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WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER: Form 990, tax year 2009

View the entire original 990 at ProPublica ↗

Organization
WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER (EIN 51-0190238)
Tax period
2009-07-01 to 2010-06-30
Filed
2011-05-12
IRS object ID
201131329349301648
Schema version
2009v1.2
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)
Timestamp2011-05-12T10:52:48-07:00Timestamp
Tax Period End Date2010-06-30TaxPeriodEndDate
Return Type990ReturnType
Tax Period Begin Date2009-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN510190238EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTERBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlWAKENameControl
Phone3367164445Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1Medical Center BlvdAddressLine1
CityWinston SalemCity
StateNCState
ZIP Code27157ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameDouglas NelsonName
TitleTreasurerTitle
Phone3367164445Phone
Date Signed2011-05-12DateSigned
FieldValueIRS element (for citing)
Tax Year2009TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonJohn D McConnell MDNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1Medical Center BlvdAddressLine1
CityWinston SalemCity
StateNCState
ZIP Code27157ZIPCode
FieldValueIRS element (for citing)
Gross Receipts205380GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501cXOrganization501c
Web Sitewfubmc.eduWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1975YearFormation
State Legal DomicileNCStateLegalDomicile
Activity Or Mission DescriptionWake Forest University Baptist Medical Center (WFUBMC) was established exclusively as a supporting organization for the benefit of Wake Forest University Health Sciences (WFUHS) and North Carolina Baptist Hospital (NCBH). WFUBMC coordinates and supports the fund-raising, planning, budgeting activities of supported organizations. In addition to coordinating major construction projects and leasing related activities for jointly owned properties, WFUBMC acts as the paying agent for contractor payments and functions as a real estate manager coordinating the collection of rental income, payment of rental expenses and distribution of rental income for the supported organizations. As a result, WFUBMC does not record the associated revenue or expenses or have title to the respective assets.ActivityOrMissionDescription
Nbr Voting Members Governing Body12NbrVotingMembersGoverningBody
Nbr Independent Voting Members11NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year749782ContributionsGrantsPriorYear
Contributions Grants Current Year10000ContributionsGrantsCurrentYear
Program Service Revenue CY0ProgramServiceRevenueCY
Investment Income Current Year195380InvestmentIncomeCurrentYear
Other Revenue Prior Year-578474OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year171308TotalRevenuePriorYear
Total Revenue Current Year205380TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Current Year0SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year186298OtherExpensePriorYear
Other Expenses Current Year25582OtherExpensesCurrentYear
Total Expenses Prior Year186298TotalExpensesPriorYear
Total Expenses Current Year25582TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-14990RevenuesLessExpensesPriorYear
Revenues Less Expenses CY179798RevenuesLessExpensesCY
Total Assets BOY1843407TotalAssetsBOY
Total Assets EOY2018545TotalAssetsEOY
Total Liabilities BOY14355TotalLiabilitiesBOY
Total Liabilities EOY2018545TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY1829052NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY0NetAssetsOrFundBalancesEOY
Mission DescriptionWake Forest University Baptist Medical Center (WFUBMC) was established exclusively as a supporting organization for the benefit of Wake Forest University Health Sciences (WFUHS) and North Carolina Baptist Hospital (NCBH). WFUBMC coordinates and supports the fund-raising, planning, budgeting activities of supported organizations. In addition to coordinating major construction projects and leasing related activities for jointly owned properties, WFUBMC acts as the paying agent for contractor payments and functions as a real estate manager coordinating the collection of rental income, payment of rental expenses and distribution of rental income for the supported organizations. As a result, WFUBMC does not record the associated revenue or expenses or have title to the respective assets.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense25582Expense
Grants0Grants
Revenue205380Revenue
DescriptionWake Forest University Baptist Medical Center is northwest North Carolina's sole academic medical center, bringing to the region the resources of one of America's top 50 ranked hospitals and a premier medical school. Wake Forest University Baptist Medical Center is a corporation one-half controlled by Wake Forest University and one-half controlled by North Carolina Baptist Hospital. The Medical Center operates the Wake Forest University School of Medicine, Wake Forest University Health Sciences (including its faculty physician practice of more than 600 doctors); a hospital system with 1,004 licensed acute care and rehabilitation beds across the system, which encompasses North Carolina Baptist Hospital (885 beds), Brenner Children's Hospital (160 beds, included in NCBH total); Lexington Memorial Hospital (94 beds, and its related physician practice of 32 LexMed doctors); and Davie County Hospital (25 beds). Wake Forest Baptist serves a primary 26-county region in northwestern North Carolina and southwestern Virginia and draws patients from across the state and nation for select services. Wake Forest Baptist is nationally recognized for clinical excellence and internationally known for pioneering research and clinical innovation. It has been ranked as one of "America's Best Hospitals" by U.S. News & World Report since 1993, holds the Gold Seal of Approval from the Joint Commission, the nation's esteemed standards-setting and accrediting body for health care quality, and is ranked 27th in the nation by America's Top Doctors for the number of its physicians who are considered best by their peers. The Best Doctors in America 2011-2012 listing includes 293 Wake Forest Baptist physicians, an increase of 37 percent over the previous year; 92 percent of the doctors listed for Forsyth County are Wake Forest doctors. The Medical Center was first in the Carolinas to earn Magnet Designation for Nursing Excellence from the American Nurses Credentialing Center, a distinction held since 1999. It also holds the distinction of being the most preferred hospital of area residents according to independent research from the National Research Corporation. Wake Forest Baptist offers expertise in more than 100 areas of medicine, encompassing comprehensive preventive and highly specialized care for all ages. It includes 21 subsidiary or affiliate hospitals, and operates more than 120 outreach activities, including satellite specialty clinics across northwest North Carolina that extend the benefit of Wake Forest Baptist subspecialty expertise throughout the region. As part of a busy tertiary care center, N.C. Baptist Hospital recorded 34,854 inpatient admissions in FY 2010, and a total of 818,089 outpatient encounters (ED, Downtown Health Plaza, Day Hospital, ambulatory visits). Total patient encounters numbered 852,943. In addition to its clinical leadership, Wake Forest Baptist is a major research center with more than 2,500 research studies under way. In the arena of cancer research alone, there are more than 475 studies being conducted. The Medical Center operates a Translational Science Institute committed to multi-disciplinary research that will speed findings from the laboratory to the bedside to benefit patients. One of the Medical Center's most innovative and growing programs is the Wake Forest Institute for Regenerative Medicine, where scientists are actively advancing knowledge about building organs and vessels from patients' own tissue -- advancing the horizons of medical possibility.Description
Total Of Other Program Service Exp0TotalOfOtherProgramServiceExp
Total Of Other Program Service Grnt0TotalOfOtherProgramServiceGrnt
Total Of Other Program Service Rev0TotalOfOtherProgramServiceRev
Total Program Service Expense25582TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments1TermOrPermanentEndowments
Balance Sheet Amounts Reported1BalanceSheetAmountsReported
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt0ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees0NumberOfEmployees
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Nbr Voting Governing Body Members12NbrVotingGoverningBodyMembers
Number Independent Voting Members11NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledNCStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonDoug LischkeNamePerson
Telephone Number3367164445TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1Medical Center BlvdAddressLine1
CityWinston SalemCity
StateNCState
ZIP Code27157ZIPCode
FieldValueIRS element (for citing)
No Listed Persons CompensatedXNoListedPersonsCompensated

Form990 Part VII Section A Form990PartVIISectionA (21 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeFormerFormer
Roger Cothran
Director1X000
Ernest L Evans
Director1X000
Arthur A Gibel
Director1X000
Joesph R Overby Jr MD
Director1X000
Stephen L Robertson
Director1X000
William C Warden Jr
Vice Chair1X000X
Graham W Denton Jr
Chair1X000X
Donald E Flow
Director1X000
Murray C Greason Jr
Director1X000
Robert E Greene
Director1X000
Nathan O Hatch PhD
Director1X000
Donna A Boswell
Director1X000
Allison Brashear MD
Director1X000
Neal D Kon MD
Director1X000
Frank M Torti MD
Director1X000
John D McConnell MD
Chief Executive Officer101213616468064X
J McLain Wallace Jr
Secretary1026093625328X
Edward G Chadwick
Treasurer1069028144001X
J Reid Morgan
Assistant Secretary1029356748746X
Thomas E Sibert MD
Chief Medical Officer1092904445144X
Douglas Nelson
Former Treasurer and Secretary40015495427697X
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs3542398TotalReportableCompFrmRltdOrgs
Total Other Compensation658980TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers Listed1FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
Frank Blum Construction
PO Box 4153Winston SalemNC27115Construction6112416
Carolina Business Interiors
4020 Yancy RoadCharlotteNC28217Construction706128
HKS Inc
PO Box 731121DallasTX75373Architect2744801
Bovis Lend Lease
PO Box 32755CharlotteNC28232Construction1887246
David Roberts & Assoc PA
500 East Morehead Suite 212CharlotteNC28203Architect601033
FieldValueIRS element (for citing)
Federated Campaigns0FederatedCampaigns
Membership Dues0MembershipDues
Fundraising Events0FundraisingEvents
Related Organizations0RelatedOrganizations
Government Grants0GovernmentGrants
All Other Contributions10000AllOtherContributions
Noncash Contributions0NoncashContributions
Total Contributions10000TotalContributions
Total Program Service Revenue0TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column195380TotalRevenueColumn
Related Or Exempt Function Income195380RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real0Real
Personal0Personal

