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WAYNE MEMORIAL HOSPITAL INC: Form 990, tax year 2014

View the entire original 990 at ProPublica ↗

Organization
WAYNE MEMORIAL HOSPITAL INC (EIN 56-1484844)
Tax period
2014-10-01 to 2015-09-30
Filed
2016-08-15
IRS object ID
201612289349303526
Schema version
2014v6.0
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2016-08-15T11:27:05-05:00ReturnTs
Tax Period End2015-09-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN410746749PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1CLIFTONLARSONALLEN LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1227 WEST TRADE STREET SUITE 800AddressLine1Txt
CityCHARLOTTECityNm
State AbbreviationNCStateAbbreviationCd
ZIP28202ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2014-10-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN561484844EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1WAYNE MEMORIAL HOSPITAL INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlWAYNBusinessNameControlTxt
Phone9197316142PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 8001AddressLine1Txt
CityGOLDSBOROCityNm
State AbbreviationNCStateAbbreviationCd
ZIP27533ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonREBECCA CRAIGPersonNm
Person TitleCFOPersonTitleTxt
Phone9197316142PhoneNum
Signature2016-08-12SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonJOHN NORMANPreparerPersonNm
PTINP01506766PTIN
Phone7049985200PhoneNum
Preparation2016-08-12PreparationDt
FieldValueIRS element (for citing)
Tax2014TaxYr
Build TS2016-09-27 15:27:22ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerJ WILLIAM PAUGHPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 8001AddressLine1Txt
CityGOLDSBOROCityNm
State AbbreviationNCStateAbbreviationCd
ZIP27533ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$253,808,864GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.WAYNEHEALTH.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1896FormationYr
Legal Domicile StateNCLegalDomicileStateCd
Activity Or MissionTO PROVIDE THE COMMUNITY QUALITY HEALTHCARE SERVICES.ActivityOrMissionDesc
Voting Members Governing Body12VotingMembersGoverningBodyCnt
Voting Members Independent11VotingMembersIndependentCnt
Total Employee1939TotalEmployeeCnt
Total Volunteers100TotalVolunteersCnt
Total Gross UBI$6,920TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$805,361PYContributionsGrantsAmt
CY Contributions Grants$807,299CYContributionsGrantsAmt
PY Program Service Revenue$228,844,116PYProgramServiceRevenueAmt
CY Program Service Revenue$247,356,207CYProgramServiceRevenueAmt
PY Investment Income$3,808,066PYInvestmentIncomeAmt
CY Investment Income$4,013,824CYInvestmentIncomeAmt
PY Other Revenue$0PYOtherRevenueAmt
CY Other Revenue$1,576,620CYOtherRevenueAmt
PY Total Revenue$233,457,543PYTotalRevenueAmt
CY Total Revenue$253,753,950CYTotalRevenueAmt
PY Grants And Similar Paid$117,169PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$144,430CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$106,667,563PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$113,261,126CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$115,551,505PYOtherExpensesAmt
CY Other Expenses$119,309,287CYOtherExpensesAmt
PY Total Expenses$222,336,237PYTotalExpensesAmt
CY Total Expenses$232,714,843CYTotalExpensesAmt
PY Revenues Less Expenses$11,121,306PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$21,039,107CYRevenuesLessExpensesAmt
Total Assets BOY$285,747,411TotalAssetsBOYAmt
Total Assets EOY$297,816,262TotalAssetsEOYAmt
Total Liabilities BOY$134,706,133TotalLiabilitiesBOYAmt
Total Liabilities EOY$151,287,887TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$151,041,278NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$146,528,375NetAssetsOrFundBalancesEOYAmt
MissionTHE MISSION OF WAYNE MEMORIAL HOSPITAL IS TO PROVIDE THE COMMUNITY QUALITY HEALTHCARE SERVICES THROUGH THE COMPASSIONATE HANDS OF WELL-TRAINED STAFF IN A TECHNOLOGICALLY ADVANCED, COST-EFFECTIVE MANNER.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$220,030,851ExpenseAmt
Grant$144,430GrantAmt
Revenue$248,925,907RevenueAmt
DescPROVIDING COMPASSIONATE PROGRESSIVE HEALTHCARE INCLUDING INPATIENT, OUTPATIENT, INTENSIVE CARE, AND EMERGENCY CARE.Desc
Total Program Service Expenses$220,030,851TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related InvstYes (1)ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To IndividualsYes (1)GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt BondsYes (1)TaxExemptBondsInd
Invest Tax Exempt Bonds0InvestTaxExemptBondsInd
Escrow Account0EscrowAccountInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded EntityYes (1)DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control Ent0TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document116IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee1939EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (1)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (1)Form990TFiledInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctYes (1)RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctYes (1)PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members12GoverningBodyVotingMembersCnt
Independent Voting Member11IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint VentureYes (1)InvestmentInJointVentureInd
Written Policy Or ProcedureYes (1)WrittenPolicyOrProcedureInd
States Where Copy Of Return Is FldNCStatesWhereCopyOfReturnIsFldCd
Other WebsiteYes (X)OtherWebsiteInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1REBECCA CRAIG CFOBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone9197316142PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 8001AddressLine1Txt
CityGOLDSBOROCityNm
State AbbreviationNCStateAbbreviationCd
ZIP27533ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (22 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtOfficerOfficerIndKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
R DANIEL BOWEN
BOARD MEMBER1.00Yes (X)$0$0$0
WILLIAM W BROADAWAY
BOARD MEMBER1.00Yes (X)$0$0$0
STEPHEN C LIES MD
BOARD MEMBER1.00Yes (X)$0$0$0
SUSAN H MCCALL
BOARD MEMBER1.00Yes (X)$0$0$0
RAY MCDONALD JR
CHAIRMAN1.00Yes (X)$0$0$0
JAMES C PARKER
BOARD MEMBER1.00Yes (X)$0$0$0
CHARLOTTE M WEAVER
BOARD MEMBER1.00Yes (X)$0$0$0
J WILLIAM PAUGH
CEO40.00Yes (X)$847,711$0$152,0671.00Yes (X)
C MUNROE BEST JR
BOARD MEMBER1.00Yes (X)$0$0$0
ARCHIE GURLEY III
BOARD MEMBER1.00Yes (X)$0$0$0
TERRY O JORDAN SR
BOARD MEMBER1.00Yes (X)$0$0$0
ROBERT WALKER JR
BOARD MEMBER1.00Yes (X)$0$0$0
BENJAMIN ESKRA MD
BOARD MEMBER1.00Yes (X)$0$0$0
REBECCA CRAIG
CFO40.00$244,856$0$65,2241.00Yes (X)
THOMAS W BRADSHAW
VP - OPERATIONS40.00$272,271$0$72,0521.00Yes (X)
RICHARD ROGERS
VP - HR40.00$190,501$0$48,4311.00Yes (X)
SHIRLEY S HARKEY
VP - NURSING SER40.00$209,982$0$56,0011.00Yes (X)
RICHARD BAZIK
CRNA40.00$214,755$0$35,291Yes (X)
AMY WILLOUGHBY
CRNA40.00$225,091$0$37,960Yes (X)
RICHARD MIDDLETON
CRNA40.00$207,317$0$38,128Yes (X)
DANIEL P BROCK
CRNA40.00$234,019$0$18,976Yes (X)
PHYLLIS HILL
DIRECTOR40.00$229,041$0$51,228Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$2,875,544TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$575,358TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K60IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
SODEXO INC
P O BOX 536922ATLANTAGA30353CONTRACT MGMT$1,067,786
DIVERSIFIED CLINICAL
28525 NETWORK PLACECHICAGOIL60673CONTRACT MGMT$866,054
ARAMARK
24863 NETWORK PLACECHICAGOIL60673CONTRACT MGMT$771,656
DANIELS & DANIELS
P O BOX 10337GOLDSBORONC27532CONSTRUCTION$648,639
BILLIE BROCK
101 MCKAYLA LANEGOLDSBORONC27530CONSTRUCTION$444,163
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K18CntrctRcvdGreaterThan100KCnt
All Other Contributions$807,299AllOtherContributionsAmt
Total Contributions$807,299TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescPATIENT REVENUEDesc
Business621110BusinessCd
Total Revenue Column$239,546,958TotalRevenueColumnAmt
Related Or Exempt Func Income$239,546,958RelatedOrExemptFuncIncomeAmt

