2020-07-14T10:47:49-05:00 2019-06-30 990 2018-07-01 560532309 HIGH POINT REGIONAL HEALTH HIGH 3368786000 PO BOX HP-5 HIGH POINT NC 27261 BRADLEY A CLARK TREASURER 3368786000 2020-07-08 152.11.92.106 2020-07-08 09:06:46 ED P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 92F11F32722E8792293CAF8DF02A44B038BF976A 2018 2020-09-23 17:36:50Z JAMES HOEKSTRA MD PO BOX HP-5 HIGH POINT NC 27261 383148892 0 X WWW.WAKEHEALTH.EDU/LOCATIONS/HOSPITALS/HIGH-POINT X 1933 NC IMPROVING THE HEALTH OF OUR REGION, STATE AND NATION 23 18 2824 570 0 0 15717125 2726902 254410469 369836005 515153 6062140 5341567 4162830 275984314 382787877 223975 123130 0 0 121057611 145839865 0 0 0 134376136 217422260 255657722 363385255 20326592 19402622 310694700 269105408 110984891 28929857 199709809 240175551 X SEE SCHEDULE O FOR CONTINUATIONHIGH POINT REGIONAL HEALTH ("HPRH"), DBA HIGH POINT MEDICAL CENTER, IS PART OF WAKE FOREST BAPTIST HEALTH, A PREEMINENT LEARNING HEALTH SYSTEM AND ACADEMIC MEDICAL CENTER OF THE HIGHEST QUALITY WITH BALANCED EXCELLENCE IN PATIENT CARE, RESEARCH AND EDUCATION THAT PROMOTES BETTER HEALTH FOR ALL THROUGH COLLABORATION, EXCELLENCE AND INNOVATION. OUR MISSION IS TO IMPROVE THE HEALTH OF OUR REGION, STATE AND NATION BY: GENERATING AND TRANSLATING KNOWLEDGE TO PREVENT, DIAGNOSE AND TREAT DISEASE; TRAINING LEADERS IN HEALTH CARE AND BIOMEDICAL SCIENCE; AND SERVING AS THE PREMIER HEALTH SYSTEM IN OUR REGION, WITH SPECIFIC CENTERS OF EXCELLENCE RECOGNIZED AS NATIONAL AND INTERNATIONAL CARE DESTINATIONS. 0 0 349535770 123130 369836005 SEE SCHEDULE O FOR COMPLETE DESCRIPTIONHIGH POINT MEDICAL CENTER ("HPRH") IS AN INTEGRAL PART OF WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER ("WFUBMC"), A PREEMINENT ACADEMIC MEDICAL CENTER AND LEARNING HEALTH SYSTEM THAT PROMOTES BETTER HEALTH FOR ALL THROUGH COLLABORATION, EXCELLENCE AND INNOVATION. WFUBMC IS NORTHWEST NORTH CAROLINA'S SOLE ACADEMIC MEDICAL CENTER, BRINGING TO THE REGION THE RESOURCES OF ONE OF AMERICA'S TOP HOSPITALS AND INNOVATIVE RESEARCH CENTERS AND A PREMIER MEDICAL SCHOOL. HIGH POINT REGIONAL HEALTH OFFICIALLY BECAME PART OF THE WAKE FOREST BAPTIST HEALTH SYSTEM ON SEPT. 1, 2018, CULMINATING AN ACQUISITION AGREEMENT WITH UNC HEALTH CARE, AND WAS RENAMED HIGH POINT MEDICAL CENTER. WITH MORE THAN 2,600 EMPLOYEES, INCLUDING MORE THAN 130 PHYSICIANS, HIGH POINT MEDICAL CENTER SERVES MORE THAN 300,000 PATIENTS EACH YEAR, IN 41 LOCATIONS ACROSS THREE COUNTIES. IN MEETING ITS OBJECTIVE OF PROVIDING QUALITY HEALTH CARE TO THE COMMUNITY, THE HOSPITAL PROVIDED MEDICAL SERVICES FOR 42,929 EMERGENCY DEPARTMENT VISITS, 235,174 OUTPATIENT VISITS, 15,913 ADULT HOSPITAL STAYS, AND 59,445 PATIENT DAYS SINCE JOINING THE WAKE FOREST BAPTIST HEALTH IN SEPTEMBER 2018.AS PART OF WAKE FOREST BAPTIST HEALTH, HPRH'S VISION IS A PREEMINENT LEARNING HEALTH SYSTEM THAT PROMOTES BETTER HEALTH FOR ALL THROUGH COLLABORATION, EXCELLENCE, & INNOVATION. THE HOSPITAL'S VALUES ARE AS FOLLOWS:-COMPASSION: RESPONSIVE TO THE PHYSICAL, EMOTIONAL, SPIRITUAL, AND INTELLECTUAL NEEDS OF ALL;-SERVICE: CULTIVATE SELFLESS CONTRIBUTION FOR THE GREATER GOOD;-EXCELLENCE: DEMONSTRATE THE HIGHEST STANDARDS OF PATIENT-CENTERED CARE, EDUCATION, RESEARCH, AND OPERATIONAL EFFECTIVENESS; -INTEGRITY: DEMONSTRATE FAIRNESS, HONESTY, SINCERITY, AND ACCOUNTABILITY;-COLLEGIALITY: FOSTER MUTUAL RESPECT, FACILITATE PROFESSIONAL GROWTH AND MENTORSHIP, AND REWARD TEAMWORK AND COLLABORATION; -INNOVATION: PROMOTE CREATIVITY TO ENHANCE DISCOVERY AND THE APPLICATION OF KNOWLEDGE; AND-DIVERSITY: HONOR INDIVIDUALITY AND PROTECT THE DIGNITY OF ALL.-SAFETY: EMBRACE CULTURE OF RELIABILITY THROUGH BETTER PROCESS DESIGN & ACCOUNTABILITY. 349535770 1 1 0 1 0 0 0 0 0 1 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 1 68 0 1 2824 1 0 0 0 0 0 0 0 0 0 0 0 0 X 23 18 0 0 1 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 X JOSEPH DOLAN 3367164445 MEDICAL CENTER BOULEVARD WINSTONSALEM NC 27157 BRACK BRIGMAN DIRECTOR 2.00 0.00 X 0 0 0 JERRY CAMP DIRECTOR 2.00 0.00 X 0 0 0 DAVID CONGDON DIRECTOR 2.00 0.00 X 0 0 0 BRADEN COVINGTON DIRECTOR 2.00 0.00 X 0 0 0 CHRIS ELLINGTON DIRECTOR (TO 8-31-18) 2.00 38.00 X 0 1148254 173340 DAVID FISHER MD DIRECTOR 2.00 0.00 X 0 100018 7944 DARRELL FRYE DIRECTOR 2.00 0.00 X 0 0 0 AB HENLEY DIRECTOR 2.00 0.00 X 0 0 0 JEFF HORNEY CHAIR 3.00 0.00 X X 0 0 0 ANTHONY LINDSEY MD DIRECTOR 2.00 0.00 X 0 0 0 KEN MCALLISTER DIRECTOR 2.00 0.00 X 0 0 0 GARY PARK DIRECTOR (TO 8-31-18) 2.00 38.00 X 0 2623154 553104 LINDA SEKHON DHSC DIRECTOR 2.00 0.00 X 0 0 0 KEN SMITH DIRECTOR 2.00 0.00 X 0 0 0 KEVIN SPEIGHT MD DIRECTOR 2.00 0.00 X 0 0 0 REVEREND FRANK THOMAS DIRECTOR 2.00 0.00 X 0 0 0 PATRICIA TRIPLETT MD DIRECTOR 2.00 38.00 X 343219 136410 40754 ROYSTER TUCKER III DIRECTOR 2.00 0.00 X 0 0 0 DON WEBB VICE CHAIR 2.00 0.00 X X 0 0 0 ERNIE BOVIO DIRECTOR/PRESIDENT (TO 8-31-18) 38.00 2.00 X X 596092 0 25771 JAMES HOEKSTRA MD DIRECTOR/PRESIDENT (EFF 9-1-18) 40.00 0.00 X X 763963 0 121645 MATTHEW EDWARDS MD DIRECTOR 2.00 0.00 X 0 0 0 KEVIN HIGH MD DIRECTOR (EFF 9-1-18) 0.30 39.70 X 0 0 0 GLEN SPIVAK DIRECTOR 2.00 38.00 X 0 318151 95566 