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NORTH CAROLINA BAPTIST HOSPITAL: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
NORTH CAROLINA BAPTIST HOSPITAL (EIN 56-0552787)
Tax period
2010-07-01 to 2011-06-30
Filed
2012-05-14
IRS object ID
201241359349301164
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)
Timestamp2012-05-14T08:54:34-05:00Timestamp
Tax Period End Date2011-06-30TaxPeriodEndDate
Return Type990ReturnType
Tax Period Begin Date2010-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN560552787EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1NORTH CAROLINA BAPTIST HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlNORTNameControl
Phone3367164445Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1MEDICAL CENTER BLVDAddressLine1
CityWINSTONSALEMCity
StateNCState
ZIP Code27157ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameJOHN D MCCONNELL MDName
TitleCEOTitle
Phone3367164445Phone
Date Signed2012-05-14DateSigned
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonJOHN D MCCONNELL MDNameOfPrincipalOfficerPerson
Gross Receipts9401531259GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.WAKEHEALTH.EDUWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1923YearFormation
State Legal DomicileNCStateLegalDomicile
Activity Or Mission DescriptionIMPROVING THE HEALTH OF OUR REGION, STATE AND NATION BY:SERVING AS THE PREMIER HEALTH SYSTEM IN OUR REGION, WITH SPECIFIC CENTERS OF EXCELLENCE RECOGNIZED AS NATIONAL AND INTERNATIONAL CARE DESTINATIONS.GENERATING AND TRANSLATING KNOWLEDGE TO PREVENT, DIAGNOSE AND TREAT DISEASE.TRAINING TOMORROW'S LEADERS IN HEALTH CARE AND BIOMEDICAL SCIENCE.ActivityOrMissionDescription
Nbr Voting Members Governing Body25NbrVotingMembersGoverningBody
Nbr Independent Voting Members22NbrIndependentVotingMembers
Total Nbr Employees8968TotalNbrEmployees
Total Nbr Volunteers1487TotalNbrVolunteers
Total Gross UBI2231838TotalGrossUBI
Net Unrelated Business Txbl Income1626588NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year1313535ContributionsGrantsPriorYear
Contributions Grants Current Year3309877ContributionsGrantsCurrentYear
Program Service Revenue Prior Year939125091ProgramServiceRevenuePriorYear
Program Service Revenue CY1042076215ProgramServiceRevenueCY
Investment Income Prior Year23721260InvestmentIncomePriorYear
Investment Income Current Year29680394InvestmentIncomeCurrentYear
Other Revenue Prior Year3514793OtherRevenuePriorYear
Other Revenue Current Year3619545OtherRevenueCurrentYear
Total Revenue Prior Year967674679TotalRevenuePriorYear
Total Revenue Current Year1078686031TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year157954GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY568909GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year448104945SalariesEtcPriorYear
Salaries Etc Current Year489928433SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year308821TotalFundrsngExpCurrentYear
Other Expense Prior Year463568592OtherExpensePriorYear
Other Expenses Current Year531040686OtherExpensesCurrentYear
Total Expenses Prior Year911831491TotalExpensesPriorYear
Total Expenses Current Year1021538028TotalExpensesCurrentYear
Revenues Less Expenses Prior Year55843188RevenuesLessExpensesPriorYear
Revenues Less Expenses CY57148003RevenuesLessExpensesCY
Total Assets BOY1373130565TotalAssetsBOY
Total Assets EOY1461474196TotalAssetsEOY
Total Liabilities BOY611594543TotalLiabilitiesBOY
Total Liabilities EOY499788836TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY761536022NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY961685360NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionSEE SCHEDULE O FOR CONTINUATIONWAKE FOREST BAPTIST MEDICAL CENTER'S MISSION IS TO IMPROVE THE HEALTH OF OUR REGION, STATE AND NATION BY:SERVING AS THE PREMIER HEALTH SYSTEM IN OUR REGION, WITH SPECIFIC CENTERS OF EXCELLENCE RECOGNIZED AS NATIONAL AND INTERNATIONAL CARE DESTINATIONS.GENERATING AND TRANSLATING KNOWLEDGE TO PREVENT, DIAGNOSE AND TREAT DISEASE.TRAINING TOMORROW'S LEADERS IN HEALTH CARE AND BIOMEDICAL SCIENCE.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense899811575Expense
Grants568909Grants
Revenue1037822092Revenue
DescriptionSEE SCHEDULE O FOR COMPLETE DESCRIPTIONOVERVIEW: WAKE FOREST BAPTIST MEDICAL CENTER IS NORTHWEST NORTH CAROLINA'S SOLE ACADEMIC MEDICAL CENTER, BRINGING TO THE REGION THE RESOURCES OF ONE OF AMERICA'S TOP HOSPITALS AND INNOVATIVE RESEARCH CENTERS AND A PREMIER MEDICAL SCHOOL. WAKE FOREST BAPTIST MEDICAL CENTER IS A CORPORATION WHOSE MEMBERS ARE WAKE FOREST UNIVERSITY AND NORTH CAROLINA BAPTIST HOSPITAL "NCBH". THE MEDICAL CENTER OPERATES WAKE FOREST SCHOOL OF MEDICINE AND HAS A FACULTY PHYSICIAN PRACTICE OF ABOUT 860 DOCTORS. THE MEDICAL CENTER HAS 1,004 ACUTE CARE AND REHABILITATION BEDS OPERATIVE ACROSS THE SYSTEM, WHICH ENCOMPASSES ITS MAIN CAMPUS (885 BEDS), BRENNER CHILDREN'S HOSPITAL (160 BEDS, INCLUDED IN MAIN CAMPUS TOTAL); WAKE FOREST BAPTIST HEALTH-LEXINGTON MEDICAL CENTER (94 BEDS); AND DAVIE COUNTY HOSPITAL (25 BEDS). THE MEDICAL CENTER PRIMARILY SERVES A 24-COUNTY REGION IN NORTHWESTERN NORTH CAROLINA AND SOUTHWESTERN VIRGINIA, BUT DRAWS PATIENTS FROM ACROSS THE STATE AND NATION FOR SELECT SERVICES.WAKE FOREST SCHOOL OF MEDICINE IS THE DRIVING FORCE BEHIND THE ESTABLISHMENT AND GROWTH OF PIEDMONT TRIAD RESEARCH PARK, A MORE THAN 200-ACRE, MIXED-USE BIOTECHNOLOGY PARK IN DOWNTOWN WINSTON-SALEM. THE PARK IS HOME TO MANY OF THE MEDICAL CENTER'S ACADEMIC AND RESEARCH PROGRAMS, INCLUDING THE WORLD-RENOWNED WAKE FOREST INSTITUTE FOR REGENERATIVE MEDICINE. 1. CLINICAL SERVICES WAKE FOREST BAPTIST MEDICAL CENTER IS NATIONALLY RECOGNIZED FOR CLINICAL EXCELLENCE AND INTERNATIONALLY KNOWN FOR PIONEERING RESEARCH AND CLINICAL INNOVATION. IT OFFERS EXPERTISE IN MORE THAN 100 AREAS OF MEDICINE, ENCOMPASSING COMPREHENSIVE PREVENTIVE AND HIGHLY SPECIALIZED CARE FOR ALL AGES, AND OPERATES BRENNER CHILDREN'S HOSPITAL, A 160-BED HOSPITAL WITHIN A HOSPITAL ON THE MAIN CAMPUS. THE MEDICAL CENTER INCLUDES 21 SUBSIDIARY OR AFFILIATE HOSPITALS, AND OPERATES MORE THAN 150 OUTREACH ACTIVITIES, INCLUDING SATELLITE SPECIALTY CLINICS, ACROSS NORTHWEST NORTH CAROLINA.THERE WERE 38,511 INPATIENT ADMISSIONS IN FY 2011, AND 913,474 OUTPATIENT ENCOUNTERS (EMERGENCY DEPARTMENT, DOWNTOWN HEALTH PLAZA, DAY HOSPITAL, AMBULATORY VISITS). THE TOTAL PATIENT ENCOUNTERS NUMBERED 951,985.2. OUTREACHTHE DOWNTOWN HEALTH PLAZA IS A FULL-SERVICE, OUTPATIENT MEDICAL CLINIC THAT SERVES MANY OF FORSYTH COUNTY'S UNINSURED AND UNDERINSURED RESIDENTS WITH A STATE-OF-THE-ART MEDICAL HOME. EXPERTS FROM 12 WAKE FOREST BAPTIST MEDICAL CENTER DEPARTMENTS PROVIDE COORDINATED CARE THAT INCLUDES ADULT MEDICINE, PEDIATRICS, OBSTETRICS AND GYNECOLOGY, AS WELL AS ONSITE PHARMACY, LABORATORY AND RADIOLOGY SERVICES (INCLUDING MAMMOGRAPHY). THE DOWNTOWN HEALTH PLAZA PLAYS A SIGNIFICANT ROLE IN COMMUNITY HEALTH, PROVIDING COMMUNITY HEALTH FAIRS, DIABETES EDUCATION AND ANNUAL, FREE PROSTATE SCREENING. NEARLY 64,000 PATIENT VISITS WERE RECORDED AT THE PLAZA BETWEEN JULY 2010 AND JUNE 2011. COSTS ARE SUBSIDIZED BY THE MEDICAL CENTER. THE MEDICAL CENTER ALSO OPERATES NUMEROUS INNOVATIVE COMMUNITY OUTREACH PROGRAMS, MOST NOTABLY ITS BESTHEALTH CENTER AT THE REGION'S LARGEST SHOPPING MALL IN WINSTON-SALEM. BESTHEALTH REACHED MORE THAN 40,000 PEOPLE LAST YEAR THROUGH 439 HEALTH SCREENINGS AND EDUCATIONAL PROGRAMS.3. EDUCATIONAL MISSION AND ACCOMPLISHMENTS THE CONSTITUENT ORGANIZATIONS OF WAKE FOREST BAPTIST MEDICAL CENTER OPERATE A BROAD RANGE OF EDUCATIONAL PROGRAMS, GRADUATING SKILLED PRACTITIONERS. IT ATTRACTS SOME OF THE WORLD'S MOST COMPETITIVE MEDICAL STUDENTS, RESIDENTS AND FELLOWS, AS WELL AS STUDENTS IN CLINICAL PASTORAL CARE, NURSE ANESTHESIA AND OTHER AREAS. THE MEDICAL CENTER IN THE PAST YEAR INVESTED MORE THAN $50 MILLION IN THE EDUCATION OF TOMORROW'S HEALTH CARE AND BIOMEDICAL LEADERS. THAT INVESTMENT LAST YEAR SUPPORTED THE TRAINING OF 482 MEDICAL STUDENTS, 664 PHYSICIAN RESIDENTS AND FELLOWS, 323 GRADUATE STUDENTS AND 117 PHYSICIAN ASSISTANTS. THE NORTHWEST AREA HEALTH EDUCATION CENTER, PART OF WAKE FOREST SCHOOL OF MEDICINE, DURING THE SAME YEAR PROVIDED 2,102 CONTINUING MEDICAL EDUCATION ACTIVITIES FOR 37,876 PARTICIPANTS THROUGHOUT THE REGION.Description
Total Program Service Expense899811575TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
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 Invest0ReportProgRelInvest
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 Member1BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp1OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions1DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Transaction Related Entity1TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With1096221NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees8968NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income1UnrelatedBusinessIncome
Form990-T Filed1Form990-TFiled
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 Members25NbrVotingGoverningBodyMembers
Number Independent Voting Members22NumberIndependentVotingMembers
Family Or Business Relationship1FamilyOrBusinessRelationship
Delegation Of Management Duties1DelegationOfManagementDuties
Changes To Organizing Docs1ChangesToOrganizingDocs
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 Venture1InvestmentInJointVenture
Written Policy Or Procedure1WrittenPolicyOrProcedure
States Where Copy Of Return Is FiledNCStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1DOUG LISCHKEBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number3367164445TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1MEDICAL CENTER BLVDAddressLine1
CityWINSTON SALEMCity
StateNCState
ZIP Code27157ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (55 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
ROGER L COTHRAN
TRUSTEE6.00X000
ARTHUR A GIBEL
CHAIRMAN13.00X000X
KATHRYN H HAMRICK
TRUSTEE2.00X000
WILLIAM N HARTSELL
TRUSTEE2.00X000
STEPHEN R LITTLE
TRUSTEE2.00X000
GEORGE E STUBBINS SR
TRUSTEE2.00X000
STANLEY R AESCHLEMAN PH D
TRUSTEE2.00X000
A WILLIAM BLACKSTOCK JR MD
TRUSTEE2.00X000
WILLIAM J IRELAND JR M DIV PH D
TRUSTEE2.00X000
KENNETH W LEWIS
TRUSTEE2.00X000
WILLIAM C WARDEN JR
CHAIRMAN2.00X000
SHEREE B WATSON
TRUSTEE2.00X000
KATY M BOLES
TRUSTEE2.00X000
RAY N HOWELL III D MIN
TRUSTEE2.00X000
JOHN D KIMBERLY
TRUSTEE2.00X000
STEPHEN L ROBERTSON
TRUSTEE2.00X000
EDWIN L WELCH JR
TRUSTEE2.00X000
R MICHAEL WELLS
TRUSTEE2.00X000
LINWOOD L DAVIS
TRUSTEE2.00X000
BRENDA B DIGGS
TRUSTEE2.00X000
ERNEST L EVANS
TRUSTEE2.00X000
RON KESSINGER
VICE - CHAIRMAN8.00X000X
PEDRO MARTINEZ
TRUSTEE2.00X000
JERRY N BROOKS
TRUSTEE2.00X49670300
DALE M BROWN
TRUSTEE2.00X000
JOSEPH R OVERBY JR MD
TRUSTEE2.00X000
JOHN D MCCONNELL MD
TRUSTEE & CEO20.60X18756120624197X
H GREG BRAY
ASST. TREASURER/ASST. SECRETARY38.70234799040520X
J MCLAIN WALLACE JR
VP GENERAL COUNSEL/SECRETARY35.00378244040349X
KAREN H HUEY
VP FACILITY PLANNING & CONSTRUCTION26.00229431059613X
KAREN Q TURNER
VP SURGICAL SERVICES40.00276515051767X
STEVE C SNELGROVE
VP OPERATIONS39.00357177098423X
RONALD H SMALL
VP QUALITY & SERVICE EXCELLENCE39.00552513057788X
MAUREEN E SINTICH
VP OPERATIONS / CNO34.80339629055686X
ROBERT S PARKER SR
VP SPECIAL OPS & COMMUNITY38.003530550103645X
DONNY C LAMBETH
PRESIDENT36.007490920408315X
SHARON ENGEBRETSON
INTERIM VP PASTORAL CARE36.00139116078306X
JOANNE C RUHLAND
VP GOVERNMENT AFFAIRS26.00210942035556X
NORMAN D POTTER JR
VP DEVELOPMENT & ALUMNI AFFAIRS26.00222258037771X
CHERYL EH LOCKE
VP CHIEF HUMAN RESOURCES OFFICER26.00710536034116X
EDWARD G CHADWICK
EXECUTIVE VP CFO & TREASURER21.007308050243782X
THOMAS E SIBERT MD
PRESIDENT & COO OF HEALTH SYSTEM26.007404780254655X
RUSSELL M HOWERTON MD
CHIEF MEDICAL OFFICER20.00580706051108X
DOUGLAS L EDGETON
EXECUTIVE VP & MED CTR ADMINISTRATOR1.00613769041279X
LISA M WYATT
VP CHIEF COMMUNICATIONS AND MARKETING26.00334084030629X
SHEILA M SANDERS
VP CHIEF INFORMATION OFFICER26.00381555045230X
BETTY PETREE
DIRECTOR NURSE ANESTHESIA40.00269091055527X
MICHAEL RIKER
DIRECTOR OF NURSE ANESTHESIA PROGRAM40.00214113038286X
VANCE MCVAY JR
CLINICAL INSTRUCTOR CRNA40.00211792036260X
ERIC STIEFEL
CLINICAL INSTRUCTOR CRNA40.00196578025372X
CHARLES WARE
ASSOCIATE VP INFRASTRUCTURE40.00202543078470X
WILLIAM YATES
VP FAITH AND MINISTRIES40.00143920-646X
PAUL LARUSSO
VP & CHIEF INFORMATION OFFICER40.001383801221X
A PATRICIA JOHNSON
FORMER VP OPERATIONS / CNO40.0025879803695X
G DOUGLAS ATKINSON
FORMER VP BUSINESS DEVELOPMENT40.00226026010725X
FieldValueIRS element (for citing)
Total Reportable Comp From Org12085960TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation2641070TotalOtherCompensation
Number Individuals GT100 K283NumberIndividualsGT100K
Formers Listed1FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources1CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
WAKE FOREST UNIVERSITY HEALTH SCIENCES
MEDICAL CENTER BLVDWINSTON SALEMNC27157PHYSICIAN/OTHER PROFESSIONAL SERVICES64434204
ARAMARK
2300 WARRENVILLE ROADDOWNER GROVEIL60515MANAGEMENT SERVICES3628454
MEDCOST LLC
3000 KIMEL PARK DRIVEWINSTON SALEMNC27103HEALTH INSURANCE ADMINISTRATOR2557080
QUEST DIAGNOSTICS INC
NICHOLS INSTITUTE DEPT 0065LOS ANGELESCA90084LAB SERVICES2341871
GE HEALTHCARE IITS USA CORP
PO BOX 277475ATLANTAGA30384MAINTENANCE CONTRACTS1927187
FieldValueIRS element (for citing)
Number Of Contractors GT100 K84NumberOfContractorsGT100K
All Other Contributions3309877AllOtherContributions
Noncash Contributions81574NoncashContributions
Total Contributions3309877TotalContributions