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities0Securities
Other0Other
FieldValueIRS element (for citing)
Cntrbtns Rprtd Fundraising Events0CntrbtnsRprtdFundraisingEvents
Total Other Revenue0TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column205380TotalRevenueColumn
Related Or Exempt Function Income195380RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount

Other Expenses OtherExpenses

FieldValueIRS element (for citing)
DescriptionMiscellaneousDescription
Total25582Total
Program Services25582ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total25582Total
Program Services25582ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY280237BOY
EOY133681EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY1527266BOY
EOY1773315EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis0LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec0LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY0BOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY35904BOY
EOY111549EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY1843407BOY
EOY2018545EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY14355BOY
EOY9695EOY

Grants Payable GrantsPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Escrow Account Liability EscrowAccountLiability

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Loans From Officers Directors LoansFromOfficersDirectors

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY0BOY
EOY2008850EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY14355BOY
EOY2018545EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY1223166BOY
EOY0EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY505886BOY
EOY0EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY100000BOY
EOY0EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY1829052BOY
EOY0EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY1843407BOY
EOY2018545EOY
FieldValueIRS element (for citing)
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3XSupportingOrganization509a3
Supporting Org509a3 Type1XSupportingOrg509a3Type1
Certification CheckboxXCertificationCheckbox
Contrib By Controlling Individual0ContribByControllingIndividual
Contribution By Related Party0ContributionByRelatedParty
Contrib By35 Controlled Entity0ContribBy35ControlledEntity

Supported Org Information SupportedOrgInformation (3 entries)

EINEINType Of OrganizationTypeOfOrganizationListed In Governing DocListedInGoverningDocSupported Organization NotifiedSupportedOrganizationNotifiedOrganized In USOrganizedInUSAmountAmount
Wake Forest University Health Sciences
2238491992 - School111$0
North Carolina Baptist Hospital
5605527873 - Hospital111$0
Wake Forest University
5605321382 - School111$0
FieldValueIRS element (for citing)
Total Number Of Supported Orgs3TotalNumberOfSupportedOrgs
Sum Of Amounts0SumOfAmounts

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 D IRS990ScheduleD

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance505886BeginningOfYearBalance
Contributions5000Contributions
Investment Earnings Or Losses36622InvestmentEarningsOrLosses
Grants Or Scholarships0GrantsOrScholarships
Other Expenditures4980OtherExpenditures
Administrative Expenses0AdministrativeExpenses
End Of Year Balance542528EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance667600BeginningOfYearBalance
Contributions5000Contributions
Investment Earnings Or Losses-161714InvestmentEarningsOrLosses
Grants Or Scholarships0GrantsOrScholarships
Other Expenditures5000OtherExpenditures
Administrative Expenses0AdministrativeExpenses
End Of Year Balance505886EndOfYearBalance
FieldValueIRS element (for citing)
Board Designated EOY Balance0.36BoardDesignatedEOYBalance
Permanent Endowment EOY Balance0.54PermanentEndowmentEOYBalance
Term Endowment EOY Balance0.1TermEndowmentEOYBalance
Endowments Held By Unrelated Orgs0EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs0EndowmentsHeldByRelatedOrgs

Land Land

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis0OtherCostOrOtherBasis
Book Value0BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis0OtherCostOrOtherBasis
Depreciation0Depreciation
Book Value0BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis0OtherCostOrOtherBasis
Depreciation0Depreciation
Book Value0BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis0OtherCostOrOtherBasis
Depreciation0Depreciation
Book Value0BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis0OtherCostOrOtherBasis
Depreciation0Depreciation
Book Value0BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings0TotalOfBookValueLandBuildings

Financial Derivatives FinancialDerivatives

FieldValueIRS element (for citing)
Book Value0BookValue
Method Of ValuationFMethodOfValuation

Closely Held Equity Interests CloselyHeldEquityInterests

FieldValueIRS element (for citing)
Book Value0BookValue
Method Of ValuationFMethodOfValuation
FieldValueIRS element (for citing)
Total Of Book Value Securities0TotalOfBookValueSecurities

Other Assets OtherAssets (3 entries)

DescriptionDescriptionBook ValueBookValue
Other Investments & Assets74100
Insurance Policies36856
Sales tax receivable593
FieldValueIRS element (for citing)
Total Book Value Other Assets111549TotalBookValueOtherAssets
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionBeneficial interest held on the behalf of OthersDescription
Amount$2,008,850Amount
FieldValueIRS element (for citing)
Total Of Amounts2008850TotalOfAmounts
Total Revenue205380TotalRevenue
Total Expenses25582TotalExpenses
Excess Or Deficit For Year179798ExcessOrDeficitForYear
Net Unrealized GL On Investments0NetUnrealizedGLOnInvestments
Donated Services And Facilities0DonatedServicesAndFacilities
Investment Expenses0InvestmentExpenses
Prior Period Adjustments-2008850PriorPeriodAdjustments
Other$0OtherAmount
Total Adjustments-2008850TotalAdjustments
Excess Or Deficit Per FS-1829052ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt202118TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments0NetUnrealizedGainsInvestments
Donated Srvc And Use Of Facilities0DonatedSrvcAndUseOfFacilities
Recoveries Of Prior Year Grants0RecoveriesOfPriorYearGrants
Other Revenues0OtherRevenues
Revenue Not Rptd F9900RevenueNotRptdF990
Revenue Subtotal202118RevenueSubtotal
Investment Expenses Not Included0InvestmentExpensesNotIncluded
Other Revenues Not Included3262OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt3262RevenueNotRptdOnFinStmt
Total Revenue Per Form990205380TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt25582TotExpensesEtcAuditedFinclStmt
Donated Services Use Of Facilities0DonatedServicesUseOfFacilities
Prior Year Adjustments0PriorYearAdjustments
Losses Reported0LossesReported
Other Expenses Included0OtherExpensesIncluded
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal25582ExpensesSubtotal
Investment Expenses Not Included20InvestmentExpensesNotIncluded2
Other Expenses Not Included0OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form99025582TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (3 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
SchD_P05_S00_L04Schedule D, Part V, Line 4The fund was established with WFUBMC to be used for the most appropriate and beneficial needs in the healthcare field.
SchD_P10_S00_L00Schedule D, Part XWake Forest University Baptist Medical Center (WFUBMC) is the coordinator for fundraising and all gifts are ultimately distributed to North Carolina Baptist Hospital and Wake Forest University Health Sciences; therefore, all gifts are recorded by WFUBMC as a liability.
SchD_P12_S00_L04bSchedule D, Part XII, Line 4bNet investment income on temporarily-restricted net assets.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
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 (7 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
John D McConnell MD
08312880266667011566104415890264750168168000
J McLain Wallace Jr
02283970242140832509175016153028626400
Edward G Chadwick
02942180350000046063016476027525073428200
J Reid Morgan
028157600011991024500024246034231300
Douglas Nelson
01390370156250292010480017217018265100
Thomas E Sibert MD
026665405500000112390016483028661097418800
Nathan O Hatch PhD
05242770340650361600209917061338086575700

Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
SchJ_P01_S00_L00Schedule J, Part IDuring the tax period, the filing organization and its affiliates, North Carolina Baptist Hospital ("NCBH") and Wake Forest University Health Sciences ("WFUHS") were operating under an agreement that provided for a single executive group to provide for the management of both the filing organization and WFUHS, which entities together have combined operating revenues for the tax period of $1,814 billion. These individuals were sought and hired after national searches in a highly competitive environment, and the medical center sought only individuals at the highest levels of ability, given their task of initiating the new management structure designed to optimize the effectiveness of both organizations in their tax-exempt missions. Three executives (John D. McConnell, M.D., medical center CEO; Thomas E. Sibert, M.D., and Edward G. Chadwick, medical center CFO), received one-time recruitment bonuses that included relocation incentives. Additionally, Dr. McConnell received a deferred compensation arrangement that replaced similar non-vested benefits forfeited from his previous employer. The bonuses were paid by its affiliate, WFUHS, and the determination of the amount of the bonuses followed the filing organization's compensation procedures as outlined in Part VI, Section B, line 15 of the Form 990. The compensation for executives John D. McConnell, M.D., medical center CEO, Thomas E. Sibert, M.D., and Edward G. Chadwick, medical center CFO, is paid to them by a related organization, WFUHS, but 50% of that compensation is reimbursed by North Carolina Baptist Hospital.
SchJ_P01_S00_L03Schedule J, Part I, Line 3See Schedule O information for Form 990, Part VI, Section B, Line 15 relating to the Process for Determining Compensation of the organization's CEO/Executive Director.
SchJ_P02_S00_L00Schedule J, Part IIThe following individuals were compensated by Wake Forest University Health Sciences, a related organization, for services performed for WFUBMC, WFUHS, and NCBH: John D. McConnell, M.D., Thomas E. Sibert, M.D., Edward G. Chadwick, and Douglas Nelson. The following individual was compensated by North Carolina Baptist Hospital, a related organization, for services performed for WFUBMC and NCBH: J. McLain Wallace, Jr. The following individuals were compensated by Wake Forest University, a related organization, for services performed for WFUBMC, WFUHS, and WFU: Nathan O. Hatch, Ph.D. and J. Reid Morgan.

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (5 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
F990_P06_S0B_L11Form 990, Part VI, Section B, Line 11WFUBMC Financial Services will distribute to the Corporation's Board of Trustees copies of the Form 990 prior to their scheduled meeting. The Board has asked the Audit and Compliance committees of WFUHS and NCBH to review the detail of the Form 990 with the Corporation's Chief Financial Officer or a delegate from Financial Services. Members of the Corporation's management team will answer questions and address any concerns the Committee Members or other Trustees raise. The minutes of the joint Audit and Compliance Committee Meeting will note that the Committee Members and other Trustees and Directors have reviewed and discussed the Form 990 with the Corporation's management. If modifications are required, Financial Services will redistribute the revised Form 990 to all Trustees and Directors, along with a report noting the modifications.
F990_P06_S0B_L12cForm 990, Part VI, Section B, Line 12cOn an annual basis, all Trustees and Officers that have significant influence over the operations of the organization are asked to complete a questionnaire noting the following: acknowledge receipt of the Conflict of Interest Policy, acknowledge that they have read and understand the policy, acknowledge that they agree to comply with the policy, and describe any potential Conflicts of Interest they may have given their role within the organization. Upon completion of the Conflict of Interest survey, the Internal Audit and Compliance Offices reviews the completed questionnaires. Any significant conflicts identified are communicated to the organization's President and presented to the organization's Board Audit and Compliance Committees. The Audit and Compliance Committee Chairs then presents the Annual Report to the full Boards. Any material Conflicts of Interest are monitored by the Boards and organizational level by the Audit and Compliance Committees and the Internal Audit and Compliance offices, and conflicted individuals are asked to conduct business, as it relates to the identified conflict, in accordance with the Conflict of Interest Policy. Opportunities exist for Trustees, Directors, and Officers that have significant influence over operations of the organization to report conflicts to the Internal Audit and Compliance Offices should a Conflict of Interest arise between annual questionnaires.
F990_P06_S0B_L15Form 990, Part VI, Section B, Line 15It is the policy of WFUBMC to establish Executive Compensation at a level appropriate to attract and retain Executive level personnel in a manner that complies with IRS Guidelines for approval of Executive Management compensation, incorporating practices currently in place from the Compensation Committees responsibilities, Executive compensation philosophy, and the Management Incentive Compensation Plan. The review and approval of compensation will be performed by the Compensation Committees of WFUHS's Board of Directors and NCBH's Board of Trustees, via delegated authority of the Board of Directors and Trustees as follows: the primary purpose of the Compensation Committees is to oversee the Executive Compensation Program to insure that it is administered in a manner which is consistent with the compensation philosophy adopted by the Board of Directors and Trustees. The Compensation Committees shall provide systematic review and evaluation of the CEO's performance and shall oversee the Executive Compensation Program to insure it is administered in a manner that is consistent with any policies and plans adopted by the Board of Directors and Trustees and in compliance with any applicable legal requirements. The Compensation Committees shall initiate and review the Executive Succession Planning Policies and Procedures. The members of the Compensation Committees shall be the Chairs of the Corporations, who shall be the Chairs of the Compensation Committees, the Vice Chairs of the Corporations, the Chairs of the Finance Committees, and the Chairs of the Governance and Nominating Committees and any other Directors and/or Trustees deemed necessary to serve the Committee purpose and elected by the Board of Directors and Trustees.
F990_P06_S0C_L19Form 990, Part VI, Section C, Line 19Photocopies of the organization's governing documents, Conflict of Interest Policy, and financial statements are available upon request at the organization's Administrative Office.
F990_P10_S00_L25Form 990, Part X, Line 25Wake Forest University Baptist Medical Center (WFUBMC) is the coordinator for fundraising and all gifts are ultimately distributed to North Carolina Baptist Hospital and Wake Forest University Health Sciences; therefore, all gifts are recorded by WFUBMC as a liability.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNA
North Carolina Baptist Hospital
Medical Center BlvdWinston SalemNC27157560552787HealthcareNC501(c)(3)Line 3N/A
Wake Forest University Health Sciences
Medical Center BlvdWinston SalemNC27157223849199Healthcare Education and ResearchNC501(c)(3)Line 2N/A
Wake Forest University
PO Box 7201Winston SalemNC27109560532138UniversityNC501(c)(3)Line 2N/A
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs1PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg