STRATEGY STUDIO / NONPROFIT PEOPLE SEARCH

WAYNE MEMORIAL HOSPITAL INC: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
WAYNE MEMORIAL HOSPITAL INC (EIN 56-1484844)
Tax period
2010-10-01 to 2011-09-30
Filed
2012-03-30
IRS object ID
201210909349300941
Schema version
2010v3.4
Source
Download XML · Original 990 at ProPublica

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

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2012-03-30T15:06:38-05:00Timestamp
Tax Period End Date2011-09-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1CLIFTONLARSONALLEN LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1101 N TRYON STREET SUITE 1000AddressLine1
CityCHARLOTTECity
StateNCState
ZIP Code28246ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN561484844EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1WAYNE MEMORIAL HOSPITAL INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlWAYNNameControl
Phone9197316142Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 8001AddressLine1
CityGOLDSBOROCity
StateNCState
ZIP Code27533ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameREBECCA CRAIGName
TitleCFOTitle
Phone9197316142Phone
Date Signed2012-03-30DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameGREGORY W JOHNSName
Phone7049985200Phone
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonJ WILLIAM PAUGHNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1PO BOX 8001AddressLine1
CityGOLDSBOROCity
StateNCState
ZIP Code27533ZIPCode
FieldValueIRS element (for citing)
Gross Receipts194680907GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.WAYNEHEALTH.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1896YearFormation
State Legal DomicileNCStateLegalDomicile
Activity Or Mission DescriptionTO PROVIDE THE COMMUNITY QUALITY HEALTHCARE SERVICES.ActivityOrMissionDescription
Nbr Voting Members Governing Body12NbrVotingMembersGoverningBody
Nbr Independent Voting Members11NbrIndependentVotingMembers
Total Nbr Employees1808TotalNbrEmployees
Total Nbr Volunteers233TotalNbrVolunteers
Total Gross UBI887TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year195922270ProgramServiceRevenuePriorYear
Program Service Revenue CY190708238ProgramServiceRevenueCY
Investment Income Prior Year2150958InvestmentIncomePriorYear
Investment Income Current Year2694349InvestmentIncomeCurrentYear
Other Revenue Prior Year927133OtherRevenuePriorYear
Other Revenue Current Year1278320OtherRevenueCurrentYear
Total Revenue Prior Year199000361TotalRevenuePriorYear
Total Revenue Current Year194680907TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year213466GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY147050GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year92365236SalariesEtcPriorYear
Salaries Etc Current Year94095168SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year100824051OtherExpensePriorYear
Other Expenses Current Year90650155OtherExpensesCurrentYear
Total Expenses Prior Year193402753TotalExpensesPriorYear
Total Expenses Current Year184892373TotalExpensesCurrentYear
Revenues Less Expenses Prior Year5597608RevenuesLessExpensesPriorYear
Revenues Less Expenses CY9788534RevenuesLessExpensesCY
Total Assets BOY214548605TotalAssetsBOY
Total Assets EOY218870213TotalAssetsEOY
Total Liabilities BOY146139215TotalLiabilitiesBOY
Total Liabilities EOY159557544TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY68409390NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY59312669NetAssetsOrFundBalancesEOY
Mission DescriptionTHE MISSION OF WAYNE MEMORIAL HOSPITAL IS TO PROVIDE THE COMMUNITY QUALITY HEALTHCARE SERVICES THROUGH THE COMPASSIONATE HANDS OF WELL-TRAINED STAFF IN A TECHNOLOGICALLY ADVANCED, COST-EFFECTIVE MANNER.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense172181020Expense
Grants147050Grants
Revenue190708238Revenue
DescriptionPROVIDING COMPASSIONATE PROGRESSIVE HEALTHCARE INCLUDING INPATIENT, OUTPATIENT, INTENSIVE CARE, AND EMERGENCY CARE.Description
Total Program Service Expense172181020TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required0ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities1LobbyingActivities
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest1ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Financial Stmt Attached1FinancialStmtAttached
Grants To Organizations1GrantsToOrganizations
Grants To Individuals1GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds1TaxExemptBonds
Invest Tax Exempt Bonds0InvestTaxExemptBonds
Escrow Account0EscrowAccount
On Behalf Of Issuer0OnBehalfOfIssuer
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity1DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With1096124NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees1808NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members12NbrVotingGoverningBodyMembers
Number Independent Voting Members11NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledNCStatesWhereCopyOfReturnIsFiled
Other WebsiteXOtherWebsite
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1REBECCA CRAIG CFOBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number9197316142TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1PO BOX 8001AddressLine1
CityGOLDSBOROCity
StateNCState
ZIP Code27533ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (22 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationInstitutional TrusteeInstitutionalTrusteeOfficerOfficerHighest Compensated EmployeeHighestCompensatedEmployee
BRASHEAR HAROLD
BOARD MEMBER1.00X000
BROADAWAY WILLIAM W
CHAIRMAN1.00X000X
BEST C MUNROE JACK
BOARD MEMBER1.00X000
GRIFFIN MD CHRISTOPHER P
VICE-CHAIRMAN1.00X000X
HUNTER SAMUEL P
BOARD MEMBER1.00X000
LIES MD STEPHEN C
BOARD MEMBER1.00X000
MCCALL SUSAN H
BOARD MEMBER1.00X000
MCDONALD JR RAY
BOARD MEMBER1.00X000
PAUGH J WILLIAM
BOARD MEMBER1.00X000
STOCKTON MD LEON
BOARD MEMBER1.00X000
WALKER JR ROBERT D
BOARD MEMBER1.00X000
WEAVER CHARLOTTE M
BOARD MEMBER1.00X000
J WILLIAM PAUGH
PRESIDENT & CEO40.005727400131660X
THOMAS BRADSHAW
VP OPERATIONS40.00221322063975X
REBECCA CRAIG
CFO40.00208624059488X
SHIRLEY HARKEY
VP NURSING SERVICES40.00176821051278X
RICHARD ROGERS
VP HR (CHRO)40.00163034044733X
HENRY COMBS
STAFF PHARMACIST40.0021867900X
RICK BAZIK
CRNA40.0020039500X
AMY WILLOUGHBY
CRNA40.0018225300X
ANGELA WHITTEN
CRNA40.0018037200X
GEORGE HAYWOOD
CRNA40.0017930500X
FieldValueIRS element (for citing)
Total Reportable Comp From Org2303545TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation351134TotalOtherCompensation
Number Individuals GT100 K46NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
T A LOVING
PO DRAWER 919GOLDSBORONC275330919CONSTRUCTION5166460
SODEXO INC & AFFILIATES
500 ROSS STREETPITTSBURGPA152620001FOOD SERVICE779846
ARAMARK
24863 NETWORK PLACECHICAGOIL606731248FOOD SERVICE726409
EASTERN MEDICAL ASSOCIATES
2609 MEDICAL OFFICE PLACEGOLDSBORONC27534CONSULTANTS722502
GOLDSBORO PATHOLOGY
BOX 8001GOLDSBORONC27530LAB SERVICES362533
FieldValueIRS element (for citing)
Number Of Contractors GT100 K14NumberOfContractorsGT100K

