2016-05-16T12:30:12-05:00 2015-06-30 990 2014-07-01 562070036 DUKE UNIVERSITY HEALTH SYSTEM INC DUKE 9196842006 324 BLACKWELL ST WASHIN BLDG NO 850 DURHAM NC 27701 KENNETH C MORRIS SVP,CFO,TREASURER 9196842006 2016-05-13 0 2014 2016-08-17 19:52:53Z X A EUGENE WASHINGTON MD 615 DOUGLAS ST STE 700 DURHAM NC 27705 4656012068 0 X WWW.DUKEHEALTH.ORG X 1998 NC SEE SCHEDULE O FOR ORGANIZATION'S MISSION STATEMENT 22 14 18031 1329 0 0 14054772 5820061 2396909183 2818682038 198777380 101336100 83624506 104331321 2693365841 3030169520 911323 1263620 0 0 1173834491 1202472908 0 0 177949 1215706033 1373610219 2390451847 2577346747 302913994 452822773 4643137100 4807967846 1802551366 1801917400 2840585734 3006050446 X DUHS IS COMMITTED TO EXCELLENCE, INNOVATION AND LEADERSHIP IN PROVIDING THE HEALTH CARE NEEDS OF THE PEOPLE WE SERVE, IMPROVING COMMUNITY HEALTH, AND FOSTERING THE VERY BEST MEDICAL EDUCATION. 0 0 1882387244 1263620 2889555870 SEE SCHEDULE O 1882387244 1 1 0 1 0 0 0 0 0 1 1 1 0 0 1 0 0 1 0 0 1 0 0 0 1 0 1 1 1 1 1 1 0 0 0 0 0 0 0 0 1 1 1 1 0 0 1 1 1 1 0 0 1 X 495 0 1 18031 1 0 1 BD 0 0 0 1 1 0 0 0 0 X 22 14 1 1 1 0 0 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 AK FL GA HI IL KS KY MD MA MI MN MS NH NJ NY OK OR PA SC TN UT WI X X LAURA ALVIS 9196138993 DUHS INC 615 DOUGLAS STREET SUITE DURHAM NC 27705 NANCY CATHERINE ANDREWS MD DIRECTOR 4.00 59.50 X 0 813137 102141 LESLIE E BAINS DIRECTOR 1.00 0.00 X 0 0 0 JACK O BOVENDER JR DIRECTOR 3.00 6.00 X 0 0 0 RICHARD H BRODHEAD DIRECTOR 10.00 52.00 X 0 1133479 200702 JAMES F GOODMON DIRECTOR 2.00 0.00 X 0 0 0 THOMAS M GORRIE DIRECTOR 3.00 9.10 X 0 0 0 WILLIAM HAWKINS DIRECTOR 1.00 2.00 X 0 0 0 CAROLYN E HENDERSON DIRECTOR 2.00 0.00 X 0 0 0 MARY KLOTMAN MD DIRECTOR 8.00 42.00 X 0 402812 43216 MICHAEL MARSICANO DIRECTOR 2.00 4.00 X 0 0 0 JOHN H MCARTHUR DIRECTOR 1.00 0.00 X 0 0 0 LLOYD B MORGAN DIRECTOR 2.00 0.00 X 0 0 0 MARK F NEWMAN DIRECTOR 1.00 44.00 X 0 312194 50683 THEODORE N PAPPAS MD DIRECTOR 2.00 40.00 X 0 384456 45160 DAVID M RUBENSTEIN DIRECTOR 1.00 7.00 X 0 0 0 STEVEN SCOTT MD DIRECTOR 4.00 2.00 X 0 0 0 SUSAN M STALNECKER DIRECTOR 2.00 2.00 X 0 0 0 KATHERINE KEITH THOMAS DIRECTOR 2.00 0.00 X 0 0 0 PETER VAN ETTEN DIRECTOR 1.00 0.00 X 0 0 0 G RICHARD WAGONER JR DIRECTOR 2.00 0.00 X 0 0 0 A EUGENE WASHINGTON MD PRESIDENT & CEO, DUHS/DIRECTOR 33.00 33.00 X X 0 0 0 JIM WHITEHURST DIRECTOR 1.00 0.00 X 0 0 0 MONTE D BROWN MD VP OF ADMINISTRATION/SECRETARY 60.00 1.00 X 544477 0 49451 WILLIAM J FULKERSON JR MD EXECUTIVE VP, DUHS 60.00 5.50 X 1250211 0 36718 KENNETH C MORRIS SVP, CFO, TREASURER 80.00 2.00 X 1111812 0 40593 MARY ANN FUCHS VP-PATIENT CARE/CHIEF NURSE EXEC 60.00 0.00 X 403794 0 37192 KATHLEEN GALBRAITH PRESIDENT, DUKE REGIONAL HOSPITAL 62.00 1.00 X 334206 0 47622 CARLA PARKER-HOLLIS VP, DUKE RALEIGH HOSPITAL 60.00 0.00 X 214847 0 38736 KEVIN W SOWERS PRESIDENT, DUKE UNIVERSITY HOSPITAL 70.00 0.00 X 649981 0 42706 DAVID W ZAAS MD PRESIDENT, DUKE RALEIGH HOSPITAL 60.00 0.00 X 245427 5530 41132 SANDRA DANOFF SVP, STRATEGIC PLANNING, BD, NS 80.00 1.00 X 590427 0 44354 JEFFREY M FERRANTI VP, CIO, DHTS ADMINISTRATION 50.00 0.00 X 486276 40970 45160 THOMAS A OWENS MD CHIEF MEDICAL OFFICER 60.00 5.00 X 611306 0 42403 JOHN M KELSCH MD PHYSICIAN 40.00 0.00 X 448558 0 49063 ROBERT N WILLIS VP, CONTROLLER & CHIEF ACC. OFFICER 55.00 5.00 X 466903 0 45160 VICTOR J DZAU MD FORMER OFFICER 40.00 48.00 X 0 8001393 39007 RICHARD GANNOTTA FORMER KEY EMPLOYEE 40.00 0.00 X 133694 0 18817 PAUL NEWMAN FORMER KEY EMPLOYEE 0.00 41.00 X 0 249543 35556 KERRY R WATSON FORMER KEY EMPLOYEE 40.00 1.00 X 111614 0 48004 7603533 11343514 1143576 1336 1 1 0 PRIVATE DIAGNOSTIC CLINIC PLLC DUMC 3070 DURHAM NC 27710 PHYSICIAN SERVICES 90020572 DELOITTE LLP PO BOX 844708 DALLAS TX 752844708 CONSULTING SERVICES 25867007 ROBINS & MORTON GROUP 400 SHADES CREEK PKW BIRMINGHAM AL 35209 CONSTRUCTION SERVICE 12207520 ARAMARK HEALTHCARE SUPPORT SERVICES 25271 NETWORK PLACE CHICAGO IL 606731252 HEALTHCARE SERVICES 7404851 KBR BUILDING GROUP INC 5605 CARNEGIE BLVD CHARLOTTE NC 28209 CONSTRUCTION SERVICE 7216522 274 30345 17337 488921 5283458 1514435 5820061 PATIENT REVENUE 621990 2797825955 2797825955 ANCILLARY MEDICAL 621990 17928122 17928122 MEDICAL SERVICES 621990 2927961 2927961 2818682038 9306012 9306012 8994458 8994458 13723882 12337984 1385898 1385898 1385898 1704412087 1072030 1613192119 261910 91219968 810120 92030088 92030088 80335 30345 50535 29800 29800 BILLING FEES 621990 41263676 41263676 DEEMED DIVIDEND 900003 20012106 20012106 PROGRAM DEV. & SUPPORT 900099 9254303 9254303 23391080 20355853 3035227 93921165 3030169520 2889555870 0 134793589 1228220 1228220 35400 35400 6095953 750770 5271711 73472 334192 139897 194295 946724099 652102819 294570797 50483 48848724 30622152 18223095 3477 133979721 73692018 60284437 3266 66490219 45565416 20916124 8679 9692302 9051659 640643 1531644 252300 1279344 494911 494911 2858218 2858218 211189628 103785745 107403883 2699543 567691 2131852 32562090 20381909 12144094 36087 50325698 3288660 47037038 59621980 51245824 8376156 6625518 4240916 2383412 1190 4098308 4097397 911 41253158 242455 41010703 145140910 108354370 36786540 9147216 9147216 MEDICAL SUPPLIES 638601759 638601759 EQUIPMENT RENTAL & MAIN 74566077 48402921 26163156 MEDICAID ASSESSMENT 70023820 70023820 LAUNDRY 9773392 9720691 52701 3404047 942616 2461047 384 2577346747 1882387244 694781554 177949 79127 83380 205430693 472424814 5801289 3844516 389980571 419624025 941907 845659 72410897 75714452 16057510 15304455 2851760542 1414031235 1488161558 1437729307 2997068 285794906 2440754778 2063136861 3944084 21109824 16577618 12355647 4643137100 4807967846 277431401 284748675 5934683 5707181 1086392745 1064585790 432792537 446875754 1802551366 1801917400 X 2781502537 2948471628 47826350 46074912 11256847 11503906 2840585734 3006050446 4643137100 4807967846 X 452822773 -41713407 -245644654 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 1 0 0 0 0 1 221534 0 1 97654 319188 0 PART II-B, LINE 1: DUKE UNIVERSITY HEALTH SYSTEM, INC. EMPLOYS STAFF WHO PERFORM SOME LOBBYING ACTIVITIES AS PART OF THEIR JOB RESPONSIBILITIES. THESE SAME EMPLOYEES AND SOME SENIOR LEADERS OF THE ORGANIZATION MAY HAVE DIRECT CONTACT WITH LEGISLATORS, THEIR STAFFS, AND GOVERNMENT OFFICIALS. DUKE UNIVERSITY HEALTH SYSTEM, INC. PAYS MEMBERSHIP DUES TO OTHER ORGANIZATIONS. PER THE MEMBERSHIP DUES INVOICES, SOME OF THESE ORGANIZATIONS PROVIDE A DISCLOSURE OF LOBBYING PERCENTAGE OF THE DUES RECEIVED. 59083195 4849436 -29888 6323927 57578816 46947089 13413723 2988057 4265674 59083195 50036781 8190873 1409233 12689798 46947089 53700068 11126530 -758496 14031321 50036781 55631465 5340437 3639795 10911629 53700068 0.42800 0.57200 0 1 1 27304086 27304086 1697060759 689474597 1007586162 688946734 466303544 222643190 438448963 258253094 180195869 1437729307 HEDGED STRATEGIES 578131362 F SHORT-TERM INVESTMENTS 110953145 F PRIVATE CAPITAL 383837839 F REAL ASSETS 264432958 F FIXED INCOME 322679137 F EQUITIES 271135091 F OTHER INVESTMENTS 131967329 F 2063136861 INTERCOMPANY PAYABLE 5676284 INTEREST PAYABLE 10963155 PROFESSIONAL LIABILITY COSTS 7720192 POST RETIREMENT BENEFIT OBLIGATION 143438000 CAPITAL LEASE OBLIGATION 124832829 DERIVATIVE INSTRUMENTS 89357965 OTHER NON-CURRENT LIABILITIES 64887329 446875754 PART V, LINE 4: THE INTENDED USE FOR THE ORGANIZATION'S ENDOWMENT: FUNDS SUPPORT CAPITAL PURCHASES, OFFSET OPERATING COSTS, IMPROVE PATIENT SAFETY, AND SUPPORT THE NEEDS OF PATIENTS AND FAMILIES. PART X, LINE 2: DUKE UNIVERSITY HEALTH SYSTEM, INC. ADOPTED THE REQUIREMENTS OF FIN 48 AND CONSIDERED ITS TAX POSITIONS. BASED ON THAT ANALYSIS, THE PROVISIONS OF FIN 48 ARE DEEMED IMMATERIAL TO THE DUKE UNIVERSITY HEALTH SYSTEM, INC. FINANCIAL STATEMENTS AND THEREFORE NO FIN 48 SPECIFIC DISCLOSURES ARE MADE IN THE AUDITED FINANCIAL STATEMENTS OF DUKE UNIVERSITY HEALTH SYSTEM, INC. AND ITS AFFILIATES FOR FISCAL YEAR ENDED JUNE 30, 2015. CENTRAL AMERICA AND THE CARIBBEAN 0 0 SEMINAR 10573 EAST ASIA AND THE PACIFIC 0 0 SEMINAR 518 EAST ASIA AND THE PACIFIC 0 0 PROGRAM SERVICES EDUCATION 34291 EUROPE 0 0 PROGRAM SERVICES EDUCATION 2413 EUROPE 0 0 PROGRAM SERVICES RESEARCH 4120 EUROPE 0 0 SEMINAR 17875 MIDDLE EAST AND NORTH AFRICA 0 0 PROGRAM SERVICES EDUCATION 29544 MIDDLE EAST AND NORTH AFRICA 0 0 SEMINAR 601 NORTH AMERICA 0 0 PROGRAM SERVICES EDUCATION 6043 0 0 SOUTH ASIA 0 0 SEMINAR 9574 SUB-SAHARAN AFRICA 0 0 PROGRAM SERVICES EDUCATION 795 SUB-SAHARAN AFRICA 0 0 SEMINAR 706 NORTH AMERICA 0 0 INVESTMENTS 196894782 NORTH AMERICA 0 0 SEMINAR 29773 SOUTH AMERICA 0 0 SEMINAR 2217 0 0 0 0 0 0 99935 196943890 197043825 0 0 1 0 0 1 GALA 110680 30345 80335 0 23015 0 13187 6400 7933 110680 30345 80335 23015 13187 6400 7933 50535 29800 FORM 990, SCHEDULE G, PART I, LINE 2B DUKE UNIVERSITY HEALTH SYSTEM, INC. SUPPORTS THE FUNDRAISING ACTIVITIES PERFORMED BY EMPLOYEES OF DUKE UNIVERSITY. SUCH ACTIVITIES ARE DESIGNED TO DEVELOP SUPPORT FOR BOTH THE UNIVERSITY AND THE DUKE UNIVERSITY HEALTH SYSTEM, INC.'S EDUCATIONAL, RESEARCH AND HEALTHCARE PURPOSES. DUKE UNIVERSITY RECEIVES AND DIRECTS THE CONTRIBUTIONS AS APPROPRIATE TO DUKE UNIVERSITY HEALTH SYSTEM, INC. THE AGREEMENT BETWEEN DUKE UNIVERSITY AND DUKE UNIVERSITY HEALTH SYSTEM, INC. DOES NOT DISTINGUISH BETWEEN PAYMENTS FOR PROFESSIONAL FUNDRAISING SERVICES AND EXPENSE PAYMENTS OR REIMBURSEMENTS. 1 1 X 1 X 1 X 1 1 0 1 1 70060429 70060429 0.02720 65315866 65315866 0.02530 135376295 135376295 0.05250 75829452 14400792 61428660 0.02380 11265165 11265165 0.00440 87094617 14400792 72693825 0.02820 222470912 14400792 208070120 0.08070 1 21458426 0 500568205 598342016 -97773811 X 1 1 3 1 DUKE UNIVERSITY HOSPITAL 2301 ERWIN ROAD PRIMARY CAMPUS DURHAM NC 27710 WWW.DUKEMEDICINE.ORG X X X X X X A 2 DUKE RALEIGH HOSPITAL 3400 WAKE FOREST ROAD PRIMARY CAMPUS RALEIGH NC 27609 WWW.DUKEMEDICINE.ORG X X X 3 DUKE REGIONAL HOSPITAL 3643 ROXBORO ROAD DURHAM NC 27704 WWW.DUKEMEDICINE.ORG X X X A DUKE UNIVERSITYDUKE REGIONAL HOSPITALS 0 0 1 X X X X X X X X X 13 1 1 1 1 X HTTP://WWW.DUKEMEDICINE.ORG X HTTP://WWW.HEALTHYDURHAM.ORG X X 1 13 1 HTTP://WWW.DUKEMEDICINE.ORG 0 0 1 X 200.000000000000 300.000000000000 X X X X 1 1 X X X 1 X HTTP://WWW.DUKEMEDICINE.ORG X HTTP://WWW.DUKEMEDICINE.ORG X HTTP://WWW.DUKEMEDICINE.ORG X X X X X X 1 X 0 X X X X 1 X 0 1 DUKE RALEIGH HOSPITAL 2 0 0 1 X X X X X X X X X 13 1 1 1 1 X HTTP://WWW.DUKEMEDICINE.ORG X HTTP://WWW.HEALTHYDURHAM.ORG X X 1 13 1 HTTP://WWW.DUKEMEDICINE.ORG 0 0 1 X 200.000000000000 300.000000000000 X X X X 1 1 X X X 1 X HTTP://WWW.DUKEMEDICINE.ORG X HTTP://WWW.DUKEMEDICINE.ORG X HTTP://WWW.DUKEMEDICINE.ORG X X X X X X 1 X 0 X X X X 1 X 0 1 PART V, SECTION B: GROUP A - FACILITY 1 - DUKE UNIVERSITY HOSPITALPART V, SECTION B, LINE 5: DUKE UNIVERSITY HOSPITAL ("DUH") COLLABORATED WITH THE PARTNERSHIP FOR A HEALTHY DURHAM AND THE DURHAM COUNTY HEALTH DEPARTMENT ON THE DURHAM COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). THE ASSESSMENT PROCESS INCLUDED 207 CITIZEN SURVEYS FROM RANDOMLY SELECTED HOUSEHOLDS AND 10 COMMUNITY LISTENING SESSIONS WITH 283 COMMUNITY MEMBERS. REPRESENTATIVES FROM DUH AND DUKE REGIONAL HOSPITAL ("DRH") PARTICIPATED AS MEMBERS ON THE COMMUNITY HEALTH ASSESSMENT TEAM ALONG WITH REPRESENTATIVES FROM OTHER UNIVERSITIES, LOCAL GOVERNMENT, SCHOOLS, NON-PROFIT ORGANIZATIONS, AND BUSINESSES. THE COMMUNITY HEALTH ASSESSMENT TEAM WORKED TO DIRECT THE ACTIVITIES OF THE ASSESSMENT AND PROVIDE WRITTEN CONTENT AND EXPERTISE ON ISSUES OF INTEREST.GROUP A - FACILITY 1 - DUKE UNIVERSITY HOSPITALPART V, SECTION B, LINE 6A: DUKE REGIONAL HOSPITAL ("DRH")GROUP A - FACILITY 1 - DUKE UNIVERSITY HOSPITALPART V, SECTION B, LINE 6B: THE PARTNERSHIP FOR A HEALTHY DURHAM AND THE DURHAM COUNTY HEALTH DEPARTMENTGROUP A - FACILITY 1 - DUKE UNIVERSITY HOSPITALPART V, SECTION B, LINE 7D: THE CHNA IS AVAILABLE ON THE WEBSITE BY NAVIGATING TO WWW.DUKEMEDICINE.ORG, CLICK ON "PATIENTS & VISITORS", THEN "FINANCIAL ASSISTANCE", "COMMUNITY HEALTH NEEDS ASSESSMENT; AND THEN CLICK THE LINK FOR "DETAILS OF OUR COMMUNITY INVOLVEMENT."GROUP A - FACILITY 1 - DUKE UNIVERSITY HOSPITALPART V, SECTION B, LINE 10A: THE IMPLEMENTATION STRATEGY AND PROGRESS REPORTS ARE AVAILABLE ON THE WEBSITE BY NAVIGATING TO HTTP://WWW.DUKEMEDICINE.ORG, CLICK ON "PATIENTS & VISITORS", THEN "FINANCIAL ASSISTANCE", THEN "COMMUNITY HEALTH NEEDS ASSESSMENT; AND THEN CLICK THE LINK FOR "DETAILS OF OUR COMMUNITY INVOLVEMENT." CHOOSE ONE OF THE LINKS FOR THE DUKE UNIVERSITY HOSPITAL PROGRESS REPORT AND IMPLEMENTATION PLAN.GROUP A - FACILITY 1 - DUKE UNIVERSITY HOSPITALPART V, SECTION B, LINE 11: DUH COLLABORATED WITH THE PARTNERSHIP FOR A HEALTHY DURHAM (THE STATE CERTIFIED HEALTHY CAROLINIANS GROUP) AND THE DURHAM COUNTY HEALTH DEPARTMENT TO CONDUCT THE DURHAM COUNTY HEALTH ASSESSMENT AND DEVELOP STRATEGIES TO ADDRESS IDENTIFIED NEEDS. THE MOST RECENT ASSESSMENT PROCESS COMPILED VALID AND RELIABLE INFORMATION ABOUT THE HEALTH OF DURHAM. IT INCLUDED 207 CITIZEN SURVEYS FROM RANDOMLY SELECTED HOUSEHOLDS AND 10 COMMUNITY LISTENING SESSIONS WITH 283 COMMUNITY MEMBERS. THE COMMUNITY HEALTH ASSESSMENT TEAM - COMPRISED OF MORE THAN 95 MEMBERS REPRESENTING, DUKE UNIVERSITY