MICHAEL T WAID DIRECTOR (EFF 9-1-18) 2.30 37.70 X 0 575650 116124 CATHLEEN WHEATLEY DIRECTOR (EFF 9-1-18) 1.50 38.50 X 0 553659 123922 KEVIN SMITH COO & SECRETARY (TO 8-31-18) 38.00 2.00 X 242714 88271 32139 WILLIAM BRYANT CFO & TREASURER (TO 8-31-18) 38.00 2.00 X 0 369268 100214 J MCLAIN WALLACE JR SECRETARY (EFF 9-1-18) 0.30 39.70 X 0 772967 82245 BRADLEY A CLARK TREASURER (EFF 9-1-18) 0.30 39.70 X 0 775777 178754 LAWRENCE WILLIAMS CMO 40.00 0.00 X 915537 162480 37075 DENISE POTTER VP 38.00 2.00 X 252916 89252 19440 ALI AKBARY MD PHYSICIAN 40.00 0.00 X 566597 223830 47618 KENNETH LENNON MD PHYSICIAN 40.00 0.00 X 946219 393622 53547 NIKHIL TEPPARA MD PHYSICIAN 40.00 0.00 X 602793 203499 44651 MICHAEL LUCAS MD PHYSICIAN 40.00 0.00 X 564745 234796 51171 STEPHEN MILLS MD PHYSICIAN 40.00 0.00 X 549737 232394 48285 6344532 9001452 1953309 139 0 1 1 MEDTRONIC USA INC 710 MEDTRONIC PARKWAY MINNEAPOLIS MN 554325604 MEDICAL DEVICES 7506502 OWENS & MINOR INC 9120 LOCKWOOD BLVD MECHANICSVILLE VA 23116 HEALTHCARE SERVICES & LOGISTICS 3672553 ARAMARK CTS 2400 MARKET STREET PHILADELPHIA PA 19103 FOOD SERVICES, FACILITIES, UNIFORMS 2572799 DEPUY ORTHOPAEDICS INC 700 ORTHOPAEDIC DRIVE WARSAW IN 46582 MEDICAL DEVICES 2542797 CAROLINA ANESTHESIOLOGY PA 401 FERNDALE BLVD HIGH POINT NC 27262 HEALTHCARE SERVICES 1091314 61 2545499 181403 2726902 PATIENT SERVICE REVENUE 621990 368885151 368885151 DIETARY 722210 882884 882884 TUITION REVENUE 611600 67970 67970 369836005 1252296 1252296 3610149 361015 3249134 3249134 3249134 4626754 183090 0 0 4626754 183090 4809844 4809844 ADMIN & OTHER 611710 544206 544206 PARKING 621990 369490 369490 913696 382787877 369836005 0 10224970 X 122601 122601 529 529 3356563 2479983 876580 113713315 109818897 3894418 6047497 5442747 604750 14277022 12792165 1484857 8445468 7600921 844547 503890 495154 8736 285677 285677 28794 28794 28047 28047 226448 226448 45619319 44394343 1224976 1348855 1011679 337176 662456 491415 171041 1145230 925910 219320 16505481 13842495 2662986 214368 190693 23675 84373 80750 3623 41576 31182 10394 12154236 10978046 1176190 1248760 1217383 31377 MEDICAL/OTHER SUPPLIES 76604093 76375048 229045 BAD DEBT 55271141 55271141 PROVIDER ASSESSMENT 5432516 5432516 INCOME TAX 17000 17000 363385255 349535770 13849485 0 23897222 27290599 12152 0 94423385 46817944 0 152737 3917003 6488185 6176969 808236 185416488 8847047 171015239 176569441 9478167 9672502 100001 100001 1258265 985763 416297 220000 310694700 269105408 101900202 21402294 582413 519297 8502276 7008266 110984891 28929857 X 196579251 235570667 3130558 4399944 204940 199709809 240175551 310694700 269105408 X 19402622 -267369 13758012 7572477 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 28047 28047 0 PART II-B, LINE 1: THE ORGANIZATION IS A MEMBER OF THE AMERICAN HOSPITAL ASSOCIATION (AHA) AND THE NORTH CAROLINA HOSPITAL ASSOCIATION (NCHA). A PORTION OF THE MEMBERSHIP DUES PAID ARE ALLOCATED TO LOBBYING EFFORTS BY THOSE ORGANIZATIONS ON BEHALF OF THEIR MEMBERSHIP BODIES. 15015406 12955 15028361 14994445 20961 15015406 14987330 7115 14994445 14927143 60187 14987330 14819502 107641 14927143 1.00000 0 1 1 13980000 13980000 132455964 3975219 128480745 1742973 135141 1607832 33266373 4711620 28554753 3971178 25067 3946111 176569441 ESTIMATED THIRD PARTY PAYOR SETTLEMENTS 3662834 OTHER LIABILITIES 3345432 7008266 X PART V, LINE 4: THE HOSPITAL'S ENDOWMENT FUNDS ARE USED TO PROVIDE SUPPORT FOR EDUCATION, SCHOLARSHIPS, INDIGENT CARE, AND OTHER DEPARTMENTAL FUNDING. PART X, LINE 2: THE ORGANIZATION HAS EVALUATED UNCERTAIN TAX POSITIONS FOR ITS FISCAL YEARS ENDED JUNE 30, 2019 AND 2018, INCLUDING A QUANTIFICATION OF TAX RISK IN AREAS SUCH AS UNRELATED BUSINESS TAXABLE INCOME AND THE TAXATION OF ITS FOR-PROFIT SUBSIDIARIES. THIS EVALUATION DID NOT HAVE A MATERIAL EFFECT ON THE ORGANIZATION'S FINANCIAL STATEMENTS FOR THE YEARS ENDED JUNE 30, 2019 AND 2018. 1 1 1 X 300.000000000000 1 X 1 1 1 0 1 1 7609281 0 7609281 0.02480 38989231 40077404 0 0.00000 7910914 4703740 3207174 0.01040 54509426 44781144 10816455 0.03520 529 529 0.00000 126544 126544 0.00040 127073 127073 0.00040 54636499 44781144 10943528 0.03560 1 13353067 127155001 149634375 -22479374 X 1 1 1 HIGH POINT SURGERY CENTER AMBULATORY SURGERY 0.90000 0.00000 0.10000 1 1 HIGH POINT REGIONAL HEALTH 601 NORTH ELM STREET HIGH POINT NC 27262 X X X DISPROPORTIONATE SHARE HOSPITAL HIGH POINT REGIONAL HEALTH 1 0 0 1 X X X X X X X X X 18 1 1 1 1 X SEE PART V, PAGE 8 X 1 18 1 SEE PART V, PAGE 8 0 1 X 300.000000000000 300.000000000000 X X X X X 1 1 X X X 1 X WWW.WAKEHEALTH.EDU/FINANCIAL-ASSISTANCE.HTM X WWW.WAKEHEALTH.EDU/FINANCIAL-ASSISTANCE.HTM X WWW.WAKEHEALTH.EDU/FINANCIAL-ASSISTANCE.HTM X X X X X X X 1 X 0 X X X X 1 X 0 0 HIGH POINT REGIONAL HEALTH PART V, SECTION B, LINE 5: ASSESSING COMMUNITY HEALTH NEEDS INVOLVED COLLECTION AND ASSESSMENT OF A WIDE RANGE OF DATA ON MEASURES OF HEALTH AND HEALTH-RELATED FACTORS. PRIMARY DATA WAS COLLECTED THROUGH A SERIES OF ONLINE KEY INFORMANT SURVEYS AND WORKSHOPS ATTENDED BY PERSONS KNOWN AS SUBJECT MATTER EXPERTS OR OTHERWISE KNOWLEDGEABLE REGARDING THE FOCUS AREAS. THE