2020-11-02T12:38:46-06:00 2019-12-31 990 2019-01-01 562120959 FORSYTH MEDICAL CENTER FOUNDATION FORS 3367182803 2085 FRONTIS PLAZA BLVD WINSTON SALEM NC 27103 FRED HARGETT EVP & CFO 3367182803 2020-10-31 170.98.106.254 2020-10-31 08:47:01 ED P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 A2315309B7343EB998963AA05290CF11231D17E5 2019 2021-01-29 14:40:06Z NOVANT HEALTH FORSYTH MEDICAL CENTER FOUNDATION CARL ARMATO 2085 FRONTIS PLAZA BLVD WINSTON SALEM NC 27103 26740152 0 X WWW.SUPPORTNOVANTHEALTH.ORG X 1981 NC SEE SCHEDULE O 20 16 0 59 0 0 2617056 2090974 0 0 4494656 3179619 -15596 -18620 7096116 5251973 3813416 3277298 0 0 0 0 0 0 451002 1121604 1312941 4935020 4590239 2161096 661734 66720825 75295968 576807 831558 66144018 74464410 X SEE SCHEDULE O 0 0 3640539 3277298 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. 3640539 1 1 0 1 0 0 0 0 0 1 1 1 0 0 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 X 20 16 1 0 0 0 0 1 0 1 1 0 0 1 1 1 1 1 1 0 0 0 NC X X KAREN DAUGHERTY 3367182803 2085 FRONTIS PLAZA BLVD WINSTON SALEM NC 27103 MYERS SCOTT ASST SEC 0.20 50.20 X 0 852980 106692 HENDERSON KIMBERLY FMR SVP FOUNDATIONS 0.00 50.00 X 0 701652 106132 VINCENT PAULA FMR SVP FOUNDATIONS 0.00 50.20 X 0 738666 31777 MORRIS JOHN ASST SEC 0.20 45.00 X 0 395561 47121 ZEKAN PATRICIA MD TRUSTEE 0.20 45.00 X 0 386298 32278 CAULKINS DOROTHY SVP FOUNDATIONS 8.30 41.50 X 0 325874 57751 TORRIBLE JAMES FMR EXECUTIVE DIRECTOR 0.20 45.00 X 0 122056 20646 FULLER-ANDREWS LYNNE TRUSTEE 0.20 0.00 X 0 74 0 JONES DANA TRUSTEE 0.20 0.00 X 0 74 0 KNIGHT ANNETTE CHAIR 0.20 0.00 X X 0 74 0 MADDEN ELIZABETH TRUSTEE 0.20 0.00 X 0 74 0 MARSHALL DEBORAH VICE CHAIR 0.20 0.00 X X 0 74 0 POLONSKY SHERRY TRUSTEE 0.20 0.00 X 0 74 0 SCHAEFER CLAUDIA TRUSTEE 0.20 0.00 X 0 74 0 ALLEN ELMS MD TRUSTEE 0.20 0.00 X 0 67 0 BROWN TADELRO TRUSTEE 0.20 0.00 X 0 67 0 BYERS KEVIN TREASURER 0.20 0.00 X X 0 67 0 ELY JOSEPH TRUSTEE 0.20 0.20 X 0 67 0 FAWLEY DANIEL TRUSTEE 0.20 0.00 X 0 67 0 HOLMES HAROLD TRUSTEE 0.20 0.00 X 0 67 0 PRATT DAMON TRUSTEE 0.20 0.00 X 0 67 0 RAMIREZ-SANTOS HERNANDO TRUSTEE 0.20 0.00 X 0 67 0 WELCH EDWIN SEC 0.20 0.00 X X 0 67 0 YARBOROUGH DCHEFF TRUSTEE 0.20 0.00 X 0 67 0 MCALLISTER JUDY TRUSTEE 0.20 0.00 X 0 0 0 PROCTOR RALAN TRUSTEE 0.20 0.00 X 0 0 0 0 3524275 402397 0 1 1 0 0 95242 61549 1934183 23616 2090974 1223815 1223815 23401378 21445574 1955804 1955804 1955804 19318 95242 39490 -20172 -20172 4667 3115 1552 1552 5251973 0 0 3160999 3139779 3139779 137519 137519 316 316 167433 167433 86971 43214 185 43572 15756 2660 6926 6170 28776 28776 11388 2847 1935 6606 1973 493 335 1145 16571 4143 2817 9611 CONTRACT LABOR 619309 154827 105283 359199 MISCELLANEOUS 320654 147331 173323 OTHER SUPPLIES 13456 152 6108 7196 TRAINING & EDUCATION 13265 3316 2255 7694 17073 4258 3006 9809 4590239 3640539 498698 451002 685182 640178 1273250 1072127 10065 6757 701 0 184302 46490 154383 137812 52548989 59351230 12048255 14087864 66720825 75295968 576807 831558 576807 831558 X 53837007 62013567 12307011 12450843 66144018 74464410 66720825 75295968 X 661734 7079947 578711 X 0 1 X 1 0 X 1966306 3249464 2835503 2617056 2090974 12759303 1966306 3249464 2835503 2617056 2090974 12759303 4211852 8547451 933373 607685 738294 1092826 1223815 4595993 -20916 -5657 -19991 -23093 -18620 -88277 17267019 144717 0.49500 0.50860 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 19 19 0 PART II-B, LINE 1: LINE 1I DUES PAID TO CERTAIN ORGANIZATIONS WHICH INCLUDE A PORTION RELATED TO LOBBYING ACTIVITIES. 