DAVIE MEDICAL CENTER: Form 990, tax year 2017
View the entire original 990 at ProPublica ↗
- Organization
- DAVIE MEDICAL CENTER (EIN 56-2276994)
- Tax period
- 2017-07-01 to 2018-06-30
- Filed
- 2019-05-14
- IRS object ID
- 201901349349304920
- Schema version
- 2017v2.3
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2019-05-14T12:14:36-05:00 | ReturnTs |
| Tax Period End | 2018-06-30 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2017-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 562276994 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DAVIE MEDICAL CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | DAVI | BusinessNameControlTxt |
| Phone | 3367164445 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 329 NC HWY 801N | AddressLine1Txt |
| City | BERMUDA RUN | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 27006 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | BRADLEY A CLARK | PersonNm |
| Person Title | TREASURER | PersonTitleTxt |
| Phone | 3367164445 | PhoneNum |
| Signature | 2019-05-14 | SignatureDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 152.11.164.57 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2019-05-14 | IPDt |
| IP Tm | 11:54:16 | IPTm |
| IP Timezone | ED | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | C519E53D4DD429C18E6E355385A0C45AA59A2EAE | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2017 | TaxYr |
| Build TS | 2019-02-21 02:37:17Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | CHAD BROWN | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 329 NC HWY 801N | AddressLine1Txt |
| City | BERMUDA RUN | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 27006 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $77,096,014 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.WAKEHEALTH.EDU/DAVIE-MEDICAL-CENTER/ | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2001 | FormationYr |
| Legal Domicile State | NC | LegalDomicileStateCd |
| Activity Or Mission | PROVISION OF PATIENT-CENTERED HEALTHCARE SERVICES TO THE SURROUNDING AREA | ActivityOrMissionDesc |
| Voting Members Governing Body | 14 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 13 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 71 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $54,006,395 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $77,007,733 | CYProgramServiceRevenueAmt |
| PY Investment Income | $42,975 | PYInvestmentIncomeAmt |
| CY Investment Income | -$51,630 | CYInvestmentIncomeAmt |
| PY Other Revenue | $24,851 | PYOtherRevenueAmt |
| CY Other Revenue | $69,515 | CYOtherRevenueAmt |
| PY Total Revenue | $54,074,221 | PYTotalRevenueAmt |
| CY Total Revenue | $77,025,618 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $26,950 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $27,279 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $16,875,266 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $23,114,797 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $32,461,771 | PYOtherExpensesAmt |
| CY Other Expenses | $38,904,068 | CYOtherExpensesAmt |
| PY Total Expenses | $49,363,987 | PYTotalExpensesAmt |
| CY Total Expenses | $62,046,144 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $4,710,234 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $14,979,474 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $23,257,241 | TotalAssetsBOYAmt |
| Total Assets EOY | $43,180,092 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $10,321,288 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $15,264,665 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $12,935,953 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $27,915,427 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | DAVIE MEDICAL CENTER IS PART OF WAKE FOREST BAPTIST HEALTH, A PREEMINENT LEARNING HEALTH SYSTEM 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. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $57,322,038 | ExpenseAmt |
| Grant | $27,279 | GrantAmt |
| Revenue | $77,077,248 | RevenueAmt |
| Desc | DAVIE MEDICAL CENTER PROVIDED MEDICAL, EMERGENCY, AND OUTPATIENT CARE SERVICES TO THE RESIDENTS OF DAVIE COUNTY, NORTH CAROLINA AND SURROUNDING AREAS. IN 2017, DAVIE MEDICAL CENTER CLOSED ITS 81 BED HOSPITAL IN MOCKSVILLE AND OPENED A NEW, STATE OF THE ART, 50 BED INPATIENT HOSPITAL THAT INCLUDES A 24/7 EMERGENCY ROOM AND AN ACUTE CARE FOR ELDERS (ACE) UNIT ON ITS BERMUDA RUN CAMPUS. DAVIE MEDICAL CENTER PROVIDES CLINICAL SERVICES AT ITS BERMUDA RUN CAMPUS IN BOTH MEDICAL PLAZA ONE AND MEDICAL PLAZA TWO THAT INCLUDES: CARDIOLOGY, OPHTHALMOLOGY, GASTROENTEROLOGY, NEUROLOGY, ORTHOPAEDICS, PULMONARY, PODIATRY, NEUROLOGY, SLEEP LAB, IMAGING, PHYSICAL THERAPY, OCCUPATIONAL THERAPY, ENDOSCOPY, LAB AND PHARMACY. DURING FISCAL YEAR 2018, THE HOSPITAL FACILITY HAD 2,861 PATIENT DAYS, WITH 1,504 INPATIENT ADMISSIONS, AND 16,899 EMERGENCY ROOM VISITS.AS PART OF WAKE FOREST BAPTIST HEALTH, DMC'S VISION IS A PREEMINENT LEARNING HEALTH SYSTEM THAT PROMOTES BETTER HEALTH FOR ALL THROUGH COLLABORATION, EXCELLENCE AND 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. | Desc |
