2019-11-15T07:36:40-06:00 2018-12-31 990 2018-01-01 562120959 FORSYTH MEDICAL CENTER FOUNDATION FORS 3367182803 2085 FRONTIS PLAZA BLVD WINSTON SALEM NC 27103 FRED HARGETT EVP & CFO 3367182803 2019-11-11 170.98.106.254 2019-11-11 12:15:24 ES P 0EB4CE1ACD44DB279B6C2D9A8476B20948576B96 A2315309B7343EB998963AA05290CF11231D17E5 2018 2020-03-31 21:24:44Z NOVANT HEALTH FORSYTH MEDICAL CENTER FOUNDATION CARL ARMATO 2085 FRONTIS PLAZA BLVD WINSTON SALEM NC 27103 30051485 0 X WWW.SUPPORTNOVANTHEALTH.ORG X 1981 NC SEE SCHEDULE O 21 16 0 50 0 0 2835503 2617056 0 0 4093933 4494656 30409 -15596 6959845 7096116 5514500 3813416 0 0 0 0 0 0 443509 1657268 1121604 7171768 4935020 -211923 2161096 72848428 66720825 1616054 576807 71232374 66144018 X SEE SCHEDULE O 0 0 4302920 3813416 7497 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. 4302920 1 1 0 0 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 0 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 21 16 0 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 X ALLEN ELMS MD TRUSTEE 2.00 X 0 0 0 BAILEY DAVID TRUSTEE 2.00 X 0 0 0 BUTLER ELAINE TRUSTEE 2.00 X 0 0 0 BYERS KEVIN TREASURER 2.00 X X 0 0 0 COPELAND DOUGLAS TRUSTEE 2.00 X 0 0 0 FULLER-ANDREWS LYNNE TRUSTEE 2.00 X 0 0 0 GREGORY CHERE MD TRUSTEE 2.00 X 0 743181 110198 HOLMES HAROLD TRUSTEE 2.00 X 0 0 0 KNIGHT ANNETTE VICE CHAIR 2.00 X X 0 0 0 MARSHALL DEBORAH TRUSTEE 2.00 X 0 0 0 MARTIN DAVIDA TRUSTEE 2.00 X 0 0 0 POLONSKY SHERRY TRUSTEE 2.00 X 0 0 0 PROCTOR RALAN TRUSTEE 2.00 X 0 0 0 RAMIREZ-SANTOS HERNANDO TRUSTEE 2.00 X 0 0 0 SCHAEFER CLAUDIA TRUSTEE 2.00 X 0 0 0 SHORE RICHARD TRUSTEE 2.00 X 0 60 0 STERRITT DE LORRAINE TRUSTEE 2.00 X 0 0 0 SUTPHIN MAMIE TRUSTEE 2.00 X 0 0 0 WELCH EDWIN TRUSTEE 2.00 X 0 0 0 YARBOROUGH DCHEFF CHAIR 2.00 X X 0 32 0 ZEKAN PATRICIA MD SEC 2.00 X X 0 360513 31467 HENDERSON KIMBERLY SVP FOUNDATIONS 60.00 X 0 585533 105101 MORRIS JOHN ASST SEC 2.00 X 0 393030 47612 MYERS SCOTT ASST SEC 2.00 X 0 742453 103004 TORRIBLE JAMES EXECUTIVE DIRECTOR 40.00 X 0 168529 37529 VINCENT PAULA FMR SVP FOUNDATIONS 0.00 X 0 801557 36296 0 3794888 471207 0 1 1 0 0 135021 70 54322 2427643 10823 2617056 1092826 1092826 26300699 22898869 3401830 3401830 3401830 28707 135021 55214 -26507 -26507 4700 1286 3414 3414 MISCELLANEOUS 900099 7497 7497 7497 7096116 7497 0 4471563 3676796 3676796 136620 136620 115543 115543 22667 11107 1360 10200 65722 32204 3943 29575 16984 5594 6253 5137 2882 1412 173 1297 30177 14787 1810 13580 24574 12041 1475 11058 1713 839 103 771 16571 8120 994 7457 CONTRACT LABOR 619134 303376 37148 278610 MISCELLANEOUS 184919 94432 10646 79841 OTHER SUPPLIES 10707 1419 8248 1040 DUES AND SUBSCRIPTIONS 6004 2953 360 2691 4007 1220 535 2252 4935020 4302920 188591 443509 1400388 685182 638626 1273250 22021 10065 2103 701 184302 29919 168644 154383 