2025-02-13T09:50:39-06:00 2023-09-30 410746749 CLIFTONLARSONALLEN LLP 227 WEST TRADE STREET SUITE 800 CHARLOTTE NC 28202 990 2022-10-01 560603898 HARNETT HEALTH SYSTEM INC HARN 9108921000 PO BOX 1706 DUNN NC 28335 BRET JOHNSON CFO 9108921000 2025-02-06 1 0 JOHN NORMAN P01506766 7049985200 2025-02-05 2022 2025-03-06 01:10:19Z BETSY JOHNSON REGIONAL HOSPITAL BRET JOHNSON PO BOX 1706 DUNN NC 28335 130545965 0 X WWW.MYHARNETTHEALTH.ORG X 1937 NC HARNETT HEALTH IS COMMITTED TO PROVIDING QUALITY HEALTHCARE TO THE RESIDENTS OF HARNETT COUNTY AND SURROUNDING COMMUNITIES. WE ARE A PRIVATE, NOT-FOR-PROFIT HEALTHCARE ORGANIZATION BASED IN HARNETT COUNTY, N.C. X 9 9 1384 0 0 0 3649213 12678645 121928216 117304766 91609 413351 640827 149203 126309865 130545965 0 0 0 0 65447353 68762056 0 0 0 66070494 60780020 131517847 129542076 -5207982 1003889 108068047 156656749 96632375 144217188 11435672 12439561 HARNETT HEALTH IS DEDICATED TO PROVIDING QUALITY AND PERSONALIZED CARE WITH RESPECT AND COMPASSION AND ARE COMMITTED TO MAKING A DIFFERENCE THROUGHOUT OUR COMMUNITIES WITH SERVICE EXCELLENCE. 0 0 119227767 117304766 AS PART OF MEETING HEALTH CARE NEEDS OF THE SERVICE AREA, HHS, INC. ADMITTED 5,135 PATIENTS, PROVIDING 23,739 PATIENT DAYS OF CARE, HAD 51,128 EMERGENCY ROOM VISITS AND HAD OVER 55,000 OUTPATIENT VISITS FOR OTHER SERVICES. 119227767 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 0 0 1 10 0 1384 1 0 0 0 0 0 0 0 0 0 0 0 0 X 9 9 0 1 0 0 0 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 NC X JOHN WORTH 9108921000 PO BOX 1706 DUNN NC 28335 WALTER MASSEY CHAIRMAN 4.00 X X 0 0 0 GENE LEWIS TREASURER 2.00 X X 0 0 0 NEIL EMORY VICE CHAIRMAN 2.00 X X 0 0 0 TERRILL BROWN DPM BOARD MEMBER 2.00 X X 0 0 0 ERIC TRUESDALE SECRETARY 2.00 X X 0 0 0 TEDDY BYRD BOARD MEMBER 2.00 X X 0 0 0 TOWNSEND QUINN BOARD MEMBER 2.00 X X 0 0 0 MICHAEL NAGOWSKI CEO 1.00 55.00 X 0 1885915 20236 BRET JOHNSON CFO - CFVH 1.00 55.00 X 0 642246 18538 CORY HESS VP 55.00 X 0 384492 18115 JESSICA LANG CFO - HARNETT 55.00 X 0 198723 10542 OLALEKAN FOLARIN MD MEDICAL DIRECTOR 55.00 X 0 235055 14146 DANIEL WEATHERLY COO 1.00 55.00 X 0 725131 19921 DEBORAH WASHBURN CNO 1.00 55.00 X 0 389056 18544 PHILIP WOOD JR CIO 1.00 55.00 X 0 526305 18356 0 4986923 138398 87 0 1 0 CONCORDANCE HEALTHCARE SOLUTIONS 276 ENTERPRISE WAY MOCKSVILLE NC 27028 MEDICAL SUPPLIES 2819177 MEDICAL SOLUTIONS LLC 1010 N 102ND ST SUITE 300 OMAHA NE 68114 STAFFING 2031852 TRUSTAFF 4675 CORNETLL ROAD SUITE 100 CINCINNATI OH 45241 STAFFING 893644 SIGHTPATH MEDICAL LLC PO BOX 204253 DALLAS TX 753204253 OPTHALMIC SURGICAL EQUIPMENT 501657 FLAGSHIP DUNN LLC 2701 COLTSGATE ROAD SUITE 300 CHARLOTTE NC 28211 RENT 478660 5 6579519 6099126 5790000 12678645 NET PATIENT SERVICE REVENUE 621400 114403153 114403153 NON-PATIENT REVENUE 900099 2901613 2901613 117304766 413351 413351 149203 0 149203 149203 149203 130545965 117304766 0 562554 X 218992 186143 32849 57192277 48613435 8578842 9048553 7691270 1357283 2302234 1956899 345335 18793671 18793671 1935170 1935170 69363 69363 2631138 2631138 7726734 7726734 MEDICAL SUPPLIES 15338500 15338500 OTHER SERVICES 7666657 7666657 PURCHASED SERVICES 6212692 6212692 406095 406095 129542076 119227767 10314309 0 2988700 10136957 4245255 6004964 19696422 31000870 2238 2612115 2207563 716690 385658 167434418 101060555 60401622 66373863 5705410 5934030 11699595 34612844 108068047 156656749 14489147 15914575 192667 865611 70905405 71307388 11045156 56129614 96632375 144217188 X 5730262 6505531 5705410 5934030 11435672 12439561 108068047 156656749 1003889 0 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 5235 5235 0 PART II-B, LINE 1: DURING THE YEAR, THE ORGANIZATION PAID MEMBERSHIP DUES TO NCHA. NCHA ESTIMATED THAT APPROXIMATELY 24.88% OF DUES WERE ATTRIBUTABLE TO LOBBYING EFFORTS NCHA CONDUCTED ON BEHALF OF ITS MEMBERS. 8363451 8363451 93479313 50159739 43319574 61879449 50512670 11366779 3712205 388146 3324059 66373863 PREPAID PENSION COSTS 174517 UNAMORTIZED LOSS ON EXTINGUISHMENT OF DEBT 803082 PENSION RELATED DEFERRED OUTFLOW 4700077 RIGHT OF USE ASSETS, NET 11679943 NEW MARKET TAX CREDIT LOAN 17200000 DUE TO HHS FOUNDATION 55225 34612844 DEFERRED INFLOWS OF RESOURCES (PENSION RELATED) 2022537 LEASE LIABILITY 8328742 INTERCOMPANY 39318322 HASP LIABILITY 5336788 DUE TO HHS FOUNDATION 55225 HEALTH INSURANCE IBNR 1068000 56129614 X PART X, LINE 2: THE SYSTEM IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. ACCORDINGLY, THE ACCOMPANYING COMBINED FINANCIAL STATEMENTS DO NOT REFLECT A PROVISION OR LIABILITY FOR FEDERAL AND STATE INCOME TAXES. 1 1 X 1 X 1 X 1 1 0 0 8195060 8195060 0.06330 27402511 18788943 8613568 0.06650 139705 103604 36101 0.00030 35737276 18892547 16844729 0.13010 10390832 3080238 7310594 0.05640 10390832 3080238 7310594 0.05640 46128108 21972785 24155323 0.18650 1 8275901 17038320 16663201 375119 X 1 1 2 1 BETSY JOHNSON REGIONAL HOSPITAL 800 TILGHMAN DRIVE DUNN NC 28835 X X X DISPROPORTIONATE SHARE HOSPITAL 2 CENTRAL HARNETT HOSPITAL 215 BRIGHTWATER DRIVE LILLINGTON NC 27546 X X X BETSY JOHNSON REGIONAL HOSPITAL 1 0 0 1 X X X X X X X X X 21 1 1 1 1 X WWW.MYHARNETTHEALTH.ORG/COMMUNITY-NEEDS/ X X 1 21 1 WWW.MYHARNETTHEALTH.ORG/COMMUNITY-NEEDS/ 0 1 X 200.000000000000 400.000000000000 X X X X X 1 1 X X X X 1 X MYHARNETTHEALTH.ORG/PATIENTS-VISITORS/ X MYHARNETTHEALTH.ORG/PATIENTS-VISITORS/ X MYHARNETTHEALTH.ORG/PATIENTS-VISITORS/ X X X X X 0 0 X X X 1 X 0 0 CENTRAL HARNETT HOSPITAL 2 0 0 1 X X X X X X X X X 21 1 1 1 1 X WWW.MYHARNETTHEALTH.ORG/COMMUNITY-NEEDS/ X 1 21 1 WWW.MYHARNETTHEALTH.ORG/COMMUNITY-NEEDS/ 0 1 X 200.000000000000 400.000000000000 X X X X X 1 1 X X X X 1 X MYHARNETTHEALTH.ORG/PATIENTS-VISITORS/ X MYHARNETTHEALTH.ORG/PATIENTS-VISITORS/ X MYHARNETTHEALTH.ORG/PATIENTS-VISITORS/ X X X X X 0 0 X X X 1 X 0 0 BETSY JOHNSON REGIONAL HOSPITAL PART V, SECTION B, LINE 5: HARNETT HEALTH SYSTEM WAS AN INTEGRAL PART OF THE COMMUNITY HEALTH ASSESSMENT TEAM (CHAT) ESTABLISHED TO ANALYZE THE COMMUNITY HEALTH NEEDS OF HARNETT COUNTY. THE CHAT REVIEWED THE PRIMARY AND SECONDARY DATA AND DISCUSSED COMMUNITY HEALTH NEEDS THAT THE HARNETT HEALTH SYSTEM MAY ADDRESS.THE CHAT PARTICIPANTS INCLUDED REPRESENTATIVES FROM HARNETT HEALTH SYSTEM, HARNETT COUNTY HEALTH DEPARTMENT, CAPE FEAR VALLEY HEALTH SYSTEM, THE HEALTHY HARNETT COALITION, AND THE DEPARTMENT OF PUBLIC HEALTH AT CAMPBELL UNIVERSITY. ATTENDEES PROVIDED INPUT REGARDING COMMUNITY HEALTH STRENGTHS AND CONCERNS AND IDENTIFIED THE TOP HEALTH CONCERNS IN HARNETT COUNTY. THOSE INDIVIDUALS REPRESENTING DIVERSE GROUPS IN HARNETT COUNTY WERE CHOSEN TO PARTICIPATE IN THE CHAT BECAUSE OF THEIR INSIGHTS INTO THE COMMUNITY'S HEALTH NEEDS.THE COMMUNITY HEALTH SURVEY FOR HARNETT COUNTY WAS CONDUCTED IN SPRING-SUMMER 2022. A TOTAL OF 568 INDIVIDUALS WERE SURVEYED. AFTER DATA CLEANING (INCLUDING LISTWISE DELETION OF INCOMPLETE SURVEY RESPONSES), THE FINAL DATASET INCLUDED 469 RESPONSES. SURVEYS WERE COLLECTED USING A COMBINATION OF HOUSEHOLD CANVASSING USING ADDRESSES RANDOMLY SELECTED AND ONLINE, SELF-ADMINISTERED CONVENIENCE SAMPLING. MUCH OF THE DATA LOSS FROM THE CLEANING PROCESS IS ATTRIBUTED TO SURVEYS STARTED BY NON-RESIDENTS AND IN WHICH PARTICIPANTS COMPLETED LESS THAN 5% OF THE ONLINE SURVEY.WITH THE COMMUNITY HEALTH SURVEY, THERE WAS A SUBSTANTIAL UNDERREPRESENTATION OF THE AFRICAN AMERICAN COMMUNITY. A COMMUNITY HEALTH FORUM TOOK PLACE AT AN AME ZION CHURCH WITHIN THE COUNTY AND DR. DAVID TILLMAN FROM CAMPBELL UNIVERSITY FACILITATED THE SESSION WITH 23 PARTICIPANTS. THE QUALITATIVE DATA FROM THE FORUM WAS INCORPORATED INTO THE INTERPRETATION OF SURVEY DATA AND THE PRIORITIZATION OF COMMUNITY HEALTH NEEDS. CENTRAL HARNETT HOSPITAL PART V, SECTION B, LINE 5: THE ASSESSMENT PROCESS INCLUDED DATA COLLECTION FROM PRIMARY AND SECONDARY SOURCES. VALUABLE INPUT FROM COMMUNITY SURVEY RESPONDENTS PROVIDED PRIMARY DATA FOR THE ASSESSMENT. SECONDARY DATA SOURCES INCLUDED THE 2020 U.S. CENSUS DATA, THE NORTH CAROLINA STATE CENTER FOR HEALTH STATISTICS, AND COUNTY-LEVEL DATA FROM HARNETT HEALTH SYSTEM AND HARNETT COUNTY DEPARTMENT OF HEALTH. HARNETT HEALTH SYSTEM WAS AN INTEGRAL PART OF THE COMMUNITY HEALTH ASSESSMENT TEAM (CHAT) ESTABLISHED TO ANALYZE THE COMMUNITY HEALTH NEEDS OF HARNETT COUNTY. THE CHAT REVIEWED THE PRIMARY AND SECONDARY DATA AND DISCUSSED COMMUNITY HEALTH NEEDS THAT THE HARNETT HEALTH SYSTEM MAY ADDRESS.THE CHAT PARTICIPANTS INCLUDED REPRESENTATIVES FROM HARNETT HEALTH SYSTEM, HARNETT COUNTY HEALTH DEPARTMENT, CAPE FEAR VALLEY HEALTH SYSTEM, THE HEALTHY HARNETT COALITION, AND THE DEPARTMENT OF PUBLIC HEALTH AT CAMPBELL UNIVERSITY. ATTENDEES PROVIDED INPUT REGARDING COMMUNITY HEALTH STRENGTHS AND CONCERNS AND IDENTIFIED THE TOP HEALTH CONCERNS IN HARNETT COUNTY. THOSE INDIVIDUALS REPRESENTING DIVERSE GROUPS IN HARNETT COUNTY WERE CHOSEN TO PARTICIPATE IN THE CHAT BECAUSE OF THEIR INSIGHTS INTO THE COMMUNITY'S HEALTH NEEDS.THE COMMUNITY HEALTH SURVEY FOR HARNETT COUNTY WAS CONDUCTED IN SPRING-SUMMER 2022. A TOTAL OF 568 INDIVIDUALS WERE SURVEYED. AFTER DATA CLEANING (INCLUDING LISTWISE DELETION OF INCOMPLETE SURVEY RESPONSES), THE FINAL DATASET INCLUDED 469 RESPONSES. SURVEYS WERE COLLECTED USING A COMBINATION OF HOUSEHOLD CANVASSING USING ADDRESSES RANDOMLY SELECTED AND ONLINE, SELF-ADMINISTERED CONVENIENCE SAMPLING. MUCH OF THE DATA LOSS FROM THE CLEANING PROCESS IS ATTRIBUTED TO SURVEYS STARTED BY NON-RESIDENTS AND IN WHICH PARTICIPANTS COMPLETED LESS THAN 5% OF THE ONLINE SURVEY.WITH THE COMMUNITY HEALTH SURVEY, THERE WAS A SUBSTANTIAL UNDERREPRESENTATION OF THE AFRICAN AMERICAN COMMUNITY. A COMMUNITY HEALTH FORUM TOOK PLACE AT AN AME ZION CHURCH WITHIN THE COUNTY AND DR. DAVID TILLMAN FROM CAMPBELL UNIVERSITY FACILITATED THE SESSION WITH 23 PARTICIPANTS. THE QUALITATIVE DATA FROM THE FORUM WAS INCORPORATED INTO THE INTERPRETATION OF SURVEY DATA AND THE PRIORITIZATION OF COMMUNITY HEALTH NEEDS. BETSY JOHNSON REGIONAL HOSPITAL PART V, SECTION B, LINE 6A: CENTRAL HARNETT HOSPITAL, BETSY JOHNSON REGIONAL HOSPITAL, AND CAPE FEAR VALLEY HEALTH SYSTEM WORKED TOGETHER TO CONDUCT THE CHNA. CENTRAL HARNETT HOSPITAL PART V, SECTION B, LINE 6A: CENTRAL HARNETT HOSPITAL, BETSY JOHNSON REGIONAL HOSPITAL, AND CAPE FEAR VALLEY HEALTH SYSTEM WORKED TOGETHER TO CONDUCT THE CHNA. BETSY JOHNSON REGIONAL HOSPITAL PART V, SECTION B, LINE 6B: HARNETT COUNTY HEALTH DEPARTMENTHEALTHY HARNETT COALITIONDEPARTMENT OF PUBLIC HEALTH AT CAMPBELL UNIVERSITY CENTRAL HARNETT HOSPITAL PART V, SECTION B, LINE 6B: HARNETT COUNTY HEALTH DEPARTMENTCAMPBELL SCHOOL OF PUBLIC HEALTH BETSY JOHNSON REGIONAL HOSPITAL PART V, SECTION B, LINE 7D: THE HOSPITAL MADE THE CHNA AVAILABLE IN PRINT AT THE HEALTH DEPARTMENT. BETSY JOHNSON REGIONAL HOSPITAL PART V, SECTION B, LINE 11: HARNETT HEALTH SYSTEM AND THE HARNETT COUNTY DEPARTMENT OF HEALTH HELD MEETINGS FOR CHAT PARTICIPANTS. AT FIRST, THE CHAT PARTICIPANTS REVIEWED THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS, PRIMARY AND SECONDARY DATA COLLECTION METHODS, AND THE REQUIRED COMMUNITY SURVEY. ADDITIONALLY, RESULTS FROM THE PREVIOUS COMMUNITY HEALTH NEEDS ASSESSMENT IMPLEMENTATION PLAN WERE SHARED WITH THE GROUP. FINALLY, EACH PARTICIPANT WAS ENCOURAGED TO SHARE THE FOLLOWING IDEAS: STRENGTHS AND VALUES OF THE COMMUNITY; AND CONCERNS AND BARRIERS OF THE COMMUNITY.RESULTS OF THE CHNA SURVEY WERE ANALYZED AT THE SECOND MEETING. IN ADDITION, ATTENDEES PROVIDED INPUT REGARDING COMMUNITY HEALTH STRENGTHS AND CONCERNS AND TOP HEALTH CONCERNS SEEN THROUGHOUT THE HARNETT COUNTY AREA.EMERGING HEALTH ISSUES THAT HAVE NOT CHANGED MUCH SINCE THE HEALTH DEPARTMENT'S LAST ASSESSMENT: DIABETES CANCER HEART DISEASE AWARENESS AND EDUCATION TO EMPOWER RESIDENTS TO TAKE CHARGE OF THEIR HEALTH OBESITY SAFETY CONCERNSTHE CHAT REVIEWED THE PRIMARY DATA AND IDENTIFIED THE COMMUNITY'S BARRIERS AND CONCERNS. THE CHAT CONTINUED TO RESEARCH COMMUNITY HEALTH NEEDS BY UTILIZING VARIOUS SECONDARY DATA. THE HARNETT HEALTH SYSTEM'S SENIOR LEADERSHIP TEAMS WILL SHARE RECOMMENDATIONS AND DATA. CENTRAL HARNETT HOSPITAL PART V, SECTION B, LINE 11: HARNETT HEALTH SYSTEM AND THE HARNETT COUNTY DEPARTMENT OF HEALTH HELD MEETINGS FOR CHAT PARTICIPANTS. AT FIRST, THE CHAT PARTICIPANTS REVIEWED THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS, PRIMARY AND SECONDARY DATA COLLECTION METHODS, AND THE REQUIRED COMMUNITY SURVEY. ADDITIONALLY, RESULTS FROM THE PREVIOUS COMMUNITY HEALTH NEEDS ASSESSMENT IMPLEMENTATION PLAN WERE SHARED WITH THE GROUP. FINALLY, EACH PARTICIPANT WAS ENCOURAGED TO SHARE THE FOLLOWING IDEAS: STRENGTHS AND VALUES OF THE COMMUNITY; AND CONCERNS AND BARRIERS OF THE COMMUNITY.RESULTS OF THE CHNA SURVEY WERE ANALYZED AT THE SECOND MEETING. IN ADDITION, ATTENDEES PROVIDED INPUT REGARDING COMMUNITY HEALTH STRENGTHS AND CONCERNS AND TOP HEALTH CONCERNS SEEN THROUGHOUT THE HARNETT COUNTY AREA.EMERGING HEALTH ISSUES THAT HAVE NOT CHANGED MUCH SINCE THE HEALTH DEPARTMENT'S LAST ASSESSMENT: DIABETES CANCER HEART DISEASE AWARENESS AND EDUCATION TO EMPOWER RESIDENTS TO TAKE CHARGE OF THEIR HEALTH OBESITY SAFETY CONCERNSTHE CHAT REVIEWED THE PRIMARY DATA AND IDENTIFIED THE COMMUNITY'S BARRIERS AND CONCERNS. THE CHAT CONTINUED TO RESEARCH COMMUNITY HEALTH NEEDS BY UTILIZING VARIOUS SECONDARY DATA. THE HARNETT HEALTH SYSTEM'S SENIOR LEADERSHIP TEAMS WILL SHARE RECOMMENDATIONS AND DATA. 10 1 - HARNETT HEALTH ANGIER MEDICAL SERVICES 185 RAWLS ROAD ANGIER NC 27501 PRIMARY CARE PROVIDER 2 - HARNETT HEALTH LILLINGTON MEDICAL SERVIC 7 EAST DUNCAN STREET LILLINGTON NC 27546 PRIMARY CARE PROVIDER 3 - HARNETT HEALTH DUNN MEDICAL SERVICES 803 TILGHMAN DRIVE STE 100 DUNN NC 28334 PRIMARY CARE PROVIDER 4 - HARNETT HEALTH HARNETT OBGYN 805-C TILGHMAN DRIVE DUNN NC 28334 OBSTETRICS/GYNECOLOGY SERVICES 5 - HARNETT HEALTH PREMIER PEDIATRICS 802 TILGHMAN DRIVE DUNN NC 28334 PRIMARY CARE PROVIDER 6 - COATS MEDICAL SERVICES 25 N JOHNSON STREET COATS NC 27521 PRIMARY CARE PROVIDER 7 - HARNETT HEALTH ORTHO & SPORTS MED 716 10TH ST LILLINGTON NC 27546 ORTHOPAEDIC & SPORTS MEDICINE 8 - BUFFALO LAKES MEDICAL SERVICES 1619 BUFFALO LAKE RD SANFORD NC 27332 PRIMARY CARE PROVIDER 9 - PREMIER PEDIATRICS 716 10TH ST LILLINGTON NC 27546 PEDRIATICS 10 - HARNETT HEALTH EAR NOSE & THROAT 805 TILGHMAN DRIVE DUNN NC 28334 ENT PROVIDER PART I, LINE 3C: INCOME LEVEL, ASSET LEVEL, MEDICAL INDIGENCY, INSURANCE STATUS, UNDERINSURANCE STATUS PART I, LINE 7: HARNETT HEALTH USED THE COST-TO-CHARGE RATIO, ESTABLISHED FROM ITS COST REPORTS FILED, TO REPORT FINANIAL ASSISTANCE SHOWN IN PART I AND PART III OF SCHEDULE H. PART III, LINE 2: COST-TO-CHARGE RATIO APPLIED AGAINST BAD DEBT CHARGES FROM UN-DISCOUNTED SELF-PAY PATIENTS. PART III, LINE 3: SEE NOTE FOR SCHEDULE H, PART III, LINE 4 PART III, LINE 4: THE ORGANIZATION'S FINANCIAL STATEMENTS DO NOT INCLUDE A FOOTNOTE ON BAD DEBT. BAD DEBT IS PRESENTED AT GROSS CHARGES. PER THE HOSPITAL'S AUDITED FINANCIAL STATEMENTS, THE ORGANIZATION ESTIMATES THAT SOME PORTION OF ITS BAD DEBT MAY QUALIFY FOR FINANCIAL ASSISTANCE DUE TO THE FACT THAT THE HOSPITAL DOES NOT HAVE 24 HOUR COVERAGE IN THE ED FOR FINANCIAL ASSISTANCE. ALSO, SOME PATIENTS TREATED REFUSE TO MEET AND DISCUSS FINANCIAL ASSISTANCE OPTIONS. THE ANDI REPORT WAS USED TO CALCULATE THE AMOUNT OF BAD DEBT THAT QUALIFIES FOR FINANCIAL ASSISTANCE. ANOTHER FACTOR CONTRIBUTING TO THE ESTIMATE OF BAD DEBT THAT MAY QUALIFY FOR FINANCIAL ASSISTANCE IS THAT WE DO NOT VISIT OUR INSURED INPATIENTS THAT MAY HAVE HIGH DEDUCTIBLES OR CO-INSURANCES. IN FUTURE YEARS, THE ORGANIZATION PLANS TO IMPROVE CONSULTATION SESSIONS TO INLCUDE INSURED PATIENTS WITH POTENTIALLY HIGH DEDUCTIBLES OR CO-PAYMENTS. PART III, LINE 9B: ALL PATIENTS RECEIVE LETTERS AND/OR STATEMENTS REGARDING THEIR ACCOUNTS AND THEY ARE GIVEN 120 DAYS FROM THE BILL DATE TO MAKE SATISFACTORY PAYMENT ARRANGEMENTS OR TO APPLY FOR FINANCIAL ASSISTANCE BEFORE THE ACCOUNT GOES TO BAD DEBT STATUS. PATIENTS WHO APPLY FOR FINANCIAL ASSISTANCE MUST COMPLY WITH THE REQUIREMENTS OF THE APPLICATION TO AVOID THE ACCOUNT GOING INTO BAD DEBT STATUS. PATIENTS APPLYING FOR AID ARE PLACED IN A HOLD STATUS BY THE PALS TEAM TO AVOID COLLECTIONS. PATIENTS WHO HAVE MADE AN EFFORT TO COMPLETE AN APPLICATION OR WHO MAY NOT HAVE HAD AN OPPORTUNITY TO DISCUSS THEIR FINANCIAL SITUATION AND THEIR ACCOUNT GOES TO A COLLECTION STATUS ARE EVALUATED ON A CASE BY CASE BASIS TO DETERMINE IF THE ACCOUNT IS REMOVED FROM COLLECTIONS AND FINANCIAL ASSISTANCE IS PROVIDED. PART VI, LINE 2: BASED ON THE DATA FROM THE HARNETT COUNTY NEEDS ASSESSMENT WE REVIEW WHAT KEY ISSUES ARE ALIGNED WITH OUR MISSION. FROM THERE, WE DEVELOP PLANS ON WHICH STRATEGIES WILL HAVE THE MOST IMPACT ON OUR COMMUNITY. PART VI, LINE 3: THE HOSPITAL SYSTEM OFFERS FINANCIAL ASSISTANCE TO ANYONE BASED ON NEED AND ABILITY TO PAY. OUR PATIENT ACCOUNT LIAISONS WILL ASSIST PATIENTS IN APPLYING FOR FINANCIAL ASSISTANCE AND ANY OTHER FUNDING SOURCES THAT MAY BE AVAILABLE. PRE-SCREENING MAYBE CONDUCTED AT PRE-ADMISSION OR POINT OF SERVICE FOR ALL UNISURED OR UNDERINSURED PATIENTS THAT CAN NOT MEET THE DEPOSIT REQUIREMENTS; HOWEVER, ALL EMERGENT SERVICES ARE PROVIDED WITHOUT REGARD TO THE ABLITY TO PAY OR NOT. PART VI, LINE 4: HARNETT HEALTH SYSTEM, INC. IS LOCATED IN THE SOUTHEASTERN/MIDDLE SECTION OF HARNETT COUNTY NORTH CAROLINA. AS A RURAL HOSPITAL, WE ARE A KEY COMPONENT OF OUR STATE'S HEALTH CARE SAFETY NET BY TREATING EVERYONE WHO COMES THROUGH OUR DOORS. OUR PATIENT VOLUMES EXEMPLIFY OUR COMMITTMENT: MEDICARE 47.0%, MEDICAID 19.9%, MANAGED CARE 18.4%, SELF PAY 10.5%, TRICARE AND ALL OTHER 4.2%. THE HOSPITAL'S SERVICE AREA INCLUDED HARNETT AND A PORTION OF THREE NEIGHBORING COUNTIES, CUMBERLAND, JOHNSTON AND SAMPSON. AGRICULTURE AND CONSTRUCTION ARE THE LEADING INDUSTRIES OF OUR ECONOMIC STRUCTURE. THE TOP LARGEST EMPLOYER IN HARNETT COUNTY IS THE PUBLIC SCHOOL SYSTEM. PART VI, LINE 5: THE ROLE OF HARNETT HEALTH SYSTEM PLAYS IN THE COMMUNITY IS TO CARE FOR AND HEAL THE SICK AND INJURED, BUT EQUALLY IMPORTANT IS EDUCATING OUR COMMUNITY THE IMPORTANCE OF GOOD HEALTH AND WAYS TO IMPROVE THEIR LIFESTYLES. WE DEFINE OUR OBLIGATION BY HOLDING COMMUNITY EDUCATION AND WELLNESS CLASSES, PARTICIPATING IN ANNUAL COMMUNITY EVENTS, AND EDUCATING HIGH SCHOOL STUDENT ON THE MANY AREA OF EMPLOYMENT IN THE HEALTHCARE FIELD. PART VI, LINE 6: THE ORGANIZATION IS OWNED BY CAPE FEAR VALLEY HEALTH SYSTEM. THE SYSTEMS WORK TOGETHER TO PROVIDE QUALITY CARE TO THE SURROUNDING COMMUNITIES. PART VI, LINE 7, REPORTS FILED WITH STATES NC 0 0 0 0 0 0 0 0 0 MICHAEL NAGOWSKI CEO 0 1069997 0 814230 0 1688 0 9150 0 11086 0 1906151 0 0 DANIEL WEATHERLY COO 0 617616 0 107515 0 0 0 9150 0 10771 0 745052 0 0 BRET JOHNSON CFO - CFVH 0 550603 0 83417 0 8226 0 9150 0 9388 0 660784 0 0 PHILIP WOOD JR CIO 0 391045 0 129285 0 5975 0 9150 0 9206 0 544661 0 0 DEBORAH WASHBURN CNO 0 337468 0 48892 0 2696 0 9150 0 9394 0 407600 0 0 CORY HESS VP 0 342022 0 42470 0 0 0 9150 0 8965 0 402607 0 0 OLALEKAN FOLARIN MD MEDICAL DIRECTOR 0 169792 0 0 0 65263 0 6090 0 8056 0 249201 0 0 JESSICA LANG CFO - HARNETT 0 155355 0 41310 0 2058 0 4661 0 5881 0 209265 0 0 PART I, LINE 3 EXECUTIVE SALARIES ARE DETERMINED BY A MARKET ANALYSIS INVOLVING COMPARABILITY DATA, INDUSTRY STANDARDS, AND LOCAL ECONOMICS. THE CEO'S SALARY IS A CONDITION OF THE MANAGEMENT AGREEMENT BETWEEN THE BOARD OF DIRECTORS AND CAPE FEAR. THE BOARD HAS INDIRECT APPROVAL OVER THE COMPENSATION PAID TO THE CEO THROUGH THIS AGREEMENT, AND HAS APPROVAL OVER ANY ADDITIONAL AMOUNTS AND INCREASES. CAPE FEAR PREPARES A COMPENSATION STUDY FOR OFFICERS AND KEY EMPLOYEES EXCLUDING THE CEO AND MAKES THE RECOMMENDATIONS TO THE CEO OF HARNETT HEALTH SYSTEM. THOSE RECOMMENDATIONS, INCLUDING ANY AMOUNTS ALLOCATED FOR RAISES AND INCENTIVES, ARE INCLUDED IN THE ANNUAL BUDGET PROCESS WHICH IS APPROVED BY THE FINANCE COMMITIEE OF THE BOARD. X 1 5790000 FMV 0 0 0 LAND AND BUILDINGS 2023-06-30 2335877 BOOK VALUE AT TIME OF TRANSFER 920441763 WILLIAMSBURG COMMUNITY HEALTH FOUNDATION 505 NELSON BLVD KINGSTREE SC 29556 501(C)(3) CASH 2023-09-30 2551532 CASH 920441763 WILLIAMSBURG COMMUNITY HEALTH FOUNDATION 505 NELSON BLVD KINGSTREE SC 29556 501(C)(3) MEDICAL EQUIPMENT 2023-01-18 228908 BOOK VALUE AT TIME OF TRANSFER 571098556 MUSC BLACK RIVER MEDICAL CENTER 3555 N WILLIAMSBURG HWY CADES SC 29518 501(C)(3) 1 0 0 0 PART II, LINE 2E: EXPLANATION OF INVOLVEMENT: SEVERAL BOARD MEMBERS OF THE HOSPITAL BECAME BOARD MEMBERS OF WILLIAMSBURG COMMUNITY HEALTH FOUNDATION. FORM 990, PART VI, SECTION A, LINE 1A THE EXECUTIVE COMMITTEE SHALL CONSIST OF THE CHAIR, THE VICE CHAIR, THE SECRETARY AND THE TREASURER. THE EXECUTIVE COMMITTEE SHALL HAVE POWER TO TRANSACT ALL REGULAR BUSINESS OF THE HOSPITAL DURING THE PERIOD BETWEEN MEETINGS OF THE BOARD OF TRUSTEES, SUBJECT TO ANY PRIOR LIMITATION IMPOSED BY THE BOARD OF TRUSTEES, AND WITH THE UNDERSTANDING THAT ALL MATTERS OF MAJOR IMPORTANCE WILL BE REPORTED TO THE BOARD OF TRUSTEES. FORM 990, PART VI, SECTION A, LINE 3 CAPE FEAR VALLEY HEALTH SYSTEM OWNS HARNETT HEALTH SYSTEM AND HAS RESERVED POWERS AS NOTED IN EXHIBIT A OF THE BYLAWS. FORM 990, PART VI, SECTION A, LINE 7A THE BOARD OF TRUSTEES OF THE ORGANIZATION IS COMPRISED OF NINE RESIDENTS, EIGHT OF HARNETT COUNTY, NC AND ONE OF CUMBERLAND COUNTY. THE APPOINTED TRUSTEES SHALL SERVE A STAGGERED TERM FOR 1 TO 3 YEARS. SEVEN TRUSTEES OF THE ORGANIZATION ARE APPOINTED BY THE HARNETT COUNTY BOARD OF COMMISSIONERS, AND SHALL, AT ALL TIMES, INCLUDE AT LEAST ONE RESIDENT OF EACH OF THE FIVE COMMISSIONERS' DISTRICTS AND TWO OTHER PERSONS RESIDING IN HARNETT COUNTY. THE REMAINING TRUSTEES ARE APPOINTED BY THE ORGANIZATION'S BOARD OF TRUSTEES AT ITS ANNUAL MEETING FROM NOMINEES THAT MEET RESIDENCY AND AGE REQUIREMENTS, AS DEFINED IN THE ORGANIZATION'S BYLAWS. CAPE FEAR VALLEY APPOINTS ONE TRUSTEE. FORM 990, PART VI, SECTION A, LINE 7B APPOINTED BOARD MEMBERS ARE APPROVED BY COUNTY COMMISSIONERS. FORM 990, PART VI, SECTION B, LINE 11B PRINTED COPIES ARE MADE AVAILABLE TO THE BOARD OF TRUSTEES AT THE ADMINISTRATIVE OFFICE PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS ANNUALLY FILE A DISCLOSURE STATEMENT WITH THE SECRETARY OF THE BOARD AT THE TIME OF THE PERSONS INITIAL APPOINTMENT AS A TRUSTEE OR COMMITTEE MEMBER AND THEREAFTER. THE STATEMENT SHALL BE ON A FORM APPROVED BY THE BOARD AND A COPY OF EACH STATEMENT SHALL BE PROVIDED TO THE CHAIR OF THE BOARD AND THE HOSPITAL'S GENERAL COUNCIL FORM 990, PART VI, SECTION B, LINE 15 EXECUTIVE SALARIES ARE DETERMINED BY A MARKET ANALYSIS INVOLVING COMPARABILITY DATA, INDUSTRY STANDARDS, AND LOCAL ECONOMICS. THE CEO'S SALARY IS A CONDITION OF THE MANAGEMENT AGREEMENT BETWEEN THE BOARD OF DIRECTORS AND CAPE FEAR (SEE THE RESPONSE TO LINE 3 ABOVE). THE BOARD HAS INDIRECT APPROVAL OVER THE COMPENSATION PAID TO THE CEO THROUGH THIS AGREEMENT, AND HAS APPROVAL OVER ANY ADDITIONAL AMOUNTS AND INCREASES. CAPE FEAR PREPARES A COMPENSATION STUDY FOR OFFICERS AND KEY EMPLOYEES EXCLUDING THE CEO AND MAKES THE RECOMMENDATIONS TO THE CEO OF HARNETT HEALTH SYSTEM. THOSE RECOMMENDATIONS, INCLUDING ANY AMOUNTS ALLOCATED FOR RAISES AND INCENTIVES, ARE INCLUDED IN THE ANNUAL BUDGET PROCESS WHICH IS APPROVED BY THE FINANCE COMMITIEE OF THE BOARD. THE PROCESS DESCRIBED HERE WAS LAST COMPLETED IN 2022. FORM 990, PART VI, SECTION C, LINE 18 PHOTOCOPIES OF RECENT FILINGS OF THE FORM 990 ARE AVAILABLE UPON REQUEST AT THE ORGANIZATION'S ADMINISTRATIVE OFFICE. IN ADDITION, RECENT FILINGS OF THE FORM 990 ARE AVAILABLE AT WWW.GUIDESTAR.ORG. FORM 990, PART VI, SECTION C, LINE 19 PHOTOCOPIES OF THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST AT THE ORGANIZATION'S ADMINISTRATIVE OFFICE. FINANCIAL STATEMENTS ARE UPLOADED TO EMMA. FORM 990, PART IX, LINE 11G CONTRACT LABOR: PROGRAM SERVICE EXPENSES 18,519,847. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 18,519,847. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 273,824. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 273,824. ANGIER MEDICAL SERVICES LLC 185 RAWLS RD ANGIER NC 27501 270906936 PRIMARY CARE PROVIDER NC 888525 605573 HARNETT HEALTH SYSTEM COATS MEDICAL SERVICES LLC 25 JOHNSON ST N COATS NC 27521 462540799 PRIMARY CARE PROVIDER NC 973464 156480 HARNETT HEALTH SYSTEM DUNN MEDICAL SERVICES LLC 803 TILGHMAN DR 100 DUNN NC 28334 273320115 PRIMARY CARE PROVIDER NC 835459 339850 HARNETT HEALTH SYSTEM HARNETT OBGYN LLC 805-C TILGHMAN DR DUNN NC 28334 273320275 OBSTETRICS/GYNECOLOGY SERVICES NC 894267 171821 HARNETT HEALTH SYSTEM LILLINGTON MEDICAL SERVICES LLC 7 EAST DUNCAN STREET LILLINGTON NC 27546 272944176 INTERNAL MEDICINE, INFECTIOUS DISEASE, AND GYNECOLOGY NC 1233862 352849 HARNETT HEALTH SYSTEM HARNETT HEALTH SYSTEM FOUNDATION 800 TILGHMAN DRIVE DUNN NC 28334 201929953 FUNDRAISING NC 501(C)(3) LINE 7 N/A 0 CUMBERLAND COUNTY HOSPITAL INC PO BOX 2000 FAYETTEVILLE NC 28302 560845796 HOSPITAL NC 501(C)(3) LINE 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0