2012-11-14T15:35:13-06:00 2011-12-31 990 2011-01-01 561376950 NOVANT HEALTH INC NOVA 3367182803 2085 FRONTIS PLAZA BLVD WINSTON SALEM NC 27103 FRED HARGETT 3367182803 2012-11-14 2011 2016-02-24 21:20:13Z CARL ARMATO 2085 FRONTIS PLAZA BLVD WINSTON SALEM NC 27103 1221454160 0 X WWW.NOVANTHEALTH.ORG X 1997 NC SEE SCHEDULE O 13 10 3504 185 15971751 1141051 0 738 431157260 477050513 83149073 25344072 -7984140 20880138 506322193 523275461 1101507 4610842 0 0 240943412 248168862 0 0 0 231249211 300805064 473294130 553584768 33028063 -30309307 2395383727 2138191052 2172206566 2025461569 223177161 112729483 X NOVANT HEALTH EXISTS TO IMPROVE THE HEALTH OF COMMUNITIES, ONE PERSON AT A TIME.SEE SCHEDULE O 0 0 76286793 109872983 PRESBYTERIAN ORTHOPAEDIC HOSPITAL, LLC (POH) IS A SINGLE MEMBER LLC IN WHICH NOVANT HEALTH IS THE SOLE MEMBER. POH EXISTS TO PROMOTE THE HEALTH OF THE INHABITANTS OF THE CHARLOTTE-MECKLENBURG COUNTY AREA, REGARDLESS OF THE PATIENT'S ABILITY TO PAY. DURING 2011, POH HAD 80 LICENSED BEDS. THERE WERE 14,026 PATIENT DAYS, WITH AN AVERAGE LENGTH OF STAY OF 4.00 DAYS, AND AN AVERAGE DAILY CENSUS OF 38.40. THERE WERE 3,506 DISCHARGES, 7,398 INPATIENT AND OUTPATIENT SURGERIES, AND 11,146 OUTPATIENT ENCOUNTERS. 55601711 56037838 BRUNSWICK COMMUNITY HOSPITAL, LLC (BCH) IS A SINGLE MEMBER LLC IN WHICH NOVANT IS THE SOLE MEMBER. BCH EXISTS TO PROMOTE THE HEALTH OF THE INHABITANTS OF THE BRUNSWICK COUNTY AREA, REGARDLESS OF THE PATIENT'S ABILITY TO PAY. DURING 2011, BCH HAD 74 LICENSED BEDS. THERE WERE 11,920 PATIENT DAYS, WITH AN AVERAGE LENGTH OF STAY OF 3.60 DAYS, AND AN AVERAGE DAILY CENSUS OF 39. THERE WERE 3,284 DISCHARGES, 55,788 INPATIENT AND OUTPATIENT ENCOUNTERS, AND 24,829 EMERGENCY DEPARTMENT VISITS. 27767777 27397280 THE HOLDING COMPANY FOR NOVANT'S AMBULATORY SERVICES WAS TRANSFERRED TO NOVANT HEALTH SOUTHERN PIEDMONT REGION, LLC, A SINGLE MEMBER LLC IN WHICH NOVANT HEALTH IS THE SOLE MEMBER. THE AMBULATORY CENTERS' OPERATIONS SERVE THE COMMUNITY BY PROVIDING ACCESS TO MUCH NEEDED HEALTHCARE SERVICES, REGARDLESS OF THE PATIENT'S ABILITY TO PAY. DURING 2011, THERE WERE 88,457 OUTPATIENT ENCOUNTERS. 295447960 4610842 298750567 NOVANT HEALTH, INC. IS THE PARENT ORGANIZATION OF A NOT-FOR-PROFIT INTEGRATED GROUP OF HOSPITALS,PHYSICIAN CLINICS, OUTPATIENT CENTERS AND OTHER HEALTHCARE SERVICES (COLLECTIVELY KNOWN AS "NOVANT HEALTH"). NOVANT HEALTH, INC. EXISTS TO SUPPORT THE OVERALL SYSTEM AND DOES SO BY PROVIDING OVERALL STRATEGIC PLANNING, CENTRALIZED ADMINISTRATIVE SUPPORT, AND THE COORDINATION OF SYSTEM-WIDE ACTIVITIES. 295447960 4610842 298750567 455104241 1 0 0 1 0 0 0 0 0 0 1 1 0 0 1 1 0 1 0 1 1 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 1 1 0 0 0 0 1 1 1 1 0 0 1 3321 0 1 3504 1 1 1 1 BD EI 0 0 0 0 0 0 0 0 X 13 10 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 NC X X KAREN DAUGHERTY 3367182803 2085 FRONTIS PLAZA BLVD WINSTON SALEM NC 27103 X WILESPAUL M 60.00 X X 2251146 0 44329 ALUKOAKINYELE OLAWALE 2.00 X 0 619426 31696 BAUGHANMICHAEL 2.00 X X 0 0 0 BELKJOHN 2.00 X 0 0 0 CONRADDEBRA 2.00 X 0 0 0 EDWARDSH RANDALL 2.00 X 6600 0 0 EVANSLISA 2.00 X X 0 0 0 GORDONROBERT 2.00 X 0 0 0 KETNERGLENN 2.00 X 0 0 0 STOLZROBERT 2.00 X 0 0 0 TILLMANKRISTA 2.00 X 0 0 0 VALENTINEPEGGY 2.00 X X 0 0 0 WOODLIEFJOHN 2.00 X 0 0 0 HARGETTFRED MCDOWELL 60.00 X 981230 0 496174 ARMATOCARL STEVEN 60.00 X 1387090 0 914024 BARTONICHOLAS MICHAEL 60.00 X 462026 0 53653 BEIERGREGORY 60.00 X 4788551 0 300333 BESTDIANA LEE 60.00 X 901827 0 377968 DANIELSJACQUELINE RENE 60.00 X 1050392 0 491412 GARRETTDAVID BRIAN 60.00 X 580304 0 45737 HEARN IIITHOMAS KERMIT 60.00 X 619766 0 38551 JOHNSONTONY W 60.00 X 547135 0 353376 LINERSALLYE ANN 60.00 X 1589681 0 179803 MCGEELAWRENCE UPCHURCH 60.00 X 1088209 0 423765 MIHALDENISE BARBARA 60.00 X 411923 0 205146 MILLERMARK FREDERICK 60.00 X 442981 0 32944 MORGANWAYNE FORREST 60.00 X 535834 0 46742 PARKDAVID G 60.00 X 626650 0 344095 PATEFIELDARTHUR J 60.00 X 3625956 0 491195 SEEHAUSEN JRROBERT H 60.00 X 569580 0 341578 SMITH-HILLJANET 60.00 X 533969 0 41598 TOBALSKIJIM GEORGE 60.00 X 798271 0 409912 WALLENHAUPTSTEPHEN L 60.00 X 1497111 0 656031 WEBERDANIELLE B 60.00 X 447518 0 37785 GARDELLAJOHN E 40.00 X 365796 0 30500 GARMON-BROWNOPHELIA E 40.00 X 418835 0 43026 LEDERER JRJAMES W 40.00 X 397412 0 50040 MOGULMARK JEFFREY 40.00 X 458216 0 35948 MYERSSCOTT A 40.00 X 392457 0 31393 WOOLLEN JRTHOMAS H 0.00 X 1320590 0 39412 29097056 619426 6588166 395 1 1 0 CROTHALL SERVICE GROUP 955 CHESTERBROOK BLVD STE 300 WAYNE PA 19087 HOUSEKEEPING 24401054 BRASFIELD & GORRIE LLC PO BOX 11407 BIRMINGHAM AL 35246 CONTRACTOR 13135505 MARSH USA INC PO BOX 100536 ATLANTA GA 30384 CONSULTING 6622698 MCKINSEY & COMPANY PO BOX 7247-7255 PHILADELPHIA PA 19170 CONSULTING 4290500 MASSMUTUAL FINANCIAL GROUP PO BOX 371368 PITTSBURGH PA 15250 INVESTING & CONSULTING 4048205 146 738 738 CORPORATE ALLOCATION 561000 270630375 270630375 NET PATIENT REVENUE 621990 191245483 191245483 AFFILIATED RENTAL 532000 15174655 15174655 477050513 30857537 12709291 18148246 9559 9559 2619082 0 2619082 2619082 2619082 683183891 9471784 694529592 3649107 -11345701 5822677 -5523024 -5523024 ADMINISTRATION 561000 15498337 12235877 3262460 SICK CLINIC 900099 2762719 2762719 18261056 523275461 492058668 15971751 15244304 4610842 4610842 28973946 28973946 168497657 146171717 22325940 16078112 13947762 2130350 21315360 18491075 2824285 13303787 11541035 1762752 3240219 3240219 1253931 1253931 482958 482958 2630742 2630742 47867727 41525253 6342474 1122525 973790 148735 9202353 7983041 1219312 16193446 14047814 2145632 41374998 35892811 5482187 3603689 3126200 477489 26146272 22681891 3464381 69337767 60150513 9187254 1496382 1298111 198271 UBIT TAXES 234961 234961 MEDICAL SUPPLIES 38070942 38070942 REPAIRS & MAINTENANCE 9956026 8636853 1319173 BAD DEBT 8004154 6943604 1060550 20585972 19010987 1574985 553584768 455104241 98480527 0 148963494 117721272 325112737 214348076 46761793 42377759 5670665 3849448 11414136 12751667 21191579 23520749 1222675633 605926509 769906614 616749124 637540618 718803283 291743196 266740062 108398721 60912011 28680174 49092470 0 11325131 2395383727 2138191052 260115778 426128737 1059642614 965223128 551003923 538915932 301444251 95193772 2172206566 2025461569 X 223177161 112729483 223177161 112729483 2395383727 2138191052 X -30309307 -80138371 X 0 1 1 X 1 1 X X X 0 0 0 FORSYTH MEMORIAL HOSPITAL INC 560928089 3 1 1 1 107200411 FOUNDATION HEALTH SYSTEMS CORP 561373175 9 1 1 1 119388 PRESBYTERIAN HOSPITAL 560554230 3 1 1 1 93564369 NOVANT MEDICAL GROUP INC 581728803 3 1 1 1 22669733 ROWAN REGIONAL MEDICAL CENTER INC 560547479 3 1 1 1 10963564 COMMUNITY GENERAL HEALTH PARTNERS 560636250 3 1 1 1 10317185 MEDICAL PARK HOSPITAL 561340424 3 1 1 1 7802074 PRESBYTERIAN MEDICAL CARE CORP 561376368 3 1 1 1 19511945 PERSONAL CARE SERVICES 541291284 9 1 1 1 50851 PRINCE WILLIAM HOSPITAL 540696355 3 1 1 1 2006130 10 274205650 0 1 0 0 0 0 1 482958 0 1 43902 526860 0 PART IV, SUPPLEMENTAL INFORMATION: SCHEDULE C, PART II-B, LINE 1I DUES PAID TO CERTAIN ORGANIZATIONS WHICH INCLUDE A PORTION RELATED TO LOBBYING ACTIVITIES. 103587775 103587775 645751165 278419435 367331730 34376470 16221657 18154813 381871216 297585502 84285714 57089007 13699915 43389092 616749124 OTHER SECURITIES 144267310 F INVESTMENTS IN AFFILIATES 122472752 C 266740062 0 LTD - SYNDICATE 214751 OTHER LIABILITIES 75861120 CAPITAL LEASE PAYABLE 19117901 95193772 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: LIABILITY UNDER FIN 48 (ASC 740) FOOTNOTE THE AUDIT FOR NOVANT HEALTH AND ITS AFFILIATES IS PREPARED ON A CONSOLIDATED BASIS. THE COMPANY WAS REQUIRED TO EVALUATE UNCERTAIN TAX POSITIONS. THIS EVALUATION INCLUDES A QUANTIFICATION OF TAX RISK IN AREAS SUCH AS UNRELATED BUSINESS TAXABLE INCOME AND THE TAXATION OF OUR FOR-PROFIT SUBSIDIARIES. THIS EVALUATION DID NOT HAVE A MATERIAL EFFECT ON THE COMPANY'S STATEMENT OF OPERATIONS FOR THE YEARS ENDED DECEMBER 31, 2011 AND 2010. CENTRAL AMERICA AND THE CARIBBEAN 1 CAPTIVE INSURER 3978871 CENTRAL AMERICA AND THE CARIBBEAN INVESTMENTS EUROPE INVESTMENTS 64000000 0 1 0 0 0 1 67978871 0 67978871 1 0 1 1 1 0 1 1 X 1 X 300.000000000000 0 1 1 0 1 1 8907941 0 8907941 0.03180 17449942 8737658 8712284 0.03110 4087989 2170611 1917378 0.00680 30445872 10908269 19537603 0.06970 218859 0 218859 0.00080 0 0 0 0.00000 10344751 5521759 4822992 0.01720 4610842 0 4610842 0.01650 15174452 5521759 9652693 0.03450 45620324 16430028 29190296 0.10420 1 8004154 0 44187583 50124217 -5936634 X 1 0 2 1 PRESBYTERIAN ORTHOPAEDIC HOSPITAL

1901 RANDOLPH ROAD CHARLOTTE NC 28207

X X 2 BRUNSWICK COMMUNITY HOSPITAL LLC

1 MEDICAL CENTER DRIVE SUPPLY NC 28462

X X X PRESBYTERIAN ORTHOPAEDIC HOSPITAL 1 1 1 300.000000000000 0 0 1 1 X X X X X X 1 0 1 X 0 0 BRUNSWICK COMMUNITY HOSPITAL LLC 2 1 1 300.000000000000 0 0 1 1 X X X X X X 1 0 1 X 0 0 7 PRESBYTERIAN IMAGING CENTER LLC

1918 RANDOLPH ROAD SUITE LL75 CHARLOTTE NC 28207

IMAGING CENTER PRESBY SAME DAY SURGERY HUNTERSVILLE

10030 GILEAD ROAD HUNTERSVILLE NC 28078

AMBULATORY SURGICAL CENTER PRESBYTERIAN BREAST CENTER LLC

1718 EAST 4TH STREET STE 103 CHARLOTTE NC 28204

IMAGING CENTER PRESBY SAME DAY SURGERY CTR BALLANTYNE

14215 BALLANTYNE CORP PLACE STE 210 CHARLOTTE NC 28277

AMBULATORY SURGICAL CENTER PRESBY SAME DAY SURGERY CTR AT MONROE

2000 WELLNESS BLVD MONROE NC 28110

AMBULATORY SURGICAL CENTER PRESBYTERIAN ENDOSCOPY CTR H'VILLE

16525 HOLLY CREST LANE STE 200 HUNTERSVILLE NC 28078

AMBULATORY SURGICAL CENTER SAMEDAY SURGERY NEW HANOVER

1801 S 17TH STREET WILMINGTON NC 28401

AMBULATORY SURGICAL CENTER PART I, LINE 3C: ALL UNINSURED PATIENTS RECEIVE A STANDARD DISCOUNT REGARDLESS OF THEIR ABILITY TO PAY. THIS DISCOUNT MIRRORS OUR AVERAGE MANAGED CARE RATE. PATIENTS BELOW 300% OF THE FEDERAL POVERTY GUIDELINES ARE DISCOUNTED AT 100% (3A: FREE CARE). OTHER PATIENTS MAY ALSO BE ELIGIBLE FOR DISCOUNTS FOR BALANCES ABOVE $5,000 (CATASTROPHIC DISCOUNT). PART I, LINE 7: COSTS REPORTED IN THE TABLE OF CHARITY CARE AND CERTAIN OTHER COMMUNITY BENEFITS AMOUNTS ARE CALCULATED USING AN ENTITY SPECIFIC COST TO CHARGE RATIO BASED ON WORKSHEET 2 (RCC). PART I, L7 COL(F): THE AMOUNT OF BAD DEBT REMOVED FROM TOTAL EXPENSES (DENOMINATOR) WAS $8,004,154. PART II: ALTHOUGH PART II FOR SCHEDULE H HAS BEEN LEFT BLANK, THE ORGANIZATION DOES ENGAGE IN MANY COMMUNITY BUILDING ACTIVITIES, WHICH SUPPORT AND STRENGTHEN THE COMMUNITY IT SERVES. THESE ACTIVITIES ARE IMPORTANT TO THE ORGANIZATION'S MISSION TO IMPROVE THE HEALTH OF THE COMMUNITY. HOWEVER, THE ORGANIZATION HAS NOT TRADITIONALLY MAINTAINED AN INFRASTRUCTURE TO TRACK, MONITOR AND REPORT THESE ACTIVITIES. THE ORGANIZATION IS PART OF THE NOVANT HEALTH CARE SYSTEM, WHICH HAS A COMMUNITY BENEFIT COMMITTEE. THE COMMUNITY BENEFIT COMMITTEE IS CURRENTLY IN THE PROCESS OF ESTABLISHING THE APPROPRIATE INTERNAL MECHANISMS TO TRACK, MONITOR AND REPORT THESE ACTIVITIES. THE ORGANIZATION IS COMMITTED TO CONTINUING TO PROVIDE THE COMMUNITY BUILDING ACTIVITIES NECESSARY TO MAINTAIN A HEALTHY, PRODUCTIVE AND VIABLE COMMUNITY. PART III, LINE 4: THE ORGANIZATION'S BAD DEBT EXPENSE (AT COST) ON LINE 2 IS CALCULATED USING THE SAME METHODOLOGY AS CHARITY CARE AND OTHER COMMUNITY BENEFITS USING AN ENTITY SPECIFIC COST TO CHARGE RATIO (RCC).BAD DEBT EXPENSE ONLY REPRESENTS ACCOUNTS FOR WHICH COLLECTION EFFORTS HAVE BEEN MADE BUT NO PAYMENTS HAVE BEEN RECEIVED. DISCOUNTS ARE RECORDED AS EITHER CONTRACTUALS (FOR PATIENTS WHO DO NOT QUALIFY FOR CHARITY) OR AS CHARITY (FOR PATIENTS WHO DO QUALIFY FOR CHARITY). THE TEXT OF THE NOVANT HEALTH, INC. CONSOLIDATED FINANCIAL STATEMENTS READS: "THE PROVISION FOR BAD DEBTS IS DETERMINED BASED ON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS, BUSINESS AND ECONOMIC CONDITIONS, THE AGE OF THE ACCOUNTS, TRENDS IN FEDERAL AND STATE GOVERNMENTAL HEALTH CARE COVERAGE AND OTHER COLLECTION INDICATORS." PART III, LINE 8: THE METHODOLOGY USED TO DETERMINE THE MEDICARE ALLOWABLE COSTS REPORTED IN THE ORGANIZATION'S MEDICARE COST REPORT AS REFLECTED IN THE AMOUNT REPORTED IN PART III, LINE 6 IS DETERMINED BY FOLLOWING THE MEDICARE PRINCIPLES OF ALLOWABLE COSTS. COST FOR THE OVERHEAD DEPARTMENTS ARE STEPPED DOWN TO THE REMAINING COST CENTERS BASED ON STATISTICS FOR EACH OVERHEAD COST CENTER. ONCE THE STEP-DOWN PROCESS IS COMPLETE, A RATIO OF COST TO CHARGES IS DEVELOPED FOR EACH COST CENTER. THE RCC IS THEN APPLIED TO THE MEDICARE REVENUE BY COST CENTER AND TOTALED.IT SHOULD BE NOTED THAT THE MEDICARE COST REPORTS DO NOT ADDRESS ANY MANAGED CARE MEDICARE REVENUES, COSTS, OR RELATED SHORTFALL. THE TOTAL REVENUES REPORTED AS RECEIVED FROM MEDICARE IN LINE 5 OF SECTION B ARE ONLY REPRESENTATIVE OF MEDICARE FEE FOR SERVICE PAYMENTS RECEIVED. THE ALLOWABLE COSTS ON LINE 6 ARE SIGNIFICANTLY LOWER THAN THE ACTUAL EXPENDITURES. AS SUCH, THE SHORTFALL IS UNDERESTIMATED. EVERY HOSPITAL TREATS MEDICARE PATIENTS. SOME HOSPITALS ARE LOCATED IN HIGH MEDICARE POPULATION AREAS OR OFFER SERVICES DISPROPORTIONATELY USED BY MEDICARE PATIENTS. MEDICARE RATES AND NUMBERS OF MEDICARE PATIENTS ARE NOT NEGOTIATED. AS REIMBURSEMENT RATES DECLINE RELATIVE TO COSTS OF CARE, HOSPITALS CONTINUE TO SERVE THE MEDICARE POPULATION. WITHOUT THIS SERVICE THESE PATIENTS WOULD BECOME AN OBLIGATION TO THE GOVERNMENT. ANY UNREIMBURSED COSTS OF THIS CARE ARE A COMMUNITY BENEFIT PROVIDED BY THE HOSPITAL TO THE COMMUNITY AND GOVERNMENT. PRESBYTERIAN ORTHOPAEDIC HOSPITAL PART V, SECTION B, LINE 10: ALL UNINSURED PATIENTS RECEIVE A STANDARD DISCOUNT REGARDLESS OF THEIR ABILITY TO PAY. THIS DISCOUNT MIRRORS OUR AVERAGE MANAGED CARE RATE. PATIENTS BELOW 300% OF THE FEDERAL POVERTY GUIDELINES ARE DISCOUNTED AT 100% (3A: FREE CARE). OTHER PATIENTS MAY ALSO BE ELIGIBLE FOR DISCOUNTS FOR BALANCES ABOVE $5,000 (CATASTROPHIC DISCOUNT). BRUNSWICK COMMUNITY HOSPITAL, LLC PART V, SECTION B, LINE 10: ALL UNINSURED PATIENTS RECEIVE A STANDARD DISCOUNT REGARDLESS OF THEIR ABILITY TO PAY. THIS DISCOUNT MIRRORS OUR AVERAGE MANAGED CARE RATE. PATIENTS BELOW 300% OF THE FEDERAL POVERTY GUIDELINES ARE DISCOUNTED AT 100% (3A: FREE CARE). OTHER PATIENTS MAY ALSO BE ELIGIBLE FOR DISCOUNTS FOR BALANCES ABOVE $5,000 (CATASTROPHIC DISCOUNT). PRESBYTERIAN ORTHOPAEDIC HOSPITAL PART V, SECTION B, LINE 17E: PRESBYTERIAN ORTHOPAEDIC HOSPITAL:PART V, SECTION B, LINES 15, 16, AND 17:WE DID NOT CHECK ANYTHING FOR QUESTION 15, 16 AND 17 BECAUSE WE PROCEED WITH ALL REASONABLE EFFORTS TO DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE PRIOR TO INITIATING ANY COLLECTION ACTIONS. BRUNSWICK COMMUNITY HOSPITAL, LLC PART V, SECTION B, LINE 17E: BRUNSWICK COMMUNITY HOSPITAL, LLC:PART V, SECTION B, LINES 15, 16, AND 17:WE DID NOT CHECK ANYTHING FOR QUESTION 15, 16 AND 17 BECAUSE WE PROCEED WITH ALL REASONABLE EFFORTS TO DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE PRIOR TO INITIATING ANY COLLECTION ACTIONS. PRESBYTERIAN ORTHOPAEDIC HOSPITAL PART V, SECTION B, LINE 19D: THE HOSPITAL FACILITY USED THE AVERAGE OF ITS NEGOTIATED COMMERCIAL INSURANCE RATES WHEN CALCULATING THE MAXIMUM AMOUNTS THAT CAN BE CHARGED. BRUNSWICK COMMUNITY HOSPITAL, LLC PART V, SECTION B, LINE 19D: THE HOSPITAL FACILITY USED THE AVERAGE OF ITS NEGOTIATED COMMERCIAL INSURANCE RATES WHEN CALCULATING THE MAXIMUM AMOUNTS THAT CAN BE CHARGED. PART VI, LINE 2: NEEDS ASSESSMENTTHE ORGANIZATION IS PART OF THE NOVANT HEALTH CARE SYSTEM, WHICH HAS A COMMUNITY BENEFIT COMMITTEE. THE COMMUNITY BENEFIT COMMITTEE IS RESPONSIBLE FOR ASSISTING THE HOSPITALS WITHIN THE HEALTH CARE SYSTEM WITH PREPARING COMMUNITY NEEDS ASSESSMENTS. THE COMMUNITY BENEFIT COMMITTEE IS MADE OF INDIVIDUALS REPRESENTING CORPORATE-WIDE DEPARTMENTS, SUCH AS COMMUNITY RELATIONS, LEGAL, TAX, INTERNAL AUDIT, MARKETING/COMMUNICATIONS, AS WELL AS INDIVIDUALS FROM VARIOUS DEPARTMENTS OF HOSPITAL OPERATIONS AND THE HEALTH CARE SYSTEM'S HOSPITAL FOUNDATIONS. EACH HOSPITAL, WITH THE ASSISTANCE OF THE COMMUNITY BENEFIT COMMITTEE, WILL IDENTIFY ORGANIZATIONS AND RESOURCES WITHIN ITS COMMUNITY TO CONTRIBUTE TO THE HOSPITAL'S COMMUNITY NEEDS ASSESSMENT. THESE ORGANIZATIONS AND RESOURCES INCLUDE LOCAL HEALTH DEPARTMENTS, UNITED WAY, UNIVERSITIES, PUBLIC HEALTH DEPARTMENTS, ETC. THE EXISTING COMMUNITY HEALTH ASSESSMENTS PREPARED BY OTHER ORGANIZATIONS IN THE COMMUNITY WILL BE COMBINED WITH INTERNAL HOSPITAL DATA AND INFORMATION COLLECTED FROM LOCAL AGENCIES TO BECOME THE HOSPITAL'S COMMUNITY NEEDS ASSESSMENT. EACH HOSPITAL HAS ALSO TRADITIONALLY RESPONDED TO REQUESTS FOR CERTAIN COMMUNITY BENEFIT ACTIVITIES OR PROGRAMS FROM PUBLIC AGENCIES OR COMMUNITY GROUPS AND THIS WILL ALSO BE INCLUDED IN THE HOSPITAL'S COMMUNITY NEEDS ASSESSMENT. ONCE THE COMMUNITY NEEDS ASSESSMENT IS COMPLETED, WHICH WILL BE EVERY THREE YEARS, THE HOSPITAL WILL PRIORITIZE THE NEEDS BY DETERMINING WHAT HOSPITAL RESOURCES ARE AVAILABLE TO MEET THE NEEDS AND WHAT OTHER COMMUNITY RESOURCES ARE BEING USED TO MEET A PARTICULAR NEED. THE HOSPITAL WILL DEVELOP A COMMUNITY BENEFIT PLAN, WHICH WILL BE REVIEWED AND UPDATED AS NECESSARY, AT LEAST EVERY THREE YEARS. ALL HOSPITALS' COMMUNITY NEEDS ASSESSMENTS WILL BE MADE AVAILABLE TO THE PUBLIC. PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCEAS A NOT-FOR-PROFIT ORGANIZATION, NOVANT HEALTH IS COMMITTED TO PROVIDING OUTSTANDING HEALTH CARE TO ALL MEMBERS OF OUR COMMUNITIES, REGARDLESS OF THEIR ABILITY TO PAY. OUR ACUTE CARE FACILITIES PROVIDE CARE IN 35 COUNTIES ACROSS THREE STATES. ADDITIONALLY, OUR PHYSICIANS AND ACUTE CARE FACILITIES OFFER CARE TO NATIONAL AND INTERNATIONAL MISSION PATIENTS. OUR FINANCIAL COUNSELING TEAMS ARE CONSTANTLY WORKING WITH THE PATIENTS WITHIN OUR COMMUNITIES TO UNDERSTAND THEIR NEEDS AND ENSURE THAT OUR POLICIES AND PROCESSES ADDRESS THESE NEEDS. WE ALSO MAINTAIN CONTRACTS WITH MEDICAID ELIGIBILITY VENDORS AND LOCAL DEPARTMENT OF SOCIAL SERVICES TEAMS TO HAVE EMBEDDED CASE WORKERS WITHIN OUR FACILITIES. THESE TEAMS OFFER ADDITIONAL SUPPORT IN PROCESSING AND ASSESSING HOW WE SERVE THE FINANCIAL NEEDS OF OUR PATIENTS. BASED ON THE ASSESSMENTS OF OUR COMMUNITIES, NOVANT HEALTH HAS DEVELOPED FINANCIAL ASSISTANCE POLICIES AND PROGRAMS THAT ADDRESS THE FINANCIAL NEEDS OR OUR PATIENTS. - UNINSURED PATIENTS WITH INCOMES OF UP TO 300% OF THE FEDERAL POVERTY LEVEL ARE ELIGIBLE FOR 100% WRITE-OFF. - UNINSURED PATIENTS WITH INCOME OVER 300% OF THE FEDERAL POVERTY LEVEL ARE ELIGIBLE FOR SELF-PAY DISCOUNTS BASED ON THE PATIENT'S ANNUAL INCOME AND OUTSTANDING MEDICAL BILLS / COSTS. - ANY PATIENT (EVEN WITH HEALTH INSURANCE) WITH A BALANCE OVER $5,000 AND / OR INCOME OVER 300% OF THE FEDERAL POVERTY LEVEL IS ELIGIBLE FOR A CATASTROPHIC DISCOUNT. OUR CATASTROPHIC DISCOUNTS ARE ALSO BASED ON THE PATIENT'S ANNUAL INCOME AND OUTSTANDING MEDICAL BILLS / COSTS.- ANY PATIENT IS ELIGIBLE FOR AN INDIVIDUALIZED PAYMENT PLAN BASED ON THE AMOUNT DUE AND THE PATIENT'S FINANCIAL STATUS, WITH TERMS EXTENDING UP TO FIVE YEARS. NO INTEREST IS CHARGED, UNLESS APPROPRIATE. WE PRIDE OURSELVES IN THE TRANSPARENCY OF OUR PROGRAMS AND THE EDUCATION WE OFFER OUR PATIENTS AROUND OUR FINANCIAL ASSISTANCE POLICIES. OUR PROGRAMS ARE DOCUMENTED ON OUR CORPORATE WEBSITE AS WELL AS EACH INDIVIDUAL FACILITY'S WEBSITE, ALONG WITH CONTACT INFORMATION FOR OUR FINANCIAL COUNSELORS. ADDITIONALLY, OUR PROGRAMS ARE DOCUMENTED ON PATIENT FLYERS THROUGHOUT THE NOVANT AFFILIATED FACILITIES AND PHYSICIAN OFFICES. OUR PATIENT ACCESS SPECIALISTS, FINANCIAL COUNSELORS AND BUSINESS OFFICE TEAMS WORK WITH ALL SELF-PAY PATIENTS AND INSURED PATIENTS WITH HIGH DEDUCTIBLES TO EDUCATE THEM ON THE VARIOUS OPTIONS AVAILABLE VIA OUR FINANCIAL ASSISTANCE PROGRAMS OR GOVERNMENT SPONSORED CARE. FINALLY, WE WORK WITH LOCAL AREA FREE HEALTH CLINICS AND OTHER CHARITABLE ORGANIZATIONS TO PROVIDE CONTINUATION OF CARE FOR THEIR PATIENTS. IN ADDITION TO OUR FINANCIAL COUNSELING PROCESSES USED TO IDENTIFY CHARITY CARE PATIENTS, OUR COLLECTIONS PROCESSES WITHIN OUR BUSINESS OFFICES ALSO HELP IDENTIFY PATIENTS WHO ARE ALREADY ELIGIBLE FOR CHARITY OR WHO MAY BE ELIGIBLE BASED ON THEIR STATUS WITHIN THE FEDERAL POVERTY GUIDELINES ("FPG"). WE UTILIZE PREVIOUSLY SUBMITTED PATIENT DOCUMENTATION AND CREDIT AGENCY REPORTED FPG FOR DETERMINATION. SUPPORTING DOCUMENTS ARE VALID 6 MONTHS FROM THE DATE OF SUBMISSION. OUR POLICIES ARE CONSIDERED FLUID AND ARE UPDATED FREQUENTLY BASED ON LOCAL AND NATIONAL MARKET STANDARDS AND NATIONAL ECONOMIC CONDITIONS. ANY UPDATES TO OUR POLICIES REQUIRE MULTI-LEVEL LEADERSHIP APPROVAL AND ARE ULTIMATELY APPROVED BY THE NOVANT EXECUTIVE TEAM. PART VI, LINE 4: COMMUNITY INFORMATIONTHE NOVANT HEALTH, INC. FORM 990 INCLUDES THE OPERATIONS OF TWO HOSPITALS. BRUNSWICK COMMUNITY HOSPITAL THE ORGANIZATION DEFINES ITS COMMUNITY BY ITS PRIMARY SERVICE AREA, WHICH IS BRUNSWICK COUNTY, NORTH CAROLINA. THIS IS A RURAL AREA. THERE ARE TWO ACUTE CARE HOSPITALS IN THE COMMUNITY, ONE OF WHICH IS THE ORGANIZATION. THE OTHER HOSPITAL IS DESIGNATED AS A CRITICAL ACCESS HOSPITAL. ACCORDING TO TRUVEN HEALTH DATA, THE SPECIFIC POPULATION GROUPS (ETHNIC AND CULTURAL) ARE AS FOLLOWS: WHITE NON-HISPANIC (91,402) 80.8%; BLACK NON-HISPANIC (12,157) 10.7%; HISPANIC (6,307) 5.6%; ASIAN AND PACIFIC ISLAND (674) 0.6%; OTHERS (2,586) 2.3%; FOR A TOTAL POPULATION OF 113,126. ACCORDING TO TRUVEN HEALTH DATA, THE MEDIAN HOUSEHOLD INCOME LEVEL WAS $42,358. ACCORDING TO TRUVEN HEALTH DATA, THE AGE BREAKDOWN IS AS FOLLOWS: 0-17 YEARS (21,127) 18.7%; 18-64 YEARS (68,756) 60.8%; 65+ YEARS (23,243) 20.5%PRESBYTERIAN ORTHOPAEDIC HOSPITAL THE ORGANIZATION DEFINES ITS COMMUNITY BY ITS PRIMARY SERVICE AREA, WHICH IS MECKLENBURG COUNTY, NORTH CAROLINA.THERE ARE FOUR NONPROFIT HOSPITALS IN THE COMMUNITY, ONE OF WHICH IS THE ORGANIZATION AND ALL OF WHICH ARE PART OF THE NOVANT HEALTH CARE SYSTEM. THERE ARE ALSO FOUR GOVERNMENTAL HOSPITALS, WHICH ARE ALL PART OF THE SAME HEALTH CARE SYSTEM. ACCORDING TO TRUVEN HEALTH DATA, THE SPECIFIC POPULATION GROUPS (ETHNIC AND CULTURAL) FOR ARE AS FOLLOWS: WHITE NON-HISPANIC (475,012) 49.1%; BLACK NON-HISPANIC (294,616) 30.5%; HISPANIC (126,051) 13.0%; OTHERS (24,126) 2.5%; ASIAN AND PACIFIC ISLAND (47,062) 4.9%; FOR A TOTAL POPULATION OF 966,867. ACCORDING TO TRUVEN HEALTH DATA, THE MEDIAN HOUSEHOLD INCOME LEVEL WAS $56,825. ACCORDING TO TRUVEN HEALTH DATA, THE AGE BREAKDOWN IS AS FOLLOWS: 0-17 YEARS (253,670) 26.2%; 18-64 YEARS (631,107) 65.3%; 65+ YEARS (82,090) 8.5% PART VI, LINE 5: PROMOTION OF COMMUNITY HEALTHTHE ORGANIZATION FURTHERS ITS EXEMPT PURPOSES BY DOING THE FOLLOWING:1. ADOPTING A CHARITY CARE POLICY, WHICH PROVIDES FREE CARE TO INDIVIDUALS WHOSE INCOME IS AT OR BELOW 300% OF THE FEDERAL POVERTY LEVEL;2. REMAINING CERTIFIED BY THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES TO PROVIDE SERVICES TO ALL BENEFICIARIES OF MEDICARE, MEDICAID, AND OTHER GOVERNMENT PAYMENT PROGRAMS, AND PROVIDING SERVICES IN A NONDISCRIMINATORY MANNER TO SUCH BENEFICIARIES;3. OPERATING A FULL-TIME EMERGENCY ROOM WHICH IS OPEN TO AND ACCEPTS ALL PERSONS, REGARDLESS OF THEIR ABILITY TO PAY; 4. MAINTAINING AN OPEN MEDICAL STAFF, SUBJECT TO EXCLUSIVE CONTRACTS FOR HOSPITAL-BASED SERVICES SUCH AS ANESTHESIOLOGY, RADIOLOGY, PATHOLOGY, HOSPITALIST, AND EMERGENCY DEPARTMENT SERVICES, TO THE EXTENT AN EXCLUSIVE CONTRACT FOR THOSE SERVICES IS REQUIRED TO OBTAIN PROPER STAFFING COVERAGE OR TO PERMIT A MORE EFFICIENT DELIVERY OF THOSE SERVICES WITHIN THE HOSPITAL FACILITY;5. MAINTAINING A GOVERNING BOARD CONSISTING PRIMARILY OF A BROAD CROSS-SECTION OF LEADERS IN THE COMMUNITY; 6. ADOPTING AND APPLYING A CONFLICT OF INTEREST POLICY, WHICH APPLIES TO THE GOVERNING BOARD AND ORGANIZATION OFFICERS;7. PROVIDING HEALTH EDUCATION LECTURES AND WORKSHOPS; 8. PROVIDING HEALTH FAIRS, EDUCATION ON SPECIFIC DISEASES OR CONDITIONS, AND HEALTH PROMOTION AND WELLNESS PROGRAMS TO THE COMMUNITIES IT SERVES; 9. PROVIDING SUPPORT GROUPS AND SELF HELP PROGRAMS TO THE COMMUNITIES IT SERVES; 10. PROVIDING COMMUNITY-BASED CLINICAL SERVICES, INCLUDING WITHOUT LIMITATION, HEALTH SCREENINGS AND CLINICS FOR UNINSURED OR UNDERINSURED PERSONS TO THE COMMUNITIES IT SERVES; 11. PROVIDING HEALTH CARE SUPPORT SERVICES, INCLUDING WITHOUT LIMITATION, INFORMATION AND REFERRAL TO COMMUNITY SERVICES, CASE MANAGEMENT OF UNDERINSURED AND UNINSURED PERSONS, TELEPHONE INFORMATION SERVICES AND ASSISTANCE TO ENROLL IN PUBLIC PROGRAMS, SUCH AS SCHIP AND MEDICAID TO THE COMMUNITIES IT SERVES; 12. PROVIDING SUBSIDIZED HEALTH SERVICES AND CLINICAL PROGRAMS TO THE COMMUNITIES IT SERVES; 13. PROVIDING CASH AND IN-KIND CONTRIBUTIONS TO NONPROFIT COMMUNITY HEALTH CARE ORGANIZATIONS IN THE COMMUNITIES IT SERVES; AND14. GENERALLY PROMOTING THE HEALTH, WELLNESS, AND WELFARE OF THE COMMUNITIES IT SERVES BY PROVIDING QUALITY HEALTH CARE SERVICES AT REASONABLE COST.FOR SPECIFIC EXAMPLES OF THIS ORGANIZATION'S COMMUNITY BENEFIT ACTIVITIES, WHICH FURTHER THE ORGANIZATION'S EXEMPT PURPOSES (AND THOSE OF ALL HOSPITALS AND HEALTH CARE FACILITIES IN THE SAME HEALTH CARE SYSTEM), PLEASE SEE THE NOVANT HEALTH COMMUNITY BENEFIT REPORT, LOCATED AT HTTP://WWW.NOVANTHEALTH.ORG/GIVEBACK/COMMUNITYBENEFITREPORT.ASPX.PLEASE NOTE THAT THE NUMERIC INFORMATION IN THIS REPORT IS NOT BASED UPON THE FORM 990, SCHEDULE H CRITERIA, BUT RATHER IT HAS BEEN PREPARED IN ACCORDANCE WITH THE NORTH CAROLINA HOSPITAL ASSOCIATION REPORTING GUIDELINES. PART VI, LINE 6: AFFILIATED HEALTH CARE SYSTEMTHE ORGANIZATION IS ONE OF TEN TAX-EXEMPT HOSPITALS IN THE NOVANT HEALTH CARE SYSTEM IN NORTH CAROLINA AND VIRGINIA. EACH HOSPITAL PROVIDES SUBSTANTIAL COMMUNITY BENEFIT TO THE COMMUNITY IT SERVES, AS REPORTED INDIVIDUALLY ON EACH HOSPITAL'S FORM 990, SCHEDULE H. THE COMMUNITY BENEFIT OF THE HEALTH CARE SYSTEM AS A WHOLE IS DOCUMENTED IN A SYSTEM-WIDE COMMUNITY BENEFIT REPORT, LOCATED AT HTTP://WWW.NOVANTHEALTH.ORG/GIVEBACK/COMMUNITYBENEFITREPORT.ASPX.PLEASE NOTE THAT THE NUMERIC INFORMATION IN THIS REPORT IS NOT BASED UPON THE FORM 990, SCHEDULE H CRITERIA, BUT RATHER IT HAS BEEN PREPARED IN ACCORDANCE WITH THE NORTH CAROLINA HOSPITAL ASSOCIATION REPORTING GUIDELINES. THE NOVANT HEALTH CARE SYSTEM ALSO INCLUDES AN ORGANIZATION THAT OWNS PHYSICIAN PRACTICES IN VIRGINIA, SOUTH CAROLINA, AND NORTH CAROLINA, WHICH PROVIDE ADDITIONAL COMMUNITY BENEFIT TO THEIR COMMUNITIES, AND FIVE HOSPITAL FOUNDATIONS, WHICH SUPPORT AND ENHANCE THE COMMUNITY BENEFIT ACTIVITIES IN THOSE HOSPITAL'S COMMUNITIES. FURTHER, THE NOVANT HEALTH CARE SYSTEM INCLUDES AMBULATORY SURGERY CENTERS, SKILLED NURSING FACILITIES, REHABILITATION PROGRAMS, AND OTHER OUTPATIENT FACILITIES, WHICH ALSO PROVIDE COMMUNITY BENEFIT TO THEIR COMMUNITIES. THERE ARE SIGNIFICANT COMMUNITY BENEFIT ACTIVITIES WITHIN THE NOVANT HEALTH SYSTEM, WHICH MAY NOT BE REPORTABLE ON A SCHEDULE H BECAUSE THEY ARE NOT CONDUCTED BY AN ENTITY WHICH OWNS OR OPERATES A HOSPITAL. THE HEALTH CARE SYSTEM HAS A COMMUNITY BENEFIT COMMITTEE, WHICH WILL OVERSEE AND ASSIST ALL TAX-EXEMPT HOSPITALS WITHIN NOVANT IN PREPARING THEIR COMMUNITY NEEDS ASSESSMENTS AND COMMUNITY BENEFIT PLANS. THE GOAL OF HAVING A SYSTEM-WIDE COMMITTEE IS TO IDENTIFY COMMUNITY BENEFIT ACTIVITIES THAT ARE DUPLICATIVE IN COMMUNITIES AND TO STREAMLINE AND COORDINATE EFFORTS TO RESULT IN BETTER AND MORE EFFICIENT USES OF RESOURCES, WHICH COULD LEAD TO ADDITIONAL RESOURCES TO BE ALLOCATED TO MEET OTHER COMMUNITY NEEDS, AND TO REPLICATE SUCCESSFUL PROGRAMS AND ACTIVITIES IN COMMUNITIES WHERE A SIMILAR NEED IS INDICATED. ALL OF THE TAX-EXEMPT HOSPITALS WITHIN THE NOVANT HEALTH CARE SYSTEM ARE COMMITTED TO IMPROVING THE HEALTH OF THEIR COMMUNITIES AND PROVIDING COMMUNITY BENEFIT ACTIVITIES TO SUPPORT THEIR MISSION. PART VI, LINE 7, STATE FILING OF COMMUNITY BENEFIT REPORT NOVANT HEALTH, INC. FILES A SYSTEM-WIDE COMMUNITY BENEFIT REPORT PREPARED IN ACCORDANCE WITH THE NORTH CAROLINA HOSPITAL ASSOCIATION REPORTING GUIDELINES WITH THE NORTH CAROLINA MEDICAL CARE COMMISSION AS PART OF THE DOCUMENTATION REQUIRED FOR THE ISSUANCE OF TAX EXEMPT BOND FINANCING. 1 WINSTON SALEM FOUNDATION 860 W 5TH STREET WINSTON SALEM NC 27101 566037615 501(C)(3) 209000 CONTRIBUTION WINSTON SALEM FORSYTH COUNTY BOARD OF EDUCATION PO BOX 2513 WINSTON SALEM NC 27102 WSFC BOARD OF ED 4035362 BOOK LAND COMMUNITY DEVELOPMENT NORTH CAROLINA NEW SCHOOLS PROJECT 460 MARRIOTT DRIVE SUITE 510 RALEIGH NC 27612 204031703 501(C)(3) 25000 CONTRIBUTION BRUNSWICK NOVANT MEDICAL CENTER FOUNDATION 2085 FRONTIS PLAZA BLVD WINSTON SALEM NC 27103 274616751 501(C)(3) 208653 CONTRIBUTION ROWAN REGIONAL MEDICAL CENTER FOUNDATION 2085 FRONTIS PLAZA BLVD WINSTON SALEM NC 27103 561424818 501(C)(3) 126052 MATCHING GIFT 5 0 PART I, LINE 2 - PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS THE ORGANIZATION IS AN AFFILIATE IN AN INTEGRATED HEALTH CARE SYSTEM AND FOLLOWS A SYSTEM-WIDE CORPORATE POLICY WITH STANDARDIZED GUIDELINES THAT ARE TO BE USED IN REVIEWING THE ELIGIBILITY AND SELECTION OF GRANTEES RECEIVING CERTAIN EXEMPT PURPOSE FUNDS. THE ORGANIZATION MAINTAINS DOCUMENTATION OF THE ELIGIBILITY AND SELECTION CRITERIA AND RECORDS OF THE AMOUNTS ARE MAINTAINED VIA THE GENERAL LEDGER. FUNDS ARE GENERALLY NOT TRACKED AFTER BEING GRANTED, AS THE ORIGINAL ELIGIBILITY AND SELECTION CRITERIA HAVE ALREADY BEEN MET. X X X X X X 1 1 X X X X 0 1 1 0 0 0 0 0 0 WILESPAUL M 1018206 0 997255 0 235685 0 14700 0 29629 0 2295475 0 1144826 0 ALUKOAKINYELE OLAWALE 0 557505 0 52019 0 9902 0 14700 0 16996 0 651122 0 52019 HARGETTFRED MCDOWELL 517638 0 407360 0 56232 0 470758 0 25416 0 1477404 0 407360 0 ARMATOCARL STEVEN 699113 0 652760 0 35217 0 883616 0 30408 0 2301114 0 652760 0 BARTONICHOLAS MICHAEL 278625 0 150000 0 33401 0 22200 0 31453 0 515679 0 150000 0 BEIERGREGORY 622574 0 649505 0 3516472 0 275551 0 24782 0 5088884 0 2465772 0 BESTDIANA LEE 301313 0 221880 0 378634 0 359723 0 18246 0 1279796 0 578586 0 DANIELSJACQUELINE RENE 507002 0 476950 0 66440 0 469834 0 21578 0 1541804 0 476950 0 GARRETTDAVID BRIAN 348761 0 207050 0 24493 0 22200 0 23537 0 626041 0 207050 0 HEARN IIITHOMAS KERMIT 72908 0 306670 0 240188 0 11751 0 26800 0 658317 0 166985 0 JOHNSONTONY W 262419 0 172200 0 112516 0 348719 0 4657 0 900511 0 258197 0 LINERSALLYE ANN 470157 0 440335 0 679189 0 157940 0 21863 0 1769484 0 1087335 0 MCGEELAWRENCE UPCHURCH 394252 0 277860 0 416097 0 400397 0 23368 0 1511974 0 673197 0 MIHALDENISE BARBARA 233915 0 153090 0 24918 0 194495 0 10651 0 617069 0 153090 0 MILLERMARK FREDERICK 292904 0 110500 0 39577 0 9231 0 23713 0 475925 0 110500 0 MORGANWAYNE FORREST 311081 0 213580 0 11173 0 21781 0 24961 0 582576 0 213580 0 PARKDAVID G 260869 0 189200 0 176581 0 324522 0 19573 0 970745 0 320872 0 PATEFIELDARTHUR J 379190 0 262650 0 2984116 0 457545 0 33650 0 4117151 0 1303295 0 SEEHAUSEN JRROBERT H 323587 0 217500 0 28493 0 317376 0 24202 0 911158 0 217500 0 SMITH-HILLJANET 308719 0 200400 0 24850 0 22200 0 19398 0 575567 0 200400 0 TOBALSKIJIM GEORGE 297622 0 194930 0 305719 0 391963 0 17949 0 1208183 0 471830 0 WALLENHAUPTSTEPHEN L 475517 0 466195 0 555399 0 631499 0 24532 0 2153142 0 976412 0 WEBERDANIELLE B 244632 0 167200 0 35686 0 22200 0 15585 0 485303 0 167200 0 GARDELLAJOHN E 264220 0 77875 0 23701 0 14700 0 15800 0 396296 0 77875 0 GARMON-BROWNOPHELIA E 303401 0 81117 0 34317 0 22200 0 20826 0 461861 0 81117 0 LEDERER JRJAMES W 303860 0 86265 0 7287 0 25958 0 24082 0 447452 0 86265 0 MOGULMARK JEFFREY 364714 0 80000 0 13502 0 9195 0 26753 0 494164 0 80000 0 MYERSSCOTT A 233729 0 135850 0 22878 0 14938 0 16455 0 423850 0 135850 0 WOOLLEN JRTHOMAS H 251984 0 0 0 1068606 0 14700 0 24712 0 1360002 0 12945 0 PART I, LINE 1A FIRST-CLASS OR CHARTER TRAVEL: FIRST-CLASS OR CHARTER TRAVEL IS NOT A COVERED TRAVEL EXPENSE FOR EXECUTIVES; THEY ARE LIMITED TO BUSINESS OR COACH CLASS FARES FOR COMMERCIAL FLIGHTS. HOWEVER, CHARTER TRAVEL IS AVAILABLE TO CERTAIN EXECUTIVES, BOARD MEMBERS, AND APPROVED BUSINESS PERSONNEL IN LIMITED CIRCUMSTANCES DEEMED TO INVOLVE BUSINESS NECESSITY. TRAVEL FOR COMPANIONS: COMPANIONS ARE ALLOWED ON CERTAIN CHARTER FLIGHTS PAID FOR BY THE ORGANIZATION. IN THAT CASE, THE VALUE OF THE COMPANION'S FLIGHT IS CALCULATED UNDER APPLICABLE TAX LAWS AND THAT AMOUNT IS INCLUDED IN THE EXECUTIVE'S TAXABLE INCOME AS PRESCRIBED BY THE APPLICABLE TAX LAWS. TAX INDEMNIFICATION AND GROSS-UP PAYMENTS: EXECUTIVES WHO PURCHASE SPLIT DOLLAR INSURANCE THROUGH THEIR DISCRETIONARY SPENDING ACCOUNT MAY HAVE THE ADDITIONAL INCOME TAX OWED ON THE PS-58 COSTS PAID BY THE ORGANIZATION. EXECUTIVES WHO RECEIVE TAXABLE RELOCATION INCOME MAY HAVE THE ADDITIONAL INCOME TAX OWED ON THE INCOME PAID BY THE ORGANIZATION. EXECUTIVES MAY RECEIVE AS SEVERANCE BENEFITS CASH PAYMENTS IN LIEU OF PREMIUMS PAID FOR COVERAGE OF CERTAIN GROUP BENEFITS THAT ENDED WITH THE EXECUTIVE'S TERMINATION. THE ORGANIZATION MAY PAY THE ADDITIONAL TAX OWED ON ACCOUNT OF THESE PAYMENTS. DISCRETIONARY SPENDING ACCOUNT: CERTAIN EXECUTIVES RECEIVE A DISCRETIONARY SPENDING ACCOUNT. THE DOLLAR AMOUNT IN THE ACCOUNT IS PRE-APPROVED BY THE COMPENSATION AND LEADERSHIP COMMITTEE OF THE BOARD. THE ACCOUNT CAN BE USED ONLY FOR AN APPROVED LIST OF EXPENDITURES. ALL OPTIONS OTHER THAN A DEFERRED, AT-RISK, COMPENSATION OPTION ARE CONSIDERED TAXABLE AND ARE INCLUDED IN THE EXECUTIVE'S TAXABLE INCOME AS PRESCRIBED BY THE APPLICABLE TAX LAWS. HOUSING ALLOWANCE OR RESIDENCE FOR PERSONAL USE: WE PROVIDE TEMPORARY HOUSING ALLOWANCES IN CERTAIN EXECUTIVE RECRUITMENT AND RELOCATION PACKAGES. IN THE CASE THAT SUCH EXPENSE IS NOT REIMBURSABLE UNDER THE ACCOUNTABLE PLAN RULES, THE VALUE IS CALCULATED UNDER APPLICABLE TAX LAWS AND THAT AMOUNT IS INCLUDED IN THE EXECUTIVE'S INCOME AS PRESCRIBED BY THE APPLICABLE TAX LAWS. THE ORGANIZATION PROVIDES A TEMPORARY RESIDENCE FOR LIMITED EXECUTIVE USE THAT AT TIMES MAY INCLUDE INCIDENTAL PERSONAL USE. IN THAT CASE, THE VALUE IS CALCULATED UNDER APPLICABLE TAX LAWS AND THAT AMOUNT IS INCLUDED IN THE EXECUTIVE'S TAXABLE INCOME AS PRESCRIBED BY THE APPLICABLE TAX LAWS. HEALTH OR SOCIAL CLUB DUES OR INITIATION FEES: IN CASES WHERE CORPORATE MEMBERSHIPS ARE NOT AVAILABLE, A MEMBERSHIP MAY BE OBTAINED IN AN EXECUTIVE'S NAME WITH A "BUSINESS USE ONLY" RESTRICTION. AT THIS TIME NOVANT HAS ONE SUCH MEMBERSHIP. PART I, LINES 4B-C SEVERANCE, NONQUALIFIED, AND EQUITY-BASED PAYMENTS SEVERANCE NONQUALIFIED EQUITY-BASED BEIER, GREGORY 3,466,826 BEST, DIANA LEE 356,706 HEARN III, THOMAS 181,081 JOHNSON, TONY W 85,977 MCGEE, LAWRENCE UPCHURCH 395,337 LINER, SALLYE 647,000 PARK, DAVID G. 131,672 PATEFIELD, ARTHUR J 2,939,088 TOBALSKI, JIM GEORGE 276,900 WALLENHAUPT, STEPHEN L 510,217 WILES, PAUL 147,571 WOOLLEN JR., THOMAS H 1,054,075 12,945 SUPPLEMENTAL INFORMATION PART III PART III - OTHER ADDITIONAL INFORMATION DESCRIPTIONS OF SUPPLEMENTAL EXECUTIVE BENEFITS INCLUDED IN PART VII AND SCHEDULE J: EXECUTIVE ANNUAL INCENTIVE PLAN: AS PART OF THE REPORTED COMPENSATION AMOUNTS, THE REPORTING ORGANIZATION PROVIDES ANNUAL INCENTIVE COMPENSATION TO OFFICERS AND KEY EMPLOYEES UNDER AN EXECUTIVE ANNUAL INCENTIVE PLAN. THE INCENTIVE PLAN IS DESIGNED TO OFFER OPPORTUNITIES FOR ADDITIONAL COMPENSATION, BUT ONLY TO THE EXTENT THAT ELIGIBLE EXECUTIVES HAVE PROVIDED EXTRAORDINARY SERVICES AND ACHIEVED EXTRAORDINARY RESULTS THAT MEET OR EXCEED PREDETERMINED GOALS IN THE AREAS OF QUALITY, PATIENT SATISFACTION, EMPLOYEE SATISFACTION AND FINANCIAL VITALITY. THESE GOALS ARE ESTABLISHED AND APPROVED BY INDEPENDENT AND DISINTERESTED MEMBERS OF THE NOVANT HEALTH BOARD OF TRUSTEES (WHO COMPRISE THE COMPENSATION AND LEADERSHIP COMMITTEE OF THE BOARD). THESE GOALS ARE WEIGHTED EQUALLY. THE ADDITIONAL COMPENSATION CAN RANGE ANYWHERE FROM ZERO TO A MAXIMUM PERCENTAGE OF BASE SALARY THAT DIFFERS BY THE CLASS OF EXECUTIVE; THIS MAXIMUM PERCENTAGE RANGES FROM 30% TO 70% OF BASE SALARY. IN ADDITION, THE INDEPENDENT MEMBERS OF THE BOARD OF TRUSTEES WHO OVERSEE THE INCENTIVE COMPENSATION PROGRAM APPLY TWO "CIRCUIT BREAKERS," WHICH ARE SUBSTANTIAL LEVELS OF ORGANIZATION-WIDE ACHIEVEMENT THAT MUST BE SATISFIED BEFORE ANY AWARDS ARE PAID TO ANY EXECUTIVE UNDER THE PROGRAM. THE INCENTIVE COMPENSATION AWARDS HAVE BEEN INCLUDED IN THE COMPENSATION AMOUNTS REPORTED IN PART VII AND IN COLUMN (B)(II) OF SCHEDULE J. THEY ARE REPORTED IN THE YEAR PAID. INDEPENDENT AND DISINTERESTED MEMBERS OF THE NOVANT HEALTH BOARD OF TRUSTEES (WHO COMPRISE THE COMPENSATION AND LEADERSHIP COMMITTEE OF THE BOARD) REVIEW, APPROVE, AND OVERSEE ALL ASPECTS AND ALL ELEMENTS OF EXECUTIVE COMPENSATION AND BENEFITS, INCLUDING THE AMOUNTS AWARDED UNDER THIS ANNUAL INCENTIVE PLAN. LONG-TERM INCENTIVE PLAN: THE REPORTING ORGANIZATION OFFERS A LONG-TERM INCENTIVE PLAN (THE "PLAN") TO CERTAIN KEY EXECUTIVES. THE PLAN TIES A KEY EXECUTIVE'S COMPENSATION TO THE ORGANIZATION'S LONG-TERM STRATEGIC PERFORMANCE, PROVIDES A RETENTION INCENTIVE FOR KEY EXECUTIVES, AND ALLOWS THE ORGANIZATION TO COMPETE IN THE MARKETPLACE FOR TOP LEADERSHIP TALENT. THE PLAN OPERATES ON THREE-YEAR PERFORMANCE CYCLES THAT BEGIN EACH YEAR. LONG-TERM STRATEGIC GOALS (IN THE PRINCIPAL AREAS OF QUALITY OF PATIENT CARE AND LONG-TERM FINANCIAL STRENGTH) ARE ESTABLISHED AND APPROVED FOR EACH CYCLE, IN ADVANCE, BY INDEPENDENT AND DISINTERESTED MEMBERS OF THE NOVANT HEALTH BOARD OF TRUSTEES (WHO COMPRISE THE COMPENSATION AND LEADERSHIP COMMITTEE OF THE BOARD). A MINIMUM LEVEL OF COMMUNITY BENEFIT AND CHARITY CARE, AS WELL AS A MINIMUM LEVEL OF FINANCIAL PERFORMANCE, IS REQUIRED BEFORE ANY AWARD CAN BE PAID UNDER THE PLAN. NOVANT HEALTH'S INTERNAL AUDIT DEPARTMENT REVIEWS THE METHODOLOGY AND PROCESS USED TO DETERMINE ACHIEVEMENT OF THE QUALITY METRICS. AWARDS ARE PAYABLE FOR A PARTICULAR THREE-YEAR PERFORMANCE CYCLE ONLY IF THE REQUISITE LEVEL OF COMMUNITY BENEFIT AND CHARITY CARE, ALONG WITH THE REQUIRED LEVEL OF FINANCIAL PERFORMANCE TO DEMONSTRATE LONG-TERM FINANCIAL STRENGTH, HAVE BEEN MET FOR THAT RESPECTIVE THREE-YEAR PERFORMANCE PERIOD. IF AN AWARD IS EARNED AT THE END OF A PERFORMANCE CYCLE, THEN THE INCENTIVE AWARD IS PAID OUT AND IS INCLUDED IN THE COMPENSATION AMOUNTS REPORTED IN PART VII AND IN COLUMN (B)(II) OF SCHEDULE J. THEY ARE REPORTED IN THE YEAR PAID. INDEPENDENT AND DISINTERESTED MEMBERS OF THE NOVANT HEALTH BOARD OF TRUSTEES (WHO COMPRISE THE COMPENSATION AND LEADERSHIP COMMITTEE OF THE BOARD) REVIEW, APPROVE, AND OVERSEE ALL ASPECTS AND ALL ELEMENTS OF EXECUTIVE COMPENSATION AND BENEFITS, INCLUDING THE AMOUNTS AWARDED UNDER THIS LONG-TERM INCENTIVE PLAN. SCHEDULE J PART I LINE 4A - SEVERANCE PLAN: ELIGIBLE EXECUTIVES MAY RECEIVE SEVERANCE PAY THAT IS A SPECIFIED MULTIPLE OF ANNUAL COMPENSATION. THE SEVERANCE PAY WOULD BE PAID ONLY IN THE EVENT OF CERTAIN TYPES OF EMPLOYMENT TERMINATION, AND IS FURTHER CONTINGENT ON THE SATISFACTION OF OTHER CONDITIONS SUCH AS COMPLIANCE WITH A NON-COMPETITION COVENANT. ANY CURRENT YEAR PAYMENTS HAVE BEEN INCLUDED IN THE COMPENSATION AMOUNTS REPORTED IN PART VII AND IN COLUMN (B)(III) OF SCHEDULE J. INDEPENDENT AND DISINTERESTED MEMBERS OF THE NOVANT HEALTH BOARD OF TRUSTEES (WHO COMPRISE THE COMPENSATION AND LEADERSHIP COMMITTEE OF THE BOARD) REVIEW, APPROVE, AND OVERSEE ALL ASPECTS AND ALL ELEMENTS OF EXECUTIVE COMPENSATION AND BENEFITS, INCLUDING THE AMOUNTS AWARDED UNDER THIS SEVERANCE PLAN. SCHEDULE J PART I LINE 4B - SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANS: THE SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN ("SERP") IS INTENDED TO SUPPORT RETENTION OF KEY EXECUTIVES, AND TO OFFER COMPETITIVE TOTAL COMPENSATION. THESE SERP BENEFITS ARE CALCULATED WITH REFERENCE TO A FORMULA THAT TAKES INTO CONSIDERATION THE EXECUTIVE'S TOTAL YEARS OF SERVICE WITH THE ORGANIZATION AND OTHER RETIREMENT INCOME. THESE BENEFITS ARE FULLY AT RISK AND WILL NOT BE PAID UNLESS THE EXECUTIVE PROVIDES SUBSTANTIAL FUTURE SERVICES TO THE ORGANIZATION. UNTIL THOSE REQUIREMENTS ARE SATISFIED, IF EVER, THE EXECUTIVE IS NOT ENTITLED TO ANY SERP BENEFIT. IF THE EXECUTIVE WERE TO HAVE LEFT THE ORGANIZATION VOLUNTARILY DURING THE YEAR FOR WHICH THESE AMOUNTS ARE BEING REPORTED (BEFORE REACHING BOTH AGE 55 AND HAVING FIVE YEARS OF SERVICE WITH THE ORGANIZATION), THE EXECUTIVE'S SERP BENEFIT WOULD HAVE BEEN ENTIRELY FORFEITED. THE SERP BENEFIT IS REDUCED AT THE RATE OF 2 PERCENTAGE POINTS PER YEAR FOR PAYMENTS RECEIVED BETWEEN THE AGES OF 55 AND 62. CURRENT YEAR PAYMENTS OF SERP BENEFITS HAVE BEEN INCLUDED IN THE COMPENSATION AMOUNTS REPORTED IN PART VII AND IN COLUMN (B)(III) OF SCHEDULE J. AN ESTIMATE OF THE ANNUAL INCREASE IN ACTUARIAL VALUE IS REPORTED AS DEFERRED COMPENSATION IN PART VII AND IN COLUMN (C) OF SCHEDULE J FOR ELIGIBLE EXECUTIVES. INDEPENDENT AND DISINTERESTED MEMBERS OF THE NOVANT HEALTH BOARD OF TRUSTEES (WHO COMPRISE THE COMPENSATION AND LEADERSHIP COMMITTEE OF THE BOARD) REVIEW, APPROVE, AND OVERSEE ALL ASPECTS AND ALL ELEMENTS OF EXECUTIVE COMPENSATION AND BENEFITS, INCLUDING THE AMOUNTS AWARDED UNDER THIS SUPPLEMENTAL RETIREMENT PLAN. RETIREMENT SECURITY AGREEMENT: IN 2000, A RETIREMENT SECURITY AGREEMENT ("RSA") WAS APPROVED BY THE COMPENSATION COMMITTEE FOR MR. BEIER WHICH PROVIDED FOR SUPPLEMENTAL RETIREMENT BENEFITS COMMENCING AT AGE 60. CURRENT YEAR PAYMENTS OF RSA BENEFITS HAVE BEEN INCLUDED IN THE COMPENSATION AMOUNTS REPORTED IN PART VII AND IN COLUMN (B)(III) OF SCHEDULE J. SCHEDULE J PART I LINE 4C - EQUITY-BASED COMPENSATION ARRANGEMENT: NOVANT HEALTH, INC. ("NOVANT") CHIEF EXECUTIVE OFFICER PAUL WILES IS A GRANDFATHERED PARTICIPANT IN A SHARE OPTION PLAN (THE "DISCOUNT STOCK OPTION PLAN"), UNDER WHICH HE RECEIVED FROM NOVANT OPTIONS TO PURCHASE CERTAIN MUTUAL FUND SHARES OWNED BY THE ORGANIZATION. NO OPTIONS WERE GRANTED AFTER MAY 8, 2002. THE OPTIONS GRANTED WERE DISCLOSED ON A PRIOR 990 OF NOVANT HEALTH, INC. WHEN THE OPTIONS ARE EXERCISED, THE RESULTING GAIN WILL BE TREATED AS TAXABLE COMPENSATION INCOME, IN ACCORDANCE WITH FEDERAL INCOME TAX LAW. NORTH CAROLINA MED CARE COMMISSION 521309402 657902K27 2003-07-17 176992363 SEE PART VI 1 0 0 NORTH CAROLINA MED CARE COMMISSION 521309402 657902U91 2004-12-08 110000000 SEE PART VI 0 0 0 NORTH CAROLINA MED CARE COMMISSION 521309402 657902V25 2004-12-08 25000000 SEE PART VI 0 0 0 NORTH CAROLINA MED CARE COMMISSION 521309402 6579025X6 2006-12-14 260647399 SEE PART VI 0 0 0 65605000 1735000 176992363 1875970 55000000 2004 1 0 1 1 110000000 916056 109083944 2007 0 0 1 1 25000000 208194 24791806 2007 0 0 1 1 260647399 1536125 204855830 2009 1 0 1 1 0 1 1 0 0 0.00000 0.00000 0.00000 1 0 1 1 0 0 0.00000 0.00000 0.00000 1 0 1 1 0 0 0.00000 0.00000 0.00000 1 0 1 1 0 0 0.00000 0.00000 0.00000 1 0 0 0 0 0 0 0 1 1 MERRILL LYNCH 28.300000000000 0 0 0 0 0 0 1 1 MERRILL LYNCH 28.300000000000 0 0 0 0 0 0 0 0 0 0 0 X FORM 990, SCHEDULE K, PART I, ENTITY 1, LINE A : DESCRIPTION OF PURPOSE (1) REFUNDING OF SERIES 1992 AND SERIES 1993 BONDS; (2) ACQUISITION AND INSTALLATION OF CAPITAL EQUIPMENT FOR HEALTHCARE FACILITIES; AND (3) PAY ISSUANCE COSTS FORM 990, SCHEDULE K, PART I, ENTITY 1, LINE B : DESCRIPTION OF PURPOSE (1) ACQUISITION AND INSTALLATION OF CAPITAL EQUIPMENT FOR HEALTHCARE FACILITIES; AND (2) PAY ISSUANCE COSTS FORM 990, SCHEDULE K, PART I, ENTITY 1, LINE C : DESCRIPTION OF PURPOSE (1) ACQUISITION AND INSTALLATION OF CAPITAL EQUIPMENT FOR HEALTHCARE FACILITIES; AND (2) PAY ISSUANCE COSTS FORM 990, SCHEDULE K, PART I, ENTITY 1, LINE D : DESCRIPTION OF PURPOSE (1) DEPOSIT TO CONSTRUCTION ACCOUNT; (2) REFINANCING OF OUTSTANDING LINE OF CREDIT; AND (3) PAY ISSUANCE COSTS FORM 990, SCHEDULE K, PART I, ENTITY 2, LINE A : DESCRIPTION OF PURPOSE (1) REFUND SERIES 1990 COMMUNITY GENERAL HOSPITAL OF THOMASVILLE PROJECT BONDS; (2) REFUND 1991 CMI BONDS; (3) REFUND 1992 PHSC BONDS; (4) PAY PREMIUM ON POLICY ISSUED IN CONNECTION WITH BONDS; AND (5) PAY ISSUANCE COSTS FORM 990, SCHEDULE K, PART I, ENTITY 2, LINE B : DESCRIPTION OF PURPOSE (1) REFUND SERIES 1998A AND 1998B BONDS (EXCEPT FOR THOSE MATURING 10/1/08); AND (2) PAY ISSUANCE COSTS FORM 990, SCHEDULE K, PART I, ENTITY 2, LINE C : DESCRIPTION OF PURPOSE (1) REFUND SERIES 1998A AND 1998B BONDS (EXCEPT FOR THOSE MATURING 10/1/08); AND (2) PAY ISSUANCE COSTS FORM 990, SCHEDULE K, PART I, ENTITY 2, LINE D : DESCRIPTION OF PURPOSE (1) ACQUISITION AND INSTALLATION OF CAPITAL EQUIPMENT FOR HEALTHCARE FACILITIES; AND (2) PAY ISSUANCE COSTS FORM 990, SCHEDULE K, PART III - PRIVATE BUSINESS USE THE ORGANIZATION IS PART OF THE NOVANT HEALTH CARE SYSTEM, WHICH HAS A LEGAL DEPARTMENT, MATERIALS MANAGEMENT DEPARTMENT AND A RESEARCH DEPARTMENT. THESE DEPARTMENTS REGULARLY REVIEW MANAGEMENT, SERVICE AND RESEARCH AGREEMENTS RELATED TO TAX-EXEMPT BOND FINANCED PROPERTY. OUTSIDE BOND COUNSEL CONDUCTS ADDITIONAL REVIEW AND DUE DILIGENCE WHEN ENGAGED FOR A BOND ISSUANCE OR REFUNDING PROJECT. FORM 990, SCHEDULE K, PART I, ENTITY 2, LINE D, COLUMN (C): THIS BOND HAS TWO CUSIP NUMBERS - 65821DFU0 AND 65821DFV8. FORM 990,SCHEDULE K, PART IV, ENTITY 2, LINES 3B AND 3C, COLUMNS A,B,AND C NOVANT HEALTH ENTERED INTO QUALIFIED HEDGES WITH RESPECT TO THE BONDS ISSUED ON 8/19/08. THE HEDGES ARE PROVIDED BY GOLDMAN SACHS MITSUI MARINE DERIVATIVE PRODUCTS, LP AND SUNTRUST BAND AND HAVE TERMS OF 17.8 AND 20.3 YEARS, RESPECTIVELY. NORTH CAROLINA MED CARE COMMISSION 521309402 65821DAE1 2008-08-19 70000000 SEE PART VI 0 0 0 NORTH CAROLINA MED CARE COMMISSION 521309402 65821DAD3 2008-08-19 75090000 SEE PART VI 0 0 0 NORTH CAROLINA MED CARE COMMISSION 521309402 65821DAC5 2008-08-19 50870000 SEE PART VI 0 0 0 NORTH CAROLINA MED CARE COMMISSION 521309402 65821DFU0 2010-11-03 259620763 SEE PART VI 0 0 0 7795000 70000000 410168 58219 2008 1 0 1 1 7795000 75090000 439993 62452 2008 1 0 1 1 5920000 50870000 298075 42309 2008 1 0 1 1 259620763 2703029 238096831 18820904 2012 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0.00000 0.00000 0.00000 1 0 1 1 SEE PART VI 0 0 0 0 1 0 1 1 SEE PART VI 0 0 0 0 1 0 1 1 SEE PART VI 0 0 0 0 1 0 0 0 0 0 0 NEW STAR RRG (NSRRG) BOARD INCLUDES: ARMATO, HARGETT, MCGEE, WALLENHAUPT, AND WILES 2500000 THE FILING ORGANIZATION HAS A LOAN IN PLACE WITH NSRRG. 0 MEDQUEST BOARD INCLUDES: HARGETT, MCGEE AND WILES 227618727 THE FILING ORGANIZATION HAS A LOAN IN PLACE WITH MEDQUEST. 0 BRIAN WEBER FAMILY MEMBER OF DANIELLE WEBER, KEY EMPLOYEE 216010 COMPENSATION PAID BY THE FILING ORGANIZATION TO A FAMILY MEMBER OF THE INTERESTED PERSON. 0 ALEXIA JOHNSON FAMILY MEMBER OF TONY JOHNSON, KEY EMPLOYEE 32468 COMPENSATION PAID BY THE FILING ORGANIZATION TO A FAMILY MEMBER OF THE INTERESTED PERSON. 0 CHASE GARRETT FAMILY MEMBER OF DAVE GARRETT, KEY EMPLOYEE 30202 COMPENSATION PAID BY THE FILING ORGANIZATION TO A FAMILY MEMBER OF THE INTERESTED PERSON. 0 MARY PATEFIELD FAMILY MEMBER OF ARTHUR PATEFIELD, KEY EMPLOYEE 46061 COMPENSATION PAID BY THE FILING ORGANIZATION TO A FAMILY MEMBER OF THE INTERESTED PERSON. 0 ORGANIZATION MISSION STATEMENT FORM 990, PART III, LINE 1: MISSION, VISION AND VALUES MISSION: NOVANT HEALTH EXISTS TO IMPROVE THE HEALTH OF COMMUNITIES, ONE PERSON AT A TIME. VISION: WE, THE EMPLOYEES OF NOVANT AND OUR PHYSICIAN PARTNERS, WILL DELIVER THE MOST REMARKABLE PATIENT EXPERIENCE, IN EVERY DIMENSION, EVERY TIME. VALUES: COMPASSION: WE TREAT OUR CUSTOMERS AND THEIR FAMILIES, STAFF AND OTHER HEALTHCARE PROVIDERS AS FAMILY MEMBERS BY SHOWING THEM KINDNESS, PATIENCE, EMPATHY AND RESPECT. DIVERSITY: WE RECOGNIZE THAT EVERY PERSON IS DIFFERENT, EACH SHAPED BY UNIQUE LIFE EXPERIENCES. THIS ENABLES US TO BETTER UNDERSTAND ONE ANOTHER AND OUR CUSTOMERS. PERSONAL EXCELLENCE: WE STRIVE TO GROW PERSONALLY AND PROFESSIONALLY, AND WE APPROACH EACH SERVICE OPPORTUNITY WITH A POSITIVE, FLEXIBLE ATTITUDE. HONESTY AND PERSONAL INTEGRITY GUIDE ALL THAT WE DO. TEAMWORK: THE NEEDS AND EXPECTATIONS OF ANY ONE CUSTOMER ARE GREATER THAN THAT WHICH ONE PERSON'S SERVICE EFFORTS CAN SATISFY. WE SUPPORT EACH OTHER SO THAT TOGETHER AS A TEAM, WE CAN BE SUCCESSFUL IN THE EYE OF THE CUSTOMER AS A QUALITY SERVICE PROVIDER. FORM 990, PART I, LINE 6: THE NUMBER OF VOLUNTEERS REPORTED INCLUDES THOSE VOLUNTEERS SERVING AS BOARD MEMBERS. ACTIVITIES FORM 990, PART I, LINE 1: ORGANIZATION'S MISSION OR MOST SIGNIFICANT NOVANT HEALTH, INC. IS THE PARENT ORGANIZATION OF A NOT-FOR-PROFIT INTEGRATED GROUP OF HOSPITALS, PHYSICIAN CLINICS, OUTPATIENT CENTERS AND OTHER HEALTHCARE SERVICES (COLLECTIVELY KNOWN AS "NOVANT HEALTH"). NOVANT HEALTH, INC. EXISTS TO SUPPORT THE OVERALL SYSTEM AND DOES SO BY PROVIDING OVERALL STRATEGIC PLANNING, CENTRALIZED ADMINISTRATIVE SUPPORT AND THE COORDINATION OF SYSTEM-WIDE ACTIVITIES. NOVANT HEALTH IS RANKED AS ONE OF OUR NATION'S 25 BEST HEALTHCARE SYSTEMS - CARING FOR PATIENTS AND COMMUNITIES IN NORTH CAROLINA, VIRGINIA AND SOUTH CAROLINA. WE EXIST TO IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE. WE ACCOMPLISH THAT MISSION BY PROVIDING EXCELLENT HEALTHCARE FACILITIES AND PHYSICIAN PRACTICES AND MAKING A COMMITMENT TO COMMUNITY OUTREACH AND SERVICE. WE PROVIDE HUNDREDS OF PROGRAMS THAT SERVE OUR PATIENTS, NEIGHBORS AND SOME OF OUR COMMUNITIES' MOST VULNERABLE CITIZENS. WE ALSO PROVIDE CHARITY MEDICAL CARE FOR THE UNINSURED, UNREIMBURSED HEALTH SERVICES TO INDIVIDUALS WITH MEDICAID COVERAGE, COMMUNITY HEALTH EDUCATION, MEDICAL SERVICES THAT LOSE MONEY BUT ARE IMPORTANT FOR THE COMMUNITY, SUPPORT GROUPS, OUTREACH SERVICES, COMMUNITY EVENTS AND SCREENINGS. IN ADDITION, WE PARTICIPATE IN MEDICAL RESEARCH, ACADEMIC HEALTH PROGRAMS AND PARTNERSHIPS WITH A DIVERSE GROUP OF ORGANIZATIONS TO PROVIDE OTHER COMMUNITY INITIATIVES. THE NOVANT HEALTH SYSTEM REPORTED $3.453 BILLION IN REVENUES IN 2011. IN 2011, NOVANT FACILITIES CONTINUED THEIR RELENTLESS FOCUS ON DELIVERING A REMARKABLE PATIENT EXPERIENCE. ALL NOVANT HOSPITALS INVITED THE PATIENT AND FAMILY MEMBERS TO PARTICIPATE IN NURSE BEDSIDE REPORTING. THIS COMMUNICATION MODEL PROVIDES A SAFER METHOD TO HAND OFF CARE FROM ONE STAFF MEMBER TO ANOTHER, AND ALLOWS NURSES TO SPEND MORE TIME WITH PATIENTS. THE MODEL ALSO ENCOURAGES PATIENTS TO PARTICIPATE IN HEALTHCARE CONVERSATIONS ABOUT THEIR OWN HEALTH, AS WELL AS CLARIFY INFORMATION AND ASK QUESTIONS. NURSE BEDSIDE REPORTING WAS JUST ONE OF MANY INNOVATIVE NEW EFFORTS DESIGNED TO FOCUS ON THE UNIQUE NEEDS OF OUR PATIENTS. ANOTHER EXAMPLE INCLUDED ASK ME 3, A NATIONAL PROGRAM THAT ENCOURAGES PATIENTS TO ASK THEIR HEALTHCARE PROVIDER THREE SIMPLE, YET CRITICAL QUESTIONS TO IMPROVE HEALTHCARE LITERACY. IN ADDITION, NOVANT'S FIRST CHIEF DIVERSITY OFFICER WAS HIRED IN 2011 AND IS WORKING WITH LEADERS TO DEVELOP STRATEGIES TO ADDRESS THE DIVERSE NEEDS OF OUR PATIENTS AND THE COMMUNITIES WE SERVE. OUR HEALTH SYSTEM ALSO ADDRESSED MAJOR COMMUNITY NEEDS IN 2011. RESIDENTS IN KERNERSVILLE, NC, SAW THEIR DREAM OF A COMMUNITY HOSPITAL BECOME A REALITY WITH THE OPENING OF KERNERSVILLE MEDICAL CENTER. THE NEW, 50-BED HOSPITAL OFFERS INPATIENT, OUTPATIENT, EMERGENCY AND SURGICAL SERVICES. ON JULY 31, 2011 THE LIGHTS WENT OUT AT BRUNSWICK COMMUNITY HOSPITAL AND CAME ON JUST A FEW MILES DOWN THE ROAD AT BRUNSWICK NOVANT MEDICAL CENTER. THIS NEW, 74-BED REPLACEMENT HOSPITAL BROUGHT STATE-OF-THE ART HEALTHCARE SERVICES TO RESIDENTS IN THE COASTAL COMMUNITIES OF BRUNSWICK COUNTY. IN ADDITION, PRINCE WILLIAM HOSPITAL IN NORTHERN VIRGINIA OPENED A NEW HEART CATHETERIZATION LAB, ALLOWING PATIENTS TO REMAIN IN THEIR COMMUNITY WHILE STILL HAVING ACCESS TO THE LATEST DIAGNOSTIC CARDIAC SERVICES. PURSUING QUALITY AND SAFETY CONTINUED AS OUR MAIN FOCUS. FORSYTH MEDICAL CENTER AND PRESBYTERIAN HOSPITAL EARNED THE SOCIETY OF THORACIC SURGEONS' THREE-STAR RATING, PLACING BOTH CARDIAC PROGRAMS AMONG THE HIGHEST RATED HEART SURGERY CENTERS IN THE NATION. MEDICAL PARK HOSPITAL, ROWAN REGIONAL MEDICAL CENTER AND THOMASVILLE MEDICAL CENTER WERE NAMED AMONG THE TOP PERFORMING HOSPITALS IN THE JOINT COMMISSION'S 2011 NATIONAL REPORT ON QUALITY AND SAFETY. IN ADDITION, NOVANT HEALTH, ITS MEDICAL GROUP AND ITS HOSPITALS BEGAN THE TRANSFORMATION TO AN ELECTRONIC HEALTH RECORD (EHR). WITH THE NOVANT MEDICAL GROUP'S EHR IMPLEMENTATION WELL UNDERWAY, WORK ALSO BEGAN ON A HOSPITAL ELECTRONIC HEALTH RECORD FOR OUR 13 HOSPITALS. SOON NOVANT CLINICIANS WILL BE ABLE TO SHARE PATIENTS' MEDICAL INFORMATION BETWEEN PHYSICIAN OFFICES, OUTPATIENT CENTERS AND HOSPITALS. THIS SHARING OF INFORMATION WILL IMPROVE SAFETY AND COORDINATION OF CARE, AS WELL AS PROMOTE CONNECTIVITY AND COMMUNICATION BETWEEN HOSPITAL CAREGIVERS, SPECIALISTS AND PRIMARY CARE PROVIDERS. EMBARKING ON THE JOURNEY TO CREATE A SHARED EHR IS THE MOST SIGNIFICANT AND IMPORTANT INVESTMENT NOVANT HEALTH HAS EVER MADE FOR ITS PATIENTS, STAFF AND PHYSICIANS. IN ADDITION TO OUR QUALITY OF SERVICES, WE'RE VERY PROUD OF OUR PATIENT FINANCIAL ASSISTANCE PROGRAM. WE WORK WITH INDIVIDUALS TO HELP QUALIFY THEM FOR PUBLIC ASSISTANCE, ESTABLISH A REASONABLE PAYMENT PLAN, DISCOUNT THEIR BILL TO REFLECT THEIR PERSONAL RESOURCES OR PROVIDE THEM WITH FREE CHARITY CARE. WE ASSIST OUR COMMUNITIES IN OTHER WAYS AS WELL. FOLLOWING ARE JUST SEVERAL EXAMPLES: THROUGH A COMMUNITY PARTNERSHIP, PRINCE WILLIAM HOSPITAL COMBATS ADOLESCENT OBESITY AND FILLS A NEED FOR ORGANIZED PHYSICAL EDUCATION IN SCHOOLS. ON WEDNESDAYS, NEARLY 4,000 VIRGINIA PUBLIC SCHOOL CHILDREN PARTICIPATE IN FITNESS WEDNESDAYS, WHICH INCLUDES EDUCATION ON NUTRITION AND HEALTHY LIFESTYLES, ALONG WITH 15 MINUTES OF AEROBIC AND STRENGTH EXERCISES USING EQUIPMENT PURCHASED BY THE PRINCE WILLIAM HEALTH SYSTEM FOUNDATION. FRANKLIN REGIONAL MEDICAL CENTER STAFF TAUGHT STRESS MANAGEMENT TECHNIQUES AND EXERCISES TO 80 ELEMENTARY SCHOOL TEACHERS. FORSYTH MEDICAL CENTER AND ROWAN REGIONAL MEDICAL CENTER PARTNERED WITH LOCAL HIGH SCHOOL FOOTBALL PROGRAMS TO PROVIDE CERTIFIED ATHLETIC TRAINERS FOR ONSITE TREATMENT AS WELL AS ANNUAL SPORTS PHYSICALS AND HEALTH EDUCATION. THE PROGRAM IS BASED ON THE MODEL DEVELOPED BY PRESBYTERIAN HOSPITAL MATTHEWS. STAFF AT UPSTATE CAROLINA MEDICAL CENTER HOSTED A HOLIDAY FOOD DRIVE TO BENEFIT PEACH CENTER MINISTRIES. MORE THAN 1,200 POUNDS OF FOOD HELPED PROVIDE EMERGENCY ASSISTANCE TO INDIVIDUALS AND FAMILIES IN CHEROKEE COUNTY. THE CARDIOVASCULAR NAVIGATOR AT PRESBYTERIAN HOSPITAL HUNTERSVILLE CONDUCTED BLOOD PRESSURE SCREENINGS AT LOCAL BARBER SHOPS, HELPING TO IDENTIFY PATIENTS AT RISK FOR HEART DISEASE AND STROKE. IN SUMMARY, NOVANT HEALTH STRETCHES ACROSS THREE STATES AND BEYOND AND INCLUDES HOSPITALS RANGING FROM METROPOLITAN TERTIARY MEDICAL CENTERS TO SMALL, COMMUNITY HOSPITALS IN RURAL AREAS. OTHER NOVANT FACILITIES AND PROGRAMS INCLUDE PHYSICIAN PRACTICES, OUTPATIENT SURGERY CENTERS, MEDICAL PLAZAS AND REHABILITATION PROGRAMS. COMMUNITY BENEFIT REPORT: HTTP://WWW.NOVANTHEALTH.ORG/GIVEBACK/COMMUNITYBENEFITREPORT.ASPX THE COMMUNITY BENEFIT REPORT PREPARED BY NOVANT HEALTH IS A SYSTEM-WIDE REPORT THAT INCLUDES QUALITATIVE AND QUANTITATIVE INFORMATION. IN THIS REPORT, THE NOVANT HEALTH SYSTEM'S COMMUNITY BENEFIT WAS APPROXIMATELY $567,000,000 IN 2011. PLEASE NOTE THAT THE NUMERIC DATA IN THIS REPORT IS NOT BASED UPON THE FORM 990, SCHEDULE H CRITERIA, BUT RATHER IT HAS BEEN PREPARED IN ACCORDANCE WITH THE NORTH CAROLINA HOSPITAL ASSOCIATION REPORTING GUIDELINES. IT SHOULD NOT BE RELIED UPON AS THE ORGANIZATION'S FORM 990, SCHEDULE H COMMUNITY BENEFIT REPORT. FORM 990, PART VI, SECTION A, LINE 2 FAMILY AND/OR BUSINESS RELATIONSHIPS: BUSINESS RELATIONSHIP CARL ARMATO ARTHUR PATEFIELD BUSINESS RELATIONSHIP PAUL WILES LARRY MCGEE FRED HARGETT BUSINESS RELATIONSHIP PAUL WILES LARRY MCGEE FRED HARGETT STEPHEN WALLENHAUPT GREG BEIER FORM 990, PART VI, SECTION B, LINE 11 ORGANIZATION'S PROCESS TO REVIEW FORM 990 THE AUDIT AND COMPLIANCE COMMITTEE OF THE BOARD OF TRUSTEES ("THE COMMITTEE") HAS RESPONSIBILITY FOR OVERSEEING THE ORGANIZATION'S TAX MATTERS. THE BOARD OF TRUSTEES HAS DELEGATED THE REVIEW OF THE FORM 990 TO THE AUDIT AND COMPLIANCE COMMITTEE. THE COMMITTEE IS THE REVIEW BODY FOR ALL OF THE FORM 990S FILED FOR ORGANIZATIONS WITHIN THE NOVANT HEALTH SYSTEM. THE AUDIT AND COMPLIANCE COMMITTEE MEETS BEFORE THE FORM 990S ARE FILED WITH THE IRS AND AFTER ALL BOARD MEMBERS HAVE RECEIVED A COPY OF THE FORM 990 AND A SUMMARY OF ITS CONTENTS. THE SENIOR DIRECTOR OF TAX AND BENEFITS AND LEGAL COUNSEL ATTEND THE MEETING TO ANSWER ANY QUESTIONS AND ADDRESS ANY SIGNIFICANT DISCLOSURES WITHIN THE FORM 990. FORM 990, PART VI, SECTION B, LINE 12C MONITORING AND ENFORCEMENT OF COI THE ORGANIZATION'S TRUSTEE CONFLICT OF INTEREST POLICY APPLIES TO ALL TRUSTEES, PRINCIPAL OFFICERS OR MEMBERS OF A COMMITTEE WITH BOARD DELEGATED POWERS INCLUDING ANY APPLICABLE DISREGARDED ENTITIES. ALL TRUSTEES ARE SENT AN ANNUAL DISCLOSURE FORM. ANY POSITIVE ANSWERS ON THE TRUSTEE ANNUAL DISCLOSURE FORM ARE REVIEWED BY THE GENERAL COUNSEL. IF THE RELATIONSHIP DISCLOSED IS DETERMINED NOT TO POSE A POTENTIAL CONFLICT OF INTEREST GENERALLY, THEN NO ACTION IS TAKEN. WITH RESPECT TO PARTICULAR TRANSACTIONS THAT COME BEFORE THE BOARD, THE POTENTIAL CONFLICT OF INTEREST IS DISCLOSED BY THE BOARD MEMBER, GENERALLY IN ADVANCE OF THE MEETING AT WHICH A VOTE IS TO TAKE PLACE, AND LEGAL COUNSEL DISCUSSES THE POTENTIAL CONFLICT OF INTEREST WITH THE BOARD MEMBER. THE BOARD MEMBER IS INSTRUCTED IN ACCORDANCE WITH THE TRUSTEE CONFLICT OF INTEREST POLICY. IF A CONFLICT OF INTEREST IS FOUND TO EXIST, THEN THE BOARD MEMBER WITH THE CONFLICT REFRAINS FROM PARTICIPATION IN THE BOARD'S DELIBERATIONS AND VOTE ON THE TRANSACTION. FORM 990, PART VI, SECTION B, LINE 15 FORM 990, PART VI, SECTION B, LINE 15A: COMPENSATION PROCESS FOR TOP OFFICIAL INDEPENDENT AND DISINTERESTED MEMBERS OF THE NOVANT HEALTH BOARD OF TRUSTEES (WHO COMPRISE THE COMPENSATION AND LEADERSHIP COMMITTEE OF THE BOARD) REVIEW, APPROVE, AND OVERSEE ALL ASPECTS OF COMPENSATION AND BENEFITS FOR CERTAIN LEADERS AND EXECUTIVES ("EXECUTIVES") SERVING RELATED OR DISREGARDED ENTITIES. THE COMMITTEE WORKS WITH AN INDEPENDENT COMPENSATION CONSULTANT, USES THIRD PARTY COMPARABILITY DATA FOR FUNCTIONALLY SIMILAR POSITIONS AT SIMILARLY SITUATED ORGANIZATIONS, AND MAKES SURE THAT TOTAL COMPENSATION AND BENEFITS FOR EACH EXECUTIVE DO NOT EXCEED FAIR MARKET VALUE WHEN COMPARED TO THE MARKET DATA FOR SIMILAR POSITIONS. THE COMMITTEE REVIEWS AND APPROVES EXECUTIVE COMPENSATION AND BENEFITS ANNUALLY, CONSISTENT WITH THE WRITTEN EXECUTIVE COMPENSATION PHILOSOPHY OF NOVANT HEALTH, AND IN A MANNER THAT QUALIFIES FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS, THEREBY ASSURING THAT TOTAL COMPENSATION AND BENEFITS PROVIDED TO EACH EXECUTIVE IS REASONABLE. THE COMMITTEE REVIEWS AND APPROVES EACH ITEM OF THE NOVANT HEALTH SYSTEM CEO'S COMPENSATION AND BENEFITS. FORM 990, PART VI, SECTION B, LINE 15B: COMPENSATION PROCESS FOR OFFICERS INDEPENDENT AND DISINTERESTED MEMBERS OF THE NOVANT HEALTH BOARD OF TRUSTEES (WHO COMPRISE THE COMPENSATION AND LEADERSHIP COMMITTEE OF THE BOARD) REVIEW, APPROVE, AND OVERSEE ALL ASPECTS OF COMPENSATION AND BENEFITS FOR CERTAIN LEADERS AND EXECUTIVES ("EXECUTIVES") SERVING RELATED OR DISREGARDED ENTITIES. THE COMMITTEE WORKS WITH AN INDEPENDENT COMPENSATION CONSULTANT, USES THIRD PARTY COMPARABILITY DATA FOR FUNCTIONALLY SIMILAR POSITIONS AT SIMILARLY SITUATED ORGANIZATIONS, AND MAKES SURE THAT TOTAL COMPENSATION AND BENEFITS FOR EACH EXECUTIVE DO NOT EXCEED FAIR MARKET VALUE WHEN COMPARED TO THE MARKET DATA FOR SIMILAR POSITIONS. THE COMMITTEE REVIEWS AND APPROVES EXECUTIVE COMPENSATION AND BENEFITS ANNUALLY, CONSISTENT WITH THE WRITTEN EXECUTIVE COMPENSATION PHILOSOPHY OF NOVANT HEALTH, AND IN A MANNER THAT QUALIFIES FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS, THEREBY ASSURING THAT TOTAL COMPENSATION AND BENEFITS PROVIDED TO EACH EXECUTIVE IS REASONABLE. LASTLY, IT REVIEWS AND APPROVES ALL OF THE ELEMENTS AND SPECIFICATIONS INCLUDED IN ALL OTHER EXECUTIVE AND LEADER COMPENSATION PLANS AND PROGRAMS (E.G., INCENTIVE PLAN DESIGN, AWARD OPPORTUNITIES, ETC.). FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS DISCLOSURE THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS CONTAINING ALL ORGANIZATIONS IN THE NOVANT HEALTH SYSTEM ARE POSTED TO THE NOVANT HEALTH WEBSITE. THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT AVAILABLE TO THE PUBLIC. FORM 990, PART VII, SECTION A, COLUMN B: RELATED ORGANIZATIONS THE ORGANIZATION EMPLOYS CERTAIN EXECUTIVES WHOSE ROLES ARE SUCH THAT THEY PROVIDE SERVICES TO NOT ONLY THE ORGANIZATION, BUT ALSO TO SOME OR ALL OF THE OTHER TAX-EXEMPT ORGANIZATIONS WITHIN THE NOVANT HEALTH CARE SYSTEM. FOR EXAMPLE, MANY OF THESE EXECUTIVES' ROLES FOCUS ON PARTICULAR SERVICE LINES WHICH CROSS THE VARIOUS GEOGRAPHIC MARKETS OUR ORGANIZATIONS SERVE, THUS THE SERVICES PROVIDED BY THESE EXECUTIVES MAY BENEFIT AND BE RECEIVED BY MULTIPLE ORGANIZATIONS WITHIN THE SYSTEM. THE EXECUTIVES DO NOT ALLOCATE THEIR HOURS BETWEEN THE VARIOUS ORGANIZATIONS, BUT RATHER THEIR TIME SPENT ON SERVICES TO THE ORGANIZATION IS INCLUSIVE OF SERVICES TO ALL OF THE ORGANIZATIONS THEY SERVE WITHIN THE SYSTEM. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED LOSSES ON INVESTMENTS: -19,095,435. MOB DEFERRED GAIN -3,856,807. PARTNERSHIPS 14,263,073. EQUITY/CAPITAL CONTRIBUTIONS 5,063,218. FASB/ACCOUNTING CHANGES -37,935,498. INTERCOMPANY ALLOCATION -5,047,191. SUBPART F -267,468. MALPRACTICE INSURANCE -899,791. DERIVATIVES/SWAP -32,362,472. TOTAL TO FORM 990, PART XI, LINE 5: -80,138,371. 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