Program Service Revenue ProgramServiceRevenue (4 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenue
PATIENT SERVICE REVENU6214001029326624102924975676868
DIETARY7223205185457517531410143
MEDICAL/LAB SERVICE62150042541234026953227170
COST RECOV. & OTHER900099331001113923541917657
FieldValueIRS element (for citing)
Total Program Service Revenue1042076215TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column28191474TotalRevenueColumn
Exclusion$28,191,474ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real490294Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real202935Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real287359Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column287359TotalRevenueColumn
Exclusion$287,359ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities8312156108Securities
Other11975105Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities8311163788Securities
Other11478505Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities992320Securities
Other496600Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column1488920TotalRevenueColumn
Exclusion$1,488,920ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmount
GIFT SHOP REVENUE4532201384775$1,384,775
PARKING FEES9000991203949$1,203,949
TUITION900099203023$203,023

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column540439TotalRevenueColumn
Exclusion$540,439ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue3332186TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column1078686031TotalRevenueColumn
Related Or Exempt Function Income1039844377RelatedOrExemptFunctionIncome
Unrelated Business Revenue2231838UnrelatedBusinessRevenue
Exclusion$33,299,939ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total455041Total
Program Services455041ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total113868Total
Program Services113868ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total12403054Total
Program Services982012ProgramServices
Management And General11112221ManagementAndGeneral
Fundraising308821Fundraising

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total137689Total
Management And General137689ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total380837917Total
Program Services341405417ProgramServices
Management And General39432500ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total19923156Total
Program Services14942367ProgramServices
Management And General4980789ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total49491294Total
Program Services42607426ProgramServices
Management And General6883868ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total27135323Total
Program Services20351492ProgramServices
Management And General6783831ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total1560160Total
Program Services14837ProgramServices
Management And General1545323ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total315249Total
Management And General315249ManagementAndGeneral

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total1807027Total
Program Services1356101ProgramServices
Management And General450926ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total95552556Total
Program Services70161086ProgramServices
Management And General25391470ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total3311559Total
Program Services1663448ProgramServices
Management And General1648111ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total293680331Total
Program Services278148047ProgramServices
Management And General15532284ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total9292707Total
Program Services4972810ProgramServices
Management And General4319897ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total349885Total
Program Services217499ProgramServices
Management And General132386ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total1145633Total
Program Services648397ProgramServices
Management And General497236ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total10933753Total
Program Services10933753ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total60904211Total
Program Services60295169ProgramServices
Management And General609042ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total6646651Total
Program Services5001841ProgramServices
Management And General1644810ManagementAndGeneral

Other Expenses OtherExpenses (3 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServices
BAD DEBT EXPENSE4503702245037022
CONTRIBUTION EXPENSE270000270000
RECRUITMENT/RELOCATION233942233942

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total1021538028Total
Program Services899811575ProgramServices
Management And General121417632ManagementAndGeneral
Fundraising308821Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY27825998BOY
EOY18078386EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY58135794BOY
EOY73571292EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY165093603BOY
EOY200506544EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY11714276BOY
EOY13859819EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY1309605BOY
EOY5260718EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis1273730287LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec805326163LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY425391533BOY
EOY468404124EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY613361983BOY
EOY607124980EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY61847344BOY
EOY57732699EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY8450428BOY
EOY16935635EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY1373130565BOY
EOY1461474196EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY121810500BOY
EOY112118064EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY333993335BOY
EOY326149760EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY155790708BOY
EOY61521256EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY611594543BOY
EOY499788836EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY756152864BOY
EOY954381677EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY2146704BOY
EOY3916110EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY3236453BOY
EOY3387818EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY761536022BOY
EOY961685360EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY1373130565BOY
EOY1461474196EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses57148003ReconcilationRevenueExpenses
Reconcilation Other Changes143001335ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit Required1FederalGrantAuditRequired
Federal Grant Audit Performed1FederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0Volunteers
Paid Staff Or Management1PaidStaffOrManagement
Media Advertisements0MediaAdvertisements
Mailings Members1MailingsMembers
Publications Or Broadcast0PublicationsOrBroadcast
Grants Other Organizations0GrantsOtherOrganizations
Direct Contact Legislators1DirectContactLegislators
Direct Contact Legislators$658,007DirectContactLegislatorsAmount
Rallies Demonstrations0RalliesDemonstrations
Other Activities0OtherActivities
Total Lobbying Expenditures IIB658007TotalLobbyingExpendituresIIB
Not Described In501c30NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierEXPLANATION OF OTHER LOBBYING ACTIVITIES:Identifier
Return ReferencePART II-B, LINE 1I:ReturnReference
ExplanationGOVERNMENT RELATIONS THE OFFICE OF GOVERNMENT RELATIONS WAS ACTIVELY INVOLVED WITH SEVERAL FEDERAL AND STATE ISSUES. THE OFFICE ASSISTED IN DEVELOPING POLITICAL ADVOCACY STRATEGIES REGARDING THE PATIENT PROTECTION AND AFFORDABLE CARE ACT (P.L. 111-148) (A/K/A THE HEALTH CARE REFORM BILL), WHICH INCLUDED EXPANSION OF INSURANCE COVERAGE; MEDICARE AND MEDICAID PAYMENT CHANGES; PROVISIONS RELATED TO WORKFORCE SUPPLY AND GRADUATE MEDICAL EDUCATION TRAINING; FUNDING FOR COMPARATIVE EFFECTIVENESS RESEARCH, WELLNESS AND PREVENTION; KEY DELIVERY SYSTEM REFORMS INCLUDING ACCOUNTABLE CARE ORGANIZATIONS, VALUE BASED PURCHASING AND INCENTIVES TO IMPROVE CARE COORDINATION AND QUALITY; AND LANGUAGE DESIGNED TO REDUCE WASTE, FRAUD AND ABUSE IN THE MEDICARE AND MEDICAID PROGRAMS. STAFF WORKED ON THE FY2011 BUDGET; THE CENTER FOR MEDICARE AND MEDICAID SERVICE'S PROPOSED RULE REGARDING THE ELECTRONIC HEALTH RECORD INCENTIVE PROGRAM AND SUBMITTED A COMMENT LETTER REGARDING ITS PROVISIONS; THE FY 2011 MEDICARE INPATIENT PROSPECTIVE PAYMENT SYSTEM (PPS) PROPOSED RULE; LEGISLATION REGARDING THE CREATION OF HEALTHCARE INNOVATION ZONES; MEDICARE PAYMENT ADVISORY COMMISSION'S DGME AND IME RECOMMENDATIONS; CHANGES TO THE MEDICARE POLICY KNOWN AS THE 72 HOUR RULE; LEGISLATION TO INCREASE RESIDENCY SLOTS; AND MEDICARE PHYSICIAN PAYMENTS (SGR ADJUSTMENTS). STAFF ALSO WORKED ON MANY OF THE FY 2011 APPROPRIATIONS BILLS AND PROPOSED LEGISLATION AND REGULATIONS THAT WERE INTRODUCED, INCLUDING REQUESTS IN THE DEPARTMENT OF TRANSPORTATION; DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF COMMERCE; STATE; JUSTICE; DEPARTMENT OF DEFENSE; DEPARTMENT OF HEALTH AND HUMAN SERVICES; AND VETERANS AFFAIRS (VA) RESEARCH AND MEDICAL CARE FUNDING. THE OFFICE ASSISTED WITH THE FOLLOWING: (1) END STAGE RENAL DISEASE PAYMENT SYSTEM PROPOSED RULE; (2) FAA REAUTHORIZATION BILL AMENDMENTS FOR AIR AMBULANCES; (3) EMPLOYEE FREE CHOICE BILL REGARDING UNIONIZATION; (4) IRS PROPERTY-TAX EXEMPTIONS FOR NONPROFITS GUIDELINES AND COMMUNITY BENEFITS ANALYSIS; (5) TAX BILL FOR EMPLOYEE PENSIONS, CHARITABLE DONATIONS; (6) NIH APPROPRIATIONS AND FUNDING FOR HEALTH PROFESSIONS AND AHEC AND THE REAUTHORIZATION OF THE NATIONAL SCIENCE FOUNDATION; (7) CHANGES PROPOSED BY HHS REGARDING CONFLICT OF INTEREST RULES; (8) THE IMPLEMENTATION OF THE TRUTH IN LENDING ACT REGARDING STUDENT LOANS; (9) FALSE CLAIMS ACT AMENDMENTS; AND (10) PATENTS AND INTELLECTUAL PROPERTY ISSUES. AT THE STATE LEVEL, EFFORTS WERE CONCENTRATED WITH THE FY 2010-11 MEDICAID BUDGET INCLUDING THE SIX MONTH EXPANSION OF FMAP FUNDING CONTAINED IN THE FEDERAL STIMULUS PACKAGE, THE MEDICAID REIMBURSEMENT INITIATIVE AND UPPER PAYMENT LIMIT PROVISIONS; ON LEGISLATION REGARDING CERTIFICATE-OF-NEED LAWS, BUSINESS INCENTIVE TAX LAWS, INCLUDING THE MILL TAX CREDIT FOR THE PIEDMONT TRIAD RESEARCH PARK; AND FUNDING FOR ALLIED HEALTH PROFESSIONAL TRAINING AT THE COMMUNITY COLLEGES, INCLUDING FORSYTH TECHNICAL COMMUNITY COLLEGE.Explanation