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$7,809,249TotalRevenueColumnAmt
Related Or Exempt Func Income$7,809,249RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$247,356,207TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$4,068,738TotalRevenueColumnAmt
Exclusion$4,068,738ExclusionAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Other$54,914OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Other-$54,914OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$54,914TotalRevenueColumnAmt
Exclusion-$54,914ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmt
MRI INCOME621500$1,730,311$1,730,311
PREMIER K-1 UBI900099$6,920$6,920
LOSS ON REFINANCING900099-$160,611-$160,611
FieldValueIRS element (for citing)
Other Revenue Total$1,576,620OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$253,753,950TotalRevenueColumnAmt
Related Or Exempt Func Income$248,925,907RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$6,920UnrelatedBusinessRevenueAmt
Exclusion$4,013,824ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$100,000TotalAmt
Program Services$100,000ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$44,430TotalAmt
Program Services$44,430ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$2,875,544TotalAmt
Management And General$2,875,544ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$79,164,094TotalAmt
Program Services$73,414,616ProgramServicesAmt
Management And General$5,749,478ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$8,321,874TotalAmt
Program Services$7,531,296ProgramServicesAmt
Management And General$790,578ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$17,103,729TotalAmt
Program Services$15,478,875ProgramServicesAmt
Management And General$1,624,854ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$5,795,885TotalAmt
Program Services$5,245,276ProgramServicesAmt
Management And General$550,609ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$294,515TotalAmt
Management And General$294,515ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$130,780TotalAmt
Management And General$130,780ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$484,712TotalAmt
Program Services$219,625ProgramServicesAmt
Management And General$265,087ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$4,007,189TotalAmt
Program Services$4,007,189ProgramServicesAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$3,148,060TotalAmt
Program Services$2,848,995ProgramServicesAmt
Management And General$299,065ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$76,621TotalAmt
Program Services$71,771ProgramServicesAmt
Management And General$4,850ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$353,399TotalAmt
Program Services$271,035ProgramServicesAmt
Management And General$82,364ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$2,074,908TotalAmt
Program Services$2,074,908ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$11,320,100TotalAmt
Program Services$11,303,832ProgramServicesAmt
Management And General$16,268ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$613,415TotalAmt
Program Services$613,415ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmt
MEDICAL SUPPLIES$37,693,174$37,693,174
BAD DEBT EXPENSE$21,793,068$21,793,068
PURCHASED SERVICES$9,584,847$9,584,847
PROFESSIONAL FEES$5,275,680$5,275,680

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$22,458,819TotalAmt
Program Services$22,458,819ProgramServicesAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$232,714,843TotalAmt
Program Services$220,030,851ProgramServicesAmt
Management And General$12,683,992ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$3,975,182BOYAmt
EOY$4,289,369EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$32,150,480BOYAmt
EOY$25,339,422EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$4,879,795BOYAmt
EOY$5,498,101EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$2,052,415BOYAmt
EOY$2,360,755EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$238,525,204LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$124,962,897LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$113,886,358BOYAmt
EOY$113,562,307EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$104,042,956BOYAmt
EOY$114,968,330EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$24,760,225BOYAmt
EOY$31,797,978EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$285,747,411BOYAmt
EOY$297,816,262EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$30,844,020BOYAmt
EOY$31,005,257EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$53,379,685BOYAmt
EOY$49,720,478EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$50,482,428BOYAmt
EOY$70,562,152EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$134,706,133BOYAmt
EOY$151,287,887EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$150,047,502BOYAmt
EOY$145,407,617EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$993,776BOYAmt
EOY$1,120,758EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$151,041,278BOYAmt
EOY$146,528,375EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$285,747,411BOYAmt
EOY$297,816,262EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$21,039,107ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$5,380,959NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$20,171,051OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

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

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other Organizations0GrantsOtherOrganizationsInd
Direct Contact Legislators0DirectContactLegislatorsInd
Rallies Demonstrations0RalliesDemonstrationsInd
Other ActivitiesYes (1)OtherActivitiesInd
Other Activities$19,753OtherActivitiesAmt
Total Lobbying Expenditures$19,753TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART II-B, LINE 1:FormAndLineReferenceDesc
ExplanationA PORTION OF THE DUES THE HOSPITAL PAYS TO THE NORTH CAROLINA HOSPITAL ASSOCIATION ARE ATTRIBUTABLE TO LOBBYING ACTIVITIES.ExplanationTxt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Endowments Held Unrelated OrgYes (1)EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org0EndowmentsHeldRelatedOrgInd

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$132,309,065OtherCostOrOtherBasisAmt
Depreciation$58,055,020DepreciationAmt
Book Value$74,254,045BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$106,216,139OtherCostOrOtherBasisAmt
Depreciation$66,907,877DepreciationAmt
Book Value$39,308,262BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$113,562,307TotalBookValueLandBuildingsAmt

Invst Program Related Org InvstProgramRelatedOrgGrp

FieldValueIRS element (for citing)
DescINVESTMENTSDesc
Book Value$114,968,330BookValueAmt
Method ValuationFMethodValuationCd
FieldValueIRS element (for citing)
Total Book Value Program Rltd$114,968,330TotalBookValueProgramRltdAmt

Other Assets Org OtherAssetsOrgGrp (5 entries)

DescDescBook ValueBookValueAmt
BOND ISSUANCE COSTS, NET$567,984
INVESTMENT IN AFFILIATE$2,666,666
OTHER RECEIVABLES$4,481,768
DUE FROM AFFILIATE$22,633,089
LONG-TERM RECEIVABLES$1,448,471
FieldValueIRS element (for citing)
Total Book Value Other Assets$31,797,978TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)