| Total Program Service Expenses | $57,322,038 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 10 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 0 | EmployeeCnt |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 14 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 13 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (1) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JOSEPH DOLAN | PersonNm |
| Phone | 3367164445 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | MEDICAL CENTER BOULEVARD | AddressLine1Txt |
| City | WINSTONSALEM | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 27157 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (25 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|---|
| KEVIN P HIGH MD | ||||||||||
| CHAIRMAN | 0.30 | 6.50 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| TERRY L BRALLEY | ||||||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |||||
| WILLIAM JUNKER | ||||||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |||||
| KEN PEACOCK | ||||||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |||||
| MICHAEL CARTWRIGHT MD | ||||||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |||||
| CRAIG M GREVEN MD | ||||||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |||||
| RUSSELL HOWERTON MD | ||||||||||
| BOARD MEMBER | 1.30 | Yes (X) | $0 | $0 | $0 | |||||
| L ANDREW KOMAN MD | ||||||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |||||
| LYNN PITMAN | ||||||||||
| BOARD MEMBER | 2.00 | 38.00 | Yes (X) | $0 | $222,872 | $32,499 | ||||
| KENNETH RETHMEIER | ||||||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |||||
| MARY RITTLING PHD | ||||||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |||||
| STEPHEN ROBERTSON | ||||||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |||||
| CHARLES L BRANCH JR MD | ||||||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |||||
| TERRY RENEGAR | ||||||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |||||
| CHAD BROWN | ||||||||||
| PRESIDENT | 40.00 | 0.00 | Yes (X) | $0 | $298,620 | $70,477 | ||||
| BRADLEY A CLARK | ||||||||||
| TREASURER | 0.30 | 39.70 | Yes (X) | $0 | $483,113 | $170,979 | ||||
| J MCLAIN WALLACE JR | ||||||||||
| SECRETARY | 0.30 | 39.70 | Yes (X) | $0 | $689,120 | $71,877 | ||||
| DINA MARTY | ||||||||||
| ASSISTANT SECRETARY | 1.00 | Yes (X) | $0 | $0 | $0 | |||||
| DANNY SQUIRES | ||||||||||
| FINANCE DIRECTOR | 15.00 | 25.00 | $0 | $163,031 | $28,621 | Yes (X) | ||||
| BRYAN C LEE | ||||||||||
| CLINICAL INSTRUCTOR CRNA | 40.00 | $0 | $179,935 | $33,664 | Yes (X) | |||||
| SARA H SHIELDS | ||||||||||
| PHARMACY MANAGER | 40.00 | $0 | $146,544 | $18,331 | Yes (X) | |||||
| KIMBERLY DEE STANBERY | ||||||||||
| NURSING DIRECTOR | 40.00 | $0 | $135,677 | $29,140 | Yes (X) | |||||
| MARTIN E GLASGO | ||||||||||
| PHARMACIST | 40.00 | $0 | $120,213 | $19,338 | Yes (X) | |||||
| ANGIE M ROARK | ||||||||||
| PHARMACY CLINICAL COORDINATOR | 40.00 | $0 | $115,987 | $14,213 | Yes (X) | |||||
| CHAD ECKES | ||||||||||
| FORMER OFFICER (AS OF 6/12/17) | 0.00 | 0.00 | $0 | $987,032 | $33,896 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $3,542,144 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $523,035 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| NEVRO CORP | |||||
| 1800 BRIDGE PARKWAY | REDWOOD CITY | CA | 94065 | MEDICAL DEVICES | $1,643,684 |
| SMITH & NEPHEW ORTHO | |||||
| 150 MINUTEMAN ROAD | ANDOVER | MA | 01810 | MEDICAL DEVICES | $1,086,391 |
| MEDLINE INDUSTRIES INC | |||||
| 1 MEDLINE PLACE | MUNDELEIN | IL | 60060 | MEDICAL DEVICES | $1,072,110 |
| DEPUY JOINT RECONSTRUCTION | |||||
| 700 ORTHOPAEDIC DRIVE | WARSAW | IN | 46582 | MEDICAL DEVICES | $957,179 |
| BOSTON SCIENTIFIC CORP | |||||
| 300 BOSTON SCIENTIFIC WAY | MARLBOUROUGH | MA | 017521234 | MEDICAL DEVICES | $887,651 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 20 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PATIENT SERVICE REVENUE | Desc |
| Business | 621400 | BusinessCd |
| Total Revenue Column | $77,007,733 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $77,007,733 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $77,007,733 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $18,766 | TotalRevenueColumnAmt |
| Exclusion | $18,766 | ExclusionAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $70,396 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -$70,396 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$70,396 | TotalRevenueColumnAmt |
| Exclusion | -$70,396 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | DIETARY | Desc |
| Business | 621990 | BusinessCd |
