FORSYTH MEDICAL CENTER FOUNDATION: Form 990, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- FORSYTH MEDICAL CENTER FOUNDATION (EIN 56-2120959)
- Tax period
- 2020-01-01 to 2020-12-31
- Filed
- 2021-11-12
- IRS object ID
- 202113169349312116
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule G
- Schedule I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2021-11-12T16:29:00-06:00 | ReturnTs |
| Tax Period End | 2020-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 346565596 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ERNST & YOUNG US LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 100 NORTH TRYON STREET SUITE 3800 | AddressLine1Txt |
| City | CHARLOTTE | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 28202 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2020-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 562120959 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FORSYTH MEDICAL CENTER FOUNDATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | FORS | BusinessNameControlTxt |
| Phone | 3367182803 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2085 FRONTIS PLAZA BLVD | AddressLine1Txt |
| City | WINSTON SALEM | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 27103 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | FRED HARGETT | PersonNm |
| Person Title | EVP & CFO | PersonTitleTxt |
| Phone | 3367182803 | PhoneNum |
| Signature | 2021-11-12 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | FRED | PersonFirstNm |
| Person Last | HARGETT | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | SCOTT TIDWELL | PreparerPersonNm |
| PTIN | P01729213 | PTIN |
| Phone | 7043726300 | PhoneNum |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 2 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2020 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NOVANT HEALTH FORSYTH MEDICAL CENTER FOUNDATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | CARL ARMATO | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2085 FRONTIS PLAZA BLVD | AddressLine1Txt |
| City | WINSTON SALEM | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 27103 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $50,160,283 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.SUPPORTNOVANTHEALTH.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1981 | FormationYr |
| Legal Domicile State | NC | LegalDomicileStateCd |
| Activity Or Mission | SEE SCHEDULE O | ActivityOrMissionDesc |
| Voting Members Governing Body | 21 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 15 | VotingMembersIndependentCnt |
| Total Employee | 6 | TotalEmployeeCnt |
| Total Volunteers | 27 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $2,090,974 | PYContributionsGrantsAmt |
| CY Contributions Grants | $2,719,712 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $0 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $0 | CYProgramServiceRevenueAmt |
| PY Investment Income | $3,179,619 | PYInvestmentIncomeAmt |
| CY Investment Income | $1,831,401 | CYInvestmentIncomeAmt |
| PY Other Revenue | -$18,620 | PYOtherRevenueAmt |
| CY Other Revenue | -$3,411 | CYOtherRevenueAmt |
| PY Total Revenue | $5,251,973 | PYTotalRevenueAmt |
| CY Total Revenue | $4,547,702 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $3,277,298 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $4,196,767 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $0 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $306,348 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $389,560 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $1,312,941 | PYOtherExpensesAmt |
| CY Other Expenses | $1,833,568 | CYOtherExpensesAmt |
| PY Total Expenses | $4,590,239 | PYTotalExpensesAmt |
| CY Total Expenses | $6,336,683 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $661,734 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$1,788,981 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $75,295,968 | TotalAssetsBOYAmt |
| Total Assets EOY | $76,412,896 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $831,558 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $329,734 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $74,464,410 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $76,083,162 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | SEE SCHEDULE O | MissionDesc |
| Significant New Program Srvc | Yes (1) | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $5,501,861 | ExpenseAmt |
| Grant | $4,196,767 | GrantAmt |
| Revenue | $0 | RevenueAmt |
| Desc | FORSYTH MEDICAL CENTER FOUNDATION FOCUSES ITS EFFORTS ON RAISING COMMUNITY SUPPORT AND FUNDING THROUGH CHARITABLE GIVING FOR MUCH-NEEDED PROGRAMS, IMPROVED FACILITIES, AND STATE-OF-THE-ART TECHNOLOGY FOR NOVANT HEALTH FORSYTH MEDICAL CENTER, NOVANT HEALTH KERNERSVILLE MEDICAL CENTER, AND NOVANT HEALTH CLEMMONS MEDICAL CENTER. | Desc |
| Total Program Service Expenses | $5,501,861 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | Yes (1) | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | Yes (1) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (1) | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | Yes (1) | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 6 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | Yes (1) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | Yes (1) | QuidProQuoContriDisclInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 21 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 15 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | NC | StatesWhereCopyOfReturnIsFldCd |
| Own Website | Yes (X) | OwnWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KAREN DAUGHERTY | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3367182803 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2085 FRONTIS PLAZA BLVD | AddressLine1Txt |
| City | WINSTON SALEM | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 27103 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (27 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|