DescDescAmtAmt
OTHER LIABILITIES$15,857,957
MINIMUM PENSION LIABILITY$48,705,679
ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS$5,572,787
CAPITAL LEASE OBLIGATIONS$425,729
FieldValueIRS element (for citing)
Total Liability$70,562,152TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART V, LINE 4:ALL ENDOWMENT FUNDS HELD BY WELLS FARGO ARE USED FOR THE CHARITABLE PURPOSES OF WAYNE MEMORIAL HOSPITAL.
PART X, LINE 2:WAYNE MEMORIAL HOSPITAL ("WMH") IS A NOT-FOR-PROFIT CORPORATION AND HAS BEEN RECOGNIZED AS TAX-EXEMPT PURSUANT TO SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. WMH ADOPTED THE PROVISIONS OF THE INCOME TAX STANDARD THAT CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN AN ORGANIZATION'S FINANCIAL STATEMENTS. THIS GUIDANCE PRESCRIBES A RECOGNITION AND MEASUREMENT OF TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN ON A TAX RETURN THAT ARE NOT CERTAIN TO BE REALIZED. THE IMPLEMENTATION OF THE ADOPTION OF THIS STANDARD HAD NO IMPACT ON WMH'S FINANCIAL STATEMENTS.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd
Percent200Yes (X)Percent200Ind
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd
Percent350Yes (X)Percent350Ind
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed BudgetYes (1)ExpensesExceedBudgetInd
Unable To Provide Care0UnableToProvideCareInd
Annual Community Bnft ReportYes (1)AnnualCommunityBnftReportInd
Report Publically AvailableYes (1)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$11,653,686TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$11,653,686NetCommunityBenefitExpnsAmt
Total Expense0.05010TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$6,726,519TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$6,726,519NetCommunityBenefitExpnsAmt
Total Expense0.02890TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$18,380,205TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$18,380,205NetCommunityBenefitExpnsAmt
Total Expense0.07900TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$2,473,384TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$2,473,384NetCommunityBenefitExpnsAmt
Total Expense0.01060TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,917,703TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,917,703NetCommunityBenefitExpnsAmt
Total Expense0.00820TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$713,280TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$713,280NetCommunityBenefitExpnsAmt
Total Expense0.00310TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$5,104,367TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$5,104,367NetCommunityBenefitExpnsAmt
Total Expense0.02190TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$23,484,572TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$23,484,572NetCommunityBenefitExpnsAmt
Total Expense0.10090TotalExpensePct

Economic Development EconomicDevelopmentGrp

FieldValueIRS element (for citing)
Activities Or Programs1ActivitiesOrProgramsCnt
Total Community Benefit Expns$432,321TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$432,321NetCommunityBenefitExpnsAmt
Total Expense0.00190TotalExpensePct

Workforce Development WorkforceDevelopmentGrp

FieldValueIRS element (for citing)
Persons Served800PersonsServedCnt
Total Community Benefit Expns$1,917,703TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,917,703NetCommunityBenefitExpnsAmt
Total Expense0.00820TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Activities Or Programs1ActivitiesOrProgramsCnt
Persons Served800PersonsServedCnt
Total Community Benefit Expns$2,350,024TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$2,350,024NetCommunityBenefitExpnsAmt
Total Expense0.01010TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (1)FinancialAssistancePrvsnInd

Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp

Entity Name EntityName

FieldValueIRS element (for citing)
Business Name Line11 WAYNE MRI LLCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Primary ActivitiesMRIPrimaryActivitiesTxt
Org Profit Or Ownership0.66700OrgProfitOrOwnershipPct
Physicians Profit Or Ownership0.33300PhysiciansProfitOrOwnershipPct
FieldValueIRS element (for citing)
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1WAYNE MEMORIAL HOSPITAL INCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line12700 WAYNE MEMORIAL DRIVEAddressLine1Txt
CityGOLDSBOROCityNm
State AbbreviationNCStateAbbreviationCd
ZIP27533ZIPCd
FieldValueIRS element (for citing)
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1WAYNE MEMORIAL HOSPITAL INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY0TaxExemptHospitalCYOrPYInd
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Information GapsYes (X)InformationGapsInd
CHNA Conducted12CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts0CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsYes (1)CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Own Website URLEXACT LINK IS: HTTP://WWW.WAYNEHEALTH.ORG/ABOUT/COMMUNITY-OUTREACH/REPORTSOwnWebsiteURLTxt
Other WebsiteYes (X)OtherWebsiteInd
Other Website URLHTTP://WWW.WAYNEGOV.COM/ARCHIVECENTER/VIEWFILE/ITEM/78OtherWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt12ImplementationStrategyAdptYr
Strategy Posted Website0StrategyPostedWebsiteInd
Strategy Attached0StrategyAttachedInd
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care200.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care350.000000000000FPGFamilyIncmLmtDscntCarePct
Income Level CriteriaYes (X)IncomeLevelCriteriaInd
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLSEE PART VIFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLSEE PART VIFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLSEE PART VIFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
FAP Notice DisplayedYes (X)FAPNoticeDisplayedInd
Other PublicityYes (X)OtherPublicityInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Collection Activities0CollectionActivitiesInd
FAP Notified Upon AdmissionYes (X)FAPNotifiedUponAdmissionInd
FAP Notified Before DischargeYes (X)FAPNotifiedBeforeDischargeInd
FAP Notified All PatientsYes (X)FAPNotifiedAllPatientsInd
Documented Elig DeterminationYes (X)DocumentedEligDeterminationInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Other Method UsedYes (X)OtherMethodUsedInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (12 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
WAYNE MEMORIAL HOSPITAL, INC.PART V, SECTION B, LINE 5: THE CHNA WAS CONDUCTED IN CONJUCTION WITH WAYNE COUNTY DEPARTMENT OF HEALTH. THE CHNA TEAM ELICITED FEEDBACK FROM KEY STAKEHOLDER GROUPS BY CONDUCTING FOCUS GROUPS IN UNDER REPRESENTED GROUPS, AS WELL AS CONDUCTING A HEALTH OPINION SURVEY. THE HEALTH OPINION SURVEY WAS ADAPTED FROM THE COMMUNITY HEALTH ASSESSMENT GUDEBOOK, NC DIVISION OF PUBLIC HEALTH AND WAS SIMILAR TO THE 2012 SURVEY. MORE THAN 500 PEOPLE SUBMITTED THEIR OPINIONS.THE STAKEHOLDER GROUPS MET PERIODICALLY AND SCHEDULED EXTRA MEETINGS, IN EARLY 2016, TO COMPLETE THE PROCESS. SIX FOCUS GROUPS WERE HELD IN SPECIFIC LOCATIONS TO DISCOVER THE COMMUNITY MEMBER'S PERCEPTION AND SUGGESSTIONS FOR IMPROVING HEALTH WITHIN THE COMMUNITY. THERE WERE A TOTAL OF 53 FOCUS GROUP PARTICIPANTS.
WAYNE MEMORIAL HOSPITAL, INC.PART V, SECTION B, LINE 6B: REPRESENTATIVES FROM THE WAYNE COUNTY HEALTH DEPARTMENT, WAYNE MEMORIAL HOSPITAL, WAYNE COUNTY BOARD OF HEALTH, WATCH AND ECU COOPERATIVELY CONDUCTED THE COMMUNITY HEALTH ASSESSMENT. THE COLLABORATION IDENTIFIED THE TYPES AND SOURCES OF DATA TO BE COLLECTED, DETERMINED THE METHODS FOR COLLECTING INPUT FROM THE COMMUNITY AND KEY STAKEHOLDERS CONCERNING HEALTH RELATED ISSUES AS WELL AS COMMUNICATING THIS INFORMATION TO THE VARIOUS STAKEHOLDERS IN ORDER TO PRIORITIZE COMMUNITY HEALTH CONCERNS.
WAYNE MEMORIAL HOSPITAL, INC.PART V, SECTION B, LINE 11: FISCAL YEAR 2016 WAS A 9 MONTH SHORT YEAR ENDING JUNE 30, 2016. THE YEAR END WAS CHANGED TO ALIGN WITH THE FISCAL YEAR OF UNC HOSPITALS, THE ORGANIZATION'S MANAGING HOSPITAL. THE ORGANIZATION'S BOARD WILL ADOPT THE IMPLEMENTATION PLAN TO ADDRESS THE 2015 CHNA AT ITS SEPT 14, 2016 MEETING, WHICH IS WITHIN THE OLD 12-MONTH FISCAL YEAR TIMELINE THAT THE ORGANIZATION ALWAYS FOLLOWED IN ADOPTING CHNAS AND IMPLEMENTATION PLANS.
WAYNE MEMORIAL HOSPITAL, INC.PART V, SECTION B, LINE 16I: ALL SELF PAY INPATIENTS RECEIVE VISITS FROM FINANCIAL COUNSELORS, AND THE CHARITY POLICY IS REVIEWD AT THAT TIME. SELF PAY OUTPATIENTS ARE SENT LETTERS OFFERING FINANCIAL ASSISTANCE. IF WE CAN IDENTIFY CHARITY STATUS AT TIME OF VISIT (BASED ON PATIENT) NO BILL IS SENT.
WAYNE MEMORIAL HOSPITAL, INC.PART V, SECTION B, LINE 22D: UNISURED PATIENTS ARE BILLED THE SAME CHARGES AS INSURED PATIENTS. HOWEVER, A 16% DISCOUNT IS APPLIED FOR UNINSURED PATIENTS AND FOR PATIENTS WHO QUALIFY FOR CHARITY. THE REMAINING 84% IS ADJUSTED.
PART V, SECTION B, LINE 16A, FAP WEBSITEHTTP://WWW.WAYNEHEALTH.ORG/PATIENTS/PATIENT-FINANCIAL-SERVICES/WAYNE-MEDICAL-ASSISTANCE-PROGRAM/
PART V, SECTION B, LINE 16B, FAP APPLICATION WEBSITEHTTP://WWW.WAYNEHEALTH.ORG/WP-CONTENT/UPLOADS/2015/07/WMAP-APPLICATION-UPDATED-062014.PDF
PART V, SECTION B, LINE 16C, FAP PLAIN LANGUAGE SUMMARY WEBSITEHTTP://WWW.WAYNEHEALTH.ORG/PATIENTS/PATIENT-FINANCIAL-SERVICES/WAYNE-MEDICAL-ASSISTANCE-PROGRAM/
PART V, SECTION B, LINE 16FINANCIAL ASSISTANCE POLICY WEBSITE AVAILABILITY
WAYNE MEMORIAL HOSPITAL, INC. PART V, SECTION B, LINE 16A WEBSITE:SEE PART VI
WAYNE MEMORIAL HOSPITAL, INC. PART V, SECTION B, LINE 16B WEBSITE:SEE PART VI
WAYNE MEMORIAL HOSPITAL, INC. PART V, SECTION B, LINE 16C WEBSITE:SEE PART VI
FieldValueIRS element (for citing)
Facility3FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (3 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
WAYNE MRI LLC
2700 WAYNE MEMORIAL DRIVEGOLDSBORONC27533MRI
GOLDSBORO WOUND CARE CENTER
2700 WAYNE MEMORIAL DRIVEGOLDSBORONC27533WOUND CARE
KINSTON WOUND CARE CENTER
204 AIRPORT ROADKINSTONNC28504WOUND CARE

