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FORSYTH MEMORIAL HOSPITAL INC: Form 990, tax year 2014

View the entire original 990 at ProPublica ↗

Organization
FORSYTH MEMORIAL HOSPITAL INC (EIN 56-0928089)
Tax period
2014-01-01 to 2014-12-31
Filed
2015-11-16
IRS object ID
201523209349302462
Schema version
2014v5.0
Source
Download XML · Original 990 at ProPublica

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

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2015-11-16T08:53:05-06:00ReturnTs
Tax Period End2014-12-31TaxPeriodEndDt
Return Type990ReturnTypeCd
Tax Period Begin2014-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN560928089EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1FORSYTH MEMORIAL HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlFORSBusinessNameControlTxt
Phone3367182803PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line12085 FRONTIS PLAZA BLVDAddressLine1Txt
CityWINSTON SALEMCityNm
State AbbreviationNCStateAbbreviationCd
ZIP27103ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonFRED HARGETTPersonNm
Person TitleEVP & CFOPersonTitleTxt
Phone3367182803PhoneNum
Signature2015-11-16SignatureDt
FieldValueIRS element (for citing)
Tax2014TaxYr
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1NOVANT HEALTH FORSYTH MEDICAL CENTERBusinessNameLine1Txt
FieldValueIRS element (for citing)
Principal OfficerDENISE MIHALPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line12085 FRONTIS PLAZA BLVDAddressLine1Txt
CityWINSTON SALEMCityNm
State AbbreviationNCStateAbbreviationCd
ZIP27103ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$1,137,028,290GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.NOVANTHEALTH.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1968FormationYr
Legal Domicile StateNCLegalDomicileStateCd
Activity Or MissionSEE SCHEDULE OActivityOrMissionDesc
Voting Members Governing Body17VotingMembersGoverningBodyCnt
Voting Members Independent14VotingMembersIndependentCnt
Total Employee7792TotalEmployeeCnt
Total Volunteers846TotalVolunteersCnt
Total Gross UBI$387,350TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$77,115NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$2,469,354PYContributionsGrantsAmt
CY Contributions Grants$4,298,738CYContributionsGrantsAmt
PY Program Service Revenue$1,004,595,686PYProgramServiceRevenueAmt
CY Program Service Revenue$1,050,066,874CYProgramServiceRevenueAmt
PY Investment Income$465,186PYInvestmentIncomeAmt
CY Investment Income-$192,327CYInvestmentIncomeAmt
PY Other Revenue$67,719,651PYOtherRevenueAmt
CY Other Revenue$82,287,326CYOtherRevenueAmt
PY Total Revenue$1,075,249,877PYTotalRevenueAmt
CY Total Revenue$1,136,460,611CYTotalRevenueAmt
PY Grants And Similar Paid$639,957PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$807,960CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$444,745,702PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$455,928,431CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$550,050,833PYOtherExpensesAmt
CY Other Expenses$604,755,786CYOtherExpensesAmt
PY Total Expenses$995,436,492PYTotalExpensesAmt
CY Total Expenses$1,061,492,177CYTotalExpensesAmt
PY Revenues Less Expenses$79,813,385PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$74,968,434CYRevenuesLessExpensesAmt
Total Assets BOY$1,060,812,977TotalAssetsBOYAmt
Total Assets EOY$1,133,278,673TotalAssetsEOYAmt
Total Liabilities BOY$54,559,584TotalLiabilitiesBOYAmt
Total Liabilities EOY$60,201,980TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$1,006,253,393NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$1,073,076,693NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionSEE SCHEDULE OMissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$863,351,155ExpenseAmt
Grant$807,960GrantAmt
Revenue$1,124,767,038RevenueAmt
DescFORSYTH MEMORIAL HOSPITAL, INC. (FMH), KERNERSVILLE MEDICAL CENTER (KMC), AND CLEMMONS MEDICAL CENTER (CMC) CARRY OUT THE PURPOSE OF THE FORSYTH COUNTY BOARD OF COMMISSIONERS BY ADVANCING AND SUPPORTING THE PROMOTION OF THE HEALTH OF THE INHABITANTS OF FORSYTH COUNTY AND THE KERNERSVILLE AREA OF NC. FMH, KMC, AND CMC MAINTAIN AN OPEN DOOR POLICY, ACCEPTING ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. FMH HAS 921 LICENSED BEDS. DURING 2014 THERE WERE 225,044 PATIENT DAYS WITH AN AVERAGE LENGTH OF STAY OF 6 DAYS, AN AVERAGE DAILY CENSUS OF 617, AND 40,240 DISCHARGES. THERE WERE 24,624 INPATIENT AND OUTPATIENT SURGERIES, A TOTAL OF 1,021,842 OUTPATIENT ENCOUNTERS AND 89,309 EMERGENCY DEPARTMENT VISITS. (CONTINUED ON SCHEDULE O)Desc
Total Program Service Expenses$863,351,155TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To IndividualsYes (1)GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan OutstandingYes (1)LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam MemYes (1)BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art ContributionYes (1)DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded EntityYes (1)DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (1)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document2IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee7792EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (1)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (1)Form990TFiledInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo ContributionsYes (1)QuidProQuoContributionsInd
Quid Pro Quo Contri DisclYes (1)QuidProQuoContriDisclInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members17GoverningBodyVotingMembersCnt
Independent Voting Member14IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEO0CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldNCStatesWhereCopyOfReturnIsFldCd
Own WebsiteYes (X)OwnWebsiteInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1KAREN DAUGHERTYBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone3367182803PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line12085 FRONTIS PLAZA BLVDAddressLine1Txt
CityWINSTON SALEMCityNm
State AbbreviationNCStateAbbreviationCd
ZIP27103ZIPCd
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (32 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
BAREFOOT SAMUEL
TRUSTEE2.00Yes (X)$0$0$0
CARROLL JOE
TRUSTEE2.00Yes (X)$0$0$0
EARNHARDT HAROLD
TRUSTEE2.00Yes (X)$0$0$0
EDWARDS JOEL
TRUSTEE2.00Yes (X)$527,528$0$75,061
ELY JOSEPH
VICE CHAIR2.00Yes (X)$0$0$0Yes (X)
FORIEST BRYANT
TRUSTEE2.00Yes (X)$0$0$0
GREEN GARY
SEC/TREAS2.00Yes (X)$0$0$0Yes (X)
HAULSEE HADA DE VARONA
CHAIR2.00Yes (X)$0$0$0Yes (X)
HAUSER CHARLES
TRUSTEE2.00Yes (X)$0$0$0
HICKMAN TOMMY
TRUSTEE2.00Yes (X)$0$0$0
JOHNSON JOIA
TRUSTEE2.00Yes (X)$0$0$0
LAMBE CLARENCE
TRUSTEE2.00Yes (X)$0$0$0
MCNEIL-MILLER KAREN
TRUSTEE2.00Yes (X)$0$0$0
POLLARD III HAROLD
TRUSTEE2.00Yes (X)$0$0$0
POLONSKY SHERRY
TRUSTEE2.00Yes (X)$0$0$0
WOLFE III JOHN
TRUSTEE2.00Yes (X)$0$0$0
ALLEN JOANNE
PRESIDENT KMC60.00$250,663$0$61,210Yes (X)
LINDSAY JEFFERY
FMR PRES FMC/ COO WS MKT60.00$1,226,070$0$83,818Yes (X)
MIHAL DENISE
PRES FMC/ COO WS MKT60.00$872,519$0$76,136Yes (X)
MORRIS JOHN
ASST SEC2.00$0$322,754$76,309Yes (X)
GREGORY CHERE
SVP WOMEN'S SERVICES60.00$16,207$406,750$107,677Yes (X)
JARRETT-PULLIAM KIMBERLY
CNO60.00$261,748$0$45,401Yes (X)
LARSON KIP
FORMER VP & SR MED DIR SPECIALTY SERV60.00$436,120$0$69,406Yes (X)
NYCUM LAWRENCE
SVP MEDICAL AFFAIRS60.00$628,222$0$120,689Yes (X)
SANZ SEAN
SVP & COO NHFMC60.00$294,938$0$91,000Yes (X)
WALLEY BRUCE
FORMER SVP MEDICAL AFFAIRS60.00$675,341$0$56,619Yes (X)
CHEN FRANKLIN
ONCOLOGIST40.00$731,217$0$95,952Yes (X)
CHRYSSON NICK
ONCOLOGIST40.00$844,637$0$102,481Yes (X)
COLLINS TIMOTHY
ONCOLOGIST40.00$700,346$0$93,632Yes (X)
GROTE THOMAS
ONCOLOGIST40.00$862,750$0$77,016Yes (X)
PASCHOLD EUGENE
ONCOLOGIST40.00$723,941$0$91,334Yes (X)
MCGEE LAWRENCE
FORMER ASST SEC0.00$0$348,935$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$9,052,247TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$1,078,439TotReportableCompRltdOrgAmt
Total Other Compensation$1,323,741TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K391IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (1)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
CROTHALL HEALTH CARE INC
955 CHESTERBROOK BLVD S300WAYNEPA19087FACILITY SERVICES$11,437,741
LABORATORY CORPORATION OF AMERICA HOLDIN
PO BOX 12140BURLINGTONNC27216LAB SERVICES$9,860,429
MORRISON MANAGEMENT SPECIALIST
PO BOX 102289ATLANTAGA30368FOOD MANAGEMENT SERVICES$9,256,419
CROSS COUNTRY STAFFING
PO BOX 404674ATLANTAGA30384STAFFING SERVICES$5,568,353
SALEM CHEST SPECIALISTS
3001 LYNDHURST AVENUEWINSTON SALEMNC27103HEALTH SERVICES$4,918,188
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K81CntrctRcvdGreaterThan100KCnt
Related Organizations$2,574,510RelatedOrganizationsAmt
Government Grants$1,476,688GovernmentGrantsAmt
All Other Contributions$247,540AllOtherContributionsAmt
Noncash Contributions$7,666NoncashContributionsAmt
Total Contributions$4,298,738TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescNET PATIENT REVENUEDesc
Business622110BusinessCd
Total Revenue Column$1,050,066,874TotalRevenueColumnAmt
Related Or Exempt Func Income$1,050,066,874RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$1,050,066,874TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$313,809TotalRevenueColumnAmt
Exclusion$313,809ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$2,477,824RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$0RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$2,477,824RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,477,824TotalRevenueColumnAmt
Exclusion$2,477,824ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Other$61,543OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Other$567,679OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Other-$506,136OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$506,136TotalRevenueColumnAmt
Exclusion-$506,136ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmtExclusionExclusionAmt
PHARMACY446110$65,506,353$65,129,457$376,896
MISCELLANEOUS REVENUE621999$8,546,980$8,536,526$10,454
CAFETERIA MEALS722514$3,437,629$3,437,629

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,318,540TotalRevenueColumnAmt
Related Or Exempt Func Income$1,034,181RelatedOrExemptFuncIncomeAmt
Exclusion$1,284,359ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$79,809,502OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,136,460,611TotalRevenueColumnAmt
Related Or Exempt Func Income$1,124,767,038RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$387,350UnrelatedBusinessRevenueAmt
Exclusion$7,007,485ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$724,877TotalAmt
Program Services$724,877ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$83,083TotalAmt
Program Services$83,083ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$5,869,024TotalAmt
Management And General$5,869,024ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$114,696TotalAmt
Management And General$114,696ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$357,846,152TotalAmt
Program Services$342,422,983ProgramServicesAmt
Management And General$15,423,169ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$14,320,067TotalAmt
Program Services$13,702,872ProgramServicesAmt
Management And General$617,195ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$53,473,143TotalAmt
Program Services$51,168,451ProgramServicesAmt
Management And General$2,304,692ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$24,305,349TotalAmt
Program Services$23,257,788ProgramServicesAmt
Management And General$1,047,561ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$2,418,787TotalAmt
Management And General$2,418,787ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$600TotalAmt
Management And General$600ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$3,292TotalAmt
Management And General$3,292ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$89,702,274TotalAmt
Program Services$75,103,059ProgramServicesAmt
Management And General$14,599,215ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$2,774,016TotalAmt
Program Services$2,654,456ProgramServicesAmt
Management And General$119,560ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$5,958,407TotalAmt
Program Services$5,701,600ProgramServicesAmt
Management And General$256,807ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$8,191,740TotalAmt
Program Services$7,838,676ProgramServicesAmt
Management And General$353,064ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$28,978,913TotalAmt
Program Services$27,729,922ProgramServicesAmt
Management And General$1,248,991ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$1,084,035TotalAmt
Program Services$1,037,313ProgramServicesAmt
Management And General$46,722ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$326,346TotalAmt
Program Services$312,280ProgramServicesAmt
Management And General$14,066ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$20,204,825TotalAmt
Program Services$19,333,997ProgramServicesAmt
Management And General$870,828ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$22,289,184TotalAmt
Program Services$21,328,520ProgramServicesAmt
Management And General$960,664ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$2,111,127TotalAmt
Program Services$2,020,137ProgramServicesAmt
Management And General$90,990ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtManagement And GeneralManagementAndGeneralAmtProgram ServicesProgramServicesAmt
CORPORATE ALLOCATION$150,609,616$150,609,616
DRUGS$101,089,993$101,089,993
UBI TAXES$32,287$32,287
MEDICAL SUPPLIES$98,361,164$98,361,164

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$70,619,180TotalAmt
Program Services$69,479,984ProgramServicesAmt
Management And General$1,139,196ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$1,061,492,177TotalAmt
Program Services$863,351,155ProgramServicesAmt
Management And General$198,141,022ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$2,589,293BOYAmt
EOY$648,893EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$111,373,192BOYAmt
EOY$122,188,230EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$87,500BOYAmt
EOY$20EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$7,887,194BOYAmt
EOY$8,389,746EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$18,536,721BOYAmt
EOY$19,779,811EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$957,274BOYAmt
EOY$365,167EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$446,743,889LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$272,156,317LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$176,162,050BOYAmt
EOY$174,587,572EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$31,015,047BOYAmt
EOY$31,015,047EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$712,204,706BOYAmt
EOY$776,304,187EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$1,060,812,977BOYAmt
EOY$1,133,278,673EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$52,210,666BOYAmt
EOY$57,773,208EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$162,314BOYAmt
EOY$265,686EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$2,186,604BOYAmt
EOY$2,163,086EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$54,559,584BOYAmt
EOY$60,201,980EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$1,006,253,393BOYAmt
EOY$1,073,076,693EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$1,006,253,393BOYAmt
EOY$1,073,076,693EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$1,060,812,977BOYAmt
EOY$1,133,278,673EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$74,968,434ReconcilationRevenueExpnssAmt
Other Changes In Net Assets-$8,145,134OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

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

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other Organizations0GrantsOtherOrganizationsInd
Direct Contact Legislators0DirectContactLegislatorsInd
Rallies Demonstrations0RalliesDemonstrationsInd
Other ActivitiesYes (1)OtherActivitiesInd
Other Activities$53,200OtherActivitiesAmt
Total Lobbying Expenditures$53,200TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART II-B, LINE 1I, LOBBYING ACTIVITIES:FormAndLineReferenceDesc
ExplanationDUES PAID TO CERTAIN ORGANIZATIONS WHICH INCLUDE A PORTION RELATED TO LOBBYING ACTIVITIES.ExplanationTxt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$6,278,279OtherCostOrOtherBasisAmt
Book Value$6,278,279BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$101,427,192OtherCostOrOtherBasisAmt
Depreciation$13,152,321DepreciationAmt
Book Value$88,274,871BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$9,803,011OtherCostOrOtherBasisAmt
Depreciation$6,128,903DepreciationAmt
Book Value$3,674,108BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$296,347,072OtherCostOrOtherBasisAmt
Depreciation$241,449,735DepreciationAmt
Book Value$54,897,337BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$32,888,335OtherCostOrOtherBasisAmt
Depreciation$11,425,358DepreciationAmt
Book Value$21,462,977BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$174,587,572TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (2 entries)

DescDescBook ValueBookValueAmt
DUE FROM AFFILIATE$776,303,645
STATE INCOME TAX RECEIVABLE$542
FieldValueIRS element (for citing)
Total Book Value Other Assets$776,304,187TotalBookValueOtherAssetsAmt
Federal Income Tax Liability$1,049FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
CAPITAL LEASE PAYABLE$57,863
THIRD PARTY PAYMENT ADJUSTMENTS$2,104,174
FieldValueIRS element (for citing)
Total Liability$2,163,086TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART X, LINE 2:FormAndLineReferenceDesc
ExplanationPART X, LINE 2: LIABILITY UNDER FIN 48 (ASC 740) FOOTNOTE THE AUDIT FOR NOVANT HEALTH AND ITS AFFILIATES IS PREPARED ON A CONSOLIDATED BASIS. THE COMPANY IS REQUIRED TO EVALUATE UNCERTAIN TAX POSITIONS. THIS EVALUATION INCLUDES A QUANTIFICATION OF TAX RISK IN AREAS SUCH AS UNRELATED BUSINESS TAXABLE INCOME AND THE TAXATION OF OUR FOR-PROFIT SUBSIDIARIES. THIS EVALUATION DID NOT HAVE A MATERIAL EFFECT ON THE COMPANY'S CONSOLIDATED STATEMENTS OF OPERATIONS AND CHANGES IN NET ASSETS FOR THE YEARS ENDED DECEMBER 31, 2014 AND 2013.ExplanationTxt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd

Free Care Oth Percentage FreeCareOthPercentageGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
Free Care Other300.000000000000FreeCareOtherPct
FieldValueIRS element (for citing)
FPG Reference Discounted Care0FPGReferenceDiscountedCareInd
Free Care Medically Indigent0FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed BudgetYes (1)ExpensesExceedBudgetInd
Unable To Provide Care0UnableToProvideCareInd
Annual Community Bnft ReportYes (1)AnnualCommunityBnftReportInd
Report Publically AvailableYes (1)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$42,518,772TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$42,518,772NetCommunityBenefitExpnsAmt
Total Expense0.04180TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$128,331,873TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$102,421,273DirectOffsettingRevenueAmt
Net Community Benefit Expns$25,910,600NetCommunityBenefitExpnsAmt
Total Expense0.02550TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$0TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$170,850,645TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$102,421,273DirectOffsettingRevenueAmt
Net Community Benefit Expns$68,429,372NetCommunityBenefitExpnsAmt
Total Expense0.06730TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,041,060TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$44,942DirectOffsettingRevenueAmt
Net Community Benefit Expns$996,118NetCommunityBenefitExpnsAmt
Total Expense0.00100TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$3,670,893TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$881,411DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,789,482NetCommunityBenefitExpnsAmt
Total Expense0.00270TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$44,427,407TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$30,447,572DirectOffsettingRevenueAmt
Net Community Benefit Expns$13,979,835NetCommunityBenefitExpnsAmt
Total Expense0.01370TotalExpensePct

Research ResearchGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$2,094,840TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$967,233DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,127,607NetCommunityBenefitExpnsAmt
Total Expense0.00110TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$634,049TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$634,049NetCommunityBenefitExpnsAmt
Total Expense0.00060TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$51,868,249TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$32,341,158DirectOffsettingRevenueAmt
Net Community Benefit Expns$19,527,091NetCommunityBenefitExpnsAmt
Total Expense0.01910TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$222,718,894TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$134,762,431DirectOffsettingRevenueAmt
Net Community Benefit Expns$87,956,463NetCommunityBenefitExpnsAmt
Total Expense0.08640TotalExpensePct

Physical Imprv And Housing PhysicalImprvAndHousingGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$0TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Economic Development EconomicDevelopmentGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$93,796TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$93,796NetCommunityBenefitExpnsAmt
Total Expense0.00010TotalExpensePct

Community Support CommunitySupportGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$77,217TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$77,217NetCommunityBenefitExpnsAmt
Total Expense0.00010TotalExpensePct

Environmental Improvements EnvironmentalImprovementsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$0TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Leadership Development LeadershipDevelopmentGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$3,000TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$3,000NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Coalition Building CoalitionBuildingGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$0TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$0TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Workforce Development WorkforceDevelopmentGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$23,000TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$23,000NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Other Communtity Building Acty OtherCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$0TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$197,013TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$197,013NetCommunityBenefitExpnsAmt
Total Expense0.00020TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$44,187,769BadDebtExpenseAmt
Bad Debt Expense Attributable$0BadDebtExpenseAttributableAmt
Reimbursed By Medicare$173,442,148ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$176,174,729CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$2,732,581MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn0FinancialAssistancePrvsnInd
Hospital Facilities3HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp (3 entries)

FacilityFacilityNumAddress Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdWebsite AddressWebsiteAddressTxtState LicenseStateLicenseNumLicensed HospitalLicensedHospitalIndGeneral Medical And SurgicalGeneralMedicalAndSurgicalIndEmergency Room24 HrsEmergencyRoom24HrsInd
FMH DBA NH FORSYTH MEDICAL CENTER
13333 SILAS CREEK PARKWAYWINSTON SALEMNC27103WWW.NOVANTHEALTH.ORGH0209Yes (X)Yes (X)Yes (X)
FMH DBA NH KERNERSVILLE MEDICAL CENTER
21750 KERNERSVILLE MEDICAL PARKWAYKERNERSVILLENC27284WWW.NOVANTHEALTH.ORGH0209Yes (X)Yes (X)Yes (X)
FMH DBA NH CLEMMONS MEDICAL CENTER
36915 VILLAGE MEDICAL CIRCLECLEMMONSNC27012WWW.NOVANTHEALTH.ORGH0209Yes (X)Yes (X)

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp (3 entries)

FacilityFacilityNumFirst Licensed CY Or PYFirstLicensedCYOrPYIndTax Exempt Hospital CY Or PYTaxExemptHospitalCYOrPYIndCHNA ConductedCHNAConductedIndCommunity DefinitionCommunityDefinitionIndCommunity DemographicsCommunityDemographicsIndHow Data ObtainedHowDataObtainedIndCommunity Health NeedsCommunityHealthNeedsIndCommunity Hlth Needs Id ProcessCommunityHlthNeedsIdProcessIndConsulting ProcessConsultingProcessIndCHNA ConductedCHNAConductedYrTake Into Account Others InputTakeIntoAccountOthersInputIndCHNA Conducted With Other FcltsCHNAConductedWithOtherFcltsIndCHNA Conducted With Non FcltsCHNAConductedWithNonFcltsIndCHNA Report Widely AvailableCHNAReportWidelyAvailableIndOther WebsiteOtherWebsiteIndOther Website URLOtherWebsiteURLTxtImplementation Strategy AdoptImplementationStrategyAdoptIndImplementation Strategy AdptImplementationStrategyAdptYrStrategy Posted WebsiteStrategyPostedWebsiteIndStrategy Website URLStrategyWebsiteURLTxtStrategy AttachedStrategyAttachedIndOrganization Incur Excise TaxOrganizationIncurExciseTaxIndElig Criteria ExplainedEligCriteriaExplainedIndFPG Family Incm Lmt Free DscntFPGFamilyIncmLmtFreeDscntIndFPG Family Incm Lmt Free CareFPGFamilyIncmLmtFreeCarePctAsset Level CriteriaAssetLevelCriteriaIndInsurance Status CriteriaInsuranceStatusCriteriaIndResidency CriteriaResidencyCriteriaIndOther CriteriaOtherCriteriaIndExplained BasisExplainedBasisIndApp Financial Asst ExplnAppFinancialAsstExplnIndDescribed InfoDescribedInfoIndDescribed Suprt DocDescribedSuprtDocIndProvided Hospital ContactProvidedHospitalContactIndIncludes Publicity MeasuresIncludesPublicityMeasuresIndFAP Available On WebsiteFAPAvailableOnWebsiteIndFAP App Available On WebsiteFAPAppAvailableOnWebsiteIndFAP Summary On WebsiteFAPSummaryOnWebsiteIndFAP Avlbl On Request No ChargeFAPAvlblOnRequestNoChargeIndFAP App Avlbl On Request No ChrgFAPAppAvlblOnRequestNoChrgIndFAP Sum Avlbl On Request No ChrgFAPSumAvlblOnRequestNoChrgIndFAP Notice DisplayedFAPNoticeDisplayedIndCommuntity Notified FAPCommuntityNotifiedFAPIndFAP Actions On NonpaymentFAPActionsOnNonpaymentIndPermit No ActionsPermitNoActionsIndCollection ActivitiesCollectionActivitiesIndFAP Notified Upon AdmissionFAPNotifiedUponAdmissionIndFAP Notified Before DischargeFAPNotifiedBeforeDischargeIndFAP Notified All PatientsFAPNotifiedAllPatientsIndDocumented Elig DeterminationDocumentedEligDeterminationIndNondis Emergency Care PolicyNondisEmergencyCarePolicyIndOther Method UsedOtherMethodUsedIndAmounts Generally BilledAmountsGenerallyBilledIndGross ChargesGrossChargesInd
NH FORSYTH MEDICAL CENTER
100Yes (1)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)13Yes (1)00Yes (1)Yes (X)WWW.NOVANTHEALTH.ORGYes (1)13Yes (1)WWW.NOVANTHEALTH.ORG00Yes (1)Yes (X)300.000000000000Yes (X)Yes (X)Yes (X)Yes (X)0Yes (1)Yes (X)Yes (X)Yes (X)Yes (1)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (1)Yes (X)0Yes (X)Yes (X)Yes (X)Yes (X)Yes (1)Yes (X)00
NH KERNERSVILLE MEDICAL CENTER
200Yes (1)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)13Yes (1)00Yes (1)Yes (X)WWW.NOVANTHEALTH.ORGYes (1)13Yes (1)WWW.NOVANTHEALTH.ORG00Yes (1)Yes (X)300.000000000000Yes (X)Yes (X)Yes (X)Yes (X)0Yes (1)Yes (X)Yes (X)Yes (X)Yes (1)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (1)Yes (X)0Yes (X)Yes (X)Yes (X)Yes (X)Yes (1)Yes (X)00
NH CLEMMONS MEDICAL CENTER
300Yes (1)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)13Yes (1)00Yes (1)Yes (X)WWW.NOVANTHEALTH.ORGYes (1)13Yes (1)WWW.NOVANTHEALTH.ORG00Yes (1)Yes (X)300.000000000000Yes (X)Yes (X)Yes (X)Yes (X)0Yes (1)Yes (X)Yes (X)Yes (X)Yes (1)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (1)Yes (X)0Yes (X)Yes (X)Yes (X)Yes (X)Yes (1)Yes (X)00