| Total Revenue Column | $69,515 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $69,515 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $69,515 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $77,025,618 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $77,077,248 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | -$51,630 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $27,279 | TotalAmt |
| Program Services | $27,279 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $412,439 | TotalAmt |
| Program Services | $265,652 | ProgramServicesAmt |
| Management And General | $146,787 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,634,098 | TotalAmt |
| Program Services | $16,290,263 | ProgramServicesAmt |
| Management And General | $3,343,835 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $761,045 | TotalAmt |
| Program Services | $570,784 | ProgramServicesAmt |
| Management And General | $190,261 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,399,302 | TotalAmt |
| Program Services | $1,048,475 | ProgramServicesAmt |
| Management And General | $350,827 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $907,913 | TotalAmt |
| Program Services | $680,935 | ProgramServicesAmt |
| Management And General | $226,978 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,780 | TotalAmt |
| Program Services | $3,780 | ProgramServicesAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,323,089 | TotalAmt |
| Program Services | $5,292,200 | ProgramServicesAmt |
| Management And General | $30,889 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $380,364 | TotalAmt |
| Program Services | $277,418 | ProgramServicesAmt |
| Management And General | $102,946 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $240,138 | TotalAmt |
| Program Services | $188,666 | ProgramServicesAmt |
| Management And General | $51,472 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,101,486 | TotalAmt |
| Program Services | $6,846,013 | ProgramServicesAmt |
| Management And General | $255,473 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,427 | TotalAmt |
| Program Services | $3,098 | ProgramServicesAmt |
| Management And General | $10,329 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,191 | TotalAmt |
| Program Services | $1,191 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,272,058 | TotalAmt |
| Program Services | $2,272,058 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $38,761 | TotalAmt |
| Program Services | $38,761 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $16,350,853 | $16,336,544 | $14,309 |
| BAD DEBT EXPENSE | $6,074,761 | $6,074,761 | |
| PROVIDER ASSESSMENT TAX | $1,104,160 | $1,104,160 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $62,046,144 | TotalAmt |
| Program Services | $57,322,038 | ProgramServicesAmt |
| Management And General | $4,724,106 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,004,037 | BOYAmt |
| EOY | $22,773,864 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,163,816 | BOYAmt |
| EOY | $8,954,410 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,084,489 | BOYAmt |
| EOY | $1,123,927 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $19,553,923 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $9,226,032 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,004,899 | BOYAmt |
| EOY | $10,327,891 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,257,241 | BOYAmt |
| EOY | $43,180,092 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,582,148 | BOYAmt |
| EOY | $13,657,976 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,739,140 | BOYAmt |
| EOY | $1,606,689 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,321,288 | BOYAmt |
| EOY | $15,264,665 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,935,953 | BOYAmt |
| EOY | $27,915,427 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,935,953 | BOYAmt |
| EOY | $27,915,427 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,257,241 | BOYAmt |
| EOY | $43,180,092 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $14,979,474 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $3,780 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $3,780 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | 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. | ExplanationTxt |
Schedule D IRS990ScheduleD
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $54,909 | OtherCostOrOtherBasisAmt |
| Depreciation | $9,026 | DepreciationAmt |
| Book Value | $45,883 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $15,781,018 | OtherCostOrOtherBasisAmt |
| Depreciation | $9,217,006 | DepreciationAmt |
| Book Value | $6,564,012 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,717,996 | OtherCostOrOtherBasisAmt |
| Book Value | $3,717,996 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $10,327,891 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | ESTIMATED 3RD PARTY PAYABLE | Desc |
