2020-07-14T10:47:49-05:00 2019-06-30 990 2018-07-01 566036688 THE MEDICAL FOUNDATION OF WAKE FOREST UN UNIVERSITY HEALTH SCIENCES AND NORTH CAR MEDI 3367164445 MEDICAL CENTER BLVD WINSTONSALEM NC 27157 BRADLEY A CLARK TREASURER 3367164445 2020-07-08 152.11.92.106 2020-07-08 08:45:56 ED P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 92F11F32722E8792293CAF8DF02A44B038BF976A 2018 2020-09-23 17:36:50Z JULIE A FREISCHLAG MD MEDICAL CENTER BLVD WINSTONSALEM NC 27157 336175 0 X N/A X 1952 NC TO AID AND PROMOTE, BY FINANCIAL ASSISTANCE AND OTHERWISE, ALL TYPES OF EDUCATION, SERVICE AND RESEARCH IN THE FIELDS OF PREVENTIVE AND CURATIVE MEDICINE; THE SCIENTIFIC DEVELOPMENT AND GENERAL IMPROVEMENT OF WAKE FOREST UNIVERSITY HEALTH SCIENCES(WFUHS) AND NORTH CAROLINA BAPTIST HOSPITAL (NCBH); TO ENLARGE AND IMPROVE THE FACILITIES OF WFUHS AND NCBH; TO RENDER AID AND ASSISTANCE TO WFUHS AND NCBH BY PROMOTION OF MEDICAL SCIENCE/MEDICAL KNOWLEDGE, PUBLICATION AND DISTRIBUTION OF LITERATURE IN FURTHERENCE OF SUCH PURPOSES; AND TO AID/ASSIST WFUHS AND NCBH IN EDUCATION AND TRAINING OF PHYSICIANS, NURSES, TECHNICIANS AND SCIENTISTS SUCH THAT WFUHS AND NCBH QUALITY OF TRAINING AND SERVICE SHALL BE STEADILY IMPROVED. 2 1 0 0 0 0 0 0 0 0 314094 185865 -106021 -126492 208073 59373 0 0 0 0 0 0 0 0 0 104519 0 104519 0 103554 59373 10723144 10811313 63806 59623 10659338 10751690 X TO AID AND PROMOTE, BY FINANCIAL ASSISTANCE AND OTHERWISE, ALL TYPES OF EDUCATION, SERVICE AND RESEARCH IN THE FIELDS OF PREVENTIVE AND CURATIVE MEDICINE; THE SCIENTIFIC DEVELOPMENT AND GENERAL IMPROVEMENT OF WAKE FOREST UNIVERSITY HEALTH SCIENCES(WFUHS) AND NORTH CAROLINA BAPTIST HOSPITAL (NCBH); TO ENLARGE AND IMPROVE THE FACILITIES OF WFUHS AND NCBH; TO RENDER AID AND ASSISTANCE TO WFUHS AND NCBH BY PROMOTION OF MEDICAL SCIENCE/MEDICAL KNOWLEDGE, PUBLICATION AND DISTRIBUTION OF LITERATURE IN FURTHERENCE OF SUCH PURPOSES; AND TO AID/ASSIST WFUHS AND NCBH IN EDUCATION AND TRAINING OF PHYSICIANS, NURSES, TECHNICIANS AND SCIENTISTS SUCH THAT WFUHS AND NCBH QUALITY OF TRAINING AND SERVICE SHALL BE STEADILY IMPROVED. 0 0 THE MEDICAL FOUNDATION OF WAKE FOREST UNIVERSITY HEALTH SCIENCES AND NORTH CAROLINA BAPTIST HOSPITAL IS A NON-PROFIT ORGANIZATION WHOSE PURPOSE IS TO RENDER AID AND ASSISTANCE TO WFUHS AND NCBH IN THEIR PURSUITS BY APPROVED METHODS FOR THE PROMOTION OF MEDICAL SCIENCE AND MEDICAL KNOWLEDGE, THE PUBLICATION AND DISTRIBUTION OF LITERATURE, THE EDUCATION AND TRAINING OF PHYSICIANS, NURSES, TECHNICIANS AND SCIENTISTS FOR PRACTICE OR EMPLOYMENT WITHIN NORTH CAROLINA AND ELSEWHERE, AND IMPROVE THE QUALITY OF TRAINING AND SERVICE RENDERED. 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 2 1 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X JOSEPH DOLAN 3367164445 MEDICAL CENTER BLVD WINSTONSALEM NC 27157 X BRADLEY A CLARK TRUSTEE/TREASURER 0.10 39.90 X X 0 0 0 JULIE A FREISCHLAG MD PRESIDENT & TRUSTEE 0.10 39.90 X X 0 1742589 353250 J MCLAIN WALLACE JR SECRETARY 0.10 39.90 X 0 0 0 J WAYNE MEREDITH MD FORMER OFFICER & TRUSTEE 0.00 40.00 X 0 828162 44693 JOHN D MCCONNELL MD FORMER OFFICER & TRUSTEE 0.00 