NORTH CAROLINA BAPTIST HOSPITAL: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- NORTH CAROLINA BAPTIST HOSPITAL (EIN 56-0552787)
- Tax period
- 2013-07-01 to 2014-06-30
- Filed
- 2015-05-14
- IRS object ID
- 201511349349305416
- Schema version
- 2013v4.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule F
- Schedule H
- Schedule I
- Schedule J
- Schedule K
- Schedule L
- Schedule M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2015-05-14T14:00:32-05:00 | ReturnTs |
| Tax Period End | 2014-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 135565207 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KPMG LLP | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 300 NORTH GREENE STREET | AddressLine1 |
| City | GREENSBORO | City |
| State | NC | State |
| ZIP Code | 27401 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2013-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 560552787 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NORTH CAROLINA BAPTIST HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | NORT | BusinessNameControlTxt |
| Phone | 3367164445 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | MEDICAL CENTER BLVD | AddressLine1 |
| City | WINSTONSALEM | City |
| State | NC | State |
| ZIP Code | 27157 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JOHN D MCCONNELL MD | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 3367164445 | PhoneNum |
| Signature | 2015-05-06 | SignatureDt |
| Discuss With Paid Preparer | 0 | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| PTIN | P00008888 | PTIN |
| Phone | 3362753394 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2016-02-25 16:41:14Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | JOHN D MCCONNELL MD | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | MEDICAL CENTER BLVD | AddressLine1 |
| City | WINSTONSALEM | City |
| State | NC | State |
| ZIP Code | 27157 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $1,287,582,255 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.WAKEHEALTH.EDU | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1923 | FormationYr |
| Legal Domicile State | NC | LegalDomicileStateCd |
| Activity Or Mission | IMPROVING THE HEALTH OF OUR REGION, STATE AND NATION | ActivityOrMissionDesc |
| Voting Members Governing Body | 17 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 16 | VotingMembersIndependentCnt |
| Total Employee | 10215 | TotalEmployeeCnt |
| Total Volunteers | 1678 | TotalVolunteersCnt |
| Total Gross UBI | $3,276,238 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $1,619,100 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $3,462,376 | PYContributionsGrantsAmt |
| CY Contributions Grants | $4,779,473 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $1,218,479,632 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $1,248,886,678 | CYProgramServiceRevenueAmt |
| PY Investment Income | $42,423,781 | PYInvestmentIncomeAmt |
| CY Investment Income | $28,301,498 | CYInvestmentIncomeAmt |
| PY Other Revenue | $3,626,103 | PYOtherRevenueAmt |
| CY Other Revenue | $4,875,926 | CYOtherRevenueAmt |
| PY Total Revenue | $1,267,991,892 | PYTotalRevenueAmt |
| CY Total Revenue | $1,286,843,575 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $1,278,528 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $1,333,090 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $547,352,388 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $588,281,320 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $712,232,895 | PYOtherExpensesAmt |
| CY Other Expenses | $710,751,095 | CYOtherExpensesAmt |
| PY Total Expenses | $1,260,863,811 | PYTotalExpensesAmt |
| CY Total Expenses | $1,300,365,505 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $7,128,081 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$13,521,930 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $1,778,311,980 | TotalAssetsBOYAmt |
| Total Assets EOY | $1,812,990,944 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $815,813,924 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $860,530,734 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $962,498,056 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $952,460,210 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | SEE SCHEDULE O FOR CONTINUATIONWAKE FOREST BAPTIST MEDICAL CENTER'S MISSION IS TO IMPROVE THE HEALTH OF THE REGION, STATE AND NATION BY:- SERVING AS THE PREMIER HEALTH SYSTEM IN THE REGION, WITH SPECIFIC CENTERS OF EXCELLENCE RECOGNIZED AS NATIONAL AND INTERNATIONAL CARE DESTINATIONS.- GENERATING AND TRANSLATING KNOWLEDGE TO PREVENT, DIAGNOSE AND TREAT DISEASE.- TRAINING TOMORROW'S LEADERS IN HEALTH CARE AND BIOMEDICAL SCIENCE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $1,192,293,137 | ExpenseAmt |
| Grant | $1,333,090 | GrantAmt |
| Revenue | $1,245,963,144 | RevenueAmt |
| Desc | SEE SCHEDULE O FOR COMPLETE DESCRIPTIONNORTH CAROLINA BAPTIST HOSPITAL IS AN INTEGRAL PART OF WAKE FOREST BAPTIST MEDICAL CENTER, A PREEMINENT, INTERNATIONALLY RECOGNIZED ACADEMIC MEDICAL CENTER OF THE HIGHEST QUALITY WITH BALANCED EXCELLENCE IN PATIENT CARE, RESEARCH AND EDUCATION. THE FOLLOWING PARAGRAPHS ARE PROVIDED TO EXPLAIN THE RELATIONSHIP OF THE FILING ORGANIZATION WITH OTHER ORGANIZATIONS WHICH TOGETHER COMPRISE "WAKE FOREST BAPTIST MEDICAL CENTER", THE NAME, NOT OF ANY ONE CORPORATE ENTITY, BUT THAT IS USED GENERICALLY TO DESCRIBE A LARGE GROUP OF MOSTLY TAX-EXEMPT 501 (C)(3) ORGANIZATIONS PERFORMING VARIOUS ACADEMIC MEDICAL CENTER ACTIVITIES IN NORTHWEST NORTH CAROLINA, INCLUDING PATIENT CARE (THE "CLINICAL ENTERPRISE"), MEDICAL RESEARCH AND TECHNOLOGY TRANSFER (THE "INNOVATION ENTERPRISE") AND MEDICAL EDUCATION (THE "ACADEMIC ENTERPRISE"). BECAUSE THESE ACTIVITIES ARE NOT ALL PERFORMED BY EACH ORGANIZATION, THE NARRATIVE THAT FOLLOWS WILL INCLUDE DESCRIPTIONS OF ACTIVITIES THAT ARE NOT PERFORMED BY THE FILING ORGANIZATION BUT BY A RELATED (OR UNRELATED BUT AFFILIATED) ORGANIZATION; THEY ARE AGAIN PROVIDED TO ILLUSTRATE A COMPLETE PICTURE OF THE FILING ORGANIZATION'S ROLE IN THIS INTEGRATED ACADEMIC MEDICAL CENTER'S COMPREHENSIVE ACTIVITIES. WAKE FOREST BAPTIST MEDICAL CENTER IS NORTHWEST NORTH CAROLINA'S SOLE ACADEMIC MEDICAL CENTER, BRINGING TO THE REGION THE RESOURCES OF ONE OF AMERICA'S TOP HOSPITALS AND INNOVATIVE RESEARCH CENTERS AND A PREMIER MEDICAL SCHOOL. WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER IS A CORPORATION WHOSE MEMBERS ARE WAKE FOREST UNIVERSITY AND NORTH CAROLINA BAPTIST HOSPITAL. THE MEDICAL CENTER OPERATES WAKE FOREST SCHOOL OF MEDICINE, WHICH HAS A FACULTY OF 1,226, INCLUDING PHYSICIANS AND BASIC SCIENTISTS. THE MEDICAL CENTER HAS 1,004 ACUTE CARE AND REHABILITATION BEDS OPERATIVE ACROSS THE SYSTEM, WHICH ENCOMPASSES ITS MAIN CAMPUS (885 BEDS), BRENNER CHILDREN'S HOSPITAL (144 BEDS, INCLUDED IN MAIN CAMPUS TOTAL), WAKE FOREST BAPTIST HEALTH-LEXINGTON MEDICAL CENTER (94 BEDS), AND WAKE FOREST BAPTIST HEALTH-DAVIE MEDICAL CENTER (25 BEDS). THE MEDICAL CENTER PRIMARILY SERVES A 24-COUNTY REGION IN NORTHWESTERN NORTH CAROLINA AND SOUTHWESTERN VIRGINIA. IT DRAWS PATIENTS FROM ACROSS THE NATION FOR SELECT SERVICES.THE MEDICAL CENTER IS THE DRIVING FORCE BEHIND THE ESTABLISHMENT OF WAKE FOREST INNOVATION QUARTER, A HUB FOR BIOMEDICAL AND MATERIAL SCIENCES AND INFORMATION TECHNOLOGY CREATED THROUGH PUBLIC-PRIVATE COLLABORATION AND LOCATED IN DOWNTOWN WINSTON-SALEM. MORE THAN 25 WAKE FOREST SCHOOL OF MEDICINE DEPARTMENTS ARE ALREADY LOCATED IN THE INNOVATION QUARTER, WHICH IS ALSO HOME TO MORE THAN 50 TECHNOLOGY COMPANIES, AND 3,000 SCIENTISTS, ENGINEERS AND OTHER PROFESSIONALS. 1. CLINICAL SERVICES WAKE FOREST BAPTIST MEDICAL CENTER IS NATIONALLY RECOGNIZED FOR CLINICAL EXCELLENCE AND INTERNATIONALLY KNOWN FOR PIONEERING RESEARCH AND CLINICAL INNOVATION. ITS CLINICAL ARM, WAKE FOREST BAPTIST HEALTH, OFFERS EXPERTISE IN MORE THAN 100 AREAS OF MEDICINE, ENCOMPASSING COMPREHENSIVE PREVENTIVE AND HIGHLY SPECIALIZED CARE FOR ALL AGES. THE MEDICAL CENTER NETWORK INCLUDES A NEWLY EXPANDED 148-BED COMPREHENSIVE CANCER CENTER THAT CONSOLIDATES INPATIENT AND OUTPATIENT SERVICES INTO A SINGLE LOCATION, COMMUNITY HOSPITALS IN NEIGHBORING DAVIDSON AND DAVIE COUNTIES, AND ACROSS ITS SERVICE AREA OF NORTHWEST NORTH CAROLINA AND SOUTHWEST VIRGINIA, 11 EMERGENCY DEPARTMENTS, 25 PRIMARY CARE AND 114 SPECIALTY CARE CLINICS, 17 DIALYSIS CENTERS, AND FREESTANDING IMAGING AND ENDOSCOPY CENTERS. THE WAKE FOREST BAPTIST HEALTH STAFF INCLUDES MORE THAN 900 PHYSICIANS, 2,500 REGISTERED NURSES, 566 RESIDENTS, 113 FELLOWS AND 2,000 OTHER PROFESSIONAL CLINICIANS.OVERALL IN FY 2014, WAKE FOREST BAPTIST HAD 36,363 INPATIENT ADMISSIONS AND 1,068,441 OUTPATIENT ENCOUNTERS (EMERGENCY DEPARTMENT, DOWNTOWN HEALTH PLAZA, WINSTON EAST PEDIATRICS, DAY HOSPITAL, LEXINGTON MEDICAL CENTER, AMBULATORY VISITS). THE TOTAL PATIENT ENCOUNTERS NUMBERED 1,104,804.2. OUTREACHWAKE FOREST BAPTIST MEDICAL CENTER CONTINUES A BROAD-BASED EFFORT TO REACH UNDERSERVED POPULATIONS ACROSS ITS SERVICE AREA. THE MEDICAL CENTER'S ANNUAL COMMUNITY BENEFITS REPORT REFLECTS THIS COMMITMENT TO UNDERSERVED POPULATIONS. IN FISCAL 2014, THE MEDICAL CENTER SPENT $273 MILLION TO SUPPORT THESE AREAS: - SUBSIDIZED HEALTH COSTS- COMMUNITY HEALTH OUTREACH- CHARITY CARE- RESEARCH- EDUCATION- UNREIMBURSED COSTS OF GOVERNMENT PROGRAMSONE ANCHOR OF OUTREACH FOR THE MEDICAL CENTER IS ITS DOWNTOWN HEALTH PLAZA, A FULL-SERVICE, OUTPATIENT MEDICAL CLINIC THAT SERVES MANY OF FORSYTH COUNTY'S UNINSURED AND UNDERINSURED RESIDENTS WITH A STATE-OF-THE-ART MEDICAL HOME. IN ADDITION TO CLINICAL CARE, THE DOWNTOWN HEALTH PLAZA OFFERS COMMUNITY HEALTH FAIRS, DIABETES EDUCATION AND A CENTERING PREGNANCY PROGRAM THAT IS REDUCING THE INCIDENCE OF LOW BIRTHWEIGHT BABIES. ALTOGETHER, 63,940 PATIENT VISITS WERE RECORDED AT THE DOWNTOWN HEALTH PLAZA BETWEEN JULY 2013 AND JUNE 2014.THE MEDICAL CENTER'S PROGRAMS AND PARTNERSHIPS REFLECT INNOVATIVE EFFORTS TO REACH UNDERSERVED POPULATIONS. THEY INCLUDE:- REGULAR COMMUNITY-BASED HEALTH CLINICS, INCLUDING: THE WEEKLY DELIVERING EQUAL ACCESS TO CARE (DEAC) CLINIC AT THE COMMUNITY CARE CENTER IN WINSTON-SALEM, THE MONTHLY TRIAD FREE HEALTH CLINIC AT COMMUNITY MOSQUE IN WINSTON-SALEM AND THE ANNUAL SHARE THE HEALTH FAIR IN DOWNTOWN WINSTON-SALEM. THESE CLINICS ATTRACT THOUSANDS OF PEOPLE TO SCREENINGS FOR ACUTE AND CHRONIC CONDITIONS.- A COLLABORATION WITH A LOCAL MEDICAL CENTER AND THE NORTHWEST COMMUNITY CARE NETWORK TO DEVELOP AN EMERGENCY DEPARTMENT CARE PLAN FOR PATIENTS SHARED BETWEEN THE TWO MEDICAL CENTERS, INCLUDING POTENTIAL HOUSING OPTIONS FOR THE HOMELESS, DEVELOPMENT OF A SPECIAL SHELTER FOR SUBSTANCE ABUSERS AND AFTER HOURS TELEPHONE PROTOCOLS.- PROVIDING STAFF SUPPORT TO A MENTAL HEALTH CLINIC DESIGNED TO HELP HOMELESS PEOPLE STABILIZE THEIR MENTAL HEALTH. THE HOMELESS OPPORTUNITIES & TREATMENT (HOT) PROJECT IS RUN AT SAMARITAN MINISTRIES, A HOMELESS SHELTER IN WINSTON-SALEM. - THE SCHOOL OF MEDICINE'S PHYSICIAN ASSISTANT PROGRAM OPENED A SECOND CAMPUS, APPALACHIAN STATE UNIVERSITY IN BOONE, WITH A GOAL OF INCREASING THE NUMBER OF PAS WORKING IN PRIMARY CARE IN NORTH CAROLINA'S RURAL APPALACHIAN COUNTIES. - FAITHHEALTHNC, AN INITIATIVE THAT CONNECTS THE CARING STRENGTHS OF CONGREGATIONS, THE CLINICAL EXPERTISE OF PROVIDERS AND A NETWORK OF COMMUNITY RESOURCES TO EASE THOSE ON THE JOURNEY TO HEALTH AND HEALING, STRENGTHENING COMMUNITIES IN THE PROCESS.3. EDUCATIONAL MISSION AND ACCOMPLISHMENTS THE CONSTITUENT ORGANIZATIONS OF WAKE FOREST BAPTIST MEDICAL CENTER OPERATE A BROAD RANGE OF EDUCATIONAL PROGRAMS, GRADUATING SKILLED PRACTITIONERS. IT ATTRACTS SOME OF THE WORLD'S MOST COMPETITIVE MEDICAL STUDENTS, RESIDENTS AND FELLOWS, AS WELL AS STUDENTS IN CLINICAL PASTORAL CARE, NURSE ANESTHESIA AND OTHER AREAS. IN THE PAST YEAR, WAKE FOREST BAPTIST INVESTED MORE THAN $77 MILLION IN THE EDUCATION OF TOMORROW'S HEALTH CARE AND BIOMEDICAL LEADERS. THAT INVESTMENT SUPPORTED THE TRAINING OF 469 MEDICAL STUDENTS, 679 PHYSICIAN RESIDENTS AND FELLOWS, 241 GRADUATE STUDENTS AND 150 PHYSICIAN ASSISTANTS. IN ADDITION, THE NORTHWEST AREA HEALTH EDUCATION CENTER, PART OF WAKE FOREST SCHOOL OF MEDICINE, OFFERED 1,883 CONTINUING MEDICAL EDUCATION ACTIVITIES THAT DREW 35,248 PARTICIPANTS FROM THROUGHOUT THE REGION. | Desc |
| Total Program Service Expenses | $1,192,293,137 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (1) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | Yes (1) | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | Yes (1) | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (1) | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | Yes (1) | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | Yes (1) | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | Yes (1) | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 263 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 10215 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Form8282 Filed | 0 | Form8282FiledCnt |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 17 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 16 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (1) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | Yes (1) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | Yes (1) | WrittenPolicyOrProcedureInd |
| States Where Copy Of Return Is Fld | NC | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DOUG LISCHKE | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3367164445 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | MEDICAL CENTER BLVD | AddressLine1 |
| City | WINSTON SALEM | City |
| State | NC | State |
| ZIP Code | 27157 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (50 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|
| ROGER L COTHRAN | |||||||||
| VICE - CHAIRMAN | 2.00 | 4.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| RON D KESSINGER | |||||||||
| CHAIRMAN | 2.00 | 6.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| ARTHUR A GIBEL | |||||||||
| TRUSTEE | 2.00 | 4.00 | Yes (X) | $0 | $0 | $0 | |||
| KATHRYN H HAMRICK | |||||||||
| TRUSTEE | 2.00 | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| A LEE HERRING | |||||||||
| TRUSTEE | 2.00 | 4.00 | Yes (X) | $0 | $0 | $0 | |||
| J WAYNE MEREDITH MD | |||||||||
| TRUSTEE | 2.00 | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| CAROL F POLK | |||||||||
| TRUSTEE | 2.00 | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| WILLIAM C WARDEN JR | |||||||||
| VICE - CHAIRMAN | 2.00 | 4.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| SHEREE B WATSON | |||||||||
| TRUSTEE | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| KATY M BOLES | |||||||||
| TRUSTEE | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| RAY N HOWELL III D MIN | |||||||||
| TRUSTEE | 2.00 | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| JOHN D KIMBERLY | |||||||||
| TRUSTEE | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| STEPHEN L ROBERTSON | |||||||||
| TRUSTEE | 2.00 | 6.00 | Yes (X) | $0 | $0 | $0 | |||
| EDWIN L WELCH JR | |||||||||
| TRUSTEE | 2.00 | 4.00 | Yes (X) | $0 | $0 | $0 | |||
| R MICHAEL WELLS | |||||||||
| TRUSTEE | 2.00 | 4.00 | Yes (X) | $0 | $0 | $0 | |||
| LINWOOD L DAVIS | |||||||||
| TRUSTEE | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| BRENDA B DIGGS | |||||||||
| TRUSTEE | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| ERNEST L EVANS | |||||||||
| TRUSTEE | 2.00 | 4.00 | Yes (X) | $0 | $0 | $0 | |||
| LOUIS B BALDWIN JR | |||||||||
| TRUSTEE | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| GEORGE D RENFRO | |||||||||
| TRUSTEE | 2.00 | 4.00 | Yes (X) | $0 | $0 | $0 | |||
| JOHN D MCCONNELL MD | |||||||||
| TRUSTEE & CEO | 22.00 | 18.00 | Yes (X) | Yes (X) | $1,019,933 | $0 | $732,938 | ||
| H GREG BRAY | |||||||||
| ASST. TREASURER/ASST. SECR | 30.00 | 10.00 | Yes (X) | $221,290 | $0 | $26,761 | |||
| J MCLAIN WALLACE JR | |||||||||
| VP GENERAL COUNSEL/SECR | 16.00 | 24.00 | Yes (X) | $416,599 | $0 | $95,729 | |||
| KAREN H HUEY | |||||||||
| VP FACILITIES | 23.00 | 17.00 | Yes (X) | $267,851 | $0 | $58,233 | |||
| ERIC TOMLINSON | |||||||||
| CHIEF INNOVATION OFFICER | 0.00 | 40.00 | Yes (X) | $542,255 | $0 | $79,923 | |||
| NORMAN D POTTER JR | |||||||||
| VP DEVELOPMENT & ALUMNI AF | 20.00 | 20.00 | Yes (X) | $302,952 | $0 | $67,706 | |||
| CHERYL EH LOCKE | |||||||||
| VP CHIEF HUMAN RESOURCES | 26.00 | 14.00 | Yes (X) | $354,281 | $0 | $82,201 | |||
| EDWARD G CHADWICK | |||||||||
| EXECUTIVE VP CFO/TREASURER | 29.00 | 11.00 | Yes (X) | $560,304 | $0 | $206,914 | |||
| THOMAS E SIBERT MD | |||||||||
| PRESIDENT/COO - HEALTH SYS | 21.00 | 19.00 | Yes (X) | $764,183 | $0 | $193,494 | |||
| LISA M WYATT | |||||||||
| VP CHIEF COMM & MARKETING | 20.00 | 20.00 | Yes (X) | $319,716 | $0 | $59,875 | |||
| EDWARD ABRAHAM MD | |||||||||
| DEAN, SCHOOL OF MEDICINE | 5.00 | 35.00 | Yes (X) | $555,548 | $0 | $134,423 | |||
| C MICHAEL RUTHERFORD | |||||||||
| CFO/TREASURER | 25.00 | 15.00 | Yes (X) | $0 | $0 | $0 | |||
| BRADLEY A CLARK | |||||||||
| ASSISTANT TREASURER | 23.00 | 17.00 | Yes (X) | $219,625 | $0 | $29,059 | |||
| TERRY G WILLIAMS | |||||||||
| EXEC. VP STRAT & NET WK DEV | 22.00 | 18.00 | Yes (X) | $74,244 | $0 | $5,634 | |||
| K BARBARA CARBONE MD | |||||||||
| PRESIDENT/COO | 28.00 | 12.00 | Yes (X) | $0 | $0 | $0 | |||
| CHAD A ECKES | |||||||||
| VP CHIEF INFORMATION OFFICER | 25.00 | 15.00 | Yes (X) | $0 | $0 | $0 | |||
| PAMELA F CIPRIANO PHD | |||||||||
| INTERIM COO | 35.00 | 5.00 | Yes (X) | $0 | $0 | $0 | |||
| BETTY PETREE | |||||||||
| DIRECTOR NURSE ANESTHESIA | 40.00 | 0.00 | $243,487 | $0 | $20,071 | Yes (X) | |||
| MICHAEL RIEKER | |||||||||
| DIRECTOR OF NURSE ANESTHES | 40.00 | 0.00 | $234,086 | $0 | $30,177 | Yes (X) | |||
| VANCE MCVAY JR | |||||||||
| CLINICAL INSTRUCTOR CRNA | 40.00 | 0.00 | $232,518 | $0 | $28,748 | Yes (X) | |||
| ERIC STIEFEL | |||||||||
| CLINICAL INSTRUCTOR CRNA | 40.00 | 0.00 | $213,906 | $0 | $25,276 | Yes (X) | |||
| CHARLES WARE | |||||||||
| AVP INFRASTRUCTURE | 40.00 | 0.00 | $195,225 | $0 | $21,980 | Yes (X) | |||
| JOANNE C RUHLAND | |||||||||
| FORMER OFFICER | 25.00 | 15.00 | $269,472 | $0 | $56,075 | Yes (X) | |||
| RUSSELL M HOWERTON MD | |||||||||
| FORMER OFFICER | 22.00 | 18.00 | $510,549 | $0 | $129,864 | Yes (X) | |||
| DOUGLAS L EDGETON | |||||||||
| FORMER OFFICER | 0.00 | 0.00 | $495,405 | $0 | $245 | Yes (X) | |||
| SHEILA M SANDERS | |||||||||
| FORMER OFFICER | 0.00 | 0.00 | $454,609 | $0 | $24,527 | Yes (X) | |||
| STEVE C SNELGROVE | |||||||||
| FORMER OFFICER | 0.00 | 40.00 | $309,837 | $0 | $65,579 | Yes (X) | |||
| MAUREEN E SINTICH | |||||||||
| FORMER OFFICER | 39.00 | 1.00 | $334,836 | $0 | $69,380 | Yes (X) | |||
| DONNY C LAMBETH | |||||||||
| FORMER OFFICER | 0.00 | 1.00 | $565,644 | $0 | $15,105 | Yes (X) | |||
| SHARON ENGEBRETSON | |||||||||
| FORMER OFFICER | 35.00 | 5.00 | $124,813 | $0 | $55,242 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $9,803,168 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $2,315,159 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 443 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | Yes (1) | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1 | CityContractorAddress/USAddress/City | StateContractorAddress/USAddress/State | ZIP CodeContractorAddress/USAddress/ZIPCode | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| ANGELICA TEXTILE SERVICES INC | |||||
| 4 ANSON ST | DURHAM | NC | 27703 | LINENS & TEXTILE SRV | $4,829,643 |
| ARAMARK | |||||
| 2300 WARRENVILLE ROAD | DOWNER GROVE | IL | 60515 | MANAGEMENT SERVICES | $4,025,365 |
| EPIC SYSTEMS CORPORATION | |||||
| 1979 MILKY WAY | VERONA | WI | 53593 | EHR CONSULTING | $2,972,829 |
| ORACLE AMERICA INC | |||||
| 500 ORACLE PKWY | REDWOOD SHORES | CA | 94065 | TECHNOLOGY | $2,621,141 |
| HCCA INTERNATIONAL | |||||
| 12 CADILLAC DRIVE | BRENTWOOD | TN | 37027 | STAFFING SERVICES | $2,372,062 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 127 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $658,692 | GovernmentGrantsAmt |
| All Other Contributions | $4,120,781 | AllOtherContributionsAmt |
| Noncash Contributions | $804,124 | NoncashContributionsAmt |
| Total Contributions | $4,779,473 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| PATIENT SERVICE REVENUE | 621400 | $1,230,156,461 | $1,230,156,461 | |
| COST RECOV. & OTHER | 900099 | $8,159,150 | $6,804,492 | $1,354,658 |
| MEDICAL/LAB SERVICE | 621500 | $6,002,512 | $4,284,857 | $1,717,655 |
| DIETARY | 722320 | $4,568,555 | $4,364,630 | $203,925 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $1,248,886,678 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $12,571,032 | TotalRevenueColumnAmt |
| Exclusion | $12,571,032 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $654,071 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $654,071 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $654,071 | TotalRevenueColumnAmt |
| Exclusion | $654,071 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $16,469,146 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
| Other | $738,680 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $16,469,146 | SecuritiesAmt |
| Other | -$738,680 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $15,730,466 | TotalRevenueColumnAmt |
| Exclusion | $15,730,466 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|---|
| PARKING FEES | 900099 | $2,282,220 | $2,282,220 | |
| GIFT SHOP REVENUE | 453220 | $1,586,931 | $1,586,931 | |
| TUITION | 900099 | $352,704 | $352,704 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $4,221,855 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,286,843,575 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,245,963,144 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $3,276,238 | UnrelatedBusinessRevenueAmt |
| Exclusion | $32,824,720 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,231,000 | TotalAmt |
| Program Services | $1,231,000 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $102,090 | TotalAmt |
| Program Services | $102,090 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,326,529 | TotalAmt |
| Management And General | $5,326,529 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $482,599,872 | TotalAmt |
| Program Services | $441,642,798 | ProgramServicesAmt |
| Management And General | $40,957,074 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,638,205 | TotalAmt |
| Program Services | $3,478,654 | ProgramServicesAmt |
| Management And General | $1,159,551 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $61,967,263 | TotalAmt |
| Program Services | $50,373,031 | ProgramServicesAmt |
| Management And General | $11,594,232 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $33,749,451 | TotalAmt |
| Program Services | $25,312,088 | ProgramServicesAmt |
| Management And General | $8,437,363 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,723 | TotalAmt |
| Program Services | $4,292 | ProgramServicesAmt |
| Management And General | $1,431 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $385,312 | TotalAmt |
| Program Services | $42,399 | ProgramServicesAmt |
| Management And General | $342,913 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $778,506 | TotalAmt |
| Program Services | $778,506 | ProgramServicesAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $64,157,169 | TotalAmt |
| Program Services | $47,909,852 | ProgramServicesAmt |
| Management And General | $16,247,317 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,314,800 | TotalAmt |
| Program Services | $2,314,800 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $35,177,010 | TotalAmt |
| Program Services | $28,056,070 | ProgramServicesAmt |
| Management And General | $7,120,940 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $20,154,792 | TotalAmt |
| Program Services | $16,123,834 | ProgramServicesAmt |
| Management And General | $4,030,958 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $36,884,870 | TotalAmt |
| Program Services | $27,699,817 | ProgramServicesAmt |
| Management And General | $9,185,053 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $721,001 | TotalAmt |
| Program Services | $443,414 | ProgramServicesAmt |
| Management And General | $277,587 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,161,771 | TotalAmt |
| Program Services | $1,755,085 | ProgramServicesAmt |
| Management And General | $406,686 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,773,400 | TotalAmt |
| Program Services | $15,481,615 | ProgramServicesAmt |
| Management And General | $291,785 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $72,695,248 | TotalAmt |
| Program Services | $72,695,248 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,391,196 | TotalAmt |
| Program Services | $12,240,720 | ProgramServicesAmt |
| Management And General | $150,476 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $279,783,578 | $277,619,174 | $2,164,404 |
| BAD DEBT | $133,137,491 | $133,137,491 | |
| INCOME TAXES | $265,888 | $265,888 | |
| PROVIDER ASSESSMENT | $33,715,186 | $33,715,186 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $248,154 | TotalAmt |
| Program Services | $135,973 | ProgramServicesAmt |
| Management And General | $112,181 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,300,365,505 | TotalAmt |
| Program Services | $1,192,293,137 | ProgramServicesAmt |
| Management And General | $108,072,368 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,762,350 | BOYAmt |
| EOY | $59,843,783 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $350,307,047 | BOYAmt |
| EOY | $308,239,500 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $32,041,387 | BOYAmt |
| EOY | $29,178,976 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,269,612 | BOYAmt |
| EOY | $30,843,735 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,712,483 | BOYAmt |
| EOY | $4,024,279 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $1,459,972,397 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $802,678,877 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $643,603,874 | BOYAmt |
| EOY | $657,293,520 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $627,932,795 | BOYAmt |
| EOY | $644,739,683 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $65,673,237 | BOYAmt |
| EOY | $65,321,353 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,009,195 | BOYAmt |
| EOY | $13,506,115 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,778,311,980 | BOYAmt |
| EOY | $1,812,990,944 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $272,033,669 | BOYAmt |
| EOY | $196,034,485 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $494,400,200 | BOYAmt |
| EOY | $499,980,630 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $49,380,055 | BOYAmt |
| EOY | $164,515,619 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $815,813,924 | BOYAmt |
| EOY | $860,530,734 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $957,729,652 | BOYAmt |
| EOY | $947,453,029 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,797,220 | BOYAmt |
| EOY | $2,798,551 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,971,184 | BOYAmt |
| EOY | $2,208,630 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $962,498,056 | BOYAmt |
| EOY | $952,460,210 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,778,311,980 | BOYAmt |
| EOY | $1,812,990,944 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$13,521,930 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $33,836,281 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$30,352,197 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | Yes (1) | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | Yes (1) | DirectContactLegislatorsInd |
| Direct Contact Legislators | $540,985 | DirectContactLegislatorsAmt |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $237,521 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $778,506 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | PRORATA PORTION OF DUES PAID TO STATE AND LOCAL 501(C)(6) ORGANIZATIONS THAT REPRESENTS LOBBYING ON BEHALF OF ITS MEMBERS. GOVERNMENT RELATIONS THE OFFICE OF GOVERNMENT RELATIONS WAS ACTIVELY INVOLVED WITH SEVERAL FEDERAL AND STATE ISSUES. THE OFFICE ASSISTED IN DEVELOPING POLITICAL ADVOCACY STRATEGIES REGARDING THE CENTERS FOR MEDICARE & MEDICAID SERVICES'(CMS) POLICY REGARDING MEDICARE AND MEDICAID DISPROPORTIONATE SHARE HOSPITAL (DSH) PAYMENTS; FY 2015 INPATIENT PROSPECTIVE PAYMENT SYSTEM (PPS) RULE; TWO-MIDNIGHT/PATIENT STATUS RULE AND LAWSUIT; AREA WAGE INDEX PAYMENTS; PROSPECTIVE CODING OFFSETS; SITE NEUTRAL PAYMENTS REGARDING PROPOSED PAYMENT CUTS FOR EVALUATION AND MANAGEMENT (E/M) SERVICES AND CERTAIN OTHER PROCEDURES PROVIDED IN HOSPITAL OUTPATIENT DEPARTMENTS (HOPD'S); REPEAL OF THE MEDICAL DEVICE TAX AND INDEPENDENT PAYMENT ADVISORY BOARD (IPAB) PROVISIONS OF THE AFFORDABLE CARE ACT; REDUCTIONS TO PAYMENTS FOR INDIRECT MEDICAL EDUCATION (IME) AND DIRECT GRADUATE MEDICAL EDUCATION (DGME) TO TEACHING HOSPITALS; CHANGES TO THE 340B DRUG DISCOUNT PROGRAM; REDUCTIONS IN PAYMENTS TO HOSPITALS FOR ASSISTANCE TO LOW-INCOME MEDICARE BENEFICIARIES (BAD DEBT); POLICY CHANGES TO THE MEDICAID PROVIDER ASSESSMENTS; MEDICAID DSH REBASING AND MEDICAID DSH AUDITING REGULATIONS; ELECTRONIC HEALTH RECORD (EHR) INCENTIVE PROGRAMS TO INCLUDE INTEROPERABILITY, MOBILE HEALTH AND CYBERSECURITY. STAFF WORKED ON THE FY2015 BUDGET; CY2015 HOSPITAL OUTPATIENT PROSPECTIVE PAYMENT SYSTEM (HOPPS)/AMBULATORY SURGICAL CENTERS (ASC) PROPOSED RULE AND THE 2015 MEDICARE PHYSICIAN FEE SCHEDULE. THEY ALSO WORKED ON THE MEDICARE PHYSICIAN PAYMENT FORMULA INCLUDING ADJUSTMENTS AND POSSIBLE REPEAL OF THE SUSTAINABLE GROWTH RATE (SGR). STAFF ALSO WORKED ON MANY OF THE FY 2015 APPROPRIATIONS BILLS AND PROPOSED LEGISLATION AND REGULATIONS THAT WERE INTRODUCED, INCLUDING THE DEPARTMENT OF HEALTH AND HUMAN SERVICES REGARDING THE NATIONAL INSTITUTES OF HEALTH (NIH) BUDGET AND EFFECTS OF SEQUESTRATION; AND VETERANS AFFAIRS (VA) RESEARCH AND MEDICAL CARE FUNDING TO EASE ACCESS FOR VETERANS SEEKING HEALTH CARE FROM NON-VA PROVIDERS; AND LEGISLATION REGARDING PATENT TROLLING AND INTELLECTUAL PROPERTY ISSUES. AT THE STATE LEVEL, EFFORTS WERE CONCENTRATED ON MEDICAID EXPANSION AND MEDICAID REFORM, INCLUDING PROVIDER-LED ACCOUNTABLE CARE ORGANIZATIONS AND REORGANIZATION OF THE DIVISION OF MEDICAL ASSISTANCE; CONTINGENCY RESERVE FUNDING FOR MEDICAID; IMPLEMENTATION PROBLEMS WITH NC TRACKS, INCREASE IN THE HOSPITAL ASSESSMENT BY THE STATE; FUNDING FOR THE WAKE FOREST ARMED FORCES INSTITUTE FOR REGENERATIVE MEDICINE (AFIRM); RECOMMENDATIONS TO INCREASE THE CONTRACTED RATES TO REIMBURSE REGIONAL AUTOPSY CENTERS AT ACTUAL COSTS, INCLUDING THE CENTER AT WAKE FOREST BAPTIST MEDICAL CENTER; ON LEGISLATION REGARDING CERTIFICATE-OF-NEED LAWS INVOLVING SINGLE-SPECIALTY SURGERY CENTERS; LEGISLATION TO DELAY THE EXPIRATION OF THE HISTORIC MILL RESTORATION TAX CREDIT FOR THE WAKE FOREST INNOVATION QUARTER; REVISIONS TO THE HEALTH CARE COST REDUCTION AND TRANSPARENCY ACT; BEHAVIORAL HEALTH CRISIS SERVICES FUNDING AND TRAUMATIC BRAIN INJURY MENTAL HEALTH FUNDING; AND PROTECTION OF THE $45 MILLION HOSPITAL SALES TAX REFUND CAP. | ExplanationTxt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $4,768,404 | BeginningYearBalanceAmt |
| Contributions | $1,443,959 | ContributionsAmt |
| Investment Earnings Or Losses | $389,849 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $1,595,031 | OtherExpendituresAmt |
| End Year Balance | $5,007,181 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $8,088,305 | BeginningYearBalanceAmt |
| Contributions | $616,961 | ContributionsAmt |
| Investment Earnings Or Losses | $185,112 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $4,121,974 | OtherExpendituresAmt |
| End Year Balance | $4,768,404 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $7,303,928 | BeginningYearBalanceAmt |
| Contributions | $1,221,778 | ContributionsAmt |
| Investment Earnings Or Losses | -$65,209 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $124,978 | GrantsOrScholarshipsAmt |
| Other Expenditures | $709,300 | OtherExpendituresAmt |
| Administrative Expenses | -$462,086 | AdministrativeExpensesAmt |
| End Year Balance | $8,088,305 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $5,383,158 | BeginningYearBalanceAmt |
| Contributions | $841,681 | ContributionsAmt |
| Investment Earnings Or Losses | $576,477 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $113,868 | GrantsOrScholarshipsAmt |
| Other Expenditures | $738,112 | OtherExpendituresAmt |
| Administrative Expenses | -$1,354,592 | AdministrativeExpensesAmt |
| End Year Balance | $7,303,928 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $5,437,445 | BeginningYearBalanceAmt |
| Contributions | $446,548 | ContributionsAmt |
| Investment Earnings Or Losses | $259,105 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $110,679 | GrantsOrScholarshipsAmt |
| Other Expenditures | $649,261 | OtherExpendituresAmt |
| End Year Balance | $5,383,158 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prmnnt Endowment Balance EOY | 0.44110 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.55890 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $29,393,571 | OtherCostOrOtherBasisAmt |
| Book Value | $29,393,571 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $867,462,501 | OtherCostOrOtherBasisAmt |
| Depreciation | $443,756,160 | DepreciationAmt |
| Book Value | $423,706,341 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $524,422 | OtherCostOrOtherBasisAmt |
| Depreciation | $147,904 | DepreciationAmt |
| Book Value | $376,518 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $544,336,177 | OtherCostOrOtherBasisAmt |
| Depreciation | $352,578,198 | DepreciationAmt |
| Book Value | $191,757,979 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $18,255,726 | OtherCostOrOtherBasisAmt |
| Depreciation | $6,196,615 | DepreciationAmt |
| Book Value | $12,059,111 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $657,293,520 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| OTHER LIABILITIES | $119,989,709 |
| PENSION LIABILITIES | $43,827,664 |
| CAPITAL LEASE | $698,246 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $164,515,619 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, LINE 4: | THE HOSPITAL'S ENDOWMENT FUNDS ARE USED TO PROVIDE SUPPORT FOR EDUCATION, SCHOLARSHIPS, INDIGENT CARE, AND OTHER DEPARTMENTAL FUNDING. |
| PART X, LINE 2: | THE ORGANIZATION HAS EVALUATED UNCERTAIN TAX POSITIONS FOR ITS FISCAL YEARS ENDED JUNE 30, 2014 AND 2013, INCLUDING A QUANTIFICATION OF TAX RISK IN AREAS SUCH AS UNRELATED BUSINESS TAXABLE INCOME AND THE TAXATION OF ITS FOR-PROFIT SUBSIDIARIES. THIS EVALUATION DID NOT HAVE A MATERIAL EFFECT ON THE ORGANIZATION'S FINANCIAL STATEMENTS FOR THE YEARS ENDED JUNE 30, 2014 AND 2013. |
Schedule F IRS990ScheduleF
Account Activities Outside US AccountActivitiesOutsideUSGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Region | CENTRAL AMERICA AND THE CARIBBEAN | RegionTxt |
| Offices | 0 | OfficesCnt |
| Employee | 0 | EmployeeCnt |
| Type Of Activities Conducted | INVESTMENTS | TypeOfActivitiesConductedTxt |
| Region Total Expenditures | $56,593,758 | RegionTotalExpendituresAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Subtotal Offices | 0 | SubtotalOfficesCnt |
| Subtotal Employees | 0 | SubtotalEmployeesCnt |
| Continutation Total Office | 0 | ContinutationTotalOfficeCnt |
| Continutation Total Employee | 0 | ContinutationTotalEmployeeCnt |
| Total Office | 0 | TotalOfficeCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Subtotal Spent | $56,593,758 | SubtotalSpentAmt |
| Continuation Spent | $0 | ContinuationSpentAmt |
| Total Spent | $56,593,758 | TotalSpentAmt |
| Transfer To Foreign Corp | Yes (1) | TransferToForeignCorpInd |
| Interest In Foreign Trust | 0 | InterestInForeignTrustInd |
| Foreign Corp Ownership | Yes (1) | ForeignCorpOwnershipInd |
| Passive Foreign Investmest Co | 0 | PassiveForeignInvestmestCoInd |
| Foreign Partnership | 0 | ForeignPartnershipInd |
| Boycott Countries | 0 | BoycottCountriesInd |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $46,820,392 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $8,993,618 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $37,826,774 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03240 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $212,528,513 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $213,682,706 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | -$1,154,193 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $26,810,631 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $18,465,519 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $8,345,112 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00710 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $286,159,536 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $241,141,843 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $45,017,693 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03950 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,169,010 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,169,010 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00190 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $96,441,072 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $23,710,842 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $72,730,230 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06230 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,979,568 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,979,568 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00170 | TotalExpensePct |
Research ResearchGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,297,097 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,297,097 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00110 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $101,886,747 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $23,710,842 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $78,175,905 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06700 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $388,046,283 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $264,852,685 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $123,193,598 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.10650 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $72,645 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $72,645 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Leadership Development LeadershipDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $262,140 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $262,140 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $334,785 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $334,785 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReportedInd |
| Bad Debt Expense | $42,627,265 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $0 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $375,150,006 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $427,414,128 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$52,264,122 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NORTH CAROLINA BAPTIST HOSPITAL | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | MEDICAL CENTER BLVD | AddressLine1 |
| City | WINSTON SALEM | City |
| State | NC | State |
| ZIP Code | 27157 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| State License | H0011 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Teaching Hospital | Yes (X) | TeachingHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NORTH CAROLINA BAPTIST HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Information Gaps | Yes (X) | InformationGapsInd |
| CHNA Conducted | 12 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (1) | CHNAConductedWithOtherFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | WWW.WAKEHEALTH.EDU/HCI/ | OwnWebsiteURLTxt |
| Rpt Available Upon Request | Yes (X) | RptAvailableUponRequestInd |
| Rpt Available Thru Other Method | Yes (X) | RptAvailableThruOtherMethodInd |
| Adopt Implementation Strategy | Yes (X) | AdoptImplementationStrategyInd |
| Exec Implementation Strategy | Yes (X) | ExecImplementationStrategyInd |
| Develop Community Wide Plan | Yes (X) | DevelopCommunityWidePlanInd |
| Exec Community Wide Plan | Yes (X) | ExecCommunityWidePlanInd |
| Include Operational Plan | Yes (X) | IncludeOperationalPlanInd |
| Adopt Budget | Yes (X) | AdoptBudgetInd |
| Prioritize Health Needs | Yes (X) | PrioritizeHealthNeedsInd |
| Prioritize Services | Yes (X) | PrioritizeServicesInd |
| All Needs Addressed | 0 | AllNeedsAddressedInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Used Deter Elig Free Care | Yes (1) | FPGUsedDeterEligFreeCareInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Used Determ Elig Dscnt Care | Yes (1) | FPGUsedDetermEligDscntCareInd |
| FPG Family Incm Lmt Dscnt Care | 400.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| Income Level | Yes (X) | IncomeLevelInd |
| Medical Indigency | Yes (X) | MedicalIndigencyInd |
| Insurance Status | Yes (X) | InsuranceStatusInd |
| Uninsured Discount | Yes (X) | UninsuredDiscountInd |
| Medicaid Medicare | Yes (X) | MedicaidMedicareInd |
| Other Factors | Yes (X) | OtherFactorsInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| Posted On Website | Yes (X) | PostedOnWebsiteInd |
| Posted In Emergency Room | Yes (X) | PostedInEmergencyRoomInd |
| Posted In Admission Office | Yes (X) | PostedInAdmissionOfficeInd |
| Available On Request | Yes (X) | AvailableOnRequestInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified Before Discharge | Yes (X) | FAPNotifiedBeforeDischargeInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Average Negotiated Rates | Yes (X) | AverageNegotiatedRatesInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| NORTH CAROLINA BAPTIST HOSPITAL | PART V, SECTION B, LINE 3: COMMUNITY INPUT WAS OBTAINED THROUGH THREE SOURCES OF PRIMARY DATA COLLECTION; (1) DOOR TO DOOR SURVEY; (2) NINE FOCUS GROUPS WITH UNDERSERVED, LOW INCOME AND MINORITY COMMUNITIES; AND (3) A YOUTH RISK BEHAVIOR SURVEY. THE HOSPITAL WORKED WITH PUBLIC HEALTH EXPERTS FROM THE FORSYTH COUNTY DEPARTMENT OF HEALTH AND FORTY ONE COMMUNITY LEADERS REPRESENTING THE FAITH COMMUNITY, PRIVATE BUSINESS, HEALTHCARE, HIGHER EDUCATION, PUBLIC SAFETY, SOCIAL SERVICES, MENTAL HEALTH, GOVERNMENT AND PRIVATE AND PUBLIC FOUNDATIONS. |
| NORTH CAROLINA BAPTIST HOSPITAL | PART V, SECTION B, LINE 4: THE HOSPITAL'S CHNA WAS CONDUCTED IN COLLABORATION WITH FORSYTH MEMORIAL HOSPITAL (DBA FORSYTH MEDICAL CENTER), A TAX-EXEMPT HOSPITAL IN FORSYTH COUNTY. |
| NORTH CAROLINA BAPTIST HOSPITAL | PART V, SECTION B, LINE 5D: THE HOSPITAL'S COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IS AVAILABLE AT THE FORSYTH COUNTY HEALTH DEPARTMENT. |
| NORTH CAROLINA BAPTIST HOSPITAL | PART V, SECTION B, LINE 6I: DURING THE FISCAL YEAR ENDED JUNE 30, 2014, THE HOSPITAL ADDRESSED THE NEEDS IDENTIFIED IN ITS MOST RECENTLY CONDUCTED CHNA AS FOLLOWS:PHYSICAL ACTIVITY AND NUTRITION AND OBESITY - SUPPORTS AND CONDUCTS BRENNER FIT, A COMPREHENSIVE PEDIATRIC WEIGHT MANAGEMENT PROGRAM, PROVIDES AN ON-SITE FARMERS MARKET FOR ALL NCBH EMPLOYEES, PROVIDES HEALTHY LIFESTYLE PROGRAMS, PARTICIPATES IN AND SUPPORTS THE DOWNTOWN HEALTH PLAZA COMMUNITY GARDEN, PARTICIPATES IN THE BE HEALTH OBESITY COALITION WITH THE FORSYTH COUNTY HEALTH DEPARTMENT AND PROVIDES EDUCATIONAL CLASSES THROUGH BEST HEALTH, A COMMUNITY OUTREACH PROGRAM. CHRONIC DISEASE PREVENTION AND MANAGEMENT CONDUCTS DIABETES HEALTH SOURCE EDUCATION PROGRAMS AT THE JOSLIN DIABETES CENTER, PARTICIPATES IN HEALTH FAIRS SUCH AS SHARE THE CARE, DOWNTOWN HEALTH PLAZA HEALTH FAIR, DAY OF CARING AND YMCA HEALTH FAIRS, CONDUCTS HEART AND STROKE LUNCH AND LEARN EVENTS, SPONSORS/CONDUCTS FREE EKG SCREENINGS AND CPR CLASSES AND CONDUCTS FREE SKIN CANCER SCREENINGS, SMOKING CESSATION CLASSES AND EDUCATIONAL PROGRAMS ON THE HAZARDS OF SMOKING.ACCESS TO CARE FREE AND SUBSIDIZED OUTPATIENT CARE THROUGH ITS DOWNTOWN HEALTH PLAZA CLINIC, PARTICIPATES IN VARIOUS HEALTH FAIRS, SUPPORTS THE ANNUAL FREE DENTAL CLINIC AND PROVIDES FREE HEALTH SCREENINGS FOR SKIN CANCER, DIABETES AND HEART DISEASE.MENTAL HEALTH PROVIDES MENTAL HEALTH SCREENINGS AND SERVICES TO THE UNINSURED AND UNDERINSURED IN COLLABORATION WITH ITS SUBSIDIARY, CARENET, AND PARTICIPATES IN THE FORSYTH BEHAVIORAL HEALTH COALITION TO OBTAIN FUNDING FOR A COUNTY ED CRISIS INTERVENTION PROGRAM AND POSSIBLE WET SHELTER PROGRAM. |
| NORTH CAROLINA BAPTIST HOSPITAL | PART V, SECTION B, LINE 7: MATERNAL AND INFANT HEALTH WAS NOT INCLUDED IN THE HOSPITAL'S TOP PRIORITIZED HEALTH NEEDS BECAUSE THE HOSPITAL DOES NOT DELIVER BABIES, EXCEPT IN EMERGENCY SITUATIONS. FORSYTH MEMORIAL HOSPITAL IS THE PRIMARY PROVIDER OF MATERNITY SERVICES IN THE COMMUNITY. |
| NORTH CAROLINA BAPTIST HOSPITAL | PART V, SECTION B, LINE 10: THE HOSPITAL USES THE FEDERAL POVERTY GUIDELINES TO DETERMINE ELIGIBILITY FOR FREE CARE. INDIVIDUALS AT OR BELOW 200% OF THE FEDERAL PROVERTY GUIDELINES ARE ELIGIBLE FOR FREE CARE. THE ORGANIZATION EVALUATES CERTAIN CREDIT FILE DATA ELEMENTS TO IDENTIFY POTENTIAL SOURCES OF HIDDEN INCOME TO MORE ACCURATELY INFORM CHARITY CARE ELIGIBILITY ASSESSMENTS. PATIENTS WITH ESTIMATED HOUSEHOLD INCOME BELOW 200% OF FPG, WHO ARE IDENTIFIED AS HAVING COMMERCIAL CREDIT ACCOUNTS THAT ARE BEING SERVICED IN A MANNER THAT SUGGESTS ADDITIONAL SOURCES OF INCOME, ARE NOT AUTOMATICALLY GRANTED PRESUMPTIVE CHARITY CARE. |
| NORTH CAROLINA BAPTIST HOSPITAL | PART V, SECTION B, LINE 11: THE ORGANIZATION USES A SLIDING SCALE OF THE FEDERAL POVERTY GUIDELINES TO DETERMINE ELIGIBILITY FOR DISCOUNTED CARE. INDIVIDUALS BETWEEN 201% AND 300% OF THE FEDERAL POVERTY GUIDELINES ARE GRANTED A 75% DISCOUNT AND INDIVIDUALS BETWEEN 301% AND 400% OF THE FEDERAL PROVERTY GUIDELINES ARE GRANTED A 60% DISCOUNT. |
| NORTH CAROLINA BAPTIST HOSPITAL | PART V, SECTION B, LINE 12I: RESIDENT OF THE MEDICAL CENTER'S 19 COUNTY SERVICE AREA. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 30 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (30 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | FacilityFacilityTxt |
|---|---|---|---|---|
| STRATFORD EXECUTIVE PARK ABDOMINAL ORGAN | ||||
| 140 CHARLOIS BOULEVARD | WINSTONSALEM | NC | 271031522 | ABDOMINAL ORGAN TRANSPLANT PROGRAM |
| DOWNTOWN HEALTH PLAZA | ||||
| 1200 N MARTIN LUTHER KING JR DRIVE | WINSTONSALEM | NC | 271013006 | FAMILY MEDICINE |
| WAKE FOREST UNIVERSITY BAPTIST IMAGING | ||||
| 265 EXECUTIVE PARK BLVD | WINSTONSALEM | NC | 27103 | IMAGING CENTER |
| WINSTON EAST PEDIATRICS | ||||
| 2295 EAST 14TH STREET | WINSTONSALEM | NC | 271056804 | PEDIATRICS |
| STRATFORD EXECUTIVE PARK INTERNAL MEDICI | ||||
| 500 SHEPHARD STREET SUITE 300 | WINSTONSALEM | NC | 271031633 | IM MULTISPECIALTY CLINICS |
| MEDICAL PLAZA COUNTRY CLUB DERMATOLOGIC | ||||
| 4618 COUNTRY CLUB ROAD | WINSTONSALEM | NC | 271043520 | GENERAL DERMATOLOGY |
| MEDICAL PLAZA COUNTRY CLUB GENERAL DERMA | ||||
| 4618 COUNTRY CLUB ROAD | WINSTONSALEM | NC | 271043520 | DERMATOLOGIC SURGERY |
| STRATFORD EXECUTIVE PARK OBGYN | ||||
| 500 SHEPHARD STREET SUITE 201 | WINSTONSALEM | NC | 271031633 | OB/GYN |
| WAKE FOREST BAPTIST HEALTH FAMILY MEDICI | ||||
| 1920 W FIRST STREET | WINSTONSALEM | NC | 271044220 | FAMILY MEDICINE |
| STRATFORD EXECUTIVE PARK MATERNAL-FETAL | ||||
| 500 SHEPHARD STREET SUITE 200 | WINSTONSALEM | NC | 271031633 | MATERNAL-FETAL MEDICINE |
| NCBH OUTPATIENT ENDOSCOPY CENTER LLC | ||||
| 100 CHARLOIS BLVD SUITE 100 | WINSTONSALEM | NC | 27103 | OUTPATIENT ENDOSCOPY |
| MEDICAL PLAZA COUNTRY CLUB - JOSLIN ADUL | ||||
| 4610 COUNTRY CLUB ROAD | WINSTONSALEM | NC | 271043520 | ADULT DIABETES CENTER |
| MEDICAL PLAZA COUNTRY CLUB - JOSLIN PEDI | ||||
| 4610 COUNTRY CLUB ROAD | WINSTONSALEM | NC | 271043520 | PEDIATRIC DIABETES CENTER |
| MEDICAL PLAZA COUNTRY CLUB - UNIVERSITY | ||||
| 4614 COUNTRY CLUB ROAD | WINSTONSALEM | NC | 271043520 | INTERNAL MEDICINE |
| MEDICAL PLAZA COUNTRY CLUB - CARDIOLOGY | ||||
| 4614 COUNTRY CLUB ROAD | WINSTONSALEM | NC | 271043520 | CARDIOLOGY |
| MEDICAL PLAZA COUNTRY CLUB - WEIGHT MANA | ||||
| 4614 COUNTRY CLUB ROAD | WINSTONSALEM | NC | 271043520 | WEIGHT MANAGEMENT |
| MEDICAL PLAZA CLEMMONS - BLDG 2311 GENER | ||||
| 2311 LEWISVILLE-CLEMMONS ROAD | CLEMMONS | NC | 27012 | PEDIATRICS |
| MEDICAL PLAZA CLEMMONS - BLDG 2311 SPECI | ||||
| 2311 LEWISVILLE-CLEMMONS ROAD | CLEMMONS | NC | 27012 | PEDIATRIC SPECIALTIES |
| MEDICAL PLAZA CLEMMONS - BLDG 2311 IMPR | ||||
| 2311 LEWISVILLE-CLEMMONS ROAD | CLEMMONS | NC | 27012 | INTERNAL MEDICINE & PRIMARY CARE |
| MEDICAL PLAZA CLEMMONS - BLDG 2311 ALLER | ||||
| 2311 LEWISVILLE-CLEMMONS ROAD | CLEMMONS | NC | 27012 | ALLERGY, ASTHMA & IMMUNOLOGY |
| MEDICAL PLAZA CLEMMONS - BLDG 2311 HEMO | ||||
| 2311 LEWISVILLE-CLEMMONS ROAD | CLEMMONS | NC | 27012 | ONCOLOGY |
| COMP REHAB | ||||
| 131 MILLER STREET | WINSTONSALEM | NC | 27103 | REHABILITATION |
| MEDICAL PLAZA CLEMMONS - BLDG 2341 | ||||
| 2341 LEWISVILLE-CLEMMONS ROAD | CLEMMONS | NC | 27012 | BREAST CARE SERVICES |
| MEDICAL PLAZA CLEMMONS - BLDG 2341 | ||||
| 2341 LEWISVILLE-CLEMMONS ROAD | CLEMMONS | NC | 27012 | ENT/HEAD AND NECK SURGERY - CLEMMONS |
| MT AIRY HEMATOLOGY & ONCOLOGY | ||||
| 450 PRICE STREET | MT AIRY | NC | 27030 | HEMATOLOGY AND ONCOLOGY |
| MEDICAL PLAZA CLEMMONS - BLDG 2341 | ||||
| 2341 LEWISVILLE-CLEMMONS ROAD | CLEMMONS | NC | 27012 | NEUROLOGY - CLEMMONS |
| MEDICAL PLAZA CLEMMONS - BLDG 2341 | ||||
| 2341 LEWISVILLE-CLEMMONS ROAD | CLEMMONS | NC | 27012 | OB/GYN |
| PAIN CENTER BROOKSTOWN | ||||
| 605 COTTON STREET | WINSTONSALEM | NC | 27101 | PAIN CLINIC AND SERVICES |
| MEDICAL PLAZA CLEMMONS - BLDG 2341 | ||||
| 2341 LEWISVILLE-CLEMMONS ROAD | CLEMMONS | NC | 27012 | SPINE CENTER - CLEMMONS |
| MEDICAL PLAZA CLEMMONS - BLDG 2341 | ||||
| 2341 LEWISVILLE-CLEMMONS ROAD | CLEMMONS | NC | 27012 | VEIN SERVICES - CLEMMONS |
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3C: | THE ORGANIZATION ALSO EVALUATES CERTAIN CREDIT FILE DATA ELEMENTS TO IDENTIFY POTENTIAL SOURCES OF HIDDEN INCOME TO MORE ACCURATELY INFORM CHARITY CARE ELIGIBILITY ASSESSMENTS. PATIENTS WITH ESTIMATED HOUSEHOLD INCOME BELOW 200% OF FPG, WHO ARE IDENTIFIED AS HAVING COMMERCIAL CREDIT ACCOUNTS THAT ARE BEING SERVICED IN A MANNER THAT SUGGESTS ADDITIONAL SOURCES OF INCOME, ARE NOT AUTOMATICALLY GRANTED PRESUMPTIVE CHARITY CARE. |
| PART I, LINE 7: | THE ORGANIZATION USED THE WORKSHEETS PROVIDED IN THE INSTRUCTIONS TO SCHEDULE H TO COMPUTE ITS COST-TO-CHARGE RATIO FOR PURPOSES OF THE 2013 SCHEDULE H.PART I, LINE 7B MEDICAID DIRECT OFF SETTING REVENUETHE HOSPITAL PARTICIPATES IN A PROVIDER ASSESSMENT PROGRAM ADMINISTERED BY THE NORTH CAROLINA DEPARTMENT OF HEALTH AND HUMAN SERVICES. UNDER THE PROGRAM, A FEE IS ASSESSED AGAINST NON-MEDICAID NET PATIENT SERVICE REVENUES OF PRIVATE HOSPITALS. THE FEDERAL GOVERNMENT MATCHES THE ASSESSMENT AT A RATE OF NEARLY 2 TO 1, AND THESE AMOUNTS ARE ALLOCATED TO NORTH CAROLINA HOSPITALS ON A QUARTERLY BASIS. |
| PART I, LN 7 COL(F): | THE ORGANIZATION'S PATIENT BAD DEBT EXPENSE PER THE AUDITED FINANCIAL STATEMENTS WAS $133,137,491 FOR THE FISCAL YEAR ENDED JUNE 30, 2014. THIS AMOUNT HAS BEEN REMOVED FROM THE CALCULATION OF CHARITY CARE FOR PART I, LINE 7. |
| PART II, COMMUNITY BUILDING ACTIVITIES: | THE HOSPITAL IS RESPONSIVE TO THE COMMUNITIES IT SERVES THROUGH A NUMBER OF ACTIVITIES, PROGRAMS AND INITIATIVES. THE HOSPITAL IS CURRENTLY ALIGNED WITH THE FORSYTH COUNTY HEALTH DEPARTMENT AND LEADS AND/OR PARTICIPATES IN A WIDE VARIETY OF PARTNERSHIPS AND LOCAL COALITIONS. THESE INCLUDE THE BE HEALTH- OBESITY COALITION, HEAT- HEALTH DISPARITIES AND THE CHRONIC DISEASE COALITION. COLLECTIVELY THESE COALITIONS ARE TASKED WITH IMPROVING THE HEALTH STATUS OF THE COMMUNITIES THEY SERVE WITH A SPECIFIC FOCUS ON CHRONIC DISEASE, PHYSICAL ACTIVITY/ NUTRITION AND TOBACCO USE. SPECIFICALLY, THE COALITIONS ARE WORKING COLLABORATIVELY TO 1) REDUCE THE CARDIOVASCULAR DISEASE MORTALITY RATE, 2) DECREASE THE INCIDENCE OF DIABETES, 3) INCREASE THE PERCENTAGE OF ADULTS REPORTING GOOD, VERY GOOD OR EXCELLENT HEALTH, 4) INCREASE THE PERCENTAGE OF HIGH SCHOOL STUDENTS WHO ARE NEITHER OVERWEIGHT NOR OBESE, 5) INCREASE THE PERCENTAGE OF ADULTS WHO REPORT THAT THEY CONSUME FRUITS AND VEGETABLES FIVE OR MORE TIMES PER DAY, 6) INCREASE THE PERCENTAGE OF ADULTS GETTING THE RECOMMENDED AMOUNT OF PHYSICAL ACTIVITY, AND 7) DECREASE THE PERCENTAGE OF HIGH SCHOOL STUDENTS REPORTING CURRENT USE OF ANY TOBACCO PRODUCT. THE HOSPITAL IS SPECIFICALLY RESPONSIVE TO THE CHRONIC HEALTH NEEDS OF THE COMMUNITY BY PROVIDING FREE CARE TO ITS RESIDENTS AND PROVIDES $4 MILLION IN SUBSIDY FUNDING FOR THE DOWNTOWN HEALTH PLAZA, A LEVEL 3 NCQA SITE AND NATIONAL HEALTH SERVICE CORP SITE. DOWNTOWN HEALTH PLAZA SERVES APPROXIMATELY 65,000 PATIENT VISITS PER YEAR INCLUDING 28,000 ADULTS, 29% OF WHICH ARE SELF-PAY; 19,000 ARE OB/GYN PATIENTS, 51% ARE SELF-PAY; AND 18,000 PEDIATRIC PATIENTS, 3% OF WHICH ARE SELF-PAY. MANY OF THE SELF-PAY PATIENTS ARE MANAGING CHRONIC DISEASES SUCH AS DIABETES, KIDNEY FAILURE AND HEART FAILURE, AND DHP PROVIDES CARE AND COUNSELING AT NO COST FOR THESE CONDITIONS. SPECIFICALLY DHP PROVIDES SIGNIFICANT BENEFIT TO THE COMMUNITY THROUGH THE FOLLOWING INITIATIVES: COLLABORATION WITH NORTHWEST COMMUNITY CARE NETWORK THROUGH ONSITE PEDIATRIC AND INTERNAL MEDICINE CASE MANAGERS; AS A PARTICIPATING WIC SITE; PROVIDES A COMMUNITY GARDEN PROVIDING FRESH VEGETABLES AND HERBS TO PATIENTS; PROVIDES A FREE FOOD PANTRY TO PATIENTS; OFFERS A CO-LOCATED MENTAL HEALTH COUNSELOR FOR CHILDREN IN PARTNERSHIP WITH THE CHILDREN'S HOME; AND A CO-LOCATED PARENT EDUCATOR PROGRAM IN PARTNERSHIP WITH IMPRINTS TO HELP FAMILIES ADDRESS DEVELOPMENTAL DELAYS. DHP ALSO COORDINATES WITH NORTHWEST COMMUNITY CARE NETWORK AND CENTERPOINT TO PROVIDE AN INNOVATIVE COMPREHENSIVE CARE MANAGEMENT FOR A HIGH RISK POPULATION (INCLUSIVE OF THE UNINSURED) THROUGH AN INTENSIVE CARE COORDINATION PROGRAM (HIGHER RISK FOR READMISSIONS AND ED VISITS). DHP ALSO PROVIDES AN ANNUAL SHARE THE HEALTH FREE HEALTH FAIR, PROVIDING FREE HEALTH SCREENINGS AND OTHER HEALTH-RELATED SERVICES AVAILABLE TO EVERYONE (ADULTS AND CHILDREN) REGARDLESS OF AGE, INSURANCE COVERAGE, AND INCOME LEVEL OR IMMIGRATION STATUS. THE HEALTH FAIR SERVES APPROXIMATELY 650 CHILDREN AND ADULTS ON AN ANNUAL BASIS. BRENNER FIT (FAMILIES IN TRAINING) HAS THE LONGEST TRACK RECORD AND THE MOST EXPERIENCE IN PROVIDING PREVENTION AND TREATMENT PROGRAMS FOR OVERWEIGHT AND OBESE POPULATIONS IN THE HOSPITAL'S SERVICE AREA. IN FY 2014, BRENNER FIT PROVIDED THE FOLLOWING:* RECEIVED 502 REFERRALS; BEGAN TREATMENT OF 220 NEW PATIENTS * GAVE 35 ACADEMIC PRESENTATIONS WITH OVER 1,300 PROFESSIONALS IN ATTENDANCE * REACHED OVER 36,000 INDIVIDUALS THROUGH COMMUNITY EDUCATION * FEATURED 44 TIMES IN BOTH REGIONAL AND NATIONAL MEDIA TOTALING OVER $339,000 IN VALUE FOR THE MEDICAL CENTER AND REACHING OVER 40.5 MILLION INDIVIDUALS * TAUGHT NEARLY 1000 SCHOOL CHILDREN BRENNER FIT'S MESSAGE * PARTICIPATED IN 12 COMMUNITY HEALTH FAIRS REACHING AN ESTIMATED 32,000 INDIVIDUALS * COMPLETED CONSTRUCTION OF A NEW TEACHING KITCHEN AT THE WILLIAM G. WHITE YMCA * OFFERED 74 COOKING CLASSES, TEACHING 794 COMMUNITY MEMBERS ABOUT HEALTHY EATING * OFFERED 19 CLASSES FOCUSED ON PHYSICAL ACTIVITY REACHING 274 COMMUNITY MEMBERS * CONTRIBUTED TO ACADEMIC AND MEDICAL LITERATURE THROUGH SIX JOURNAL PUBLICATIONS AND TWO BOOK CHAPTERS THE HOSPITAL ALSO PROVIDES A NUMBER OF PUBLIC EDUCATIONAL PROGRAMS THROUGH BEST HEALTH. BESTHEALTH , THE COMMUNITY WELLNESS OUTREACH PROGRAM OF WAKE FOREST BAPTIST HEALTH, OFFERED 145 CLASSES AND SCREENINGS IN FY 2014. MORE THAN HALF OF THESE EVENTS FOCUSED ON NUTRITION, HEART DISEASE, OBESITY AND EXERCISE. BESTHEALTH PROVIDED 7 COOKING CLASSES, 16 EXERCISE CLASSES, 28 SCREENINGS AND 94 SEMINARS FREE TO THE PUBLIC. IN ADDITION, BESTHEALTH COMMUNICATES MONTHLY TO THE COMMUNITY ABOUT ACCESS TO THE MANY SUPPORT GROUPS AND CLINICAL TRIALS AVAILABLE AT WAKE FOREST BAPTIST HEALTH. AS A HEART AND VASCULAR CENTER OF EXCELLENCE, THE HOSPITAL ALSO SPONSORS SEVERAL HEART RELATED SCREENINGS EACH YEAR INCLUDING FREE EKG SCREENINGS, HEART HEALTH TALKS, FREE COMMUNITY CPR CLASSES, COORDINATION WITH THE BE HEALTHY COALITION TO ENCOURAGE PHYSICAL ACTIVITY AMONG ALL FORSYTH COUNTY RESIDENTS THROUGH A TWO-MONTH PROGRAM WITH STEP UP FORSYTH, A FREE COMMUNITY WIDE PROGRAM COLLABORATION WITH THE YMCA, A SIX WEEK CHRONIC DISEASE MANAGEMENT WORKSHOP AND HEART AND STROKE PREVENTION CLASSES AT COUNTY GOVERNMENT WORKSITES. AS A CANCER CENTER OF EXCELLENCE AND AN NCI DESIGNATED CANCER CENTER, OUTREACH TO THE COMMUNITY IS A VITAL COMPONENT TO SERVING PATIENTS AND FAMILIES. OUTREACH AND COLLABORATIONS INCLUDE ANNUAL SKIN CANCER SCREENINGS, NUTRITION CLASSES, FREE YOGA FOR BREAST CANCER PATIENTS AND SURVIVORS, AS WELL AS SEVERAL FREE LUNCH AND LEARN WORKSHOPS ON CANCER AWARENESS AND PREVENTION.THE HOSPITAL'S DIVISION OF FAITH AND HEALTH MINISTRIES HAS A NEW INITIATIVE, FAITHHEALTHNC. FAITHHEALTHNC IS A DYNAMIC PARTNERSHIP BETWEEN FAITH COMMUNITIES, HEALTH SYSTEMS AND HEALTHCARE PROVIDERS FOCUSED ON IMPROVING HEALTH IN THE COMMUNITY. SINCE ITS IMPLEMENTATION, ALMOST 130 NORTH CAROLINA CONGREGATIONS HAVE PARTNERED WITH FAITHHEALTH NC TO SHARE IN THE MISSION OF HEALING. FAITHHEALTHNC PROVIDES HEALTH CARE LIASIONS WHO ASSIST THE COMMUNITY'S CLERGY AND FAITH VOLUNTEERS TO ENSURE THAT THEIR MEMBERS' HEALTHCARE NEEDS ARE MET DURING TIMES OF ILLNESS.THE HOSPITAL IS AN ACTIVE PARTICIPANT IN THE FORSYTH BEHAVIORAL HEALTH COALITION WHICH INCLUDES REPRESENTATIVES FROM WAKE FOREST BAPTIST MEDICAL CENTER, FORSYTH MEDICAL CENTER, CENTERPOINT AND NORTHWEST COMMUNITY CARE NETWORK (NCCN). DURING THE FISCAL YEAR, THE COALITION WORKED WITH THE NORTH CAROLINA HOSPITAL ASSOCIATION ON A COMPREHENSIVE PLAN TO TAKE TO THE NORTH CAROLINA STATE LEGISLATURE WITH THE FOLLOWING PRIORITIES:- DEVELOPMENT AND OBTAIN FUNDING FOR A COUNTY ED CRISIS INTERVENTION PROGRAM, AS THERE IS NO CURRENT CRISIS INTERVENTION SUPPORT IN FORSYTH OR SURROUNDING COUNTIES; AND- OBTAIN LEGISLATIVE SUPPORT FOR A WET SHELTER PROGRAM.THE COALITION IS ALSO WORKING TO ENSURE THAT WE HAVE STRUCTURES AND PROCESSES IN PLACE TO IMPROVE THE PATIENT FLOW AND TO ELIMINATE DUPLICATION OF SERVICES. LASTLY, NCCN IS WORKING WITH CENTERPOINT TO ENSURE THE BIDIRECTIONAL FLOW OF ELECTRONIC INFORMATION. |
| PART III, LINE 4: | THE ORGANIZATION'S FINANCIAL STATEMENTS DO NOT INCLUDE A DISCRETE FOOTNOTE EXPLAINING BAD DEBT EXPENSE. BAD DEBT HAS NOT BEEN INCLUDED IN THE COMPUTATION OF COMMUNITY BENEFIT ON PART I, LINE 7. THE ORGANIZATION HAS A THOROUGH PROCESS OF EVALUATING BAD DEBT ACCOUNTS AS INFORMATION BECOMES AVAILABLE AND RECLASSIFIES BAD DEBT ACCOUNTS AS CHARITY CARE AS PROVIDED BY THE CHARITY CARE POLICY. AMOUNTS USED TO COMPUTE CHARITY CARE AND BAD DEBT ON SCHEDULE H USE THE MOST CURRENT DATA AVAILABLE AT THE TIME OF FILING. THE ORGANIZATION USED WORKSHEET 2 OF THE 2013 SCHEDULE H INSTRUCTIONS TO COMPUTE A COST TO CHARGES RATIO USED TO CALCULATE BAD DEBT AT COST. |
| PART III, LINE 8: | THE HOSPITAL USES AN OVERALL COST TO CHARGE RATIO CALCULATION BASED ON AUDITED FINANCIAL STATEMENTS BUT REMOVES COST ASSOCIATED WITH BAD DEBT, GME, COMMUNITY BUILDING, AND CHARITY CARE SO AS NOT TO COUNT THOSE COSTS TWICE. |
| PART III, LINE 9B: | PATIENT FINANCIAL RESOURCES SERVICES WORKS WITH THE PATIENT FOR ANY PATIENT LIABILITY. OUR MAIN FOCUS IS PRIOR TO SERVICESAND/OR DISCHARGE; HOWEVER, WE DO WORK WITH PATIENTS AFTER SERVICES HAVEBEEN RECEIVED AND BILLED. PATIENT FINANCIAL RESOURCES SERVICES IS REALLYTWO AREAS IN ONE--THE RESOURCE RECOVERY SPECIALIST/RRS (FORMERLY FINANCIALCOUNSELING) AND THE MEDICAID ELIGIBILITY TEAM/MPS. THESE TWO AREAS WORKTOGETHER TO FIND A RESOLUTION TO PATIENT LIABILITY, SELF PAY OR INSURED.THE RRS WORKS TO NOTIFY THE PATIENT OF ANY PATIENT LIABILITY AND ASK FORPAYMENT FOR THAT LIABILITY. IF THE PATIENT INDICATES THAT HE/SHE NEEDSASSISTANCE, THEN THE RRS WILL COMPLETE A FINANCIAL STATEMENT ON THEPATIENT. WHILE TAKING THAT FINANCIAL STATEMENT THE RRS IS LOOKING FORINFORMATION THAT COULD QUALIFY THE PATIENT FOR MEDICAID OR FOR OTHERAGENCY PROGRAMS THAT ARE AVAILABLE TO THE MEDICAL CENTER. WHEN THATINFORMATION IS IDENTIFIED THE RRS WILL LET THE PATIENT KNOW THAT AREFERRAL WILL BE MADE FOR MEDICAID OR OTHER ASSISTANCE AND A MPS WILL BEIN TOUCH WITH HIM/HER. THE RRS ALSO EXPLAINS TO THE PATIENT OR FAMILY THATCHARITY CARE IS A LAST RESORT AND THEY MUST COOPERATE WITH ANY OTHERASSISTANCE PROGRAMS THAT WE HAVE IDENTIFIED AND BE FOUND INELIGIBLE BEFORECHARITY CARE WILL BE APPROVED/APPLIED. IT IS ALSO COMMUNICATED WITH THEPATIENT OR FAMILY IS INFORMED IF ANY SUPPORTING DOCUMENTATION IS NEEDED FOR ANY ASSISTANCE, WHETHER THAT BE CHARITY, MEDICAID, OR OTHER PROGRAMS. |
| PART VI, LINE 2: | TO COMPLETE A COMPREHENSIVE ASSESSMENT OF THE NEEDS OF THE COMMUNITY, AN INTERNAL COMMUNITY HEALTH TEAM RELIED ON THE ASSOCIATION FOR COMMUNITY HEALTH IMPROVEMENT'S (ACHI) 6-STEP COMMUNITY HEALTH ASSESSMENT PROCESS AND PARTICIPATED WITH THE NORTH CAROLINA DIVISION OF PUBLIC HEALTH IN THEIR ASSESSMENT PROCESS. A COMMUNITY WIDE TEAM COMPRISED OF THE FORSYTH COUNTY HEALTH DEPARTMENT, WAKE FOREST BAPTIST MEDICAL CENTER, FORSYTH MEDICAL CENTER AND VARIOUS COMMUNITY GROUPS INCLUDING THE UNITED WAY, THE YMCA, YWCA AND THE COUNTY GOVERNMENT AMONG MANY OTHERS HAS CONVENED TO CONDUCT A COLLABORATIVE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) EVERY THREE YEARS WITH INPUT FROM KEY COMMUNITY LEADERS, THE ACADEMIC COMMUNITY, THE SCHOOL DISTRICT, THE PUBLIC AND OTHERS. FOUNDED ON THE PRINCIPLES OF COLLABORATION, COMMUNITY MOBILIZATION AND EMPOWERMENT, THE COMMUNITY HEALTH ASSESSMENT PROCESS IS USED TO IDENTIFY PRIORITY HEALTH ISSUES AND TO PLAN INTERVENTIONS TO BUILD HEALTHIER COMMUNITIES WITH THE ULTIMATE GOAL OF MAKING NORTH CAROLINA, INCLUDING FORSYTH COUNTY, ONE OF THE HEALTHIEST STATES IN THE NATION. THE HOSPITAL'S INTERNAL TEAM HAS ADOPTED THE ACHI PROCESS TO ENSURE BOTH PUBLIC HEALTH AND THE REQUIRED COMMUNITY HEALTH NEEDS ASSESSMENT REQUIREMENTS INCLUDED IN THE AFFORDABLE CARE ACT WOULD BE MET. THE FIVE STEP PROCESS INCLUDES:1) DEFINE AND UNDERSTAND THE SERVICE AREASTEP 1: DEFINE SERVICE AREASTEP 2: RESEARCH THE SERVICE AREA'S DEMOGRAPHICSSTEP 3: IDENTIFY ZIP CODES WITH HIGH SOCIOECONOMIC NEED2) ANALYZE SECONDARY DATASTEP 1: COMPARE DATA TO OTHER LOCATIONSSTEP 2: COMPARE DATA TO HEALTHY PEOPLE 2020STEP 3: COMPARE DATA TO A PREVIOUS YEARSTEP 4: IDENTIFY DISPARITIES3) GATHER COMMUNITY INPUT ABOUT HEALTH NEEDSIDENTIFY COMMUNITY INPUT SOURCES, PRIMARILY FOCUSING ON:A) COMMUNITY PERSPECTIVE THROUGH RESIDENT INTERVIEWS AND FOCUS GROUPSB) HEALTH EXPERTS C) COMMUNITY-KEY INFORMANT LEADERS 4) DETERMINE SIGNIFICANT HEALTH NEEDSDETERMINE IF SOMETHING IS A SIGNIFICANT HEALTH NEED, BY USING SPECIFIC CRITERIA TO PRIORITIZE THE SIGNIFICANT HEALTH NEEDS. SUCH CRITERIA INCLUDES:- MULTIPLE INDICATORS TRENDING POORLY- LARGE DISPARITIES AMONG DIFFERENT GROUPS- ROOT CAUSES TO SEVERAL CHRONIC CONDITIONS- COMMON THEMES DISCUSSED BY FOCUS GROUPS/KEY INFORMANTS- SIGNIFICANT HEALTH PROBLEMS INDENTIFIED DURING COMMUNITY INPUT - SIGNIFICANT POPULATION IS AFFECTED5) UNDERSTAND COMMUNITY RESOURCESAN IMPORTANT PART OF ASSESSING THE HEALTH OF OUR COMMUNITY NEEDS IS ANALYZING ACTIVITIES CURRENTLY AVAILABLE. STEP 1: COMPILE CURRENT COMMUNITY PROGRAMS AND ASSET INVENTORYSTEP 2: CONTACT COMMUNITY ORGANIZATIONS TO DETERMINE THE CURRENT PROGRAM'S VALIDITY |
| PART VI, LINE 3: | THE ORGANIZATION USES A VARIETY OF MEANS TO EDUCATE AND INFORM PATIENTS OF THEIR CHARITY CARE OPTIONS, INCLUDING INFORMATION ON A WEBSITE, BILLING PAMPHLETS AVAILABLE IN CLINICAL OFFICES AND THE BUSINESS OFFICE, SIGNS IN CHECK-IN AREAS, INFORMATION ON PATIENT BILL STATEMENTS, AND FROM STAFF MEMBERS DURING CONVERSATIONS CONCERNING A PATIENT'S LIABILITY FOR SERVICES. THE HOSPITAL EMPLOYS A ROBUST PRE-SERVICE FINANCIAL CLEARANCE PROCESS THAT SCREENS PATIENTS PRIOR TO SERVICE DELIVERY FOR EXISTING OR AVAILABLE PAYER SOURCES AS A MEANS OF AVOIDING BAD DEBT AND INAPPROPRIATE BILLING TO PATIENTS WITHOUT THE MEANS TO PAY. IF A PAYER SOURCE IS IDENTIFIED, HOSPITAL STAFF ASSIST THE PATIENT WITH ENROLLMENT. |
| PART VI, LINE 4: | IN FISCAL YEAR 2014, THE MEDICAL CENTER PROVIDED CARE TO A NINETEEN COUNTY SERVICE AREA WHICH COMPRISES 3.3% OF TOTAL INPATIENT DISCHARGES FOR NORTH CAROLINA. THE PRIMARY AND SECONDARY SERVICE AREA INCLUDE:PRIMARY SERVICE AREA COUNTIES - FORSYTH, DAVIE, DAVIDSON, STOKES, SURRY, YADKINSECONDARY SERVICE AREA COUNTIES - ROCKINGHAM, GUILFORD, RANDOLPH, ROWAN, IREDELL, CATAWBA, ALEXANDER, WILKES, ALLEGHANY, ASHE, WATAUGA, CALDWELL, BURKE PERCENT OF UNINSURED INPATIENTS 6.6%PERCENT OF INPATIENTS WHO ARE MEDICAID RECIPIENTS 19.4%THE HOSPITAL IS LOCATED IN CENTRAL FORSYTH COUNTY, WHICH COMPRISES THE SINGLE LARGEST COUNTY IN TOTAL INPATIENT DISCHARGES, ACCOUNTING FOR 11,752 OR 32.6% OF ALL DISCHARGES IN FY 14. ACCORDINGLY, THE HOSPITAL SERVES A WIDE SERVICE AREA; HOWEVER, IT IS RESOURCE PROHIBITIVE TO PARTICIPATE AND FUND HEALTH ASSESSMENTS IN EACH COMMUNITY/COUNTY FROM WHICH ITS PATIENT POPULATION ORIGINATES. THEREFORE, THE PRIMARY COMMUNITY BENEFIT SERVICE AREA (CBSA)IS FORSYTH COUNTY, NORTH CAROLINA.BELOW IS A DEMOGRAPHIC SNAPSHOT OF FORSYTH COUNTY BASED ON 2010 CENSUS DATA: POPULATION AND GEOGRAPHY TOTAL POPULATION 350,670POPULATION CHANGE SINCE 2000 + 12.7%LAND AREA 408.1 SQUARE MILESPOPULATION DENSITY 859.5 PERSONS PER SQUARE MILE POPULATION BY RACE/ETHNICITYWHITE 58.7%BLACK/AFRICAN-AMERICAN 25.5%HISPANIC 11.9%ASIAN 1.8%AMERICAN INDIAN/ 0.3%ALASKA NATIVE NATIVE HAWAIIAN/ 0.04%PACIFIC ISLANDERMULTIRACIAL 1.5%OTHER 0.2% POPULATION BY AGE DISTRIBUTIONUNDER 5 YEARS OLD 6.8%UNDER 18 YEARS OLD 24.4%= 65 YEARS OLD 13.0%MEDIAN AGE 37.5 YEARS POPULATION BY SEXMALE 47.5%FEMALE 52.5% POPULATION BY EDUCATIONAL ATTAINMENT PERCENT OF PERSONS = 25 YEARS OLD WHO HAVE:< HIGH SCHOOL DIPLOMA OR GED 13.8%A HIGH SCHOOL DIPLOMA OR GED 28.2%A BACHELOR'S DEGREE 20.7%GRADUATE DEGREE 10.0%PERCENTAGE OF FAMILIES LIVING BELOW POVERTY LEVELALL FAMILIES 11.0%FAMILIES WITH A HOUSEHOLDER WHO IS:WHITE 4.6%BLACK/AFRICAN AMERICAN 21.6%HISPANIC 31.4%ASIAN 6.6%AMERICAN INDIAN/ 17.2%OTHER RACE 34.7 PERCENTAGE OF POPULATION LIVING BELOW POVERTY LEVELCHILDREN (0-17YR OLD) 22.8%ADULTS (18-64YR OLD) 12.9%SENIORS (= 65YR OLD) 7.1% COUNTY SCHOOLSK-12 ENROLLMENT 53,627GRADUATION RATE 72.7% UNEMPLOYMENT UNEMPLOYMENT RATE 9.9%LOST JOBS & LAYOFFS 1,900 INCOMEMEDIAN FAMILY HOUSEHOLD $55,075MEDIAN NON-FAMILY HOUSEHOLD $28,023 |
| PART VI, LINE 6: | WAKE FOREST BAPTIST MEDICAL CENTER'S MISSION IS TOIMPROVE THE HEALTH OF OUR REGION, STATE AND NATION BY:1) GENERATING AND TRANSLATING KNOWLEDGE TO PREVENT, DIAGNOSE AND TREATDISEASE.2) TRAINING LEADERS IN HEALTH CARE AND BIOMEDICAL SCIENCE.3) SERVING AS THE PREMIER HEALTH SYSTEM IN OUR REGION, WITH SPECIFICCENTERS OF EXCELLENCE RECOGNIZED AS NATIONAL AND INTERNATIONAL CAREDESTINATIONS. THE HOSPITAL, WHICH IS THE INPATIENT COMPONENT OF WAKE FOREST BAPTIST MEDICAL CENTER, OPERATES THE FOLLOWING PROGRAMS CONSTITUTING COMMUNITY HEALTH IMPROVEMENT SERVICES AND COMMUNITY BENEFIT OPERATIONS REPORTED ON PART I,LINE 7E:WINSTON-SALEM/FORSYTH CTY SCHOOLS'ALLIED HEALTH PROGRAM $4,993CHURCH COMMUNITY RELATIONS $98,913PALLIATIVE CARE PROGRAMS $148,479COMMUNITY HEALTH SALARIES $359,149PHYSICIANS COMMUNITY HEALTH ACCESS $357,833CARENET/PASTORAL COUNSELING $526,770ACCELERATED BACHELOR OF SCIENCE IN NURSING PROGRAM $344,702COUNTY RENT ON CLEVELAND AVE DENTAL CLINIC $111,559DIABETIC EDUCATION $19,192BRENNER FIT $169,431FAMILY RESOURCES $27,989TOTAL TO PART I, LINE 7E: $2,169,010 |
| PART VI, LINE 7, REPORTS FILED WITH STATES | NC |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (6 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt | Non Cash AssistanceNonCashAssistanceAmt | Valuation Method UsedValuationMethodUsedDesc | Non Cash AssistanceNonCashAssistanceDesc |
|---|---|---|---|---|---|---|---|---|---|---|
| CANCER SERVICES | ||||||||||
| 3175 MAPLEWOOD AVE | WINSTON SALEM | NC | 27103 | 560656375 | 501(C)3 | $10,000 | COMMUNITY SUPPORT | |||
| CITY OF WINSTON SALEM | ||||||||||
| 101 N MAIN STREET | WINSTON SALEM | NC | 27101 | GOVT | $400,000 | CITY OF WINSTON SALEM'S "WE PLAY" INITIATIVE TO UPGRADE PLAYGROUND EQUIPMENT | ||||
| THE SHEPHERD'S CENTER OF GREATER WINSTON SALEM | ||||||||||
| 1700 EBERT STREET | WINSTON SALEM | NC | 27103 | 561646960 | 501(C)3 | $25,000 | COMMUNITY SUPPORT | |||
| CITY OF WINSTON SALEM | ||||||||||
| PO BOX 2511 | WINSTON SALEM | NC | 27102 | GOVT | COMMUNITY SUPPORT | $611,000 | APPRAISED TAX VALUE | BUILDINGS AND LAND | ||
| PIEDMONT REGIONAL TRAUMA SYSTEMS | ||||||||||
| MEDICAL CENTER BLVD | WINSTON SALEM | NC | 27157 | 562036036 | 501(C)3 | $100,000 | INTEGRATED TRAUMA SYSTEM | |||
| FORSYTH HEALTHCARE INC | ||||||||||
| 515 N CLEVELAND AVENUE | WINSTON SALEM | NC | 27101 | 320097975 | 501(C)3 | $85,000 | HEALTHCARE ACCESS | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 5 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp (3 entries)
| Grant TypeGrantTypeTxt | RecipientRecipientCnt | Cash GrantCashGrantAmt |
|---|---|---|
| LETTIE PATE WHITEHEAD SCHOLARS | 68 | $78,000 |
| MEDICAL SCHOLARSHIPS | 6 | $17,090 |
| RUTH HOLLEMAN SCHOLARSHIPS | 4 | $7,000 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE HOSPITAL FOLLOWS THE MEDICAL CENTER'S CORPORATE POLICY USED IN REVIEWING THE ELIGIBILITY AND SELECTION OF GRANTEES RECEIVING CERTAIN EXEMPT PURPOSE FUNDS. THE HOSPITAL MAINTAINS DOCUMENTATION OF THE ELIGIBILITY AND SELECTION CRITERIA AND RECORDS OF THE AMOUNTS DISBURSED. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Housing Allowance Or Residence | Yes (X) | HousingAllowanceOrResidenceInd |
| Club Dues Or Fees | Yes (X) | ClubDuesOrFeesInd |
| Written Policy Ref T And E Expnss | Yes (1) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (1) | SubstantiationRequiredInd |
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | Yes (1) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (25 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JOHN D MCCONNELL MD | ||||||||||||||
| TRUSTEE & CEO | $996,889 | $0 | $0 | $0 | $23,044 | $0 | $711,356 | $0 | $21,582 | $0 | $1,752,871 | $0 | $0 | $0 |
| H GREG BRAY | ||||||||||||||
| ASST. TREASURER/ASST. SECR | $220,794 | $0 | $0 | $0 | $496 | $0 | $8,608 | $0 | $18,153 | $0 | $248,051 | $0 | $0 | $0 |
| J MCLAIN WALLACE JR | ||||||||||||||
| VP GENERAL COUNSEL/SECR | $397,130 | $0 | $0 | $0 | $19,469 | $0 | $77,582 | $0 | $18,147 | $0 | $512,328 | $0 | $0 | $0 |
| KAREN H HUEY | ||||||||||||||
| VP FACILITIES | $266,979 | $0 | $0 | $0 | $872 | $0 | $37,235 | $0 | $20,998 | $0 | $326,084 | $0 | $0 | $0 |
| ERIC TOMLINSON | ||||||||||||||
| CHIEF INNOVATION OFFICER | $380,988 | $0 | $120,000 | $0 | $41,267 | $0 | $71,047 | $0 | $8,876 | $0 | $622,178 | $0 | $0 | $0 |
| NORMAN D POTTER JR | ||||||||||||||
| VP DEVELOPMENT & ALUMNI AF | $294,426 | $0 | $0 | $0 | $8,526 | $0 | $44,623 | $0 | $23,083 | $0 | $370,658 | $0 | $0 | $0 |
| CHERYL EH LOCKE | ||||||||||||||
| VP CHIEF HUMAN RESOURCES | $348,737 | $0 | $0 | $0 | $5,544 | $0 | $61,610 | $0 | $20,591 | $0 | $436,482 | $0 | $0 | $0 |
| EDWARD G CHADWICK | ||||||||||||||
| EXECUTIVE VP CFO/TREASURER | $537,212 | $0 | $0 | $0 | $23,092 | $0 | $187,965 | $0 | $18,949 | $0 | $767,218 | $0 | $0 | $0 |
| THOMAS E SIBERT MD | ||||||||||||||
| PRESIDENT/COO - HEALTH SYS | $732,409 | $0 | $0 | $0 | $31,774 | $0 | $171,432 | $0 | $22,062 | $0 | $957,677 | $0 | $0 | $0 |
| LISA M WYATT | ||||||||||||||
| VP CHIEF COMM & MARKETING | $298,604 | $0 | $0 | $0 | $21,112 | $0 | $49,066 | $0 | $10,809 | $0 | $379,591 | $0 | $0 | $0 |
| EDWARD ABRAHAM MD | ||||||||||||||
| DEAN, SCHOOL OF MEDICINE | $489,389 | $0 | $43,115 | $0 | $23,044 | $0 | $115,221 | $0 | $19,202 | $0 | $689,971 | $0 | $0 | $0 |
| BRADLEY A CLARK | ||||||||||||||
| ASSISTANT TREASURER | $219,144 | $0 | $0 | $0 | $481 | $0 | $8,248 | $0 | $20,811 | $0 | $248,684 | $0 | $0 | $0 |
| BETTY PETREE | ||||||||||||||
| DIRECTOR NURSE ANESTHESIA | $226,884 | $0 | $0 | $0 | $16,603 | $0 | $11,590 | $0 | $8,481 | $0 | $263,558 | $0 | $0 | $0 |
| MICHAEL RIEKER | ||||||||||||||
| DIRECTOR OF NURSE ANESTHES | $233,903 | $0 | $0 | $0 | $183 | $0 | $9,212 | $0 | $20,965 | $0 | $264,263 | $0 | $0 | $0 |
| VANCE MCVAY JR | ||||||||||||||
| CLINICAL INSTRUCTOR CRNA | $232,181 | $0 | $0 | $0 | $337 | $0 | $9,016 | $0 | $19,732 | $0 | $261,266 | $0 | $0 | $0 |
| ERIC STIEFEL | ||||||||||||||
| CLINICAL INSTRUCTOR CRNA | $213,569 | $0 | $0 | $0 | $337 | $0 | $7,852 | $0 | $17,424 | $0 | $239,182 | $0 | $0 | $0 |
| CHARLES WARE | ||||||||||||||
| AVP INFRASTRUCTURE | $86,987 | $0 | $0 | $0 | $108,238 | $0 | $10,171 | $0 | $11,809 | $0 | $217,205 | $0 | $0 | $0 |
| JOANNE C RUHLAND | ||||||||||||||
| FORMER OFFICER | $248,060 | $0 | $0 | $0 | $21,412 | $0 | $36,293 | $0 | $19,782 | $0 | $325,547 | $0 | $0 | $0 |
| RUSSELL M HOWERTON MD | ||||||||||||||
| FORMER OFFICER | $489,437 | $0 | $0 | $0 | $21,112 | $0 | $105,522 | $0 | $24,342 | $0 | $640,413 | $0 | $0 | $0 |
| DOUGLAS L EDGETON | ||||||||||||||
| FORMER OFFICER | $0 | $0 | $0 | $0 | $495,405 | $0 | $0 | $0 | $245 | $0 | $495,650 | $0 | $0 | $0 |
| SHEILA M SANDERS | ||||||||||||||
| FORMER OFFICER | $186,846 | $0 | $0 | $0 | $267,763 | $0 | $6,696 | $0 | $17,831 | $0 | $479,136 | $0 | $63,700 | $0 |
| STEVE C SNELGROVE | ||||||||||||||
| FORMER OFFICER | $289,444 | $0 | $0 | $0 | $20,393 | $0 | $47,689 | $0 | $17,890 | $0 | $375,416 | $0 | $0 | $0 |
| MAUREEN E SINTICH | ||||||||||||||
| FORMER OFFICER | $333,140 | $0 | $0 | $0 | $1,696 | $0 | $51,944 | $0 | $17,436 | $0 | $404,216 | $0 | $0 | $0 |
| DONNY C LAMBETH | ||||||||||||||
| FORMER OFFICER | $0 | $0 | $0 | $0 | $565,644 | $0 | $0 | $0 | $15,105 | $0 | $580,749 | $0 | $0 | $0 |
| SHARON ENGEBRETSON | ||||||||||||||
| FORMER OFFICER | $123,925 | $0 | $0 | $0 | $888 | $0 | $7,880 | $0 | $47,362 | $0 | $180,055 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 1A | CERTAIN OFFICERS RECEIVE, AS PART OF THEIR APPROVED COMPENSATION PACKAGE, RELOCATION ASSISTANCE INCLUDING A HOUSING ALLOWANCE, AND HEALTH OR SOCIAL CLUB DUES OR INITIATION FEES. BELOW IS A SUMMARY OF THE BENEFITS INCLUDED IN THE OFFICERS' 2013 CALENDAR YEAR COMPENSATION: - RELOCATION ASSISTANCE, INCLUDING A HOUSING ALLOWANCE - $51,556 AS FOLLOWS: ERIC TOMLINSON - $13,556 RELOCATION ASSISTANCE SHARON ENGEBRETSON - $38,000 MINISTERIAL HOUSING - DUES AND INITIATION FEES - $12 FOR NORMAN POTTER |
| PART I, LINE 3 | THE EXECUTIVE COMMITTEE OF THE WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER ("WFUBMC") BOARD OF DIRECTORS IS RESPONSIBLE FOR REVIEWING AND APPROVING ALL WFUBMC OFFICERS' COMPENSATION. THE COMMITTEE UTILIZES AN INDEPENDENT, EXTERNAL COMPENSATION CONSULTANT FIRM EXPERIENCED IN HEALTH CARE AND HIGHER EDUCATION COMPENSATION THAT BASED RECOMMENDATIONS ON COMPENSATION SURVEYS AND STUDIES TO DETERMINE THE APPROPRIATENESS OF EACH OFFICER'S COMPENSATION. THESE COMPENSATION CONSULTANTS PRESENT TOTAL COMPENSATION COMPARABILITY DATA FOR THE POSITIONS FOR WHICH COMPENSATION IS BEING DETERMINED. THE DATA IS REVIEWED BY THE EXECUTIVE COMMITTEE OF WFUBMC'S GOVERNING BOARD AT ITS MEETING; NONE OF THE MEMBERS OF THAT COMMITTEE ARE EMPLOYEES OF THE FILING ORGANIZATION. MINUTES OF THE DELIBERATIONS OF THE COMMITTEE ARE CONTEMPORANEOUSLY RECORDED. IN THE EVENT THAT ANY MEMBER OF THE EXECUTIVE COMMITTEE HAS A CONFLICT OF INTEREST, THAT COMMITTEE MEMBER DOES NOT PARTICIPATE IN THE DELIBERATION OR APPROVAL PROCESS, AND THEIR ABSTENTION FROM THE PROCESS IS REFLECTED IN THE MINUTES. |
| PART I, LINES 4A-B | CERTAIN EXECUTIVES PARTICIPATE IN OR RECEIVE SEVERANCE PAYMENTS AND PAYMENTS FROM SUPPLEMENTAL NON QUALIFIED RETIREMENT PLANS. THE DETERMINATION OF THE AMOUNT OF THE NON QUALIFIED RETIREMENT PLANS FOLLOWED THE FILING ORGANIZATION'S COMPENSATION PROCEDURES AS OUTLINED IN PART VI, SECTION B, LINE 15 OF THE FORM 990. THE FOLLOWING KEY EMPLOYEE AND FORMER OFFICERS RECEIVED SEVERANCE AND SERP PAYMENTS IN THEIR CALENDAR YEAR 2013 COMPENSATION: NAME SEVERANCE NON-QUAL RETIRE SHELIA SANDERS 189,500 77,297 DONNY C LAMBETH 565,644 DOUG EDGETON 495,405 CHARLES WARE 104,746 |
| PART I, LINE 7 | OFFICERS AND KEY EMPLOYEES HAVE INCENTIVE COMPENSATION COMPONENTS CONTAINED IN THEIR EMPLOYMENT AGREEMENTS. THESE ARE OFTEN GOAL-BASED AND ARE DETERMINED IN THE COURSE OF EVALUATION OF THE INDIVIDUAL'S PERFORMANCE BY HIS/HER DEPARTMENT CHAIR, SUPERVISOR OR THE COMPENSATION COMMITTEE OF THE BOARD, AS APPLICABLE. OTHER NON-FIXED PAYMENTS MAY INCLUDE SUMS FOR RELOCATION AND/OR TEMPORARY HOUSING THAT ARE TYPICALLY INCLUDED AS A PROVISION IN THE EMPLOYMENT AGREEMENT. ALL SUCH PAYMENTS ARE REFLECTED ON THE INDIVIDUAL'S W-2. |
| SCHEDULE J, PART III | IN JULY OF 2010, WAKE FOREST UNIVERSITY HEALTH SCIENCES (WFUHS), NORTH CAROLINA BAPTIST HOSPITAL (NCBH), WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER (WFUBMC) AND WAKE FOREST UNIVERSITY (WFU)) APPROVED A MEDICAL CENTER INTEGRATION AGREEMENT THAT ALLOWS FOR THE LEVERAGING OF COMBINED RESOURCES OF NCBH AND WFUHS TO FULFILL A SINGLE MISSION OF IMPROVING HEALTH, OPTIMIZING PERFORMANCE WHILE BALANCING PATIENT CARE, EDUCATION AND RESEARCH. NCBH, WFUBMC, WFUHS AND THEIR SUBSIDIARIES HAVE COMBINED OPERATING REVENUES OF APPROXIMATELY $2 BILLION FOR THE FISCAL YEAR ENDED JUNE 30, 2014. IN GENERAL, EXECUTIVES PERFORMING KEY MANAGEMENT FUNCTIONS FOR THE MEDICAL CENTER ARE SOUGHT AND HIRED AFTER NATIONAL SEARCHES IN A HIGHLY COMPETITIVE ENVIRONMENT, AND ONLY INDIVIDUALS AT THE HIGHEST LEVELS OF ABILITY ARE HIRED AND GIVEN THE TASK OF OPTIMIZING THE EFFECTIVENESS OF THE MEDICAL CENTER AND ITS TAX-EXEMPT MISSION. CERTAIN EXECUTIVES HOLD THE IDENTICAL OFFICES/TITLES IN WFUHS, NCBH AND WFUBMC AND ARE ELIGIBLE TO RECEIVE INCENTIVE COMPENSATION AT THE END OF EACH FISCAL YEAR. THE INCENTIVE STRUCTURE IS BASED UPON GOALS ESTABLISHED BY THE EXECUTIVE COMMITTEE ON BEHALF OF THE FILING ORGANIZATION'S BOARD AT THE BEGINNING OF THE YEAR, INCLUDING MEASURES OF CLINICAL QUALITY, PATIENT SATISFACTION, AND FINANCIAL OPERATING PERFORMANCE. THE DETERMINATION OF THE AMOUNT OF INCENTIVE COMPENSATION IS SUBJECT TO THE FILING ORGANIZATION'S COMPENSATION PROCEDURES AS OUTLINED IN PART VI, SECTION B, LINE 15 OF THE 990. |
| FORM 990, PART VII, LINE 5 - COMPENSATION FROM UNREALTED ORGANIZATION | THE FOLLOWING CURRENT AND FORMER OFFICERS AND DIRECTORS WERE COMPENSATED BY WAKE FOREST UNIVERSITY HEALTH SCIENCES FOR SERVICES PERFORMED FOR THE HOSPITAL. SEE PART VII AND SCHEDULE J, PART II, FOR THEIR COMPENSATION: JOHN D MCCONNELL MD JOANNE C RUHLAND NORMAN D POTTER, JR. CHERYL E.H. LOCKE EDWARD G CHADWICK THOMAS E SIBERT, MD RUSSELL M HOWERTON, MD DOUGLAS L EDGETON LISA M WYATT SHEILA M SANDERS EDWARD ABRAHAM, MD ERIC TOMLINSON, DCS, PH BRADLEY A. CLARK TERRY WILLIAMS |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (3 entries)
| Bond ReferenceBondReferenceCd | Bond Issuer EINBondIssuerEIN | CUSIPCUSIPNum | Bond IssuedBondIssuedDt | Issue PriceIssuePriceAmt | PurposePurposeDesc | DefeasedDefeasedInd | On Behalf Of IssuerOnBehalfOfIssuerInd | Pool FinancingPoolFinancingInd |
|---|---|---|---|---|---|---|---|---|
| NORTH CAROLINA MEDICAL CARE COMMISSION | ||||||||
| A | 521309402 | 65820HD67 | 2010-03-01 | $334,002,408 | CURRENT REFUNDING | 0 | 0 | 0 |
| NORTH CAROLINA MEDICAL CARE COMMISSION | ||||||||
| B | 521309402 | NONEAVAIL | 2012-12-31 | $80,000,000 | VARIOUS CAPITAL PROJECTS | 0 | 0 | 0 |
| NORTH CAROLINA MEDICAL CARE COMMISSION | ||||||||
| C | 521309402 | 65821DMM0 | 2012-11-15 | $122,822,821 | VARIOUS CAPITAL PROJECTS | 0 | 0 | 0 |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (3 entries)
| Bond ReferenceBondReferenceCd | RetiredRetiredAmt | Total ProceedsTotalProceedsAmt | Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt | Other Spent ProceedsOtherSpentProceedsAmt | Substantial CompletionSubstantialCompletionYr | Current RefundingCurrentRefundingInd | Advance RefundingAdvanceRefundingInd | Final Allocation MadeFinalAllocationMadeInd | Adequate Books And Rec MaintAdequateBooksAndRecMaintInd | Capital ExpendituresCapitalExpendituresAmt | UnspentUnspentAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| A | $32,235,000 | $334,002,408 | $3,307,037 | $330,695,370 | 2010 | Yes (1) | 0 | Yes (1) | Yes (1) | ||
| B | $80,000,000 | $1,000 | 0 | 0 | 0 | Yes (1) | $77,567,793 | $2,431,207 | |||
| C | $122,822,821 | $2,485 | 2013 | 0 | 0 | Yes (1) | Yes (1) | $122,820,336 |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (2 entries)
| Bond ReferenceBondReferenceCd | Owning Bond Financed PropertyOwningBondFinancedPropertyInd | Any Lease ArrangementsAnyLeaseArrangementsInd | Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd | Any Research AgreementsAnyResearchAgreementsInd | Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd | Change In Use Bond Financed PropChangeInUseBondFinancedPropInd | Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd |
|---|---|---|---|---|---|---|---|
| B | 0 | 0 | 0 | 0 | 0 | 0 | Yes (1) |
| C | 0 | Yes (1) | 0 | 0 | 0 | 0 | Yes (1) |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (3 entries)
| Bond ReferenceBondReferenceCd | Form8038 T FiledForm8038TFiledInd | Rebate Not Due YetRebateNotDueYetInd | Exception To RebateExceptionToRebateInd | No Rebate DueNoRebateDueInd | Variable Rate IssueVariableRateIssueInd | Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd | Term Of HedgeTermOfHedgePct | Superintegrated HedgeSuperintegratedHedgeInd | Hedge TerminatedHedgeTerminatedInd | Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd | Gross Proceeds InvestedGrossProceedsInvestedInd | Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DEUTSCHE BANK AG | ||||||||||||
| A | 0 | Yes (1) | 0 | 0 | 0 | Yes (1) | 5.000000000000 | 0 | 0 | 0 | 0 | Yes (1) |
| (no name) | ||||||||||||
| B | 0 | Yes (1) | 0 | 0 | Yes (1) | 0 | 0 | 0 | Yes (1) | |||
| (no name) | ||||||||||||
| C | 0 | Yes (1) | 0 | 0 | 0 | 0 | 0 | 0 | Yes (1) | |||
Procedures Corrective Action ProceduresCorrectiveActionGrp (3 entries)
| Bond ReferenceBondReferenceCd | Procedures Corrective ActionProceduresCorrectiveActionInd |
|---|---|
| A | Yes (1) |
| B | Yes (1) |
| C | Yes (1) |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE A, COLUMN F | THE PURPOSE OF THE ISSUE WAS TO REFUND ISSUES DATED 10/29/1992, 6/27/1996, 6/15/2000, AND 1/29/2009 |
| PART II, COLUMN A, LINE 11 | THE OTHER SPENT PROCEEDS ARE THE CURRENT REFUNDING PROCEEDS OF THE ISSUE. |
| PART III, COLUMN A | ALL ISSUES REFUNDED BY THE 2010 ISSUE ARE EITHER PRIOR TO 12/31/2002 OR THROUGH A SERIES OF REFUNDINGS THAT REFUND AN ISSUE PRIOR TO 12/31/2002. THEREFORE, THIS ISSUE IS EXEMPT FROM SECTION III REPORTING. |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (4 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| DAVID E BRANN | |||
| FAMILY MEMBER OF DONNY LAMBETH | $93,053 | REPORTABLE COMPENSATION | 0 |
| JUDY M SLOCUM | |||
| FAMILY MEMBER OF MAUREEN SINTICH | $44,302 | REPORTABLE COMPENSATION | 0 |
| MEDCOST | |||
| BOARD MEMBER EDWARD CHADWICK | $2,168,302 | TOTAL PAID BY ORGANIZATION TO MEDCOST LLC, THE INTERESTED PERSON, FOR ADMINISTRATION OF HEALTH AND DENTAL CLAIMS. | 0 |
| KRISTIN LAMBETH | |||
| FAMILY MEMBER OF DONNY LAMBETH | $24,388 | REPORTABLE COMPENSATION | 0 |
Schedule M IRS990ScheduleM
Books And Publications BooksAndPublicationsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Noncash Contributions Rpt F990 | $3,328 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | FMV | MethodOfDeterminingRevenuesTxt |
Clothing And Household Goods ClothingAndHouseholdGoodsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Noncash Contributions Rpt F990 | $19,091 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | FMV | MethodOfDeterminingRevenuesTxt |
Securities Publicly Traded SecuritiesPubliclyTradedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 3 | ContributionCnt |
| Noncash Contributions Rpt F990 | $5,352 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | FMV | MethodOfDeterminingRevenuesTxt |
Real Estate Commercial RealEstateCommercialGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 1 | ContributionCnt |
| Noncash Contributions Rpt F990 | $611,000 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | APPRAISED TAX VALUE | MethodOfDeterminingRevenuesTxt |
Food Inventory FoodInventoryGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 2 | ContributionCnt |
| Noncash Contributions Rpt F990 | $199 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | FMV | MethodOfDeterminingRevenuesTxt |
Other Non Cash Contri Table OtherNonCashContriTableGrp (2 entries)
| Non Cash CheckboxNonCashCheckboxInd | DescDesc | ContributionContributionCnt | Noncash Contributions Rpt F990NoncashContributionsRptF990Amt | Method Of Determining RevenuesMethodOfDeterminingRevenuesTxt |
|---|---|---|---|---|
| Yes (X) | MEDICAL EQUIP | 5 | $164,904 | FMV |
| Yes (X) | GIFT CARD | 2 | $250 | FMV |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form8283 Received | 0 | Form8283ReceivedCnt |
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | Yes (1) | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | 0 | ThirdPartiesUsedInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, COLUMN (B): | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION DETERMINES THE NUMBER OF CONTRIBUTIONS BY USING THE TOTAL NUMBER OF NON-CASH ITEMS RECEIVED PER DONOR PER OCCURANCE. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 3 | EFFECTIVE JULY 1, 2010, THE GOVERNING BOARDS OF FOUR NORTH CAROLINA NONPROFIT CORPORATIONS (WAKE FOREST UNIVERSITY, NORTH CAROLINA BAPTIST HOSPITAL, WAKE FOREST UNIVERSITY HEALTH SCIENCES, AND WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER) ENTERED INTO AN AGREEMENT (THE "MEDICAL CENTER INTEGRATION AGREEMENT" OR "MCIA") UNDER WHICH THE OPERATION OF EACH OF NORTH CAROLINA BAPTIST HOSPITAL ("NCBH") AND WAKE FOREST UNIVERSITY HEALTH SCIENCES ("WFUHS") WAS DELEGATED TO WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER ("WFUBMC"). WFUHS IS A WHOLLY-CONTROLLED SUBSIDIARY ENTITY OF WAKE FOREST UNIVERSITY ("WFU"). WFUBMC IS A MEMBERSHIP NONPROFIT CORPORATION WHOSE TWO EQUAL MEMBERS ARE NCBH (WHICH ENTITY IS UNRELATED TO WFUHS AND WFU) AND WFU. THE GOAL IS CONSOLIDATION OF MANAGEMENT IN WFUBMC OF THE VARIOUS ACADEMIC MEDICAL CENTER OPERATIONS, SUBJECT TO SUBSTANTIAL RESERVED POWERS IN EACH OF THE CONSTITUENT MEMBERS' BOARDS. EFFECTIVE MARCH 17, 2014, THE ENTITY CONTRACTED WITH C. MICHAEL RUTHERFORD AS ITS CHIEF FINANCIAL OFFICER AND TREASURER. MR. RUTHERFORD IS AN EMPLOYEE OF WARBIRD CONSULTING PARTNERS, A HEALTHCARE EXECUTIVE MANAGEMENT SERVICES COMPANY. EFFECTIVE NOVEMBER 2013, THE BOARD APPROVED PAMELA F. CIPRIANO, PH.D., AS INTERIM COO. PAMELA IS AN EMPLOYEE OF GALLOWAY CONSULTING, A HEALTHCARE STRATEGIC ADVISORY FIRM. THE MEDICAL CENTER PAID GALLOWAY $334,100 IN CALENDAR YEAR 2013 FOR HER SERVICES AS INTERIM COO. |
| FORM 990, PART VI, SECTION B, LINE 11 | THE FILING ORGANIZATION'S BOARD OF DIRECTORS RECEIVE A COPY OF THE FORM 990 WITH SUFFICIENT TIME TO PERMIT REVIEW, COMMENT, AND QUESTIONS PRIOR TO ITS FILING. THE AUDIT AND COMPLIANCE COMMITTEE OF THE GOVERNING BOARD OF WFUBMC, COMPRISED OF THE AUDIT AND COMPLIANCE COMMITTEES OF WFUHS AND NCBH, REVIEW IN ADDITIONAL DETAIL THE FILING ORGANIZATION'S FORM 990 WITH THE ORGANIZATION'S CHIEF FINANCIAL OFFICER OR HIS DESIGNEE, WHO ANSWERS QUESTIONS AND ADDRESSES CONCERNS RAISED BY SUCH COMMITTEE MEMBERS OR OTHER FILING ORGANIZATION DIRECTORS. IF MODIFICATIONS ARE REQUIRED FOLLOWING SUCH REVIEW AND COMMENT, THE REVISED FORM 990 IS REDISTRIBUTED TO ALL BOARD MEMBERS PRIOR TO ITS FILING WITH THE IRS, ALONG WITH A REPORT NOTING THE MODIFICATIONS. |
| FORM 990, PART VI, SECTION B, LINE 12C | ON AN ANNUAL BASIS (AND AS THEY ARISE), ALL TRUSTEES AND OFFICERS OF THE FILING ORGANIZATION ARE ASKED TO REVIEW THE APPLICABLE CONFLICTS OF INTEREST POLICY AND TO DESCRIBE ANY POTENTIAL CONFLICTS OF INTEREST THEY MAY HAVE. UPON COMPLETION OF THE CONFLICTS OF INTEREST SURVEY, THE LEGAL DEPARTMENT REVIEWS THE COMPLETED QUESTIONNAIRES ON BEHALF OF THE FILING ORGANIZATION. ANY CONFLICTS IDENTIFIED ARE COMMUNICATED TO THE FILING ORGANIZATION'S CHAIRMAN OF THE BOARD AND ARE PRESENTED TO THE AUDIT AND COMPLIANCE COMMITTEE. ALL CONFLICTS OF INTEREST ARE RESOLVED BY MANAGEMENT PLANS DEVELOPED BY THE FILING ORGANIZATION BOARD'S AUDIT AND COMPLIANCE COMMITTEE AND THE INTERNAL AUDIT AND COMPLIANCE OFFICES. THE AUDIT AND COMPLIANCE COMMITTEE'S CHAIR PRESENTS AN ANNUAL REPORT ON CONFLICTS TO THE FULL BOARD OF THE FILING ORGANIZATION. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE EXECUTIVE COMMITTEE OF WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER ("WFUBMC")BOARD OF DIRECTORS FUNCTIONS AS THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS AND PURSUANT TO A DELEGATION BY THE FILING ORGANIZATION, REVIEWS AND APPROVES THE APPOINTMENT AND COMPENSATION OF THE SENIOR EXECUTIVES OF THE FILING ORGANIZATION. NO MEMBER OF THE WFUBMC EXECUTIVE COMMITTEE IS AN EMPLOYEE OF THE MEDICAL CENTER. THE EXECUTIVE COMMITTEE RELIES UPON AN EXTERNAL, INDEPENDENT COMPENSATION CONSULTANT EXPERIENCED IN HEALTHCARE TO PROVIDE THE COMMITTEE WITH COMPENSATION COMPARABILITY DATA FOR NEW EXECUTIVE POSITION APPOINTMENTS AND FOR COMPENSATION REVIEWS FOR EXISTING EXECUTIVES. THE CONSULTANT, WHICH IS RETAINED DIRECTLY BY THE EXECUTIVE COMMITTEE, PROVIDES THIRD-PARTY INFORMATION AND EVALUATES THE COMPETITIVENESS AND REASONABLENESS OF EXECUTIVE COMPENSATION AND BENEFITS PROGRAMS IN RELATION TO MARKET PRACTICES FOR SIMILARLY-SITUATED NONPROFIT HEALTHCARE ORGANIZATIONS. THE COMMITTEE MAKES ITS DECISIONS WITH RESPECT TO EXECUTIVE COMPENSATION IN ACCORDANCE WITH THE FILING ORGANIZATION'S POLICIES, IRS REGULATIONS, AND STANDARD CORPORATE GOVERNANCE PRACTICES. SUCH POLICIES INCLUDE ADHERENCE TO: BOARD-ESTABLISHED EXECUTIVE COMPENSATION PHILOSOPHY AND REVIEW PROCESSES; PROCESSES ENSURING EXECUTIVE COMMITTEE MEMBER AND COMPENSATION CONSULTANT INDEPENDENCE; USE OF VALID MARKET COMPARISONS OF DATA FROM PEER ACADEMIC MEDICAL CENTERS OF SIMILAR ORGANIZATIONAL STRUCTURE, SIZE, AND COMPLEXITY; CAREFUL DOCUMENTATION OF ALL COMPENSATION DECISIONS; AND ESTABLISHMENT OF THE REBUTTABLE PRESUMPTION OF REASONABLENESS, PER IRS GUIDELINES. MINUTES OF THE DELIBERATIONS OF THE EXECUTIVE COMMITTEE ARE CONTEMPORANEOUSLY MAINTAINED AND THAT COMPARABILITY DATA IS MAINTAINED IN THE MEDICAL CENTER'S OFFICE OF EXECUTIVE COMPENSATION SERVICES. IN THE EVENT THAT A MEMBER OF THE EXECUTIVE COMMITTEE HAS A CONFLICT OF INTEREST RELATED TO EXECUTIVE APPOINTMENT OR COMPENSATION, THAT MEMBER DOES NOT PARTICIPATE IN THE DELIBERATION OR APPROVAL OF APPOINTMENT OR COMPENSATION AND SUCH ABSTENTION IS NOTED IN THE COMMITTEE'S MEETING MINUTES. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION'S ARTICLES OF INCORPORATION ARE AVAILABLE TO THE PUBLIC ON REQUEST AND ARE AVAILABLE ON THE WEBSITE OF THE NORTH CAROLINA SECRETARY OF STATE. THE ORGANIZATION'S BYLAWS ARE NOT PUBLISHED, BUT PROVISIONS FROM THE BYLAWS ARE INCLUDED AS NECESSARY IN THE ORGANIZATION'S POLICIES, AND ARE ATTACHED TO THE FORM 1023 FILED FOR THE ORGANIZATION WITH THE IRS, WHICH IS PUBLICLY AVAILABLE. THE CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE NOT AVAILABLE TO THE PUBLIC. |
| PART VII, SECTION A, COLUMN B - OFFICERS' AND FORMER OFFICERS' AVERAGE HOUR | ROGER L COTHRAN FILING ORG 2.0 RELATED ORG 4.0 RON D KESSINGER FILING ORG 2.0 RELATED ORG 6.0 ARTHUR A GIBEL FILING ORG 2.0 RELATED ORG 4.0 KATHRYN H HAMRICK FILING ORG 2.0 RELATED ORG 2.0 A. LEE HERRING FILING ORG 2.0 RELATED ORG 4.0 J. WAYNE MEREDITH, MD FILING ORG 2.0 RELATED ORG 2.0 CAROL F. POLK FILING ORG 2.0 RELATED ORG 2.0 WILLIAM C. WARDEN, JR. FILING ORG 2.0 RELATED ORG 4.0 SHEREE B WATSON FILING ORG 2.0 KATY M BOLES FILING ORG 2.0 RAY N HOWELL, III D. MIN FILING ORG 2.0 RELATED ORG 2.0 JOHN D KIMBERLY FILING ORG 2.0 STEPHEN L ROBERTSON FILING ORG 2.0 RELATED ORG 6.0 EDWIN L WELCH, JR. FILING ORG 2.0 RELATED ORG 4.0 R. MICHAEL WELLS FILING ORG 2.0 RELATED ORG 4.0 LINWOOD L DAVIS FILING ORG 2.0 BRENDA B DIGGS FILING ORG 2.0 ERNEST L EVANS FILING ORG 2.0 RELATED ORG 4.0 LOUIS B BALDWIN, JR. FILING ORG 2.0 GEORGE D RENFRO FILING ORG 2.0 RELATED ORG 4.0 JOHN D MCCONNELL, MD FILING ORG 22.0 RELATED ORG 5.0 UNRELATED ORG 13.0 H. GREG BRAY FILING ORG 30.0 RELATED ORG 4.0 UNRELATED ORG 6.0 J MCLAIN WALLACE, JR FILING ORG 16.0 RELATED ORG 8.0 UNRELATED ORG 16.0 KAREN H HUEY FILING ORG 23.0 RELATED ORG 6.0 UNRELATED ORG 11.0 ERIC TOMLINSON FILING ORG 0.0 RELATED ORG 5.0 UNRELATED ORG 35.0 NORMAN D POTTER, JR. FILING ORG 20.0 RELATED ORG 5.0 UNRELATED ORG 15.0 CHERYL E.H. LOCKE FILING ORG 26.0 RELATED ORG 6.0 UNRELATED ORG 8.0 EDWARD G CHADWICK FILING ORG 29.0 RELATED ORG 5.0 UNRELATED ORG 6.0 THOMAS E SIBERT, MD FILING ORG 21.0 RELATED ORG 11.0 UNRELATED ORG 8.0 LISA M WYATT FILING ORG 20.0 RELATED ORG 5.0 UNRELATED ORG 15.0 EDWARD ABRAHAM, MD FILING ORG 5 RELATED ORG 5 UNRELATED ORG 30 C. MICHAEL RUTHERFORD FILING ORG 25.0 RELATED ORG 5.0 UNRELATED ORG 10.0 BRADLEY A. CLARK FILING ORG 23.0 RELATED ORG 7.0 UNRELATED ORG 10.0 TERRY G. WILLIAMS FILING ORG 22.0 RELATED ORG 5.0 UNRELATED ORG 13.0 K. BARBARA CARBONE, MD FILING ORG 28.0 RELATED ORG 10.0 UNRELATED ORG 2.0 CHAD A. ECKES FILING ORG 25.0 RELATED ORG 5.0 UNRELATED ORG 10.0 PAMELA F. CIPRIANO, PH.D. FILING ORG 35.0 RELATED ORG 5.0 BETTY PETREE FILING ORG 40.0 MICHAEL RIEKER FILING ORG 40.0 VANCE MCVAY, JR. FILING ORG 40.0 ERIC STIEFEL FILING ORG 40.0 CHARLES WARE FILING ORG 40.0 JOANNE C RUHLAND FILING ORG 25.0 RELATED ORG 0.0 UNRELATED ORG 15.0 RUSSELL M HOWERTON, MD FILING ORG 22.0 RELATED ORG 0.0 UNRELATED ORG 18.0 STEVE C SNELGROVE FILING ORG 0 RELATED ORG 40.0 MAUREEN E SINTICH FILING ORG 39.0 RELATED ORG 1.0 DONNY C LAMBETH FILING ORG 0.0 RELATED ORG 1.0 SHARON ENGEBRETSON FILING ORG 35.0 RELATED ORG 5.0 WAKE FOREST UNIVERSITY HEALTH SCIENCES IS AN UNRELATED ORGANIZATION TO THE FILING ORGANIZATION AND THE INFORMATION CONCERNING HOURS DEVOTED TO IT ARE NOT REQUIRED TO BE REPORTED, BUT ARE INCLUDED BECAUSE OF THE STRUCTURE OF WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER, OF WHICH THE FILING ORGANIZATION AND WAKE FOREST UNIVERSITY HEALTH SCIENCES ARE PRINCIPAL PARTS. THE CORPORATE OFFICERS OF THE MEDICAL CENTER ALSO SERVE AS THE CORPORATE OFFICERS OF NORTH CAROLINA BAPTIST HOSPITAL AND WAKE FOREST UNIVERSITY HEALTH SCIENCES. |
| FORM 990, PART XI, LINE 9: | CHANGE IN PENSION LIABILITY -34,261,191. AFFILIATE EARNINGS & TRANSFERS 3,908,994. |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLEMMONS MEDICAL PARK LLC | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | MEDICAL CENTER BLVD | AddressLine1 |
| City | WINSTON SALEM | City |
| State | NC | State |
| ZIP Code | 27157 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 800870210 | EIN |
| Primary Activities | REAL ESTATE HOLDING COMPANY | PrimaryActivitiesTxt |
| Legal Domicile State | NC | LegalDomicileStateCd |
| Total Income | $1,201,847 | TotalIncomeAmt |
| End Of Year Assets | $30,562,527 | EndOfYearAssetsAmt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NORTH CAROLINA BAPTIST HOSPITAL | BusinessNameLine1 |
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (8 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| NORTH CAROLINA BAPTIST HOSPITAL FOUNDATION | |||||||||||
| MEDICAL CENTER BLVD | WINSTON SALEM | NC | 27157 | 561685120 | SUPPORTING ORGANIZATION | NC | 501(C)(3) | LINE 11A, I | NORTH CAROLINA BAPTIST HOSPITAL | Yes (1) | |
| THE REHABILITATION & SKILLED NURSING | |||||||||||
| MEDICAL CENTER BLVD | WINSTON SALEM | NC | 27157 | 561826396 | HEALTHCARE (INACTIVE) | NC | 501(C)(3) | LINE 9 | NORTH CAROLINA BAPTIST HOSPITAL FOUNDATION | Yes (1) | |
| THE HAWTHORNE INN & CONFERENCE CENTER INC | |||||||||||
| 420 HIGH STREET | WINSTON SALEM | NC | 27101 | 561793617 | LODGING/CONFERENCE ACCOMODATION | NC | 501(C)(3) | LINE 11A, I | NORTH CAROLINA BAPTIST HOSPITAL | Yes (1) | |
| CARENET INC | |||||||||||
| 2000 WEST FIRST STREET SUITE 410 | WINSTON SALEM | NC | 27104 | 561977341 | HEALTHCARE | NC | 501(C)(3) | LINE 11B, II | NORTH CAROLINA BAPTIST HOSPITAL | Yes (1) | |
| WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER | |||||||||||
| MEDICAL CENTER BLVD | WINSTON SALEM | NC | 27157 | 510190238 | HEALTHCARE | NC | 501(C)(3) | LINE 11A, I | 0 | N/A | |
| CENTER FOR CONGREGATIONAL HEALTH INC | |||||||||||
| MEDICAL CENTER BLVD | WINSTON SALEM | NC | 27157 | 237426944 | HEALTHCARE | NC | 501(C)(3) | LINE 9 | NORTH CAROLINA BAPTIST HOSPITAL | Yes (1) | |
| DAVIE COUNTY EMERGENCY HEALTH CORPORATION | |||||||||||
| 223 HOSPITAL STREET | MOCKSVILLE | NC | 27028 | 562276994 | HEALTHCARE | NC | 501(C)(3) | LINE 3 | NORTH CAROLINA BAPTIST HOSPITAL | Yes (1) | |
| MEDICAL FND OF WFUHS & NCBH | |||||||||||
| MEDICAL CENTER BLVD | WINSTON SALEM | NC | 27157 | 566036688 | HEALTHCARE | NC | 501(C)(3) | LINE 11A, I | 0 | N/A | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | Yes (1) | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (11 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| NORTH CAROLINA BAPTIST HOSPITAL FOUNDATION | ||
| A | $145,043 | COST |
| THE HAWTHORNE INN & CONFERENCE CENTER INC | ||
| K | $227,760 | COST |
| THE HAWTHORNE INN & CONFERENCE CENTER INC | ||
| Q | $402,034 | COST |
| CARENET INC | ||
| Q | $4,019,168 | FMV |
| DAVIE COUNTY EMERGENCY HEALTH CORP | ||
| Q | $4,446,091 | FMV |
| NORTH CAROLINA BAPTIST HOSPITAL FOUNDATION | ||
| Q | $229,251 | FMV |
| THE HAWTHORNE INN & CONFERENCE CENTER INC | ||
| S | $100,000 | COST |
| NORTH CAROLINA BAPTIST HOSPITAL FOUNDATION | ||
| S | $323,440 | COST |
| NORTH CAROLINA BAPTIST HOSPITAL FOUNDATION | ||
| C | $1,350,000 | COST |
| THE HAWTHORNE INN & CONFERENCE CENTER INC | ||
| P | $42,133 | FMV |
| DAVIE COUNTY EMERGENCY HEALTH CORP | ||
| R | $11,043,185 | FMV |