| Amt | $1,606,689 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $1,606,689 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION HAS EVALUATED UNCERTAIN TAX POSITIONS FOR ITS FISCAL YEARS ENDED JUNE 30, 2017 AND 2018, 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, 2017 AND 2018. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,191,221 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,191,221 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02130 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,101,777 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,328,303 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,773,474 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03170 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,149,897 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,940,137 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $209,760 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00370 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $6,442,895 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,268,440 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,174,455 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05670 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $27,279 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $27,279 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00050 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $27,279 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $27,279 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00050 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $6,470,174 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,268,440 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,201,734 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05720 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $1,326,054 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $22,412,362 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $25,878,416 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$3,466,054 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DAVIE MEDICAL CENTER | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 329 NC HWY 801N | AddressLine1Txt |
| City | BERMUDA RUN | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 27006 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.WAKEHEALTH.EDU/DAVIE-MEDICAL-CENTE | WebsiteAddressTxt |
| State License | H0171 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DAVIE MEDICAL CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 15 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (1) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | 0 | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | SEE PART V, PAGE 8 | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 16 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | SEE PART V, PAGE 8 | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 400.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Income Level Criteria | Yes (X) | IncomeLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Residency Criteria | Yes (X) | ResidencyCriteriaInd |
| Other Criteria | Yes (X) | OtherCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | HTTP://WWW.WAKEHEALTH.EDU/DAVIE-MEDICAL-CENTER/INFORMATION/FINANCIAL-ASSIST | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | HTTP://WWW.WAKEHEALTH.EDU/DAVIE-MEDICAL-CENTER/INFORMATION/FINANCIAL-ASSIST | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | HTTP://WWW.WAKEHEALTH.EDU/DAVIE-MEDICAL-CENTER/INFORMATION/FINANCIAL-ASSIST | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| DAVIE MEDICAL CENTER | PART V, SECTION B, LINE 5: COMMUNITY INPUT WAS OBTAINED THROUGH THE FOLLOWING SOURCES: (1) THE DAVIE COUNTY HEALTH DEPARTMENT'S COMMUNITY HEALTH ASSESSMENT CONDUCTED IN SUMMER 2014 VIA SURVEY MONKEY; (2) TWO FAITHHEALTH NC (A DEPARTMENT OF WAKE FOREST BAPTIST MEDICAL CENTER) COMMUNITY ASSET MAPPING WORKSHOPS WHICH SOUGHT OPINIONS OF BOTH HEALTH PROVIDERS AND HEALTH SEEKERS IN DAVIE COUNTY'S MOST VULNERABLE COMMUNITIES; (3) TWO COMMUNITY HEALTH WORKSHOPS, AND (4) COMMENTS FROM PRIOR COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY.ADDITIONALLY, MORE THAN TEN SECONDARY DATA SOURCES WERE REVIEWED, INCLUDING THE COUNTY HEALTH RANKINGS & ROADMAPS, 2014 STATE OF THE COUNTY HEALTH, US CENSUS BUREAU, N.C. CENTER FOR HEALTH STATISTICS, CENTERS FOR DISEASE CONTROL YOUTH RISK BEHAVIOR SURVEILLANCE SYSTEM, BEHAVIOR RISK FACTOR SURVEILLANCE SYSTEM, HEALTHY PEOPLE 2020, HEALTHY NORTH CAROLINA 2020, AND CENTERS FOR MEDICARE & MEDICAID. |
| DAVIE MEDICAL CENTER | PART V, SECTION B, LINE 6A: THE HOSPITAL'S MOST RECENT CHNA WAS CONDUCTED IN COLLABORATION WITH NORTH CAROLINA BAPTIST HOSPITAL AND LEXINGTON MEDICAL CENTER. BOTH LEXINGTON MEDICAL CENTER AND NORTH CAROLINA BAPTIST HOSPITAL ARE AFFILIATE HOSPITALS OF WAKE FOREST BAPTIST MEDICAL CENTER. |
| DAVIE MEDICAL CENTER | PART V, SECTION B, LINE 7D: N/APART V, SECTION B, LINE 7A:HTTP://WWW.WAKEHEALTH.EDU/DAVIE-MEDICAL-CENTER/ABOUT/COMMUNITY-BENEFITS/COMMUNITY-BENEFITS.HTMPART V, SECTION B, LINE 10A:HTTP://WWW.WAKEHEALTH.EDU/DAVIE-MEDICAL-CENTER/ABOUT/COMMUNITY-BENEFITS/COMMUNITY-BENEFITS.HTM |
| DAVIE MEDICAL CENTER | PART V, SECTION B, LINE 11: THE MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT IDENTIFIED THE FOLLOWING SIGNIFICANT HEALTH NEEDS WITHIN THE COMMUNITY: (1) ACCESS TO HEALTH CARE, (2) CHRONIC DISEASE MANAGEMENT AND INFORMATION, (3) BEHAVIORAL AND MENTAL DISTRESS, (4) INADEQUATE EMERGENCY CARE, (5) DENTAL CARE, (6) HOUSING, (7) FOOD INSECURITIES, (8) LACK OF FINANCES, AND (9) LACK OF TRANSPORTATION.DAVIE MEDICAL CENTER (DMC) PRIORITIZED THE FOLLOWING THREE SIGNIFICANT COMMUNITY HEALTH NEEDS FOR ITS CURRENT CHNA AS FOLLOWS: (1) ACCESS TO CARE; (2) CHRONIC DISEASE MANAGEMENT; AND (3) BEHAVIORAL/MENTAL HEALTH DISTRESS. DMC PLANS TO PROVIDE COMMUNITY BENEFIT PROGRAMS RESPONSIVE TO THESE HEALTH NEEDS THROUGH ITS APPROVED CHNA IMPLEMENTATION STRATEGY. THE DMC 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. ACCESS TO CAREBARRIERS SUCH AS TRANSPORTATION AND ACCESS TO COMMUNITY CENTERED SOCIAL AND HEALTH EDUCATION SERVICES CAN LEAD TO UNMET HEALTH NEEDS. THE HOSPITAL'S CURRENT STRATEGIES INCLUDE:--REDUCING TRANSPORTATION BARRIERS FOR INDIVIDUALS IN RURAL AREAS OF THE COMMUNITY THROUGH 1.) ASSESSING NEED FOR TRANSPORTATION ASSISTANCE THROUGH VARIOUS COMMUNITY AGENCIES TO DETERMINE HOW TO EASE ACCESS THROUGH PUBLIC TRANSPORTATION OR ONSITE CLINICS IN HIGH NEED AREAS, AND 2.) WORKING WITH LOCAL AGENCIES TO DETERMINE RESOURCES AVAILABLE TO BRING CARE TO AREAS IMPACTED BY TRANSPORTATION ISSUES.--IMPROVING ACCESS TO COMMUNITY CENTERED SOCIAL AND HEALTH EDUCATION SERVICES AND REGULAR SOURCES OF HEALTH CARE THROUGH 1.) PROVIDING HEALTH EDUCATION EVENTS AND SCREENINGS AT VARIOUS LOCATIONS IN DAVIE COUNTY, 2.) CREATING OPPORTUNITIES TO INVOLVE FAMILIES IN REGULAR PROGRAMMING VIA THE HEALTHY DAVIE INITIATIVE, 3.) WORKING WITH LOCAL CHURCHES TO PROVIDE PROGRAMS AND ENLIST LAY LEADER SUPPORT TO ASSIST PARISHIONERS NEEDING ACCESS, 4.) CONTINUING TO EXPLORE THE USE OF A MOBILE MEDICAL CLINIC IN LOW ACCESS SERVICE AREAS, AND 5.) CONTINUING TO PROVIDE COMMUNITY ENGAGEMENT SUPPORT THROUGH 5 SUPPORTERS OF HEALTH, 311 CONGREGATIONAL PARTNERS, 25 CONNECTORS ACROSS THE SERVICE AREA AND 7 FAITHHEALTH FELLOWS.2. CHRONIC DISEASE MANAGEMENTDMC RECOGNIZES THE EFFECT OF CONTINUITY OF CARE WITH HEALTH CARE PROVIDERS ON PATIENT BEHAVIORS, DISEASE MANAGEMENT, AND HEALTH STATUS.THE HOSPITAL'S CURRENT STRATEGIES INCLUDE:--IMPROVING THE CAPACITY OF COMMUNITY BASED ORGANIZATIONS AND HEALTH CARE PROVIDERS TO SUPPORT EFFORTS RELATED TO CHRONIC DISEASE PREVENTION AND MANAGEMENT THROUGH 1.) CONTINUING TO SUPPORT FAITHHEALTH NC COMMUNITY HEALTH WORKERS TO ADDRESS CHRONIC DISEASE MANAGEMENT AND COMMUNITY HEALTH PROGRAMMING, 2.) INCREASING COMMUNITY AND HEALTHCARE PROVIDER ACCESS TO EXISTING CHRONIC DISEASE MANAGEMENT RESOURCES BY CENTRALIZING AND DISTRIBUTING INFORMATION AND 3.) PROVIDING AND EXPANDING CHRONIC DISEASE SELF-MANAGEMENT PROGRAMS OFFERED BY THE MEDICAL CENTER THROUGH EMMI SOFTWARE.--PROVIDING EDUCATION AND SUPPORT PROGRAMS TO REDUCE DIABETIC PREVALENCE AND IMPROVING DIABETES MANAGEMENT THROUGH 1.) WORKING WITH DAVIE COUNTY HEALTH DEPARTMENT TO IMPROVE ACCESS TO AREA DIABETES MANAGEMENT PROGRAMS FOR PRE-DIABETIC AND EARLY ONSET DIABETIC PATIENTS, 2.) CONTINUING TO PROVIDE BESTHEALTH DIABETES PREVENTION AND NUTRITION EDUCATION/COOKING CLASSES AT CONVENIENT LOCATIONS IN DAVIE COUNTY, AND 3.) EXPLORING PARTNERSHIP WITH DAVIE COUNTY AGENCIES TO FOCUS DIABETES PREVENTION AND MANAGEMENT PROGRAMS IN IDENTIFIED HIGH NEED NEIGHBORHOODS.--PROVIDING EDUCATION AND SUPPORT PROGRAMS TO REDUCE OBESITY PREVALENCE AND IMPROVE OBESITY MANAGEMENT THROUGH 1.) EXPANDING PROGRAMMING IN DAVIE COUNTY TO INCREASE EDUCATION AND AWARENESS OF NUTRITION AND HEALTHY LIFESTYLE CHOICES FOR UNINSURED AND MEDICAID PATIENTS, 2.) PROMOTING HEALTHY DIET AND WEIGHT MANAGEMENT THROUGH EMPLOYEE WELLNESS PROGRAMS, 3.) CONTINUING TO SUPPORT COMMUNITY WEIGHT MANAGEMENT EDUCATION THROUGH BESTHEALTH, 4.) INCREASING AWARENESS AMONG EXISTING PATIENTS AND EMPLOYEES OF WEIGHT MANAGEMENT PROGRAMS, AND 5.) WORKING WITH INDUSTRY AND DAVIE COUNTY SCHOOL SYSTEM TO IDENTIFY AT RISK INDIVIDUALS AND PROVIDE SUPPORT AND PROGRAMMING THROUGH THE HEALTHY DAVIE INITIATIVE.3. BEHAVIORAL/MENTAL HEALTH DISTRESSDMC RECOGNIZES THE OVERLAP OF MENTAL, MEDICAL AND SOCIAL DISPARITIES AND THE IMPORTANT ROLE OF BEHAVIORAL HEALTH IN TREATING THE WHOLE PERSON. THE HOSPITAL'S CURRENT STRATEGIES INCLUDE:--WORKING WITH CENTERPOINT TO IDENTIFY KEY RESOURCES FOR ACCESS AND PROGRAMMING FOR PATIENTS NEEDING MENTAL HEALTH SERVICES;--INCREASING THE CURRENT 30+ STAFF AT THE MEDICAL CENTER WHO WORK IN AREAS DEFINED AS INTEGRATED BEHAVIORAL HEALTH;--BUILDING CAPACITY AMONG LAY PERSONS IN THE COMMUNITY IN THE AREAS OF MENTAL HEALTH FIRST AID, COMMUNITY RESILIENCE MODEL AND SUICIDE PREVENTION PROGRAMS;--DEVELOPING A PLAN TO CREATE MORE INTEGRATED BEHAVIORAL HEALTH GRADUATE MEDICAL EDUCATION OFFERINGS FOR MEDICAL STUDENTS, RESIDENTS, FACULTY AND STAFF THAT SEE PATIENTS ACROSS THE MEDICAL CENTER NETWORK.ALL OF THE AFOREMENTIONED EFFORTS IN COMBINATION WITH THE HOSPITAL'S VALUES OF NONDISCRIMINATION AND COMPASSIONATE CARE ARE DESIGNED TO MEET THE SIGNIFICANT HEALTH NEEDS OF THE MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT. |
