2011-08-12T09:31:24-05:00 2010-09-30 LarsonAllen LLP 101 N Tryon Street Suite 1000 Charlotte NC 28246 990 2009-10-01 566017737 WAKEMED WAKE 9193500535 3000 NEW BERN AVE RALEIGH NC 27610 Michael DeVaughn 9193500535 2011-08-11 1 7049985200 2009 2016-02-24 21:20:13Z See schedule O dr william atkinson 3000 NEW BERN AVE RALEIGH NC 27610 1335557233 0 X WWW.WAKEMED.ORG X 1965 NC WAKEMED IS A MULTI-FACILITY HEALTH SYSTEM, PROVIDING STATE OF THE ART, HIGH QUALITY CARE. 14 14 8807 1095 2293492 -177371 7115585 5965412 869635965 877653989 6013068 11942993 1007373 1013153 883771991 896575547 1410354 1217664 0 484677214 475390247 0 0 400487762 416779932 886575330 893387843 -2803339 3187704 1287675913 1335640583 655573436 663145048 632102477 672495535 WakeMed provides outstanding and compassionate care to all who seek our services. We are committed to the health & wellness of the communities we serve by providing preventive, diagnostic, in/out patient, rehabilitative and skilled nursing care to all regardless of ability to pay. Based on community need a diverse array of educational and outreach programs are offered. We also collaborate with other community organizations to improve health status & access. 0 0 231633557 223852915 SURGICAL SERVICES - WakeMed offers surgical services in 3 locations; WakeMed Raleigh Campus, WakeMed Cary Campus and WakeMed North Healthplex. All of them provide surgical services, both in and outpatient to all regardless of their ability to pay. By having services in 3 distinct locations throughout the county, WakeMed has improved access to these services. Access to specialty care continues to be one of the key concerns facing our community. WakeMed has expanded its network of specialists and WakeMed Faculty Physicians is one of the key groups of physicians who provide subspeciality care to the underinsured and work with the patient to provide discounted fees based on income and need. Many physicians on the medical staff continue this practice of provding quality care to patients regardless of ability to pay. Last year, surgeries were performed on 28,567 total patients in the WakeMed system. 217157931 239529072 HEART SERVICES - WakeMed's heart and vascular program is one of the largest and most well respected in NC. Last year, more than 29,000 cardiovascular procedures were conducted for nearly 14,000 patients in the WakeMed system. Procedures included surgery, cardiac catherizations and electrophysiology and thousands of others were treated medically as in and outpatients throughout the system. The 2008 State of the County Health Report indicated heart disease as the second leading cause of death in Wake County. Additionally, the county's Health Assessment identified management of chronic disease of paramount importance to Wake County residents' overall health. WakeMed's Heart Center has made significant strides in programs and services aiming to reduce heart disease and diabetes and improve patients' understanding of disease management. The Wake Heart Center provides a comprehensive continuum of care for the cardiac patient from education and prevention to diagnosis, intervention, surgery, cardiac rehabilitation and on-going disease management for heart failure. Free education programs are offered regularly for our patients, their family members and the community to complement our comprehensive care services. Our intentions are to teach patients about their risk factors for heart disease and encourage healthy behaviors through lifestyle changes, thus building a foundation for a healthier population. WakeMed Mobile Critical Care Services provides critical care transport via ground and air servicing. Serving approximately 1,000 critically ill patients each month, it is the busiest inter-facility ground transport service in the state. Each year, WakeMed's Heart Center provides free health screenings including cholesterol screenings, blood pressure checks, vascular screenings and stroke assessments throughout the community. These screenings are designed to be a secondary prevention activity to detect early onset of disease and illness. WakeMed conducts training for the program CPR Anytime at multiple locations in Wake County, and provides CPR Anytime kits throughout the community at more than a 70 percent discounted cost. Last fiscal year, WakeMed treated 13,896 patients in our Heart Center; of these, 8,148 were insured under Medicare, 938 were insured under Medicaid and 444 of these patients were uninsured. 