HEALTHCARE FOUNDATION OF WILSON: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- HEALTHCARE FOUNDATION OF WILSON (EIN 56-6024172)
- Tax period
- 2015-01-01 to 2015-12-31
- Filed
- 2016-11-14
- IRS object ID
- 201603199349301145
- Schema version
- 2015v2.1
- 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 B
- Schedule D
- Schedule G
- Schedule H
- Schedule I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2016-11-14T08:19:23-06:00 | ReturnTs |
| Tax Period End | 2015-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 621517792 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PERSHING YOAKLEY & ASSOCIATES P C | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2220 SUTHERLAND AVE | AddressLine1Txt |
| City | KNOXVILLE | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 37919 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 566024172 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HEALTHCARE FOUNDATION OF WILSON | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | HEAL | BusinessNameControlTxt |
| Phone | 2522812105 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 3697 | AddressLine1Txt |
| City | WILSON | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 27895 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DENISE O'HARA | PersonNm |
| Person Title | EXECUTIVE DIRECTOR | PersonTitleTxt |
| Phone | 2522812105 | PhoneNum |
| Signature | 2016-11-14 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | DEBORAH O ERNSBERGER | PreparerPersonNm |
| PTIN | P00364912 | PTIN |
| Phone | 8656730844 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2017-02-10 21:41:12Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | DENISE O'HARA | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 3697 | AddressLine1Txt |
| City | WILSON | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 27895 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $23,102,218 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | HTTPS://HEALTHCAREFOUNDATIONOFWILSON.ORG/ | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1964 | FormationYr |
| Legal Domicile State | NC | LegalDomicileStateCd |
| Activity Or Mission | TO SUPPORT THE HEALTH CARE NEEDS OF THE PEOPLE OF WILSON COUNTY AND NEIGHBORING COMMUNITIES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 16 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 16 | VotingMembersIndependentCnt |
| Total Employee | 3 | TotalEmployeeCnt |
| Total Volunteers | 15 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $7,217 | PYContributionsGrantsAmt |
| CY Contributions Grants | $51,474 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $131,325 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $11,548,684 | CYProgramServiceRevenueAmt |
| PY Investment Income | $2,758,228 | PYInvestmentIncomeAmt |
| CY Investment Income | $11,472,348 | CYInvestmentIncomeAmt |
| PY Other Revenue | $1,062 | PYOtherRevenueAmt |
| CY Other Revenue | $29,111 | CYOtherRevenueAmt |
| PY Total Revenue | $2,897,832 | PYTotalRevenueAmt |
| CY Total Revenue | $23,101,617 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $12,630 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $54,120 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $83,725 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $209,513 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $94,794 | PYOtherExpensesAmt |
| CY Other Expenses | $615,052 | CYOtherExpensesAmt |
| PY Total Expenses | $191,149 | PYTotalExpensesAmt |
| CY Total Expenses | $878,685 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $2,706,683 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $22,222,932 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $149,892,256 | TotalAssetsBOYAmt |
| Total Assets EOY | $147,476,872 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $7,553,789 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $4,844,435 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $142,338,467 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $142,632,437 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | HEALTHCARE FOUNDATION OF WILSON (THE FOUNDATION) INVESTS IN COLLABORATIVE EFFORTS THAT IMPACT AND MEASURABLY IMPROVE THE HEALTH AND WELL-BEING OF ALL WILSON COUNTY RESIDENTS. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $506,166 | ExpenseAmt |
| Grant | $54,120 | GrantAmt |
| Revenue | $11,548,684 | RevenueAmt |
| Desc | THE FOUNDATION SERVES AS A HEALTH LEGACY CHARITABLE FOUNDATION TO SUPPORT THE HEALTH CARE NEEDS OF ITS COMMUNITY AND MAINTAINS ASSETS ASSOCIATED WITH THE WILSON MEDICAL CENTER, INC. FACILITY. THE FOUNDATION PROVIDES GRANT-MAKING WITH THE OBJECTIVE OF IMPROVING HEALTH AND WELLNESS WITH THE FOLLOWING FOUR FOCUS AREAS:- ADOLESCENT PREGNANCY EDUCATION AND PREVENTION;- ALCOHOL AND SUBSTANCE ABUSE IN YOUTHS;- OBESITY PREVENTION; AND- SEXUALLY TRANSMITTED DISEASE PREVENTION.ADDITIONALLY, AS DESCRIBED IN DETAIL IN SCHEDULE A, PART VI, THE FOUNDATION RETAINS AN OWNERSHIP INTEREST AND EFFECTIVE CONTROL OF DLP WILSON HOLDING COMPANY, LLC, WHICH OPERATES THE HOSPITAL AND NURSING HOME PREVIOUSLY OWNED AND OPERATED BY THE FOUNDATION. THROUGH ITS OWNERSHIP OF DLP WILSON HOLDING COMPANY, LLC, THE FOUNDATION CONTINUES TO SUPPORT PROGRAMS THAT FOSTER THE DELIVERY, QUALITY, OR AFFORDABILITY OF HEALTH CARE OR HEALTH CARE-RELATED SERVICES AND TO SUPPORT ANY ACTIVITY DESIGNED AND CARRIED ON TO SERVE THE GENERAL HEALTH AND WELL-BEING OF THE COMMUNITY; TO AID IN THE INSTRUCTION AND PROMOTION OF RESEARCH AND SCIENTIFIC INVESTIGATION IN ALL BRANCHES OF MEDICINE AND SURGERY; AND TO SUPPORT ANY EDUCATIONAL ACTIVITIES RELATED TO THE CARE OF THE SICK AND DISABLED, THE PROMOTION OF HEALTH AND PREVENTATIVE MEDICINE, AND THE GENERAL HEALTH AND WELL-BEING OF THE COMMUNITY. | Desc |
| Total Program Service Expenses | $506,166 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | 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 | Yes (1) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | Yes (1) | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | 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 | Yes (1) | 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 | 17 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 3 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| 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 | 16 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 16 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | 0 | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | Yes (1) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | Yes (1) | WrittenPolicyOrProcedureInd |
| States Where Copy Of Return Is Fld | NC | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DENISE O'HARA | PersonNm |
| Phone | 2522812105 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 3697 | AddressLine1Txt |
| City | WILSON | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 27895 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (18 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|
| CARLETHA WARD | |||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| CARROLL COLEMAN | |||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| FRANK BATTEN DVM | |||||||
| CHAIR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| GEORGE ISAACS MD | |||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| HUITT MATTOX MD | |||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| JEROME VICK | |||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| JOHN ANTHONY | |||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| JONATHON DEWALD MD | |||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| LEESA LAWRENCE MD | |||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| TOMMY SHINGLETON | |||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| JERRY WOODARD MD | |||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| KEITH LERRO MD | |||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| THOMAS LUCAS | |||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| SHERYLETTA LACEWELL | |||||||
| SECRETARY | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| JOHN TILTON | |||||||
| TREASURER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| VANCE FORBES | |||||||
| VICE CHAIR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| DENISE O'HARA | |||||||
| EXECUTIVE DIRECTOR | 40.00 | $151,963 | $0 | $56,241 | Yes (X) | ||
| RICHARD HUDSON | |||||||
| FORMER CEO | 0.00 | $273,273 | $0 | $10,369 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $425,236 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $66,610 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 2 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (2 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| WOMBLE CARLYLE SANDRIDGE & RICE LLP | |||||
| PO BOX 607879 | CHARLOTTE | NC | 28260 | LEGAL SERVICES | $100,693 |
| RSM US LLP | |||||
| 5155 PAYSPHERE CIRCLE | CHICAGO | IL | 60674 | ACCOUNTING SERVICES | $100,658 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 2 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $51,474 | AllOtherContributionsAmt |
| Total Contributions | $51,474 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT SERVICE REVENUE | 621110 | $11,575,454 | $11,575,454 |
| DISCONTINUED OPERATIONS | 621110 | -$26,770 | -$26,770 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $11,548,684 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $11,472,348 | TotalRevenueColumnAmt |
| Exclusion | $11,472,348 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $29,412 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $601 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $28,811 | TotalRevenueColumnAmt |
| Exclusion | $28,811 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | OTHER INCOME | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $300 | TotalRevenueColumnAmt |
| Exclusion | $300 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $300 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $23,101,617 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $11,548,684 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $11,501,459 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $54,120 | TotalAmt |
| Program Services | $54,120 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $151,963 | TotalAmt |
| Program Services | $136,767 | ProgramServicesAmt |
| Management And General | $15,196 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,116 | TotalAmt |
| Program Services | $17,204 | ProgramServicesAmt |
| Management And General | $1,912 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $35,853 | TotalAmt |
| Program Services | $32,268 | ProgramServicesAmt |
| Management And General | $3,585 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,581 | TotalAmt |
| Program Services | $2,323 | ProgramServicesAmt |
| Management And General | $258 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $163,179 | TotalAmt |
| Management And General | $163,179 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $162,503 | TotalAmt |
| Management And General | $162,503 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $117,486 | TotalAmt |
| Program Services | $105,737 | ProgramServicesAmt |
| Management And General | $11,749 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,001 | TotalAmt |
| Program Services | $9,901 | ProgramServicesAmt |
| Management And General | $1,100 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,006 | TotalAmt |
| Program Services | $16,205 | ProgramServicesAmt |
| Management And General | $1,801 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,046 | TotalAmt |
| Program Services | $7,241 | ProgramServicesAmt |
| Management And General | $805 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,149 | TotalAmt |
| Program Services | $1,149 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $58,296 | TotalAmt |
| Program Services | $52,466 | ProgramServicesAmt |
| Management And General | $5,830 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| SUPPLIES | $27,148 | $24,433 | $2,715 |
| SPECIAL EVENTS | $20,033 | $20,033 | |
| COMMUNITY HEALTH INITIA | $9,353 | $9,353 | |
| PENSION LIQUIDATION | $7,363 | $6,627 | $736 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,489 | TotalAmt |
| Program Services | $10,339 | ProgramServicesAmt |
| Management And General | $1,150 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $878,685 | TotalAmt |
| Program Services | $506,166 | ProgramServicesAmt |
| Management And General | $372,519 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,760,376 | BOYAmt |
| EOY | $8,294,092 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,755,666 | BOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,575,160 | BOYAmt |
| EOY | $172,238 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $74,317 | BOYAmt |
| EOY | $84,759 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $49,288 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $8,100 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $41,188 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $110,235,814 | BOYAmt |
| EOY | $121,559,424 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,907,003 | BOYAmt |
| EOY | $16,807,837 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $583,920 | BOYAmt |
| EOY | $517,334 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $149,892,256 | BOYAmt |
| EOY | $147,476,872 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,409,954 | BOYAmt |
| EOY | $466,396 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,143,835 | BOYAmt |
| EOY | $4,378,039 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,553,789 | BOYAmt |
| EOY | $4,844,435 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $142,338,467 | BOYAmt |
| EOY | $142,031,474 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $600,963 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $142,338,467 | BOYAmt |
| EOY | $142,632,437 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $149,892,256 | BOYAmt |
| EOY | $147,476,872 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $22,222,932 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$12,429,267 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$9,499,695 | 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) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| 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 |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 3 | FormAndLineReferenceDesc |
| Explanation | THE HEALTHCARE FOUNDATION OF WILSON AND WILMED GENERATIONS, INC. ENTERED INTO AN AGREEMENT WITH DLP HEALTHCARE, LLC, IN 2014 TO FORM A JOINT VENTURE, DLP WILSON HOLDING COMPANY, LLC, THAT WOULD OPERATE THE HOSPITAL AND NURSING HOME PREVIOUSLY OWNED AND OPERATED BY THE FOUNDATION AND WILMED GENERATIONS, INC. THE FOUNDATION THEREFORE CEASED DIRECTLY PROVIDING HEALTH CARE SERVICES AND PROVIDES MEDICAL SERVICES INDIRECTLY THROUGH THE JOINT VENTURE. THE GOVERNING DOCUMENTS OF THE JOINT VENTURE REQUIRE THAT THE JOINT VENTURE OPERATE THE HOSPITAL IN A MANNER AS TO SATISFY THE CHARITABLE PURPOSES GENERALLY REQUIRED OF HOSPITALS RECOGNIZED AS EXEMPT UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE, INCLUDING THE FOLLOWING: - THE HOSPITAL ACCEPT MEDICARE AND MEDICAID PATIENTS, - MAINTAIN AN EMERGENCY DEPARTMENT THAT ACCEPTS ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY, - ADOPT THE CHARITY CARE POLICIES UTILIZED BY THE FOUNDATION PRIOR TO THE TRANSFER OF THE HOSPITAL TO THE JOINT VENTURE, AND - COMPLY WITH THE REQUIREMENTS OF SECTION 501(R) OF THE INTERNAL REVENUE CODE REGARDING CHARITY CARE AND FINANCIAL ASSISTANCE POLICIES AND THE CONDUCTING OF COMMUNITY HEALTH NEEDS ASSESSMENTS. THE GOVERNING DOCUMENTS OF THE JOINT VENTURE INCLUDE PROVISIONS WHICH PROVIDE THE FOUNDATION, THROUGH ITS REPRESENTATIVES ON THE GOVERNING BODY OF THE JOINT VENTURE, WITH THE POWER TO ENFORCE COMPLIANCE WITH THESE CHARITABLE HOSPITAL REQUIREMENTS. THE FOUNDATION WAS ALSO A "PUBLIC HOSPITAL" PURSUANT TO CHAPTER 131E, ARTICLE 2, OF THE NORTH CAROLINA GENERAL STATUTES (PUBLIC HOSPITAL STATUTES). THE PUBLIC HOSPITAL STATUTES AT THE TIME OF CREATION OF THE JOINT VENTURE REQUIRED THAT ANY TRANSFER OF A PUBLIC HOSPITAL FACILITY MUST BE MADE TO A CORPORATION, AND THE PUBLIC HOSPITAL STATUTES DID NOT PERMIT THE TRANSFER OF A PUBLIC HOSPITAL FACILITY TO A LIMITED LIABILITY COMPANY. WITH THE CREATION OF THIS JOINT VENTURE IN MIND, THE NORTH CAROLINA GENERAL ASSEMBLY PASSED A TECHNICAL CORRECTIONS STATUTE WHICH ENABLED THE TRANSFER OF A PUBLIC HOSPITAL FACILITY TO BE MADE TO A LIMITED LIABILITY COMPANY AS WELL AS TO A CORPORATION. THE EFFECTIVE DATE OF THE NORTH CAROLINA GENERAL ASSEMBLY'S CHANGE TO THE PUBLIC HOSPITAL STATUTE WAS AFTER THE CREATION OF THE JOINT VENTURE. IN ORDER TO COMPLY WITH THE REQUIREMENTS OF THE PUBLIC HOSPITAL STATUTE AT THAT TIME, THE HOSPITAL FACILITY WAS TRANSFERRED TO DLP WILSON MEDICAL CENTER, INC., WHICH WAS WHOLLY OWNED BY THE JOINT VENTURE, WITH THE INTENTION THAT DLP WILSON MEDICAL CENTER, INC. WOULD BE CONVERTED TO A LIMITED LIABILITY COMPANY AFTER THE ENACTMENT OF THE NORTH CAROLINA GENERAL ASSEMBLY'S TECHNICAL CORRECTION TO THE NORTH CAROLINA PUBLIC HOSPITAL STATUTES. AFTER THE CONVERSION OF THE DLP WILSON MEDICAL CENTER, INC. TO A LIMITED LIABILITY COMPANY, IT WAS TREATED AS A DISREGARDED ENTITY FOR FEDERAL TAX PURPOSES, AND THE JOINT VENTURE IS TREATED AS OPERATING THE HOSPITAL DIRECTLY. THE NORTH CAROLINA PUBLIC HOSPITAL STATUTES ALSO REQUIRE THAT THE JOINT VENTURE, AS THE TRANSFEREE OF THE PUBLIC HOSPITAL FACILITY, CONTINUE TO PROVIDE THE SAME HOSPITAL SERVICES, INDIGENT CARE, FINANCIAL ASSISTANCE POLICIES, AND MEDICARE AND MEDICAID SERVICES AS WERE PROVIDED BY THE FOUNDATION PRIOR TO THE TRANSFER, AND THE JOINT VENTURE IS REQUIRED TO PROVIDE AN ANNUAL REPORT THAT SHOWS COMPLIANCE WITH THIS REQUIREMENT. FAILURE TO COMPLY WITH THIS REQUIREMENT WILL CAUSE THE HOSPITAL FACILITY TO REVERT TO WILSON COUNTY. | ExplanationTxt |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $49,288 | OtherCostOrOtherBasisAmt |
| Depreciation | $8,100 | DepreciationAmt |
| Book Value | $41,188 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $41,188 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | INVESTMENTS | Desc |
| Book Value | $121,559,424 | BookValueAmt |
| Method Valuation | F | MethodValuationCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $121,559,424 | TotalBookValueSecuritiesAmt |
Invst Program Related Org InvstProgramRelatedOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | INVESTMENT IN DLP WILSON HOLDING COMPANY, LLC | Desc |
| Book Value | $16,807,837 | BookValueAmt |
| Method Valuation | F | MethodValuationCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Program Rltd | $16,807,837 | TotalBookValueProgramRltdAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| DEFERRED COMPENSATION | $272,465 |
| DUE TO THIRD PARTY | $2,499,404 |
| ENVIRONMENTAL REMEDIATION LIABILITY | $1,606,170 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $4,378,039 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $1,169,845 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | -$12,429,267 | NetUnrealizedGainsInvstAmt |
| Other Revenue | $601 | OtherRevenueAmt |
| Revenue Not Reported | -$12,428,666 | RevenueNotReportedAmt |
| Revenue Subtotal | $13,598,511 | RevenueSubtotalAmt |
| Other Revenues Not Included | $9,503,106 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $9,503,106 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $23,101,617 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $875,875 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $601 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $601 | ExpensesNotReportedAmt |
| Expenses Subtotal | $875,274 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $3,411 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $3,411 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $878,685 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART X, LINE 2: | THE FOUNDATION IS A NONPROFIT ORGANIZATION EXEMPT FROM INCOME TAXES UNDER INTERNAL REVENUE CODE SECTION 501(C)(3). THE FOUNDATION DOES NOT HAVE ANY MATERIAL UNRECOGNIZED TAX BENEFITS OR OBLIGATIONS AS OF DECEMBER 31, 2015. IT IS THE FOUNDATION'S POLICY TO EVALUATE ALL TAX POSITIONS TO IDENTIFY ANY THAT MAY BE CONSIDERED UNCERTAIN. NO MATERIAL UNCERTAIN TAX POSITIONS WERE IDENTIFIED FOR 2015 THAT WOULD REQUIRE RECOGNITION OR DISCLOSURE IN THE FINANCIAL STATEMENTS. |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | FUNDRAISING EXPENSES IN REVENUE 601. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | PARTNERSHIP BOOK-TAX DIFFERENCE 9,503,106. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | FUNDRAISING EXPENSES IN REVENUE 601. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | PARTNERSHIP BOOK-TAX DIFFERENCE 3,411. |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | AUXILIARY - UNIFORM AND JEWELRY | Event1Nm |
| Gross Receipts Event1 | $29,412 | GrossReceiptsEvent1Amt |
| Gross Revenue Event1 | $29,412 | GrossRevenueEvent1Amt |
| Other Direct Expenses Event1 | $601 | OtherDirectExpensesEvent1Amt |
| Gross Receipts Total | $29,412 | GrossReceiptsTotalAmt |
| Gross Revenue Total Events | $29,412 | GrossRevenueTotalEventsAmt |
| Oth Direct Expnss Total Events | $601 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $601 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $28,811 | NetIncomeSummaryAmt |
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 |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | 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 | $778,758 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $778,758 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00600 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $778,758 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $778,758 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00600 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,653,170 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,653,170 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02050 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $72,392 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $72,392 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00060 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $43,227 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $43,227 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,768,789 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,768,789 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02140 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,547,547 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $3,547,547 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02740 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $10,279 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $10,279 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $138,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $138,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00110 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $148,279 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $148,279 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00120 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReportedInd |
| Bad Debt Expense | $43,601,039 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $10,624,716 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $37,364,775 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $43,181,298 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$5,816,523 | 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 | DLP WILSON MEDICAL CENTER | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1705 TARBORO STREET SW | AddressLine1Txt |
| City | WILSON | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 27893 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DLP WILSON 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 |
| Information Gaps | Yes (X) | InformationGapsInd |
| CHNA Conducted | 13 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | 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 | HTTPS://HEALTHCAREFOUNDATIONOFWILSON.ORG | OwnWebsiteURLTxt |
| Other Website | Yes (X) | OtherWebsiteInd |
| Other Website URL | HTTP://WWW.WILSON-CO.COM/85/HEALTH-DEPARTMENT | OtherWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 13 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | HTTPS://HEALTHCAREFOUNDATIONOFWILSON.ORG | 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 | 300.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Income Level Criteria | Yes (X) | IncomeLevelCriteriaInd |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | HTTP://WWW.WILSONMEDICAL.COM/ABOUT-US/CHARITY-CARE-POLICY | FAPAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | HTTP://WWW.WILSONMEDICAL.COM/ABOUT-US/CHARITY-CARE-POLICY | 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 |
| 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 |
| Medicare Rates | Yes (X) | MedicareRatesInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| DLP WILSON MEDICAL CENTER | PART V, SECTION B, LINE 5: WILSON MEDICAL CENTER WAS A PART OF A COMMUNITY-BASED ASSESSMENT CONDUCTED BY THE WILSON COUNTY COMMUNITY HEALTH ASSESSMENT TEAM. THE HEALTH ASSESSMENT NEEDS OF THE COMMUNITY WERE DETERMINED BY THE WILSON COUNTY COMMUNITY. IN 2013, 1,000 WILSON COUNTY HEALTH ASSESSMENT SURVEYS WERE DISTRIBUTED THROUGHOUT THE COUNTY. FIVE HUNDRED AND THIRTEEN (513) RESIDENTS COMPLETED AND RETURNED THE SURVEY. THE DATA WAS COMPILED AND FORMAL PRESENTATIONS WERE MADE TO THE WILSON COUNTY BOARD OF HEALTH AND WILSON MEDICAL CENTER HOSPITAL BOARD OF DIRECTORS. EACH TEAM MEMBER WAS PROVIDED WITH THE OPPORTUNITY TO VOTE ON THE TOP THREE (3) CONCERNS OF THE COMMUNITY OUT OF THE TOP TEN (10) CONCERNS. THE SURVEY WAS ANALYZED BY SURVEY MONKEY. THE WILSON COUNTY BOARD OF HEALTH INCLUDED:-DR. WILLIAM BOLES, III, DDS-DR. ERNESTINE FITCH, MD-DR. MARIE GLENNON, DVM-MICHAEL LAMONDS-GEORGE LEACH-THOMAS LUCAS-DR. JESSICA MCKEE-DR. RUSSELL STONE, OD-RON SUTTON AND-SAMUEL TERUEL-VELEZTHE WILSON COUNTY BOARD OF DIRECTORS INCLUDED:-JIM PRIDGEN-PAGE THOMAS SMITH-CARLETHA WARD-CARROLL COLEMAN-WILLIAM BYNUM, IV, MD-JONATHON DEWALD, MD-SHERYLETTA LACEWELL-LEESA LAWRENCE, MD-THOMAS LUCAS-REV. WILLIAM PRESNELL-TOMMY SHINGLETON-JOHN TILTON, AND -DAVID WEST. |
| DLP WILSON MEDICAL CENTER | PART V, SECTION B, LINE 11: WILSON MEDICAL CENTER REVIEWED THE HEALTHCARE NEEDS AND THREE PRIORITY AREAS WERE IDENTIFIED. THEY ARE 1) ACCESS TO CARE, 2) OBESITY, AND 3) SUBSTANCE ABUSE. ACTION PLANS ARE IN PLACE TO ADDRESS THESE NEEDS. OTHER AT-RISK BEHAVIOR IDENTIFIED IN THE CHNA, SUCH AS GANG VIOLENCE, HAS BEEN ADDRESSED BY LAW ENFORCEMENT, AS THEY ARE EQUIPPED AND TRAINED TO DEAL WITH THIS ISSUE. THE ORGANIZATION WILL PROVIDE SUPPORT TO THE LAW ENFORCEMENT DEPARTMENTS AS NEEDED. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 2 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - DLP WILMED NURSING CARE AND REHAB CENTER | ||||
| 1705 TARBORO STREET SW | WILSON | NC | 27893 | REHABILITATION CENTER |
| 2 - DLP WILSON PHYSICIAN PRACTICES | ||||
| 1705 TARBORO STREET SW | WILSON | NC | 27893 | PHYSICIAN OFFICE |
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3C: | ELIGIBILITY IS GENERALLY DETERMINED BY MEASURING THE GROSS FAMILY INCOME AGAINST THE FEDERAL POVERTY INCOME GUIDELINES. IN ADDITION, OTHER RELEVANT NON-INCOME RESOURCES, INCLUDING BUT NOT LIMITED TO REAL ESTATE, SAVINGS, LIFE INSURANCE, MOTOR VEHICLES, ETC., WILL BE CONSIDERED IN REACHING A DETERMINATION OF ELIGIBILITY. ELIGIBILITY GUIDELINES WILL ALSO TAKE INTO CONSIDERATION CATASTROPHIC EVENTS FOR PATIENTS WHOSE INCOME FALLS OUTSIDE THE GUIDELINES. PATIENTS WHOSE GROSS INCOME IS LESS THAN THREE TIMES THE FEDERAL POVERTY INCOME GUIDELINES MAY BE ELIGIBLE FOR REDUCED MONTHLY PAYMENTS OR UNCOMPENSATED SERVICES IN PART OR IN FULL. |
| FORM 990, SCHEDULE H | EFFECTIVE MARCH 1, 2014, WILSON MEDICAL CENTER, INC. AND WILMED GENERATIONS, INC. ENTERED INTO AN AGREEMENT WITH DLP HEALTHCARE, LLC TO FORM A JOINT VENTURE, DLP WILSON HOLDING COMPANY, LLC, THAT WOULD OPERATE THE HOSPITAL AND NURSING HOME PREVIOUSLY OWNED AND OPERATED BY WILSON MEDICAL CENTER, INC. AND WILMED GENERATIONS, INC. WILSON MEDICAL CENTER, INC. THEREFORE CEASED DIRECTLY PROVIDING HEALTH CARE SERVICES ON FEBRUARY 28, 2014 AND IS PROVIDING MEDICAL SERVICES INDIRECTLY THROUGH THE JOINT VENTURE. EFFECTIVE OCTOBER 1, 2014, WILSON MEDICAL CENTER, INC. CHANGED ITS NAME TO HEALTHCARE FOUNDATION OF WILSON (THE "FOUNDATION"). THE GOVERNING DOCUMENTS OF THE JOINT VENTURE REQUIRE THAT THE JOINT VENTURE OPERATE THE HOSPITAL IN A MANNER AS TO SATISFY THE CHARITABLE PURPOSES GENERALLY REQUIRED OF HOSPITALS RECOGNIZED AS EXEMPT UNDER SECTION 501(C)(3) OF THE CODE, INCLUDING THAT THE HOSPITAL ACCEPT MEDICARE AND MEDICAID PATIENTS, MAINTAIN AN EMERGENCY DEPARTMENT THAT ACCEPTS ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY, ADOPT THE CHARITY CARE POLICIES UTILIZED BY WILSON MEDICAL CENTER, INC. PRIOR TO THE TRANSFER OF THE HOSPITAL TO THE JOINT VENTURE, AND COMPLY WITH THE REQUIREMENTS OF SECTION 501(R) OF THE CODE REGARDING CHARITY CARE AND FINANCIAL ASSISTANCE POLICIES AND THE CONDUCTING OF COMMUNITY HEALTH NEEDS ASSESSMENTS. THE GOVERNING DOCUMENTS OF THE JOINT VENTURE INCLUDE PROVISIONS WHICH PROVIDE THE FOUNDATION, THROUGH ITS REPRESENTATIVES ON THE GOVERNING BODY OF THE JOINT VENTURE, WITH THE POWER TO ENFORCE COMPLIANCE WITH THESE CHARITABLE HOSPITAL REQUIREMENTS. WILSON MEDICAL CENTER, INC. WAS ALSO A "PUBLIC HOSPITAL" PURSUANT TO CHAPTER 131E, ARTICLE 2, OF THE NORTH CAROLINA GENERAL STATUTES (THE "PUBLIC HOSPITAL STATUTES"). THE PUBLIC HOSPITAL STATUTES AT THE TIME OF CREATION OF THE JOINT VENTURE REQUIRED THAT ANY TRANSFER OF A PUBLIC HOSPITAL FACILITY MUST BE MADE TO A CORPORATION, AND THE PUBLIC HOSPITAL STATUTES DID NOT PERMIT THE TRANSFER OF A PUBLIC HOSPITAL FACILITY TO A LIMITED LIABILITY COMPANY. WITH THE CREATION OF THIS JOINT VENTURE IN MIND, THE NORTH CAROLINA GENERAL ASSEMBLY PASSED A TECHNICAL CORRECTIONS STATUTE WHICH ENABLED THE TRANSFER OF A PUBLIC HOSPITAL FACILITY TO BE MADE TO A LIMITED LIABILITY COMPANY AS WELL AS TO A CORPORATION. THE EFFECTIVE DATE OF THE NORTH CAROLINA GENERAL ASSEMBLY'S CHANGE TO THE PUBLIC HOSPITAL STATUTE WAS OCTOBER 1, 2014, WHICH WAS AFTER THE CREATION OF THE JOINT VENTURE. IN ORDER TO COMPLY WITH THE REQUIREMENTS OF THE PUBLIC HOSPITAL STATUTE AT THAT TIME, THE HOSPITAL FACILITY WAS TRANSFERRED TO DLP WILSON MEDICAL CENTER, INC., WHICH WAS WHOLLY OWNED BY THE JOINT VENTURE, WITH THE INTENTION THAT DLP WILSON MEDICAL CENTER, INC., WOULD BE CONVERTED TO A LIMITED LIABILITY COMPANY AFTER THE ENACTMENT OF THE NORTH CAROLINA GENERAL ASSEMBLY'S TECHNICAL CORRECTION TO THE NORTH CAROLINA PUBLIC HOSPITAL STATUTES, AND THE CONVERSION WAS COMPLETED EFFECTIVE ON DECEMBER 31, 2014. AFTER THE CONVERSION OF THE DLP WILSON MEDICAL CENTER, INC., TO A LIMITED LIABILITY COMPANY, IT WAS TREATED AS A DISREGARDED ENTITY FOR FEDERAL TAX PURPOSES, AND THE JOINT VENTURE IS TREATED AS OPERATING THE HOSPITAL DIRECTLY. THE NORTH CAROLINA PUBLIC HOSPITAL STATUTES ALSO REQUIRE THAT THE JOINT VENTURE, AS THE TRANSFEREE OF THE PUBLIC HOSPITAL FACILITY, CONTINUE TO PROVIDE THE SAME HOSPITAL SERVICES, INDIGENT CARE, FINANCIAL ASSISTANCE POLICIES, AND MEDICARE AND MEDICAID SERVICES AS WERE PROVIDED BY WILSON MEDICAL CENTER, INC. PRIOR TO THE TRANSFER, AND THE JOINT VENTURE IS REQUIRED TO PROVIDE AND ANNUAL REPORT THAT SHOWS COMPLIANCE WITH THIS REQUIREMENT. FAILURE TO COMPLY WITH THIS REQUIREMENT WILL CAUSE THE HOSPITAL FACILITY TO REVERT TO WILSON COUNTY.THE INFORMATION REPORTED ON SCHEDULE H REPRESENTS FINANCIAL DATA AS PROVIDED BY THE JOINT VENTURE HOSPITAL AND NON-HOSPITAL FACILITIES. PERCENTAGES OF COMMUNITY BENEFIT REPRESENT COMMUNITY BENEFIT (AT COST) AS A PERCENTAGE OF TOTAL JOINT VENTURE EXPENSES, INCLUDING DLP WILSON MEDICAL CENTER, LLC, DLP WILMED NURSING CARE AND REHABILITATION CENTER, LLC AND DLP WILSON PHYSICIAN PRACTICES, LLC. |
| PART II, COMMUNITY BUILDING ACTIVITIES: | THE "WILSON CHAMBER OF COMMERCE" PROGRAM PROVIDES FOR THE DEVELOPMENT AND GROWTH OF THE CITY OF WILSON, NORTH CAROLINA. |
| PART III, LINE 2: | THE COMPANY HAS AN ESTABLISHED PROCESS TO DETERMINE THE ADEQUACY OF THE ALLOWANCE FOR BAD DEBTS THAT RELIES ON A NUMBER OF ANALYTICAL TOOLS AND BENCHMARKS TO ARRIVE AT A REASONABLE ALLOWANCE. NO SINGLE STATISTIC OR MEASUREMENT DETERMINE THE ADEQUACY OF THE ALLOWANCE FOR BAD DEBTS. SOME OF THE ANALYTICAL TOOLS THAT THE COMPANY UTILIZES INCLUDE, BUT ARE NOT LIMITED TO, HISTORICAL CASH COLLECTION EXPERIENCE, REVENUE TRENDS BY PAYOR CLASSIFICATION, AND REVENUE DAYS IN ACCOUNTS RECEIVABLE. |
| PART III, LINE 3: | THE AMOUNT ATTRIBUTABLE TO CHARITY IS $3,481,248, AND THE AMOUNT ATTRIBUTABLE TO UNCOMPENSATED CARE IS $7,143,468. |
| PART III, LINE 4: | THE WILSON MEDICAL CENTER, INC. PROVIDES SERVICES TO THE RESIDENTS OF WILSON AND SURROUNDING COUNTIES WITHOUT COLLATERAL. AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IS PROVIDED IN AN AMOUNT EQUAL TO THE ESTIMATED LOSSES TO BE INCURRED IN COLLECTION OF THE RECEIVABLES. |
| PART III, LINE 8: | COSTS ARE DETERMINED USING THE STEP-DOWN METHOLODOGY FROM THE MEDICARE COST REPORT. |
| PART III, LINE 9B: | PATIENTS IDENTIFIED AS QUALIFYING FOR CHARITY CARE HAVE THEIR ACCOUNTS ADJUSTED AND ARE NOT SUBJECTED TO COLLECTION EFFORTS. |
| PART VI, LINE 4: | BASED ON THE 2013 CENSUS ESTIMATES FOR WILSON COUNTY THERE ARE 81,667 PEOPLE; 31,932 HOUSEHOLDS; AND 21,292 FAMILIES. THE POPULATION DENSITY WAS 220.6 PEOPLE PER SQUARE MILE. THERE WERE 35,514 HOUSING UNITS. THE RACIAL MAKEUP OF THE COUNTY WAS WHITE (NOT HISPANIC/LATINO), 48.8%; BLACK OR AFRICAN AMERICAN, 39.6%; NATIVE AMERICAN, .5%; ASIAN, 1%; PACIFIC ISLANDER, .1%; HISPANIC OR LATINO, 10%. PEOPLE OF TWO OR MORE RACES ACCOUNTED FOR 1.4%.OF THE 31,932 HOUSEHOLDS, 28.2% FAMILIES WITH CHILDREN OF THEIR OWN WERE UNDER 18 YEARS OLD. 45% OF THEM WERE MARRIED COUPLES LIVING TOGETHER. 16.4% HAD A FEMALE HEAD OF HOUSEHOLD WITH NO HUSBAND PRESENT. 33.3% WERE NON FAMILIES. 11.1% OF THE HOUSEHOLDS WERE MADE UP OF SOMEONE LIVING ALONE WHO IS 65 YEARS OF AGE AND OLDER. THE AVERAGE HOUSEHOLD SIZE WAS 2.48. THE AVERAGE FAMILY SIZE WAS 3.05.THE 81,667 PEOPLE WERE BROKEN DOWN IN THESE AGE GROUPS: 19,429 WERE UNDER THE AGE OF 18, 7,425 ARE AGED 18 TO 24 YEARS OLD, 19,416 ARE AGED 25 TO 44 YEARS OLD, 22,342 WERE AGED 46 TO 64 YEARS OLD, 13,055 WERE 65 YEARS OLD AND OLDER, AND 1,627 ARE PEOPLE AGED 85 YEARS OLD AND OLDER. THE MEDIAN AGE IS 39.8.OF THE 81,667 PEOPLE, 38,881 WERE MALE AND 42,786 WERE FEMALE. OF THE 62,238 PEOPLE AGED 18 AND OLDER, 28,913 WERE MALE AND 33,325 WERE FEMALE.THE MEDIAN INCOME FOR A HOUSEHOLD IN THE COUNTY WAS $38,398. THE MEDIAN INCOME FOR FAMILY WAS $47,647. MALES HAD A MEDIAN INCOME OF $38,297 VERSUS $30,861 FOR FEMALES. THE PER CAPITA INCOME FOR THE COUNTY WAS $20,671. 17% OF THE FAMILIES IN THE COUNTY LIVE BELOW THE POVERTY LINE. 22.8% OF THE POPULATION LIVES BELOW THE POVERTY LINE. 19.1% OF THOSE OVER THE AGE OF 18 LIVE BELOW THE POVERTY LINE. 12.6% OF THOSE AGED 65 AND OLDER LIVE BELOW THE POVERTY LINE. |
| PART VI, LINE 5: | DLP WILSON MEDICAL CENTER HAS AN OPEN MEDICAL STAFF. THE BOARD OF TRUSTEES IS COMPRISED OF INDIVIDUALS THAT ARE ACTIVE IN OTHER ORGANIZATIONS IN THE COMMUNITY. SURPLUS FUNDS ARE REINVESTED IN THE FACILITY AND EQUIPMENT THAT PROVIDE HEALTHCARE SERVICES. HEALTHCARE FOUNDATION OF WILSON'S (HFW) BOARD OF DIRECTORS IS ALSO COMPRISED OF INDIVIDUALS ACTIVE IN OTHER ORGANIZATIONS IN THE COMMUNITY. IN ADDITION, HFW, IN COLLABORATION WITH THE LOCAL HEALTH DEPARTMENT, PROVIDES FREE FLU VACCINATIONS TO INDIVIDUALS IN THE COMMUNITY WHO DO NOT HAVE HEALTH INSURANCE COVERAGE. VACCINATIONS ARE PROVIDED FREE OF CHARGE, THEREBY REINVESTING IN HEALTHCARE SERVICES TO PROMOTE THE HEALTH OF THE COMMUNITY. |
| PART VI, LINE 6: | N/A |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WILSON COUNTY HEALTH DEPARTMENT | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1801 GLENDALE DRIVE | AddressLine1Txt |
| City | WILSON | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 27893 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 566000351 | RecipientEIN |
| IRC Section | 115 | IRCSectionDesc |
| Cash Grant | $20,000 | CashGrantAmt |
| Purpose Of Grant | BREAST AND CERVICAL CANCER CONTROL PROGRAM | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | Total501c3OrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION PROVIDES FUNDS IN FURTHERANCE OF ITS MISSION TO SUPPORT THE HEALTH CARE NEEDS WITHIN ITS COMMUNITY. THE EXECUTIVE DIRECTOR OVERSEES EXPENDITURES OF ALL FUNDS, AND REPORTS ARE PRESENTED AT BOARD MEETINGS. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | Yes (1) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DENISE O'HARA | ||||||||||||||
| EXECUTIVE DIRECTOR | $135,000 | $0 | $0 | $0 | $16,963 | $0 | $52,191 | $0 | $4,050 | $0 | $208,204 | $0 | $0 | $0 |
| RICHARD HUDSON | ||||||||||||||
| FORMER CEO | $0 | $0 | $0 | $0 | $273,273 | $0 | $0 | $0 | $10,369 | $0 | $283,642 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 4A | FormAndLineReferenceDesc |
| Explanation | DENISE O'HARA, EXECUTIVE DIRECTOR - $16,963 SEVERANCE IN RELATION TO DUTIES PERFORMED FOR WILSON MEDICAL CENTER, INC. PRIOR TO THE OWNERSHIP CHANGE AS DESCRIBED IN FURTHER DETAIL IN SCHEDULES A, H, AND O. RICHARD HUDSON, FORMER OFFICER - $273,273 SEVERANCE IN RELATION TO DUTIES PERFORMED FOR WILSON MEDICAL CENTER, INC. PRIOR TO HIS DEPARTURE. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11 | A DRAFT OF FORM 990 IS PROVIDED TO THE EXECUTIVE DIRECTOR AND LEGAL COUNSEL WHO REVIEW THE DRAFT PRIOR TO FILING WITH THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | ONCE A YEAR, EACH PERSON IS REQUIRED TO REVIEW AND SIGN THE CONFLICT OF INTEREST POLICY. IF THERE IS A CONFLICT OF INTEREST, THE EXECUTIVE DIRECTOR IS NOTIFIED AND A DISCUSSION SHOULD OCCUR AT THAT TIME TO DETERMINE THE EXTENT, WHETHER POTENTIAL OR ACTUAL. BOARD MEMBERS WITH CONFLICTS ARE RECUSED FROM VOTING. |
| FORM 990, PART VI, SECTION B, LINE 15 | AT LEAST EVERY TWO YEARS, AN INDEPENDENT SURVEY IS UTILIZED TO DETERMINE THE APPROPRIATE COMPENSATION FOR THE EXECUTIVE DIRECTOR. THE BOARD DETERMINES A STRATEGY AND GUIDELINES AS TO WHAT PERCENTILE AT WHICH THEY WOULD PLACE SALARY FOR THE EXECUTIVE DIRECTOR. UPON RECEIPT OF THE INDEPENDENT DATA, THE HUMAN RESOURCES COMMITTEE OF THE BOARD REVIEWS THE DATA AND DETERMINES IF ANY ADJUSTMENTS SHOULD BE MADE. THIS PROCESS LAST TOOK PLACE DURING 2015. |
| FORM 990, PART VI, SECTION C, LINE 19 | GOVERNING DOCUMENTS, POLICIES AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 105,737. MANAGEMENT AND GENERAL EXPENSES 11,749. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 117,486. |
| FORM 990, PART XI, LINE 9: | PARTNERSHIP BOOK-TAX DIFFERENCE -9,499,695. |
Schedule R IRS990ScheduleR
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DLP WILSON HOLDING COMPANY LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 330 SEVEN SPRINGS WAY | AddressLine1Txt |
| City | BRENTWOOD | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 37027 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 901034226 | EIN |
| Primary Activities | PROVIDING HEALTH CARE AND OTHER HEALTH RELATED SERVICES | PrimaryActivitiesTxt |
| Legal Domicile State | NC | LegalDomicileStateCd |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Predominant Income Type | RELATED | PredominantIncomeTypeTxt |
| Share Of Total Income | $11,569,959 | ShareOfTotalIncomeAmt |
| Disproportionate Allocations | 0 | DisproportionateAllocationsInd |
| General Or Managing Partner | 0 | GeneralOrManagingPartnerInd |
| Ownership | 0.20000 | OwnershipPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | 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 | 0 | 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 | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DLP WILSON HOLDING COMPANY LLC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | B | TransactionTypeTxt |
| Involved | $14,725,511 | InvolvedAmt |
| Method Of Amount Determination | FAIR MARKET VALUE | MethodOfAmountDeterminationTxt |