53645120 52548989 16971526 12048255 72848428 66720825 66625 0 1549429 576807 1616054 576807 X 59307745 53837007 0 0 11924629 12307011 71232374 66144018 72848428 66720825 X 2161096 -9298280 90 469622 1579116 X 0 1 X 1 0 X 2509103 1966306 3249464 2835503 2617056 13177432 2509103 1966306 3249464 2835503 2617056 13177432 4004252 9173180 1425875 933373 607685 738294 1092826 4798053 28095 33407 61502 18036987 170599 0.50860 0.54360 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: GROSS INCOME FROM FUNDRAISING EVENTS EXCLUDING CONTRIBUTIONS - 2017 AMOUNT: $ 25,850. 2018 AMOUNT: $ 28,707. GROSS INCOME FROM GAMING ACTIVITIES - 2017 AMOUNT: $ 2,245. 2018 AMOUNT: $ 4,700. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 11924629 2719034 -111564 39421 2185667 12307011 11815684 2485091 193146 33832 2535460 11924629 10764944 2472752 74729 284479 1212262 11815684 11259915 1107979 -36768 24547 1541635 10764944 11810510 1816278 31724 144134 2254463 11259915 0.00000 1.00000 0.00000 0 0 184302 29919 154383 154383 OTHER SECURITIES 12048255 F 12048255 0 DUE TO AFFILIATE 576807 576807 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, 2018 AND 2017. 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 80246 65511 14735 1037 14253 12332 BOURBON & BREWS 45014 36174 8840 9229 1 38468 33336 5132 1700 16663 163728 135021 28707 2737 23482 28995 55214 -26507 1 CANCER SERVICES INC 3175 MAPLEWOOD AVENUE WINSTONSALEM NC 27103 560656375 501(C)(3) 44490 COMMUNITY OUTREACH COMMUNITY CARE CENTER FOR FORSYTH COUNTY 2135 NEW WALKERTOWN ROAD WINSTONSALEM NC 27101 581403699 501(C)(3) 326130 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) 29194 TO SUPPORT CARE CONNECTIONS PHARMACY AND OTHER VARIOUS PROGRAMS MEDICAL PARK HOSPITAL INC 2085 FRONTIS PLAZA BLVD WINSTONSALEM NC 27103 561340424 501(C)(3) 30307 TO SUPPORT MEDICAL PARK HOSPITAL, INC. FORSYTH MEMORIAL HOSPITAL INC 2085 FRONTIS PLAZA BLVD WINSTONSALEM NC 27103 560928089 501(C)(3) 2470495 TO SUPPORT NHFMC, NHKMC, AND FMCI NOVANT MEDICAL GROUP INC 2085 FRONTIS PLAZA BLVD WINSTONSALEM NC 27103 581728803 501(C)(3) 23590 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 8 0 EMPLOYEE EMERGENCY FUND 66 35675 SCHOLARSHIPS 7 15000 MAMMOGRAMS 290 40656 SKIN CANCER SCREENINGS 40 384 PATIENT TRANSPORTATION 346 11647 FMV CAB FARES FOR INDIGENT PATIENTS MEDICATION TO INDIGENT PATIENTS 93 4703 FMV MEDICATION FOR INDIGENT PATIENTS PATIENT ASSISTANCE - ZOLL VEST 2 6300 FMV ZOLL LIFE VESTS PATIENT ASSISTANCE 469 22255 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. 0 1 0 0 0 0 0 0 0 GREGORY CHERE MD TRUSTEE 0 406827 0 250606 0 85748 0 78427 0 31771 0 853379 0 60000 ZEKAN PATRICIA MD SEC 0 330033 0 0 0 30480 0 16500 0 14967 0 391980 0 0 HENDERSON KIMBERLY SVP FOUNDATIONS 0 334673 0 212054 0 38806 0 77848 0 27253 0 690634 0 0 MORRIS JOHN ASST SEC 0 258746 0 101077 0 33207 0 24000 0 23612 0 440642 0 7500 MYERS SCOTT ASST SEC 0 394537 0 251457 0 96459 0 86007 0 16997 0 845457 0 52584 TORRIBLE JAMES EXECUTIVE DIRECTOR 0 147802 0 20248 0 479 0 9201 0 28328 0 206058 0 0 VINCENT PAULA FMR SVP FOUNDATIONS 0 454883 0 274707 0 71967 0 16500 0 19796 0 837853 0 22500 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, LINE 4A-C: SEVERANCE, NONQUALIFIED, AND EQUITY-BASED PAYMENTS SEVERANCE NONQUALIFIED EQUITY-BASED GREGORY, CHERE MD 52,500 MYERS, SCOTT 45,084 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. 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 SUPPORTING THE NOVANT HEALTH SYSTEM AND IMPROVING THE HEALTH OF OUR COMMUNITIES, ONE PERSON AT A TIME. LOCATED IN WINSTON SALEM, NC, IT HAS EXPANDED ITS REACH TO INCLUDE ADVISORY BOARDS AT NEW MEDICAL CENTERS IN KERNERSVILLE, NC AND CLEMMONS, NC. 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 28,000 EMPLOYEES WHO MAKE HEALTHCARE REMARKABLE AT OVER 640 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 FOUR MILLION PATIENTS ANNUALLY. NOVANT HEALTH IS RANKED AS ONE OF THE NATION'S TOP 25 INTEGRATED HEALTH SYSTEMS BY SK&A. IN 2018, THE NOVANT HEALTH SYSTEM REPORTED $5 BILLION IN REVENUES. 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 COMMUNITY OUTREACH IS A CRITICAL COMPONENT TO THE MISSION OF NOVANT HEALTH FORSYTH MEDICAL CENTER. 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 2018, THE FOUNDATION GIFTS, GRANTS, AND EARNINGS FROM INVESTMENTS TOUCHED VIRTUALLY EVERY SERVICE AREA AT EACH OF THE THREE NOVANT HEALTH MEDICAL CENTERS IN FORSYTH. SOME EXAMPLES ARE AS FOLLOWS: - RESTRICTED GIFTS FROM FOUNDATION FUNDS WENT TO SUPPORT ONCOLOGY NURSE NAVIGATORS, PATIENT SUPPORT, 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. - EXPANSION INTO DAVIDSON COUNTY OF FORSYTH CONNECTS PROGRAMS FOR NEW MOMS WHICH ALLOWS PATIENTS TO RECEIVE A VISIT BY A TRAINED NURSE SHORTLY AFTER A BABY IS BORN AT NOVANT HEALTH. - A ONE DAY RETREAT LED BY RUSS GREENFIELD, MD FOR ANYONE WHO HAS COMPLETED TREATMENT FOR CANCER. THE RETREAT IS DESIGNED TO HELP ATTENDEES LEARN HOW TO SUPPORT THEIR HEALING CAPACITIES, BUILDING ON THEIR OWN UNIQUE STRENGTHS AND CREATIVITY, IN SUPPORT OF OPTIMAL PHYSICAL, EMOTIONAL AND SPIRITUAL HEALTH. - WEIGHT SCALES FOR PATIENTS WHO ARE UNABLE TO AFFORD THEM; FOR HEART FAILURE AND POST CORONARY ARTERY BYPASS GRAFT PATIENTS THIS IS AN IMPORTANT PART OF THEIR RECOVERY TO DETERMINE EARLY ON IF THEY ARE HAVING ISSUES. - NEUROSCIENCES PROVIDES A MONTHLY SUPPORT GROUP AND SERVICES TO SURVIVORS OF RUPTURED ANEURYSMS AND THEIR CAREGIVERS. - ENHANCED THE ENVIRONMENT OF THE PUMPING ROOM SPACES IN ORDER TO BETTER SERVE NICU MOTHERS, CREATING A WELCOME AND COMFORTABLE ATMOSPHERE IN NEUTRAL PATTERNS FOCUSED ON VARIOUS NATURE THEMES. - FUNDS USED TO CERTIFY 4 ADDITIONAL NURSES TO PERFORM SEXUAL ASSAULT EXAMINATIONS. WE CURRENTLY DO NOT HAVE ENOUGH TEAM MEMBERS TO COVER 24/7 ON CALL FOR PATIENTS THAT PRESENT TO OUR FACILITY AND REQUIRE SEXUAL ASSAULT EXAMS AND EVIDENCE COLLECTION. SEXUAL ASSAULT NURSE EXAMINERS ARE REGISTERED NURSES THAT HAVE COMPLETED SPECIALIZED EDUCATION AND CLINICAL PREPARATION IN THE MEDICAL FORENSIC CARE OF THE PATIENT THAT HAS EXPERIENCED SEXUAL ASSAULT OR ABUSE. THE SANE WORKSHOP IS AN INTENSIVE 5-DAY COURSE TO FAMILIARIZE PARTICIPANTS WITH ALL ASPECTS OF THE FORENSICS AND HEALTHCARE PROCESS FOR SEXUAL ASSAULT VICTIMS. THE COURSE IS TAUGHT BY EXPERTS IN THE AREAS OF FORENSIC NURSING, LAW ENFORCEMENT, ADVOCACY, AND CRIMINAL PROSECUTION. IT EMPHASIZES THEIR ROLE IN THE INTERDISCIPLINARY SEXUAL ASSAULT RESPONSE TEAM. - THE WOMEN'S COUNCIL OF NOVANT HEALTH FOUNDATION FORSYTH MEDICAL CENTER HAS A MISSION TO ENGAGE COMMUNITY WOMEN IN RAISING THE STANDARD FOR WOMEN'S HEALTHCARE AND EXPANDING HEALTHCARE OPPORTUNITIES FOR ALL WOMEN, REGARDLESS OF THEIR ECONOMIC CIRCUMSTANCES. THE WOMEN'S COUNCIL HAS PROVIDED GRANTS TO FUND 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 $525,000 SINCE ITS FOUNDING. COMMUNITY BENEFIT REPORT HTTPS://WWW.NOVANTHEALTH.ORG/HOME/ABOUT-US/COMMUNITY-INVOLVEMENT/COMMUNI TY-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 $884,000,000, INCLUDING $155,000,000 IN FINANCIAL ASSISTANCE FOR 2018. 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 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 VII, SECTION A, COLUMN B: RELATED ORGANIZATIONS THE ORGANIZATION EMPLOYS CERTAIN EXECUTIVES WHOSE ROLES ARE SUCH THAT THEY PROVIDE SERVICES TO NOT ONLY THE ORGANIZATION, BUT ALSO TO SOME OR ALL OF THE OTHER TAX-EXEMPT ORGANIZATIONS WITHIN THE HEALTHCARE SYSTEM. FOR EXAMPLE, MANY OF THESE EXECUTIVES' ROLES FOCUS ON PARTICULAR SERVICE LINES WHICH CROSS THE VARIOUS GEOGRAPHIC MARKETS OUR ORGANIZATIONS SERVE, THUS THE SERVICES PROVIDED BY THESE EXECUTIVES MAY BENEFIT AND BE RECEIVED BY MULTIPLE ORGANIZATIONS WITHIN THE SYSTEM. THE EXECUTIVES DO NOT ALLOCATE THEIR HOURS BETWEEN THE VARIOUS ORGANIZATIONS, BUT RATHER THEIR TIME SPENT ON SERVICES TO THE ORGANIZATION IS INCLUSIVE OF SERVICES TO ALL OF THE ORGANIZATIONS THEY SERVE WITHIN THE SYSTEM. FORM 990, PART XI, LINE 9: AFFILIATE TRANSFERS: 1,510,878. PLEDGES RECEIVABLE: 184,003. BOOK ADJUSTMENT: -115,765. 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 NMG SERVICES INC 2085 FRONTIS PLAZA BLVD WINSTON SALEM NC 27103 562098809 HEALTHCARE NC 501(C)(3) LINE 10 NOVANT HEALTH INC 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 INC 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 ROWAN MEDICAL FACILITIES INC 2085 FRONTIS PLAZA BLVD WINSTON SALEM NC 27103 561424672 MEDICAL SUPPLIES 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