FORSYTH MEMORIAL HOSPITAL INC: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- FORSYTH MEMORIAL HOSPITAL INC (EIN 56-0928089)
- Tax period
- 2013-01-01 to 2013-12-31
- Filed
- 2014-11-14
- IRS object ID
- 201413189349300926
- Schema version
- 2013v3.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2014-11-14T08:11:40-06:00 | ReturnTs |
| Tax Period End | 2013-12-31 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2013-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 560928089 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FORSYTH MEMORIAL HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | FORS | BusinessNameControlTxt |
| Phone | 3367182803 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2085 FRONTIS PLAZA BLVD | AddressLine1 |
| City | WINSTON SALEM | City |
| State | NC | State |
| ZIP Code | 27103 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | FRED HARGETT | PersonNm |
| Person Title | EVP & CFO | PersonTitleTxt |
| Phone | 3367182803 | PhoneNum |
| Signature | 2014-11-13 | SignatureDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NOVANT HEALTH FORSYTH MEDICAL CENTER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | DENISE MIHAL | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2085 FRONTIS PLAZA BLVD | AddressLine1 |
| City | WINSTON SALEM | City |
| State | NC | State |
| ZIP Code | 27103 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $1,075,713,502 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.NOVANTHEALTH.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1968 | FormationYr |
| Legal Domicile State | NC | LegalDomicileStateCd |
| Activity Or Mission | SEE SCHEDULE O | ActivityOrMissionDesc |
| Voting Members Governing Body | 18 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 16 | VotingMembersIndependentCnt |
| Total Employee | 7747 | TotalEmployeeCnt |
| Total Volunteers | 920 | TotalVolunteersCnt |
| Total Gross UBI | $407,537 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $94,513 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $3,227,743 | PYContributionsGrantsAmt |
| CY Contributions Grants | $2,469,354 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $994,150,186 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $1,004,595,686 | CYProgramServiceRevenueAmt |
| PY Investment Income | $302,022 | PYInvestmentIncomeAmt |
| CY Investment Income | $465,186 | CYInvestmentIncomeAmt |
| PY Other Revenue | $66,353,407 | PYOtherRevenueAmt |
| CY Other Revenue | $67,719,651 | CYOtherRevenueAmt |
| PY Total Revenue | $1,064,033,358 | PYTotalRevenueAmt |
| CY Total Revenue | $1,075,249,877 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $174,071 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $639,957 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $442,325,759 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $444,745,702 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $515,637,285 | PYOtherExpensesAmt |
| CY Other Expenses | $550,050,833 | CYOtherExpensesAmt |
| PY Total Expenses | $958,137,115 | PYTotalExpensesAmt |
| CY Total Expenses | $995,436,492 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $105,896,243 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $79,813,385 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $988,511,859 | TotalAssetsBOYAmt |
| Total Assets EOY | $1,060,812,977 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $49,625,408 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $54,559,584 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $938,886,451 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $1,006,253,393 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | SEE SCHEDULE O | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $799,468,388 | ExpenseAmt |
| Grant | $639,957 | GrantAmt |
| Revenue | $1,064,712,615 | RevenueAmt |
| Desc | FORSYTH 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 2013 THERE WERE 22,478 PATIENT DAYS WITH AN AVERAGE LENGTH OF STAY OF 6 DAYS, AN AVERAGE DAILY CENSUS OF 616, AND 40,535 DISCHARGES. THERE WERE 25,157 INPATIENT AND OUTPATIENT SURGERIES, A TOTAL OF 1,011,042 OUTPATIENT ENCOUNTERS AND 91,575 EMERGENCY DEPARTMENT VISITS. (CONTINUED ON SCHEDULE O) | Desc |
| Total Program Service Expenses | $799,468,388 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | Yes (1) | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | Yes (1) | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (1) | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | Yes (1) | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 4 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 7747 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | Yes (1) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | Yes (1) | QuidProQuoContriDisclInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 18 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 16 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | NC | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KAREN DAUGHERTY | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3367182803 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2085 FRONTIS PLAZA BLVD | AddressLine1 |
| City | WINSTON SALEM | City |
| State | NC | State |
| ZIP Code | 27103 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (33 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|
| EDWARDS JOEL | |||||||||
| TRUSTEE | 2.00 | Yes (X) | $508,633 | $0 | $123,402 | ||||
| MCNEIL-MILLER KAREN | |||||||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $1,015 | $0 | ||||
| SIGAL BARRY | |||||||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $5,436 | $0 | ||||
| BAREFOOT SAMUEL | |||||||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 | ||||
| CARROLL JOE | |||||||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 | ||||
| EARNHARDT HAROLD | |||||||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 | ||||
| ELY JOSEPH | |||||||||
| VICE CHAIR | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |||
| FORIEST BRYANT | |||||||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 | ||||
| GREEN GARY | |||||||||
| SEC/TREAS | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |||
| HAULSEE HADA DE VARONA | |||||||||
| CHAIR | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |||
| HAUSER CHARLES | |||||||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 | ||||
| HICKMAN TOMMY | |||||||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 | ||||
| JOHNSON JOIA | |||||||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 | ||||
| LAMBE CLARENCE | |||||||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 | ||||
| POLLARD III HAROLD | |||||||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 | ||||
| POLONSKY SHERRY | |||||||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 | ||||
| REAVES DONALD | |||||||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 | ||||
| WOLFE III JOHN | |||||||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 | ||||
| LINDSAY JEFFERY PRES FMCCOO WS MKT | |||||||||
| (*SEE ADD'L INFO IN SCH J P3) | 60.00 | $2,880,561 | $0 | $75,721 | Yes (X) | ||||
| MCGEE LAWRENCE ASST SEC | |||||||||
| (*SEE ADD'L INFO IN SCH J P3) | 2.00 | $0 | $1,280,041 | $180,634 | Yes (X) | ||||
| MORRIS JOHN | |||||||||
| ASST SEC | 2.00 | $0 | $323,127 | $75,001 | Yes (X) | ||||
| ALLEN JOANNE | |||||||||
| PRESIDENT NHKMC | 60.00 | $243,716 | $0 | $115,482 | Yes (X) | ||||
| LARSON KIP | |||||||||
| VP & SR MED DIR SPECIALTY SERV | 60.00 | $547,190 | $0 | $66,513 | Yes (X) | ||||
| LEWIS LINDA | |||||||||
| VP NURSING | 60.00 | $205,994 | $0 | $29,552 | Yes (X) | ||||
| MIHAL DENISE SVP WS MKT COO | |||||||||
| (*SEE ADD'L INFO IN SCH J P3) | 60.00 | $1,655,123 | $0 | $72,930 | Yes (X) | ||||
| WALLEY BRUCE | |||||||||
| SVP MEDICAL AFFAIRS | 60.00 | $613,981 | $0 | $61,346 | Yes (X) | ||||
| CHEN FRANKLIN | |||||||||
| ONCOLOGIST | 40.00 | $717,726 | $0 | $87,977 | Yes (X) | ||||
| CHRYSSON NICK | |||||||||
| ONCOLOGIST | 40.00 | $945,036 | $0 | $99,729 | Yes (X) | ||||
| GROTE THOMAS | |||||||||
| ONCOLOGIST | 40.00 | $925,026 | $0 | $74,805 | Yes (X) | ||||
| HINES SUSAN | |||||||||
| ONCOLOGIST | 40.00 | $721,190 | $0 | $88,437 | Yes (X) | ||||
| PASCHOLD EUGENE | |||||||||
| ONCOLOGIST | 40.00 | $787,430 | $0 | $89,189 | Yes (X) | ||||
| ALLEN ELMS | |||||||||
| FMR SVP MAJOR GIFTS | 0.00 | $105,717 | $0 | $28,126 | Yes (X) | ||||
| HAMMES PAUL | |||||||||
| FMR SVO & COO FMC | 0.00 | $374,068 | $0 | $23,925 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $11,231,391 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,609,619 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $1,292,769 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 372 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1 | CityContractorAddress/USAddress/City | StateContractorAddress/USAddress/State | ZIP CodeContractorAddress/USAddress/ZIPCode | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| CROTHALL HEALTH CARE INC | |||||
| 955 CHESTERBROOK BLVD STE 300 | WAYNE | PA | 19087 | FACILITY SERVICES | $10,249,716 |
| MORRISON MANAGEMENT SPECIALISTS | |||||
| PO BOX 102289 | ATLANTA | GA | 30368 | FOOD SERVICES | $9,473,985 |
| LABORATORY CORPORATION OF AMERICA | |||||
| PO BOX 12140 | BURLINGTON | NC | 27216 | LAB SERVICES | $8,894,470 |
| NURSEFINDERS INC | |||||
| PO BOX 910738 | DALLAS | TX | 75391 | STAFFING | $6,855,679 |
| SALEM CHEST SPECIALISTS | |||||
| 3001 LYNDHURST AVE | WINSTONSALEM | NC | 27103 | HEALTH SERVICES | $4,565,597 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 75 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $2,227,734 | RelatedOrganizationsAmt |
| All Other Contributions | $241,620 | AllOtherContributionsAmt |
| Noncash Contributions | $9,993 | NoncashContributionsAmt |
| Total Contributions | $2,469,354 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | NET PATIENT REVENUE | Desc |
| Business | 622110 | BusinessCd |
| Total Revenue Column | $1,004,595,686 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,004,595,686 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $1,004,595,686 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $719,522 | TotalRevenueColumnAmt |
| Exclusion | $719,522 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $2,598,729 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $2,598,729 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,598,729 | TotalRevenueColumnAmt |
| Exclusion | $2,598,729 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $209,289 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $463,625 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -$254,336 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$254,336 | TotalRevenueColumnAmt |
| Exclusion | -$254,336 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt | ExclusionExclusionAmt |
|---|---|---|---|---|---|
| PHARMACY | 446110 | $52,066,181 | $51,659,255 | $406,926 | |
| MISCELLANEOUS REVENUE | 621999 | $7,259,321 | $7,259,321 | ||
| CAFETERIA MEALS | 722514 | $3,243,826 | $3,243,826 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,551,594 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,198,353 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $611 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,352,630 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $65,120,922 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,075,249,877 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,064,712,615 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $407,537 | UnrelatedBusinessRevenueAmt |
| Exclusion | $7,660,371 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $559,314 | TotalAmt |
| Program Services | $559,314 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $80,643 | TotalAmt |
| Program Services | $80,643 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,200,145 | TotalAmt |
| Management And General | $7,200,145 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $531,836 | TotalAmt |
| Management And General | $531,836 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $345,271,920 | TotalAmt |
| Program Services | $321,517,212 | ProgramServicesAmt |
| Management And General | $23,754,708 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,982,754 | TotalAmt |
| Program Services | $17,676,741 | ProgramServicesAmt |
| Management And General | $1,306,013 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $49,776,918 | TotalAmt |
| Program Services | $46,352,266 | ProgramServicesAmt |
| Management And General | $3,424,652 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,982,129 | TotalAmt |
| Program Services | $21,400,959 | ProgramServicesAmt |
| Management And General | $1,581,170 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,551,639 | TotalAmt |
| Management And General | $2,551,639 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $90,590 | TotalAmt |
| Management And General | $90,590 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,174 | TotalAmt |
| Management And General | $3,174 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $82,497,342 | TotalAmt |
| Program Services | $66,267,894 | ProgramServicesAmt |
| Management And General | $16,229,448 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,716,161 | TotalAmt |
| Program Services | $2,529,289 | ProgramServicesAmt |
| Management And General | $186,872 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,757,180 | TotalAmt |
| Program Services | $5,361,086 | ProgramServicesAmt |
| Management And General | $396,094 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,007,931 | TotalAmt |
| Program Services | $8,388,185 | ProgramServicesAmt |
| Management And General | $619,746 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $28,332,397 | TotalAmt |
| Program Services | $26,383,128 | ProgramServicesAmt |
| Management And General | $1,949,269 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $986,061 | TotalAmt |
| Program Services | $918,220 | ProgramServicesAmt |
| Management And General | $67,841 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $351,991 | TotalAmt |
| Program Services | $327,774 | ProgramServicesAmt |
| Management And General | $24,217 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,669,275 | TotalAmt |
| Program Services | $13,659,997 | ProgramServicesAmt |
| Management And General | $1,009,278 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,608,724 | TotalAmt |
| Program Services | $21,053,244 | ProgramServicesAmt |
| Management And General | $1,555,480 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,032,630 | TotalAmt |
| Program Services | $1,892,785 | ProgramServicesAmt |
| Management And General | $139,845 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Management And GeneralManagementAndGeneralAmt | Program ServicesProgramServicesAmt |
|---|---|---|---|
| CORPORATE ALLOCATION | $131,533,468 | $131,533,468 | |
| UBI TAXES | $37,881 | $37,881 | |
| MEDICAL SUPPLIES | $94,691,371 | $94,691,371 | |
| DRUGS | $90,484,872 | $90,484,872 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $61,698,146 | TotalAmt |
| Program Services | $59,923,408 | ProgramServicesAmt |
| Management And General | $1,774,738 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $995,436,492 | TotalAmt |
| Program Services | $799,468,388 | ProgramServicesAmt |
| Management And General | $195,968,104 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,937,802 | BOYAmt |
| EOY | $2,589,293 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $116,770,799 | BOYAmt |
| EOY | $111,373,192 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $211,460 | BOYAmt |
| EOY | $87,500 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,686,015 | BOYAmt |
| EOY | $7,887,194 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,877,650 | BOYAmt |
| EOY | $18,536,721 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,306,979 | BOYAmt |
| EOY | $957,274 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $431,232,380 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $255,070,330 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $145,819,696 | BOYAmt |
| EOY | $176,162,050 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $31,015,047 | BOYAmt |
| EOY | $31,015,047 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $671,886,411 | BOYAmt |
| EOY | $712,204,706 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $988,511,859 | BOYAmt |
| EOY | $1,060,812,977 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $43,830,247 | BOYAmt |
| EOY | $52,210,666 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $177,878 | BOYAmt |
| EOY | $162,314 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,617,283 | BOYAmt |
| EOY | $2,186,604 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $49,625,408 | BOYAmt |
| EOY | $54,559,584 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $938,886,451 | BOYAmt |
| EOY | $1,006,253,393 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $938,886,451 | BOYAmt |
| EOY | $1,006,253,393 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $988,511,859 | BOYAmt |
| EOY | $1,060,812,977 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $79,813,385 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | -$12,446,443 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $143,403 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $143,403 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1I, LOBBYING ACTIVITIES: | FormAndLineReferenceDesc |
| Explanation | DUES PAID TO CERTAIN ORGANIZATIONS WHICH INCLUDE A PORTION RELATED TO LOBBYING ACTIVITIES. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,082,278 | OtherCostOrOtherBasisAmt |
| Book Value | $4,082,278 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $100,637,282 | OtherCostOrOtherBasisAmt |
| Depreciation | $9,100,389 | DepreciationAmt |
| Book Value | $91,536,893 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $8,772,389 | OtherCostOrOtherBasisAmt |
| Depreciation | $5,902,743 | DepreciationAmt |
| Book Value | $2,869,646 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $291,395,801 | OtherCostOrOtherBasisAmt |
| Depreciation | $229,258,920 | DepreciationAmt |
| Book Value | $62,136,881 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $26,344,630 | OtherCostOrOtherBasisAmt |
| Depreciation | $10,808,278 | DepreciationAmt |
| Book Value | $15,536,352 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $176,162,050 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (2 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| DUE FROM AFFILIATE | $712,204,040 |
| STATE INCOME TAX RECEIVABLE | $666 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $712,204,706 | TotalBookValueOtherAssetsAmt |
| Federal Income Tax Liability | $386 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| CAPITAL LEASE PAYABLE | $105,001 |
| THIRD PARTY PAYMENT ADJUSTMENTS | $2,081,217 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $2,186,604 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | PART 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 WAS 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 STATEMENT OF OPERATIONS FOR THE YEARS ENDED DECEMBER 31, 2013 AND 2012. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| Most Hospitals Policy | Yes (X) | MostHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 300.000000000000 | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | 0 | FPGReferenceDiscountedCareInd |
| Free Care Medically Indigent | 0 | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $38,715,314 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $38,715,314 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04030 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $121,589,838 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $112,690,394 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $8,899,444 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00930 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $8,922,098 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $6,038,632 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,883,466 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00300 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $169,227,250 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $118,729,026 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $50,498,224 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05260 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $677,303 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $45,449 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $631,854 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00070 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $7,693,996 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $875,181 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $6,818,815 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00710 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $42,863,137 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $29,252,750 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $13,610,387 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01420 | TotalExpensePct |
Research ResearchGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,871,612 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,236,404 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $635,208 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00070 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $495,802 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $495,802 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00050 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $53,601,850 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $31,409,784 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $22,192,066 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02320 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $222,829,100 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $150,138,810 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $72,690,290 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07580 | TotalExpensePct |
Physical Imprv And Housing PhysicalImprvAndHousingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Economic Development EconomicDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $62,947 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $62,947 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $72,426 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $72,426 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Environmental Improvements EnvironmentalImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Leadership Development LeadershipDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $577 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $577 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Coalition Building CoalitionBuildingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,540 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,540 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $447 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $447 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $418,945 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $418,945 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00040 | TotalExpensePct |
Other Communtity Building Acty OtherCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $556,882 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $556,882 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00060 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $35,902,559 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $0 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $185,321,784 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $194,682,672 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$9,360,888 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | 0 | FinancialAssistancePrvsnInd |
| Hospital Facilities | 3 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp (3 entries)
| FacilityFacilityNum | Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | Website AddressWebsiteAddressTxt | State LicenseStateLicenseNum | Licensed HospitalLicensedHospitalInd | General Medical And SurgicalGeneralMedicalAndSurgicalInd | Emergency Room24 HrsEmergencyRoom24HrsInd |
|---|---|---|---|---|---|---|---|---|---|
| FMH DBA NH FORSYTH MEDICAL CENTER | |||||||||
| 1 | 3333 SILAS CREEK PARKWAY | WINSTON SALEM | NC | 27103 | WWW.NOVANTHEALTH.ORG | H0209 | Yes (X) | Yes (X) | Yes (X) |
| FMH DBA NH KERNERSVILLE MEDICAL CENTER | |||||||||
| 2 | 1750 KERNERSVILLE MEDICAL PARKWAY | KERNERSVILLE | NC | 27284 | WWW.NOVANTHEALTH.ORG | H0209 | Yes (X) | Yes (X) | Yes (X) |
| FMH DBA NH CLEMMONS MEDICAL CENTER | |||||||||
| 3 | 6915 VILLAGE MEDICAL CIRCLE | CLEMMONS | NC | 27012 | WWW.NOVANTHEALTH.ORG | H0209 | Yes (X) | Yes (X) | |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp (3 entries)
| FacilityFacilityNum | CHNA ConductedCHNAConductedInd | Community DefinitionCommunityDefinitionInd | Community DemographicsCommunityDemographicsInd | How Data ObtainedHowDataObtainedInd | Community Health NeedsCommunityHealthNeedsInd | Community Hlth Needs Id ProcessCommunityHlthNeedsIdProcessInd | Consulting ProcessConsultingProcessInd | CHNA ConductedCHNAConductedYr | Take Into Account Others InputTakeIntoAccountOthersInputInd | CHNA Conducted With Other FcltsCHNAConductedWithOtherFcltsInd | CHNA Report Widely AvailableCHNAReportWidelyAvailableInd | Other WebsiteOtherWebsiteInd | Other Website URLOtherWebsiteURLTxt | Adopt Implementation StrategyAdoptImplementationStrategyInd | Exec Implementation StrategyExecImplementationStrategyInd | Prioritize Health NeedsPrioritizeHealthNeedsInd | Prioritize ServicesPrioritizeServicesInd | All Needs AddressedAllNeedsAddressedInd | Organization Incur Excise TaxOrganizationIncurExciseTaxInd | Elig Criteria ExplainedEligCriteriaExplainedInd | FPG Used Deter Elig Free CareFPGUsedDeterEligFreeCareInd | FPG Family Incm Lmt Free CareFPGFamilyIncmLmtFreeCarePct | FPG Used Determ Elig Dscnt CareFPGUsedDetermEligDscntCareInd | Explained BasisExplainedBasisInd | App Financial Asst ExplnAppFinancialAsstExplnInd | Includes Publicity MeasuresIncludesPublicityMeasuresInd | Posted On WebsitePostedOnWebsiteInd | Attached To InvoiceAttachedToInvoiceInd | Posted In Emergency RoomPostedInEmergencyRoomInd | Posted In Admission OfficePostedInAdmissionOfficeInd | Provided On AdmissionProvidedOnAdmissionInd | Available On RequestAvailableOnRequestInd | FAP Actions On NonpaymentFAPActionsOnNonpaymentInd | Collection ActivitiesCollectionActivitiesInd | FAP Notified Upon AdmissionFAPNotifiedUponAdmissionInd | FAP Notified Before DischargeFAPNotifiedBeforeDischargeInd | FAP Notified All PatientsFAPNotifiedAllPatientsInd | Documented Elig DeterminationDocumentedEligDeterminationInd | Nondis Emergency Care PolicyNondisEmergencyCarePolicyInd | Other Method UsedOtherMethodUsedInd | Amounts Generally BilledAmountsGenerallyBilledInd | Gross ChargesGrossChargesInd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NOVANT HEALTH FORSYTH MEDICAL CENTER | ||||||||||||||||||||||||||||||||||||||||||
| 1 | Yes (1) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | 13 | Yes (1) | 0 | Yes (1) | Yes (X) | WWW.NOVANTHEALTH.ORG | Yes (X) | Yes (X) | Yes (X) | Yes (X) | 0 | 0 | Yes (1) | Yes (1) | 300.000000000000 | 0 | 0 | Yes (1) | Yes (1) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (1) | 0 | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (1) | Yes (X) | 0 | 0 |
| NOVANT HEALTH KERNERSVILLE MEDICAL CENTE | ||||||||||||||||||||||||||||||||||||||||||
| 2 | Yes (1) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | 13 | Yes (1) | 0 | Yes (1) | Yes (X) | WWW.NOVANTHEALTH.ORG | Yes (X) | Yes (X) | Yes (X) | Yes (X) | 0 | 0 | Yes (1) | Yes (1) | 300.000000000000 | 0 | 0 | Yes (1) | Yes (1) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (1) | 0 | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (1) | Yes (X) | 0 | 0 |
| NOVANT HEALTH CLEMMONS MEDICAL CENTER | ||||||||||||||||||||||||||||||||||||||||||
| 3 | Yes (1) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | 13 | Yes (1) | 0 | Yes (1) | Yes (X) | WWW.NOVANTHEALTH.ORG | Yes (X) | Yes (X) | Yes (X) | Yes (X) | 0 | 0 | Yes (1) | Yes (1) | 300.000000000000 | 0 | 0 | Yes (1) | Yes (1) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (1) | 0 | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (1) | Yes (X) | 0 | 0 |
Supplemental Information SupplementalInformationGrp (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| NOVANT HEALTH FORSYTH MEDICAL CENTER | PART V, SECTION B, LINE 3: 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. |
| NOVANT HEALTH KERNERSVILLE MEDICAL CENTER | PART V, SECTION B, LINE 3: 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. |
| NOVANT HEALTH CLEMMONS MEDICAL CENTER | PART V, SECTION B, LINE 3: 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. |
| NOVANT HEALTH FORSYTH MEDICAL CENTER | PART V, SECTION B, LINE 7: 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 ARE WORKING DILIGENTLY TO ADDRESS EACH OF THE IDENTIFIED AREAS OF NEED THROUGH RESOURCE ALLOCATION AND SUPPORT. 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 LINE 5B FOR THE URL. |
| NOVANT HEALTH KERNERSVILLE MEDICAL CENTER | PART V, SECTION B, LINE 7: 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 ARE WORKING DILIGENTLY TO ADDRESS EACH OF THE IDENTIFIED AREAS OF NEED THROUGH RESOURCE ALLOCATION AND SUPPORT. 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 LINE 5B FOR THE URL. |
| NOVANT HEALTH CLEMMONS MEDICAL CENTER | PART V, SECTION B, LINE 7: 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 ARE WORKING DILIGENTLY TO ADDRESS EACH OF THE IDENTIFIED AREAS OF NEED THROUGH RESOURCE ALLOCATION AND SUPPORT. 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 LINE 5B FOR THE URL. |
| NOVANT HEALTH FORSYTH MEDICAL CENTER | PART V, SECTION B, LINE 11: ALL UNINSURED PATIENTS RECEIVE A STANDARD DISCOUNT REGARDLESS OF THEIR ABILITY TO PAY. THIS DISCOUNT MIRRORS OUR AVERAGE MANAGED CARE RATE. PATIENTS BELOW 300% OF THE FEDERAL POVERTY GUIDELINES ARE DISCOUNTED AT 100%. |
| NOVANT HEALTH KERNERSVILLE MEDICAL CENTER | PART V, SECTION B, LINE 11: ALL UNINSURED PATIENTS RECEIVE A STANDARD DISCOUNT REGARDLESS OF THEIR ABILITY TO PAY. THIS DISCOUNT MIRRORS OUR AVERAGE MANAGED CARE RATE. PATIENTS BELOW 300% OF THE FEDERAL POVERTY GUIDELINES ARE DISCOUNTED AT 100%. |
| NOVANT HEALTH CLEMMONS MEDICAL CENTER | PART V, SECTION B, LINE 11: ALL UNINSURED PATIENTS RECEIVE A STANDARD DISCOUNT REGARDLESS OF THEIR ABILITY TO PAY. THIS DISCOUNT MIRRORS OUR AVERAGE MANAGED CARE RATE. PATIENTS BELOW 300% OF THE FEDERAL POVERTY GUIDELINES ARE DISCOUNTED AT 100%. |
| NOVANT HEALTH FORSYTH MEDICAL CENTER | PART V, SECTION B, LINE 20D: ALL FINANCIAL ASSISTANCE POLICY (FAP) ELIGIBLE PATIENTS RECEIVE 100% FREE CARE AND THEREFORE 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. |
| NOVANT HEALTH KERNERSVILLE MEDICAL CENTER | PART V, SECTION B, LINE 20D: ALL FINANCIAL ASSISTANCE POLICY (FAP) ELIGIBLE PATIENTS RECEIVE 100% FREE CARE AND THEREFORE 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. |
| NOVANT HEALTH CLEMMONS MEDICAL CENTER | PART V, SECTION B, LINE 20D: ALL FINANCIAL ASSISTANCE POLICY (FAP) ELIGIBLE PATIENTS RECEIVE 100% FREE CARE AND THEREFORE 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. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 53 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (53 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | FacilityFacilityTxt | Address Line2USAddress/AddressLine2 |
|---|---|---|---|---|---|
| NH ARCADIA FAMILY MEDICINE | |||||
| 12208 HWY 150 NORTH | WINSTONSALEM | NC | 27127 | PHYSICIAN CLINIC | |
| NH BREAST CENTER | |||||
| 2025 FRONTIS PLAZA BLVD STE 119300 | WINSTONSALEM | NC | 27103 | IMAGING CENTER | |
| NH CHAIR CITY FAMILY PRACTICE | |||||
| 903 RANDOLPH STREET | THOMASVILLE | NC | 27360 | PHYSICIAN CLINIC | |
| NH CLEMMONS FAMILY MEDICINE | |||||
| 6301 STADIUM DRIVE | CLEMMONS | NC | 27012 | PHYSICIAN CLINIC | |
| NH DAVIE MEDICAL ASSOCIATES | |||||
| 485 VALLEY ROAD | MOCKSVILLE | NC | 27028 | PHYSICIAN CLINIC | |
| NH FORSYTH ENDOCRINE CONSULTANTS | |||||
| 755 HIGHLAND OAKS DRIVE SUITE 201 | WINSTONSALEM | NC | 27103 | PHYSICIAN CLINIC | |
| NH FORSYTH FAMILY MEDICINE | |||||
| 400 JONESTOWN RD | WINSTONSALEM | NC | 27104 | PHYSICIAN CLINIC | |
| NH FORSYTH INTERNAL MEDICINE | |||||
| 1381 WESTGATE CENTER DRIVE | WINSTONSALEM | NC | 27103 | PHYSICIAN CLINIC | |
| NH FORSYTH NEUROLOGY | |||||
| 2025 FRONTIS PLAZA BLVD SUITE 120 | WINSTONSALEM | NC | 27103 | PHYSICIAN CLINIC | |
| NH GATEWAY FAMILY MEDICINE | |||||
| 390 SALEM AVENUE | WINSTONSALEM | NC | 27101 | PHYSICIAN CLINIC | |
| NH HILLSDALE MEDICAL ASSOCIATES | |||||
| 121 MEDICAL DRIVE | ADVANCE | NC | 27006 | PHYSICIAN CLINIC | |
| NH IMAGING KERNERSVILLE | |||||
| 445 PINEVIEW DRIVE SUITE 100 | KERNERSVILLE | NC | 27284 | IMAGING CENTER | |
| NH IMAGING MAPLEWOOD | |||||
| 3155 MAPLEWOOD AVENUE | WINSTONSALEM | NC | 27103 | IMAGING CENTER | |
| NH IMAGING WINSTON-SALEM HEALTHCA | |||||
| 250 CHARLOIS BOULEVARD | WINSTONSALEM | NC | 27103 | IMAGING CENTER | |
| NH INFECTIOUS DISEASE SPECIALISTS | |||||
| 1381 WESTGATE CENTER DRIVE | WINSTONSALEM | NC | 27103 | PHYSICIAN CLINIC | |
| NH KERNERSVILLE FAMILY MEDICINE | |||||
| 291 BROAD STREET | KERNERSVILLE | NC | 27284 | PHYSICIAN CLINIC | |
| NH KERNERSVILLE INTERNAL MEDICINE | |||||
| 445 PINEVIEW DRIVE SUITE 240 | KERNERSVILLE | NC | 27284 | PHYSICIAN CLINIC | |
| NH LEWISVILLE FAMILY MEDICINE | |||||
| 1225 LEWISVILLE-CLEMMONS ROAD | LEWISVILLE | NC | 27023 | PHYSICIAN CLINIC | |
| NH LEXINGTON PRIMARY CARE | |||||
| 110 WEST MEDICAL PARK DRIVE | LEXINGTON | NC | 27292 | PHYSICIAN CLINIC | |
| NH MAPLEWOOD FAMILY MEDICINE | |||||
| ROBINHOOD MEDICAL PLAZA BLDG 100 | WINSTONSALEM | NC | 27106 | PHYSICIAN CLINIC | |
| NH MOUNTAINVIEW MEDICAL | |||||
| 216 MOORE ROAD | KING | NC | 27021 | PHYSICIAN CLINIC | |
| NH NEW GARDEN MEDICAL ASSOCIATES | |||||
| 1941 NEW GARDEN ROAD SUITE 216 | GREENSBORO | NC | 27410 | PHYSICIAN CLINIC | |
| NH NORTH POINT MEDICAL ASSOCIATES | |||||
| 1995 BETHABARA ROAD | WINSTONSALEM | NC | 27106 | PHYSICIAN CLINIC | |
| NH NORTHWEST FAMILY MEDICINE | |||||
| 7607 NC HIGHWAY 68 N STE B | OAK RIDGE | NC | 27310 | PHYSICIAN CLINIC | |
| NH ONCOLOGY SPECIALISTS | |||||
| 276 OLD MOCKSVILLE ROAD | STATESVILLE | NC | 28625 | PHYSICIAN CLINIC | |
| NH ONCOLOGY SPECIALISTS | |||||
| 865 WESTLAKE DRIVE SUITE 200 | MOUNT AIRY | NC | 27030 | PHYSICIAN CLINIC | |
| NH ONCOLOGY SPECIALISTS | |||||
| 1010 BETHESDA COURT | WINSTONSALEM | NC | 27103 | PHYSICIAN CLINIC | |
| NH ONCOLOGY SPECIALISTS | |||||
| 1370 PIEDMONT DRIVE SUITE 202 | LEXINGTON | NC | 27295 | PHYSICIAN CLINIC | |
| NH ONCOLOGY SPECIALISTS | |||||
| 1710 KERNERSVILLE MEDICAL PLZ STE | KERNERSVILLE | NC | 27284 | PHYSICIAN CLINIC | 116 |
| NH PHARMACY | |||||
| 105 VEST MILL CIRCLE | WINSTONSALEM | NC | 27103 | PHARMACY | |
| NH PHARMACY | |||||
| 212 MOORE ROAD | KING | NC | 27021 | PHARMACY | |
| NH PHARMACY | |||||
| 291 BROAD STREET | KERNERSVILLE | NC | 27284 | PHARMACY | |
| NH PHARMACY | |||||
| 100 ROBINHOOD MEDICAL PLAZA | WINSTONSALEM | NC | 27106 | PHARMACY | |
| NH PHARMACY | |||||
| 1381 WESTGATE CENTER DRIVE | WINSTONSALEM | NC | 27103 | PHARMACY | |
| NH PHARMACY | |||||
| 1010 BETHESDA COURT | WINSTONSALEM | NC | 27103 | PHARMACY | |
| NH PHARMACY | |||||
| 255 CHARLOIS BLVD | WINSTONSALEM | NC | 27103 | PHARMACY | |
| NH PILOT MOUNTAIN MEDICAL CARE | |||||
| 207 MEDICAL STREET | PILOT MOUNTAIN | NC | 27041 | PHYSICIAN CLINIC | |
| NH PINEVIEW FAMILY MEDICINE | |||||
| 500 PINEVIEW DRIVE SUITE 101 | KERNERSVILLE | NC | 27284 | PHYSICIAN CLINIC | |
| NH PREMIER MEDICAL ASSOCIATES | |||||
| 3333 BROOKVIEW HILLS BLVD ST | WINSTONSALEM | NC | 27103 | PHYSICIAN CLINIC | 203/204 |
| NH RHEUMATOLOGY AND ARTHRITIS | |||||
| 1995 BETHABARA ROAD | WINSTONSALEM | NC | 27106 | PHYSICIAN CLINIC | |
| NH SALEM FAMILY MEDICINE | |||||
| 105 VEST MILL CIRCLE | WINSTONSALEM | NC | 27103 | PHYSICIAN CLINIC | |
| NH SURRY MEDICAL ASSOCIATES | |||||
| 865 WESTLAKE DRIVE | MOUNT AIRY | NC | 27030 | PHYSICIAN CLINIC | |
| NH THOMASVILLE MEDICAL ASSOCIATES | |||||
| 309 PINEYWOOD ROAD | THOMASVILLE | NC | 27360 | PHYSICIAN CLINIC | |
| NH TRIAD ENDOCRINE | |||||
| 500 PINEVIEW DRIVE SUITE 101 | KERNERSVILLE | NC | 27284 | PHYSICIAN CLINIC | |
| NH UROLOGY PARTNERS | |||||
| 2010 BALDWIN LANE | WINSTONSALEM | NC | 27103 | PHYSICIAN CLINIC | |
| NH UROLOGY PARTNERS | |||||
| 1710 KERNERSVILLE MEDICAL PKY STE | KERNERSVILLE | NC | 27284 | PHYSICIAN CLINIC | 201 |
| NH WEST FORSYTH INTERNAL MED & PED | |||||
| 105 STADIUM OAKS DRIVE | CLEMMONS | NC | 27012 | PHYSICIAN CLINIC | |
| NH WINSTON-SALEM CARDIOLOGY | |||||
| 186 KIMEL PARK DR | WINSTONSALEM | NC | 27103 | PHYSICIAN CLINIC | |
| NH WINSTON-SALEM CARDIOLOGY | |||||
| 1710 KERNERSVILLE MEDICAL PKY STE | KERNERSVILLE | NC | 27284 | PHYSICIAN CLINIC | 205 |
| NH WINSTON-SALEM CARDIOLOGY | |||||
| 5175 OLD CLEMMONS SCHOOL RD | CLEMMONS | NC | 27012 | PHYSICIAN CLINIC | |
| NH WINSTON-SALEM HEALTH CARE | |||||
| 250 CHARLOIS BOULEVARD | WINSTONSALEM | NC | 27103 | PHYSICIAN CLINIC | |
| NH WINSTON-SALEM HEALTH CARE | |||||
| 175 KIMEL PARK DRIVE | WINSTONSALEM | NC | 27103 | PHYSICIAN CLINIC | |
| NH YADKIN MEDICAL ASSOCIATES | |||||
| 305 EAST LEE AVENUE | YADKINVILLE | NC | 27055 | PHYSICIAN CLINIC | |
Supplemental Information Detail SupplementalInformationDetail (14 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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 $35,902,559. |
| 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: | BAD DEBT EXPENSE ONLY REPRESENTS ACCOUNTS FOR WHICH COLLECTION EFFORTS HAVE BEEN MADE BUT NO PAYMENTS HAVE BEEN RECEIVED. DISCOUNTS ARE RECORDED AS EITHER CONTRACTUALS (FOR PATIENTS WHO DO NOT QUALIFY FOR CHARITY) OR AS CHARITY (FOR PATIENTS WHO DO QUALIFY FOR CHARITY). THE TEXT OF THE NOVANT HEALTH, INC. CONSOLIDATED FINANCIAL STATEMENTS READS: "THE ALLOWANCE FOR BAD DEBTS 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 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 AND LOCAL DEPARTMENT OF SOCIAL SERVICES TEAMS TO HAVE EMBEDDED CASE WORKERS WITHIN OUR FACILITIES. 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 IN 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. |
| 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 ANOTHER THAT IS A PART OF NOVANT HEALTH ALSO. THERE IS ALSO ONE ACADEMIC, TEACHING HOSPITAL. ACCORDING TO SG2 DATA, THE SPECIFIC POPULATION GROUPS (ETHNIC AND CULTURAL) ARE AS FOLLOWS: WHITE NON-HISPANIC (230,015) 59.62%; BLACK NON-HISPANIC (92,491) 23.98%; HISPANIC (47,526) 12.32%; ASIAN AND PACIFIC ISLAND (8,947) 2.32%; OTHERS (6,795) 1.76%; FOR A TOTAL POPULATION OF 385,774. ACCORDING TO SG2 DATA, THE MEDIAN HOUSEHOLD INCOME LEVEL WAS $45,462.ACCORDING TO SG2 DATA, THE AGE BREAKDOWN IS AS FOLLOWS: 0-17 YEARS (92,148) 23.43%; 18-64 YEARS (238,440) 60.27%; 65+ YEARS (55,186) 16.31%. |
| 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 25 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 REPORT | NOVANT 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (14 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt | Address Line2USAddress/AddressLine2 |
|---|---|---|---|---|---|---|---|---|
| AMERICAN HEART ASSOCIATION | ||||||||
| 7272 GREENVILLE AVE | DALLAS | TX | 75231 | 135613797 | 501(C)(3) | $108,750 | COMMUNITY OUTREACH | |
| ARTS COUNCIL | ||||||||
| 206 N SPRUCE ST SUITE 3 | WINSTONSALEM | NC | 27101 | 560526856 | 501(C)(3) | $10,000 | COMMUNITY OUTREACH | |
| GREATER WINSTON-SALEM CHAMBER OF COMMERCE | ||||||||
| 411 W 4TH STREET SUITE 211 | WINSTONSALEM | NC | 27101 | 560459820 | 501(C)(6) | $26,500 | COMMUNITY OUTREACH | |
| CRISIS CONTROL MINISTRY | ||||||||
| 200 E TENTH STREET | WINSTONSALEM | NC | 27101 | 237348168 | 501(C)(3) | $7,500 | COMMUNITY OUTREACH | |
| FORSYTH FUTURES | ||||||||
| 301 N MAIN STREET SUITE 1700 | WINSTONSALEM | NC | 27101 | 561092807 | 501(C)(3) | $25,000 | COMMUNITY OUTREACH | |
| JUVENILE DIABETES FOUNDATION | ||||||||
| 408 N EUGENE STREET | GREENSBORO | NC | 27401 | 231907729 | 501(C)(3) | $20,000 | COMMUNITY OUTREACH | |
| SUSAN G KOMEN BREAST CANCER FOUNDATION | ||||||||
| 1106 BURKE STREET | WINSTONSALEM | NC | 27101 | 752891104 | 501(C)(3) | $15,000 | COMMUNITY OUTREACH | |
| MARCH OF DIMES | ||||||||
| 410 BROOKSTOWN AVE | WINSTONSALEM | NC | 27101 | 131846366 | 501(C)(3) | $12,500 | COMMUNITY OUTREACH | |
| OLD HICKORY COUNCIL | ||||||||
| 6600 SILAS CREEK PARKWAY | WINSTONSALEM | NC | 27106 | 560529985 | 501(C)(3) | $10,000 | COMMUNITY OUTREACH | |
| SCEPTOR PAIN FOUNDATION | ||||||||
| 145 KIMEL PARK DRIVE SUITE 300 | WINSTONSALEM | NC | 27103 | 020723571 | 501(C)(3) | $25,000 | COMMUNITY OUTREACH | |
| SENIOR SERVICES INC | ||||||||
| 2895 SHOREFAIR DRIVE NW | WINSTONSALEM | NC | 27105 | 561085968 | 501(C)(3) | $20,000 | COMMUNITY OUTREACH | |
| UNITED WAY OF FORSYTH COUNTY | ||||||||
| 301 N MAIN STREET SUITE 1700 | WINSTONSALEM | NC | 27101 | 237357234 | 501(C)(3) | $91,131 | COMMUNITY OUTREACH | |
| WS ALLIANCE | ||||||||
| 100 N MAIN STREET SUITE 2550 | WINSTONSALEM | NC | 27101 | 311726654 | 501(C)(6) | $30,000 | COMMUNITY OUTREACH | |
| WS STATE UNIVERSITY FOUNDATION | ||||||||
| 601 S MARTIN LUTHER KING JR DRIVE | WINSTONSALEM | NC | 27110 | 560989620 | 501(C)(3) | $100,000 | COMMUNITY OUTREACH | SUITE 304 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 12 | Total501c3OrgCnt |
| Total Other Org | 2 | TotalOtherOrgCnt |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Type | DISCOUNTED PRESCRIPTION DRUG PROGRAM | GrantTypeTxt |
| Recipient | 900 | RecipientCnt |
| Non Cash Assistance | $80,643 | NonCashAssistanceAmt |
| Valuation Method Used | FMV | ValuationMethodUsedDesc |
| Non Cash Assistance | PRESCRIPTION DRUG ASSISTANCE | NonCashAssistanceDesc |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2 - PROCEDURES FOR MONITORING THE USE OF THE GRANT FUNDS | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION IS AN AFFILIATE IN AN INTEGRATED HEALTHCARE SYSTEM AND FOLLOWS 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 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| First Class Or Charter Travel | Yes (X) | FirstClassOrCharterTravelInd |
| Travel For Companions | Yes (X) | TravelForCompanionsInd |
| Idemnification Gross Up Pmts | Yes (X) | IdemnificationGrossUpPmtsInd |
| Discretionary Spending Acct | Yes (X) | DiscretionarySpendingAcctInd |
| Housing Allowance Or Residence | Yes (X) | HousingAllowanceOrResidenceInd |
| Club Dues Or Fees | Yes (X) | ClubDuesOrFeesInd |
| Written Policy Ref T And E Expnss | Yes (1) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (1) | SubstantiationRequiredInd |
| Severance Payment | Yes (1) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (16 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| EDWARDS JOEL | ||||||||||||||
| TRUSTEE | $481,069 | $0 | $6,742 | $0 | $20,822 | $0 | $104,804 | $0 | $18,598 | $0 | $632,035 | $0 | $7,500 | $0 |
| LINDSAY JEFFERY PRES FMCCOO WS MKT | ||||||||||||||
| (*SEE ADD'L INFO IN SCH J P3) | $598,311 | $0 | $355,104 | $0 | $1,927,146 | $0 | $52,049 | $0 | $23,672 | $0 | $2,956,282 | $0 | $708,380 | $0 |
| MCGEE LAWRENCE ASST SEC | ||||||||||||||
| (*SEE ADD'L INFO IN SCH J P3) | $0 | $384,909 | $0 | $304,420 | $0 | $590,712 | $0 | $156,200 | $0 | $24,434 | $0 | $1,460,675 | $0 | $445,287 |
| MORRIS JOHN | ||||||||||||||
| ASST SEC | $0 | $237,363 | $0 | $80,201 | $0 | $5,563 | $0 | $56,043 | $0 | $18,957 | $0 | $398,127 | $0 | $0 |
| ALLEN JOANNE | ||||||||||||||
| PRESIDENT NHKMC | $174,431 | $0 | $59,136 | $0 | $10,149 | $0 | $105,722 | $0 | $9,760 | $0 | $359,198 | $0 | $0 | $0 |
| LARSON KIP | ||||||||||||||
| VP & SR MED DIR SPECIALTY SERV | $344,453 | $0 | $186,900 | $0 | $15,837 | $0 | $37,300 | $0 | $29,213 | $0 | $613,703 | $0 | $0 | $0 |
| LEWIS LINDA | ||||||||||||||
| VP NURSING | $86,036 | $0 | $101,943 | $0 | $18,015 | $0 | $24,947 | $0 | $4,604 | $0 | $235,545 | $0 | $0 | $0 |
| MIHAL DENISE SVP WS MKT COO | ||||||||||||||
| (*SEE ADD'L INFO IN SCH J P3) | $405,664 | $0 | $219,529 | $0 | $1,029,930 | $0 | $56,800 | $0 | $16,130 | $0 | $1,728,053 | $0 | $405,349 | $0 |
| WALLEY BRUCE | ||||||||||||||
| SVP MEDICAL AFFAIRS | $349,797 | $0 | $245,580 | $0 | $18,604 | $0 | $46,117 | $0 | $15,229 | $0 | $675,327 | $0 | $0 | $0 |
| CHEN FRANKLIN | ||||||||||||||
| ONCOLOGIST | $341,354 | $0 | $373,367 | $0 | $3,005 | $0 | $57,224 | $0 | $30,753 | $0 | $805,703 | $0 | $0 | $0 |
| CHRYSSON NICK | ||||||||||||||
| ONCOLOGIST | $655,683 | $0 | $245,033 | $0 | $44,320 | $0 | $63,300 | $0 | $36,429 | $0 | $1,044,765 | $0 | $0 | $0 |
| GROTE THOMAS | ||||||||||||||
| ONCOLOGIST | $443,829 | $0 | $435,078 | $0 | $46,119 | $0 | $47,814 | $0 | $26,991 | $0 | $999,831 | $0 | $0 | $0 |
| HINES SUSAN | ||||||||||||||
| ONCOLOGIST | $394,448 | $0 | $283,111 | $0 | $43,631 | $0 | $62,734 | $0 | $25,703 | $0 | $809,627 | $0 | $0 | $0 |
| PASCHOLD EUGENE | ||||||||||||||
| ONCOLOGIST | $442,960 | $0 | $295,964 | $0 | $48,506 | $0 | $57,226 | $0 | $31,963 | $0 | $876,619 | $0 | $0 | $0 |
| ALLEN ELMS | ||||||||||||||
| FMR SVP MAJOR GIFTS | $76,883 | $0 | $12,600 | $0 | $16,234 | $0 | $10,240 | $0 | $17,885 | $0 | $133,842 | $0 | $7,500 | $0 |
| HAMMES PAUL | ||||||||||||||
| FMR SVO & COO FMC | $0 | $0 | $102,268 | $0 | $271,800 | $0 | $0 | $0 | $23,925 | $0 | $397,993 | $0 | $7,500 | $0 |
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 1A | PART I, LINE 1A: FRINGE 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 DEEMED TO INVOLVE BUSINESS NECESSITY. 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 PURCHASE SPLIT DOLLAR INSURANCE THROUGH THEIR DISCRETIONARY SPENDING ACCOUNT MAY HAVE THE ADDITIONAL INCOME TAX OWED ON THE PS-58 COSTS PAID BY THE ORGANIZATION. 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 3 | PART I, LINE 3: THE FILING ORGANIZATION IS AN AFFILIATE IN AN INTEGRATED HEALTHCARE SYSTEM AND IS SUPPORTED BY A PARENT ORGANIZATION THAT 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, LINES 4A-B | PART I, LINE 4A-C: SEVERANCE, NONQUALIFIED, AND EQUITY-BASED PAYMENTS SEVERANCE NONQUALIFIED EQUITY-BASED HAMMES, PAUL 271,800 0 0 LINDSAY, JEFFERY 0 *1,885,932 0 MCGEE, LAWRENCE 0 *437,787 0 MIHAL, DENISE 0 *999,460 0 |
| *SCHEDULE J PART II COLUMN B (III): | IN 2012, THE INDEPENDENT AND DISINTERESTED MEMBERS OF THE NOVANT HEALTH BOARD OF TRUSTEES COMPENSATION AND LEADERSHIP COMMITTEE (THE "COMMITTEE") ENGAGED INTEGRATED HEALTHCARE STRATEGIES TO ASSESS THE MARKET AND DESIGN A NEW SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN ("NEW SERP") THAT WOULD BE MORE IN LINE WITH MARKET PRACTICE AND INDUSTRY TRENDS AND THAT WOULD BETTER ACCOMPLISH NOVANT HEALTH'S STRATEGIC EXECUTIVE RETENTION AND ATTRACTION GOALS, AND TO REPLACE THE EXISTING PLAN. IN 2013, THE COMMITTEE APPROVED A NEW DEFINED CONTRIBUTION SERP, TO BE EFFECTIVE 1/1/2014, AND TERMINATED THE EXISTING DEFINED BENEFIT PLAN, WHICH HAS BEEN DESCRIBED IN DETAIL IN PRIOR NOVANT HEALTH FORM 990S. AS 2013 WAS A TRANSITION YEAR, SERP BENEFITS PAID OUT AS A RESULT OF THE TERMINATION OF THE EXISTING DEFINED BENEFIT PLAN HAVE BEEN INCLUDED IN THE COMPENSATION AMOUNTS REPORTED IN PART VII AND IN COLUMN (B)(III) OF SCHEDULE J, AND DEFERRED COMPENSATION AMOUNTS THAT ACCRUED IN 2013 UNDER THE NEW SERP TO BE CONTRIBUTED TO PARTICIPANTS IN 2014 ARE REPORTED IN COLUMN (C) OF SCHEDULE J. THE AMOUNTS REFLECTED IN COLUMN F AS PREVIOUSLY REPORTED REFLECT THE CUMULATIVE AMOUNTS RECORDED ON PRIOR 990S IN COLUMN C AS DEFERRED COMPENSATION. THE AMOUNT IS THEN ADJUSTED FOR ANY PRIOR YEAR'S PAYMENTS THAT HAVE BEEN REPORTED PREVIOUSLY IN COLUMNS B(III) AND F. THE AMOUNTS PREVIOUSLY REPORTED AS DEFERRED COMPENSATION IN COLUMN C WERE DETERMINED USING AN ACTUARIAL CALCULATION THAT IS BASED ON SEVERAL FACTORS INCLUDING CURRENT AND FUTURE SALARY EXPECTATIONS, EXPECTED FUTURE YEARS OF SERVICE, AND DISCOUNTED USING INTEREST RATES IN PLACE AT THE TIME OF CALCULATION. THE AMOUNT REPORTED IN COLUMN B(III) FOR THE PLAN PAYOUT WILL NOT EXACTLY REFLECT THE CUMULATIVE ACCRUALS REPORTED IN COLUMN F BECAUSE OF THE VARIABILITY OF THE CALCULATION'S FACTORS OVER TIME. IN ADDITION, DUE TO THE LUMP SUM NATURE OF THE FINAL PAYOUT, THE AMOUNTS REPORTED IN COLUMN C AS ACCRUED IN THE PRIOR YEAR WOULD NOT INCLUDE A PORTION OF THE AMOUNTS ACCELERATED INTO 2013. THE EXISTING DEFINED BENEFIT PLAN PARTICIPANTS' PAYMENTS VARIED BASED ON LENGTH OF SERVICE TO THE ORGANIZATION, WHICH RANGED FROM 8 TO 37 YEARS, AND VESTING STATUS AT THE TIME OF PLAN TERMINATION. THE NEW 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. 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 COMMITTEE REVIEWS, APPROVES, AND OVERSEES ALL ASPECTS AND ALL ELEMENTS OF EXECUTIVE COMPENSATION AND BENEFITS. |
| PART III - OTHER ADDITIONAL INFORMATION | DESCRIPTIONS 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 OFFICERS AND KEY EMPLOYEES 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; THIS MAXIMUM PERCENTAGE RANGES FROM 30% TO 70% OF BASE SALARY. 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. AWARDS ARE PAYABLE FOR A PARTICULAR THREE-YEAR PERFORMANCE CYCLE ONLY IF THE REQUISITE LEVEL OF COMMUNITY BENEFIT AND CHARITY CARE, ALONG WITH THE REQUIRED LEVEL OF FINANCIAL PERFORMANCE TO DEMONSTRATE LONG-TERM FINANCIAL STRENGTH, HAVE BEEN MET FOR THAT 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. |
Schedule L IRS990ScheduleL
Loans Btwn Org Interested Prsn LoansBtwnOrgInterestedPrsnGrp (4 entries)
| Relationship With OrgRelationshipWithOrgTxt | Loan PurposeLoanPurposeTxt | Loan From OrganizationLoanFromOrganizationInd | Original PrincipalOriginalPrincipalAmt | Balance DueBalanceDueAmt | DefaultDefaultInd | Board Or Committee ApprovalBoardOrCommitteeApprovalInd | Written AgreementWrittenAgreementInd |
|---|---|---|---|---|---|---|---|
| NICK CHRYSSON | |||||||
| EMPLOYEE | EMPLOYMENT RELATED | Yes (X) | $105,000 | $21,875 | 0 | Yes (1) | Yes (1) |
| THOMAS GROTE | |||||||
| EMPLOYEE | EMPLOYMENT RELATED | Yes (X) | $105,000 | $21,875 | 0 | Yes (1) | Yes (1) |
| EUGENE PASCHOLD | |||||||
| EMPLOYEE | EMPLOYMENT RELATED | Yes (X) | $105,000 | $21,875 | 0 | Yes (1) | Yes (1) |
| SUSAN HINES | |||||||
| EMPLOYEE | EMPLOYMENT RELATED | Yes (X) | $105,000 | $21,875 | 0 | Yes (1) | Yes (1) |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Balance Due | $87,500 | TotalBalanceDueAmt |
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (2 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| ELIZABETH WALLEY | |||
| FAMILY MEMBER OF BRUCE WALLEY, KEY EMPLOYEE | $99,724 | COMPENSATION PAID BY THE FILING ORGANIZATION TO A FAMILY MEMBER OF THE INTERESTED PERSON. | 0 |
| MARY J ALLEN | |||
| FAMILY MEMBER OF ELMS ALLEN, FORMER KEY EMPLOYEE | $51,203 | COMPENSATION PAID BY THE FILING ORGANIZATION TO A FAMILY MEMBER OF THE INTERESTED PERSON. | 0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (15 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PI, L1: ORGANIZATION'S MISSION OR MOST SIGNIFICANT ACTIVITIES | FORSYTH MEMORIAL HOSPITAL, INC. DOING BUSINESS AS NOVANT HEALTH FORSYTH MEDICAL CENTER (NHFMC) IS A TERTIARY CARE HOSPITAL LOCATED IN WINSTON-SALEM, NC. NHFMC IS FOCUSED ON PROVIDING COMMUNITY SUPPORT, CONSISTENT QUALITY, EXCELLENT SERVICE AND A REMARKABLE WORK ENVIRONMENT FOR STAFF. IT 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 IS RANKED AS ONE OF OUR NATION'S TOP 25 INTEGRATED HEALTHCARE SYSTEMS CARING FOR PATIENTS AND COMMUNITIES IN GEORGIA, NORTH CAROLINA, SOUTH CAROLINA AND VIRGINIA. IN 2013, THE SYSTEM REPORTED $3.6 BILLION IN REVENUES. NHFMC IS COMMITTED TO IMPROVING THE HEALTH OF OUR COMMUNITIES IN THE PIEDMONT TRIAD REGION OF NORTH CAROLINA, 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. QUALITY 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 (ACS) 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 (AAGL). 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. 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 (HCAHPS) 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." SAFETY 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. 2013 HIGHLIGHTS DURING 2013, NHFMC EXPANDED ACCESS TO MEDICAL CARE AND PROVIDED ADDITIONAL RESOURCES TO HELP PATIENTS AND OUR LOCAL COMMUNITIES TO GET BETTER AND STAY HEALTHY. -NOVANT HEALTH CLEMMONS MEDICAL CENTER (NHCMC) OPENED APRIL 3 IN CLEMMONS, NC, STAFFED BY APPROXIMATELY 100 EMPLOYEES. THE NEW $26 MILLION FACILITY INCLUDES AN EMERGENCY ROOM WITH 12 BAYS, TWO OPERATING ROOMS, LABORATORY AND AN IMAGING CENTER. A SECOND PHASE OF THE MEDICAL PLAZA, PLANNED FOR THE END OF 2014, WILL INCLUDE A MEDICAL OFFICE BUILDING. CLEMMONS VILLAGE LEADERS EXPECT THE NEW FACILITY TO STIMULATE FURTHER DEVELOPMENT OF A 124-ACRE VILLAGE POINT MIXED-USE AREA THAT WILL EVENTUALLY INCLUDE APARTMENTS AND CONDOMINIUMS AS WELL AS 30,000 SQUARE FEET OF RETAIL SPACE. NOVANT HEALTH DONATED MORE THAN 17 ACRES OF LAND TO THE VILLAGE AND REBUILT THE ADJACENT REYNOLDS POND DAM TO HELP ENCOURAGE DEVELOPMENT FOR THIS MASTER PLANNED AREA. -IN ITS SECOND FULL YEAR OF OPERATION, NOVANT HEALTH FORSYTH MEDICAL CENTER AFFILIATE HOSPITAL, NOVANT HEALTH KERNERSVILLE MEDICAL CENTER (NHKMC) IN KERNERSVILLE, NC, FOCUSED ON PROVIDING A FAST-ACCESS EMERGENCY DEPARTMENT, GENERAL, ORTHOPEDIC AND EYE SURGICAL SERVICES, CONSISTENT QUALITY, EXCELLENT SERVICE AND A REMARKABLE WORK ENVIRONMENT FOR STAFF TO RESIDENTS IN THE KERNERSVILLE, NC AREA, WESTERN GUILFORD AND ROCKINGHAM COUNTIES OF NC, AS WELL AS EASTERN STOKES AND FORSYTH COUNTIES OF NC. THE MEDICAL CENTER ALSO OPENED A BREAST HEALTH CENTER AND A CANCER CENTER, AND SUCCESSFULLY COMPLETED ITS SECOND JOINT COMMISSION ACCREDITATION SURVEY WITH OUTSTANDING RESULTS. -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. -THE MEDICAL CENTER ADDED A NEW HELICOPTER LANDING PAD ON THE TOP OF ITS PARKING DECK. IT ALLOWS FOR AIR TRANSPORTATION FOR PATIENTS NEEDING QUICK ACCESS TO HIGHLY SPECIALIZED TREATMENT, SUCH AS FOR STROKE AND CARDIAC PATIENTS. -NHFMC'S CARDIAC SURGERY PROGRAM IS RANKED AMONG THE HIGHEST IN THE NATION WITH A 3-STAR RATING FROM THE SOCIETY OF THORACIC SURGEONS. ONLY 13.5 PERCENT OF ALL CARDIAC SURGERY HOSPITALS IN THE U.S. RECEIVED THIS TOP RANKING. IN ADDITION, THE HEART AND VASCULAR INSTITUTE PERFORMED ITS FIRST TRANSCATHETER AORTIC VALVE REPLACEMENT (TAVR) PROCEDURE, A NEW TREATMENT OPTION FOR PEOPLE WITH SEVERE AORTIC STENOSIS WHO CANNOT UNDERGO SURGERY. NOVANT HEALTH WAS AMONG THE FIRST MEDICAL CENTERS IN THE COUNTRY APPROVED TO OFFER THIS NON-SURGICAL TREATMENT THAT INSERTS A WIRE MESH VALVE INTO THE HEART THROUGH AN ARTERY IN THE LEG. |
| COMMUNITY BENEFIT REPORT: | HTTP://WWW.NOVANTHEALTH.ORG/HOME/ABOUT-US/COMPANY - INFORMATION/FINANCIALPROFILE/COMMUNITY-BENEFIT-REPORT.ASPX THE COMMUNITY BENEFIT REPORT PREPARED BY NOVANT HEALTH IS A SYSTEM-WIDE REPORT THAT INCLUDES QUALITATIVE AND QUANTITATIVE INFORMATION. IN THIS REPORT, THE NOVANT HEALTH SYSTEM'S COMMUNITY BENEFIT WAS APPROXIMATELY $566,000,000, INCLUDING $129,000,000 IN CHARITY CARE, IN 2013. 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. |
| FORM 990, PART III, LINE 1: MISSION, VISION, AND VALUES | MISSION: NOVANT HEALTH EXISTS TO IMPROVE THE HEALTH OF COMMUNITIES, ONE PERSON AT A TIME. VISION: WE, THE EMPLOYEES OF NOVANT HEALTH AND OUR PHYSICIAN PARTNERS, 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: WE RECOGNIZE THAT EVERY PERSON IS DIFFERENT, EACH SHAPED BY UNIQUE LIFE EXPERIENCES. THIS ENABLES US TO BETTER UNDERSTAND ONE ANOTHER AND OUR CUSTOMERS. PERSONAL EXCELLENCE: WE STRIVE TO GROW PERSONALLY AND PROFESSIONALLY, AND 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. NOVANT HEALTH'S BRAND PROMISE: WE ARE MAKING YOUR HEALTHCARE EXPERIENCE REMARKABLE. WE WILL BRING YOU WORLD-CLASS TECHNOLOGY, CLINICIANS, AND CARE - WHEN AND WHERE YOU NEED IT. 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 I, LINE 1 | -THE NOVANT HEALTH MAYA ANGELOU WOMEN'S HEALTH AND WELLNESS CENTER CONTINUED TO PROVIDE A WIDE RANGE OF CLINICAL PROGRAMS AND SERVICES THAT TOUCH WOMEN'S HEALTH, INCLUDING HEART, WELLNESS, CANCER, SURGICAL SERVICES, MATERNITY, EMERGENCY CARE, BONE AND JOINT HEALTH, BEHAVIORAL HEALTHCARE AND A MIDLIFE WOMEN'S CENTER. -THE NOVANT HEALTH BREAST CENTER (FORSYTH) -HAS EARNED A THREE-YEAR ACCREDITATION IN BREAST MAGNETIC RESONANCE IMAGING (MRI) BY THE AMERICAN COLLEGE OF RADIOLOGY (ACR), MAKING IT WINSTON-SALEM, NC'S ONLY ACR-ACCREDITED BREAST MRI FACILITY. THE MEDICAL CENTER ALSO MADE SIGNIFICANT CONTRIBUTIONS TOWARD IMPROVING THE HEALTH OF THE COMMUNITIES WE SERVE. THE HIGHLIGHTS FOR 2013 INCLUDED THE FOLLOWING: -NHFMC HOSTED A HEALTH INSURANCE MARKETPLACE EVENT, A FREE INFORMATIONAL EVENT FOR PATIENTS AND COMMUNITY MEMBERS WHO ARE ELIGIBLE FOR INSURANCE PLANS THROUGH THE MARKETPLACE. MORE THAN 125 PEOPLE ATTENDED THE EVENT IN WINSTON-SALEM, NC TO HEAR AN EXPERT SPEAKER AND HAVE AN OPPORTUNITY TO SIGN UP FOR PLANS THROUGH ONSITE INSURANCE BROKERS, AS WELL AS TO LEARN ABOUT HEALTH AND WELLNESS SERVICES THAT NOVANT HEALTH PROVIDES. -THE MEDICAL CENTER JOINED WITH THE AMERICAN HEART ASSOCIATION/AMERICAN STROKE ASSOCIATION TO START A PARTNERSHIP TO PROMOTE AWARENESS OF STROKE SYMPTOMS. THE GOAL IS TO TEACH PEOPLE TO MORE EASILY RECOGNIZE STROKE WARNING SIGNS, WHICH OFTEN COME ON SUDDENLY, THROUGH AN ACRONYM CALLED F.A.S.T. - FACE DROOPING, ARM WEAKNESS, SPEECH DIFFICULTY AND TIME TO CALL 9-1-1. A FIRST EVENT WAS HELD AT THE MEDICAL CENTER'S CONFERENCE CENTER AND INCLUDED A SPECIAL LUNCHEON TO THANK CAREGIVERS OF STROKE SURVIVORS, HELPING THEM TO TAKE CARE OF THEMSELVES SO THAT THEY CAN CONTINUE TO CARE FOR OTHERS. -FOR THE FIFTH CONSECUTIVE YEAR, NHFMC JOINED WITH THE WINSTON-SALEM, NC MAYOR'S OFFICE AND THE AMERICAN HEART ASSOCIATION'S GO RED FOR WOMEN INITIATIVE TO HOST AN AWARENESS BREAKFAST EVENT AT THE MEDICAL CENTER'S CONFERENCE CENTER. APPROXIMATELY 150 GUESTS ATTENDED. -VASCULAR CLINIC/PAD SCREENINGS COMBINE FREE EDUCATION AND SCREENINGS ON CARDIOVASCULAR DISEASE RISK FACTORS WITH AN EMPHASIS ON PREVENTING PERIPHERAL ARTERIAL DISEASE (PAD) IN THE COMMUNITY. -BEHAVIORAL HEALTH COMMUNITY OUTREACH WHICH PROVIDES A 24/7 BEHAVIORAL HEALTH CALL CENTER, DEPRESSIONS AND BIPOLAR SUPPORT GROUP, DIALECTIC BEHAVIORAL THERAPY SKILLS TRAINING, A FAMILY RECOVERY PROGRAM AND A MOBILE CRISIS RESPONSE TEAM. -THE NOVANT HEALTH DERRICK L. DAVIS CANCER CENTER'S COMMUNITY SERVICES INCLUDE COMMUNITY EDUCATION FORUMS, A PALLIATIVE CARE SYMPOSIUM, AN EMPLOYEE MAMMOGRAM PROGRAM AS WELL AS PUBLIC SUPPORT GROUPS AND LEARNING SESSIONS FOR CAREGIVERS AND THOSE WITH LEUKEMIA AND LYMPHOMA, GASTROINTESTINAL CANCER, GYNECOLOGIC CANCER AS WELL AS TEACHING ABOUT SPIRITUALITY AND CANCER. -CARDIAC COMMUNITY SERVICES INCLUDE COMMUNITY HEALTH & NUTRITION EDUCATION AND SCREENINGS, A HEART FAILURE CLINIC AND LIPID CLINIC, AN OPEN HEART CLINIC, STRESS MANAGEMENT PROGRAMS AS WELL AS TOBACCO AND SMOKING CESSATION PROGRAMS. -DIABETES SERVICES FEATURE CONTINUOUS GLUCOSE MONITORING, DIABETES PREVENTION AND SCREENINGS SESSIONS, DIABETES SELF-MANAGEMENT EDUCATION AND SUPPORT GROUPS AS WELL AS INSULIN PUMP TRAINING. -REHABILITATION SERVICES TO THE COMMUNITY INCLUDE AN APHASIA SUPPORT GROUP, AUDIOLOGY AND POSTURE SCREENINGS. -STROKE AND NEUROSCIENCES COMMUNITY SUPPORT INCLUDES A SLEEP MEDICINE SYMPOSIUM, A STROKE SYMPOSIUM AS WELL AS STROKE EDUCATION AND SUPPORT GROUPS. -WOMEN'S SERVICES COMMUNITY OUTREACH INCLUDE BABY BOOT CAMP, BIRTH AND BEGINNING CLASSES, BREASTFEEDING EDUCATION AND SUPPORT GROUPS, A FREE ON-LINE HEALTH RISK ASSESSMENT AND GIRLS ON THE RUN AND GIRLS ON TRACK WHICH PROMOTE YOUTH TO LEAD ACTIVE, HEALTHY LIFESTYLES. IN ADDITION TO OUR QUALITY AND COMPREHENSIVE CATEGORIES OF SERVICES, 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. |
| FORM 990, PART III, LINE 4A: PROGRAM SERVICE ACCOMPLISHMENTS | KMC HAS 50 LICENSED BEDS. DURING 2013 THERE WERE 8,920 PATIENT DAYS WITH AN AVERAGE LENGTH OF STAY OF 4 DAYS, AND AVERAGE DAILY CENSUS OF 24, AND 2,422 DISCHARGES. THERE WERE 2,749 INPATIENT AND OUTPATIENT SURGERIES, A TOTAL OF 33,104 OUTPATIENT ENCOUNTERS AND 29,419 EMERGENCY DEPARTMENT VISITS. DURING 2013 CMC HAD 427 OUTPATIENT SURGERIES, A TOTAL OF 7,393 OUTPATIENT ENCOUNTERS AND 6,732 EMERGENCY DEPARTMENT VISITS. |
| FORM 990, PART VI, SECTION A, LINE 6 | FORM 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 7A | FORM 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 7B | FORM 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 11 | FORM 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, WHICH OVERSEES TAX MATTERS FOR NOVANT HEALTH. THE AUDIT AND COMPLIANCE COMMITTEE IS THE REVIEW BODY FOR ALL OF THE FORM 990S FILED FOR ORGANIZATIONS WITHIN THE NOVANT HEALTH SYSTEM. THE AUDIT AND COMPLIANCE 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 12C | FORM 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. ANY POSITIVE ANSWERS ON THE TRUSTEE ANNUAL DISCLOSURE FORM ARE REVIEWED BY THE GENERAL COUNSEL. IF THE RELATIONSHIP DISCLOSED IS DETERMINED NOT TO POSE A POTENTIAL CONFLICT OF INTEREST GENERALLY, THEN NO ACTION IS TAKEN. 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 15 | FORM 990, PART VI, SECTION B, LINE 15A: COMPENSATION PROCESS FOR TOP OFFICIAL INDEPENDENT AND DISINTERESTED MEMBERS OF THE NOVANT HEALTH BOARD OF TRUSTEES (WHO COMPRISE THE COMPENSATION AND LEADERSHIP COMMITTEE OF THE BOARD) REVIEW, APPROVE, AND OVERSEE ALL ASPECTS OF COMPENSATION AND BENEFITS FOR NOVANT HEALTH'S CEO AND FOR CERTAIN LEADERS AND EXECUTIVES ("EXECUTIVES") SERVING NOVANT HEALTH AND ITS RELATED OR DISREGARDED ENTITIES. THE COMMITTEE WORKS WITH AN INDEPENDENT COMPENSATION CONSULTANT, USES THIRD PARTY COMPARABILITY DATA FOR FUNCTIONALLY SIMILAR POSITIONS AT SIMILARLY SITUATED ORGANIZATIONS, AND MAKES SURE 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 INDEPENDENT AND DISINTERESTED MEMBERS OF THE NOVANT HEALTH 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 NOVANT HEALTH AND ITS RELATED OR DISREGARDED ENTITIES. THE COMMITTEE WORKS WITH AN INDEPENDENT COMPENSATION CONSULTANT, USES THIRD PARTY COMPARABILITY DATA FOR FUNCTIONALLY SIMILAR POSITIONS AT SIMILARLY SITUATED ORGANIZATIONS, AND MAKES SURE 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 19 | FORM 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 ORGANIZATIONS | THE 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 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: -2,227,734. AFFILIATE TRANSFERS: -8,192,357. MALPRACTICE INSURANCE: -2,451,841. ROUNDING 5. PROGRAM INVESTMENT ADJUSTMENT 425,484. |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp (3 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Total IncomeTotalIncomeAmt | End Of Year AssetsEndOfYearAssetsAmt | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|
| EXCEL IMAGING LLC | |||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTONSALEM | NC | 27103 | 204253946 | INACTIVE | NC | $0 | $0 | FORSYTH MEMORIAL HOSPITAL |
| SALEM MRI LLC | |||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTONSALEM | NC | 27103 | INACTIVE | NC | $0 | $0 | FORSYTH MEMORIAL HOSPITAL | |
| THE BREAST CLINIC MRI LLC | |||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTONSALEM | NC | 27103 | INACTIVE | NC | $0 | $0 | FORSYTH MEMORIAL HOSPITAL | |
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (23 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| AUXILIARY OF FORSYTH MEMORIAL HOSPITAL | |||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 560862112 | HEALTHCARE | NC | 501(C)(3) | LINE 9 | FORSYTH MEMORIAL HOSPITAL INC | Yes (1) | |
| BRUNSWICK NOVANT MEDICAL CENTER FOUNDATION | |||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 274616751 | HEALTHCARE | NC | 501(C)(3) | LINE 7 | BRUNSWICK COMMUNITY HOSPITAL LLC | 0 | |
| CAROLINA MEDICORP ENTERPRISES INC | |||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 581466368 | HEALTHCARE | NC | 501(C)(3) | LINE 11B, II | NOVANT MEDICAL GROUP INC | 0 | |
| COMMUNITY GENERAL HEALTH PARTNERS INC | |||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 560636250 | HEALTHCARE | NC | 501(C)(3) | LINE 3 | NOVANT HEALTH TRIAD REGION LLC | 0 | |
| COMMUNITY GENERAL HOSPITAL FOUNDATION INC | |||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 561828629 | HEALTHCARE | NC | 501(C)(3) | LINE 7 | COMMUNITY GENERAL HEALTH PARTNERS INC | 0 | |
| FORSYTH MEDICAL CENTER FOUNDATION | |||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 562120959 | HEALTHCARE | NC | 501(C)(3) | LINE 7 | FORSYTH MEMORIAL HOSPITAL INC | Yes (1) | |
| FOUNDATION HEALTH SYSTEMS CORP | |||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 561373175 | HEALTHCARE | NC | 501(C)(3) | LINE 9 | NOVANT HEALTH INC | 0 | |
| MEDICAL PARK HOSPITAL INC | |||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 561340424 | HEALTHCARE | NC | 501(C)(3) | LINE 3 | NOVANT HEALTH TRIAD REGION LLC | 0 | |
| NOVANT HEALTH INC | |||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 561376950 | HEALTHCARE | NC | 501(C)(3) | LINE 11C, III-FI | 0 | N/A | |
| NOVANT MEDICAL GROUP INC | |||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 581728803 | HEALTHCARE | NC | 501(C)(3) | LINE 3 | NMG SERVICES INC | 0 | |
| PERSONAL CARE SERVICES | |||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 541291284 | HEALTHCARE | VA | 501(C)(3) | LINE 9 | PRINCE WILLIAM HEALTH SYSTEM | 0 | |
| THE PRESBYTERIAN HOSPITAL | |||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 560554230 | HEALTHCARE | NC | 501(C)(3) | LINE 3 | NOVANT HEALTH SOUTHERN PIEDMONT REGION LLC | 0 | |
| PRESBYTERIAN HOSPITAL FOUNDATION | |||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 581413074 | HEALTHCARE | NC | 501(C)(3) | LINE 7 | NOVANT HEALTH SOUTHERN PIEDMONT REGION LLC | 0 | |
| PRESBYTERIAN MEDICAL CARE CORPORATION | |||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 561376368 | HEALTHCARE | NC | 501(C)(3) | LINE 3 | NOVANT HEALTH SOUTHERN PIEDMONT REGION LLC | 0 | |
| PRINCE WILLIAM HEALTH SYSTEM | |||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 541278944 | HEALTHCARE | VA | 501(C)(3) | LINE 11C, III-FI | NOVANT HEALTH INC | 0 | |
| PWHS FOUNDATION | |||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 541307595 | HEALTHCARE | VA | 501(C)(3) | LINE 7 | PRINCE WILLIAM HEALTH SYSTEM | 0 | |
| PRINCE WILLIAM HOSPITAL | |||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 540696355 | HEALTHCARE | VA | 501(C)(3) | LINE 3 | PRINCE WILLIAM HEALTH SYSTEM | 0 | |
| ROWAN HEALTH SERVICES CORP | |||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 561424814 | HEALTHCARE | NC | 501(C)(3) | LINE 11C, III-FI | NOVANT HEALTH INC | 0 | |
| NMG SERVICES INC | |||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 562098809 | HEALTHCARE | NC | 501(C)(3) | LINE 9 | NOVANT HEALTH INC | 0 | |
| ROWAN REGIONAL MEDICAL CENTER AUXILIARY | |||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 237022472 | HEALTHCARE | NC | 501(C)(3) | LINE 9 | ROWAN REGIONAL MEDICAL CENTER INC | 0 | |
| ROWAN REGIONAL MEDICAL CENTER FOUNDATION INC | |||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 561424818 | HEALTHCARE | NC | 501(C)(3) | LINE 7 | ROWAN REGIONAL MEDICAL CENTER INC | 0 | |
| ROWAN REGIONAL MEDICAL CENTER INC | |||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 560547479 | HEALTHCARE | NC | 501(C)(3) | LINE 3 | ROWAN HEALTH SERVICES CORP | 0 | |
| SELF INSURANCE FUND - NOVANT HEALTH INC | |||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 581867242 | HEALTHCARE | NC | 501(C)(3) | LINE 11C, III-FI | NOVANT HEALTH INC | 0 | |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (14 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd | Address Line1ForeignAddress/AddressLine1 | CityForeignAddress/City | Province Or StateForeignAddress/ProvinceOrState | CountryForeignAddress/Country | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| COMMUNICARE INC | ||||||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 561952950 | RENTAL REAL ESTATE | NC | N/A | C | 0 | |||||
| CHOICEHEALTH INC | ||||||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 561896065 | MANAGED CARE | NC | N/A | C | 0 | |||||
| NOVANT HEALTH SHARED SERVICES INC (FKA ADEPT HEALTH INC) | ||||||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 562226937 | ADMIN SVCS | NC | N/A | C | 0 | |||||
| SALEM HEALTH SERVICES INC | ||||||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 561342654 | HEALTH RELATED | NC | N/A | C | 0 | |||||
| SALEM DIAGNOSTICS INC | ||||||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 561513621 | HEALTH RELATED | NC | N/A | C | 0 | |||||
| MEDQUEST ASSOCIATES INC | ||||||||||||||
| 3480 PRESTON RIDGE RD STE 600 | ALPHARETTA | GA | 30005 | 223860764 | DIAGNOSTIC IMAGING | DE | N/A | C | 0 | |||||
| TRINOVA INSURANCE LTD | ||||||||||||||
| 980615601 | INSURANCE | N/A | C | 0 | 58 PAR LA VILLE ROAD PO BOX 1995 | HAMILTON | BERMUDA HMHX | BD | BD | |||||
| PRESBYTERIAN WOMEN'S CARE CORP | ||||||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 562217545 | HEALTHCARE | NC | N/A | C | 0 | |||||
| NOVANT HEALTH RISK RETENTION GROUP INC | ||||||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 203382230 | INSURANCE | SC | N/A | C | 0 | |||||
| ROWAN MEDICAL FACILITIES INC | ||||||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 561424672 | MEDICAL SUPPLIES | NC | N/A | C | 0 | |||||
| ROWAN MEDICAL ALLIANCE INC | ||||||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 561992669 | INSURANCE | NC | N/A | C | 0 | |||||
| FISCAL CORP LTD | ||||||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 541282069 | HEALTH RELATED | VA | N/A | C | 0 | |||||
| PRINCE WILLIAM FAMILY HEALTHCARE | ||||||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 541748199 | HEALTH RELATED | VA | N/A | C | 0 | |||||
| PRINCE WILLIAM MEDICAL SUPPLY | ||||||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 541307554 | HEALTH RELATED | VA | N/A | C | 0 | |||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (1) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (2 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| FORSYTH MEDICAL CENTER FOUNDATION | ||
| C | $2,217,741 | CASH |
| FORSYTH MEDICAL CENTER FOUNDATION | ||
| R | $8,192,357 | CASH |