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 3C:WAYNE MEMORIAL MANAGEMENT USES 200% OF FEDERAL POVERTY GUIDELINES TO DETERMINE ELIGIBILITY FOR PATIENTS WHO PROVIDES INFOMRATION TO US. WE ALSO USE A PROPRIETARY CREDIT SCORING TOOL TO FURTHER DETERMINE ELIGIBILITY AND FOR NON-COMPLIANT PATIENTS. THIS PROPRIETARY TOOL USES ALGORITHMS, CONSUMER DATA, AND OTHER INFORMATION TO ASSIST WITH UNDERSTANDING PATIENT'S ABILITY TO PAY.
PART I, LINE 7:AMOUNTS SHOWN IN PART I, LINE 7, COLUMN C WERE COMPUTED USING THE COST-TO-CHARGE RATIO WORKSHEET (WORKSHEET 2) FROM THE IRS INSTRUCTIONS FOR SCHEDULE H.
PART I, LN 7 COL(F):FOR PURPOSES OF CALCULATING THE COMMUNITY BENEFIT PERCENTAGE IN PART I, COLUMN (F), THE ORGANIZATION SUBTRACTED $21,818,418 (WHICH WAS REPORTED ON FORM 990, PART IX, LINE 25) AS BAD DEBT EXPENSE).
PART II, COMMUNITY BUILDING ACTIVITIES:THE HOSPITAL SURVEYS THE NEEDS OF THE MEDICAL COMMUNITY (PROVIDERS) TO ENABLE THE BOARD OF DIRECTORS TO ADOPT A MEDICAL STAFF DEVELOPMENT PLAN, FROM WHICH THEY DETERMINE RECRUITMENT TARGETS. IN THE CURRENT ENVIRONMENT, HOSPITALS ARE WORKING WITH MEDICAL STAFFS TO MEET THE NEED FOR PRIMARY CARE, AS WELL AS SPECIALTY CARE. THE HOSPITAL HAS PROVIDED SUPPORT IN THE FORM OF LOANS TO DOCTORS NEW TO THE AREA FOR THE FIRST YEAR OF PRACTICE, WHICH ARE FORGIVEN AS THESE PHYSICIANS STAY AND MEET COMMUNITY NEEDS.WAYNE MEMORIAL HOSPITALS EMPLOYS MORE THAN 700 REGISTERED NURSES, PLUS OTHER LICENSED HEALTH PROVIDERS (LAB TECHNOLOGISTS, IMAGING TECHNOLOGISTS, PHARMACISTS, PHARMACY TECHNOLOGISTS) TO CARE FOR RESIDENTS OF WAYNE COUNTY WHO NEED HOSPITAL SERVICES. IN SUPPORT OF THIS MISSION, THE HOSPITAL HAS CONTRIBUTED SCHOLARSHIP FUNDS TO ENABLE STUDENTS AT WAYNE COMMUNITY COLLEGE TO PURSUE DEGREES IN HEALTH SCIENCES. NURSES FROM WAYNE MEMORIAL ARE A VITAL PART OF SCHOOL-BASED HEALTH, AND ARE ALSO PART OF MANY LOCAL BUSINESSES WHICH SEE THE VALUE OF HAVING ON-SITE HEALTH EXPERTISE IN KEEPING THEIR EMPLOYEES PRODUCTIVE AND WELL. EDUCATING OUR LOCAL WORKFORCE IS A PRIORITY OF THIS HOSPITAL, IN TERMS OF CARE OF PATIENTS, AND CREATING A CULTURE OF WELLNESS WITHIN OUR COMMUNITY, BOTH AT SCHOOLS, IN BUSINESSES AND IN HOMES.
PART III, LINE 4:THE HOSPITAL USES HISTORICAL COLLECTION EXPERIENCE AND A REVIEW OF CURRENT RECEIVABLES TO PROVIDE AN ESTIMATE OF THE ALLOWANCE FOR UNCOLLECTIBLES AND THE BAD DEBT EXPENSE. ACCOUNTS PAST DUE FOR MORE THAN 90 DAYS ARE INDIVIDUALLY ANALYZED FOR COLLECTIBILITY. IF DEEMED UNCOLLECTIBLE, ACCOUNTS ARE REFERRED TO ONE OF TWO OUTSIDE COLLECTION AGENCIES UNLESS THE ACCOUNT IS BEING REVIEWED UNDER THE HOSPITAL'S CHARITY POLICY. THE HOSPITAL PROVIDES SERVICES TO PATIENTS REGARDLESS OF ABILITY TO PAY. AS A RESULT, THE HOSPITAL HAS INCURRED LOSSES FROM BAD DEBT EXPENSE. THESE UNREIMBURSED SERVICES ARE CONSIDERED A COMMUNITY BENEFIT SINCE THE HEALTHCARE NEEDS OF THE COMMUNITY WOULD OTHERWISE BE UNMET. NOTE 2 ON PAGE 18 OF THE AUDITED FINANCIAL STATEMENTS DISCUSSES BAD DEBTS.PART III, SECTION A, LINE 2:THE AMOUNT ON LINE 2 WAS DERIVED BY TAKING THE BAD DEBT EXPENSE PER THE AUDITED FINANCIAL STATEMENTS AND MULTIPLYING IT BY THE RATIO OF PATIENT CARE COST TO CHARGES DERIVED USING WORKSHEET 2 OF THE IRS INSTRUCTIONS FOR SCHEDULE H.PART III, SECTION A, LINE 3:THE HOSPITAL DOES NOT HAVE A PROCESS IN PLACE THAT ESTIMATES THE AMOUNT OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER A FINANCIAL ASSISTANCE POLICY.
PART III, LINE 8:THE HOSPITAL PROVIDES SERVICES TO PATIENTS REGARDLESS OF ABILITY TO PAY. AS A RESULT, THE HOSPITAL HAS INCURRED LOSSES BY SERVING MEDICARE PATIENTS. THE UNREIMBURSED SERVICES THE HOSPITAL PROVIDES TO PATIENTS COVERED BY MEDICARE SHOULD BE CONSIDERED A COMMUNITY BENEFIT SINCE THE HEALTHCARE NEEDS OF THE COMMUNITY WOULD OTHERWISE BE UNMET.PART III, SECTION B, LINE 8:THE COST TO CHARGE RATIO AS CALCULATED BY THE MOST RECENTLY FILED COST REPORT WAS USED TO DETERMINE MEDICARE ALLOWABLE COSTS.
PART III, LINE 9B:OUR COLLECTION POLICY INDICATES OUR USE OF A CREDIT SCORING TOOL WHICH ASSISTS OUR COLLECTION STAFF IN THE IDENTIFICATION OF PATIENTS THAT QUALIFY FOR UNCOMPENSATED CARE.
PART VI, LINE 2:WAYNE MEMORIAL HOSPITAL ROUTINELY CONDUCTS A JOINT COMMUNITY HEALTH NEEDS ASSESSMENT WITH THE WAYNE COUNTY HEALTH DEPARTMENT. IN 2015, A JOINT CHNA WAS BEGUN, WHICH CONCLUDED IN THE FALL OF 2015, AND WAS REPORTED TO THE COMMUNITY IN SUMMER 2016, PART OF THE HOSPITAL'S FYE 9/30/2016. AS PART OF THIS CHNA, AN ELECTRONIC AND PAPER SURVEY WAS CONDUCTED, WITH MORE THAN 500 RESPONSES. FOCUS GROUPS WERE CONVENED IN 6 DIFFERENT SETTINGS (DIVERSE IN GEOGRAPHY AND CULTURE) TO ADD MORE UNDERSTANDING. ACTIONS ARE BEING COORDINATED AND TAKEN BY KEY CONSTITUENTS FROM WAYNE COUNTY, IN PARTNERSHIP WITH THE WAYNE COUNTY HEALTH DEPARTMENT, THE CITY OF GOLDSBORO, THE HOSPITAL AND OTHER AGENCIES TO ENCOURAGE GOOD HEALTH COUNTY-WIDE.FINDINGS FROM THE 2015 COMMUNITY HEALTH NEEDS ASSESSMENT SHOWED SIGNIFICANT OVERLAP WITH THOSE FROM THE 2012 COMMUNITY HEALTH NEEDS ASSESSMENT. OBESITY CONTINUES TO BE THE SINGLE MORE PERVASIVE HEALTH ISSUE IN WAYNE COUNTY, FOLLOWED BY CHRONIC DISEASES. TOGETHER, THESE ARE TAKING A HEAVY TOLL ON WAYNE COUNTYS HEALTH. MORE THAN 12% OF WAYNE COUNTY ADULTS ARE DIAGNOSED WITH DIABETES. OBESITY HAS BEEN SHOWN TO CONTRIBUTE TO THE LEADING CAUSES OF DEATH INCLUDING HEART DISEASE, SOME CANCERS, AND DIABETES. THE PERCENTAGE OF OVERWEIGHT AND OBESE ADULTS IN WAYNE COUNTY HAS INCREASED TO MORE THAN 70% - MORE THAN 65,000 PEOPLE. IN RESPONSE TO THIS ISSUE, COMMUNITY PARTNERS HAVE COME TOGETHER TO FORM THE "HEALTHY WAYNE TASK FORCE", WHICH HAS PLACE HEALTHY LIVING AT ITS CENTER. ITS FIRST INITIATIVE, BEGUN IN THE SUMMER OF 2013, IS CALLED GOWAYNEGO. INITIAL EFFORTS HAVE BEEN TO CENTRALIZE COMMUNICATIONS TO LOCAL CITIZENS ABOUT THE IMPORTANCE OF INCREASING DAILY MOVEMENT, AND EDUCATING CITIZENS ABOUT FREE AND LOW-COST WAYS TO GET MORE ACTIVE IN WAYNE COUNTY. MORE THAN 3,000 T-SHIRTS WITH THE GOWAYNEGO LOGO