THE REX HEALTHCARE FOUNDATION INC: Form 990, tax year 2020

View the entire original 990 at ProPublica ↗

Organization
THE REX HEALTHCARE FOUNDATION INC (EIN 56-6052117)
Tax period
2020-07-01 to 2021-06-30
Filed
2022-05-11
IRS object ID
202211319349300821
Schema version
2020v4.1
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)
Return2022-05-11T07:18:15-05:00ReturnTs
Tax Period End2021-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1BDO USA LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1421 Fayetteville Street Suite 300AddressLine1Txt
CityRaleighCityNm
State AbbreviationNCStateAbbreviationCd
ZIP27601ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2020-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN566052117EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1The Rex Healthcare Foundation IncBusinessNameLine1Txt
FieldValueIRS element (for citing)
In Care Of% ANDREW ZUKOWSKIInCareOfNm
Business Name ControlREXHBusinessNameControlTxt
Phone9197844424PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line14420 Lake Boone TrailAddressLine1Txt
CityRaleighCityNm
State AbbreviationNCStateAbbreviationCd
ZIP27607ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonAndrew ZukowskiPersonNm
Person TitleCFOPersonTitleTxt
Phone9197844424PhoneNum
Signature2022-05-10SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstAndrewPersonFirstNm
Person LastZukowskiPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonSandra L FeinsmithPreparerPersonNm
PTINP01064157PTIN
Phone9192781936PhoneNum
Preparation2022-05-10PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer2TrustedCustomerCd
FieldValueIRS element (for citing)
Tax2020TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1REX HOSPITAL FOUNDATIONBusinessNameLine1Txt
FieldValueIRS element (for citing)
Principal OfficerErnie BovioPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line14420 Lake Boone TrailAddressLine1Txt
CityRaleighCityNm
State AbbreviationNCStateAbbreviationCd
ZIP27607ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$6,740,859GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.rexhealthcarefoundation.comWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1958FormationYr
Legal Domicile StateNCLegalDomicileStateCd
Activity Or MissionTO PROVIDE OPPORTUNITIES FOR OUR COMMUNITY TO INVEST RESOURCES IN THE EXCELLENT WORK OF UNC REX HEALTHCAREActivityOrMissionDesc
Voting Members Governing Body15VotingMembersGoverningBodyCnt
Voting Members Independent11VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers11TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$3,251,990PYContributionsGrantsAmt
CY Contributions Grants$2,746,318CYContributionsGrantsAmt
PY Program Service Revenue$0PYProgramServiceRevenueAmt
CY Program Service Revenue$0CYProgramServiceRevenueAmt
PY Investment Income$253,821PYInvestmentIncomeAmt
CY Investment Income$268,121CYInvestmentIncomeAmt
PY Other Revenue-$106,628PYOtherRevenueAmt
CY Other Revenue-$98,355CYOtherRevenueAmt
PY Total Revenue$3,399,183PYTotalRevenueAmt
CY Total Revenue$2,916,084CYTotalRevenueAmt
PY Grants And Similar Paid$1,054,624PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$807,123CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$0PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$0CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$16,998PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$15,908CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$863,911CYTotalFundraisingExpenseAmt
PY Other Expenses$1,054,648PYOtherExpensesAmt
CY Other Expenses$895,237CYOtherExpensesAmt
PY Total Expenses$2,126,270PYTotalExpensesAmt
CY Total Expenses$1,718,268CYTotalExpensesAmt
PY Revenues Less Expenses$1,272,913PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$1,197,816CYRevenuesLessExpensesAmt
Total Assets BOY$5,851,305TotalAssetsBOYAmt
Total Assets EOY$7,822,343TotalAssetsEOYAmt
Total Liabilities BOY$188,085TotalLiabilitiesBOYAmt
Total Liabilities EOY$47,548TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$5,663,220NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$7,774,795NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionOUR MISSION IS TO PROVIDE OPPORTUNITIES FOR OUR COMMUNITY TO INVEST RESOURCES IN THE EXCELLENT WORK OF UNC REX HEALTHCARE. THE CORE ACTIVITIES THROUGH WHICH THE FOUNDATION FULFILLS THIS MISSION INCLUDE: ADVOCACY, EDUCATION, PROGRAM DEVELOPMENT, FUNDRAISING, STRATEGIC PARTNERSHIPS AND DONOR ENGAGEMENT.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$807,123ExpenseAmt
Grant$807,123GrantAmt
Revenue$0RevenueAmt
DescTHE REX HEALTHCARE FOUNDATION SUPPORTS UNC REX HOSPITAL THROUGH A VARIETY OF PATIENT ASSISTANCE PROGRAMS, ASSISTS IN UPGRADING FACILITIES AND ACQUIRING THE MEDICAL EQUIPMENT NECESSARY TO CONTINUE EXCELLENT HEALTHCARE SERVICES. THESE PROGRAMS INCLUDE A MOBILE MAMMOGRAPHY UNIT THAT TRAVELS THE REGION PROVIDING FREE MAMMOGRAPHY SCREENING SERVICES TO UNDERSERVED PATIENTS, PATIENT ASSISTANCE THROUGH THE REX CANCER CENTER ANGEL FUND, NURSING EDUCATION, BLANKET WARMERS, PATIENT TRANSPORTATION TO TREATMENT AND MORE.Desc
Total Program Service Expenses$807,123TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Donor Rstr Or Quasi EndowmentsYes (true)DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstYes (true)ReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesfalseReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (true)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (true)IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingYes (true)ProfessionalFundraisingInd
Fundraising ActivitiesYes (true)FundraisingActivitiesInd
Gaming ActivitiesYes (true)GamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsYes (true)GrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With35 Ctrl EntfalseBusinessRlnWith35CtrlEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document3IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee0EmployeeCnt
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsYes (true)QuidProQuoContributionsInd
Quid Pro Quo Contri DisclYes (true)QuidProQuoContriDisclInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members15GoverningBodyVotingMembersCnt
Independent Voting Member11IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonANDREW ZUKOWSKIPersonNm
Phone9197844424PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line14420 LAKE BOONE TRAILAddressLine1Txt
CityRaleighCityNm
State AbbreviationNCStateAbbreviationCd
ZIP27607ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (21 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerInd
GARY L PARK
DIRECTOR1.02.0Yes (X)$0$2,775,022$658,840
WESLEY A BURKS MD
DIRECTOR1.02.0Yes (X)$0$2,498,969$568,840
STEPHEN W BURRISS
DIRECTOR1.02.0Yes (X)$0$1,579,915$194,016
ERNEST L BOVIO JR
PRESIDENT1.059.0Yes (X)$0$725,920$124,360Yes (X)
RIG S PATEL MD
DIRECTOR1.02.0Yes (X)$0$811,335$34,360
ANDREW K ZUKOWSKI
TREASURER1.059.0$0$431,095$75,210Yes (X)
SYLVIA D HACKETT
VICE PRESIDENT1.059.0$0$374,316$65,893Yes (X)
TATE M BOMBARD
SECRETARY1.059.0$0$315,211$55,963Yes (X)
BENJAMIN J MATHEW
ASST TREASURER/ASST SECRETARY1.059.0$0$173,301$20,803Yes (X)
KEVIN T ANDERSON
DIRECTOR1.02.0Yes (X)$0$0$0
CATHARINE B ARROWOOD
DIRECTOR/VICE CHAIRMAN1.02.0Yes (X)$0$0$0Yes (X)
TERESA C ARTIS
DIRECTOR1.02.0Yes (X)$0$0$0
ANN S COLLINS MD
DIRECTOR/CHAIRMAN1.02.0Yes (X)$0$0$0Yes (X)
COURTNEY A CROWDER
DIRECTOR1.02.0Yes (X)$0$0$0
MELISSA A FITZPATRICK
DIRECTOR1.02.0Yes (X)$0$0$0
KEVIN D HOWELL
DIRECTOR1.02.0Yes (X)$0$0$0
DAVID F MILLS
DIRECTOR1.02.0Yes (X)$0$0$0
C HOWARD NYE
DIRECTOR1.02.0Yes (X)$0$0$0
ROBERT B OAKES
DIRECTOR1.02.0Yes (X)$0$0$0
BOBBY T PARKER
DIRECTOR1.02.0Yes (X)$0$0$0
JASON T SANDNER
DIRECTOR1.02.0Yes (X)$0$0$0
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$9,685,084TotReportableCompRltdOrgAmt
Total Other Compensation$1,798,285TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt
Fundraising$494,120FundraisingAmt
Related Organizations$771,427RelatedOrganizationsAmt
All Other Contributions$1,480,771AllOtherContributionsAmt
Total Contributions$2,746,318TotalContributionsAmt
Total Program Service Revenue$0TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$71,795TotalRevenueColumnAmt
Exclusion$71,795ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$0RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$3,869,290SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$3,672,964SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$196,326SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$196,326TotalRevenueColumnAmt
Exclusion$196,326ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$34,756FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event$494,120ContriRptFundraisingEventAmt
Fundraising Direct Expenses$150,805FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column-$116,049TotalRevenueColumnAmt
Exclusion-$116,049ExclusionAmt
FieldValueIRS element (for citing)
Gaming Gross Income$18,700GamingGrossIncomeAmt
Gaming Direct Expenses$1,006GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$17,694TotalRevenueColumnAmt
Exclusion$17,694ExclusionAmt
FieldValueIRS element (for citing)
Gross Sales Of Inventory$0GrossSalesOfInventoryAmt
Cost Of Goods Sold$0CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Other Revenue Total$0OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,916,084TotalRevenueColumnAmt
Exclusion$169,766ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$807,123TotalAmt
Program Services$807,123ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$18,500TotalAmt
Management And General$18,500ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$15,908TotalAmt
Fundraising$15,908FundraisingAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$21,560TotalAmt
Management And General$21,560ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$56,401TotalAmt
Fundraising$56,401FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$17,357TotalAmt
Fundraising$17,357FundraisingAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$9,163TotalAmt
Management And General$6,042ManagementAndGeneralAmt
Fundraising$3,121FundraisingAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$54,871TotalAmt
Fundraising$54,871FundraisingAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$120TotalAmt
Management And General$120ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Expenses OtherExpensesGrp (2 entries)

DescDescTotalTotalAmtFundraisingFundraisingAmtManagement And GeneralManagementAndGeneralAmt
COST REIMBURSEMENT$711,705$711,705
MISCELLANEOUS$5,560$4,548$1,012

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$1,718,268TotalAmt
Program Services$807,123ProgramServicesAmt
Management And General$47,234ManagementAndGeneralAmt
Fundraising$863,911FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$1,679,868BOYAmt
EOY$2,156,014EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$416,342BOYAmt
EOY$673,023EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$15,226LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$15,226LandBldgEquipAccumDeprecAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$3,755,095BOYAmt
EOY$4,993,306EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$5,851,305BOYAmt
EOY$7,822,343EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$188,085BOYAmt
EOY$47,548EOYAmt

Grants Payable GrantsPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$188,085BOYAmt
EOY$47,548EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$780,785BOYAmt
EOY$1,948,904EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$4,882,435BOYAmt
EOY$5,825,891EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$5,663,220BOYAmt
EOY$7,774,795EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$5,851,305BOYAmt
EOY$7,822,343EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$1,197,816ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$913,759NetUnrlzdGainsLossesInvstAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consol And Sep Basis Fincl StmtYes (X)ConsolAndSepBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3Yes (X)SupportingOrganization509a3Ind
Supporting Org Type2Yes (X)SupportingOrgType2Ind
Supported Organizations1SupportedOrganizationsCnt

Supported Org Information SupportedOrgInformationGrp

Supported Organization Name SupportedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1REX HOSPITAL INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
EIN561509260EIN
Organization Type3OrganizationTypeCd
Governing Document ListedYes (true)GoverningDocumentListedInd
Support$807,123SupportAmt
Other Support$0OtherSupportAmt
FieldValueIRS element (for citing)
Supported Organizations Total1SupportedOrganizationsTotalCnt
Support Sum$807,123SupportSumAmt
Other Support Sum$0OtherSupportSumAmt

Form990 Sch A Supporting Org Form990SchASupportingOrgGrp

FieldValueIRS element (for citing)
Listed By Name Governing DocfalseListedByNameGoverningDocInd
Suprt Org No IRS DeterminationfalseSuprtOrgNoIRSDeterminationInd
Supported Org Section C456falseSupportedOrgSectionC456Ind
Supported Org Not Organized USfalseSupportedOrgNotOrganizedUSInd
Organization Change Suprt OrgfalseOrganizationChangeSuprtOrgInd
Support Non Supported OrgfalseSupportNonSupportedOrgInd
Payment Substantial ContribtrfalsePaymentSubstantialContribtrInd
Loan Disqualified PersonfalseLoanDisqualifiedPersonInd
Controlled Disqualified PrsnfalseControlledDisqualifiedPrsnInd
Disqualified Prsn Controll IntfalseDisqualifiedPrsnControllIntInd
Disqualified Prsn Ownr IntfalseDisqualifiedPrsnOwnrIntInd
Excess Business Holdings RulesfalseExcessBusinessHoldingsRulesInd
Contribution ControllerfalseContributionControllerInd
Contribution FamilyfalseContributionFamilyInd
Contribution35 ControlledfalseContribution35ControlledInd
FieldValueIRS element (for citing)
Majority Dir Trst Supported OrgYes (true)MajorityDirTrstSupportedOrgInd

Form990 Schedule A Part VI Form990ScheduleAPartVIGrp

FieldValueIRS element (for citing)
Form And Line ReferencePART IV, LINE 1FormAndLineReferenceDesc
ExplanationTHE ORGANIZATION AND THE SUPPORTED ORGANIZATION, REX HOSPITAL, INC., HAVE A HISTORIC RELATIONSHIP THAT HAS BEEN ONGOING FROM THE FORMATION OF REX HEALTHCARE FOUNDATION. REX HOSPITAL, INC. IS THE ONLY SUPPORTED ORGANIZATION OF REX HEALTHCARE FOUNDATION. ALL OF THE FINANCIAL SUPPORT PROVIDED BY THE ORGANIZATION GOES TO REX HOSPITAL, INC.ExplanationTxt

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmountsArtPublicExhibitionAmountsGrp
Held Works ArtHeldWorksArtGrp

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$432,364BeginningYearBalanceAmt
End Year Balance$432,364EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$389,989BeginningYearBalanceAmt
Contributions$42,375ContributionsAmt
End Year Balance$432,364EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$399,989BeginningYearBalanceAmt
Other Expenditures$10,000OtherExpendituresAmt
End Year Balance$389,989EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$300,391BeginningYearBalanceAmt
Contributions$99,598ContributionsAmt
End Year Balance$399,989EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$403,891BeginningYearBalanceAmt
Grants Or Scholarships$103,500GrantsOrScholarshipsAmt
End Year Balance$300,391EndYearBalanceAmt
FieldValueIRS element (for citing)
Prmnnt Endowment Balance EOY1.00000PrmnntEndowmentBalanceEOYPct
Endowments Held Unrelated OrgfalseEndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgfalseEndowmentsHeldRelatedOrgInd
LandLandGrp
BuildingsBuildingsGrp
Leasehold ImprovementsLeaseholdImprovementsGrp

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$15,226OtherCostOrOtherBasisAmt
Depreciation$15,226DepreciationAmt
Book Value$0BookValueAmt
FieldValueIRS element (for citing)
Other Land BuildingsOtherLandBuildingsGrp
Total Book Value Land Buildings$0TotalBookValueLandBuildingsAmt

Invst Program Related Org InvstProgramRelatedOrgGrp

FieldValueIRS element (for citing)
DescEQUITIESDesc
Book Value$4,993,306BookValueAmt
Method ValuationFMethodValuationCd
FieldValueIRS element (for citing)
Total Book Value Program Rltd$4,993,306TotalBookValueProgramRltdAmt
Federal Income Tax Liability$0FederalIncomeTaxLiabilityAmt
Total Liability$0TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$3,808,283TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$913,759NetUnrealizedGainsInvstAmt
Revenue Not Reported$913,759RevenueNotReportedAmt
Revenue Subtotal$2,894,524RevenueSubtotalAmt
Investment Expenses Not Incld$21,560InvestmentExpensesNotIncldAmt
Revenue Not Reported Fincl Stmt$21,560RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$2,916,084TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$1,696,708TotExpnsEtcAuditedFinclStmtAmt
Expenses Subtotal$1,696,708ExpensesSubtotalAmt
Investment Expenses Not Incld2$21,560InvestmentExpensesNotIncld2Amt
Expenses Not Rpt Fincl Stmt$21,560ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$1,718,268TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART V, LINE 4:THE INTENDED USE OF THE ENDOWMENT FUNDS IS TO FURTHER THE MISSION OF REX HEALTHCARE FOUNDATION.
PART X, LINE 2:The FOundation is exempt from federal income taxes under Section 501(c)(3) of the Internal Revenue Code; accordingly, the accompanying financial statements do not reflect a provision or liability for federal and state income taxes. The Foundation has determined that it does not have any material unrecognized tax benefits or obligations as of June 30, 2021 or 2020.

Schedule G IRS990ScheduleG

FieldValueIRS element (for citing)
Mail SolicitationsYes (X)MailSolicitationsInd
Email SolicitationsYes (X)EmailSolicitationsInd
Phone SolicitationsYes (X)PhoneSolicitationsInd
In Person SolicitationsYes (X)InPersonSolicitationsInd
Solicitation Of Non Govt GrantsYes (X)SolicitationOfNonGovtGrantsInd
Special Fundraising EventsYes (X)SpecialFundraisingEventsInd
Agrmt Prof Fundraising ActyYes (true)AgrmtProfFundraisingActyInd

Fundraiser Activity Info FundraiserActivityInfoGrp

FieldValueIRS element (for citing)
PersonCAPITAL DEVELOPMENT SVCS INCPersonNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1633 W 4TH STREET SUITE 202AddressLine1Txt
CityWINSTON SALEMCityNm
State AbbreviationNCStateAbbreviationCd
ZIP27101ZIPCd
FieldValueIRS element (for citing)
ActivityCONSULTINGActivityTxt
Fundraiser Control Of FundsfalseFundraiserControlOfFundsInd
Gross Receipts$0GrossReceiptsAmt
Retained By Contractor$15,908RetainedByContractorAmt
Net To Organization-$15,908NetToOrganizationAmt
FieldValueIRS element (for citing)
Total Gross Receipts$0TotalGrossReceiptsAmt
Total Retained By Contractors$15,908TotalRetainedByContractorsAmt
Total Net To Organization-$15,908TotalNetToOrganizationAmt
Licensed StatesNCLicensedStatesCd

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Event1REX HOSPITAL OPEvent1Nm
Gross Receipts Event1$528,876GrossReceiptsEvent1Amt
Charitable Contri Event1$494,120CharitableContriEvent1Amt
Gross Revenue Event1$34,756GrossRevenueEvent1Amt
Other Direct Expenses Event1$150,805OtherDirectExpensesEvent1Amt
Other Events Total0OtherEventsTotalCnt
Gross Receipts Other Events$0GrossReceiptsOtherEventsAmt
Charitable Contri Other Events$0CharitableContriOtherEventsAmt
Gross Revenue Other Events$0GrossRevenueOtherEventsAmt
Oth Direct Expnss Other Events$0OthDirectExpnssOtherEventsAmt
Gross Receipts Total$528,876GrossReceiptsTotalAmt
Charitable Contributions Tot$494,120CharitableContributionsTotAmt
Gross Revenue Total Events$34,756GrossRevenueTotalEventsAmt
Oth Direct Expnss Total Events$150,805OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events$150,805DirectExpenseSummaryEventsAmt
Net Income Summary-$116,049NetIncomeSummaryAmt

Gaming Information GamingInformationGrp

FieldValueIRS element (for citing)
Gross Revenue Other Gaming$18,700GrossRevenueOtherGamingAmt
Oth Direct Expnss Other Gaming$1,006OthDirectExpnssOtherGamingAmt
Gross Revenue Total Gaming$18,700GrossRevenueTotalGamingAmt
Oth Direct Expnss Total Gaming$1,006OthDirectExpnssTotalGamingAmt
Direct Expense Summary Gaming$1,006DirectExpenseSummaryGamingAmt
Net Gaming Income Summary$17,694NetGamingIncomeSummaryAmt
FieldValueIRS element (for citing)
States Where Gaming ConductedNCStatesWhereGamingConductedCd
LicensedfalseLicensedInd
Explanation If NoA LICENSE IS NOT REQUIRED IN NORTH CAROLINA FOR RAFFLE CONDUCTED BY A NOT-FOR-PROFIT.ExplanationIfNoTxt
License Suspended EtcfalseLicenseSuspendedEtcInd
Gaming With NonmembersfalseGamingWithNonmembersInd
Member Of Other EntityfalseMemberOfOtherEntityInd
Gaming Own Facility1.00000GamingOwnFacilityPct
Individual With BooksUNC HCS SYSTEM ACCOUNTINGIndividualWithBooksNm

Persons With Books US Address PersonsWithBooksUSAddress

FieldValueIRS element (for citing)
Address Line15221 PARAMOUNT PKWY SUITE 230AddressLine1Txt
CityMORRISVILLECityNm
State AbbreviationNCStateAbbreviationCd
ZIP27560ZIPCd
FieldValueIRS element (for citing)
Cntrct With3rd Prty For Game RevfalseCntrctWith3rdPrtyForGameRevInd
Gaming Manager PersonBRIAN KRUSOEGamingManagerPersonNm
Gaming Manager Compensation$1,006GamingManagerCompensationAmt
Gaming Manager Services ProvDEVELOPED AND ORGANIZED RAFFLE AND SOLD TICKETSGamingManagerServicesProvTxt
Gaming Manager Is Ind CntrctYes (X)GamingManagerIsIndCntrctInd
Charitable Distribution RqrYes (true)CharitableDistributionRqrInd
Distributed$17,694DistributedAmt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE G, PART I, LINE 2B, LIST OF TEN HIGHEST PAID FUNDRAISERSFormAndLineReferenceDesc
Explanation(I) NAME OF FUNDRAISER: CAPITAL DEVELOPMENT SVCS, INC. (I) ADDRESS OF FUNDRAISER: 633 W 4TH STREET, SUITE 202, WINSTON SALEM, NC 27101ExplanationTxt

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (true)GrantRecordsMaintainedInd

Recipient Table RecipientTable

Recipient Business Name RecipientBusinessName

FieldValueIRS element (for citing)
Business Name Line1REX HOSPITAL INCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line14420 Lake Boone TrailAddressLine1Txt
CityRaleighCityNm
State AbbreviationNCStateAbbreviationCd
ZIP27607ZIPCd
FieldValueIRS element (for citing)
Recipient EIN561509260RecipientEIN
IRC Section501(c)(3)IRCSectionDesc
Cash Grant$807,123CashGrantAmt
Purpose Of GrantGENERAL SUPPORTPurposeOfGrantTxt
FieldValueIRS element (for citing)
Total501c3 Org1Total501c3OrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 2:FormAndLineReferenceDesc
ExplanationREX HEALTHCARE FOUNDATION'S SOLE RECIPIENT OF ASSISTANCE IS REX HOSPITAL, INC. THE TWO ORGANIZATIONS WORK CLOSELY TOGETHER, ALLOWING FOR REAL-TIME AND CONSISTENT MONITORING OF GRANTS.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (true)SupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
WESLEY A BURKS MD
DIRECTOR$0$948,107$0$1,538,262$0$12,600$0$556,149$0$12,691$0$3,067,809$0$0
STEPHEN W BURRISS
DIRECTOR$0$764,204$0$537,287$0$278,424$0$180,308$0$13,708$0$1,773,931$0$0
GARY L PARK
DIRECTOR$0$967,959$0$1,301,938$0$505,125$0$646,149$0$12,691$0$3,433,862$0$505,125
RIG S PATEL MD
DIRECTOR$0$785,340$0$25,345$0$650$0$13,000$0$21,360$0$845,695$0$0
ERNEST L BOVIO JR
PRESIDENT$0$576,278$0$143,174$0$6,468$0$103,000$0$21,360$0$850,280$0$0
SYLVIA D HACKETT
VICE PRESIDENT$0$296,041$0$62,505$0$15,770$0$52,635$0$13,258$0$440,209$0$0
ANDREW K ZUKOWSKI
TREASURER$0$354,964$0$75,601$0$530$0$54,750$0$20,460$0$506,305$0$0
TATE M BOMBARD
SECRETARY$0$257,692$0$57,438$0$81$0$34,758$0$21,205$0$371,174$0$0
BENJAMIN J MATHEW
ASST TREASURER/ASST SECRETARY$0$158,046$0$14,605$0$650$0$5,079$0$15,724$0$194,104$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 4BFormAndLineReferenceDesc
ExplanationGARY PARK RECEIVED DISTRIBUTIONS TOTALING $505,125 FROM A NON-QUALIFIED SUPPLEMENTAL RETIREMENT PLAN FUNDED AND CONTROLLED BY A RELATED ORGANIZATION, UNC HCS.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (7 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 7ATHE UNIVERSITY OF NORTH CAROLINA HEALTH CARE SYSTEM APPOINTS ALL DIRECTORS ON THE ORGANIZATION'S BOARD OF TRUSTEES, WHICH SHALL NOT BE LESS THAN 9 NOR MORE THAN 13.
FORM 990, PART VI, SECTION A, LINE 7BTHE ORGANIZATION'S BOARD REQUIRES PRIOR APPROVAL OF THE UNIVERSITY OF NORTH CAROLINA HEALTH CARE SYSTEM FOR CERTAIN POWERS, INCLUDING BUT NOT LIMITED TO ADDITION OR DELETION OF A HEALTH CARE SERVICE, PARTICIPATION, DIRECTLY OR INDIRECTLY, IN A JOINT VENTURE, INDEBTEDNESS AND CAPITAL BUDGETS, OPERATING BUDGETS AND NON-BUDGETED MATERIAL EXPENDITURES.
FORM 990, PART VI, SECTION B, LINE 11BTHE ORGANIZATION'S EXECUTIVE TEAM DISCUSSES AND REVIEWS THE FORM 990 AND ALL ASSOCIATED SCHEDULES THROUGHOUT THE INFORMATION GATHERING STAGE. THE FORM 990 AND ASSOCIATED SCHEDULES ARE THEN REVIEWED AND APPROVED BY THE BOARD AS A WHOLE. A COPY OF THE APPROVED FORM 990 ALONG WITH THE ASSOCIATED SCHEDULES IS PROVIDED TO ALL BOARD MEMBERS PRIOR TO FILING.
FORM 990, PART VI, SECTION B, LINE 12CTHE ORGANIZATION REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY BY REQUIRING ALL BOARD MEMBERS TO ANNUALLY COMPLETE AND SIGN A QUESTIONNAIRE DOCUMENTING ANY AREA OF CONFLICT OF INTEREST. THE BOARD MEMBERS ARE REQUIRED TO REPORT AND DOCUMENT ANY NEW AREAS OF CONFLICT OF INTEREST AS THEY ARISE.
FORM 990, PART VI, SECTION B, LINE 15THE ORGANIZATION USES AN INDEPENDENT CONSULTANT TO MEASURE FAIR VALUE OF COMPENSATION FOR THE ORGANIZATION'S PRESIDENT AND OTHER TOP MANAGEMENT. BOTH REX AND UNIVERSITY OF NORTH CAROLINA HEALTH CARE SYSTEM BOARDS REVIEW AND APPROVE THE COMPENSATION FOR ALL OFFICERS EXCEPT THE ASSISTANT SECRETARY AND ASSISTANT TREASURER.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION'S FORM 990 IS AVAILABLE UPON REQUEST AND ON GUIDESTAR'S WEBSITE AND THE FINANCIAL STATEMENTS ARE AVAILABLE ON MUNICIPAL SECURITIES RULEMAKING BOARD'S WEBSITE. THE ORGANIZATION DOES NOT MAKE OTHER GOVERNING DOCUMENTS AND THE CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC.
FORM 990, PART XII, LINE 2CTHIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (10 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
UNC ROCKINGHAM HEALTH CARE INC
117 E Kings HwyEdenNC27288823745228HEALTHCARENC501(c)(3)Line 3UNC HEALTH Cfalse
UNC HEALTH CARE SYSTEM
101 Manning DriveChapel HillNC27514562206970HEALTHCARENCSECTION 115UNC HEALTH Cfalse
UNC HOSPITALS
101 Manning DriveChapel HillNC27514561118388HEALTHCARENCSection 115UNC HEALTH Cfalse
CALDWELL MEMORIAL HOSPITAL
PO Box 1890LenoirNC28645560554204HEALTHCARENC501(c)(3)Line 3UNC HEALTH Cfalse
CHATHAM HOSPITAL INC
PO Box 649Siler CityNC27344560611546HEALTHCARENC501(c)(3)Line 3UNC HEALTH Cfalse
PIEDMONT TRIAD HEALTH SERVICES
101 Manning Dr Medical Wing 2nd FChapel HillNC27514561497163HEALTHCARENC501(c)(3)Line 12B,IIUNC HEALTH Cfalse
REX HEALTHCARE INC
4420 Lake Boone TrailRaleighNC27607561509129HEALTHCARENC501(c)(3)Line 12A, IUNC HEALTH Cfalse
REX HOSPITAL INC
4420 Lake Boone TrailRaleighNC27607561509260HEALTHCARENC501(c)(3)Line 3UNC HEALTH Cfalse
UNC PHYSICIANS NETWORK
1600 Perimeter Park DR Ste 225MorrisvilleNC27560271081647HEALTHCARENC501(c)(3)Line 10UNC HEALTH Cfalse
CALDWELL MEMORIAL HOSPITAL FOUNDATION
PO Box 1890LenoirNC28645581935514SUPPORT OF CANC501(c)(3)Line 7CALDWELL MEMfalse

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (6 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtPredominant Income TypePredominantIncomeTypeTxt
REX SURGERY CENTER OF CARY
4420 Lake Boone TrailRaleighNC27607273684056ASCNCNAN/A
JRH VENTURES LLC
4420 Lake Boone TrailRaleighNC27607274092967MED CAMPUS DVLPMTNCNAN/A
REX HEALTH VENTURES I LP
4420 Lake Boone TrailRaleighNC27607371690478VENTURE CAPITALNCNAN/A
ORTHOPAEDIC SURGERY CENTER OF Raleigh LL
4420 Lake Boone TrailRaleighNC27607271740526ORTHOPAEDIC SURGENCNAN/A
TRO VENTURES LLC
4420 Lake Boone TrailRaleighNC27607821330195HealthcareNCNAN/A
REX SURGERY CENTER OF WAKEFIELD
4420 Lake Boone TrailRaleighNC27607465511168ASCNCNAN/A

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (3 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationInd
REX ENTERPRISES COMPANY INC
4420 Lake Boone TrailRaleighNC27607561553957Operations SupporNCNAC-CORPfalse
UNC Physicians Network Group Practice II
2500 Blue Ridge Road Suite 401RaleighNC27607852823886HealthcareNCNAC-CORPfalse
UNC HEALTH INNOVATIONS INC
4420 Lake Boone TrailRaleighNC27607871233049OPERATIONS SUpporNCNAC-CORPfalse
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (true)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgfalseGiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (true)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (true)SharingOfFacilitiesInd
Paid Employees SharingfalsePaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (true)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrgInd
Transfer To Other OrgfalseTransferToOtherOrgInd
Transfer From Other OrgfalseTransferFromOtherOrgInd

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