| GROTE THOMAS MD | |||||||||
| TRUSTEE | 0.20 | 45.00 | Yes (X) | $0 | $928,518 | $39,742 | |||
| CARD JOHN MD | |||||||||
| TRUSTEE | 0.20 | 45.00 | Yes (X) | $0 | $342,753 | $42,531 | |||
| BARRETT ROLLAND MD | |||||||||
| TRUSTEE | 0.20 | 45.00 | Yes (X) | $0 | $9,906 | $0 | |||
| ALLEN ELMS MD | |||||||||
| TRUSTEE | 0.20 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| BAILEY DAVID | |||||||||
| TRUSTEE | 0.20 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| BROWN TADELRO | |||||||||
| TRUSTEE | 0.20 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| BYERS KEVIN | |||||||||
| TREASURER | 0.20 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| CAMERON MARY | |||||||||
| TRUSTEE | 0.20 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| CARR KATHERYN | |||||||||
| TRUSTEE | 0.20 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| ELY JOSEPH | |||||||||
| TRUSTEE | 0.20 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| HOLMES HAROLD | |||||||||
| TRUSTEE | 0.20 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| KNIGHT ANNETTE | |||||||||
| CHAIR | 0.20 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| LOGAN JOSEPH | |||||||||
| TRUSTEE | 0.20 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| MADDEN ELIZABETH | |||||||||
| TREAS | 0.20 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| MARSHALL DEBORAH | |||||||||
| VICE CHAIR | 0.20 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| POLONSKY SHERRY | |||||||||
| TRUSTEE | 0.20 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| PRATT DAMON | |||||||||
| TRUSTEE | 0.20 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| WARREN REBA | |||||||||
| TRUSTEE | 0.20 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| WELCH EDWIN | |||||||||
| SEC | 0.20 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| WILLARD RONNIE | |||||||||
| TRUSTEE | 0.20 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| WOLFE IV JOHN | |||||||||
| TRUSTEE | 0.20 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| YARBOROUGH D CHEFF | |||||||||
| TRUSTEE | 0.20 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| MYERS SCOTT | |||||||||
| ASST SEC | 0.20 | 50.00 | $0 | $850,348 | $102,781 | Yes (X) | |||
| CAULKINS DOROTHY | |||||||||
| SVP FOUNDATIONS | 8.30 | 41.50 | $0 | $525,895 | $97,478 | Yes (X) | |||
| MORRIS JOHN | |||||||||
| ASST SEC | 0.20 | 45.00 | $0 | $277,596 | $35,453 | Yes (X) | |||
| EGAN HEATHER | |||||||||
| CHIEF DEVELOPMENT OFFICER | 45.00 | 0.00 | $78,505 | $48,140 | $39,211 | Yes (X) | |||
| HENDERSON KIMBERLY | |||||||||
| FMR SVP FOUNDATIONS | 0.00 | 50.00 | $0 | $752,280 | $101,924 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $78,505 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $3,735,436 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $459,120 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $68,102 | FundraisingAmt |
| Related Organizations | $538,943 | RelatedOrganizationsAmt |
| Government Grants | $40,748 | GovernmentGrantsAmt |
| All Other Contributions | $2,071,919 | AllOtherContributionsAmt |
| Noncash Contributions | $12,398 | NoncashContributionsAmt |
| Total Contributions | $2,719,712 | TotalContributionsAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $962,053 | TotalRevenueColumnAmt |
| Exclusion | $962,053 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $46,465,276 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $45,595,928 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $869,348 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $869,348 | TotalRevenueColumnAmt |
| Exclusion | $869,348 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $13,242 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $68,102 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $16,653 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$3,411 | TotalRevenueColumnAmt |
| Exclusion | -$3,411 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,547,702 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,827,990 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,075,995 | TotalAmt |
| Program Services | $4,075,995 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $120,772 | TotalAmt |
| Program Services | $120,772 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $224,964 | TotalAmt |
| Program Services | $57,908 | ProgramServicesAmt |
| Management And General | $38,614 | ManagementAndGeneralAmt |
| Fundraising | $128,442 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,141 | TotalAmt |
| Program Services | $2,536 | ProgramServicesAmt |
| Management And General | $1,724 | ManagementAndGeneralAmt |
| Fundraising | $5,881 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $58,883 | TotalAmt |
| Program Services | $14,955 | ProgramServicesAmt |
| Management And General | $10,063 | ManagementAndGeneralAmt |
| Fundraising | $33,865 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,360 | TotalAmt |
| Program Services | $3,090 | ProgramServicesAmt |
| Management And General | $2,101 | ManagementAndGeneralAmt |
| Fundraising | $7,169 | FundraisingAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $129,641 | TotalAmt |
| Management And General | $129,641 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,685 | TotalAmt |
| Program Services | $767 | ProgramServicesAmt |
| Management And General | $338 | ManagementAndGeneralAmt |
| Fundraising | $580 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $161,194 | TotalAmt |
| Program Services | $80,597 | ProgramServicesAmt |
| Fundraising | $80,597 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,045 | TotalAmt |
| Program Services | $2,096 | ProgramServicesAmt |
| Management And General | $5,191 | ManagementAndGeneralAmt |
| Fundraising | $1,758 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,771 | TotalAmt |
| Program Services | $693 | ProgramServicesAmt |
| Management And General | $471 | ManagementAndGeneralAmt |
| Fundraising | $1,607 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $30,289 | TotalAmt |