HAVE BEEN DISTRIBUTED TO WAYNE COUNTY RESIDENTS, AND A WEBSITE HAS BEEN SET UP TO ENCOURAGE GETTING ROUTINE EXERCISE. PARTNERS IN THE HEALTHY WAYNE TASK FORCE INCLUDE WAYNE COUNTY HEALTH DEPARTMENT, WAYNE HEALTH FOUNDATION (DBA WATCH), GOLDSBORO FAMILY YMCA, CITY OF GOLDSBORO PARKS & RECREATION DEPARTMENT, UNITED WAY OF WAYNE COUNTY, SEYMOUR JOHNSON AIR FORCE BASE, GOLDSBORO PEDIATRICS, PARTNERSHIP FOR CHILDREN OF WAYNE COUNTY, WAYNE INITIATIVE FOR SCHOOL HEALTH, AND OTHERS. HEALTH LITERACY AND MENTAL HEALTH WERE THE OTHER MOST SIGNIFICANT ISSUES COMING OUT OF THE 2015 COMMUNITY HEALTH ASSESSMENT. A SUMMARY OF ALL INITIATIVES SELECTED, RESOURCES, USED, AND EVALUATION OF RESULTS IS INCLUDED AT WWW.WAYNEHEALTH.ORG.HEALTH LITERACY IS AN ISSUE IN RURAL AREAS LIKE EASTERN NORTH CAROLINA. IN WAYNE COUNTY, 10% OF ADULTS ARE NON-READERS, AND 26% STRUGGLE WITH BASIC LITERACY. WAYNE MEMORIAL HOSPITAL HAS A TEAM OF NURSES AND TRAINERS WORKING TO INCORPORATE MORE UNDERSTANDABLE DISCHARGE INSTRUCTIONS FOR PATIENTS AND FAMILIES, TO REDUCE THE NUMBERS OF PATIENTS WHO MUST RETURN TO THE HOSPITAL SOON AFTER DISCHARGE FOR PROBLEMS THAT MIGHT NOT HAVE ARISEN IF THERE WERE BETTER UNDERSTANDING OF FOLLOW UP CARE. THIS TEAM IS USING RESOURCES DEVELOPED FROM AROUND THE COUNTRY TO TRY TO GET IMPROVED RESULTS (LOWER READMISSIONS). WITH RESPECT TO TEACHING READING SKILLS, IN WAYNE COUNTY, LITERACY CONNECTIONS OF WAYNE COUNTY IS A NON-PROFIT AGENCY CREATED TO IMPROVE ADULT LITERACY. LITERACY CONNECTIONS PROVIDES FREE, CONFIDENTIAL, ONE-ON-ONE TUTORING FOR ADULTS TO IMPROVE THEIR READING SKILLS. IT IS SUPPORTED BY WAYNE COUNTY GOVERNMENT, AND UNITED WAY OF WAYNE COUNTY. IN SCHOOLS, WAYNE MEMORIAL PROVIDES AN AWARD-WINNING QUARTERLY "KIDS PAGE" TO EACH ELEMENTARY STUDENT TO ENCOURAGE HEALTH LITERACY. MENTAL HEALTH IS AN ISSUE THAT CONTINUES TO IMPACT HEALTH CARE IN OUR COMMUNITY, OUR STATE AND THE ENTIRE COUNTRY. IN RECOGNITION OF THE SPECIAL NEEDS OF PATIENTS WITH BEHAVIORAL HEALTH ISSUES, THE HOSPITAL DESIGNED ITS NEW EMERGENCY DEPARTMENT (OPENED IN 2012) TO ENABLE SEPARATION OF PATIENTS WITH MENTAL ISSUES FROM PATIENTS WITH PHYSICAL HEALTH ISSUES. THE OBJECTIVE WAS TO GIVE THESE PATIENTS AN AREA WHERE THEY CAN BE CARED FOR IN A CALM CONTROLLED ENVIRONMENT, WHERE THEY AND THOSE THAT ARE CARING FOR THEM CAN BE SAFE. IN ADDITION, THE HOSPITAL'S PARENT ORGANIZATION, WAYNE HEALTH CORPORATION, RECOGNIZING THE NEED TO REPLACE PSYCHIATRISTS WHO WERE APPROACHING RETIREMENT, RECRUITED THREE ADDITIONAL PSYCHIATRISTS, EMPLOYED BY HOSPITAL'S SISTER ORGANIZATION, WAYNE HEALTH PHYSICIANS, TO SEE PATIENTS IN OFFICES AS OUTPATIENTS, PLUS TREAT PATIENTS ADMITTED TO THE INPATIENT UNIT. A SUMMARY OF ALL INITIATIVE SELECTED, RESOURCES USED, AND EVALUATION OF RESULTS IS INCLUDED AT WWW.WAYNEHEALTH.ORG.
PART VI, LINE 3:WE HAVE FINANCIAL COUNSELORS THAT ASSIST WHILE THEY ARE PATIENTS. WE ALSO SEND FINANCIAL ASSISTANCE LETTERS TO PATIENTS THAT WE ARE UNABLE TO SEE WHILE THEY ARE IN-HOUSE. WE ALSO PROVIDE INFORMATIONAL PAMPHLETS AND HAVE INFORMATION AVAILABLE ON THE HOSPITAL WEBSITE.
PART VI, LINE 4:WAYNE MEMORIAL HOSPITAL SERVES PRIMARILY WAYNE COUNTY,NORTH CAROLINA, WITH AN ESTIMATED POPULATION WAS 124,000 IN 2015, ACCORDING TO THE US CENSUS QUICKFACTS. THE POPULATION IS SLIGHTLY YOUNGER THAN THE AVERAGE IN NORTH CAROLINA, LIKELY DUE TO THE PRESENCE OF SEYMOUR JOHNSON AIR FORCE BASE, WITH ABOUT 6,000 ACTIVE DUTY AND RESERVISTS PLUS THEIR FAMILIES. AVERAGE HOUSEHOLD INCOME IN WAYNE COUNTY IS LOWER, AT $41,172, THAN NORTH CAROLINA'S AVERAGE OF $46,693. CHILDREN LIVING IN POVERTY IN WAYNE COUNTY, (AVERAGE 2010-2014) IS HIGHER, AT 35%, COMPARED TO NORTH CAROLINA'S AVERAGE OF 26%. WAYNE COUNTY'S POPULATION IS 51.1% WHITE, 32% BLACK, AND 11.2% HISPANIC. THE COUNTY IS LARGE, AT 553 SQUARE MILES, AND IT IS THE 4TH LARGEST AGRICULTURAL PRODUCER IN THE STATE. POVERTY IMPACTS ACCESS TO CARE, WITH EMERGENCY DEPARTMENT USE HIGHER IN AREAS WITH HIGHER PROVERTY, AND SHORTER LIVES ON AVERAGE.
PART VI, LINE 5:WAYNE MEMORIAL HOSPITAL HAS AN OPEN MEDICAL STAFF, WHICH MEANS THAT ANY PHYSICIAN WHO MEETS QUALITY STANDARDS SET BY A COMMITTEE OF THE HOSPITAL (WHICH INCLUDES BOARD MEMBERS) IS WELCOME TO JOIN THE STAFF, IN RETURN FOR CERTAIN RESPONSIBILITIES RELATED TO PROVIDING CARE TO PATIENTS SEEN IN THE EMERGENCY DEPARTMENT WHO NEED INPATIENT CARE. THE BOARD OF DIRECTORS IS COMPRISED ON 12 CITIZENS OF WAYNE COUNTY, INCLUDING THE CEO, WHO ARE CHARGED WITH ENSURING THAT QUALITY, EFFICIENT CARE IS PROVIDED AT THE HOSPITAL, AND FOR ENSURING PLANNING, WITH COMMUNITY PARTNERS, FOR FUTURE HEALTH NEEDS.
PART VI, LINE 6:AS THE PROVIDER OF CARE WITHIN THE COMMUNITY WITH THE MOST DIVERSE AND SOPHISTICATED EQUIPMENT, THE BOARD, MANAGEMENT AND STAFF OF WAYNE MEMORIAL HOSPITAL SEES ITS ROLE AS BOTH COORDINATOR OF CARE FOR THOSE WHO ARE THE SICKEST IN OUR COMMUNITY AS WELL AS PROMOTER OF HEALTHY LIVING FOR ALL RESIDENTS, IN COORDINATION WITH OUR PARTNERS IN HEALTH THROUGHOUT WAYNE COUNTY. THE HOSPITAL HAS TWO PRIMARY AFFILIATES THAT ARE INTEGRAL TO COMMUNITY HEALTH. ONE IS WAYNE HEALTH FOUNDATION,DBA "WATCH", WHICH HAS OPERATED A MOBILE VAN FOR UNINSURED SINCE THE 1990'S, ADDED TWO FIXED CLINICS SINCE 2009, AND WHOSE OTHER PRIMARY FOCUS HAS BEEN ADDRESSING COMMUNITY NEEDS IDENTIFIED IN FREQUENT HEALTH NEEDS ASSESSMENTS SINCE THAT TIME. THE SECOND SISTER CORPORATION, WAYNE HEALTH PHYSICIANS, WAS ORGANIZED IN 2009 TO HELP MEET THE NEEDS FOR PRIMARY AND SPECIALTY PHYSICIAN CARE IN WAYNE COUNTY. THIS WAS IN RESPONSE TO NATIONAL TRENDS THAT SHOWED PHYSICIANS SEEKING EMPLOYMENT IN SYSTEM ENVIRONMENTS TO ALLOW THEM MORE FOCUS ON PATIENT CARE, AND LESS ON THE BUSINESS ASPECTS OF MEDICAL PRACTICES. THIS COMPANY IS PROVIDING AN AVENUE TO WORK TOWARD LOWER OVERALL HEALTH CARE COSTS THROUGH BETTER COORDINATION OF CARE, WITH THE OBJECTIVE OF PROVIDING SERVICES TO PATIENTS IN THE LOWEST COST SETTING.
PART VI, LINE 7, REPORTS FILED WITH STATESNC

