2012-08-15T08:07:05-05:00 2011-09-30 MCGLADREY LLP 300 NORTH 3RD STREET FIFTH FLOOR WILMINGTON NC 28401 990 2010-10-01 566024172 WILSON MEDICAL CENTER INC WILS 2523998040 1705 SOUTH TARBORO STREET WILSON NC 27893 LYNN LAMBERT 2523998141 2012-08-13 1 JENNIFER PRESNELL 9107629623 2010 2016-02-24 21:20:13Z RICHARD E HUDSON 1705 SOUTH TARBORO STREET WILSON NC 27893 300790607 0 X WWW.WILMED.ORG X 1964 NC TO DELIVER QUALITY HEALTH CARE FOR THE PEOPLE OF WILSON COUNTY AND NEIGHBORING COMMUNITIES. 13 13 1526 176 256897 0 14496 55574 133299590 132775081 1745829 9180699 1858183 0 136918098 142011354 20000 29593 0 0 62842684 66123304 0 0 0 71216288 65633283 134078972 131786180 2839126 10225174 192361254 203113543 55492620 54512623 136868634 148600920 X WILSON MEDICAL CENTER, INC. DELIVERS QUALITY HEALTH CARE FOR THE PEOPLE OF WILSON COUNTY AND NEIGHBORING COMMUNITIES. IN KEEPING WITH OUR COMMITMENT TO SERVE ALL PEOPLE OF OUR COMMUNITY, WE RECOGNIZE THAT NOT ALL INDIVIDUALS CAN PURCHASE ESSENTIAL MEDICAL SERVICES. THEREFORE, FREE AND/OR SUBSIDIZED CARE, CARE PROVIDED TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS AT BELOW COST, HEALTH PROGRAMS AND ACTIVITIES ARE CONSIDERED WHERE THE NEED AND/OR INDIVIDUAL'S INABILITY TO PAY COEXISTS. SUCH ACTIVITIES AVAILABLE TO THE COMMUNITY INCLUDE WELLNESS PROGRAMS, COMMUNITY EDUCATION PROGRAMS, SPECIAL PROGRAMS FOR UNDERSERVED AUDIENCES AND A BROAD RANGE OF SUPPORT THROUGH MANY MORE COMMUNITY SERVICE EVENTS AND ACTIVITIES. 0 0 119403646 29593 132429884 WILSON MEDICAL CENTER, INC. SERVED 8,528 INPATIENTS AND RECEIVED MORE THAN 102,000 VISITS FOR HEALTHCARE SERVICES PROVIDED ON AN OUTPATIENT BASIS. REIMBURSEMENT FROM GOVERNMENT SOURCES FOR MEDICARE AND MEDICAID PATIENTS WAS $9.5 MILLION LESS THAN THE COST OF PROVIDING THOSE SERVICES. THE COST OF SERVICES DEEMED CHARITY CARE (FOR THOSE UNABLE TO PAY) WAS $9.4 MILLION AND BAD DEBTS (FOR THOSE UNWILLING TO PAY) WAS $6.3 MILLION. COMMUNITY BENEFIT/HEALTH PROGRAMS COST THE HOSPITAL $1.9 MILLION. 119403646 1 1 0 1 0 0 0 0 0 0 1 1 0 0 1 0 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 129 0 1 1526 1 1 1 0 0 0 0 0 0 0 0 0 X 13 13 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 NC CA X LYNN LAMBERT 2523998141 1705 SOUTH TARBORO STREET WILSON NC 27893 FRANK T BATTEN DVM 1.00 X 0 0 0 DAVID WILSON 1.00 X 0 0 0 JERRY DORSEY 1.00 X 0 0 0 RS SID BOYETTE 1.00 X 0 0 0 DAVID HINNANT 1.00 X 0 0 0 JAMES PRIDGEN 1.00 X 0 0 0 CARLETHA WARD 1.00 X 0 0 0 DANIEL MICHALAK MD 1.00 X 0 0 0 PAGE THOMAS SMITH 1.00 X 0 0 0 REV WILLIAM M PRESNELL 1.00 X 0 0 0 GERALD VANDEN BOSCH MD 1.00 X 0 0 0 SHERYLETTA LACEWELL 1.00 X 0 0 0 EDWARD BREZINA MD 1.00 X 0 0 0 RICHARD HUDSON 40.00 X 363721 0 27680 DAMONE SORENSEN 40.00 X 213852 0 15999 DENISE O'HARA 40.00 X 143900 0 20836 DAVID BOERNER MD 40.00 X 256452 0 19536 MELINDA LAIRD 40.00 X 173711 0 14921 KENNETH LEE JOHNSON 40.00 X 360427 0 22862 DORIS CRAFT 40.00 X 137873 0 460 HAROLD USHER 40.00 X 135494 0 16231 CATHRYN HARRELL 40.00 X 134627 0 12100 MICHAEL SMITH 40.00 X 125580 0 8497 2045637 0 159122 32 0 1 0 AMERICAN ANESTHESIOLOGY OF NC 3100 SPRING FOREST RD STE 130 RALEIGH NC 27616 ANESTHESIOLOGY 1075181 RODGERS BUILDERS PO BOX 18446 CHARLOTTE NC 28218 CONSTRUCTION 1060757 OUTSOURCE RECEIVABLE SERVICES 153 HELSABECK ROAD KING NC 27021 COLLECTIONS 815060 ALLIANCE HEALTHCARE SERVICES PO BOX 96485 CHICAGO IL 60693 DIAGNOSTIC IMAGING 558373 HALIFAX LINEN SERVICE PO BOX 129 ROANOKE RAPIDS NC 27870 LAUNDRY 496521 59 55574 55574 PATIENT REVENUE 621110 129158185 129158185 FOOD & NUTRITION 621110 1323386 1323386 PARTNERSHIP INCOME REL 621110 273364 273364 OUTSIDE LAB & RADIOLOG 621500 256360 256360 PARTNERSHIP INCOME 541900 537 537 1763249 1763249 132775081 2128774 2128774 165820550 10628 158680325 98928 7140225 -88300 7051925 -88300 7140225 142011354 132429884 256897 9268999 29593 29593 1151636 430163 721473 52973145 48583092 4390053 2047404 1863138 184266 6212040 5652955 559085 3739079 3402562 336517 185719 185719 110704 110704 450206 450206 3612851 3612851 472929 472929 2113857 1472284 641573 650567 122214 528353 2580735 2348469 232266 61340 19504 41836 2264379 2264379 701582 701582 9421727 9421727 966475 966475 MEDICAL SUPPLIES 29984771 29984771 BAD DEBT 6363205 6363205 DRUGS 3847655 3847655 FOOD COSTS 1442863 1442863 OTHER ADMIN EXPENSES 296700 296700 105018 105018 131786180 119403646 12382534 0 4470788 987845 7397183 7403288 20199159 28587300 4987568 3594394 3947374 5718906 1156742 178918683 114312366 54366592 64606317 91931382 86909114 300940 4682850 4227055 192361254 203113543 10128285 7287914 38888798 36729537 43735 24297 6431802 10470875 55492620 54512623 X 136868634 148600920 136868634 148600920 192361254 203113543 X 10225174 1507112 X X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 16209 16209 0 EXPLANATION OF OTHER LOBBYING ACTIVITIES: PART II-B, LINE 1I: NORTH CAROLINA HOSPITAL ASSOCIATION MEMBERSHIP DUES (LOBBYING 23.25% X $37,619 = $9,187) AMERICAN HOSPITAL ASSOCIATION MEMBERSHIP DUES (LOBBYING 24.42% X $30,206 = $7,022) 2417489 2417489 77218329 46356918 30861411 3749343 2882595 866748 86359880 65072853 21287027 9173642 9173642 64606317 INVESTMENTS 86909114 F 86909114 DUE TO HEALTH INSURANCE PROGRAM 2887394 GROUP INSURANCE 772382 OTHER LIABILTIES 1173242 PAYABLE TO AFFILIATES 618633 ACCRUED VACATION 2585924 ACCRUED INTEREST 514800 ACCRUED UNEMPLOYMENT COMP 223840 ACCRUED PAYROLL 1694660 10470875 1 1 1 X 1 X 1 1 1 0 1 1 9435956 9435956 0.07520 4519340 4519340 0.03600 3931805 3931805 0.03130 17887101 17887101 0.14250 1515336 1515336 0.01210 397452 397452 0.00320 0 0 48430 48430 0.00040 1961218 1961218 0.01570 19848319 19848319 0.15820 29593 29593 0.00020 29593 29593 0.00020 1 1879116 6363205 43659683 53188991 -9529308 X 1 1 1 PREMIER PURCHASING PARTNERS LP GROUP PURCHASING 0.00009 0.00000 0.00000 1 1 WILSON MEDICAL CENTER INC

1705 SOUTH TARBORO STREET WILSON NC 27893

X X X WILSON MEDICAL CENTER INC 1 0 1 1 200.000000000000 1 300.000000000000 1 X X X X X X 1 1 X X X X X X 1 X X X 1 X X X X X 1 X 0 0 PART I, LINE 3C: ELIGIBILITY IS GENERALLY DETERMINED BY MEASURING THE GROSS FAMILY INCOME AGAINST THE FEDERAL POVERTY INCOME GUIDELINES. IN ADDITION, OTHER RELEVENT NON-INCOME RESOURCES, INCLUDING BUT NOT LIMITED TO REAL ESTATE, SAVINGS, LIFE INSURANCE, MOTOR VEHICLES, ETC., WILL BE CONSIDERED IN REACHING A DETERMINATION OF ELIGIBILITY. ELIGIBILITY GUIDELINES WILL ALSO TAKE INTO CONSIDERATION CATASTROPHIC EVENTS FOR PATIENTS WHOSE INCOME FALLS OUTSIDE THE GUIDELINES. PATIENTS WHOSE GROSS INCOME IS LESS THAN THREE TIMES THE FEDERAL POVERTY INCOME GUIDELINES MAY BE ELIGIBLE FOR REDUCED MONTHLY PAYMENTS OR UNCOMPENSATED SERVICES IN PART OR IN FULL. PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 6363205. PART I, LINE 6A: NORTH CAROLINA HOSPITAL ASSOCIATION. SEE WWW.NCHA.ORG. PART II: THE "WILSON ON THE MOVE" PROGRAM PROVIDES FOR THE DEVELOPMENT AND GROWTH OF THE CITY OF WILSON, NORTH CAROLINA. PART III, LINE 4: THE MEDICAL CENTER PROVIDES SERVICES TO THE RESIDENTS OF WILSON AND SURROUNDING COUNTIES WITHOUT COLLATERAL. AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IS PROVIDED IN AN AMOUNT EQUAL TO THE ESTIMATED LOSSES TO BE INCURRED IN COLLECTION OF THE RECEIVABLES. PART III, LINE 8: COSTS ARE DETERMINED USING THE STEP-DOWN METHODOLOGY FROM THE MEDICARE COST REPORT. PART III, LINE 9B: PATIENTS IDENTIFIED AS QUALIFYING FOR CHARITY CARE HAVE THEIR ACCOUNTS ADJUSTED OFF AS CHARITY CARE AND ARE NOT SUBJECTED TO COLLECTION EFFORTS. PART VI, LINE 3: STAFF WORKS DIRECTLY WITH PATIENTS TO PROVIDE AWARENESS OF EXISTING ASSISTANCE AND IN APPLYING FOR ANY APPLICABLE PROGRAMS. PART VI, LINE 4: AS OF THE CENSUS OF 2006, THERE ARE 73,814 PEOPLE, 28,613 HOUSEHOLDS, AND 19,771 FAMILIES RESIDING IN THE COUNTY. THE POPULATION DENSITY WAS 199 PEOPLE PER SQUARE MILE (77/KM). THERE WERE 30,729 HOUSING UNITS AT AN AVERAGE DENSITY OF 83 PER SQUARE MILE (32/KM). THE RACIAL MAKEUP OF THE CONTY WAS 55.83% WHITE, 39.33% BLACK OR AFRICAN AMERICAN, 0.27% NATIVE AMERICAN, 0.42% ASIAN, 0.02% PACIFIC ISLANDER, 3.21% FROM OTHER RACES, AND 0.92% FROM TWO OR MORE RACES. 6.04% OF THE POPULATION WERE HISPANIC OR LATINO OF ANY RACE.THERE WERE 28,613 HOUSEHOLDS OUT OF WHICH 31.90% HAD CHILDREN UNDER THE AGE OF 18 LIVING WITH THEM, 48.10% WERE MARRIED COUPLES LIVING TOGETHER, 16.50% HAD A FEMALE HOUSEHOLDER WITH NO HUSBAND PRESENT, AND 30.90% WERE NON-FAMILIES. 26.40% OF ALL HOUSEHOLDS WERE MADE UP OF INDIVIDUALS AND 10.20% HAD SOMEONE LIVING ALONE WHO WAS 65 YEARS OF AGE OR OLDER. THE AVERAGE HOUSEHOLD SIZE WAS 2.51 AND THE AVERAGE FAMILY SIZE WAS 3.03.IN THE COUNTY THE POPULATION WAS SPREAD OUT WITH 25.60% UNDER THE AGE OF 18, 9.10% FROM 18 TO 24, 28.80% FROM 25 TO 44, 23.60% FROM 45 TO 64, AND 12.90% WHO WERE 65 YEARS OF AGE OR OLDER. THE MEDIAN AGE WAS 36 YEARS. FOR EVERY 100 FEMAILES THERE WERE 91.30 MALES. FOR EVERY 100 FEMALES AGE 18 AND OVER, THERE WERE 87.20 MALES.THE MEDIAN INCOME FOR A HOUSEHOLD IN THE COUNTY WAS $33,116, AND THE MEDIAN INCOME FOR A FAMILY WAS $41,551. MALES HAD A MEDIAN INCOME OF $30,364 VERSUS $21,997 FOR FEMALES. THE PER CAPITA INCOME FOR THE COUNTY WAS $17,102. ABOUT 13.80% OF FAMILIES AND 18.50% OF THE POPULATION WERE BELOW THE POVERTY LINE, INCLUDING 24.70% OF THOSE UNDER AGE 18 AND 21.30% OF THOSE AGE 65 OR OVER. PART VI, LINE 6: WILSON MEDICAL CENTER HAS AN OPEN MEDICAL STAFF. THE BOARD OF DIRECTORS IS COMPRISED OF INDIVIDUALS THAT ARE ACTIVE IN OTHER ORGANIZATIONS IN THE COMMUNITY. SURPLUS FUNDS ARE RE-INVESTED IN THE FACILITY AND EQUIPMENT THAT PROVIDE HEALTHCARE SERVICES. PART VI, LINE 7: N/A REPORTS FILED WITH STATES PART VI, LINE 7 NC 1 WILSON ON THE MOVE PO BOX 728 WILSON NC 27893 561549221 501(C)(3) 29593 PROMOTE HEALTHY LIFESTYLE IN THE COMMUNITY. 1 0 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: WILSON MEDICAL CENTER, INC. MAKES GRANTS TO OTHER 501(C)(3) ORGANIZATIONS. X X X X 0 0 0 0 0 0 0 0 0 RICHARD HUDSON 363721 0 0 0 0 0 22000 0 5680 0 391401 0 0 0 DAMONE SORENSEN 213852 0 0 0 0 0 8819 0 7180 0 229851 0 0 0 DENISE O'HARA 143900 0 0 0 0 0 16110 0 4726 0 164736 0 0 0 DAVID BOERNER MD 256452 0 0 0 0 0 15532 0 4004 0 275988 0 0 0 MELINDA LAIRD 173711 0 0 0 0 0 7241 0 7680 0 188632 0 0 0 KENNETH LEE JOHNSON 360427 0 0 0 0 0 16500 0 6362 0 383289 0 0 0 HAROLD USHER 135494 0 0 0 0 0 16231 0 0 0 151725 0 0 0 NORTH CAROLINA MEDICAL CARE COMMISSION 521309402 65820HA86 2007-08-27 34517040 REFUNDING OF SERIES 1997 BONDS & INSTALLING NEW EQUIPMENT 0 1 0 33825000 24459800 474351 9582889 0 1 0 1 0 0 0 0 1 0 0 0 0 0 0 FORM 990, PART VI, SECTION B, LINE 11 A DRAFT OF FORM 990 IS PROVIDED TO EVERY MEMBER OF THE GOVERNING BODY PRIOR TO FILING WITH THE IRS. THE CFO REVIEWS THE DRAFT PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C ONCE A YEAR, EACH PERSON IS REQUIRED TO REVIEW AND SIGN THE CONFLICT OF INTEREST POLICY (THROUGH THE WILLEARN SYSTEM). THIS IS ONE OF THE ANNUAL MODULES THAT MUST BE COMPLETED EACH YEAR. IT ENSURES THAT EMPLOYEES ARE FAMILIAR WITH THE POLICY. IF THERE IS A CONFLICT OF INTEREST, THE VP IS NOTIFIED AND A DISCUSSION SHOULD OCCUR AT THAT TIME TO DETERMINE THE EXTENT, WHETHER POTENTIAL OR ACTUAL. BOARD MEMBERS WITH CONFILCTS ARE RECUSED FROM VOTING. FORM 990, PART VI, SECTION B, LINE 15 AT LEAST EVERY TWO YEARS, AN INDEPENDENT FIRM IS UTILIZED TO DETERMINE THE APPROPRIATE COMPENSATION FOR THE CEO AND VP'S. THE BOARD DETERMINED A STRATEGY AND GUIDELINES AS TO WHAT PERCENTILE AT WHICH THEY WOULD PLACE SALARIES FOR THE CEO AND VP'S. UPON RECEIPT OF THE INDEPENDENT DATA, THE HR COMMITTEE OF THE BOARD REVIEWS THE DATA AND DETERMINES IF ANY ADJUSTMENTS SHOULD BE MADE. THIS PROCESS LAST TOOK PLACE DURING 2008. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, POLICIES AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED LOSSES ON INVESTMENTS: -10,163,930. PRIOR PERIOD ADJUSTMENTS: -1,492,300. WILMED HOME CARE MERGED ASSETS 756,036. WILMED HEALTHCARE MERGED ASSETS 12,407,306. TOTAL TO FORM 990, PART XI, LINE 5: 1,507,112. PART XII, LINE 2C THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. WILMED GENERATIONS INC 1705 SOUTH TARBORO STREET WILSON NC 27893 561572076 LONG-TERM NURSING CARE NC 501(C)(3) LINE 11A, I N/A 0 WILMED HEALTHCARE FOUNDATION INC 1705 SOUTH TARBORO STREET WILSON NC 27893 561572064 SUPPORT ACTIVITIES NC 501(C)(3) LINE 11B, II N/A 0 0 1 1 0 0 0 0 0 0 0 0 0 1 1 0 1 1 0 WILMED HEALTHCARE FOUNDATION N 166015 WAGES & BENEFITS PAID WILMED GENERATIONS N 4541014 WAGES & BENEFITS PAID WILMED GENERATIONS P 2387027 CASH REIMBURSEMENTS