NORTH CAROLINA BAPTIST HOSPITAL: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- NORTH CAROLINA BAPTIST HOSPITAL (EIN 56-0552787)
- Tax period
- 2012-07-01 to 2013-06-30
- Filed
- 2014-05-14
- IRS object ID
- 201441349349300824
- Schema version
- 2012v2.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule F
- Schedule H
- Schedule I
- Schedule J
- Schedule K
- Schedule L
- Schedule M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2014-05-14T07:36:58-05:00 | Timestamp |
| Tax Period End Date | 2013-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 135565207 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KPMG LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 300 NORTH GREENE STREET | AddressLine1 |
| City | GREENSBORO | City |
| State | NC | State |
| ZIP Code | 27401 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 560552787 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NORTH CAROLINA BAPTIST HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | NORT | NameControl |
| Phone | 3367164445 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | MEDICAL CENTER BLVD | AddressLine1 |
| City | WINSTONSALEM | City |
| State | NC | State |
| ZIP Code | 27157 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | JOHN D MCCONNELL MD | Name |
| Title | CEO | Title |
| Phone | 3367164445 | Phone |
| Date Signed | 2014-05-12 | DateSigned |
| Authorize Third Party | 0 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| PTIN | P00008888 | PTIN |
| Phone | 3362753394 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | JOHN D MCCONNELL MD | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | MEDICAL CENTER BLVD | AddressLine1 |
| City | WINSTONSALEM | City |
| State | NC | State |
| ZIP Code | 27157 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 1268161053 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.WAKEHEALTH.EDU | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1923 | YearFormation |
| State Legal Domicile | NC | StateLegalDomicile |
| Activity Or Mission Description | IMPROVING THE HEALTH OF OUR REGION, STATE AND NATION | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 17 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 16 | NbrIndependentVotingMembers |
| Total Nbr Employees | 10138 | TotalNbrEmployees |
| Total Nbr Volunteers | 1000 | TotalNbrVolunteers |
| Total Gross UBI | 3483187 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 2085085 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 3031792 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 3462376 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 1186396254 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 1218479632 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 77580140 | InvestmentIncomePriorYear |
| Investment Income Current Year | 42423781 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 3718388 | OtherRevenuePriorYear |
| Other Revenue Current Year | 3626103 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 1270726574 | TotalRevenuePriorYear |
| Total Revenue Current Year | 1267991892 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 591467 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 1278528 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 539950281 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 547352388 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 629349396 | OtherExpensePriorYear |
| Other Expenses Current Year | 712232895 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 1169891144 | TotalExpensesPriorYear |
| Total Expenses Current Year | 1260863811 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 100835430 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 7128081 | RevenuesLessExpensesCY |
| Total Assets BOY | 1619889593 | TotalAssetsBOY |
| Total Assets EOY | 1778311980 | TotalAssetsEOY |
| Total Liabilities BOY | 671420988 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 815813924 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 948468605 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 962498056 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | SEE SCHEDULE O FOR CONTINUATIONTHE ORGANIZATION IS PART OF WAKE FOREST BAPTIST MEDICAL CENTER, A PREEMINENT, INTERNATIONALLY RECOGNIZED ACADEMIC MEDICAL CENTER OF THE HIGHEST QUALITY WITH BALANCED EXCELLENCE IN PATIENT CARE, RESEARCH AND EDUCATION. WAKE FOREST BAPTIST MEDICAL CENTER'S MISSION IS TO IMPROVE THE HEALTH OF THE REGION, STATE AND NATION BY:- SERVING AS THE PREMIER HEALTH SYSTEM IN THE REGION, WITH SPECIFIC CENTERS OF EXCELLENCE RECOGNIZED AS NATIONAL AND INTERNATIONAL CARE DESTINATIONS.- GENERATING AND TRANSLATING KNOWLEDGE TO PREVENT, DIAGNOSE AND TREAT DISEASE.- TRAINING TOMORROW'S LEADERS IN HEALTH CARE AND BIOMEDICAL SCIENCE. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 1147158690 | Expense |
| Grants | 1278528 | Grants |
| Revenue | 1215255766 | Revenue |
| Description | SEE SCHEDULE O FOR COMPLETE DESCRIPTIONTHE HOSPITAL IS AN INTEGRAL PART OF WAKE FOREST BAPTIST MEDICAL CENTER, A PREEMINENT, INTERNATIONALLY RECOGNIZED ACADEMIC MEDICAL CENTER OF THE HIGHEST QUALITY WITH BALANCED EXCELLENCE IN PATIENT CARE, RESEARCH AND EDUCATION. WAKE FOREST BAPTIST MEDICAL CENTER IS NORTHWEST NORTH CAROLINA'S SOLE ACADEMIC MEDICAL CENTER, BRINGING TO THE REGION THE RESOURCES OF ONE OF AMERICA'S TOP HOSPITALS AND INNOVATIVE RESEARCH CENTERS AND A PREMIER MEDICAL SCHOOL. WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER IS A CORPORATION WHOSE MEMBERS ARE WAKE FOREST UNIVERSITY AND NORTH CAROLINA BAPTIST HOSPITAL. WAKE FOREST BAPTIST MEDICAL CENTER OPERATES WAKE FOREST SCHOOL OF MEDICINE AND HAS A FACULTY OF 1,165, INCLUDING PHYSICIANS AND BASIC SCIENTISTS. THE MEDICAL CENTER HAS 1,004 ACUTE CARE AND REHABILITATION BEDS OPERATIVE ACROSS THE SYSTEM, WHICH ENCOMPASSES ITS MAIN CAMPUS (885 BEDS), BRENNER CHILDREN'S HOSPITAL (160 BEDS, INCLUDED IN MAIN CAMPUS TOTAL); WAKE FOREST BAPTIST HEALTH-LEXINGTON MEDICAL CENTER (94 BEDS); AND WAKE FOREST BAPTIST HEALTH-DAVIE MEDICAL CENTER (25 BEDS). THE MEDICAL CENTER PRIMARILY SERVES A 24-COUNTY REGION IN NORTHWESTERN NORTH CAROLINA AND SOUTHWESTERN VIRGINIA, BUT DRAWS PATIENTS FROM ACROSS THE STATE AND NATION FOR SELECT SERVICES.WAKE FOREST SCHOOL OF MEDICINE IS THE DRIVING FORCE BEHIND THE ESTABLISHMENT OF WAKE FOREST INNOVATION QUARTER, A FAST-GROWING HUB FOR BIOMEDICAL AND MATERIAL SCIENCES AND INFORMATION TECHNOLOGY IN DOWNTOWN WINSTON-SALEM. IN 2014, THE INNOVATION QUARTER WILL WELCOME INMAR, AN INFORMATION SERVICES COMPANY THAT WILL HAVE 900 EMPLOYEES AT ITS NEW HOME IN A RENOVATED FORMER R.J. REYNOLDS TOBACCO CO. BUILDING. IT WILL BE IN ONE OF TWO NEW BUILDINGS TO BE OPENED IN THE INNOVATION QUARTER; THE SECOND BUILDING WILL BE HOME BOTH TO WAKE FOREST SCHOOL OF MEDICINE'S DIVISION OF PUBLIC HEALTH SCIENCES, ITS PHYSICIAN ASSISTANT PROGRAM AND TO A NEW CENTER FOR EMERGING TECHNOLOGIES THAT WILL BE OPENED BY FORSYTH TECHNICAL COMMUNITY COLLEGE. THE BUSINESS, ACADEMIC AND RESEARCH CORE AT THE INNOVATION QUARTER COMBINES WITH OTHER OFFERINGS SUCH AS A PUBLIC PARK (OFFERING OUTDOOR YOGA, A FILM SERIES AND MORE) AND A BRANCH OF THE YMCA TO MAKE IT A DIVERSE AREA OF GROWTH IN WINSTON-SALEM.1. CLINICAL SERVICES WAKE FOREST BAPTIST MEDICAL CENTER IS NATIONALLY RECOGNIZED FOR CLINICAL EXCELLENCE AND INTERNATIONALLY KNOWN FOR PIONEERING RESEARCH AND CLINICAL INNOVATION. IT OFFERS EXPERTISE IN MORE THAN 100 AREAS OF MEDICINE, ENCOMPASSING COMPREHENSIVE PREVENTIVE AND HIGHLY SPECIALIZED CARE FOR ALL AGES. THE WAKE FOREST BAPTIST MEDICAL CENTER INCLUDES 42 SUBSIDIARIES, JOINT VENTURES AND AFFILIATE HOSPITALS, AND OPERATES ABOUT 80 OUTREACH ACTIVITIES, INCLUDING SATELLITE SPECIALTY CLINICS, ACROSS NORTHWEST NORTH CAROLINA.IN THE PAST FISCAL YEAR, WAKE FOREST BAPTIST MEDICAL CENTER COMPLETED A $125 MILLION EXPANSION OF ITS COMPREHENSIVE CANCER CENTER, WHICH CONSOLIDATED INPATIENT AND OUTPATIENT SERVICES INTO A SINGLE LOCATION. THE NEW CENTER OFFERS 530,600 SQUARE FEET OF SPACE TO PATIENTS, MAKING IT THE LARGEST INTEGRATED CANCER CENTER IN NORTH CAROLINA. ALSO IN 2013, WAKE FOREST BAPTIST MEDICAL CENTER OPENED A NEW STATE-OF-THE-ART CLINICAL CAMPUS, DAVIE MEDICAL CENTER - BERMUDA RUN, WHICH INCLUDES A 24/7/365 EMERGENCY DEPARTMENT, AND A NEW WEIGHT MANAGEMENT CENTER AT ITS MEDICAL PLAZA - COUNTRY CLUB SITE THAT COMBINES MEDICAL AND SURGICAL WEIGHT LOSS PROGRAMS IN ONE LOCATION. OVERALL IN FY 2013, WAKE FOREST BAPTIST MEDICAL CENTER HAD 38,696 INPATIENT ADMISSIONS AND 1,051,359 OUTPATIENT ENCOUNTERS (EMERGENCY DEPARTMENT, DOWNTOWN HEALTH PLAZA, DAY HOSPITAL, AMBULATORY VISITS). THE TOTAL PATIENT ENCOUNTERS NUMBERED 1,090,055.2. OUTREACHTHE DOWNTOWN HEALTH PLAZA IS A FULL-SERVICE, OUTPATIENT MEDICAL CLINIC THAT SERVES MANY OF FORSYTH COUNTY'S UNINSURED AND UNDERINSURED RESIDENTS WITH A STATE-OF-THE-ART MEDICAL HOME. EXPERTS FROM 12 WAKE FOREST BAPTIST MEDICAL CENTER DEPARTMENTS PROVIDE COORDINATED CARE THAT INCLUDES ADULT MEDICINE, PEDIATRICS, OBSTETRICS AND GYNECOLOGY, AS WELL AS AN ONSITE PHARMACY, LABORATORY AND RADIOLOGY SERVICES (INCLUDING MAMMOGRAPHY). THE DOWNTOWN HEALTH PLAZA PLAYS A SIGNIFICANT ROLE IN COMMUNITY HEALTH, PROVIDING COMMUNITY HEALTH FAIRS, DIABETES EDUCATION AND A CENTERING PREGNANCY PROGRAM THAT IS REDUCING THE INCIDENCE OF LOW BIRTH-WEIGHT BABIES. A TOTAL OF 65,541 PATIENT VISITS WERE RECORDED AT THE PLAZA BETWEEN JULY 2012 AND JUNE 2013. COSTS ARE SUBSIDIZED BY WAKE FOREST BAPTIST MEDICAL CENTER. WAKE FOREST BAPTIST MEDICAL CENTER ALSO OPERATES NUMEROUS INNOVATIVE COMMUNITY OUTREACH PROGRAMS, INCLUDING:- BESTHEALTH, WHICH OFFERS HEALTH SEMINARS LED BY WAKE FOREST BAPTIST HEALTH EXPERTS, HEALTH SCREENINGS, COOKING AND FITNESS CLASSES, AND ONLINE HEALTH RESOURCES.- FAITHHEALTHNC, AN INITIATIVE THAT CONNECTS THE CARING STRENGTHS OF CONGREGATIONS, THE CLINICAL EXPERTISE OF PROVIDERS AND A NETWORK OF COMMUNITY RESOURCES TO EASE THOSE ON THE JOURNEY TO HEALTH AND HEALING, STRENGTHENING COMMUNITIES IN THE PROCESS.- BE INVOLVED, AN ONLINE RESOURCE THAT ALLOWS THE PUBLIC ACCESS TO INFORMATION ABOUT HUNDREDS OF CLINICAL STUDIES. THE SITE ALLOWS PEOPLE TO REGISTER TO BE NOTIFIED WHEN STUDIES BEGIN THAT COULD MATCH CONDITIONS THEY FACE.3. EDUCATIONAL MISSION AND ACCOMPLISHMENTS THE CONSTITUENT ORGANIZATIONS OF WAKE FOREST BAPTIST MEDICAL CENTER OPERATE A BROAD RANGE OF EDUCATIONAL PROGRAMS, GRADUATING SKILLED PRACTITIONERS. IT ATTRACTS SOME OF THE WORLD'S MOST COMPETITIVE MEDICAL STUDENTS, RESIDENTS AND FELLOWS, AS WELL AS STUDENTS IN CLINICAL PASTORAL CARE, NURSE ANESTHESIA AND OTHER AREAS. IN THE PAST YEAR, WAKE FOREST BAPTIST MEDICAL CENTER INVESTED MORE THAN $56 MILLION IN THE EDUCATION OF TOMORROW'S HEALTH CARE AND BIOMEDICAL LEADERS. THAT INVESTMENT SUPPORTED THE TRAINING OF 469 MEDICAL STUDENTS, 683 PHYSICIAN RESIDENTS AND FELLOWS, 308 GRADUATE STUDENTS AND 124 PHYSICIAN ASSISTANTS. ALSO LAST YEAR, THE NORTHWEST AREA HEALTH EDUCATION CENTER, PART OF WAKE FOREST SCHOOL OF MEDICINE, PROVIDED 1,910 CONTINUING MEDICAL EDUCATION ACTIVITIES FOR 33,518 PARTICIPANTS THROUGHOUT THE REGION. | Description |
| Total Program Service Expense | 1147158690 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 1 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 1 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 1 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 1 | FinancialStmtAttached |
| Grants To Organizations | 1 | GrantsToOrganizations |
| Grants To Individuals | 1 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 1 | TaxExemptBonds |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBonds |
| Escrow Account | 0 | EscrowAccount |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 1 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 1 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 1 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 1 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transaction Related Entity | 1 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 186 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 10138 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 1 | UnrelatedBusinessIncome |
| Form990-T Filed | 1 | Form990-TFiled |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 17 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 16 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 1 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 1 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 1 | InvestmentInJointVenture |
| Written Policy Or Procedure | 1 | WrittenPolicyOrProcedure |
| States Where Copy Of Return Is Filed | NC | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DOUG LISCHKE | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 3367164445 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | MEDICAL CENTER BLVD | AddressLine1 |
| City | WINSTON SALEM | City |
| State | NC | State |
| ZIP Code | 27157 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (48 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Average Hours Per Week RelatedAverageHoursPerWeekRelated | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Highest Compensated EmployeeHighestCompensatedEmployee | FormerFormer |
|---|---|---|---|---|---|---|---|---|---|
| ROGER L COTHRAN | |||||||||
| VICE - CHAIRMAN | 2.00 | 4.00 | X | X | 0 | 0 | 0 | ||
| RON KESSINGER | |||||||||
| CHAIRMAN | 2.00 | 6.00 | X | X | 0 | 0 | 0 | ||
| ARTHUR A GIBEL | |||||||||
| TRUSTEE | 2.00 | 4.00 | X | 0 | 0 | 0 | |||
| KATHRYN H HAMRICK | |||||||||
| TRUSTEE | 2.00 | 2.00 | X | 0 | 0 | 0 | |||
| A LEE HERRING | |||||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | ||||
| J WAYNE MEREDITH M D | |||||||||
| TRUSTEE | 2.00 | 2.00 | X | 0 | 0 | 0 | |||
| STANLEY R AESCHLEMAN PH D | |||||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | ||||
| A WILLIAM BLACKSTOCK JR MD | |||||||||
| TRUSTEE | 2.00 | 2.00 | X | 0 | 0 | 0 | |||
| KENNETH W LEWIS | |||||||||
| TRUSTEE | 2.00 | 2.00 | X | 0 | 0 | 0 | |||
| WILLIAM C WARDEN JR | |||||||||
| TRUSTEE | 2.00 | 4.00 | X | 0 | 0 | 0 | |||
| SHEREE B WATSON | |||||||||
| TRUSTEE | 2.00 | 4.00 | X | 0 | 0 | 0 | |||
| KATY M BOLES | |||||||||
| TRUSTEE | 2.00 | 2.00 | X | 0 | 0 | 0 | |||
| RAY N HOWELL III D MIN | |||||||||
| TRUSTEE | 2.00 | 2.00 | X | 0 | 0 | 0 | |||
| JOHN D KIMBERLY | |||||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | ||||
| STEPHEN L ROBERTSON | |||||||||
| TRUSTEE | 2.00 | 6.00 | X | 0 | 0 | 0 | |||
| EDWIN L WELCH JR | |||||||||
| TRUSTEE | 2.00 | 4.00 | X | 0 | 0 | 0 | |||
| R MICHAEL WELLS | |||||||||
| TRUSTEE | 2.00 | 6.00 | X | 0 | 0 | 0 | |||
| LINWOOD L DAVIS | |||||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | ||||
| BRENDA B DIGGS | |||||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | ||||
| ERNEST L EVANS | |||||||||
| TRUSTEE | 2.00 | 4.00 | X | 0 | 0 | 0 | |||
| LOUIS B BALDWIN JR | |||||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | ||||
| GEORGE D RENFRO | |||||||||
| TRUSTEE | 2.00 | 4.00 | X | 0 | 0 | 0 | |||
| JOHN D MCCONNELL MD | |||||||||
| TRUSTEE & CEO | 20.00 | 20.00 | X | X | 1370748 | 0 | 690944 | ||
| H GREG BRAY | |||||||||
| ASST. TREASURER/ASST. SECR | 30.20 | 9.80 | X | 231473 | 0 | 37925 | |||
| J MCLAIN WALLACE JR | |||||||||
| VP GENERAL COUNSEL/SECR | 17.70 | 22.30 | X | 516658 | 0 | 110280 | |||
| KAREN H HUEY | |||||||||
| VP FACILITIES | 33.70 | 6.30 | X | 363748 | 0 | 71481 | |||
| ERIC TOMLINSON | |||||||||
| CHIEF INNOVATION OFFICER | 5.00 | 35.00 | X | 266943 | 0 | 31786 | |||
| NORMAN D POTTER JR | |||||||||
| VP DEVELOPMENT & ALUMNI AF | 20.00 | 20.00 | X | 348231 | 0 | 83878 | |||
| CHERYL EH LOCKE | |||||||||
| VP CHIEF HUMAN RESOURCES | 23.40 | 16.60 | X | 439652 | 0 | 97854 | |||
| EDWARD G CHADWICK | |||||||||
| EXECUTIVE VP CFO/TREASURER | 29.80 | 10.20 | X | 709971 | 0 | 246494 | |||
| THOMAS E SIBERT MD | |||||||||
| PRESIDENT/COO - HEALTH SYS | 26.60 | 13.40 | X | 885483 | 0 | 141102 | |||
| LISA M WYATT | |||||||||
| VP CHIEF COMM & MARKETING | 18.10 | 21.90 | X | 386954 | 0 | 75110 | |||
| SHEILA M SANDERS | |||||||||
| VP CHIEF INFORMATION OFFIC | 26.00 | 14.00 | X | 478904 | 0 | 104120 | |||
| EDWARD ABRAHAM MD | |||||||||
| DEAN, SCHOOL OF MEDICINE | 5.00 | 35.00 | X | 669778 | 0 | 181890 | |||
| BETTY PETREE | |||||||||
| DIRECTOR NURSE ANESTHESIA | 40.00 | 250470 | 0 | 37328 | X | ||||
| MICHAEL RIEKER | |||||||||
| DIRECTOR OF NURSE ANESTHES | 40.00 | 242909 | 0 | 45099 | X | ||||
| VANCE MCVAY JR | |||||||||
| CLINICAL INSTRUCTOR CRNA | 40.00 | 231310 | 0 | 39322 | X | ||||
| ERIC STIEFEL | |||||||||
| CLINICAL INSTRUCTOR CRNA | 40.00 | 193145 | 0 | 33982 | X | ||||
| CHARLES WARE | |||||||||
| ASSOCIATE VP INFRASTRUCTUR | 40.00 | 220774 | 0 | 39020 | X | ||||
| JOANNE C RUHLAND | |||||||||
| FORMER OFFICER | 20.00 | 20.00 | 255643 | 0 | 71023 | X | |||
| RUSSELL M HOWERTON MD | |||||||||
| FORMER OFFICER | 20.00 | 20.00 | 602178 | 0 | 155013 | X | |||
| DOUGLAS L EDGETON | |||||||||
| FORMER OFFICER | 1.00 | 39.00 | 606902 | 0 | 19712 | X | |||
| STEVE C SNELGROVE | |||||||||
| FORMER OFFICER | 0.00 | 40.00 | 379156 | 0 | 86678 | X | |||
| RONALD H SMALL | |||||||||
| FORMER OFFICER | 0.00 | 2.00 | 241797 | 0 | 6355 | X | |||
| MAUREEN E SINTICH | |||||||||
| FORMER OFFICER | 34.00 | 6.00 | 390731 | 0 | 87080 | X | |||
| ROBERT S PARKER SR | |||||||||
| FORMER OFFICER | 0.00 | 0.00 | 117589 | 0 | 4468 | X | |||
| DONNY C LAMBETH | |||||||||
| FORMER OFFICER | 20.00 | 20.00 | 1137417 | 0 | 42640 | X | |||
| SHARON ENGEBRETSON | |||||||||
| FORMER OFFICER | 35.00 | 5.00 | 173949 | 0 | 67457 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 11712513 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 2608041 | TotalOtherCompensation |
| Number Individuals GT100 K | 437 | NumberIndividualsGT100K |
| Formers Listed | 1 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 1 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| INTELLECT RESOURCES INC | |||||
| 3824 N ELM STREET | GREENSBORO | NC | 27455 | TECHNOLOGY | 6597090 |
| FASTAFF INC | |||||
| 6399 S FIDDLERS GREEN | GREENWOOD VILLAGE | CO | 80111 | NURSING | 5058061 |
| MEDCOST | |||||
| 165 KIMEL PARK DRIVE | WINSTON SALEM | NC | 27103 | TPA | 3253732 |
| ARAMARK | |||||
| 2300 WARRENVILLE ROAD | DOWNER GROVE | IL | 60515 | MANAGEMENT SERVICES | 2864085 |
| ORACLE AMERICA INC | |||||
| 500 ORACLE PKWY | REDWOOD SHORES | CA | 94065 | TECHNOLOGY | 2557598 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 120 | NumberOfContractorsGT100K |
| Related Organizations | 405031 | RelatedOrganizations |
| Government Grants | 1022052 | GovernmentGrants |
| All Other Contributions | 2035293 | AllOtherContributions |
| Noncash Contributions | 73316 | NoncashContributions |
| Total Contributions | 3462376 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (4 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue |
|---|---|---|---|---|
| PATIENT SERVICE REVENUE | 621400 | 1198897791 | 1198897791 | |
| COST RECOV. & OTHER | 900099 | 10108989 | 7720451 | 2388538 |
| MEDICAL/LAB SERVICE | 621500 | 4888948 | 3828442 | 1060506 |
| DIETARY | 722320 | 4583904 | 4549761 | 34143 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 1218479632 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 13994366 | TotalRevenueColumn |
| Exclusion | $13,994,366 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 659246 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 0 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 659246 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 659246 | TotalRevenueColumn |
| Exclusion | $659,246 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 28598576 | Securities |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 0 | Securities |
| Other | 169161 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 28598576 | Securities |
| Other | -169161 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 28429415 | TotalRevenueColumn |
| Exclusion | $28,429,415 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|---|
| GIFT SHOP REVENUE | 453220 | 1458318 | $1,458,318 | |
| PARKING FEES | 900099 | 1249218 | $1,249,218 | |
| TUITION | 900099 | 259321 | 259321 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 2966857 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1267991892 | TotalRevenueColumn |
| Related Or Exempt Function Income | 1215255766 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 3483187 | UnrelatedBusinessRevenue |
| Exclusion | $45,790,563 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | X | InfoInScheduleOPartIX |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 799335 | Total |
| Program Services | 799335 | ProgramServices |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 479193 | Total |
| Program Services | 479193 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4460290 | Total |
| Program Services | 2577907 | ProgramServices |
| Management And General | 1882383 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 430641699 | Total |
| Program Services | 389943893 | ProgramServices |
| Management And General | 40697806 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 21691102 | Total |
| Program Services | 16268172 | ProgramServices |
| Management And General | 5422930 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 58535634 | Total |
| Program Services | 52773005 | ProgramServices |
| Management And General | 5762629 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 32023663 | Total |
| Program Services | 24017749 | ProgramServices |
| Management And General | 8005914 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 25243 | Total |
| Program Services | 25243 | ProgramServices |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 284953 | Total |
| Program Services | 2369 | ProgramServices |
| Management And General | 282584 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 562889 | Total |
| Program Services | 562889 | ProgramServices |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 169243636 | Total |
| Program Services | 142854750 | ProgramServices |
| Management And General | 26388886 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3662270 | Total |
| Program Services | 2181481 | ProgramServices |
| Management And General | 1480789 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 46597147 | Total |
| Program Services | 37699439 | ProgramServices |
| Management And General | 8897708 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 22864019 | Total |
| Program Services | 17682465 | ProgramServices |
| Management And General | 5181554 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 31073685 | Total |
| Program Services | 23874048 | ProgramServices |
| Management And General | 7199637 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 511803 | Total |
| Program Services | 338771 | ProgramServices |
| Management And General | 173032 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1816624 | Total |
| Program Services | 1355404 | ProgramServices |
| Management And General | 461220 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 11947910 | Total |
| Program Services | 11947910 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 63671136 | Total |
| Program Services | 63671136 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7274052 | Total |
| Program Services | 7255280 | ProgramServices |
| Management And General | 18772 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| MEDICAL SUPPLIES | 252612372 | 251461811 | 1150561 |
| INCOME TAXES | 653680 | 653680 | |
| BAD DEBT | 73332237 | 73332237 | |
| PROVIDER ASSESSMENT | 25920249 | 25920249 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 178990 | Total |
| Program Services | 133954 | ProgramServices |
| Management And General | 45036 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1260863811 | Total |
| Program Services | 1147158690 | ProgramServices |
| Management And General | 113705121 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 25325467 | BOY |
| EOY | 18762350 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 38604347 | BOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 303304584 | BOY |
| EOY | 350307047 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 32041387 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 17078515 | BOY |
| EOY | 22269612 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7131300 | BOY |
| EOY | 4712483 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 1451087502 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 807483628 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 553420299 | BOY |
| EOY | 643603874 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 608352455 | BOY |
| EOY | 627932795 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 41336484 | BOY |
| EOY | 65673237 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 25336142 | BOY |
| EOY | 13009195 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1619889593 | BOY |
| EOY | 1778311980 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 159427458 | BOY |
| EOY | 272033669 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 317847467 | BOY |
| EOY | 494400200 | EOY |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 96476032 | BOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 97670031 | BOY |
| EOY | 49380055 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 671420988 | BOY |
| EOY | 815813924 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 940380300 | BOY |
| EOY | 957729652 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4535459 | BOY |
| EOY | 2797220 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3552846 | BOY |
| EOY | 1971184 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 948468605 | BOY |
| EOY | 962498056 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1619889593 | BOY |
| EOY | 1778311980 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 7128081 | ReconcilationRevenueExpenses |
| Reconciliation Unrealized Invest | 882818 | ReconciliationUnrealizedInvest |
| Reconcilation Other Changes | 6018552 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | 1 | AuditCommittee |
| Federal Grant Audit Required | 1 | FederalGrantAuditRequired |
| Federal Grant Audit Performed | 1 | FederalGrantAuditPerformed |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| 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) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | Volunteers |
| Paid Staff Or Management | 1 | PaidStaffOrManagement |
| Media Advertisements | 0 | MediaAdvertisements |
| Mailings Members | 0 | MailingsMembers |
| Publications Or Broadcast | 0 | PublicationsOrBroadcast |
| Grants Other Organizations | 0 | GrantsOtherOrganizations |
| Direct Contact Legislators | 1 | DirectContactLegislators |
| Direct Contact Legislators | $510,138 | DirectContactLegislatorsAmount |
| Rallies Demonstrations | 0 | RalliesDemonstrations |
| Other Activities | 1 | OtherActivities |
| Other Activities | $52,751 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 562889 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | 0 | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | EXPLANATION OF LOBBYING ACTIVITIES: | Identifier |
| Return Reference | PART II-B, LINE 1: | ReturnReference |
| Explanation | GOVERNMENT RELATIONS THE OFFICE OF GOVERNMENT RELATIONS WAS ACTIVELY INVOLVED WITH SEVERAL FEDERAL AND STATE ISSUES. THE OFFICE ASSISTED IN DEVELOPING POLITICAL ADVOCACY STRATEGIES REGARDING THE CENTERS FOR MEDICARE & MEDICAID SERVICES' (CMS) POLICY ON REBILLING PART A CLAIMS; CMS' IMPLEMENTATION OF THE "TWO-MIDNIGHT" POLICY REGARDING PATIENT STATUS; CUTS TO PAYMENTS FOR EVALUATION AND MANAGEMENT SERVICES AND CERTAIN OTHER PROCEDURES PROVIDED IN HOSPITAL OUTPATIENT DEPARTMENTS (HOPD'S); REDUCTIONS TO PAYMENTS FOR GRADUATE MEDICAL EDUCATION (GME); CHANGES TO THE 340B DRUG DISCOUNT PROGRAM; REDUCTIONS IN PAYMENTS TO HOSPITALS FOR ASSISTANCE TO LOW-INCOME MEDICARE BENEFICIARIES (BAD DEBT); RESTRICTIONS ON MEDICAID PROVIDER ASSESSMENTS; REALIGNMENT OF MEANINGFUL USE STAGE 2 REQUIREMENTS TO ENSURE A SAFE, ORDERLY TRANSITION; MODIFICATIONS TO THE HOSPITAL READMISSIONS REDUCTION PROGRAM (HRRP); CHANGES TO THE HOSPITAL-ACQUIRED CONDITION (HACS) REDUCTION PROGRAM AND GUIDANCE REGARDING SEQUESTRATION FOR MEDICARE AND THE NIH. STAFF WORKED ON THE FY2014 BUDGET; FY 2014 MEDICARE INPATIENT PROSPECTIVE PAYMENT SYSTEM (PPS) PROPOSED RULE; CY2014 HOSPITAL OUTPATIENT PROSPECTIVE PAYMENT SYSTEM (HOPPS)/AMBULATORY SURGICAL CENTERS (ASC) PROPOSED RULE AND THE 2014 MEDICARE PHYSICIAN FEE SCHEDULE. THEY ALSO WORKED ON TAX REFORM REGARDING INVESTMENT TAX CREDITS AND MEDICARE PHYSICIAN PAYMENTS INCLUDING ADJUSTMENTS AND POSSIBLE REPEAL OF THE SUSTAINABLE GROWTH RATE (SGR). STAFF ALSO WORKED ON MANY OF THE FY 2014 APPROPRIATIONS BILLS AND PROPOSED LEGISLATION AND REGULATIONS THAT WERE INTRODUCED, INCLUDING DEPARTMENT OF DEFENSE; DEPARTMENT OF HEALTH AND HUMAN SERVICES; AND VETERANS AFFAIRS (VA) RESEARCH AND MEDICAL CARE FUNDING; THE "TRAINING TOMORROW'S DOCTORS TODAY ACT" (HR 1201), THE "RESIDENT PHYSICIAN SHORTAGE REDUCTION ACT OF 2013" (S577), THE "MEDICARE AUDIT IMPROVEMENT ACT" (HR 1250, S 1-12); THE "DSH REDUCTION RELIEF ACT" (HR 1920)AND THE "FAIRNESS IN HEALTH CARE CLAIMS, GUIDANCE AND INVESTIGATIONS ACT" (HR 2931). THE OFFICE ASSISTED WITH THE FOLLOWING: (1) IRS PROPERTY-TAX EXEMPTIONS FOR NONPROFITS GUIDELINES AND COMMUNITY BENEFITS ANALYSIS; (2) NIH APPROPRIATIONS AND FUNDING FOR HEALTH PROFESSIONS; (3) DELAY OF THE COMPLIANCE DATE FOR ICD-10-CM AND ICD-10-PCS MEDICAL DATA CODE SETS; AND (4) PATENTS AND INTELLECTUAL PROPERTY ISSUES. AT THE STATE LEVEL, EFFORTS WERE CONCENTRATED ON FUNDING FOR THE WAKE FOREST INSTITUTE FOR REGENERATIVE MEDICINE; LEGISLATION REGARDING ADDITIONAL FUNDING FOR AUTOPSIES; THE FEDERALLY RUN INSURANCE EXCHANGE AND MEDICAID EXPANSION UNDER THE AFFORDABLE CARE ACT; THE FY 2014-5 MEDICAID BUDGET, THE MEDICAID REIMBURSEMENT INITIATIVE AND UPPER PAYMENT LIMIT PROVISIONS; ON LEGISLATION REGARDING CERTIFICATE-OF-NEED LAWS, BUSINESS INCENTIVE TAX LAWS, INCLUDING THE MILL TAX CREDIT FOR THE PIEDMONT TRIAD RESEARCH PARK; MENTAL HEALTH ISSUES, TRANSPARENCY AND REFORMING THE TAX CODE INCLUDING SALES TAX REFUND PROTECTION PROVISIONS. PART II-B, LINE 1J - PRORATA PORTION OF DUES PAID TO STATE AND LOCAL 501(C)(6) ORGANIZATIONS THAT REPRESENTS LOBBYING ON BEHALF OF ITS MEMBERS. | Explanation |
Schedule D IRS990ScheduleD
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 8088305 | BeginningOfYearBalance |
| Contributions | 616961 | Contributions |
| Investment Earnings Or Losses | 185112 | InvestmentEarningsOrLosses |
| Other Expenditures | 4121974 | OtherExpenditures |
| End Of Year Balance | 4768404 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 7303928 | BeginningOfYearBalance |
| Contributions | 1221778 | Contributions |
| Investment Earnings Or Losses | -65209 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 124978 | GrantsOrScholarships |
| Other Expenditures | 709300 | OtherExpenditures |
| Administrative Expenses | -462086 | AdministrativeExpenses |
| End Of Year Balance | 8088305 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 5383158 | BeginningOfYearBalance |
| Contributions | 841681 | Contributions |
| Investment Earnings Or Losses | 576477 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 113868 | GrantsOrScholarships |
| Other Expenditures | 738112 | OtherExpenditures |
| Administrative Expenses | -1354592 | AdministrativeExpenses |
| End Of Year Balance | 7303928 | EndOfYearBalance |
Current Year Minus3 Years CurrentYearMinus3Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 5437445 | BeginningOfYearBalance |
| Contributions | 446548 | Contributions |
| Investment Earnings Or Losses | 259105 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 110679 | GrantsOrScholarships |
| Other Expenditures | 649261 | OtherExpenditures |
| End Of Year Balance | 5383158 | EndOfYearBalance |
Current Year Minus4 Years CurrentYearMinus4Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 4470108 | BeginningOfYearBalance |
| Contributions | 117064 | Contributions |
| Investment Earnings Or Losses | -780842 | InvestmentEarningsOrLosses |
| Other Expenditures | 17979 | OtherExpenditures |
| Administrative Expenses | -1649094 | AdministrativeExpenses |
| End Of Year Balance | 5437445 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Permanent Endowment EOY Balance | 0.41340 | PermanentEndowmentEOYBalance |
| Term Endowment EOY Balance | 0.58660 | TermEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | 0 | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | 0 | EndowmentsHeldByRelatedOrgs |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 12409538 | OtherCostOrOtherBasis |
| Book Value | 12409538 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 681801862 | OtherCostOrOtherBasis |
| Depreciation | 416279094 | Depreciation |
| Book Value | 265522768 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 393730 | OtherCostOrOtherBasis |
| Depreciation | 93844 | Depreciation |
| Book Value | 299886 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 556678663 | OtherCostOrOtherBasis |
| Depreciation | 381076068 | Depreciation |
| Book Value | 175602595 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 199803709 | OtherCostOrOtherBasis |
| Depreciation | 10034622 | Depreciation |
| Book Value | 189769087 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 643603874 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities (3 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| OTHER LIABILITIES | $33,312,862 |
| PENSION LIABILITIES | $14,478,459 |
| CAPITAL LEASE | $1,588,734 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 49380055 | TotalOfAmounts |
| Footnote In Part XIII | X | FootnoteInPartXIII |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: | PART V, LINE 4: | THE HOSPITAL'S ENDOWMENT FUNDS ARE USED TO PROVIDE SUPPORT FOR EDUCATION, SCHOLARSHIPS, INDIGENT CARE, AND OTHER DEPARTMENTAL FUNDING. |
| DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | PART X, LINE 2: | THE ORGANIZATION HAS EVALUATED UNCERTAIN TAX POSITIONS FOR ITS FISCAL YEARS ENDED JUNE 30, 2013 AND 2012, INCLUDING A QUANTIFICATION OF TAX RISK IN AREAS SUCH AS UNRELATED BUSINESS TAXABLE INCOME AND THE TAXATION OF ITS FOR-PROFIT SUBSIDIARIES. THIS EVALUATION DID NOT HAVE A MATERIAL EFFECT ON THE ORGANIZATION'S FINANCIAL STATEMENTS FOR THE YEARS ENDED JUNE 30, 2013 AND 2012. |
Schedule F IRS990ScheduleF
Accts Actvs Out US Table AcctsActvsOutUSTable
| Field | Value | IRS element (for citing) |
|---|---|---|
| Region | CENTRAL AMERICA AND THE CARIBBEAN | Region |
| Number Of Offices | 0 | NumberOfOffices |
| Number Of Employees | 0 | NumberOfEmployees |
| Type Of Activities Conducted | INVESTMENTS | TypeOfActivitiesConducted |
| Total Expenditures | 65020409 | TotalExpenditures |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Subtotal Number Of Offices | 0 | SubtotalNumberOfOffices |
| Subtotal Number Of Employees | 0 | SubtotalNumberOfEmployees |
| Cont Number Of Offices | 0 | ContNumberOfOffices |
| Cont Number Of Employees | 0 | ContNumberOfEmployees |
| Total Number Of Offices | 0 | TotalNumberOfOffices |
| Total Number Of Employees | 0 | TotalNumberOfEmployees |
| Subtotal Amount Spent | 65020409 | SubtotalAmountSpent |
| Cont Amount Spent | 0 | ContAmountSpent |
| Total Amount Spent | 65020409 | TotalAmountSpent |
| Transfer To Foreign Corp | 1 | TransferToForeignCorp |
| Interest In Foreign Trust | 0 | InterestInForeignTrust |
| Own Foreign Corp | 1 | OwnForeignCorp |
| Passive Foreign Invest Co | 0 | PassiveForeignInvestCo |
| Foreign Partnership | 0 | ForeignPartnership |
| Boycott Countries | 0 | BoycottCountries |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent200 | X | Pcent200 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent400 | X | Pcent400 |
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 1 | ExpensesExceededBudget |
| Unable To Provide Care | 0 | UnableToProvideCare |
| Annual Community Benefit Report | 1 | AnnualCommunityBenefitReport |
| Report Publically Available | 1 | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 52840837 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 7148924 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 45691913 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03620 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 213271887 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 221113529 | DirectOffsettingRevenue |
| Net Community Benefit Expense | -7841642 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Unreimbursed Costs UnreimbursedCosts
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 27741302 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 18462791 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 9278511 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00740 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 293854026 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 246725244 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 47128782 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04360 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 2150873 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 2150873 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00170 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 70673253 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 21482929 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 49190324 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03900 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1504434 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 1504434 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00120 | PercentOfTotalExpense |
Research Research
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 13346735 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 13346735 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01060 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 876907 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 876907 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00070 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 88552202 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 21482929 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 67069273 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.05320 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 382406228 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 268208173 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 114198055 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.09680 | PercentOfTotalExpense |
Community Support CommunitySupport
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 105489 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 105489 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Leadership Development LeadershipDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 270326 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 270326 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00020 | PercentOfTotalExpense |
Health Improvement Advocacy HealthImprovementAdvocacy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 248782 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 248782 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00020 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 624597 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 624597 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00050 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReported |
| Bad Debt Expense | $28,000,801 | BadDebtExpenseAmount |
| Amount Attributable To | 0 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 376979402 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 440408271 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -63428869 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NORTH CAROLINA BAPTIST HOSPITAL | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | MEDICAL CENTER BLVD | AddressLine1 |
| City | WINSTON SALEM | City |
| State | NC | State |
| ZIP Code | 27157 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Teaching Hospital | X | TeachingHospital |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NORTH CAROLINA BAPTIST HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| CHNA Conducted | 1 | CHNAConducted |
| Community Definition | X | CommunityDefinition |
| Community Demographics | X | CommunityDemographics |
| Existing Resources | X | ExistingResources |
| How Data Obtained | X | HowDataObtained |
| Community Health Needs | X | CommunityHealthNeeds |
| Other Health Issues | X | OtherHealthIssues |
| Identifying Process | X | IdentifyingProcess |
| Consulting Process | X | ConsultingProcess |
| Information Gaps | X | InformationGaps |
| Needs Assessment Conducted | 12 | NeedsAssessmentConducted |
| Take Into Account | 1 | TakeIntoAccount |
| Other Facilities | 1 | OtherFacilities |
| CHNA Widely Available | 1 | CHNAWidelyAvailable |
| Own Website | X | OwnWebsite |
| On Request | X | OnRequest |
| Other Method | X | OtherMethod |
| Adopt Implement Strategy | X | AdoptImplementStrategy |
| Execute Implement Strategy | X | ExecuteImplementStrategy |
| Develop Community Plan | X | DevelopCommunityPlan |
| Participate Community Plan | X | ParticipateCommunityPlan |
| Include Operational Plans | X | IncludeOperationalPlans |
| Adopt Budget | X | AdoptBudget |
| Prioritize Health Needs | X | PrioritizeHealthNeeds |
| Prioritize Services | X | PrioritizeServices |
| All Needs Addressed | 0 | AllNeedsAddressed |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTax |
| Eligibility Criteria Explained | 1 | EligibilityCriteriaExplained |
| Uses FPG Free | 1 | UsesFPGFree |
| FPG Free Percent | 200.000000000000 | FPGFreePercent |
| Uses FPG Discounted | 1 | UsesFPGDiscounted |
| FPG Discount Percent | 400.000000000000 | FPGDiscountPercent |
| Explains Basis | 1 | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Medical Indigency | X | MedicalIndigency |
| Insurance Status | X | InsuranceStatus |
| Uninsured Discount | X | UninsuredDiscount |
| Medicaid Medicare | X | MedicaidMedicare |
| Other Factors | X | OtherFactors |
| Explains Application Method | 1 | ExplainsApplicationMethod |
| Includes Publicity Measures | 1 | IncludesPublicityMeasures |
| Posted On Website | X | PostedOnWebsite |
| Posted In Emergency Room | X | PostedInEmergencyRoom |
| Posted In Admission Office | X | PostedInAdmissionOffice |
| Available On Request | X | AvailableOnRequest |
| Actions On Nonpayment | 1 | ActionsOnNonpayment |
| Collection Activities | 0 | CollectionActivities |
| Notify Upon Admission | X | NotifyUponAdmission |
| Notify Before Discharge | X | NotifyBeforeDischarge |
| Notified All Patients | X | NotifiedAllPatients |
| Documented Determination | X | DocumentedDetermination |
| Nondiscrim Emergency Care Policy | 1 | NondiscrimEmergencyCarePolicy |
| Average Negotiated Rates | X | AverageNegotiatedRates |
| Amounts Generally Billed | 0 | AmountsGenerallyBilled |
| Gross Charges | 0 | GrossCharges |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 30 | NumberOfOtherFacilities |
Other Facilities OtherFacilities (30 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Facility TypeFacilityType |
|---|---|---|---|---|
| STRATFORD EXECUTIVE PARK ABDOMINAL ORGAN | ||||
| 140 CHARLOIS BOULEVARD | WINSTONSALEM | NC | 271031522 | ABDOMINAL ORGAN TRANSPLANT PROGRAM |
| DOWNTOWN HEALTH PLAZA | ||||
| 1200 N MARTIN LUTHER KING JR DRIVE | WINSTONSALEM | NC | 271013006 | FAMILY MEDICINE |
| WAKE FOREST UNIVERSITY BAPTIST IMAGING | ||||
| 265 EXECUTIVE PARK BLVD | WINSTONSALEM | NC | 27103 | IMAGING CENTER |
| WINSTON EAST PEDIATRICS | ||||
| 2295 EAST 14TH STREET | WINSTONSALEM | NC | 271056804 | PEDIATRICS |
| STRATFORD EXECUTIVE PARK INTERNAL MEDICI | ||||
| 500 SHEPHARD STREET SUITE 300 | WINSTONSALEM | NC | 271031633 | IM MULTISPECIALTY CLINICS |
| MEDICAL PLAZA COUNTRY CLUB DERMATOLOGIC | ||||
| 4618 COUNTRY CLUB ROAD | WINSTONSALEM | NC | 271043520 | GENERAL DERMATOLOGY |
| MEDICAL PLAZA COUNTRY CLUB GENERAL DERMA | ||||
| 4618 COUNTRY CLUB ROAD | WINSTONSALEM | NC | 271043520 | DERMATOLOGIC SURGERY |
| STRATFORD EXECUTIVE PARK OBGYN | ||||
| 500 SHEPHARD STREET SUITE 201 | WINSTONSALEM | NC | 271031633 | OB/GYN |
| WAKE FOREST BAPTIST HEALTH FAMILY MEDICI | ||||
| 1920 W FIRST STREET | WINSTONSALEM | NC | 271044220 | FAMILY MEDICINE |
| STRATFORD EXECUTIVE PARK MATERNAL-FETAL | ||||
| 500 SHEPHARD STREET SUITE 200 | WINSTONSALEM | NC | 271031633 | MATERNAL-FETAL MEDICINE |
| NCBH OUTPATIENT ENDOSCOPY CENTER LLC | ||||
| 100 CHARLOIS BLVD SUITE 100 | WINSTONSALEM | NC | 27103 | OUTPATIENT ENDOSCOPY |
| MEDICAL PLAZA COUNTRY CLUB - JOSLIN ADUL | ||||
| 4610 COUNTRY CLUB ROAD | WINSTONSALEM | NC | 271043520 | ADULT DIABETES CENTER |
| MEDICAL PLAZA COUNTRY CLUB - JOSLIN PEDI | ||||
| 4610 COUNTRY CLUB ROAD | WINSTONSALEM | NC | 271043520 | PEDIATRIC DIABETES CENTER |
| MEDICAL PLAZA COUNTRY CLUB - UNIVERSITY | ||||
| 4614 COUNTRY CLUB ROAD | WINSTONSALEM | NC | 271043520 | INTERNAL MEDICINE |
| MEDICAL PLAZA COUNTRY CLUB - CARDIOLOGY | ||||
| 4614 COUNTRY CLUB ROAD | WINSTONSALEM | NC | 271043520 | CARDIOLOGY |
| MEDICAL PLAZA COUNTRY CLUB - WEIGHT MANA | ||||
| 4614 COUNTRY CLUB ROAD | WINSTONSALEM | NC | 271043520 | WEIGHT MANAGEMENT |
| MEDICAL PLAZA CLEMMONS - BLDG 2311 GENER | ||||
| 2311 LEWISVILLE-CLEMMONS ROAD | CLEMMONS | NC | 27012 | PEDIATRICS |
| MEDICAL PLAZA CLEMMONS - BLDG 2311 SPECI | ||||
| 2311 LEWISVILLE-CLEMMONS ROAD | CLEMMONS | NC | 27012 | PEDIATRIC SPECIALTIES |
| MEDICAL PLAZA CLEMMONS - BLDG 2311 IMPR | ||||
| 2311 LEWISVILLE-CLEMMONS ROAD | CLEMMONS | NC | 27012 | INTERNAL MEDICINE & PRIMARY CARE |
| MEDICAL PLAZA CLEMMONS - BLDG 2311 ALLER | ||||
| 2311 LEWISVILLE-CLEMMONS ROAD | CLEMMONS | NC | 27012 | ALLERGY, ASTHMA & IMMUNOLOGY |
| MEDICAL PLAZA CLEMMONS - BLDG 2311 HEMO | ||||
| 2311 LEWISVILLE-CLEMMONS ROAD | CLEMMONS | NC | 27012 | ONCOLOGY |
| COMP REHAB | ||||
| 131 MILLER STREET | WINSTONSALEM | NC | 27103 | REHABILITATION |
| MEDICAL PLAZA CLEMMONS - BLDG 2341 | ||||
| 2341 LEWISVILLE-CLEMMONS ROAD | CLEMMONS | NC | 27012 | BREAST CARE SERVICES |
| MEDICAL PLAZA CLEMMONS - BLDG 2341 | ||||
| 2341 LEWISVILLE-CLEMMONS ROAD | CLEMMONS | NC | 27012 | ENT/HEAD AND NECK SURGERY - CLEMMONS |
| MT AIRY HEMATOLOGY & ONCOLOGY | ||||
| 450 PRICE STREET | MT AIRY | NC | 27030 | HEMATOLOGY AND ONCOLOGY |
| MEDICAL PLAZA CLEMMONS - BLDG 2341 | ||||
| 2341 LEWISVILLE-CLEMMONS ROAD | CLEMMONS | NC | 27012 | NEUROLOGY - CLEMMONS |
| MEDICAL PLAZA CLEMMONS - BLDG 2341 | ||||
| 2341 LEWISVILLE-CLEMMONS ROAD | CLEMMONS | NC | 27012 | OB/GYN |
| PAIN CENTER BROOKSTOWN | ||||
| 605 COTTON STREET | WINSTONSALEM | NC | 27101 | PAIN CLINIC AND SERVICES |
| MEDICAL PLAZA CLEMMONS - BLDG 2341 | ||||
| 2341 LEWISVILLE-CLEMMONS ROAD | CLEMMONS | NC | 27012 | SPINE CENTER - CLEMMONS |
| MEDICAL PLAZA CLEMMONS - BLDG 2341 | ||||
| 2341 LEWISVILLE-CLEMMONS ROAD | CLEMMONS | NC | 27012 | VEIN SERVICES - CLEMMONS |
Form990 Schedule H Part VI Form990ScheduleHPartVI (19 entries)
| ExplanationExplanation | IdentifierIdentifier | Return ReferenceReturnReference |
|---|---|---|
| PART I, LINE 3C: THE ORGANIZATION ALSO EVALUATES CERTAIN CREDIT FILE DATA ELEMENTS TO IDENTIFY POTENTIAL SOURCES OF HIDDEN INCOME TO MORE ACCURATELY INFORM CHARITY CARE ELIGIBILITY ASSESSMENTS. PATIENTS WITH ESTIMATED HOUSEHOLD INCOME BELOW 200% OF FPG, WHO ARE IDENTIFIED AS HAVING COMMERCIAL CREDIT ACCOUNTS THAT ARE BEING SERVICED IN A MANNER THAT SUGGESTS ADDITIONAL SOURCES OF INCOME, ARE NOT AUTOMATICALLY GRANTED PRESUMPTIVE CHARITY CARE. | ||
| PART I, LINE 7: THE ORGANIZATION USED THE WORKSHEETS PROVIDED IN THE INSTRUCTIONS TO SCHEDULE H TO COMPUTE ITS COST-TO-CHARGE RATIO FOR PURPOSES OF THE 2012 SCHEDULE H.PART I, LINE 7B MEDICAID DIRECT OFF SETTING REVENUETHE HOSPITAL PARTICIPATES IN A PROVIDER ASSESSMENT PROGRAM ADMINISTERED BY THE NORTH CAROLINA DEPARTMENT OF HEALTH AND HUMAN SERVICES. UNDER THE PROGRAM, A FEE IS ASSESSED AGAINST NON-MEDICAID NET PATIENT SERVICE REVENUES OF PRIVATE HOSPITALS. THE FEDERAL GOVERNMENT MATCHES THE ASSESSMENT ON A 2 TO 1 BASIS AND THESE AMOUNTS ARE ALLOCATED TO NORTH CAROLINA HOSPITALS ON A QUARTERLY BASIS. | ||
| PART I, L7 COL(F): THE ORGANIZATION'S PATIENT BAD DEBT EXPENSE PER THE AUDITED FINANCIAL STATEMENTS WAS $73,332,237 FOR THE FISCAL YEAR ENDED JUNE 30, 2013. THIS AMOUNT HAS BEEN REMOVED FROM THE CALCULATION OF CHARITY CARE FOR PART I, LINE 7. | ||