Schedule I IRS990ScheduleI

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

Recipient Table RecipientTable

Recipient Business Name RecipientBusinessName

FieldValueIRS element (for citing)
Business Name Line1THE FOUNDATION OF WAYNE COMMUNITY COLLEGEBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 8002AddressLine1Txt
CityGOLDSBOROCityNm
State AbbreviationNCStateAbbreviationCd
ZIP27533ZIPCd
FieldValueIRS element (for citing)
Recipient EIN561556512RecipientEIN
IRC Section501(C)(3)IRCSectionDesc
Cash Grant$100,000CashGrantAmt
Purpose Of GrantNURSING SCHOLARSHIPSPurposeOfGrantTxt
FieldValueIRS element (for citing)
Total501c3 Org1Total501c3OrgCnt

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp

FieldValueIRS element (for citing)
Grant TypeEDUCATIONAL SCHOLARSHIPSGrantTypeTxt
Recipient32RecipientCnt
Cash Grant$44,430CashGrantAmt
Non Cash AssistanceADDITIONAL COURSE STUDYNonCashAssistanceDesc

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 2:FormAndLineReferenceDesc
ExplanationWAYNE MEMORIAL HOSPITAL, INC. MAKES GRANTS TO SUPPORT THE ACTIVITIES OF ITS RELATED ORGANIZATIONS AND TO PROMOTE GOOD COMMUNITY RELATIONS.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Club Dues Or FeesYes (X)ClubDuesOrFeesInd
Written Policy Ref T And E ExpnssYes (1)WrittenPolicyRefTAndEExpnssInd
Substantiation RequiredYes (1)SubstantiationRequiredInd
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
Written Employment ContractYes (X)WrittenEmploymentContractInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (1)SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (10 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
J WILLIAM PAUGH
CEO$544,834$0$76,847$0$226,030$0$94,745$0$57,322$0$999,778$0$0$0
REBECCA CRAIG
CFO$232,336$0$11,617$0$903$0$47,590$0$17,634$0$310,080$0$0$0
THOMAS W BRADSHAW
VP - OPERATIONS$258,398$0$12,920$0$953$0$36,718$0$35,334$0$344,323$0$0$0
RICHARD ROGERS
VP - HR$173,514$0$6,940$0$10,047$0$18,142$0$30,289$0$238,932$0$0$0
SHIRLEY S HARKEY
VP - NURSING SER$200,824$0$10,041$0-$883$0$38,870$0$17,131$0$265,983$0$0$0
RICHARD BAZIK
CRNA$214,755$0$0$0$0$0$20,402$0$14,889$0$250,046$0$0$0
AMY WILLOUGHBY
CRNA$225,091$0$0$0$0$0$21,384$0$16,576$0$263,051$0$0$0
RICHARD MIDDLETON
CRNA$207,317$0$0$0$0$0$6,472$0$31,656$0$245,445$0$0$0
DANIEL P BROCK
CRNA$234,019$0$0$0$0$0$7,015$0$11,961$0$252,995$0$0$0
PHYLLIS HILL
DIRECTOR$229,041$0$0$0$0$0$21,759$0$29,469$0$280,269$0$0$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 1ALESS THAN $300 PAID ANNUALLY.
PART I, LINE 1BCERTAIN DUES AND FEES AND COMPANION TRAVEL ARE REIMBURSED BY THE ORGANIZATION.
PART I, LINE 4BJ. WILLIAM PAUGH PARTICIPATED IN A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN AND RECEIVED $100,093 IN PAYMENTS FROM THE PLAN DURING THE YEAR.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (2 entries)

Bond ReferenceBondReferenceCdBond Issuer EINBondIssuerEINCUSIPCUSIPNumBond IssuedBondIssuedDtIssue PriceIssuePriceAmtPurposePurposeDescDefeasedDefeasedIndOn Behalf Of IssuerOnBehalfOfIssuerIndPool FinancingPoolFinancingInd
NORTH CAROLINA MEDICAL CARE COMMISSION
A52130940265820HB932009-03-19$35,720,000REFUND PRIOR BONDS000
NORTH CAROLINA MEDICAL CARE COMMISSION
B521309402NONEAVAIL2015-07-21$17,455,000000

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)

Bond ReferenceBondReferenceCdRetiredRetiredAmtTotal ProceedsTotalProceedsAmtIssuance Costs From ProceedsIssuanceCostsFromProceedsAmtCredit EnhancementCreditEnhancementAmtOther Spent ProceedsOtherSpentProceedsAmtSubstantial CompletionSubstantialCompletionYrCurrent RefundingCurrentRefundingIndAdvance RefundingAdvanceRefundingIndFinal Allocation MadeFinalAllocationMadeIndAdequate Books And Rec MaintAdequateBooksAndRecMaintInd
A$3,705,000$35,720,000$400,705$219,295$35,100,0002009Yes (1)0Yes (1)Yes (1)
B$17,455,000Yes (1)0Yes (1)Yes (1)

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (2 entries)

Bond ReferenceBondReferenceCdOwning Bond Financed PropertyOwningBondFinancedPropertyIndAny Lease ArrangementsAnyLeaseArrangementsIndMgmt Contract Bond Fincd PropMgmtContractBondFincdPropIndEngage Bond Counsel ContractsEngageBondCounselContractsIndAny Research AgreementsAnyResearchAgreementsIndPrivate Bus Concerning UBIPrivateBusConcerningUBIPctTotal Private Business UseTotalPrivateBusinessUsePctBond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestIndChange In Use Bond Financed PropChangeInUseBondFinancedPropIndProcs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd
A00Yes (1)Yes (1)00.039900.0399000Yes (1)
B0Yes (1)Yes (1)Yes (1)00.025900.0259000Yes (1)

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (2 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledIndRebate Not Due YetRebateNotDueYetIndException To RebateExceptionToRebateIndNo Rebate DueNoRebateDueIndVariable Rate IssueVariableRateIssueIndHedge Identified In Bks And RecHedgeIdentifiedInBksAndRecIndTerm Of HedgeTermOfHedgePctSuperintegrated HedgeSuperintegratedHedgeIndHedge TerminatedHedgeTerminatedIndGross Proceeds Invested In GICGrossProceedsInvestedInGICIndGross Proceeds InvestedGrossProceedsInvestedIndWritten Proc To Monitor ReqsWrittenProcToMonitorReqsInd
WELLS FARGO
A0000Yes (1)Yes (1)21.00000000000000000
(no name)
B00Yes (1)00000Yes (1)

Procedures Corrective Action ProceduresCorrectiveActionGrp

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

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11A DRAFT OF FORM 990 IS MADE AVAILABLE TO THE GOVERNING BODY FOR REVIEW BEFORE IT IS FILED WITH THE IRS.
FORM 990, PART VI, SECTION B, LINE 12CALL PERSONNEL ARE RESPONSIBLE FOR ADHERING TO THE CORPORATE COMPLIANCE PLAN. THIS PLAN REQUIRES PERSONNEL TO DISCLOSE CONFLICTS AS THEY ARISE. VOTING MEMBERS OF THE GOVERNING BODY ARE RECUSED FROM VOTING WHEN A CONFLICT ARISES.
FORM 990, PART VI, SECTION B, LINE 15COMPENSATION IS REVIEWED AGAINST COMPARABILITY DATA AND APPROVED BY THE BOARD. WRITTEN COMPENSATION AGREEMENTS ARE KEPT UP-TO-DATE. OFFICER AND KEY EMPLOYEE COMPENSATION IS REVIEWED ANNUALLY.
FORM 990, PART VI, SECTION C, LINE 19THESE DOCUMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. THE CORPORATE COMPLIANCE POLICY IS AVAILABLE ON THE HOSPITAL'S WEBSITE. ADDITIONALLY, THE AUDITED FINANCIAL STATEMENTS ARE AVAILABLE ON WWW.DACBOND.COM AND WWW.GUIDESTAR.ORG.
FORM 990, PART XI, LINE 9:NET ASSETS RELEASED FROM RESTRICTIONS -680,317. CHANGE IN MINIMUM PENSION LIABILITY -17,367,299. CHANGE IN VALUE OF DERIVATIVE FINANCIAL INSTRUMENT -2,116,515. DISTRIBUTIONS FROM MEMBERS PREMIER K-1 UBI NOT REFLECTED IN AUDIT REPORT -6,920.
FORM 990, PART XII, LINE 2CNO CHANGE FROM PRIOR YEAR.

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1AMERICAN MANAGEMENT ASSOCIATES LLCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line12719 GRAVES DRIVEAddressLine1Txt
CityGOLDSBOROCityNm
State AbbreviationNCStateAbbreviationCd
ZIP27534ZIPCd
FieldValueIRS element (for citing)
EIN561622637EIN
Primary ActivitiesCOLLECTIONSPrimaryActivitiesTxt
Legal Domicile StateNCLegalDomicileStateCd
Total Income$972,763TotalIncomeAmt
End Of Year Assets$926,771EndOfYearAssetsAmt
Direct Controlling NAN/ADirectControllingNACd

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (3 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtDirect Controlling NADirectControllingNACdControlled OrganizationControlledOrganizationInd
WAYNE HEALTH FOUNDATION INC
2700 WAYNE MEMORIAL DRIVEGOLDSBORONC27533581881912SUPPORTNC501(C)(3)LINE 9N/A0
WAYNE HEALTH CORPORATION
PO BOX 8001GOLDSBORONC27534561479733HEALTHCARENC501(C)(3)LINE 11A, IN/A0
WAYNE HEALTH PHYSICIANS
2700 WAYNE MEMORIAL DRIVEGOLDSBORONC27533264291056HEALTHCARENC501(C)(3)LINE 9N/A0

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1WAYNE MRI LLCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line12700 WAYNE MEMORIAL DRIVEAddressLine1Txt
CityGOLDSBOROCityNm
State AbbreviationNCStateAbbreviationCd
ZIP27533ZIPCd
FieldValueIRS element (for citing)
EIN342043934EIN
Primary ActivitiesMRI SERVICESPrimaryActivitiesTxt
Legal Domicile StateNCLegalDomicileStateCd
Direct Controlling NAN/ADirectControllingNACd
Predominant Income TypeRELATEDPredominantIncomeTypeTxt
Disproportionate Allocations0DisproportionateAllocationsInd
General Or Managing PartnerYes (1)GeneralOrManagingPartnerInd
Ownership0.66670OwnershipPct

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtShare Of Total IncomeShareOfTotalIncomeAmtShare Of EOY AssetsShareOfEOYAssetsAmtOwnershipOwnershipPctControlled OrganizationControlledOrganizationInd
WAYNE HEALTH ENTERPRISES INC
PO BOX 8001GOLDSBORONC27533561622624NCWAYNE MEMORIAL HOSPITAL INCC-$3,338$400,5631.00000Yes (1)
WAYNE HEALTH PROPERTIES
PO BOX 8001GOLDSBORONC27533561756076NCWAYNE HEALTH ENTERPRISESC0
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsYes (1)ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth OrgYes (1)RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (1)PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other OrgYes (1)TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (2 entries)

Transaction TypeTransactionTypeTxtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
WAYNE HEALTH CORPORATION
KACTUAL CASH TRANSFER
WAYNE HEALTH PHYSICIANS
DACTUAL CASH TRANSFER