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionPATIENT REVENUEDescription
Business Code621110BusinessCode
Total Revenue Column183609412TotalRevenueColumn
Related Or Exempt Function Income183609412RelatedOrExemptFunctionIncome

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

FieldValueIRS element (for citing)
Total Revenue Column7098826TotalRevenueColumn
Related Or Exempt Function Income7098826RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue190708238TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column2694349TotalRevenueColumn
Exclusion$2,694,349ExclusionAmount

Other Revenue Misc OtherRevenueMisc (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmountUnrelated Business RevenueUnrelatedBusinessRevenue
DISTRIBUTIONS FROM MEM9000991277433$1,277,433
PREMIER PURCHASING GAI561000887887
FieldValueIRS element (for citing)
Total Other Revenue1278320TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column194680907TotalRevenueColumn
Related Or Exempt Function Income190708238RelatedOrExemptFunctionIncome
Unrelated Business Revenue887UnrelatedBusinessRevenue
Exclusion$3,971,782ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total91667Total
Program Services91667ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total55383Total
Program Services55383ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total1341214Total
Management And General1341214ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total72222276Total
Program Services65000048ProgramServices
Management And General7222228ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total7070202Total
Program Services6363182ProgramServices
Management And General707020ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total8191612Total
Program Services7372451ProgramServices
Management And General819161ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total5269864Total
Program Services4742878ProgramServices
Management And General526986ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total913106Total
Program Services913106ProgramServices

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total317890Total
Management And General317890ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total222182Total
Management And General222182ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total13915011Total
Program Services13223698ProgramServices
Management And General691313ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total2737212Total
Program Services2737212ProgramServices

Travel Travel

FieldValueIRS element (for citing)
Total34832Total
Program Services26882ProgramServices
Management And General7950ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total317504Total
Program Services211860ProgramServices
Management And General105644ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total2902429Total
Program Services2902429ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total8485230Total
Program Services8449099ProgramServices
Management And General36131ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total432116Total
Management And General432116ManagementAndGeneral

Other Expenses OtherExpenses (3 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServices
MEDICAL SUPPLIES3136417531364175
BAD DEBT EXPENSE1533085915330859
AMA EXPENSES953311953311

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total12724298Total
Program Services12442780ProgramServices
Management And General281518ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total184892373Total
Program Services172181020ProgramServices
Management And General12711353ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY10817048BOY
EOY1086296EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY38142BOY
EOY39126EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY20813931BOY
EOY21661901EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY4111581BOY
EOY4185565EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY2385320BOY
EOY3063478EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis186455452LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec96582573LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY86952334BOY
EOY89872879EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY80014299BOY
EOY89996554EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY9415950BOY
EOY8964414EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY214548605BOY
EOY218870213EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY23312884BOY
EOY19962625EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY60865584BOY
EOY60874598EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY108992BOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY61851755BOY
EOY78720321EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY146139215BOY
EOY159557544EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY67484094BOY
EOY58301068EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY925296BOY
EOY1011601EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY68409390BOY
EOY59312669EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY214548605BOY
EOY218870213EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses9788534ReconcilationRevenueExpenses
Reconcilation Other Changes-18885255ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0Volunteers
Paid Staff Or Management0PaidStaffOrManagement
Media Advertisements0MediaAdvertisements
Mailings Members0MailingsMembers
Publications Or Broadcast0PublicationsOrBroadcast
Grants Other Organizations0GrantsOtherOrganizations
Direct Contact Legislators0DirectContactLegislators
Rallies Demonstrations0RalliesDemonstrations
Other Activities1OtherActivities
Total Lobbying Expenditures IIB0TotalLobbyingExpendituresIIB

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierEXPLANATION OF OTHER LOBBYING ACTIVITIES:Identifier
Return ReferencePART II-B, LINE 1I:ReturnReference
Explanation(NCHA DUES)Explanation

Schedule D IRS990ScheduleD

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis93157657OtherCostOrOtherBasis
Depreciation38586999Depreciation
Book Value54570658BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis81129397OtherCostOrOtherBasis
Depreciation54218886Depreciation
Book Value26910511BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis12168398OtherCostOrOtherBasis
Depreciation3776688Depreciation
Book Value8391710BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings89872879TotalOfBookValueLandBuildings

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
DescriptionINVESTMENTSDescription
Book Value89996554BookValue
Method Of ValuationFMethodOfValuation
FieldValueIRS element (for citing)
Total Of Book Value Program Related89996554TotalOfBookValueProgramRelated

Other Liabilities OtherLiabilities (3 entries)

DescriptionDescriptionAmountAmount
OTHER LIABILITIES$16,477,635
MINIMUM PENSION LIABILITY$57,531,886
ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS$4,710,800
FieldValueIRS element (for citing)
Total Of Amounts78720321TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierDESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:Identifier
Return ReferencePART X:ReturnReference
ExplanationWAYNE MEMORIAL HOSPITAL ("WMH") IS A NOT-FOR-PROFIT CORPORATION AND HAS BEEN RECOGNIZED AS TAX-EXEMPT PURSUANT TO SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. WMH ADOPTED THE PROVISIONS OF THE INCOME TAX STANDARD THAT CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN AN ORGANIZATION'S FINANCIAL STATEMENTS. THIS GUIDANCE PRESCRIBES A RECOGNITION AND MEASUREMENT OF TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN ON A TAX RETURN THAT ARE NOT CERTAIN TO BE REALIZED. THE IMPLEMENTATION OF THE ADOPTION OF THIS STANDARD HAD NO IMPACT ON WMH'S FINANCIAL STATEMENTS.Explanation

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
FPG Reference Free Care1FPGReferenceFreeCare
Pcent200XPcent200
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent350XPcent350
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget1ExpensesExceededBudget
Unable To Provide Care0UnableToProvideCare
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available1ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense11843457TotalCommunityBenefitExpense
Net Community Benefit Expense11843457NetCommunityBenefitExpense
Percent Of Total Expense0.06980PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense26181068TotalCommunityBenefitExpense
Direct Offsetting Revenue17034773DirectOffsettingRevenue
Net Community Benefit Expense9146295NetCommunityBenefitExpense
Percent Of Total Expense0.05390PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense38024525TotalCommunityBenefitExpense
Direct Offsetting Revenue17034773DirectOffsettingRevenue
Net Community Benefit Expense20989752NetCommunityBenefitExpense
Percent Of Total Expense0.12370PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense2220124TotalCommunityBenefitExpense
Net Community Benefit Expense2220124NetCommunityBenefitExpense
Percent Of Total Expense0.01310PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense3076000TotalCommunityBenefitExpense
Net Community Benefit Expense3076000NetCommunityBenefitExpense
Percent Of Total Expense0.01810PercentOfTotalExpense

Research Research

FieldValueIRS element (for citing)
Total Community Benefit Expense100609TotalCommunityBenefitExpense
Net Community Benefit Expense100609NetCommunityBenefitExpense
Percent Of Total Expense0.00060PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense5396733TotalCommunityBenefitExpense
Net Community Benefit Expense5396733NetCommunityBenefitExpense
Percent Of Total Expense0.03180PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense43421258TotalCommunityBenefitExpense
Direct Offsetting Revenue17034773DirectOffsettingRevenue
Net Community Benefit Expense26386485NetCommunityBenefitExpense
Percent Of Total Expense0.15550PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported1BadDebtExpenseReported
Bad Debt Expense$6,348,498BadDebtExpenseAmount
Amount Attributable To0AmountAttributableTo
Amount Reimbursed By Medicare68888052AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare69548670CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-660618MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care1ProvisionForCharityCare

Form990 Schedule H Part IV Form990ScheduleHPartIV

Name Of Entity NameOfEntity

FieldValueIRS element (for citing)
Business Name Line11 WAYNE MRI LLCBusinessNameLine1
FieldValueIRS element (for citing)
Description Ent Primary ActivityMRIDescriptionEntPrimaryActivity
Organization Profit Or Ownership0.66700OrganizationProfitOrOwnership
Physicans Profit Or Ownership0.33300PhysicansProfitOrOwnership
FieldValueIRS element (for citing)
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1WAYNE MEMORIAL HOSPITAL INCBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line12700 WAYNE MEMORIAL DRIVEAddressLine1
CityGOLDSBOROCity
StateNCState
ZIP Code27533ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1WAYNE MEMORIAL HOSPITAL INCBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
Eligibility Criteria Explained1EligibilityCriteriaExplained
Uses FPG Free1UsesFPGFree
FPG Free Percent200.000000000000FPGFreePercent
Uses FPG Discounted1UsesFPGDiscounted
FPG Discount Percent350.000000000000FPGDiscountPercent
Explains Basis0ExplainsBasis
Explains Application Method1ExplainsApplicationMethod
Includes Publicity Measures1IncludesPublicityMeasures
Posted On WebsiteXPostedOnWebsite
Available On RequestXAvailableOnRequest
Other PublicityXOtherPublicity
Actions On Nonpayment1ActionsOnNonpayment
Permit Lien On ResidenceXPermitLienOnResidence
Collection Activities1CollectionActivities
Lien On ResidenceXLienOnResidence
Notify Upon AdmissionXNotifyUponAdmission
Notify Before DischargeXNotifyBeforeDischarge
Notified All PatientsXNotifiedAllPatients
Documented DeterminationXDocumentedDetermination
Nondiscrim Emergency Care Policy1NondiscrimEmergencyCarePolicy
Used Other MethodXUsedOtherMethod
Amounts Generally Billed0AmountsGenerallyBilled
Gross Charges0GrossCharges

Form990 Schedule H Part VI Form990ScheduleHPartVI (17 entries)

ExplanationExplanationIdentifierIdentifierReturn ReferenceReturnReference
PART I, LINE 3C: WE USE 200% OF FEDERAL POVERTY GUIDELINES TO DETERMINE ELIGIBILITY. WE ALSO USE A PROPRIETARY CREDIT SCORING TOOL TO FURTHER DETERMINE ELIGIBILITY AND FOR NON-COMPLIANT PATIENTS. THIS PROPRIETARY TOOL USES ALGORITHMS, CONSUMER DATA, AND OTHER INFORMATION TO ASSIST WITH PATIENT ABILITY TO PAY.
PART I, LINE 6A: N/A
PART I, LINE 7: AMOUNTS SHOWN IN PART I, LINE 7, COLUMN C WERE COMPUTED USING THE COST-TO-CHARGE RATIO WORKSHEET (WORKSHEET 2) FROM THE IRS INSTRUCTIONS FOR SCHEDULE H.
PART I, LINE 7G: N/A
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 $ 15330859.
PART II: THE HOSPITAL IS ACTIVE IN ITS SUPPORT FOR ORGANIZATIONS SEEKING TO MAKE ENCOURAGE GROWTH IN WAYNE COUNTY, BY MAKING IT A DESIRABLE LOCATION TO LIVE AND WORK. ATTRACTING QUALITY EMPLOYERS IS THE KEY TO JOB GROWTH. HAVING A HIGH QUALITY HOSPITAL IS THE HOSPITAL'S FIRST PRIORITY, AND THAT INCLUDES RECRUITMENT OF PHYSICIANS TO MEET GROWTH NEEDS, REPLACE RETIRING PHYSICIANS, AND SUPPLEMENT CLINICAL AREAS WHICH NEED MORE EXPERTISE. RECRUITMENT OF ADDITIONAL PHYSICIANS AND OTHER PROVIDERS, PARTICULARLY IN AREAS OF DIABETES TREATMENT AND PRIMARY CARE, HAS BEEN A KEY GOAL FOR SEVERAL YEARS. THE MEDICAL STAFF DEVELOPMENT PLAN ADOPTED BY THE BOARD OF DIRECTORS IN LATE 2009 IS THE PLATFORM FOR MOVING AHEAD. THE HOSPITAL BEGAN HIRING PHYSICIANS IN 2009, AND WILL CONTINUE TO DO THIS, AS THE MARKET DEMAND CONTINUES. NATIONALLY, THERE IS A MOVE BY PHYSICIANS TO BE EMPLOYED BY HOSPITALS, VERSUS RUNNING INDIVIDUAL/GROUP PRACTICES, AND THE HOSPITAL IS RESPONDING TO THAT DESIRE, WHICH IS BENEFITING WAYNE COUNTY.
PART III, LINE 4: THE HOSPITAL USES HISTORICAL COLLECTION EXPERIENCE AND A REVIEW OF CURRENT RECEIVABLES TO PROVIDE AN ESTIMATE OF THE ALLOWANCE FOR UNCOLLECTIBLES AND THE BAD DEBT EXPENSE. ACCOUNTS PAST DUE FOR MORE THAN 90 DAYS ARE INDIVIDUALLY ANALYZED FOR COLLECTIBLITY. IF DEEMED UNCOLLECTIBLE, ACCOUNTS ARE REFERRED TO ONE OF TWO OUTSIDE COLLECTION AGENCIES UNLESS THE ACCOUNT IS BEING REVIEWED UNDER THE HOSPITAL'S CHARITY POLICY.THE HOSPITAL PROVIDES SERVICES TO PATIENTS REGARDLESS OF ABILITY TO PAY. AS A RESULT, THE HOSPITAL HAS INCURRED LOSSES FROM BAD DEBT EXPENSE. THESE UNREIMBURSED SERVICES THE HOSPITAL PROVIDES TO THE COMMUNITY SHOULD BE CONSIDERED A COMMUNITY BENEFIT SINCE THE HEALTHCARE NEEDS OF THE COMMUNITY WOULD OTHERWISE BE UNMET.PART III, SECTION A, LINE 2:THE AMOUNT ON LINE 2 WAS DERIVED BY TAKING THE BAD DEBT EXPENSE PER THE AUDITED FINANCIAL STATEMENTS AND MULTIPLYING IT BY THE RATIO OF PATIENT CARE COST TO CHARGES DERIVED USING WORKSHEET 2 OF THE IRS INSTRUCTIONS FOR SCHEDULE H.PART III, SECTION A, LINE 3:THE HOSPITAL DOES NOT HAVE A PROCESS IN PLACE THAT ESTIMATES THE AMOUNT OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER A FINANCIAL ASSISTANCE POLICY.
PART III, LINE 8: THE HOSPITAL PROVIDES SERVICES TO PATIENTS REGARDLESS OF ABILITY TO PAY. AS A RESULT, THE HOSPITAL HAS INCURRED LOSSES BY SERVING MEDICARE PATIENTS. THE UNREIMBURSED SERVICES THE HOSPITAL PROVIDES TO THE COMMUNITY SHOULD BE CONSIDERED A COMMUNITY BENEFIT SINCE THE HEALTHCARE NEEDS OF THE COMMUNITY WOULD OTHERWISE BE UNMET.PART III, SECTION B, LINE 8:THE COST TO CHARGE RATIO AS CALCULATED BY THE MOST RECENTLY FILED COST REPORT WAS USED TO DETERMINE MEDICARE ALLOWABLE COSTS.
PART III, LINE 9B: THE HOSPITAL ATTEMPTS TO IDENTIFY PATIENTS THAT MAY QUALIFY FOR CHARITY BY REVIEWING PRIOR PATIENT HISTORY OF CHARITY ELIGIBILITY OR BY USING A CREDIT SCORING TOOL THAT WILL INDICATE POTENTIAL CHARITY CASES BASED ON OUR CHARITY CARE GUIDELINES.
PART V, SECTION B, LINE 13G: ALL SELF PAY INPATIENTS RECEIVE VISITS FROM FINANCIAL COUNSELORS AND CHARITY POLICY IS REVIEWED AT THAT TIME. SELF PAY OUTPATIENTS ARE SENT LETTERS OFFERING FINANCIAL ASSISTANCE.WAYNE MEMORIAL HOSPITAL, INC.
PART V, SECTION B, LINE 19D: UNINSURED PATIENTS ARE BILLED THE SAME AMOUNTS AS INSURED PATIENTS.WAYNE MEMORIAL HOSPITAL, INC.
PART VI, LINE 2: EVERY THREE YEARS, THE HOSPITAL PARTNERS WITH WAYNE COUNTY DEPARTMENT OF HEALTH, WAYNE ACTION TEAMS FOR COMMUNITY HEALTH (WATCH) AND OTHER AGENCIES IN WAYNE COUNTY TO SPONSOR A COMMUNITY-WIDE HEALTH ASSESSMENT, WHICH IS THEN UPDATED BY THE HEALTH DEPARTMENT ANNUALLY, USING STATE AND LOCAL STATISTICS. THIS ANNUAL HEALTH ASSESSMENT IS PUBLISHED ON THE WAYNE COUNTY HEALTH DEPARTMENT WEBSITE, AND IS REFERRED TO BY VIRTUALLY ALL ENTITIES IN WAYNE COUNTY WHO ARE INTERESTED IN IMPROVING HEALTH. EXTERNAL CONSULTANTS ARE ENGAGED TO PUT TOGETHER COMMUNITY SURVEYS (EVERY THIRD YEAR) AND HELP SET PRIORITIES. THE HOSPITAL HAS TAKEN A LEADERSHIP ROLE IN RECRUITING PHYSICIANS TO WAYNE COUNTY WITH SKILLS THAT ARE IN SHORT SUPPLY. THIS IS HANDLED THROUGH A FORMAL PHYSICIAN NEEDS ASSESSMENT, WHICH WAS COMPLETED IN FY 2010, AND ADOPTED BY THE BOARD OF DIRECTORS IN DECEMBER 2009.THE HOSPITAL IS ACTIVE IN ITS SUPPORT FOR ORGANIZATIONS SEEKING TO MAKE ENCOURAGE GROWTH IN WAYNE COUNTY, BY MAKING IT A DESIRABLE LOCATION TO LIVE AND WORK. ATTRACTING QUALITY EMPLOYERS IS THE KEY TO JOB GROWTH. HAVING A HIGH QUALITY HOSPITAL IS THE HOSPITAL'S FIRST PRIORITY, AND THAT INCLUDES RECRUITMENT OF PHYSICIANS TO MEET GROWTH NEEDS, REPLACE RETIRING PHYSICIANS, AND SUPPLEMENT CLINICAL AREAS WHICH NEED MORE EXPERTISE. RECRUITMENT OF ADDITIONAL PHYSICIANS AND OTHER PROVIDERS, PARTICULARLY IN AREAS OF DIABETES TREATMENT AND PRIMARY CARE, HAS BEEN A KEY GOAL FOR SEVERAL YEARS. THE MEDICAL STAFF DEVELOPMENT PLAN ADOPTED BY THE BOARD OF DIRECTORS IN LATE 2009 IS THE PLATFORM FOR MOVING AHEAD. THE HOSPITAL BEGAN HIRING PHYSICIANS IN 2009, AND WILL CONTINUE TO DO THIS, AS THE MARKET DEMAND CONTINUES. NATIONALLY, THERE IS A MOVE BY PHYSICIANS TO BE EMPLOYED BY HOSPITALS, VERSUS RUNNING INDIVIDUAL/GROUP PRACTICES, AND THE HOSPITAL IS RESPONDING TO THAT DESIRE, WHICH IS BENEFITING WAYNE COUNTY.
PART VI, LINE 3: PROVIDE COUNSELING TO PATIENTS, PROVIDE PATIENT BROCHURES WITH INFORMATION AND HOSPITAL WEBSITE.
PART VI, LINE 4: LIKE MOST OF EASTERN NORTH CAROLINA, WAYNE COUNTY IS A RURAL AND RELATIVELY POOR COUNTY WITH A PER CAPITA INCOME OF $17,000, BELOW NORTH CAROLINA AND NATIONAL AVERAGES. ABOUT 15% OF ITS 122,000 POPULATION HAVE INCOMES AT THE POVERTY RATE [US CENSUS - 2010] AND 25% OF WAYNE COUNTY CHILDREN LIVE IN POVERTY. WAYNE COUNTY HAS THE THIRD HIGHEST AGRICULTURAL PRODUCTION OF ALL 100 NORTH CAROLINA COUNTIES. ITS DEEP ROOTS IN AGRICULTURE HAVE PROPAGATED GENERATIONS OF SMOKERS AND UNHEALTHY EATERS, MUCH OF WHICH WAS OFFSET, BEFORE AGRICULTURE BECAME SO MECHANIZED, WITH PHYSICAL EXERCISE. NOW, WAYNE RANKS 53 OUT OF 100 NORTH CAROLINA COUNTIES IN HEALTH BEHAVIORS. [COUNTY HEALTH RANKINGS, ROBERT WOOD JOHNSON FOUNDATION]. THIS IS ACTUALLY AN IMPROVEMENT OVER PRIOR YEARS, AND THERE IS A COMMITMENT FROM LOCAL HEALTH LEADERS TO CONTINUE TO IMPROVE THE RANKING, THROUGH COMBINED EFFORTS TO COMBAT CHILDHOOD OBESITY, DIABETES, AND OTHER HEALTH ISSUES. WAYNE COUNTY RESIDENTS ARE INVOLVED IN HIGH NUMBERS OF CANCER TRIALS, WHICH BRING HOPE TO LOCAL CANCER PATIENTS, AND WHICH MAY LEAD TO BREAKTHROUGHS IN CANCER TREATMENT AND POSSIBLY CURES. THE COUNTY IS SMALL ENOUGH THAT COOPERATION BETWEEN LOCAL HEALTH PROVIDERS IS EASY TO ACHIEVE, AND NETWORKS EXIST TO IMPROVE THE HEALTH OF WAYNE COUNTY RESIDENTS.
PART VI, LINE 6: THE HOSPITAL HAS BEEN GOVERNED, SINCE 1985, BY A BOARD OF COMMUNITY REPRESENTATIVES, FROM BUSINESS, LAW, AND MEDICINE, AND HAS HAD THE BENEFIT, OVER THESE YEARS, OF CONSISTENT PROFESSIONAL ACCOUNTING AND LEGAL ADVICE. IT HAS A STATED COMMITMENT TO CARE FOR PATIENTS WHO ARE UNABLE TO PAY FOR CARE, AND WITH GREATER THAN 5% OF REVENUES DEDICATED TO THIS TASK, IT MAKES GOOD ON THIS COMMITMENT EVERY YEAR. IN ADDITION, THE HOSPITAL HAS BEEN THE BEDROCK OF THE WAYNE ACTION TEAMS ON COMMUNITY HEALTH (WATCH), WHICH REACHES UNINSURED PERSONS THROUGHOUT THE COUNTY. RATES FOR HOSPITAL CARE ARE AMONG THE LOWEST IN THE STATE OF NORTH CAROLINA, IN AN ATTEMPT TO KEEP HOSPITAL CARE AFFORDABLE. CHARITY POLICY IS GENEROUS, AND THE HOSPITAL WORKS WITH PATIENTS ON PAYMENT PLANS DAILY. THE MEDICAL STAFF IS OPEN TO ALL QUALIFIED PROVIDERS, AND IS REPRESENTED ON THE BOARD OF DIRECTORS. SURPLUS FUNDS ARE DEDICATED TO IMPROVEMENT OF FACILITIES AND TO PROVIDING FINANCIAL STABILITY TO ALLOW THE HOSPITAL TO BORROW FUNDS IF NECESSARY TO PURCHASE LONG TERM ASSETS, TO IMPROVE HEALTH CARE IN WAYNE COUNTY. NO PRIVATE PERSON BENEFITS FROM CASH GENERATED FROM HOSPITAL OPERATIONS.
PART VI, LINE 7: N/A
NCREPORTS FILED WITH STATESPART VI, LINE 7

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Recipient Table RecipientTable

Recipient Name Business RecipientNameBusiness

FieldValueIRS element (for citing)
Business Name Line1THE FOUNDATION OF WAYNE COMMUNITY COLLEGEBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1PO BOX 8002AddressLine1
CityGOLDSBOROCity
StateNCState
ZIP Code27533ZIPCode
FieldValueIRS element (for citing)
EIN Of Recipient561556512EINOfRecipient
IRC Section501(C)(3)IRCSection
Amount Of Cash Grant91667AmountOfCashGrant
Purpose Of GrantHEALTHCARE EDUCATIONPurposeOfGrant
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants1TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations1TotalNbrOfOtherOrganizations

Form990 Schedule I Part III Form990ScheduleIPartIII

FieldValueIRS element (for citing)
Type Of GrantEDUCATIONAL SCHOLARSHIPSTypeOfGrant
Number Of Recipients6NumberOfRecipients
Amount Of Cash Grant55383AmountOfCashGrant

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierPROCEDURE FOR MONITORING GRANTS IN THE U.S.:Identifier
Return ReferencePART I, LINE 2:ReturnReference
ExplanationSCHEDULE I, PART I, LINE 2: WAYNE MEMORIAL HOSPITAL, INC. MAKES GRANTS TO SUPPORT THE ACTIVITIES OF ITS RELATED ORGANIZATIONS AND TO PROMOTE GOOD COMMUNITY RELATIONS.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Club Dues Or FeesXClubDuesOrFees
Written Policy Re T And E Expenses1WrittenPolicyReTAndEExpenses
Substantiation Required1SubstantiationRequired
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (10 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
J WILLIAM PAUGH
4540020860330327050697660618940704400000
THOMAS BRADSHAW
2206050007170355990283760285297000
REBECCA CRAIG
20513000034940426430168450268112000
SHIRLEY HARKEY
17682100000247880264900228099000
RICHARD ROGERS
15788800051460167910279420207767000
HENRY COMBS
218679000000000218679000
RICK BAZIK
200395000000000200395000
AMY WILLOUGHBY
182253000000000182253000
ANGELA WHITTEN
180372000000000180372000
GEORGE HAYWOOD
179305000000000179305000

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

Return ReferenceReturnReferenceExplanationExplanation
PART I, LINE 1ACERTAIN DUES AND FEES AND COMPANION TRAVEL ARE REIMBURSED BY THE ORGANIZATION.
PART I, LINE 4BJ. WILLIAM PAUGH PARTICIPATED IN A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN AND RECEIVED $86,032 IN PAYMENTS FROM THE PLAN DURING THE YEAR.

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1NORTH CAROLINA MEDICAL CARE COMMISSIONBusinessNameLine1
FieldValueIRS element (for citing)
Issuer EIN521309402IssuerEIN
CUSIP Number65820HB93CUSIPNumber
Date Issued2009-03-19DateIssued
Issue Price35720000IssuePrice
Description Of PurposeCAPITAL EXPENDITURESDescriptionOfPurpose
Defeased0Defeased
On Behalf Of Issuer0OnBehalfOfIssuer
Pool Financing0PoolFinancing

Form990 Schedule K Part II Form990ScheduleKPartII

FieldValueIRS element (for citing)
Total Proceeds35720000TotalProceeds
Year Of Subst Completion2009YearOfSubstCompletion
Current Refunding1CurrentRefunding
Advance Refunding0AdvanceRefunding
Final Allocation Made1FinalAllocationMade
Adequate Books And Recds Maintaind1AdequateBooksAndRecdsMaintaind

Form990 Schedule K Part III Form990ScheduleKPartIII

FieldValueIRS element (for citing)
Owning Bond Financed Property0OwningBondFinancedProperty
Any Lease Arrangements0AnyLeaseArrangements
Mngment Cntrct Bond Financd Prprty0MngmentCntrctBondFinancdPrprty
Any Research Agreements0AnyResearchAgreements
Bond Counsel Routinely Engaged1BondCounselRoutinelyEngaged
Post Issuance Compliance Procdrs1PostIssuanceComplianceProcdrs

Form990 Schedule K Part IV Form990ScheduleKPartIV

FieldValueIRS element (for citing)
Form8038 T Filed0Form8038TFiled
Variable Rate Issue1VariableRateIssue
Hedge Identified In Books And Recds1HedgeIdentifiedInBooksAndRecds
Superintegrated Hedge0SuperintegratedHedge
Hedge Terminated0HedgeTerminated
Gross Proceeds Invested In GIC0GrossProceedsInvestedInGIC
Gross Proceeds Invested0GrossProceedsInvested
Exception To Rebate0ExceptionToRebate

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (6 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
FORM 990, PART VI, SECTION B, LINE 11A DRAFT OF FORM 990 IS MADE AVAILABLE TO THE GOVERNING BODY FOR REVIEW BEFORE IT IS FILED WITH THE IRS.
ALL PERSONNEL ARE RESPONSIBLE FOR ADHERING TO THE CORPORATE COMPLIANCE PLAN. THIS PLAN REQUIRES PERSONNEL TO DISCLOSE CONFLICTS AS THEY ARISE. VOTING MEMBERS OF THE GOVERNING BODY ARE RECUSED FROM VOTING WHEN A CONFLICT ARISES.FORM 990, PART VI, SECTION B, LINE 12C
COMPENSATION IS REVIEWED AGAINST COMPARABILITY DATA AND APPROVED BY THE BOARD. WRITTEN COMPENSATION AGREEMENTS ARE KEPT UP-TO-DATE. OFFICER AND KEY EMPLOYEE COMPENSATION IS REVIEWED ANNUALLY.FORM 990, PART VI, SECTION B, LINE 15
THESE DOCUMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. THE CORPORATE COMPLIANCE POLICY IS AVAILABLE ON THE HOSPITAL'S WEBSITE. ADDITIONALLY, THE AUDITED FINANCIAL STATEMENTS ARE AVAILABLE ON WWW.DACBOND.COM.FORM 990, PART VI, SECTION C, LINE 19
CHANGES IN NET ASSETS OR FUND BALANCES:CHANGE IN MINIMUM PENSION LIABILITY -14,064,417. CHANGE IN VALUE OF DERIVATIVE FINANCIAL INSTRUMENT -2,204,795. TEMPORARILY RESTRICTED NET ASSET ACTIVITY 86,305. CHANGE IN NET UNREALIZED LOSS ON OTHER THAN TRADING SECURITIES -2,702,348. TOTAL TO FORM 990, PART XI, LINE 5: -18,885,255.FORM 990, PART XI, LINE 5:
THE PROCESS FOR APPROVING AUDITED FINANCIAL STATEMENTS AND FOR SELECTING INDEPENDENT ACCOUNTANTS HAS NOT CHANGED FROM THE PRIOR YEAR.FORM 990, PART XII, LINE 2C:

Schedule R IRS990ScheduleR

Form990 Schedule R Part I Form990ScheduleRPartI

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1AMERICAN MANAGEMENT ASSOCIATES LLCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line12719 GRAVES DRIVEAddressLine1
CityGOLDSBOROCity
StateNCState
ZIP Code27534ZIPCode
FieldValueIRS element (for citing)
EIN561622637EIN
Primary ActivitiesCOLLECTIONSPrimaryActivities
Legal Domicile StateNCLegalDomicileState
Direct Controlling Entity NAN/ADirectControllingEntityNA

Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNAControlled OrgControlledOrg
WAYNE HEALTH FOUNDATION INC
2700 WAYNE MEMORIAL DRIVEGOLDSBORONC27533581881912SUPPORTNC501(C)(3)LINE 9N/A0
WAYNE HEALTH CORPORATION
PO BOX 8001GOLDSBORONC27534561479733HEALTHCARENC501(C)(3)LINE 11A, IN/A0

Form990 Schedule R Part III Form990ScheduleRPartIII

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1WAYNE MRI LLCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line12700 WAYNE MEMORIAL DRIVEAddressLine1
CityGOLDSBOROCity
StateNCState
ZIP Code27533ZIPCode
FieldValueIRS element (for citing)
EIN342043934EIN
Primary ActivityMRI SERVICESPrimaryActivity
Legal Domicile StateNCLegalDomicileState
Direct Controlling Entity NAN/ADirectControllingEntityNA
Predominant Income TypeRELATEDPredominantIncomeType
Share Of Total Income1073668ShareOfTotalIncome
Share Of EOY Assets4185980ShareOfEOYAssets
Disproportionate Allocations0DisproportionateAllocations
General Or Managing Partner1GeneralOrManagingPartner
Percentage Ownership0.66670PercentageOwnership
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties1ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org1OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (2 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
WAYNE HEALTH CORPORATION
J250000ACTUAL CASH PAYMENT
WAYNE HEALTH FOUNDATION INC
N502345ACTUAL CASH PAYMENT