12307011 1435742 234221 69505 1459728 12447741 11924629 2719034 -111564 39421 2185667 12307011 11815684 2485091 193146 33832 2535460 11924629 10764944 2472752 74729 284479 1212262 11815684 11259915 1107979 -36768 24547 1541635 10764944 0.00000 1.00000 0.00000 0 0 184302 46490 137812 137812 OTHER SECURITIES 14087864 F 14087864 0 DUE TO AFFILIATE 831558 831558 X 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, 2019 AND 2018. 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. GARDEN PARTY 74597 63117 11480 1089 10108 14643 BOURBON & BREWS 39963 32125 7838 13649 0 114560 95242 19318 1089 23757 14643 39489 -20171 1 CANCER SERVICES INC 3175 MAPLEWOOD AVENUE WINSTONSALEM NC 27103 560656375 501(C)(3) 10000 COMMUNITY OUTREACH COMMUNITY CARE CENTER FOR FORSYTH COUNTY 2135 NEW WALKERTOWN ROAD WINSTONSALEM NC 27101 581403699 501(C)(3) 250000 COMMUNITY OUTREACH FORSYTH HEALTHCARE INC 515 N CLEVELAND AVE WINSTONSALEM NC 27101 320097975 501(C)(3) 250000 COMMUNITY OUTREACH NOVANT HEALTH INC 2085 FRONTIS PLAZA BLVD WINSTONSALEM NC 27103 561376950 501(C)(3) 582372 TO SUPPORT CARE CONNECTIONS PHARMACY AND OTHER VARIOUS PROGRAMS FORSYTH MEMORIAL HOSPITAL INC 2085 FRONTIS PLAZA BLVD WINSTONSALEM NC 27103 560928089 501(C)(3) 1487599 TO SUPPORT NHFMC, NHKMC, AND FMCI NOVANT MEDICAL GROUP INC 2085 FRONTIS PLAZA BLVD WINSTONSALEM NC 27103 581728803 501(C)(3) 35782 TO SUPPORT NOVANT MEDICAL GROUP, INC. FOUNDATION HEALTH SYSTEMS CORP 2085 FRONTIS PLAZA BLVD WINSTONSALEM NC 27103 561373175 501(C)(3) 500000 TO SUPPORT TODAY'S WOMAN WAKE FOREST UNIVERSITY HEALTH SCIENCES MEDICAL CENTER BLVD WINSTONSALEM NC 27157 223849199 501(C)(3) 11275 COMMUNITY OUTREACH 8 0 EMPLOYEE EMERGENCY FUND 66 49005 SCHOLARSHIPS 9 20000 PATIENT TRANSPORTATION 377 15448 FMV CAB FARES FOR INDIGENT PATIENTS MEDICATION TO INDIGENT PATIENTS 179 8082 FMV MEDICATION FOR INDIGENT PATIENTS PATIENT ASSISTANCE - ZOLL VEST 7 22900 FMV ZOLL LIFE VESTS PATIENT ASSISTANCE 630 22083 PART I, LINE 2: PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS 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. 1 1 0 0 0 0 0 0 0 MYERS SCOTT ASST SEC 0 414679 0 269244 0 169057 0 89408 0 17284 0 959672 0 59121 HENDERSON KIMBERLY FMR SVP FOUNDATIONS 0 362011 0 228192 0 111449 0 81917 0 24215 0 807784 0 23975 VINCENT PAULA FMR SVP FOUNDATIONS 0 398174 0 304728 0 35764 0 16800 0 14977 0 770443 0 0 MORRIS JOHN ASST SEC 0 228652 0 126620 0 40289 0 22287 0 24834 0 442682 0 7500 ZEKAN PATRICIA MD TRUSTEE 0 329775 0 5333 0 51190 0 16800 0 15478 0 418576 0 0 CAULKINS DOROTHY SVP FOUNDATIONS 0 245515 0 34000 0 46359 0 38250 0 19501 0 383625 0 0 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, LINES 4A-B PART I, LINES 4A-C: SEVERANCE, NONQUALIFIED, AND EQUITY-BASED PAYMENTS SEVERANCE TORRIBLE, JAMES $42,425 NONQUALIFIED HENDERSON, KIMBERLY $23,975 MYERS, SCOTT $51,621 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. X 3 3490 FMV X 9487 COST X FOOD & DRINK 56 6393 COST X GIFT CARDS 22 2142 COST X JEWELRY 11 1575 COST X EVENT TICKETS 1 530 COST 0 0 1 0 PART I, COLUMN (B): REPRESENTS NUMBER OF CONTRIBUTIONS 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 AS NOVANT HEALTH FORSYTH MEDICAL CENTER AND ITS STRATEGIC PARTNERS PROVIDING HEALTHCARE IN THE COMMUNITY. THE FOUNDATION'S MISSION IS TO ENGAGE AND CONNECT DONORS TO NOVANT HEALTH PROGRAMS AND INITIATIVES THAT SAVE LIVES AND IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE. LOCATED IN WINSTON SALEM, NC, IT HAS EXPANDED ITS REACH TO INCLUDE ADVISORY BOARDS AT MEDICAL CENTERS IN KERNERSVILLE, NC AND CLEMMONS, NC. NOVANT HEALTH FOUNDATION FORSYTH MEDICAL CENTER 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 FACILITIES AND OTHER HEALTHCARE SERVICE PROVIDERS. NOVANT HEALTH CONSISTS OF MORE THAN 1,600 PHYSICIANS AND OVER 29,000 EMPLOYEES THAT PROVIDE CARE AT NEARLY 700 LOCATIONS, INCLUDING 15 MEDICAL CENTERS AND HUNDREDS OF OUTPATIENT FACILITIES AND PHYSICIAN CLINICS. DIVERSITY MBA MAGAZINE HAS RANKED NOVANT HEALTH THIRD ON ITS 2019 LIST OF "BEST PLACES FOR WOMEN & DIVERSE MANAGERS TO WORK." GENERAL INFORMATION THE 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. THE 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. THE FOUNDATION'S 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 THE FOUNDATION HOSTS A WIDE RANGE OF FUNDRAISING EVENTS EACH YEAR, INCLUDING THE "GARDEN PARTY" LUNCHEON THROUGH THE WOMEN'S COUNCIL, A FUNDRAISER TO SUPPORT IMPROVED HEALTH OF ALL WOMEN IN THE LOCAL COMMUNITY. THE FOUNDATION EXISTS TO RAISE AWARENESS AND FUNDING TO ENHANCE THE ABILITY OF NOVANT HEALTH TO DELIVER REMARKABLE MEDICINE AND COMPASSIONATE CARE. IN 2019, THE FOUNDATION GIFTS, GRANTS, AND EARNINGS FROM INVESTMENTS TOUCHED VIRTUALLY EVERY SERVICE AREA AT NOVANT HEALTH FORSYTH MEDICAL CENTER. SOME EXAMPLES ARE AS FOLLOWS: -A STATE-OF-THE-ART HARNESS SYSTEM FOR STROKE PATIENTS UNDERGOING REHABILITATION. THIS SYSTEM PROVIDES COMPUTER DRIVEN FEEDBACK, RESULTING IN IMPROVED MOBILITY AND FASTER RECOVERY TIMES. -RESTRICTED GIFTS FROM FOUNDATION FUNDS WENT TO SUPPORT ONCOLOGY NURSE NAVIGATORS, PATIENT SUPPORT, TRANSPORTATION, NURSING EDUCATION FINANCIAL AWARDS AND NURSING RECRUITMENT AND RETENTION, STAFF EDUCATION, RESEARCH, MAMMOGRAMS, DISEASE PREVENTION, SCREENINGS AND PATIENT ASSISTANCE IN REHABILITATION. -ENHANCED ARTS AND HEALTH ACTIVITIES THROUGHOUT THE GREATER WINSTON SALEM MARKET THAT PROVIDES A THERAPEUTIC DISTRACTION THROUGH PERCUSSION AND OTHER SOOTHING MUSIC AND ART ACTIVITIES FOR PATIENTS WHO ARE IN THE MEDICAL CENTERS FOR LONG PERIODS OF TIME. -FAMILY CONNECTS, AN IN-HOME NURSE VISIT PROGRAM FOR NEW MOTHERS FROM FORSYTH AND DAVIDSON COUNTIES WHO DELIVER AT NOVANT HEALTH FACILITIES. FAMILY CONNECTS RNS PROVIDE A COMPREHENSIVE HEALTH ASSESSMENT FOR MOTHER AND BABY, AND CONNECTS FAMILIES WITH A RANGE OF COMMUNITY