72299532 104290971 EMERGENCY SERVICES - Access to affordable health care continues to be a critical challenge facing Wake County's residents. One of the many ways WakeMed has improved access for Wake County residents is through our multiple locations and physicians offices throughout the community. Over the past couple of years, WakeMed has opened stand alone emergency departments, which are geographically spread throughout the county, increasing convenient access to emergency care for patients. WakeMed is among the top three volume providers of emergency care in NC. Its four adult emergency departments are located throughout Wake County. Our Children's Emergency Department in Raleigh is the only Children's ED in the county. WakeMed's Raleigh Campus is also home to Wake County's only Level I Trauma Center, the highest designation awarded to trauma centers in NC. Our Trauma Service includes five adult intensive care units and a pediatric intensive care unit as well as a comprehensive acute, inpatient and outpatient physical rehabilitation program. WakeMed's emergency and trauma services treat all patients who present seeking medical care, regardless of their ability to pay. In FY10, 191,600 patients were treated in WakeMed's Emergency Departments; of these patients 30,965 were insured under Medicare; 50,827 of these patients were insured under Medicaid; and 39,583 of these patients were uninsured. Nearly 47 percent of all patients seen in our EDs are either Medicaid or uninsured resulting in WakeMed providing care for more than 80 percent of the county's uninsured and Medicaid patients. 274351323 1217664 28902589 274351323 1217664 28902589 795442343 1 1 0 1 0 0 0 0 1 1 0 1 0 0 1 0 0 0 0 0 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 548 0 1 8807 1 1 1 0 0 0 0 0 0 0 0 0 0 0 14 14 0 0 0 0 0 1 1 1 1 0 0 1 1 1 1 1 1 1 0 1 1 NC X michael devaugh cfo 9193500535 3000 NEW BERN AVE RALEIGH NC 27610 billie j redmond 5.00 X 0 0 0 larry d barbour 5.00 X 0 0 0 thomas b oxholm 5.00 X 0 0 0 Richard F Baker 4.00 X 0 0 0 jerry bernstein md 4.00 X 0 0 0 dana d copeland md 3.50 X 0 0 0 ron e doggett 6.00 X 0 0 0 brenda c gibson 4.00 X 0 0 0 david w jessen 3.00 X 0 0 0 william h mcbride 5.00 X 0 0 0 m jackson nichols 4.00 X 0 0 0 lorraine m wright phd 4.50 X 0 0 0 Lloyd M Yates 2.00 X 0 0 0 Robert A Cerwin 2.00 X 0 0 0 paul coble 3.00 X 0 0 0 jack o clayton 4.00 X 0 0 0 william p pinna 2.00 X 0 0 0 william k atkinson ii 40.00 X 797522 0 143276 michael devaughn 40.00 X 386390 0 19979 deborah g friberg 40.00 X 460619 0 36093 kathleen k gormley 40.00 X 455375 0 30222 david c coulter 40.00 X 373103 0 33681 mary a wilcox 40.00 X 290680 0 33254 jeanene r martin 40.00 X 263201 0 34859 evin d arledge 40.00 X 269187 0 33385 thomas cavender 40.00 X 248889 0 29190 carolyn knapp 40.00 X 206465 0 31445 BETSY GASKINS-mcclaine 40.00 X 202577 0 30165 Georgia c sumiel 40.00 X 173047 0 22774 derrick miles 40.00 X 195638 0 23096 timothy e harris 40.00 X 575608 0 31173 mark l wood 40.00 X 559642 0 33728 johnathan d chappell 40.00 X 540584 0 23323 Gurvinder S Deol 40.00 X 499759 0 25954 Robert D Matthews 40.00 X 392743 0 32802 6891029 0 648399 408 0 1 0 Brasfield & Gorrie LLC 8521 Six Forks Rd 110 Raleigh NC 27615 construction 54927515 Owens & Minor 4200 Global St raleigh NC 27610 medical supplies 32891858 amerisourcebergen po box 530494 atlanta GA 30384 pharmaceuticals 26173280 medtronic po box 409201 atlanta GA 30384 medical devices 24943468 University of NC Hospitals 211 Friday Center Dr Chapel Hill NC 27517 Physician Services 18213280 341 4739649 1225763 5965412 patient services 621500 850868534 850374069 494465 26785455 18944425 1799027 6042003 877653989 13658349 13658349 713238 85124 628114 628114 628114 436269069 912137 438267201 629361 -1998132 282776 -1715356 -1715356 investment in subsidia 621610 385039 385039 385039 896575547 869703533 2293492 18613110 1217664 1217664 4551496 4551496 385683188 327830710 57852478 13836978 11761431 2075547 44532648 37852751 6679897 26785937 22768046 4017891 1074198 1009746 64452 214890 196732 18158 226300 212722 13578 1071131 1006863 64268 79173463 74423055 4750408 4954166 4656916 297250 187887141 176613913 11273228 10051391 9448308 603083 17385127 16342019 1043108 660464 620836 39628 979923 921127 58796 13893557 13893557 63022153 63022153 6691941 6290425 401516 repairs/maint 16936239 13548991 3387248 minor equipment 3784557 3557484 227073 8773291 