DAVIE MEDICAL CENTER: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- DAVIE MEDICAL CENTER (EIN 56-2276994)
- Tax period
- 2015-07-01 to 2016-06-30
- Filed
- 2017-05-12
- IRS object ID
- 201711329349301106
- Schema version
- 2015v3.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-05-12T07:46:10-05:00 | ReturnTs |
| Tax Period End | 2016-06-30 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 562276994 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DAVIE COUNTY EMERGENCY HEALTH | BusinessNameLine1Txt |
| Business Name Line2 | CORPORATION | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | DAVI | BusinessNameControlTxt |
| Phone | 3369981300 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 329 NC HWY 801N | AddressLine1Txt |
| City | BERMUDA RUN | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 27006 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | CHAD A ECKES | PersonNm |
| Person Title | CFO & ASST TREASURER | PersonTitleTxt |
| Phone | 3369981300 | PhoneNum |
| Signature | 2017-05-04 | SignatureDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Change | Yes (X) | AddressChangeInd |
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DAVIE MEDICAL CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | CHAD BROWN | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 329 NC HWY 801N | AddressLine1Txt |
| City | BERMUDA RUN | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 27006 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $43,243,713 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.WAKEHEALTH.EDU/DAVIE-MEDICAL-CENTER/ | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2001 | FormationYr |
| Legal Domicile State | NC | LegalDomicileStateCd |
| Activity Or Mission | PROVISION OF PATIENT-CENTERED HEALTHCARE SERVICES TO THE SURROUNDING AREA | ActivityOrMissionDesc |
| Voting Members Governing Body | 14 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 14 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 58 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $39,839,894 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $43,214,651 | CYProgramServiceRevenueAmt |
| PY Investment Income | $4,093 | PYInvestmentIncomeAmt |
| CY Investment Income | -$272,177 | CYInvestmentIncomeAmt |
| PY Other Revenue | $20,821 | PYOtherRevenueAmt |
| CY Other Revenue | $29,062 | CYOtherRevenueAmt |
| PY Total Revenue | $39,864,808 | PYTotalRevenueAmt |
| CY Total Revenue | $42,971,536 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $26,400 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $36,500 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $9,954,379 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $14,411,477 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $20,174,959 | PYOtherExpensesAmt |
| CY Other Expenses | $23,641,764 | CYOtherExpensesAmt |
| PY Total Expenses | $30,155,738 | PYTotalExpensesAmt |
| CY Total Expenses | $38,089,741 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $9,709,070 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $4,881,795 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $27,517,085 | TotalAssetsBOYAmt |
| Total Assets EOY | $25,778,727 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $24,173,161 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $17,553,008 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $3,343,924 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $8,225,719 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | THE MEDICAL CENTER'S MISSION IS TO IMPROVE THE HEALTH OF OUR REGION BY: PROVIDING EXCELLENT CARE & AN EXCEPTIONAL EXPERIENCE; PROMOTING HEALTH & WELLNESS THROUGH COMMUNITY PARTNERSHIPS; & CONNECTING PEOPLE TO THE WORLD CLASS EXPERTISE OF WAKE FOREST BAPTIST MEDICAL CENTER. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $34,795,085 | ExpenseAmt |
| Grant | $36,500 | GrantAmt |
| Revenue | $43,243,713 | RevenueAmt |
| Desc | DAVIE MEDICAL CENTER PROVIDED MEDICAL, EMERGENCY, AND OUTPATIENT CARE SERVICES TO THE RESIDENTS OF DAVIE COUNTY, NORTH CAROLINA, AND THE SURROUNDING AREAS. DURING THE FISCAL YEAR, THE HOSPITAL HAD 81 LICENSED INPATIENT BEDS, 5,267 PATIENT DAYS WITH 151 INPATIENT ADMISSIONS, 28,254 OUTPATIENT CLINICAL VISITS AND 13,596 EMERGENCY ROOM VISITS. THE HOSPITAL'S VISIONTO BE A MEDICAL CENTER OF CHOICE, PROMOTING HEALTH AND SERVING AS A DESTINATION FOR EXCELLENCE IN PATIENT CARE.THE HOSPITAL'S VALUES- COMPASSION: RESPONSIVE TO THE PHYSICAL, EMOTIONAL, SPIRITUAL, AND INTELLECTUAL NEEDS OF ALL;-SERVICE: CULTIVATE SELFLESS CONTRIBUTION FOR THE GREATER GOOD;-EXCELLENCE: DEMONSTRATE THE HIGHEST STANDARDS OF PATIENT-CENTERED CARE, EDUCATION, RESEARCH, AND OPERATIONAL EFFECTIVENESS; - INTEGRITY: DEMONSTRATE FAIRNESS, HONESTY, SINCERITY, AND ACCOUNTABILITY;- COLLEGIALITY: FOSTER MUTUAL RESPECT, FACILITATE PROFESSIONAL GROWTH AND MENTORSHIP, AND REWARD TEAMWORK AND COLLABORATION; - INNOVATION: PROMOTE CREATIVITY TO ENHANCE DISCOVERY AND THE APPLICATION OF KNOWLEDGE; AND- DIVERSITY: HONOR INDIVIDUALITY AND PROTECT THE DIGNITY OF ALL. | Desc |
| Total Program Service Expenses | $34,795,085 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 21 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 0 | EmployeeCnt |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 14 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 14 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (1) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JOSEPH DOLAN | PersonNm |
| Phone | 3367164445 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | MEDICAL CENTER BOULEVARD | AddressLine1Txt |
| City | WINSTONSALEM | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 27157 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (20 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd |
|---|---|---|---|---|---|---|---|
| KEVIN P HIGH MD | |||||||
| CHAIRMAN | 4.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| C DANIEL BARRETT | |||||||
| VICE CHAIR | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| TERRY BRALLEY | |||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| MICHAEL CARTWRIGHT MD | |||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| CRAIG M GREVEN MD | |||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| RUSSELL HOWERTON MD | |||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| WILLIAM F JUNKER | |||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| L ANDREW KOMAN MD | |||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| DOUGLAS NELSON | |||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| LYNN PITMAN | |||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| KEN RETHMEIER | |||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| MARY RITTLING PHD | |||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| STEPHEN ROBERTSON | |||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| KENNON WHITE | |||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| CHAD BROWN | |||||||
| PRESIDENT | 40.00 | Yes (X) | $298,268 | $0 | $73,086 | ||
| BRADLEY A CLARK | |||||||
| TREASURER | 10.00 | Yes (X) | $0 | $0 | $0 | ||
| CHAD ECKES | |||||||
| CFO / ASST TREASURER | 10.00 | Yes (X) | $0 | $0 | $0 | ||
| J MCLAIN WALLACE JR | |||||||
| SECRETARY | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| DINA MARTY | |||||||
| ASSISTANT SECRETARY | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| DANNY SQUIRES | |||||||
| FINANCE DIRECTOR | 15.00 | $198,446 | $0 | $25,505 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $496,714 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $98,591 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | Yes (1) | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| LINCARE INC | |||||
| 3900 WESTPOINT BLVD | WINSTON SALEM | NC | 27103 | RESPIRATORY SPECIALISTS | $838,150 |
| ALLIANCE HEALTHCARE SERVICES | |||||
| 100 BAYVIEW CIRCLE | NEWPORT BEACH | CA | 92660 | MEDICAL SERVICES | $543,855 |
| NURSEFINDERS | |||||
| PO BOX 3749 | BATON ROUGE | LA | 70821 | STAFFING | $325,364 |
| SIEMENS MEDICAL SOLUTIONS DIAGNOSTICS | |||||
| P O BOX 120001 | DALLAS | TX | 75312 | EQUIPMENT MAINTENANCE SERVICES | $198,688 |
| UNIVERSAL PROTECTION SERVICE LLC | |||||
| 26375 NETWORK PLACE | CHICAGO | IL | 606731263 | SECURITY SERVICES | $154,634 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 7 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PATIENT SERVICE REVENUE | Desc |
| Business | 621400 | BusinessCd |
| Total Revenue Column | $43,214,651 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $43,214,651 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $43,214,651 | TotalProgramServiceRevenueAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $272,177 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -$272,177 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$272,177 | TotalRevenueColumnAmt |
| Exclusion | -$272,177 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | DIETARY | Desc |
| Business | 621990 | BusinessCd |
| Total Revenue Column | $29,062 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $29,062 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $29,062 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $42,971,536 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $43,243,713 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | -$272,177 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $36,500 | TotalAmt |
| Program Services | $36,500 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,508,593 | TotalAmt |
| Program Services | $9,980,252 | ProgramServicesAmt |
| Management And General | $1,528,341 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $447,104 | TotalAmt |
| Program Services | $387,729 | ProgramServicesAmt |
| Management And General | $59,375 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,714,330 | TotalAmt |
| Program Services | $1,486,667 | ProgramServicesAmt |
| Management And General | $227,663 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $741,450 | TotalAmt |
| Program Services | $642,985 | ProgramServicesAmt |
| Management And General | $98,465 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,380 | TotalAmt |
| Management And General | $1,380 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,640 | TotalAmt |
| Program Services | $2,640 | ProgramServicesAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,969,252 | TotalAmt |
| Program Services | $1,707,735 | ProgramServicesAmt |
| Management And General | $261,517 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $245,137 | TotalAmt |
| Program Services | $245,137 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $73,535 | TotalAmt |
| Program Services | $63,770 | ProgramServicesAmt |
| Management And General | $9,765 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,960,324 | TotalAmt |
| Program Services | $5,168,793 | ProgramServicesAmt |
| Management And General | $791,531 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,494 | TotalAmt |
| Program Services | $21,241 | ProgramServicesAmt |
| Management And General | $3,253 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,979 | TotalAmt |
| Program Services | $21,662 | ProgramServicesAmt |
| Management And General | $3,317 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,889,176 | TotalAmt |
| Program Services | $1,638,293 | ProgramServicesAmt |
| Management And General | $250,883 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $37,522 | TotalAmt |
| Program Services | $32,539 | ProgramServicesAmt |
| Management And General | $4,983 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $9,212,971 | $9,212,971 | |
| BAD DEBT EXPENSE | $3,272,320 | $3,272,320 | |
| PROVIDER ASSESSMENT TAX | $520,021 | $520,021 | |
| MISCELLANEOUS EXPENSE | $408,013 | $353,830 | $54,183 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $38,089,741 | TotalAmt |
| Program Services | $34,795,085 | ProgramServicesAmt |
| Management And General | $3,294,656 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,329,826 | BOYAmt |
| EOY | $12,905,389 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,848,879 | BOYAmt |
| EOY | $4,349,664 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $911,583 | BOYAmt |
| EOY | $969,064 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $50,000 | BOYAmt |
| EOY | $28,000 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $13,215,196 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $5,873,774 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,216,399 | BOYAmt |
| EOY | $7,341,422 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $160,398 | BOYAmt |
| EOY | $185,188 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,517,085 | BOYAmt |
| EOY | $25,778,727 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,874,985 | BOYAmt |
| EOY | $17,063,603 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,298,176 | BOYAmt |
| EOY | $489,405 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $24,173,161 | BOYAmt |
| EOY | $17,553,008 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,342,911 | BOYAmt |
| EOY | $8,224,706 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,013 | BOYAmt |
| EOY | $1,013 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,343,924 | BOYAmt |
| EOY | $8,225,719 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,517,085 | BOYAmt |
| EOY | $25,778,727 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $4,881,795 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $2,640 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $2,640 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION IS A MEMBER OF THE AMERICAN HOSPITAL ASSOCIATION (AHA) AND THE NORTH CAROLINA HOSPITAL ASSOCIATION (NCHA). A PORTION OF THE MEMBERSHIP DUES PAID ARE ALLOCATED TO LOBBYING EFFORTS BY THOSE ORGANIZATIONS ON BEHALF OF THEIR MEMBERSHIP BODIES. | ExplanationTxt |
Schedule D IRS990ScheduleD
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $384,692 | OtherCostOrOtherBasisAmt |
| Depreciation | $237,943 | DepreciationAmt |
| Book Value | $146,749 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $12,830,504 | OtherCostOrOtherBasisAmt |
| Depreciation | $5,635,831 | DepreciationAmt |
| Book Value | $7,194,673 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $7,341,422 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | ESTIMATED 3RD PARTY PAYABLE | Desc |
| Amt | $489,405 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $489,405 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION HAS EVALUATED UNCERTAIN TAX POSITIONS FOR ITS FISCAL YEARS ENDED JUNE 30, 2016 AND 2015, INCLUDING A QUANTIFICATION OF TAX RISK IN AREAS SUCH AS UNRELATED BUSINESS TAXABLE INCOME AND THE TAXATION OF ITS JOINT VENTURES. THIS EVALUATION DID NOT HAVE A MATERIAL EFFECT ON THE ORGANIZATION'S FINANCIAL STATEMENTS FOR THE YEARS ENDED JUNE 30, 2016 AND 2015. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,429,454 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,429,454 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04110 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,092,644 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,195,566 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,897,078 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05450 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $139,241 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $167,767 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | -$28,526 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,661,339 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,363,333 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,298,006 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.09560 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $36,500 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $36,500 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00100 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $36,500 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $36,500 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00100 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,697,839 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,363,333 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,334,506 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.09660 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $866,608 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $0 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $12,325,891 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $13,303,934 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$978,043 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DAVIE MEDICAL CENTER | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 329 NC HWY 801N | AddressLine1Txt |
| City | BERMUDA RUN | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 27006 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.WAKEHEALTH.EDU/DAVIE-MEDICAL-CENTE | WebsiteAddressTxt |
| State License | H0171 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DAVIE MEDICAL CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| CHNA Conducted | 15 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (1) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | 0 | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | SEE PART V, PAGE 7 | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 16 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | SEE PART V, PAGE 7 | StrategyWebsiteURLTxt |
| Strategy Attached | 0 | StrategyAttachedInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 400.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Income Level Criteria | Yes (X) | IncomeLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Residency Criteria | Yes (X) | ResidencyCriteriaInd |
| Other Criteria | Yes (X) | OtherCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | HTTP://WWW.WAKEHEALTH.EDU/DAVIE-MEDICAL-CENTER/INFORMATION/FINANCIAL-ASSIST | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | HTTP://WWW.WAKEHEALTH.EDU/DAVIE-MEDICAL-CENTER/INFORMATION/FINANCIAL-ASSIST | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | HTTP://WWW.WAKEHEALTH.EDU/DAVIE-MEDICAL-CENTER/INFORMATION/FINANCIAL-ASSIST | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| FAP Notice Displayed | Yes (X) | FAPNoticeDisplayedInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified Before Discharge | Yes (X) | FAPNotifiedBeforeDischargeInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Other Method Used | Yes (X) | OtherMethodUsedInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| DAVIE MEDICAL CENTER | PART V, SECTION B, LINE 5: COMMUNITY INPUT WAS OBTAINED THROUGH THE FOLLOWING SOURCES: (1) THE DAVIE COUNTY HEALTH DEPARTMENT'S COMMUNITY HEALTH ASSESSMENT CONDUCTED IN SUMMER 2014 VIA SURVEY MONKEY; (2) TWO FAITHHEALTH NC (A DEPARTMENT OF WAKE FOREST BAPTIST MEDICAL CENTER) COMMUNITY ASSET MAPPING WORKSHOPS WHICH SOUGHT OPINIONS OF BOTH HEALTH PROVIDERS AND HEALTH SEEKERS IN DAVIE COUNTY'S MOST VULNERABLE COMMUNITIES; (3) TWO COMMUNITY HEALTH WORKSHOPS, AND (4) COMMENTS FROM PRIOR COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY.ADDITIONALLY, MORE THAN TEN SECONDARY DATA SOURCES WERE REVIEWED, INCLUDING THE COUNTY HEALTH RANKINGS & ROADMAPS, 2014 STATE OF THE COUNTY HEALTH, US CENSUS BUREAU, N.C. CENTER FOR HEALTH STATISTICS, CENTERS FOR DISEASE CONTROL YOUTH RISK BEHAVIOR SURVEILLANCE SYSTEM, BEHAVIOR RISK FACTOR SURVEILLANCE SYSTEM, HEALTHY PEOPLE 2020, HEALTHY NORTH CAROLINA 2020, AND CENTER FOR MEDICARE & MEDICAID. |
| DAVIE MEDICAL CENTER | PART V, SECTION B, LINE 6A: THE HOSPITAL'S MOST RECENT CHNA WAS CONDUCTED IN COLLABORATION WITH NORTH CAROLINA BAPTIST HOSPITAL AND LEXINGTON MEDICAL CENTER. BOTH LEXINGTON MEDICAL CENTER AND NORTH CAROLINA BAPTIST HOSPITAL ARE AFFILIATE HOSPITALS OF WAKE FOREST BAPTIST MEDICAL CENTER. |
| DAVIE MEDICAL CENTER | PART V, SECTION B, LINE 7D: N/APART V, SECTION B, LINE 7A:HTTP://WWW.WAKEHEALTH.EDU/DAVIE-MEDICAL-CENTER/ABOUT/COMMUNITY-BENEFITS/COMMUNITY-BENEFITS.HTMPART V, SECTION B, LINE 10A:HTTP://WWW.WAKEHEALTH.EDU/DAVIE-MEDICAL-CENTER/ABOUT/COMMUNITY-BENEFITS/COMMUNITY-BENEFITS.HTM |
| DAVIE MEDICAL CENTER | PART V, SECTION B, LINE 11: THE MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT IDENTIFIED THE FOLLOWING SIGNIFICANT HEALTH NEEDS WITHIN THE COMMUNITY: (1) ACCESS TO HEALTH CARE, (2) CHRONIC DISEASE MANAGEMENT AND INFORMATION, (3) BEHAVIORAL AND MENTAL DISTRESS, (4) INADEQUATE EMERGENCY CARE, (5) DENTAL CARE, (6) HOUSING, (7) FOOD INSECURITIES, (8) LACK OF FINANCES, AND (9) LACK OF TRANSPORTATION.DAVIE COUNTY EMERGENCY HEALTH CORPORATION DBA DAVIE MEDICAL CENTER (DMC) PRIORITIZED THE FOLLOWING THREE SIGNIFICANT COMMUNITY HEALTH NEEDS FOR ITS CURRENT CHNA AS FOLLOWS: (1) ACCESS TO CARE; (2) CHRONIC DISEASE MANAGEMENT; AND (3) BEHAVIORAL/MENTAL HEALTH DISTRESS. DMC PLANS TO PROVIDE COMMUNITY BENEFIT PROGRAMS RESPONSIVE TO THESE HEALTH NEEDS THROUGH ITS APPROVED CHNA IMPLEMENTATION STRATEGY. THE DMC CHNA IMPLEMENTATION STRATEGY OUTLINES THE IMPLEMENTATION OF PROGRAMS AND THE EVALUATION OF IMPACT OF THOSE PROGRAMS ON PRIORITY COMMUNITY HEALTH NEEDS IDENTIFIED FROM THE CHNA. SPECIFICALLY, THE HOSPITAL IS ADDRESSING THE SIGNIFICANT HEALTH NEEDS AS FOLLOWS:1. ACCESS TO CAREBARRIERS SUCH AS TRANSPORTATION AND ACCESS TO COMMUNITY CENTERED SOCIAL AND HEALTH EDUCATION SERVICES CAN LEAD TO UNMET HEALTH NEEDS. THE HOSPITAL'S CURRENT STRATEGIES INCLUDE:--REDUCING TRANSPORTATION BARRIERS FOR INDIVIDUALS IN RURAL AREAS OF THE COMMUNITY THROUGH 1.) ASSESSING NEED FOR TRANSPORTATION ASSISTANCE THROUGH VARIOUS COMMUNITY AGENCIES TO DETERMINE HOW TO EASE ACCESS THROUGH PUBLIC TRANSPORTATION OR ONSITE CLINICS IN HIGH NEED AREAS, AND 2.) WORKING WITH LOCAL AGENCIES TO DETERMINE RESOURCES AVAILABLE TO BRING CARE TO AREAS IMPACTED BY TRANSPORTATION ISSUES.--IMPROVING ACCESS TO COMMUNITY CENTERED SOCIAL AND HEALTH EDUCATION SERVICES AND REGULAR SOURCES OF HEALTH CARE THROUGH 1.) PROVIDING HEALTH EDUCATION EVENTS AND SCREENINGS AT VARIOUS LOCATIONS IN DAVIE COUNTY, 2.) CREATING OPPORTUNITIES TO INVOLVE FAMILIES IN REGULAR PROGRAMMING VIA THE HEALTHY DAVIE INITIATIVE, 3.) WORKING WITH LOCAL CHURCHES TO PROVIDE PROGRAMS AND ENLIST LAY LEADER SUPPORT TO ASSIST PARISHIONERS NEEDING ACCESS, 4.) CONTINUING TO EXPLORE THE USE OF A MOBILE MEDICAL CLINIC IN LOW ACCESS SERVICE AREAS, AND 5.) CONTINUING TO PROVIDE COMMUNITY ENGAGEMENT SUPPORT THROUGH 5 SUPPORTERS OF HEALTH, 311 CONGREGATIONAL PARTNERS, 25 CONNECTORS ACROSS THE SERVICE AREA AND 7 FAITHHEALTH FELLOWS.2. CHRONIC DISEASE MANAGEMENTDMC RECOGNIZES THE EFFECT OF CONTINUITY OF CARE WITH HEALTH CARE PROVIDERS ON PATIENT BEHAVIORS, DISEASE MANAGEMENT, AND HEALTH STATUS.THE HOSPITAL'S CURRENT STRATEGIES INCLUDE:--IMPROVING THE CAPACITY OF COMMUNITY BASED ORGANIZATIONS AND HEALTH CARE PROVIDERS TO SUPPORT EFFORTS RELATED TO CHRONIC DISEASE PREVENTION AND MANAGEMENT THROUGH 1.) CONTINUING TO SUPPORT FAITHHEALTH NC COMMUNITY HEALTH WORKERS TO ADDRESS CHRONIC DISEASE MANAGEMENT AND COMMUNITY HEALTH PROGRAMMING, 2.) INCREASING COMMUNITY AND HEALTHCARE PROVIDER ACCESS TO EXISTING CHRONIC DISEASE MANAGEMENT RESOURCES BY CENTRALIZING AND DISTRIBUTING INFORMATION AND 3.) PROVIDING AND EXPANDING CHRONIC DISEASE SELF-MANAGEMENT PROGRAMS OFFERED BY THE MEDICAL CENTER THROUGH EMMI SOFTWARE.--PROVIDING EDUCATION AND SUPPORT PROGRAMS TO REDUCE DIABETIC PREVALENCE AND IMPROVING DIABETES MANAGEMENT THROUGH 1.) WORKING WITH DAVIE COUNTY HEALTH DEPARTMENT TO IMPROVE ACCESS TO AREA DIABETES MANAGEMENT PROGRAMS FOR PRE-DIABETIC AND EARLY ONSET DIABETIC PATIENTS, 2.) CONTINUING TO PROVIDE BESTHEALTH DIABETES PREVENTION AND NUTRITION EDUCATION/COOKING CLASSES AT CONVENIENT LOCATIONS IN DAVIE COUNTY, AND 3.) EXPLORING PARTNERSHIP WITH DAVIE COUNTY AGENCIES TO FOCUS DIABETES PREVENTION AND MANAGEMENT PROGRAMS IN IDENTIFIED HIGH NEED NEIGHBORHOODS.--PROVIDING EDUCATION AND SUPPORT PROGRAMS TO REDUCE OBESITY PREVALENCE AND IMPROVE OBESITY MANAGEMENT THROUGH 1.) EXPANDING PROGRAMMING IN DAVIE COUNTY TO INCREASE EDUCATION AND AWARENESS OF NUTRITION AND HEALTHY LIFESTYLE CHOICES FOR UNINSURED AND MEDICAID PATIENTS, 2.) PROMOTING HEALTHY DIET AND WEIGHT MANAGEMENT THROUGH EMPLOYEE WELLNESS PROGRAMS, 3.) CONTINUING TO SUPPORT COMMUNITY WEIGHT MANAGEMENT EDUCATION THROUGH BESTHEALTH, 4.) INCREASING AWARENESS AMONG EXISTING PATIENTS AND EMPLOYEES OF WEIGHT MANAGEMENT PROGRAMS, AND 5.) WORKING WITH INDUSTRY AND DAVIE COUNTY SCHOOL SYSTEM TO IDENTIFY AT RISK INDIVIDUALS AND PROVIDE SUPPORT AND PROGRAMMING THROUGH THE HEALTHY DAVIE INITIATIVE.3. BEHAVIORAL/MENTAL HEALTH DISTRESSDMC RECOGNIZES THE OVERLAP OF MENTAL, MEDICAL AND SOCIAL DISPARITIES AND THE IMPORTANT ROLE OF BEHAVIORAL HEALTH IN TREATING THE WHOLE PERSON. THE HOSPITAL'S CURRENT STRATEGIES INCLUDE:--WORKING WITH CENTERPOINT TO IDENTIFY KEY RESOURCES FOR ACCESS AND PROGRAMMING FOR PATIENTS NEEDING MENTAL HEALTH SERVICES;--INCREASING THE CURRENT 30+ STAFF AT THE MEDICAL CENTER WHO WORK IN AREAS DEFINED AS INTEGRATED BEHAVIORAL HEALTH;--BUILDING CAPACITY AMONG LAY PERSONS IN THE COMMUNITY IN THE AREAS OF MENTAL HEALTH FIRST AID, COMMUNITY RESILIENCE MODEL AND SUICIDE PREVENTION PROGRAMS;--DEVELOPING A PLAN TO CREATE MORE INTEGRATED BEHAVIORAL HEALTH GRADUATE MEDICAL EDUCATION OFFERINGS FOR MEDICAL STUDENTS, RESIDENTS, FACULTY AND STAFF THAT SEE PATIENTS ACROSS THE MEDICAL CENTER NETWORK.ALL OF THE AFOREMENTIONED EFFORTS IN COMBINATION WITH THE HOSPITAL'S VALUES OF NONDISCRIMINATION AND COMPASSIONATE CARE ARE DESIGNED TO MEET THE SIGNIFICANT HEALTH NEEDS OF THE MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT. |
| DAVIE MEDICAL CENTER | PART V, SECTION B, LINE 13H: THE HOSPITAL MAY USE COMMERCIALLY AVAILABLE FINANCIAL PROFILING AND CREDIT SCORING TECHNOLOGIES TO PRESUMPTIVELY SCREEN RESPONSIBLE INDIVIDUALS TO DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE DISCOUNTS. |
| DAVIE MEDICAL CENTER | PART V, SECTION B, LINE 16I: IN ADDITION TO THE METHODS PREVIOUSLY DESCRIBED, THE HOSPITAL INFORMS PATIENTS ABOUT ITS FAP DURING INTAKE AND DISCHARGE BY PROVIDING A PLAIN LANGUAGE SUMMARY OF THE FAP. THE HOSPITAL ALSO PLACES A CONSPICUOUS WRITTEN NOTICE OF THE FAP ON ITS PATIENT BILLING STATEMENTS. |
| DAVIE MEDICAL CENTER | PART V, SECTION B, LINE 22D: THE HOSPITAL CHARGES FAP ELIGIBLE INDIVIDUALS AN AMOUNT NOT TO EXCEED AMOUNTS GENERALLY BILLED ("AGB") FOR EMERGENCY AND OTHER MEDICALLY NECESSARY CARE. THE HOSPITAL CALCULATES AGB UNDER THE LOOKBACK METHOD USING CLAIMS ALLOWED BY PRIVATE INSURERS AND MEDICARE FEE FOR SERVICE OVER THE IMMEDIATELY PRECEDING YEAR. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 12 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (12 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - DMC BERMUDA RUN - GASTROENTEROLOGY | ||||
| 313 NC HWY 801 N | BERMUDA RUN | NC | 27006 | GASTROENTEROLOGY |
| 2 - DMC BERMUDA RUN - PHYSICAL MEDICINEREHA | ||||
| 313 NC HWY 801 N | BERMUDA RUN | NC | 27006 | PHYSICAL MEDICINE/REHABILITATION SPINE |
| 3 - DMC BERMUDA RUN - CARDIOLOGY | ||||
| 313 NC HWY 801 N | BERMUDA RUN | NC | 27006 | CARDIAC REHAB |
| 4 - DMC BERMUDA RUN - PODIATRY | ||||
| 313 NC HWY 801 N | BERMUDA RUN | NC | 27006 | PODIATRY |
| 5 - DMC BERMUDA RUN - ORTHOPAEDICS | ||||
| 313 NC HWY 801 N | BERMUDA RUN | NC | 27006 | X-RAY & ORTHOPAEDICS |
| 6 - DMC BERMUDA RUN - PULMONARY | ||||
| 313 NC HWY 801 N | BERMUDA RUN | NC | 27006 | PULMONARY FUNCTION LAB |
| 7 - DMC BERMUDA RUN - NEUROLOGY | ||||
| 313 NC HWY 801 N | BERMUDA RUN | NC | 27006 | EEG/EMG TESTING, SLEEP LAB |
| 8 - DMC BERMUDA RUN - EYE CENTER | ||||
| 313 NC HWY 801 N | BERMUDA RUN | NC | 27006 | OPTHALMOLOGY |
| 9 - DMC BERMUDA RUN - EMERGENCY DEPARTMENT | ||||
| 313 NC HWY 801 N | BERMUDA RUN | NC | 27006 | EMERGENCY SERVICES |
| 10 - DMC BERMUDA RUN - LAB | ||||
| 313 NC HWY 801 N | BERMUDA RUN | NC | 27006 | PHLEBOTOMY |
| 11 - DMC BERMUDA RUN - RADIOLOGY | ||||
| 313 NC HWY 801 N | BERMUDA RUN | NC | 27006 | RADIOLOGY |
| 12 - DMC BERMUDA RUN - OCCUPATIONAL THERAPY | ||||
| 313 NC HWY 801 N | BERMUDA RUN | NC | 27006 | OCCUPATIONAL THERAPY |
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3C: | THE ORGANIZATION ALSO EVALUATES CERTAIN CREDIT FILE DATA ELEMENTS TO IDENTIFY POTENTIAL SOURCES OF INCOME TO MORE ACCURATELY INFORM CHARITY CARE ELIGIBILITY ASSESSMENTS. PATIENTS WITH ESTIMATED HOUSEHOLD INCOME BELOW 200% OF FPG, WHO ARE IDENTIFIED AS HAVING COMMERCIAL CREDIT ACCOUNTS THAT ARE BEING SERVICED IN A MANNER THAT SUGGESTS ADDITIONAL SOURCES OF INCOME, ARE NOT AUTOMATICALLY GRANTED PRESUMPTIVE CHARITY CARE. |
| PART I, LINE 7: | THE ORGANIZATION USED THE WORKSHEETS PROVIDED IN THE INSTRUCTIONS TO SCHEDULE H TO COMPUTE ITS COST TO CHARGE RATIO FOR PURPOSES OF THE 2015 SCHEDULE H.PART I, LINE 7B MEDICAID DIRECT OFF-SETTING REVENUETHE HOSPITAL PARTICIPATES IN A PROVIDER ASSESSMENT PROGRAM ADMINISTERED BY THE NORTH CAROLINA DEPARTMENT OF HEALTH AND HUMAN SERVICES. UNDER THE PROGRAM, A FEE IS ASSESSED AGAINST NON-MEDICAID PATIENT SERVICE REVENUE OF PRIVATE HOSPITALS. THE FEDERAL GOVERNMENT MATCHES THE ASSESSMENT AT A RATE OF 2 TO 1 AND THESE AMOUNTS ARE ALLOCATED TO NORTH CAROLINA HOSPITALS QUARTERLY. ADDITIONALLY, THE HOSPITAL PARTICIPATES IN THE NORTH CAROLINA MEDICAID REIMBURSEMENT INITIATIVE (MRI). UNDER THE MRI, THE HOSPITAL RECEIVES ADDITIONAL REIMBURSEMENT BASED ON MEDICAID COST DEFICITS AND TREATMENT OF A DISPROPORTIONATE SHARE OF UNINSURED PATIENTS. |
| PART I, LN 7 COL(F): | THE ORGANIZATION'S PATIENT BAD DEBT EXPENSE PER THE AUDITED FINANCIAL STATEMENTS WAS $3,272,320 FOR THE FISCAL YEAR ENDED JUNE 30, 2016. THIS AMOUNT IS NOT INCLUDED IN THE CALCULATION OF CHARITY CARE FOR PART I, LINE 7. |
| PART II, COMMUNITY BUILDING ACTIVITIES: | WAKE FOREST BAPTIST HEALTH - DAVIE MEDICAL CENTER IS COMMITTED TO IMPROVING THE HEALTH OF THE INDIGENT AND MEDICALLY UNDERSERVED IN DAVIE COUNTY AND SURROUNDING AREAS. DAVIE MEDICAL CENTER REPRESENTATIVES ARE INVOLVED IN THE COMMUNITY THROUGH INITIATIVES SUCH AS HEALTHY DAVIE, PART OF THE DAVIE COMMUNITY FOUNDATION. THE MEDICAL CENTER HOSTS FREE CLASSES, SCREENINGS AND COOKING DEMONSTRATIONS THROUGH ITS BESTHEALTH PROGRAM. DAVIE MEDICAL CENTER PARTNERS WITH OTHER AGENCIES THROUGHOUT THE COMMUNITY TO CONTINUE TO IMPROVE HEALTH. AGENCIES INCLUDE SENIOR SERVICES, DRAGONFLY HOUSE, SMART START OF DAVIE COUNTY AND THE DAVIE YMCA. |
| PART III, LINE 4: | THE ORGANIZATION'S FINANCIAL STATEMENTS DO NOT INCLUDE A DISCRETE FOOTNOTE EXPLAINING BAD DEBT EXPENSE. BAD DEBT HAS NOT BEEN INCLUDED IN THE COMPUTATION OF COMMUNITY BENEFIT ON PART I, LINE 7. AMOUNTS USED TO COMPUTE CHARITY CARE AND BAD DEBT ON SCHEDULE H USE THE MOST CURRENT DATA AVAILABLE AT THE TIME OF FILING. THE ORGANIZATION USED WORKSHEET 2 OF THE 2015 SCHEDULE H INSTRUCTIONS TO COMPUTE A COST TO CHARGES RATIO USED TO CALCULATE BAD DEBT AT COST. |
| PART III, LINE 8: | THE HOSPITAL USES AN OVERALL COST TO CHARGE RATIO CALCULATION BASED ON AUDITED FINANCIAL STATEMENTS BUT REMOVES COST ASSOCIATED WITH BAD DEBT, COMMUNITY BUILDING, AND CHARITY CARE SO AS NOT TO COUNT THOSE COSTS TWICE. |
| PART III, LINE 9B: | THE HOSPITAL MAKES A REASONABLE EFFORT TO DETERMINE AN INDIVIDUAL'S ELIGIBILITY FOR FINANCIAL ASSISTANCE BEFORE ENGAGING IN ANY COLLECTION ACTIONS. ALL COLLECTION ACTIONS WILL BE SUSPENDED IF THE INDIVIDUAL SUBMITS A COMPLETED FAP APPLICATION DURING THE APPLICATION PERIOD, OR IF THE INDIVIDUAL SUBMITS AN INCOMPLETE APPLICATION DURING THE APPLICATION PERIOD THAT IS SUBSEQUENTLY COMPLETED WITHIN A REASONABLE TIME AFTER THE HOSPITAL REQUESTS FURTHER INFORMATION. IF THE INDIVIDUAL IS DETERMINED NOT TO BE ELIGIBLE FOR A FULL DISCOUNT UNDER THE FAP, ANY COLLECTION ACTIVITIES WILL BE RESUMED AS TO THE OUTSTANDING BALANCE OWED. IF THE INDIVIDUAL IS DETERMINED TO BE ELIGIBLE FOR ANY LEVEL OF ASSISTANCE UNDER THE FAP, APPROPRIATE MEASURES ARE TAKEN TO REFUND ANY AMOUNTS OWED TO THE INDIVIDUAL AND REVERSE OR MODIFY COLLECTION ACTIONS CONSISTENT WITH THE NEW BALANCE OWED AFTER APPLYING THE APPLICABLE FAP DISCOUNTS. |
| PART VI, LINE 2: | THE HOSPITAL'S CURRENT NEEDS ASSESSMENT PLAN WAS BASED ON A SET OF BEST PRACTICES FOR COMMUNITY HEALTH ASSESSMENTS WITH THE PURPOSE OF IDENTIFYING TWO TO THREE REGIONAL PRIORITY AREAS TO FOCUS ON FOR FY 2017-2018. THE PROCESS WAS DESIGNED TO RELY ON EXISTING PUBLIC DATA, DIRECTLY ENGAGE COMMUNITY STAKEHOLDERS AND COLLABORATE WITH LOCAL PUBLIC HEALTH, OTHER HEALTH PROVIDERS, AS WELL AS COMMUNITY PARTNERS SUCH AS FAITH NETWORKS RELEVANT TO THE SOCIAL FACTORS UNDERLYING PATTERNS OF ACCESS. THE HOSPITAL'S ASSESSMENT WAS CONDUCTED IN THREE STAGES: (1) DATA REVIEW (PRIMARY AND SECONDARY DATA), (2) SETTING PRIORITIES, AND (3) COMMUNITY ASSET INVENTORY. THE DATA REVIEW AND PRIORITY SETTING PHASE BEGAN WITH THE COMPILATION OF EXISTING HEALTH-RELATED DATA. STAKEHOLDERS REVIEWED MULTIPLE DATA SETS INCLUDING FORSYTH, DAVIDSON, AND THE DAVIE COUNTY HEALTH DEPARTMENT'S PUBLIC HEALTH NEEDS ASSESSMENTS, NORTH CAROLINA INDICATORS FOR COMMUNITY HEALTH ASSESSMENT, INTERNAL DISEASE REGISTRIES, AND COUNTY HEALTH RANKINGS. ONCE THE COMMUNITY HEALTH NEEDS WERE IDENTIFIED, AN INTERNAL STEERING COMMITTEE AND SENIOR LEADERSHIP REVIEW A SET OF CRITERIA TO DEVELOP THE PRIORITY RANKINGS. THE PRIORITIZATION PROCESS IDENTIFIED THE FOLLOWING TOP THREE PRIORITY CHALLENGES FOR THE COMMUNITY: (1) ACCESS/LACK OF MEDICAL SERVICES/SCREENINGS, (2) CHRONIC DISEASE - CANCER, DIABETES, OBESITY, AND (3) BEHAVIORAL/MENTAL HEALTH DISTRESS.FAITHHEALTHNC (A DIVISION OF THE MEDICAL CENTER) PROVIDED COMMUNITY ENGAGEMENT THROUGH A COMPREHENSIVE ASSET MAPPING STRATEGY BASED ON AN APPROACH FROM SOUTH AFRICA AND REDEFINED IN MEMPHIS, TN DESIGNED TO BUILD COMMUNITY PARTNERSHIPS ON THE ASSETS THAT EXIST, INSTEAD OF JUST NEEDS. THE MAPPING DEVELOPED AN INVENTORY OF EXISTING PROGRAMS AND SERVICES WITHIN THE REGION RELATED TO THE PRIORITY AREAS IDENTIFIED IN THE NEEDS ASSESSMENT. THE INVENTORY INCLUDED THE LOCATION OF THE PROGRAM (HOSPITAL, CLINIC, OR COMMUNITY SERVICE) AS WELL AS THE NATURE OF THE INTANGIBLE FACTORS, ESPECIALLY TRUST, THAT DETERMINE ACCESS AND COLLABORATION AMONG COMMUNITY PARTNERS. THE PURPOSE OF THE INVENTORY WAS TO IDENTIFY GAPS IN SERVICES, OPPORTUNITIES FOR NEW WORK, WHERE AND WITH WHOM THERE IS ALREADY WORK BEING DONE, AND OPPORTUNITIES FOR PARTNERSHIP AND COLLABORATION. FROM THIS THREE STEP PROCESS, THE HOSPITAL DEVELOPED AN IMPLEMENTATION STRATEGY TO IDENTIFY THE MEANS THROUGH WHICH IT PLANS TO ADDRESS NEEDS THAT ARE CONSISTENT WITH THE CHARITABLE MISSION AS PART OF ITS COMMUNITY BENEFIT PROGRAMS FOR THE NEXT THREE FISCAL YEARS. BEYOND THE PROGRAMS THAT WILL BE ADDRESSED IN THE IMPLEMENTATION STRATEGY, THE HOSPITAL WILL CONTINUE TO ADDRESS MANY OF THE PRIORITIES BY PROVIDING CARE TO ALL, REGARDLESS OF THE ABILITY TO PAY. |
| PART VI, LINE 3: | THE ORGANIZATION USES A VARIETY OF MEANS TO EDUCATE AND INFORM PATIENTS OF THEIR CHARITY CARE OPTIONS, INCLUDING INFORMATION ON A WEBSITE, PAMPHLETS, CONSPICUOUSLY DISPLAYED SIGNAGE, INFORMATION ON PATIENT BILL STATEMENTS, AND FROM STAFF MEMBERS DURING CONVERSATIONS CONCERNING A PATIENT'S LIABILITY FOR SERVICES. THE HOSPITAL EMPLOYS A ROBUST PRE-SERVICE FINANCIAL CLEARANCE PROCESS THAT SCREENS PATIENTS PRIOR TO SERVICE DELIVERY FOR EXISTING OR AVAILABLE PAYER SOURCES AS A MEANS OF AVOIDING BAD DEBT AND INAPPROPRIATE BILLING TO PATIENTS WITHOUT THE MEANS TO PAY. IF A PAYER SOURCE IS IDENTIFIED, HOSPITAL STAFF WILL ASSIST THE PATIENT WITH ENROLLMENT. |
| PART VI, LINE 4: | DAVIE COUNTY IS LOCATED IN THE PIEDMONT TRIAD REGION OF NORTH CAROLINA, COVERING 264 SQUARE MILES WITH A POPULATION OF APPROXIMATELY 41,750. WIDELY RURAL, THE COUNTY IS CHARACTERIZED BY ROLLING FARMLAND. THE NEAREST METROPOLITAN AREA IS WINSTON-SALEM, LOCATED JUST 12 MILES TO THE NORTHEAST. OVER 80% OF THE COUNTY'S POPULATION LIVES IN UNINCORPORATED AREAS. APPROXIMATELY 54% OF DAVIE COUNTY'S RESIDENTS TRAVEL OUTSIDE OF THE COUNTY FOR EMPLOYMENT. OF THOSE, 62% WORK IN FORSYTH COUNTY. THE MEDIAN INCOME FOR DAVIE COUNTY RESIDENTS IS APPROXIMATELY $51,500. THE DAVIE COUNTY UNEMPLOYMENT RATE AS REPORTED IN JUNE 2016 WAS 4.7%.THE FOLLOWING DEMOGRAPHIC FIGURES REFLECT THE POPULATION FOR DAVIE COUNTY: - 51% FEMALE, 49% MALE - BELOW 18 YEARS: 21.6% - AGE 65 AND OLDER: 19.6%THE COUNTY POPULATION BREAKDOWN BY RACE IS: - WHITE NON-HISPANIC (84.7%) - BLACK (6.7%) - HISPANIC (6.5%) - TWO OR MORE RACES (1.6%) - OTHER ASIAN (0.8%) - AMERICAN INDIAN (0.6%)THERE ARE SEVEN TOWNSHIPS IN DAVIE COUNTY. MOCKSVILLE IS THE LARGEST MUNICIPALITY WITH 5,104 RESIDENTS, AND IS ALSO THE COUNTY SEAT. A COMPARISON OF MOCKSVILLE TO DAVIE COUNTY AND NORTH CAROLINA REVEALS MEDIAN HOUSEHOLD INCOME AND MEDIAN HOUSE VALUE ARE WELL BELOW COUNTY AND STATE AVERAGES. DAVIE COUNTY EXPERIENCED UNPRECEDENTED GROWTH BETWEEN YEARS 2000 AND 2015 AT 2% ANNUALLY, COMPARED TO THE PIEDMONT TRIAD'S AVERAGE GROWTH RATE OF 1.3% ANNUALLY FOR THAT SAME PERIOD. THE MAJORITY OF THE POPULATION GROWTH OCCURRED IN THE EASTERN PART OF THE COUNTY THAT BORDERS WINSTON-SALEM. |
| PART VI, LINE 5: | THE HOSPITAL HAS MAINTAINED A STRONG COMMITMENT TO PROMOTING AND EXPANDING COMMUNITY HEALTH PROGRAMS IN DAVIE COUNTY. SUCH PROGRAMS INCLUDE BESTHEALTH COMMUNITY EDUCATION CLASSES, CHRONIC DISEASES SELF MANAGEMENT PROGRAMS, PUBLIC SCREENINGS, AND OTHER HEALTH EDUCATION EVENTS HELD LOCALLY THROUGHOUT THE YEAR. |
| PART VI, LINE 6: | THE MEMBER OF THE ORGANIZATION IS NORTH CAROLINA BAPTIST HOSPITAL ("NCBH"). THE FILING ORGANIZATION AND NCBH ARE INTEGRAL PARTS OF WAKE FOREST BAPTIST MEDICAL CENTER, A PREEMINENT, INTERNATIONALLY RECOGNIZED ACADEMIC MEDICAL CENTER OF THE HIGHEST QUALITY WITH BALANCED EXCELLENCE IN PATIENT CARE, RESEARCH AND EDUCATION. WAKE FOREST BAPTIST MEDICAL CENTER'S MISSION IS TO IMPROVE THE HEALTH OF OUR REGION, STATE AND NATION BY:1) GENERATING AND TRANSLATING KNOWLEDGE TO PREVENT, DIAGNOSE AND TREATDISEASE.2) TRAINING LEADERS IN HEALTH CARE AND BIOMEDICAL SCIENCE.3) SERVING AS THE PREMIER HEALTH SYSTEM IN OUR REGION, WITH SPECIFICCENTERS OF EXCELLENCE RECOGNIZED AS NATIONAL AND INTERNATIONAL CAREDESTINATIONS. |
| PART VI, LINE 7, REPORTS FILED WITH STATES | NC |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|
| KIDS & PROS | |||||||
| PO BOX 2093 | BUFORD | GA | 30515 | 264298822 | 501(C)(3) | $10,000 | YOUTH CHARACTER DEVELOPMENT AND SPORTS SKILLS |
| DAVIE COMMUNITY FOUNDATION | |||||||
| 107 N SALISBURY | MOCKSVILLE | NC | 27028 | 581850531 | 501(C)(3) | $5,500 | COMMUNITY SUPPORT |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 2 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE HOSPITAL FOLLOWS THE MEDICAL CENTER'S CORPORATE POLICY USED IN REVIEWING THE ELIGIBILITY AND SELECTION OF GRANTEES RECEIVING CERTAIN EXEMPT PURPOSE FUNDS. THE HOSPITAL MAINTAINS DOCUMENTATION OF THE ELIGIBILITY AND SELECTION CRITERIA AND RECORDS OF THE AMOUNTS DISBURSED. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (2 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CHAD BROWN | ||||||||||||||
| PRESIDENT | $225,008 | $0 | $61,709 | $0 | $11,551 | $0 | $37,537 | $0 | $35,549 | $0 | $371,354 | $0 | $0 | $0 |
| DANNY SQUIRES | ||||||||||||||
| FINANCE DIRECTOR | $168,265 | $0 | $29,545 | $0 | $636 | $0 | $9,613 | $0 | $15,892 | $0 | $223,951 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 4B | CERTAIN OFFICERS OF THE FILING ORGANIZATION PARTICIPATED IN SUPPLEMENTAL NON QUALIFIED RETIREMENT PLANS (SERP), ALL OF WHICH WERE PAID BY AN UNRELATED ORGANIZATION, WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER, AS PART OF THE INDIVIDUAL'S COMPENSATION FROM THE UNRELATED ORGANIZATION. THE DETERMINATION OF THE AMOUNT OF THE NON QUALIFIED RETIREMENT PLANS FOLLOWED THE UNRELATED ORGANIZATION'S COMPENSATION PROCEDURES AS OUTLINED IN PART VI, SECTION B, LINE 15 OF THE FORM 990. |
| FORM 990, PART VII, LINE 5 - COMPENSATION FROM UNRELATED ORGANIZATION | THE FOLLOWING INDIVIDUAL RECEIVED COMPENSATION FROM AN AFFILIATED BUT UNRELATED ORGANIZATION, WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER, FOR SERVICES RENDERED TO THIS ORGANIZATION AS AN OFFICER OR KEY EMPLOYEE: CHAD BROWN DANNY SQUIRES |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART IV, LINE 20B | THE HOSPITAL HAS ATTACHED A COPY OF ITS CONSOLIDATED AUDITED FINANCIAL STATEMENTS FOR ITS FISCAL YEAR ENDED JUNE 30, 2016 TO THE FORM 990. THE CONSOLIDATED FINANCIAL STATEMENTS HAVE BEEN PREPARED ON THE ACCRUAL BASIS IN CONFORMITY WITH U.S. GENERALLY ACCEPTED ACCOUNTING PRINCIPLES (GAAP) AND INCLUDE THE ASSETS AND OPERATIONS OF NORTH CAROLINA BAPTIST HOSPITAL (NCBH), DAVIE COUNTY EMERGENCY HEALTH CORPORATION (THE FILING ORGANIZATION), CARENET, INC., THE HAWTHORNE INN AND CONFERENCE CENTER, NORTH CAROLINA BAPTIST HOSPITAL FOUNDATION AND CLEMMONS MEDICAL PARK, LLC. ALL SIGNIFICANT INTERCOMPANY TRANSACTIONS HAVE BEEN ELIMINATED IN CONSOLIDATION. |
| FORM 990, PART VI, SECTION A, LINE 3 | AS ESTABLISHED IN THE ORGANIZATIONS BYLAWS, THE BOARD OF TRUSTEES MAY ESTABLISH AN EXECUTIVE COMMITTEE CONSISTING OF THREE OR MORE TRUSTEES, THE MAJORITY OF WHOM SHALL BE NORTH CAROLINA BAPTIST HOSPITAL (NCBH) TRUSTEES AND THE REMAINDER SHALL BE DAVIE HOSPITAL TRUSTEES. DURING THE INTERVALS BETWEEN MEETINGS OF THE BOARD OF TRUSTEES, THE EXECUTIVE COMMITTEE SHALL HAVE AND MAY EXERCISE THE POWERS OF THE BOARD OF TRUSTEES IN THE MANAGEMENT OF THE BUSINESS AND AFFAIRS OF THE CORPORATION; PROVIDED THAT THE EXECUTIVE COMMITTEE MAY NOT TAKE ANY ACTION THAT WOULD REQUIRE A SUPERMAJORITY VOTE OF THE BOARD OF TRUSTEES. |
| FORM 990, PART VI, SECTION A, LINE 6 | THE SOLE MEMBER OF THE ORGANIZATION IS NORTH CAROLINA BAPTIST HOSPITAL, A NORTH CAROLINA NONPROFIT CORPORATION. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE SOLE MEMBER OF THE ORGANIZATION SHALL HAVE THE RIGHT AT ALL TIMES, WITH RESPECT TO THE ORGANIZATION, TO ELECT AND REMOVE THE TRUSTEES, AS PROVIDED IN THE ORGANIZATION'S BYLAWS. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE SOLE MEMBER OF THE ORGANIZATION SHALL HAVE THE RIGHT AT ALL TIMES, WITH RESPECT TO THE ORGANIZATION, TO APPROVE OF THE SALE, LEASE, OR TRANSFER OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE ORGANIZATION, AS PROVIDED IN THE ORGANIZATION'S BYLAWS. THE SOLE MEMBER MAY ACT WITHOUT A MEETING. |
| FORM 990, PART VI, SECTION B, LINE 11 | THE FILING ORGANIZATION'S BOARD OF DIRECTORS RECEIVES COPIES OF THE FORM 990 WITH SUFFICIENT TIME TO PERMIT REVIEW, COMMENT, AND QUESTIONS PRIOR TO ITS FILING. THE AUDIT AND COMPLIANCE COMMITTEES OF THE GOVERNING BOARDS OF WFUHS AND NCBH REVIEW IN ADDITIONAL DETAIL THE FILING ORGANIZATION'S FORM 990 WITH THE ORGANIZATION'S CHIEF FINANCIAL OFFICER OR HIS DESIGNEE, WHO ANSWERS QUESTIONS AND ADDRESSES CONCERNS RAISED BY SUCH COMMITTEE MEMBERS OR OTHER FILING ORGANIZATION DIRECTORS. IF MODIFICATIONS ARE REQUIRED FOLLOWING SUCH REVIEW AND COMMENT, THE REVISED FORM 990 IS REDISTRIBUTED TO ALL DIRECTORS PRIOR TO ITS FILING WITH THE IRS, ALONG WITH A REPORT NOTING THE MODIFICATIONS. |
| FORM 990, PART VI, SECTION B, LINE 12C | ON AN ANNUAL BASIS (AND AS THEY ARISE), ALL TRUSTEES AND OFFICERS OF THE FILING ORGANIZATION ARE ASKED TO REVIEW THE APPLICABLE CONFLICTS OF INTEREST POLICY AND TO DESCRIBE ANY POTENTIAL CONFLICTS OF INTEREST THEY MAY HAVE. UPON COMPLETION OF THE CONFLICTS OF INTEREST SURVEY, THE LEGAL DEPARTMENT REVIEWS THE COMPLETED QUESTIONNAIRES ON BEHALF OF THE FILING ORGANIZATION. ANY CONFLICTS IDENTIFIED ARE COMMUNICATED TO THE FILING ORGANIZATION'S CHAIRMAN OF THE BOARD AND ARE PRESENTED TO THE AUDIT AND COMPLIANCE COMMITTEE. ALL CONFLICTS OF INTEREST ARE RESOLVED BY MANAGEMENT PLANS DEVELOPED BY THE FILING ORGANIZATION BOARD'S AUDIT AND COMPLIANCE COMMITTEE AND THE INTERNAL AUDIT AND COMPLIANCE OFFICES. THE AUDIT AND COMPLIANCE COMMITTEE'S CHAIR PRESENTS AN ANNUAL REPORT ON CONFLICTS TO THE FULL BOARD OF THE FILING ORGANIZATION. |
| FORM 990, PART VI, SECTION B, LINE 15 | DAVIE COUNTY EMERGENCY HEALTH CORPORATION (DBA DAVIE MEDICAL CENTER) IS AN INTEGRAL PART OF WAKE FOREST BAPTIST MEDICAL CENTER, A PREEMINENT, INTERNATIONALLY RECOGNIZED ACADEMIC MEDICAL CENTER OF THE HIGHEST QUALITY WITH BALANCED EXCELLENCE IN PATIENT CARE, RESEARCH AND EDUCATION. THE FILING ORGANIZATION PAYS NO COMPENSATION TO OFFICERS OR DIRECTORS. ALL COMPENSATION PAID TO OFFICERS AND DIRECTORS AND TO FORMER OFFICERS AND DIRECTORS WAS PAID BY UNRELATED ORGANIZATIONS, WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER AND WAKE FOREST UNIVERSITY HEALTH SCIENCES, BOTH ENITITES WITHIN THE WAKE FOREST BAPTIST MEDICAL CENTER LEGAL STRUCTURE. COMPENSATION PAID TO THESE INDIVIDUALS ARE REVIEWED AND APPROVED IN ACCORDANCE WITH THE APPLICABLE ORGANIZATION'S COMPENSATION POLICIES AND PROCEDURES WHICH INCLUDE INDEPENDENT COMPENSATION CONSULTANTS, COMPENSATION SURVEYS AND STUDIES TO DETERMINE THE APPROPRIATENESS OF EACH OFFICER'S AND DIRECTOR'S COMPENSATION. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION'S ARTICLES OF INCORPORATION ARE AVAILABLE TO THE PUBLIC ON REQUEST AND ARE AVAILABLE ON THE WEBSITE OF THE NORTH CAROLINA SECRETARY OF STATE. THE ORGANIZATION'S BYLAWS ARE NOT PUBLISHED, BUT PROVISIONS FROM THE BYLAWS ARE INCLUDED AS NECESSARY IN THE ORGANIZATION'S POLICIES, AND ARE ATTACHED TO THE FORM 1023 FILED FOR THE ORGANIZATION WITH THE IRS, WHICH IS PUBLICLY AVAILABLE. THE CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE NOT AVAILABLE TO THE PUBLIC. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (6 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| NORTH CAROLINA BAPTIST HOSPITAL | |||||||||||
| MEDICAL CENTER BLVD | WINSTON SALEM | NC | 27157 | 560552787 | HEALTHCARE | NC | 501(C)(3) | LINE 3 | N/A | 0 | |
| NORTH CAROLINA BAPTIST HOSPITAL FOUNDATION | |||||||||||
| MEDICAL CENTER BLVD | WINSTON SALEM | NC | 27157 | 561685120 | SUPPORTING ORGANIZATION | NC | 501(C)(3) | LINE 11A, I | 0 | NORTH CAROLINA BAPTIST HOSPITAL | |
| THE REHABILITATION & SKILLED NURSING FACILITY AT OAK SUMMIT | |||||||||||
| MEDICAL CENTER BLVD | WINSTON SALEM | NC | 27157 | 561826396 | HEALTHCARE (INACTIVE) | NC | 501(C)(3) | LINE 9 | 0 | NORTH CAROLINA BAPTIST HOSPITAL FOUNDATION | |
| THE HAWTHORNE INN & CONFERENCE CENTER INC | |||||||||||
| 420 HIGH STREET | WINSTON SALEM | NC | 27101 | 561793617 | LODGING/ CONFERENCE ACCOMMODATION | NC | 501(C)(3) | LINE 11A, I | 0 | NORTH CAROLINA BAPTIST HOSPITAL | |
| CARENET INC | |||||||||||
| 2000 WEST FIRST STREET SUITE 410 | WINSTON SALEM | NC | 27104 | 561977341 | HEALTHCARE | NC | 501(C)(3) | LINE 11B, II | 0 | NORTH CAROLINA BAPTIST HOSPITAL | |
| DAVIE COUNTY HOSPITAL FOUNDATION | |||||||||||
| 156 ROLAND RD | MOCKSVILLE | NC | 27028 | 581477280 | SUPPORTING ORGANIZATION | NC | 501(C)(3) | LINE 11C, III-FI | N/A | 0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |