WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER (EIN 51-0190238)
- Tax period
- 2011-07-01 to 2012-06-30
- Filed
- 2013-05-13
- IRS object ID
- 201321339349302787
- Schema version
- 2011v1.5
- 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 D
- Schedule G
- Schedule I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-05-13T12:55:36-05:00 | Timestamp |
| Tax Period End Date | 2012-06-30 | TaxPeriodEndDate |
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 510190238 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WAKE FOREST UNIVERSITY BAPTIST MEDICAL C | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | WAKE | 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 | 3367163480 | Phone |
| Date Signed | 2013-05-13 | DateSigned |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | 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 | 735821 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WAKEHEALTH.EDU | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1975 | 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 | 14 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 13 | NbrIndependentVotingMembers |
| Total Nbr Employees | 0 | TotalNbrEmployees |
| Total Nbr Volunteers | 0 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 0 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 190873 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 0 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 0 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 12836 | InvestmentIncomePriorYear |
| Investment Income Current Year | 0 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 0 | OtherRevenuePriorYear |
| Other Revenue Current Year | 0 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 12836 | TotalRevenuePriorYear |
| Total Revenue Current Year | 190873 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 190873 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 0 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 0 | 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 | 12836 | OtherExpensePriorYear |
| Other Expenses Current Year | 0 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 12836 | TotalExpensesPriorYear |
| Total Expenses Current Year | 190873 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 0 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 0 | RevenuesLessExpensesCY |
| Total Assets BOY | 21556774 | TotalAssetsBOY |
| Total Assets EOY | 56983145 | TotalAssetsEOY |
| Total Liabilities BOY | 21556774 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 56983145 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 0 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 0 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | SEE SCHEDULE OTHE 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. OUR MISSION IS TO IMPROVE THE HEALTH OF OUR REGION, STATE AND NATION BY: GENERATING AND TRANSLATING KNOWLEDGE TO PREVENT, DIAGNOSE AND TREAT DISEASE; TRAINING LEADERS IN HEALTH CARE AND BIOMEDICAL SCIENCE; AND SERVING AS THE PREMIER HEALTH SYSTEM IN OUR REGION, WITH SPECIFIC CENTERS OF EXCELLENCE RECOGNIZED AS NATIONAL AND INTERNATIONAL CARE DESTINATIONS. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 190873 | Expense |
| Grants | 190873 | Grants |
| Description | 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 BAPTIST MEDICAL CENTER IS A CORPORATION WHOSE MEMBERS ARE WAKE FOREST UNIVERSITY AND NORTH CAROLINA BAPTIST HOSPITAL. THE MEDICAL CENTER OPERATES WAKE FOREST SCHOOL OF MEDICINE AND HAS A FACULTY PHYSICIAN PRACTICE OF ABOUT NEARLY 900 DOCTORS. 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-LEXINGTONMEDICAL CENTER (94 BEDS); AND WAKE FOREST BAPTIST HEALTH-DAVIE HOSPITAL (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 AND GROWTH OF PIEDMONT TRIAD RESEARCH PARK, A 200-ACRE, MIXED-USE BIOTECHNOLOGY PARK IN DOWNTOWN WINSTON-SALEM. BIOTECH PLACE, THE SIXTH BUILDING IN THE PARK, OPENED IN FEBRUARY 2012. THE $100 MILLION BIOTECH PLACE IS A 242,000-SQUARE-FOOT, STATE-OF-THE-ART MULTIPURPOSE BIOTECHNOLOGY RESEARCH AND INNOVATION CENTER. IT NOW HOUSES SEVERAL WAKE FOREST SCHOOL OF MEDICINE DEPARTMENTS AND PRIVATE BUSINESSES IN THE BIOTECH FIELD. IN ADDITION TO DRIVING INNOVATION IN BIOTECHNOLOGY-PTRP IS HOME OF THE WORLDRENOWNED WAKE FOREST INSTITUTE FOR REGENERATIVE MEDICINE. THE RESEARCH PARK ALSO IS A GOOD EXAMPLE OF PRIVATE-CIVIC PARTNERSHIP AS IT DRIVES NEW DEVELOPMENT IN THE EASTERN PORTION OF DOWNTOWN WINSTON-SALEM.1. CLINICAL SERVICESWAKE 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 MEDICAL CENTER INCLUDES 19 SUBSIDIARY OR AFFILIATE HOSPITALS, AND OPERATES MORE THAN 80 OUTREACH ACTIVITIES, INCLUDING SATELLITE SPECIALTY CLINICS, ACROSS NORTHWEST NORTH CAROLINA.IN THE PAST FISCAL YEAR, WAKE FOREST BAPTIST OPENED TWO STATE-OF-THE-ART CLINICAL SITES, MEDICAL PLAZA-COUNTRY CLUB AND MEDICAL PLAZA-CLEMMONS.THE COUNTRY CLUB LOCATION BECAME HOME TO A WAKE FOREST BAPTIST AFFILIATE OF THE JOSLIN DIABETES CENTER, AN INTERNATIONAL LEADER IN DIABETES RESEARCH, CARE AND EDUCATION THAT HAS BEEN PART OF HARVARD MEDICAL SCHOOL SINCE ITS FOUNDING IN 1898. THE JOSLIN PRACTICE MODEL OFFERS THE FULL RANGE OF DIABETES SERVICES IN A SINGLE LOCATION WITH CONVENIENT SCHEDULING AND EASY ACCESS TO RELATED MEDICAL SERVICES. MEDICAL PLAZA-COUNTRY CLUB ALSO INCLUDES SPECIALTY SERVICES IN DERMATOLOGY, CARDIOLOGY AND WEIGHT MANAGEMENT, AMONG OTHERS. MEDICAL PLAZA-CLEMMONS OFFERS URGENT CARE, A WOMEN'S CENTER, PEDIATRICS AND NUMEROUS OTHER SPECIALTY SERVICES.OVERALL IN FY 2012, WAKE FOREST BAPTIST HAD 38,601 INPATIENT ADMISSIONS AND 1,034,842 OUTPATIENT ENCOUNTERS (EMERGENCY DEPARTMENT, DOWNTOWN HEALTH PLAZA, DAY HOSPITAL, AMBULATORY VISITS). THE TOTAL PATIENT ENCOUNTERS NUMBERED 1,073,443.2. 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 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 BIRTHWEIGHT BABIES. MORE THAN 68,073 PATIENT VISITS WERE RECORDED AT THE PLAZA BETWEEN JULY 2011 AND JUNE 2012. COSTS ARE SUBSIDIZED BY THE MEDICAL CENTER.THE MEDICAL CENTER ALSO OPERATES NUMEROUS INNOVATIVE COMMUNITY OUTREACH PROGRAMS, MOST NOTABLY, BESTHEALTH, WHICH OFFERS HEALTH SEMINARS LED BY WAKE FOREST BAPTIST HEALTH EXPERTS, HEALTH SCREENINGS, COOKING AND FITNESS CLASSES, AND ONLINE HEALTH RESOURCES. FREE MEMBERSHIP IS OFFERED TO JOIN BESTHEALTH, AND MEMBERS RECEIVE ADDITIONAL BENEFITS SUCH AS MEMBERS-ONLY EVENTS AND SCREENINGS, DISCOUNTS AT LOCAL BUSINESSES, HEALTH RISK APPRAISALS AND ACCESS TO THE ONLINE HEALTH AND WELLNESS STORE, WWW.SHOPBESTHEALTH.COM.3. EDUCATIONAL MISSION AND ACCOMPLISHMENTSTHE 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.WAKE FOREST BAPTIST IN THE PAST YEAR INVESTED MORE THAN $57 MILLION IN THE EDUCATION OF TOMORROW'S HEALTH CARE AND BIOMEDICAL LEADERS. THAT INVESTMENT LAST YEAR SUPPORTED THE TRAINING OF 486 MEDICAL STUDENTS, 665 PHYSICIAN RESIDENTS AND FELLOWS, 322 GRADUATE STUDENTS AND 127 PHYSICIAN ASSISTANTS. THE NORTHWEST AREA HEALTH EDUCATION CENTER, PART OF WAKE FOREST SCHOOL OF MEDICINE, DURING THE SAME YEAR PROVIDED 2,110 CONTINUING MEDICAL EDUCATION ACTIVITIES FOR 40,674 PARTICIPANTS THROUGHOUT THE REGION. | Description |
| Total Program Service Expense | 190873 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | 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 | 1 | 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 | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 1 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 1 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| 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 | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 0 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 0 | NumberOfEmployees |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| 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 | 1 | QuidProQuoContributions |
| Quid Pro Quo Disclosure | 1 | QuidProQuoDisclosure |
| 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 | 14 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 13 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | 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 | 0 | InvestmentInJointVenture |
| 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 | WINSTONSALEM | 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 (29 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | FormerFormer |
|---|---|---|---|---|---|---|---|
| ERNEST L EVANS | |||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | ||
| ARTHUR A GIBEL | |||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | ||
| RON D KESSINGER | |||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | ||
| STEPHEN L ROBERTSON | |||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | ||
| WILLIAM C WARDEN JR | |||||||
| CHAIR (AND DIRECTOR) | 6.00 | X | 0 | 0 | 0 | X | |
| SHEREE B WATSON | |||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | ||
| EDWIN L WELCH | |||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | ||
| GRAHAM F BENNETT | |||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | ||
| DONNA A BOSWELL | |||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | ||
| GRAHAM W DENTON JR | |||||||
| VICE CHAIR (AND DIRECTOR) | 4.00 | X | 0 | 0 | 0 | X | |
| DONALD E FLOW | |||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | ||
| ROBERT E GREENE | |||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | ||
| NATHAN O HATCH | |||||||
| DIRECTOR | 4.00 | X | 0 | 957446 | 342888 | ||
| ANDREW H SCHINDLER | |||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | ||
| JOHN D MCCONNELL MD | |||||||
| CEO | 5.00 | 0 | 1406491 | 638363 | X | ||
| J MCLAIN WALLACE JR | |||||||
| SECRETARY | 5.00 | 0 | 397129 | 94398 | X | ||
| EDWARD G CHADWICK | |||||||
| TREASURER | 5.00 | 0 | 741340 | 238080 | X | ||
| J REID MORGAN | |||||||
| ASSISTANT SECRETARY | 6.00 | 0 | 421023 | 110325 | X | ||
| THOMAS E SIBERT MD | |||||||
| PRESIDENT & COO | 5.00 | 0 | 897345 | 238466 | X | ||
| RUSSELL M HOWERTON MD | |||||||
| CHIEF MEDICAL OFFICER | 5.00 | 0 | 614047 | 42978 | X | ||
| DOUGLAS L EDGETON | |||||||
| EVP | 5.00 | 0 | 671069 | 39660 | X | ||
| LISA M WYATT | |||||||
| VP, CHIEF COMM & MKTG OFFICER | 5.00 | 0 | 394305 | 30732 | X | ||
| CHERYL E H LOCKE | |||||||
| VP, CHIEF HR OFFICER | 5.00 | 0 | 549595 | 34974 | X | ||
| SHEILA M SANDERS | |||||||
| VP, CHIEF INFO OFFICER | 5.00 | 0 | 425038 | 39505 | X | ||
| NORMAN B POTTER JR | |||||||
| VP, DEV & ALUMNI AFFAIRS | 5.00 | 0 | 297291 | 45278 | X | ||
| KAREN H HUEY | |||||||
| VP, FACILITIES | 5.00 | 0 | 269934 | 72133 | X | ||
| MAUREEN E SINTICH | |||||||
| CHIEF NURSING OFFICER | 5.00 | 0 | 401366 | 88127 | X | ||
| JOANNE C RUHLAND | |||||||
| VP, GOVT AFFAIRS | 5.00 | 0 | 218060 | 33991 | X | ||
| DOUGLAS NELSON | |||||||
| FORMER TREAS & SEC | 0.00 | 0 | 192192 | 35628 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 0 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 8853671 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 2125526 | TotalOtherCompensation |
| Number Individuals GT100 K | 0 | NumberIndividualsGT100K |
| Formers Listed | 1 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
| Number Of Contractors GT100 K | 0 | NumberOfContractorsGT100K |
| All Other Contributions | 190873 | AllOtherContributions |
| Total Contributions | 190873 | TotalContributions |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 393308 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 393308 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 0 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Fundraising Events | 151640 | GrossIncomeFundraisingEvents |
| Fundraising Direct Expenses | 151640 | FundraisingDirectExpenses |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 190873 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 190873 | Total |
| Program Services | 190873 | ProgramServices |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 190873 | Total |
| Program Services | 190873 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 206775 | BOY |
| EOY | 32387 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1701454 | BOY |
| EOY | 219918 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 31450777 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 393308 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 19536217 | BOY |
| EOY | 31057469 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 25280064 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 112328 | BOY |
| EOY | 393307 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 21556774 | BOY |
| EOY | 56983145 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9407 | BOY |
| EOY | 9131 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 21547367 | BOY |
| EOY | 56974014 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 21556774 | BOY |
| EOY | 56983145 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 21556774 | BOY |
| EOY | 56983145 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | 0 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 0 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | X | SupportingOrganization509a3 |
| Supporting Org509a3 Type1 | X | SupportingOrg509a3Type1 |
| Certification Checkbox | X | CertificationCheckbox |
| Contrib By Controlling Individual | 0 | ContribByControllingIndividual |
| Contribution By Related Party | 0 | ContributionByRelatedParty |
| Contrib By35 Controlled Entity | 0 | ContribBy35ControlledEntity |
Supported Org Information SupportedOrgInformation (3 entries)
| EINEIN | Type Of OrganizationTypeOfOrganization | Listed In Governing DocListedInGoverningDoc | AmountAmount |
|---|---|---|---|
| WAKE FOREST UNIV HEALTH SCIENCES | |||
| 223849199 | 2 | 1 | $21,595 |
| NORTH CAROLINA BAPTIST HOSPITAL | |||
| 560552787 | 3 | 1 | $169,278 |
| WAKE FOREST UNIVERSITY | |||
| 560532138 | 2 | 1 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Number Of Supported Orgs | 3 | TotalNumberOfSupportedOrgs |
| Sum Of Amounts | 190873 | SumOfAmounts |
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 D IRS990ScheduleD
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 313255 | BeginningOfYearBalance |
| Investment Earnings Or Losses | -13705 | InvestmentEarningsOrLosses |
| Other Expenditures | 299550 | OtherExpenditures |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 542528 | BeginningOfYearBalance |
| Contributions | 5725 | Contributions |
| Investment Earnings Or Losses | 58087 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 288510 | GrantsOrScholarships |
| Other Expenditures | 4575 | OtherExpenditures |
| End Of Year Balance | 313255 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 505886 | BeginningOfYearBalance |
| Contributions | 5000 | Contributions |
| Investment Earnings Or Losses | 36622 | InvestmentEarningsOrLosses |
| Other Expenditures | 4980 | OtherExpenditures |
| End Of Year Balance | 542528 | EndOfYearBalance |
Current Year Minus3 Years CurrentYearMinus3Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 667600 | BeginningOfYearBalance |
| Contributions | 5000 | Contributions |
| Investment Earnings Or Losses | -161714 | InvestmentEarningsOrLosses |
| Other Expenditures | 5000 | OtherExpenditures |
| End Of Year Balance | 505886 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated EOY Balance | 1.00000 | BoardDesignatedEOYBalance |
| Permanent Endowment EOY Balance | 0.00000 | PermanentEndowmentEOYBalance |
| Term Endowment EOY Balance | 0.00000 | 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 | 3768724 | OtherCostOrOtherBasis |
| Book Value | 3768724 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 15667453 | OtherCostOrOtherBasis |
| Depreciation | 393308 | Depreciation |
| Book Value | 15274145 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 12014600 | OtherCostOrOtherBasis |
| Book Value | 12014600 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 31057469 | TotalOfBookValueLandBuildings |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | INVESTMENT IN LEXINGTON MEDICAL CENTER | Description |
| Book Value | 25280064 | BookValue |
| Method Of Valuation | C | MethodOfValuation |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Program Related | 25280064 | TotalOfBookValueProgramRelated |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | BENEFICIAL INTEREST HELD ON BEHALF OF OTHERS | Description |
| Amount | $56,974,014 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 56974014 | TotalOfAmounts |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | PART X: | THE ORGANIZATION WAS REQUIRED TO EVALUATE UNCERTAIN TAX POSITIONS. THIS EVALUATION INCLUDES A QUANTIFICATION OF TAX RISK IN AREAS SUCH AS UNRELATED BUSINESS TAXABLE INCOME AND THE TAXATION OF FOR-PROFIT SUBSIDIARIES. THIS EVALUATION DID NOT HAVE A MATERIAL EFFECT ON THE ORGANIZATION'S STATEMENT OF OPERATIONS FOR THE YEARS ENDED JUNE 30, 2012 AND 2011. |
| PART V, LINE 4 ENDOWMENT FUNDS ENDOWMENT FUNDS WERE USED FOR MEDICAL CENTER CAPTIAL EXPANSION, TRAINING AND EDUCATION AND THE OVERALL CHARITABLE AND EDUCATIONAL MISSION OF THE MEDICAL CENTER. |
Schedule G IRS990ScheduleG
Events Information EventsInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | GOLF TOURNAMENT | NameOfEvent1 |
| Gross Receipts Event1 | 24140 | GrossReceiptsEvent1 |
| Gross Revenue Event1 | 24140 | GrossRevenueEvent1 |
| Rent Facility Costs Event1 | 10192 | RentFacilityCostsEvent1 |
| Other Direct Expenses Event1 | 13948 | OtherDirectExpensesEvent1 |
| Name Of Event2 | HAWTHORNE HILL SOCIETY BANQUET | NameOfEvent2 |
| Gross Receipts Event2 | 127500 | GrossReceiptsEvent2 |
| Gross Revenue Event2 | 127500 | GrossRevenueEvent2 |
| Rent Facility Costs Event2 | 4723 | RentFacilityCostsEvent2 |
| Food And Beverage Event2 | 33090 | FoodAndBeverageEvent2 |
| Entertainment Event2 | 5400 | EntertainmentEvent2 |
| Other Direct Expenses Event2 | 84287 | OtherDirectExpensesEvent2 |
| Gross Receipts Total | 151640 | GrossReceiptsTotal |
| Gross Revenue Total Events | 151640 | GrossRevenueTotalEvents |
| Rent Facility Costs Total Events | 14915 | RentFacilityCostsTotalEvents |
| Food And Beverage Total Events | 33090 | FoodAndBeverageTotalEvents |
| Entertainment Total Events | 5400 | EntertainmentTotalEvents |
| Other Direct Expenses Total Events | 98235 | OtherDirectExpensesTotalEvents |
| Direct Expense Summary Events | 151640 | DirectExpenseSummaryEvents |
| Net Income Summary | 0 | NetIncomeSummary |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 1 | RecordsMaintained |
Recipient Table RecipientTable (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EIN Of RecipientEINOfRecipient | IRC SectionIRCSection | Amount Of Cash GrantAmountOfCashGrant | Purpose Of GrantPurposeOfGrant |
|---|---|---|---|---|---|---|---|
| NORTH CAROLINA BAPTIST HOSPITAL | |||||||
| MEDICAL CENTER BLVD | WINSTON SALEM | NC | 27157 | 560552787 | 501(C)(3) | 169278 | COMPREHENSIVE CANCER CTR EXPANSION |
| WAKE FOREST UNIVERSITY HEALTH SCIENCES | |||||||
| MEDICAL CENTER BLVD | WINSTON SALEM | NC | 27157 | 223849199 | 501(C)(3) | 21595 | BRENNER CHILDREN'S HOSPITAL |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 2 | TotalNbrOf501C3AndGovtGrants |
| Total Nbr Of Other Organizations | 0 | TotalNbrOfOtherOrganizations |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | PROCEDURE FOR MONITORING GRANTS IN THE U.S.: | Identifier |
| Return Reference | PART I, LINE 2: | ReturnReference |
| Explanation | SCHEDULE I, PART I, LINE 2: THE MEDICAL CENTER ACCEPTS GIFTS ON BEHALF OF AND FOR THE BETTERMENT OF ITS SUPPORTING ORGANIZATIONS, WAKE FOREST UNIVERSITY HEALTH SCIENCE AND NORTH CAROLINA BAPTIST HOSPITAL. SUCH GIFTS ARE DISTRIBUTED TO THESE ORGANIZATIONS FOR EDUCATION, RESEARCH, HEALTH CARE AND MEDICAL CENTER EXPANSION. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | 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 | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (16 entries)
| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NATHAN O HATCH | |||||||||||||
| 0 | 740425 | 0 | 75000 | 0 | 142021 | 0 | 286012 | 0 | 56876 | 0 | 1300334 | 0 | 0 |
| JOHN D MCCONNELL MD | |||||||||||||
| 0 | 983777 | 0 | 384203 | 0 | 38511 | 0 | 619002 | 0 | 19361 | 0 | 2044854 | 0 | 0 |
| J MCLAIN WALLACE JR | |||||||||||||
| 0 | 298581 | 0 | 79784 | 0 | 18764 | 0 | 50729 | 0 | 43669 | 0 | 491527 | 0 | 0 |
| EDWARD G CHADWICK | |||||||||||||
| 0 | 527216 | 0 | 189929 | 0 | 24195 | 0 | 216774 | 0 | 21306 | 0 | 979420 | 0 | 0 |
| J REID MORGAN | |||||||||||||
| 0 | 358673 | 0 | 50000 | 0 | 12350 | 0 | 24500 | 0 | 85825 | 0 | 531348 | 0 | 0 |
| THOMAS E SIBERT MD | |||||||||||||
| 0 | 631297 | 0 | 234540 | 0 | 31508 | 0 | 216925 | 0 | 21541 | 0 | 1135811 | 0 | 0 |
| RUSSELL M HOWERTON MD | |||||||||||||
| 0 | 295714 | 0 | 300786 | 0 | 17547 | 0 | 19588 | 0 | 23390 | 0 | 657025 | 0 | 0 |
| DOUGLAS L EDGETON | |||||||||||||
| 0 | 490485 | 0 | 162367 | 0 | 18217 | 0 | 18602 | 0 | 21058 | 0 | 710729 | 0 | 0 |
| LISA M WYATT | |||||||||||||
| 0 | 282972 | 0 | 83494 | 0 | 27839 | 0 | 21549 | 0 | 9183 | 0 | 425037 | 0 | 0 |
| CHERYL E H LOCKE | |||||||||||||
| 0 | 353441 | 0 | 97552 | 0 | 98602 | 0 | 18602 | 0 | 16372 | 0 | 584569 | 0 | 0 |
| SHEILA M SANDERS | |||||||||||||
| 0 | 333961 | 0 | 89145 | 0 | 1932 | 0 | 20247 | 0 | 19258 | 0 | 464543 | 0 | 0 |
| NORMAN B POTTER JR | |||||||||||||
| 0 | 232664 | 0 | 58825 | 0 | 5802 | 0 | 23670 | 0 | 21608 | 0 | 342569 | 0 | 0 |
| KAREN H HUEY | |||||||||||||
| 0 | 219062 | 0 | 46557 | 0 | 4315 | 0 | 55150 | 0 | 16983 | 0 | 342067 | 0 | 0 |
| MAUREEN E SINTICH | |||||||||||||
| 0 | 299332 | 0 | 77535 | 0 | 24499 | 0 | 52111 | 0 | 36016 | 0 | 489493 | 0 | 5334 |
| JOANNE C RUHLAND | |||||||||||||
| 0 | 199124 | 0 | 0 | 0 | 18936 | 0 | 16008 | 0 | 17983 | 0 | 252051 | 0 | 0 |
| DOUGLAS NELSON | |||||||||||||
| 0 | 171296 | 0 | 20242 | 0 | 654 | 0 | 16130 | 0 | 19498 | 0 | 227820 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)
| Return ReferenceReturnReference | ExplanationExplanation |
|---|---|
| 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 MEDICAL CENTER OFFICERS' COMPENSATION. THE COMMITTEE UTILIZED 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, LINE 4B | MAUREEN E SINTICH'S COMPENSATION INCLUDED A NON-QUALIFIED RETIREMENT PLAN PAYMENT OF $8,787. LAST YEAR, 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 TO FULFIL A SINGLE MISSION OF IMPROVING HEALTH, OPTIMIZING PERFORMANCE WHILE BALANCING PATIENT CARE, EDUCATION AND RESEARCH. NCBH, WFUBMC, WFUHS AND ITS SUBSIDIARIES HAVE COMBINED OPERATING REVENUES OF APPROXIMATELY $2 BILLION FOR THE FISCAL YEAR ENDED JUNE 30, 2012. IN GENERAL, EXECUTIVES PERFORMING KEY MANAGEMENT FUNCTIONS WERE SOUGHT AND HIRED AFTER NATIONAL SEARCHES IN A HIGHLY COMPETITIVE ENVIRONMENT, AND ONLY INDIVIDUALS AT THE HIGHEST LEVELS OF ABILITY WERE SOUGHT, GIVEN THE TASK OF INITIATING AND IMPLEMENTING THE NEW MANAGEMENT STRUCTURE DESIGNED TO OPTIMIZE THE EFFECTIVENESS OF THE MEDICAL CENTER AND ITS TAX-EXEMPT MISSION. CERTAIN EXECUTIVES HOLD THE IDENTICAL OFFICES/TITLES IN WFUHS, NCBH AND WFUBMC 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 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 O IRS990ScheduleO
General Explanation GeneralExplanation (7 entries)
| Return ReferenceReturnReference | ExplanationExplanation |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | THE ORGANIZATION'S TWO MEMBERS ARE NORTH CAROLINA BAPTIST HOSPITAL AND WAKE FOREST UNIVERSITY. |
| FORM 990, PART VI, SECTION A, LINE 7A | HALF OF THE BOARD IS ELECTED BY NORTH CAROLINA BAPTIST HOSPITAL FROM ITS BOARD MEMBERS. THE OTHER HALF IS ELECTED BY WAKE FOREST UNIVERSITY FROM THE WAKE FOREST UNIVERSITY HEALTH SCIENCES BOARD MEMBERS. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE ORGANIZATION WILL CARRY OUT THE FUNCTIONS AND PURPOSES STATED IN THE MEDICAL CENTER INTEGRATION AGREEMENT, SUBJECT TO THE RESERVE POWERS OR APPROVAL OF THE MEMBERS ON SELECT ISSUES, INCLUDING DAY TO DAY MANGEMENT, STRATEGIC DIRECTION, MANAGED CARE CONTRACTING AND OTHER BUSINESS ACTIVITIES. |
| FORM 990, PART VI, SECTION B, LINE 11 | THE FILING ORGANIZATION'S BOARD OF DIRECTORS RECEIVES COPIES OF THE FORM 990 WITH SUFFICIENT TIME TO PERMIT REVIEW, COMMENT, AND QUESTIONS PRIOR TO ITS FILING. THE AUDIT AND COMPLIANCE COMMITTEES OF THE GOVERNING BOARDS 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 DIRECTORS PRIOR TO ITS FILING WITH THE IRS, ALONG WITH A REPORT NOTING THE MODIFICATIONS. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE ORGANIZATION REQUIRES ITS OFFICERS, DIRECTORS AND KEY EMPLOYEES TO ANNUALLY REVIEW THE CONFLICT OF INTEREST POLICY AND DETERMINE ANY POTENTIAL CONFLICTS OF INTEREST. ANY POTENTIAL CONFLICTS NOTED IN THE QUESTIONNAIRE ARE REVIEWED BY A STANDING COMMITTEE FOR APPROPRIATE RESOLUTION. ALL MEMBERS OF THE BOARD OF DIRECTORS ARE REQUIRED TO DETERMINE AND REPORT ANNUALLY, AND AS THEY ARISE, ANY POTENTIAL CONFLICTS OF INTEREST TO THE SECRETARY OF THE BOARD OF DIRECTORS. THE RESOLUTION OF POTENTIAL AND ACTUAL CONFLICTS IS SUBJECT TO THE APPROVAL OF THE CHAIR OF THE BOARD AND IS REPORTED TO THE CHAIR OF THE AUDIT & COMPLIANCE COMMITTEE OF THE BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE FILING ORGANIZATION'S EXECUTIVE COMMITTEE OF ITS BOARD OF DIRECTORS FUNCTIONS AS THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS AND PURSUANT TO A DELEGATION BY SUCH OTHER ENTITIES, REVIEWS AND APPROVES THE APPOINTMENT AND COMPENSATION OF THE SENIOR EXECUTIVES OF THE FILING ORGANIZATION. NO MEMBER OF THE FILING ORGANIZATION'S EXECUTIVE COMMITTEE IS AN EMPLOYEE OF THE MEDICAL CENTER. THE EXECUTIVE COMMITTEE RELIES UPON AN EXTERNAL, INDEPENDENT COMPENSATION CONSULTANT EXPERIENCED IN HEALTHCARE TO PROVIDE THE COMMITTEE WITH COMPENSATION COMPARABILITY DATA FOR NEW EXECUTIVE POSITION APPOINTMENTS AND FOR COMPENSATION REVIEWS FOR EXISTING EXECUTIVES. THE CONSULTANT, WHICH IS RETAINED DIRECTLY BY THE EXECUTIVE COMMITTEE, PROVIDES THIRD-PARTY INFORMATION AND EVALUATES THE COMPETITIVENESS AND REASONABLENESS OF EXECUTIVE COMPENSATION AND BENEFITS PROGRAMS IN RELATION TO MARKET PRACTICES FOR SIMILARLY-SITUATED NONPROFIT HEALTHCARE ORGANIZATIONS. THE COMMITTEE MAKES ITS DECISIONS WITH RESPECT TO EXECUTIVE COMPENSATION IN ACCORDANCE WITH THE FILING ORGANIZATION'S POLICIES, IRS REGULATIONS, AND STANDARD CORPORATE GOVERNANCE PRACTICES. SUCH POLICIES INCLUDE ADHERENCE TO: BOARD-ESTABLISHED EXECUTIVE COMPENSATION PHILOSOPHY AND REVIEW PROCESSES; PROCESSES ENSURING EXECUTIVE COMMITTEE MEMBER AND COMPENSATION CONSULTANT INDEPENDENCE; USE OF VALID MARKET COMPARISONS OF DATA FROM PEER ACADEMIC MEDICAL CENTERS OF SIMILAR ORGANIZATIONAL STRUCTURE, SIZE, AND COMPLEXITY; CAREFUL DOCUMENTATION OF ALL COMPENSATION DECISIONS; AND ESTABLISHMENT OF THE REBUTTABLE PRESUMPTION OF REASONABLENESS, PER IRS GUIDELINES. MINUTES OF THE DELIBERATIONS OF THE EXECUTIVE COMMITTEE ARE CONTEMPORANEOUSLY MAINTAINED AND THAT COMPARABILITY DATA IS MAINTAINED IN THE MEDICAL CENTER'S OFFICE OF EXECUTIVE COMPENSATION SERVICES. IN THE EVENT THAT A MEMBER OF THE EXECUTIVE COMMITTEE HAS A CONFLICT OF INTEREST RELATED TO EXECUTIVE APPOINTMENT OR COMPENSATION, THAT MEMBER DOES NOT PARTICIPATE IN THE DELIBERATION OR APPROVAL OF APPOINTMENT OR COMPENSATION AND SUCH ABSTENTION IS NOTED IN THE COMMITTEE'S MEETING MINUTES. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION'S ARTICLES OF INCORPORATION ARE AVAILABLE TO THE PUBLIC ON REQUEST AND ARE AVAILABLE ON THE WEBSITE OF THE NORTH CAROLINA SECRETARY OF STATE. THE ORGANIZATION'S BYLAWS ARE NOT PUBLISHED, BUT PROVISIONS FROM THE BYLAWS ARE INCLUDED AS NECESSARY IN THE ORGANIZATION'S POLICIES, AND ARE ATTACHED TO THE FORM 1023 FILED FOR THE ORGANIZATION WITH THE IRS, WHICH IS PUBLICLY AVAILABLE. THE CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE NOT AVAILABLE TO THE PUBLIC. PART VII, SECTION A, COLUMN B - AVERAGE HOURS - RELATED ORGANIZATIONS ERNEST L EVANS FILING ORG 2.0 RELATED ORG 4.0 ARTHUR A GIBEL FILING ORG 2.0 RELATED ORG 6.0 RON D KESSINGER FILING ORG 2.0 RELATED ORG 6.0 STEPHEN L ROBERTSON FILING ORG 2.0 RELATED ORG 4.0 WILLIAM C WARDEN, JR FILING ORG 6.0 RELATED ORG 4.0 SHEREE B WATSON FILING ORG 2.0 RELATED ORG 4.0 EDWIN L WELCH FILING ORG 2.0 RELATED ORG 4.0 GRAHAM F BENNETT FILING ORG 2.0 RELATED ORG 4.0 DONNA A. BOSWELL FILING ORG 2.0 RELATED ORG 10.0 GRAHAM W DENTON, JR. FILING ORG 4.0 RELATED ORG 9.0 DONALD E FLOW FILING ORG 2.0 RELATED ORG 8.0 ROBERT E GREENE FILING ORG 2.0 RELATED ORG 5.0 NATHAN O HATCH FILING ORG 4.0 RELATED ORG 36.0 ANDREW H SCHINDLER FILING ORG 2.0 RELATED ORG 7.0 JOHN D MCCONNELL, MD FILING ORG 5.0 RELATED ORG 35.0 J MCLAIN WALLACE JR FILING ORG 5.0 RELATED ORG 35.0 EDWARD G CHADWICK FILING ORG 5.0 RELATED ORG 35.0 J REID MORGAN FILING ORG 6.0 RELATED ORG 34.0 THOMAS E SIBERT, MD FILING ORG 5.0 RELATED ORG 35.0 RUSSELL M HOWERTON, MD FILING ORG 5.0 RELATED ORG 35.0 DOUGLAS L EDGETON FILING ORG 5.0 RELATED ORG 35.0 LISA M WYATT FILING ORG 5.0 RELATED ORG 35.0 CHERYL E H LOCKE FILING ORG 5.0 RELATED ORG 35.0 SHEILA M SANDERS FILING ORG 5.0 RELATED ORG 35.0 NORMAN B POTTER, JR FILING ORG 5.0 RELATED ORG 35.0 KAREN H HUEY FILING ORG 5.0 RELATED ORG 35.0 MAUREEN E SINTICH FILING ORG 5.0 RELATED ORG 35.0 JOANNE C RUHLAND FILING ORG 5.0 RELATED ORG 35.0 DOUGLAS NELSON FILING ORG 0.0 RELATED ORG 40.0 |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (4 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Direct Controlling Entity NADirectControllingEntityNA | Controlled OrgControlledOrg | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| NORTH CAROLINA BAPTIST HOSPITAL | |||||||||||
| MEDICAL CENTER BLVD | WINSTONSALEM | NC | 27157 | 560552787 | HEALTHCARE | NC | 501(C)(3) | LINE 3 | N/A | 0 | |
| WAKE FOREST UNIVERSITY HEALTH SCIENCES | |||||||||||
| MEDICAL CENTER BLVD | WINSTONSALEM | NC | 27157 | 223849199 | HEALTHCARE EDUCATION AND RESEARCH | NC | 501(C)(3) | LINE 2 | 0 | WAKE FOREST UNIVERSITY | |
| WAKE FOREST UNIVERSITY | |||||||||||
| PO BOX 7201 | WINSTONSALEM | NC | 27109 | 560532138 | UNIVERSITY | NC | 501(C)(3) | LINE 2 | N/A | 0 | |
| LEXINGTON MEDICAL CENTER | |||||||||||
| 250 HOSPITAL DRIVE | LEXINGTON | NC | 27293 | 560543238 | HEALTHCARE | NC | 501(C)(3) | LINE 3 | 1 | WAKE FOREST UNIVBAPTIST MED CENTER | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 1 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| 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 | 1 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 1 | 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 | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 1 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 1 | OtherTransferFromOtherOrg |