40.00 X 0 5552781 44771 0 8123532 442714 0 1 1 0 0 30941 30941 150310 276802 -126492 -126492 -126492 154924 0 154924 154924 154924 59373 0 0 59373 0 0 0 0 2384654 2562023 143550 147303 3358713 1263913 2106013 2094800 6088927 6007187 10723144 10811313 4183 0 59623 59623 63806 59623 X 10659338 10751690 10659338 10751690 10723144 10811313 59373 32979 0 X 0 1 X 1 0 X X 2 WFU HEALTH SCIENCES 223849199 2 1 0 0 NC BAPTIST HOSPITAL 560552787 3 1 0 0 2 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 6088927 242944 324684 6007187 6101391 318424 330888 6088927 6012206 425243 336058 6101391 6363788 -34546 317036 6012206 6605474 90721 332407 6363788 1.00000 0 1 1 2000721 2000721 1357992 1263913 94079 2094800 VERGER INVESTMENT FUNDS 6007187 6007187 ANNUITY PAYABLE 48633 SECURITY DEPOSITS 10990 59623 X PART V, LINE 4: ENDOWMENT FUNDS PROVIDE AID AND ASSISTANCE TO WAKE FOREST UNIVERSITY HEALTH SCIENCES AND TO NORTH CAROLINA BAPTIST HOSPITAL IN THE EDUCATION AND TRAINING OF PHYSICIANS, NURSES, TECHNICIANS AND SCIENTISTS FOR PRACTICE OR EMPLOYMENT. PART X, LINE 2: THE ORGANIZATION HAS EVALUATED UNCERTAIN TAX POSITIONS FOR ITS FISCAL YEARS ENDED JUNE 30, 2018 AND 2019, INCLUDING A QUANTIFICATION OF TAX RISK IN AREAS SUCH AS UNRELATED BUSINESS TAXABLE INCOME AND THE TAXATION OF ITS JOINT VENTURES. THIS EVALUATION DID NOT HAVE A MATERIAL EFFECT ON THE ORGANIZATION'S FINANCIAL STATEMENTS FOR THE YEARS ENDED JUNE 30, 2018 AND 2019. 0 1 0 0 0 0 0 0 0 JULIE A FREISCHLAG MD PRESIDENT & TRUSTEE 0 1198946 0 533149 0 10494 0 330402 0 22848 0 2095839 0 0 J WAYNE MEREDITH MD FORMER OFFICER & TRUSTEE 0 747397 0 59979 0 20786 0 23648 0 21045 0 872855 0 0 JOHN D MCCONNELL MD FORMER OFFICER & TRUSTEE 0 1038530 0 0 0 4514251 0 23648 0 21123 0 5597552 0 3858352 PART I, LINE 4B CERTAIN TRUSTEES, OFFICERS AND FORMER OFFICERS AND/OR FORMER TRUSTEES OF THE FILING ORGANIZATION PARTICIPATED IN AND RECEIVED PAYMENTS FROM SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANS (SERP) (ALL OF WHICH WAS PAID BY A RELATED ORGANIZATION, WAKE FOREST UNIVERSITY HEALTH SCIENCES, AS PART OF THE INDIVIDUALS' COMPENSATION FROM THE RELATED ORGANIZATION). THE FOLLOWING FORMER OFFICER AND FORMER TRUSTEE RECEIVED SERP PAYMENTS FOR THE CALENDAR YEAR ENDING DECEMBER 31, 2018: JOHN D. MCCONNELL, MD $4,477,272 ($3,858,352 OF WHICH WAS REPORTED ON PRIOR YEARS' FORMS 990) FORM 990, PART VI, SECTION A, LINE 6 THE FILING ORGANIZATION HAS TWO MEMBERS, WAKE FOREST UNIVERSITY HEALTH SCIENCES AND NORTH CAROLINA BAPTIST HOSPITAL. EACH OF THE MEMBERS IS ALSO A NC NONPROFIT CORPORATION. FORM 990, PART VI, SECTION A, LINE 7A THE BOARD OF TRUSTEES OF THE FILING ORGANIZATION IS ELECTED BY THE ORGANIZATION'S TWO MEMBERS, WAKE FOREST UNIVERSITY HEALTH SCIENCES AND NORTH CAROLINA BAPTIST HOSPITAL. FORM 990, PART VI, SECTION B, LINE 11B THE FILING ORGANIZATION'S BOARD OF TRUSTEES RECEIVES A COPY OF THE FORM 990 WITH SUFFICIENT TIME TO PERMIT REVIEW, COMMENT AND QUESTIONS PRIOR TO ITS FILING. IF MODIFICATIONS ARE REQUIRED FOLLOWING SUCH REVIEW, THE REVISED FORM 990 IS REDISTRIBUTED PRIOR TO ITS FILING WITH THE IRS, ALONG WITH A SUMMARY OF THE MODIFICATIONS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION QUERIES ITS MEMBERS AND OFFICERS WITH RESPECT TO POTENTIAL CONFLICTS OF INTEREST ANNUALLY, AND AS THEY ARISE. ANY POTENITAL CONFLICTS DISCLOSED ARE REVIEWED AND MANAGED IN ACCORDANCE WITH THE ORGANIZATION'S CONFLICTS OF INTEREST POLICY. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION PAYS NO COMPENSATION TO OFFICERS OR TRUSTEES; AS THE ORGANIZATION HAS NO EMPLOYEES, IT DOES NOT PAY ANY COMPENSATION TO ANY KEY EMPLOYEES. ALL COMPENSATION PAID TO OFFICERS OR TRUSTEES WAS PAID BY A RELATED ORGANIZATION OR BY AN UNRELATED ORGANIZATION. THE GOVERNANCE & COMMITTEE OF THE WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER BOARD IS (THROUGH AUTHORITY DELEGATED TO IT BY WAKE FOREST UNIVERSITY HEALTH SCIENCES AND NORTH CAROLINA BAPTIST HOSPITAL - THE FILING ORGANIZATION'S TWO MEMBERS) RESPONSIBLE FOR REVIEWING AND APPROVING THE APPLICABLE EXECUTIVE'S COMPENSATION. THE COMMITTEE UTILIZES INDEPENDENT COMPENSATION CONSULTANTS, COMPENSATION SURVEYS, AND STUDIES TO DETERMINE THE APPROPRIATENESS OF EACH SUCH EXECUTIVE'S COMPENSATION. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S ARTICLES OF INCORPORATION ARE AVAILABLE TO THE PUBLIC ON REQUEST AND ARE AVAILABLE ON THE WEBSITE OF THE NORTH CAROLINA SECRETARY OF STATE. THE ORGANIZATION'S BYLAWS ARE NOT PUBLISHED, BUT PROVISIONS FROM THE BYLAWS ARE INCLUDED AS NECESSARY IN THE ORGANIZATION'S POLICIES, AND ARE ATTACHED TO THE FORM 1023 FILED FOR THE ORGANIZATION WITH THE IRS, WHICH IS PUBLICLY AVAILABLE. THE CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC ON REQUEST. PART VII, SECTION A, COLUMN B - HOURS JULIE A. FREISCHLAG, MD FILING ORG 0.1 RELATED ORG 33.8 UNRELATED ORG 6.1 BRADLEY A. CLARK FILING ORG 0.1 RELATED ORG 29.6 UNRELATED ORG 10.3 J. MCLAIN WALLACE, JR. FILING ORG 0.1 RELATED ORG 30.6 UNRELATED ORG 9.3 J. WAYNE MEREDITH, MD FILING ORG 0.0 RELATED ORG 40.0 JOHN D. MCCONNELL, MD FILING ORG 0.0 RELATED ORG .1 UNRELATED ORG 39.9 PURSUANT TO THE TERMS OF THE "MEDICAL CENTER INTEGRATION AGREEMENT" (AN AGREEMENT ENTERED INTO IN 2010 AMONG FOUR PARTIES: WAKE FOREST UNIVERSITY (WFU), WAKE FOREST UNIVERSITY HEALTH SCIENCES (WFUHS), WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER (WFUBMC), AND NORTH CAROLINA BAPTIST HOSPITAL (NCBH), UNDER WHICH AGREEMENT THE OPERATION OF WFUHS AND NCBH AND ALL SUBSIDIARIES OF EACH WAS DELEGATED TO WFUBMC), THE CORPORATE OFFICERS OF WFUBMC (UNRELATED TO THE FILING ORGANIZATION) GENERALLY SERVE AS THE CORPORATE OFFICERS OF WFUHS AND NCBH. THUS, CERTAIN OFFICERS OF THE FILING ORGANIZATION ALSO DEVOTE HOURS TO TO RELATED ORGANIZATIONS (WFU, WFUHS & NCBH) AS WELL AS TO UNRELATED ORGANIZATIONS (WFUBMC & ITS SUBSIDIARIES), AS SHOWN IN THE BREAKDOWN ABOVE. WAKE FOREST UNIVERSITY HEALTH SCIENCES MEDICAL CENTER BOULEVARD WINSTONSALEM NC 27157 223849199 HEALTH CARE - CLINICAL SERVICES, RESEARCH AND EDUCATION NC 501(C)(3) 2 WAKE FOREST UNIVERSITY 0 NORTH CAROLINA BAPTIST HOSPITAL MEDICAL CENTER BOULEVARD WINSTONSALEM NC 27157 560552787 HEALTH CARE - HOSPITAL NC 501(C)(3) 3 N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0