Supplemental Information SupplementalInformationGrp (12 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
NH FORSYTH MEDICAL CENTERPART V, SECTION B, LINE 5: WHILE CONDUCTING THE CHNA, THE HOSPITAL FACILITY(IES) SOLICITED INPUT FROM, AND CONSULTED WITH, A VARIETY OF COMMUNITY REPRESENTATIVES INCLUDING, BUT NOT LIMITED TO, REPRESENTATIVES OF CITY AND COUNTY GOVERNMENT INCLUDING HEALTH DEPARTMENTS, COMMUNITY-BASED ORGANIZATIONS, FOUNDATIONS, CHURCHES, COLLEGES/UNIVERSITIES, COMMUNITY COALITIONS AND OTHER SOCIAL SERVICE AGENCIES. THE SCOPE OF EXPERTISE WAS BROAD AND INCLUDED SUCH AREAS AS PUBLIC HEALTH, MINORITY POPULATIONS, HEALTH DISPARITIES, AND SOCIAL SERVICES. THE ORGANIZATION IS A PART OF NOVANT HEALTH, AN INTEGRATED NOT-FOR-PROFIT HEALTH SYSTEM. AS SUCH, NOVANT HEALTH INCLUDES MULTIPLE HOSPITAL FACILITIES AND HAS ENGAGED IN CHNAS FOR ALL OF THE COMMUNITIES BEING SERVED. WHERE POSSIBLE, WE HAVE LEVERAGED THE RESOURCES OF THE ORGANIZATION TO BEST ADDRESS THOSE NEEDS THAT ARE HIGHEST IN PRIORITY AND CONSISTENT ACROSS COMMUNITIES.
NH KERNERSVILLE MEDICAL CENTERPART V, SECTION B, LINE 5: WHILE CONDUCTING THE CHNA, THE HOSPITAL FACILITY(IES) SOLICITED INPUT FROM, AND CONSULTED WITH, A VARIETY OF COMMUNITY REPRESENTATIVES INCLUDING, BUT NOT LIMITED TO, REPRESENTATIVES OF CITY AND COUNTY GOVERNMENT INCLUDING HEALTH DEPARTMENTS, COMMUNITY-BASED ORGANIZATIONS, FOUNDATIONS, CHURCHES, COLLEGES/UNIVERSITIES, COMMUNITY COALITIONS AND OTHER SOCIAL SERVICE AGENCIES. THE SCOPE OF EXPERTISE WAS BROAD AND INCLUDED SUCH AREAS AS PUBLIC HEALTH, MINORITY POPULATIONS, HEALTH DISPARITIES, AND SOCIAL SERVICES. THE ORGANIZATION IS A PART OF NOVANT HEALTH, AN INTEGRATED NOT-FOR-PROFIT HEALTH SYSTEM. AS SUCH, NOVANT HEALTH INCLUDES MULTIPLE HOSPITAL FACILITIES AND HAS ENGAGED IN CHNAS FOR ALL OF THE COMMUNITIES BEING SERVED. WHERE POSSIBLE, WE HAVE LEVERAGED THE RESOURCES OF THE ORGANIZATION TO BEST ADDRESS THOSE NEEDS THAT ARE HIGHEST IN PRIORITY AND CONSISTENT ACROSS COMMUNITIES.
NH CLEMMONS MEDICAL CENTERPART V, SECTION B, LINE 5: WHILE CONDUCTING THE CHNA, THE HOSPITAL FACILITY(IES) SOLICITED INPUT FROM, AND CONSULTED WITH, A VARIETY OF COMMUNITY REPRESENTATIVES INCLUDING, BUT NOT LIMITED TO, REPRESENTATIVES OF CITY AND COUNTY GOVERNMENT INCLUDING HEALTH DEPARTMENTS, COMMUNITY-BASED ORGANIZATIONS, FOUNDATIONS, CHURCHES, COLLEGES/UNIVERSITIES, COMMUNITY COALITIONS AND OTHER SOCIAL SERVICE AGENCIES. THE SCOPE OF EXPERTISE WAS BROAD AND INCLUDED SUCH AREAS AS PUBLIC HEALTH, MINORITY POPULATIONS, HEALTH DISPARITIES, AND SOCIAL SERVICES. THE ORGANIZATION IS A PART OF NOVANT HEALTH, AN INTEGRATED NOT-FOR-PROFIT HEALTH SYSTEM. AS SUCH, NOVANT HEALTH INCLUDES MULTIPLE HOSPITAL FACILITIES AND HAS ENGAGED IN CHNAS FOR ALL OF THE COMMUNITIES BEING SERVED. WHERE POSSIBLE, WE HAVE LEVERAGED THE RESOURCES OF THE ORGANIZATION TO BEST ADDRESS THOSE NEEDS THAT ARE HIGHEST IN PRIORITY AND CONSISTENT ACROSS COMMUNITIES.
NH FORSYTH MEDICAL CENTERPART V, SECTION B, LINE 11: THE HOSPITAL FACILITY(IES) IS/ARE A PART OF NOVANT HEALTH, AN INTEGRATED NOT-FOR-PROFIT HEALTH SYSTEM. AS SUCH, NOVANT HEALTH INCLUDES MULTIPLE HOSPITAL FACILITIES AND HAS ENGAGED IN CHNAS FOR ALL OF THE COMMUNITIES BEING SERVED. THE FACILITY'S CHNA IDENTIFIED MULTIPLE NEEDS FOR THE COMMUNITY SERVED. THE NEEDS IDENTIFIED WERE REVIEWED AND PRIORITIZED BY THE CHNA RESOURCE GROUP AND SUBSEQUENTLY BY THE ORGANIZATION'S BOARD AND THE NOVANT HEALTH EXECUTIVE TEAM. THEY EVALUATED EACH DOCUMENTED NEED AND ITS INTERSECTION WITH THE ORGANIZATION'S VISION, COMMITMENTS, AND KEY STRENGTHS BEFORE FURTHER PRIORITIZING THE HEALTH NEEDS AND AGREEING UPON THE TOP HEALTH PRIORITIES TO BE ADDRESSED. WHERE POSSIBLE, WE HAVE LEVERAGED THE SYSTEM'S STRENGTHS AND RESOURCES TO BEST ADDRESS THOSE NEEDS THAT ARE HIGHEST IN PRIORITY AND CONSISTENT ACROSS COMMUNITIES. NOVANT HEALTH AND EACH OF ITS HOSPITAL FACILITIES HAVE ADOPTED AND EXECUTED AN IMPLEMENTATION STRATEGY THAT ADDRESSES THE PRIORITIZED COMMUNITY HEALTH NEEDS FROM THE CHNAS. THE IMPLEMENTATION STRATEGIES OUTLINE THE PLAN THAT THE HOSPITAL FACILITY(IES) WILL UNDERTAKE TO MEET THOSE HEALTH NEEDS IN EACH OF ITS COMMUNITIES. CERTAIN NEEDS THAT WERE IDENTIFIED BY THE CHNA HAVE NOT BEEN ADDRESSED. IT WAS DETERMINED THAT THERE ARE OTHER RESOURCES IN THE COMMUNITY THAT CAN MORE APPROPRIATELY ADDRESS THESE NEEDS BASED ON SCOPE OF SERVICES AND SKILL SET. FOR MORE DETAILED INFORMATION, REFER TO THE PUBLICLY AVAILABLE IMPLEMENTATION PLAN AVAILABLE ON THE WEBSITE; REFER TO THE URL GIVEN PREVIOUSLY FOR THE POSTING OF THE PLAN.
NH KERNERSVILLE MEDICAL CENTERPART V, SECTION B, LINE 11: THE HOSPITAL FACILITY(IES) IS/ARE A PART OF NOVANT HEALTH, AN INTEGRATED NOT-FOR-PROFIT HEALTH SYSTEM. AS SUCH, NOVANT HEALTH INCLUDES MULTIPLE HOSPITAL FACILITIES AND HAS ENGAGED IN CHNAS FOR ALL OF THE COMMUNITIES BEING SERVED. THE FACILITY'S CHNA IDENTIFIED MULTIPLE NEEDS FOR THE COMMUNITY SERVED. THE NEEDS IDENTIFIED WERE REVIEWED AND PRIORITIZED BY THE CHNA RESOURCE GROUP AND SUBSEQUENTLY BY THE ORGANIZATION'S BOARD AND THE NOVANT HEALTH EXECUTIVE TEAM. THEY EVALUATED EACH DOCUMENTED NEED AND ITS INTERSECTION WITH THE ORGANIZATION'S VISION, COMMITMENTS, AND KEY STRENGTHS BEFORE FURTHER PRIORITIZING THE HEALTH NEEDS AND AGREEING UPON THE TOP HEALTH PRIORITIES TO BE ADDRESSED. WHERE POSSIBLE, WE HAVE LEVERAGED THE SYSTEM'S STRENGTHS AND RESOURCES TO BEST ADDRESS THOSE NEEDS THAT ARE HIGHEST IN PRIORITY AND CONSISTENT ACROSS COMMUNITIES. NOVANT HEALTH AND EACH OF ITS HOSPITAL FACILITIES HAVE ADOPTED AND EXECUTED AN IMPLEMENTATION STRATEGY THAT ADDRESSES THE PRIORITIZED COMMUNITY HEALTH NEEDS FROM THE CHNAS. THE IMPLEMENTATION STRATEGIES OUTLINE THE PLAN THAT THE HOSPITAL FACILITY(IES) WILL UNDERTAKE TO MEET THOSE HEALTH NEEDS IN EACH OF ITS COMMUNITIES. CERTAIN NEEDS THAT WERE IDENTIFIED BY THE CHNA HAVE NOT BEEN ADDRESSED. IT WAS DETERMINED THAT THERE ARE OTHER RESOURCES IN THE COMMUNITY THAT CAN MORE APPROPRIATELY ADDRESS THESE NEEDS BASED ON SCOPE OF SERVICES AND SKILL SET. FOR MORE DETAILED INFORMATION, REFER TO THE PUBLICLY AVAILABLE IMPLEMENTATION PLAN AVAILABLE ON THE WEBSITE; REFER TO THE URL GIVEN PREVIOUSLY FOR THE POSTING OF THE PLAN.
NH CLEMMONS MEDICAL CENTERPART V, SECTION B, LINE 11: THE HOSPITAL FACILITY(IES) IS/ARE A PART OF NOVANT HEALTH, AN INTEGRATED NOT-FOR-PROFIT HEALTH SYSTEM. AS SUCH, NOVANT HEALTH INCLUDES MULTIPLE HOSPITAL FACILITIES AND HAS ENGAGED IN CHNAS FOR ALL OF THE COMMUNITIES BEING SERVED. THE FACILITY'S CHNA IDENTIFIED MULTIPLE NEEDS FOR THE COMMUNITY SERVED. THE NEEDS IDENTIFIED WERE REVIEWED AND PRIORITIZED BY THE CHNA RESOURCE GROUP AND SUBSEQUENTLY BY THE ORGANIZATION'S BOARD AND THE NOVANT HEALTH EXECUTIVE TEAM. THEY EVALUATED EACH DOCUMENTED NEED AND ITS INTERSECTION WITH THE ORGANIZATION'S VISION, COMMITMENTS, AND KEY STRENGTHS BEFORE FURTHER PRIORITIZING THE HEALTH NEEDS AND AGREEING UPON THE TOP HEALTH PRIORITIES TO BE ADDRESSED. WHERE POSSIBLE, WE HAVE LEVERAGED THE SYSTEM'S STRENGTHS AND RESOURCES TO BEST ADDRESS THOSE NEEDS THAT ARE HIGHEST IN PRIORITY AND CONSISTENT ACROSS COMMUNITIES. NOVANT HEALTH AND EACH OF ITS HOSPITAL FACILITIES HAVE ADOPTED AND EXECUTED AN IMPLEMENTATION STRATEGY THAT ADDRESSES THE PRIORITIZED COMMUNITY HEALTH NEEDS FROM THE CHNAS. THE IMPLEMENTATION STRATEGIES OUTLINE THE PLAN THAT THE HOSPITAL FACILITY(IES) WILL UNDERTAKE TO MEET THOSE HEALTH NEEDS IN EACH OF ITS COMMUNITIES. CERTAIN NEEDS THAT WERE IDENTIFIED BY THE CHNA HAVE NOT BEEN ADDRESSED. IT WAS DETERMINED THAT THERE ARE OTHER RESOURCES IN THE COMMUNITY THAT CAN MORE APPROPRIATELY ADDRESS THESE NEEDS BASED ON SCOPE OF SERVICES AND SKILL SET. FOR MORE DETAILED INFORMATION, REFER TO THE PUBLICLY AVAILABLE IMPLEMENTATION PLAN AVAILABLE ON THE WEBSITE; REFER TO THE URL GIVEN PREVIOUSLY FOR THE POSTING OF THE PLAN.
NH FORSYTH MEDICAL CENTERPART V, SECTION B, LINE 13H: OTHER ELIGIBILITY CRITERIA EXPLAINED IN THE NOVANT HEALTH FAP INCLUDE THE FOLLOWING: FREE CARE IS ONLY APPLICABLE TO MEDICALLY NECESSARY SERVICES; PROVIDER BASED PHYSICIAN CLINICS REQUIRE THAT PATIENTS MUST HAVE BEEN TREATED BY A NOVANT HEALTH MEDICAL GROUP PRIMARY CARE PHYSICIAN WITHIN THE PREVIOUS THREE YEARS; PATIENTS MUST BE UNABLE TO ACCESS ENTITLEMENT PROGRAMS; PATIENTS WITH SPECIAL CIRCUMSTANCES SUCH AS BANKRUPTCY MAY ALSO BE ELIGIBLE FOR CHARITY CARE.
NH KERNERSVILLE MEDICAL CENTERPART V, SECTION B, LINE 13H: OTHER ELIGIBILITY CRITERIA EXPLAINED IN THE NOVANT HEALTH FAP INCLUDE THE FOLLOWING: FREE CARE IS ONLY APPLICABLE TO MEDICALLY NECESSARY SERVICES; PROVIDER BASED PHYSICIAN CLINICS REQUIRE THAT PATIENTS MUST HAVE BEEN TREATED BY A NOVANT HEALTH MEDICAL GROUP PRIMARY CARE PHYSICIAN WITHIN THE PREVIOUS THREE YEARS; PATIENTS MUST BE UNABLE TO ACCESS ENTITLEMENT PROGRAMS; PATIENTS WITH SPECIAL CIRCUMSTANCES SUCH AS BANKRUPTCY MAY ALSO BE ELIGIBLE FOR CHARITY CARE.
NH CLEMMONS MEDICAL CENTERPART V, SECTION B, LINE 13H: OTHER ELIGIBILITY CRITERIA EXPLAINED IN THE NOVANT HEALTH FAP INCLUDE THE FOLLOWING: FREE CARE IS ONLY APPLICABLE TO MEDICALLY NECESSARY SERVICES; PROVIDER BASED PHYSICIAN CLINICS REQUIRE THAT PATIENTS MUST HAVE BEEN TREATED BY A NOVANT HEALTH MEDICAL GROUP PRIMARY CARE PHYSICIAN WITHIN THE PREVIOUS THREE YEARS; PATIENTS MUST BE UNABLE TO ACCESS ENTITLEMENT PROGRAMS; PATIENTS WITH SPECIAL CIRCUMSTANCES SUCH AS BANKRUPTCY MAY ALSO BE ELIGIBLE FOR CHARITY CARE. NH FORSYTH MEDICAL CENTERPART V, LINE 16A, FAP WEBSITE: WWW.NOVANTHEALTH.ORG/HOME/PATIENTS--VISITORS/YOUR-HEALTHCARE-COSTS/ FINANCIAL-ASSISTANCE-FOR-THE-UNINSURED.ASPXNH KERNERSVILLE MEDICAL CENTERPART V, LINE 16A, FAP WEBSITE: WWW.NOVANTHEALTH.ORG/HOME/PATIENTS--VISITORS/YOUR-HEALTHCARE-COSTS/ FINANCIAL-ASSISTANCE-FOR-THE-UNINSURED.ASPXNH CLEMMONS MEDICAL CENTERPART V, LINE 16A, FAP WEBSITE: WWW.NOVANTHEALTH.ORG/HOME/PATIENTS--VISITORS/YOUR-HEALTHCARE-COSTS/ FINANCIAL-ASSISTANCE-FOR-THE-UNINSURED.ASPXNH FORSYTH MEDICAL CENTERPART V, LINE 16B, FAP APPLICATION WEBSITE: WWW.NOVANTHEALTH.ORG/HOME/PATIENTS--VISITORS/YOUR-HEALTHCARE-COSTS/ FINANCIAL-ASSISTANCE-FOR-THE-UNINSURED.ASPXNH KERNERSVILLE MEDICAL CENTERPART V, LINE 16B, FAP APPLICATION WEBSITE: WWW.NOVANTHEALTH.ORG/HOME/PATIENTS--VISITORS/YOUR-HEALTHCARE-COSTS/ FINANCIAL-ASSISTANCE-FOR-THE-UNINSURED.ASPXNH CLEMMONS MEDICAL CENTERPART V, LINE 16B, FAP APPLICATION WEBSITE: WWW.NOVANTHEALTH.ORG/HOME/PATIENTS--VISITORS/YOUR-HEALTHCARE-COSTS/ FINANCIAL-ASSISTANCE-FOR-THE-UNINSURED.ASPXNH FORSYTH MEDICAL CENTERPART V, LINE 16C, FAP PLAIN LANGUAGE SUMMARY WEBSITE: WWW.NOVANTHEALTH.ORG/HOME/PATIENTS--VISITORS/YOUR-HEALTHCARE-COSTS/ FINANCIAL-ASSISTANCE-FOR-THE-UNINSURED.ASPXNH KERNERSVILLE MEDICAL CENTERPART V, LINE 16C, FAP PLAIN LANGUAGE SUMMARY WEBSITE: WWW.NOVANTHEALTH.ORG/HOME/PATIENTS--VISITORS/YOUR-HEALTHCARE-COSTS/ FINANCIAL-ASSISTANCE-FOR-THE-UNINSURED.ASPXNH CLEMMONS MEDICAL CENTERPART V, LINE 16C, FAP PLAIN LANGUAGE SUMMARY WEBSITE: WWW.NOVANTHEALTH.ORG/HOME/PATIENTS--VISITORS/YOUR-HEALTHCARE-COSTS/ FINANCIAL-ASSISTANCE-FOR-THE-UNINSURED.ASPX
NH FORSYTH MEDICAL CENTERPART V, SECTION B, LINE 22D: AFTER APPLICATION AND APPROVAL, ALL FINANCIAL ASSISTANCE POLICY (FAP) ELIGIBLE PATIENTS RECEIVE 100% FREE CARE AND THEREFORE ARE NOT CHARGED FOR CARE AND DO NOT RECEIVE BILLS ONCE FAP ELIGIBILITY HAS BEEN ESTABLISHED. ALL PATIENTS DO RECEIVE INFORMATIONAL STATEMENTS WHICH INCLUDE TOTAL CHARGES LESS ANY NON-FINANCIAL ASSISTANCE POLICY ADJUSTMENTS.
NH KERNERSVILLE MEDICAL CENTERPART V, SECTION B, LINE 22D: AFTER APPLICATION AND APPROVAL, ALL FINANCIAL ASSISTANCE POLICY (FAP) ELIGIBLE PATIENTS RECEIVE 100% FREE CARE AND THEREFORE ARE NOT CHARGED FOR CARE AND DO NOT RECEIVE BILLS ONCE FAP ELIGIBILITY HAS BEEN ESTABLISHED. ALL PATIENTS DO RECEIVE INFORMATIONAL STATEMENTS WHICH INCLUDE TOTAL CHARGES LESS ANY NON-FINANCIAL ASSISTANCE POLICY ADJUSTMENTS.
NH CLEMMONS MEDICAL CENTERPART V, SECTION B, LINE 22D: AFTER APPLICATION AND APPROVAL, ALL FINANCIAL ASSISTANCE POLICY (FAP) ELIGIBLE PATIENTS RECEIVE 100% FREE CARE AND THEREFORE ARE NOT CHARGED FOR CARE AND DO NOT RECEIVE BILLS ONCE FAP ELIGIBILITY HAS BEEN ESTABLISHED. ALL PATIENTS DO RECEIVE INFORMATIONAL STATEMENTS WHICH INCLUDE TOTAL CHARGES LESS ANY NON-FINANCIAL ASSISTANCE POLICY ADJUSTMENTS.
FieldValueIRS element (for citing)
Facility60FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (60 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxtAddress Line2USAddress/AddressLine2Txt
NH ARCADIA FAMILY MEDICINE
12208 NC HWY 150 NORTHWINSTONSALEMNC27127PHYSICIAN CLINIC
NH BREAST CENTER
2025 FRONTIS PLAZA BLVDSTE 123WINSTONSALEMNC27103IMAGING CENTER
NH BREAST CENTER
2025 FRONTIS PLAZA BLVDSTE 119 300WINSTONSALEMNC27103IMAGING CENTER
NH CARDIOLOGY CLEMMONS
7114 VILLAGE MEDICAL CIRCLECLEMMONSNC27012PHYSICIAN CLINIC
NH CHAIR CITY FAMILY MEDICINE
903 RANDOLPH STTHOMASVILLENC27360PHYSICIAN CLINIC
NH CLEMMONS FAMILY MEDICINE
6301 STADIUM DRIVECLEMMONSNC27012PHYSICIAN CLINIC
NH DAVIE MEDICAL ASSOCIATES
485 VALLEY ROADMOCKSVILLENC27028PHYSICIAN CLINIC
NH FORSYTH ENDOCRINE CONSULTANTS
755 HIGHLAND OAKS DRSTE 201WINSTONSALEMNC27103PHYSICIAN CLINIC
NH FORSYTH FAMILY MEDICINE
400 JONESTOWN ROADWINSTONSALEMNC27104PHYSICIAN CLINIC
NH FORSYTH INTERNAL MEDICINE
1381 WESTGATE CENTER DRIVEWINSTONSALEMNC27103PHYSICIAN CLINIC
NH FORSYTH NEUROLOGY
2025 FRONTIS PLAZA BLVDSTE 120WINSTONSALEMNC27103PHYSICIAN CLINIC
NH GATEWAY FAMILY MEDICINE
390 SALEM AVENUEWINSTONSALEMNC27101PHYSICIAN CLINIC
NH HAWTHORNE OUTPATIENT SURGERY
1999 S HAWTHORNE ROADWINSTONSALEMNC27103AMBULATORY SURGERY CENTER
NH HILLSDALE MEDICAL ASSOCIATES
121 MEDICAL DRIVEADVANCENC27006PHYSICIAN CLINIC
NH IMAGING KERNERSVILLE
445 PINEVIEW DRIVE SUITE 100KERNERSVILLENC27284IMAGING CENTER
NH IMAGING MAPLEWOOD
3155 MAPLEWOOD AVENUEWINSTONSALEMNC27103IMAGING CENTER
NH INFECTIOUS DISEASE SPECIALISTS
1381 WESTGATE CENTER DRIVEWINSTONSALEMNC27103PHYSICIAN CLINIC
NH INPATIENT CARE SPECIALISTS KVILLE
1750 KERNERSVILLE MEDICAL PKWYKERNERSVILLENC27284PHYSICIAN CLINIC
NH KERNERSVILLE FAMILY MEDICINE
291 BROAD STREETWINSTONSALEMNC27284PHYSICIAN CLINIC
NH LEWISVILLE FAMILY MEDICINE
1225 LEWISVILLE-CLEMMONS ROADLEWISVILLENC27023PHYSICIAN CLINIC
NH LEXINGTON PRIMARY CARE
110 WEST MEDICAL PARK DRIVELEXINGTONNC27292PHYSICIAN CLINIC
NH MAPLEWOOD FAMILY MEDICINE
ROBINHOOD MEDICAL PLAZA BLDG 100WINSTONSALEMNC27106PHYSICIAN CLINIC
NH MEADOWLARK PEDIATRICS
5110 ROBINHOOD VILLAGE DR SUITE C-1WINSTONSALEMNC27106PHYSICIAN CLINIC
NH MOUNTAINVIEW MEDICAL
216 MOORE ROADKINGNC27021PHYSICIAN CLINIC
NH NEW GARDEN MEDICAL ASSOCIATES
1941 NEW GARDEN RD STES 212 216GREENSBORONC27410PHYSICIAN CLINIC
NH NORTH POINT MEDICAL ASSOCIATES
1995 BETHABARA ROADWINSTONSALEMNC27106PHYSICIAN CLINIC
NH NORTHWEST FAMILY MEDICINE
7607 NC HIGHWAY 68 N STE BOAK RIDGENC27310PHYSICIAN CLINIC
NH ONCOLOGY SPECIALISTS
276 OLD MOCKSVILLE RDSTE 800STATESVILLENC28625PHYSICIAN CLINIC
NH ONCOLOGY SPECIALISTS
865 WESTLAKE DRIVE STE 200MOUNT AIRYNC27030PHYSICIAN CLINIC
NH ONCOLOGY SPECIALISTS
1010 BETHESDA COURTWINSTONSALEMNC27103PHYSICIAN CLINIC
NH ONCOLOGY SPECIALISTS
1370 PIEDMONT DRIVE STE 202LEXINGTONNC27295PHYSICIAN CLINIC
NH ONCOLOGY SPECIALISTS
1710 KERNERSVILLE MED PKWY STE 116KERNERSVILLENC27284PHYSICIAN CLINIC
NH PFAFFTOWN FAMILY MEDICINE
4611 YADKINVILLE ROADPFAFFTOWNNC27040PHYSICIAN CLINIC
NH PHARMACY
105 VEST MILL CIRCLEWINSTONSALEMNC27103PHARMACY
NH PHARMACY
212 MOORE ROADKINGNC27021PHARMACY
NH PHARMACY
291 BROAD STREETKERNERSVILLENC27284PHARMACY
NH PHARMACY
100 ROBINHOOD MEDICAL PLAZAWINSTONSALEMNC27106PHARMACY
NH PHARMACY
1381 WESTGATE CENTER DRIVEWINSTONSALEMNC27103PHARMACY
NH PHARMACY
1010 BETHESDA COURTWINSTONSALEMNC27103PHARMACY
NH PHARMACY
255 CHARLOIS BLVDWINSTONSALEMNC27103PHARMACY
NH PILOT MOUNTAIN MEDICAL CARE
207 MEDICAL STREETPILOT MOUNTAINNC27041PHYSICIAN CLINIC
NH PINEVIEW FAMILY MEDICINE
490 PINEVIEW DRIVEKERNERSVILLENC27284PHYSICIAN CLINIC
NH PREMIER MEDICAL ASSOCIATES
3333 BROOKVIEW HILLS BLVD STEWINSTONSALEMNC27103PHYSICIAN CLINIC203204
NH PSYCHIATRIC MEDICINE
175 KIMEL PARK DR STE 100WINSTONSALEMNC27103PHYSICIAN CLINIC
NH RHEUMATOLOGY AND ARTHRITIS
1995 BETHABARA ROADWINSTONSALEMNC27106PHYSICIAN CLINIC
NH SALEM FAMILY MEDICINE
105 VEST MILL CIRCLEWINSTONSALEMNC27103PHYSICIAN CLINIC
NH SURRY MEDICAL ASSOCIATES
865 WESTLAKE DRIVEMOUNT AIRYNC27030PHYSICIAN CLINIC
NH THOMASVILLE MEDICAL ASSOCIATES
309 PINEYWOOD ROADTHOMASVILLENC27360PHYSICIAN CLINIC
NH TRIAD ENDOCRINE
500 PINEVIEW DR SUITE 101KERNERSVILLENC27284PHYSICIAN CLINIC
NH UROLOGY PARTNERS
2010 BALDWIN LANEWINSTONSALEMNC27103PHYSICIAN CLINIC
NH UROLOGY PARTNERS
1710 KERNERSVILLE MED PKWY STE 201KERNERSVILLENC27284PHYSICIAN CLINIC
NH WEST FORSYTH INTERNAL MED & PED
105 STADIUM OAKS DRIVECLEMMONSNC27012PHYSICIAN CLINIC
NH WINSTON-SALEM CARDIOLOGY
445 PINEVIEW DRIVE SUITE 220WINSTONSALEMNC27284PHYSICIAN CLINIC
NH WINSTON-SALEM CARDIOLOGY
186 KIMEL PARK DRIVEWINSTONSALEMNC27103PHYSICIAN CLINIC
NH WINSTON-SALEM CARDIOLOGY
1710 KERNERSVILLE MED PKWY STE 205KERNERSVILLENC27284PHYSICIAN CLINIC
NH WINSTON-SALEM HEALTH CARE
250 CHARLOIS BLVDWINSTONSALEMNC27103PHYSICIAN CLINIC
NH WINSTON-SALEM HEALTH CARE
175 KIMEL PARK DR STE 250WINSTONSALEMNC27103PHYSICIAN CLINIC
NH WINSTON-SALEM HEALTH CARE PSYCH
280 CHARLOIS BLVD 3RD FLOORWINSTONSALEMNC27103PHYSICIAN CLINIC
NH WOUND CARE & HYPERBARIC MEDICINE
1901 S HAWTHORNE RDSTE 220WINSTONSALEMNC27103PHYSICIAN CLINIC
NH YADKIN MEDICAL ASSOCIATES
305 EAST LEE AVENUEYADKINVILLENC27055PHYSICIAN CLINIC