| DAVIE MEDICAL CENTER | 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. |
| DAVIE MEDICAL CENTER | PART V, SECTION B, LINE 16J: IN ADDITION TO THE METHODS PREVIOUSLY DESCRIBED, DAVIE 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. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 8 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (8 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - DMC BERMUDA RUN - GASTROENTEROLOGY | ||||
| 329 NC HWY 801 N | BERMUDA RUN | NC | 27006 | GASTROENTEROLOGY |
| 2 - DMC BERMUDA RUN - SPINE | ||||
| 329 NC HWY 801 N | BERMUDA RUN | NC | 27006 | PHYSICAL MEDICINE/REHABILITATION SPINE |
| 3 - DMC BERMUDA RUN - CARDIOLOGY | ||||
| 329 NC HWY 801 N | BERMUDA RUN | NC | 27006 | CARDIAC REHAB |
| 4 - DMC BERMUDA RUN - PODIATRY | ||||
| 329 NC HWY 801 N | BERMUDA RUN | NC | 27006 | PODIATRY |
| 5 - DMC BERMUDA RUN - ORTHOPAEDICS | ||||
| 329 NC HWY 801 N | BERMUDA RUN | NC | 27006 | X-RAY & ORTHOPAEDICS |
| 6 - DMC BERMUDA RUN - PULMONOLOGY | ||||
| 329 NC HWY 801 N | BERMUDA RUN | NC | 27006 | PULMONARY |
| 7 - DMC BERMUDA RUN - NEUROLOGY | ||||
| 329 NC HWY 801 N | BERMUDA RUN | NC | 27006 | EEG/EMG TESTING, SLEEP LAB |
| 8 - DMC BERMUDA RUN - EYE CENTER | ||||
| 329 NC HWY 801 N | BERMUDA RUN | NC | 27006 | OPTHALMOLOGY |
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3C: | THE ORGANIZATION ALSO EVALUATES CERTAIN CREDIT FILE DATA ELEMENTS TO IDENTIFY POTENTIAL SOURCES OF INCOME TO MORE ACCURATELY INFORM CHARITY CARE ELIGIBILITY ASSESSMENTS. PATIENTS WITH ESTIMATED HOUSEHOLD INCOME BELOW 200% OF FPG, WHO ARE IDENTIFIED AS HAVING COMMERCIAL CREDIT ACCOUNTS THAT ARE BEING SERVICED IN A MANNER THAT SUGGESTS ADDITIONAL SOURCES OF INCOME, ARE NOT AUTOMATICALLY GRANTED PRESUMPTIVE CHARITY CARE. |
| 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 2017 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 PATIENT SERVICE REVENUE OF PRIVATE HOSPITALS. THE FEDERAL GOVERNMENT MATCHES THE ASSESSMENT AT A RATE OF 2 TO 1 AND THESE AMOUNTS ARE ALLOCATED TO NORTH CAROLINA HOSPITALS QUARTERLY. 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 $6,074,761 FOR THE FISCAL YEAR ENDED JUNE 30, 2018. THIS AMOUNT IS NOT INCLUDED IN THE CALCULATION OF CHARITY CARE FOR PART I, LINE 7. |
| PART II, COMMUNITY BUILDING ACTIVITIES: | WAKE FOREST BAPTIST HEALTH - DAVIE MEDICAL CENTER IS COMMITTED TO IMPROVING THE HEALTH OF THE INDIGENT AND MEDICALLY UNDERSERVED IN DAVIE COUNTY AND SURROUNDING AREAS. DAVIE MEDICAL CENTER REPRESENTATIVES ARE INVOLVED IN THE COMMUNITY THROUGH INITIATIVES SUCH AS HEALTHY DAVIE, PART OF THE DAVIE COMMUNITY FOUNDATION. THE MEDICAL CENTER HOSTS FREE CLASSES, SCREENINGS AND COOKING DEMONSTRATIONS THROUGH ITS BESTHEALTH PROGRAM. DAVIE MEDICAL CENTER PARTNERS WITH OTHER AGENCIES THROUGHOUT THE COMMUNITY TO CONTINUE TO IMPROVE HEALTH. AGENCIES INCLUDE SENIOR SERVICES, DRAGONFLY HOUSE, SMART START OF DAVIE COUNTY AND THE DAVIE YMCA. |
| 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 2017 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, 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 ANY LEVEL OF 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 TWO TO THREE REGIONAL PRIORITY AREAS TO FOCUS ON FOR FY 2017-2019. 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) COMMUNITY ASSET INVENTORY. THE DATA REVIEW AND PRIORITY SETTING PHASE BEGAN WITH THE COMPILATION OF EXISTING HEALTH-RELATED DATA. STAKEHOLDERS REVIEWED MULTIPLE DATA SETS INCLUDING FORSYTH, DAVIDSON, AND THE DAVIE COUNTY HEALTH DEPARTMENT'S PUBLIC HEALTH NEEDS ASSESSMENTS, NORTH CAROLINA INDICATORS FOR COMMUNITY HEALTH ASSESSMENT, INTERNAL DISEASE REGISTRIES, AND COUNTY HEALTH RANKINGS. ONCE THE COMMUNITY HEALTH NEEDS WERE IDENTIFIED, AN INTERNAL STEERING COMMITTEE AND SENIOR LEADERSHIP REVIEW A SET OF CRITERIA TO DEVELOP THE PRIORITY RANKINGS. THE PRIORITIZATION PROCESS IDENTIFIED THE FOLLOWING TOP THREE PRIORITY CHALLENGES FOR THE COMMUNITY: (1) ACCESS/LACK OF MEDICAL SERVICES/SCREENINGS, (2) CHRONIC DISEASE - CANCER, DIABETES, OBESITY, AND (3) BEHAVIORAL/MENTAL HEALTH DISTRESS.FAITHHEALTHNC (A DIVISION OF THE MEDICAL CENTER) PROVIDED COMMUNITY ENGAGEMENT THROUGH A COMPREHENSIVE ASSET MAPPING STRATEGY BASED ON AN APPROACH FROM SOUTH AFRICA AND REDEFINED IN MEMPHIS, TN DESIGNED TO BUILD COMMUNITY PARTNERSHIPS ON THE ASSETS THAT EXIST, INSTEAD OF JUST NEEDS. THE MAPPING DEVELOPED AN INVENTORY OF EXISTING PROGRAMS AND SERVICES WITHIN THE REGION RELATED TO THE PRIORITY AREAS IDENTIFIED IN THE NEEDS ASSESSMENT. THE INVENTORY INCLUDED THE LOCATION OF THE PROGRAM (HOSPITAL, CLINIC, OR COMMUNITY SERVICE) AS WELL AS THE NATURE OF THE INTANGIBLE FACTORS, ESPECIALLY TRUST, THAT DETERMINE ACCESS AND COLLABORATION AMONG COMMUNITY PARTNERS. THE PURPOSE OF THE INVENTORY WAS TO IDENTIFY GAPS IN SERVICES, OPPORTUNITIES FOR NEW WORK, WHERE AND WITH WHOM THERE IS ALREADY WORK BEING DONE, AND OPPORTUNITIES FOR PARTNERSHIP AND COLLABORATION. FROM THIS THREE STEP 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 FISCAL YEARS 2017-2019. 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. |
| 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: | DAVIE COUNTY IS LOCATED IN THE PIEDMONT TRIAD REGION OF NORTH CAROLINA, COVERING 264 SQUARE MILES WITH A POPULATION OF APPROXIMATELY 42,500. WIDELY RURAL, THE COUNTY IS CHARACTERIZED BY ROLLING FARMLAND. THE NEAREST METROPOLITAN AREA IS WINSTON-SALEM, LOCATED JUST 12 MILES TO THE NORTHEAST. OVER 80% OF THE COUNTY'S POPULATION LIVES IN UNINCORPORATED AREAS. APPROXIMATELY 61% OF DAVIE COUNTY'S RESIDENTS TRAVEL OUTSIDE OF THE COUNTY FOR EMPLOYMENT. THE MEDIAN INCOME FOR DAVIE COUNTY RESIDENTS IS APPROXIMATELY $51,662. THE DAVIE COUNTY UNEMPLOYMENT RATE AS REPORTED IN JUNE 2016 WAS 3.7%.THE FOLLOWING DEMOGRAPHIC FIGURES REFLECT THE POPULATION FOR DAVIE COUNTY: - 51% FEMALE, 49% MALE - BELOW 18 YEARS: 21.4% - AGE 65 AND OLDER: 20.4%THE COUNTY POPULATION BREAKDOWN BY RACE IS: - WHITE NON-HISPANIC (84.2%) - BLACK (6.5%) - HISPANIC (6.9%) - TWO OR MORE RACES (1.7%) - AMERICAN INDIAN (0.7%)THERE ARE SEVEN TOWNSHIPS IN DAVIE COUNTY. MOCKSVILLE IS THE LARGEST MUNICIPALITY WITH 5,271 RESIDENTS, AND IS ALSO THE COUNTY SEAT. APPROXIMATELY 70% OF DAVIE COUNTY'S POPULATION IS CONTAINED WITHIN RURAL AREAS OF THE COUNTY. |
| PART VI, LINE 5: | THE HOSPITAL HAS MAINTAINED A STRONG COMMITMENT TO PROMOTING AND EXPANDING COMMUNITY HEALTH PROGRAMS IN DAVIE COUNTY. SUCH PROGRAMS INCLUDE BESTHEALTH COMMUNITY EDUCATION CLASSES, CHRONIC DISEASES SELF MANAGEMENT PROGRAMS, PUBLIC SCREENINGS, AND OTHER HEALTH EDUCATION EVENTS HELD LOCALLY THROUGHOUT THE YEAR. IN FEBRUARY 2018, DAVIE MEDICAL CENTER AND BEST HEALTH, WAKE FOREST BAPTIST HEALTH'S COMMUNITY WELLNESS PROGRAM, INTRODUCED THE CAREGIVER ACADEMY PROGRAM, WHICH FEATURES FREE CLASSES TO EDUCATE THE COMMUNITY ON HOW TO PREPARE FOR CAREGIVING AND PROVIDE ASSISTANCE FOR LOVED ONES, INCLUDING FINDING THE RIGHT RESOURCES, BEING YOUR OWN HEALTH CARE ADVOCATE, AND DEALING WITH THE PAPERWORK AND FINANCIAL BURDENS. |
| PART VI, LINE 6: | THE FILING ORGANIZATION, NORTH CAROLINA BAPTIST HOSPITAL, LEXINGTON MEDICAL CENTER, WILKES REGIONAL MEDICAL CENTER, WAKE FOREST UNIVERSITY HEALTH SCIENCES, AND WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER ARE INTEGRAL PARTS 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. WFUHS OPERATES THE UNIVERSITY'S SCHOOL OF MEDICINE AND WAKE FOREST INNOVATION QUARTER (RESEARCH PARK). THE MEDICAL CENTER COMPRISES 1,004 ACUTE CARE AND REHABILITATION BEDS AND OFFERS EXPERTISE IN MORE THAN 100 AREAS OF MEDICINE, ENCOMPASSING COMPREHENSIVE PREVENTIVE AND HIGHLY SPECIALIZED CARE FOR ALL AGES. WAKE FOREST BAPTIST MEDICAL CENTER HAS BEEN RANKED AS ONE OF "AMERICA'S TOP HOSPITALS" BY U.S. NEWS AND WORLD REPORT SINCE 1993. |
| PART VI, LINE 7, REPORTS FILED WITH STATES | NC |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | Yes (1) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| LYNN PITMAN | ||||||||||||||
| BOARD MEMBER | $0 | $204,314 | $0 | $17,540 | $0 | $1,018 | $0 | $18,496 | $0 | $14,003 | $0 | $255,371 | $0 | $0 |
| CHAD BROWN | ||||||||||||||
| PRESIDENT | $0 | $244,302 | $0 | $52,597 | $0 | $1,721 | $0 | $51,184 | $0 | $19,293 | $0 | $369,097 | $0 | $0 |
| BRADLEY A CLARK | ||||||||||||||
| TREASURER | $0 | $406,688 | $0 | $75,755 | $0 | $670 | $0 | $150,891 | $0 | $20,088 | $0 | $654,092 | $0 | $0 |
| J MCLAIN WALLACE JR | ||||||||||||||
| SECRETARY | $0 | $483,693 | $0 | $102,659 | $0 | $102,768 | $0 | $55,373 | $0 | $16,504 | $0 | $760,997 | $0 | $0 |
| DANNY SQUIRES | ||||||||||||||
| FINANCE DIRECTOR | $0 | $162,418 | $0 | $0 | $0 | $613 | $0 | $13,032 | $0 | $15,589 | $0 | $191,652 | $0 | $0 |
| BRYAN C LEE | ||||||||||||||
| CLINICAL INSTRUCTOR CRNA | $0 | $179,814 | $0 | $0 | $0 | $121 | $0 | $15,023 | $0 | $18,641 | $0 | $213,599 | $0 | $0 |
| SARA H SHIELDS | ||||||||||||||
| PHARMACY MANAGER | $0 | $146,453 | $0 | $0 | $0 | $91 | $0 | $10,974 | $0 | $7,357 | $0 | $164,875 | $0 | $0 |
| KIMBERLY DEE STANBERY | ||||||||||||||
| NURSING DIRECTOR | $0 | $123,897 | $0 | $11,683 | $0 | $97 | $0 | $8,196 | $0 | $20,944 | $0 | $164,817 | $0 | $0 |
| CHAD ECKES | ||||||||||||||
| FORMER OFFICER (AS OF 6/12/17) | $0 | $346,612 | $0 | $0 | $0 | $640,420 | $0 | $22,984 | $0 | $10,912 | $0 | $1,020,928 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINES 4A-B | FormAndLineReferenceDesc |