| Management And General | $30,289 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,914 | TotalAmt |
| Program Services | $829 | ProgramServicesAmt |
| Management And General | $518 | ManagementAndGeneralAmt |
| Fundraising | $1,567 | FundraisingAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,993 | TotalAmt |
| Program Services | $1,717 | ProgramServicesAmt |
| Management And General | $839 | ManagementAndGeneralAmt |
| Fundraising | $1,437 | FundraisingAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,572 | TotalAmt |
| Program Services | $7,126 | ProgramServicesAmt |
| Management And General | $3,480 | ManagementAndGeneralAmt |
| Fundraising | $5,966 | FundraisingAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| DISASTER RELIEF | $926,043 | $926,043 | $0 | $0 |
| MISCELLANEOUS | $341,177 | $156,716 | $184,426 | $35 |
| CONTRACT LABOR | $190,696 | $47,674 | $32,418 | $110,604 |
| OTHER SUPPLIES | $7,651 | $449 | $3,302 | $3,900 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,897 | TotalAmt |
| Program Services | $1,898 | ProgramServicesAmt |
| Management And General | $1,847 | ManagementAndGeneralAmt |
| Fundraising | $6,152 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,336,683 | TotalAmt |
| Program Services | $5,501,861 | ProgramServicesAmt |
| Management And General | $445,262 | ManagementAndGeneralAmt |
| Fundraising | $389,560 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $640,178 | BOYAmt |
| EOY | $767,076 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,072,127 | BOYAmt |
| EOY | $1,225,146 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,757 | BOYAmt |
| EOY | $11,853 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $184,302 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $63,061 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $137,812 | BOYAmt |
| EOY | $121,241 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $59,351,230 | BOYAmt |
| EOY | $59,142,928 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,087,864 | BOYAmt |
| EOY | $15,144,652 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $75,295,968 | BOYAmt |
| EOY | $76,412,896 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $77,198 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $831,558 | BOYAmt |
| EOY | $252,536 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $831,558 | BOYAmt |
| EOY | $329,734 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $62,013,567 | BOYAmt |
| EOY | $64,589,588 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,450,843 | BOYAmt |
| EOY | $11,493,574 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $74,464,410 | BOYAmt |
| EOY | $76,083,162 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $75,295,968 | BOYAmt |
| EOY | $76,412,896 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$1,788,981 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $2,638,885 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $768,848 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $3,249,464 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,835,503 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,617,056 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,090,974 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $2,719,712 | CurrentTaxYearAmt |
| Total | $13,512,709 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $3,249,464 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,835,503 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,617,056 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,090,974 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $2,719,712 | CurrentTaxYearAmt |
| Total | $13,512,709 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $4,393,748 | SubstantialContributorsTotAmt |
| Public Support Total170 | $9,118,961 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $607,685 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $738,294 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,092,826 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,223,815 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $962,053 | CurrentTaxYearAmt |
| Total | $4,624,673 | TotalAmt |
Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | -$5,657 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | -$19,991 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | -$23,093 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | -$18,620 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | -$3,411 | CurrentTaxYearAmt |
| Total | -$70,772 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $18,066,610 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $98,876 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.50470 | PublicSupportCY170Pct |
| Public Support PY170 | 0.49500 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $12,447,741 | BeginningYearBalanceAmt |
| Contributions | $1,914,567 | ContributionsAmt |
| Investment Earnings Or Losses | $117,023 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $50,841 | GrantsOrScholarshipsAmt |
| Other Expenditures | $2,934,916 | OtherExpendituresAmt |
| End Year Balance | $11,493,574 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $12,307,011 | BeginningYearBalanceAmt |
| Contributions | $1,435,742 | ContributionsAmt |
| Investment Earnings Or Losses | $234,221 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $69,505 | GrantsOrScholarshipsAmt |
| Other Expenditures | $1,459,728 | OtherExpendituresAmt |
| End Year Balance | $12,447,741 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $11,924,629 | BeginningYearBalanceAmt |
| Contributions | $2,719,034 | ContributionsAmt |
| Investment Earnings Or Losses | -$111,564 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $39,421 | GrantsOrScholarshipsAmt |
| Other Expenditures | $2,185,667 | OtherExpendituresAmt |
| End Year Balance | $12,307,011 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $11,815,684 | BeginningYearBalanceAmt |
| Contributions | $2,485,091 | ContributionsAmt |
| Investment Earnings Or Losses | $193,146 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $33,832 | GrantsOrScholarshipsAmt |
| Other Expenditures | $2,535,460 | OtherExpendituresAmt |
| End Year Balance | $11,924,629 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $10,764,944 | BeginningYearBalanceAmt |
| Contributions | $2,472,752 | ContributionsAmt |
| Investment Earnings Or Losses | $74,729 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $284,479 | GrantsOrScholarshipsAmt |
| Other Expenditures | $1,212,262 | OtherExpendituresAmt |
| End Year Balance | $11,815,684 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.00000 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 1.00000 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.00000 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $184,302 | OtherCostOrOtherBasisAmt |
| Depreciation | $63,061 | DepreciationAmt |
| Book Value | $121,241 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $121,241 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | OTHER SECURITIES | Desc |
| Book Value | $15,144,652 | BookValueAmt |
| Method Valuation | F | MethodValuationCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $15,144,652 | TotalBookValueSecuritiesAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | DUE TO AFFILIATE | Desc |
| Amt | $252,536 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $252,536 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART X, LINE 2: | PART X, LINE 2: LIABILITY UNDER FIN 48 (ASC 740) FOOTNOTE THE AUDIT FOR NOVANT HEALTH AND ITS AFFILIATES IS PREPARED ON A CONSOLIDATED BASIS. THE COMPANY IS REQUIRED TO EVALUATE UNCERTAIN TAX POSITIONS. THIS EVALUATION INCLUDES A QUANTIFICATION OF TAX RISK IN AREAS SUCH AS UNRELATED BUSINESS TAXABLE INCOME AND THE TAXATION OF OUR FOR-PROFIT SUBSIDIARIES. THIS EVALUATION DID NOT HAVE A MATERIAL EFFECT ON THE COMPANY'S CONSOLIDATED STATEMENTS OF OPERATIONS AND CHANGES IN NET ASSETS FOR THE YEARS ENDED DECEMBER 31, 2020 AND 2019. |
| PART V, LINE 4: INTENDED USES FOR ENDOWMENT FUNDS | THE ENDOWMENT FUNDS ARE HELD FOR AFFILIATE HOSPITAL SERVICE COSTS RELATED TO VARIOUS CENTERS AT THE ACUTE CARE FACILITIES AND SUPPORT FOR THE SURROUNDING COMMUNITY. THE VARIOUS ENDOWMENT FUNDS SUPPORT CANCER SERVICES, BEHAVIORAL HEALTH MEDICAL PROGRAMS, NEUROLOGY/STROKE PROGRAMS & EDUCATION, MEDICAL STAFF DEVELOPMENT, NURSING EDUCATION, REHABILITATION SERVICES, NEONATAL SERVICES, WOMEN'S HEALTH SERVICES, ASSISTANCE TO EMPLOYEES, AND OTHER PROGRAMS THAT BENEFIT NOVANT HEALTH FACILITIES. |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | GARDEN PARTY | Event1Nm |
| Gross Receipts Event1 | $81,344 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $68,102 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $13,242 | GrossRevenueEvent1Amt |
| Non Cash Prizes Event1 | $623 | NonCashPrizesEvent1Amt |
| Food And Beverage Event1 | $889 | FoodAndBeverageEvent1Amt |
| Other Direct Expenses Event1 | $15,141 | OtherDirectExpensesEvent1Amt |
| Gross Receipts Total | $81,344 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $68,102 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $13,242 | GrossRevenueTotalEventsAmt |
| Non Cash Prizes Total Events | $623 | NonCashPrizesTotalEventsAmt |
| Food And Beverage Total Events | $889 | FoodAndBeverageTotalEventsAmt |
| Oth Direct Expnss Total Events | $15,141 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $16,653 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | -$3,411 | NetIncomeSummaryAmt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (7 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|
| COMMUNITY CARE CENTER FOR FORSYTH COUNTY | |||||||
| 2135 NEW WALKERTOWN ROAD | WINSTONSALEM | NC | 27101 | 581403699 | 501(C)(3) | $10,639 | COMMUNITY OUTREACH |
| FORSYTH HEALTHCARE INC | |||||||
| 515 N CLEVELAND AVE | WINSTONSALEM | NC | 27101 | 320097975 | 501(C)(3) | $250,000 | COMMUNITY OUTREACH |
| FORSYTH MEMORIAL HOSPITAL INC | |||||||
| 2085 FRONTIS PLAZA BLVD | WINSTONSALEM | NC | 27103 | 560928089 | 501(C)(3) | $2,239,229 | TO SUPPORT NHFMC, NHKMC, AND FMCI |
| NOVANT MEDICAL GROUP INC | |||||||
| 2085 FRONTIS PLAZA BLVD | WINSTONSALEM | NC | 27103 | 581728803 | 501(C)(3) | $26,130 | TO SUPPORT NOVANT MEDICAL GROUP, INC. |
| FOUNDATION HEALTH SYSTEMS CORP | |||||||
| 2085 FRONTIS PLAZA BLVD | WINSTONSALEM | NC | 27103 | 561373175 | 501(C)(3) | $735,206 | TO SUPPORT TODAY'S WOMAN |
| COMMUNITY CARE CLINIC OF ROWAN COUNTY INC | |||||||
| 315 MOCKSVILLE AVE STE G | SALISBURY | NC | 28144 | 561964773 | 501(C)(3) | $125,000 | COMMUNITY OUTREACH |
| NOVANT HEALTH INC | |||||||
| 2085 FRONTIS PLAZA BLVD | WINSTONSALEM | NC | 27103 | 561376950 | 501(C)(3) | $689,791 | TO SUPPORT NOVANT HEALTH, INC |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 7 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp (6 entries)
| Grant TypeGrantTypeTxt | RecipientRecipientCnt | Cash GrantCashGrantAmt | Non Cash AssistanceNonCashAssistanceAmt | Valuation Method UsedValuationMethodUsedDesc | Non Cash AssistanceNonCashAssistanceDesc |
|---|---|---|---|---|---|
| EMPLOYEE EMERGENCY FUND | 62 | $45,792 | |||
| SCHOLARSHIPS | 7 | $22,500 | |||
| PATIENT TRANSPORTATION | 190 | $7,798 | FMV | CAB FARES FOR INDIGENT PATIENTS | |
| MEDICATION TO INDIGENT PATIENTS | 53 | $2,413 | FMV | MEDICATION FOR INDIGENT PATIENTS | |
| PATIENT ASSISTANCE - ZOLL VEST | 2 | $6,400 | FMV | ZOLL LIFE VESTS | |
| PATIENT ASSISTANCE | 1023 | $35,869 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS | FormAndLineReferenceDesc |
| Explanation | THE FILING ORGANIZATION IS PART OF THE INTEGRATED HEALTHCARE SYSTEM OPERATED BY NOVANT HEALTH, INC. ("NOVANT HEALTH"), THE PARENT ORGANIZATION. NOVANT HEALTH'S BYLAWS AUTHORIZE IT TO ESTABLISH CERTAIN POLICIES FOR ALL OF ITS SUBSIDIARIES WITHIN THE SYSTEM. NOVANT HEALTH HAS ESTABLISHED A SYSTEM-WIDE CORPORATE POLICY WITH STANDARDIZED GUIDELINES THAT ARE TO BE USED IN REVIEWING THE ELIGIBILITY AND SELECTION OF GRANTEES RECEIVING CERTAIN EXEMPT PURPOSE FUNDS. THE FILING ORGANIZATION MAINTAINS DOCUMENTATION OF THE ELIGIBILITY AND SELECTION CRITERIA AND RECORDS OF THE AMOUNTS ARE MAINTAINED VIA THE GENERAL LEDGER. FUNDS ARE GENERALLY NOT TRACKED AFTER BEING GRANTED, AS THE ORIGINAL ELIGIBILITY AND SELECTION CRITERIA HAVE ALREADY BEEN MET. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| First Class Or Charter Travel | Yes (X) | FirstClassOrCharterTravelInd |