Schedule D IRS990ScheduleD

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance3918191BeginningOfYearBalance
Contributions141511Contributions
Investment Earnings Or Losses396088InvestmentEarningsOrLosses
Other Expenditures16623OtherExpenditures
End Of Year Balance4439167EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance3788351BeginningOfYearBalance
Contributions68200Contributions
Investment Earnings Or Losses78265InvestmentEarningsOrLosses
Other Expenditures16625OtherExpenditures
End Of Year Balance3918191EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance4470108BeginningOfYearBalance
Contributions117064Contributions
Investment Earnings Or Losses-780842InvestmentEarningsOrLosses
Other Expenditures17979OtherExpenditures
End Of Year Balance3788351EndOfYearBalance
FieldValueIRS element (for citing)
Board Designated EOY Balance0.03000BoardDesignatedEOYBalance
Permanent Endowment EOY Balance0.76000PermanentEndowmentEOYBalance
Term Endowment EOY Balance0.21000TermEndowmentEOYBalance
Endowments Held By Unrelated Orgs1EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs0EndowmentsHeldByRelatedOrgs

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis11535276OtherCostOrOtherBasis
Book Value11535276BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis650858378OtherCostOrOtherBasis
Depreciation369135178Depreciation
Book Value281723200BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis7615567OtherCostOrOtherBasis
Depreciation5737023Depreciation
Book Value1878544BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis537178371OtherCostOrOtherBasis
Depreciation430453962Depreciation
Book Value106724409BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis66542695OtherCostOrOtherBasis
Book Value66542695BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings468404124TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (4 entries)

DescriptionDescriptionAmountAmount
OTHER LIABILITIES$45,705,970
PENSION LIABILITIES$11,507,142
DEFERRED COMPENSATION$309,148
OTHER LONG-TERM LIABILITIES$3,998,996
FieldValueIRS element (for citing)
Total Of Amounts61521256TotalOfAmounts
Total Revenue1078686031TotalRevenue
Total Expenses1021538028TotalExpenses
Excess Or Deficit For Year57148003ExcessOrDeficitForYear
Net Unrealized GL On Investments72309986NetUnrealizedGLOnInvestments
Donated Services And Facilities38943DonatedServicesAndFacilities
Other$70,652,406OtherAmount
Total Adjustments143001335TotalAdjustments
Excess Or Deficit Per FS200149338ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt1217689568TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments72309986NetUnrealizedGainsInvestments
Donated Srvc And Use Of Facilities38943DonatedSrvcAndUseOfFacilities
Other Revenues68731634OtherRevenues
Revenue Not Rptd F990141080563RevenueNotRptdF990
Revenue Subtotal1076609005RevenueSubtotal
Other Revenues Not Included2077026OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt2077026RevenueNotRptdOnFinStmt
Total Revenue Per Form9901078686031TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt1019461001TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal1019461001ExpensesSubtotal
Other Expenses Not Included2077026OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt2077026ExpensesNotRptdOnFinStmt
Total Expenses Per Form9901021538027TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (3 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS:PART V, LINE 4:THE HOSPITAL'S ENDOWMENT FUNDS ARE USED TO PROVIDE SUPPORT FOR EDUCATION, SCHOLARSHIPS, INDIGENT CARE, AND SUPPORT AS DESIGNATED BY THE INDIVIDUAL DONORS.
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:PART X:NCBH AND ITS SUBSIDIARIES ARE TAX-EXEMPT ORGANIZATIONS AS DESCRIBED IN SECTION 501(C)3 OF THE INTERNAL REVENUE CODE (THE "CODE"), AND ARE GENERALLY EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. ACCORDINGLY, NO PROVISION FOR INCOME TAXES IS MADE IN THE CONSOLIDATED FINANCIAL STATEMENTS. UNRELATED BUSINESS INCOME OF NCBH IS REPORTED ON FORM 990-T. THE SYSTEM RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. FISCAL YEARS ENDING ON OR AFTER JUNE 30, 2008 REMAIN SUBJECT TO EXAMINATION BY FEDERAL AND STATE TAX AUTHORITIES.
PART XI, LINE 8 - OTHER ADJUSTMENTS: CHANGE IN PENSION LIABILITY: 77,335,733 NET GAIN FROM DISCOUNTINUED OPERATIONS: 1,064,813 CHANGE IN VALUE OF INTEREST RATE SWAP: 226,522 LOSS FROM AFFILIATES: -1,629,817 TRANSFER FROM AFFILIATES: -1,896,299 NET CHANGE IN RESTRICTED ASSETS: 1,920,769 CAPITAL CONTRIBUTION: 996,344 TRANSFER OF AFFILIATE TO INTEGRATED GROUP: -3,458,460 OTHER ADJUSTMENTS: -2,911,099 PART XII, LINE 2D - OTHER ADJUSTMENTS: LOSS FROM AFFILIATES: -1,629,817 TRANSFERS FROM AFFILIATES: -1,896,299 CHANGE IN PENSION LIABILITY: 77,335,733 CAPITAL CONTRIBUTION: 996,344 NET GAIN FROM DISCONTINUED OPERATIONS: 1,064,813 CHANGE IN VALUE OF INTEREST RATE SWAP: 226,522 TRANSFER OF AFFILIATE TO INTEGRATED GROUP: -3,458,460 OTHER: -2,910,858 PART XII, LINE 4B - OTHER ADJUSTMENTS: CONTRIBUTION REVENUE: 270,000 PART XIII, LINE 2D - OTHER ADJUSTMENTS CONTRIBUTION REVENUE: 270,000

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
FPG Reference Free Care1FPGReferenceFreeCare
Pcent200XPcent200
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent400XPcent400
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 Expense53167036TotalCommunityBenefitExpense
Direct Offsetting Revenue5357227DirectOffsettingRevenue
Net Community Benefit Expense47809809NetCommunityBenefitExpense
Percent Of Total Expense0.04900PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense157225696TotalCommunityBenefitExpense
Direct Offsetting Revenue143400711DirectOffsettingRevenue
Net Community Benefit Expense13824985NetCommunityBenefitExpense
Percent Of Total Expense0.01420PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

FieldValueIRS element (for citing)
Total Community Benefit Expense16551045TotalCommunityBenefitExpense
Direct Offsetting Revenue15675743DirectOffsettingRevenue
Net Community Benefit Expense875302NetCommunityBenefitExpense
Percent Of Total Expense0.00090PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense226943777TotalCommunityBenefitExpense
Direct Offsetting Revenue164433681DirectOffsettingRevenue
Net Community Benefit Expense62510096NetCommunityBenefitExpense
Percent Of Total Expense0.06410PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense3580158TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense3580158NetCommunityBenefitExpense
Percent Of Total Expense0.00370PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense66003137TotalCommunityBenefitExpense
Direct Offsetting Revenue21832021DirectOffsettingRevenue
Net Community Benefit Expense44171116NetCommunityBenefitExpense
Percent Of Total Expense0.04520PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense4512644TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense4512644NetCommunityBenefitExpense
Percent Of Total Expense0.00460PercentOfTotalExpense

Research Research

FieldValueIRS element (for citing)
Total Community Benefit Expense1645178TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense1645178NetCommunityBenefitExpense
Percent Of Total Expense0.00170PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense1481303TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense1481303NetCommunityBenefitExpense
Percent Of Total Expense0.00150PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense77222420TotalCommunityBenefitExpense
Direct Offsetting Revenue21832021DirectOffsettingRevenue
Net Community Benefit Expense55390399NetCommunityBenefitExpense
Percent Of Total Expense0.05670PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense304166197TotalCommunityBenefitExpense
Direct Offsetting Revenue186265702DirectOffsettingRevenue
Net Community Benefit Expense117900495NetCommunityBenefitExpense
Percent Of Total Expense0.12080PercentOfTotalExpense

Physical Improvements And Housing PhysicalImprovementsAndHousing

FieldValueIRS element (for citing)
Total Community Building Expense0TotalCommunityBuildingExpense

Economic Development EconomicDevelopment

FieldValueIRS element (for citing)
Total Community Building Expense104821TotalCommunityBuildingExpense
Net Community Building Expense104821NetCommunityBuildingExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Total Community Building Expense127505TotalCommunityBuildingExpense
Net Community Building Expense127505NetCommunityBuildingExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Environmental Improvements EnvironmentalImprovements

FieldValueIRS element (for citing)
Total Community Building Expense0TotalCommunityBuildingExpense

Leadership Development LeadershipDevelopment

FieldValueIRS element (for citing)
Total Community Building Expense146558TotalCommunityBuildingExpense
Net Community Building Expense146558NetCommunityBuildingExpense
Percent Of Total Expense0.00020PercentOfTotalExpense

Coalition Building CoalitionBuilding

FieldValueIRS element (for citing)
Total Community Building Expense0TotalCommunityBuildingExpense

Health Improvement Advocacy HealthImprovementAdvocacy

FieldValueIRS element (for citing)
Total Community Building Expense46201TotalCommunityBuildingExpense
Net Community Building Expense46201NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Workforce Development WorkforceDevelopment

FieldValueIRS element (for citing)
Total Community Building Expense639184TotalCommunityBuildingExpense
Net Community Building Expense639184NetCommunityBuildingExpense
Percent Of Total Expense0.00070PercentOfTotalExpense

Other Other

FieldValueIRS element (for citing)
Total Community Building Expense0TotalCommunityBuildingExpense

Total Total

FieldValueIRS element (for citing)
Total Community Building Expense1064269TotalCommunityBuildingExpense
Net Community Building Expense1064269NetCommunityBuildingExpense
Percent Of Total Expense0.00110PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported0BadDebtExpenseReported
Bad Debt Expense$16,978,571BadDebtExpenseAmount
Amount Attributable To0AmountAttributableTo
Amount Reimbursed By Medicare340177974AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare371950001CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-31772027MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care1ProvisionForCharityCare
Number Of Hospital Facilities2NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA (2 entries)

Facility NumberFacilityNumberAddress Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeLicensed HospitalLicensedHospitalGeneral Medical And SurgicalGeneralMedicalAndSurgicalTeaching HospitalTeachingHospitalEr24 HoursEr24HoursOtherOther
NORTH CAROLINA BAPTIST HOSPITAL
1MEDICAL CENTER BLVDWINSTON SALEMNC27157XXXX
NORTH CAROLINA BAPTIST HOSPITAL AMBULANC
2MEDICAL CENTER BLVDWINSTON SALEMNC27157AMBULANCE SERVICES

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1NA PER IRS ANNOUNCEMENT 2011-37BusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities13NumberOfOtherFacilities

Other Facilities OtherFacilities (13 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityTypeAddress Line2Address/AddressLine2
STRATFORD EXECUTIVE PARK ABDOMINAL ORGAN
140 CHARLOIS BOULEVARDWINSTONSALEMNC271031522ABDOMINAL ORGAN TRANSPLANT PROGRAM
DOWNTOWN HEALTH PLAZA
1200 N MARTIN LUTHER KING JR DRIVEWINSTONSALEMNC271013006FAMILY MEDICINE
WAKE FOREST UNIVERSITY BAPTIST IMAGING
265 EXECUTIVE PARK BLVDWINSTONSALEMNC27103IMAGING CENTER
WINSTON EAST PEDIATRICS
2295 EAST 14TH STREETWINSTONSALEMNC271056804PEDIATRICS
STRATFORD EXECUTIVE PARK INTERNAL MEDICI
500 SHEPHARD STREET SUITE 300WINSTONSALEMNC271031633IM MULTISPECIALTY CLINICS
CANCER CENTER OF DAVIDSON COUNTY LLC
107 WEST MEDICAL PARK DRIVE SUITESLEXINGTONNC27292CANCER CENTER101
COUNTRY CLUB DERMATOLOGIC SURGERY
4618 COUNTRY CLUB ROADWINSTONSALEMNC271043520GENERAL DERMATOLOGY
COUNTRY CLUB GENERAL DERMATOLOGY
4618 COUNTRY CLUB ROADWINSTONSALEMNC271043520DERMATOLOGIC SURGERY
STRATFORD EXECUTIVE PARK OBGYN
500 SHEPHARD STREET SUITE 201WINSTONSALEMNC271031633OB/GYN
WAKE FOREST BAPTIST HEALTH FAMILY MEDICI
1920 W FIRST STREETWINSTONSALEMNC271044220FAMILY MEDICINE
STRATFORD EXECUTIVE PARK MATERNAL-FETAL
500 SHEPHARD STREET SUITE 200WINSTONSALEMNC271031633MATERNAL-FETAL MEDICINE
WAKE FOREST BAPTIST HEART CENTER
755 HIGHLAND OAKS SUITE 204WINSTONSALEMNC271037106CARDIOLOGY
NCBH OUTPATIENT ENDOSCOPY CENTER LLC
100 CHARLOIS BLVD SUITE 100WINSTONSALEMNC27103OUTPATIENT ENDOSCOPY

Form990 Schedule H Part VI Form990ScheduleHPartVI (12 entries)

ExplanationExplanationIdentifierIdentifierReturn ReferenceReturnReference
PART I, LINE 3C: THE ORGANIZATION USES A SLIDING SCALE OF THE FEDERAL POVERTY GUIDELINES TO DETERMINE ELIGIBILITY FOR DISCOUNTED CARE BETWEEN 201% AND 300%, THE DISCOUNT IS 75%. BETWEEN 301% AND 400%, THE DISCOUNT IS 50%, AT 200% OR BELOW, THE INDIVIDUAL IS ELIGIBLE FOR FREE CARE
PART I, LINE 7: THE ORGANIZATION USED THE WORKSHEETS PROVIDED IN THE INSTRUCTIONS TO SCHEDULE H TO COMPUTE ITS COST-TO-CHARGE RATIO FOR PURPOSES OF THE 2010 SCHEDULE H
PART I, L7 COL(F): THE ORGANIZATION'S BAD DEBT EXPENSE PER THE AUDITED FINANCIAL STATEMENTS WAS $45,037,022 FOR THE FISCAL YEAR. THIS AMOUNT HAS BEEN REMOVED FROM THE CALCULATION OF CHARITY CARE FOR PART I, LINE 7.
PART II: THROUGH COMMUNITY BUILDING NORTH CAROLINA BAPTIST HELPS THE COMMUNITY BY OPERATING "BEST HEALTH" WHICH IS A RESOURCE CENTER LOCATED AT A LOCAL SHOPPING MALL. THERE, THE PUBLIC CAN RESEARCH A WIDE VARIETY OF HEALTH AND WELLNESS TOPICS. OUR COMMUNITY ALSO BENEFITS FROM OUR PHYSICIAN RECRUITMENT PROGRAM, COMMUNITY TRAINING AND NETWORKS AS WELL AS OUR PARTICIPATION IN THE LEADERSHIP WINSTON-SALEM PROGRAM. WE FURTHER HELP OUR COMMUNITY BYSUPPORTING OUR LOCAL GOODWILL ENDEAVORS
PART III, LINE 4: THE ORGANIZATION'S FINANCIAL STATEMENTS DO NOT INCLUDE A DISCRETE FOOTNOTE EXPLAINING BAD DEBT EXPENSE. BAD DEBT HAS NOT BEEN INCLUDED IN THE COMPUTATION OF COMMUNITY BENEFIT ON PART I, LINE 7. THE ORGANIZATION HAS A THOROUGH PROCESS OF EVALUATING BAD DEBT ACCOUNTS AS INFORMATION BECOMES AVAILABLE AND RECLASSIFIES BAD DEBT ACCOUNTS AS CHARITY CARE AS PROVIDED BY THE CHARITY CARE POLICY. AMOUNTS USED TO COMPUTE CHARITY CARE AND BAD DEBT ON SCHEDULE H USE THE MOST CURRENT DATA AVAILABLE AT THE TIME OF FILING.THE ORGANIZTION USED WORKSHEET 2 OF THE 2010 SCHEDULE H INSTRUCTIONS TO COMPUTE A COST TO CHARGES RATIO USED TO CALCULATE BAD DEBT AT COST.
PART III, LINE 8: FOR THE FISCAL YEAR, THE PORTION OF PAYORS FOR WHICHMEDICARE WAS THE PRIMARY SOURCE OF PAYMENT WAS 29.5%. OF THAT PORTION OFPATIENTS, 27.3% WERE FOUND TO HAVE ALSO QUALIFIED FOR MEDICAID AS ASECONDARY INSURANCE; THEREFORE BASED ON THIS RATIO, APPROXIMATELY 27%, OR$8.6 MILLION, OF THE MEDICARE SHORTFALL MAY BE CONSIDERED A COMMUNITYBENEFIT. THE HOSPITAL USES AN OVERALL COST TO CHARGE RATIO CALCULATION BASED ON AUDITED FINANCIAL STATEMENTS BUT REMOVES COST ASSOCIATED WITH BAD DEBT, GME, COMMUNITY BUILDING, AND CHARITY CARE SO AS NOT TO COUNT THOSE COSTS TWICE.
PART III, LINE 9B: PATIENT FINANCIAL RESOURCES SERVICES WORKS WITH THE PATIENT FOR ANY PATIENT LIABILITY. OUR MAIN FOCUS IS PRIOR TO SERVICESAND/OR DISCHARGE; HOWEVER, WE DO WORK WITH PATIENTS AFTER SERVICES HAVEBEEN RECEIVED AND BILLED. PATIENT FINANCIAL RESOURCES SERVICES IS REALLYTWO AREAS IN ONE--THE RESOURCE RECOVERY SPECIALIST/RRS (FORMERLY FINANCIALCOUNSELING) AND THE MEDICAID ELIGIBILITY TEAM/MPS. THESE TWO AREAS WORKTOGETHER TO FIND A RESOLUTION TO PATIENT LIABILITY, SELF PAY OR INSURED.THE RRS WORKS TO NOTIFY THE PATIENT OF ANY PATIENT LIABILITY AND ASK FORPAYMENT FOR THAT LIABILITY. IF THE PATIENT INDICATES THAT HE/SHE NEEDSASSISTANCE, THEN THE RRS WILL COMPLETE A FINANCIAL STATEMENT ON THEPATIENT. WHILE TAKING THAT FINANCIAL STATEMENT THE RRS IS LOOKING FORINFORMATION THAT COULD QUALIFY THE PATIENT FOR MEDICAID OR FOR OTHERAGENCY PROGRAMS THAT ARE AVAILABLE TO THE MEDICAL CENTER. WHEN THATINFORMATION IS IDENTIFIED THE RRS WILL LET THE PATIENT KNOW THAT AREFERRAL WILL BE MADE FOR MEDICAID OR OTHER ASSISTANCE AND A MPS WILL BEIN TOUCH WITH HIM/HER. THE RRS ALSO EXPLAINS TO THE PATIENT OR FAMILY THATCHARITY CARE IS A LAST RESORT AND THEY MUST COOPERATE WITH ANY OTHERASSISTANCE PROGRAMS THAT WE HAVE IDENTIFIED AND BE FOUND INELIGIBLE BEFORECHARITY CARE WILL BE APPROVED/APPLIED. IT IS ALSO COMMUNICATED WITH THEPATIENT OR FAMILY IS INFORMED IF ANY SUPPORTING DOCUMENTATION IS NEEDED FOR ANYASSISTANCE, WHETHER THAT BE CHARITY, MEDICAID, OR OTHER PROGRAMS.
PART VI, LINE 2: DATA IS COLLECTED THROUGH PRIMARY AND SECONDARY COLLECTION PROCESSES. POPULATION, PREGNANCY, BIRTH, MORTALITY, ANDMORBIDITY DATA IS REVIEWED TO ASSESS THE POPULATION'S HEALTH. PRIMARYDATA COLLECTION INCLUDES DOOR-TO-DOOR INTERVIEWS IN HIGH RISKCOMMUNITIES; FOCUS GROUPS; AND A COMMUNITY HEALTH OPINION SURVEY THAT ISCONDUCTED THROUGH THE SCHOOL SYSTEM. SECONDARY DATA IS COLLECTED THROUGHDATA FROM THE NC DEPARTMENT OF HEALTH AND HUMAN SERVICES, VITALSTATISTICS, AND SURVEILLANCE REPORTS. OTHER COMMUNITY REPORTS SUCH AS THEUNITED WAY ANNUAL REPORT AND US CENSUS BUREAU COMMUNITY PROFILES AREREVIEWED AS WELL. WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER ("WFUBMC" - SEE SCHEDULE O, PAGE 66) ALSO REGULARLY PULLS MARKET DATA TO IDENTIFYWHAT HEALTH SERVICES ARE BEING USED BY THE PUBLIC AND TO GAUGE THEAVAILABILITY OF THOSE SERVICES WITHIN THE COMMUNITIES THEY LIVE.THE PURPOSE OF DATA COLLECTION IS TO IDENTIFY FACTORS THAT AFFECT THEHEALTH OF FORSYTH COUNTY'S POPULATION AND DETERMINE THE AVAILABILITY OFRESOURCES WITHIN THE COMMUNITY TO ADEQUATELY ADDRESS THESE FACTORS.WFUBMC PARTICIPATES IN A COLLABORATIVE PROCESS WITH OTHER COMMUNITYLEADERS, PUBLIC HEALTH AGENCIES, HOSPITALS, AND PRIVATE PRACTITIONERS TOANSWER THE KEY QUESTIONS OF (1) WHAT HEALTH CONCERNS OR NEEDS DOES THECOMMUNITY HAVE, AND (2) WHAT RESOURCES ARE AVAILABLE AND WHAT DO WE NEEDIN THE COMMUNITY TO ADDRESS THESE CONCERNS. WORKGROUPS WHICH INCLUDEMEMBERS FROM WFUBMC, ALONG WITH A STATISTICIAN FROM THE PUBLIC HEALTHDEPARTMENT, MEET TO DISCUSS THE PRIMARY AND SECONDARY DATA COLLECTED TOSYNTHESIZE TRENDS AND PRIORITIZE THE TOP NEEDS, SUCH AS "REDUCINGINFANT MORTALITY" AND "REDUCING THE INCIDENCE OF COLON CANCER." RATES AREMEASURED AGAINST PEER COUNTY AND STATE RANKINGS. STRATEGIES ARERECOMMENDED AND VOTED UPON BY THE COMMUNITY ASSESSMENT TASK FORCE, WHICHINCLUDES COMMUNITY LEADERS, PUBLIC HEALTH AGENCIES, HOSPITALS, PRIVATEPRACTITIONERS, AND OTHER NON-PROFIT AGENCIES. THE LAST ASSESSMENT WAS IN2009 AND THE LATEST ASSESSMENT OF COMMUNITY NEEDS WAS INITIATED IN OCTOBER2010. WORK IS PLANNED TO BE COMPLETED BY THE SUMMER OF 2012. WFUBMC HASSEVERAL REPRESENTATIVES ON THE TASK FORCE MANAGED BY THE FORSYTH COUNTYHEALTH DEPARTMENT AND SEVERAL EMPLOYEES PARTICIPATE DIRECTLY IN DATA WORKGROUPS AND ARE PART OF REVIEWING THE EXISTING AND COLLECTING NEW COMMUNITYSPECIFIC DATA. WFUBMC EMPLOYEES ARE ALSO ON VARIOUS COMMUNITY HEALTHBOARDS WORKING TO ADDRESS SPECIFIC COMMUNITY HEALTH NEEDS SUCH AS THEINFANT MORTALITY REDUCTION BOARD, FORSYTH FUTURES, AND UNITED WAY; ALL OFWHICH ADDRESS DIFFERENT HEALTH DISPARITIES IN FORSYTH COUNTY
PART VI, LINE 3: THE ORGANIZATION USES A VARIETY OF MEANS TO EDUCATEAND INFORM PATIENTS OF THEIR CHARITY CARE OPTIONS, INCLUDING INFORMATIONON A WEBSITE, BILLING PAMPHLETS AVAILABLE IN CLINICAL OFFICES AND THEBUSINESS OFFICE, SIGNS IN CHECK-IN AREAS, INFORMATION ON PATIENT BILLSTATEMENTS, AND FROM STAFF MEMBERS DURING CONVERSATIONS CONCERNING APATIENT'S LIABILITY FOR SERVICES.IF A PATIENT QUALIFIES FOR 100% CHARITY CARE PRIOR TO THE ACCOUNT BEINGBILLED TO THE PATIENT, THE ACCOUNT IS CODED AND THE ADJUSTMENT IS TAKENTHE TIME THE BALANCE DROPS TO THE PATIENT AND WOULD NOT PROCEED THROUGHANY FURTHER STATEMENTS OR COLLECTION PROCESS. IF THE PATIENT QUALIFIESFOR PARTIAL CHARITY, THE ADJUSTMENT IS TAKEN AND THE REMAINING BALANCE ISBILLED TO THE PATIENT AND WOULD FOLLOW THE NORMAL COLLECTION PRACTICES ANDPOSSIBLE BAD DEBT PLACEMENT. IF THE PATIENT QUALIFIES FOR 100% CHARITYAFTER BEING BILLED, THE ACCOUNT IS CODED AND THE ADJUSTMENT IS TAKEN ATTHAT TIME AND THE PATIENT WOULD NO LONGER RECEIVE ANY STATEMENTS OR COLLECTIONACTIVITY. IF THE PATIENT QUALIFIES FOR PARTIAL CHARITY, THE ACCOUNT ISADJUSTED ACCORDINGLY AND HE/SHE WOULD STILL BE RESPONSIBLE TO THE REMAININGBALANCE AND CONTINUE TO RECEIVE STATEMENTS OR COLLECTION CALLS AND BESUBJECT FOR BAD DEBT PLACEMENT.
PART VI, LINE 4: WAKE FOREST BAPTIST MEDICAL CENTER IS THE ONLY ACADEMIC MEDICAL CENTER SERVING A 24-COUNTY REGION IN NORTHWEST NORTH CAROLINA AND SOUTHWEST VIRGINIA. IT IS ONE OF TWO MAJOR MEDICAL CENTERS OPERATING IN FORSYTH COUNTY. THE POPULATION OF OUR 24-COUNTY REGION FOR 2011 WAS 2,522,841. ACCORDING TO STATISTICS FROM THE NORTH CAROLINA DEPARTMENT OF COMMERCE, IN OUR NARROWER, NINE-COUNTY PRIMARY SERVICE AREA, 15.5 PERCENT OF THE POPULATION IS AT OR BELOW THE POVERTY LINE. IN ADDITION, 69.9 PERCENT OF THE PRIMARY SERVICE AREA POPULATION IS WHITE, 20.8 PERCENT IS BLACK AND 9.3 PERCENT IS MADE UP OF OTHER RACES. THE UNEMPLOYMENT LEVEL IN THE PRIMARY SERVICE AREA AS OF THE THIRD QUARTER OF 2011 WAS 10.2 PERCENT. THE MEDIAN HOUSEHOLD INCOME WAS $43,645. THE 2010-11 GROWTH RATE OF THE PRIMARY SERVICE AREA WAS 0.8 PERCENT.
PART VI, LINE 7: WAKE FOREST BAPTIST MEDICAL CENTER'S MISSION IS TOIMPROVE THE HEALTH OF OUR REGION, STATE AND NATION BY:1) GENERATING AND TRANSLATING KNOWLEDGE TO PREVENT, DIAGNOSE AND TREATDISEASE.2) TRAINING LEADERS IN HEALTH CARE AND BIOMEDICAL SCIENCE.3) SERVING AS THE PREMIER HEALTH SYSTEM IN OUR REGION, WITH SPECIFICCENTERS OF EXCELLENCE RECOGNIZED AS NATIONAL AND INTERNATIONAL CAREDESTINATIONS. THE HOSPITAL OPERATES THE FOLLOWING PROGRAMS CONSTITUTING COMMUNITY HEALTH IMPROVEMENT SERVICES AND COMMUNITY BENEFIT OPERATIONS REPORTED ON PART I,LINE 7E:WS/FC SCHOOLS ALLIED HEALTH PROGRAM $4,911 PHYSICIAN RECRUITMENT FEES 1,500,000COMMUNITY HEALTH/HEALTHCARE ACCESS 11,987 CHURCH COMMUNITY RELATIONS 341,551COMMUNITY HEALTH SALARIES 485,000PHYSICIANS COMMUNITY HEALTH ACCESS 213,773CARENET/PASTORAL COUNSELING 327,495ACCELERATED BSN PROGRAM 639,184COUNTY RENT ON CLEVELAND DENTAL 56,257TOTAL TO PART I, LINE 7E: 3,580,158
NCREPORTS FILED WITH STATESPART VI, LINE 7

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Recipient Table RecipientTable (11 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantPurpose Of GrantPurposeOfGrant
AMERICAN HEART ASSOCIATION
101 CENTREPORT DRIVE STE 130GREENSBORONC27409135613797501(C)335000SPONSOR HEART AND STROKE BALL
ARTS COUNCIL
305 W FOURTH STREET SUITE 1CWINSTON SALEMNC27101560526856501(C)3100000TO HELP PROVIDE CULTURAL OPPORTUNITIES IN THE COMMUNITY
CARINGBRIDGE
1715 YANKEE DOODLE ROAD SUITE 301EAGANMN551214215293946000SUPPORT FOR PROGRAM DEVELOPMENT
CHILDREN'S MUSEUM OF WINSTON SALEM
300 SOUTH LIBERTY STREETWINSTON SALEMNC2710156219363425500TO HELP PROVIDE CULTRUAL OPPORTUNITIES IN THE COMMUNITY
CITY OF WINSTON SALEM
GOV'T ENTITY120000TO SUPPORT FOR NEW FACILITIES NEED IN THE COMMUNITY
FOUNDATION FOR NURSING EXCELLENCE
PO BOX 2129RALEIGHNC2760230010524115000SUPPORT FOR PROGRAM DEVELOPMENT
HOSPICE & PALLIATIVE CARECENTER
101 HOSPICE LANEWINSTON SALEMNC27103581343313501(C)314525SUPPORT NEW FACILITY NEEDED IN COMMUNITY
KOMEN NC TRIAD
1106 BURKE STREETWINSTON SALEMNC27101501(C)325000FUNDRAISING EVENT SPONSORSHIP FOR CANCER RESEARCH
MARCH OF DIMES
410 BROOKSTOWN AVENUEWINSTON SALEMNC27101501(C)36000FUNDRAISING EVENT SPONSORSHIP FOR CANCER RESEARCH
RONALD MCDONALD HOUSE
419 S HAWTHORNE ROADWINSTON SALEMNC27103581454715501(C)345500FUNDRAISING EVENT SPONSORSHIP FOR CANCER RESEARCH
UNITED WAY OF FORSYTH COUNTY
301 NORTH MAIN STREET SUITE 1700WINSTON SALEMNC27101237357234501(C)362516PROGRAM SUPPORT FOR LOCAL PROGRAMS NEEDED IN THE COMMUNITY

Form990 Schedule I Part III Form990ScheduleIPartIII (4 entries)

Type Of GrantTypeOfGrantNumber Of RecipientsNumberOfRecipientsAmount Of Cash GrantAmountOfCashGrant
WHITEHEAD NURSING4238775
WHITEHEAD MED TECH413000
WHITEHEAD NURSE ANESTHESIA1225000
WL CARTER SCHOLARSHIP2037093

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierOTHER INFORMATION:Identifier
Return ReferencePART IV:ReturnReference
ExplanationSCHEDULE I, PART I, LINE 2: SCHOLARSHIPS ARE MONITORED TO ASSURE THE TERMS OF THE PROGRAM ARE MET. AN ANNUAL REPORT IS SENT TO THE ORGANIZATION STARTING THE USE OF THE FUNDS AND THE IDENTIFICATION OF BENEFICIARIES TO ASSURE COMPLIANCE WITH SCHOLARSHIP PROVISIONS. LETITE PATE WHITEHEAD DETAILS THE LETTIE PATE WHITEHEAD FOUNDATION PROVIDES SCHOLARSHIPS TO TAX-EXEMPT, NON-PROFIT HOSPITALS OR INSTITUTIONS FOR THE CARE OF INDIGENT CHRISTIAN WOMEN IN SPECIFIED STATES INCLUDING NORTH CAROLINA. THE FINANCIAL NEED IS ESTABLISHED BY THE COLLEGES THAT THE STUDENTS ATTEND. NAMES OF STUDENTS ARE PROVIDED TO OUR STAFF DEVELOPMENT DEPARTMENT. THE WHITEHEAD FUNDS ARE REVIEWED AND ADMINISTERED BY A FUND CUSTODIAN. W.L. CARTER REQUIREMENTS TO RECEIVE THIS SCHOLARSHIP, AN EMPLOYEE MUST BE ACCEPTED INTO AN APPROVED NURSING PROGRAM AND RECOMMENDED BY HIS/HER MANAGER WITH SATISFACTORY PERFORMANCE EVALUATION AND ATTENDANCE. IN EXCHANGE FOR THE SCHOLARSHIP, THE EMPLOYEE AGREES TO MAKE ADEQUATE ACADEMIC PROGRESS TO COMPLETE HIS/HER DEGREE.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Idemnification Gross Up PaymentsXIdemnificationGrossUpPayments
Housing Allowance Or ResidenceXHousingAllowanceOrResidence
Club Dues Or FeesXClubDuesOrFees
Personal ServicesXPersonalServices
Written Policy Re T And E Expenses1WrittenPolicyReTAndEExpenses
Substantiation Required1SubstantiationRequired
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Form990 Of Other OrganizationsXForm990OfOtherOrganizations
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment1SeverancePayment
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 (28 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
JERRY N BROOKS
000049670300000496703000
JOHN D MCCONNELL MD
87890905000000496703060614501805202499809000
H GREG BRAY
196539033532047280244300160900275319000
J MCLAIN WALLACE JR
25215101078780182150244580158910418593000
KAREN H HUEY
185780040206034450434980161150289044000
KAREN Q TURNER
225760041272094830362310155360328282000
STEVE C SNELGROVE
2491470695210385090833340150890455600000
RONALD H SMALL
22460108855802393540474280103600610301000
MAUREEN E SINTICH
2624210601420170660402030154830395315000
ROBERT S PARKER SR
2020200535290975060934710101740456700000
DONNY C LAMBETH
5379970186261024834038849601981901157407000
SHARON ENGEBRETSON
105226030656032340443020340040217422000
JOANNE C RUHLAND
1526820405000177600175070180490246498000
NORMAN D POTTER JR
192124027500026340167520210190260029000
CHERYL EH LOCKE
34014608370002866900188480152680744652000
EDWARD G CHADWICK
503663020000002714202195780242040974587000
THOMAS E SIBERT MD
545517016602702893402312820233730995133000
RUSSELL M HOWERTON MD
13609104277010169140260090250990631814000
DOUGLAS L EDGETON
48436001117000177090186020226770655048000
LISA M WYATT
265711038300030073021246093830364713000
SHEILA M SANDERS
3137680551000126870270140182160426785000
BETTY PETREE
209780037569021742047897076300324618000
MICHAEL RIKER
20821900058940163190219670252399000
VANCE MCVAY JR
2115920002000195220167380248052000
ERIC STIEFEL
196380000198087060166660221950000
CHARLES WARE
170426027290048270661500123200281013000
A PATRICIA JOHNSON
000025879800036950262493000
G DOUGLAS ATKINSON
0000226026000107250236751000

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
PART I, LINE 1APART I, LINE 1A: CERTAIN EXECUTIVES RECEIVE, AS PART OF THEIR APPROVED COMPENSATION PACKAGE,TAX INDEMNIFICATION AND GROSS-UP PAYMENTS, RELOCATION ASSISTANCE INCLUDING A HOUSING ALLOWANCE, AND HEALTH OR SOCIAL CLUB DUES OR INITIATION FEES.
PART IIIPART I, LINE 4A: SEVERANCE PAYMENTS: THE FOLLOWING FORMER EMPLOYEES RECEIVED COMPENSATION FROM A SEVERANCE PACKAGE IN 2010. PLEASE SEE PART II, COLUMN C FOR DETAILS: PATRICIA A. JOHNSON G. DOUGLAS ATKINSON SCHEDULE J, PART III DURING THE TAX PERIOD, THE FILING ORGANIZATION, WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER ("WFUBMC") AND WAKE FOREST UNIVERSITY HEALTH SCIENCES ("WFUHS") (AND WAKE FOREST UNIVERSITY ("WFU")) WERE OPERATING UNDER AN AGREEMENT THAT PROVIDED FOR THE OPERATION OF WFUHS AND NCBH BY WFUBMC. WFUBMC, WFUHS, AND THE FILING ORGANIZATION ARE ENTITIES WHICH TOGETHER HAVE COMBINED OPERATING REVENUES FOR THE TAX PERIOD OF $1.9 BILLION. IN GENERAL, EXECUTIVES PERFORMING KEY MANAGEMENT FUNCTIONS WERE SOUGHT AND HIRED AFTER NATIONAL SEARCHES IN A HIGHLY COMPETITIVE ENVIRONMENT, AND ONLY INDIVIDUALS AT THE HIGHEST LEVELS OF ABILITY WERE SOUGHT, GIVEN THE TASK OF INITIATING AND IMPLEMENTING THE NEW MANAGEMENT STRUCTURE DESIGNED TO OPTIMIZE THE EFFECTIVENESS OF BOTH ORGANIZATIONS (NCBH AND WFUHS) IN THEIR TAX-EXEMPT MISSIONS, AS PARTICIPANTS IN A FULLY-INTEGRATED ACADEMIC MEDICAL CENTER. CERTAIN EXECUTIVES OF THE FILING ORGANIZATION (WHO EACH HOLD THE IDENTICAL OFFICES/TITLES IN WFUHS, WFUBMC, AND THE FILING ORGANIZATION) ARE ELIGIBLE TO RECEIVE INCENTIVE COMPENSATION AT THE END OF EACH FISCAL YEAR. THE INCENTIVE STRUCTURE IS BASED UPON GOALS ESTABLISHED BY THE EXECUTIVE COMMITTEE OF THE FILING ORGANIZATION'S BOARD AT THE BEGINNING OF THE YEAR, INCLUDING MEASURES OF CLINICAL QUALITY, PATIENT SATISFACTION, AND FINANCIAL OPERATING PERFORMANCE. THE DETERMINATION OF THE AMOUNT OF INCENTIVE COMPENSATION IS SUBJECT TO THE FILING ORGANIZATION'S COMPENSATION PROCEDURES AS OUTLINED IN PART VI, SECTION B, LINE 15 OF THE 990. SCHEDULE J. PART I. LINE 1A - COMPENSATION BY UNRELATED ORGANIZATIONS: THE FOLLOWING INDIVIDUALS WERE COMPENSATED BY WFUHS FOR SERVICES PERFORMED JOHN D. MCCONNELL NORMAN D. POTTER, JR. EDWARD G. CHADWICK JOANNE C. RUHLAND CHERYL E.H. LOCKE THOMAS E. SIBERT RUSSELL M. HOWERTON DOUGLAS L. EDGETON LISA M. WYATT SHEILA M. SANDERS SCHEDULE J. PART I, LINE 3 - THE EXECUTIVE COMMITTEE OF THE WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER BOARD OF DIRECTORS IS RESPONSIBLE FOR REVIEWING AND APPROVING ALL OFFICER COMPENSATION. THE COMMITTEE UTILIZED INDEPENDENT COMPENSATION CONSULTANTS, COMPENSATION SURVEYS, AND STUDIES TO DETERMINE THE APPROPRIATENESS OF EACH OFFICER'S COMPENSATION. AN EXTERNAL COMPENSATION CONSULTANT EXPERIENCED IN HEALTH CARE AND HIGHER EDUCATION COMPENSATION PRESENTS TOTAL COMPENSATION COMPARABILITY DATA FOR THE POSITIONS FOR WHICH CONPENSATION IS BEING DETERMINED. THE DATA IS REVIEWED BY THE EXECUTIVE COMMITTEE OF WFUBMC'S GOVERNING BOARD AT ITS MEETING; NONE OF THE MEMBERS OF THAT COMMITTEE ARE EMPLOYEES OF THE FILING ORGANIZATION. MINUTES OF THE DELIBERATIONS OF THE COMMITTEE ARE CONTEMPORANEOUSLY RECORDED. IN THE EVENT THAT ANY MEMBER OF THE EXECUTIVE COMMITTEE HAS A CONFLICT OF INTEREST, THAT COMMITTEE MEMBER DOES NOT PARTICIPATE IN THE DELIBERATION OR APPROVAL PROCESS, AND THEIR ABSTENTION FROM THE PROCESS IS REFLECTED IN THE MINUTES. SCHEDULE J. PART I, LINE 4 - CERTAIN EXECUTIVES PARTICIPATE IN OR RECEIVE PAYMENTS FROM SUPPLEMENTAL NON QUALIFIED RETIREMENT PLANS. THE DETERMINATION OF THE AMOUNT OF THE NON QUALIFIED RETIREMENT PLANS FOLLOWED THE FILING ORGANIZATION'S COMPENSATION PROCEDURES AS OUTLINED IN PART VI, SECTION B, LINE 15 OF THE 990.SUPPLEMENTAL INFORMATION

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 Number65820HD67CUSIPNumber
Date Issued2010-03-01DateIssued
Issue Price334002408IssuePrice
Description Of PurposeCURRENT REFUNDINGDescriptionOfPurpose
Defeased0Defeased
On Behalf Of Issuer0OnBehalfOfIssuer
Pool Financing0PoolFinancing

Form990 Schedule K Part II Form990ScheduleKPartII

FieldValueIRS element (for citing)
Amount Retired7705000AmountRetired
Total Proceeds334002408TotalProceeds
Issuance Costs From Proceeds3307037IssuanceCostsFromProceeds
Other Spent Proceeds330695370OtherSpentProceeds
Year Of Subst Completion2010YearOfSubstCompletion
Current Refunding1CurrentRefunding
Advance Refunding0AdvanceRefunding
Final Allocation Made1FinalAllocationMade
Adequate Books And Recds Maintaind1AdequateBooksAndRecdsMaintaind

Form990 Schedule K Part IV Form990ScheduleKPartIV

FieldValueIRS element (for citing)
Form8038 T Filed0Form8038TFiled
Variable Rate Issue0VariableRateIssue
Hedge Identified In Books And Recds1HedgeIdentifiedInBooksAndRecds

Name Of Hedge Provider NameOfHedgeProvider

FieldValueIRS element (for citing)
Business Name Line1DEUTSCHE BANK AGBusinessNameLine1
FieldValueIRS element (for citing)
Term Of Hedge5.000000000000TermOfHedge
Superintegrated Hedge0SuperintegratedHedge
Hedge Terminated0HedgeTerminated
Gross Proceeds Invested In GIC0GrossProceedsInvestedInGIC
Gross Proceeds Invested0GrossProceedsInvested
Exception To Rebate1ExceptionToRebate

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (5 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
DAVID E BRANN
FAMILY MEMBER OF DONNY LAMBETH67063COMPENSATION0
SCOTT O JOHNSON
FAMILY MEMBER OF A. PATRICIA JOHNSON13383COMPENSATION0
THOMAS P JOHNSON
FAMILY MEMBER OF A. PATRICIA JOHNSON11846COMPENSATION0
JUDY M SLOCUM
FAMILY MEMBER OF MAUREEN SINTICH45397COMPENSATION0
HINSON & HALE MEDICAL TECHNOLOGY
BOARD MEMBER WILLIAM WARDEN SERVED AS A DIRECTOR157581PURCHASE OF SUPPLIES0

Schedule M IRS990ScheduleM

Clothing And Household Goods ClothingAndHouseholdGoods

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
Noncash Contribs Rptd F99024081NoncashContribsRptdF990
Method Of Determining RevenuesFMVMethodOfDeterminingRevenues

Food Inventory FoodInventory

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
Number Of Contributions1NumberOfContributions
Noncash Contribs Rptd F990600NoncashContribsRptdF990
Method Of Determining RevenuesFMVMethodOfDeterminingRevenues

Other Non Cash Contributions Table OtherNonCashContributionsTable

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
DescriptionOTHER EQUIPMENTDescription
Number Of Contributions9NumberOfContributions
Noncash Contribs Rptd F99056893NoncashContribsRptdF990
Method Of Determining RevenuesFMVMethodOfDeterminingRevenues
FieldValueIRS element (for citing)
Any Property That Must Be Held0AnyPropertyThatMustBeHeld
Review Process Unusual NC Gifts1ReviewProcessUnusualNCGifts
Third Parties Used0ThirdPartiesUsed

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (12 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
FORM 990, PART VI, SECTION A, LINE 2EDWARD G. CHADWICK, H. GREGORY BRAY, AND STEVEN C. SNELGROVE HAVE A BUSINESS RELATIONSHIP THROUGH THEIR BOARD/LEADERSHIP POSITION IN MEDCOST, LLC, AN UNRELATED ORGANIZATION.
FORM 990, PART VI, SECTION A, LINE 3EFFECTIVE JULY 1, 2010, THE GOVERNING BOARDS OF FOUR NORTH CAROLINA NONPROFIT CORPORATIONS (WAKE FOREST UNIVERSITY, NORTH CAROLINA BAPTIST HOSPITAL, WAKE FOREST UNIVERSITY HEALTH SCIENCES, AND WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER) ENTERED INTO AN AGREEMENT (THE MEDICAL CENTER INTEGRATION AGREEMENT OR MCIA) UNDER WHICH THE OPERATION OF EACH OF NORTH CAROLINA BAPTIST HOSPITAL (NCBH) AND WAKE FOREST UNIVERSITY HEALTH SCIENCES (WFUHS) WAS DELEGATED TO WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER (WFUBMC). WFUHS IS A WHOLLY-CONTROLLED SUBSIDIARY ENTITY OF WAKE FOREST UNIVERSITY (WFU). WFUBMC IS NOW A MEMBERSHIP NONPROFIT CORPORATION WHOSE TWO EQUAL MEMBERS ARE NCBH (WHICH ENTITY IS UNRELATED TO WFU) AND WFU. THIS CONSOLIDATION OF MANAGEMENT IN WFUBMC OF THE VARIOUS ACADEMIC MEDICAL CENTER OPERATIONS, SUBJECT TO SUBSTANTIAL RESERVED POWERS IN EACH OF THE CONSTITUENT MEMBERS' (OR IN WFUHS') BOARDS, MANDATED CHANGES IN THE GOVERNANCE DOCUMENTS OF EACH ORGANIZATION.
FORM 990, PART VI, SECTION A, LINE 4ARTICLES OF INCORPORATION ADDS AS A PURPOSE THAT NCBH WILL CONDUCT ITS OPERATIONS AS A PART OF THE INTEGRATED HEALTH SYSTEM OF WFUBMC. AS REQUIRED BY THE STATE NONPROFIT CORPORATION ACT, INCLUDES PROVISION ON THE DELEGATION TO WFUBMC OF CERTAIN POWERS TO OPERATE NCBH; IT IS ALSO NOTED THAT POWERS NOT SO DELEGATED ARE RETAINED BY THE NCBH BOARD. BYLAWS ARTICLE V, WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER: STATES THAT WFU AND NCBH ARE THE TWO MEMBERS, EQUAL IN ALL RESPECTS, OF WFUBMC, AND EACH ELECT ONE-HALF OF ITS VOTING BOARD MEMBERS. REFERENCES AND CHARACTERIZES THE MCIA, AND STATES THAT ALL OPERATIONS OF NCBH AND OF WFUHS (INCLUDING ALL SUBSIDIARIES OF BOTH) ARE UNDER THE AUTHORITY OF WFUBMC. WFUBMC IS DELEGATED CERTAIN POWERS TO OPERATE NCBH, AND ALL CORPORATE POWERS NOT SO DELEGATED ARE RETAINED BY THE NCBH BOARD. ARTICLE VI OFFICERS: THE CEO REPLACES THE PRESIDENT AS THE CHIEF EXECUTIVE OFFICER OF THE CORPORATION. AS PROVIDED IN THE MCIA, THE CORPORATE OFFICERS OF WFUBMC SERVE AS THE CORPORATE OFFICERS OF NCBH IN ADDITION TO THE CEO, THE PRESIDENT AND THE VICE PRESIDENTS. ARTICLE VII COMMITTEES: THE STANDING COMMITTEES OF THE NCBH BOARD ARE AN EXECUTIVE COMMITTEE (WHOSE MEMBERS ARE THE NCBH BOARD MEMBERS ELECTED TO THE WFUBMC BOARD), AN ARTICLES OF INCORPORATION AND BYLAWS COMMITTEE, AN AUDIT AND COMPLIANCE COMMITTEE, A GOVERNANCE AND NOMINATING COMMITTEE, AN INVESTMENT COMMITTEE AND A FAITH AND HEALTH MINISTRIES COMMITTEE. THE FINANCE AND BUSINESS AFFAIRS COMMITTEE, HEALTH SYSTEM OPERATIONS AND QUALITY COMMITTEE, FACILITIES COMMITTEE, RESEARCH PARK COMMITTEE AND ACADEMIC AFFAIRS COMMITTEE OF THE WFUBMC BOARD ARE ADDITIONAL STANDING COMMITTEES OF THE NCBH BOARD. THE NCBH BOARD HAS THE AUTHORITY TO APPOINT FROM AMONG ITS MEMBERSHIP NON-WFUBMC BOARD MEMBERS TO THE WFUBMC BOARD COMMITTEES. ARTICLE VIII MEDICAL STAFF: THE NCBH BOARD DELEGATES TO THE WFUBMC BOARD THE APPOINTMENTS AND REAPPOINTMENTS TO THE MEDICAL STAFF, ASSIGNMENT OF MEDICAL STAFF PRIVILEGES AND THE RIGHT OF APPROVAL OF THE MEDICAL STAFF BYLAWS, RULES AND REGULATIONS.
FORM 990, PART VI, SECTION B, LINE 11THE FILING ORGANIZATION'S BOARD OF DIRECTORS RECEIVES COPIES OF THE FORM 990 WITH SUFFICIENT TIME TO PERMIT REVIEW, COMMENT, AND QUESTIONS PRIOR TO ITS FILING. THE AUDIT AND COMPLIANCE COMMITTEES OF THE GOVERNING BOARDS OF WFUHS AND NCBH REVIEW IN ADDITIONAL DETAIL THE FILING ORGANIZATION'S FORM 990 WITH THE ORGANIZATION'S CHIEF FINANCIAL OFFICER OR HIS DESIGNEE, WHO ANSWERS QUESTIONS AND ADDRESSES CONCERNS RAISED BY SUCH COMMITTEE MEMBERS OR OTHER FILING ORGANIZATION DIRECTORS. IF MODIFICATIONS ARE REQUIRED FOLLOWING SUCH REVIEW AND COMMENT, THE REVISED FORM 990 IS REDISTRIBUTED TO ALL DIRECTORS PRIOR TO ITS FILING WITH THE IRS, ALONG WITH A REPORT NOTING THE MODIFICATIONS.
ON AN ANNUAL BASIS (AND AS THEY ARISE), ALL DIRECTORS AND OFFICERS OF THE FILING ORGANIZATION ARE ASKED TO REVIEW THE APPLICABLE CONFLICTS OF INTEREST POLICY AND TO DESCRIBE ANY POTENTIAL CONFLICTS OF INTEREST THEY MAY HAVE. UPON COMPLETION OF THE CONFLICTS OF INTEREST SURVEY, THE APPLICABLE INTERNAL AUDIT AND COMPLIANCE OFFICES REVIEW THE COMPLETED QUESTIONNAIRES ON BEHALF OF THE FILING ORGANIZATION. ANY CONFLICTS IDENTIFIED ARE COMMUNICATED TO THE FILING ORGANIZATION'S CEO AND ARE PRESENTED TO THE APPLICABLE AUDIT AND COMPLIANCE COMMITTEES (ANY POTENTIAL CONFLICT REPORTED BY THE CEO IS COMMUNICATED TO THE FILING ORGANIZATION'S BOARD CHAIR). ALL CONFLICTS OF INTEREST ARE RESOLVED BY MANAGEMENT PLANS DEVELOPED BY SUCH BOARDS' AUDIT AND COMPLIANCE COMMITTEES AND THE APPLICABLE INTERNAL AUDIT AND COMPLIANCE OFFICES. THE AUDIT AND COMPLIANCE COMMITTEES' CHAIRS PRESENT AN ANNUAL REPORT ON CONFLICTS TO THE FULL BOARDS OF THE APPLICABLE ORGANIZATIONSFORM 990, PART VI, SECTION B, LINE 12C
THE FILING ORGANIZATION'S EXECUTIVE COMMITTEE OF ITS BOARD OF DIRECTORS FUNCTIONS AS THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS AND PURSUANT TO A DELEGATION BY SUCH OTHER ENTITIES, REVIEWS AND APPROVES THE APPOINTMENT AND COMPENSATION OF THE SENIOR EXECUTIVES OF WFUHS, WFUBMC, AND THE FILING ORGANIZATION. THE EXECUTIVE COMMITTEE RELIES UPON AN EXTERNAL, INDEPENDENT COMPENSATION CONSULTANT EXPERIENCED IN HEALTHCARE TO PROVIDE THE COMMITTEE WITH COMPENSATION COMPARABILITY DATA FOR NEW EXECUTIVE POSITION APPOINTMENTS AND FOR COMPENSATION REVIEWS FOR EXISTING EXECUTIVES. THE CONSULTANT, WHICH IS RETAINED DIRECTLY BY THE EXECUTIVE COMMITTEE, PROVIDES THIRD-PARTY INFORMATION AND EVALUATES THE COMPETITIVENESS AND REASONABLENESS OF EXECUTIVE COMPENSATION AND BENEFITS PROGRAMS IN RELATION TO MARKET PRACTICES FOR SIMILARLY-SITUATED NONPROFIT HEALTHCARE ORGANIZATIONS. THE COMMITTEE MAKES ITS DECISIONS WITH RESPECT TO EXECUTIVE COMPENSATION IN ACCORDANCE WITH THE FILING ORGANIZATION'S (AND WFUHS AND NCBH) POLICIES, IRS REGULATIONS, AND STANDARD CORPORATE GOVERNANCE PRACTICES. SUCH POLICIES INCLUDE ADHERENCE TO: BOARD-ESTABLISHED EXECUTIVE COMPENSATION PHILOSOPHY AND REVIEW PROCESSES; PROCESSES ENSURING EXECUTIVE COMMITTEE MEMBER AND COMPENSATION CONSULTANT INDEPENDENCE; USE OF VALID MARKET COMPARISONS OF DATA FROM PEER ACADEMIC MEDICAL CENTERS OF SIMILAR ORGANIZATIONAL STRUCTURE, SIZE, AND COMPLEXITY; CAREFUL DOCUMENTATION OF ALL COMPENSATION DECISIONS; AND ESTABLISHMENT OF THE REBUTTABLE PRESUMPTION OF REASONABLENESS, PER IRS GUIDELINES. MINUTES OF THE DELIBERATIONS OF THE EXECUTIVE COMMITTEE ARE CONTEMPORANEOUSLY MAINTAINED AND THAT COMPARABILITY DATA IS MAINTAINED IN THE MEDICAL CENTER'S OFFICE OF EXECUTIVE COMPENSATION SERVICES. IN THE EVENT THAT A MEMBER OF THE EXECUTIVE COMMITTEE HAS A CONFLICT OF INTEREST RELATED TO EXECUTIVE APPOINTMENT OR COMPENSATION, THAT MEMBER DOES NOT PARTICIPATE IN THE DELIBERATION OR APPROVAL OF APPOINTMENT OR COMPENSATION AND SUCH ABSTENTION IS NOTED IN THE COMMITTEE'S MEETING MINUTES.FORM 990, PART VI, SECTION B, LINE 15
PHOTOCOPIES OF THE FORM 1023 AND RECENT FILINGS OF THE FORM 990 ARE AVAILABLE UPON REQUEST AT THE ORGANIZATION'S ADMINISTRATIVE OFFICE.FORM 990, PART VI, SECTION C, LINE 18
PHOTOCOPIES OF THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST AT THE ORGANIZATION'S ADMINISTRATIVE OFFICE.FORM 990, PART VI, SECTION C, LINE 19
THE FOLLOWING PERSONS WERE COMPENSATED DIRECTLY BY NORTH CAROLINA BAPTIST HOSPITAL, FILING ORGANIZATION, OR WAKE FOREST UNIVERSITY HEALTH SCIENCES, AS UNRELATED ORGANIZATION, FOR SERVICES PERFORMED FOR THE FILING ORGANIZATION. EACH PERSON'S POSITION IN EACH ORGANIZATION, AND THE AVERAGE HOURS PER WEEK THAT THEY DEVOTE TO EACH ENTITY, ARE SHOWN BELOW.FORM 990, PART VII, SECTION A
JOHN D. MCCONNELL, M.D. DIRECTOR/CEO, NC BAPTIST HOSPITAL _20.6 HOURS PER WEEK CEO, WFUBMC _5__ HOURS PER WEEK DIRECTOR, CEO, WFUHS __11_ HOURS PER WEEK DIRECTOR, PIEDMONT TRIAD RESEARCH PARK __1__ HOUR PER WEEK DIRECTOR, PTRP DEVELOPMENT CORPORATION __1__ HOUR PER WEEK DIRECTOR, IDEALLIANCE __.2 _ HOURS PER WEEK DIRECTOR, IDEALLIANCE FOUNDATION __.2_ HOURS PER WEEK DIRECTOR/CHAIR, PRESIDENT, DIALYSIS CENTERS (GROUP RETURN) __.5_ HOURS PER WEEK PRESIDENT, DIALYSIS ACCESS GROUP OF WAKE FOREST UNIVERSITY, LLC __.5 _ HOURS PER WEEK H. GREG BRAY ASSISTANT TREASURER/ASSISTANT SECRETARY, FILING ORGANIZATION _38.7 HOURS PER WEEK TRUSTEE, CARENET, INC. __.1 _ HOURS PER WEEK SECRETARY, THE NURSING CENTER AT OAK SUMMIT (1/1 - 6/30) __.1 HOURS PER WEEK SECRETARY, NORTH CAROLINA BAPTIST HOSPITAL FOUNDATION (1/1 - 6/30) _.1 _HOURS PER WEEK TREASURER, HAWTHORNE INN & CONFERENCE CENTER __ 1 _ HOURS PER WEEK SHARON ENGEBRETSON INTERIM VP PASTORAL CARE, FILING ORGANIZATION __36_ HOURS PER WEEK TRUSTEE, CENTER FOR CONGREGATIONAL HEALTH __ 4 _ HOURS PER WEEK DOUGLAS L. EDGETON EXECUTIVE VICE PRESIDENT, FILING ORGANIZATION __1_ HOUR PER WEEK EXECUTIVE VICE PRESIDENT, WFUBMC __5__ HOURS PER WEEK EXECUTIVE VICE PRESIDENT, WFUHS __15_ HOURS PER WEEK DIRECTOR, PRESIDENT, PIEDMONT TRIAD RESEARCH PARK __10_ HOURS PER WEEK DIRECTOR, PRESIDENT, PTRP DEVELOPMENT CORPORATION ___5_ HOURS PER WEEK DIRECTOR, PRESIDENT, IDEALLIANCE __.2 _ HOURS PER WEEK DIRECTOR, PRESIDENT, IDEALLIANCE FOUNDATION __.2_ HOURS PER WEEK TRUSTEE, SECRETARY, TREASURER, THE MEDICAL FOUNDATION OF WFUHS AND NCBH __.1_ HOURS PER WEEK VICE PRESIDENT/TREASURER, DIALYSIS ACCESS GROUP OF WAKE FOREST UNIVERSITY, LLC __1__ HOUR PER WEEK DIRECTOR, VP/TREASURER, DIALYSIS CENTERS (GROUP RETURN) __3.5 HOURS PER WEEK EDWARD G. CHADWICK TREASURER, FILING ORGANIZATION _21 _ HOURS PER WEEK TREASURER, WFUBMC _ 5__ HOURS PER WEEK TREASURER, CFO, WFUHS _14__ HOURS PER WEEK J. MCLAIN WALLACE VP GENERAL COUNSEL/SECRETARY, FILING ORGANIZATION _ 35_ HOURS PER WEEK VP GENERAL COUNSEL/SECRETARY, WFUBMC _ 5__ HOURS PER WEEK RUSSELL M. HOWERTON, M.D. CHIEF MEDICAL OFFICER, WFU BAPTIST HEALTH SYSTEM, FILING ORGANIZATION __20_ HOURS PER WEEK CHIEF MEDICAL OFFICER, WFU BAPTIST HEALTH SYSTEM, WFUBMC __5_ HOURS PER WEEK CHIEF MEDICAL OFFICER, WFU BAPTIST HEALTH SYSTEM, WFUHS __15_ HOURS PER WEEK MEMBER, DAVIE COUNTY EMERGENCY HEALTH CORPORATION __ 1_ HOUR PER WEEK KAREN H. HUEY VP, FACILITIES, FILING ORGANIZATION __26 HOURS PER WEEK VP, FACILITIES, WFUBMC _ 5__ HOURS PER WEEK VP, FACILITIES, WFUHS _9 HOURS PER WEEK DONNY LAMBETH PRESIDENT, FILING ORGANIZATION __36_ HOUR PER WEEK PRESIDENT, WFUBMC COMMUNITY PHYSICIANS __ 1_ HOURS PER WEEK DIRECTOR, DAVIDSON HEALTHCARE, INC. __1_ HOUR PER WEEK DIRECTOR, LEXINGTON MEMORIAL HOSPITAL, INC. __1 HOUR PER WEEK DIRECTOR, LEXMEDICAL, INC. __1 _ HOUR PER WEEK CHAIRMAN, HAWTHORNE INN & CONFERENCE CENTER __.1 _ HOURS PER WEEK SECRETARY, THE NURSING CENTER AT OAK SUMMIT (7/1 - 12/31) __.1 HOURS PER WEEK SECRETARY, NORTH CAROLINA BAPTIST HOSPITAL FOUNDATION (7/1 - 12/31)__.1 _HOURS PER WEEK MEMBER, NORTHWEST COMMUNITY CARE NETWORK, INC. __.1 _ HOURS PER WEEK TRUSTEE, CARENET, INC. __.1 _ HOURS PER WEEK CHAIR, DAVIE COUNTY EMERGENCY HEALTH CORPORATION __ 1_ HOUR PER WEEK TRUSTEE, SECRETARY, TREASURER, THE MEDICAL FOUNDATION OF WFUHS AND NCBH __.1_ HOURS PER WEEK CHERYL E. H. LOCKE VP, CHIEF HUMAN RESOURCES OFFICER, FILING ORGANIZATION __26 HOURS PER WEEK VP, CHIEF HUMAN RESOURCES OFFICER, WFUBMC _ 5_ HOURS PER WEEK VP CHIEF HUMAN RESOURCES OFFICER, WFUHS _9 HOURS PER WEEK TRUSTEE, HAWTHORNE INN & CONFERENCE CENTER __.1 _ HOURS PER WEEK NORMAN B. POTTER, JR. VP, DEVELOPMENT AND ALUMNI AFFAIRS, FILING ORGANIZATION __26 HOURS PER WEEK VP, DEVELOPMENT AND ALUMNI AFFAIRS, WFUBMC _5_ HOURS PER WEEK VP, DEVELOPMENT AND ALUMNI AFFAIRS, WFUHS _ 9 HOURS PER WEEK ROBERT S. PARKER, SR. VP SPECIAL OPERATIONS/COMMUNITY, FILING ORGANIZATION _38 HOURS PER WEEK CHAIR, NORTHWEST COMMUNITY CARE NETWORK, INC. __2 _ HOURS PER WEEK JOANNE C. RUHLAND VP, GOVERNMENT AFFAIRS, FILING ORGANIZATION __26 HOURS PER WEEK VP, GOVERNMENT AFFAIRS, WFUBMC _ 5_ HOURS PER WEEK VP, GOVERNMENT AFFAIRS, WFUHS _ 9 HOURS PER WEEK SHEILA M. SANDERS VP, CHIEF INFORMATION OFFICER, FILING ORGANIZATION _26 HOURS PER WEEK VP, CHIEF INFORMATION OFFICER, WFUBMC _5_ HOURS PER WEEK VP, CHIEF INFORMATION OFFICER, WFUHS _9 HOURS PER WEEK THOMAS E. SIBERT, M.D. PRESIDENT AND COO, WFU BAPTIST HEALTH SYSTEM, FILING ORGANIZATION _26 HOURS PER WEEK PRESIDENT AND COO, WFU BAPTIST HEALTH SYSTEM, WFUBMC _5__ HOURS PER WEEK PRESIDENT AND COO, WFU BAPTIST HEALTH SYSTEM, WFUHS _8 HOURS PER WEEK TRUSTEE, WFUBMC COMMUNITY PHYSICIANS _ 1 HOUR PER WEEK MAUREEN E. SINTICH VP OPERATIONS/CNO, FILING ORGANIZATION _34.8 HOURS PER WEEK CHIEF NURSING OFFICER, WFUBMC __5 _ HOURS PER WEEK TRUSTEE, CARENET, INC. __.1 _ HOURS PER WEEK TRUSTEE, HAWTHORNE INN & CONFERENCE CENTER __.1 _ HOURS PER WEEK STEVEN C. SNELGOVE VP OPERATIONS, FILING ORGANIZATION _39 HOURS PER WEEK TRUSTEE, HAWTHORNE INN & CONFERENCE CENTER __.1 _ HOURS PER WEEK MEMBER, DAVIE COUNTY EMERGENCY HEALTH CORPORATION __ 1_ HOUR PER WEEK RONALD H. SMALL VP QUALITY & SERVICES EXCELLENCE, FILING ORGANIZATION _39 HOURS PER WEEK MEMBER, DAVIE COUNTY EMERGENCY HEALTH CORPORATION __ 1_ HOUR PER WEEK KAREN Q. TURNER VP SURGICAL SERVICES _40 HOURS PER WEEK LISA M. WYATT VP, FACILITIES, FILING ORGANIZATION _26 HOURS PER WEEK VP, FACILITIES, WFUBMC _5__ HOURS PER WEEK VP, CHIEF COMMUNICATIONS AND MARKETING OFFICER, WFUHS _9 HOURS PER WEEK ROGER COTHRAN TRUSTEE, FILING ORGANIZATION __6__ HOURS PER WEEK TRUSTEE, WFUBMC __2__ HOURS PER WEEK ERNEST L. EVANS TRUSTEE, FILING ORGANIZATION __2__ HOURS PER WEEK TRUSTEE, WFUBMC __2__ HOURS PER WEEK ARTHUR A. GIBEL TRUSTEE, FILING ORGANIZATION _13__ HOURS PER WEEK TRUSTEE, WFUBMC __2_ HOURS PER WEEK RON D. KESSINGER TRUSTEE, FILING ORGANIZATION __8__ HOURS PER WEEK TRUSTEE, WFUBMC __2__ HOURS PER WEEK STEPHEN L. ROBERTSON TRUSTEE, FILING ORGANIZATION __2__ HOURS PER WEEK TRUSTEE, WFUBMC __2__ HOURS PER WEEK MEMBER, DAVIE COUNTY EMERGENCY HEALTH CORPORATION __ 1_ HOUR PER WEEK WILLIAM C. WARDEN, JR. TRUSTEE, FILING ORGANIZATION __2__ HOURS PER WEEK TRUSTEE, WFUBMC __6__ HOURS PER WEEK SHEREE B. WATSON TRUSTEE, FILING ORGANIZATION __2__ HOURS PER WEEK TRUSTEE, WFUBMC __2__ HOURS PER WEEK MEMBER, THE NURSING CENTER AT OAK SUMMIT __.1 HOURS PER WEEK MEMBER, NORTH CAROLINA BAPTIST HOSPITAL FOUNDATION _.1 _HOURS PER WEEK KATHRYN H. HAMRICK TRUSTEE, FILING ORGANIZATION __2__ HOURS PER WEEK MEMBER, THE NURSING CENTER AT OAK SUMMIT __.1 HOURS PER WEEK MEMBER, NORTH CAROLINA BAPTIST HOSPITAL FOUNDATION _.1 _HOURS PER WEEK WILLIAM N. HARTSELL TRUSTEE, FILING ORGANIZATION __2__ HOURS PER WEEK STEPHEN R. LITTLE TRUSTEE, FILING ORGANIZATION __2__ HOURS PER WEEK GEORGE E. STUBBINS, SR. TRUSTEE, FILING ORGANIZATION __2__ HOURS PER WEEK STANLEY R. AESCHLEMAN, PHD TRUSTEE, FILING ORGANIZATION __2__ HOURS PER WEEK A. WILLIAM BLACKSTOCK, JR., M.D. TRUSTEE, FILING ORGANIZATION __2__ HOURS PER WEEK MEMBER, THE NURSING CENTER AT OAK SUMMIT __.1 HOURS PER WEEK MEMBER, NORTH CAROLINA BAPTIST HOSPITAL FOUNDATION _.1 _HOURS PER WEEK WILLIAM J. IRELAND, JR. M. DIV PHD TRUSTEE, FILING ORGANIZATION __2__ HOURS PER WEEK KENNETH W. LEWIS TRUSTEE, FILING ORGANIZATION __2__ HOURS PER WEEK MEMBER, THE NURSING CENTER AT OAK SUMMIT __.1 HOURS PER WEEK MEMBER, NORTH CAROLINA BAPTIST HOSPITAL FOUNDATION _.1 _HOURS PER WEEK KATY M. BOLES TRUSTEE, FILING ORGANIZATION __2__ HOURS PER WEEK MEMBER, THE NURSING CENTER AT OAK SUMMIT __.1 HOURS PER WEEK MEMBER, NORTH CAROLINA BAPTIST HOSPITAL FOUNDATION _.1
RAY N HOWELL, III D. MIN. TRUSTEE, FILING ORGANIZATION __2__ HOURS PER WEEK MEMBER, THE NURSING CENTER AT OAK SUMMIT __.1 HOURS PER WEEK MEMBER, NORTH CAROLINA BAPTIST HOSPITAL FOUNDATION _.1 _HOURS PER WEEK JOHN D. KIMBERLY TRUSTEE, FILING ORGANIZATION __2__ HOURS PER WEEK EDWIN L. WELCH, JR. TRUSTEE, FILING ORGANIZATION __2__ HOURS PER WEEK R. MICHAEL WELLS TRUSTEE, FILING ORGANIZATION __2__ HOURS PER WEEK CHAIR, THE NURSING CENTER AT OAK SUMMIT (1/1 - 6/30) _1 HOUR PER WEEK MEMBER, NORTH CAROLINA BAPTIST HOSPITAL FOUNDATION _.1 _HOURS PER WEEK LINWOOD L. DAVIS TRUSTEE, FILING ORGANIZATION __2__ HOURS PER WEEK BRENDA B. DIGGS TRUSTEE, FILING ORGANIZATION __2__ HOURS PER WEEK PEDRO MARTINEZ TRUSTEE, FILING ORGANIZATION __2__ HOURS PER WEEK MEMBER, THE NURSING CENTER AT OAK SUMMIT __.1 HOURS PER WEEK MEMBER, NORTH CAROLINA BAPTIST HOSPITAL FOUNDATION _.1 _HOURS PER WEEK JERRY N. BROOKS (7/1/ - 12/31) TRUSTEE, FILING ORGANIZATION __2__ HOURS PER WEEK DALE M. BROWN (7/1/ - 12/31) TRUSTEE, FILING ORGANIZATION __2__ HOURS PER WEEK JOSEPH R. OVERBY, JR., MD (7/1/ - 12/31) TRUSTEE, FILING ORGANIZATION __2__ HOURS PER WEEK
CHANGES IN NET ASSETS OR FUND BALANCES:NET UNREALIZED GAINS ON INVESTMENTS: 72,309,986. DONATED SERVICES AND USE OF FACILITIES: 38,943. CHANGE IN PENSION LIABILITY 77,335,733. NET GAIN FROM DISCONTINUED OPERATIONS 1,064,813. CHANGE IN VALUE OF INTEREST RATE SWAP 226,522. LOSS FROM AFFILIATES -1,629,817. TRANSFERS TO AFFILIATES -1,896,299. NET CHANGE IN RESTRICTED ASSETS 1,920,769. TRANSFER OF AFFILIATE TO INTEGRATED GROUP -3,458,460. OTHER ADJUSTMENTS -2,910,855. TOTAL TO FORM 990, PART XI, LINE 5: 143,001,335.FORM 990, PART XI, LINE 5:

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (7 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
NORTH CAROLINA BAPTIST HOSPITAL FOUNDATION
MEDICAL CENTER BLVDWINSTON SALEMNC27157561685120SUPPORTING ORGANIZATIONNC501(C)(3)LINE 11A, INORTH CAROLINA BAPTIST HOSPITAL1
THE REHABILITATION & SKILLED NURSING
MEDICAL CENTER BLVDWINSTON SALEMNC27157561826396HEALTHCARE (INACTIVE)NC501(C)(3)LINE 9NORTH CAROLINA BAPTIST HOSPITAL FOUNDATION1
THE HAWTHORNE INN & CONFERENCE CENTER INC
420 HIGH STREETWINSTON SALEMNC27101561793617LODGING/CONFERENCE ACCOMODATIONNC501(C)(3)LINE 11A, INORTH CAROLINA BAPTIST HOSPITAL1
CARENET INC
2000 WEST FIRST STREET SUITE 410WINSTON SALEMNC27104561977341HEALTHCARENC501(C)(3)LINE 11B, IINORTH CAROLINA BAPTIST HOSPITAL1
WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER
3540 CLEMMONS ROADCLEMMONSNC27012561903275HEALTHCARENC501(C)(3)LINE 3WAKE FOREST UNIVERSITY HEALTH SCIENCES1
CENTER FOR CONGREGATIONAL HEALTH INC
MEDICAL CENTER BLVDWINSTON SALEMNC27157237426944HEALTHCARENC501(C)(3)LINE 9NORTH CAROLINA BAPTIST HOSPITAL1
DAVIE COUNTY EMERGENCY HEALTH CORPORATION
223 HOSPITAL STREETMOCKSVILLENC27028562276994HEALTHCARENC501(C)(3)LINE 3NORTH CAROLINA BAPTIST HOSPITAL1
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 Org1GiftGrantOrCapContrFrOtherOrg
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 Orgs1RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs1RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org1OtherTransferToOtherOrg
Other Transfer From Other Org1OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (16 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
NORTH CAROLINA BAPTIST HOSPITAL FOUNDATION
A210030RECEIPT OF INTEREST
WFUBMC COMMUNITY PHYSICIANS
A101293RECEIPT OF INTEREST
NORTH CAROLINA BAPTIST HOSPITAL FOUNDATION
C15000GRANT FUNDING
WFUBMC COMMUNITY PHYSICIANS
I75610RECEIPT OF PAYMENT
THE HAWTHORNE INN & CONFERENCE CENTER INC
J227760CHECK PAYMENT
THE HAWTHORNE INN & CONFERENCE CENTER INC
O30925CHECK PAYMENT
CARENET INC
P2513900ACCRUED EXPENSE
CENTER FOR CONGREGATIONAL HEALTH INC
P11706ACCRUED EXPENSE
DAVIE COUNTY EMERGENCY HEALTH CORP
P666792ACCRUED EXPENSE
NORTH CAROLINA BAPTIST HOSPITAL FOUNDATION
P477172ACCRUED EXPENSE
THE HAWTHORNE INN & CONFERENCE CENTER INC
P444076ACCRUED EXPENSE
WFUBMC COMMUNITY PHYSICIANS
P1613631ACCRUED EXPENSE
WFUBMC COMMUNITY PHYSICIANS
Q1218304WIRE TRANSFER
THE HAWTHORNE INN & CONFERENCE CENTER INC
R0CASH
NORTH CAROLINA BAPTIST HOSPITAL FOUNDATION
R258453NOTE PAYMENT
WFUBMC COMMUNITY PHYSICIANS
R86720NOTE PAYMENT