| Explanation | CERTAIN DIRECTORS AND OFFICERS OF THE FILING ORGANIZATION RECEIVED SEVERANCE PAYMENTS AND PARTICIPATED IN SUPPLEMENTAL NON QUALIFIED RETIREMENT PLANS (SERP), ALL OF WHICH WERE PAID BY A RELATED ORGANIZATION, WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER, AS PART OF THE INDIVIDUAL'S COMPENSATION FROM THE RELATED ORGANIZATION. THE DETERMINATION OF THE AMOUNT OF THE NON QUALIFIED RETIREMENT PLANS FOLLOWED THE RELATED ORGANIZATION'S COMPENSATION PROCEDURES AS OUTLINED IN PART VI, SECTION B, LINE 15 OF THE FORM 990. THE FOLLOWING DIRECTOR AND OFFICER RECEIVED SERP PAYMENTS IN THEIR CALENDAR YEAR 2017 COMPENSATION: J. MCLAIN WALLACE $81,156 THE FOLLOWING FORMER OFFICER RECEIVED SEVERANCE PAYMENTS IN HIS CALENDAR YEAR 2017 COMPENSATION: CHAD ECKES $640,000 | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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, 2018 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 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), CORNERSTONE HEALTH CARE, LLC, WILKES REGIONAL MEDICAL CENTER AND AFFILIATE, AND OTHER WFUBMC AFFILIATES. ALL SIGNIFICANT INTERCOMPANY TRANSACTIONS HAVE BEEN ELIMINATED IN CONSOLIDATION. |
| FORM 990, PART VI, SECTION A, LINE 3 | PURSUANT TO THE ORGANIZATION'S BYLAWS, THE BOARD OF TRUSTEES MAY ESTABLISH AN EXECUTIVE COMMITTEE CONSISTING OF THREE OR MORE TRUSTEES, THE MAJORITY OF WHOM SHALL BE SOLE MEMBER TRUSTEES (WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER TRUSTEES) AND THE REMAINDER SHALL BE DAVIE COUNTY TRUSTEES. DURING THE INTERVALS BETWEEN MEETINGS OF THE BOARD OF TRUSTEES, THE EXECUTIVE COMMITTEE SHALL HAVE AND MAY EXERCISE THE POWERS OF THE BOARD OF TRUSTEES IN THE MANAGEMENT OF THE BUSINESS AND AFFAIRS OF THE CORPORATION; PROVIDED THAT THE EXECUTIVE COMMITTEE MAY NOT TAKE ANY ACTION THAT WOULD REQUIRE A SUPERMAJORITY VOTE OF THE BOARD OF TRUSTEES. |
| FORM 990, PART VI, SECTION A, LINE 6 | PURSUANT TO ITS ARTICLES OF AMENDMENT FILED ON MAY 1, 2017, 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 | THE SOLE MEMBER OF THE ORGANIZATION SHALL HAVE THE RIGHT AT ALL TIMES, WITH RESPECT TO THE ORGANIZATION, TO ELECT AND REMOVE THE TRUSTEES, AS PROVIDED IN THE ORGANIZATION'S BYLAWS. |
| 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 | ON AN ANNUAL BASIS (AND AS THEY ARISE), 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. 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 | DAVIE 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 WAS 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 ARE 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 NOT AVAILABLE TO THE PUBLIC. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (9 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| DAVIE COUNTY HOSPITAL FOUNDATION | |||||||||||
| 156 ROLAND RD | MOCKSVILLE | NC | 27028 | 581477280 | SUPPORTING ORGANIZATION | NC | 501(C)(3) | LINE 12C, III-FI | N/A | 0 | |
| WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER | |||||||||||
| MEDICAL CENTER BLVD | WINSTON SALEM | NC | 27157 | 510190238 | HEALTHCARE | NC | 501(C)(3) | LINE 12A, I | 0 | ||
| LEXINGTON MEDICAL CENTER | |||||||||||
| 250 HOSPITAL DRIVE | LEXINGTON | NC | 27292 | 560543238 | HEALTHCARE | NC | 501(C)(3) | LINE 3 | 0 | WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER | |
| LEXINGTON MEDICAL CENTER FOUNDATION | |||||||||||
| 250 HOSPITAL DRIVE | LEXINGTON | NC | 27292 | 581876553 | FUNDRAISING | NC | 501(C)(3) | LINE 12B, II | 0 | LEXINGTON MEDICAL CENTER | |
| NORTHWEST COMMUNITY CARE NETWORK | |||||||||||
| 2000 WEST FIRST STREET | WINSTON SALEM | NC | 27104 | 020774853 | HEALTHCARE | NC | 501(C)(3) | LINE 7 | 0 | WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER | |
| FAITHHEALTH INNOVATIONS INC | |||||||||||
| MEDICAL CENTER BLVD | WINSTON SALEM | NC | 27157 | 237426944 | HEALTHCARE | NC | 501(C)(3) | LINE 10 | 0 | WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER | |
| WRMC HOSPITAL OPERATING CORPORATION | |||||||||||
| PO BOX 609 | NORTH WILKESBORO | NC | 28659 | 830343789 | HEALTHCARE | NC | 501(C)(3) | LINE 3 | 0 | WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER | |
| WILKES PHYSICIAN NETWORK INC | |||||||||||
| PO BOX 609 | NORTH WILKESBORO | NC | 28659 | 262971169 | HEALTHCARE | NC | 501(C)(3) | LINE 3 | 0 | WRMC HOSPITAL OPERATING CORPORATION | |
| WAKE FOREST EMERGENCY PROVIDERS (FKA WFUBMC COMM PHYS) | |||||||||||
| MEDICAL CENTER BLVD | WINSTON SALEM | NC | 27157 | 561903275 | HEALTHCARE | NC | 501(C)(3) | LINE 3 | 0 | WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MS LAND HOLDING CO LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1901 MOONEY STREET | AddressLine1Txt |
| City | WINSTON SALEM | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 27103 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 824005370 | EIN |
| Primary Activities | REAL ESTATE | PrimaryActivitiesTxt |
| Legal Domicile State | NC | LegalDomicileStateCd |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Predominant Income Type | N/A | PredominantIncomeTypeTxt |
| Disproportionate Allocations | 0 | DisproportionateAllocationsInd |
| General Or Managing Partner | 0 | GeneralOrManagingPartnerInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
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