. DUHS IS A KEY PARTICIPANT IN THE ANNUAL BULL CITY FRESH START EVENT. STAFF FROM THE DUKE SCHOOL OF NURSING, DUKE EYE CENTER, AND STAFF AFFILIATED WITH LINCOLN COMMUNITY HEALTH CENTER HEALTHCARE FOR THE HOMELESS CLINIC VOLUNTEER TIME AND RESOURCES AT THIS IMPORTANT EVENT. STUDENTS FROM THE DUKE SCHOOLS OF MEDICINE AND NURSING ENGAGE COMMUNITIES IN DURHAM AND BEYOND IN ACTIVITIES THAT INCLUDE FREE BLOOD PRESSURE SCREENINGS FOR THE HOMELESS, AND IDENTIFYING THE HEALTH CARE NEEDS OF A LOW WEALTH COMMUNITY SCHOOL AND DEVELOPING A CURRICULUM FOR STUDENTS AND PARENTS THAT ADDRESSES THOSE NEEDS.AFFILIATED HEALTH CARE SYSTEM ROLES:PART VI, LINE 6:DUHS PROVIDES VIRTUALLY ALL LEVELS OF CARE BEGINNING WITH DUKE UNIVERSITY AFFILIATED PHYSICIANS (DBA DUKE PRIMARY CARE) (DPC). THE HOSPITALS PROVIDE ROUTINE INPATIENT AND OUTPATIENT CARE. IN DURHAM COUNTY, DUH AND DRH WORK TOGETHER TO MAXIMIZE FACILITY UTILIZATION PROVIDING ROUTINE AND ADVANCED LEVELS OF CARE. DUH ALSO OPERATES A TRAUMA CENTER WITH AIR AMBULANCE SERVICE. DRAH SERVES THE WAKE COUNTY AREA AS A COMMUNITY HOSPITAL. THE DRAH CAMPUS HAS SEVERAL MEDICAL OFFICE BUILDINGS ENHANCING CONVENIENCE FOR THE PATIENT IN NON-EMERGENT CASES AND PROVIDES STREAMLINED ACCESS TO HIGH-DEMAND PROCEDURES SUCH AS CARDIAC CATHETERIZATION AND RADIOLOGY PROCEDURES. DUHS ALSO OPERATES HOME HEALTH AND HOME INFUSION SERVICES TO TREAT AND CARE FOR PATIENTS IN THE COMFORT OF THEIR HOME. THIS IS OBVIOUSLY PRACTICAL FOR PATIENTS NOT REQUIRING AN INPATIENT STAY BUT IN NEED OF ONGOING CARE AT A SUB-ACUTE LEVEL. FINALLY, HOSPICE PROVIDES PALLIATIVE CARE FOR PATIENTS NOT RESPONDING TO CURATIVE CARE. PAIN MANAGEMENT, SYMPTOM MANAGEMENT, AND PSYCHOLOGICAL AND SPIRITUAL SUPPORT PROVIDE A ROUNDED APPROACH TO COMPASSIONATELY ASSIST TERMINAL PATIENTS AND THEIR FAMILIES WITH THE PROCESS OF DYING. ALL OF THE OPERATING UNITS OF DUHS WORK TOGETHER TO PROVIDE THE RIGHT LEVEL OF CARE FOR THE PATIENT IN THE MOST BENEFICIAL MANNER. IN ADDITION TO THE REACTIVE ACTIVITIES OF DIAGNOSTIC CARE, DUHS ALSO SUPPORTS AND PROMOTES HEALTHY LIFESTYLES IN THE DIET & FITNESS CENTER, CENTER FOR LIVING, AND DUKE INTEGRATIVE MEDICINE. THESE OPERATIONS FOCUS LARGELY ON PREVENTION AND EDUCATION TO AVOID OR MITIGATE THE POTENTIAL FOR FUTURE ILLNESS.LIST OF ALL STATES WHICH ORGANIZATION FILES A COMMUNITY BENEFIT REPORT:PART VI, LINE 7:NORTH CAROLINA

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Recipient Table RecipientTable (44 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtPurpose Of GrantPurposeOfGrantTxt
ALLIANCE MEDICAL MINISTRY INC
101 DONALD ROSS DRRALEIGHNC27610562168673501(C)(3)$17,500GENERAL SUPPORT
AMERICAN HEART ASSOCIATION
PO BOX 50045PRESCOTTAZ863045045560529996501(C)(3)$34,000GENERAL SUPPORT
AMERICAN ORG OF NURSE EXECUTIVES
75 REMITTANCE DR SUITE 1201CHICAGOIL606751201363591337501(C)(6)$12,000GENERAL SUPPORT
AUTISM SOCIETY OF NORTH CAROLINA
505 OBERLILN RD SUITE 230RALEIGHNC27605237087887501(C)(3)$25,000GENERAL SUPPORT
BOYS & GIRLS CLUB OF GREATER DURHAM
808 E PETTIGREW STDURHAMNC27701566001906501(C)(3)$6,500GENERAL SUPPORT
BOYS CLUB OF WAKE COUNTY INC
701 N RALEIGH BLVDRALEIGHNC27610560863051501(C)(3)$20,000GENERAL SUPPORT
CARING HOUSE INC
2625 PICKETT RDDURHAMNC277055603561647154501(C)(3)$10,000GENERAL SUPPORT
CAROLINA THEATRE OF DURHAM INC
309 W MORGAN STREETDURHAMNC277012119561759337501(C)(3)$20,000SPONSORSHIP
CEO ROUNDTABLE ON CANCER INC
101 SAS CAMPUS DRCARYNC27513651230448501(C)(3)$40,000GENERAL SUPPORT
CITY OF DURHAM
101 CITY HALL PLAZADURHAMNC27701566000225GOV'T ENTITY$25,000GENERAL SUPPORT
COMMUNITIES IN PARTNERSHIP
PO BOX 11247DURHAMNC27703475567396501(C)(3)$15,000GENERAL SUPPORT
DIX VISIONARIES
PO BOX 28575RALEIGHNC27611208421281501(C)(3)$10,000GENERAL SUPPORT
DUKE SCHOOL FOR CHILDREN
3716 OLD ERWIN RDDURHAMNC27705581521494501(C)(3)$25,000GENERAL SUPPORT
DURHAM ACADEMY INC
3130 PICKETT RDDURHAMNC277055599560538019501(C)(3)$25,000GENERAL SUPPORT
DURHAM CONGREGATIONS IN ACTION
504 W CHAPEL HILL STDURHAMNC27701237208424501(C)(3)$11,500GENERAL SUPPORT
DURHAM PUBLIC SCHOOLS
301 CRUTCHFIELD STDURHAMNC27704566001021GOV'T ENTITY$15,000GENERAL SUPPORT
EAST DURHAM CHILDRENS INITIATIVE
107 N DRIVER ST 3RD FLOORDURHAMNC27703320263133501(C)(3)$10,000GENERAL SUPPORT
ECONOMIC DEVELOPMENT PARTNERSHIP
15000 WESTON PKYCARYNC27513464840814501(C)(3)$10,000GENERAL SUPPORT
EL CENTRO HISPANO INC
2000 CHAPEL HILL RDDURHAMNC277071197562011661501(C)(3)$6,000GENERAL SUPPORT
FAMILY VIOLENCE PREVENTION CTR
1012 OBERLINE RD SUITE 100RALEIGHNC27605581320613501(C)(3)$20,000GENERAL SUPPORT
GREATER RALEIGH CHAMBER OF COMMERCE
PO BOX 2978RALEIGHNC276022978560370850501(C)(6)$27,750GENERAL SUPPORT
HABITAT FOR HUMANITY OF WAKE COUNTY
2420 RALEIGH BLVDRALEIGHNC27604561492703501(C)(3)$20,000GENERAL SUPPORT
HOLT BROTHERS FOUNDATION INC
421 FAYETTEVILLE ST STE 1300RALEIGHNC27601566570426501(C)(3)$5,500GENERAL SUPPORT
HUMAN RIGHTS CAMPAIGN INC
1640 RHODE ISLAND AVE NWWASHINGTONDC20036521243457501(C)(4)$15,000GENERAL SUPPORT
JUNIOR LEAGUE OF RALEIGH INC
PO BOX 25728RALEIGHNC276115728560562849501(C)(3)$10,000GENERAL SUPPORT
MARCH OF DIMES FOUNDATION
6504 FALLS OF NEUSE ROAD STE 100RALEIGHNY27615131846366501(C)(3)$7,500GENERAL SUPPORT
MEDICAL FOUNDATION OF NC INC
CB 7145 SUITE 4100 BONDURANTCHAPEL HILLNC275997120566057494501(C)(3)$50,000GENERAL SUPPORT
MIDTOWN EVENTS LLC
PO BOX 19107RALEIGHNC27619271832351$50,000SPONSORSHIP
MIDTOWN RALEIGH ALLIANCE
1110 NAVAHO DR SUITE 100RALEIGHNC27609452559048501(C)(6)$12,000SPONSORSHIP
MUSEUM OF DURHAM HISTORY
PO BOX 362DURHAMNC27702943455685501(C)(3)$10,000GENERAL SUPPORT
NC LUNG CANCER PARTNERSHIP
4000 BLUE RIDGE RD SUITE 170RALEIGHNC27612262300885501(C)(3)$25,000GENERAL SUPPORT
NC PHYSICIANS HEALTH PROGRAM INC
220 HORIZON DRIVE 201RALEIGHNC27615561846599501(C)(3)$16,000GENERAL SUPPORT
NORTH CAROLINA SYMPHONY SOCIETY
3700 GLENWOOD AVE SUITE 130RALEIGHNC27612560556755501(C)(3)$33,500GENERAL SUPPORT
ORANGE COUNTY RAPE CRISIS CENTER
1506 E FRANKLIN ST SUITE 302CHAPEL HILLNC27514581356356501(C)(3)$10,000GENERAL SUPPORT
POLKA DOT MAMA MELANOMA FOUNDATION
925 ALDEN BRIDGE DRCARYNC27519474543960501(C)(3)$10,250GENERAL SUPPORT
RACE 131 LLC
3803-B COMPUTER DR STE 205RALEIGHNC27609464157559$7,500SPONSORSHIP
RALEIGH SCHOOL OF NURSE ANESTHESIA
3900 BARRETT DR SUITE 200RALEIGHNC27609561684241501(C)(3)$18,151GENERAL SUPPORT
RONALD MCDONALD HOUSE OF DURHAM
506 ALEXANDER AVEDURHAMNC27705561220376501(C)(3)$15,000GENERAL SUPPORT
SENIOR PHARMASSIST INC
406 RIGSBEE AVE STE 201DURHAMNC277012186562084639501(C)(3)$20,000GENERAL SUPPORT
SHAW UNIVERSITY
118 E SOUTH STRALEIGHNC27601560530235501(C)(3)$6,500GENERAL SUPPORT
SUSAN G KOMEN FOR THE CURE NC
600 AIRPORT BLVD SUITE 100MORRISVILLENC27560752845066501(C)(3)$65,000GENERAL SUPPORT
THE UNIVERSITY OF NORTH CAROLINA
CAMPUS BOX 3480CHAPEL HILLNC275993480566001393501(C)(3)$12,000SPONSORSHIP
UNITED WAY OF THE GREATER TRIANGLE
2400 PERIMETER PARK DR 150MORRISVILLENC27560561949103501(C)(3)$593,895SPONSORSHIP
YMCA OF THE TRIANGLE AREA INC
801 CORPORATE CENTER DR STE 20RALEIGHNC27606560591307501(C)(3)$10,000GENERAL SUPPORT
FieldValueIRS element (for citing)
Total501c3 Org36Total501c3OrgCnt
Total Other Org8TotalOtherOrgCnt

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp

FieldValueIRS element (for citing)
Grant TypeFINANCIAL ASSISTANCEGrantTypeTxt
Recipient43RecipientCnt
Cash Grant$56,000CashGrantAmt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE I, PART I, LINE 2FormAndLineReferenceDesc
ExplanationDUKE UNIVERSITY HEALTH SYSTEM, INC. PROVIDES GENERAL SUPPORT TO LOCAL ORGANIZATIONS BASED ON OUR AWARENESS OF THEIR ACTIVITIES WITHIN THE LOCAL COMMUNITY. DUKE UNIVERSITY HEALTH SYSTEM, INC. ALSO MAINTAINS A CHARITABLE GRANTS COMMITTEE THAT REVIEWS COMMUNITY REQUESTS FOR PHILANTHROPIC ASSISTANCE THAT PROMOTE HEALTH AND WELLNESS.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Idemnification Gross Up PmtsYes (X)IdemnificationGrossUpPmtsInd
Written Policy Ref T And E Expnss0WrittenPolicyRefTAndEExpnssInd
Substantiation Required0SubstantiationRequiredInd
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
Form990 Of Other OrganizationsYes (X)Form990OfOtherOrganizationsInd
Written Employment ContractYes (X)WrittenEmploymentContractInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (1)SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsYes (1)AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (18 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
NANCY ANDREWS MD
DIRECTOR$0$594,822$0$346,539$0$18,000$0$32,411$0$59,782$0$1,051,554$0$0
RICHARD H BRODHEAD
DIRECTOR$0$994,475$0$0$0$263,534$0$153,161$0$15,585$0$1,426,755$0$115,000
MARY E KLOTMAN MD
DIRECTOR$0$310,727$0$76,114$0$18,000$0$32,411$0$13,859$0$451,111$0$0
MARK F NEWMAN
DIRECTOR$0$184,681$0$0$0$29,008$0$26,603$0$20,784$0$261,076$0$0
A EUGENE WASHINGTON MD
PRESIDENT & CEO DUHS/DIRECTOR$0$1,161,674$0$904,735$0$23,700$0$132,411$0$15,246$0$2,237,766$0$0
MONTE D BROWN MD
VP FOR ADMINISTRATION/SECRETARY$329,638$0$247,336$0$92,973$0$32,411$0$18,667$0$721,025$0$0$0
WILLIAM J FULKERSON MD
EXECUTIVE VP, DUHS$813,955$0$594,041$0$18,000$0$32,411$0$7,243$0$1,465,650$0$0$0
KENNETH C MORRIS
SVP, CFO, TREASURER$728,235$0$473,611$0$69,442$0$32,411$0$11,345$0$1,315,044$0$0$0
MARY ANN FUCHS
VP-PATIENT CARE/CHIEF NURSE EXEC$321,029$0$137,705$0$0$0$32,411$0$7,018$0$498,163$0$0$0
KATHLEEN GALBRAITH
PRESIDENT, DUKE REGIONAL HOSPITAL$372,099$0$114,986$0$27,367$0$32,411$0$17,405$0$564,268$0$0$0
KEVIN SOWERS
PRESIDENT, DUKE UNIVERSITY HOSPITAL$480,618$0$222,708$0$18,000$0$32,411$0$12,029$0$765,766$0$0$0
DAVID ZAAS MD
PRESIDENT, DUKE RALEIGH HOSPITAL$370,857$0$150,721$0$18,016$0$32,411$0$15,449$0$587,454$0$0$0
RHONDA BRANDON
CHIEF HUMAN RESOURCES OFFICER$308,231$0$212,744$0$24,046$0$32,411$0$23,587$0$601,019$0$0$0
MARC CALABRESE
PHYSICIAN$377,657$0$42,986$0$19,260$0$32,411$0$23,643$0$495,957$0$0$0
CAROLYN C CARPENTER
CHIEF OPERATING OFFICER DUH$320,062$0$124,421$0$0$0$32,411$0$19,802$0$496,696$0$0$0
JEFFREY M FERRANTI
VP, CIO, DHTS ADMINISTRATION$399,756$21,236$204,904$80,984$18,000$0$32,411$0$21,886$0$676,957$102,220$0$0
THOMAS A OWENS MD
CHIEF MEDICAL OFFICER$429,419$0$199,154$0$82,701$0$32,411$0$13,144$0$756,829$0$0$0
VICTOR J DZAU MD
FORMER DIRECTOR/OFFICER$0$0$0$143,032$0$0$0$18,666$0$15$0$161,713$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE J, PART I, LINE 1AFormAndLineReferenceDesc
ExplanationTAX INDEMNIFICATION: RHONDA BRANDON AND DAVID ZAAS, MD RECEIVED A BENEFIT THAT WAS GROSSED UP TO COMPENSATE FOR WITHHOLDING OF TAXES. SCHEDULE J, PART I, LINE 4B SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: THE FOLLOWING INDIVIDUAL PARTICIPATED IN AND RECEIVED PAYMENTS UNDER A DEFERRED COMPENSATION PLAN DESCRIBED UNDER SECTION 457(F) OF THE INTERNAL REVENUE CODE: RICHARD H. BRODHEAD $230,000. SUCH AMOUNT WAS SUBJECT TO A SUBSTANTIAL RISK OF FORFEITURE AS DEFINED UNDER IRC SECTION 457(F). SCHEDULE J, PART I, LINE 7 NON-FIXED PAYMENTS: DUHS MAINTAINS AN EXECUTIVE INCENTIVE COMPENSATION PLAN. PAYMENTS UNDER THE PLAN ARE BASED ON PRE-ESTABLISHED PERFORMANCE METRICS AND A FIXED CALCULATION METHODOLOGY APPROVED BY THE DUHS COMPENSATION COMMITTEE WITH ASSISTANCE AND INPUT FROM AN EXECUTIVE COMPENSATION CONSULTING FIRM ASSURING COMPARABILITY WITH SIMILAR SYSTEMS. THE PLAN ALLOWS FOR A MODIFICATION TO AN INDIVIDUAL'S INCENTIVE PAYMENT BASED ON LEADERSHIP COMPETENCIES AND OTHER FACTORS WITH PAYOUTS (AND MODIFICATIONS, IF ANY) APPROVED BY THE DUHS COMPENSATION COMMITTEE.ExplanationTxt

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (4 entries)

Bond ReferenceBondReferenceCdBond Issuer EINBondIssuerEINBond IssuedBondIssuedDtIssue PriceIssuePriceAmtPurposePurposeDescDefeasedDefeasedIndOn Behalf Of IssuerOnBehalfOfIssuerIndPool FinancingPoolFinancingIndCUSIPCUSIPNum
NORTH CAROLINA MEDICAL CARE COMMISSION
A5213094022012-03-22$322,140,000SEE PART VI000
NORTH CAROLINA MEDICAL CARE COMMISSION
B5213094022012-05-30$214,598,930SEE PART VI000
NORTH CAROLINA MEDICAL CARE COMMISSION
C5213094022015-03-19$128,325,000SEE PART VI000
NORTH CAROLINA MEDICAL CARE COMMISSION
D5213094022012-06-28$326,853,753SEE PART VI00065821DLJ8

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (4 entries)

Bond ReferenceBondReferenceCdRetiredRetiredAmtTotal ProceedsTotalProceedsAmtOther Spent ProceedsOtherSpentProceedsAmtCurrent RefundingCurrentRefundingIndAdvance RefundingAdvanceRefundingIndFinal Allocation MadeFinalAllocationMadeIndAdequate Books And Rec MaintAdequateBooksAndRecMaintIndSubstantial CompletionSubstantialCompletionYrCapitalized InterestCapitalizedInterestAmtIssuance Costs From ProceedsIssuanceCostsFromProceedsAmtCapital ExpendituresCapitalExpendituresAmt
A$228,820,000$322,140,000$322,140,000Yes (1)0Yes (1)Yes (1)
B$184,550,000$214,760,000$214,760,000Yes (1)0Yes (1)Yes (1)
C$6,705,000$128,325,000$128,325,000Yes (1)0Yes (1)Yes (1)2009
D$21,695,000$326,995,39400Yes (1)Yes (1)2013$14,871,185$2,737,864$309,386,345

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (2 entries)

Bond ReferenceBondReferenceCdOwning Bond Financed PropertyOwningBondFinancedPropertyIndAny Lease ArrangementsAnyLeaseArrangementsIndMgmt Contract Bond Fincd PropMgmtContractBondFincdPropIndEngage Bond Counsel ContractsEngageBondCounselContractsIndAny Research AgreementsAnyResearchAgreementsIndPrivate Bus Use By OthersPrivateBusUseByOthersPctPrivate Bus Concerning UBIPrivateBusConcerningUBIPctTotal Private Business UseTotalPrivateBusinessUsePctBond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestIndChange In Use Bond Financed PropChangeInUseBondFinancedPropIndChange In Use Bond Financed PropChangeInUseBondFinancedPropPctRemedial Action TakenRemedialActionTakenIndProcs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd
C00Yes (1)Yes (1)00.000000.000000.000000Yes (1)0.00070Yes (1)Yes (1)
D00Yes (1)Yes (1)00.000000.000000.0000000Yes (1)

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (4 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledIndRebate Not Due YetRebateNotDueYetIndException To RebateExceptionToRebateIndNo Rebate DueNoRebateDueIndVariable Rate IssueVariableRateIssueIndHedge Identified In Bks And RecHedgeIdentifiedInBksAndRecIndGross Proceeds Invested In GICGrossProceedsInvestedInGICIndGross Proceeds InvestedGrossProceedsInvestedIndWritten Proc To Monitor ReqsWrittenProcToMonitorReqsInd
A000Yes (1)Yes (1)000Yes (1)
B000Yes (1)Yes (1)000Yes (1)
C0Yes (1)00Yes (1)000Yes (1)
D000Yes (1)0000Yes (1)

Procedures Corrective Action ProceduresCorrectiveActionGrp (4 entries)

Bond ReferenceBondReferenceCdProcedures Corrective ActionProceduresCorrectiveActionInd
AYes (1)
BYes (1)
CYes (1)
DYes (1)

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE K, PART I, COLUMN FFormAndLineReferenceDesc
ExplanationBOND ISSUE A: THE PURPOSE OF THE BONDS ISSUED 03/22/2012 WAS TO REFUND THE 2005ABC BONDS ISSUED ON 08/21/2009, WHICH REFUNDED THE ORIGINAL 2005ABC BONDS ISSUED ON 5/19/2005. THE PURPOSE OF THE BONDS ISSUED 05/19/2005 WAS TO PARTIALLY REFUND THE 1996C BONDS ISSUED ON 10/24/1996, 1998A BONDS ISSUED ON 08/27/1998, AND THE 1998B BONDS ISSUED ON 10/13/1998. BOND ISSUE B: THE PURPOSE OF THE BONDS ISSUED 05/30/2012 WAS TO PARTIALLY REFUND THE 2005ABC BONDS ISSUED ON 03/22/12, WHICH REFUNDED THE 2005ABC BONDS ISSUED ON 08/21/2009, WHICH REFUNDED THE ORIGINAL 2005ABC BONDS ISSUED ON 5/19/2005. THE PURPOSE OF THE BONDS ISSUED 05/19/2005 WAS TO PARTIALLY REFUND THE 1996C BONDS ISSUED ON 10/24/1996, 1998A BONDS ISSUED ON 08/27/1998, AND THE 1998B BONDS ISSUED ON 10/13/1998. BOND ISSUE C: THE PURPOSE OF THE BONDS ISSUED 03/19/2015 WAS TO REFUND THE 2006ABC BONDS ISSUED ON 10/06/2011,WHICH REFUNDED THE BONDS ISSUED 11/15/2006 FOR HOSPITAL IMPROVEMENTS INCLUDING: ROUTINE INFRASTRUCTURE, RENOVATION AND IMPROVEMENT PROJECTS AT DUKE UNIVERSITY HOSPITAL AND DUKE RALEIGH HOSPITAL, IMPROVEMENTS TO INFORMATION SYSTEMS, RENOVATION AND EXPANSION OF EMERGENCY DEPARTMENT AT DUKE UNIVERSITY HOSPITAL, HELIPORT AND NEW ROOF IMPROVEMENTS AT DUKE UNIVERSITY HOSPITAL, AND PHASES 1 AND 2 OF AN OPERATING ROOM SUITE RENOVATION AND EXPANSION AT DUKE UNIVERSITY HOSPITAL. BOND ISSUE D: THE PURPOSE OF THE BONDS ISSUED 06/14/12 WAS TO FINANCE PART OF THE COST OF HOSPITAL CAPITAL IMPROVEMENTS INCLUDING: THE CONSTRUCTION OF A MAJOR TERTIARY CARE ADDITION TO DUKE UNIVERSITY HOSPITAL REFERRED TO AS THE DUKE MEDICINE PAVILION (DMP) WHICH INCLUDED A NEW 609,000 SQUARE FOOT TERTIARY CARE ADDITION INCLUDING FOUR 24-BED INTENSIVE CARE UNITS, TWO 32 BED INTERMEDIATE /STEP-DOWN UNITS, 16 OPERATING ROOMS, EXPANDED IMAGING FACILTITES, AND PATIENT AND FAMILY ORIENTED AMENITIES; A 9,000 SQUARE FOOT SOUTH CONCOURSE CONNECTOR CORRIDOR BETWEEN THE EXISTING CANCER CENTER AND DUKE CLINICS AND THE DMP; A 46,000 SQUARE FOOT NORTH CONCOURSE CONNECTOR CORRIDOR BETWEEN THE DMP AND DUKE UNIVERSITY HOSPITAL-NORTH; RENOVATION OF APPROXIMATELY 29,000 SQUARE FEET IN DUKE UNIVERSITY HOSPITAL AND ROAD IMPROVEMENT AND VEHICLE PARKING PROJECTS REQUIRED TO COMPLETE AND OPERATE THE NEW ADDITION. BOND ISSUE A (2): THE PURPOSE OF THE BONDS ISSUED 08/28/2012 WAS TO REFUND THE ORIGINAL 1985B BONDS ISSUED ON 10/02/1985 FOR THE ACQUISITION OF A MAINTENANCE BUILDING, PARKING, AND A DEBT SERVICE FUND, AND TO REFUND THE ORIGINAL 1993A BONDS ISSUED ON 08/12/1993. THE PURPOSE OF THE BONDS ISSUED 08/12/1993 WAS TO PARTIALLY REFUND THE 1991D BONDS ISSUED ON 7/1/1991 AND THE 1985A BONDS ISSUED ON 10/02/1985. THE 2012C BONDS WERE PAID OFF EFFECTIVE JUNE 1, 2015. BOND ISSUE B (2): THE PURPOSE OF THE BONDS ISSUED 05/26/16 WAS TO REFUND THE ORIGINAL 2009A BONDS ISSUED ON 10/22/09 TO FINANCE HOSPITAL IMPROVEMENTS INCLUDING THE AMBULATORY CANCER CENTER AT DUKE UNIVERSITY HOSPITAL AND OTHER RENOVATION AND IMPROVEMENT PROJECTS AT DUKE RALEIGH HOSPITAL, AND TO REFUND THE 2005C BONDS ISSUED ON 05/30/12 AND TO PARTIALLY REFUND THE 2005B BONDS ISSUED ON 05/30/12. THE PURPOSE OF THE BONDS ISSUED 05/30/2012 WAS TO PARTIALLY REFUND THE 2005ABC BONDS ISSUED ON 03/22/12, WHICH REFUNDED THE 2005ABC BONDS ISSUED ON 08/21/2009, WHICH REFUNDED THE ORIGINAL 2005ABC BONDS ISSUED ON 5/19/2005. THE PURPOSE OF THE BONDS ISSUED 05/19/2005 WAS TO PARTIALLY REFUND THE 1996C BONDS ISSUED ON 10/24/1996, 1998A BONDS ISSUED ON 08/27/1998, AND THE 1998B BONDS ISSUED ON 10/13/1998. BOND ISSUE C (2): THE PURPOSE OF THE BONDS ISSUED 08/11/16 WAS TO REFUND THE ORIGINAL 2010A BONDS ISSUED ON 04/2/10 TO FINANCE HOSPITAL CAPITAL IMPROVEMENTS INCLUDING: THE CONSTRUCTION OF A MAJOR TERTIARY CARE ADDITION TO DUKE UNIVERSITY HOSPITAL REFERRED TO AS THE DUKE MEDICINE PAVILION (DMP) WHICH INCLUDED A NEW 582,000 SQUARE FOOT TERTIARY CARE ADDITION INCLUDING FOUR 24-BED INTENSIVE CARE UNITS, TWO 32 BED INTERMEDIATE /STEP-DOWN UNITS, 16 OPERATING ROOMS, EXPANDED IMAGING FACILTITES, AND PATIENT AND FAMILY ORIENTED AMENITIES; A 9,000 SQUARE FOOT SOUTH CONCOURSE CONNECTOR CORRIDOR BETWEEN THE EXISTING CANCER CENTER AND DUKE CLINICS AND THE DMP; A 46,000 SQUARE FOOT NORTH CONCOURSE CONNECTOR CORRIDOR BETWEEN THE DMP AND DUKE UNIVERSITY HOSPITAL-NORTH; RENOVATION OF APPROXIMATELY 29,000 SQUARE FEET IN DUKE UNIVERSITY HOSPITAL AND ROAD IMPROVEMENT AND VEHICLE PARKING PROJECTS REQUIRED TO COMPLETE AND OPERATE THE NEW ADDITION. BOND ISSUE D (2): DRAW-DOWN FINANCING LEASE PROGRAM WITH BANC OF AMERICA PUBLIC CAPITAL CORP. IN THE MAXIMUM PRINCIPAL AMOUNT OF $40,000,000 TO FINANCE MEDICAL, COMPUTER, OFFICE, AND CAPITAL EQUIPMENT. BOND ISSUE A (3): DRAW-DOWN FINANCING LEASE PROGRAM WITH SUNTRUST EQUIPMENT FINANCE AND LEASING CORP. IN THE MAXIMUM PRINCIPAL AMOUNT OF $40,000,000 TO FINANCE MEDICAL, COMPUTER, OFFICE, AND CAPITAL EQUIPMENT. SCHEDULE K, PART II, LINE 3 BOND ISSUE B: PROCEEDS INCLUDE ISSUE PRICE PLUS ORIGINAL ISSUE DISCOUNT / UPFRONT FEE PAID DIRECTLY BY DUHS TO THE BANK UPON ISSUANCE. BOND ISSUES D: PROCEEDS INCLUDE INVESTMENT EARNINGS. BOND ISSUES D (2) AND A (3): PROCEEDS REFLECT ACTUAL PRINCIPAL DRAWN DOWN UNDER DRAW DOWN FINANCING LEASE PROGRAM. SCHEDULE K, PART III, B(2), LINES 4-6: RESPONSES REFLECT THE COMPUTATION OF THE PORTION OF THE ISSUE ALLOCABLE TO THE REFUNDING OF THE 2009A BONDS. SCHEDULE K, PART IV, LINE 2C BOND ISSUES A, B, AND D: BOND ISSUE (A) ARBITRAGE REPORT COMPLETED 03/22/17; (B) COMPLETED 05/30/17; (D) COMPLETED 05/31/17. AS TO D(2) AND A(3), NO ARBITRAGE COMPUTATION WAS NECESSARY BECAUSE NO PROCEEDS WERE REINVESTED. BOND ISSUES A, B, C AND A (2): THESE PROCEEDS WERE DISBURSED OR DEEMED DISBURSED UPON ISSUANCE TO CURRENTLY REFUND THE PRIOR BONDS. BOND ISSUES D (2), AND A (3): SALES PROCEEDS ALLOCATED UPON ISSUANCE AND NOT INVESTED. SCHEDULE K, PART III, LINE 8C, BOND ISSUE (C): DISPOSITION WAS THE SUBJECT OF A CLOSING AGREEMENT ACCEPTED AND CLOSED WITH THE IRS IN OCTOBER 2014 THROUGH THE TAX EXEMPT BONDS VOLUNTARY CLOSING AGREEMENT PROGRAM.ExplanationTxt

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (4 entries)

Bond ReferenceBondReferenceCdBond Issuer EINBondIssuerEINBond IssuedBondIssuedDtIssue PriceIssuePriceAmtPurposePurposeDescDefeasedDefeasedIndOn Behalf Of IssuerOnBehalfOfIssuerIndPool FinancingPoolFinancingIndCUSIPCUSIPNum
NORTH CAROLINA MEDICAL CARE COMMISSION
A5213094022012-08-28$48,225,000SEE PART VI000
NORTH CAROLINA MEDICAL CARE COMMISSION
B5213094022016-05-26$383,990,154SEE PART VI00065821DUD1
NORTH CAROLINA MEDICAL CARE COMMISSION
C5213094022016-08-11$140,200,389SEE PART VI00065821DVK4
NORTH CAROLINA MEDICAL CARE COMMISSION
D5213094022012-03-06$40,000,000SEE PART VI000

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (4 entries)

Bond ReferenceBondReferenceCdRetiredRetiredAmtTotal ProceedsTotalProceedsAmtOther Spent ProceedsOtherSpentProceedsAmtCurrent RefundingCurrentRefundingIndAdvance RefundingAdvanceRefundingIndFinal Allocation MadeFinalAllocationMadeIndAdequate Books And Rec MaintAdequateBooksAndRecMaintIndRefunding EscrowRefundingEscrowAmtIssuance Costs From ProceedsIssuanceCostsFromProceedsAmtSubstantial CompletionSubstantialCompletionYr
A$19,575,000$48,225,000$48,225,000Yes (1)0Yes (1)Yes (1)
B$11,355,000$383,990,154$180,000,000Yes (1)Yes (1)Yes (1)Yes (1)$201,888,819$2,101,335
C$140,200,3890Yes (1)Yes (1)Yes (1)$139,008,505$1,191,884
D$14,988,274$30,861,504$30,861,50400Yes (1)Yes (1)2014

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (3 entries)

Bond ReferenceBondReferenceCdOwning Bond Financed PropertyOwningBondFinancedPropertyIndAny Lease ArrangementsAnyLeaseArrangementsIndMgmt Contract Bond Fincd PropMgmtContractBondFincdPropIndEngage Bond Counsel ContractsEngageBondCounselContractsIndAny Research AgreementsAnyResearchAgreementsIndBond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestIndChange In Use Bond Financed PropChangeInUseBondFinancedPropIndProcs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdIndPrivate Bus Use By OthersPrivateBusUseByOthersPctPrivate Bus Concerning UBIPrivateBusConcerningUBIPctTotal Private Business UseTotalPrivateBusinessUsePct
B00Yes (1)Yes (1)000Yes (1)
C00Yes (1)Yes (1)00000.000000.000000.00000
D00Yes (1)Yes (1)000Yes (1)0.000000.000000.00000

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (4 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledIndRebate Not Due YetRebateNotDueYetIndException To RebateExceptionToRebateIndNo Rebate DueNoRebateDueIndVariable Rate IssueVariableRateIssueIndHedge Identified In Bks And RecHedgeIdentifiedInBksAndRecIndGross Proceeds Invested In GICGrossProceedsInvestedInGICIndGross Proceeds InvestedGrossProceedsInvestedIndWritten Proc To Monitor ReqsWrittenProcToMonitorReqsInd
A0Yes (1)00Yes (1)000Yes (1)
B0Yes (1)00Yes (1)000Yes (1)
C0Yes (1)000000Yes (1)
D000Yes (1)0000Yes (1)

Procedures Corrective Action ProceduresCorrectiveActionGrp (4 entries)

Bond ReferenceBondReferenceCdProcedures Corrective ActionProceduresCorrectiveActionInd
AYes (1)
BYes (1)
CYes (1)
DYes (1)

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1NORTH CAROLINA MEDICAL CARE COMMISSIONBusinessNameLine1Txt
FieldValueIRS element (for citing)
Bond Issuer EIN521309402BondIssuerEIN
Bond Issued2015-04-21BondIssuedDt
Issue Price$40,000,000IssuePriceAmt
PurposeSEE PART VIPurposeDesc
Defeased0DefeasedInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Pool Financing0PoolFinancingInd

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Retired$1,457,421RetiredAmt
Total Proceeds$19,035,078TotalProceedsAmt
Capital Expenditures$19,035,078CapitalExpendituresAmt
Current Refunding0CurrentRefundingInd
Advance Refunding0AdvanceRefundingInd
Final Allocation Made0FinalAllocationMadeInd
Adequate Books And Rec MaintYes (1)AdequateBooksAndRecMaintInd

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Owning Bond Financed Property0OwningBondFinancedPropertyInd
Any Lease Arrangements0AnyLeaseArrangementsInd
Mgmt Contract Bond Fincd PropYes (1)MgmtContractBondFincdPropInd
Engage Bond Counsel ContractsYes (1)EngageBondCounselContractsInd
Any Research Agreements0AnyResearchAgreementsInd
Private Bus Use By Others0.00000PrivateBusUseByOthersPct
Private Bus Concerning UBI0.00000PrivateBusConcerningUBIPct
Total Private Business Use0.00000TotalPrivateBusinessUsePct
Bond Iss Meet Prvt Sec Pymt Test0BondIssMeetPrvtSecPymtTestInd
Change In Use Bond Financed Prop0ChangeInUseBondFinancedPropInd
Procs Nonqualified Bond RemdtdYes (1)ProcsNonqualifiedBondRemdtdInd

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Form8038 T Filed0Form8038TFiledInd
Rebate Not Due YetYes (1)RebateNotDueYetInd
Exception To Rebate0ExceptionToRebateInd
No Rebate Due0NoRebateDueInd
Variable Rate Issue0VariableRateIssueInd
Hedge Identified In Bks And Rec0HedgeIdentifiedInBksAndRecInd
Gross Proceeds Invested In GIC0GrossProceedsInvestedInGICInd
Gross Proceeds Invested0GrossProceedsInvestedInd
Written Proc To Monitor ReqsYes (1)WrittenProcToMonitorReqsInd

Procedures Corrective Action ProceduresCorrectiveActionGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Procedures Corrective ActionYes (1)ProceduresCorrectiveActionInd

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (2 entries)

Relationship DescriptionRelationshipDescriptionTxtTransactionTransactionAmtTransactionTransactionDescSharing Of RevenuesSharingOfRevenuesInd
BIOVENTUS LLC
SEE PART V$636,582SEE PART V0
DANIEL J SCOTT MD
SEE PART V$67,752SEE PART V0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCH L, PART IV, BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS:FormAndLineReferenceDesc
Explanation(A) NAME OF INTERESTED PERSON: BIOVENTUS, LLC(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: BIOVENTUS LLC, DIRECTOR IS A DUHS, INC. DIRECTOR(C) AMOUNT OF TRANSACTION: $636,582(D) DESCRIPTION OF TRANSACTION: PAYMENT FOR GOODS OR SERVICES(E) SHARING OF ORGANIZATION REVENUE? = NO(A) NAME OF INTERESTED PERSON: DANIEL J. SCOTT, MD(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: DANIEL J. SCOTT, MD IS A FAMILY MEMBER OF A DUHS, INC. DIRECTOR(C) AMOUNT OF TRANSACTION: $67,752(D) DESCRIPTION OF TRANSACTION: PAYMENT FOR SALARY AND BENEFITS(E) SHARING OF ORGANIZATION REVENUE? = NOExplanationTxt

Schedule M IRS990ScheduleM

Books And Publications BooksAndPublicationsGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
Noncash Contributions Rpt F990$2NoncashContributionsRptF990Amt
Method Of Determining RevenuesTHRIFT STORE VALUEMethodOfDeterminingRevenuesTxt

Clothing And Household Goods ClothingAndHouseholdGoodsGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
Noncash Contributions Rpt F990$2,813NoncashContributionsRptF990Amt
Method Of Determining RevenuesTHRIFT STORE VALUEMethodOfDeterminingRevenuesTxt

Securities Publicly Traded SecuritiesPubliclyTradedGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
Contribution10ContributionCnt
Noncash Contributions Rpt F990$50,398NoncashContributionsRptF990Amt
Method Of Determining RevenuesMARKET QUOTEMethodOfDeterminingRevenuesTxt

Other Non Cash Contri Table OtherNonCashContriTableGrp (3 entries)

Non Cash CheckboxNonCashCheckboxIndDescDescContributionContributionCntNoncash Contributions Rpt F990NoncashContributionsRptF990AmtMethod Of Determining RevenuesMethodOfDeterminingRevenuesTxt
Yes (X)EQUIPMENT2$20,696MARKET QUOTE
Yes (X)ENTERTAINMENT9$790MARKET QUOTE
Yes (X)SPORTS4$744MARKET QUOTE
FieldValueIRS element (for citing)
Form8283 Received0Form8283ReceivedCnt
Any Property That Must Be Held0AnyPropertyThatMustBeHeldInd
Review Process Unusual NC GiftsYes (1)ReviewProcessUnusualNCGiftsInd
Third Parties UsedYes (1)ThirdPartiesUsedInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 32B:FormAndLineReferenceDesc
ExplanationDUKE UNIVERSITY HEALTH SYSTEM, INC. USES INVESTMENT BROKERS TO SELL INVESTMENTS. DUKE UNIVERSITY HEALTH SYSTEM, INC. MAY OCCASIONALLY USE THIRD PARTIES TO SELL OTHER TYPES OF NON-CASH CONTRIBUTIONS, AS THE NEED ARISES.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART I, LINE 1, & PART III, DESCRIPTION OF ORGANIZATION MISSION:DUHS, AS PART OF DUKE HEALTH, IS COMMITTED TO ADVANCING HEALTH TOGETHER BY DELIVERING TOMORROW'S HEALTH CARE TODAY, ACCELERATING DISCOVERY AND ITS TRANSLATION, CREATING EDUCATION THAT IS TRANSFORMING, BUILDING HEALTHY COMMUNITIES, AND CONNECTING WITH THE WORLD TO IMPROVE HEALTH GLOBALLY.
FORM 990, PART III, LINE 4ASTATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS HISTORY AND ORGANIZATION IN 1925, JAMES B. DUKE WILLED $4 MILLION TO ESTABLISH DUKE UNIVERSITY HOSPITAL AND ITS MEDICAL SCHOOL TO IMPROVE HEALTH CARE IN THE CAROLINAS, THEN A POOR REGION LACKING HOSPITALS AND HEALTH CARE PROVIDERS. DUKE UNIVERSITY HOSPITAL HAS GROWN TO BE RECOGNIZED AS ONE OF THE WORLD'S GREAT HEALTH CARE PROVIDERS. IN 1998 AND CONCURRENT WITH ACQUIRING CONTROL OF TWO LOCAL COMMUNITY HOSPITALS, THE DUKE UNIVERSITY BOARD OF TRUSTEES ESTABLISHED DUKE UNIVERSITY HOSPITAL AS THE FLAGSHIP OF THE NEWLY INCORPORATED DUKE UNIVERSITY HEALTH SYSTEM, INC. (DUHS) TO MANAGE A WIDE RANGE OF HEALTH CARE PROGRAMS AT THE SAME HIGH LEVEL OF QUALITY THAT HAS TRADITIONALLY MADE DUKE UNIVERSITY HOSPITAL A WORLD LEADER. THIS NETWORK OF REGIONAL HEALTH CARE ORGANIZATIONS IS DEDICATED TO EMPLOYING DUKE'S STRENGTHS IN PATIENT CARE, EDUCATION, AND RESEARCH. DUHS IS A COMPONENT OF DUKE HEALTH WHICH CONCEPTUALLY INTEGRATES THE DUKE UNIVERSITY SCHOOL OF MEDICINE, DUKE-NUS MEDICAL SCHOOL, DUKE UNIVERSITY SCHOOL OF NURSING, DUKE UNIVERSITY HEALTH SYSTEM, PRIVATE DIAGNOSTIC CLINIC (DUKE PHYSICIANS PRACTICE), AND INCORPORATES THE HEALTH AND HEALTH RESEARCH PROGRAMS WITHIN THE DUKE GLOBAL HEALTH INSTITUTE AS WELL AS THOSE IN SCHOOLS AND CENTERS ACROSS DUKE UNIVERSITY, INCLUDING THE DUKE ROBERT J. MARGOLIS CENTER FOR HEALTH POLICY. THE DUKE HEALTH CLINICAL ENTERPRISE IS INTENDED TO FUNCTION AS A FULLY ALIGNED AND UNIFIED ORGANIZATION FOCUSED ON IMPROVING THE HEALTH OF THE COMMUNITIES WE SERVE, DELIVERING ADVANCED TREATMENT FOR THOSE WHO NEED IT, AND EXTENDING NEW KNOWLEDGE BEYOND OUR SYSTEMS TO THE BENEFIT OF OTHERS. LEVERAGING THE DEPTH AND BREADTH OF CAPABILITIES THAT EXIST ACROSS DUKE HEALTH AND THE ENTIRE UNIVERSITY, WE PLAN TO ACHIEVE THE VISION TO DELIVER TOMORROW'S HEALTH CARE TODAY BY LEADING IN THE DELIVERY OF HIGHEST-QUALITY, PATIENT CENTERED CARE, INTEGRATING TO OPTIMIZE COORDINATION OF CARE, GROWING AND EXTENDING OUR REACH LOCALLY, REGIONALLY, AND NATIONALLY, INVESTING IN INNOVATION TO CREATE SUSTAINABLE DIFFERENTIATION AND VALUE AND DELIVERING ON THE PROMISE OF POPULATION HEALTH. MANY PROGRAM SERVICE ACCOMPLISHMENTS ARE INCLUDED IN SCHEDULE H OF THIS FORM INCLUDING THE FINANCIAL COMMITMENT MADE TO THE COMMUNITY BY DUHS IN TERMS OF CHARITY CARE AND OTHER DIRECT AND MEASURABLE INVESTMENTS. BELOW ARE EXCERPTS FROM THE ANNUAL DUHS REPORT ON COMMUNITY BENEFIT. THE COST OF THESE ACTIVITIES CAN BE DIFFICULT TO MEASURE. SOMETIMES THEY INCLUDE THE PARTICIPATION OF DUKE UNIVERSITY SO REFERENCES TO "DUKE" ARE MEANT TO INCLUDE DUHS AND DUKE UNIVERSITY IN THEIR RESPECTIVE MISSION CAPACITIES. DUKE: A PARTNER IN CARE FOR PEOPLE, COMMUNITIES ACROSS NORTH CAROLINA WHEN ITS MEDICAL SCHOOL AND FIRST HOSPITAL OPENED MORE THAN 85 YEARS AGO, DUKE DEDICATED ITSELF TO IMPROVING THE HEALTH OF PEOPLE ACROSS NORTH CAROLINA. TODAY, IN WHAT HAS EVOLVED INTO DUKE UNIVERSITY HEALTH SYSTEM, THAT PROUD COMMITMENT TO CARE CONTINUES. THIS EDITION OF OUR ANNUAL REPORT ON COMMUNITY BENEFIT TELLS HOW. FOR THE FISCAL YEAR THAT ENDED JUNE 30, 2017, DUKE PROVIDED A TOTAL COMMUNITY BENEFIT AND INVESTMENT OF $509 MILLION. OF THAT FIGURE, $97 MILLION REPRESENTS CHARITY CARE AT ESTIMATED COST PROVIDED TO 235,417 PATIENTS, WITH 95% FROM NORTH CAROLINA. INCLUDING THE $509 MILLION FOR FY2017, DUKE'S TOTAL COMMUNITY BENEFIT AND INVESTMENT OVER THE PAST 10 YEARS EXCEEDS $3 BILLION. MORE THAN 7,000 DUKE-TRAINED HEALTHCARE PROFESSIONALS MAKE THEIR HOME IN NORTH CAROLINA: * PHYSICIANS 3,348 * NURSES 2,734 * PHYSICIAN ASSISTANTS 653 * PHYSICAL THERAPISTS 299 * PATHOLOGY ASSISTANTS 28 FOR A TOTAL OF 7,062 DUKE PROVIDED $97 MILLION IN CHARITY CARE AT ESTIMATED COST TO 235,417 PATIENTS DURING THE FISCAL YEAR THAT ENDED ON JUNE 30, 2017. 95 PERCENT OF THESE PATIENTS WERE RESIDENTS OF NORTH CAROLINA. 84 PERCENT RESIDED IN DUKE'S PRIMARY SERVICE AREA OF ALAMANCE, DURHAM, GRANVILLE, ORANGE, PERSON, VANCE AND WAKE COUNTIES. HIGHLIGHTS OF DUKE'S CHARITY CARE AND DISCOUNTED CARE POLICIES: * DUKE PROVIDES WORLD-CLASS CARE WITH A CONSISTENTLY HIGH LEVEL OF DIGNITY, RESPECT AND SKILL TO ALL PATIENTS, REGARDLESS OF THEIR ABILITY TO PAY. * DUKE PROVIDES ELIGIBLE CARE AT A DISCOUNT OR WITHOUT CHARGE TO ALL QUALIFYING PATIENTS WHO DO NOT HAVE HEALTH INSURANCE, OR WHO CANNOT PAY FOR CARE BECAUSE OF FINANCIAL HARDSHIP (ONLY MEDICALLY NECESSARY SERVICES ARE ELIGIBLE.) * DUKE PHYSICIANS DONATE EMERGENCY, PRIMARY, AND SPECIALTY CARE SERVICES TO ELIGIBLE UNINSURED PATIENTS THROUGH PROJECT ACCESS, A PROGRAM IN DURHAM AND WAKE COUNTIES. * DUKE HELPS PATIENTS NAVIGATE THROUGH GOVERNMENT-SPONSORED FINANCIAL-ASSISTANCE PROGRAMS. * DUKE ABSORBS COST DIFFERENCES WHEN GOVERNMENT PROGRAMS SUCH AS MEDICAID DO NOT COMPLETELY COVER THE COST OF CARE. DUKE UNIVERSITY HEALTH SYSTEM, AS WELL AS DUKE HEALTH, WORKS WITHIN THE COMMUNITIES IT SERVES TO PROMOTE WELLNESS AND ACCESS TO CARE. PARTNERING WITH LOCAL RESIDENTS, WE ADDRESS PRESSING NEEDS TO ENSURE HEALTHY NORTH CAROLINIANS. IN ADDITION, THROUGH ITS TWO HOSPITALS IN DURHAM AND ONE IN RALEIGH, DUKE COLLABORATES WITH PUBLIC HEALTH DEPARTMENTS IN DURHAM AND WAKE COUNTIES AND NUMEROUS COMMUNITY ORGANIZATIONS TO BETTER UNDERSTAND THE NEEDS OF THE PEOPLE WHO LIVE HERE. SUPPORTING THE WORK OF COMMUNITY GROUPS: DUKE AND ITS LOCAL PARTNERS CONTINUE COLLABORATIVE EFFORTS TO ELIMINATE HEALTHCARE DISPARITIES AND IMPROVE ACCESS TO HIGH-QUALITY MEDICAL CARE. IN THE 2017 FISCAL YEAR, DUKE PROVIDED $12 MILLION IN CASH AND IN-KIND SUPPORT FOR COMMUNITY GROUPS, INCLUDING: (1) $8.0 MILLION FOR LINCOLN COMMUNITY HEALTH CENTER AND ITS SATELLITE COMMUNITY CLINICS, WHICH SERVE A MAJORITY POOR AND UNINSURED POPULATION; (2) $2.4 MILLION FOR DURHAM COUNTY'S EMERGENCY MEDICAL SERVICES PROGRAM; (3) $1.6 MILLION IN CASH CONTRIBUTIONS TO OTHER COMMUNITY ORGANIZATIONS. INVESTING IN HEALTH PROFESSIONS EDUCATION: EDUCATING THE NEXT GENERATION OF PHYSICIANS, NURSES, NURSE PRACTITIONERS, PHYSICIAN ASSISTANTS, PHYSICAL THERAPISTS, AND PATHOLOGY ASSISTANTS IS CENTRAL TO DUKE'S MISSION TO IMPROVE HEALTHCARE FOR PATIENTS AND THE COMMUNITY. IN THE 2017 FISCAL YEAR, DUKE INVESTED MORE THAN $65 MILLION IN ITS HEALTH PROFESSIONS EDUCATION PROGRAM. THE PROGRAM REMAINS AMONG THE MOST CHALLENGING AND INNOVATIVE IN THE COUNTRY AND EMPHASIZES NEW MODELS OF COMMUNITY-FOCUSED CARE ON HEALTH, WELLNESS, AND SELF-CARE, AS WELL AS POPULATION HEALTH MANAGEMENT.
FORM 990, PART VI, SECTION A, LINE 2DIRECTORS JACK O. BOVENDER, JR., RICHARD H. BRODHEAD, THOMAS M. GORRIE, WILLIAM HAWKINS, MICHAEL MARSICANO, DAVID M. RUBENSTEIN, AND STEVEN SCOTT, MD ARE TRUSTEES OF DUKE UNIVERSITY. DIRECTOR AND PRESIDENT/CEO, A. EUGENE WASHINGTON, MD, IS AN OFFICER OF DUKE UNIVERSITY. THE FOLLOWING INDIVIDUALS ARE EMPLOYEES OF DUKE UNIVERSITY: NANCY CATHERINE ANDREWS, MD, MARY KLOTMAN, MD, AND MARK F. NEWMAN. DIRECTOR AND PRESIDENT/CEO, A. EUGENE WASHINGTON, MD, DIRECTOR MARK F. NEWMAN, AND OFFICERS WILLIAM J. FULKERSON, MD, AND KENNETH C. MORRIS ARE DIRECTORS OF DURHAM CASUALTY COMPANY, LTD. DIRECTOR AND PRESIDENT/CEO, A. EUGENE WASHINGTON, MD, DIRECTORS MARY KLOTMAN, MD, MARK F. NEWMAN, AND OFFICER WILLIAM J. FULKERSON, MD, ARE BOARD MEMBERS OF PRIVATE DIAGNOSTIC CLINIC, PLLC. OFFICERS WILLIAM J. FULKERSON, MD AND KENNETH C. MORRIS ARE BOTH DIRECTORS AND OFFICERS OF HEALTH SYSTEM MEDICAL STRATEGIES, INC.
FORM 990, PART VI, SECTION A, LINE 3DUHS DELEGATES CONTROL TO A SUPPORTING ORGANIZATION FOR THE MANAGEMENT OF INVESTMENTS.
FORM 990, PART VI, SECTION A, LINE 4DUHS AMENDED BYLAWS BECAME EFFECTIVE APRIL 7, 2017 STATING THE FOLLOWING SIGNIFICANT CHANGE: QUORUM - AT ALL MEETINGS OF THE BOARD OF DIRECTORS, THE PRESENCE OF ONE-HALF (1/2 ) OF THE DIRECTORS THEN HOLDING OFFICE SHALL BE NECESSARY AND SUFFICIENT TO CONSTITUTE A QUORUM FOR THE TRANSACTION OF BUSINESS, AND THE ACT OF A MAJORITY OF THE DIRECTORS PRESENT AT ANY MEETING AT WHICH THERE IS A QUORUM SHALL BE THE ACT OF THE BOARD OF DIRECTORS, EXCEPT AS MAY BE OTHERWISE SPECIFICALLY PROVIDED BY STATUTE, THE ARTICLES OF INCORPORATION, OR THESE BYLAWS.
FORM 990, PART VI, SECTION A, LINE 7ATHE MEMBERS OF THE BOARD OF DIRECTORS OF DUHS, OTHER THAN THE EX OFFICIO MEMBERS, WILL BE NOMINATED BY THE BOARD OF DIRECTORS OF DUHS, AND WILL BE APPOINTED BY THE BOARD OF TRUSTEES OF DUKE UNIVERSITY. MEMBERS OF THE BOARD OF DIRECTORS OF DUHS WILL BE SUBJECT TO REMOVAL AT THE DISCRETION OF THE BOARD OF TRUSTEES OF DUKE UNIVERSITY IN ACCORDANCE WITH THE BYLAWS OF DUHS.
FORM 990, PART VI, SECTION A, LINE 7BTHE DUHS BYLAWS PROVIDE THAT DUHS MUST OBTAIN DUKE UNIVERSITY BOARD OF TRUSTEES APPROVAL FOR CERTAIN SIGNIFICANT TRANSACTIONS REGARDING DEBT ISSUANCES, CAPITAL ACQUISITIONS AND TANGIBLE PERSONAL AND REAL PROPERTY SALES.
FORM 990, PART VI, SECTION B, LINE 11BAFTER STAFF PREPARATION AND MANAGEMENT REVIEW, THE DUHS FORM 990 IS PRESENTED TO THE DUHS COMPLIANCE/AUDIT COMMITTEE OF THE BOARD OF DIRECTORS FOR REVIEW AND DISCUSSION. DUHS BOARD LEVEL COMMENT AND DISCUSSION ARE INCORPORATED INTO THE FORM AS APPROPRIATE PRIOR TO FILING. A FINAL VERSION OF THE FORM IS EMAILED TO THE DUHS BOARD OF DIRECTORS FOR FURTHER REVIEW AND COMMENT BEFORE FILING.
FORM 990, PART VI, SECTION B, LINE 12CDUHS MONITORS AND ENFORCES COMPLIANCE RELATED TO CONFLICT OF INTEREST VIA AN ANNUAL CONFLICT OF INTEREST QUESTIONNAIRE, RELYING ON SELF DISCLOSURE OF ALL THOSE SUBJECT TO THE COI POLICY.
FORM 990, PART VI, SECTION B, LINE 15THE DUHS COMPENSATION COMMITTEE, COMPRISED OF MEMBERS OF THE DUHS BOARD OF DIRECTORS, REVIEWS AND APPROVES ALL EXECUTIVE COMPENSATION FOR ALL DISQUALIFIED PERSONS AND OTHER KEY EMPLOYEES. THE DUHS COMPENSATION COMMITTEE REVIEWS AND RECOMMENDS TO THE DUKE UNIVERSITY COMPENSATION COMMITTEE THE COMPENSATION FOR THE PRESIDENT AND CEO OF DUHS WHO IS ALSO AN OFFICER OF DUKE UNIVERSITY. DUHS HAS ADOPTED A STATEMENT OF COMPENSATION PHILOSOPHY THAT ARTICULATES BROAD OBJECTIVES TO HELP GUIDE THE DUHS COMPENSATION COMMITTEE IN ITS MISSION. THE DUHS COMPENSATION COMMITTEE ENGAGES THE SERVICES OF AN OUTSIDE EXECUTIVE COMPENSATION CONSULTING FIRM TO ESTABLISH COMPARABILITY DATA OF OTHER HEALTH CARE SYSTEMS OF SIMILAR SIZE AND COMPLEXITY AS DUHS. THE DUHS COMPENSATION COMMITTEE REVIEWS THE MARKET ANALYSIS THEN DETERMINES THE REASONABLENESS AND APPROPRIATENESS OF ALL ASPECTS OF EXECUTIVE COMPENSATION. THE DUHS COMPENSATION COMMITTEE ALSO SETS THE METRICS AND APPROVES THE PAYOUTS FOR THE DUHS INCENTIVE COMPENSATION PLANS FOR THESE INDIVIDUALS. THE DELIBERATIONS AND CONCLUSIONS OF THE DUHS COMPENSATION COMMITTEE ARE KEPT BY A RECORDING SECRETARY WHO RECORDS THE MINUTES OF THE COMMITTEE MEETINGS.
FORM 990, PART VI, SECTION C, LINE 18DUKE UNIVERSITY HEALTH SYSTEM, INC.'S FORM 990 IS AVAILABLE TO THE PUBLIC ON WWW.GUIDESTAR.ORG. GUIDESTAR INDEPENDENTLY POSTS TAX-EXEMPT ORGANIZATIONS' FORM 990'S ON THEIR WEBSITE, OBTAINED FROM THE INTERNAL REVENUE SERVICE.
FORM 990, PART VI, SECTION C, LINE 19DUKE UNIVERSITY HEALTH SYSTEM, INC.'S GOVERNING DOCUMENTS (ARTICLES OF INCORPORATION AND ANY SUBSEQUENT AMENDMENTS OR RESTATEMENTS) ARE AVAILABLE TO THE PUBLIC ON THE NORTH CAROLINA SECRETARY OF STATE WEBSITE. DUKE UNIVERSITY HEALTH SYSTEM, INC. MAKES ITS CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. INDEPENDENTLY AUDITED FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC BY GOING TO WWW.DUKEHEALTH.ORG; SELECTING "ABOUT DUKEHEALTH; CLICKING ON "CLINICAL ENTERPRISE AND SELECTING "FINANCIAL INFORMATION".
FORM 990, PART XI, LINE 9:NONPERIODIC CHANGES IN DEFINED BENEFIT PLANS: 83,820,252. NET TRANSFERS TO THE UNIVERSITY AND AFFILIATES: -125,875,511. CHANGE IN MARKET VALUE OF DERIVATIVES: 36,536,402.

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdTotal IncomeTotalIncomeAmtEnd Of Year AssetsEndOfYearAssetsAmtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Txt
DUKE PRMO LLC
615 DOUGLAS STREET SUITE 700DURHAMNC27705MEDICAL BILLINGNC$145,211,047$1,925,658DUKE UNIVERSITY HEALTH SYSTEM INC
DUHS GLOBAL LLC
310 BLACKWELL STREET 4TH FLOOR BOXDURHAMNC27710SUPPORTNC$0$0DUKE UNIVERSITY HEALTH SYSTEM INC

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (34 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationIndEINEINDirect Controlling NADirectControllingNACd
AMER ASSOC FOR GIFTED CHILDREN - 56-1686219
324 BLACKWELL STREET STE 850DURHAMNC27701SUPPORTNC501(C)(3)11 TYPE 1DUKE UNIVERSITY0
ASSOCIATED HEALTH SVCS INC
324 BLACKWELL STREET STE 850DURHAMNC27701HEALTHCARENC501(C)(3)11 TYPE 1DUKE UNIVERSITY HEALTH SYSTEM INCYes (1)561845329
DU SPECIAL VENTURES FUND INC
280 S MANGUM STREET STE 210DURHAMNC27701INVESTMENTSNC501(C)(3)11 TYPE 1DUKE UNIVERSITY0561465177
DUKE ALUMNI ASSOCIATION INC
324 BLACKWELL STREET STE 850DURHAMNC27701SUPPORTNC501(C)(3)11 TYPE 1DUKE UNIVERSITY0561594088
DUKE CORPORATE EDUCATION
310 BLACKWELL STDURHAMNC27701EDUCATIONNC501(C)(3)11 TYPE 1DUKE UNIVERSITY0421672476
DUKE GIFT PROPERTIES INC
324 BLACKWELL STREET STE 850DURHAMNC27701SUPPORTNC501(C)(3)11 TYPE 1DUKE UNIVERSITY0571211078
DUKE GLOBAL INC
324 BLACKWELL STREET STE 850DURHAMNC27701SUPPORTNC501(C)(3)11 TYPE 1DUKE UNIVERSITY0611588319
DUKE HOSPITAL AUXILIARY INC
PO BOX 2895DURHAMNC27710SUPPORTNC501(C)(3)11 TYPE III-O0561825604N/A
DUKE INTEGRATED NETWORK INC
324 BLACKWELL STREET STE 850DURHAMNC27701SUPPORTNC501(C)(3)11 TYPE 1DUKE UNIVERSITY HEALTH SYSTEM INCYes (1)463129771
DUKE MEDICINE GLOBAL SUPP CORP- 61-1593721
324 BLACKWELL STREET STE 850DURHAMNC27701SUPPORTNC501(C)(3)11 TYPE 1DUKE UNIVERSITY0
DUKE QUALITY NETWORK INC
324 BLACKWELL STREET STE 850DURHAMNC27701SUPPORTNC501(C)(3)11 TYPE 1DUKE UNIVERSITY HEALTH SYSTEM INCYes (1)461340679
DUKE SCHOLARLY EXHIBITS INC
324 BLACKWELL STREET STE 850DURHAMNC27701SUPPORTNC501(C)(3)11 TYPE 1DUKE UNIVERSITY0561701245
DUKE UNIV AFFILIATED PHYSICIANS
324 BLACKWELL STREET STE 850DURHAMNC27701HEALTHCARENC501(C)(3)11 TYPE 1DUKE UNIVERSITY HEALTH SYSTEM INCYes (1)561902501
DUKE UNIV PHILANTHROPIES INC
324 BLACKWELL STREET STE 850DURHAMNC27701SUPPORTNC501(C)(3)11 TYPE 1DUKE UNIVERSITY0571211099
DUKE UNIV SCH OF MED RESEARCH FDN 56-2247203
324 BLACKWELL STREET STE 850DURHAMNC27701SUPPORTNC501(C)(3)11 TYPE 1DUKE UNIVERSITY0
DUKE UNIVERSITY
324 BLACKWELL STREET STE 850DURHAMNC27701EDUCATIONNC501(C)(3)LINE 20560532129N/A
DUMAC INC
280 S MANGUM STREET STE 210DURHAMNC27701SUPPORTNC501(C)(3)11 TYPE 1DUKE UNIVERSITY0900754895
DURHAM ASSET MGMT COMPANY INC
324 BLACKWELL STREET STE 850DURHAMNC27701SUPPORTNC501(C)(3)11 TYPE 1DUKE UNIVERSITY0561757238
DURHAM REALTY INC
324 BLACKWELL STREET STE 850DURHAMNC27701SUPPORTNC501(C)(3)11 TYPE 1DUKE UNIVERSITY0561917936
GOTHIC CORPORATION
280 S MANGUM STREET STE 210DURHAMNC27701INVESTMENTSNC501(C)(3)11 TYPE 1DUKE UNIVERSITY0561776668
GOTHIC HSP CORPORATION
280 S MANGUM STREET STE 210DURHAMNC27701INVESTMENTSNC501(C)(3)11 TYPE 1DUKE UNIVERSITY HEALTH SYSTEM INCYes (1)271325761
HIGH POINT REALTY ASSOCIATES INC
324 BLACKWELL STREET STE 850DURHAMNC27701SUPPORTNC501(C)(3)11 TYPE 1DUKE UNIVERSITY0561917939
INNOVATIONS IN HEALTHCARE INC
324 BLACKWELL STREET STE 850DURHAMNC27701SUPPORTNC501(C)(3)11 TYPE 1DUKE UNIVERSITY0320358709
RUTH K BROAD BIOMED RES FDN
324 BLACKWELL STREET STE 850DURHAMNC27701SUPPORTNC501(C)(3)11 TYPE 1DUKE UNIVERSITY0650045051
THE CTR FOR DOCUMENTARY STUDIES
1317 PETTIGREW STREETDURHAMNC27705SUPPORTNC501(C)(3)11 TYPE 1DUKE UNIVERSITY0561655039
THE LORD FDN OF NORTH CAROLINA
324 BLACKWELL STREET STE 850DURHAMNC27701SUPPORTNC501(C)(3)11 TYPE 1DUKE UNIVERSITY0561415423
DUKE JANJUN SERVICES INC
324 BLACKWELL STREET STE 850DURHAMNC27701SUPPORTNC501(C)(3)11 TYPE 1DUKE UNIVERSITY0471150667
DUKE JULDEC SERVICES INC
324 BLACKWELL STREET STE 850DURHAMNC27701SUPPORTNC501(C)(3)11 TYPE 1DUKE UNIVERSITY0471143245
DUKE ALLMO SERVICES INC
324 BLACKWELL STREET STE 850DURHAMNC27701SUPPORTNC501(C)(3)11 TYPE 1DUKE UNIVERSITY0471133466
DUKE INVESTMENT EDUCATION INC
324 BLACKWELL STREET STE 850DURHAMNC27701SUPPORTNC501(C)(3)11 TYPE 1DUKE UNIVERSITY0475555092
FSB REALTY INC
324 BLACKWELL STREET STE 850DURHAMNC27701SUPPORTNC501(C)(3)11 TYPE 1DUKE UNIVERSITY0811309454
DUKE AFFILIATIONS NETWORK INC
324 BLACKWELL STREET STE 850DURHAMNC27701SUPPORTNC501(C)(3)11 TYPE 1DUKE UNIVERSITY HEALTH SYSTEM INCYes (1)812623775
TRIANGLE FIBER GROUP
310 BLACKWELL STREET 4TH FLOORDURHAMNC27701SUPPORTNC501(C)(3)11 TYPE 1DUKE UNIVERSITY0815328550
DUKE UNIV FED CRED UNION
2200 WEST MAIN STREETDURHAMNC27705BANKINGNC501(C)(1)0561632379N/A

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (21 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdDirect Controlling NADirectControllingNACdPredominant Income TypePredominantIncomeTypeTxtDisproportionate AllocationsDisproportionateAllocationsIndGeneral Or Managing PartnerGeneralOrManagingPartnerIndAddress Line1ForeignAddress/AddressLine1TxtCityForeignAddress/CityNmCountryForeignAddress/CountryCdForeign PostalForeignAddress/ForeignPostalCdLegal Domicile Foreign CountryLegalDomicileForeignCountryCdEINEIN
BLACKWELL PARTNERS LLC - SERIES A - 20-8075455
280 S MANGUM ST STE 210DURHAMNC27701INVESTMENTSDEN/AN/A00
CANYON BLUE INV FD 27-0186996
AVE OF STARSLACA90067INVESTMENTSDEN/AN/A00
CD FUND LP - 27-0130641
MCKINNEY AVEDALLASTX75201INVESTMENTSTXN/AN/A00
LIQUID REALTY PTR 05-0537755
LINDA MESADANVILLECA94526INVESTMENTSDEN/AN/A00
LYRICAL BLUE RL PT 27-2994514
32 N DEAN STENGLEWOODNJ07631INVESTMENTSDEN/AN/A00
LYRICAL-BLUE RGNT 45-3626577
32 N DEAN STENGLEWOODNJ07631INVESTMENTSDEN/AN/A00
OCTAVIAN BLUE FD 27-2408711
5TH AVENUENYNY10151INVESTMENTSDEN/AN/A00
SBER LUCKY STRIKE 20-3891303
310 BLACKWELL STDURHAMNC27701REAL ESTATENCN/AN/A00
MANGUM II LLC - 46-5135858
280 S MANGUM STREET STE 210DURHAMNC27701INVESTMENTSNCN/AN/A00
LS INVESTOR LLC 20-3891381
310 BLACKWELL STDURHAMNC27701REAL ESTATENCN/AN/A00
DILWEG BLUE PF LP 47-1225569
5310 S ALSTON AVE STE 210DURHAMNC27713INVESTMENTSDEN/AN/A00
LYRICAL BLUE RL PT IV 47-2172270
32 N DEAN STENGLEWOODNJ07631INVESTMENTSDEN/AN/A00
LYRICAL BLUE CHP PT 35-2503856
32 N DEAN STENGLEWOODNJ07631INVESTMENTSDEN/AN/A00
LIQUID RLT PTR II TE - 20-4362819
INVESTMENTSDEN/AN/A0010 MARKET ST 769 CAMANA BAYGRAND CAYMANCJKY1-9006
STRATUS CAPITAL PARTNERS C LP
INVESTMENTSN/AN/A0050 LOTHIAN ROAD FESTIVAL SQUAREEDINBURGHUKEH3 9WJUK
ALTOS HYBRID D LLC
2882 SAND HILL ROAD SUITE 100MENLO PARKCA94025INVESTMENTSDEN/AN/A00473996176
GPE HOLDCO LLC
2000 AVE OF THE STARS 11TH FLLOS ANGELESCA90067INVESTMENTSDEN/AN/A00475652832
BLACKWELL PARTNERS LLC - SERIES C
280 S MANGUM ST STE 210DURHAMNC27701INVESTMENTSDEN/AN/A00811264533
BLACKWELL PARTNERS LLC - SERIES B
280 S MANGUM ST STE 210DURHAMNC27701INVESTMENTSDEN/AN/A00472530719
BLACKWELL PARTNERS LLC - SERIES D
280 S MANGUM ST STE 210DURHAMNC27701INVESTMENTSDEN/AN/A00813385353
BLACKWELL PARTNERS LLC - SERIES E
280 S MANGUM ST STE 210DURHAMNC27701INVESTMENTSDEN/AN/A00811511048

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (24 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdDirect Controlling NADirectControllingNACdEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationIndAddress Line1ForeignAddress/AddressLine1TxtCityForeignAddress/CityNmCountryForeignAddress/CountryCdForeign PostalForeignAddress/ForeignPostalCdLegal Domicile Foreign CountryLegalDomicileForeignCountryCdProvince Or StateForeignAddress/ProvinceOrStateNmBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtShare Of Total IncomeShareOfTotalIncomeAmtShare Of EOY AssetsShareOfEOYAssetsAmtOwnershipOwnershipPct
DUKE CE LS INC
310 BLACKWELL STREETDURHAMNC27701202004016REAL ESTATENCN/AC0
DUKE CE (SEA) PRIVATE LIMITED
SUPPORTN/AC01 RAFFLES PLACE TOWER 2SINGAPORESN048616SN
DUKE CORP EDU INDIA PRIVATE
421672476CONSULTINGN/AC0ACADEMIC BLOCK NEW CAMPUSVASTRAPURIN380015INAHMEDABAD
DUKE CORPORATE EDUCATION LIM
421672476EDUCATION CONSULTINGN/AC0165 FLEET STREETLONDONUKEC4A 2DYUK
DUKE CORPORATE EDUCATION RSA
421672476CONSULTINGN/AC0GROUND FLOOR TWICKEHNHAM BLDGBRYANSTONSF02021SFJOHANNESBURG
DUKE GLOBAL CONSULTING (KUNSHAN)
CONSULTINGN/AC01666 WEI CHEN NAN RDKUNSHAN PRCH215300CHKUNSHAN
DUKE MEDICAL STRATEGIES INC
2200 WEST MAIN STREET STE 920DURHAMNC27705561993799HEALTHCARENCN/AC0
DUKE MEDICINE ASIA PTE LTD
MEDICAL RESEARCHN/AC05 SHENTON WAY 07-00 UIC BLDSINGSN0688SN
DURHAM CASUALTY COMPANY LTD
980113277INSURANCECYes (1)AON HOUSE 30 WOODBOURNE AVEPEMBROKEBDHM 08BDDUHS INC$29,397,168$211,773,9451.00000
DUSVF EUROPEAN LP
980346042INVESTMENTSN/AC07 CAVENDISH SQUARELONDONUKW1G 0PEUK
GOTHIC INTERNATIONAL LTD
INVESTMENTSN/AC0113 S CHURCH STREET QUEENSGATE HOUGRAND CAYMANCJKY1-1108CJ
HEALTH SYSTEM MEDICAL STRATEGIES INC
324 BLACKWELL STREET STE 850DURHAMNC27701562222444HEALTH CARENCCYes (1)DUHS INC$133,974$11,3451.00000
MARATHON BLUE CAYMAN FUND
INVESTMENTSN/AC089 NEXUS WAY PO BOX 31106GRAND CAYMANCJKY1-1205CJ
GHI HOLDINGS MAURITIUS
INVESTMENTSN/AC09TH FL ORANGE TOWER CYBERCITYEBENEMPMP
GHI ERP LTD
INVESTMENTSN/AC09TH FL ORANGE TOWER CYBERCITYEBENEMPMP
GHI HSP LTD
INVESTMENTSN/AC09TH FL ORANGE TOWER CYBERCITYEBENEMPMP
GHI JBD LTD
INVESTMENTSN/AC09TH FL ORANGE TOWER CYBERCITYEBENEMPMP
GHI LTP LTD
INVESTMENTSN/AC09TH FL ORANGE TOWER CYBERCITYEBENEMPMP
QUORUM FUND LIMITED
INVESTMENTSN/AC0PO BOX 1043 GEORGE TOWNGRAND CAYMANCJKY1-1102CJ
MCP PRIVATE CAPITAL (FEEDER) FUND I LP
INVESTMENTSN/AC06 RUE GABRIEL LIPPMANLUXEMBOURGLUL-5365LU
DUKE INDIA SERVICES PRIVATE LIMITED
MEDICAL RESEARCHN/AC0302 PRIDE ELITE 10 MUSEUM ROADBANGALOREIN560001INKARNATAKA
CPP OFFICE PORTFOLIO (FEEDER) LP
981152490REAL ESTATEN/AC050 LOTHIAN ROAD FESTIVAL SQUAREEDINBURGHUKEH3 9WJUK
INDOCHINA LAND INVESTMENTS III
INVESTMENTSN/AC0CAPITAL PLACE 6 THAI VAN LUNGHO CHI MINH CITYVMVM
TOWER VIEW LIMITED
INVESTMENTSN/AC089 NEXUS WAY CAMAN BAYGRAND CAYMANCJKY1-9007CJ
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (1)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (1)TransferToOtherOrgInd
Transfer From Other OrgYes (1)TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (13 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
DUKE UNIVERSITY AFFILIATED PHYSICIANS INC
R$20,053,633FMV
DUKE UNIVERSITY AFFILIATED PHYSICIANS INC
S$77,710FMV
ASSOCIATED HEALTH SERVICES INC
R$630,745FMV
ASSOCIATED HEALTH SERVICES INC
S$4,635,652FMV
ASSOCIATED HEALTH SERVICES INC
O$4,510,710FMV
DURHAM CASUALTY COMPANY INC
R$7,404,663FMV
DURHAM CASUALTY COMPANY INC
S$5,648,118FMV
GOTHIC HSP CORPORATION
B$668,688,240FMV
GOTHIC HSP CORPORATION
C$386,440,219FMV
DUKE INTEGRATED NETWORK INC
R$2,036,792FMV
DUKE INTEGRATED NETWORK INC
O$7,279,021FMV
DUKE AFFILIATIONS NETWORK INC
R$125,372FMV
DUKE QUALITY NETWORK INC
S$417,770FMV