SURVEY INCLUDED QUESTIONS ABOUT KEY CHALLENGES TO MAKING IMPROVEMENTS IN THE PRIORITY FOCUS AREAS, AS WELL AS DISPARITIES AND POPULATION SUBGROUPS IMPACTED, GAPS AND NEEDS IN EXISTING SERVICES AND PROGRAMS, EXISTING PROGRAMS AND POLICIES THAT ARE PERCEIVED TO BE EFFECTIVE AND IDEAS FOR NEEDED PROGRAMS AND POLICIES. AT A SERIES OF HALF-DAY WORKSHOPS, PARTICIPANTS ENGAGED IN FACILITATED DISCUSSION TO CONSIDER BOTH QUANTITATIVE DATA AND DATA FROM THE KEY INFORMANT SURVEYS TO IDENTIFY KEY ISSUES AND RECOMMENDATIONS FOR IMPROVEMENTS.ADDITIONALLY, SECONDARY DATA SOURCES WERE REVIEWED, INCLUDING COUNTY HEALTH DATA BOOK PUBLISHED BY THE NORTH CAROLINA STATE CENTER FOR HEALTH STATISTICS AND AMERICAN COMMUNITY SURVEY ADMINISTERED BY THE US BUREAU OF THE CENSUS. HIGH POINT REGIONAL HEALTH PART V, SECTION B, LINE 6A: THE HOSPITAL'S MOST RECENT CHNA WAS CONDUCTED IN COLLABORATION WITH CONE HOSPITAL. HIGH POINT REGIONAL HEALTH PART V, SECTION B, LINE 6B: THE HOSPITAL'S MOST RECENT CHNA WAS CONDUCTED IN COLLABORATION WITH THE FOLLOWING OTHER COMMUNITY ORGANIZATIONS:- GUILFORD COUNTY DHHS, PUBLIC HEALTH DIVISION- ALCOHOL & DRUG SERVICES OF GUILFORD, INC.- FELLOWSHIP HALL- GUILFORD COMMUNITY CARE NETWORK- UNIVERSITY OF NORTH CAROLINA AT GREENSBORO DEPT OF PUBLIC HEALTH & DEPT OF NUTRITION- UNITED WAY OF GREATER HIGH POINT- UNITED WAY OF GREATER GREENSBORO HIGH POINT REGIONAL HEALTH PART V, SECTION B, LINE 7D: N/APART V, SECTION B, LINE 7A:WWW.WAKEHEALTH.EDU/HCI/NEEDS-ASSESSMENT-AND-IMPLEMENTATION-REPORTS.HTMPART V, SECTION B, LINE 10A:WWW.WAKEHEALTH.EDU/HCI/NEEDS-ASSESSMENT-AND-IMPLEMENTATION-REPORTS.HTM HIGH POINT REGIONAL HEALTH PART V, SECTION B, LINE 11: THE MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT ("CHNA") IDENTIFIED THE FOLLOWING SIGNIFICANT HEALTH CHALLENGES WITHIN THE COMMUNITY: (1) CLINICAL CARE & HEALTH INSURANCE, (2) CHRONIC & COMMUNICABLE DISEASES, (3) BEHAVIORAL HEALTH, (4) MATERAL & CHILD HEALTH, (5) UNINTENTIONAL INJURY, (6) VIOLENT CRIME & INTENTIONAL INJURY, (7) SOCIAL DETERMINANTS OF HEALTH, (8) HEALTHY EATING & ACTIVE LIVING, (9) MORTALITY & MORBIDITY, (10) ORAL HEALTH, (11) TEEN PREGNANCY, AND (12) AIR QUALITY.HIGH POINT MEDICAL CENTER ("HPRH") PRIORITIZED THE FOLLOWING FOUR SIGNIFICANT COMMUNITY HEALTH NEEDS FOR ITS CURRENT CHNA AS FOLLOWS: (1) HEALTHY EATING & ACTIVE LIVING; (2) SOCIAL DETERMINANTS OF HEALTH, (3) BEHAVIORAL HEALTH; AND (4) MATERNAL & CHILD HEALTH. HPRH PLANS TO PROVIDE COMMUNITY BENEFIT PROGRAMS RESPONSIVE TO THESE HEALTH NEEDS THROUGH ITS APPROVED CHNA IMPLEMENTATION STRATEGY. THE HPRH CHNA IMPLEMENTATION STRATEGY OUTLINES THE IMPLEMENTATION OF PROGRAMS AND THE EVALUATION OF IMPACT OF THOSE PROGRAMS ON PRIORITY COMMUNITY HEALTH NEEDS IDENTIFIED FROM THE CHNA. SPECIFICALLY, THE HOSPITAL IS ADDRESSING THE SIGNIFICANT HEALTH NEEDS AS FOLLOWS:1. HEALTHY EATING & ACTIVE LIVING-HPRH SCREENS PATIENTS FOR FOOD SECURITY UPON ADMISSION UTILIZING A SCREENING TOOL BUILT INTO THE ELECTRONIC MEDICAL RECORD, FOCUSING SPECIFICALLY ON PATIENTS LIVING IN VULNERABLE COMMUNITIES. -HPRH COLLABORATES WITH INTERNAL RESOURCES INCLUDING CLINICAL NUTRITION, SOCIAL WORK, AND FAITHHEALTH TO PROVIDE RESOURCES TO PATIENTS INCLUDING INFORMATION ABOUT COMMUNITY RESOURCES AND NUTRITION EDUCATION.-HPRH COLLABORATES WITH VARIOUS AGENCIES TO DETERMINE ADDITIONAL RESOURCES AND TO ASSESS NEEDS THROUGHOUT GREATER HIGH POINT.2. SOCIAL DETERMINANTS OF HEALTH-HPRH CONNECTS WITH COMMUNITY RESOURCES INCLUDING THE UNITED WAY JOBS PROGRAM TO FOSTER EDUCATION AND CONNECT APPLICANTS WITH JOB OPPORTUNITIES.-HPRH PARTICIPATES IN THE GUILFORD APPRENTICE PROGRAM (GAP) IN CONNECTION WITH GUILFORD TECHNICAL COMMUNITY COLLEGE TO PROVIDE STUDENTS WITH A PATH TO OBTAIN HIGHER EDUCATION.-HPRH UTILIZES FAITHHEALTH, A DIVISION OF WAKE FOREST BAPTIST HEALTH, TO EDUCATE THE COMMUNITY ON THE SERVICES THEY PROVIDE, FOCUSING ON VULNERABLE ZIP CODES, WITH THE GOAL OF INCREASING THE UTILIZATION OF THE FAITHHEALTH PROGRAM IN THE COMMUNITY. FAITHHEALTH ALSO CONNECTS HEART FAILURE PATIENTS AT HIGH RISK FOR READMISSION TO PROVIDED NEEDED RESOURCES.3. BEHAVIORAL HEALTH-HPRH COLLABORATES WITH COMMUNITY PARTNERS TO PROVIDE LOCAL RESOURCES TO SUPPORT BEHAVIORAL HEALTH NEEDS OF THE COMMUNITY, INCLUDING A WEEKLY SUPPORT PROGRAM PROVIDED BY RHA BEHAVIORAL HEALTH FOR ADMITTED PATIENTS.-HPRH COLLABORATES WITH RHA BEHAVIORAL HEALTH TO CONNECT PATIENTS WITH A PEER SUPPORT PROGRAM TO IMPROVE OUTCOMES ONCE A PATIENT IS DISCHARGED, INCLUDING TRANSPORTATION ASSISTANCE TO APPOINTMENTS/MEETINGS TO SUPPORT EFFICIENT DISCHARGE PLANNING AND PREVENT READMISSION.-HPRH WILL CONTINUE TO SUPPORT RHA BEHAVIORAL HEALTH IN THEIR PLANS TO OPEN A SUBSTANCE ABUSE INTENSIVE OUTPATIENT TREATMENT CENTER IN HIGH POINT.4. MATERNAL & CHILD HEALTH-HPRH IS EXPLORING COLLABORATION WITH FOUNDATION FOR A HEALTHY HIGH POINT AND THE JUST TEEN'S PROGRAM BY IDENTIFYING A CLINIC PARTNER TO CONNECT TEENS WITH HEALTH EDUCATION.-HPRH PROVIDES MOMMY & ME AND PRENATAL CLASSES ON-SITE, AND PROVIDES INFORMATION ABOUT THESE PROGRAMS THROUGHOUT ITS PHYSICIAN OFFICES. HIGH POINT REGIONAL HEALTH PART V, SECTION B, LINE 13H: THE HOSPITAL MAY USE COMMERCIALLY AVAILABLE FINANCIAL PROFILING AND CREDIT SCORING TECHNOLOGIES TO PRESUMPTIVELY SCREEN RESPONSIBLE INDIVIDUALS TO DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE DISCOUNTS. HIGH POINT REGIONAL HEALTH PART V, SECTION B, LINE 16J: IN ADDITION TO THE METHODS PREVIOUSLY DESCRIBED, HIGH POINT MEDICAL CENTER INFORMS PATIENTS ABOUT ITS FAP DURING INTAKE AND DISCHARGE BY PROVIDING A PLAIN LANGUAGE SUMMARY OF THE FAP. THE HOSPITAL ALSO PLACES A CONSPICUOUS WRITTEN NOTICE OF THE FAP ON ITS PATIENT BILLING STATEMENTS. 7 1 - WOUND CARE CENTER - HPMC 601 N ELM STREET HIGH POINT NC 27262 WOUND CARE CENTER 2 - BREAST CARE SERVICES - HIGH POINT 601 N ELM STREET HIGH POINT NC 27262 BREAST CARE CENTER 3 - GENETIC COUNSELING - HIGH POINT 601 N ELM STREET HIGH POINT NC 27262 GENETIC COUNSELING 4 - GYNECOLOGIC ONCOLOGY - HIGH POINT 601 N ELM STREET HIGH POINT NC 27262 GYNECOLOGIC ONCOLOGY 5 - HPMC HEMATOLOGY AND ONCOLOGY 601 N ELM STREET HIGH POINT NC 27262 HEMATOLOGY/ONCOLOGY 6 - HPMC RADIATION ONCOLOGY 601 N ELM STREET HIGH POINT NC 27262 RADIATION ONCOLOGY 7 - PULMONARY & CRITICAL CARE - HIGH POINT 601 N ELM STREET HIGH POINT NC 27262 CRITICAL CARE PART I, LINE 3C: THE ORGANIZATION UTILIZES COMMERCIALLY AVAILABLE FINANCIAL PROFILING AND CREDIT SCORING TECHNOLOGIES TO DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE DISCOUNTS UNDER ITS FAP POLICY. ADDITIONAL ELIGIBILITY CRITERIA INCLUDES THE FOLLOWING:-PATIENT MUST BE UNINSURED OR HAVE NO OTHER THIRD PARTY FUNDING SOURCE OR GUARANTOR.-SERVICES FOR WHICH DISCOUNTS APPLY MUST BE EMERGENT AND MEDICALLY NECESSARY CARE.-PATIENT MUST BE A VALID RESIDENT WITHIN A ZIP CODE BOUNDED BY OR INTERSECTING ON OF THE COUNTIES DEFINED AS WAKE FOREST BAPTIST HEALTH'S SERVICE AREA. -PATIENTS MUST ENROLL IN ALL OTHER PRIMARY PAYER PROGRAMS FOR WHICH THE PATIENT IS ELIGIBLE AND MUST ASSIGN BENEFITS TO WAKE FOREST BAPTIST HEALTH EXCEPT IN THE CASE WHERE SUCH POLICY PREMIUM FOR ENROLLMENT WOULD RESULT IN MEDICAL INDIGENCE. PART I, LINE 6A: N/A PART I, LINE 7: THE ORGANIZATION USED THE WORKSHEETS PROVIDED IN THE INSTRUCTIONS TO SCHEDULE H TO COMPUTE ITS COST-TO-CHARGE RATIO FOR PURPOSES OF THE 2018 SCHEDULE H.PART I, LINE 7B MEDICAID DIRECT OFF-SETTING REVENUETHE HOSPITAL PARTICIPATES IN A PROVIDER ASSESSMENT PROGRAM ADMINISTERED BY THE NORTH CAROLINA DEPARTMENT OF HEALTH AND HUMAN SERVICES. UNDER THE PROGRAM, A FEE IS ASSESSED AGAINST NON-MEDICAID NET PATIENT SERVICE REVENUE OF PRIVATE HOSPITALS. THE FEDERAL GOVERNMENT MATCHES THE ASSESSMENT AT A RATE OF NEARLY 2 TO 1, AND THESE AMOUNTS ARE ALLOCATED TO NORTH CAROLINA HOSPITALS ON A QUARTERLY BASIS. ADDITIONALLY, THE HOSPITAL PARTICIPATES IN THE NORTH CAROLINA MEDICAID REIMBURSEMENT INITIATIVE (MRI). UNDER THE MRI, THE HOSPITAL RECEIVES ADDITIONAL REIMBURSEMENT BASED ON MEDICAID COST DEFICITS AND TREATMENT OF A DISPROPORTIONATE SHARE OF UNINSURED PATIENTS. PART I, LN 7 COL(F): THE ORGANIZATION'S PATIENT BAD DEBT EXPENSE PER THE AUDITED FINANCIAL STATEMENTS WAS $55,271,141 FOR THE FISCAL YEAR ENDED JUNE 30, 2019. THIS AMOUNT IS NOT INCLUDED IN THE CALCULATION OF CHARITY CARE FOR PART I, LINE 7. PART II, COMMUNITY BUILDING ACTIVITIES: HIGH POINT MEDICAL CENTER ("HPRH") PROMOTES THE HEALTH OF THE COMMUNITY IT SERVES BY SPONSORING A WIDE ARRAY OF FREE HEALTH EDUCATION OPPORTUNITIES FOR COMMUNITY MEMBERS AND BY SUPPORTING ORGANIZATIONS THAT PROVIDE SERVICES INVOLVED WITH ECONOMIC DEVELOPMENT AND COMMUNITY SUPPORT. THE MILLIS HEALTH EDUCATION CENTER IS A HEALTH EDUCATION FACILITY SPECIFICALLY DESIGNED TO GIVE CHILDREN A HANDS-ON APPROACH TO HEALTH EDUCATION. MILLIS CENTER IS DEVOTED TO HELPING SCHOOL STUDENTS, CHURCH GROUPS, LOCAL ORGANIZATIONS AND INDIVIDUALS LEARN ABOUT THE HUMAN BODY AND HOW TO KEEP THEMSELVES HEALTHY. PROGRAMS PROVIDED BY THE MILLIS STAFF COVER TOPICS SUCH AS NUTRITION AND PHYSICAL ACTIVITY, GENERAL HEALTH, PUBERTY, BULLYING PREVENTION, SUBSTANCE USE/ABUSE PREVENTION, AND DENTAL HEALTH ALL IN A HANDS-ON, AGE APPROPRIATE WAY. PART III, LINE 4: THE ORGANIZATION'S FINANCIAL STATEMENTS DO NOT INCLUDE A DISCRETE FOOTNOTE EXPLAINING BAD DEBT EXPENSE. BAD DEBT HAS NOT BEEN INCLUDED IN THE COMPUTATION OF COMMUNITY BENEFIT ON PART I, LINE 7. AMOUNTS USED TO COMPUTE CHARITY CARE AND BAD DEBT ON SCHEDULE H USE THE MOST CURRENT DATA AVAILABLE AT THE TIME OF FILING. THE ORGANIZATION USED WORKSHEET 2 OF THE 2018 SCHEDULE H INSTRUCTIONS TO COMPUTE A COST TO CHARGES RATIO USED TO CALCULATE BAD DEBT AT COST. PART III, LINE 8: THE HOSPITAL USES AN OVERALL COST TO CHARGE RATIO CALCULATION BASED ON AUDITED FINANCIAL STATEMENTS BUT REMOVES COST ASSOCIATED WITH BAD DEBT, GME, COMMUNITY BUILDING, AND CHARITY CARE SO AS NOT TO COUNT THOSE COSTS TWICE. PART III, LINE 9B: THE HOSPITAL MAKES A REASONABLE EFFORT TO DETERMINE AN INDIVIDUAL'S ELIGIBILITY FOR FINANCIAL ASSISTANCE BEFORE ENGAGING IN ANY COLLECTION ACTIONS. ALL COLLECTION ACTIONS WILL BE SUSPENDED IF THE INDIVIDUAL SUBMITS A COMPLETED FAP APPLICATION DURING THE APPLICATION PERIOD, OR IF THE INDIVIDUAL SUBMITS AN INCOMPLETE APPLICATION DURING THE APPLICATION PERIOD THAT IS SUBSEQUENTLY COMPLETED WITHIN A REASONABLE TIME AFTER THE HOSPITAL REQUESTS FURTHER INFORMATION. IF THE INDIVIDUAL IS DETERMINED NOT TO BE ELIGIBLE FOR A FULL DISCOUNT UNDER THE FAP, ANY COLLECTION ACTIVITIES WILL BE RESUMED AS TO THE OUTSTANDING BALANCE OWED. IF THE INDIVIDUAL IS DETERMINED TO BE ELIGIBLE FOR ASSISTANCE UNDER THE FAP, APPROPRIATE MEASURES ARE TAKEN TO REFUND ANY AMOUNTS OWED TO THE INDIVIDUAL AND REVERSE OR MODIFY COLLECTION ACTIONS CONSISTENT WITH THE NEW BALANCE OWED AFTER APPLYING THE APPLICABLE FAP DISCOUNTS. PART VI, LINE 2: THE HOSPITAL'S CURRENT NEEDS ASSESSMENT PLAN WAS BASED ON A SET OF BEST PRACTICES FOR COMMUNITY HEALTH ASSESSMENTS WITH THE PURPOSE OF IDENTIFYING REGIONAL PRIORITY AREAS TO FOCUS ON FOR FY 2020-2022. THE PROCESS WAS DESIGNED TO RELY ON EXISTING PUBLIC DATA, DIRECTLY ENGAGING COMMUNITY STAKEHOLDERS AND COLLABORATE WITH LOCAL PUBLIC HEALTH, OTHER HEALTH PROVIDERS, AS WELL AS COMMUNITY PARTNERS SUCH AS FAITH NETWORKS RELEVANT TO THE SOCIAL FACTORS UNDERLYING PATTERNS OF ACCESS. THE HOSPITAL'S ASSESSMENT WAS CONDUCTED IN THREE STAGES: (1) DATA REVIEW (PRIMARY AND SECONDARY DATA), (2) SETTING PRIORITIES, AND (3) A DEEP DIVE APPROACH INTO AREAS OF CONCERN. AN INTERNAL STEERING COMMITTEE AND SENIOR LEADERSHIP REVIEW A SET OF CRITERIA TO DEVELOP THE PRIORITY RANKINGS. THE PRIORITIZATION PROCESS IDENTIFIED THE FOLLOWING FOUR PRIORITY CHALLENGES FOR THE COMMUNITY: (1) HEALTHY EATING & ACTIVE LIVING, (2) SOCIAL DETERMINANTS OF HEALTH, (3) BEHAVIORAL HEALTH, AND (4) MATERAL & CHILD HEALTH.FROM THE CHNA PROCESS, THE HOSPITAL DEVELOPED AN IMPLEMENTATION STRATEGY TO IDENTIFY THE MEANS THROUGH WHICH IT PLANS TO ADDRESS NEEDS THAT ARE CONSISTENT WITH THE CHARITABLE MISSION AS PART OF ITS COMMUNITY BENEFIT PROGRAMS FOR THE NEXT THREE FISCAL YEARS. BEYOND THE PROGRAMS THAT WILL BE ADDRESSED IN THE IMPLEMENTATION STRATEGY, THE HOSPITAL WILL CONTINUE TO ADDRESS MANY OF THE PRIORITIES BY PROVIDING CARE TO ALL, REGARDLESS OF THE ABILITY TO PAY.IN ADDITION TO THE CHNA PROCESS, DEMOGRAPHIC TRENDS AND PROJECTIONS,INCLUDING POPULATION GROWTH, AGE DISTRIBUTION AND HOUSEHOLD INCOME BY ZIP CODE IN PRIMARY AND SECONDARY SERVICE AREAS, ARE USED TO IDENTIFY FUTURE SERVICE NEEDS. THIS DATA IS COLLECTED BY THE ORGANIZATION'S PLANNING DEPARTMENT. DATA SOURCES INCLUDE CLARITAS, NC DIVISION OF AGING AND ADULT SERVICES, STATEHEALTHFACTS.ORG, THE HIGH POINT ECONOMIC DEVELOPMENT CORPORATION AND OTHERS. A LIAISON FROM THE DEVELOPMENT DEPARTMENT ALSO WORKS WITH THE LOCAL UNITED WAY AGENCY, PROVIDING THE HOSPITAL WITH A METHOD FOR SHARING THE DATA GATHERED THROUGH THEIR ANNUAL COMMUNITY NEEDS ASSESSMENT. ADDITIONALLY, THERE IS EVALUATION OF SERVICE GROWTH OPPORTUNITES DEFINED IN THE NORTH CAROLINA STATE MEDICAL FACILITIES PLAN. DATA IS ALSO COLLECTED AND TRENDED THROUGH VOICE-OF-THE-CUSTOMER METHODS, INCLUDING PATIENT COMMENTS ON SATISFACTION SURVEYS AND THROUGH OUR SERVICE RECOVERY PROCESS. THIS DATA INFORMS THE ORGANIZATION'S STRATEGIC DECISION-MAKERS REGARDING NEW OR IMPROVED HEALTH CARE ACCESS POINTS, PROGRAMS, COLLABORATIVE EFFORTS AND TECHNOLOGY NEEDED TO SERVE CHANGING POPULATION DEMOGRAPHICS. PART VI, LINE 3: THE ORGANIZATION USES A VARIETY OF MEANS TO EDUCATE AND INFORM PATIENTS OF THEIR CHARITY CARE OPTIONS, INCLUDING INFORMATION ON A WEBSITE, PAMPHLETS, CONSPICUOUSLY DISPLAYED SIGNAGE, INFORMATION ON PATIENT BILL STATEMENTS, AND FROM STAFF MEMBERS DURING CONVERSATIONS CONCERNING A PATIENT'S LIABILITY FOR SERVICES. THE HOSPITAL EMPLOYS A PRE-SERVICE FINANCIAL CLEARANCE PROCESS THAT SCREENS PATIENTS PRIOR TO SERVICE DELIVERY FOR EXISTING OR AVAILABLE PAYER SOURCES AS A MEANS OF AVOIDING BAD DEBT AND INAPPROPRIATE BILLING TO PATIENTS WITHOUT THE MEANS TO PAY. IF A PAYER SOURCE IS IDENTIFIED, HOSPITAL STAFF WILL ASSIST THE PATIENT WITH ENROLLMENT. PART VI, LINE 4: IN FISCAL YEAR 2019, HIGH POINT MEDICAL CENTER ("HPRH"), LOCATED IN SOUTHERN GUILFORD COUNTY, PROVIDED CARE TO A FOUR COUNTY SERVICE AREA IN NORTH CAROLINA. HPRH HAS A PRIMARY SERVICE AREA COMPRISED OF THE GEOGRAPHIC AREA THAT INCLUDES HIGH POINT, ARCHDALE, TRINITY, THOMASVILLE AND JAMESTOWN, NORTH CAROLINA. THE SECONDARY SERVICE AREA INCLUDES COLFAX, DENTON, SOUTHWESTERN GREENSBORO, KERNERSVILLE, LEXINGTON, ASHEBORO, RANDLEMAN, SOPHIA AND SOUTHEASTERN WINSTON-SALEM, NORTH CAROLINA. THE HOSPITAL SERVES A WIDE SERVICE AREA; HOWEVER, IT IS RESOURCE PROHIBITIVE TO PARTICIPATE AND FUND HEALTH ASSESSMENTS IN EACH COMMUNITY/COUNTY FROM WHICH ITS PATIENT POPULATION ORIGINATES. THEREFORE, THE PRIMARY COMMUNITY BENEFIT SERVICE AREA (CBSA) IS GUILFORD COUNTY, NORTH CAROLINA.BELOW IS A DEMOGRAPHIC SNAPSHOT OF GUILFORD COUNTY BASED ON THE UNITED STATES CENSUS BUREAU'S 2018 ESTIMATED CENSUS DATA AND COUNTY HEALTH RANKINGS AND ROADMAPS 2018: POPULATION AND GEOGRAPHYTOTAL POPULATION: 533,670POPULATION CHANGE SINCE 2010 +9.3%5TH LARGEST COUNTY IN NORTH CAROLINALAND AREA: 645.70 SQUARE MILESPOPULATION DENSITY: 826.5 PERSONS PER SQUARE MILE POPULATION BY RACE/ETHNICITYNON-HISPANIC WHITE 49.8%NON-HISPANIC AFRICAN-AMERICAN 35.1%HISPANIC OR LATINO 8.2%ASIAN 5.4%ALL OTHER 1.5% POPULATION BY AGE DISTRIBUTIONUNDER 5 YEARS OLD 5.9%UNDER 18 YEARS OLD 22.3%>= 65 YEARS OLD 15.2% POPULATION BY SEXMALE 47.3%FEMALE 52.7% POPULATION BY EDUCATIONAL ATTAINMENT PERCENT OF PERSONS = 25 YEARS OLD WHO HAVE:< HIGH SCHOOL DIPLOMA OR GED 10.9%A HIGH SCHOOL DIPLOMA OR HIGHER 89.1%A BACHELOR'S DEGREE OR HIGHER 35.3%PERSONS IN POVERTY 15.4%UNEMPLOYMENT RATE (2018) 4.5% COUNTY SCHOOLSK-12 ENROLLMENT APPROXIMATELY 72,000GRADUATION RATE 89.1% INCOMEMEDIAN FAMILY HOUSEHOLD (2018) $51,072MEDIAN NON-FAMILY HOUSEHOLD (2018) $29,708 PART VI, LINE 5: A MAJORITY OF THE HOSPITAL'S GOVERNING BODY IS COMPRISED OF PERSONS WHO RESIDE IN THE PRIMARY SERVICE AREA, AND WHO ARE NEITHER EMPLOYEES NOR INDEPENDENT CONTRACTORS OF THE ORGANIZATION, NOR FAMILY MEMBERS OR BUSINESS ASSOCIATES OF SUCH PERSONS. HPRH UTILIZES SURPLUS FUNDS TO IMPROVE THE QUALITY OF PATIENT CARE AND TO UPDATE FACILITES. PART VI, LINE 6: HIGH POINT MEDICAL CENTER ("HPRH") IS A SUBSIDIARY OF WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER.WAKE FOREST BAPTIST HEALTH'S MISSION IS TO IMPROVE THE HEALTH OF THE REGION, STATE AND NATION BY:-SERVING AS THE PREMIER HEALTH SYSTEM IN THE REGION, WITH SPECIFIC CENTERS OF EXCELLENCE RECOGNIZED AS NATIONAL AND INTERNATIONAL CARE DESTINATIONS.-GENERATING AND TRANSLATING KNOWLEDGE TO PREVENT, DIAGNOSE AND TREAT DISEASE.-TRAINING TOMORROW'S LEADERS IN HEALTH CARE AND BIOMEDICAL SCIENCE. PART VI, LINE 7, REPORTS FILED WITH STATES NC 1 BUSINESS HIGH POINT INC (DBA HIGH POINT CHAMBER OF COMMERCE) PO BOX 5025 HIGH POINT NC 27262 560473292 501(C)(6) 25500 COMMUNITY SUPPORT YOUNG WOMEN'S CHRISTIAN ASSOCIATION OF HP 155 WEST WESTWOOD AVE HIGH POINT NC 27262 560579600 501(C)(3) 5000 COMMUNITY SUPPORT THE COMMUNITY CLINIC OF HIGH POINT INC PO BOX 5607 HIGH POINT NC 27262 561795022 501(C)(3) 73401 SUPPORT FOR HEALTHCARE OF INDIGENT POPULATION 2 1 PART I, LINE 2: THE HOSPITAL FOLLOWS THE MEDICAL CENTER'S CORPORATE POLICY USED IN REVIEWING THE ELIGIBILITY AND SELECTION OF GRANTEES RECEIVING CERTAIN EXEMPT PURPOSE FUNDS. THE HOSPITAL MAINTAINS DOCUMENTATION OF THE ELIGIBILITY AND SELECTION CRITERIA AND RECORDS OF THE AMOUNTS DISBURSED. X 1 1 X X X X X 1 1 0 0 0 0 0 1 0 CHRIS ELLINGTON DIRECTOR (TO 8-31-18) 0 684185 0 231196 0 232873 0 152107 0 21233 0 1321594 0 180594 GARY PARK DIRECTOR (TO 8-31-18) 0 526087 0 507300 0 1589767 0 532111 0 20993 0 3176258 0 1461911 PATRICIA TRIPLETT MD DIRECTOR 239496 136014 94298 0 9425 396 6176 9515 18837 6226 368232 152151 0 0 ERNIE BOVIO DIRECTOR/PRESIDENT (TO 8-31-18) 390194 0 197104 0 8794 0 7115 0 18656 0 621863 0 0 0 JAMES HOEKSTRA MD DIRECTOR/PRESIDENT (EFF 9-1-18) 600334 0 111246 0 52383 0 101836 0 19809 0 885608 0 0 0 GLEN SPIVAK DIRECTOR 0 254311 0 45584 0 18256 0 74513 0 21053 0 413717 0 0 MICHAEL T WAID DIRECTOR (EFF 9-1-18) 0 421146 0 112161 0 42343 0 91980 0 24144 0 691774 0 0 CATHLEEN WHEATLEY DIRECTOR (EFF 9-1-18) 0 447879 0 100236 0 5544 0 113338 0 10584 0 677581 0 0 KEVIN SMITH COO & SECRETARY (TO 8-31-18) 174043 88211 44515 0 24156 60 3818 6277 15935 6109 262467 100657 0 0 WILLIAM BRYANT CFO & TREASURER (TO 8-31-18) 0 288747 0 72308 0 8213 0 78981 0 21233 0 469482 0 0 J MCLAIN WALLACE JR SECRETARY (EFF 9-1-18) 0 494762 0 136968 0 141237 0 65532 0 16713 0 855212 0 0 BRADLEY A CLARK TREASURER (EFF 9-1-18) 0 591354 0 183583 0 840 0 155477 0 23277 0 954531 0 0 LAWRENCE WILLIAMS CMO 329447 155917 59167 0 526923 6563 10050 11803 10116 5106 935703 179389 0 0 DENISE POTTER VP 139863 88994 36231 0 76822 258 5631 5000 6194 2615 264741 96867 0 0 ALI AKBARY MD PHYSICIAN 395675 223572 164893 0 6029 258 8780 17592 15020 6226 590397 247648 0 0 KENNETH LENNON MD PHYSICIAN 414777 393532 504875 0 26567 90 7115 22417 17789 6226 971123 422265 0 0 NIKHIL TEPPARA MD PHYSICIAN 316744 203439 274358 0 11691 60 6223 11831 19855 6742 628871 222072 0 0 MICHAEL LUCAS MD PHYSICIAN 400561 228620 143190 0 20994 6176 9062 17711 18172 6226 591979 258733 0 0 STEPHEN MILLS MD PHYSICIAN 475848 231735 60754 0 13135 659 9193 16132 18838 4122 577768 252648 0 0 PART I, LINE 1A UNDER THE UNC HCS LEGAL STRUCTURE, THE FILING ORGANIZATION PROVIDED A CORPORATE MEMBERSHIP TO A LOCAL SOCIAL CLUB FOR USE BY OFFICERS OF THE ORGANIZATION. PART I, LINES 4A-B CERTAIN OFFICERS/DIRECTORS & KEY EMPLOYEES OF THE FILING ORGANIZATION PARTICIPATED IN AND/OR RECEIVED PAYMENTS FROM SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLANS (SERP) OF THEIR EMPLOYER, THE FILING ORGANIZATION OR RELATED ORGANIZATIONS (UNC HCS OR WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER). THE DETERMINATION OF THE AMOUNT OF THE NON QUALIFIED RETIREMENT PLANS FOLLOWED THE FILING ORGANIZATION OR RELATED ORGANIZATIONS' COMPENSATION PROCEDURES AS OUTLINED IN PART VI, SECTION B, LINE 15 OF THEIR FORMS 990. THE FOLLOWING DIRECTORS, OFFICERS & KEY EMPLOYEES RECEIVED SERP PAYMENTS IN THEIR CALENDAR YEAR 2018 COMPENSATION FROM THE FILING ORGANIZATION OR RELATED ORGANIZATION (UNC HCS OR WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER): CHRIS ELLINGTON $180,594 GARY PARK $1,461,911 KEVIN SMITH, MD $11,186 LAWRENCE WILLIAMS $511,923 JAMES HOEKSTRA, MD $26,294 DENISE POTTER $63,485 J. MCLAIN WALLACE, JR. $119,125 MICHAEL WAID $21,911 PART I, LINE 7 UNDER THE UNC HCS LEGAL STRUCTURE, EMPLOYEES IN MANAGERIAL ROLES AND CERTAIN OTHER EMPLOYEES PARTICIPATED IN INCENTIVE COMPENSATION PLAN APPROVED ANNUALLY BY THE UNC HCS BOARD OF DIRECTORS. THE COMPENSATION COMPONENTS CONTAINED IN THEIR EMPLOYMENT AGREEMENTS WERE INDIVIDUAL PERFORMANCE AND GOAL BASED THAT WERE DETERMINED IN THE COURSE OF THE INDIVIDUAL'S ANNUAL REVIEW AND PERFORMANCE OF THE ORGANIZATION. THE INCENTIVES WERE REVIEWED BY THE INDIVIDUAL'S DEPARTMENT CHAIR OR COMPENSATION COMMITTEE. FORM 990, PART VII, LINE 5 - COMPENSATION FROM UNRELATED ORGANIZATION THE FOLLOWING DIRECTOR/OFFICER WAS COMPENSATED BY WAKE FOREST UNIVERSITY HEALTH SCIENCES, AN UNRELATED ORGANIZATION, FOR SERVICES RENDERED AS AN OFFICER OF THE HOSPITAL. SEE PART VII AND SCHEDULE J, PART II FOR HIS COMPENSATION. JAMES HOEKSTRA, MD FORM 990, PART IV, LINE 20B THE HOSPITAL HAS ATTACHED A COPY OF ITS CONSOLIDATED AUDITED FINANCIAL STATEMENTS FOR ITS FISCAL YEAR ENDED JUNE 30, 2019 TO THE FORM 990. THE CONSOLIDATED FINANCIAL STATEMENTS HAVE BEEN PREPARED ON THE ACCRUAL BASIS IN CONFORMITY WITH U.S. GENERALLY ACCEPTED ACCOUNTING PRINCIPLES (GAAP) AND INCLUDE THE ASSETS AND OPERATIONS OF HIGH POINT REGIONAL HEALTH AND AFFILIATES, LEXINGTON MEDICAL CENTER AND AFFILIATE, NORTH CAROLINA BAPTIST HOSPITAL AND AFFILIATES, WAKE FOREST UNIVERSITY HEALTH SCIENCES AND AFFILIATES, DAVIE MEDICAL CENTER, NORTHWEST COMMUNITY CARE NETWORK, INC., FAITHHEALTH INNOVATIONS, WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER (WFUBMC), WAKE FOREST HEALTH NETWORK, LLC, WILKES REGIONAL MEDICAL CENTER, AND OTHER WFUBMC AFFILIATES. ALL SIGNIFICANT INTERCOMPANY TRANSACTIONS HAVE BEEN ELIMINATED IN CONSOLIDATION. FORM 990, PART VI, SECTION A, LINE 4 PURSUANT TO THE ORGANIZATION'S ARTICLES OF AMENDMENT (EFFECTIVE SEPTEMBER 1, 2018), THE NAME OF THE CORPORATION IS HIGH POINT REGIONAL HEALTH, WHOSE EXEMPT PURPOSE IS THE OWNERSHIP, OPERATION, AND MAINTENANCE OF THE HOSPITAL DBA HIGH POINT MEDICAL CENTER. PURSUANT TO THE ORGANIZATION'S ARTICLES OF AMENDMENT AND AMENDED BYLAWS (EFFECTIVE SEPTEMBER 1, 2018), THE SOLE MEMBER OF THE CORPORATION IS WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER, A NORTH CAROLINA NONPROFIT CORPORATION. PURSUANT TO THE ORGANIZATION'S ARTICLES OF AMENDMENT, IN THE EVENT OF DISSOLUTION, THE BOARD OF DIRECTORS SHALL AFTER PAYMENT OF ALL LIABILITIES, DISTRIBUTE ALL REMAINING ASSETS TO ONE OR MORE ORGANIZATIONS WHICH ARE EXEMPT FROM TAXATION UNDER 501(C)(3). THE AMENDED BYLAWS PROVIDE THAT THE SOLE MEMBER SHALL HAVE THE FOLLOWING POWERS AT ALL TIMES WITH RESPECT TO THE ORGANIZATION AND ITS SUBSIDIARIES AFFILIATES: -THE POWER TO TAKE ALL ACTIONS AND EXERCISE ALL POWERS OF A SOLE MEMBER OF A NORTH CAROLINA NONPROFIT CORPORATION, INCLUDING ACTIONS TO INTEGRATE THE CORPORATION INTO THE MEMBER'S SYSTEM AND/OR TO CAUSE THE ORGANIZATION TO PARTICIPATE IN MEMBER INITIATIVES AND PROGRAMS IN A MANNER CONSISTENT WITH THE MEMBER SUBSTITUTION AGREEMENT (THE "MSA") DATED MARCH 8, 2018; -THE POWER TO PLAN, DIRECT AND ESTABLISH POLICY TO ASSURE THE DEVELOPMENT AND DELIVERY OF QUALITY HEALTH SERVICES; -THE POWER TO APPOINT/REMOVE THE CHAIRMAN OF THE BOARD, VICE CHAIRMAN, PRESIDENT, VICE PRESIDENTS, SECRETARY AND TREASURER AND OTHER CORPORATE OFFICERS; -THE POWER TO NOMINATE/APPOINT/REMOVE INDIVIDUAL MEMBERS OF THE BOARD OF DIRECTORS; -THE POWER TO ESTABLISH A SCHEDULE OF ASSESSMENTS PAYABLE; -THE POWER TO DEVELOP GUIDELINES FOR CONSTRUCTION AND RENOVATION PROJECTS; -THE POWER TO DEVELOP/MONITOR/EVALUATE THE QUALITY, SERVICE DELIVERY AND FINANCIAL STANDARDS TO BE OBSERVED BY THE ORGANIZATION TO ALIGN WITH THE OVERALL OBJECTIVES OF THE SOLE MEMBER; -THE POWER TO APPROVE ANY VOTE BY THE ORGANIZATION OF ITS CAPITAL STOCK OR MEMBERSHIP VOTING RIGHTS IN ALL OF ITS AFFILIATES; -THE POWER TO NEGOTIATE/DEVELOP/APPROVE ALL MANAGED CARE AGREEMENTS; -THE POWER TO APPROVE STRATEGIC PLANS AND CHANGES TO THE MISSION STATEMENTS PROPOSED BY THE BOARD OF DIRECTORS; AND -THE POWER TO APPROVE THE CAPITAL/OPERATING BUDGETS AND MATERIAL EXPENDITURES. PURSUANT TO THE AMENDED BYLAWS, THE BUSINESS AFFAIRS OF THE CORPORATION SHALL BE MANAGED BY THE BOARD OF DIRECTORS, CONSISTING OF 17 TO 24 PERSONS APPOINTED/REMOVED BY THE MEMBER IN ITS SOLE DISCRETION. THE DIRECTORS SHALL NOT RECEIVE COMPENSATION FOR THEIR SERVICES, EXCEPT FOR REIMBURSEMENT FOR REASONABLE EXPENSES INCURRED IN CONNECTION WITH SERVICES RENDERED TO THE BOARD OF DIRECTORS. AT ALL MEETINGS OF THE BOARD OF DIRECTORS, A MAJORITY OF THE DIRECTORS SHALL CONSTITUTE A QUORUM FOR THE TRANSACTION OF BUSINESS. THE BOARD OF DIRECTORS MAY ESTABLISH AN EXECUTIVE COMMITTEE, FINANCE COMMITTEE, QUALITY COMMITTEE, JOINT CONFERENCE COMMITTEE, AND ANY SPECIAL COMMITTEE SUGGESTED BY THE CHAIRMAN OR DESIRED BY THE DIRECTORS/EXECUTIVE COMMITTEE, GOVERNED BY THE RULES AND REGULATIONS APPLICABLE TO THE BOARD OF DIRECTORS AS STATED IN THE AMENDED BYLAWS. PURSUANT TO THE AMENDED BYLAWS, THE BOARD OF DIRECTORS SHALL APPOINT EXECUTIVE OFFICERS, CONSISTING OF PRESIDENT, SECRETARY, TREASURER, AND VICE PRESIDENTS SERVING UNTIL DEATH/ RESIGNATION/ REMOVAL/ RETIREMENT OR THEIR SUCCESSORS ARE APPOINTED. THE PRESIDENT, AS CHIEF EXECUTIVE OFFICER OF THE CORPORATION, SHALL BE RESPONSIBLE FOR SEEING THAT POLICIES/DIRECTIVES OF THE BOARD OF DIRECTORS ARE PROPERLY CARRIED OUT AND IS IN GENERAL CHARGE OF THE AFFAIRS OF THE CORPORATION IN THE ORDINARY COURSE OF BUSINESS, SUBJECT TO THE CONTROL OF THE BOARD OF DIRECTORS. PURSUANT TO THE AMENDED BYLAWS, THE FISCAL YEAR OF THE ORGANIZATION SHALL BE JUNE 30TH OF EACH CALENDAR YEAR. FORM 990, PART VI, SECTION A, LINE 6 PURSUANT TO ITS ARTICLES OF AMENDMENT FILED ON AUGUST 30, 2018 AND EFFECTIVE SEPTEMBER 1, 2018, THE SOLE MEMBER OF THE ORGANIZATION IS WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER, A NORTH CAROLINA NONPROFIT CORPORATION. FORM 990, PART VI, SECTION A, LINE 7A AS PROVIDED IN THE ORGANIZATION'S BYLAWS, THE SOLE MEMBER OF THE ORGANIZATION SHALL HAVE THE RIGHT AT ALL TIMES, WITH RESPECT TO THE ORGANIZATION AND ITS AFFILIATE, TO NOMINATE, APPOINT, AND REMOVE INDIVIDUAL MEMBERS OF THE CORPORATION'S BOARD OF DIRECTORS, AS WELL AS CORPORATE OFFICERS. FORM 990, PART VI, SECTION A, LINE 7B AS PROVIDED IN THE ORGANIZATION'S BYLAWS, THE SOLE MEMBER OF THE ORGANIZATION SHALL HAVE THE RIGHT AT ALL TIMES, WITH RESPECT TO THE ORGANIZATION, TO APPROVE OF THE SALE, LEASE, OR TRANSFER OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE ORGANIZATION, TO APPROVE ANY AMENDMENTS TO THE ORGANIZATION'S ARTICLES OR BYLAWS, AND TO APPROVE THE MISSION, VISION AND VALUE STATEMENTS OF THE ORGANIZATION. THE SOLE MEMBER MAY ACT WITHOUT A MEETING. FORM 990, PART VI, SECTION B, LINE 11B THE FILING ORGANIZATION'S BOARD OF DIRECTORS RECEIVE COPIES OF THE FORM 990 WITH SUFFICIENT TIME TO PERMIT REVIEW, COMMENT, AND QUESTIONS PRIOR TO ITS FILING. IF MODIFICATIONS ARE REQUIRED FOLLOWING SUCH REVIEW AND COMMENT, THE REVISED FORM 990 IS REDISTRIBUTED TO ALL DIRECTORS PRIOR TO ITS FILING WITH THE IRS, ALONG WITH A REPORT NOTING THE MODIFICATIONS. FORM 990, PART VI, SECTION B, LINE 12C THROUGH AUGUST 31, 2018, UNDER THE UNC HCS LEGAL STRUCTURE, THE FILING ORGANIZATION REQUIRED BOARD MEMBERS, OFFICERS AND KEY EMPLOYEES TO COMPLETE A CONFLICT OF INTEREST QUESTIONNAIRE ANNUALLY. THE ORGANIZATION HAD ADMINISTRATIVE STAFF MONITOR AND TRACK THAT ALL FORMS WERE COMPLETE. IF ANY ISSUES WERE RAISED ON THOSE DISCLOSURES, UNC HCS COMPLIANCE WAS NOTIFIED AND APPROPRIATE MEASURES WERE TAKEN AT THE BOARD'S DISCRETION. AS OF SEPTEMBER 1, 2018, UNDER THE WAKE FOREST BAPTIST HEALTH LEGAL STRUCTURE, ALL TRUSTEES AND OFFICERS OF THE FILING ORGANIZATION ARE ASKED TO REVIEW THE APPLICABLE CONFLICTS OF INTEREST POLICY AND TO DESCRIBE ANY POTENTIAL CONFLICTS OF INTEREST THEY MAY HAVE ON AN ANNUAL BASIS (OR AS THEY ARISE). UPON COMPLETION OF THE CONFLICTS OF INTEREST SURVEY, THE LEGAL DEPARTMENT REVIEWS THE COMPLETED QUESTIONNAIRES ON BEHALF OF THE FILING ORGANIZATION. ANY CONFLICTS IDENTIFIED ARE COMMUNICATED TO THE FILING ORGANIZATION'S CHAIRMAN OF THE BOARD AND ARE PRESENTED TO THE MEDICAL CENTER GOVERNANCE AND COMPENSATION COMMITTEE. ALL CONFLICTS OF INTEREST ARE RESOLVED BY MANAGEMENT PLANS DEVELOPED BY THE MEDICAL CENTER GOVERNANCE AND COMPENSATION COMMITTEE AND THE INTERNAL AUDIT AND COMPLIANCE OFFICES. THE MEDICAL CENTER GOVERNANCE AND COMPENSATION COMMITTEE'S CHAIR PRESENTS AN ANNUAL REPORT ON CONFLICTS TO THE FULL BOARD OF THE FILING ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 15 THROUGH AUGUST 31, 2018, UNDER THE UNC HCS LEGAL STRUCTURE, THE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES SET COMPENSATION FOR THE CEO AND APPROVED COMPENSATION FOR VICE PRESIDENTS. AN INDEPENDENT EXECUTIVE COMPENSATION CONSULTING FIRM, THE HAY GROUP, EVALUATED THESE POSITIONS AND PROVIDED COMPARISONS AGAINST A NATIONAL DATABASE. COMPENSATION WAS SET AGAINST THE 50TH PERCENTILE OF THE MARKET. AS OF SEPTEMBER 1, 2018, HIGH POINT MEDICAL CENTER IS AN INTEGRAL PART OF WAKE FOREST BAPTIST HEALTH, A PREEMINENT, INTERNATIONALLY RECOGNIZED ACADEMIC MEDICAL CENTER OF THE HIGHEST QUALITY WITH BALANCED EXCELLENCE IN PATIENT CARE, RESEARCH AND EDUCATION. THE FILING ORGANIZATION PAYS NO COMPENSATION TO OFFICERS, DIRECTORS AND KEY EMPLOYEES. ALL COMPENSATION PAID TO OFFICERS, DIRECTORS AND KEY EMPLOYEES IS PAID BY A RELATED ORGANIZATION, WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER, AN ENTITY WITHIN THE WAKE FOREST BAPTIST HEALTH LEGAL STRUCTURE. COMPENSATION PAID TO THESE INDIVIDUALS IS REVIEWED AND APPROVED IN ACCORDANCE WITH THE APPLICABLE ORGANIZATION'S COMPENSATION POLICIES AND PROCEDURES WHICH INCLUDE INDEPENDENT COMPENSATION CONSULTANTS, COMPENSATION SURVEYS AND STUDIES TO DETERMINE THE APPROPRIATENESS OF EACH OFFICER'S AND DIRECTOR'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. FORM 990, PART IX, LINE 11G OTHER PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 44,394,343. MANAGEMENT AND GENERAL EXPENSES 1,224,976. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 45,619,319. FORM 990, PART XI, LINE 9: ACTUARY GAINS /(LOSSES) 7,313,213. AFFILIATE GAINS/( LOSSES) 259,264. 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