Supplemental Information Detail SupplementalInformationDetail (15 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 3C:OTHER CRITERIA BESIDES INCOME AND FPG USED IN DETERMINING ELIGIBILITY FOR FREE CARE INCLUDE: (1) RESIDENCY - PATIENTS MUST RESIDE WITHIN THE SERVICE AREA OF THE HOSPITAL; (2) THE KIND OF SERVICE PROVIDED - ONLY MEDICALLY NECESSARY SERVICES ARE COVERED; (3) PATIENT STATUS - IN PROVIDER BASED PHYSICIAN CLINICS, PATIENTS MUST HAVE BEEN TREATED BY A NOVANT HEALTH MEDICAL GROUP PRIMARY CARE PHYSICIAN WITHIN THE PREVIOUS THREE YEARS; AND (4) ACCESS TO HEALTH CARE COVERAGE - PATIENTS MUST BE UNABLE TO ACCESS EMPLOYER SPONSORED HEALTH PLANS OR ENTITLEMENT PROGRAMS. LASTLY, THE PATIENT MUST BE WITHOUT SUBSTANTIAL LIQUID ASSETS (I.E. CASH-ON-HAND). ASSETS SUCH AS HOUSES, CARS, PENALIZED RETIREMENT SAVINGS FUNDS, ETC. ARE NOT CONSIDERED LIQUID ASSETS. SUBSTANTIAL ASSETS ARE DEFINED AS ENOUGH CASH-ON-HAND TO COVER THE MEDICAL EXPENSES WITHOUT PLACING A HARDSHIP ON THE PATIENT. PATIENTS WITH SPECIAL CIRCUMSTANCES SUCH AS BANKRUPTCY MAY ALSO BE ELIGIBLE FOR CHARITY CARE; DETERMINATION IS MADE ON A CASE BY CASE BASIS UNDER THESE CIRCUMSTANCES.
PART I, LINE 6A:THE ORGANIZATION IS A PART OF NOVANT HEALTH, AN INTEGRATED NOT-FOR-PROFIT HEALTH SYSTEM. THE COMMUNITY BENEFIT REPORT IS PREPARED BY A RELATED ORGANIZATION. NOVANT HEALTH, INC. IS THE NOVANT HEALTH PARENT COMPANY AND PRODUCES A COMMUNITY BENEFIT REPORT REPRESENTING THE HEALTH SYSTEM AS A WHOLE. THE REPORT CAN BE FOUND AT HTTP://WWW.NOVANTHEALTH.ORG/HOME/ABOUT-US/COMPANY-INFORMATION/FINANCIAL -PROFILE/COMMUNITY-BENEFIT-REPORT.ASPX. PLEASE NOTE THAT THE NUMERIC INFORMATION IN THIS REPORT IS NOT BASED UPON THE FORM 990, SCHEDULE H CRITERIA, BUT RATHER IT HAS BEEN PREPARED IN ACCORDANCE WITH THE NORTH CAROLINA HOSPITAL ASSOCIATION REPORTING GUIDELINES.
PART I, LINE 7:COSTS REPORTED IN THE TABLE FOR CHARITY CARE AND CERTAIN OTHER COMMUNITY BENEFITS AMOUNTS ARE CALCULATED USING AN ENTITY SPECIFIC COST TO CHARGE RATIO BASED ON WORKSHEET 2 (CCR).
PART I, LN 7 COL(F):THE AMOUNT OF BAD DEBT REMOVED FROM TOTAL EXPENSES (DENOMINATOR) WAS $44,187,769.
PART II, COMMUNITY BUILDING ACTIVITIES:THE ORGANIZATION IS A PART OF NOVANT HEALTH, AN INTEGRATED NOT-FOR-PROFIT HEALTH SYSTEM. NOVANT HEALTH'S COMMUNITY BUILDING ACTIVITIES IMPACTS THE HEALTH OF OUR COMMUNITY THROUGH PARTNERSHIPS WITH LOCAL AGENCIES DEDICATED TO IMPROVING THE LIVES OF ALL INDIVIDUALS. OUTREACH INCLUDES PROVIDING SUPPORT FOR ORGANIZATIONS SUCH AS HABITAT FOR HUMANITY AND LOCAL CHAMBERS OF COMMERCE, ASSISTING WITH COMMUNITY/COUNTY COALITIONS, PROVIDING EDUCATIONAL SEMINARS AND TRAINING FOR COMMUNITY WORKFORCES, AND SUPPORTING COMMUNITY AGENCIES SUCH AS ROTARY, LIONS CLUBS AND MORE. THROUGH EACH OF THESE PARTNER AGENCIES, NOVANT HEALTH ADDRESSES THE UNDERLYING ISSUES IMPACTING THE HEALTH OF OUR COMMUNITIES AND ENSURES THAT OUR COMMUNITIES GROW FOR YEARS TO COME.
PART III, LINE 2:THE ALLOWANCE FOR BAD DEBT IS DETERMINED BASED ON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS, BUSINESS AND ECONOMIC CONDITIONS, THE AGE OF THE ACCOUNTS, TRENDS IN FEDERAL AND STATE GOVERNMENTAL HEALTHCARE COVERAGE AND OTHER COLLECTION INDICATORS.
PART III, LINE 4:THE ORGANIZATION'S BAD DEBT EXPENSE (AT COST) ON LINE 2 IS CALCULATED USING THE SAME METHODOLOGY AS CHARITY CARE AND OTHER COMMUNITY BENEFITS USING AN ENTITY SPECIFIC COST TO CHARGE RATIO (CCR). FOOTNOTE 2 (ACCOUNTS RECEIVABLE) ON PAGE 7 OF THE AUDITED FINANCIAL STATEMENTS DESCRIBES THE BAD DEBT EXPENSE.
PART III, LINE 8:THE METHODOLOGY USED TO DETERMINE THE MEDICARE ALLOWABLE COSTS REPORTED IN THE ORGANIZATION'S MEDICARE COST REPORT AS REFLECTED IN THE AMOUNT REPORTED IN PART III, LINE 6 IS DETERMINED BY FOLLOWING THE MEDICARE PRINCIPLES OF ALLOWABLE COSTS. COST FOR THE OVERHEAD DEPARTMENTS ARE STEPPED DOWN TO THE REMAINING COST CENTERS BASED ON STATISTICS FOR EACH OVERHEAD COST CENTER. ONCE THE STEP-DOWN PROCESS IS COMPLETE, A RATIO OF COST TO CHARGES IS DEVELOPED FOR EACH COST CENTER. THE CCR IS THEN APPLIED TO THE MEDICARE REVENUE BY COST CENTER AND TOTALED. IT SHOULD BE NOTED THAT THE MEDICARE COST REPORTS DO NOT ADDRESS ANY MANAGED CARE MEDICARE REVENUES, COSTS, OR RELATED SHORTFALL. THE TOTAL REVENUES REPORTED AS RECEIVED FROM MEDICARE IN LINE 5 OF SECTION B ARE ONLY REPRESENTATIVE OF MEDICARE FEE FOR SERVICE PAYMENTS RECEIVED. THE ALLOWABLE COSTS ON LINE 6 ARE SIGNIFICANTLY LOWER THAN THE ACTUAL EXPENDITURES. AS SUCH, THE SHORTFALL IS UNDERESTIMATED. EVERY HOSPITAL TREATS MEDICARE PATIENTS. SOME HOSPITALS ARE LOCATED IN HIGH MEDICARE POPULATION AREAS; OTHERS PROVIDE SERVICES DISPROPORTIONATELY USED BY MEDICARE PATIENTS. MEDICARE RATES AND NUMBERS OF MEDICARE PATIENTS ARE NOT NEGOTIATED. AS REIMBURSEMENT RATES DECLINE RELATIVE TO COSTS OF CARE, HOSPITALS CONTINUE TO SERVE THE MEDICARE POPULATION. WITHOUT THIS SERVICE THESE PATIENTS WOULD BECOME AN OBLIGATION ON THE GOVERNMENT. ANY UNREIMBURSED COSTS OF THIS CARE ARE A COMMUNITY BENEFIT PROVIDED BY THE HOSPITAL TO THE COMMUNITY AND GOVERNMENT.
PART III, LINE 9B:THE ORGANIZATION'S BILLING AND COLLECTIONS POLICY DOES EXPLAIN ACTIONS AGAINST PATIENTS WHO HAVE OUTSTANDING DELINQUENT AMOUNTS, BUT THE POLICY DOES NOT CONTAIN PROVISIONS FOR COLLECTION PRACTICES AGAINST PATIENTS WHO ARE ELIGIBLE UNDER THE FINANCIAL ASSISTANCE POLICY (FAP) BECAUSE FAP ELIGIBLE PATIENTS RECEIVE 100% FREE CARE AND THEREFORE DO NOT RECEIVE BILLS ONCE FAP ELIGIBILITY HAS BEEN ESTABLISHED.
PART VI, LINE 2:PART VI, LINE 2: NEEDS ASSESSMENTTHE ORGANIZATION IS PART OF NOVANT HEALTH, AN INTEGRATED NOT-FOR-PROFIT HEALTH SYSTEM, WHICH HAS A COMMUNITY BENEFIT COMMITTEE. THE COMMUNITY BENEFIT COMMITTEE IS RESPONSIBLE FOR ASSISTING THE HOSPITALS WITHIN THE SYSTEM PREPARE THEIR COMMUNITY HEALTH NEEDS ASSESSMENTS (CHNA) INCLUDING THE CHNAS REPORTED IN PART V, SECTION B. THE COMMUNITY BENEFIT COMMITTEE IS MADE OF INDIVIDUALS REPRESENTING CORPORATE-WIDE DEPARTMENTS, SUCH AS COMMUNITY RELATIONS, LEGAL, TAX, INTERNAL AUDIT, MARKETING/COMMUNICATIONS, AS WELL AS INDIVIDUALS FROM VARIOUS DEPARTMENTS OF HOSPITAL OPERATIONS AND THE SYSTEM'S HOSPITAL FOUNDATIONS. EACH HOSPITAL, WITH THE ASSISTANCE OF THE COMMUNITY BENEFIT COMMITTEE, IDENTIFIES ORGANIZATIONS AND RESOURCES WITHIN ITS COMMUNITY THAT CONTRIBUTE TO THE PROCESS. THESE ORGANIZATIONS AND RESOURCES INCLUDE LOCAL HEALTH DEPARTMENTS, UNITED WAY, UNIVERSITIES, PUBLIC HEALTH DEPARTMENTS, ETC. COMMUNITY HEALTH ASSESSMENTS PREPARED BY OTHER ORGANIZATIONS IN THE COMMUNITY ARE USED IN COMBINATION WITH INTERNAL HOSPITAL DATA AND INFORMATION COLLECTED FROM LOCAL AGENCIES TO PREPARE THE HOSPITAL'S CHNA. IN ADDITION TO ADDRESSING NEEDS IDENTIFIED THROUGH THE CHNA, EACH HOSPITAL MAY RESPOND TO REQUESTS FOR SPECIFIC COMMUNITY BENEFIT ACTIVITIES OR PROGRAMS FROM PUBLIC AGENCIES OR COMMUNITY GROUPS.
PART VI, LINE 3:PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCETHE ORGANIZATION IS PART OF NOVANT HEALTH, AN INTEGRATED NOT-FOR-PROFIT HEALTH SYSTEM. AS A NOT-FOR-PROFIT ORGANIZATION, NOVANT HEALTH IS COMMITTED TO PROVIDING OUTSTANDING HEALTHCARE TO ALL MEMBERS OF OUR COMMUNITIES, REGARDLESS OF THEIR ABILITY TO PAY. OUR ACUTE CARE FACILITIES PROVIDE CARE IN 35 COUNTIES ACROSS FOUR STATES. ADDITIONALLY, OUR PHYSICIANS AND ACUTE CARE FACILITIES OFFER CARE TO NATIONAL AND INTERNATIONAL MISSION PATIENTS. OUR FINANCIAL COUNSELING TEAMS ARE CONSTANTLY WORKING WITH THE PATIENTS WITHIN OUR COMMUNITIES TO UNDERSTAND THEIR NEEDS AND ENSURE THAT OUR POLICIES AND PROCESSES ADDRESS THESE NEEDS. WE ALSO MAINTAIN CONTRACTS WITH MEDICAID ELIGIBILITY VENDORS. THESE TEAMS OFFER ADDITIONAL SUPPORT IN PROCESSING AND ASSESSING HOW WE SERVE THE FINANCIAL NEEDS OF OUR PATIENTS. BASED ON THE ASSESSMENTS OF OUR COMMUNITIES, NOVANT HEALTH HAS DEVELOPED FINANCIAL ASSISTANCE POLICIES AND PROGRAMS THAT ADDRESS THE FINANCIAL NEEDS OF OUR PATIENTS. WE PRIDE OURSELVES ON THE TRANSPARENCY OF OUR PROGRAMS AND THE EDUCATION WE OFFER OUR PATIENTS AROUND OUR FINANCIAL ASSISTANCE POLICIES. OUR PROGRAMS ARE DOCUMENTED ON OUR WEBSITE, ALONG WITH CONTACT INFORMATION FOR OUR FINANCIAL COUNSELORS. ADDITIONALLY, OUR PROGRAMS ARE DOCUMENTED ON PATIENT FLYERS THROUGHOUT THE NOVANT HEALTH AFFILIATED FACILITIES AND PHYSICIAN OFFICES. OUR PATIENT ACCESS SPECIALISTS, FINANCIAL COUNSELORS AND BUSINESS OFFICE TEAMS WORK WITH ALL ELIGIBLE PATIENTS TO EDUCATE THEM ON THE VARIOUS OPTIONS AVAILABLE VIA OUR FINANCIAL ASSISTANCE PROGRAMS OR GOVERNMENT SPONSORED CARE. THEY ALSO REFERENCE OUR FINANCIAL ASSISTANCE POLICY IN ALL CONVERSATIONS RELATED TO PATIENTS BILLS. FINALLY, WE WORK WITH LOCAL AREA FREE HEALTH CLINICS AND OTHER CHARITABLE ORGANIZATIONS TO PROVIDE CONTINUATION OF CARE FOR THEIR PATIENTS. IN ADDITION TO OUR FINANCIAL COUNSELING PROCESSES USED TO IDENTIFY CHARITY CARE PATIENTS, OUR COLLECTIONS PROCESSES WITHIN OUR BUSINESS OFFICES ALSO HELP IDENTIFY PATIENTS WHO ARE ALREADY ELIGIBLE FOR CHARITY OR WHO MAY BE ELIGIBLE BASED ON THEIR STATUS WITHIN THE FEDERAL POVERTY GUIDELINES ("FPG"). WE UTILIZE PREVIOUSLY SUBMITTED PATIENT DOCUMENTATION AND CREDIT AGENCY REPORTED FPG FOR DETERMINATION. SUPPORTING DOCUMENTS ARE VALID 6 MONTHS FROM THE DATE OF SUBMISSION. OUR POLICIES ARE CONSIDERED FLUID AND ARE UPDATED FREQUENTLY BASED ON LOCAL AND NATIONAL MARKET STANDARDS AND NATIONAL ECONOMIC CONDITIONS. ANY UPDATES TO OUR POLICIES REQUIRE MULTI-LEVEL LEADERSHIP APPROVAL AND ARE ULTIMATELY APPROVED BY THE NOVANT HEALTH EXECUTIVE TEAM AND/OR THE NOVANT HEALTH BOARD OF DIRECTORS.
PART VI, LINE 4:PART VI, LINE 4: COMMUNITY INFORMATIONTHE FORSYTH MEMORIAL HOSPITAL, INC. FORM 990 INCLUDES THE OPERATIONS OF THREE HOSPITALS. FORSYTH MEMORIAL HOSPITAL, INC. DBA NOVANT HEALTH FORSYTH MEDICAL CENTER, AS NOVANT HEALTH KERNERSVILLE MEDICAL CENTER AND AS NOVANT HEALTH CLEMMONS MEDICAL CENTERTHE ORGANIZATION DEFINES ITS COMMUNITY BY ITS PRIMARY SERVICE AREA, WHICH IS FORSYTH COUNTY, NORTH CAROLINA. THIS IS AN URBAN AREA.THERE ARE FOUR NONPROFIT ACUTE CARE HOSPITALS IN THE COMMUNITY, THREE OF WHICH ARE THE ORGANIZATION AND ONE OF WHICH IS PART OF THE NOVANT HEALTH SYSTEM. THERE IS ALSO ONE ACADEMIC, TEACHING HOSPITAL. ACCORDING TO SG2 DATA, THE SPECIFIC POPULATION GROUPS (ETHNIC AND CULTURAL) ARE AS FOLLOWS: WHITE NON-HISPANIC (236,234) 59.27%; BLACK NON-HISPANIC (97,658) 24.50%; HISPANIC (50,985) 12.79%; ASIAN AND PACIFIC ISLAND (9,761) 2.45%; OTHERS (3,938) .99%; FOR A TOTAL POPULATION OF 398,576. ACCORDING TO US CENSUS BUREAU DATA, THE MEDIAN HOUSEHOLD INCOME LEVEL WAS $45,724.ACCORDING TO SG2 DATA, THE AGE BREAKDOWN IS AS FOLLOWS: 0-17 YEARS (92,040) 23.68%; 18-64 YEARS (239,642) 61.64%; 65+ YEARS (57,057) 14.68%.
PART VI, LINE 5:PART VI, LINE 5: PROMOTION OF COMMUNITY HEALTHTHE ORGANIZATION FURTHERS ITS EXEMPT PURPOSES BY DOING THE FOLLOWING:1. ADOPTING A CHARITY CARE POLICY, WHICH PROVIDES FREE CARE TO INDIVIDUALS WHOSE INCOME IS AT OR BELOW 300% OF THE FEDERAL POVERTY LEVEL;2. REMAINING CERTIFIED BY THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES TO PROVIDE SERVICES TO ALL BENEFICIARIES OF MEDICARE, MEDICAID, AND OTHER GOVERNMENT PAYMENT PROGRAMS, AND PROVIDING SERVICES IN A NONDISCRIMINATORY MANNER TO SUCH BENEFICIARIES;3. OPERATING A FULL-TIME EMERGENCY ROOM WHICH IS OPEN TO AND ACCEPTS ALL PERSONS, REGARDLESS OF THEIR ABILITY TO PAY;4. MAINTAINING AN OPEN MEDICAL STAFF, SUBJECT TO EXCLUSIVE CONTRACTS FOR HOSPITAL-BASED SERVICES SUCH AS ANESTHESIOLOGY, RADIOLOGY, PATHOLOGY, HOSPITALIST, AND EMERGENCY DEPARTMENT SERVICES, TO THE EXTENT AN EXCLUSIVE CONTRACT FOR THOSE SERVICES IS REQUIRED TO OBTAIN PROPER STAFFING COVERAGE OR TO PERMIT A MORE EFFICIENT DELIVERY OF THOSE SERVICES WITHIN THE HOSPITAL FACILITY;5. MAINTAINING A GOVERNING BOARD CONSISTING PRIMARILY OF A BROAD CROSS-SECTION OF LEADERS IN THE COMMUNITY;6. ADOPTING AND APPLYING A CONFLICT OF INTEREST POLICY, WHICH APPLIES TO THE GOVERNING BOARD AND ORGANIZATION OFFICERS;7. PROVIDING HEALTH EDUCATION LECTURES AND WORKSHOPS;8. PROVIDING HEALTH FAIRS, EDUCATION ON SPECIFIC DISEASES OR CONDITIONS, AND HEALTH PROMOTION AND WELLNESS PROGRAMS TO THE COMMUNITIES IT SERVES;9. PROVIDING SUPPORT GROUPS AND SELF HELP PROGRAMS TO THE COMMUNITIES IT SERVES;10. PROVIDING COMMUNITY-BASED CLINICAL SERVICES, INCLUDING WITHOUT LIMITATION, HEALTH SCREENINGS AND CLINICS FOR UNINSURED OR UNDERINSURED PERSONS TO THE COMMUNITIES IT SERVES;11. PROVIDING HEALTHCARE SUPPORT SERVICES, INCLUDING WITHOUT LIMITATION, INFORMATION AND REFERRAL TO COMMUNITY SERVICES, CASE MANAGEMENT OF UNDERINSURED AND UNINSURED PERSONS, TELEPHONE INFORMATION SERVICES AND ASSISTANCE TO ENROLL IN PUBLIC PROGRAMS, SUCH AS STATE CHILDREN'S HEALTH INSURANCE PROGRAM (SCHIP) AND MEDICAID TO THE COMMUNITIES IT SERVES;12. PROVIDING SUBSIDIZED HEALTH SERVICES AND CLINICAL PROGRAMS TO THE COMMUNITIES IT SERVES;13. PROVIDING CASH AND IN-KIND CONTRIBUTIONS TO NONPROFIT COMMUNITY HEALTHCARE ORGANIZATIONS IN THE COMMUNITIES IT SERVES; AND14. GENERALLY PROMOTING THE HEALTH, WELLNESS, AND WELFARE OF THE COMMUNITIES IT SERVES BY PROVIDING QUALITY HEALTHCARE SERVICES AT REASONABLE COST.FOR SPECIFIC EXAMPLES OF THIS ORGANIZATION'S COMMUNITY BENEFIT ACTIVITIES, WHICH FURTHER THE ORGANIZATION'S EXEMPT PURPOSES (AND THOSE OF ALL HOSPITALS AND HEALTHCARE FACILITIES IN THE SAME HEALTHCARE SYSTEM), PLEASE SEE THE NOVANT HEALTH COMMUNITY BENEFIT REPORT, LOCATED AT HTTP://WWW.NOVANTHEALTH.ORG/HOME/ABOUT-US/COMPANY-INFORMATION/FINANCIAL -PROFILE/COMMUNITY-BENEFIT-REPORT.ASPX.PLEASE NOTE THAT THE NUMERIC INFORMATION IN THIS REPORT IS NOT BASED UPON THE FORM 990, SCHEDULE H CRITERIA, BUT RATHER IT HAS BEEN PREPARED IN ACCORDANCE WITH THE NORTH CAROLINA HOSPITAL ASSOCIATION REPORTING GUIDELINES.
PART VI, LINE 6:PART VI, LINE 6: AFFILIATED HEALTH CARE SYSTEMTHE ORGANIZATION IS AN INTEGRAL PART OF NOVANT HEALTH, A NOT-FOR-PROFIT INTEGRATED GROUP OF HOSPITALS, PHYSICIAN CLINICS, OUTPATIENT CENTERS AND OTHER HEALTHCARE SERVICE PROVIDERS. NOVANT HEALTH IS RANKED AS ONE OF OUR NATION'S TOP 20 INTEGRATED HEALTHCARE SYSTEMS - CARING FOR PATIENTS AND COMMUNITIES IN GEORGIA, NORTH CAROLINA, SOUTH CAROLINA, AND VIRGINIA. EACH HOSPITAL PROVIDES SUBSTANTIAL COMMUNITY BENEFIT TO THE COMMUNITY IT SERVES, AS REPORTED INDIVIDUALLY ON EACH HOSPITAL'S FORM 990, SCHEDULE H. THE COMMUNITY BENEFIT OF THE SYSTEM AS A WHOLE IS DOCUMENTED IN A SYSTEM-WIDE COMMUNITY BENEFIT REPORT, LOCATED AT HTTP://WWW.NOVANTHEALTH.ORG/HOME/ABOUT-US/COMPANY-INFORMATION/FINANCIAL -PROFILE/COMMUNITY-BENEFIT-REPORT.ASPX. PLEASE NOTE THAT THE NUMERIC INFORMATION IN THIS REPORT IS NOT BASED UPON THE FORM 990, SCHEDULE H CRITERIA, BUT RATHER IT HAS BEEN PREPARED IN ACCORDANCE WITH THE NORTH CAROLINA HOSPITAL ASSOCIATION REPORTING GUIDELINES. THERE ARE SIGNIFICANT COMMUNITY BENEFIT ACTIVITIES WITHIN NOVANT HEALTH WHICH MAY NOT BE REPORTABLE ON A SCHEDULE H BECAUSE THEY ARE NOT CONDUCTED BY AN ENTITY WHICH OWNS OR OPERATES A HOSPITAL.IN ADDITION TO HOSPITALS, NOVANT HEALTH INCLUDES A PHYSICIAN ORGANIZATION WITH PRACTICES IN GEORGIA, NORTH CAROLINA, SOUTH CAROLINA, AND VIRGINIA AND FIVE HOSPITAL FOUNDATIONS WHICH SUPPORT AND ENHANCE THE ACTIVITIES IN THOSE HOSPITALS' COMMUNITIES. FURTHER, NOVANT HEALTH INCLUDES AMBULATORY SURGERY CENTERS, IMAGING CENTERS, REHABILITATION CENTERS, AND OTHER OUTPATIENT FACILITIES; ALL DEDICATED TO PROMOTING THE HEALTH OF THEIR RESPECTIVE COMMUNITIES.
PART VI, LINE 7: STATE FILING OF COMMUNITY BENEFIT REPORTNOVANT HEALTH, INC. FILES A SYSTEM-WIDE COMMUNITY BENEFIT REPORT PREPARED IN ACCORDANCE WITH THE NORTH CAROLINA HOSPITAL ASSOCIATION REPORTING GUIDELINES WITH THE NORTH CAROLINA MEDICAL CARE COMMISSION AS PART OF THE DOCUMENTATION REQUIRED FOR THE ISSUANCE OF TAX EXEMPT BOND FINANCING.