HOSPITAL AND DUKE REGIONAL HOSPITAL (FORMERLY DURHAM REGIONAL HOSPITAL), UNIVERSITIES, LOCAL GOVERNMENT, SCHOOLS, NON-PROFIT ORGANIZATIONS AND BUSINESSES - WORKED TO DIRECT THE ACTIVITIES OF THE ASSESSMENT AND PROVIDE WRITTEN CONTENT AND EXPERTISE ON ISSUES OF INTEREST. THE ASSESSMENT IDENTIFIED SIX HEALTH PRIORITIES FOR 2012 - 2015: 1. OBESITY AND CHRONIC ILLNESS 2. ACCESS TO MEDICAL AND DENTAL CARE 3. MENTAL HEALTH AND SUBSTANCE ABUSE 4. HIV AND SEXUALLY TRANSMITTED INFECTIONS 5. POVERTY 6. EDUCATIONACTIONS TAKEN TO ADDRESS THE SIGNIFICANT HEALTH NEEDS IDENTIFIED IN THE CHNA ARE AS FOLLOWS:1. OBESITY AND CHRONIC ILLNESS INITIATIVESFOUR OF THE 10 LEADING CAUSES OF DEATH IN NORTH CAROLINA ARE RELATED TO OBESITY: HEART DISEASE, TYPE 2 DIABETES, STROKE AND SOME KINDS OF CANCER. OVERWEIGHT AND OBESITY WERE THE SECOND LEADING CAUSES OF PREVENTABLE DEATH IN NORTH CAROLINA IN 2010. OBESITY RATES CONTINUE TO RISE ACROSS ALL AGES, GENDERS AND RACIAL/ETHNIC GROUPS IN DURHAM COUNTY. THE MOST RECENT COMBINED OBESITY AND OVERWEIGHT RATES ARE: ADULTS, 65%; DURHAM PUBLIC SCHOOL HIGH SCHOOL STUDENTS, 32%, AND ENTERING KINDERGARTENERS, 19%. DIABETES IS THE 7TH LEADING CAUSE OF DEATH IN DURHAM COUNTY AND 8% OF ADULTS HAVE DIABETES.KOHL'S BULL CITY FIT IS A COMMUNITY-BASED WELLNESS PROGRAM AND IS PART OF THE LARGER DUKE CHILDREN'S HEALTHY LIFESTYLES PROGRAM. THE HEALTHY LIFESTYLES PROGRAM SEEKS TO ADDRESS WEIGHT-RELATED HEALTH PROBLEMS FOR CHILDREN BY OFFERING CARING PROVIDERS, FAMILY-CENTERED TREATMENT PROGRAMS, HIGHLY TRAINED EDUCATORS AND RESEARCHERS, AND STRONG COMMUNITY PARTNERSHIPS. KOHL'S BULL CITY FIT HELPS IN THIS EFFORT BY OFFERING FREE EVENING AND WEEKEND ACTIVITY SESSIONS FOR THE LARGER COMMUNITY. THESE SESSIONS COVER VARIOUS THEMES THAT ENCOURAGE AND PROMOTE ACTIVE LIVING, SUCH AS FITNESS GAMES, SPORT LESSONS, EXERCISE ROUTINES, SWIMMING, COOKING, AND GARDENING. EACH ACTIVITY IS FACILITATED WITH THE SUPPORT OF ENERGETIC STAFF AND VOLUNTEERS TO CREATE A POSITIVE AND FUN ENVIRONMENT FOR ALL. KOHL'S BULL CITY FIT EMPOWERS THE WHOLE FAMILY TO INCREASE KNOWLEDGE AND PRACTICE OF PHYSICAL ACTIVITY AND HEALTHY EATING ; ADDRESS CURRENT WEIGHT-RELATED ILLNESS AND PREVENT CHRONIC DISEASE THROUGH INCREASED ACTIVITY LEVELS; IMPROVE QUALITY OF LIFE BY PROMOTING HEALTHY BEHAVIORS; INCREASE CONFIDENCE, SUPPORT POSITIVE CHANGE, AND BUILD A LIFELONG COMMITMENT TO A HEALTHY LIFESTYLE.PARTNERS INCLUDE: DURHAM PARKS AND RECREATION; DURHAM CITY GOVERNMENT; DURHAM COUNTY DEPARTMENT OF PUBLIC HEALTH; EAST DURHAM CHILDREN'S INITIATIVE; LINCOLN COMMUNITY HEALTH CENTER; COMMUNITY NUTRITION PARTNERSHIP; VEGGIE VAN; BLUE POINTE YOGA; DURHAM PUBLIC SCHOOLS; PARTNERSHIP FOR A HEALTHY DURHAM; DUKE SERVICE LEARNING; DUKE FAMILY MEDICINE; DUKE CHILDREN'S HOSPITAL AND THE UNC SCHOOL OF SOCIAL WORK2. ACCESS TO MEDICAL AND DENTAL CARE INITIATIVESACCESS TO HEALTH CARE IN A COMMUNITY REFERS TO THE ABILITY OF RESIDENTS TO FIND A CONSISTENT MEDICAL PROVIDER FOR THEIR PRIMARY CARE NEEDS, TO FIND A SPECIALTY PROVIDER WHEN NEEDED AND TO BE ABLE TO RECEIVE THAT CARE WITHOUT ENCOUNTERING SIGNIFICANT BARRIERS. ALTHOUGH THERE ARE MANY MEDICAL PROVIDERS, DURHAM COUNTY IS PARTICULARLY HAMPERED BY A LACK OF HEALTH INSURANCE COVERAGE (WHETHER PRIVATE OR PUBLIC, SUCH AS MEDICAID) FOR MANY OF ITS RESIDENTS. IN DURHAM COUNTY, 19% OF ADULTS LESS THAN 65 YEARS ARE UNINSURED. PROJECT ACCESS OF DURHAM COUNTY (PADC) LINKS ELIGIBLE LOW-INCOME, UNINSURED, DURHAM COUNTY RESIDENTS WITH ACCESS TO SPECIALTY MEDICAL CARE FULLY DONATED TO THE PATIENTS BY THE PHYSICIANS, HOSPITALS INCLUDING DUH, LABS, CLINICS AND OTHER PROVIDERS PARTICIPATING IN THE PADC NETWORK. IN FY15, PADC PROVIDED SERVICES TO MORE THAN 1,000 PATIENTS.LOCAL ACCESS TO COORDINATED HEALTHCARE (LATCH) WAS INITIATED IN 2002 WITH HEALTHY COMMUNITIES ACCESS PROGRAM (HCAP) FUNDING FROM THE US HEALTH RESOURCES AND SERVICES ADMINISTRATION (HRSA) TO DUKE'S DIVISION OF COMMUNITY HEALTH, DEPARTMENT OF COMMUNITY AND FAMILY MEDICINE. THE FOUNDING AND SUSTAINING LATCH PARTNERSHIP INCLUDES DUH (WHICH NOW PROVIDES THE MAJORITY OF OPERATING FUNDS), LINCOLN COMMUNITY HEALTH CENTER, THE DURHAM COUNTY DEPARTMENTS OF HEALTH AND SOCIAL SERVICES, EL CENTRO HISPANO, AND A NUMBER OF COMMUNITY BASED ORGANIZATIONS (CBOS). THROUGH COMMUNITY-BASED, LINGUISTICALLY AND CULTURALLY-RELEVANT CARE MANAGEMENT, LATCH AIMS TO IMPROVE HEALTH KNOWLEDGE AND SELF-CARE, ACCESS TO HEALTH CARE AND HEALTH SERVICES UTILIZATION OUTCOMES AMONG DURHAM COUNTY'S UNINSURED. CARE MANAGEMENT SERVICES INCLUDE: HEALTH SERVICES COORDINATION AND NAVIGATION (MEDICAL, SOCIAL, BEHAVIORAL); POST-HOSPITALIZATION FOLLOW-UP; PATIENT EDUCATION; CHRONIC DISEASE MANAGEMENT; PSYCHO-SOCIAL SUPPORT; ACCESS TO BENEFITS (MEDICAID/SUPPLEMENTAL SECURITY INCOME (SSI)/SOCIAL SECURITY DISABILTY INCURANCE (SSDI)); BILLS ASSISTANCE; INTERPRETATION/TRANSLATION; AND, TRANSPORTATION COORDINATION. IN PARTNERSHIP WITH OTHER COMMUNITY STAKEHOLDERS-HEALTH CARE AND SOCIAL SERVICE PROVIDERS, LOCAL GOVERNMENT AND COMMUNITY-BASED ORGANIZATIONS-LATCH MONITORS HEALTH CARE TRENDS, IDENTIFIES BARRIERS FACING UNINSURED PATIENTS, AND, WORKING AS A CONSORTIUM, ADDRESSES AND ELIMINATES BARRIERS. IN FY15 LATCH PROVIDED MORE THAN 6,000 CARE MANAGEMENT SERVICE ENCOUNTERS WITH PATIENTS. PRE- AND POST- ANALYSIS OF PATIENTS SERVED BY LATCH SHOWS A 17% DECREASE IN HOSPITALIZATIONS. THE COMPLEX CHILD PROGRAM (CCP) PROVIDES THE COORDINATION OF MEDICAL AND CO-MANAGEMENT OF MEDICAL CARE FOR CHILDREN WITH MULTIPLE MEDICALLY COMPLEX ISSUES THAT REQUIRE THE INTERACTION WITH MULTIPLE SPECIALISTS. ON AVERAGE THESE CHILDREN WORK WITH 13 SPECIALISTS. BEFORE THE COMPLEX CHILD PROGRAM, CARE WAS VERY FRAGMENTED AND PATIENTS/FAMILIES HAD NO CENTRAL "QUARTERBACK" HELPING TO OVERSEE THE BIG PICTURE. THROUGH THE CCP PARENTS NOW HAVE DIRECT PHONE ACCESS TO A COMPLEX CARE SERVICE (CCS) PROVIDER OR RN 24/7. THE CCP TEAM WORKS WITH PARENTS TO CREATE A COMPREHENSIVE "COMPLEX CARE PLAN" THAT IS PLACED IN THE CHILD'S EPIC RECORD AND GIVEN TO THE PARENTS. IN ADDITION, THE CCP TEAM COORDINATES INPATIENT INTENSIVE CARE TRANSITIONS PRIOR TO DISCHARGE AND CONDUCTS INTENSIVE OUTPATIENT BETWEEN-VISIT CONTACTS (PHONE, CLINIC VISITS, AND IN SOME CASES, HOME VISITS). IN FY15, CCP SERVED 22 CHILDREN AND THEIR FAMILIES. GROUP A - FACILITY 1 - DUKE UNIVERSITY HOSPITAL DUKE-DURHAM FOSTER CARE CLINIC PROGRAM IS A HIGHLY EFFECTIVE PARTNERSHIP BETWEEN DUKE AND DURHAM COUNTY. IN SEPTEMBER OF 2013 THE DUKE CHILD ABUSE AND NEGLECT MEDICAL EVALUATION CLINIC (CANMEC) PARTNERED WITH DURHAM COUNTY DEPARTMENT OF SOCIAL SERVICES (DSS) TO FORMALIZE A FOSTER CARE CLINIC. THIS CLINIC PROVIDES THE INITIAL SCREENING AND COMPREHENSIVE HEALTH ASSESSMENT ACCORDING TO THE AMERICAN ACADEMY OF PEDIATRICS (AAP) STANDARDS FOR CHILDREN IN FOSTER CARE IN DURHAM. CHILDREN RECEIVE A COMPREHENSIVE MEDICAL EVALUATION INCLUDING COMPLETE PHYSICAL EXAM, MEDICAL RECORD REVIEW AS WELL AS SCREENING FOR DENTAL, DEVELOPMENTAL, MENTAL HEALTH, AND SOCIAL CONCERNS. UNMET MEDICAL NEEDS ARE IDENTIFIED AND THE CLINIC IDENTIFIES A MEDICAL HOME; ARRANGES MEDICAL, MENTAL HEALTH, AND SOCIAL REFERRALS; PROVIDES FOLLOW UP CARE UNTIL A MEDICAL HOME IS ESTABLISHED; AND SUPPORTS SOCIAL WORKERS WITH NAVIGATING THE COMPLEX HEALTH SYSTEM. CHILDREN IN DURHAM COUNTY FOSTER CARE WHO HAVE COMPLETED A COMPREHENSIVE ASSESSMENT AT THE DUKE FOSTER CARE CLINIC ARE CURRENT ON IMMUNIZATIONS, ARE ENROLLED IN A MEDICAL HOME, ARE REFERRED FOR MENTAL HEALTH TREATMENT IF NEEDED, AND ARE HAVING THEIR ONGOING MEDICAL, DEVELOPMENTAL AND SOCIAL NEEDS ADDRESSED. THE DUKE-DURHAM FOSTER CARE CLINIC SERVES ALL CHILDREN IN THE FOSTER CARE SYSTEM IN DURHAM COUNTY. SOUTHERN HIGH SCHOOL WELLNESS CENTER PROVIDES COMPREHENSIVE PRIMARY CARE AND MENTAL HEALTH SERVICES AT SOUTHERN HIGH SCHOOL TO STUDENTS AT THE SCHOOL AND IS OPEN TO ALL STUDENTS AND STAFF OF DURHAM PUBLIC SCHOOLS. OPERATED BY DUKE'S DIVISION OF COMMUNITY HEALTH ON BEHALF OF DUH, THE SOUTHERN HIGH SCHOOL WELLNESS CENTER WILL CELEBRATE ITS 20TH ANNIVERSARY IN 2016. IN FY15 THE SOUTHERN HIGH SCHOOL WELLNESS CENTER HAD TO SCALE BACK HOURS DUE TO STAFFING ISSUES, BUT STILL COMPLETED 188 PATIENT VISITS. DURHAM CHILD HEALTH ASSESSMENT AND PREVENTION PROGRAM (CHAPP) WAS CREATED TO CLOSE GAPS IN ACCESS FOR CHILDREN WHO HAVE MISSED PREVENTIVE VISITS. IN ADDITION, THE PROGRAM SEEKS TO RECONNECT THESE CHILDREN AND THEIR FAMILIES TO SUPPORTIVE MEDICAL HOMES. TOGETHER, DUH THROUGH THE DUKE DIVISION OF COMMUNITY HEALTH, THE DURHAM COUNTY DEPARTMENT OF PUBLIC HEALTH, AND DURHAM PUBLIC SCHOOLS CONVERTED THREE DUH ELEMENTARY SCHOOL BASED HEALTH CENTERS AND OPENED TWO ADDITIONAL ONES UTILIZING ENHANCED ROLE REGISTERED NURSES (ERRNS) TO DELIVER WELL-CHILD CARE TO CHILDREN WHO ARE OVERDUE FOR THEIR WELL-CHILD CHECKUPS. THE FIVE SCHOOLS ARE IN AREAS OF THE COUNTY THAT DEMONSTRATE SIGNIFICANT GAPS IN PEDIATRIC CARE AND THE CHAPP CLINICS OPERATE AS SATELLITES OF THE DURHAM COUNTY DEPARTMENT OF PUBLIC HEALTH. DUH CONTINUES TO SUPPORT MENTAL HEALTH SERVICES AT ALL FIVE OF THE SITES AND PROVIDES MEDICAL BACK UP. JUST FOR US (JFU) PROVIDES IN-HOME CARE PROGRAM FOR LOW-INCOME, FRAIL ELDERLY AND DISABLED. JFU WAS LAUNCHED IN 2002 AS A COLLABORATION OF DUKE, LINCOLN COMMUNITY HEALTH CENTER, DURHAM DEPARTMENT OF SOCIAL SERVICES (DSS), THE LOCAL AREA MENTAL HEALTH ENTITY, AND THE DURHAM HOUSING AUTHORITY. DUH PROVIDES THE MAJORITY OF ONGOING SUPPORT FOR THE PROGRAM. THROUGH JUST FOR US, AN INTERDISCIPLINARY TEAM OF PROVIDERS SERVES CLIENTS IN THEIR HOMES, PROVIDING MEDICAL CARE, MANAGEMENT OF CHRONIC ILLNESSES, AND CASE MANAGEMENT. EACH PARTICIPANT RECEIVES A HOME VISIT EVERY 5 WEEKS UNLESS THERE IS AN ACUTE EPISODE OR A HOSPITAL DISCHARGE, FOR WHICH A VISIT IS SCHEDULED IMMEDIATELY. VISITS INCLUDE MEDICATION RECONCILIATION, SOCIAL ISSUES, SUPPORT SERVICES, CHRONIC DISEASE MANAGEMENT, AND POST-HOSPITAL CARE. THE HEALTH CARE TEAM CONSISTS OF A CLINICAL PROVIDER (PA, NP OR MD), OCCUPATIONAL THERAPIST, REGISTERED DIETITIAN, SOCIAL WORKER, PHLEBOTOMIST, AND COMMUNITY HEALTH WORKER. IN FY15, JUST FOR US TRANSITIONED TO EPIC (ELECTRONIC MEDICAL RECORD SYSTEM) AND EXPERIENCED THE TYPICAL DECREASE IN PRODUCTIVITY ASSOCIATED WITH SUCH TRANSITIONS. IN ADDITION, JUST FOR US LOST ONE OF ITS TEAM MEMBERS CAUSING A FURTHER REDUCTION IN THE ABILITY TO PROVIDE SERVICES. IN FY15 JUST FOR US COMPLETED 841 PATIENT ENCOUNTERS.COMMUNITY CLINICS: DUH IN PARTNERSHIP WITH LINCOLN COMMUNITY HEALTH CENTER COLLABORATIVELY OPERATES THREE COMMUNITY HEALTH CLINICS; THE LYON PARK COMMUNITY CLINIC, THE WALLTOWN NEIGHBORHOOD CLINIC AND THE HOLTON WELLNESS CENTER. THE CLINICS WERE DESIGNED TO PROVIDE PRIMARY CARE, HEALTH EDUCATION, AND DISEASE PREVENTION TO THE UNDERSERVED POPULATIONS OF DURHAM. THE CLINICS PROVIDE MEDICAL CARE FOR PERSONS WITH AND WITHOUT HEALTH INSURANCE. THOSE WITHOUT INSURANCE ARE SEEN BASED ON A SLIDING FEE SCALE. NO PATIENT IS DENIED CARE BASED ON INABILITY TO PAY FOR SERVICES. THE LYON PARK CLINIC WAS THE FIRST OF THE COLLABORATIVE NEIGHBORHOOD CLINICS, OPENING ITS DOORS FOR PATIENT CARE IN APRIL 2003. THE WALLTOWN CLINIC OPENED IN JANUARY 2005 AND THE HOLTON CLINIC OPENED IN AUGUST 2009. EACH CLINIC RECEIVED START-UP FUNDS THROUGH A DUKE ENDOWMENT GRANT. CLINICS GENERATE REVENUE THROUGH A CONTRACT WITH LINCOLN COMMUNITY HEALTH CENTER AND RECEIVE SIGNIFICANT SUPPORT FROM DUH. THE CLINICS OPERATE AS FAMILY MEDICINE PRACTICES AND ARE OPEN 5 DAYS A WEEK. STAFFING INCLUDES PHYSICIAN ASSISTANTS, NURSE PRACTITIONERS AND FAMILY PHYSICIANS, WHO SERVE AS SUPERVISING DOCTORS. EACH CLINIC IS SUPPORTED BY NURSING STAFF: CERTIFIED NURSING ASSISTANTS, LICENSED PRACTICAL NURSES, OR CERTIFIED MEDICAL ASSISTANTS AND A STAFF ASSISTANT. THE STAFF ASSISTANT PERFORMS ALL ADMINISTRATIVE TASKS FOR THE CLINIC INCLUDING ANSWERING INCOMING PHONE CALLS, REGISTRATION, SCHEDULING, ETC. IN FY2015, THE COMMUNITY CLINICS TRANSITIONED TO EPIC (ELECTRONIC MEDICAL RECORD SYSTEM) AND EXPERIENCED THE TYPICAL DECREASE IN PRODUCTIVITY ASSOCIATED WITH SUCH TRANSITIONS. IN FY15, THE CLINICS COMPLETED 11,000 PATIENT VISITS.3. MENTAL HEALTH AND SUBSTANCE ABUSE INITIATIVESAN ESTIMATED 17,000 RESIDENTS OF DURHAM COUNTY NEED MENTAL HEALTH TREATMENT AND 19,000 NEED SUBSTANCE ABUSE TREATMENT. ALCOHOL IS THE PRIMARY SUBSTANCE ABUSED BY DURHAM COUNTY RESIDENTS SEEKING CRISIS DETOXIFICATION SERVICES AND BY ADOLESCENTS IN DURHAM'S MIDDLE AND HIGH SCHOOLS. RESPONDENTS IN THE COMMUNITY HEALTH OPINION SURVEY IDENTIFIED ADDICTION TO ALCOHOL, DRUGS OR PRESCRIPTION PILLS AS THE NUMBER ONE COMMUNITY HEALTH PROBLEM. DUH HAS PARTNERED WITH AND SUPPORTS A NUMBER OF COLLABORATIVE INITIATIVES TO IMPROVE ACCESS TO MENTAL HEALTH SERVICES AND REDUCE SUBSTANCE ABUSE.PROJECT LAZARUS IN CONJUNCTION WITH COMMUNITY CARE OF NORTH CAROLINA (CCNC) AND DUH SEEKS TO REDUCE OPIOID-RELATED OVERDOSES; OPTIMIZE TREATMENT OF CHRONIC PAIN; AND MANAGE SUBSTANCE ABUSE ISSUES RELATED TO OPIOIDS. THE CORE COMPONENTS OF THE PROJECT LAZARUS MODEL ARE: 1) PUBLIC AWARENESS, 2) COALITION ACTION, AND 3) DATA & EVALUATION. STRATEGIES OF THE MODEL INCLUDE: COMMUNITY EDUCATION; PROVIDER EDUCATION; HOSPITAL EMERGENCY DEPARTMENT POLICIES; DIVERSION CONTROL; PAIN PATIENT