| Travel For Companions | Yes (X) | TravelForCompanionsInd |
| Discretionary Spending Acct | Yes (X) | DiscretionarySpendingAcctInd |
| Housing Allowance Or Residence | Yes (X) | HousingAllowanceOrResidenceInd |
| Written Policy Ref T And E Expnss | Yes (1) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (1) | SubstantiationRequiredInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (7 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| GROTE THOMAS MD | ||||||||||||||
| TRUSTEE | $0 | $598,580 | $0 | $296,214 | $0 | $33,724 | $0 | $17,100 | $0 | $22,642 | $0 | $968,260 | $0 | $0 |
| MYERS SCOTT | ||||||||||||||
| ASST SEC | $0 | $434,926 | $0 | $297,675 | $0 | $117,747 | $0 | $85,463 | $0 | $17,318 | $0 | $953,129 | $0 | $64,283 |
| HENDERSON KIMBERLY | ||||||||||||||
| FMR SVP FOUNDATIONS | $0 | $376,255 | $0 | $266,932 | $0 | $109,093 | $0 | $77,022 | $0 | $24,902 | $0 | $854,204 | $0 | $49,833 |
| CAULKINS DOROTHY | ||||||||||||||
| SVP FOUNDATIONS | $0 | $327,698 | $0 | $154,813 | $0 | $43,384 | $0 | $68,800 | $0 | $28,678 | $0 | $623,373 | $0 | $0 |
| CARD JOHN MD | ||||||||||||||
| TRUSTEE | $0 | $320,724 | $0 | $1,350 | $0 | $20,679 | $0 | $17,100 | $0 | $25,431 | $0 | $385,284 | $0 | $0 |
| MORRIS JOHN | ||||||||||||||
| ASST SEC | $0 | $206,012 | $0 | $6,069 | $0 | $65,515 | $0 | $12,720 | $0 | $22,733 | $0 | $313,049 | $0 | $7,500 |
| EGAN HEATHER | ||||||||||||||
| CHIEF DEVELOPMENT OFFICER | $76,215 | $45,149 | $1,731 | $0 | $559 | $2,991 | $4,873 | $2,866 | $20,553 | $10,919 | $103,931 | $61,925 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 1A | PART I, LINE 1A: FRINGE OR EXPENSE EXPLANATION FIRST-CLASS OR CHARTER TRAVEL: FIRST-CLASS OR CHARTER TRAVEL IS NOT A COVERED TRAVEL EXPENSE FOR EXECUTIVES; THEY ARE LIMITED TO BUSINESS OR COACH CLASS FARES FOR COMMERCIAL FLIGHTS. HOWEVER, CHARTER TRAVEL IS AVAILABLE TO CERTAIN EXECUTIVES, BOARD MEMBERS, AND APPROVED BUSINESS PERSONNEL MEETING APPLICABLE POLICY CRITERIA. TRAVEL FOR COMPANIONS: COMPANIONS ARE ALLOWED ON CERTAIN CHARTER FLIGHTS PAID FOR BY THE ORGANIZATION. IN THAT CASE, THE VALUE OF THE COMPANION'S FLIGHT IS CALCULATED UNDER APPLICABLE TAX LAWS AND THAT AMOUNT IS INCLUDED IN THE EXECUTIVE'S TAXABLE INCOME AS PRESCRIBED BY THE APPLICABLE TAX LAWS. DISCRETIONARY SPENDING ACCOUNT: CERTAIN EXECUTIVES RECEIVE A DISCRETIONARY SPENDING ACCOUNT. THE DOLLAR AMOUNT IN THE ACCOUNT IS PRE-APPROVED BY THE COMPENSATION AND LEADERSHIP COMMITTEE OF THE NOVANT HEALTH BOARD OF TRUSTEES. THE ACCOUNT CAN BE USED ONLY FOR AN APPROVED LIST OF EXPENDITURES. ALL OPTIONS OTHER THAN A DEFERRED, AT-RISK, COMPENSATION OPTION ARE CONSIDERED TAXABLE AND ARE INCLUDED IN THE EXECUTIVE'S TAXABLE INCOME AS PRESCRIBED BY THE APPLICABLE TAX LAWS. HOUSING ALLOWANCE OR RESIDENCE FOR PERSONAL USE: WE PROVIDE TEMPORARY HOUSING ALLOWANCES IN CERTAIN EXECUTIVE RECRUITMENT AND RELOCATION PACKAGES. THE VALUE IS CALCULATED UNDER APPLICABLE TAX LAWS AND THAT AMOUNT IS INCLUDED IN THE EXECUTIVE'S INCOME AS PRESCRIBED BY THE APPLICABLE TAX LAWS. |
| PART I, LINE 3 | THE FILING ORGANIZATION IS AN INTEGRAL PART OF NOVANT HEALTH, AN INTEGRATED HEALTHCARE SYSTEM AND RELIES UPON NOVANT HEALTH, INC., THE PARENT ORGANIZATION, TO USE THE PROCESS DESCRIBED IN PART VI, LINE 15A/15B OF THIS RETURN TO ESTABLISH COMPENSATION FOR CERTAIN EXECUTIVES. THIS PROCESS ADHERES TO THE REQUIREMENTS SET FORTH TO SECURE THE REBUTTABLE PRESUMPTION OF REASONABLENESS AND INCLUDES A REVIEW AND APPROVAL BY INDEPENDENT AND DISINTERESTED MEMBERS OF A COMPENSATION COMMITTEE, CONSULTATION WITH INDEPENDENT COMPENSATION CONSULTANTS, THE UTILIZATION OF THIRD-PARTY COMPARABILITY DATA SUCH AS PUBLISHED COMPENSATION SURVEYS, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. |
| PART I, LINE 4B | PART I, LINES 4A-C: SEVERANCE, NONQUALIFIED, AND EQUITY-BASED PAYMENTS SEVERANCE NONE NONQUALIFIED HENDERSON, KIMBERLY $42,333 MYERS, SCOTT $56,783 EQUITY-BASED NONE |
| PART I, LINE 4A - SEVERANCE PLAN: | ELIGIBLE EXECUTIVES MAY RECEIVE SEVERANCE PAY THAT IS BASED ON ANNUAL COMPENSATION FOR A SPECIFIED PERIOD OF TIME. THE SEVERANCE PAY WOULD BE PAID ONLY IN THE EVENT OF CERTAIN TYPES OF EMPLOYMENT TERMINATION, AND IS FURTHER CONTINGENT ON THE SATISFACTION OF OTHER CONDITIONS SUCH AS COMPLIANCE WITH A NON-COMPETITION COVENANT. ANY CURRENT YEAR PAYMENTS HAVE BEEN INCLUDED IN THE COMPENSATION AMOUNTS REPORTED IN PART VII AND IN COLUMN (B)(III) OF SCHEDULE J. THE COMPENSATION AND LEADERSHIP COMMITTEE OF THE NOVANT HEALTH BOARD REVIEWS, APPROVES, AND OVERSEES ALL ASPECTS AND ALL ELEMENTS OF EXECUTIVE COMPENSATION AND BENEFITS, INCLUDING THE AMOUNTS AWARDED UNDER THIS SEVERANCE PLAN. |
| PART I, LINE 4B - SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANS: | THE SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN ("SERP") IS INTENDED TO SUPPORT RETENTION OF KEY EXECUTIVES, AND TO OFFER COMPETITIVE TOTAL COMPENSATION. ELIGIBLE EXECUTIVES WILL BE NOMINATED BY THE CEO AND APPROVED BY THE NOVANT HEALTH COMPENSATION AND LEADERSHIP COMMITTEE ("THE COMMITTEE") TO PARTICIPATE. GENERALLY, ANNUAL CONTRIBUTIONS TO THE PLAN OR PAYMENTS TO PARTICIPANTS WILL BE BASED ON A PERCENTAGE OF THE PARTICIPANT'S BASE SALARY AS OF JANUARY 1ST OF THE PREVIOUS PLAN YEAR AND ARE REPORTED IN COLUMN (C) OF SCHEDULE J. PRIOR TO MAKING THE CONTRIBUTIONS OR PAYMENTS, THE COMMITTEE WILL APPROVE THE AMOUNTS AS TO REASONABLENESS, WHEN COMBINED WITH ALL OTHER ANNUAL COMPENSATION. A 3 YEAR CLASS-YEAR VESTING PERIOD WILL APPLY UP TO AGE 62, WHEN ALL MONEY WOULD BE VESTED AND PAID OUT TO THE PARTICIPANT. OTHERWISE, VESTING WILL OCCUR ON JANUARY 1ST OF EACH YEAR FOR THE APPROPRIATE CLASS-YEAR VESTING PERIOD. THE COMMITTEE REVIEWS, APPROVES, AND OVERSEES ALL ASPECTS AND ALL ELEMENTS OF EXECUTIVE COMPENSATION AND BENEFITS. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PI, L1: ORGANIZATION'S MISSION OR MOST SIGNIFICANT ACTIVITIES | FORSYTH MEDICAL CENTER FOUNDATION, DOING BUSINESS AS NOVANT HEALTH FORSYTH MEDICAL CENTER FOUNDATION ("THE FOUNDATION") WAS FORMED TO ACCEPT GIFTS, SEEK GRANTS AND INVEST FUNDS TO SUPPORT FORSYTH MEMORIAL HOSPITAL DOING BUSINESS AT NOVANT HEALTH FORSYTH MEDICAL CENTER AS WELL AS THEIR STRATEGIC PARTNERS PROVIDING HEALTHCARE IN THE COMMUNITY. NOVANT HEALTH FORSYTH MEDICAL CENTER FOUNDATION'S MISSION IS SUPPORTING THE NOVANT HEALTH SYSTEM AND IMPROVING THE HEALTH OF OUR COMMUNITIES, ONE PERSON AT A TIME. NOVANT HEALTH FORSYTH MEDICAL CENTER FOUNDATION IS AN INTEGRAL PART OF THE NOVANT HEALTH SYSTEM (COLLECTIVELY KNOWN AS "NOVANT HEALTH"), A NOT-FOR-PROFIT INTEGRATED GROUP OF HOSPITALS, PHYSICIAN CLINICS, OUTPATIENT CENTERS AND OTHER HEALTHCARE SERVICE PROVIDERS. NOVANT HEALTH CONSISTS OF MORE THAN 1,600 PHYSICIANS AND OVER 29,000 EMPLOYEES WHO MAKE HEALTHCARE REMARKABLE AT NEARLY 700 LOCATIONS, INCLUDING 15 MEDICAL CENTERS AND HUNDREDS OF OUTPATIENT FACILITIES AND PHYSICIAN CLINICS. HEADQUARTERED IN WINSTON SALEM, NC, NOVANT HEALTH IS COMMITTED TO MAKING HEALTHCARE REMARKABLE FOR PATIENTS AND COMMUNITIES, SERVING MORE THAN FIVE MILLION PATIENTS ANNUALLY. IN 2020, NOVANT HEALTH WAS THE ONLY HEALTHCARE SYSTEM IN NORTH CAROLINA TO BE INCLUDED ON FORBES' BEST EMPLOYERS FOR DIVERSITY LIST. IN 2020, THE NOVANT HEALTH SYSTEM REPORTED $5.7 BILLION IN REVENUES. GENERAL INFORMATION NOVANT HEALTH FORSYTH MEDICAL CENTER FOUNDATION SUPPORTS PATIENTS, FAMILIES AND CAREGIVERS AS WELL AS TEAM MEMBERS WITH PROGRAMS AND SERVICES WITHIN THE MEDICAL CENTERS, PROVIDING EXPANDED TREATMENT AND PREVENTION OPTIONS. NOVANT HEALTH FORSYTH MEDICAL CENTER FOUNDATION ALSO PROVIDES A MISSION-ALIGNED GRANT TO COMMUNITY PARTNERS THAT HELP SUPPLEMENT HEALTHCARE AND PREVENTION PROGRAMS FOR UNDERSERVED PATIENTS AT THE COMMUNITY CARE CENTER. ITS DIVERSE BOARD OF COMMUNITY LEADERS IN WINSTON SALEM, CLEMMONS, AND KERNERSVILLE, NC PROVIDES STEWARDSHIP AND OVERSIGHT OF THE ORGANIZATION'S OPERATIONS AND ACTIVITIES. COMMUNITY OUTREACH COMMUNITY OUTREACH IS A CRITICAL COMPONENT TO THE MISSION OF NOVANT HEALTH FORSYTH MEDICAL CENTER FOUNDATION. IN 2020, ITS GIFTS, GRANTS, AND EARNINGS FROM INVESTMENTS TOUCHED VIRTUALLY EVERY SERVICE AREA AT NOVANT HEALTH FORSYTH MEDICAL CENTER. SOME EXAMPLES ARE AS FOLLOWS: - RESTRICTED GIFTS FROM FOUNDATION FUNDS WENT TO SUPPORT ONCOLOGY NURSE NAVIGATORS, PATIENT SUPPORT, TRANSPORTATION, NURSING EDUCATION FINANCIAL AWARDS, MAMMOGRAMS, PATIENT TRANSPORTATION, MEDICATION, AND STAFF EDUCATION. - FAMILY CONNECTS, AN IN-HOME NURSE VISIT PROGRAM FOR NEW MOTHERS IN FORSYTH AND DAVIDSON COUNTIES WHO DELIVER AT NOVANT HEALTH FACILITIES. DURING COVID-19, CARE WAS PROVIDED BY FAMILY CONNECTS RNS THROUGH A VIRTUAL PLATFORM. PATIENTS WERE CONNECTED WITH A RANGE OF COMMUNITY RESOURCES, NOTABLY POSTPARTUM DEPRESSION SUPPORT. - DENTAL WORK FOR PATIENTS WITH HEAD AND NECK CANCER. MANY OF THESE PATIENTS REQUIRE EXPENSIVE ORAL SURGERY BEFORE THEY ARE ABLE TO UNDERGO TREATMENT. - A MONTHLY SUPPORT GROUP FOR PATIENTS WITH DEMENTIA AND THEIR CAREGIVERS. DURING COVID-19, THESE ACTIVITIES WERE OFFERED OVER A VIRTUAL PLATFORM. - ONGOING FUNDING FOR ANGEL EYE CAMERAS IN THE NICU AT NOVANT HEALTH FORSYTH MEDICAL CENTER. THIS TECHNOLOGY PROVIDES FAMILIES WITH AN OPPORTUNITY TO SEE THEIR BABIES WHEN THEY CANNOT BE AT THE BEDSIDE. FAMILIES CAN LOG IN 24 HOURS A DAY, PROVIDING PEACE OF MIND AND ASSURANCE THAT THEIR NEWBORNS ARE BEING CARED FOR. - BLOOD PRESSURE CUFFS FOR PATIENTS WHO HAVE RECOVERED FROM A STROKE OR HAVE HIGH BLOOD PRESSURE. THIS WAS NEEDED ESPECIALLY DURING COVID-19, WHEN PATIENTS WERE NOT ABLE TO EASILY VISIT A PROVIDER'S OFFICE OR PHARMACY TO MONITOR THEIR BLOOD PRESSURE. - FUNDING FOR NOVANT HEALTH TODAY'S WOMAN, AN OBSTETRICS, GYNECOLOGY AND PEDIATRIC CLINIC WHICH CARES FOR PATIENTS IN AN UNDERSERVED COMMUNITY. BILINGUAL TEAM MEMBERS PROVIDE A RANGE OF SERVICES, INCLUDING TRANSPORTATION TO AND FROM APPOINTMENTS. - FINANCIAL ASSISTANCE TO SUPPORT RENT, UTILITIES, AND GROCERIES FOR TEAM MEMBERS FACING EMERGENCIES OR OTHER FINANCIAL CHALLENGES. - THE WOMEN'S COUNCIL OF NOVANT HEALTH FORSYTH MEDICAL CENTER FOUNDATION HAS A MISSION TO ENGAGE WOMEN IN RAISING THE STANDARD FOR WOMEN'S HEALTH AND EXPANDING HEALTHCARE OPPORTUNITIES FOR ALL WOMEN, REGARDLESS OF THEIR ECONOMIC CIRCUMSTANCES. THE WOMEN'S COUNCIL HAS PROVIDED GRANTS FOR MAMMOGRAPHY, MEDICATION AND TRANSPORTATION SUPPORT FOR WOMEN BATTLING GYNECOLOGIC CANCER; FUNDING FOR A PART-TIME LICENSED CLINICAL SOCIAL WORKER AT NOVANT HEALTH TODAY'S WOMAN; AND EQUIPMENT FOR FORSYTH CONNECTS, A HOME VISIT PROGRAM FOR NEW MOTHERS RESIDING IN FORSYTH COUNTY. THROUGH THESE GRANTS AND OTHERS, THE WOMEN'S COUNCIL HAS PROVIDED OVER $1,100,000 SINCE ITS FOUNDING. LEARN MORE ABOUT HOW GIFTS THROUGH NOVANT HEALTH FORSYTH MEDICAL CENTER FOUNDATION SAVE AND IMPROVE THE LIVES OF THOSE IN THE COMMUNITIES WE SERVE, VISIT SUPPORTNOVANTHEALTH.ORG/2020FMCFANNUALREPORT. COMMUNITY BENEFIT REPORT HTTPS://WWW.NOVANTHEALTH.ORG/HOME/ABOUT-US/COMMUNITY-ENGAGEMENT/OUR-IMPA CT.ASPX THE COMMUNITY BENEFIT REPORT, REFERRED TO AS A COMMUNITY IMPACT REPORT, PREPARED BY NOVANT HEALTH IS A SYSTEM-WIDE REPORT THAT INCLUDES QUALITATIVE AND QUANTITATIVE INFORMATION. PLEASE NOTE THAT THE NUMERIC DATA IN THIS REPORT IS NOT BASED UPON THE FORM 990, SCHEDULE H CRITERIA, BUT RATHER IT HAS BEEN PREPARED IN ACCORDANCE WITH THE NORTH CAROLINA HOSPITAL ASSOCIATION REPORTING GUIDELINES. IT SHOULD NOT BE RELIED UPON AS THE ORGANIZATION'S FORM 990, SCHEDULE H COMMUNITY BENEFIT REPORT, ITS COMMUNITY HEALTH NEEDS ASSESSMENT OR COMMUNITY BENEFIT IMPLEMENTATION STRATEGY. IN THIS REPORT, THE NOVANT HEALTH SYSTEM'S COMMUNITY BENEFIT WAS APPROXIMATELY $1,018,000,000, INCLUDING $179,000,000 IN FINANCIAL ASSISTANCE FOR 2020. |