RESOURCES. -A NEW MOBILE MAMMOGRAM UNIT WITH 3-D TECHNOLOGY FOR FORSYTH AND SURROUNDING COUNTIES. THIS NEW UNIT SERVES 5,000 WOMEN ANNUALLY, PROVIDING MAMMOGRAMS FOR WOMEN WITHOUT INSURANCE, TRANSPORTATION, OR RESOURCES TO TAKE TIME OFF THEIR JOBS. -COURTESY SHUTTLES AT NOVANT HEALTH FORSYTH MEDICAL CENTER AND NOVANT HEALTH KERNERSVILLE MEDICAL CENTER PROVIDE CAMPUS ACCESS TO VISITORS AND PATIENTS WITH MOBILITY ISSUES. -WEIGHT SCALES FOR PATIENTS WHO ARE UNABLE TO AFFORD THEM. HEART FAILURE AND POST CORONARY ARTERY BYPASS GRAFT PATIENTS MUST MONITOR THEIR WEIGHT AS PART OF THEIR RECOVERY TO DETERMINE EARLY ON IF THEY ARE HAVING ISSUES. -A MONTHLY SUPPORT GROUP FOR PATIENTS WITH DEMENTIA AND THEIR CAREGIVERS, WHICH INCLUDES MEANINGFUL ACTIVITIES SUCH AS SCRAPBOOKING, DANCING, AND MUSIC. -NEW SOFA BEDS ON INPATIENT ONCOLOGY UNITS, ALLOWING FAMILY MEMBERS TO COMFORTABLY STAY WITH THEIR LOVED ONES WHO ARE BATTLING CANCER. -SUPPORT FOR NOVANT HEALTH TODAY'S WOMAN, A CLINIC SPECIALIZING IN OBSTETRICS AND GYNECOLOGY IN A COMMUNITY WHICH HAS HISTORICALLY FACED HIGH INFANT MORTALITY RATES. STAFFED WITH BILINGUAL TEAM MEMBERS, THIS FACILITY ACTS AS A COMMUNITY RESOURCE AND PROVIDES TRANSPORTATION TO AND FROM APPOINTMENTS. -ONGOING FUNDING FOR ANGEL EYE CAMERAS IN THE NICU AT NOVANT HEALTH FORSYTH MEDICAL CENTER, ALLOWS FAMILIES 24/7 VIDEO ACCESS TO THEIR BABIES. THIS TECHNOLOGY GIVES PARENTS PEACE OF MIND EVEN WHEN THEY CANNOT BE AT THE BEDSIDE, KNOWING THEIR TINY CHILDREN ARE BEING WELL CARED FOR. -A BILINGUAL BEHAVIORAL HEALTH THERAPIST AT NOVANT HEALTH WAUGHTOWN PEDIATRICS TO WORK WITH PATIENTS AGED 5-21. THE THERAPISTS COORDINATES WITH PARENTS, SCHOOL COUNSELORS, AND PEDIATRICIANS TO PROVIDE A COMPREHENSIVE, INDIVIDUAL PLAN FOR EACH PATIENT. -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. COMMUNITY BENEFIT REPORT HTTPS://WWW.NOVANTHEALTH.ORG/HOME/ABOUT-US/COMMUNITY-ENGAGEMENT/COMMUNIT Y-BENEFIT.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 $993,000,000, INCLUDING $152,000,000 IN FINANCIAL ASSISTANCE FOR 2019. 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 ONE ANOTHER AND OUR CUSTOMERS. BY ENGAGING THE STRENGTHS AND TALENTS OF EACH TEAM MEMBER, WE ENSURE A STRONG ORGANIZATION CAPABLE OF PROVIDING REMARKABLE HEALTHCARE TO OUR PATIENTS, FAMILIES AND COMMUNITIES. -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 THAT WHICH 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 WE ARE AN INCLUSIVE TEAM OF PURPOSE-DRIVEN PEOPLE INSPIRED AND UNITED BY OUR PASSION TO CARE FOR EACH OTHER, OUR PATIENTS AND OUR COMMUNITIES. 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 VI, SECTION A, LINE 2 FAMILY AND/OR BUSINESS RELATIONSHIPS BUSINESS RELATIONSHIP TADELRO BROWN ALAN PROCTOR 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: 796,333. PLEDGES RECEIVABLE: -217,622. 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 12B, II 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 12C, III-FI N/A 0 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 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 0 1 1 0 0 0 0 0 0 0 0 1 1 1 1 1 0 0 1