8246894 526397 893387843 795442343 97945500 0 33990 47880 434301087 526517265 1068584 668736 116134806 116153089 18879703 19481828 6611930 9621002 1168838902 642523807 509325275 526315095 56652762 48902633 144667776 87933055 1287675913 1335640583 117184225 128040889 7002196 1351501 465827140 463845902 65559875 69906756 655573436 663145048 X 631688951 671933552 413526 561983 632102477 672495535 1287675913 1335640583 X 0 1 1 X 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 0 0 1 77327 1 148972 0 0 226299 0 Part II-B, Line 1i: Explanation of Other Lobbying Activities: WakeMed and its office of government affairs work to maintain and strengthen effective relationships with legislators and policy makers at the State, Local and National levels. The Objective is to ensure that WakeMed's point of view is consistently and continually heard so that legislation, regulations and the setting of health policy support the organization's ability to fulfill its mission of care for all regardless of the ability to pay. 316547 7328 1206 322669 350781 9625 42650 1209 316547 0.00000 1.00000 0.00000 0 0 3392317 3392317 553751337 171132908 382618429 8087691 3997896 4089795 565962333 453203156 112759177 37645224 14189847 23455377 526315095 assets whose life is limited 5990999 PREPAID PENSION OBLIGATION 1899038 DEFERRED BOND FINANCING COSTS 11357739 other equity investments 2962199 restricted funds 30510065 designated funds 35213015 87933055 capital leases 114652 misc leases - LT 533251 due to 3rd party payer 50192098 ESTIMATED MALPRACTICE 19011587 accrued interest 55168 69906756 Part V, Line 4: Description of Intended Use of Endowment Funds: The allen trust endowment funds are used to provide poor and indigent patients with private duty nursing care. wakemed defines poor and indigent patients as those with a financial class of self-pay or medicaid. a sitter can be in either the hospital or homecare setting. North America 0 0 Conferences 4112 Europe 0 0 Conferences 1000 Central Amercica 0 0 Program Service Patient Transport 3599 central Amercica 0 0 Conferences 1484 0 0 10195 1 1 X 1 X 1 X 1 1 1 0 1 1 65883417 65883417 0.07370 41056359 41056359 0.04600 106939776 106939776 0.11970 3424736 3424736 0.00380 16177063 7918304 8258759 0.00920 638802 638802 0.00070 20240601 7918304 12322297 0.01370 127180377 7918304 119262073 0.13340 84754 84754 0.00010 211026 211026 0.00020 231695 231695 0.00030 19419 19419 0.00000 809575 809575 0.00090 1356469 1356469 0.00150 0 10666728 0 246501712 241929320 4572392 X 1 1 Mid-Carolina Home Care LLC Home Infusion/Medical Equipment 0.50000 0.00000 0.00000 Wake PET Services LLC Equipment Leasing 0.50000 0.00000 0.50000 Cardiac Innovations LLC Equipment Leasing 1.00000 0.00000 0.00000 Wake Orthopedics LLC Medical Practice 1.00000 0.00000 0.00000 Wake Specialty Physicians LLC Medical Practice 1.00000 0.00000 0.00000 Blue Ridge GP LLC medical Practice 0.51000 0.00000 0.00000 Partners in Practice LLC Medical Practice 1.00000 0.00000 0.00000 wakemed raleigh campus

3000 new bern ave raleigh NC 27610

X X X X wakemed cary hospital

1900 kildare road cary NC 27518

X X X Part I, Line 6a: wakemed prepares a community benefit report per the guidelines of our state hospital association. this report is available on the wakemed and ncha website. Part I, Line 7: charity care is reported as the system charity care at cost. medicaid costs are derived from our cost accounting system, which addresses all patient segments. Part I, Line 7f: The amount reported in Part III, line 2 is the system bad debt at cost. charity and bad debt accounts are recorded at current account balance levels. the balance may be net of contractual allowances and/or payments received. for example, bad debt or charity resulting from an unpaid patient liability after insurance is recorded at the amount unpaid by the patient. the text of the footnote to wakemed's financial statements regarding bad debt expense is as follows: "wakemed has presented its provision for uncollectible accounts as a direct reduction of patient service revenue in accordance with the AICPA audit guide for health care organizations. based on the most recent update of the audit guide's interpretations of the requirements of GASB statement no. 34, governmental health care organizations are required to present uncollectible accounts as a component of net patient service revenue rather than within operating expenses." Part III, Line 4: The amount reported in Part III, line 2 is the system bad debt at cost. charity and bad debt accounts are recorded at current account balance levels. the balance may be net of contractual allowances and/or payments received. for example, bad debt or charity resulting from an unpaid patient liability after insurance is recorded at the amount unpaid by the patient. the text of the footnote to wakemed's financial statements regarding bad debt expense is as follows: "wakemed has presented its provision for uncollectible accounts as a direct reduction of patient service revenue in accordance with the AICPA audit guide for health care organizations. based on the most recent update of the audit guide's interpretations of the requirements of GASB statement no. 34, governmental health care organizations are required to present uncollectible accounts as a component of net patient service revenue rather than within operating expenses." Part III, Line 8: there are significant costs involved in the treatment of Medicare patients that are not reportable on the cost report. some of these costs are $1,915,841 for laboratory and therapy services, $12,534,645 for non-covered and non-compliant costs, $5,816,206 for physician costs, $16,032,265 for cost excluded per Medicare cost reporting requirements and $933,154 for unreimbursed Medicare bad debt.The medicare allowable costs were determined from the medicare cost report, as specified in the provider reimbursement manual. Part III, Line 9b: the wakemed collections policy applies to all patients. once an account balance is determined to be patient liability, a letter is sent to the patient requesting payment on the balance of the account. if no payment or response is received within 30 days, a second notice is mailed requesting payment. at day 60, the patient is sent a third letter instructing them to settle the account within 10 days. at day 75, the patient is sent a final notice requesting payment within 10 days or the account will be moved to a collection agency. while the letter states 10 days to receive this payment, wakemed allows 30 days for payment to be received and posted to the account before the account is sent to the collection agency on day 105. Note, due to medicare regulations, medicare patient accounts do not move to the collection agency until day 125. Part V: In addition to the facilities listed in part V, the wakemed system includes six OP rehabilitation facilities, two freestanding 24 hour ED/OR facilities with OP services, and two skilled nursing/OP facilities. Part VI, Line 2: WakeMed assesses the health needs in the community in multiple ways. The organization collects primary data by partnering with Wake County Human Services to conduct a community-wide assessment of perceived health issues facing the community, gaps and needs and the existing assets currently available. In addition, WakeMed consistently surveys patients served both formally and informally through discussions, focus groups, etc. We also work with partnering organizations to understand the needs of certain segments of the population even further. Quantitative secondary data is also collected and analyzed on an on-going basis from a wide variety of sources to help determine the demographics, socioeconomics, health status, chronic illnesses, and barriers to access that exist in all markets that WakeMed serves. Part VI, Line 3: WakeMed posts the required EMTALA notice at all portals of entry, including Emergency Departments. The signage notes that WakeMed participates in the Medicaid program. The WakeMed website provides detailed information regarding financial assistance and charity care. in addition, the financial assistance form is located on the website for any patient to complete and submit. as part of the intake process/registration for all patients, wakemed provides a copy of the financial and billing policy, which refers patients to patient financial services if they have concerns regarding their ability to pay the bill. all inpatients and patients scheduled for selected outpatient procedures, and who are designated "uninsured" at the time of admission, are contacted personally by a financial counselor. in addition, any patient, regardless of insurance coverage, may request to see a financial counselor. The financial counselor will assess possible Medicaid eligilbilty and provide an application/financial statement that is submitted to patient financial services to request assistance with medical expenses. wakemed also has on-site employees from wake county human services to process medicaid applications for residents of wake county. any patient who is uninsured and may be elibible for disabilty is referred to a wakemed disabilty specialist who will assist with the application. wakemed includes information regarding the financial assistance policy in all patient billing statements. Part VI, Line 4: Although wakemed serves patients from all of north Carolinas 100 counties and beyond, its primary service area can best be described as the contiguous zone including wake county, Durham county, orange county and Johnston county in central north Carolina. These counties are growing areas consisting of a central city core in Raleigh-Durham-Chapel Hill, and dozens of smaller communities that view Raleigh-Durham-chapel hill as their primary source for tertiary level care. The market itself is fiercely competitive, the only market in the state with 3 major health systems competing against one another. Wakemed shoulders the vast majority of the charity care in the market. The growth of the population base and the gradual aging of the population are indicating an extensive need for more capacity to serve the community over the few next decades. Residents of these 4 counties currently number over 1.5 million in population, and that population has continued to grow even amidst the worst economic recession in many decades. The population is fairly diverse. Key health indicators for this population are collected and reviewed by wakemed frequently. Health facilities investment is lacking in areas with high self-pay & Medicaid rates. The western and northern parts of the market are much more prosperous than southern and eastern. Not dissimilar from most urban parts of America, the majority of deaths come from cancer, heart, and vascular diseases. In addition, the primary service area is growing and aging. With health care changes afoot, wakemed will see intense demands on capital and tight reimbursement over the next decade. All of these factors are coming together to require that community investments to meet needs be determined with razor-sharp accuracy. Part VI, Line 5: Based on the information gathered from many sources and the needs determined, wakemed develops and implements numerous community-building activities that address the root causes of many health problems. Specifically, we provide financial and in-kind support to community-based organizations whose mission is to address the specific health needs of those populations which are underserved and/or are dealing with critical health issues; we are frequently stationed throughout the community (outside the walls of our organizations) providing health education (stroke, heart disease, diabetes, injury prevention, nutrition), screenings, flu shots, first aid, etc. throughout the community; we have built coalitions that focus on improving access for the uninsured, on encouraging healthy eating and physical activity to reduce obesity, and on identifying children at risk for and who have been victims of sexual abuse and domestic violence; we lead collaborative efforts to help the community prepare and respond to disasters both natural and man-made; we are actively involved in economic development efforts that are focused on building the small business community, revitalizing neighborhoods by growing the economic base and reducing crime; we are actively involved in advocacy to advance public policy as it relates to cost, access and quality; and we lead extensive efforts to help prepare the workforce of tomorrow. These are but a few examples of the extensive outreach provided by wakemed that further our value to the communities we serve. Part VI, Line 6: Beyond the care currently provided within our facilities, wakemed continues to develop programs and services in those areas which are underserved and are growing. Access to primary care providers is a critical need. As a result, we are expanding our network of primary care providers who serve community residents, regardless of their ability to pay. Wakemed helps improve the health of the community by outreach that takes on many forms from the direct provision of care to mentoring at-risk youth. The 14-member, volunteer, wakemed board of directors, is a true cross section of the communities we serve. They are corporate/business leaders, community and volunteer leaders and community physicians. Eight of the 14 members are appointed by the wake county commissioners and there are no employees or vendors. Each board member completes a conflict of interest statement to ensure they represent the best interest of the community. In addition, the board has appointed a community benefit task force, which also represents the broader community to help determine where the need is the greatest and provide advice and recommendations to the board with regard to wakemeds role and benefit to the community. The medical staffs are open to all community physicians and privileges are extended to those who apply and meet the credentials as established by the by-laws. There are currently nearly 1,000 physicians on the medical staffs from all specialties and segments of the community. As a private, not-for-profit organization, net income is reinvested in the organization for capital equipment, facility improvements or expansion, new services and service locations, the education of health professionals, research as it relates to the improvement of care and outcomes, and efforts to continually improve the quality and safety of patient care. NC 1 alliance medical ministries 101 Donald Ross Dr raleigh NC 27610 562168673 501(c)(3) 402125 medical care urban ministries of wake county 1390 Capital Boulevard raleigh NC 27603 581422700 501(c)(3) 174486 medical care raleigh rescue mission inc po box 27391 raleigh NC 27611 566024168 501(c)(3) 30000 Medical Care American Heart Association 4217 park pl ct glen allen VA 23060 135613797 501(c)(3) 5500 general support artsplosure po box 391 raleigh NC 27602 581387567 501(c)(3) 5000 general support Camp Oak Hill 3824 Barrett Dr 107 Raleigh NC 27609 561108825 501(c)(3) 16455 general support Cary Visual Arts Inc PO Box 4322 Cary NC 27519 562023686 501(c)(3) 5000 General Support interact 1012 oberlin rd raleigh NC 27605 581320613 501(c)(3) 7500 10900 FMV 2 Vehicles general support interfaith food shuttle po box 14638 raleigh NC 27620 561753180 501(c)(3) 6000 general support Junior League of Raleigh Inc PO Box 26821 Raleigh NC 27611 560562849 501(c)(3) 8000 General Support marbles kids museum 201 east harget st raleigh NC 27601 581647538 501(c)(3) 10000 general support march of dimes foundation 6504 falls of the neuse rd raleigh NC 27615 131846366 501(c)(3) 5000 general support NC Museum of art foundation inc 4630 mail service cntr raleigh NC 27699 237071511 501(c)(3) 10000 general support nc physicians health program inc 200 horizon dr 218 raleigh NC 27615 561846599 501(c)(3) 12000 general support NC Spinal Cord Injury Association 3701 Spring Forest Rd Raleigh NC 27609 510491208 501(c)(3) 5000 general support ncsu engineering foundation inc 911 Oval Dr raleigh NC 27695 566046987 501(c)(3) 5000 education support SAFE Child 864 W Morgan St Raleigh NC 27603 561817816 501(c)(3) 5000 general support United Way of the Greater Triangle PO Box 110387 RTP NC 27709 561949103 501(c)(3) 34000 general support wake education partnership 706 hillsborough st A raleigh NC 27603 581518182 501(c)(3) 5000 general support Project Health for Leon 3816 Carnegie Ln Raleigh NC 27612 561917546 501(c)(3) 5450 FMV Medical Equipment general support UNC Center for Public TV PO Box 14900 RTP NC 27809 Gov't 40000 education support Debnam Clinic 524 Blount St Raleigh NC 27601 561977593 300000 medical care Procedure for Monitoring Grants in the U.S.: Part I, Line 2: Schedule I, Part I, Line 2: All requests must be in writing. They are reviewed according to our donations/sponsorship guidelines as it relates to community need and ties to WakeMed's mission and designation as a 501(c)(3) organization. All donations are logged on a spreadsheet with the reason for the gift. We also keep a file on each organization and all associated paperwork. In many cases we also track how the gift is used and the benefits. In the case of a large grant, the organization is also asked for a report on results. X X 0 1 X X X X X 1 0 0 0 0 0 0 1 0 william k atkinson ii 758693 0 24707 0 14122 0 126239 0 17037 0 940798 0 0 0 michael devaughn 343472 0 28375 0 14543 0 12250 0 7729 0 406369 0 0 0 deborah g friberg 414864 0 30107 0 15648 0 17943 0 18150 0 496712 0 0 0 kathleen k gormley 409578 0 30130 0 15667 0 15925 0 14297 0 485597 0 0 0 david c coulter 344764 0 7518 0 20821 0 14700 0 18981 0 406784 0 0 0 mary a wilcox 268576 0 6373 0 15731 0 14700 0 18554 0 323934 0 0 0 jeanene r martin 243652 0 5460 0 14089 0 18375 0 16484 0 298060 0 0 0 evin d arledge 262712 0 5123 0 1352 0 15925 0 17460 0 302572 0 0 0 thomas cavender 229232 0 4695 0 14962 0 15925 0 13265 0 278079 0 0 0 carolyn knapp 188533 0 3943 0 13989 0 14724 0 16721 0 237910 0 0 0 BETSY GASKINS-mcclaine 198067 0 3685 0 825 0 16399 0 13766 0 232742 0 0 0 Georgia c sumiel 169505 0 3187 0 355 0 10502 0 12272 0 195821 0 0 0 derrick miles 144945 0 0 0 50693 0 10599 0 12497 0 218734 0 0 0 timothy e harris 371288 0 203877 0 443 0 15925 0 15248 0 606781 0 0 0 mark l wood 293280 0 266090 0 272 0 15925 0 17803 0 593370 0 0 0 johnathan d chappell 238106 0 302295 0 183 0 14700 0 8623 0 563907 0 0 0 Gurvinder S Deol 291619 0 207405 0 735 0 7350 0 18604 0 525713 0 0 0 Robert D Matthews 383501 0 8623 0 619 0 15925 0 16877 0 425545 0 0 0 Part I, Line 1a tax indemnification, gross-up payments are paid to some key employees. gross-up payments are included in taxable compensation. Part I, Line 1B: ceo benefits requiring gross-up are covered by his employment agreement; any additional ones are approved by the board of directors. other staff gross-ups occur for service award gift checks ($50/5 years of service). ceo travel for spouse is included in his employment contract. Part I, Line 4a: severance paid to 1 executive - Miles $41,779 Part I, Line 7 The organization has incentive based programs that are driven by accomplishing targets associated with quality of care, workforce excellence, patient satisfaction, and a minimum operating margin. nc medical care commission 521309402 65821dcr0 2009-02-10 169225082 See Schedule O 0 0 nc medical care commission 521309402 65821dcs8 2009-02-26 75000000 see Schedule O 0 0 nc medical care commission 521309402 65821dcw9 2009-07-16 81780000 See schedule O 0 0 169806880 11946013 568437 6340248 150653193 2010 0 0 0 1 75570285 9384637 873463 65062519 2010 0 0 0 1 87780000 858472 2010 1 0 1 1 0 0 1 0 1 0.00000 0.00000 0.00000 1 0 0 1 0 1 0.00000 0.00000 0.00000 1 0 1 1 0 1 0.00440 0.00000 0.00440 1 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 Form 990, Part VI, Section A, line 7a 8 members of the board are appointed to the board of directors by wake county. Form 990, Part VI, Section A, line 7b the wake county board of commissioners holds limited approval over some governing body decisions pertaining to ARticles V, Vi, Vii and ix in the articles of incorporation. the transfer agreement with wake county indicates approval/consent for transactions pertaining to substantial disposition of assets and covenants on liens. Form 990, Part VI, Section B, line 11 The entire 990 and associated schedules are reviewed over a period of months by the finance committee of the board of directors to acknowledge they have reviewed forms and schedules and then recommend approval to the board. a final copy is provided to the board before filing. Form 990, Part VI, Section B, line 12c the organization monitors and enforces the conflict of interest policy in various ways. each year, members of the board, committees with board delegated powers, ceo, corporate staff, executive staff, directors, managers are required to complete and submit a conflict of interest questionnaire. those individuals are required to provide written documentation of any potential conflict of interest, identifying material financial interest/personal conflicts of interest. remedial measures implemented to address conflicts of interest include abstention from voting on certain issues as well as recusal from the decision-making process and participation involving the identified issue/area. the code of conduct provides guidance on gifts and travel. gifts should not be accepted and prior to any travel/lodging paid for by a third party, written approval must be obtained from an executive vice president. also, employees who own or work in a private business outside of wakemed are not allowed to recruit or promote their products and services during work hours or through wakemed printed materials. Form 990, Part VI, Section B, line 15a review of the compensation for the CEO, officers and key employees is done regularly by the human resource department. the facility regularly uses an independent consulting firm as a source of compensation information, benchmarking and review to ensure consistent and fair compensation practices. the CEO's compensation is approved by the Board. Form 990, Part VI, Section C, line 19 the 990 is available by request and is published on guidestar. Financial statements are publically available through the medical care commission as it relates to tax exempt debt. The annual audited financial statements and transfer agreement are provided each year to wake county commissioners and become public information. Articles of incorporation are available on NC secretary of state website. form 990, part xi, line 2c: No changes for approving audited financial statements or selection of independent accountants have occurred from the prior year. Schedule H, Page 3, Part V: Facility Information: Part V lists those facilities separately licensed and/or registered under state law. It is not a complete listing of all sites where services are provided. the complete listing can be found on wakemed.org. Schedule K, Page 1, Part I, Row A, Column F: Description of Purpose: Financing (a) costs of constructing, expanding, renovating, and equipping certain hospital facilities including WakeMed Care 2-story vertical expansion, 10 bed Labor and Delivery Unit expansion and parking deck, WakeMed Raleigh 4-story patient tower, parking deck for visitors and patients, employee parking deck, portion of Rehabilitation Hospital for inpatient beds, the first floor of main hospital for 25 observation bed unit and related and other equipment (b) a debt service reserve fund, (c) the premium for a financial guaranty insurance policy and (d) issuance fees and expenses. On Part II, line 3, the premium for bond insurance was added per IRS instructions. Schedule K, Page 1, Part I, Row B, Column F: Description of Purpose: Financing (a) costs of constructing, renovating and equipping certain hospital facilities including WakeMed Cary 2-story vertical expansion 10-bed labor and delivery unit expansion and parking deck, WakeMed Raleigh 4-story patient tower, parking deck for visitors and patients, employee parking deck portions of Rehabilitation Hospital for inpatient beds, the first floor main hospital for 25 observation bed unit and related and other equipment, (b) initial costs for a credit facility for the bonds, and (c) issuance fees and expenses. Schedule K, Page 1, Part I, Row C, Column F: Description of Purpose: Financing (a) costs of currently refunding all outstanding Series 1997 bonds issued. The 1997 issue was used to refund all of 1993 and 1988 bonds which were issued to finance costs of constructing expanding, renovating, and equipping certain hospital facilities including construction of WakeMed Cary Hospital, 2-story addition to the WakeMed main campus, 45 bed rehabilitation hospital and related and other equipmnet, and (b) issuance fees and expenses. Schedule K, Part II, 5 Bond Insurance: A - Premium for bond insurance added as per instructions Form 990, Page 1, Box C: Doing Business As: Legal entity name WakeMed Legal entiy EIN 56-6017737 dba name(s): 1. wake medical center 2. western wake hospital 3. northern wake hospital 4. wake heart center 5. western wake medical center 6. wake rehabilitation hospital 7. wake area health education center 8. wake ahec 9. eastern wake day hospital and skilled nursing facility 10. wakemed home care 11. wakemed - new bern avenue campus 12. wakemed - western wake med. center 13. wakemed - rehab 14. wakemed - fuquay-varina 15. wakemed - zebulon-wendell 16. wakemed raleigh campus 17. wakemed cary hospital 18. wakemed north healthplex 19. wakemed clayton medical park 20. wakemed cary outpatient rehab center 21. wakemed fuquay-varina outpatient & skilled nursing facility 22. wakemed zebulon/wendell outpatient & skilled nursing facility 23. wakemed wake forest road outpatient rehab center 24. wakemed home health 25. wakemed health & hospitals 26. wakemed emergency services institute 27. wakemed center for patient safety 28. wakemed apex healthplex 29. wakemed professional staff 30. wakemed mobile critical care services Form 990, Part I, Line 6: Volunteers: WakeMed has approximately 1,095 volunteers. They are technically classified as volunteers of the organizations; "The Volunteers at WakeMed Raleigh Campus" and "The Volunteers at WakeMed Cary Hospital" but we list them here for informational purposes. Form 990, Page 6, Part VI, Section A, Line 8A and 8B: Documentation of Meetings: WakeMed documents all meetings held by the governing body and each committee meeting in the form of "Minutes of the Meetings". These minutes are kept in 2 formats; paper and disks which are stored at separate locations. 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