| FORM 990, PART III, LINE 1: MISSION, VISION AND VALUES | MISSION NOVANT HEALTH EXISTS TO IMPROVE THE HEALTH OF COMMUNITIES, ONE PERSON AT A TIME. VISION WE, THE NOVANT HEALTH TEAM, WILL DELIVER THE MOST REMARKABLE PATIENT EXPERIENCE, IN EVERY DIMENSION, EVERY TIME. VALUES -COMPASSION: WE TREAT OUR CUSTOMERS AND THEIR FAMILIES, STAFF AND OTHER HEALTHCARE PROVIDERS AS FAMILY MEMBERS BY SHOWING THEM KINDNESS, PATIENCE, EMPATHY AND RESPECT. -DIVERSITY AND INCLUSION: WE RECOGNIZE THAT EVERY PERSON IS DIFFERENT, EACH SHAPED BY UNIQUE LIFE EXPERIENCES. THIS ENABLES US TO BETTER UNDERSTAND EACH OTHER AND OUR CUSTOMERS. -PERSONAL EXCELLENCE: WE STRIVE TO GROW PERSONALLY AND PROFESSIONALLY, AND WE APPROACH EACH SERVICE OPPORTUNITY WITH A POSITIVE, FLEXIBLE ATTITUDE. HONESTY AND PERSONAL INTEGRITY GUIDE ALL THAT WE DO. -TEAMWORK: THE NEEDS AND EXPECTATIONS OF ANY ONE CUSTOMER ARE GREATER THAN WHAT ONE PERSON'S SERVICE EFFORTS CAN SATISFY. WE SUPPORT EACH OTHER SO THAT TOGETHER AS A TEAM, WE CAN BE SUCCESSFUL IN THE EYE OF THE CUSTOMER AS A QUALITY SERVICE PROVIDER. -COURAGE: WE ACT BOLDLY IN MAKING THE CHANGES NECESSARY TO ACHIEVE OUR MISSION, VISION AND PROMISE OF DELIVERING REMARKABLE HEALTHCARE. OUR PEOPLE AT NOVANT HEALTH, PEOPLE ARE OUR BUSINESS. WE TREAT EACH OTHER WITH RESPECT AND COMPASSION. WE EMBRACE THE DIFFERENCES IN OUR STRENGTHS WHILE FOSTERING AN ENVIRONMENT OF INCLUSION, EMPOWERMENT, INSPIRATION AND COURAGE. WE ALWAYS REMEMBER, OUR BUSINESS IS THE CARE OF ALL PEOPLE, STARTING WITH OUR TEAM MEMBERS. OUR PROMISE TO PATIENTS WE ARE MAKING YOUR HEALTHCARE EXPERIENCE REMARKABLE. WE WILL BRING YOU WORLD-CLASS CLINICIANS, CARE AND TECHNOLOGY - WHEN AND WHERE YOU NEED THEM. WE ARE REINVENTING THE HEALTHCARE EXPERIENCE TO BE SIMPLER, MORE CONVENIENT AND MORE AFFORDABLE, SO THAT YOU CAN FOCUS ON GETTING BETTER AND STAYING HEALTHY. |
| FORM 990, PART III, LINE 2 | LEARN ABOUT HOW WE ARE SERVING OUR COMMUNITIES IN THE PANDEMIC BY VISITING HTTPS://WWW.NOVANTHEALTH.ORG/PORTALS/92/ASSETS/DOCUMENTS/ANNUAL-FINANCIA L-INFORMATION/NOVANT-HEALTH-2020-ANNUAL-REPORT_RISING-UP.PDF |
| FORM 990, PART VI, SECTION A, LINE 7A | FORM 990, PART VI, SECTION A, LINE 7A: ELECTION OF MEMBERS AND THEIR RIGHTS FORSYTH MEMORIAL HOSPITAL, INC. APPOINTS THE MAJORITY OF THE FORSYTH MEDICAL CENTER FOUNDATION'S BOARD. |
| FORM 990, PART VI, SECTION B, LINE 11B | FORM 990, PART VI, SECTION B, LINE 11: ORGANIZATION'S PROCESS TO REVIEW FORM 990 THE BOARD HAS DELEGATED REVIEW OF THE FORM 990 TO NOVANT HEALTH'S BOARD OF TRUSTEES' AUDIT AND COMPLIANCE COMMITTEE ("THE COMMITTEE"), WHICH OVERSEES TAX MATTERS FOR ENTITIES IN THE NOVANT HEALTH SYSTEM. THE COMMITTEE IS THE REVIEW BODY FOR ALL OF THE FORM 990S FILED FOR ORGANIZATIONS WITHIN THE NOVANT HEALTH SYSTEM. THE COMMITTEE MEETS BEFORE THE FORM 990S ARE FILED WITH THE IRS AND AFTER ALL BOARD MEMBERS HAVE BEEN PROVIDED A PAPER OR ELECTRONIC COPY OF THE FORM 990 AND A SUMMARY OF ITS CONTENTS. THE VICE PRESIDENT OF TAX AND LEGAL COUNSEL FOR NOVANT HEALTH ATTEND THE MEETING TO ANSWER ANY QUESTIONS AND ADDRESS ANY SIGNIFICANT DISCLOSURES WITHIN THE FORM 990. |
| FORM 990, PART VI, SECTION B, LINE 12C | FORM 990, PART VI, SECTION B, LINE 12C: MONITORING AND ENFORCEMENT OF COI THE ORGANIZATION'S TRUSTEE CONFLICT OF INTEREST POLICY APPLIES TO ALL TRUSTEES, PRINCIPAL OFFICERS OR MEMBERS OF A COMMITTEE WITH BOARD DELEGATED POWERS INCLUDING ANY APPLICABLE DISREGARDED ENTITIES. ALL TRUSTEES ARE SENT AN ANNUAL DISCLOSURE QUESTIONNAIRE. THE TRUSTEE ANNUAL DISCLOSURE QUESTIONNAIRES ARE REVIEWED BY THE COMPLIANCE DEPARTMENT. WITH RESPECT TO PARTICULAR TRANSACTIONS THAT COME BEFORE THE BOARD, THE CONFLICT OF INTEREST POLICY WOULD BE FOLLOWED. THE POTENTIAL CONFLICT OF INTEREST WOULD BE DISCLOSED BY THE BOARD MEMBER BEFORE A VOTE ON THE TRANSACTION AND THE REST OF THE BOARD WOULD DETERMINE WHETHER A CONFLICT OF INTEREST EXISTS. IF THE REST OF THE BOARD DETERMINED THAT A CONFLICT OF INTEREST EXISTED THEN THE BOARD MEMBER WITH THE CONFLICT OF INTEREST WOULD NOT PARTICIPATE IN THE DELIBERATIONS AND VOTE. |
| FORM 990, PART VI, SECTION B, LINE 15 | FORM 990, PART VI, SECTION B, LINE 15A/15B: THE FILING ORGANIZATION IS AN INTEGRAL PART OF NOVANT HEALTH, AN INTEGRATED HEALTHCARE SYSTEM COLLECTIVELY REFERRED TO AS "NOVANT HEALTH." NOVANT HEALTH, INC. IS THE PARENT ORGANIZATION AND INDEPENDENT AND DISINTERESTED MEMBERS OF THE NOVANT HEALTH, INC. BOARD OF TRUSTEES (WHO COMPRISE THE COMPENSATION AND LEADERSHIP COMMITTEE OF THE BOARD) REVIEW, APPROVE, AND OVERSEE ALL ASPECTS OF COMPENSATION AND BENEFITS FOR CERTAIN LEADERS AND EXECUTIVES ("EXECUTIVES") SERVING AS OFFICERS, INCLUDING THE TOP MANAGEMENT OFFICIAL, OR KEY EMPLOYEES FOR NOVANT HEALTH ENTITIES. THE COMMITTEE WORKS WITH AN INDEPENDENT COMPENSATION CONSULTANT AND USES THIRD PARTY COMPARABILITY DATA FOR FUNCTIONALLY SIMILAR POSITIONS AT SIMILARLY SITUATED ORGANIZATIONS TO ENSURE THAT TOTAL COMPENSATION AND BENEFITS FOR EACH EXECUTIVE IS REASONABLE FOR THAT EXECUTIVE'S POSITION. THE COMMITTEE REVIEWS AND APPROVES EXECUTIVE COMPENSATION AND BENEFITS ANNUALLY, CONSISTENT WITH THE WRITTEN EXECUTIVE COMPENSATION PHILOSOPHY OF NOVANT HEALTH, AND IN A MANNER THAT QUALIFIES FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS, THEREBY ASSURING THAT TOTAL COMPENSATION AND BENEFITS PROVIDED TO EACH EXECUTIVE IS REASONABLE. THE ORGANIZATION DOES NOT HAVE ANY KEY EMPLOYEES AND THE ORGANIZATION'S ONLY OFFICERS, OTHER THAN THE TOP MANAGEMENT OFFICIAL, ARE STATE LAW BOARD OFFICERS. THESE EMPLOYEES DO NOT HOLD A CORPORATE POSITION OF INFLUENCE THAT RESULTS IN REVIEW OF THEIR COMPENSATION BY THE PARENT ORGANIZATION'S COMPENSATION AND LEADERSHIP COMMITTEE. |
| FORM 990, PART VI, SECTION C, LINE 19 | FORM 990, PART VI, SECTION C, LINE 19: GOVERNING DOCUMENTS DISCLOSURE THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS CONTAINING ALL ORGANIZATIONS IN THE NOVANT HEALTH SYSTEM ARE POSTED TO THE NOVANT HEALTH WEBSITE. THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT AVAILABLE TO THE PUBLIC. |