SUPPORT; HARM REDUCTION; ADDICTION TREATMENT. DUH IS A KEY PARTNER IN SUPPORTING THE FOLLOWING ACTIVITIES:A) COMMUNITY COALITIONS: DURHAM CRISIS COLLABORATIVE; PARTNERSHIP FOR A HEALTHY DURHAM SUBSTANCE USE/ AND MENTAL HEALTH COMMITTEE AND DURHAM TOGETHER FOR RESILIENT YOUTH.B) NALOXONE OUTREACH: PHARMACIES (DUKE SOUTH, CLINIC PHARMACY, MAIN STREET, GURLEY'S, JOSEF'S, & DUKE CANCER SPECIALTY); DURHAM COUNTY DEPARTMENT OF PUBLIC HEALTH; DURHAM MOBILE CRISIS UNIT. C) PROVIDER EDUCATION: PROVIDER TOOLKITS AND CME EDUCATION; USE OF PAIN AGREEMENTS; USE OF CONTROLLED SUBSTANCE REPORTING SYSTEM (CSRS); CHRONIC PAIN PROVIDER CONSULTATION CALLS. D) DIVERSION CONTROL: PERMANENT DROP BOXES IN 5 OF 6 COUNTIES (DURHAM, FRANKLIN, PERSON, GRANVILLE, & VANCE).E) CHRONIC PAIN PATIENT SUPPORT: CHRONIC PAIN SELF-MANAGEMENT WORKSHOPS; CHRONIC PAIN MANAGEMENT RESOURCES; KEY COMMUNITY PRESENTATIONS. FY15 ACCOMPLISHMENTS INCLUDE: 62 NALOXONE KITS PROVIDED TO PHARMACIES, 7 CLINICS WITH PROVIDERS PRESCRIBING NALOXONE, 35 PROVIDERS RECEIVED CME TRAINING FOR PROJECT LAZARUS, 6 MONTHLY CHRONIC PAIN TELEPHONE CONSULTATIONS FOR PRIMARY CARE PROVIDERS HELD REACHING 20 PROVIDERS, 20 PATIENTS RECEIVED CHRONIC DISEASE SELF-MANAGEMENT EDUCATION (STANFORD MODEL), 120 PHARMACIES RECEIVED ANNOUNCEMENT FOR CME TRAINING OPPORTUNITIES, 50 PROVIDERS RECEIVED INFORMATION ON CHRONIC PAIN RESOURCES AND TELEPHONE CONSULTATION AT NPCC BI-ANNUAL MEETING SESSION, 180 PROVIDER EDUCATIONAL HANDOUTS DISSEMINATED, 70 REFERRALS FOR CHRONIC PAIN RESOURCES, 60 PATIENT REMINDER CALLS FOR DUH-OUTPATIENT CLINIC (DOC) PAIN CLASSES, 5 PATIENTS TO COMPLETE 8 WEEK DUH-DOC PAIN CLASS. GROUP A - FACILITY 1 - DUKE UNIVERSITY HOSPITAL HOMEBASE: IS AN INTEGRATED MODEL OF PRIMARY CARE AND MENTAL HEALTH DELIVERED BY A DUALLY-TRAINED PHYSICIAN ASSISTANTS AND SUPPORTED BY IN THE DUH-DOC. THE GOALS OF THE PROGRAM ARE TO IMPROVE CARE AND OUTCOMES FOR DOC PATIENTS WITH CO-MORBID MENTAL HEALTH CONDITIONS; ENCOURAGE AND ENABLE PATIENTS TO SEEK SERVICES AT THE DOC FIRST AND NOT THE EMERGENCY DEPARTMENT; REINVENT A CARE TEAM MODEL AT DOC TO INCREASE PATIENT-PROVIDER CONTINUITY, PROVIDER ACCOUNTABILITY FOR PATIENT OUTCOMES, USE OF BEST PRACTICES; AND IMPROVE TRANSITIONS OF CARE FROM HOSPITAL AND EMERGENCY DEPARTMENT SETTINGS TO CLINIC AND HOME, PARTICULARLY FOR HIGH UTILIZER (HU) PATIENTS. DURING ITS LAST TWO PILOT YEARS, HOMEBASE SERVED 44 PATIENTS DECREASING THEIR EMERGENCY DEPARTMENT USE BY 53% AND THEIR HOSPITALIZATIONS BY 36%.DUHS SAFE OPIOID TASK FORCE: WAS CREATED TO IMPROVE THE SAFETY OF PAIN MANAGEMENT BY ENCOURAGING CLINICAL PRACTICE STANDARDIZATION, WHERE CLINICALLY APPROPRIATE, WHEN OPIOID THERAPY IS DESIGNATED FOR TREATMENT. THE OPIOID SAFETY TASK FORCE PROVIDES RECOMMENDATIONS FOR THE INITIATION AND MANAGEMENT OF OPIOID THERAPY ACROSS DUHS TO IMPROVE PERSONAL AND COMMUNITY SAFETY AND REDUCE HARM ASSOCIATED WITH THE HIGH RISK TREATMENTS WHILE ENGAGING PATIENTS IN THEIR OWN CARE. DUH ALONG WITH DRH AND DUKE RALEIGH HOSPITAL ("DRAH") SERVES AS A PIVOTAL PLAYER IN ALL ASPECTS OF THE WORK OF THE TASK FORCE. OVER THE LAST TWO YEARS, ALL THREE HOSPITALS ENGAGED IN THE STANDARDIZATION OF NC MEDICAL BOARD GUIDELINES; HELPED TO DEVELOP 12 SMARTPHRASES DEVELOPED IN EPIC; CREATED 12 PATIENT EDUCATION VIDEOS; AND PROVIDED 35 ADVANCED PRACTITIONERS WITH EDUCATION ON PAIN MANAGEMENT & SAFE OPIOID PRESCRIBING.4. HIV AND SEXUALLY TRANSMITTED INFECTIONSSEXUALLY TRANSMITTED INFECTIONS (STI) MAY LEAD TO PREMATURE DEATH AND DISABILITY AND CAN RESULT IN SIGNIFICANT HEALTH CARE COSTS. CHLAMYDIA, GONORRHEA, AND SYPHILIS ARE THE THREE MOST COMMON STIS IN NORTH CAROLINA AND DURHAM COUNTY. ALTHOUGH HIV IS NOT AS COMMON, DURHAM RANKS FOURTH HIGHEST IN NORTH CAROLINA, WITH AN AVERAGE RATE OF HIV DISEASE (29.9 PER 100,000) WELL ABOVE THE STATE RATE (16.4 PER 100,000). WHILE DUH THROUGH THE PROGRAMS DESCRIBED IN THIS DOCUMENT SUPPORTS MECHANISMS TO ADDRESS HIV AND SEXUALLY TRANSMITTED INFECTIONS, IT DOES NOT INCLUDE SPECIFIC STRATEGIES IN THIS PLAN TO ADDRESS THE RATE OF HIV AND SEXUALLY TRANSMITTED INFECTIONS, BECAUSE CONSIDERABLE WORK IS ALREADY BEING DONE THROUGH ORGANIZATIONS WITHIN THE COMMUNITY. THROUGH THE PARTNERSHIP FOR A HEALTHY DURHAM, THE HIV/STI ADVISORY COUNCIL BRINGS TOGETHER COMMUNITY MEMBERS AND AGENCIES TO FOCUS ON STRATEGIES TO PREVENT THE SPREAD OF SYPHILIS AND HIV/AIDS. IN ADDITION, LINCOLN COMMUNITY HEALTH CENTER OPERATES AN EARLY INTERVENTION CLINIC FOR PATIENTS WITH HIV/AIDS AT THE DURHAM COUNTY HEALTH DEPARTMENT.5. POVERTYPEOPLE WITH HIGHER INCOMES, MORE YEARS OF EDUCATION, AND A HEALTHY AND SAFE ENVIRONMENT TO LIVE IN HAVE BETTER HEALTH OUTCOMES AND GENERALLY HAVE LONGER LIFE EXPECTANCIES. IN DURHAM COUNTY, 16.6% OF INDIVIDUALS LIVE IN POVERTY. FEMALE SINGLE-PARENT FAMILIES ARE DISPROPORTIONATELY AT RISK FOR POVERTY THAN MARRIED COUPLE FAMILIES (41.5% TO 8.7%) AND 40.6% OF FEMALE SINGLE-PARENT FAMILIES WITH RELATED CHILDREN UNDER 18 YEARS ARE LIVING IN POVERTY. NEARLY ONE-HALF OF DURHAM'S RENTERS ARE PAYING 30% OR MORE OF THEIR INCOME FOR HOUSING.DURHAM'S BULL CITY CONNECTOR: IS A FARE-FREE CONNECTOR BUS SERVICE THAT CONTINUOUSLY LOOPS THROUGH STOPS FROM DOWNTOWN DURHAM ALL THE WAY TO THE DUKE HOSPITAL, DUKE CLINICS, AND DUKE EYE CENTER CAMPUSES. ON AVERAGE, BULL CITY CONNECTOR BUSES ACCUMULATE 1,500 RIDERS EVERY WEEKDAY AND COMPLETE THEIR LOOPS IN 17 MINUTE INTERVALS. SAFE AND EFFECTIVE TRANSPORTATION IS A KEY CORRELATE IN HEALTH AND ECONOMIC WELL-BEING. THE BULL CITY CONNECTOR HAS PROVEN TO BE AN ASSET FOR DUKE EMPLOYEES, STUDENTS, AND PATIENTS.SSI/SSDI OUTREACH, ACCESS AND RECOVERY (SOAR): HELPS PATIENTS WHO ARE CHRONICALLY HOMELESS, OR AT RISK OF HOMELESSNESS ACCESS HEALTH INSURANCE, A STABLE INCOME, AND MEDICAL CARE BY ASSISTING THESE INDIVIDUALS IN APPLYING FOR SUPPLEMENTAL SECURITY INCOME (SSI) AND SOCIAL SECURITY DISABILITY INSURANCE (SSDI). THE HOMELESS POPULATION AND THOSE REENTERING THE COMMUNITY FROM AN INSTITUTION FACE NUMEROUS CHALLENGES IN ACCESSING SERVICES. APPROVAL ON INITIAL SSI AND SSDI APPLICATIONS FOR THESE AT-RISK POPULATIONS, WHO HAVE NO ONE TO ASSIST, IS ABOUT 10-15 PERCENT. FOR THOSE WITH MENTAL ILLNESS, SUBSTANCE ABUSE ISSUES, AND/OR CO-COGNITIVE IMPAIRMENT, THE APPLICATION PROCESS IS EVEN MORE DIFFICULT. EVEN WITH ASSISTANCE, THE APPLICATION PROCESS CAN TAKE UP TO SIX MONTHS. THROUGH SOAR, THESE INDIVIDUALS WITH COMPLEX NEEDS ARE PROVIDED CASE MANAGEMENT FOR HOME, HOSPITAL, AND CLINIC VISITS; PROVIDED WITH A STEP BY STEP EXPLANATION AND COMPLETION OF ALL APPLICATIONS FOR FEDERAL DISABILITY BENEFITS; RECEIVE EXPEDITED APPLICATIONS FOR MONTHLY INCOME AND MEDICAID/MEDICARE; AND LINKED TO COMMUNITY RESOURCES. DUH CURRENTLY FUNDS TWO SOAR CASE MANAGERS WHO HAVE SUCCESSFULLY HELPED MORE THAN 100 PATIENTS IN THE LAST 3 YEARS.DURHAM MEDICAL RESPITE PROGRAM: IS A PILOT PROGRAM FOR HOMELESS PATIENTS THAT EMANATED OUT OF THE WORK OF PADC (NOTED EARLIER IN THIS PLAN) IN 2014. THE MEDICAL RESPITE PILOT PROGRAM OPERATES 24/7 AND PROVIDES PARTICIPANTS WITH CLEAN AND SAFE HOUSING WHICH WILL MEET THE STANDARDS THAT HOSPITALS USE WHEN PLANNING FOR DISCHARGE TO HOME. DEPENDING ON PARTICIPANT NEEDS AND DEMOGRAPHICS, POTENTIAL SITES INCLUDE TRANSITIONAL HOUSING (JUST A CLEAN HOUSE), MOTELS, OR HEALING WITH CAARE, INC. PER DIEM HOUSING. ROOM AND BOARD IS FUNDED BY DURHAM COUNTY DEPARTMENT OF PUBLIC HEALTH THROUGH A CONTRACT WITH PROJECT ACCESS OF DURHAM COUNTY (PADC), ALONG WITH PRIVATE DONATIONS. AS THE PROGRAM BECOMES FULLY OPERATIONAL, EACH PROGRAM PARTICIPANT WILL WORK WITH A TRANSITIONAL NURSE CARE MANAGER (PROVIDED BY DUKE'S DIVISION OF COMMUNITY HEALTH) TO MAXIMIZE THEIR HEALTH AND CONNECT WITH APPROPRIATE COMMUNITY RESOURCES AND SERVICES.6. EDUCATIONQUALITY CHILD CARE AND EARLY EDUCATION PREDICT A CHILD'S FUTURE SUCCESS AND THE ACADEMIC SUCCESS OF YOUNG ADULTS IS STRONGLY LINKED WITH THEIR HEALTH THROUGHOUT THEIR LIFETIME. THE IMPORTANCE OF A HIGH SCHOOL DIPLOMA AND HIGHER EDUCATION CANNOT BE OVERSTATED. COLLEGE GRADUATES AGE 25 AND OVER EARN NEARLY TWICE AS MUCH AS WORKERS WHO ONLY HAVE A HIGH SCHOOL DIPLOMA. THE UNEMPLOYMENT RATE FOR WORKERS WHO DROPPED OUT OF HIGH SCHOOL IS NEARLY FOUR TIMES THE RATE FOR COLLEGE GRADUATES. IN DURHAM COUNTY, THE FOUR-YEAR HIGH SCHOOL GRADUATION RATE IS 79.6% COMPARED TO NORTH CAROLINA'S RATE OF 82.5%. THE OVERALL 4-YEAR COHORT GRADUATION RATE HAS INCREASED BY NEARLY 10% SINCE 2010-11, BUT THERE IS STILL A DISPARITY IN THE PERCENTAGES OF WHITE VERSUS MINORITY STUDENTS WHO ARE GRADUATING FROM HIGH SCHOOL. FOR EXAMPLE, 84.7% OF WHITES GRADUATED IN 2011-2012 COMPARED TO 74.7% OF BLACKS AND 73% OF HISPANIC STUDENTS.LEARNING TOGETHER: PROVIDES TRAINING AND OPPORTUNITIES FOR DUKE UNIVERSITY STUDENTS (LEARNERS) TO PARTICIPATE IN HEALTH-RELATED COMMUNITY SERVICE ACTIVITIES. SERVICE OPPORTUNITIES MAY INCLUDE PROVIDING HEALTH EDUCATION TO ELEMENTARY SCHOOL CHILDREN, HELPING FRAIL SENIORS COMPLETE THE APPLICATION PROCESS FOR FOOD STAMPS, AND CONDUCTING WORKSHOPS TO TEACH PATIENTS HOW TO EFFECTIVELY COMMUNICATE WITH THEIR DOCTOR. THROUGH LEARNING TOGETHER, LEARNERS WORK WITH A VARIETY OF POPULATIONS, EXPERIENCE THE INTERDISCIPLINARY NATURE OF COMMUNITY WORK, AND DEVELOP COMPETENCE FOR WORKING WITH DIVERSE COMMUNITIES AND CULTURES. LEARNERS WHO PARTICIPATE GAIN SKILLS THEY CAN USE TO WORK EFFECTIVELY WITH ANY COMMUNITY. IN FY15 LEARNING TOGETHER TRAINED 126 DUKE LEARNERS WHO IN TURN VOLUNTEERED FOR COMMUNITY SERVICES ACTIVITIES WHICH PROVIDED ASSISTANCE FOR 300 ADULTS AND 1,125 CHILDREN. GROUP A - FACILITY 1 - DUKE UNIVERSITY HOSPITALPART V, SECTION B, LINE 16I: DUHS PROVIDES A BROCHURE TO ALL ADMISSIONS THAT INCLUDES A BRIEF SUMMARY OF DUHS FINANCIAL ASSISTANCE POLICIES. DUHS ALSO COMMENTS ON THE BACK OF ITS BILLING INVOICES THAT PATIENTS SHOULD CONTACT PATIENT ACCOUNT REPRESENTATIVES TO HELP THEM IF THEY CANNOT PAY THEIR BILL IN FULL. THIS COMMENT REFERENCES GOVERNMENT-SPONSORED PROGRAMS, MONTHLY PAYMENT PROGRAMS, AND OTHER FINANCIAL ASSISTANCE PROGRAMS AVAILABLE FOR PATIENTS WHO MEET CERTAIN FINANCIAL CRITERIA. DUHS ALSO PUBLICIZED ITS FINANCIAL ASSISTANCE POLICY VERBALLY THROUGH ITS FINANCIAL CARE COUNSELORS.GROUP A - FACILITY 1 - DUKE UNIVERSITY HOSPITALPART V, SECTION B, LINE 22D: DUHS USED THE LOOK BACK METHOD AND SUMMED ALL CLAIMS SUBMITTED TO MEDICARE AND ALL PRIVATE HEALTH INSURERS DURING THE PRIOR 12 MONTH PERIOD DIVIDED BY THE SUM OF THE ASSOCIATED GROSS CHARGES RELATED TO THOSE CLAIMS. GROUP A - FACILITY 1 - DUKE UNIVERSITY HOSPITAL PART V, SECTION B, LINE 24: CERTAIN ELECTIVE COSMETIC/AESTHETIC SERVICES, AND OTHER SERVICES NOT TYPICALLY COVERED BY INSURANCE, WILL BE BILLED AT AN AMOUNT EQUAL TO GROSS CHARGES.DUKE RALEIGH HOSPITAL:PART V, SECTION B, LINE 5: DUKE RALEIGH HOSPITAL ("DRAH") USED THE WAKE COUNTY COMMUNITY ASSESSMENT IN DEVELOPING ITS CHNA AND IMPLEMENTATION PLAN. THE WAKE COUNTY ASSESSMENT INCLUDED INPUT FROM 1,349 CITIZEN SURVEYS, 34 FOCUS GROUPS, 8 WORKGROUPS, AND 3 COMMUNITY MEETINGS. A STEERING COMMITTEE, CO-CHAIRED BY DRAH'S PRESIDENT, COMPRISED OF 50 MEMBERS FROM HOSPITALS, LOCAL GOVERNMENTS, FAITH-BASED ORGANIZATIONS, SCHOOLS, MEDIA, NON-PROFIT ORGANIZATIONS, AND BUSINESSES WORKED TO DIRECT THE ACTIVITIES OF THE ASSESSMENT PROCESS AND PROVIDE INPUT.DUKE RALEIGH HOSPITAL:PART V, SECTION B, LINE 6A: REX HEALTHCARE, HOLLY HILL HOSPITAL, WAKEMED HOSPITALSDUKE RALEIGH HOSPITAL:PART V, SECTION B, LINE 6B: WAKE HEALTH SERVICES, TRIANGLE UNITED WAY AND WAKE COUNTY HUMAN SERVICESDUKE RALEIGH HOSPITAL:PART V, SECTION B, LINE 7D: THE CHNA IS AVAILABLE ON THE WEBSITE BY NAVIGATING TO WWW.DUKEMEDICINE.ORG, CLICK ON "PATIENTS & VISITORS", THEN "FINANCIAL ASSISTANCE", "COMMUNITY HEALTH NEEDS ASSESSMENT; AND THEN CLICK THE LINK FOR "DETAILS OF OUR COMMUNITY INVOLVEMENT."DUKE RALEIGH HOSPITAL:PART V, SECTION B, LINE 10ATHE IMPLEMENTATION STRATEGY AND PROGRESS REPORTS ARE AVAILABLE ON THE WEBSITE BY NAVIGATING TO HTTP://WWW.DUKEMEDICINE.ORG, CLICK ON "PATIENTS & VISITORS", THEN "FINANCIAL ASSISTANCE", THEN "COMMUNITYHEALTH NEEDS ASSESSMENT; AND THEN CLICK THE LINK FOR "DETAILS OF OUR COMMUNITY INVOLVEMENT." CHOOSE ONE OF THE LINKS FOR THE DUKE RALEIGH HOSPITAL PROGRESS REPORT AND IMPLEMENTATION PLAN.DUKE RALEIGH HOSPITAL:PART V, SECTION B, LINE 11: THE WAKE COUNTY ASSESSMENT EVALUATED HEALTH NEEDS IN THE AREAS OF HEALTHCARE ACCESS AND UTILIZATION; MENTAL HEALTH AND SUBSTANCE ABUSE AND NUTRITION, PHYSICAL ACTIVITY AND OBESITY PREVENTION. DUKE RALEIGH HOSPITAL'S RESOURCES HAVE THE BIGGEST IMPACT IN THE FOLLOWING AREAS WITH KEY DATA INCLUDED FROM THE 2013 WAKE COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT.NUTRITION, PHYSICAL ACTIVITY AND OBESITY PREVENTION:- THE THREE LEADING CAUSES OF DEATH IN WAKE COUNTY ARE CANCER, HEART DISEASE AND STROKE. PROMOTING HEALTHY LIFESTYLES GREATLY REDUCES THE RISK OF DEVELOPING THOSE DISEASES.- CANCER IS THE LEADING CAUSE OF DEATH IN WAKE COUNTY. ACCORDING TO THE CENTER FOR DISEASE CONTROL (CDC), A PERSON'S CANCER RISK CAN BE REDUCED BY RECEIVING REGULAR MEDICAL CARE, MAINTAINING A HEALTHY WEIGHT AND MAKING LIFESTYLE CHANGES INCLUDING PHYSICAL ACTIVITY AND A DIET RICH IN FRUITS AND VEGETABLES. CANCER SCREENING HELPS FIND THE DISEASE EARLY AT AN OFTEN HIGHLY TREATABLE STAGE (CENTERS FOR DISEASE CONTROL AND PREVENTION, CANCER PREVENTION AND CONTROL WEBSITE).