| PART II: THE HOSPITAL IS RESPONSIVE TO THE COMMUNITIES IT SERVES THROUGH A NUMBER OF ACTIVITIES, PROGRAMS AND INITIATIVES. THE HOSPITAL IS CURRENTLY ALIGNED WITH THE FORSYTH COUNTY HEALTH DEPARTMENT AND LEADS AND/OR PARTICIPATES IN A WIDE VARIETY OF PARTNERSHIPS AND LOCAL COALITIONS. THESE INCLUDE THE BE HEALTH- OBESITY COALITION, HEAT- HEALTH DISPARITIES AND THE CHRONIC DISEASE COALITION. COLLECTIVELY THESE COALITIONS ARE TASKED WITH IMPROVING THE HEALTH STATUS OF THE COMMUNITIES THEY SERVE WITH A SPECIFIC FOCUS ON CHRONIC DISEASE, PHYSICAL ACTIVITY/ NUTRITION AND TOBACCO USE. SPECIFICALLY, THE COALITIONS ARE WORKING COLLABORATIVELY TO 1) REDUCE THE CARDIOVASCULAR DISEASE MORTALITY RATE, 2) DECREASE THE INCIDENCE OF DIABETES, 3) INCREASE THE PERCENTAGE OF ADULTS REPORTING GOOD, VERY GOOD OR EXCELLENT HEALTH, 4) INCREASE THE PERCENTAGE OF HIGH SCHOOL STUDENTS WHO ARE NEITHER OVERWEIGHT NOR OBESE, 5) INCREASE THE PERCENTAGE OF ADULTS WHO REPORT THAT THEY CONSUME FRUITS AND VEGETABLES FIVE OR MORE TIMES PER DAY, 6) INCREASE THE PERCENTAGE OF ADULTS GETTING THE RECOMMENDED AMOUNT OF PHYSICAL ACTIVITY, AND 7) DECREASE THE PERCENTAGE OF HIGH SCHOOL STUDENTS REPORTING CURRENT USE OF ANY TOBACCO PRODUCT. THE HOSPITAL IS SPECIFICALLY RESPONSIVE TO THE CHRONIC HEALTH NEEDS OF THE COMMUNITY BY PROVIDING FREE CARE TO ITS RESIDENTS AND PROVIDES $4 MILLION IN SUBSIDY FUNDING FOR THE DOWNTOWN HEALTH PLAZA, A LEVEL 3 NCQA SITE AND NATIONAL HEALTH SERVICE CORP SITE. DOWNTOWN HEALTH PLAZA SERVES APPROXIMATELY 65,000 PATIENT VISITS PER YEAR INCLUDING 28,000 ADULTS, 29% OF WHICH ARE SELF-PAY; 19,000 ARE OB/GYN PATIENTS, 51% ARE SELF-PAY; AND 18,000 PEDIATRIC PATIENTS, 3% OF WHICH ARE SELF-PAY. MANY OF THE SELF-PAY PATIENTS ARE MANAGING CHRONIC DISEASES SUCH AS DIABETES, KIDNEY FAILURE AND HEART FAILURE, AND DHP PROVIDES CARE AND COUNSELING AT NO COST FOR THESE CONDITIONS. SPECIFICALLY DHP PROVIDES SIGNIFICANT BENEFIT TO THE COMMUNITY THROUGH THE FOLLOWING INITIATIVES: COLLABORATION WITH NORTHWEST COMMUNITY CARE NETWORK THROUGH ONSITE PEDIATRIC AND INTERNAL MEDICINE CASE MANAGERS; AS A PARTICIPATING WIC SITE; PROVIDES A COMMUNITY GARDEN PROVIDING FRESH VEGETABLES AND HERBS TO PATIENTS; PROVIDES A FREE FOOD PANTRY TO PATIENTS; OFFERS A CO-LOCATED MENTAL HEALTH COUNSELOR FOR CHILDREN IN PARTNERSHIP WITH THE CHILDREN'S HOME; AND A CO-LOCATED PARENT EDUCATOR PROGRAM IN PARTNERSHIP WITH IMPRINTS TO HELP FAMILIES ADDRESS DEVELOPMENTAL DELAYS. DHP ALSO COORDINATES WITH NORTHWEST COMMUNITY CARE NETWORK AND CENTERPOINT TO PROVIDE AN INNOVATIVE COMPREHENSIVE CARE MANAGEMENT FOR A HIGH RISK POPULATION (INCLUSIVE OF THE UNINSURED) THROUGH AN INTENSIVE CARE COORDINATION PROGRAM (HIGHER RISK FOR READMISSIONS AND ED VISITS). DHP ALSO PROVIDES AN ANNUAL SHARE THE HEALTH FREE HEALTH FAIR, PROVIDING FREE HEALTH SCREENINGS AND OTHER HEALTH-RELATED SERVICES AVAILABLE TO EVERYONE (ADULTS AND CHILDREN) REGARDLESS OF AGE, INSURANCE COVERAGE, AND INCOME LEVEL OR IMMIGRATION STATUS. THE HEALTH FAIR SERVES APPROXIMATELY 650 CHILDREN AND ADULTS ON AN ANNUAL BASIS. THE HOSPITAL ALSO PROVIDES A NUMBER OF PUBLIC EDUCATIONAL PROGRAMS THROUGH BEST HEALTH. BEST HEALTH IS THE COMMUNITY WELLNESS OUTREACH PROGRAM OF WAKE FOREST BAPTIST HEALTH AND IN FY 2013 IT PROVIDED 18 SUPPORT GROUP SESSIONS PRIMARILY FOR STROKE AND OBESE PATIENTS, 28 NUTRITION/HEALTHY COOKING CLASSES, 32 EXERCISE CLASSES FOR HEART/VASCULAR PATIENTS, AND 16 HEART HEALTH SCREENING IN THE COMMUNITY. BRENNER FIT (FAMILIES IN TRAINING) HAS THE LONGEST TRACK RECORD AND THE MOST EXPERIENCE IN PROVIDING PREVENTION AND TREATMENT PROGRAMS FOR OVERWEIGHT AND OBESE POPULATIONS IN THE HOSPITAL'S SERVICE AREA. OVER THE PAST FIVE YEARS, BRENNER FIT HAS ACCOMPLISHED THE FOLLOWING:- PROVIDED TREATMENT FOR MORE THAN 500 CHILDREN THROUGH THE BRENNER FIT CLINIC, MANY OF WHOM ARE UNINSURED/UNDERINSURED, REPRESENTING APPROXIMATELY 2000 DIFFERENT FAMILY MEMBERS FROM OUR COMMUNITY; - GAVE OVER 150 COMMUNITY PRESENTATIONS, REACHING AN ESTIMATED AUDIENCE OF 25,000; - PUBLISHED 30 JOURNAL ARTICLES, RESEARCH PAPERS AND BOOK CHAPTERS, AND HAVE BEEN REPRESENTED IN MULTIPLE ON-LINE MEDICAL RESOURCES;- PRESENTED OVER 60 TIMES TO ACADEMIC OR CLINICAL AUDIENCES;- FEATURED OVER 80 TIMES IN REGIONAL AND NATIONAL MEDIA;- TRAINED 15 STUDENTS, FELLOWS, AND INTERNS, IN ADDITION TO DEVELOPING A MEDICAL STUDENT WORKSHOP;AND-DEVELOPED 22 NEW PROGRAMS FOCUSED ON CHILDHOOD OBESITY PREVENTION AND TREATMENT.AS A HEART AND VASCULAR CENTER OF EXCELLENCE, THE HOSPITAL ALSO SPONSORS SEVERAL HEART RELATED SCREENINGS EACH YEAR INCLUDING FREE EKG SCREENINGS, HEART HEALTH TALKS, FREE COMMUNITY CPR CLASSES AND HEART AND STROKE PREVENTION CLASSES AT COUNTY GOVERNMENT WORKSITES. FINALLY, AS A CANCER CENTER OF EXCELLENCE AND AN NCI DESIGNATED CANCER CENTER, OUTREACH TO THE COMMUNITY IS A VITAL COMPONENT TO SERVING PATIENTS AND FAMILIES. OUTREACH AND COLLABORATIONS INCLUDE ANNUAL SKIN CANCER SCREENINGS , NUTRITION CLASSES, COORDINATION WITH THE BE HEALTHY COALITION TO ENCOURAGE PHYSICAL ACTIVITY AMONG ALL FORSYTH COUNTY RESIDENTS THROUGH A TWO-MONTH PROGRAM WITH STEP UP FORSYTH, A FREE COMMUNITY WIDE PROGRAM COLLABORATION WITH THE YMCA, A 6 WEEK CHRONIC DISEASE MANAGEMENT WORKSHOP , FREE YOGA FOR BREAST CANCER PATIENTS AND SURVIVORS, AS WELL AS SEVERAL FREE LUNCH AND LEARN WORKSHOPS ON CANCER AWARENESS AND PREVENTION.CURRENTLY THE HOSPITAL IS AN ACTIVE PARTICIPANT IN THE FORSYTH BEHAVIORAL HEALTH COALITION WHICH INCLUDES REPRESENTATIVES FROM WAKE FOREST BAPTIST MEDICAL CENTER, FORSYTH MEDICAL CENTER, CENTERPOINT AND NORTHWEST COMMUNITY CARE NETWORK (NCCN). THE COALITION IS ACTIVELY WORKING WITH THE NORTH CAROLINA HOSPITAL ASSOCIATION ON A COMPREHENSIVE PLAN TO TAKE TO THE NORTH CAROLINA STATE LEGISLATURE WITH THE FOLLOWING PRIORITIES:- DEVELOPMENT AND OBTAIN FUNDING FOR A COUNTY ED CRISIS INTERVENTION PROGRAM, AS THERE IS NO CURRENT CRISIS INTERVENTION SUPPORT IN FORSYTH OR SURROUNDING COUNTIES; AND- OBTAIN LEGISLATIVE SUPPORT FOR A WET SHELTER PROGRAM.THE COALITION IS ALSO WORKING TO ENSURE THAT WE HAVE STRUCTURES AND PROCESSES IN PLACE TO IMPROVE THE PATIENT FLOW AND TO ELIMINATE DUPLICATION OF SERVICES. LASTLY, NCCN IS WORKING WITH CENTERPOINT TO ENSURE THE BIDIRECTIONAL FLOW OF ELECTRONIC INFORMATION. | ||
| PART III, LINE 4: THE ORGANIZATION'S FINANCIAL STATEMENTS DO NOT INCLUDE A DISCRETE FOOTNOTE EXPLAINING BAD DEBT EXPENSE. BAD DEBT HAS NOT BEEN INCLUDED IN THE COMPUTATION OF COMMUNITY BENEFIT ON PART I, LINE 7. THE ORGANIZATION HAS A THOROUGH PROCESS OF EVALUATING BAD DEBT ACCOUNTS AS INFORMATION BECOMES AVAILABLE AND RECLASSIFIES BAD DEBT ACCOUNTS AS CHARITY CARE AS PROVIDED BY THE CHARITY CARE POLICY. AMOUNTS USED TO COMPUTE CHARITY CARE AND BAD DEBT ON SCHEDULE H USE THE MOST CURRENT DATA AVAILABLE AT THE TIME OF FILING. THE ORGANIZATION USED WORKSHEET 2 OF THE 2012 SCHEDULE H INSTRUCTIONS TO COMPUTE A COST TO CHARGES RATIO USED TO CALCULATE BAD DEBT AT COST. | ||
| PART III, LINE 8: THE HOSPITAL USES AN OVERALL COST TO CHARGE RATIO CALCULATION BASED ON AUDITED FINANCIAL STATEMENTS BUT REMOVES COST ASSOCIATED WITH BAD DEBT, GME, COMMUNITY BUILDING, AND CHARITY CARE SO AS NOT TO COUNT THOSE COSTS TWICE. | ||
| PART III, LINE 9B: PATIENT FINANCIAL RESOURCES SERVICES WORKS WITH THE PATIENT FOR ANY PATIENT LIABILITY. OUR MAIN FOCUS IS PRIOR TO SERVICESAND/OR DISCHARGE; HOWEVER, WE DO WORK WITH PATIENTS AFTER SERVICES HAVEBEEN RECEIVED AND BILLED. PATIENT FINANCIAL RESOURCES SERVICES IS REALLYTWO AREAS IN ONE--THE RESOURCE RECOVERY SPECIALIST/RRS (FORMERLY FINANCIALCOUNSELING) AND THE MEDICAID ELIGIBILITY TEAM/MPS. THESE TWO AREAS WORKTOGETHER TO FIND A RESOLUTION TO PATIENT LIABILITY, SELF PAY OR INSURED.THE RRS WORKS TO NOTIFY THE PATIENT OF ANY PATIENT LIABILITY AND ASK FORPAYMENT FOR THAT LIABILITY. IF THE PATIENT INDICATES THAT HE/SHE NEEDSASSISTANCE, THEN THE RRS WILL COMPLETE A FINANCIAL STATEMENT ON THEPATIENT. WHILE TAKING THAT FINANCIAL STATEMENT THE RRS IS LOOKING FORINFORMATION THAT COULD QUALIFY THE PATIENT FOR MEDICAID OR FOR OTHERAGENCY PROGRAMS THAT ARE AVAILABLE TO THE MEDICAL CENTER. WHEN THATINFORMATION IS IDENTIFIED THE RRS WILL LET THE PATIENT KNOW THAT AREFERRAL WILL BE MADE FOR MEDICAID OR OTHER ASSISTANCE AND A MPS WILL BEIN TOUCH WITH HIM/HER. THE RRS ALSO EXPLAINS TO THE PATIENT OR FAMILY THATCHARITY CARE IS A LAST RESORT AND THEY MUST COOPERATE WITH ANY OTHERASSISTANCE PROGRAMS THAT WE HAVE IDENTIFIED AND BE FOUND INELIGIBLE BEFORECHARITY CARE WILL BE APPROVED/APPLIED. IT IS ALSO COMMUNICATED WITH THEPATIENT OR FAMILY IS INFORMED IF ANY SUPPORTING DOCUMENTATION IS NEEDED FOR ANY ASSISTANCE, WHETHER THAT BE CHARITY, MEDICAID, OR OTHER PROGRAMS. | ||
| PART V, SECTION B, LINE 3: COMMUNITY INPUT WAS OBTAINED THROUGH THREE SOURCES OF PRIMARY DATA COLLECTION; (1) DOOR TO DOOR SURVEY; (2) NINE FOCUS GROUPS WITH UNDERSERVED, LOW INCOME AND MINORITY COMMUNITIES; AND (3) A YOUTH RISK BEHAVIOR SURVEY. THE HOSPITAL WORKED WITH PUBLIC HEALTH EXPERTS FROM THE FORSYTH COUNTY DEPARTMENT OF HEALTH AND FORTY ONE COMMUNITY LEADERS REPRESENTING THE FAITH COMMUNITY, PRIVATE BUSINESS, HEALTHCARE, HIGHER EDUCATION, PUBLIC SAFETY, SOCIAL SERVICES, MENTAL HEALTH, GOVERNMENT AND PRIVATE AND PUBLIC FOUNDATIONS. | NORTH CAROLINA BAPTIST HOSPITAL | |
| PART V, SECTION B, LINE 4: THE HOSPITAL'S CHNA WAS CONDUCTED IN COLLABORATION WITH FORSYTH MEMORIAL HOSPITAL (DBA FORSYTH MEDICAL CENTER), A TAX-EXEMPT HOSPITAL IN FORSYTH COUNTY. | NORTH CAROLINA BAPTIST HOSPITAL | |
| PART V, SECTION B, LINE 5C: THE HOSPITAL'S COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND CHNA IMPLEMENTATION STRATEGY CAN BE LOCATED ON ITS WEBSITE AT WWW.WAKEHEALTH.EDU/COMMUNITY-HEALTH.HTM. IN ADDITION, A COPY OF THE HOSPITAL'S CHNA IS AVAILABLE AT THE FORSYTH COUNTY HEALTH DEPARTMENT. | NORTH CAROLINA BAPTIST HOSPITAL | |
| PART V, SECTION B, LINE 7: MATERNAL AND INFANT HEALTH WAS NOT INCLUDED IN THE HOSPITAL'S TOP PRIORITIZED HEALTH NEEDS BECAUSE THE HOSPITAL DOES NOT DELIVER BABIES, EXCEPT IN EMERGENCY SITUATIONS. FORSYTH MEMORIAL HOSPITAL IS THE PRIMARY PROVIDER OF MATERNITY SERVICES IN THE COMMUNITY. | NORTH CAROLINA BAPTIST HOSPITAL | |
| PART V, SECTION B, LINE 10: THE HOSPITAL USES THE FEDERAL POVERTY GUIDELINES TO DETERMINE ELIGIBILITY FOR FREE CARE. INDIVIDUALS AT OR BELOW 200% OF THE FEDERAL PROVERTY GUIDELINES ARE ELIGIBLE FOR FREE CARE. THE ORGANIZATION EVALUATES CERTAIN CREDIT FILE DATA ELEMENTS TO IDENTIFY POTENTIAL SOURCES OF HIDDEN INCOME TO MORE ACCURATELY INFORM CHARITY CARE ELIGIBILITY ASSESSMENTS. PATIENTS WITH ESTIMATED HOUSEHOLD INCOME BELOW 200% OF FPG, WHO ARE IDENTIFIED AS HAVING COMMERCIAL CREDIT ACCOUNTS THAT ARE BEING SERVICED IN A MANNER THAT SUGGESTS ADDITIONAL SOURCES OF INCOME, ARE NOT AUTOMATICALLY GRANTED PRESUMPTIVE CHARITY CARE. | NORTH CAROLINA BAPTIST HOSPITAL | |
| PART V, SECTION B, LINE 11: THE ORGANIZATION USES A SLIDING SCALE OF THE FEDERAL POVERTY GUIDELINES TO DETERMINE ELIGIBILITY FOR DISCOUNTED CARE. INDIVIDUALS BETWEEN 201% AND 300% OF THE FEDERAL POVERTY GUIDELINES ARE GRANTED A 75% DISCOUNT AND INDIVIDUALS BETWEEN 301% AND 400% OF THE FEDERAL PROVERTY GUIDELINES ARE GRANTED A 60% DISCOUNT. | NORTH CAROLINA BAPTIST HOSPITAL | |
| PART V, SECTION B, LINE 12H: RESIDENT OF THE MEDICAL CENTER'S 19 COUNTY SERVICE AREA. | NORTH CAROLINA BAPTIST HOSPITAL | |
| PART VI, LINE 2: TO COMPLETE A COMPREHENSIVE ASSESSMENT OF THE NEEDS OF THE COMMUNITY, AN INTERNAL COMMUNITY HEALTH TEAM RELIED ON THE ASSOCIATION FOR COMMUNITY HEALTH IMPROVEMENT'S (ACHI) 6-STEP COMMUNITY HEALTH ASSESSMENT PROCESS ALONG WITH PARTICIPATION IN THE NORTH CAROLINA DIVISION OF PUBLIC HEALTH ASSESSMENT PROCESS AS ORGANIZING METHODOLOGIES. A COMMUNITY WIDE TEAM COMPRISED OF THE FORSYTH COUNTY HEALTH DEPARTMENT, WAKE FOREST BAPTIST MEDICAL CENTER, FORSYTH MEDICAL CENTER AND VARIOUS COMMUNITY GROUPS INCLUDING THE UNITED WAY, THE YMCA, YWCA AND THE COUNTY GOVERNMENT AMONG MANY OTHERS HAS CONVENED TO CONDUCT A COLLABORATIVE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) EVERY THREE YEARS WITH INPUT FROM KEY COMMUNITY LEADERS, THE ACADEMIC COMMUNITY, THE SCHOOL DISTRICT, THE PUBLIC AND OTHERS. FOUNDED ON THE PRINCIPLES OF COLLABORATION, COMMUNITY MOBILIZATION AND EMPOWERMENT, THE COMMUNITY HEALTH ASSESSMENT PROCESS IS USED TO IDENTIFY PRIORITY HEALTH ISSUES AND TO PLAN INTERVENTIONS TO BUILD HEALTHIER COMMUNITIES WITH THE ULTIMATE GOAL OF MAKING NORTH CAROLINA, INCLUDING FORSYTH COUNTY, ONE OF THE HEALTHIEST STATES IN THE NATION. TO ENSURE A COMPLETE ASSESSMENT, THE HOSPITAL'S INTERNAL TEAM HAS ADOPTED THE ACHI PROCESS TO ENSURE BOTH PUBLIC HEALTH AND THE NEWLY REQUIRED COMMUNITY HEALTH NEEDS ASSESSMENT REQUIREMENTS INCLUDED IN THE AFFORDABLE CARE ACT WOULD BE MET. THE ASSESSMENT PROCESS CONSISTS OF COLLECTING PRIMARY AND SECONDARY DATA FOR EACH OF THE FOLLOWING COMPONENTS: A) COMMUNITY PERSPECTIVE B) HEALTH EXPERTS C) COMMUNITY LEADERS D) SOCIAL DETERMINANTS OF HEALTH (SDOH) E) HEALTH STATISTICS/INDICATORS F) WFBMC DATA-ED AND INPATIENT CHRONIC DISEASE DATA | ||
| PART VI, LINE 3: THE ORGANIZATION USES A VARIETY OF MEANS TO EDUCATE AND INFORM PATIENTS OF THEIR CHARITY CARE OPTIONS, INCLUDING INFORMATION ON A WEBSITE, BILLING PAMPHLETS AVAILABLE IN CLINICAL OFFICES AND THE BUSINESS OFFICE, SIGNS IN CHECK-IN AREAS, INFORMATION ON PATIENT BILL STATEMENTS, AND FROM STAFF MEMBERS DURING CONVERSATIONS CONCERNING A PATIENT'S LIABILITY FOR SERVICES. THE HOSPITAL EMPLOYS A ROBUST PRE-SERVICE FINANCIAL CLEARANCE PROCESS THAT SCREENS PATIENTS PRIOR TO SERVICE DELIVERY FOR EXISTING OR AVAILABLE PAYER SOURCES AS A MEANS OF AVOIDING BAD DEBT AND INAPPROPRIATE BILLING TO PATIENTS WITHOUT THE MEANS TO PAY. IF A PAYER SOURCE IS IDENTIFIED, HOSPITAL STAFF ASSIST THE PATIENT WITH ENROLLMENT. | ||
| PART VI, LINE 4: IN FISCAL YEAR 2013, THE MEDICAL CENTER PROVIDED CARE TO A NINETEEN COUNTY SERVICE AREA WHICH COMPRISES 3.5% OF TOTAL INPATIENT DISCHARGES FOR NORTH CAROLINA. THE PRIMARY AND SECONDARY SERVICE AREA INCLUDE:PRIMARY SERVICE AREA COUNTIES - FORSYTH, DAVIE, DAVIDSON, STOKES, SURRY, YADKINSECONDARY SERVICE AREA COUNTIES - ROCKINGHAM, GUILFORD, RANDOLPH, ROWAN, IREDELL, CATAWBA, ALEXANDER, WILKES, ALLEGHANY, ASHE, WATAUGA, CALDWELL, BURKE PERCENT OF UNINSURED INPATIENTS 7.3%PERCENT OF INPATIENTS WHO ARE MEDICAID RECIPIENTS 20.4%THE HOSPITAL IS LOCATED IN CENTRAL FORSYTH COUNTY, WHICH COMPRISES THE SINGLE LARGEST COUNTY IN TOTAL INPATIENT DISCHARGES, ACCOUNTING FOR 13,142 OR 29.6% OF ALL DISCHARGES IN FY 13. ACCORDINGLY, THE HOSPITAL SERVES A WIDE SERVICE AREA; HOWEVER, IT IS RESOURCE PROHIBITIVE TO PARTICIPATE AND FUND HEALTH ASSESSMENTS IN EACH COMMUNITY/COUNTY FROM WHICH ITS PATIENT POPULATION ORIGINATES. THEREFORE, THE PRIMARY COMMUNITY BENEFIT SERVICE AREA (CBSA)IS FORSYTH COUNTY, NORTH CAROLINA.BELOW IS A DEMOGRAPHIC SNAPSHOT OF FORSYTH COUNTY BASED ON 2010 CENSUS DATA: POPULATION AND GEOGRAPHY TOTAL POPULATION 350,670POPULATION CHANGE SINCE 2000 + 12.7%LAND AREA 408.1 SQUARE MILESPOPULATION DENSITY 859.5 PERSONS PER SQUARE MILE POPULATION BY RACE/ETHNICITYWHITE 58.7%BLACK/AFRICAN-AMERICAN 25.5%HISPANIC 11.9%ASIAN 1.8%AMERICAN INDIAN/ 0.3%ALASKA NATIVE NATIVE HAWAIIAN/ 0.04%PACIFIC ISLANDERMULTIRACIAL 1.5%OTHER 0.2% POPULATION BY AGE DISTRIBUTIONUNDER 5 YEARS OLD 6.8%UNDER 18 YEARS OLD 24.4%= 65 YEARS OLD 13.0%MEDIAN AGE 37.5 YEARS POPULATION BY SEXMALE 47.5%FEMALE 52.5% POPULATION BY EDUCATIONAL ATTAINMENT PERCENT OF PERSONS = 25 YEARS OLD WHO HAVE:< HIGH SCHOOL DIPLOMA OR GED 13.8%A HIGH SCHOOL DIPLOMA OR GED 28.2%A BACHELOR'S DEGREE 20.7%GRADUATE DEGREE 10.0%PERCENTAGE OF FAMILIES LIVING BELOW POVERTY LEVELALL FAMILIES 11.0%FAMILIES WITH A HOUSEHOLDER WHO IS:WHITE 4.6%BLACK/AFRICAN AMERICAN 21.6%HISPANIC 31.4%ASIAN 6.6%AMERICAN INDIAN/ 17.2%OTHER RACE 34.7 PERCENTAGE OF POPULATION LIVING BELOW POVERTY LEVELCHILDREN (0-17YR OLD) 22.8%ADULTS (18-64YR OLD) 12.9%SENIORS (= 65YR OLD) 7.1% COUNTY SCHOOLSK-12 ENROLLMENT 53,627GRADUATION RATE 72.7% UNEMPLOYMENT UNEMPLOYMENT RATE 9.9%LOST JOBS & LAYOFFS 1,900 INCOMEMEDIAN FAMILY HOUSEHOLD $55,075MEDIAN NON-FAMILY HOUSEHOLD $28,023 | ||
| PART VI, LINE 6: WAKE FOREST BAPTIST MEDICAL CENTER'S MISSION IS TOIMPROVE THE HEALTH OF OUR REGION, STATE AND NATION BY:1) GENERATING AND TRANSLATING KNOWLEDGE TO PREVENT, DIAGNOSE AND TREATDISEASE.2) TRAINING LEADERS IN HEALTH CARE AND BIOMEDICAL SCIENCE.3) SERVING AS THE PREMIER HEALTH SYSTEM IN OUR REGION, WITH SPECIFICCENTERS OF EXCELLENCE RECOGNIZED AS NATIONAL AND INTERNATIONAL CAREDESTINATIONS. THE HOSPITAL, WHICH IS THE INPATIENT COMPONENT OF WAKE FOREST BAPTIST MEDICAL CENTER, OPERATES THE FOLLOWING PROGRAMS CONSTITUTING COMMUNITY HEALTH IMPROVEMENT SERVICES AND COMMUNITY BENEFIT OPERATIONS REPORTED ON PART I,LINE 7E:WINSTON-SALEM/FORSYTH CTY SCHOOLS'ALLIED HEALTH PROGRAM $4,889COMMUNITY HEALTH/HEALTHCARE ACCESS $1,500 CHURCH COMMUNITY RELATIONS $401,995COMMUNITY HEALTH SALARIES $343,925PHYSICIANS COMMUNITY HEALTH ACCESS $371,418CARENET/PASTORAL COUNSELING $294,399ACCELERATED BACHELOR OF SCIENCE IN NURSING PROGRAM $395,004COUNTY RENT ON CLEVELAND AVE DENTAL CLINIC $111,559DIABETIC EDUCATION $79,284BRENNER FIT $141,358FAMILY RESOURCES $5,542TOTAL TO PART I, LINE 7E: $2,150,873 | ||
| NC | REPORTS FILED WITH STATES | PART VI, LINE 7 |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 1 | RecordsMaintained |
Recipient Table RecipientTable (16 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EIN Of RecipientEINOfRecipient | IRC SectionIRCSection | Amount Of Cash GrantAmountOfCashGrant | Purpose Of GrantPurposeOfGrant |
|---|---|---|---|---|---|---|---|
| ALLIANCE FOR NORTH CAROLINA NONPROFITS | |||||||
| 2501 BLUE RIDGE ROAD | RALEIGH | NC | 27607 | 461358968 | 501(C)3 | 100000 | COMMUNITY SUPPORT |
| AMERICAN HEART ASSOCIATION | |||||||
| 101 CENTREPORT DRIVE STE 130 | GREENSBORO | NC | 27409 | 135613797 | 501(C)3 | 50000 | COMMUNITY SUPPORT |
| ARTS FOR LIFE | |||||||
| PO BOX 5132 | WINSTON SALEM | NC | 27113 | 562250962 | 501(C)3 | 25000 | COMMUNITY SUPPORT |
| CANCER SERVICES | |||||||
| 3175 MAPLEWOOD AVE | WINSTON SALEM | NC | 27103 | 560656375 | 501(C)3 | 10000 | COMMUNITY SUPPORT |
| EL BUEN PASTOR LATINO COMMUNITY SERVICES | |||||||
| 4637 TIM ROAD | WINSTON SALEM | NC | 27106 | 203751959 | 501(C)3 | 7000 | COMMUNITY SUPPORT |
| FORSYTH TECHNICAL COMMUNITY COLLEGE | |||||||
| 2100 SILAS CREEK PARKWAY | WINSTON SALEM | NC | 27103 | 560792614 | 501(C)3 | 68360 | GREENE HALL EXPANSION |
| JDRF PIEDMONT TRIAD CHAPTER | |||||||
| 312 N EUGENE STREET SUITE D | GREENSBORO | NC | 27401 | 231907729 | 501(C)3 | 25000 | COMMUNITY SUPPORT |
| MAKE A WISH FOUNDATION | |||||||
| 212 S TRYON ST SUITE 1080 | CHARLOTTE | NC | 28281 | 860481941 | 501(C)3 | 6000 | COMMUNITY SUPPORT |
| MARCH OF DIMES | |||||||
| 410 BROOKSTOWN AVENUE | WINSTON SALEM | NC | 27101 | 131846366 | 501(C)3 | 7500 | COMMUNITY SUPPORT |
| NC TRIAD AFFILIATE - SUSAN G KOMEN FOR THE CURE | |||||||
| 1106 BURKE STREET | WINSTON SALEM | NC | 27101 | 751835298 | 501(C)3 | 25000 | COMMUNITY SUPPORT |
| RONALD MCDONALD HOUSE | |||||||
| 419 S HAWTHORNE ROAD | WINSTON SALEM | NC | 27103 | 581454715 | 501(C)3 | 12500 | COMMUNITY SUPPORT |
| SENIOR SERVICES | |||||||
| 2895 SHOREFIELD DRIVE | WINSTON SALEM | NC | 27105 | 561085968 | 501(C)3 | 30000 | COMMUNITY SUPPORT |
| THE WOMEN'S FUND OF WINSTON SALEM | |||||||
| 860 W FIFTH STREET | WINSTON SALEM | NC | 27101 | 566037615 | 501(C)3 | 10000 | COMMUNITY SUPPORT |
| WINSTON SALEM FOUNDATION | |||||||
| 860 W FIFTH STREET | WINSTON SALEM | NC | 27101 | 566037615 | 501(C)3 | 15000 | COMMUNITY SUPPORT |
| WS FORSYTH COUNTY SCHOOLS | |||||||
| PO BOX 2513 | WINSTON SALEM | NC | 27102 | 560795164 | GOV'T ENTITY | 250000 | COMMUNITY SUPPORT |
| YMCA | |||||||
| 301 N MAIN STREET | WINSTON SALEM | NC | 27101 | 560530015 | 501(C)3 | 10000 | COMMUNITY SUPPORT |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 16 | TotalNbrOf501C3AndGovtGrants |
| Total Nbr Of Other Organizations | 0 | TotalNbrOfOtherOrganizations |
Form990 Schedule I Part III Form990ScheduleIPartIII (3 entries)
| Type Of GrantTypeOfGrant | Number Of RecipientsNumberOfRecipients | Amount Of Cash GrantAmountOfCashGrant |
|---|---|---|
| LETTIE PATE WHITEHEAD SCHOLARS | 57 | 39500 |
| WSSU NURSING | 395004 | |
| MEDICAL SCHOLARSHIPS | 29 | 44689 |
Form990 Schedule I Part IV Form990ScheduleIPartIV (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| PROCEDURE FOR MONITORING GRANTS IN THE U.S.: | PART I, LINE 2: | SCHEDULE I, PART I, LINE 2: THE HOSPITAL FOLLOWS THE MEDICAL CENTER'S CORPORATE POLICY USED IN REVIEWING THE ELIGIBILITY AND SELECTION OF GRANTEES RECEIVING CERTAIN EXEMPT PURPOSE FUNDS. THE HOSPITAL MAINTAINS DOCUMENTATION OF THE ELIGIBILITY AND SELECTION CRITERIA AND RECORDS OF THE AMOUNTS DISBURSED. |
| SCHEDULE I, PART III | GRANTS & OTHER ASSISTANCE TO INDIVIDUALS IN THE U.S. | THE HOSPITAL FOLLOWS WAKE FOREST BAPTIST MEDICAL CENTER'S POLICY USED IN REVIEWING THE ELIGIBILITY AND SELECTION OF GRANTEES RECEIVING SCHOLARSHIPS. THE HOSPITAL MONITORS THE ACADEMIC PERFORMANCE AND OTHER ACHIEVEMENTS OF STUDENTS RECEIVING SCHOLARSHIP FUNDS TO ENSURE THAT THE SCHOLARSHIP REQUIREMENTS ARE BEING MET BY THE STUDENTS. LETTIE PATE WHITEHEAD SCHOLARSHIPS THE LETTIE PATE WHITEHEAD FOUNDATION PROVIDES SCHOLARSHIPS TO TAX-EXEMPT HOSPITALS OR INSTITUTIONS FOR THE CARE OF INDIGENT CHRISTIAN WOMEN IN SPECIFIED STATES, INCLUDING NORTH CAROLINA. THE FINANCIAL NEED IS ESTABLISHED BY THE COLLEGES THAT THE STUDENTS ATTEND. NAMES OF THE STUDENTS ARE PROVIDED TO OUR STAFF DEVELOPMENT DEPARTMENT. THE WHITEHEAD FUNDS ARE REVIEWED AND ADMINISTERED BY A FUND CUSTODIAN. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Idemnification Gross Up Payments | X | IdemnificationGrossUpPayments |
| Housing Allowance Or Residence | X | HousingAllowanceOrResidence |
| Club Dues Or Fees | X | ClubDuesOrFees |
| Written Policy Re T And E Expenses | 1 | WrittenPolicyReTAndEExpenses |
| Substantiation Required | 1 | SubstantiationRequired |
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Form990 Of Other Organizations | X | Form990OfOtherOrganizations |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 1 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 1 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 1 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (26 entries)
| TitleTitle | Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JOHN D MCCONNELL MD | ||||||||||||||
| TRUSTEE & CEO | 998061 | 0 | 334267 | 0 | 38420 | 0 | 670368 | 0 | 20576 | 0 | 2061692 | 0 | 0 | 0 |
| H GREG BRAY | ||||||||||||||
| ASST. TREASURER/ASST. SECR | 208575 | 0 | 20988 | 0 | 1910 | 0 | 19831 | 0 | 18094 | 0 | 269398 | 0 | 0 | 0 |
| J MCLAIN WALLACE JR | ||||||||||||||
| VP GENERAL COUNSEL/SECR | 391182 | 0 | 74659 | 0 | 50817 | 0 | 91097 | 0 | 19183 | 0 | 626938 | 0 | 31386 | 0 |
| KAREN H HUEY | ||||||||||||||
| VP FACILITIES | 248083 | 0 | 55426 | 0 | 60239 | 0 | 49655 | 0 | 21826 | 0 | 435229 | 0 | 30346 | 0 |
| ERIC TOMLINSON | ||||||||||||||
| CHIEF INNOVATION OFFICER | 199154 | 0 | 50000 | 0 | 17789 | 0 | 27667 | 0 | 4119 | 0 | 298729 | 0 | 0 | 0 |
| NORMAN D POTTER JR | ||||||||||||||
| VP DEVELOPMENT & ALUMNI AF | 279198 | 0 | 61828 | 0 | 7205 | 0 | 62297 | 0 | 21581 | 0 | 432109 | 0 | 0 | 0 |
| CHERYL EH LOCKE | ||||||||||||||
| VP CHIEF HUMAN RESOURCES | 358614 | 0 | 75494 | 0 | 5544 | 0 | 80419 | 0 | 17435 | 0 | 537506 | 0 | 0 | 0 |
| EDWARD G CHADWICK | ||||||||||||||
| EXECUTIVE VP CFO/TREASURER | 533120 | 0 | 152385 | 0 | 24466 | 0 | 225493 | 0 | 21001 | 0 | 956465 | 0 | 0 | 0 |
| THOMAS E SIBERT MD | ||||||||||||||
| PRESIDENT/COO - HEALTH SYS | 690081 | 0 | 164710 | 0 | 30692 | 0 | 119996 | 0 | 21106 | 0 | 1026585 | 0 | 0 | 0 |
| LISA M WYATT | ||||||||||||||
| VP CHIEF COMM & MARKETING | 292924 | 0 | 70218 | 0 | 23812 | 0 | 67097 | 0 | 8013 | 0 | 462064 | 0 | 0 | 0 |
| SHEILA M SANDERS | ||||||||||||||
| VP CHIEF INFORMATION OFFIC | 365614 | 0 | 79700 | 0 | 33590 | 0 | 85397 | 0 | 18723 | 0 | 583024 | 0 | 0 | 0 |
| EDWARD ABRAHAM MD | ||||||||||||||
| DEAN, SCHOOL OF MEDICINE | 478061 | 0 | 136885 | 0 | 54832 | 0 | 158364 | 0 | 23526 | 0 | 851668 | 0 | 0 | 0 |
| BETTY PETREE | ||||||||||||||
| DIRECTOR NURSE ANESTHESIA | 212853 | 0 | 20485 | 0 | 17132 | 0 | 28803 | 0 | 8525 | 0 | 287798 | 0 | 0 | 0 |
| MICHAEL RIEKER | ||||||||||||||
| DIRECTOR OF NURSE ANESTHES | 218222 | 0 | 23626 | 0 | 1061 | 0 | 21293 | 0 | 23806 | 0 | 288008 | 0 | 0 | 0 |
| VANCE MCVAY JR | ||||||||||||||
| CLINICAL INSTRUCTOR CRNA | 223143 | 0 | 0 | 0 | 8167 | 0 | 20378 | 0 | 18944 | 0 | 270632 | 0 | 0 | 0 |
| ERIC STIEFEL | ||||||||||||||
| CLINICAL INSTRUCTOR CRNA | 182037 | 0 | 0 | 0 | 11108 | 0 | 16478 | 0 | 17504 | 0 | 227127 | 0 | 0 | 0 |
| CHARLES WARE | ||||||||||||||
| ASSOCIATE VP INFRASTRUCTUR | 196162 | 0 | 18409 | 0 | 6203 | 0 | 25311 | 0 | 13709 | 0 | 259794 | 0 | 0 | 0 |
| JOANNE C RUHLAND | ||||||||||||||
| FORMER OFFICER | 234968 | 0 | 0 | 0 | 20675 | 0 | 53297 | 0 | 17726 | 0 | 326666 | 0 | 0 | 0 |
| RUSSELL M HOWERTON MD | ||||||||||||||
| FORMER OFFICER | 479102 | 0 | 102464 | 0 | 20612 | 0 | 126197 | 0 | 28816 | 0 | 757191 | 0 | 0 | 0 |
| DOUGLAS L EDGETON | ||||||||||||||
| FORMER OFFICER | 78648 | 0 | 91875 | 0 | 436379 | 0 | 5927 | 0 | 13785 | 0 | 626614 | 0 | 0 | 0 |
| STEVE C SNELGROVE | ||||||||||||||
| FORMER OFFICER | 262908 | 0 | 59250 | 0 | 56998 | 0 | 69197 | 0 | 17481 | 0 | 465834 | 0 | 36276 | 0 |
| RONALD H SMALL | ||||||||||||||
| FORMER OFFICER | 0 | 0 | 0 | 0 | 241797 | 0 | 0 | 0 | 6355 | 0 | 248152 | 0 | 0 | 0 |
| MAUREEN E SINTICH | ||||||||||||||
| FORMER OFFICER | 315758 | 0 | 52624 | 0 | 22349 | 0 | 69497 | 0 | 17583 | 0 | 477811 | 0 | 11958 | 0 |
| ROBERT S PARKER SR | ||||||||||||||
| FORMER OFFICER | 1537 | 0 | 116052 | 0 | 0 | 0 | 0 | 0 | 4468 | 0 | 122057 | 0 | 0 | 0 |
| DONNY C LAMBETH | ||||||||||||||
| FORMER OFFICER | 191296 | 0 | 134313 | 0 | 811808 | 0 | 27524 | 0 | 15116 | 0 | 1180057 | 0 | 99432 | 0 |
| SHARON ENGEBRETSON | ||||||||||||||
| FORMER OFFICER | 107217 | 0 | 27736 | 0 | 38996 | 0 | 19888 | 0 | 47569 | 0 | 241406 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (5 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| PART I, LINE 1A | CERTAIN OFFICERS RECEIVE, AS PART OF THEIR APPROVED COMPENSATION PACKAGE,TAX INDEMNIFICATION AND GROSS-UP PAYMENTS, RELOCATION ASSISTANCE INCLUDING A HOUSING ALLOWANCE, AND HEALTH OR SOCIAL CLUB DUES OR INITIATION FEES. BELOW IS A SUMMARY OF THE BENEFITS INCLUDED IN THE OFFICERS' COMPENSATION FOR THE FISCAL YEAR ENDED JUNE 30, 2013: - TAX INDEMNIFICATION AND GROSS UP PAYMENTS - $1,486 FOR ONE FORMER OFFICER; - RELOCATION ASSISTANCE, INCLUDING A HOUSING ALLOWANCE - $117,601 FOR FOUR OFFICERS AND ONE FORMER OFFICER; AND - DUES AND INITIATION FEES - $285 FOR ONE OFFICER | |
| PART I, LINE 3 | THE EXECUTIVE COMMITTEE OF THE WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER ("WFUBMC") BOARD OF DIRECTORS IS RESPONSIBLE FOR REVIEWING AND APPROVING ALL WFUBMC OFFICERS' COMPENSATION. THE COMMITTEE UTILIZE AN INDEPENDENT, EXTERNAL COMPENSATION CONSULTANT FIRM EXPERIENCED IN HEALTH CARE AND HIGHER EDUCATION COMPENSATION THAT BASED RECOMMENDATIONS ON COMPENSATION SURVEYS AND STUDIES TO DETERMINE THE APPROPRIATENESS OF EACH OFFICER'S COMPENSATION. THESE COMPENSATION CONSULTANTS PRESENT TOTAL COMPENSATION COMPARABILITY DATA FOR THE POSITIONS FOR WHICH COMPENSATION IS BEING DETERMINED. THE DATA IS REVIEWED BY THE EXECUTIVE COMMITTEE OF WFUBMC'S GOVERNING BOARD AT ITS MEETING; NONE OF THE MEMBERS OF THAT COMMITTEE ARE EMPLOYEES OF THE FILING ORGANIZATION. MINUTES OF THE DELIBERATIONS OF THE COMMITTEE ARE CONTEMPORANEOUSLY RECORDED. IN THE EVENT THAT ANY MEMBER OF THE EXECUTIVE COMMITTEE HAS A CONFLICT OF INTEREST, THAT COMMITTEE MEMBER DOES NOT PARTICIPATE IN THE DELIBERATION OR APPROVAL PROCESS, AND THEIR ABSTENTION FROM THE PROCESS IS REFLECTED IN THE MINUTES. | |
| PART I, LINES 4A-B | NAME SEVERANCE NON-QUAL RETIRE RONALD H SMALL 251,360 MAUREEN E SINTICH 20,648 ROBERT S PARKER, SR. 115,769 DONNY C LAMBETH 253,846 501,126 DOUG EDGETON 423,536 JERRY M WALLACE, JR. 31,386 KAREN H HUEY 58,468 STEVEN C SNELGROVE 36,276 | |
| PART I, LINE 7 | OFFICERS, KEY EMPLOYEES AND FACULTY MEMBERS HAVE INCENTIVE COMPENSATION COMPONENTS CONTAINED IN THEIR EMPLOYMENT AGREEMENTS. THESE ARE OFTEN GOAL-BASED AND ARE DETERMINED IN THE COURSE OF EVALUATION OF THE INDIVIDUAL'S PERFORMANCE BY HIS/HER DEPARTMENT CHAIR, SUPERVISOR OR THE COMPENSATION COMMITTEE OF THE BOARD, AS APPLICABLE. OTHER NON-FIXED PAYMENTS MAY INCLUDE SUMS FOR RELOCATION AND/OR TEMPORARY HOUSING THAT ARE TYPICALLY INCLUDED AS A PROVISION IN THE EMPLOYMENT AGREEMENT. ALL SUCH PAYMENTS ARE REFLECTED ON THE INDIVIDUAL'S W-2. | |
| PART III | SCHEDULE J, PART III IN JULY OF 2010, WAKE FOREST UNIVERSITY HEALTH SCIENCES (WFUHS), NORTH CAROLINA BAPTIST HOSPITAL (NCBH), WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER (WFUBMC) AND WAKE FOREST UNIVERSITY (WFU)) APPROVED A MEDICAL CENTER INTEGRATION AGREEMENT THAT ALLOWS FOR THE LEVERAGING OF COMBINED RESOURCES OF NCBH AND WFUHS TO FULFILL A SINGLE MISSION OF IMPROVING HEALTH, OPTIMIZING PERFORMANCE WHILE BALANCING PATIENT CARE, EDUCATION AND RESEARCH. NCBH, WFUBMC, WFUHS AND THEIR SUBSIDIARIES HAVE COMBINED OPERATING REVENUES OF APPROXIMATELY $2 BILLION FOR THE FISCAL YEAR ENDED JUNE 30, 2013. IN GENERAL, EXECUTIVES PERFORMING KEY MANAGEMENT FUNCTIONS FOR THE MEDICAL CENTER ARE SOUGHT AND HIRED AFTER NATIONAL SEARCHES IN A HIGHLY COMPETITIVE ENVIRONMENT, AND ONLY INDIVIDUALS AT THE HIGHEST LEVELS OF ABILITY ARE HIRED AND GIVEN THE TASK OF OPTIMIZING THE EFFECTIVENESS OF THE MEDICAL CENTER AND ITS TAX-EXEMPT MISSION. CERTAIN EXECUTIVES HOLD THE IDENTICAL OFFICES/TITLES IN WFUHS, NCBH AND WFUBMC AND ARE ELIGIBLE TO RECEIVE INCENTIVE COMPENSATION AT THE END OF EACH FISCAL YEAR. THE INCENTIVE STRUCTURE IS BASED UPON GOALS ESTABLISHED BY THE EXECUTIVE COMMITTEE ON BEHALF OF THE FILING ORGANIZATION'S BOARD AT THE BEGINNING OF THE YEAR, INCLUDING MEASURES OF CLINICAL QUALITY, PATIENT SATISFACTION, AND FINANCIAL OPERATING PERFORMANCE. THE DETERMINATION OF THE AMOUNT OF INCENTIVE COMPENSATION IS SUBJECT TO THE FILING ORGANIZATION'S COMPENSATION PROCEDURES AS OUTLINED IN PART VI, SECTION B, LINE 15 OF THE 990. SCHEDULE J. PART I, LINE 4 - CERTAIN EXECUTIVES PARTICIPATE IN OR RECEIVE SEVERANCE PAYMENTS AND/OR PAYMENTS FROM SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLANS. THE DETERMINATION OF THE AMOUNT OF THE SEVERANCE AND/OR NON-QUALIFIED RETIREMENT PLAN PAYMENTS FOLLOW THE FILING ORGANIZATION'S COMPENSATION PROCEDURES AS OUTLINED ABOVE AND IN PART VI, SECTION B, LINE 15 OF THE FORM 990. FORM 990, PART VII, LINE 5 - COMPENSATION FROM UNRELATED ORGANIZATION THE FOLLOWING INDIVIDUALS WERE COMPENSATED BY WAKE FOREST UNIVERSITY HEALTH SCIENCES FOR SERVICES PERFORMED FOR THE HOSPITAL. SEE PART VII AND SCHEDULE J, PART II, FOR THEIR COMPENSATION: JOHN D MCCONNELL MD JOANNE C RUHLAND NORMAN D POTTER, JR. CHERYL E.H. LOCKE EDWARD G CHADWICK THOMAS E SIBERT, MD RUSSELL M HOWERTON, MD DOUGLAS L EDGETON LISA M WYATT SHEILA M SANDERS EDWARD ABRAHAM, MD ERIC TOMLINSON, DCS, PHD | SUPPLEMENTAL INFORMATION |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI (3 entries)
| Bond ReferenceBondReferenceCd | Issuer EINIssuerEIN | CUSIP NumberCUSIPNumber | Date IssuedDateIssued | Issue PriceIssuePrice | Description Of PurposeDescriptionOfPurpose | DefeasedDefeased | On Behalf Of IssuerOnBehalfOfIssuer | Pool FinancingPoolFinancing |
|---|---|---|---|---|---|---|---|---|
| NORTH CAROLINA MEDICAL CARE COMMISSION | ||||||||
| A | 521309402 | 65820HD67 | 2010-03-01 | 334002408 | CURRENT REFUNDING | 0 | 0 | 0 |
| NORTH CAROLINA MEDICAL CARE COMMISSION | ||||||||
| B | 521309402 | NONEAVAIL | 2012-12-31 | 80000000 | VARIOUS CAPITAL PROJECTS | 0 | 0 | 0 |
| NORTH CAROLINA MEDICAL CARE COMMISSION | ||||||||
| C | 521309402 | 65821DMM0 | 2012-11-15 | 122822821 | VARIOUS CAPITAL PROJECTS | 0 | 0 | 0 |
Form990 Schedule K Part II Form990ScheduleKPartII (3 entries)
| Bond ReferenceBondReferenceCd | Amount RetiredAmountRetired | Total ProceedsTotalProceeds | Issuance Costs From ProceedsIssuanceCostsFromProceeds | Other Spent ProceedsOtherSpentProceeds | Year Of Subst CompletionYearOfSubstCompletion | Current RefundingCurrentRefunding | Advance RefundingAdvanceRefunding | Final Allocation MadeFinalAllocationMade | Adequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind | Capital ExpendituresCapitalExpenditures | Amount UnspentAmountUnspent |
|---|---|---|---|---|---|---|---|---|---|---|---|
| A | 25240591 | 334002408 | 3307037 | 330695370 | 2010 | 1 | 0 | 1 | 1 | ||
| B | 80000000 | 1000 | 0 | 0 | 0 | 1 | 62893246 | 17105754 | |||
| C | 122822821 | 2485 | 2013 | 0 | 0 | 0 | 1 | 122820336 |
Form990 Schedule K Part III Form990ScheduleKPartIII (3 entries)
| Bond ReferenceBondReferenceCd | Owning Bond Financed PropertyOwningBondFinancedProperty | Any Lease ArrangementsAnyLeaseArrangements | Mngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprty | Any Research AgreementsAnyResearchAgreements | Bond Iss Meet Prvt Security Pay TestBondIssMeetPrvtSecurityPayTest | Change In Use Bond Financed PropChangeInUseBondFinancedProp | Non Qualified Bond Remed ProcdrsNonQualifiedBondRemedProcdrs | Prcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthers | Percentage Of Prvt Business Re UBIPercentageOfPrvtBusinessReUBI | Total Private Business UseTotalPrivateBusinessUse |
|---|---|---|---|---|---|---|---|---|---|---|
| A | 0 | 0 | 0 | 0 | 0 | 0 | 1 | |||
| B | 0 | 0 | 0 | 0 | 0 | 0 | 1 | 0.00000 | 0.00000 | 0.00000 |
| C | 0 | 1 | 0 | 0 | 0 | 0 | 1 | 0.00000 | 0.00000 | 0.00000 |
Form990 Schedule K Part IV Form990ScheduleKPartIV (3 entries)
| Bond ReferenceBondReferenceCd | Form8038 T FiledForm8038TFiled | Rebate Not Due YetRebateNotDueYet | Exception To RebateExceptionToRebate | No Rebate DueNoRebateDue | Variable Rate IssueVariableRateIssue | Hedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecds | Term Of HedgeTermOfHedge | Superintegrated HedgeSuperintegratedHedge | Hedge TerminatedHedgeTerminated | Gross Proceeds Invested In GICGrossProceedsInvestedInGIC | Gross Proceeds InvestedGrossProceedsInvested | Written Proc To Monitor ReqsWrittenProcToMonitorReqs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DEUTSCHE BANK AG | ||||||||||||
| A | 0 | 1 | 0 | 0 | 0 | 1 | 5.000000000000 | 0 | 0 | 0 | 0 | 1 |
| (no name) | ||||||||||||
| B | 0 | 1 | 0 | 0 | 1 | 0 | 0 | 0 | 1 | |||
| (no name) | ||||||||||||
| C | 0 | 1 | 0 | 0 | 0 | 0 | 0 | 0 | 1 | |||
Form990 Schedule K Part V Form990ScheduleKPartV (3 entries)
| Bond ReferenceBondReferenceCd | Proc To Undertk Corrective ActionProcToUndertkCorrectiveAction |
|---|---|
| A | 1 |
| B | 1 |
| C | 1 |
Form990 Schedule K Part VI Form990ScheduleKPartVI (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| PART I, LINE A, COLUMN F | CURRENT REFUNDING | THE 2010 ISSUE CURRENTLY REFUNDED PRE 12/31/2002 ISSUES. |
| PART II, COLUMN A, LINE 11 | OTHER SPENT PROCEEDS | THE OTHER SPENT PROCEEDS LISTED ARE THE CURRENT REFUNDING PROCEEDS OF THE ISSUE. |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV (4 entries)
| RelationshipRelationship | Amount Of TransactionAmountOfTransaction | Description Of TransactionDescriptionOfTransaction | Sharing Of RevenuesSharingOfRevenues |
|---|---|---|---|
| DAVID E BRANN | |||
| FAMILY MEMBER OF DONNY LAMBETH | 108782 | COMPENSATION | 0 |
| JUDY M SLOCUM | |||
| FAMILY MEMBER OF MAUREEN SINTICH | 56256 | COMPENSATION | 0 |
| MEDCOST | |||
| BOARD MEMBER EDWARD CHADWICK | 2130677 | THIRD PARTY ADMINISTRATOR | 0 |
| ROBIN LEWIS | |||
| FAMILY MEMBER OF KENNETH LEWIS | 69438 | COMPENSATION | 0 |
Schedule M IRS990ScheduleM
Books And Publications BooksAndPublications
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | X | NonCashCheckbox |
| Noncash Contribs Rptd F990 | 1735 | NoncashContribsRptdF990 |
| Method Of Determining Revenues | FMV | MethodOfDeterminingRevenues |
Clothing And Household Goods ClothingAndHouseholdGoods
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | X | NonCashCheckbox |
| Noncash Contribs Rptd F990 | 5729 | NoncashContribsRptdF990 |
| Method Of Determining Revenues | FMV | MethodOfDeterminingRevenues |
Securities Publicly Traded SecuritiesPubliclyTraded
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | X | NonCashCheckbox |
| Number Of Contributions | 1 | NumberOfContributions |
| Noncash Contribs Rptd F990 | 1093 | NoncashContribsRptdF990 |
Other Non Cash Contributions Table OtherNonCashContributionsTable
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | X | NonCashCheckbox |
| Description | MEDICAL EQUIP | Description |
| Number Of Contributions | 9 | NumberOfContributions |
| Noncash Contribs Rptd F990 | 64759 | NoncashContribsRptdF990 |
| Method Of Determining Revenues | FMV | MethodOfDeterminingRevenues |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of8283 Received | 0 | NumberOf8283Received |
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeld |
| Review Process Unusual NC Gifts | 1 | ReviewProcessUnusualNCGifts |
| Third Parties Used | 0 | ThirdPartiesUsed |
Form990 Schedule M Part II Form990ScheduleMPartII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | METHOD FOR DETERMINING NUMBER OF CONTRIBUTIONS: | Identifier |
| Return Reference | PART I, COLUMN (B): | ReturnReference |
| Explanation | THE ORGANIZATION DETERMINES THE NUMBER OF CONTRIBUTIONS BY USING THE TOTAL NUMBER OF NON-CASH ITEMS RECEIVED PER DONOR PER OCCURANCE. | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (8 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| FORM 990, PART VI, SECTION A, LINE 2 | EDWARD G. CHADWICK AND H. GREGORY BRAY HAVE A BUSINESS RELATIONSHIP THROUGH THEIR BOARD/LEADERSHIP POSITION IN MEDCOST, LLC, A JOINT VENTURE IN WHICH THE HOSPITAL HOLDS A 50% MEMBERSHIP INTEREST. | |
| FORM 990, PART VI, SECTION A, LINE 3 | EFFECTIVE JULY 1, 2010, THE GOVERNING BOARDS OF FOUR NORTH CAROLINA NONPROFIT CORPORATIONS (WAKE FOREST UNIVERSITY, NORTH CAROLINA BAPTIST HOSPITAL, WAKE FOREST UNIVERSITY HEALTH SCIENCES, AND WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER) ENTERED INTO AN AGREEMENT (THE MEDICAL CENTER INTEGRATION AGREEMENT OR MCIA) UNDER WHICH THE OPERATION OF EACH OF NORTH CAROLINA BAPTIST HOSPITAL (NCBH) AND WAKE FOREST UNIVERSITY HEALTH SCIENCES (WFUHS) WAS DELEGATED TO WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER (WFUBMC). WFUHS IS A WHOLLY-CONTROLLED SUBSIDIARY ENTITY OF WAKE FOREST UNIVERSITY (WFU). WFUBMC IS NOW A MEMBERSHIP NONPROFIT CORPORATION WHOSE TWO EQUAL MEMBERS ARE NCBH AND WFU. THIS CONSOLIDATION OF MANAGEMENT IN WFUBMC OF THE VARIOUS ACADEMIC MEDICAL CENTER OPERATIONS, SUBJECT TO SUBSTANTIAL RESERVED POWERS IN EACH OF THE CONSTITUENT MEMBERS' (OR IN WFUHS') BOARDS, MANDATED CHANGES IN THE GOVERNANCE DOCUMENTS OF EACH ORGANIZATION. | |
| FORM 990, PART VI, SECTION B, LINE 11 | THE FILING ORGANIZATION'S BOARD OF DIRECTORS RECEIVE A COPY OF THE FORM 990 WITH SUFFICIENT TIME TO PERMIT REVIEW, COMMENT, AND QUESTIONS PRIOR TO ITS FILING. THE AUDIT AND COMPLIANCE COMMITTEE OF THE GOVERNING BOARD OF WFUBMC, COMPRISED OF THE AUDIT AND COMPLIANCE COMMITTEES OF WFUHS AND NCBH, REVIEW IN ADDITIONAL DETAIL THE FILING ORGANIZATION'S FORM 990 WITH THE ORGANIZATION'S CHIEF FINANCIAL OFFICER OR HIS DESIGNEE, WHO ANSWERS QUESTIONS AND ADDRESSES CONCERNS RAISED BY SUCH COMMITTEE MEMBERS OR OTHER FILING ORGANIZATION DIRECTORS. IF MODIFICATIONS ARE REQUIRED FOLLOWING SUCH REVIEW AND COMMENT, THE REVISED FORM 990 IS REDISTRIBUTED TO ALL BOARD MEMBERS PRIOR TO ITS FILING WITH THE IRS, ALONG WITH A REPORT NOTING THE MODIFICATIONS. | |
| FORM 990, PART VI, SECTION B, LINE 12C | ON AN ANNUAL BASIS (AND AS THEY ARISE), ALL TRUSTEES AND OFFICERS OF THE FILING ORGANIZATION ARE ASKED TO REVIEW THE APPLICABLE CONFLICTS OF INTEREST POLICY AND TO DESCRIBE ANY POTENTIAL CONFLICTS OF INTEREST THEY MAY HAVE. UPON COMPLETION OF THE CONFLICTS OF INTEREST SURVEY, THE LEGAL DEPARTMENT REVIEWS THE COMPLETED QUESTIONNAIRES ON BEHALF OF THE FILING ORGANIZATION. ANY CONFLICTS IDENTIFIED ARE COMMUNICATED TO THE FILING ORGANIZATION'S CHAIRMAN OF THE BOARD AND ARE PRESENTED TO THE AUDIT AND COMPLIANCE COMMITTEE. ALL CONFLICTS OF INTEREST ARE RESOLVED BY MANAGEMENT PLANS DEVELOPED BY THE FILING ORGANIZATION BOARD'S AUDIT AND COMPLIANCE COMMITTEE AND THE INTERNAL AUDIT AND COMPLIANCE OFFICES. THE AUDIT AND COMPLIANCE COMMITTEE'S CHAIR PRESENTS AN ANNUAL REPORT ON CONFLICTS TO THE FULL BOARD OF THE FILING ORGANIZATION. | |
| FORM 990, PART VI, SECTION B, LINE 15 | THE FILING ORGANIZATION HAS DELEGATED TO THE EXECUTIVE COMMITTEE OF THE WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER'S BOARD OF DIRECTORS THE FUNCTION OF THE COMPENSATION COMMITTEE OF THE BOARD OF THE FILING ORGANIZATION AND AS SUCH, THAT COMMITTEE REVIEWS AND APPROVES THE APPOINTMENT AND COMPENSATION OF THE SENIOR EXECUTIVES OF WFUHS, WFUBMC, AND THE FILING ORGANIZATION. THE EXECUTIVE COMMITTEE RELIES UPON AN EXTERNAL, INDEPENDENT COMPENSATION CONSULTANT EXPERIENCED IN HEALTHCARE TO PROVIDE THE COMMITTEE WITH COMPENSATION COMPARABILITY DATA FOR NEW EXECUTIVE POSITION APPOINTMENTS AND FOR COMPENSATION REVIEWS FOR EXISTING EXECUTIVES. THE CONSULTANT, WHICH IS RETAINED DIRECTLY BY THE EXECUTIVE COMMITTEE, PROVIDES THIRD-PARTY INFORMATION AND EVALUATES THE COMPETITIVENESS AND REASONABLENESS OF EXECUTIVE COMPENSATION AND BENEFITS PROGRAMS IN RELATION TO MARKET PRACTICES FOR SIMILARLY-SITUATED NONPROFIT HEALTHCARE ORGANIZATIONS. THE COMMITTEE MAKES ITS DECISIONS WITH RESPECT TO EXECUTIVE COMPENSATION IN ACCORDANCE WITH THE FILING ORGANIZATION'S (AND WFUHS AND NCBH) POLICIES, IRS REGULATIONS, AND STANDARD CORPORATE GOVERNANCE PRACTICES. SUCH POLICIES INCLUDE ADHERENCE TO: BOARD-ESTABLISHED EXECUTIVE COMPENSATION PHILOSOPHY AND REVIEW PROCESSES; PROCESSES ENSURING EXECUTIVE COMMITTEE MEMBER AND COMPENSATION CONSULTANT INDEPENDENCE; USE OF VALID MARKET COMPARISONS OF DATA FROM PEER ACADEMIC MEDICAL CENTERS OF SIMILAR ORGANIZATIONAL STRUCTURE, SIZE, AND COMPLEXITY; CAREFUL DOCUMENTATION OF ALL COMPENSATION DECISIONS; AND ESTABLISHMENT OF THE REBUTTABLE PRESUMPTION OF REASONABLENESS, PER IRS GUIDELINES. MINUTES OF THE DELIBERATIONS OF THE EXECUTIVE COMMITTEE ARE CONTEMPORANEOUSLY MAINTAINED AND THAT COMPARABILITY DATA IS MAINTAINED IN THE MEDICAL CENTER'S OFFICE OF EXECUTIVE COMPENSATION SERVICES. IN THE EVENT THAT A MEMBER OF THE EXECUTIVE COMMITTEE HAS A CONFLICT OF INTEREST RELATED TO EXECUTIVE APPOINTMENT OR COMPENSATION, THAT MEMBER DOES NOT PARTICIPATE IN THE DELIBERATION OR APPROVAL OF APPOINTMENT OR COMPENSATION AND SUCH ABSTENTION IS NOTED IN THE COMMITTEE'S MEETING MINUTES. | |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION'S ARTICLES OF INCORPORATION ARE AVAILABLE TO THE PUBLIC ON REQUEST AND ARE AVAILABLE ON THE WEBSITE OF THE NORTH CAROLINA SECRETARY OF STATE. THE ORGANIZATION'S BYLAWS ARE NOT PUBLISHED, BUT PROVISIONS FROM THE BYLAWS ARE INCLUDED AS NECESSARY IN THE ORGANIZATION'S POLICIES, AND ARE ATTACHED TO THE FORM 1023 FILED FOR THE ORGANIZATION WITH THE IRS, WHICH IS PUBLICLY AVAILABLE. THE CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE NOT AVAILABLE TO THE PUBLIC. PART VII, SECTION A, COLUMN B - OFFICERS' AND FORMER OFFICERS' AVERAGE HOURS FOR RELATED ORGANIZATIONS H GREG BRAY FILING ORG 30.2 RELATED ORG 4.3 UNRELATED ORG 5.5 J MCLAIN WALLACE, JR FILING ORG 17.7 RELATED ORG 6.6 UNRELATED ORG 15.7 KAREN H HUEY FILING ORG 33.7 RELATED ORG 6.3 ERIC TOMLINSON FILING ORG 5.0 RELATED ORG 5.0 UNRELATED ORG 30.0 STEVE C SNELGROVE FILING ORG 0 RELATED ORG 6.0 UNRELATED ORG 34.0 MAUREEN E SINTICH FILING ORG 34.0 RELATED ORG 6.0 DONNY C LAMBETH FILING ORG 20.0 RELATED ORG 14.0 UNRELATED ORG 6.0 SHARON ENGEBRETSON FILING ORG 35.0 RELATED ORG 5.0 JOANNE C RUHLAND FILING ORG 20 RELATED ORG 5 UNRELATED ORG 15 NORMAN D POTTER, JR. FILING ORG 20 RELATED ORG 5 UNRELATED ORG 15 CHERYL E.H. LOCKE FILING ORG 23.4 RELATED ORG 5.3 UNRELATED ORG 11.3 EDWARD G CHADWICK FILING ORG 29.8 RELATED ORG 7.0 UNRELATED ORG 3.2 THOMAS E SIBERT, MD FILING ORG 26.6 RELATED ORG 7.0 UNRELATED ORG 3.2 RUSSELL M HOWERTON, MD FILING ORG 20 RELATED ORG 2 UNRELATED ORG 18 DOUGLAS L EDGETON FILING ORG 1.0 UNRELATED ORG 39.0 LISA M WYATT FILING ORG 18.1 RELATED ORG 6.8 UNRELATED ORG 15.1 SHEILA M SANDERS FILING ORG 26 RELATED ORG 5 UNRELATED ORG 9 JOHN D MCCONNELL, MD FILING ORG 20.0 RELATED ORG 5.0 UNRELATED ORG 15.0 EDWARD ABRAHAM, MD FILING ORG 5 RELATED ORG 5 UNRELATED ORG 30 WAKE FOREST UNIVERSITY HEALTH SCIENCES IS AN UNRELATED ORGANIZATION TO THE FILING ORGANIZATION AND THE INFORMATION CONCERNING HOURS DEVOTED TO IT ARE NOT REQUIRED TO BE REPORTED, BUT ARE INCLUDED BECAUSE OF THE STRUCTURE OF WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER, OF WHICH THE FILING ORGANIZATION AND WAKE FOREST UNIVERSITY HEALTH SCIENCES ARE PRINCIPAL PARTS. THE CORPORATE OFFICERS OF THE MEDICAL CENTER ALSO SERVE AS THE CORPORATE OFFICERS OF NORTH CAROLINA BAPTIST HOSPITAL AND WAKE FOREST UNIVERSITY HEALTH SCIENCES. | |
| FORM 990, PART IX, LINE 11G | MCIA: PROGRAM SERVICE EXPENSES 36,156,000. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 36,156,000. MEDICAL FEES: PROGRAM SERVICE EXPENSES 67,268,456. MANAGEMENT AND GENERAL EXPENSES 1,710,086. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 68,978,542. OTHER PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 39,430,294. MANAGEMENT AND GENERAL EXPENSES 24,678,800. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 64,109,094. | OTHER FEES |
| FORM 990, PART XI, LINE 9: | CHANGE IN PENSION LIABILITY 29,278,783. CHANGE IN VALUE OF INTEREST RATE SWAP -560,284. AFFILIATE EARNINGS & TRANSFERS -22,699,947. | CHANGES IN NET ASSETS OR FUND BALANCES: |
Schedule R IRS990ScheduleR
Form990 Schedule R Part I Form990ScheduleRPartI
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLEMMONS MEDICAL PARK LLC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | MEDICAL CENTER BLVD | AddressLine1 |
| City | WINSTON SALEM | City |
| State | NC | State |
| ZIP Code | 27157 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 800870210 | EIN |
| Primary Activities | REAL ESTATE HOLDING COMPANY | PrimaryActivities |
| Legal Domicile State | NC | LegalDomicileState |
| Total Income | 597732 | TotalIncome |
| EOY Assets | 30423819 | EOYAssets |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NORTH CAROLINA BAPTIST HOSPITAL | BusinessNameLine1 |
Form990 Schedule R Part II Form990ScheduleRPartII (8 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrgControlledOrg | Direct Controlling Entity NADirectControllingEntityNA |
|---|---|---|---|---|---|---|---|---|---|---|---|
| NORTH CAROLINA BAPTIST HOSPITAL FOUNDATION | |||||||||||
| MEDICAL CENTER BLVD | WINSTON SALEM | NC | 27157 | 561685120 | SUPPORTING ORGANIZATION | NC | 501(C)(3) | LINE 11A, I | NORTH CAROLINA BAPTIST HOSPITAL | 1 | |
| THE REHABILITATION & SKILLED NURSING | |||||||||||
| MEDICAL CENTER BLVD | WINSTON SALEM | NC | 27157 | 561826396 | HEALTHCARE (INACTIVE) | NC | 501(C)(3) | LINE 9 | NORTH CAROLINA BAPTIST HOSPITAL FOUNDATION | 1 | |
| THE HAWTHORNE INN & CONFERENCE CENTER INC | |||||||||||
| 420 HIGH STREET | WINSTON SALEM | NC | 27101 | 561793617 | LODGING/CONFERENCE ACCOMODATION | NC | 501(C)(3) | LINE 11A, I | NORTH CAROLINA BAPTIST HOSPITAL | 1 | |
| CARENET INC | |||||||||||
| 2000 WEST FIRST STREET SUITE 410 | WINSTON SALEM | NC | 27104 | 561977341 | HEALTHCARE | NC | 501(C)(3) | LINE 11B, II | NORTH CAROLINA BAPTIST HOSPITAL | 1 | |
| WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER | |||||||||||
| MEDICAL CENTER BLVD | WINSTON SALEM | NC | 27157 | 510190238 | HEALTHCARE | NC | 501(C)(3) | LINE 11A, I | 0 | N/A | |
| CENTER FOR CONGREGATIONAL HEALTH INC | |||||||||||
| MEDICAL CENTER BLVD | WINSTON SALEM | NC | 27157 | 237426944 | HEALTHCARE | NC | 501(C)(3) | LINE 9 | NORTH CAROLINA BAPTIST HOSPITAL | 1 | |
| DAVIE COUNTY EMERGENCY HEALTH CORPORATION | |||||||||||
| 223 HOSPITAL STREET | MOCKSVILLE | NC | 27028 | 562276994 | HEALTHCARE | NC | 501(C)(3) | LINE 3 | NORTH CAROLINA BAPTIST HOSPITAL | 1 | |
| MEDICAL FND OF WFUHS & NCBH | |||||||||||
| MEDICAL CENTER BLVD | WINSTON SALEM | NC | 27157 | 566036688 | HEALTHCARE | NC | 501(C)(3) | LINE 11A, I | 0 | N/A | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 1 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 1 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Dividends Related Organization | 0 | DividendsRelatedOrganization |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 1 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 1 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 1 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (11 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| NORTH CAROLINA BAPTIST HOSPITAL FOUNDATION | ||
| A | 168344 | COST |
| THE HAWTHORNE INN & CONFERENCE CENTER INC | ||
| K | 227760 | COST |
| THE HAWTHORNE INN & CONFERENCE CENTER INC | ||
| P | 42133 | COST |
| CARENET INC | ||
| Q | 2723473 | FMV |
| CENTER FOR CONGREGATIONAL HEALTH INC | ||
| Q | 289726 | FMV |
| DAVIE COUNTY EMERGENCY HEALTH CORP | ||
| Q | 1342906 | FMV |
| NORTH CAROLINA BAPTIST HOSPITAL FOUNDATION | ||
| Q | 281385 | FMV |
| THE HAWTHORNE INN & CONFERENCE CENTER INC | ||
| S | 200000 | COST |
| NORTH CAROLINA BAPTIST HOSPITAL FOUNDATION | ||
| S | 300139 | COST |
| NORTH CAROLINA BAPTIST HOSPITAL FOUNDATION | ||
| C | 405031 | COST |
| THE HAWTHORNE INN & CONFERENCE CENTER INC | ||
| Q | 384069 | FMV |