| FORM 990, PART XI, LINE 9: | AFFILIATE TRANSFER: 631,212. PLEDGES RECEIVABLE: 137,636. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (24 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| AUXILIARY OF FORSYTH MEMORIAL HOSPITAL | |||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 560862112 | HEALTHCARE | NC | 501(C)(3) | LINE 10 | FORSYTH MEMORIAL HOSPITAL INC | 0 | |
| BRUNSWICK NOVANT MEDICAL CENTER FOUNDATION | |||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 274616751 | HEALTHCARE | NC | 501(C)(3) | LINE 7 | BRUNSWICK COMMUNITY HOSPITAL LLC | 0 | |
| CAROLINA MEDICORP ENTERPRISES INC | |||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 581466368 | HEALTHCARE | NC | 501(C)(3) | LINE 10 | NOVANT MEDICAL GROUP INC | 0 | |
| COMMUNITY GENERAL HEALTH PARTNERS INC | |||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 560636250 | HEALTHCARE | NC | 501(C)(3) | LINE 3 | NOVANT HEALTH TRIAD REGION LLC | 0 | |
| COMMUNITY GENERAL HOSPITAL FOUNDATION INC | |||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 561828629 | HEALTHCARE | NC | 501(C)(3) | LINE 7 | COMMUNITY GENERAL HEALTH PARTNERS INC | 0 | |
| FORSYTH MEMORIAL HOSPITAL INC | |||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 560928089 | HEALTHCARE | NC | 501(C)(3) | LINE 3 | NOVANT HEALTH TRIAD REGION LLC | 0 | |
| FOUNDATION HEALTH SYSTEMS CORP | |||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 561373175 | HEALTHCARE | NC | 501(C)(3) | LINE 10 | NOVANT HEALTH INC | 0 | |
| MEDICAL PARK HOSPITAL INC | |||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 561340424 | HEALTHCARE | NC | 501(C)(3) | LINE 3 | NOVANT HEALTH TRIAD REGION LLC | 0 | |
| NOVANT HEALTH INC | |||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 561376950 | HEALTHCARE | NC | 501(C)(3) | LINE 3 | 0 | N/A | |
| NOVANT MEDICAL GROUP INC | |||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 581728803 | HEALTHCARE | NC | 501(C)(3) | LINE 3 | NMG SERVICES LLC | 0 | |
| PERSONAL CARE SERVICES | |||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 541291284 | HEALTHCARE | VA | 501(C)(3) | LINE 10 | PRINCE WILLIAM HEALTH SYSTEM | 0 | |
| PRESBYTERIAN HOSPITAL FOUNDATION | |||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 581413074 | HEALTHCARE | NC | 501(C)(3) | LINE 7 | NOVANT HEALTH SOUTHERN PIEDMONT REGION LLC | 0 | |
| PRESBYTERIAN MEDICAL CARE CORPORATION | |||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 561376368 | HEALTHCARE | NC | 501(C)(3) | LINE 3 | NOVANT HEALTH SOUTHERN PIEDMONT REGION LLC | 0 | |
| PRINCE WILLIAM HEALTH SYSTEM | |||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 541278944 | HEALTHCARE | VA | 501(C)(3) | LINE 12C, III-FI | NOVANT HEALTH UVA HEALTH SYSTEM | 0 | |
| PRINCE WILLIAM HOSPITAL | |||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 540696355 | HEALTHCARE | VA | 501(C)(3) | LINE 3 | PRINCE WILLIAM HEALTH SYSTEM | 0 | |
| PWHS FOUNDATION | |||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 541307595 | HEALTHCARE | VA | 501(C)(3) | LINE 7 | PRINCE WILLIAM HEALTH SYSTEM | 0 | |
| ROWAN HEALTH SERVICES CORPORATION | |||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 561424814 | HEALTHCARE | NC | 501(C)(3) | LINE 12C, III-FI | NOVANT HEALTH INC | 0 | |
| ROWAN REGIONAL MEDICAL CENTER AUXILIARY | |||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 237022472 | HEALTHCARE | NC | 501(C)(3) | LINE 10 | ROWAN REGIONAL MEDICAL CENTER INC | 0 | |
| ROWAN REGIONAL MEDICAL CENTER FOUNDATION INC | |||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 561424818 | HEALTHCARE | NC | 501(C)(3) | LINE 7 | ROWAN REGIONAL MEDICAL CENTER INC | 0 | |
| ROWAN REGIONAL MEDICAL CENTER INC | |||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 560547479 | HEALTHCARE | NC | 501(C)(3) | LINE 3 | ROWAN HEALTH SERVICES CORPORATION | 0 | |
| SELF INSURANCE FUND - NOVANT HEALTH INC | |||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 581867242 | HEALTHCARE | NC | 501(C)(3) | LINE 12C, III-FI | NOVANT HEALTH INC | 0 | |
| THE PRESBYTERIAN HOSPITAL | |||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 560554230 | HEALTHCARE | NC | 501(C)(3) | LINE 3 | NOVANT HEALTH SOUTHERN PIEDMONT REGION LLC | 0 | |
| CULPEPER MEMORIAL HOSPITAL INC | |||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 540622371 | HEALTHCARE | VA | 501(C)(3) | LINE 3 | NOVANT HEALTH UVA HEALTH SYSTEM | 0 | |
| NOVANT HEALTH UVA HEALTH SYSTEM | |||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 810868533 | HEALTHCARE | VA | 501(C)(3) | LINE 12A, I | NOVANT HEALTH INC | 0 | |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (9 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| ADEPT HEALTH INC | |||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 562226937 | ADMIN SERVICES | NC | N/A | C | 0 |
| CHOICEHEALTH INC | |||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 561896065 | MANAGED CARE | NC | N/A | C | 0 |
| COMMUNICARE INC | |||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 561952950 | RENTAL REAL ESTATE | NC | N/A | C | 0 |
| KERNERSVILLE MEDICAL CENTER PARK OWNERS' ASSOCIATION | |||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 471511401 | RENTAL REAL ESTATE | NC | N/A | C | 0 |
| MEDQUEST INC & SUBSIDIARIES | |||||||||
| 3480 PRESTON RIDGE RD STE 600 | ALPHARETTA | GA | 30005 | 223860764 | DIAGNOSTIC IMAGING | DE | N/A | C | 0 |
| NOVANT HEALTH TRINOVA INSURANCE PROTECTED CELL INC | |||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 812963143 | INSURANCE | NC | N/A | C | 0 |
| SALEM DIAGNOSTICS INC | |||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 561513621 | HEALTH RELATED | NC | N/A | C | 0 |
| SALEM HEALTH SERVICES INC | |||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 561342654 | HEALTH RELATED | NC | N/A | C | 0 |
| THE PARK AT MONROE PROPERTY OWNERS ASSOCIATION INC | |||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 463910256 | RENTAL REAL ESTATE | NC | N/A | C | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |