2022-11-14T07:27:47-06:00 2021-12-31 990 2021-07-01 566036688 THE MEDICAL FOUNDATION OF WAKE FOREST UNIVERSITY HEALTH SCIENCES AND NORTH CAR MEDI 3367164445 MEDICAL CENTER BOULEVARD WINSTONSALEM NC 27157 BRADLEY A CLARK TREASURER 3367164445 2022-11-14 BRADLEY CLARK 999009999 3 AAL1 IAL1 2021 2022-09-23 18:48:47Z JULIE A FREISCHLAG MD MEDICAL CENTER BOULEVARD WINSTONSALEM NC 27157 181953 0 X N/A X 1952 NC TO AID AND PROMOTE, BY FINANCIAL ASSISTANCE AND OTHERWISE, ALL TYPES OF EDUCATION, SERVICE AND RESEARCH IN THE FIELDS OF PREVENTIVE AND CURATIVE MEDICINE 2 1 0 2 0 0 0 0 0 0 346415 181953 -43925 -62832 302490 119121 0 0 0 0 0 0 0 0 0 0 0 0 0 302490 119121 12352332 12625570 59623 59623 12292709 12565947 X TO AID AND PROMOTE, BY FINANCIAL ASSISTANCE AND OTHERWISE, ALL TYPES OF EDUCATION, SERVICE AND RESEARCH IN THE FIELDS OF PREVENTIVE AND CURATIVE MEDICINE; THE SCIENTIFIC DEVELOPMENT AND GENERAL IMPROVEMENT OF WAKE FOREST UNIVERSITY HEALTH SCIENCES ("WFUHS") AND NORTH CAROLINA BAPTIST HOSPITAL ("NCBH"); TO ENLARGE AND IMPROVE THE FACILITIES OF WFUHS AND NCBH; TO RENDER AID AND ASSISTANCE TO WFUHS AND NCBH BY PROMOTION OF MEDICAL SCIENCE AND MEDICAL KNOWLEDGE, PUBLICATION AND DISTRIBUTION OF LITERATURE IN FURTHERENCE OF SUCH PURPOSES; AND TO AID/ASSIST WFUHS AND NCBH IN EDUCATION AND TRAINING OF PHYSICIANS, NURSES, TECHNICIANS AND SCIENTISTS SUCH THAT WFUHS AND NCBH QUALITY OF TRAINING AND SERVICE SHALL BE STEADILY IMPROVED. 0 0 THE MEDICAL FOUNDATION OF WAKE FOREST UNIVERSITY HEALTH SCIENCES AND NORTH CAROLINA BAPTIST HOSPITAL IS A NON-PROFIT ORGANIZATION WHOSE PURPOSE IS TO RENDER AID AND ASSISTANCE TO WFUHS AND NCBH IN THEIR PURSUITS BY APPROVED METHODS FOR THE PROMOTION OF MEDICAL SCIENCE AND MEDICAL KNOWLEDGE, THE PUBLICATION AND DISTRIBUTION OF LITERATURE, THE EDUCATION AND TRAINING OF PHYSICIANS, NURSES, TECHNICIANS AND SCIENTISTS FOR PRACTICE OR EMPLOYMENT WITHIN NORTH CAROLINA AND ELSEWHERE, AND IMPROVE THE QUALITY OF TRAINING AND SERVICE RENDERED. 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 2 1 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X ERIN KOEWING 3367164445 MEDICAL CENTER BLVD WINSTONSALEM NC 27157 X JULIE A FREISCHLAG MD TRUSTEE & PRESIDENT 0.10 39.90 X X 0 3375350 555809 BRADLEY A CLARK TRUSTEE & TREASURER 0.10 39.90 X X 0 0 0 J MCLAIN WALLACE JR SECRETARY 0.10 39.90 X 0 0 0 JOHN D MCCONNELL MD FORMER TRUSTEE/OFF (4/26/17) 0.00 40.00 X 0 456795 45242 0 3832145 601051 0 1 1 0 0 33327 33327 62832 -62832 -62832 -62832 148626 0 148626 148626 148626 119121 0 0 119121 0 0 0 0 3090615 2950505 203390 203390 3358713 1288887 2073145 2069826 6985182 7401849 12352332 12625570 59623 59623 59623 59623 X 12292709 12565947 12292709 12565947 12352332 12625570 119121 154117 0 X 0 1 X 1 0 X X 2 WFU HEALTH SCIENCES 223849199 2 1 0 0 NC BAPTIST HOSPITAL 560552787 3 1 0 0 2 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 6985182 575915 159248 7401849 5748753 1557500 321071 6985182 6007187 61985 320419 5748753 6088927 242944 324684 6007187 6101391 318424 330888 6088927 1.00000 0 1 1 2000721 2000721 1357992 1288887 69105 2069826 VERGER INVESTMENT FUNDS 7401849 7401849 ANNUITY PAYABLE 48633 SECURITY DEPOSITS 10990 59623 X PART V, LINE 4: ENDOWMENT FUNDS PROVIDE AID AND ASSISTANCE TO WAKE FOREST UNIVERSITY HEALTH SCIENCES AND TO NORTH CAROLINA BAPTIST HOSPITAL IN THE EDUCATION AND TRAINING OF PHYSICIANS, NURSES, TECHNICIANS AND SCIENTISTS FOR PRACTICE OR EMPLOYMENT. PART X, LINE 2: THE ORGANIZATION HAS EVALUATED UNCERTAIN TAX POSITIONS FOR ITS SHORT YEAR ENDED DECEMBER 31, 2021 AND ITS FISCAL YEAR ENDED JUNE 30, 2021, INCLUDING A QUANTIFICATION OF TAX RISK IN AREAS SUCH AS UNRELATED BUSINESS TAXABLE INCOME AND THE TAXATION OF ITS JOINT VENTURES. THIS EVALUATION DID NOT HAVE A MATERIAL EFFECT ON THE ORGANIZATION'S FINANCIAL STATEMENTS FOR THE TAX YEARS ENDED DECEMBER 31, 2021 AND JUNE 30, 2021. 0 1 0 0 0 0 0 0 0 JULIE A FREISCHLAG MD TRUSTEE & PRESIDENT 0 1899767 0 1003777 0 471806 0 529516 0 26293 0 3931159 0 396368 JOHN D MCCONNELL MD FORMER TRUSTEE/OFF (4/26/17) 0 418681 0 0 0 38114 0 21816 0 23426 0 502037 0 0 PART I, LINE 4B CERTAIN TRUSTEES, OFFICERS AND FORMER OFFICERS/TRUSTEES OF THE FILING ORGANIZATION PARTICIPATED IN AND/OR RECEIVED PAYMENTS FROM SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANS (SERP) (ALL OF WHICH WAS PAID BY A RELATED ORGANIZATION, WAKE FOREST UNIVERSITY HEALTH SCIENCES, AS PART OF THE INDIVIDUALS' COMPENSATION FROM THE RELATED ORGANIZATION). THE FOLLOWING CURRENT OFFICER RECEIVED SERP PAYMENTS IN HER CALENDAR YEAR 2021 COMPENSATION: JULIE A. FREISCHLAG, MD $396,368 FORM 990, PART VI, SECTION A, LINE 6 THE FILING ORGANIZATION HAS TWO MEMBERS, WAKE FOREST UNIVERSITY HEALTH SCIENCES AND NORTH CAROLINA BAPTIST HOSPITAL. EACH OF THE MEMBERS IS ALSO A NORTH CAROLINA NONPROFIT CORPORATION. FORM 990, PART VI, SECTION A, LINE 7A THE BOARD OF TRUSTEES OF THE FILING ORGANIZATION IS ELECTED BY THE ORGANIZATION'S TWO MEMBERS, WAKE FOREST UNIVERSITY HEALTH SCIENCES AND NORTH CAROLINA BAPTIST HOSPITAL. FORM 990, PART VI, SECTION B, LINE 11B THE FILING ORGANIZATION'S BOARD OF TRUSTEES RECEIVES A COPY OF THE FORM 990 WITH SUFFICIENT TIME TO PERMIT REVIEW, COMMENT AND QUESTIONS PRIOR TO ITS FILING. IF MODIFICATIONS ARE REQUIRED FOLLOWING SUCH REVIEW, THE REVISED FORM 990 IS REDISTRIBUTED PRIOR TO ITS FILING WITH THE IRS, ALONG WITH A SUMMARY OF THE MODIFICATIONS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION QUERIES ITS BOARD MEMBERS AND OFFICERS WITH RESPECT TO POTENTIAL CONFLICTS OF INTEREST ANNUALLY, AND AS THEY ARISE. ANY POTENITAL CONFLICTS DISCLOSED ARE REVIEWED AND MANAGED IN ACCORDANCE WITH THE ORGANIZATION'S CONFLICTS OF INTEREST POLICY. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION PAYS NO COMPENSATION TO OFFICERS OR TRUSTEES; AS THE ORGANIZATION HAS NO EMPLOYEES, IT DOES NOT PAY ANY COMPENSATION TO ANY KEY EMPLOYEES. ALL COMPENSATION PAID TO OFFICERS OR TRUSTEES WAS PAID BY A RELATED ORGANIZATION AS EMPLOYEES OF SUCH RELATED ORGANIZATION. THE SENIOR EXECUTIVE COMPENSATION COMMITTEE OF THE WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER ("WFUBMC") BOARD (ACTING, PURSUANT TO A DELEGATION, ON BEHALF OF RELATED ORGANIZATION WAKE FOREST UNIVERSITY HEALTH SCIENCES ("WFUHS") ONE OF THE TWO EQUAL MEMBERS OF THE FILING ORGANIZATION WITH RESPECT TO THE CURRENT OR FORMER FILING ORGANIZATION OFFICERS EMPLOYED BY WFUHS) IS RESPONSIBLE FOR REVIEWING AND APPROVING SUCH CURRENT OR FORMER FILING ORGANIZATION OFFICERS' COMPENSATION. THE COMMITTEE USES INDEPENDENT COMPENSATION CONSULTANTS, COMPENSATION SURVEYS, AND STUDIES TO DETERMINE THE APPROPRIATENESS OF EACH SUCH OFFICER'S COMPENSATION. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S ARTICLES OF INCORPORATION ARE AVAILABLE TO THE PUBLIC ON REQUEST AND ARE AVAILABLE ON THE WEBSITE OF THE NORTH CAROLINA SECRETARY OF STATE. THE ORGANIZATION'S BYLAWS ARE NOT PUBLISHED, BUT PROVISIONS FROM THE BYLAWS ARE INCLUDED AS NECESSARY IN THE ORGANIZATION'S POLICIES, AND ARE ATTACHED TO THE FORM 1023 FILED FOR THE ORGANIZATION WITH THE IRS, WHICH IS PUBLICLY AVAILABLE. THE CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC ON REQUEST. PART VII, SECTION A, COLUMN B - HOURS JULIE A. FREISCHLAG, MD FILING ORG 0.1 RELATED ORG 31.4 UNRELATED ORG 8.5 BRADLEY A. CLARK FILING ORG 0.1 RELATED ORG 3.2 UNRELATED ORG 36.7 J. MCLAIN WALLACE, JR. FILING ORG 0.1 RELATED ORG 18.8 UNRELATED ORG 21.1 JOHN D. MCCONNELL, MD FILING ORG 0.0 RELATED ORG 0.0 UNRELATED ORG 40.0 A MEDICAL CENTER INTEGRATION AGREEMENT ("MCIA") WAS ORIGINALLY ENTERED INTO IN 2010 AMONG FOUR PARTIES: WAKE FOREST UNIVERSITY ("WFU"), WAKE FOREST UNIVERSITY HEALTH SCIENCES ("WFUHS"), WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER ("WFUBMC"), AND NORTH CAROLINA BAPTIST HOSPITAL ("NCBH"). PURSUANT TO THE TERMS OF THE ORIGINAL MCIA, THE OPERATION OF WFUHS AND NCBH, AND ALL OF THE RESPECTIVE SUBSIDIARIES OF EACH, IS DELEGATED TO WFUBMC. ADDITIONALLY, THE CORPORATE OFFICERS OF WFUBMC GENERALLY SERVE AS THE CORPORATE OFFICERS OF WFUHS AND NCBH. THE MCIA WAS REVISED AND RESTATED IN 2020 TO DELEGATE OVERSIGHT AND MANAGEMENT AUTHORITY OVER WFUBMC TO ATRIUM HEALTH, INC. ("AHI"). CERTAIN DIRECTORS AND/OR CORPORATE OFFICERS OF WFUHS, NCBH, & WFUBMC ALSO SERVE AS DIRECTORS OR CORPORATE OFFICERS OF AHI. WFUHS AND NCBH ARE ORGANIZATIONS RELATED TO THE FILING ORGANIZATION. WFU, WFUBMC, AND AHI ARE ORGANIZATIONS UNRELATED TO THE FILING ORGANIZATION. THUS, CERTAIN DIRECTORS AND OFFICERS OF THE FILING ORGANIZATION DEVOTE HOURS TO RELATED ORGANIZATIONS (NCBH & WFUHS) AND UNRELATED ORGANIZATIONS (WFUBMC, WFU, AND AHI) AS SHOWN IN THE BREAKDOWN OF HOURS ABOVE. WAKE FOREST UNIVERSITY HEALTH SCIENCES MEDICAL CENTER BOULEVARD WINSTONSALEM NC 27157 223849199 HEALTHCARE, EDUCATION, & RESEARCH NC 501(C)(3) LINE 2 WAKE FOREST UNIVERSITY 0 NORTH CAROLINA BAPTIST HOSPITAL MEDICAL CENTER BOULEVARD WINSTONSALEM NC 27157 560552787 HEALTHCARE NC 501(C)(3) LINE 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 1 0