Schedule I IRS990ScheduleI

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

Recipient Table RecipientTable (20 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtPurpose Of GrantPurposeOfGrantTxtAddress Line2USAddress/AddressLine2Txt
AMERICAN HEART ASSOCIATION
7272 GREENVILLE AVEDALLASTX75231135613797501(C)(3)$122,000COMMUNITY OUTREACH
ARTS COUNCIL
206 N SPRUCE ST SUITE 3WINSTONSALEMNC27101560526856501(C)(3)$35,000COMMUNITY OUTREACH
CRISIS CONTROL MINISTRY
200 E TENTH STREETWINSTONSALEMNC27101237348168501(C)(3)$10,000COMMUNITY OUTREACH
FORSYTH FUTURES
301 N MAIN STREET SUITE 1700WINSTONSALEMNC27101561092807501(C)(3)$25,000COMMUNITY OUTREACH
JUVENILE DIABETES FOUNDATION
216 WEST MARKET STREET SUITE BGREENSBORONC27401231907729501(C)(3)$15,000COMMUNITY OUTREACH
SUSAN G KOMEN BREAST CANCER FOUNDATION
1106 BURKE STREETWINSTONSALEMNC27101752891104501(C)(3)$15,000COMMUNITY OUTREACH
MARCH OF DIMES
410 BROOKSTOWN AVEWINSTONSALEMNC27101131846366501(C)(3)$10,000COMMUNITY OUTREACH
OLD HICKORY COUNCIL
6600 SILAS CREEK PARKWAYWINSTONSALEMNC27106560529985501(C)(3)$13,000COMMUNITY OUTREACH
SENIOR SERVICES INC
2895 SHOREFAIR DRIVE NWWINSTONSALEMNC27105561085968501(C)(3)$27,500COMMUNITY OUTREACH
UNITED WAY OF FORSYTH COUNTY
301 N MAIN STREET SUITE 1700WINSTONSALEMNC27101237357234501(C)(3)$40,000COMMUNITY OUTREACH
WS ALLIANCE
100 N MAIN STREET SUITE 2550WINSTONSALEMNC27101311726654501(C)(6)$35,000COMMUNITY OUTREACH
WS STATE UNIVERSITY FOUNDATION
601 S MARTIN LUTHER KING JR DRIVEWINSTONSALEMNC27110560989620501(C)(3)$100,000COMMUNITY OUTREACHSUITE 304
JUNIOR LEAGUE OF WINSTON-SALEM
390 S LIBERTY ST 100WINSTONSALEMNC27101566047957501(C)(3)$12,500COMMUNITY OUTREACH
CHAMBER OF COMMERCE OF WINSTON-SALEM
411 W 4TH STREE SUITE 211WINSTONSALEMNC27101560459820501(C)(6)$25,500COMMUNITY OUTREACH
CHAMBER OF COMMERCE OF KERNERSVILLE
136 E MOUNTAIN STKERNERSVILLENC27284560934946501(C)(6)$7,766COMMUNITY OUTREACH
WINSTON-SALEM SYMPHONY ASSOCIATION
201 N BROAD STREET SUITE 200WINSTONSALEMNC27105560692826501(C)(3)$55,000COMMUNITY OUTREACH
SCIWORKS
400 W HANES MILL ROADWINSTONSALEMNC27105560815746501(C)(3)$15,000COMMUNITY OUTREACH
DAVIE COUNTY ECONOMIC DEVELOPMENT
135 SOUTH SALISBURY STREETMOCKSVILLENC27028561932514501(C)(3)$15,000COMMUNITY OUTREACH
JUNIOR LEAGUE OF GREENSBORO
3101 W FRIENDLY AVENUEGREENSBORONC27408560685368501(C)(3)$8,000COMMUNITY OUTREACH
SCEPTOR PAIN FOUNDATION
145 KIMEL PARK DRIVE SUTIE 300WINSTONSALEMNC27103020723571501(C)(3)$50,000COMMUNITY OUTREACH
FieldValueIRS element (for citing)
Total501c3 Org17Total501c3OrgCnt
Total Other Org3TotalOtherOrgCnt

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp

FieldValueIRS element (for citing)
Grant TypeDISCOUNTED PRESCRIPTION DRUG PROGRAMGrantTypeTxt
Recipient1086RecipientCnt
Non Cash Assistance$83,083NonCashAssistanceAmt
Valuation Method UsedFMVValuationMethodUsedDesc
Non Cash AssistancePRESCRIPTION DRUG ASSISTANCENonCashAssistanceDesc

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 2 : PROCEDURES FOR MONITORING THE USE OF THE GRANT FUNDSFormAndLineReferenceDesc
ExplanationTHE FILING ORGANIZATION IS PART OF THE INTEGRATED HEALTHCARE SYSTEM OPERATED BY NOVANT HEALTH, INC. ("NOVANT HEALTH"), THE PARENT ORGANIZATION. NOVANT HEALTH'S BYLAWS AUTHORIZE IT TO ESTABLISH CERTAIN POLICIES FOR ALL OF ITS SUBSIDIARIES WITHIN THE SYSTEM. NOVANT HEALTH HAS ESTABLISHED A SYSTEM-WIDE CORPORATE POLICY WITH STANDARDIZED GUIDELINES THAT ARE TO BE USED IN REVIEWING THE ELIGIBILITY AND SELECTION OF GRANTEES RECEIVING CERTAIN EXEMPT PURPOSE FUNDS. THE FILING ORGANIZATION MAINTAINS DOCUMENTATION OF THE ELIGIBILITY AND SELECTION CRITERIA AND RECORDS OF THE AMOUNTS ARE MAINTAINED VIA THE GENERAL LEDGER. FUNDS ARE GENERALLY NOT TRACKED AFTER BEING GRANTED, AS THE ORIGINAL ELIGIBILITY AND SELECTION CRITERIA HAVE ALREADY BEEN MET.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
First Class Or Charter TravelYes (X)FirstClassOrCharterTravelInd
Travel For CompanionsYes (X)TravelForCompanionsInd
Idemnification Gross Up PmtsYes (X)IdemnificationGrossUpPmtsInd
Discretionary Spending AcctYes (X)DiscretionarySpendingAcctInd
Housing Allowance Or ResidenceYes (X)HousingAllowanceOrResidenceInd
Club Dues Or FeesYes (X)ClubDuesOrFeesInd
Written Policy Ref T And E ExpnssYes (1)WrittenPolicyRefTAndEExpnssInd
Substantiation RequiredYes (1)SubstantiationRequiredInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (1)SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (17 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
EDWARDS JOEL
TRUSTEE$491,797$0$0$0$35,731$0$56,100$0$18,961$0$602,589$0$7,500$0
ALLEN JOANNE
PRESIDENT KMC$179,815$0$57,330$0$13,518$0$45,527$0$15,683$0$311,873$0$0$0
LINDSAY JEFFERY
FMR PRES FMC/ COO WS MKT$709,856$0$382,813$0$133,401$0$58,100$0$25,718$0$1,309,888$0$7,500$0
MIHAL DENISE
PRES FMC/ COO WS MKT$536,038$0$235,258$0$101,223$0$57,100$0$19,036$0$948,655$0$0$0
MORRIS JOHN
ASST SEC$0$245,757$0$60,571$0$16,426$0$55,603$0$20,706$0$399,063$0$0
GREGORY CHERE
SVP WOMEN'S SERVICES$15,543$331,653$0$48,870$664$26,227$0$84,610$424$22,643$16,631$514,003$0$0
JARRETT-PULLIAM KIMBERLY
CNO$236,515$0$0$0$25,233$0$32,260$0$13,141$0$307,149$0$0$0
LARSON KIP
FORMER VP & SR MED DIR SPECIALTY SER$226,721$0$194,367$0$15,032$0$47,956$0$21,450$0$505,526$0$0$0
NYCUM LAWRENCE
SVP MEDICAL AFFAIRS$355,215$0$241,467$0$31,540$0$85,651$0$35,038$0$748,911$0$0$0
SANZ SEAN
SVP & COO NHFMC$249,982$0$27,000$0$17,956$0$63,467$0$27,533$0$385,938$0$0$0
WALLEY BRUCE
FORMER SVP MEDICAL AFFAIRS$359,448$0$248,798$0$67,095$0$46,630$0$9,989$0$731,960$0$0$0
CHEN FRANKLIN
ONCOLOGIST$340,573$0$389,945$0$699$0$57,524$0$38,428$0$827,169$0$0$0
CHRYSSON NICK
ONCOLOGIST$655,047$0$158,596$0$30,994$0$63,600$0$38,881$0$947,118$0$0$0
COLLINS TIMOTHY
ONCOLOGIST$401,530$0$275,267$0$23,549$0$58,090$0$35,542$0$793,978$0$0$0
GROTE THOMAS
ONCOLOGIST$444,096$0$391,318$0$27,336$0$48,114$0$28,902$0$939,766$0$0$0
PASCHOLD EUGENE
ONCOLOGIST$442,488$0$252,637$0$28,816$0$57,526$0$33,808$0$815,275$0$0$0
MCGEE LAWRENCE
FORMER ASST SEC$0$0$0$257,268$0$91,667$0$0$0$0$0$348,935$0$7,500

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 1AFRINGE OR EXPENSE EXPLANATION FIRST-CLASS OR CHARTER TRAVEL: FIRST-CLASS OR CHARTER TRAVEL IS NOT A COVERED TRAVEL EXPENSE FOR EXECUTIVES; THEY ARE LIMITED TO BUSINESS OR COACH CLASS FARES FOR COMMERCIAL FLIGHTS. HOWEVER, CHARTER TRAVEL IS AVAILABLE TO CERTAIN EXECUTIVES, BOARD MEMBERS, AND APPROVED BUSINESS PERSONNEL IN LIMITED CIRCUMSTANCES MEETING APPLICABLE POLICY CRITERIA. TRAVEL FOR COMPANIONS: COMPANIONS ARE ALLOWED ON CERTAIN CHARTER FLIGHTS PAID FOR BY THE ORGANIZATION. IN THAT CASE, THE VALUE OF THE COMPANION'S FLIGHT IS CALCULATED UNDER APPLICABLE TAX LAWS AND THAT AMOUNT IS INCLUDED IN THE EXECUTIVE'S TAXABLE INCOME AS PRESCRIBED BY THE APPLICABLE TAX LAWS. TAX INDEMNIFICATION AND GROSS-UP PAYMENTS: EXECUTIVES WHO USE FUNDS MADE AVAILABLE THROUGH THEIR DISCRETIONARY SPENDING ACCOUNT UNDER THE EXECUTIVE PERQUISITE PLAN (THE "PLAN") TO PAY PREMIUMS ON CASH VALUE LIFE INSURANCE POLICIES MAY RECEIVE ADDITIONAL COMPENSATION TO ADJUST FOR THE INCOME TAX LIABILITY ASSOCIATED WITH PAYING PREMIUMS FOR THIS INSURANCE. EXECUTIVES WHO RECEIVE TAXABLE RELOCATION INCOME MAY HAVE THE ADDITIONAL INCOME TAX OWED ON THE INCOME PAID BY THE ORGANIZATION. EXECUTIVES MAY RECEIVE AS SEVERANCE BENEFITS CASH PAYMENTS IN LIEU OF PREMIUMS PAID FOR COVERAGE OF CERTAIN BENEFITS THAT ENDED WITH THE EXECUTIVE'S TERMINATION. THE ORGANIZATION MAY PAY THE ADDITIONAL TAX OWED ON ACCOUNT OF THESE PAYMENTS. DISCRETIONARY SPENDING ACCOUNT: CERTAIN EXECUTIVES RECEIVE A DISCRETIONARY SPENDING ACCOUNT. THE DOLLAR AMOUNT IN THE ACCOUNT IS PRE-APPROVED BY THE COMPENSATION AND LEADERSHIP COMMITTEE OF THE NOVANT HEALTH BOARD OF TRUSTEES. THE ACCOUNT CAN BE USED ONLY FOR AN APPROVED LIST OF EXPENDITURES. ALL OPTIONS OTHER THAN A DEFERRED, AT-RISK, COMPENSATION OPTION ARE CONSIDERED TAXABLE AND ARE INCLUDED IN THE EXECUTIVE'S TAXABLE INCOME AS PRESCRIBED BY THE APPLICABLE TAX LAWS. HOUSING ALLOWANCE OR RESIDENCE FOR PERSONAL USE: WE PROVIDE TEMPORARY HOUSING ALLOWANCES IN CERTAIN EXECUTIVE RECRUITMENT AND RELOCATION PACKAGES. IN THE CASE THAT SUCH EXPENSE IS NOT REIMBURSABLE UNDER THE ACCOUNTABLE PLAN RULES, THE VALUE IS CALCULATED UNDER APPLICABLE TAX LAWS AND THAT AMOUNT IS INCLUDED IN THE EXECUTIVE'S INCOME AS PRESCRIBED BY THE APPLICABLE TAX LAWS. HEALTH OR SOCIAL CLUB DUES OR INITIATION FEES: IN CASES WHERE CORPORATE MEMBERSHIPS ARE NOT AVAILABLE, A MEMBERSHIP MAY BE OBTAINED IN AN EXECUTIVE'S NAME WITH A "BUSINESS USE ONLY" RESTRICTION.
PART I, LINE 3THE FILING ORGANIZATION IS AN INTEGRAL PART OF NOVANT HEALTH, AN INTEGRATED HEALTHCARE SYSTEM. NOVANT HEALTH, INC. IS THE PARENT ORGANIZATION AND USES THE PROCESS DESCRIBED IN PART VI, LINE 15A OF THIS RETURN TO ESTABLISH THE COMPENSATION OF THE TOP MANAGEMENT OFFICIAL OF THE FILING ORGANIZATION. THIS PROCESS ADHERES TO THE REQUIREMENTS SET FORTH TO SECURE THE REBUTTABLE PRESUMPTION OF REASONABLENESS AND INCLUDES A REVIEW AND APPROVAL BY INDEPENDENT AND DISINTERESTED MEMBERS OF A COMPENSATION COMMITTEE, CONSULTATION WITH INDEPENDENT COMPENSATION CONSULTANTS, THE UTILIZATION OF THIRD-PARTY COMPARABILITY DATA SUCH AS PUBLISHED COMPENSATION SURVEYS, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION.
PART I, LINE 4BPART I, LINE 4A-C: SEVERANCE, NONQUALIFIED, AND EQUITY-BASED PAYMENTS SEVERANCE NONQUALIFIED EQUITY-BASED GREGORY, CHERE 0 52,500 0 NYCUM, LAWRENCE 0 28,125 0 SANZ, SEAN 0 25,550 0
PART III - OTHER ADDITIONAL INFORMATIONDESCRIPTIONS OF SUPPLEMENTAL EXECUTIVE BENEFITS INCLUDED IN PART VII AND SCHEDULE J: EXECUTIVE ANNUAL INCENTIVE PLAN: AS PART OF THE REPORTED COMPENSATION AMOUNTS, THE REPORTING ORGANIZATION PROVIDES ANNUAL INCENTIVE COMPENSATION TO CERTAIN KEY EXECUTIVES UNDER AN EXECUTIVE ANNUAL INCENTIVE PLAN. THE INCENTIVE PLAN IS DESIGNED TO OFFER OPPORTUNITIES FOR ADDITIONAL COMPENSATION, BUT ONLY TO THE EXTENT THAT ELIGIBLE EXECUTIVES HAVE PROVIDED EXTRAORDINARY SERVICES AND ACHIEVED EXTRAORDINARY RESULTS THAT MEET OR EXCEED PREDETERMINED GOALS IN THE AREAS OF QUALITY, PATIENT SATISFACTION, EMPLOYEE SATISFACTION AND FINANCIAL VITALITY. THESE GOALS ARE ESTABLISHED AND APPROVED BY INDEPENDENT AND DISINTERESTED MEMBERS OF THE NOVANT HEALTH BOARD OF TRUSTEES (WHO COMPRISE THE COMPENSATION AND LEADERSHIP COMMITTEE OF THE BOARD). THESE GOALS ARE WEIGHTED EQUALLY. THE ADDITIONAL COMPENSATION CAN RANGE ANYWHERE FROM ZERO TO A MAXIMUM PERCENTAGE OF BASE SALARY THAT DIFFERS BY THE CLASS OF EXECUTIVE. IN ADDITION, THE COMPENSATION AND LEADERSHIP COMMITTEE OF THE BOARD WHO OVERSEE THE INCENTIVE COMPENSATION PROGRAM APPLY TWO "CIRCUIT BREAKERS," WHICH ARE SUBSTANTIAL LEVELS OF ORGANIZATION-WIDE ACHIEVEMENT THAT MUST BE SATISFIED BEFORE ANY AWARDS ARE PAID TO ANY EXECUTIVE UNDER THE PROGRAM. THE INCENTIVE COMPENSATION AWARDS HAVE BEEN INCLUDED IN THE COMPENSATION AMOUNTS REPORTED IN PART VII AND IN COLUMN (B)(II) OF SCHEDULE J. THEY ARE REPORTED IN THE YEAR PAID. THE COMPENSATION AND LEADERSHIP COMMITTEE OF THE BOARD REVIEW, APPROVE, AND OVERSEE ALL ASPECTS AND ALL ELEMENTS OF EXECUTIVE COMPENSATION AND BENEFITS, INCLUDING THE AMOUNTS AWARDED UNDER THIS ANNUAL INCENTIVE PLAN. LONG-TERM INCENTIVE PLAN: THE REPORTING ORGANIZATION OFFERS A LONG-TERM INCENTIVE PLAN (THE "PLAN") TO CERTAIN KEY EXECUTIVES. THE PLAN TIES A KEY EXECUTIVE'S COMPENSATION TO THE ORGANIZATION'S LONG-TERM STRATEGIC PERFORMANCE, PROVIDES A RETENTION INCENTIVE FOR KEY EXECUTIVES, AND ALLOWS THE ORGANIZATION TO COMPETE IN THE MARKETPLACE FOR TOP LEADERSHIP TALENT. THE PLAN OPERATES ON THREE-YEAR PERFORMANCE CYCLES THAT BEGIN EACH YEAR. LONG-TERM STRATEGIC GOALS (IN THE PRINCIPAL AREAS OF QUALITY OF PATIENT CARE AND LONG-TERM FINANCIAL STRENGTH) ARE ESTABLISHED AND APPROVED FOR EACH CYCLE, IN ADVANCE, BY INDEPENDENT AND DISINTERESTED MEMBERS OF THE NOVANT HEALTH BOARD OF TRUSTEES (WHO COMPRISE THE COMPENSATION AND LEADERSHIP COMMITTEE OF THE BOARD). NOVANT HEALTH'S INTERNAL AUDIT DEPARTMENT REVIEWS THE METHODOLOGY AND PROCESS USED TO DETERMINE ACHIEVEMENT OF THE QUALITY METRICS. IN ADDITION, THE COMPENSATION AND LEADERSHIP COMMITTEE OF THE BOARD WHO OVERSEE THE INCENTIVE COMPENSATION PROGRAM APPLY TWO "CIRCUIT BREAKERS," RELATING TO COMMUNITY HEALTH NEEDS ASSESSMENTS AND IMPLEMENTATION PLANS, AND FINANCIAL PERFORMANCE; AWARDS ARE PAYABLE FOR A PARTICULAR THREE-YEAR PERFORMANCE CYCLE ONLY IF THE CIRCUIT BREAKERS ARE MET FOR THE RESPECTIVE THREE-YEAR PERFORMANCE PERIOD. IF AN AWARD IS EARNED AT THE END OF A PERFORMANCE CYCLE, THEN THE INCENTIVE AWARD IS PAID OUT AND IS INCLUDED IN THE COMPENSATION AMOUNTS REPORTED IN PART VII AND IN COLUMN (B)(II) OF SCHEDULE J. THEY ARE REPORTED IN THE YEAR PAID. THE COMPENSATION AND LEADERSHIP COMMITTEE OF THE BOARD REVIEWS, APPROVES, AND OVERSEES ALL ASPECTS AND ALL ELEMENTS OF EXECUTIVE COMPENSATION AND BENEFITS, INCLUDING THE AMOUNTS AWARDED UNDER THE PLAN. PART I, LINE 4A - SEVERANCE PLAN: ELIGIBLE EXECUTIVES MAY RECEIVE SEVERANCE PAY THAT IS BASED ON ANNUAL COMPENSATION FOR A SPECIFIED PERIOD OF TIME. THE SEVERANCE PAY WOULD BE PAID ONLY IN THE EVENT OF CERTAIN TYPES OF EMPLOYMENT TERMINATION, AND IS FURTHER CONTINGENT ON THE SATISFACTION OF OTHER CONDITIONS SUCH AS COMPLIANCE WITH A NON-COMPETITION COVENANT. ANY CURRENT YEAR PAYMENTS HAVE BEEN INCLUDED IN THE COMPENSATION AMOUNTS REPORTED IN PART VII AND IN COLUMN (B)(III) OF SCHEDULE J. THE COMPENSATION AND LEADERSHIP COMMITTEE OF THE BOARD REVIEWS, APPROVES, AND OVERSEES ALL ASPECTS AND ALL ELEMENTS OF EXECUTIVE COMPENSATION AND BENEFITS, INCLUDING THE AMOUNTS AWARDED UNDER THIS SEVERANCE PLAN. PART I, LINE 4B - SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANS: THE SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN ("SERP") IS INTENDED TO SUPPORT RETENTION OF KEY EXECUTIVES, AND TO OFFER COMPETITIVE TOTAL COMPENSATION. ELIGIBLE EXECUTIVES WILL BE NOMINATED BY THE CEO AND APPROVED BY THE COMMITTEE TO PARTICIPATE. GENERALLY, ANNUAL CONTRIBUTIONS TO THE PLAN OR PAYMENTS TO PARTICIPANTS WILL BE BASED ON A PERCENTAGE OF THE PARTICIPANT'S BASE SALARY AS OF JANUARY 1ST OF THE PREVIOUS PLAN YEAR AND ARE REPORTED IN COLUMN (C) OF SCHEDULE J. PRIOR TO MAKING THE CONTRIBUTIONS OR PAYMENTS, THE COMMITTEE WILL APPROVE THE AMOUNTS AS TO REASONABLENESS, WHEN COMBINED WITH ALL OTHER ANNUAL COMPENSATION. A 3 YEAR CLASS-YEAR VESTING PERIOD WILL APPLY UP TO AGE 62, WHEN ALL MONEY WOULD BE VESTED AND PAID OUT TO THE PARTICIPANT. OTHERWISE, VESTING WILL OCCUR ON JANUARY 1ST OF EACH YEAR FOR THE APPROPRIATE CLASS-YEAR VESTING PERIOD. THE COMPENSATION AND LEADERSHIP COMMITTEE OF THE BOARD REVIEWS, APPROVES, AND OVERSEES ALL ASPECTS AND ALL ELEMENTS OF EXECUTIVE COMPENSATION AND BENEFITS INCLUDING THE AMOUNTS AWARDED UNDER THE PLAN.

Schedule L IRS990ScheduleL

Loans Btwn Org Interested Prsn LoansBtwnOrgInterestedPrsnGrp

FieldValueIRS element (for citing)
PersonCHERE GREGORYPersonNm
Relationship With OrgEMPLOYEERelationshipWithOrgTxt
Loan PurposeEMPLOYMENT RELATEDLoanPurposeTxt
Loan From OrganizationYes (X)LoanFromOrganizationInd
Original Principal$63,125OriginalPrincipalAmt
Balance Due$20BalanceDueAmt
Default0DefaultInd
Board Or Committee ApprovalYes (1)BoardOrCommitteeApprovalInd
Written AgreementYes (1)WrittenAgreementInd
FieldValueIRS element (for citing)
Total Balance Due$20TotalBalanceDueAmt

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

FieldValueIRS element (for citing)
PersonMARY E WALLEYPersonNm
FieldValueIRS element (for citing)
Relationship DescriptionFAMILY MEMBER OF BRUCE WALLEY, KEY EMPLOYEERelationshipDescriptionTxt
Transaction$93,255TransactionAmt
TransactionCOMPENSATION PAID BY THE FILING ORGANIZATION TO A FAMILY MEMBER OF THE INTERESTED PERSON.TransactionDesc
Sharing Of Revenues0SharingOfRevenuesInd

Schedule M IRS990ScheduleM

Works Of Art WorksOfArtGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
Contribution1ContributionCnt
Noncash Contributions Rpt F990$5,452NoncashContributionsRptF990Amt
Method Of Determining RevenuesFMVMethodOfDeterminingRevenuesTxt
FieldValueIRS element (for citing)
Form8283 Received0Form8283ReceivedCnt
Any Property That Must Be Held0AnyPropertyThatMustBeHeldInd
Review Process Unusual NC GiftsYes (1)ReviewProcessUnusualNCGiftsInd
Third Parties Used0ThirdPartiesUsedInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, COLUMN (B):FormAndLineReferenceDesc
ExplanationNUMBER OF CONTRIBUTIONSExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PI, L1: ORGANIZATION'S MISSION OR MOST SIGNIFICANT ACTIVITIESFORSYTH MEMORIAL HOSPITAL, INC. DOING BUSINESS AS NOVANT HEALTH FORSYTH MEDICAL CENTER ("NHFMC") IS AN INTEGRAL PART OF THE NOVANT HEALTH SYSTEM (COLLECTIVELY KNOWN AS "NOVANT HEALTH"), A NOT-FOR-PROFIT INTEGRATED GROUP OF HOSPITALS, PHYSICIAN CLINICS, OUTPATIENT CENTERS AND OTHER HEALTHCARE SERVICE PROVIDERS. NOVANT HEALTH CONSISTS OF MORE THAN 1,200 PHYSICIANS AND 26,000 EMPLOYEES WHO MAKE HEALTHCARE REMARKABLE AT NEARLY 500 LOCATIONS, INCLUDING 14 MEDICAL CENTERS AND HUNDREDS OF OUTPATIENT FACILITIES AND PHYSICIAN CLINICS. HEADQUARTERED IN WINSTON-SALEM, NC, NOVANT HEALTH IS COMMITTED TO MAKING HEALTHCARE REMARKABLE FOR PATIENTS AND COMMUNITIES, SERVING MORE THAN FOUR MILLION PATIENTS ANNUALLY. NOVANT HEALTH IS RANKED AS ONE OF THE NATION'S TOP 20 INTEGRATED DELIVERY NETWORKS BY IMS HEALTH. IN 2014, THE NOVANT HEALTH SYSTEM REPORTED $3.8 BILLION IN REVENUES. GENERAL INFORMATION NHFMC IS A TERTIARY HOSPITAL COMMITTED TO IMPROVING THE HEALTH OF OUR COMMUNITIES IN THE PIEDMONT TRIAD REGION OF NC, ONE PERSON AT A TIME. IT OFFERS A FULL CONTINUUM OF EMERGENCY, MEDICAL, SURGICAL, REHABILITATIVE AND BEHAVIORAL HEALTH SERVICES. CENTERS OF EXCELLENCE INCLUDE THE FOLLOWING: NOVANT HEALTH MAYA ANGELOU WOMEN'S HEALTH AND WELLNESS CENTER, NOVANT HEALTH HEART AND VASCULAR INSTITUTE, NOVANT HEALTH DERRICK L. DAVIS CANCER CENTER, NOVANT HEALTH STROKE AND NEUROSCIENCES SPECIALISTS, NOVANT HEALTH ORTHOPEDIC CENTER AND NOVANT HEALTH FORSYTH BEHAVIORAL HEALTH. IN ADDITION, NHFMC IS FOCUSED ON PROVIDING COMMUNITY SUPPORT, CONSISTENT QUALITY, EXCELLENT SERVICE AND A REMARKABLE WORK ENVIRONMENT FOR STAFF. IN ITS THIRD FULL YEAR OF OPERATION, NOVANT HEALTH FORSYTH MEDICAL CENTER AFFILIATE HOSPITAL, NOVANT HEALTH KERNERSVILLE MEDICAL CENTER IN KERNERSVILLE, NC, FOCUSED ON PROVIDING A REMARKABLE PATIENT EXPERIENCE VIA A FAST-ACCESS EMERGENCY DEPARTMENT, GENERAL, ORTHOPEDIC AND EYE SURGICAL SERVICES, CONSISTENT QUALITY, AND EXCELLENT SERVICE TO RESIDENTS IN THE KERNERSVILLE AREA, WESTERN GUILFORD AND ROCKINGHAM COUNTIES OF NC, AS WELL AS EASTERN STOKES AND FORSYTH COUNTIES OF NC. IN ADDITION, THE MEDICAL CENTER OPENED A BREAST HEALTH CENTER AND A CANCER CENTER IN 2014. NOVANT HEALTH FORSYTH MEDICAL CENTER'S AFFILIATE HOSPITAL, NOVANT HEALTH CLEMMONS MEDICAL CENTER IN CLEMMONS, NC FOCUSED ON PROVIDING A REMARKABLE PATIENT EXPERIENCE VIA A FAST-ACCESS EMERGENCY DEPARTMENT, GENERAL, ORTHOPEDIC, PODIATRIC AND EAR, NOSE AND THROAT SURGICAL SERVICES, CONSISTENT QUALITY, AND EXCELLENT SERVICE TO RESIDENTS IN WESTERN FORSYTH COUNTY, DAVIE COUNTY AND YADKIN COUNTY. IN ADDITION TO OUR QUALITY OF SERVICES AND COMPREHENSIVE CATEGORIES OF SERVICE, WE'RE VERY PROUD OF OUR PATIENT FINANCIAL ASSISTANCE PROGRAM. WE WORK WITH CUSTOMERS TO HELP QUALIFY THEM FOR PUBLIC ASSISTANCE, ESTABLISH A REASONABLE PAYMENT PLAN, DISCOUNT THEIR BILL OR PROVIDE THEM WITH FREE CHARITY CARE. NEW TECHNOLOGY & SERVICES DURING 2014, NHFMC EXPANDED ACCESS TO MEDICAL CARE AND PROVIDED ADDITIONAL RESOURCES TO HELP PATIENTS AND OUR LOCAL COMMUNITIES GET BETTER AND STAY HEALTHY. NOVANT HEALTH PATIENTS DISCHARGED FROM NHFMC EXPERIENCE A SIMPLER TRANSITION TO HOME FROM THE HOSPITAL DUE TO READY AT HOME. THE PROGRAM'S TEAM COORDINATES DETAILS AROUND A PATIENT'S DISCHARGE AND AT-HOME MEDICATIONS. IF PATIENTS NEED MEDICATIONS OR OTHER HEALTHCARE SUPPLIES, THE TEAM'S TRANSITION SPECIALISTS PROVIDE AFFORDABLE SOLUTIONS. SINCE DISCHARGE MEDICATIONS AND SUPPLIES ARE NOT INCLUDED IN THE HOSPITAL BILL, READY AT HOME HELPS MAKE SURE THEY ARE PROPERLY PROCESSED BY THE INSURER. NEARLY HALF OF ALL AMERICANS NEVER FILL THEIR PRESCRIPTIONS, FILL THEM BUT NEVER TAKE THE DRUG, OR DON'T TAKE THE FULL DOSE. READY AT HOME IS ADDRESSING THAT PROBLEM. A CONCURRENT ELECTRONIC HEALTH RECORD (EHR) INITIATIVE IS BEING UNDERTAKEN BY BOTH THE ACUTE AND AMBULATORY FACILITIES IN THE NOVANT HEALTH SYSTEM. IN JULY, 2013, NOVANT HEALTH MEDICAL GROUP FINALIZED THE IMPLEMENTATION OF THE EHR IN ALL PHYSICIAN PRACTICES ACROSS THE NOVANT HEALTH SYSTEM. MANY NOVANT HEALTH FACILITIES HAVE SUCCESSFULLY IMPLEMENTED THE EHR AND CLINICIANS CAN NOW SHARE PATIENTS' MEDICAL INFORMATION BETWEEN PHYSICIAN OFFICES, OUTPATIENT CENTERS AND HOSPITALS. THIS SHARING OF INFORMATION IMPROVES SAFETY AND COORDINATION OF CARE AND PROMOTES CONNECTIVITY AND COMMUNICATION BETWEEN HOSPITAL CAREGIVERS, SPECIALISTS AND PRIMARY CARE PROVIDERS. EMBARKING ON THE JOURNEY TO CREATE A SHARED EHR IS THE MOST SIGNIFICANT AND IMPORTANT INVESTMENT NOVANT HEALTH HAS EVER MADE FOR ITS PATIENTS, STAFF AND PHYSICIANS. AWARDS, RECOGNITIONS & RECERTIFICATIONS WE ARE PROUD OF THE ACHIEVEMENTS IN QUALITY THIS YEAR AS WE RANK WELL ABOVE STATE AVERAGES IN HEART ATTACK, HEART FAILURE AND PNEUMONIA CARE. IN ADDITION, NHFMC'S BREAST CANCER CENTER PROGRAM IS NATIONALLY CERTIFIED. THE CENTER'S STROKE AND NEUROSCIENCES INSTITUTE AND CARDIAC AND VASCULAR CENTER HEART FAILURE PROGRAM AND STROKE REHABILITATION PROGRAM ARE ALL NATIONALLY ACCREDITED AS WELL AS ITS TOTAL HIP AND KNEE JOINT REPLACEMENT PROGRAM. NHFMC IS AMONG 22 HOSPITALS NATIONWIDE TO EARN THE ADVANCED COMPREHENSIVE STROKE CENTER DESIGNATION FROM THE JOINT COMMISSION AND THE AMERICAN HEART ASSOCIATION/AMERICAN STROKE ASSOCIATION. THE DESIGNATION WAS EARNED FOR HAVING ADVANCED CAPABILITIES AND EXPERTISE IN TREATING THE MOST COMPLEX STROKE CASES. NHFMC'S HEART FAILURE PROGRAM RECEIVED ADVANCED HEART FAILURE CERTIFICATION FOR EXCEPTIONAL EFFORTS TO IMPROVE HEART FAILURE PATIENT OUTCOMES AND THE AMERICAN COLLEGE OF SURGEONS NAMED NHFMC WITHIN ITS NATIONAL SURGICAL QUALITY IMPROVEMENT PROGRAM. THE NOVANT HEALTH MAYA ANGELOU WOMEN'S HEALTH AND WELLNESS CENTER WAS DESIGNATED A CENTER OF EXCELLENCE IN MINIMALLY INVASIVE GYNECOLOGIC SURGERY BY THE AMERICAN ASSOCIATION OF GYNECOLOGIC LAPAROSCOPISTS. NHFMC HAS BEEN RECOGNIZED FOR ACHIEVING THE TOP 10 PERCENT OF HOSPITALS NATIONALLY FOR PATIENT SATISFACTION BASED ON HOSPITAL CONSUMER ASSESSMENT OF HEALTHCARE PROVIDERS AND SYSTEMS DATA. IN ADDITION, U.S. NEWS & WORLD REPORT RELEASED ITS 2013-2014 BEST HOSPITALS REPORT, RANKING NHFMC IN EIGHT SPECIALTIES: DIABETES & ENDOCRINOLOGY, GASTROENTEROLOGY & GI SURGERY, GERIATRICS, GYNECOLOGY, NEPHROLOGY, NEUROLOGY & NEUROSURGERY, ORTHOPEDICS AND PULMONOLOGY. OUR COMMITMENT TO EXCELLENCE IN PATIENT CARE, INCLUDING NURSING CARE, CONTINUED DURING THE YEAR. NHFMC IS AMONG ONLY 6.9 PERCENT OF HOSPITALS IN THE UNITED STATES TO BE DESIGNATED BY THE AMERICAN NURSES CREDENTIALING CENTER AS A MAGNET FACILITY, CONFIRMING THE EXCEPTIONAL QUALITY OF CARE THAT OUR NURSES PROVIDE. AT THE STATE LEVEL, TWO NURSES FROM NHFMC WERE SELECTED BY THE NORTH CAROLINA NURSES' ASSOCIATION TO BE AMONG THE "GREAT 100 NURSES." OVER THE PAST SEVERAL YEARS, NHFMC HAS ACHIEVED SIGNIFICANT PROGRESS IN THIS AREA BY PROVIDING SAFETY EDUCATION FOR ALL TEAM MEMBERS AND MAKING CHANGES IN AREAS WHERE THE FREQUENCY OF SERIOUS SAFETY EVENTS IS GREATER THAN ZERO. IN 2013, NHFMC IMPLEMENTED NEW BIOMETRIC TECHNOLOGY TO AID PATIENT SAFETY. THE RIGHTPATIENT BIOMETRIC PATIENT IDENTIFICATION SYSTEM IS NOW PART OF THE ADMISSION PROCESS AND USES IRIS RECOGNITION TO IDENTIFY PATIENTS. THIS TECHNOLOGY IMPROVES PATIENT SAFETY BY ACCURATELY IDENTIFYING PATIENTS AND LIMITING DUPLICATE MEDICAL RECORDS. IT ALSO HELPS TO ELIMINATE MEDICAL IDENTIFY THEFT AT THE POINT OF SERVICE. ACCREDITATION NHFMC HAS BEEN FULLY ACCREDITED BY THE JOINT COMMISSION, AN INDEPENDENT ORGANIZATION THAT EVALUATES A HEALTHCARE ORGANIZATION'S PERFORMANCE IN AREAS THAT MOST AFFECT PATIENT HEALTH AND SAFETY. IN 2014, NHFMC ALSO PASSED A SUCCESSFUL SURVEY BY THE JOINT COMMISSION TO ACHIEVE ACCREDITATION FOR ADVANCED PALLIATIVE CARE. THE ONSITE SURVEYOR CONGRATULATED STAFF FOR HAVING A "PHENOMENAL" PROGRAM THAT IS A NATIONAL LEADER IN TEAMWORK, BEST PRACTICES AND DATA UTILIZATION. NHKMC SUCCESSFULLY COMPLETED ITS SECOND JOINT COMMISSION ACCREDITATION SURVEY WITH OUTSTANDING RESULTS. COMMUNITY BENEFIT REPORT HTTP://WWW.NOVANTHEALTH.ORG/HOME/ABOUT-US/COMPANY-INFORMATION/FINANCIAL -PROFILE/COMMUNITY-BENEFIT-REPORT.ASPX THE COMMUNITY BENEFIT REPORT PREPARED BY NOVANT HEALTH IS A SYSTEM-WIDE REPORT THAT INCLUDES QUALITATIVE AND QUANTITATIVE INFORMATION. PLEASE NOTE THAT THE NUMERIC DATA IN THIS REPORT IS NOT BASED UPON THE FORM 990, SCHEDULE H CRITERIA, BUT RATHER IT HAS BEEN PREPARED IN ACCORDANCE WITH THE NORTH CAROLINA HOSPITAL ASSOCIATION REPORTING GUIDELINES. IT SHOULD NOT BE RELIED UPON AS THE ORGANIZATION'S FORM 990, SCHEDULE H COMMUNITY BENEFIT REPORT, ITS COMMUNITY HEALTH NEEDS ASSESSMENT OR COMMUNITY BENEFIT IMPLEMENTATION STRATEGY. IN THIS REPORT, THE NOVANT HEALTH SYSTEM'S COMMUNITY BENEFIT WAS APPROXIMATELY $639,000,000, INCLUDING $135,000,000 IN CHARITY CARE FOR 2014.
FORM 990, PART III, LINE 1: MISSION, VISION, AND VALUESMISSION: NOVANT HEALTH EXISTS TO IMPROVE THE HEALTH OF COMMUNITIES, ONE PERSON AT A TIME. VISION: WE, THE NOVANT HEALTH TEAM, WILL DELIVER THE MOST REMARKABLE PATIENT EXPERIENCE, IN EVERY DIMENSION, EVERY TIME. VALUES: - COMPASSION: WE TREAT OUR CUSTOMERS AND THEIR FAMILIES, STAFF AND OTHER HEALTHCARE PROVIDERS AS FAMILY MEMBERS BY SHOWING THEM KINDNESS, PATIENCE, EMPATHY AND RESPECT. - DIVERSITY AND INCLUSION: WE RECOGNIZE THAT EVERY PERSON IS DIFFERENT, EACH SHAPED BY UNIQUE LIFE EXPERIENCES. THIS ENABLES US TO BETTER UNDERSTAND ONE ANOTHER AND OUR CUSTOMERS. BY ENGAGING THE STRENGTHS AND TALENTS OF EACH TEAM MEMBER, WE ENSURE A STRONG ORGANIZATION CAPABLE OF PROVIDING REMARKABLE HEALTHCARE TO OUR PATIENTS, FAMILIES AND COMMUNITIES. - PERSONAL EXCELLENCE: WE STRIVE TO GROW PERSONALLY AND PROFESSIONALLY, AND WE APPROACH EACH SERVICE OPPORTUNITY WITH A POSITIVE, FLEXIBLE ATTITUDE. HONESTY AND PERSONAL INTEGRITY GUIDE ALL THAT WE DO. - TEAMWORK: THE NEEDS AND EXPECTATIONS OF ANY ONE CUSTOMER ARE GREATER THAN THAT WHICH ONE PERSON'S SERVICE EFFORTS CAN SATISFY. WE SUPPORT EACH OTHER SO THAT TOGETHER AS A TEAM, WE CAN BE SUCCESSFUL IN THE EYE OF THE CUSTOMER AS A QUALITY SERVICE PROVIDER. - COURAGE: WE ACT BOLDLY IN MAKING THE CHANGES NECESSARY TO ACHIEVE OUR MISSION, VISION AND PROMISE OF DELIVERING REMARKABLE HEALTHCARE. OUR PROMISE TO PATIENTS WE ARE MAKING YOUR HEALTHCARE EXPERIENCE REMARKABLE. WE WILL BRING YOU WORLD-CLASS CLINICIANS, CARE AND TECHNOLOGY - WHEN AND WHERE YOU NEED THEM. WE ARE REINVENTING THE HEALTHCARE EXPERIENCE TO BE SIMPLER, MORE CONVENIENT AND MORE AFFORDABLE, SO THAT YOU CAN FOCUS ON GETTING BETTER AND STAYING HEALTHY.
FORM 990, PART I, LINE 6:THE NUMBER OF VOLUNTEERS REPORTED INCLUDES THOSE VOLUNTEERS SERVING AS BOARD MEMBERS.
FORM 990, PART III, LINE 4A: PROGRAM SERVICE ACCOMPLISHMENTSKMC HAS 50 LICENSED BEDS. DURING 2014 THERE WERE 9,303 PATIENT DAYS WITH AN AVERAGE LENGTH OF STAY OF 4 DAYS, AND AVERAGE DAILY CENSUS OF 25, AND 2,540 DISCHARGES. THERE WERE 3,070 INPATIENT AND OUTPATIENT SURGERIES, A TOTAL OF 40,267 OUTPATIENT ENCOUNTERS AND 31,034 EMERGENCY DEPARTMENT VISITS. DURING 2014 CMC HAD 928 OUTPATIENT SURGERIES, A TOTAL OF 12,920 OUTPATIENT ENCOUNTERS AND 11,640 EMERGENCY DEPARTMENT VISITS.
FORM 990, PART VI, SECTION A, LINE 6FORM 990, PART VI, SECTION A, LINE 6: CLASSES OF MEMBERS OR STOCKHOLDERS THE CORPORATION IS A NONPROFIT CORPORATION WITH MEMBERS (OR A MEMBER).
FORM 990, PART VI, SECTION A, LINE 7AFORM 990, PART VI, SECTION A, LINE 7A: ELECTION OF MEMBERS AND THEIR RIGHTS NOVANT HEALTH, INC. ELECTS ALL MEMBERS OF THE GOVERNING BODY OF FORSYTH MEMORIAL HOSPITAL,INC.
FORM 990, PART VI, SECTION A, LINE 7BFORM 990, PART VI, SECTION A, LINE 7B: DECISIONS SUBJECT TO APPROVAL OF MEMBERS NOVANT HEALTH, INC. HAS CERTAIN RESERVED POWERS, SUCH AS APPROVAL OF AMENDMENTS TO THE ARTICLES AND BYLAWS OF THE CORPORATION, AND TO ADOPT CERTAIN POLICIES WHICH SHALL BE IMPLEMENTED BY THE CORPORATION BOARD.
FORM 990, PART VI, SECTION B, LINE 11FORM 990, PART VI, SECTION B, LINE 11: ORGANIZATION'S PROCESS TO REVIEW FORM 990 THE BOARD HAS DELEGATED REVIEW OF THE FORM 990 TO NOVANT HEALTH'S AUDIT AND COMPLIANCE COMMITTEE ("THE COMMITTEE"), WHICH OVERSEES TAX MATTERS FOR NOVANT HEALTH. THE COMMITTEE IS THE REVIEW BODY FOR ALL OF THE FORM 990S FILED FOR ORGANIZATIONS WITHIN THE NOVANT HEALTH SYSTEM. THE COMMITTEE MEETS BEFORE THE FORM 990S ARE FILED WITH THE IRS AND AFTER ALL BOARD MEMBERS HAVE RECEIVED A COPY OF THE FORM 990 AND A SUMMARY OF ITS CONTENTS. THE SENIOR DIRECTOR OF TAX AND LEGAL COUNSEL FOR NOVANT HEALTH ATTEND THE MEETING TO ANSWER ANY QUESTIONS AND ADDRESS ANY SIGNIFICANT DISCLOSURES WITHIN THE FORM 990.
FORM 990, PART VI, SECTION B, LINE 12CFORM 990, PART VI, SECTION B, LINE 12C: MONITORING AND ENFORCEMENT OF COI THE ORGANIZATION'S TRUSTEE CONFLICT OF INTEREST POLICY APPLIES TO ALL TRUSTEES, PRINCIPAL OFFICERS OR MEMBERS OF A COMMITTEE WITH BOARD DELEGATED POWERS INCLUDING ANY APPLICABLE DISREGARDED ENTITIES. ALL TRUSTEES ARE SENT AN ANNUAL DISCLOSURE FORM. THE TRUSTEE ANNUAL DISCLOSURE FORMS ARE REVIEWED BY THE LEGAL DEPARTMENT. WITH RESPECT TO PARTICULAR TRANSACTIONS THAT COME BEFORE THE BOARD, THE CONFLICT OF INTEREST POLICY WOULD BE FOLLOWED. THE POTENTIAL CONFLICT OF INTEREST WOULD BE DISCLOSED BY THE BOARD MEMBER BEFORE A VOTE ON THE TRANSACTION AND THE REST OF THE BOARD WOULD DETERMINE WHETHER A CONFLICT OF INTEREST EXISTS. IF THE REST OF THE BOARD DETERMINED THAT A CONFLICT OF INTEREST EXISTED THEN THE BOARD MEMBER WITH THE CONFLICT OF INTEREST WOULD NOT PARTICIPATE IN THE DELIBERATIONS AND VOTE.
FORM 990, PART VI, SECTION B, LINE 15BFORM 990, PART VI, SECTION B, LINE 15A: COMPENSATION PROCESS FOR TOP OFFICIAL THE FILING ORGANIZATION IS AN INTEGRAL PART OF NOVANT HEALTH, AN INTEGRATED HEALTHCARE SYSTEM COLLECTIVELY REFERRED TO AS "NOVANT HEALTH." NOVANT HEALTH, INC. IS THE PARENT ORGANIZATION AND INDEPENDENT AND DISINTERESTED MEMBERS OF THE NOVANT HEALTH, INC. BOARD OF TRUSTEES (WHO COMPRISE THE COMPENSATION AND LEADERSHIP COMMITTEE OF THE BOARD) REVIEW, APPROVE, AND OVERSEE ALL ASPECTS OF COMPENSATION AND BENEFITS FOR CERTAIN EXECUTIVES ("EXECUTIVES") SERVING AS THE TOP MANAGEMENT OFFICIAL(S) FOR NOVANT HEALTH ENTITIES. THE COMMITTEE WORKS WITH AN INDEPENDENT COMPENSATION CONSULTANT AND USES THIRD PARTY COMPARABILITY DATA FOR FUNCTIONALLY SIMILAR POSITIONS AT SIMILARLY SITUATED ORGANIZATIONS TO ENSURE THAT TOTAL COMPENSATION AND BENEFITS FOR EACH EXECUTIVE IS REASONABLE FOR THAT EXECUTIVE'S POSITION. THE COMMITTEE REVIEWS AND APPROVES EXECUTIVE COMPENSATION AND BENEFITS ANNUALLY, CONSISTENT WITH THE WRITTEN EXECUTIVE COMPENSATION PHILOSOPHY OF NOVANT HEALTH, AND IN A MANNER THAT QUALIFIES FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS, THEREBY ASSURING THAT TOTAL COMPENSATION AND BENEFITS PROVIDED TO EACH EXECUTIVE IS REASONABLE. FORM 990, PART VI, SECTION B, LINE 15B: COMPENSATION PROCESS FOR OFFICERS THE FILING ORGANIZATION IS AN INTEGRAL PART OF NOVANT HEALTH, AN INTEGRATED HEALTHCARE SYSTEM COLLECTIVELY REFERRED TO AS "NOVANT HEALTH." NOVANT HEALTH, INC. IS THE PARENT ORGANIZATION AND INDEPENDENT AND DISINTERESTED MEMBERS OF THE NOVANT HEALTH, INC. BOARD OF TRUSTEES (WHO COMPRISE THE COMPENSATION AND LEADERSHIP COMMITTEE OF THE BOARD) REVIEW, APPROVE, AND OVERSEE ALL ASPECTS OF COMPENSATION AND BENEFITS FOR CERTAIN LEADERS AND EXECUTIVES ("EXECUTIVES") SERVING AS OFFICERS OR KEY EMPLOYEES FOR NOVANT HEALTH ENTITIES. THE COMMITTEE WORKS WITH AN INDEPENDENT COMPENSATION CONSULTANT AND USES THIRD PARTY COMPARABILITY DATA FOR FUNCTIONALLY SIMILAR POSITIONS AT SIMILARLY SITUATED ORGANIZATIONS TO ENSURE THAT TOTAL COMPENSATION AND BENEFITS FOR EACH EXECUTIVE IS REASONABLE FOR THAT EXECUTIVE'S POSITION. THE COMMITTEE REVIEWS AND APPROVES EXECUTIVE COMPENSATION AND BENEFITS ANNUALLY, CONSISTENT WITH THE WRITTEN EXECUTIVE COMPENSATION PHILOSOPHY OF NOVANT HEALTH, AND IN A MANNER THAT QUALIFIES FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS, THEREBY ASSURING THAT TOTAL COMPENSATION AND BENEFITS PROVIDED TO EACH EXECUTIVE IS REASONABLE.
FORM 990, PART VI, SECTION C, LINE 19FORM 990, PART VI, SECTION C, LINE 19: GOVERNING DOCUMENTS DISCLOSURE THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS CONTAINING ALL ORGANIZATIONS IN THE NOVANT HEALTH SYSTEM ARE POSTED TO THE NOVANT HEALTH WEBSITE. THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT AVAILABLE TO THE PUBLIC.
FORM 990, PART VII, SECTION A, COLUMN B: RELATED ORGANIZATIONSTHE ORGANIZATION EMPLOYS CERTAIN EXECUTIVES WHOSE ROLES ARE SUCH THAT THEY PROVIDE SERVICES TO NOT ONLY THE ORGANIZATION, BUT ALSO TO SOME OR ALL OF THE OTHER TAX-EXEMPT ORGANIZATIONS WITHIN THE NOVANT HEALTH HEALTHCARE SYSTEM. FOR EXAMPLE, MANY OF THESE EXECUTIVES' ROLES FOCUS ON PARTICULAR SERVICE LINES WHICH CROSS THE VARIOUS GEOGRAPHIC MARKETS OUR ORGANIZATIONS SERVE, THUS THE SERVICES PROVIDED BY THESE EXECUTIVES MAY BENEFIT AND BE RECEIVED BY MULTIPLE ORGANIZATIONS WITHIN THE SYSTEM. THE EXECUTIVES DO NOT ALLOCATE THEIR HOURS BETWEEN THE VARIOUS ORGANIZATIONS, BUT RATHER THEIR TIME SPENT ON SERVICES TO THE ORGANIZATION IS INCLUSIVE OF SERVICES TO ALL OF THE ORGANIZATIONS THEY SERVE WITHIN THE SYSTEM.
FORM 990, PART XI, LINE 9:FMCF AND AUXILIARY OF FMC CONTRIBUTION: -2,574,510. MALPRACTICE INSURANCE: -3,817,958. AFFILIATE TRANSFERS: -1,752,670. ROUNDING: 4.

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp (3 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdTotal IncomeTotalIncomeAmtEnd Of Year AssetsEndOfYearAssetsAmtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Txt
EXCEL IMAGING LLC
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103204253946INACTIVENC$0$0FORSYTH MEMORIAL HOSPITAL
SALEM MRI LLC
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103INACTIVENC$0$0FORSYTH MEMORIAL HOSPITAL
THE BREAST CLINIC MRI LLC
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103INACTIVENC$0$0FORSYTH MEMORIAL HOSPITAL

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (23 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationIndDirect Controlling NADirectControllingNACd
AUXILIARY OF FORSYTH MEMORIAL HOSPITAL
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103560862112HEALTHCARENC501(C)(3)LINE 9FORSYTH MEMORIAL HOSPITAL INCYes (1)
BRUNSWICK NOVANT MEDICAL CENTER FOUNDATION
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103274616751HEALTHCARENC501(C)(3)LINE 7BRUNSWICK COMMUNITY HOSPITAL LLC0
CAROLINA MEDICORP ENTERPRISES INC
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103581466368HEALTHCARENC501(C)(3)LINE 11B, IINOVANT MEDICAL GROUP INC0
COMMUNITY GENERAL HEALTH PARTNERS INC
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103560636250HEALTHCARENC501(C)(3)LINE 3NOVANT HEALTH TRIAD REGION LLC0
COMMUNITY GENERAL HOSPITAL FOUNDATION INC
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103561828629HEALTHCARENC501(C)(3)LINE 7COMMUNITY GENERAL HEALTH PARTNERS INC0
FORSYTH MEDICAL CENTER FOUNDATION
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103562120959HEALTHCARENC501(C)(3)LINE 7FORSYTH MEMORIAL HOSPITAL INCYes (1)
FOUNDATION HEALTH SYSTEMS CORP
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103561373175HEALTHCARENC501(C)(3)LINE 9NOVANT HEALTH INC0
MEDICAL PARK HOSPITAL INC
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103561340424HEALTHCARENC501(C)(3)LINE 3NOVANT HEALTH TRIAD REGION LLC0
NOVANT HEALTH INC
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103561376950HEALTHCARENC501(C)(3)LINE 11C, III-FI0N/A
NOVANT MEDICAL GROUP INC
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103581728803HEALTHCARENC501(C)(3)LINE 3NMG SERVICES INC0
PERSONAL CARE SERVICES
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103541291284HEALTHCAREVA501(C)(3)LINE 9PRINCE WILLIAM HEALTH SYSTEM0
THE PRESBYTERIAN HOSPITAL
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103560554230HEALTHCARENC501(C)(3)LINE 3NOVANT HEALTH SOUTHERN PIEDMONT REGION LLC0
PRESBYTERIAN HOSPITAL FOUNDATION
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103581413074HEALTHCARENC501(C)(3)LINE 7NOVANT HEALTH SOUTHERN PIEDMONT REGION LLC0
PRESBYTERIAN MEDICAL CARE CORPORATION
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103561376368HEALTHCARENC501(C)(3)LINE 3NOVANT HEALTH SOUTHERN PIEDMONT REGION LLC0
PRINCE WILLIAM HEALTH SYSTEM
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103541278944HEALTHCAREVA501(C)(3)LINE 11C, III-FINOVANT HEALTH INC0
PWHS FOUNDATION
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103541307595HEALTHCAREVA501(C)(3)LINE 7PRINCE WILLIAM HEALTH SYSTEM0
PRINCE WILLIAM HOSPITAL
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103540696355HEALTHCAREVA501(C)(3)LINE 3PRINCE WILLIAM HEALTH SYSTEM0
ROWAN HEALTH SERVICES CORP
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103561424814HEALTHCARENC501(C)(3)LINE 11C, III-FINOVANT HEALTH INC0
NMG SERVICES INC
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103562098809HEALTHCARENC501(C)(3)LINE 9NOVANT HEALTH INC0
ROWAN REGIONAL MEDICAL CENTER AUXILIARY
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103237022472HEALTHCARENC501(C)(3)LINE 9ROWAN REGIONAL MEDICAL CENTER INC0
ROWAN REGIONAL MEDICAL CENTER FOUNDATION INC
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103561424818HEALTHCARENC501(C)(3)LINE 7ROWAN REGIONAL MEDICAL CENTER INC0
ROWAN REGIONAL MEDICAL CENTER INC
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103560547479HEALTHCARENC501(C)(3)LINE 3ROWAN HEALTH SERVICES CORP0
SELF INSURANCE FUND - NOVANT HEALTH INC
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103581867242HEALTHCARENC501(C)(3)LINE 11C, III-FINOVANT HEALTH INC0

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (15 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdDirect Controlling NADirectControllingNACdEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationIndAddress Line1ForeignAddress/AddressLine1TxtCityForeignAddress/CityNmProvince Or StateForeignAddress/ProvinceOrStateNmCountryForeignAddress/CountryCdLegal Domicile Foreign CountryLegalDomicileForeignCountryCd
COMMUNICARE INC
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103561952950RENTAL REAL ESTATENCN/AC0
CHOICEHEALTH INC
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103561896065MANAGED CARENCN/AC0
NOVANT HEALTH SHARED SERVICES INC
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103562226937ADMIN SVCSNCN/AC0
SALEM HEALTH SERVICES INC
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103561342654HEALTH RELATEDNCN/AC0
SALEM DIAGNOSTICS INC
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103561513621HEALTH RELATEDNCN/AC0
MEDQUEST INC
3480 PRESTON RIDGE RD STE 600ALPHARETTAGA30005223860764DIAGNOSTIC IMAGINGDEN/AC0
TRINOVA INSURANCE LTD
980615601INSURANCEN/AC058 PAR LA VILLE ROAD PO BOX 1995HAMILTONBERMUDA HMHXBDBD
NOVANT HEALTH RISK RETENTION GROUP INC
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103203382230INSURANCESCN/AC0
ROWAN MEDICAL FACILITIES INC
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103561424672MEDICAL SUPPLIESNCN/AC0
ROWAN MEDICAL ALLIANCE INC
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103561992669INSURANCENCN/AC0
FISCAL CORP LTD
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103541282069HEALTH RELATEDVAN/AC0
PRINCE WILLIAM FAMILY HEALTHCARE
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103541748199HEALTH RELATEDVAN/AC0
PRINCE WILLIAM MEDICAL SUPPLY
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103541307554HEALTH RELATEDVAN/AC0
THE PARK AT MONROE PROPERTY OWNERS ASSOCIATION INC
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103463910256RENTAL REAL ESTATENCN/AC0
KERNERSVILLE MEDICAL CENTER PARK OWNERS' ASSOCIATION
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103471511401RENTAL REAL ESTATENCN/AC0
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth OrgYes (1)RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (1)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (1)TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (2 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
FORSYTH MEDICAL CENTER FOUNDATION
C$2,548,859CASH
FORSYTH MEDICAL CENTER FOUNDATION
R$1,752,669CASH