- WAKE COUNTY'S MORTALITY RATE FOR CEREBROVASCULAR DISEASE (STROKE) IS 15% HIGHER THAN THE NATIONAL RATE.- IN WAKE COUNTY, ALMOST 2 OUT OF 3 ADULTS ARE EITHER OVERWEIGHT OR OBESE (NC STATE CENTER FOR HEALTH STATISTICS, BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM, 2009). HEALTHCARE ACCESS AND UTILIZATION:- AFRICAN AMERICANS AND HISPANICS IN WAKE COUNTY EXPERIENCE DISPROPORTIONATELY HIGHER MORTALITY RATES FROM CANCER, HEART DISEASE, STROKE AND DIABETES.- IN 2012, MORE THAN 1700 WAKE COUNTY PATIENTS WERE SEEN IN WAKE COUNTY EMERGENCY DEPARTMENTS FOR DIABETES (TYPES 1 AND 2) RELATED ISSUES, A 17% INCREASE SINCE 2010.- IN THREE FOCUS GROUPS, DIABETES WAS IDENTIFIED AS A HEALTH CONCERN FOR WAKE COUNTY.NUTRITION, PHYSICAL ACTIVITY AND OBESITY PREVENTION:DUKE RALEIGH LIFESTYLE AND DISEASE MANAGEMENT CENTER: THE DUKE RALEIGH LIFESTYLE AND DISEASE MANAGEMENT CENTER IS DESIGNED TO SUPPORT PATIENTS WITH CHRONIC ILLNESSES IN IMPROVING THEIR QUALITY OF LIFE. THE CENTERINCLUDES CARDIAC AND PULMONARY REHABILITATION, DIABETES EDUCATION, MEDICAL NUTRITION THERAPY FOR BARIATRIC SURGERY PATIENTS AND GENERAL WELLNESS, NUTRITION AND FITNESS PROGRAMS TO SUPPORT INDIVIDUALS IN ACHIEVING BETTER OVERALL HEALTH. THE LOSE TO LIVE WEIGHT LOSS PROGRAM IS DESIGNED TO HELP PARTICIPANTS MAKE IMPORTANT LIFESTYLE MODIFICATIONS TO DIET AND PHYSICAL ACTIVITY TO ACHIEVE WEIGHT LOSS SUCCESS.WEIGHT LOSS SURGERY: DUKE RALEIGH HOSPITAL IS ACCREDITED AS A LEVEL 1 FACILITY BY THE BARIATRIC SURGERY CENTER NETWORK ACCREDITATION PROGRAM OF THE AMERICAN COLLEGE OF SURGEONS. THE PROGRAM INCLUDES A SUPPORT PROGRAM FOR BARIATRIC SURGERY PATIENTS AFTER SURGERY AS WELL AS AN OPTIONAL MAINTENANCE WELLNESS PROGRAM OFFERED THROUGH THE DUKE RALEIGH LIFESTYLE AND DISEASE MANAGEMENT CENTER.COMMUNITY OUTREACH: HEALTHY FOCUS EDUCATIONAL SERIES: FOR MORE THAN EIGHT YEARS, DUKE RALEIGH HOSPITAL HAS HOSTED THE HEALTHY FOCUS COMMUNITY EDUCATION SERIES OF FREE PROGRAMS AVAILABLE TO COMMUNITY MEMBERS. - LUNG CANCER- CARE OF THE AGING SHOULDER- NECK PAIN: HOW TO BEAT IT AND TREAT IT- ANKLE ARTHRITIS- MEN'S HEALTHTHE TRIANGLE STROKE EDUCATION OUTREACH INITIATIVE: DUKE RALEIGH HOSPITAL HAS PARTNERED WITH THE MINORITY WOMEN'S HEALTH PROJECT, INC., THE AMERICAN HEART ASSOCIATION AND REX HEALTHCARE TO PROMOTE THE SHARING OF SUPPORT, WELL-BEING, STRENGTHS, CHALLENGES AND RESOURCES FOR PEOPLE AFFECTED BY STROKE, THOSE WHO HAVE EXPERIENCED STROKE, AND THEIR FAMILY, FRIENDS, AND CARE PROVIDERS THROUGH A SUPPORT GROUP OFFERED AT AREA COMMUNITY CENTERS AND FAITH-BASED ORGANIZATIONS.DUKE RALEIGH HOSPITAL SUPPORTS THE DUKE HEART CENTER IN AN ANNUAL WOMEN AND HEART HEALTH INITIATIVE DURING THE MONTH OF FEBRUARY. EVENTS INCLUDE A WOMEN'S PRETTY PARTY IN RED OFFERING HEALTH SCREENINGS, HEART HEALTH EDUCATION AND A CELEBRATION OF HEART DISEASE SURVIVORSHIP. IN 2015, DUKE RALEIGH HOSPITAL SUPPORTED THE AMERICAN HEART ASSOCIATION GO RED FOR WOMEN LUNCHEON.DUKE RALEIGH HOSPITAL PARTNERS WITH DUKE MEDICINE AND THE AMERICAN HEART ASSOCIATION IN THE ANNUAL AMERICAN HEART WALK AT THE PNC ARENA. DUKE RALEIGH HOSPITAL DEPARTMENTS HOLD SEVERAL ON-CAMPUS FUNDRAISERS IN SUPPORT OF THE EVENT EACH YEAR.DUKE RALEIGH HOSPITAL'S EMPLOYEES ANNUALLY SUPPORT THE BACKPACK BUDDIES INITIATIVE COORDINATED THROUGH THE NC FOOD BANK.MIDTOWN FARMERS MARKET: DUKE RALEIGH HOSPITAL IS THE PRESENTING SPONSOR OF THE MIDTOWN FARMERS MARKET AND WELLNESS WEDNESDAYS LOCATED AT NORTH HILLS SHOPPING CENTER IN NORTH RALEIGH AND THE EXCLUSIVE HEALTH AND WELLNESS PARTNER. THE MARKET PROMOTES A HEALTHY LIFESTYLE FOR FAMILIES THROUGH THE PROVISION OF LOCAL PRODUCE, FRUITS, CHEESES AND OTHER PRODUCTS AVAILABLE EVERY SATURDAY MORNING FROM APRIL UNTIL NOVEMBER. DUKE RALEIGH HOSPITAL PROVIDES A WEEKLY BOOTH OFFERING HEALTH EDUCATION ACTIVITIES AND ENGAGEMENT AT THEMARKET INCLUDING HEALTHY RECIPES, RESOURCE MATERIALS AND SCREENINGS. HEALTH TOPICS AT THE FY15 DUKE RALEIGH HOSPITAL BOOTH HAVE INCLUDED STROKE AWARENESS, HEALTHY EATING AND CANCER PREVENTION.WELLNESS WEDNESDAYS OFFERS A SEASONAL FITNESS PROGRAM HOSTED BY AREA GYMS AND FITNESS PROGRAMS. DUKE RALEIGH HOSPITAL'S PARTNERSHIP BEGAN IN APRIL 2015. SOCIAL MEDIA: DUKE RALEIGH HOSPITAL'S SOCIAL MEDIA EFFORTS INCLUDE A COMMUNITY BLOG OFFERING HEALTHY RECIPES AND CONTENT TO SUPPORT A HEALTHY LIFESTYLE. DUKE RALEIGH HOSPITAL HAS ADDITIONALLY LIVE TWEETED EDUCATIONAL CONTENT FROM THE MONTHLY HEALTHY FOCUS EDUCATIONAL SEMINARS.CANCER: CANCER PATIENT NAVIGATOR PROGRAM: DUKE RALEIGH HOSPITAL'S PATIENT NAVIGATOR PROGRAM INCLUDES FOUR INDIVIDUALS WHO EACH HAVE A DISEASE-SPECIFIC FOCUS FOR THEIR PATIENT POPULATION. PATIENT NAVIGATORSPROVIDE IMPORTANT SUPPORT TO CANCER PATIENTS IN OBTAINING KNOWLEDGE AND RESOURCES TO HELP THEM COPE WITH THEIR CANCER DIAGNOSIS AND TO SERVE AS ADVOCATES FOR PATIENTS BY EMPOWERING THEM TO MAKE INFORMED DECISIONS ABOUT THEIR CARE.LUNG CANCER: DUKE CANCER CENTER RALEIGH'S LUNG CANCER CARE PROGRAM IS A MULTIDISCIPLINARY CLINIC COMPRISED OF LUNG CANCER SPECIALISTS WHO PROVIDE COMPREHENSIVE CARE. DUKE CANCER CENTER RALEIGH OFFERS A LUNG CANCER SCREENING CLINIC TO HELP THOSE AT RISK FOR LUNG CANCER AND A SURVIVORSHIP CLINIC TO EMPOWER LUNG CANCER SURVIVORS TO BE ENGAGED IN THEIR HEALTH. INDIVIDUALS AT HIGH RISK FOR DEVELOPING LUNG CANCER CAN PARTICIPATE IN THE LUNG CANCER SCREENING PROGRAM PROVIDING ACCESS TO THE MOST ADVANCED DIAGNOSTIC SCREENING TOOL: LOW-DOSE SPIRAL COMPUTED TOMOGRAPHY (CT) SCANS. IN ADDITION, SMOKING CESSATION EVALUATION AND COUNSELING IS PROVIDED AS WELL AS FOLLOW-UP TREATMENT IF NEEDED -- ALL FROM A TEAM OF LUNG CANCER SPECIALISTS. DUKE RALEIGH HOSPITAL: SUPPORT AND EDUCATION: THE DUKE CANCER INSTITUTE IN WAKE COUNTY OFFERS A VARIETY OF SUPPORT SERVICES AVAILABLE AT NO COST TO CANCER CENTER PATIENTS AS WELL AS COMMUNITY MEMBERS.- CANCER SUPPORT GROUP: MONTHLY SUPPORT GROUP FOR PATIENTS LIVING WITH CANCER. THE GROUP IS OPEN TO PATIENTS WITH ANY TYPE OF CANCER, AND PATIENTS MAY BRING A FAMILY MEMBER IF THEY CHOOSE.- BREAST CANCER SUPPORT GROUP: PROVIDES A PLACE WHERE BREAST CANCER SURVIVORS CAN MEET OTHERS GOING THROUGH SIMILAR EXPERIENCES AND CAN ENJOY SUPPORT AND CAMARADERIE.- LOOK GOOD, FEEL BETTER: THIS SUPPORT GROUP WORKS WITH FEMALE CANCER PATIENTS TO IMPROVE THEIR APPEARANCE AND SELF-CONFIDENCE. MANY PATIENTS COMMENT ON THE MARKED IMPROVEMENT IN THEIR EMOTIONAL AND PHYSICAL HEALTH ONCE THEY FELT LIKE THEY LOOKED "NORMAL."- GYNECOLOGIC ONCOLOGY SUPPORT GROUP: THIS GROUP OFFERS A COMPASSIONATE AND UNDERSTANDING PLACE FOR PATIENTS WITH GYNECOLOGIC CANCER TO DISCUSS THEIR EXPERIENCES AND FIND SUPPORT THROUGH OTHERS.- SELF-HYPNOSIS TRAINING FOR CANCER PATIENTS: PATIENTS LEARN HOW TO USE SELF-HYPNOSIS TO HELP IN MANAGING ILLNESS AND SYMPTOMS, REDUCING PAIN AND STRESS, CONTROLLING THE SIDE EFFECTS OF MEDICATIONS AND RADIATION THERAPIES, AND GENERALLY ENHANCING QUALITY OF LIFE. THIS FOUR-WEEK COURSE IS AVAILABLE FREE OF CHARGE FOR CANCER PATIENTS.COMMUNITY OUTREACH:LUNG CANCER INITIATIVE OF NORTH CAROLINA: DUKE RALEIGH HOSPITAL HAS BEEN THE PRESENTING SPONSOR OF THE LUNG CANCER INITIATIVE OF NORTH CAROLINA LUNGE FORWARD 5K RUN/WALK SINCE ITS INCEPTION IN 2007. PROCEEDS FROM THIS ANNUAL EVENT SUPPORT LUNG CANCER RESEARCH AND ADVOCACY IN NORTH CAROLINA. IN FY15, DUKE RALEIGH HOSPITAL HAD A RUN/WALK TEAM TO SUPPORT THE EVENT IN ADDITION TO PROVIDING COLLABORATION AND SUPPORT IN EXECUTION OF THE EVENT.OVARIAN CANCER AWARENESS WALK: THIS ANNUAL EVENT BENEFITS THE DUKE GYNECOLOGIC ONCOLOGY PROGRAM AND PROVIDES MUCH NEEDED FUNDING FOR RESEARCH AND EDUCATION FOR OVARIAN CANCER. DUKE RALEIGH HOSPITAL CANCER CENTER STAFFS A PATIENT RESOURCE AND EDUCATION BOOTH AT THIS EVENT EACH YEAR.CANCER SURVIVOR'S DAY CELEBRATION: IN JUNE 2015, DUKE RALEIGH HOSPITAL CANCER CENTER STAFF CELEBRATED CANCER SURVIVORSHIP WITH ENTERTAINMENT AND PROGRAMMING FOR SURVIVORS AS WELL AS A BUTTERFLY RELEASE. THE CELEBRATION WAS ALSO EXTENDED TO THE MIDTOWN FARMERS' MARKET ON SATURDAY, JUNE 6.ACCESS TO CARE:URBAN MINISTRIES OPEN DOOR CLINIC: DUKE RALEIGH HOSPITAL HAS PARTNERED WITH URBAN MINISTRIES SINCE THE INCEPTION OF THE OPEN DOOR CLINIC IN 1985. THE IN-KIND VALUE OF LAB SERVICES PROVIDED TO URBAN MINISTRIES BY DUKE RALEIGH HOSPITAL TOTALED MORE THAN $1.6 MILLION IN FY15. MANY DUKE RALEIGH STAFF INCLUDING NURSING AND PHYSICIANS HAVE ALSO CONTRIBUTED THEIR TIME TO THE OPEN DOOR CLINIC.ALLIANCE MEDICAL MINISTRIES: DUKE RALEIGH HOSPITAL HAS IMPACTED MORE THAN 1,000 PATIENTS EACH MONTH THROUGH PARTNERSHIP WITH ALLIANCE MEDICAL MINISTRIES. AMM PROVIDES WORKING, UNINSURED PATIENTS, AGES 18-64 AND ADULT FAMILY MEMBERS WITH PRIMARY CARE AND ACCESS TO AFFORDABLE AND HIGH QUALITY HEALTH CARE.THE DUKE RALEIGH LIFESTYLE AND DISEASE MANAGEMENT CENTER PROVIDES A DIABETES EDUCATION PROGRAM OF TWO, THREE-HOUR CLASSES IN BOTH ENGLISH AND SPANISH FOR ALLIANCE PATIENTS. THROUGH THE CLASS, PARTICIPANTS LEARN ABOUT HOW TO MANAGE THEIR DIABETES AS WELL AS HEALTHY COOKING AND DINING OPTIONS. DUKE RALEIGH HOSPITAL STAFF EVALUATE THREE, SIX AND 12-MONTH FOLLOW-UP DATA ON PARTICIPANTS TO MEASURE THE EFFECTIVENESS OF THE PROGRAM AND THE PARTICIPANT'S DIABETES METRICS INCLUDING GLUCOSE LEVEL, A1C, BMI AND WEIGHT.PROJECT ACCESS: DUKE RALEIGH HOSPITAL PROVIDED $1.3 MILLION OF IN-KIND SUPPORT IN FY15. MANY OF DUKE RALEIGH HOSPITAL'S MEDICAL STAFF SUPPORT THIS PROGRAM PROVIDING FREE CARE TO POOR, UNINSURED MEN, WOMEN AND CHILDREN IN WAKE COUNTY. THE PROGRAM RUNS THROUGH THE COLLABORATION OF COMMUNITY HEALTH CLINICS, HOSPITALS AND PHYSICIANS. PATIENTS ARE REFERRED INTO THE PROGRAM TO BE ABLE TO ACCESS THE FREE MEDICAL SERVICES.WAKE COUNTY MEDICAL SOCIETY COMMUNITY HEALTH FOUNDATION: DUKE RALEIGH HOSPITAL IS AN ACTIVE PARTICIPANT IN THE WAKE COUNTY MEDICAL SOCIETY COMMUNITY HEALTH FOUNDATION WHICH SEEKS COLLABORATIVE WAYS TO ADDRESS THE NEEDS OF UNINSURED AND MEDICAID PATIENTS AND INCLUDES CAPITAL CARE COLLABORATIVE, COMMUNITY CARE OF NC, AND PROJECT ACCESS. DUKE RALEIGH HOSPITAL'S DIRECTOR OF CASE MANAGEMENT PROVIDES LEADERSHIP AS A MEMBER OF ADVISORY BOARD FOR THE COMMUNITY HEALTH FOUNDATION.NORTH CAROLINA-VIRGINIA HOSPITAL ENGAGEMENT NETWORK (HEN): DUKE RALEIGH HOSPITAL IS THE ONLY HOSPITAL IN WAKE COUNTY PARTICIPATING IN THIS INITIATIVE THROUGH THE NORTH CAROLINA HOSPITAL ASSOCIATION (NCHA) AND THE CAROLINAS CENTER FOR MEDICAL EXCELLENCE (CCME) AS A PART OF THE CENTERS FOR MEDICARE & MEDICAID SERVICES (CMS) $1 BILLION PARTNERSHIP FOR PATIENTS INITIATIVE. THE GOAL FOR THE PARTNERSHIP IS TO MAKE MEANINGFUL STRIDES IN ADVANCING THE QUALITY, SAFETY AND AFFORDABILITY OF HEALTH CARE. TEN AREAS OF FOCUS THROUGH THE HEN ARE ADVERSE DRUG EVENTS, CATHETER-ASSOCIATED URINARY TRACT INFECTIONS, CENTRAL LINE-ASSOCIATED BLOOD STREAM INFECTIONS, INJURIES FROM FALLS AND IMMOBILITY, OBSTETRICAL ADVERSE EVENTS, PRESSURE ULCERS, SURGICAL SITE INFECTIONS, VENOUS THROMBOEMBOLISM, VENTILATOR-ASSOCIATED PNEUMONIA AND PREVENTABLE READMISSIONS.DUKE RALEIGH HOSPITAL'S AREA OF FOCUS AS A PART OF THE HEN IS TO REDUCE READMISSIONS BY 20 PERCENT. DUKE RALEIGH HOSPITAL STAFF WORKED CLOSELY WITH PRIMARY CARE PHYSICIANS TO STREAMLINE COMMUNICATIONS AND IMPLEMENT A NEW PROTOCOL FOR PRIMARY CARE PHYSICIANS TO BE NOTIFIED WITHIN 48 HOURS OF A PATIENT'S ADMISSION. UPON DISCHARGE, A FOLLOW-UP APPOINTMENT IS SCHEDULED WITH THE PATIENT'S PRIMARY CARE PHYSICIAN WITHIN SEVEN DAYS.HOSPITAL LONG-TERM CARE COLLABORATION: DUKE RALEIGH HOSPITAL IS A PART OF THIS COLLABORATION AMONG ALL THREE WAKE COUNTY HOSPITALS AND A PORTION OF SKILLED NURSING FACILITIES, ASSISTED LIVING FACILITIES AND HOME HEALTH ORGANIZATIONS. THE GOAL OF THE COLLABORATION IS TO BETTER UNDERSTAND THE REGULATORY REQUIREMENTS AND OTHER IMPORTANT PROCESSES THAT WOULD AFFECT A PATIENT BEING TRANSFERRED FROM THE HOSPITAL INTO THE CARE OF ANOTHER POST-ACUTE CARE PARTNER. THE GROUP HAS ALREADY DEVELOPED LITERATURE PROVIDED TO PATIENTS UPON DISCHARGE THAT OUTLINES REALISTIC EXPECTATIONS IN A SKILLED NURSING FACILITY (SNF), HOME HOSPICE, HOME HEALTH OR AN ASSISTED LIVING FACILITY.DUKE RALEIGH HOSPITAL'S CASE MANAGEMENT TEAM VISITS NURSING HOMES AND OTHER POST-ACUTE CARE PARTNERS TO BETTER COLLABORATE AND TO DETERMINE WHAT OPPORTUNITIES EXIST IN THE PATIENT TRANSITION PROCESS. THE DUKE RALEIGH HOSPITAL TEAM ALSO REVIEWS ALL READMISSIONS WITH THE POST-ACUTE PARTNER TO DETERMINE WHAT OPPORTUNITIES MAY EXIST. AS A RESULT, THE DUKE RALEIGH HOSPITAL TEAM INSTITUTED A PROTOCOL TO MAKE A FOLLOW-UP CALL TO THE PATIENT'S POST-ACUTE CARE PROVIDER ONE DAY AFTER TRANSFER. THIS NEW PROCESS HAS PREVENTED READMISSIONS IN SEVERAL INSTANCES.WAKE CRISIS COOPERATIVE: THE COOPERATIVE INCLUDES ALL WAKE COUNTY HOSPITALS, REPRESENTATIVES FROM MENTAL HEALTH, LAW ENFORCEMENT AND OTHER STAKEHOLDERS IN CRISIS RESPONSE IN WAKE COUNTY.THE COOPERATIVE HAS:- STANDARDIZED THE MENTAL HEALTH ASSESSMENT TOOL FOR HEALTHCARE PROVIDERS IN WAKE COUNTY.- DEVELOPED MENTAL HEALTH AND SUBSTANCE ABUSE TRANSFER GUIDELINES FROM ACUTE TO INPATIENT TO BE USED ACROSS NORTH CAROLINA.- DEFINED HIGH ACUITY PATIENTS TO ASSIST IN PRIORITIZATION OF PATIENTS FROM THE EMERGENCY DEPARTMENT.- DEVELOPED A UNIFORM PROCESS FOR INVOLUNTARY COMMITMENT.- DESIGNED A ROTATION SCHEDULE FOR ACCEPTING PATIENTS WHEN THE MENTAL HEALTH CENTER GOES ON DIVERSION.DRAH DID NOT ADDRESS DENTAL CARE AS DENTAL CARE IS NOT OFFERED AS PART OF DRAH'S CONTINUUM OF SERVICES.DUKE RALEIGH HOSPITAL:PART V, SECTION B, LINE 16I: DUHS PROVIDES A BROCHURE TO ALL ADMISSIONS THAT INCLUDES A BRIEF SUMMARY OF DUHS FINANCIAL ASSISTANCE POLICIES. DUHS ALSO COMMENTS ON THE BACK OF ITS BILLING INVOICES THAT PATIENTS SHOULD CONTACT PATIENT ACCOUNT REPRESENTATIVES TO HELP THEM IF THEY CANNOT PAY THEIR BILL IN FULL. THIS COMMENT REFERENCES GOVERNMENT-SPONSORED PROGRAMS, MONTHLY PAYMENT PROGRAMS, AND OTHER FINANCIAL ASSISTANCE PROGRAMS AVAILABLE FOR PATIENTS WHO MEET CERTAIN FINANCIAL CRITERIA. DUHS ALSO PUBLICIZED ITS FINANCIAL ASSISTANCE POLICY VERBALLY THROUGH ITS FINANCIAL CARE COUNSELORS.DUKE RALEIGH HOSPITAL:PART V, SECTION B, LINE 22D: DUHS USED THE LOOK BACK METHOD AND SUMMED ALL CLAIMS SUBMITTED TO MEDICARE AND ALL PRIVATE HEALTH INSURERS DURING THE PRIOR 12 MONTH PERIOD DIVIDED BY THE SUM OF THE ASSOCIATED GROSS CHARGES RELATED TO THOSE CLAIMS.DUKE RALEIGH HOSPITAL:PART V, SECTION B, LINE 24: CERTAIN ELECTIVE COSMETIC/AESTHETIC SERVICES, AND OTHER SERVICES NOT TYPICALLY COVERED BY INSURANCE, WILL BE BILLED AT AN AMOUNT EQUAL TO GROSS CHARGES. SCHEDULE H, PART V, SECTION B. GROUP A - FACILITY 3 - DUKE REGIONAL HOSPITAL:PART V, SECTION B, LINE 5: DUKE REGIONAL HOSPITAL ("DRH") COLLABORATED WITH THE PARTNERSHIP FOR A HEALTHY DURHAM AND THE DURHAM COUNTY HEALTH DEPARTMENT ON THE DURHAM COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). THE ASSESSMENT PROCESS INCLUDED 207 CITIZEN SURVEYS FROM RANDOMLY SELECTED HOUSEHOLDS AND 10 COMMUNITY LISTENING SESSIONS WITH 283 COMMUNITY MEMBERS. REPRESENTATIVES FROM DUKE UNIVERSITY HOSPITAL (DUH) AND DRH PARTICIPATED AS MEMBERS ON THE COMMUNITY HEALTH ASSESSMENT TEAM ALONG WITH REPRESENTATIVES FROM OTHER UNIVERSITIES, LOCAL GOVERNMENT, SCHOOLS, NON-PROFIT ORGANIZATIONS, AND BUSINESSES. THE COMMUNITY HEALTH ASSESSMENT TEAM WORKED TO DIRECT THE ACTIVITIES OF THE ASSESSMENT AND PROVIDE WRITTEN CONTENT AND EXPERTISE ON ISSUES OF INTEREST.GROUP A - FACILITY 3 - DUKE REGIONAL HOSPITAL:PART V, SECTION B, LINE 6A: DUKE UNIVERSITY HOSPITALGROUP A - FACILITY 3 - DUKE REGIONAL HOSPITAL:PART V, SECTION B, LINE 6B: THE PARTNERSHIP FOR A HEALTHY DURHAM AND THE DURHAM COUNTY HEALTH DEPARTMENTGROUP A - FACILITY 3 - DUKE REGIONAL HOSPITAL:PART V, SECTION B, LINE 7D: THE CHNA IS AVAILABLE ON THE WEBSITE BY NAVIGATING TO WWW.DUKEMEDICINE.ORG, CLICK ON "PATIENTS & VISITORS", THEN "FINANCIAL ASSISTANCE", "COMMUNITY HEALTH NEEDS ASSESSMENT; AND THEN CLICK THE LINK FOR "DETAILS OF OUR COMMUNITY INVOLVEMENT."GROUP A - FACILITY 3 - DUKE REGIONAL HOSPITAL:PART V, SECTION B, LINE 10ATHE IMPLEMENTATION STRATEGY AND PROGRESS REPORTS ARE AVAILABLE ON THE WEBSITE BY NAVIGATING TO HTTP://WWW.DUKEMEDICINE.ORG, CLICK ON "PATIENTS & VISITORS", THEN "FINANCIAL ASSISTANCE", THEN "COMMUNITYHEALTH NEEDS ASSESSMENT; AND THEN CLICK THE LINK FOR "DETAILS OF OUR COMMUNITY INVOLVEMENT." CHOOSE ONE OF THE LINKS FOR THE DUKE REGIONAL HOSPITAL PROGRESS REPORT AND IMPLEMENTATION PLAN.GROUP A - FACILITY 3 - DUKE REGIONAL HOSPITAL:PART V, SECTION B, LINE 11: DRH WAS A PARTNER ON THE 2011 DURHAM COMMUNITY HEALTH ASSESSMENT, LED BY PARTNERSHIP FOR A HEALTHY DURHAM. THE ASSESSMENT PROCESS COMPILED VALID AND RELIABLE INFORMATION ABOUT THE HEALTH OF DURHAM. IT INCLUDED 207 CITIZEN SURVEYS FROM RANDOMLY SELECTED HOUSEHOLDS AND 10 COMMUNITY LISTENING SESSIONS WITH 283 COMMUNITY MEMBERS. THE COMMUNITY HEALTH ASSESSMENT TEAM COMPRISED OF MORE THAN 95 MEMBERS REPRESENTING DUKE REGIONAL HOSPITAL AS WELL AS OTHER HOSPITALS, UNIVERSITIES, LOCAL GOVERNMENT, SCHOOLS, NON-PROFIT ORGANIZATIONS AND BUSINESSES WORKED TO DIRECT THE ACTIVITIES OF THE ASSESSMENT AND PROVIDE WRITTEN CONTENT AND EXPERTISE ON ISSUES OF INTEREST.THE ASSESSMENT IDENTIFIED SIX HEALTH PRIORITIES FOR 2012 - 2015:1. OBESITY AND CHRONIC ILLNESS2. POVERTY3. EDUCATION4. ACCESS TO MEDICAL AND DENTAL CARE5. MENTAL HEALTH AND SUBSTANCE ABUSE6. HIV AND SEXUALLY TRANSMITTED INFECTIONSACTIONS TAKEN TO ADDRESS THE SIGNIFICANT HEALTH NEEDS IDENTIFIED IN THE CHNA ARE AS FOLLOWS:1. OBESITY AND CHRONIC ILLNESS:LOOK GOOD FEEL BETTER: THE AMERICAN CANCER SOCIETY'S LOOK GOOD FEEL BETTER PROGRAM PROVIDES SUPPORT FOR FEMALE CANCER TREATMENT PATIENTS WHO HAVE EXPERIENCED HAIR LOSS OR OTHER PHYSICAL APPEARANCE CHANGES DUE TO CHEMOTHERAPY OR RADIATION TREATMENTS.STROKE AWARENESS: DUKE REGIONAL HOSPITAL OFFERS A MONTHLY STROKE SUPPORT GROUP TO EDUCATE STROKE SURVIVORS, CARE GIVERS AND PEOPLE IN THE COMMUNITY ABOUT STROKE PREVENTION AND STROKE DISABILITIES. APPROXIMATELY, 25 PEOPLE ATTEND THE GROUP EACH MONTH.2. POVERTY:FILL THAT BUS: EMPLOYEES DONATED BINS OF SCHOOL SUPPLIES TO FILL THAT BUS IN AUGUST 2015 TO SUPPORT DURHAM PUBLIC SCHOOLS. TEACHERS FROM THE HIGHEST POVERTY SCHOOLS WERE INVITED TO PICK OUT SUPPLIES NEEDED IN THEIR CLASSROOMS. SALVATION ARMY ANGEL TREE: EACH DECEMBER, EMPLOYEES ADOPT APPROXIMATELY 100 ANGELS FROM DUKE REGIONAL'S SALVATION ARMY ANGEL TREE. CHILDREN IN DURHAM HAVE RECEIVED BIKES, CLOTHING, DOLLS AND TOYS THANKS TO THE GENEROUS DONATIONS. EXTRA GIFTS ARE ALSO DONATED TO THE SALVATION ARMY FOR OTHER NEEDY FAMILIES IN THE AREA.3. EDUCATION:BYSTANDER CPR: TO CELEBRATE HEART MONTH IN FEBRUARY, DUKE REGIONAL OFFERS A FREE SEMINAR CALLED AND THE BEAT GOES ON...." PARTICIPANTS LEARN BYSTANDER CPR FROM DUKE REGIONAL EDUCATION SERVICES AND THE WARNING SIGNS AND TREATMENTS FOR ATRIAL FIBRILLATION. EDUCATION SERVICES ALSO PROVIDES A HEART SAVER CPR CLASS FOR A LOCAL YOUTH ORGANIZATION.HEALTH PROFESSIONS EDUCATION: DUKE REGIONAL HOSPITAL IS COMMITTED TO HELPING TRAIN THE HEALTHCARE WORKERS OF THE FUTURE. IN FY 2015, DRH CONTRIBUTED OVER $3 MILLION TOWARD THE TRAINING AND TEACHING OF TOMORROW'S HEALTHCARE PROFESSIONALS. PROJECT SEARCH: DUKE REGIONAL HOSPITAL IS THE HOST BUSINESS FOR PROJECT SEARCH, A PARTNERSHIP WITH DURHAM PUBLIC SCHOOLS, OE ENTERPRISES, VOCATIONAL REHAB AND DURHAM CENTER ACCESS THAT PROVIDES CAREER DEVELOPMENT EXPERIENCES TO SENIOR HIGH SCHOOL STUDENTS WITH DEVELOPMENTAL DISABILITIES. THE STUDENTS, ACCOMPANIED BY A TEACHER, TEACHER'S ASSISTANT AND JOB COACHES, COMPLETE INTERNSHIPS IN SEVERAL HOSPITAL DEPARTMENTS DURING THE ACADEMIC YEAR. SIX STUDENTS GRADUATED IN MAY 2015, AND FIVE WERE EMPLOYED IN THE COMMUNITY BY THE END OF THE SUMMER.CITY OF MEDICINE ACADEMY: DRH HAS BEEN A PARTNER WITH CITY OF MEDICINE ACADEMY (CMA) AND DURHAM PUBLIC SCHOOLS SINCE THE PROGRAM'S INCEPTION AT SOUTHERN HIGH SCHOOL IN THE 1990S. IN AUGUST 2011, CMA MOVED TO A NEW FACILITY LOCATED ON THE DUKE REGIONAL CAMPUS. AS PART OF OUR PARTNERSHIP, DUKE REGIONAL HOSTS STUDENTS FOR CLINICAL ROTATIONS AND INTERNSHIPS, PROVIDES CPR TRAINING AND HOSTS THE ANNUAL SENIOR AWARDS NIGHT.4. ACCESS TO MEDICAL AND DENTAL CARE:LINCOLN COMMUNITY HEALTH CENTER: LINCOLN COMMUNITY HEALTH CENTER (LCHC) IS A FEDERALLY QUALIFIED COMMUNITY HEALTH CENTER THAT PROVIDES PRIMARY CARE SERVICES FOR ABOUT 40,000 PATIENTS EACH YEAR. APPROXIMATELY 80 PERCENT OF LCHC PATIENTS ARE UNINSURED AND LIVING AT OR BELOW THE POVERTY LEVEL. IN ADDITION TO GENEROUS FINANCIAL SUPPORT, DUKE REGIONAL PROVIDES ENGINEERING, ENVIRONMENTAL, LABORATORY, PHARMACY AND RADIOLOGY SERVICES. THE TOTAL DUKE REGIONAL HOSPITAL CONTRIBUTION TO LCHC IN FISCAL YEAR (FY) 2015, INCLUDING MONETARY AND IN-KIND SERVICES, WAS MORE THAN $7.5 MILLION.DURHAM COUNTY EMERGENCY MEDICAL SERVICES: DURHAM COUNTY EMERGENCY MEDICAL SERVICES (EMS) SERVES AS THE PRIMARY PROVIDER OF EMERGENCY AMBULANCE SERVICES AND ALTERNATIVE MEDICAL TRANSPORTATION IN DURHAM COUNTY. IN FY 2015, DUKE REGIONAL HOSPITAL PAID THE COUNTY MORE THAN $2.3 MILLION TO SUPPORT DURHAM EMS.PROJECT ACCESS DURHAM COUNTY: PROJECT ACCESS OF DURHAM COUNTY (PADC) COORDINATES SPECIALTY CARE AT NO CHARGE TO UNINSURED AND UNDERINSURED DURHAM RESIDENTS LIVING AT OR BELOW 200 PERCENT OF THE FEDERAL POVERTY LEVEL. THESE RESIDENTS HAVE ACCESS TO PRIMARY HEALTH CARE THROUGH LINCOLN COMMUNITY HEALTH CENTER.CHARITY CARE: EACH YEAR DUKE REGIONAL HOSPITAL PROVIDES NO-COST OR DISCOUNTED URGENT OR EMERGENT HEALTH CARE SERVICES TO PATIENTS WHO WERE UNABLE TO PAY. IN FY 2015 DUKE REGIONAL PROVIDED $16.7 MILLION IN CHARITY CARE.5. MENTAL HEALTH AND SUBSTANCE ABUSE:DURHAM CENTER ACCESS (OAKLEIGH)EACH YEAR DUKE REGIONAL HOSPITAL PROVIDES $100,000 TO SUPPORT DURHAM CENTER ACCESS, AN INPATIENT TREATMENT FACILITY FOR MENTAL HEALTH, DEVELOPMENTAL DISABILITY AND SUBSTANCE ABUSE SERVICES.6. HIV AND SEXUALLY TRANSMITTED INFECTIONS: DRH DOES NOT HAVE A SPECIFIC GOAL TO ADDRESS THE RATE OF HIV AND SEXUALLY TRANSMITTED INFECTIONS BECAUSE CONSIDERABLE WORK IS ALREADY BEING DONE THROUGH ORGANIZATIONS WITHIN THE COMMUNITY. THROUGH THE PARTNERSHIP FOR A HEALTHY DURHAM, THE HIV/STI ADVISORY COUNCIL BRINGS TOGETHER COMMUNITY MEMBERS AND AGENCIES TO FOCUS ON STRATEGIES TO PREVENT THE SPREAD OF SYPHILIS AND HIV/AIDS. IN ADDITION, LINCOLN COMMUNITY HEALTH CENTER, WHICH DUKE REGIONAL HOSPITAL SUPPORTS, OPERATES AN EARLY INTERVENTION CLINIC FOR PATIENTS WITH HIV/AIDS AT THE DURHAM COUNTY HEALTH DEPARTMENT.GROUP A - FACILITY 3 - DUKE REGIONAL HOSPITALPART V, SECTION B, LINE 16I: DUHS PROVIDES A BROCHURE TO ALL ADMISSIONS THAT INCLUDES A BRIEF SUMMARY OF DUHS FINANCIAL ASSISTANCE POLICIES. DUHS ALSO COMMENTS ON THE BACK OF ITS BILLING INVOICES THAT PATIENTS SHOULD CONTACT PATIENT ACCOUNT REPRESENTATIVES TO HELP THEM IF THEY CANNOT PAY THEIR BILL IN FULL. THIS COMMENT REFERENCES GOVERNMENT-SPONSORED PROGRAMS, MONTHLY PAYMENT PROGRAMS, AND OTHER FINANCIAL ASSISTANCE PROGRAMS AVAILABLE FOR PATIENTS WHO MEET CERTAIN FINANCIAL CRITERIA. DUHS ALSO PUBLICIZED ITS FINANCIAL ASSISTANCE POLICY VERBALLY THROUGH ITS FINANCIAL CARE COUNSELORS.GROUP A - FACILITY 3 - DUKE REGIONAL HOSPITAL:PART V, SECTION B, LINE 22D: DUHS USED THE LOOK BACK METHOD AND SUMMED ALL CLAIMS SUBMITTED TO MEDICARE AND ALL PRIVATE HEALTH INSURERS DURING THE PRIOR 12 MONTH PERIOD DIVIDED BY THE SUM OF THE ASSOCIATED GROSS CHARGES RELATED TO THOSE CLAIMS. GROUP A - FACILITY 3 - DUKE REGIONAL HOSPITAL: PART V, SECTION B, LINE 24: CERTAIN ELECTIVE COSMETIC/AESTHETIC SERVICES, AND OTHER SERVICES NOT TYPICALLY COVERED BY INSURANCE, WILL BE BILLED AT AN AMOUNT EQUAL TO GROSS CHARGES. PART V, SECTION B, LINE 16 FINANCIAL ASSISTANCE POLICY WEBSITE AVAILABILITY DUKE UNIVERSITY/DUKE REGIONAL HOSPITALS PART V, SECTION B, LINE 16A WEBSITE: HTTP://WWW.DUKEMEDICINE.ORG DUKE UNIVERSITY/DUKE REGIONAL HOSPITALS PART V, SECTION B, LINE 16B WEBSITE: HTTP://WWW.DUKEMEDICINE.ORG DUKE UNIVERSITY/DUKE REGIONAL HOSPITALS PART V, SECTION B, LINE 16C WEBSITE: HTTP://WWW.DUKEMEDICINE.ORG DUKE RALEIGH HOSPITAL PART V, SECTION B, LINE 16A WEBSITE: HTTP://WWW.DUKEMEDICINE.ORG DUKE RALEIGH HOSPITAL PART V, SECTION B, LINE 16B WEBSITE: HTTP://WWW.DUKEMEDICINE.ORG DUKE RALEIGH HOSPITAL PART V, SECTION B, LINE 16C WEBSITE: HTTP://WWW.DUKEMEDICINE.ORG 2 HOSPICE OF MEADOWLANDS 1001 CORPORATE DRIVE HILLSBOROUGH NC 27278 HOSPICE HOCK FAMILY PAVILION 4023 NORTH ROXBORO ROAD DURHAM NC 27704 HOSPICE PART I, LINE 3C: NOT APPLICABLEPART I, LINE 6A:NOT APPLICABLEPART I, LINE 7G:NOT APPLICABLEPART I, LINE 7, COLUMN F:TOTAL GROSS COMMUNITY BENEFIT EXPENSE AS A PERCENT OF TOTAL EXPENSES IS 8.63%.PART I, LINE 7:CHARITY CARE AT COST IS DETERMINED USING THE COST-TO-CHARGE CALCULATION FROM WORKSHEET 2, IN ORDER TO CALCULATE THE AMOUNTS REPORTED ON THE TABLE. UNREIMBURSED MEDICAID IS DETERMINED USING A COST ACCOUNTING SYSTEM THAT ADDRESSES ALL PATIENT SEGMENTS.PART II, COMMUNITY BUILDING ACTIVITIES:THESE ACTIVITIES ARE INCLUDED IN DUKE UNIVERSITY HEALTH SYSTEM, INC.'S (DUHS) OPERATING EXPENSES AND ARE NOT TRACKED SEPARATELY FOR COMMUNITY BENEFIT REPORTING PURPOSES.PART III, LINE 2:BAD DEBT AT COST IS DETERMINED USING THE COST-TO-CHARGE RATIO CALCULATION FROM WORKSHEET 2.PART III, LINE 3:A PORTION OF BAD DEBT EXPENSE SHOULD BE INCLUDED AS A COMMUNITY BENEFIT, BUT THIS PORTION THAT IS ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER OUR FINANCIAL ASSISTANCE POLICY IS INDETERMINABLE BECAUSE THEY FAIL TO APPLY FOR OR PROVIDE INFORMATION NEEDED TO DETERMINE THEIR ELIGIBILITY UNDER THE DUHS FAP. DUHS, INC. FOLLOWS ITS MISSION TO THE COMMUNITY AND PROVIDES EMERGENT SERVICES TO PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. BAD DEBT IS FURTHER COMPLICATED BY DOCUMENTATION REQUIRED BY THE CENTERS FOR MEDICARE AND MEDICAID SERVICES (CMS) FOR REPORTING CHARITY CARE. THEREFORE, PATIENTS WHO MAY QUALIFY FOR CHARITY CARE ARE REPORTED AS BAD DEBT EXPENSE INSTEAD DUE TO PATIENTS' INABILITY OR UNWILLINGNESS TO PROVIDE THE NECESSARY DOCUMENTATION REQUIRED TO DETERMINE CHARITY CARE CLASSIFICATION.PART III, LINE 4:PAGES 16-18 IN THE FY2015 AUDITED FINANCIAL STATEMENT FOOTNOTES DESCRIBE BAD DEBT EXPENSE.PART III, LINE 7:TOTAL UNREIMBURSED COSTS ATTRIBUTABLE TO PROVIDING SERVICES UNDER MEDICARE AS REPORTED IN THE JUNE 30, 2015 DUHS CONSOLIDATED FINANCIAL STATEMENTS ARE $179,456,000 AS COMPARED TO $97,773,811 AS REPORTED IN SECTION B, LINE 7 OF SCHEDULE H. THE DUHS TOTAL MEDICARE SHORTFALL OF $179,456,000 IS DERIVED FROM THE COST ACCOUNTING SYSTEM WHICH INCLUDES ALL PAYMENTS AND COSTS ASSOCIATED WITH MEDICARE PATIENTS, WHEREAS THE AMOUNT REPORTED IN SECTION B OF SCHEDULE H IS DERIVED BASED ON IRS INSTRUCTIONS. IRS INSTRUCTIONS SPECIFY THAT ONLY A PORTION OF COSTS ASSOCIATED WITH MEDICARE BENEFICIARIES BE REPORTED ON SCHEDULE H. SIGNIFICANT MEDICARE COSTS EXCLUDED FROM SCHEDULE H DATA INCLUDE THOSE ASSOCIATED WITH MEDICARE PATIENTS COVERED UNDER MANAGED CARE PLANS AND COSTS REIMBURSED THROUGH MEANS NOT REPORTED ON THE COST REPORT.PART III, LINE 8:MEDICARE RATES AND THE NUMBER OF MEDICARE PATIENTS DUHS TREATS ARE NOT NEGOTIATED. MEDICARE DOES NOT FULLY COMPENSATE DUHS FOR THE COST OF PROVIDING CARE TO MEDICARE BENEFICIARIES. DUHS CONTINUES TO SERVE THE MEDICARE POPULATION AS MEDICARE REIMBURSEMENT RATES DECLINE RELATIVE TO THE COST OF CARE. THEREFORE, ANY LOSS RELATED TO PROVIDING CARE FOR MEDICARE PATIENTS SHOULD BE CLASSIFIED AS A COMMUNITY BENEFIT. DUHS FOLLOWED THE MEDICARE COST REPORT RULES AND GUIDELINES IN DETERMINING THE COSTS REPORTED ON LINE 6. THESE RULES USE A VARIETY OF DIFFERENT METHODOLOGIES BASED ON THE TYPE OF SERVICE.PART III, LINE 9B:COLLECTION EFFORTS ARE IMMEDIATELY STOPPED FOR PATIENTS WHO SUBMIT A FINANCIAL ASSISTANCE APPLICATION. PATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE ARE NOT PURSUED USING ANY DEBT COLLECTION PRACTICES. NEEDS ASSESSMENT: PART VI, LINE 2:DUHS USES SEVERAL MECHANISMS TO ASSESS AND ADDRESS THE HEALTH CARE NEEDS OF THE COMMUNITIES IT SERVES. IN DURHAM COUNTY, DUHS AND THE DUKE UNIVERSITY SCHOOL OF MEDICINE FACULTY ARE ACTIVELY INVOLVED IN THE PARTNERSHIP FOR A HEALTHY DURHAM. THE PARTNERSHIP IS A COALITION OF LOCAL ORGANIZATIONS AND COMMUNITY MEMBERS WITH THE GOAL OF COLLABORATIVELY IMPROVING THE PHYSICAL, MENTAL, SOCIAL, HEALTH, AND WELL-BEING OF DURHAM COUNTY'S RESIDENTS. THE NETWORK IS A CERTIFIED HEALTH CAROLINIAN'S WORKGROUP. THE PARTNERSHIP EVALUATES COMMUNITY HEALTH CARE INFORMATION, THEN IDENTIFIES AND PRIORITIZES COMMUNITY-IDENTIFIED HEALTH CARE NEEDS AMONG FOUR SUBCOMMITTEES THAT EACH FOCUS ON A DURHAM COUNTY HEALTH PRIORITY: MENTAL HEALTH AND SUBSTANCE ABUSE, ACCESS TO MEDICAL AND DENTAL CARE, OBESITY AND CHRONIC ILLNESS, EDUCATION, POVERTY, AND HIV/STI'S. POVERTY AND EDUCATION ARE NEW HEALTH PRIORITIES FOR THE COALITION. NEW STANDING COMMITTEES HAVE NOT BEEN ESTABLISHED YET FOR THESE PRIORITIES. THE COALITION IS ADDRESSING EDUCATION AND POVERTY THROUGH THE FOUR HEALTH COMMITTEES AND BY WORKING COLLABORATIVELY WITH EXISTING COMMUNITY WORK GROUPS. SINCE 2002, DUHS' OFFICE OF COMMUNITY RELATIONS HAS PLAYED A CENTRAL ROLE IN CONDUCTING A DURHAM HEALTH SUMMIT. THIS IS AN EVENT THAT ATTRACTS HUNDREDS OF COMMUNITY MEMBERS, HEALTH OFFICIALS, ELECTED OFFICIALS, AND DUHS EXECUTIVES AND PHYSICIANS TO RAISE AWARENESS OF KEY HEALTH ISSUES IN THE COMMUNITY AND SEEK COLLABORATIVE SOLUTIONS TO THESE ISSUES. THE SUMMIT HAS PRODUCED A NUMBER OF COMMUNITY-DRIVEN HEALTH CARE PROGRAMS AND INITIATIVES, INCLUDING SPECIALTY PROJECT ACCESS, IN WHICH PHYSICIANS WHO PRACTICE AT DUHS FACILITIES AND OTHER DURHAM COUNTY PHYSICIANS OFFER FREE SPECIALTY CARE SERVICES TO RESIDENTS WHO OTHERWISE COULD NOT AFFORD IT. DUHS ALSO PLAYS A CENTRAL ROLE IN REGIONAL AND STATE HEALTH CARE SUMMITS USING THE SUMMITS' INFORMATION AND DATA TO ADDRESS THE HEALTH CARE NEEDS OF THOSE BROADER COMMUNITIES. DUHS ALSO USES DATA FROM THE ANNUAL DURHAM STATE OF THE COUNTY HEALTH REPORT AND THE DURHAM COUNTY HEALTH ASSESSMENT (SEEWWW.HEALTHYDURHAM.ORG) CONDUCTED EVERY 3 YEARS TO ENSURE DUHS IS ADDRESSING IMPORTANT HEALTH CARE ISSUES IDENTIFIED BY THE COMMUNITY.DUKE RALEIGH HOSPITAL WORKS CLOSELY WITH THE WAKE COUNTY HUMAN SERVICES AGENCIES AND OTHER COMMUNITY STAKEHOLDERS ON THE WAKE COUNTY COMMUNITY HEALTH ASSESSMENTS.PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE:PART VI, LINE 3:DUHS EMPLOYS NUMEROUS MEANS TO EDUCATE PATIENTS ABOUT THEIR ELIGIBILITYFOR ASSISTANCE UNDER FEDERAL, STATE, OR LOCAL GOVERNMENT PROGRAMS ORUNDER THE DUHS CHARITY CARE POLICY. DETAILED INFORMATION IS POSTED ONDUKEMEDICINE.ORG (DUHS' WEBSITE) ALONG WITH HARDCOPY BROCHURES THAT AREAVAILABLE IN ENGLISH OR SPANISH AT ALL OF OUR PATIENT REGISTRATIONLOCATIONS. ALL INPATIENTS AND EMERGENCY DEPARTMENT PATIENTS ARE ALSOPROVIDED WITH A HARDCOPY, ONE-PAGE SUMMARY OF THE WAYS DUHS CAN ASSISTPATIENTS FINANCIALLY. FOR OUTPATIENTS, THIS SAME ONE-PAGE SUMMARY IS PROVIDED ON THEIR FIRST VISIT TO THE INSTITUTION. IN ADDITION, DUHS EMPLOYS FINANCIAL CARE COUNSELORS WHO MEET INDIVIDUALLY WITH PATIENTS WHO HAVE QUESTIONS REGARDING PAYMENT FOR THEIR CARE. DUHS ALSO EMPLOYS MEDICAID ASSISTANCE COUNSELORS WHO SPECIALIZE IN ASSISTING PATIENTS TO APPLY FOR MEDICAID, DISABILITY, AND OTHER FEDERAL, STATE, AND LOCAL PROGRAMS. DUHS ASSISTS BETWEEN 12,000-15,000 PATIENTS IN APPLYING AND BECOMING ELIGIBLE FOR THESE PROGRAMS ANNUALLY. FINALLY, PATIENTS MAY ALWAYS CONTACT DUHS' TOLL FREE CUSTOMER SERVICE NUMBER TO REQUEST INFORMATION ABOUT THEIR BILL OR OBTAIN A CHARITY CARE APPLICATION. COMMUNITY INFORMATION: PART VI, LINE 4:DUHS SERVES A BROAD, CULTURALLY, RACIALLY AND SOCIALLY DIVERSE GEOGRAPHIC AND DEMOGRAPHIC REGION. DUHS' HOME CITY OF DURHAM IS THE CORE, BUT DUHS' REACH EXTENDS INTO THE SURROUNDING RESEARCH TRIANGLE AREA OF NORTH CAROLINA AND THE STATE'S LARGER NORTHERN PIEDMONT REGION, AS WELL AS STATEWIDE, NATIONALLY AND GLOBALLY. DUHS PRIMARY SERVICE AREA IS A 7-COUNTY REGION IN NC THAT INCLUDES ALAMANCE, DURHAM, GRANVILLE, ORANGE, PERSON, VANCE AND WAKE COUNTIES. THIS 7-COUNTY REGION REPRESENTS APPROXIMATELY 18% OF NC'S POPULATION BASED ON FEDERAL FISCAL YEAR (FFY) 2014 DATA. APPROXIMATELY 68% OF INPATIENT DISCHARGES FROM DUHS FACILITIES IN FFY 2014 WERE PATIENTS FROM ITS PRIMARY SERVICE AREA. DUHS' SECONDARY SERVICE AREA COVERS 15 COUNTIES IN NORTH CAROLINA AND SOUTHERN VIRGINIA WITH A POPULATION OF APPROXIMATELY 2 MILLION. PROMOTION OF COMMUNITY HEALTH:PART VI, LINE 5:DUHS PROMOTES THE HEALTH OF THE COMMUNITIES IT SERVES THROUGH A NUMBER OF COMMUNITY BUILDING ACTIVITIES. CENTRAL TO MANY OF THE EFFORTS IS DUHS' OFFICE OF COMMUNITY RELATIONS, WHOSE ASSOCIATE VICE PRESIDENT REPORTS DIRECTLY TO DUHS' CEO AND SERVES AS A FULL-TIME LIAISON WITH THE DURHAM COMMUNITY. THE OFFICE SPONSORS AND FACILITATES COMMUNITY EVENTS SUCH AS THE ANNUAL DURHAM HEALTH SUMMIT AND SIMILAR REGIONAL AND STATE HEALTH SUMMITS THAT RAISE AWARENESS OF COMMUNITY HEALTH NEEDS, PROMOTE PREVENTION AND WELLNESS, AND CHART A COURSE FOR SOLVING HEALTH ISSUES AND DISPARITIES. IN ADDITION, THE OFFICE PROVIDES A POINT OF DIRECT CONTACT FOR COMMUNITY MEMBERS WHO HAVE QUESTIONS OR CONCERNS ABOUT COMMUNITY ISSUES OR ABOUT ACCESS TO HEALTH CARE SERVICES. THE OFFICE ALSO PROVIDES DIRECT FINANCIAL SUPPORT TO A VARIETY OF COMMUNITY GROUPS THROUGH THE CHARITABLE GRANTS AND GOODWILL GRANTS PROGRAM. THE ASSOCIATE VICE-PRESIDENT AND STAFF SERVE ON A NUMBER OF HEALTH CARE-RELATED COMMUNITY BOARDS AND HEALTH-RELATED COMMITTEES. STAFF FROM THE OFFICE OF COMMUNITY RELATIONS AND MEMBERS OF THE DUHS COMMUNITY HEALTH PLANNING GROUP CREATED A FORMAL PRINCIPLES OF COMMUNITY ENGAGEMENT POLICY THAT COMMITS DUHS AND ITS COMMUNITY PARTNERS TO DEVELOPING PROPOSED PROJECTS AND INITIATIVES ON TRUST, RESPECT, DIVERSITY, SAFETY AND COMMUNITY-IDENTIFIED NEEDS. THESE PRINCIPLES HAVE BEEN INCORPORATED INTO COMMUNITY-BASED HEALTH CARE PROJECTS SUCH AS THE DEVELOPMENT OF THE HOLTON WELLNESS CENTER AND DURHAM HEALTH INNOVATIONS, A MULTIDISCIPLINARY COMMUNITY BASED PARTNERSHIP BETWEEN DUHS AND THE DURHAM COMMUNITY THAT FOCUSES ON IMPROVING HEALTH OUTCOMES THROUGH NEW AND CREATIVE APPROACHES TO HEALTH CARE DELIVERY.IN ADDITION TO COMMUNITY BUILDING ACTIVITIES, DUHS PROMOTES THE HEALTH OF ITS COMMUNITIES IN A NUMBER OF IMPORTANT WAYS. ONE OF DUHS' THREE CONSTITUENT HOSPITALS, DUKE REGIONAL, HAS AN OPEN MEDICAL STAFF AND A HOSPITAL CORPORATION BOARD, WHICH IS A COUNTY APPOINTED BOARD RESPONSIBLE FOR HOSPITAL OVERSIGHT. IN ADDITION, APPROXIMATELY 50 LOCAL LEADERS IN THE DURHAM FAITH COMMUNITY ARE WORKING WITH DUKE MEDICINE (DUHS, DUKE UNIVERSITY SCHOOL OF MEDICINE, AND DUKE UNIVERSITY SCHOOL OF NURSING) TO LOOK AT HOW TO ADDRESS THE NEEDS OF THEIR CONGREGATIONS AND COMMUNITIES BY COMBINING THE TRADITIONS OF THE FAITH COMMUNITY WITH THE KNOWLEDGE OF MODERN MEDICINE. MEETINGS ARE HELD TO DETERMINE HOW DUKE MEDICINE CAN PARTNER WITH THE FAITH COMMUNITY TO SUPPORT HEALTH MINISTRY ACTIVITIES IN THEIR COMMUNITY AND PLACES OF WORSHIP.DUHS' CEO ALSO HAS A CHANCELLOR'S COMMUNITY HEALTH ADVISORY BOARD TO PROVIDE FEEDBACK ON A VARIETY OF ISSUES, INCLUDING USE OF DUHS RESOURCES, HEALTH SERVICE DELIVERY SYSTEMS AND LONG-RANGE GOALS TO REDUCE HEALTH RISKS AND DISPARITIES IN DURHAM COUNTY. THE BOARD INCLUDES STATE AND LOCAL ELECTED OFFICIALS, NEIGHBORHOOD COUNCILS AND OTHER GRASSROOTS ORGANIZATIONS, POLITICAL GROUPS, LOCAL PHYSICIANS, THE DURHAM PUBLIC SCHOOLS, AMONG OTHERS. DUHS MAINTAINS A CHARITABLE GRANTS COMMITTEE TO REVIEW COMMUNITY REQUESTS FOR PHILANTHROPIC ASSISTANCE THAT PROMOTE HEALTH AND WELLNESS. DUKE MEDICINE PROVIDES VARIOUS OPPORTUNITIES FOR STUDENTS TO INTERACT WITH DIFFERENT HEALTH CARE PROFESSIONALS ACROSS THE SYSTEM. THE OFFICE OF COMMUNITY RELATIONS, DRH, AND OTHER KEY COMMUNITY PARTNERS ARE PARTICIPATING IN A WORKFORCE DEVELOPMENT PROJECT CALLED PROJECT SEARCH. THIS PROGRAM, MODELED AFTER THE PROGRAM AT CINCINNATI CHILDREN'S HOSPITAL, PROVIDES YOUTH WITH DISABILITIES EMPLOYMENT TRAINING AND CAREER OPPORTUNITIES IN THE HEALTHCARE FIELD. THE OFFICE OF COMMUNITY RELATIONS WORKS WITH THE DURHAM-ORANGE MEDICAL SOCIETY AND THE DURHAM ACADEMY OF MEDICINE, DENTISTRY AND PHARMACY (AN ASSOCIATION FOR AFRICAN-AMERICAN MEDICAL PROFESSIONALS) TO PROMOTE THE SUCCESS OF THE CITY OF MEDICINE ACADEMY (CMA). THE CMA IS A PUBLIC MAGNET HIGH SCHOOL DESIGNED FOR STUDENTS INTERESTED IN HEALTH CARE CAREERS. FACULTY ARE INVOLVED WITH MENTORING STUDENTS AND CLASSROOM LECTURES. IN ADDITION, THE HEALTH SYSTEM CEO IS WORKING WITH THE NEW SCHOOLS PROJECT TO HELP THE CMA BECOME THE PREMIER HEALTH SCIENCE HIGH SCHOOL IN NORTH CAROLINA. IN 2011, CMA MOVED INTO A NEW BUILDING ON THE DRH CAMPUS ON LAND DUHS RELEASED BACK TO DURHAM COUNTY. DUHS, INC. IS A KEY PARTNER IN ANNUAL DURHAM PROJECT HOMELESS CONNECT EVENT. STAFF FROM THE DUKE SCHOOL OF NURSING, DUKE EYE CENTER, AND STAFF AFFILIATED WITH LINCOLN COMMUNITY HEALTH CENTER HEALTHCARE FOR THE HOMELESS CLINIC VOLUNTEER TIME AND RESOURCES AT THIS IMPORTANT EVENT. STUDENTS FROM THE DUKE SCHOOLS OF MEDICINE AND NURSING ENGAGE COMMUNITIES IN DURHAM AND BEYOND IN ACTIVITIES THAT INCLUDE FREE BLOOD PRESSURE SCREENINGS FOR THE HOMELESS, AND IDENTIFYING THE HEALTH CARE NEEDS OF A LOW WEALTH COMMUNITY SCHOOL AND DEVELOPING A CURRICULUM FOR STUDENTS AND PARENTS THAT ADDRESSES THOSE NEEDS. AFFILIATED HEALTH CARE SYSTEM ROLES:PART VI, LINE 6:DUHS PROVIDES VIRTUALLY ALL LEVELS OF CARE BEGINNING WITH DUKE UNIVERSITY AFFILIATED PHYSICIANS (DBA DUKE PRIMARY CARE) (DPC). THE HOSPITALS PROVIDE ROUTINE INPATIENT AND OUTPATIENT CARE. IN DURHAM COUNTY, DUH AND DRH WORK TOGETHER TO MAXIMIZE FACILITY UTILIZATION PROVIDING ROUTINE AND ADVANCED LEVELS OF CARE. DUH ALSO OPERATES A TRAUMA CENTER WITH AIR AMBULANCE SERVICE. DRAH SERVES THE WAKE COUNTY AREA AS A COMMUNITY HOSPITAL. THE DRAH CAMPUS HAS SEVERAL MEDICAL OFFICE BUILDINGS ENHANCING CONVENIENCE FOR THE PATIENT IN NON-EMERGENT CASES AND PROVIDES STREAMLINED ACCESS TO HIGH-DEMAND PROCEDURES SUCH AS CARDIAC CATHETERIZATION AND RADIOLOGY PROCEDURES. DUHS ALSO OPERATES HOME HEALTH AND HOME INFUSION SERVICES TO TREAT AND CARE FOR PATIENTS IN THE COMFORT OF THEIR HOME. THIS IS OBVIOUSLY PRACTICAL FOR PATIENTS NOT REQUIRING INPATIENT STAY BUT IN NEED OF ONGOING CARE AT A SUB-ACUTE LEVEL. FINALLY, HOSPICE PROVIDES PALLIATIVE CARE FOR PATIENTS NOT RESPONDING TO CURATIVE CARE. PAIN MANAGEMENT, SYMPTOM MANAGEMENT, AND PSYCHOLOGICAL AND SPIRITUAL SUPPORT PROVIDE A ROUNDED APPROACH TO COMPASSIONATELY ASSIST TERMINAL PATIENTS AND THEIR FAMILIES WITH THE PROCESS OF DYING. ALL OF THE OPERATING UNITS OF DUHS WORK TOGETHER TO PROVIDE THE RIGHT LEVEL OF CARE FOR THE PATIENT IN THE MOST BENEFICIAL MANNER. IN ADDITION TO THE REACTIVE ACTIVITIES OF DIAGNOSTIC CARE, DUHS ALSO SUPPORTS AND PROMOTES HEALTHY LIFESTYLES IN THE DIET & FITNESS CENTER, CENTER FOR LIVING, AND DUKE INTEGRATIVE MEDICINE. THESE OPERATIONS FOCUS LARGELY ON PREVENTION AND EDUCATION TO AVOID OR MITIGATE THE POTENTIAL FOR FUTURE ILLNESS.LIST OF ALL STATES WHICH ORGANIZATION FILES A COMMUNITY BENEFIT REPORT:PART VI, LINE 7:NORTH CAROLINA 1 AMERICAN HEART ASSOCIATION 3131 RDU CENTER DR SUITE 100 MORRISVILLE NC 27560 135613797 501(C)(3) 30756 GENERAL SUPPORT CARING HOUSE INC 2625 PICKETT RD DURHAM NC 277055603 561647154 501(C)(3) 165000 GENERAL SUPPORT CITY OF DURHAM 1900 CAMDEN AVE DURHAM NC 27704 566000225 GOV'T ENTITY 0 20000 FMV AMBULANCE GENERAL SUPPORT COALITION TO PROTECT AMERICAS PO BOX 30211 BETHESDA MD 20824 522253225 501(C)(4) 90000 GENERAL SUPPORT DURHAM ACADEMY 3601 RIDGE RD DURHAM NC 277055599 560538019 501(C)(3) 50000 GENERAL SUPPORT DURHAM AT RISK YOUTH COLLABORA 107 N DIVER ST DURHAM NC 27703 320263133 501(C)(3) 15000 GENERAL SUPPORT FOR EAST DURHAM CHILDREN'S INITIATIVE EL CENTRO HISPANO INC 600 E MAIN STREET DURHAM NC 27701 562011661 501(C)(3) 13500 GENERAL SUPPORT FAMILY VIOLENCE PREVENTION CENTER 1012 OBERLINE RD SUITE 100 RALEIGH NC 27605 581320613 501(C)(3) 25000 GENERAL SUPPORT FOUNDATION FOR NURSING EXCELLENCE PO BOX 31824 RALEIGH NC 27622 300105241 501(C)(3) 20000 GENERAL SUPPORT GREAT 100 INC PO BOX 4875 GREENSBORO NC 274044875 561705456 501(C)(3) 15000 GENERAL SUPPORT GREATER RALEIGH CHAMBER OF COMMERCE PO BOX 2978 RALEIGH NC 276022978 560370850 501(C)(6) 25000 GENERAL SUPPORT HUMAN RIGHTS CAMPAIGN INC 1640 RHODE ISLAND AVE NW WASHINGTON DC 20036 521243457 501(C)(4) 15000 GENERAL SUPPORT MEDICAL FOUNDATION OF NC INC CB7120 CHAPEL HILL NC 275997120 566057494 501(C)(3) 50000 GENERAL SUPPORT MIDTOWN EVENTS LLC PO BOX 19107 RALEIGH NC 27619 271832351 - 100000 GENERAL SUPPORT FOR LOCAL FARMER'S MARKET NORTH CAROLINA INDEPENDENT 530 N BLOUNT ST RALEIGH NC 27604 560775353 501(C)(3) 50000 GENERAL SUPPORT NORTH CAROLINA INSTITUTE OF MEDICINE 630 DAVIS DR STE 100 MORRISVILLE NC 27560 561506066 NC GOVERNMENT 6000 GENERAL SUPPORT NORTH CAROLINA PHYSICIANS HEAL 220 HORIZON DRIVE 201 RALEIGH NC 27615 561846599 501(C)(3) 12000 GENERAL SUPPORT PROJECT ACCESS OF DURHAM COUNTY PO BOX 15339 DURHAM NC 27704 261925378 501(C)(3) 16500 GENERAL SUPPORT FOR DURABLE MEDICAL EQUIPMENT PROGRAM RALEIGH SCHOOL OF NURSE ANESTHESIA 3900 BARRETT DR SUITE 200 RALEIGH NC 27609 561684241 501(C)(3) 90757 GENERAL SUPPORT SENIOR PHARMASSIST INC 406 RIGSBEE AVE STE 201 DURHAM NC 277012186 562084639 501(C)(3) 10000 GRANT AWARD UNITED WAY OF THE GREATER TRIANGLE 2400 PERIMETER PARK DR 150 MORRISVILLE NC 27560 561949103 501(C)(3) 108085 GENERAL SUPPORT WAKE COUNTY MEDICAL SOCIETY 2500 BLUE RIDGE RD STE 330 RALEIGH NC 27616 562205175 501(C)(3) 20000 GENERAL SUPPORT FOR CAPITAL CARE COLLABORATIVE WAKE TECHNICAL COMMUNITY COLLEGE 9101 FAYETTEVILLE ROAD RALEIGH NC 276035696 237017752 501(C)(3) 15000 GENERAL SUPPORT 19 4 FINANCIAL ASSISTANCE 16 18900 STUDENT SCHOLARSHIP 12 16500 SCHEDULE I, PART I, LINE 2 DUKE UNIVERSITY HEALTH SYSTEM, INC. PROVIDES GENERAL SUPPORT TO LOCAL ORGANIZATIONS BASED ON OUR AWARENESS OF THEIR ACTIVITIES WITHIN THE LOCAL COMMUNITY. DUKE UNIVERSITY HEALTH SYSTEM, INC. ALSO MAINTAINS A CHARITABLE GRANTS COMMITTEE THAT REVIEWS COMMUNITY REQUESTS FOR PHILANTHROPIC ASSISTANCE THAT PROMOTE HEALTH AND WELLNESS. X 0 0 X X X X X X 0 1 0 0 0 0 0 1 0 NANCY CATHERINE ANDREWS MD DIRECTOR 0 545233 0 250404 0 17500 0 31860 0 72382 0 917379 0 0 RICHARD H BRODHEAD DIRECTOR 0 911794 0 0 0 221685 0 137360 0 66907 0 1337746 0 100000 MARY KLOTMAN MD DIRECTOR 0 288627 0 96685 0 17500 0 31860 0 12432 0 447104 0 0 MARK F NEWMAN DIRECTOR 0 204719 0 91308 0 16167 0 31860 0 19656 0 363710 0 0 THEODORE N PAPPAS MD DIRECTOR 0 316905 0 67551 0 0 0 31860 0 14581 0 430897 0 0 MONTE D BROWN MD VP OF ADMINISTRATION/SECRETARY 349974 0 177003 0 17500 0 31860 0 18912 0 595249 0 0 0 WILLIAM J FULKERSON JR MD EXECUTIVE VP, DUHS 764984 0 467727 0 17500 0 31860 0 7836 0 1289907 0 0 0 KENNETH C MORRIS SVP, CFO, TREASURER 694820 0 326926 0 90066 0 31860 0 11431 0 1155103 0 0 0 MARY ANN FUCHS VP-PATIENT CARE/CHIEF NURSE EXEC 296103 0 98036 0 9655 0 31860 0 6438 0 442092 0 0 0 KATHLEEN GALBRAITH PRESIDENT, DUKE REGIONAL HOSPITAL 307617 0 20000 0 6589 0 31860 0 16925 0 382991 0 0 0 CARLA PARKER-HOLLIS VP, DUKE RALEIGH HOSPITAL 179847 0 35000 0 0 0 26313 0 13113 0 254273 0 0 0 KEVIN W SOWERS PRESIDENT, DUKE UNIVERSITY HOSPITAL 456103 0 176378 0 17500 0 31860 0 12591 0 694432 0 0 0 DAVID W ZAAS MD PRESIDENT, DUKE RALEIGH HOSPITAL 169527 5530 58400 0 17500 0 30970 890 13018 1909 289415 8329 0 0 SANDRA DANOFF SVP, STRATEGIC PLANNING, BD, NS 439895 0 133032 0 17500 0 31860 0 14174 0 636461 0 0 0 JEFFREY M FERRANTI VP, CIO, DHTS ADMINISTRATION 364914 35504 103862 5466 17500 0 31860 0 14703 142 532839 41112 0 0 THOMAS A OWENS MD CHIEF MEDICAL OFFICER 410466 0 152397 0 48443 0 31860 0 12117 0 655283 0 0 0 JOHN M KELSCH MD PHYSICIAN 343257 0 54843 0 50458 0 31860 0 18497 0 498915 0 0 0 ROBERT N WILLIS VP, CONTROLLER & CHIEF ACC. OFFICER 368975 0 0 0 97928 0 31860 0 14697 0 513460 0 0 0 VICTOR J DZAU MD FORMER OFFICER 0 553095 0 4035460 0 3412838 0 31860 0 9301 0 8042554 0 3115749 RICHARD GANNOTTA FORMER KEY EMPLOYEE 97405 0 0 0 36289 0 17133 0 2073 0 152900 0 0 0 PAUL NEWMAN FORMER KEY EMPLOYEE 0 249543 0 0 0 0 0 30698 0 5848 0 286089 0 0 KERRY R WATSON FORMER KEY EMPLOYEE 105781 0 0 0 5833 0 13961 0 34450 0 160025 0 0 0 SCHEDULE J, PART I, LINE 1A FIRST-CLASS OR CHARTER TRAVEL: JOHN H. MCARTHUR TRAVELED FIRST CLASS FOR BUSINESS PURPOSES WHEN LOWER LEVEL CLASSES WERE NOT AVAILABLE. THIS TRAVEL WAS FOR NECESSARY BUSINESS PURPOSES. SCHEDULE J, PART I, LINE 4B SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: THE FOLLOWING INDIVIDUALS PARTICIPATED IN AND RECEIVED PAYMENTS UNDER A DEFERRED COMPENSATION PLAN DESCRIBED UNDER SECTION 457(F) OF THE INTERNAL REVENUE CODE: RICHARD H. BRODHEAD $200,000, AND VICTOR J. DZAU MD $3,365,525. SUCH AMOUNTS WERE SUBJECT TO A SUBSTANTIAL RISK OF FORFEITURE AS DEFINED UNDER IRC SECTION 457(F). SCHEDULE J, PART I, LINE 7 NON-FIXED PAYMENTS: DUHS MAINTAINS AN EXECUTIVE INCENTIVE COMPENSATION PLAN. PAYMENTS UNDER THE PLAN ARE BASED ON PRE-ESTABLISHED PERFORMANCE METRICS AND A FIXED CALCULATION METHODOLOGY APPROVED BY THE DUHS COMPENSATION COMMITTEE WITH ASSISTANCE AND INPUT FROM AN EXECUTIVE COMPENSATION CONSULTING FIRM ASSURING COMPARABILITY WITH SIMILAR SYSTEMS. THE PLAN ALLOWS FOR A MODIFICATION TO AN INDIVIDUAL'S INCENTIVE PAYMENT BASED ON LEADERSHIP COMPETENCIES AND OTHER FACTORS WITH PAYOUTS (AND MODIFICATIONS, IF ANY) APPROVED BY THE DUHS COMPENSATION COMMITTEE. A NORTH CAROLINA MEDICAL CARE COMMISSION 521309402 2012-03-22 322140000 SEE PART VI 0 0 0 B NORTH CAROLINA MEDICAL CARE COMMISSION 521309402 2012-05-30 214598930 SEE PART VI 0 0 0 C NORTH CAROLINA MEDICAL CARE COMMISSION 521309402 2015-03-19 128325000 SEE PART VI 0 0 0 D NORTH CAROLINA MEDICAL CARE COMMISSION 521309402 65821DDB4 2009-11-10 178598850 SEE PART VI 0 0 0 A 214760000 322140000 322140000 1 0 1 1 B 214760000 214760000 1 0 1 1 C 6705000 128325000 128325000 2009 1 0 1 1 D 179713706 15924326 2472104 161317276 2012 0 0 1 1 C 0 0 1 1 0 0.00000 0.00000 0.00000 0 1 0.00070 1 1 D 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 1 A 0 1 0 0 1 0 0 0 1 B 0 1 0 0 1 0 0 0 1 C 0 1 0 0 1 0 0 0 1 D 0 0 0 1 0 0 0 0 1 A 1 B 1 C 1 D 1 SCHEDULE K, PART I, COLUMN F BOND ISSUE A: THE PURPOSE OF THE BONDS ISSUED 03/22/2012 WAS TO REFUND THE 2005ABC BONDS ISSUED ON 08/21/2009, WHICH REFUNDED THE ORIGINAL 2005ABC BONDS ISSUED ON 5/19/2005. THE PURPOSE OF THE BONDS ISSUED 05/19/2005 WAS TO PARTIALLY REFUND THE 1996C BONDS ISSUED ON 10/24/1996, 1998A BONDS ISSUED ON 08/27/1998, AND THE 1998B BONDS ISSUED ON 10/13/1998. BOND ISSUE B: THE PURPOSE OF THE BONDS ISSUED 05/30/2012 WAS TO PARTIALLY REFUND THE 2005ABC BONDS ISSUED ON 03/22/12, WHICH REFUNDED THE 2005ABC BONDS ISSUED ON 08/21/2009, WHICH REFUNDED THE ORIGINAL 2005ABC BONDS ISSUED ON 5/19/2005. THE PURPOSE OF THE BONDS ISSUED 05/19/2005 WAS TO PARTIALLY REFUND THE 1996C BONDS ISSUED ON 10/24/1996, 1998A BONDS ISSUED ON 08/27/1998, AND THE 1998B BONDS ISSUED ON 10/13/1998. BOND ISSUE C: THE PURPOSE OF THE BONDS ISSUED 03/09/2015 WAS TO REFUND THE 2006ABC BONDS ISSUED ON 10/06/2011,WHICH REFUNDED THE BONDS ISSUED 11/15/2006 FOR HOSPITAL IMPROVEMENTS INCLUDING: ROUTINE INFRASTRUCTURE, RENOVATION AND IMPROVEMENT PROJECTS AT DUKE UNIVERSITY HOSPITAL AND DUKE RALEIGH HOSPITAL, IMPROVEMENTS TO INFORMATION SYSTEMS, RENOVATION AND EXPANSION OF EMERGENCY DEPARTMENT AT DUKE UNIVERSITY HOSPITAL, HELIPORT AND NEW ROOF IMPROVEMENTS AT DUKE UNIVERSITY HOSPITAL, AND PHASES 1 AND 2 OF AN OPERATING ROOM SUITE RENOVATION AND EXPANSION AT DUKE UNIVERSITY HOSPITAL. BOND ISSUE D: HOSPITAL IMPROVEMENTS FINANCED INCLUDE: THE AMBULATORY CANCER CENTER AT DUKE UNIVERSITY HOSPITAL AND OTHER RENOVATION AND IMPROVEMENT PROJECTS AT DUKE UNIVERSITY HOSPITAL AND DUKE RALEIGH HOSPITAL. BOND ISSUE A (2): HOSPITAL IMPROVEMENTS INCLUDE THE DUKE MEDICINE PAVILION AT DUKE UNIVERSITY HOSPITAL. BOND ISSUE B (2): HOSPITAL IMPROVEMENTS INCLUDE THE DUKE MEDICINE PAVILION AND THE DUKE NORTH CONCOURSE AT DUKE UNIVERSITY HOSPITAL. BOND ISSUE C (2): THE PURPOSE OF THE BONDS ISSUED 08/28/2012 WAS TO REFUND THE ORIGINAL 1985B BONDS ISSUED ON 10/02/1985 FOR THE ACQUISITION OF A MAINTENANCE BUILDING, PARKING, AND A DEBT SERVICE FUND; AND TO REFUND THE ORIGINAL 1993A BONDS ISSUED ON 08/12/1993. THE PURPOSE OF THE BONDS ISSUED 08/12/1993 WAS TO PARTIALLY REFUND THE 1991D BONDS ISSUED ON 7/1/1991 AND THE 1985A BONDS ISSUED ON 10/02/1985. THE 2012C BONDS WERE PAID OFF EFFECTIVE JUNE 1, 2015. BOND ISSUE D (2): DRAW-DOWN FINANCING LEASE PROGRAM WITH BANC OF AMERICA PUBLIC CAPITAL CORP. IN THE MAXIMUM PRINCIPAL AMOUNT OF $40,000,000 TO FINANCE MEDICAL, COMPUTER, OFFICE, AND CAPITAL EQUIPMENT. BOND ISSUE A (3): DRAW-DOWN FINANCING LEASE PROGRAM WITH BANC OF AMERICA PUBLIC CAPITAL CORP. IN THE MAXIMUM PRINCIPAL AMOUNT OF $40,000,000 TO FINANCE MEDICAL, COMPUTER, OFFICE, AND CAPITAL EQUIPMENT. BOND ISSUE B (3): DRAW-DOWN FINANCING LEASE PROGRAM WITH SUNTRUST EQUIPMENT FINANCE & LEASING CORP. IN THE MAXIMUM PRINCIPAL AMOUNT OF $40,000,000 TO FINANCE MEDICAL, COMPUTER, OFFICE, AND CAPITAL EQUIPMENT. SCHEDULE K, PART II, LINE 3 BOND ISSUE B: PROCEEDS INCLUDE ISSUE PRICE PLUS ORIGINAL ISSUE DISCOUNT / UPFRONT FEE PAID DIRECTLY BY DUHS TO THE BANK UPON ISSUANCE. BOND ISSUES D, A (2), AND B (2): PROCEEDS INCLUDE INVESTMENT EARNINGS. BOND ISSUES D (2) AND A (3) AND B (3): PROCEEDS REFLECT ACTUAL PRINCIPAL DRAWN DOWN UNDER DRAW DOWN FINANCING LEASE PROGRAM. SCHEDULE K, PART IV, LINE 2C BOND ISSUES A, B, C, D, A (2), B (2) AND C (2): BOND ISSUE A AND B ARBITRAGE REPORT COMPLETED 3/22/13, BOND ISSUE C COMPLETED 9/30/2013, BOND ISSUE D COMPLETED 11/1/2014, BOND ISSUE A (2) COMPLETED 4/1/2015, BOND ISSUE B (2) COMPLETED 5/31/2013 AND BOND ISSUE C(2) COMPLETED 05/31/2013. AS TO BOND ISSUE D (2), A (3), AND B (3), NO ARBITRAGE COMPUTATION WAS NECESSARY BECAUSE NO PROCEEDS WERE REINVESTED. BOND ISSUES A, B, C AND C (2): THESE PROCEEDS WERE DISBURSED OR DEEMED DISBURSED UPON ISSUANCE TO CURRENTLY REFUND THE PRIOR BONDS. BOND ISSUES D (2), AND A (3): SALES PROCEEDS ALLOCATED UPON ISSUANCE AND NOT INVESTED. SCHEDULE K, PART III, LINE 8C, BOND ISSUE C: DISPOSITION WAS THE SUBJECT OF A CLOSING AGREEMENT ACCEPTED AND CLOSED WITH THE IRS IN OCTOBER 2014 THROUGH THE TAX EXEMPT BONDS VOLUNTARY CLOSING AGREEMENT PROGRAM. A NORTH CAROLINA MEDICAL CARE COMMISSION 521309402 65821DDX6 2010-04-28 120836075 SEE PART VI 0 0 0 B NORTH CAROLINA MEDICAL CARE COMMISSION 521309402 65821DLJ8 2012-06-28 326853753 SEE PART VI 0 0 0 C NORTH CAROLINA MEDICAL CARE COMMISSION 521309402 2012-08-28 48225000 SEE PART VI 0 0 0 D NORTH CAROLINA MEDICAL CARE COMMISSION 521309402 2008-12-04 40000000 SEE PART VI 0 0 0 A 121162021 1460854 119701167 2013 0 0 1 1 B 18485000 326995394 14871185 2737864 309386345 2013 0 0 1 1 C 19575000 48225000 48225000 1 0 1 1 D 14490523 16484844 16484844 2011 0 0 1 1 A 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 1 B 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 1 D 0 0 1 1 0 0.00000 0.00000 0.00000 0 1 0.04330 1 1 A 0 0 0 1 0 0 0 0 1 B 0 1 0 0 0 0 0 0 1 C 0 1 0 0 1 0 0 0 1 D 0 0 0 1 0 0 0 0 1 A 1 B 1 C 1 D 1 A NORTH CAROLINA MEDICAL CARE COMMISSION 521309402 2012-03-06 40000000 SEE PART VI 0 0 0 B NORTH CAROLINA MEDICAL CARE COMMISSION 521309402 2015-04-21 40000000 SEE PART VI 0 0 0 A 7500391 30861504 30861504 2014 0 0 1 1 B 35761 1386412 1386412 0 0 0 1 A 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 1 B 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 1 A 0 1 0 0 0 0 0 0 1 B 0 1 0 0 0 0 0 0 1 A 1 B 1 THE DURHAM BULLS BASEBALL CLUB INC SEE PART V 32997 SEE PART V 0 GENESE NEWMAN SEE PART V 122175 SEE PART V 0 TAMELA VINSEL SEE PART V 70706 SEE PART V 0 DANIEL J SCOTT MD SEE PART V 52414 SEE PART V 0 SCH L, PART IV, BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS: (A) NAME OF INTERESTED PERSON: THE DURHAM BULLS BASEBALL CLUB, INC.(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: THE DURHAM BULLS BASEBALL CLUB, INC. CEO IS DUHS, INC. DIRECTOR.(C) AMOUNT OF TRANSACTION: $32,997(D) DESCRIPTION OF TRANSACTION: PAYMENT FOR GOODS OR SERVICES(E) SHARING OF ORGANIZATION REVENUE? = NO(A) NAME OF INTERESTED PERSON: GENESE NEWMAN(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: GENESE NEWMAN IS A FAMILY MEMBER OF DUHS, INC. FORMER KEY EMPLOYEE(C) AMOUNT OF TRANSACTION: $122,175(D) DESCRIPTION OF TRANSACTION: PAYMENT FOR SALARY AND BENEFITS(E) SHARING OF ORGANIZATION REVENUE? = NO(A) NAME OF INTERESTED PERSON: TAMELA VINSEL(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: TAMELA VINSEL IS A FAMILY MEMBER OF DUHS, INC. FORMER KEY EMPLOYEE(C) AMOUNT OF TRANSACTION: $70,706(D) DESCRIPTION OF TRANSACTION: PAYMENT FOR SALARY AND BENEFITS(E) SHARING OF ORGANIZATION REVENUE? = NO(A) NAME OF INTERESTED PERSON: DANIEL J. SCOTT, MD(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: DANIEL J.SCOTT IS A FAMILY MEMBER OF DUHS, INC. DIRECTOR(C) AMOUNT OF TRANSACTION: $52,414(D) DESCRIPTION OF TRANSACTION: PAYMENT FOR SALARY AND BENEFITS(E) SHARING OF ORGANIZATION REVENUE? = NO X 2 50100 APPRAISED VALUE X 229 THRIFT STORE VALUE X 31 1463869 MARKET QUOTE X 1 58 VARIOUS X MISCELLANEOUS 55 180 VARIOUS 0 0 1 1 PART I, LINE 32B: DUKE UNIVERSITY HEALTH SYSTEM, INC. USES INVESTMENT BROKERS TO SELL INVESTMENTS. DUKE UNIVERSITY HEALTH SYSTEM, INC. MAY OCCASIONALLY USE THIRD PARTIES TO SELL OTHER TYPES OF NON-CASH CONTRIBUTIONS, AS THE NEED ARISES. FORM 990, PART I, LINE 1 DUHS IS COMMITTED TO EXCELLENCE, INNOVATION AND LEADERSHIP IN PROVIDING THE HEALTH CARE NEEDS OF THE PEOPLE WE SERVE, IMPROVING COMMUNITY HEALTH, AND FOSTERING THE VERY BEST MEDICAL EDUCATION. FORM 990, PART III, LINE 4A STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS HISTORY AND ORGANIZATION IN 1925, JAMES B. DUKE WILLED $4 MILLION TO ESTABLISH DUKE HOSPITAL AND ITS MEDICAL SCHOOL TO IMPROVE HEALTH CARE IN THE CAROLINAS, THEN A POOR REGION LACKING HOSPITALS AND HEALTH CARE PROVIDERS. DUKE UNIVERSITY HOSPITAL HAS GROWN TO BE RECOGNIZED AS ONE OF THE WORLD'S GREAT HEALTH CARE PROVIDERS. IN 1998 AND CONCURRENT WITH ACQUIRING CONTROL OF TWO LOCAL COMMUNITY HOSPITALS, THE DUKE UNIVERSITY BOARD OF TRUSTEES ESTABLISHED DUKE UNIVERSITY HOSPITAL AS THE FLAGSHIP OF THE NEWLY INCORPORATED DUKE UNIVERSITY HEALTH SYSTEM, INC. (DUHS) TO MANAGE A WIDE RANGE OF HEALTH CARE PROGRAMS AT THE SAME HIGH LEVEL OF QUALITY THAT HAS TRADITIONALLY MADE DUKE UNIVERSITY HOSPITAL A WORLD LEADER. THIS NETWORK OF REGIONAL HEALTH CARE ORGANIZATIONS IS DEDICATED TO EMPLOYING DUKE'S STRENGTHS IN PATIENT CARE, EDUCATION, AND RESEARCH TO ENHANCE AND IMPROVE HEALTH CARE THROUGHOUT NORTH CAROLINA AND SOUTHERN VIRGINIA. THE DUHS MISSION IS CLINICAL CARE AND IS ENHANCED BY THE RESEARCH AND EDUCATION MISSIONS OF DUKE UNIVERSITY (THE DUKE UNIVERSITY SCHOOL OF MEDICINE AND SCHOOL OF NURSING). TOGETHER THEY SERVE THE COMMUNITY AS DUKE MEDICINE. (IN JANUARY 2016, LEADERSHIP ANNOUNCED THAT THE NAME IS CHANGING FROM DUKE MEDICINE TO DUKE HEALTH. THE WEB ADDRESSES AND OTHER REFERENCES TO DUKE MEDICINE IN THIS FORM 990 WILL BE UPDATED IN THE FUTURE TO REFLECT THIS CHANGE.) MANY PROGRAM SERVICE ACCOMPLISHMENTS ARE INCLUDED IN SCHEDULE H OF THIS FORM INCLUDING THE FINANCIAL COMMITMENT MADE TO THE COMMUNITY BY DUHS IN TERMS OF CHARITY CARE AND OTHER DIRECT AND MEASURABLE INVESTMENTS. BELOW ARE EXCERPTS FROM THE ANNUAL DUHS REPORT ON COMMUNITY BENEFIT. THE COST OF THESE ACTIVITIES CAN BE DIFFICULT TO MEASURE. SOMETIMES THEY INCLUDE THE PARTICIPATION OF DUKE UNIVERSITY SO REFERENCES TO "DUKE" ARE MEANT TO INCLUDE DUHS AND DUKE UNIVERSITY IN THEIR RESPECTIVE MISSION CAPACITIES. DUKE: A PARTNER IN CARE FOR PEOPLE, COMMUNITIES ACROSS NORTH CAROLINA WHEN ITS MEDICAL SCHOOL AND FIRST HOSPITAL OPENED MORE THAN 85 YEARS AGO, DUKE DEDICATED ITSELF TO IMPROVING THE HEALTH OF PEOPLE ACROSS NORTH CAROLINA. TODAY, IN WHAT HAS EVOLVED INTO DUKE UNIVERSITY HEALTH SYSTEM, THAT PROUD COMMITMENT TO CARE CONTINUES. THIS EDITION OF OUR ANNUAL REPORT ON COMMUNITY BENEFIT TELLS HOW. FOR THE FISCAL YEAR THAT ENDED JUNE 30, 2015, DUKE PROVIDED A TOTAL COMMUNITY BENEFIT AND INVESTMENT OF $409 MILLION. OF THAT FIGURE, $70 MILLION REPRESENTS CHARITY CARE AT ESTIMATED COST TO 139,250 PATIENTS FROM EVERY CORNER OF THE STATE WHO ARE UNINSURED OR WHO CANNOT PAY FOR CARE BECAUSE OF FINANCIAL HARDSHIP. ANOTHER $138 MILLION REFLECTS THE THREE OTHER FEDERALLY RECOGNIZED COMMUNITY BENEFIT CATEGORIES: UNREIMBURSED MEDICAID EXPENSES, HEALTH PROFESSIONS EDUCATION, AND CONTRIBUTIONS TO COMMUNITY GROUPS. ADDITIONAL COMMUNITY INVESTMENT TOTALS $201 MILLION FOR UNREIMBURSED MEDICARE EXPENSES AND UNRECOVERABLE PATIENT DEBT. OVER THE PAST FIVE YEARS ALONE, DUKE'S TOTAL COMMUNITY BENEFIT AND INVESTMENT HAS EXCEEDED $1.85 BILLION. THE 2016 REPORT ON COMMUNITY BENEFIT IS AVAILABLE ONLINE AT WWW.DUKEMEDICINE.ORG/ABOUTUS. CLICK ON "COMMUNITY HEALTH & BENEFITS" IN THE LEFT-HAND COLUMN. A LINK TO A PDF OF THE REPORT IS LOCATED AT THE BOTTOM OF THE RIGHT-HAND COLUMN ON THE FOLLOWING PAGE. MORE THAN 6,000 DUKE-TRAINED HEALTHCARE PROFESSIONALS MAKE THEIR HOME IN NORTH CAROLINA: * PHYSICIANS 2,797 * NURSES 2,462 * PHYSICIAN ASSISTANTS 724 * PHYSICAL THERAPISTS 261 * PATHOLOGY ASSISTANTS 32 FOR A TOTAL OF 6,276 DUKE PROVIDES QUALITY CARE TO ALL PATIENTS, REGARDLESS OF THEIR ABILITY TO PAY. DUKE PROVIDED $70 MILLION OF CHARITY CARE AT ESTIMATED COST TO 139,250 PATIENTS DURING THE FISCAL YEAR THAT ENDED ON JUNE 30, 2015. NEARLY 95 PERCENT OF THESE PATIENTS WERE RESIDENTS OF NORTH CAROLINA. HIGHLIGHTS OF DUKE'S CHARITY CARE AND DISCOUNTED CARE POLICIES: * DUKE PROVIDES WORLD-CLASS, EFFECTIVE CARE WITH A CONSISTENTLY HIGH LEVEL OF DIGNITY, RESPECT AND SKILL TO ALL PATIENTS IT SERVES, REGARDLESS OF THEIR ABILITY TO PAY. * DUKE PROVIDES ELIGIBLE CARE AT A DISCOUNT OR WITHOUT CHARGE TO ALL QUALIFYING PATIENTS WHO DO NOT HAVE HEALTH INSURANCE, OR WHO BECAUSE OF FINANCIAL HARDSHIP CANNOT PAY FOR THE CARE THEY RECEIVE. (COSMETIC PROCEDURES ARE NOT ELIGIBLE.) * IN ADDITION TO PROVIDING EMERGENCY AND PRIMARY CARE AT NO CHARGE, DUKE PHYSICIANS DONATE SPECIALTY CARE SERVICES TO ELIGIBLE UNINSURED PATIENTS THROUGH PROJECT ACCESS, A PROGRAM IN DURHAM AND WAKE COUNTIES. * DUKE HELPS PATIENTS NAVIGATE THROUGH GOVERNMENT-SPONSORED FINANCIAL-ASSISTANCE PROGRAMS FOR WHICH THEY MAY QUALIFY. * WHEN GOVERNMENT PROGRAMS SUCH AS MEDICAID DO NOT COMPLETELY COVER DUKE'S COST OF CARE, DUKE ABSORBS THE DIFFERENCE IN ACCORDANCE WITH ITS POLICIES. DUKE WORKS WITH COMMUNITIES TO PROMOTE HEALTH, WELLNESS, AND ACCESS COLLABORATING TO IDENTIFY COMMUNITY HEALTH NEEDS: DUKE UNIVERSITY HEALTH SYSTEM HAS MANY PARTNERS IN COMMUNITIES IT SERVES. WORKING TOGETHER, THEY IDENTIFY AND ADDRESS THE HEALTHCARE NEEDS OF THOSE COMMUNITIES. IN ADDITION, THROUGH ITS TWO HOSPITALS IN DURHAM AND ONE IN RALEIGH, DUKE COLLABORATES WITH THE PUBLIC HEALTH DEPARTMENTS IN DURHAM AND WAKE COUNTIES, COMMUNITY MEMBERS, AND NUMEROUS COMMUNITY PARTNER ORGANIZATIONS TO CONDUCT REGULAR ASSESSMENTS OF COMMUNITY HEALTH NEEDS. IN ACCORDANCE WITH FEDERAL REQUIREMENTS, LINKS ARE AVAILABLE TO THE ASSESSMENTS FOR DURHAM AND WAKE COUNTIES, AND TO EACH OF THE DUKE HOSPITALS' REPORTS. GO TO WWW.DUKEMEDICINE.ORG/ABOUTUS. CLICK ON "COMMUNITY HEALTH NEEDS ASSESSMENT" IN THE LEFT-HAND COLUMN. SUPPORTING THE WORK OF COMMUNITY GROUPS: DUKE AND ITS COMMUNITY PARTNERS CONTINUE THEIR LONGSTANDING COLLABORATIVE EFFORT TO ELIMINATE HEALTHCARE DISPARITIES AND IMPROVE RESIDENTS' ACCESS TO HIGH-QUALITY MEDICAL CARE. IN THE 2015 FISCAL YEAR, DUKE PROVIDED MORE THAN $11 MILLION IN CASH AND IN-KIND SUPPORT FOR COMMUNITY GROUPS, INCLUDING: (1) $7.52 MILLION FOR LINCOLN COMMUNITY HEALTH CENTER AND ITS SATELLITE COMMUNITY CLINICS, WHICH SERVE A MAJORITY POOR AND UNINSURED POPULATION; (2) $2.38 MILLION FOR DURHAM COUNTY'S EMERGENCY MEDICAL SERVICES PROGRAM; (3) $1.37 MILLION IN CASH CONTRIBUTIONS TO OTHER COMMUNITY ORGANIZATIONS. INVESTING IN HEALTH PROFESSIONS EDUCATION: EDUCATING THE NEXT GENERATION OF PHYSICIANS, NURSES, NURSE PRACTITIONERS, PHYSICIAN ASSISTANTS, AND PHYSICAL THERAPISTS IS AT THE HEART OF DUKE'S MISSION TO IMPROVE HEALTHCARE FOR PATIENTS AND THE COMMUNITY. IN THE 2015 FISCAL YEAR, DUKE INVESTED $62 MILLION IN ITS HEALTH PROFESSIONS EDUCATION PROGRAM. THE PROGRAM REMAINS AMONG THE MOST CHALLENGING AND INNOVATIVE IN THE COUNTRY AS NEW MODELS OF COMMUNITY FOCUSED CARE EMERGE THAT EMPHASIZE HEALTH, WELLNESS, AND INDIVIDUAL SELF-CARE, AS WELL AS POPULATION HEALTH MANAGEMENT. FORM 990, PART V, LINE 3B THE ORGANIZATION DID NOT HAVE ANY UNRELATED BUSINESS GROSS INCOME DURING THE FISCAL YEAR ENDED JUNE 30, 2015. AS A RESULT, FORM 990-T IS NOT REQUIRED FOR THE FISCAL YEAR ENDED JUNE 30, 2015. FORM 990, PART VI, SECTION A, LINE 2 DIRECTORS JACK O. BOVENDER, JR., RICHARD H. BRODHEAD, THOMAS M. GORRIE, WILLIAM HAWKINS, MICHAEL MARSICANO, DAVID M. RUBENSTEIN, STEVEN SCOTT, AND SUSAN M. STALNECKER ARE TRUSTEES OF DUKE UNIVERSITY. DIRECTOR AND PRESIDENT/CEO, A. EUGENE WASHINGTON, MD, IS AN OFFICER OF DUKE UNIVERSITY. THE FOLLOWING INDIVIDUALS ARE EMPLOYEES OF DUKE UNIVERSITY: RICHARD H. BRODHEAD, NANCY CATHERINE ANDREWS, MD, MARY KLOTMAN, MD, MARK F. NEWMAN, AND THEODORE NICK PAPPAS, MD. DIRECTOR AND PRESIDENT/CEO, A. EUGENE WASHINGTON, MD, DIRECTOR MARK F. NEWMAN, AND OFFICERS WILLIAM J. FULKERSON, MD, AND KENNETH C. MORRIS ARE DIRECTORS OF DURHAM CASUALTY COMPANY, LTD. DIRECTOR AND PRESIDENT/CEO, A. EUGENE WASHINGTON, MD, DIRECTORS MARY KLOTMAN, MD, MARK F. NEWMAN, AND OFFICER WILLIAM J. FULKERSON, MD, ARE BOARD MEMBERS OF PRIVATE DIAGNOSTIC CLINIC, PLLC. OFFICER KENNETH C. MORRIS IS DIRECTOR OF DUKE MEDICAL STRATEGIES, INC. OFFICERS WILLIAM J. FULKERSON, MD AND KENNETH C. MORRIS ARE BOTH DIRECTORS AND OFFICERS OF HEALTH SYSTEM MEDICAL STRATEGIES, INC. FORM 990, PART VI, SECTION A, LINE 3 DUHS DELEGATES CONTROL TO A SUPPORTING ORGANIZATION FOR THE MANAGEMENT OF INVESTMENTS. FORM 990, PART VI, SECTION A, LINE 4 DUHS AND ITS BOARD OF DIRECTORS HAVE REVISED AND APPROVED THE AMENDMENT OF DUKE UNIVERSITY HEALTH SYSTEM, INC. BYLAWS. SIGNIFICANT CHANGES ARE SUMMARIZED AS FOLLOWS: THE AMENDED AND RESTATED DUHS BYLAWS STATE THAT IN THE EVENT OF A TRANSITION OF THE PRESIDENT OF THE CORPORATION WITHIN ONE (1) YEAR OF THE EXPIRATION OF THE DIRECTOR'S TERM, THE BOARD OF DIRECTORS MAY ACT TO EXTEND FOR A MAXIMUM OF ONE (1) YEAR, THE TERM OF A DIRECTOR WHOSE SERVICE WOULD OTHERWISE HAVE REACHED ITS MAXIMUM APPOINTMENT. FORM 990, PART VI, SECTION A, LINE 7A THE MEMBERS OF THE BOARD OF DIRECTORS OF DUHS, OTHER THAN THE EX OFFICIO MEMBERS, WILL BE NOMINATED BY THE BOARD OF DIRECTORS OF DUHS, AND WILL BE APPOINTED BY THE BOARD OF TRUSTEES OF DUKE UNIVERSITY. MEMBERS OF THE BOARD OF DIRECTORS OF DUHS WILL BE SUBJECT TO REMOVAL AT THE DISCRETION OF THE BOARD OF TRUSTEES OF DUKE UNIVERSITY IN ACCORDANCE WITH THE BYLAWS OF DUHS. FORM 990, PART VI, SECTION A, LINE 7B THE DUHS BYLAWS PROVIDE THAT DUHS MUST OBTAIN DUKE UNIVERSITY BOARD OF TRUSTEES APPROVAL FOR CERTAIN SIGNIFICANT TRANSACTIONS REGARDING DEBT ISSUANCES, CAPITAL ACQUISITIONS AND TANGIBLE PERSONAL AND REAL PROPERTY SALES. FORM 990, PART VI, SECTION B, LINE 11 AFTER STAFF PREPARATION AND MANAGEMENT REVIEW, THE DUHS FORM 990 IS PRESENTED TO THE DUHS COMPLIANCE/AUDIT COMMITTEE OF THE BOARD OF DIRECTORS FOR REVIEW AND DISCUSSION. BOARD LEVEL COMMENT AND DISCUSSION ARE INCORPORATED INTO THE FORM AS APPROPRIATE PRIOR TO FILING. A FINAL VERSION OF THE FORM IS EMAILED TO THE BOARD OF DIRECTORS FOR FURTHER REVIEW AND COMMENT BEFORE FILING. FORM 990, PART VI, SECTION B, LINE 12C DUHS MONITORS AND ENFORCES COMPLIANCE RELATED TO CONFLICT OF INTEREST VIA AN ANNUAL CONFLICT OF INTEREST QUESTIONNAIRE, RELYING ON SELF DISCLOSURE OF ALL THOSE SUBJECT TO THE COI POLICY. FORM 990, PART VI, SECTION B, LINE 15 THE DUHS COMPENSATION COMMITTEE, COMPRISED OF MEMBERS OF THE DUHS BOARD OF DIRECTORS, REVIEWS AND APPROVES ALL EXECUTIVE COMPENSATION FOR ALL DISQUALIFIED PERSONS AND OTHER KEY EMPLOYEES. THE DUHS COMPENSATION COMMITTEE REVIEWS AND RECOMMENDS TO THE DUKE UNIVERSITY COMPENSATION COMMITTEE THE COMPENSATION FOR THE PRESIDENT AND CEO OF DUHS WHO IS ALSO AN OFFICER OF DUKE UNIVERSITY. DUHS HAS ADOPTED A STATEMENT OF COMPENSATION PHILOSOPHY THAT ARTICULATES BROAD OBJECTIVES TO HELP GUIDE THE DUHS COMPENSATION COMMITTEE IN ITS MISSION. THE DUHS COMPENSATION COMMITTEE ENGAGES THE SERVICES OF AN OUTSIDE EXECUTIVE COMPENSATION CONSULTING FIRM TO ESTABLISH COMPARABILITY DATA OF OTHER HEALTH CARE SYSTEMS OF SIMILAR SIZE AND COMPLEXITY AS DUHS. THE DUHS COMPENSATION COMMITTEE REVIEWS THE MARKET ANALYSIS THEN DETERMINES THE REASONABLENESS AND APPROPRIATENESS OF ALL ASPECTS OF EXECUTIVE COMPENSATION. THE DUHS COMPENSATION COMMITTEE ALSO SETS THE METRICS AND APPROVES THE PAYOUTS FOR THE DUHS INCENTIVE COMPENSATION PLANS FOR THESE INDIVIDUALS. THE DELIBERATIONS AND CONCLUSIONS OF THE DUHS COMPENSATION COMMITTEE ARE KEPT BY A RECORDING SECRETARY WHO RECORDS THE MINUTES OF THE COMMITTEE MEETINGS. FORM 990, PART VI, SECTION C, LINE 18 DUKE UNIVERSITY HEALTH SYSTEM, INC.'S FORM 990 IS AVAILABLE TO THE PUBLIC ON WWW.GUIDESTAR.ORG. GUIDESTAR INDEPENDENTLY POSTS TAX-EXEMPT ORGANIZATIONS' FORM 990'S ON THEIR WEBSITE, OBTAINED FROM THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION C, LINE 19 DUKE UNIVERSITY HEALTH SYSTEM, INC.'S GOVERNING DOCUMENTS (ARTICLES OF INCORPORATION AND ANY SUBSEQUENT AMENDMENTS OR RESTATEMENTS) ARE AVAILABLE TO THE PUBLIC ON THE NORTH CAROLINA SECRETARY OF STATE WEBSITE. DUKE UNIVERSITY HEALTH SYSTEM, INC. MAKES ITS CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FINANCIAL STATEMENTS ARE ALSO AVAILABLE TO THE PUBLIC ON THE ELECTRONIC MUNICIPAL MARKET ACCESS WEBSITE. NAVIGATE TO HTTP://EMMA.MSRB.ORG AND ENTER "DUKE UNIVERSITY HEALTH SYSTEM" IN THE SEARCH BOX, CHOOSE ANY "ISSUE DESCRIPTION" WITH A "DATED DATE", ACCEPT THE TERMS OF THE WEBSITE, AND CLICK ON "CONTINUING DISCLOSURE". FORM 990, PART XI, LINE 9: NONPERIODIC CHANGES IN DEFINED BENEFIT PLANS: -301,434. NET TRANSFERS TO PARENT & AFFILIATES: -225,985,101. CHANGE IN MARKET VALUE OF DERIVATIVES: 653,987. DEEMED DIVIDEND: -20,012,106. 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