2019-05-14T12:14:36-05:00 2018-06-30 990 2017-07-01 560552787 NORTH CAROLINA BAPTIST HOSPITAL NORT 3367164445 MEDICAL CENTER BLVD WINSTONSALEM NC 27157 BRADLEY A CLARK EVP-CFO 3367164445 2019-05-14 152.11.164.57 2019-05-14 11:58:56 ED P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 C519E53D4DD429C18E6E355385A0C45AA59A2EAE 2017 2019-02-21 02:37:17Z JULIE ANN FREISCHLAG MD MEDICAL CENTER BLVD WINSTONSALEM NC 27157 1798573416 0 X WWW.WAKEHEALTH.EDU X 1923 NC IMPROVING THE HEALTH OF OUR REGION, STATE AND NATION 9 8 0 2050 7243407 4225972 3544874 6737612 1714387607 1764285189 13548008 17004688 6025132 7747473 1737505621 1795774962 1234809 1660168 0 0 609286376 704542867 0 0 0 1071651556 1096470026 1682172741 1802673061 55332880 -6898099 1934393445 1951468151 875307080 832972853 1059086365 1118495298 X SEE SCHEDULE O FOR CONTINUATIONTHE ORGANIZATION 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. 0 0 1609298706 1660168 1764285189 SEE SCHEDULE O FOR COMPLETE DESCRIPTIONNORTH CAROLINA BAPTIST HOSPITAL IS AN INTEGRAL PART OF WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER, A PREEMINENT ACADEMIC MEDICAL CENTER AND LEARNING HEALTH SYSTEM THAT PROMOTES BETTER HEALTH FOR ALL THROUGH COLLABORATION, EXCELLENCE AND INNOVATION. THE FOLLOWING PARAGRAPHS ARE PROVIDED TO EXPLAIN THE RELATIONSHIP OF THE FILING ORGANIZATION WITH OTHER ORGANIZATIONS WHICH TOGETHER COMPRISE "WAKE FOREST BAPTIST HEALTH," THE NAME NOT OF ANY ONE CORPORATE ENTITY, BUT USED GENERICALLY TO DESCRIBE A LARGE GROUP OF MOSTLY TAX-EXEMPT 501 (C)(3) ORGANIZATIONS PERFORMING VARIOUS ACADEMIC MEDICAL CENTER ACTIVITIES IN NORTHWEST NORTH CAROLINA, INCLUDING PATIENT CARE, MEDICAL RESEARCH, TECHNOLOGY TRANSFER AND MEDICAL EDUCATION. WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER (WFUBMC) IS A CORPORATION WHOSE TWO EQUAL MEMBERS ARE WAKE FOREST UNIVERSITY AND NORTH CAROLINA BAPTIST HOSPITAL (THEMSELVES NORTH CAROLINA NONPROFIT CORPORATIONS). BECAUSE THE VARIOUS ACTIVITIES DESCRIBED BELOW ARE NOT ALL PERFORMED BY EACH ORGANIZATION, THE NARRATIVE THAT FOLLOWS WILL INCLUDE DESCRIPTIONS OF ACTIVITIES THAT ARE PERFORMED BY THE FILING ORGANIZATION AND BY A RELATED (OR UNRELATED BUT AFFILIATED) ORGANIZATION; THEY ARE AGAIN PROVIDED TO ILLUSTRATE A COMPLETE PICTURE OF THE FILING ORGANIZATION'S ROLE IN THIS INTEGRATED ACADEMIC MEDICAL CENTER'S COMPREHENSIVE ACTIVITIES. WFUBMC IS NORTHWEST NORTH CAROLINA'S SOLE ACADEMIC MEDICAL CENTER, BRINGING TO THE REGION THE RESOURCES OF ONE OF AMERICA'S TOP HOSPITALS AND INNOVATIVE RESEARCH CENTERS AND A PREMIER MEDICAL SCHOOL. WFUBMC OPERATES WAKE FOREST SCHOOL OF MEDICINE, WHICH HAS A FACULTY OF 1,344, INCLUDING PHYSICIANS AND BASIC SCIENTISTS. IT ALSO OPERATES, THROUGH THE UNINCORPORATED OPERATING DIVISION KNOWN AS "WAKE FOREST BAPTIST HEALTH," A MULTI-LOCATION HEALTH SYSTEM. WAKE FOREST BAPTIST HEALTH HAS 1,535 ACUTE CARE AND REHABILITATION BEDS OPERATIVE ACROSS THE SYSTEM, WHICH ENCOMPASSES ITS MAIN CAMPUS (885 BEDS), WAKE FOREST BAPTIST HEALTH LEXINGTON MEDICAL CENTER (94 BEDS), WAKE FOREST BAPTIST HEALTH DAVIE MEDICAL CENTER (50 BEDS), WAKE FOREST BAPTIST HEALTH WILKES MEDICAL CENTER (130 BEDS), ALLEGHANY HEALTH (25 BEDS) AND WAKE FOREST BAPTIST HEALTH HIGH POINT MEDICAL CENTER (351 BEDS), WHICH JOINED THE WAKE FOREST BAPTIST HEALTH SYSTEM IN FISCAL YEAR 2019. OVERALL, WAKE FOREST BAPTIST HEALTH SERVES A 24-COUNTY REGION IN NORTHWESTERN NORTH CAROLINA AND SOUTHWESTERN VIRGINIA AND ALSO DRAWS PATIENTS FROM ACROSS THE NATION FOR SELECT SERVICES.WFUBMC IS THE DRIVING FORCE BEHIND THE ESTABLISHMENT OF WAKE FOREST INNOVATION QUARTER, A GROWING URBAN-BASED DISTRICT FOR RESEARCH, BUSINESS AND EDUCATION IN BIOMEDICAL SCIENCE, INFORMATION TECHNOLOGY, CLINICAL SERVICES AND ADVANCED MATERIALS LOCATED IN DOWNTOWN WINSTON-SALEM. HOME TO MORE THAN 176 COMPANIES, FIVE LEADING INSTITUTIONS, MORE THAN 3,700 WORKERS AND MORE THAN 1,400 STUDENTS AND 8,000 WORKFORCE TRAINEE PARTICIPANTS, THE INNOVATION QUARTER CURRENTLY COMPRISES MORE THAN 2 MILLION SQUARE FEET OF OFFICE, LABORATORY AND EDUCATIONAL SPACE ON ITS MORE THAN 200 DEVELOPABLE ACRES. WFUBMC AND WRMC HOSPITAL OPERATING CORPORATION (DBA WAKE FOREST BAPTIST HEALTH WILKES REGIONAL MEDICAL CENTER) BEGAN ITS INITIAL 30-YEAR LEASE OF WILKES REGIONAL MEDICAL CENTER ON JULY 1, 2017, AFTER OFFICIALLY COMPLETING AN AGREEMENT WITH THE TOWN OF NORTH WILKESBORO, NORTH CAROLINA. UNDER THE TERMS OF THE INITIAL 30-YEAR LEASE AGREEMENT, WAKE FOREST BAPTIST HEALTH WILL INVEST $238 MILLION IN SUPPORT OF WILKES REGIONAL MEDICAL CENTER, THE TOWN OF NORTH WILKESBORO, THE WILKES COMMUNITY AND PATIENTS SERVED IN THE REGION.WFUBMC AND UNC HEALTH CARE, THE FORMER PARENT ORGANIZATION OF HIGH POINT REGIONAL HEALTH, SIGNED A LETTER OF INTENT IN OCTOBER 2017 THAT WOULD ALLOW WFUBMC TO ACQUIRE AND INTEGRATE HIGH POINT REGIONAL AND ITS AFFILIATES INTO THE WAKE FOREST BAPTIST HEALTH SYSTEM DURING THE FIRST QUARTER OF FISCAL YEAR 2019.IN FEBRUARY 2018, WFUBMC PARTNERED WITH HUGH CHATHAM MEMORIAL HOSPITAL TO OWN AND OPERATE ALLEGHANY HEALTH IN SPARTA, N.C. IT ALSO ENTERED INTO A PARTNERSHIP WITH ALLEGACY FEDERAL CREDIT UNION TO ESTABLISH WELLQ, A MEMBERSHIP-BASED SERVICE, LOCATED IN INNOVATION QUARTER IN DOWNTOWN WINSTON-SALEM, DESIGNED TO IMPROVE BOTH THE PHYSICAL AND FINANCIAL WELL-BEING OF ITS MEMBERS.IN JUNE 2018, WAKE FOREST BAPTIST HEALTH LEXINGTON MEDICAL CENTER BROKE GROUND ON A NEW 26,500-SQUARE-FOOT, $31.5 MILLION SURGICAL FACILITY. THIS FACILITY INCLUDES FOUR OPERATING ROOMS, A 10-BAY POST-ANESTHESIA CARE UNIT, UROLOGY PROCEDURE ROOM, WAITING AREA AND CONSULTATION ROOMS. THE FOUR EXISTING OPERATING ROOMS WILL BE CONVERTED TO PROCEDURE ROOMS.SIGNIFICANT GRANTS AWARDED TO WAKE FOREST UNIVERSITY HEALTH SCIENCES DURING FISCAL YEAR 2018 INCLUDED A FIVE-YEAR, $9.2 MILLION GRANT FROM THE NATIONAL CANCER INSTITUTE FOR ITS SCIENTISTS TO CONTINUE THEIR WORK TO DEVELOP NEW TREATMENTS FOR GLIOBLASTOMA, AN AGGRESSIVE BRAIN CANCER; A GRANT FROM THE NATIONAL INSTITUTES OF HEALTH (NIH) WORTH AN ESTIMATED $8 MILLION OVER FIVE YEARS TO ESTABLISH A NEW CENTER FOR RESEARCH INTO ALCOHOL ADDICTION; AND TWO FIVE-YEAR GRANTS FROM THE NIH WORTH MORE THAN $5 MILLION COMBINED TO PROSPECTIVELY STUDY THE EFFECTS OF A GENETIC VARIATION IN ORGAN DONORS THAT APPEARS TO CONTRIBUTE TO SURVIVAL OF KIDNEYS AFTER TRANSPLANTATION. 1. CLINICAL SERVICES THE CLINICIANS AND RESEARCH SCIENTISTS OF WAKE FOREST BAPTIST HEALTH ARE NATIONALLY RECOGNIZED FOR CLINICAL EXCELLENCE AND INTERNATIONALLY KNOWN FOR PIONEERING RESEARCH AND CLINICAL INNOVATION. ITS CLINICAL ENTERPRISE OFFERS EXPERTISE IN MORE THAN 100 AREAS OF MEDICINE, ENCOMPASSING COMPREHENSIVE PREVENTIVE AND HIGHLY SPECIALIZED CARE FOR ALL AGES. THE MEDICAL CENTER NETWORK INCLUDES THE 167-BED COMPREHENSIVE CANCER CENTER AND THE 144-BED BRENNER CHILDREN'S HOSPITAL, BOTH OF WHICH ARE ON THE MAIN CAMPUS IN WINSTON-SALEM, AS WELL AS COMMUNITY HOSPITALS IN DAVIDSON, DAVIE AND WILKES COUNTIES. ACROSS ITS SERVICE AREA OF NORTHWEST NORTH CAROLINA AND SOUTHWEST VIRGINIA, WAKE FOREST BAPTIST HEALTH HAS 6 EMERGENCY DEPARTMENTS; THREE URGENT CARE CENTERS; 83 PRIMARY CARE CLINICS; 274 SPECIALTY CLINICS; 18 OUTPATIENT DIALYSIS CENTERS AND ONE FREE-STANDING DIALYSIS ACCESS CENTER; AND ONE FREESTANDING IMAGING AND ENDOSCOPY CENTER. THE WAKE FOREST BAPTIST HEALTH SYSTEM EMPLOYS MORE THAN 2,000 PHYSICIANS, 4,249 REGISTERED NURSES, AND 732 RESIDENTS AND FELLOWS. IT HAS A TOTAL STAFF OF 14,430 ON THE MEDICAL CENTER CAMPUS IN WINSTON-SALEM AND 19,220 WITHIN THE WAKE FOREST BAPTIST HEALTH SYSTEM. OVERALL IN FY 2018, WAKE FOREST BAPTIST HEALTH HAD 60,023 INPATIENT ADMISSIONS, 187,510 EMERGENCY DEPARTMENT VISITS AND 1,984,198 CLINIC VISITS (AMBULATORY VISITS AND OUTPATIENT DEPARTMENTS).2. OUTREACHWAKE FOREST BAPTIST HEALTH CONTINUES A BROAD-BASED EFFORT TO REACH UNDERSERVED POPULATIONS ACROSS ITS SERVICE AREA. WAKE FOREST BAPTIST HEALTH'S ANNUAL COMMUNITY BENEFITS REPORT REFLECTS THIS COMMITMENT. IN FISCAL 2018, WAKE FOREST BAPTIST HEALTH SPENT $450.6 MILLION TO SUPPORT THESE AREAS: SUBSIDIZED HEALTH COSTS COMMUNITY HEALTH OUTREACH CHARITY CARE RESEARCH EDUCATION UNREIMBURSED COSTS OF GOVERNMENT PROGRAMSONE ANCHOR OF OUTREACH FOR WAKE FOREST BAPTIST HEALTH IS ITS DOWNTOWN HEALTH PLAZA, A FULL-SERVICE, OUTPATIENT MEDICAL CLINIC THAT SERVES MANY OF FORSYTH COUNTY'S UNINSURED AND UNDERINSURED RESIDENTS WITH A STATE-OF-THE-ART MEDICAL HOME. IN ADDITION TO CLINICAL CARE, THE DOWNTOWN HEALTH PLAZA OFFERS COMMUNITY HEALTH FAIRS, DIABETES EDUCATION AND A CENTERING PREGNANCY PROGRAM THAT IS REDUCING THE INCIDENCE OF LOW BIRTH WEIGHT BABIES. ALTOGETHER, 60,877 PATIENT VISITS WERE RECORDED AT THE DOWNTOWN HEALTH PLAZA IN THE 2018 FISCAL YEAR, AND ANOTHER 10,697 VISITS WERE RECORDED AT WINSTON EAST PEDIATRICS, A NEARBY WAKE FOREST BAPTIST HEALTH CARE FACILITY SERVING THE UNINSURED AND UNDERINSURED.WAKE FOREST BAPTIST HEALTH'S PROGRAMS AND PARTNERSHIPS REFLECT INNOVATIVE EFFORTS TO REACH UNDERSERVED POPULATIONS. THEY INCLUDE:_ REGULAR COMMUNITY-BASED HEALTH CLINICS, INCLUDING: THE WEEKLY DELIVERING EQUAL ACCESS TO CARE (DEAC) CLINIC AT THE COMMUNITY CARE CENTER IN WINSTON-SALEM, THE MONTHLY TRIAD FREE HEALTH CLINIC AT COMMUNITY MOSQUE IN WINSTON-SALEM, THE MONTHLY GRACE CLINIC AT NEW LIGHT MISSIONARY BAPTIST CHURCH IN WINSTON-SALEM AND THE ANNUAL SHARE THE HEALTH FAIR AT THE DOWNTOWN HEALTH PLAZA IN WINSTON-SALEM. THESE CLINICS, SPONSORED BY PRIVATE ORGANIZATIONS AND CHURCHES WITH VOLUNTEER ASSISTANCE FROM WAKE FOREST BAPTIST HEALTH PHYSICIANS, NURSES, MEDICAL STUDENTS AND OTHERS, ATTRACT THOUSANDS OF PEOPLE TO SCREENINGS FOR ACUTE AND CHRONIC CONDITIONS. _ THE SCHOOL OF MEDICINE'S PHYSICIAN ASSISTANT (PA) PROGRAM, WHICH IS INCREASING THE NUMBER OF PAS WORKING IN PRIMARY CARE IN NORTH CAROLINA'S RURAL APPALACHIAN COUNTIES THROUGH ITS SECOND CAMPUS AT APPALACHIAN STATE UNIVERSITY IN BOONE. _ FAITHHEALTHNC, AN INITIATIVE THAT CONNECTS THE CARING STRENGTHS OF CONGREGATIONS, THE CLINICAL EXPERTISE OF PROVIDERS AND A NETWORK OF COMMUNITY RESOURCES TO EASE THOSE ON THE JOURNEY TO HEALTH AND HEALING, STRENGTHENING COMMUNITIES IN THE PROCESS. ONE EXAMPLE OF THIS WORK IS A FAITHHEALTH PROGRAM IN WHICH WORKERS KNOWN AS SUPPORTERS OF HEALTH CONNECT PATIENTS WITH RESOURCES THEY NEED AFTER A HEALTH INCIDENT OR HOSPITALIZATION. THE GOAL IS TO HELP THESE PATIENTS AVOID READMISSION, IN PARTICULAR TO THE EMERGENCY DEPARTMENT. 3. EDUCATIONAL MISSION AND ACCOMPLISHMENTS THE CONSTITUENT ORGANIZATIONS OF WAKE FOREST BAPTIST HEALTH OPERATE A BROAD RANGE OF EDUCATIONAL PROGRAMS THAT TEACH AND GRADUATE SKILLED HEALTH PRACTITIONERS. IT ATTRACTS SOME OF THE WORLD'S MOST COMPETITIVE MEDICAL STUDENTS, RESIDENTS AND FELLOWS, AS WELL AS STUDENTS IN CLINICAL PASTORAL CARE, NURSE ANESTHESIA AND OTHER AREAS. IN THE MOST RECENT REPORTING PERIOD, FISCAL 2017, WAKE FOREST BAPTIST HEALTH INVESTED MORE THAN $109 MILLION IN THE EDUCATION OF TOMORROW'S HEALTH CARE AND BIOMEDICAL LEADERS AND IN RESEARCH FUNDING NOT COVERED BY OUTSIDE SOURCES. SUCH INVESTMENTS SUPPORT THE TRAINING OF HUNDREDS OF STUDENTS. IN FISCAL 2018, THOSE INCLUDED 510 MD STUDENTS, 732 PHYSICIAN RESIDENTS AND FELLOWS, 319 GRADUATE STUDENTS, 173 PHYSICIAN ASSISTANTS, 48 NURSE ANESTHESIA STUDENTS, 22 PASTORAL CARE CHAPLAIN RESIDENTS AND INTERNS, AND 63 STUDENTS IN THE VIRGINIA TECH WAKE FOREST UNIVERSITY SCHOOL OF BIOMEDICAL ENGINEERING AND SCIENCES. IN ADDITION, THE NORTHWEST AREA HEALTH EDUCATION CENTER, PART OF WAKE FOREST SCHOOL OF MEDICINE, OFFERED 2,460 CONTINUING PROFESSIONAL DEVELOPMENT ACTIVITIES FOR PRACTICING HEALTH CARE PROFESSIONALS THAT DREW 42,076 PARTICIPANTS FROM THROUGHOUT THE REGION. 1609298706 1 1 0 1 0 0 0 0 0 1 1 0 1 0 1 1 0 1 0 0 1 0 0 0 0 0 1 1 1 1 1 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 1 0 0 1 380 0 1 0 1 1 0 0 0 0 0 0 0 0 0 X 9 8 1 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 X JOSEPH DOLAN 3367164445 MEDICAL CENTER BLVD WINSTON SALEM NC 27157 X ARTHUR A GIBEL VICE CHAIRMAN 2.00 6.00 X X 0 0 0 A LEE HERRING TRUSTEE 2.00 6.00 X 0 0 0 WILLIAM C WARDEN JR TRUSTEE 2.00 4.00 X 0 0 0 SHEREE B WATSON CHAIRMAN 2.00 6.00 X X 0 0 0 STEPHEN L ROBERTSON TRUSTEE 2.00 6.00 X 0 0 0 EDWIN L WELCH JR TRUSTEE 2.00 2.00 X 0 0 0 GEORGE D RENFRO TRUSTEE 2.00 6.00 X 0 0 0 R MICHAEL WELLS TRUSTEE 2.00 2.00 X 0 0 0 JULIE A FREISCHLAG MD CEO, DEAN 16.20 23.80 X X 992415 0 208694 J MCLAIN WALLACE JR SVP, GEN COUNSEL & SEC 29.70 10.30 X 0 689120 71877 KAREN H HUEY VP FACILITIES 21.50 18.50 X 0 398461 59685 ERIC TOMLINSON CHIEF INNOV OFF (TO 3-1-18) 5.20 34.80 X 694716 0 35598 BRADLEY A CLARK EVP, CFO, TREASURER 19.30 20.70 X 0 483113 170979 TERRY G WILLIAMS EVP CH STRATEGY OFFICER 26.70 13.30 X 0 739261 176980 KEVIN P HIGH MD PRESIDENT, HEALTH SYSTEM 23.70 16.30 X 752824 0 169813 DEETTE M EMON VP & CIO (TO 7/31/17) 22.50 17.50 X 0 356983 28522 ROBERT GFELLER EVP, EXT REL & CH MKTG OFF 20.00 20.00 X 0 654099 148104 LILICIA BAILEY SVP, CHIEF PEOPLE OFFICER 32.60 7.40 X 0 601203 131832 WILLIAM D SHOWALTER SVP, CIO (FROM 8/15/17) 30.00 10.00 X 0 214093 28128 MICHAEL T WAID SVP HLTH SYS OPS & INTEG 33.70 6.30 X 0 517582 130154 CATHLEEN WHEATLEY CHIEF NURSE EXEC, VP CLINI 38.60 1.40 X 0 529421 120155 CHARLES R VIGNOS VP MANAGED CARE 37.80 2.20 X 0 489686 111119 ERWIN STAINBACK VP, CLINICAL OPERATIONS 40.00 0.00 X 0 470915 21977 DENISE CHAMBERLAIN AVP, ASST CFO 40.00 0.00 X 0 494591 28133 JOANNE C RUHLAND FORMER OFFICER 25.00 15.00 X 0 372403 42972 NORMAN D POTTER JR FORMER OFFICER (2/28/17) 0.00 0.00 X 530131 0 9972 CHERYL EH LOCKE FORMER OFFICER 0.00 0.00 X 0 485469 30450 RUSSELL M HOWERTON MD FORMER OFFICER 20.70 19.30 X 809126 0 54231 JOHN D MCCONNELL MD FORMER OFFICER (4/26/17) 0.00 40.00 X 1860397 0 289177 EDWARD ABRAHAM MD FORMER OFFICER (6/30/17) 0.00 0.00 X 650802 0 30994 CHAD A ECKES FORMER OFFICER (6/11/17) 0.00 0.00 X 0 987032 33896 6290411 8483432 2133442 0 1 1 1 MEDTRONIC USA INC 710 MEDTRONIC PARKWAY MINNEAPOLIS MN 55432 MEDICAL PRODUCTS 17929553 MEDLINE INDUSTRIES INC THREE LAKES DRIVE NORTHFIELD IL 60093 MEDICAL PRODUCTS 10970027 STRYKER CORPORATION 2825 AIRVIEW BLVD PORTAGE MI 49002 MEDICAL TECHNOLOGY 8029937 ARAMARK 1101 MARKET STREET PHILADELPHIA PA 19107 FOOD/FACILITY/UNIFORM SERVICES 7929175 BOSTON SCIENTIFIC CORPORATION 300 BOSTON SCIENTIFIC WAY MARLBOROUGH MA 01752 MEDICAL PRODUCTS 7761805 295 3132675 1650062 1954875 22097 6737612 PATIENT SERVICE REVENUE 621990 1749023854 1749023854 MEDICAL/LAB SERVICE 621500 7418714 3062250 4356464 DIETARY 722210 6138637 5892949 245688 TUITION 611600 1703984 1703984 1764285189 17678786 2641255 15037531 6258092 2124356 4133736 4133736 4133736 192746 481352 -192746 -481352 -674098 -674098 PARKING FEES 900099 3554300 3554300 GIFT SHOP REVENUE 453220 59437 59437 3613737 1795774962 1759683037 7243407 22110906 X 1637768 1637768 22400 22400 19598989 8249006 11349983 533800541 449032958 84767583 32092573 26518553 5574020 79767849 65913317 13854532 39282915 32460036 6822879 4150253 1739050 2411203 504845 504845 564230 564230 3469766 3469766 279356072 245405464 33950608 4882549 1810015 3072534 49601395 31815778 17785617 53196858 43621424 9575434 16866327 16023011 843316 1384831 772589 612242 1607615 993182 614433 18440998 18174362 266636 83965781 83965781 5231864 5179545 52319 MEDICAL SUPPLIES 369673525 369673063 462 BAD DEBT 156577093 156577093 0 PROVIDER ASSESSMENT 45680315 45680315 0 INCOME TAXES 1315709 0 1315709 1802673061 1609298706 193374355 0 107549664 35990583 0 717634 258930978 294257046 20600547 191594 35477898 39205388 15462829 30780515 1684397969 1045157547 646151593 639240422 634322349 680713308 108363714 75451497 99707452 154920164 7826421 0 1934393445 1951468151 268727950 268834406 469287569 458462586 11749528 11749528 125542033 93926333 875307080 832972853 X 1052738469 1108809879 3786499 7071156 2561397 2614263 1059086365 1118495298 1934393445 1951468151 X -6898099 -380271 66687303 X 0 1 X 1 1 1 X 0 1 0 0 0 0 1 369411 0 1 194819 564230 0 PART II-B, LINE 1: SUPPORT OF GOVT. RELATIONS OFFICE AND PRORATA PORTION OF DUES PAID TO STATE AND LOCAL 501(C)(6) ORGANIZATIONS THAT REPRESENTS LOBBYING ON BEHALF OF ITS MEMBERS. THE MEDICAL CENTER'S OFFICE OF GOVERNMENT RELATIONS WAS ACTIVELY INVOLVED WITH SEVERAL FEDERAL AND STATE ISSUES. THE OFFICE ASSISTED IN DEVELOPING POLITICAL ADVOCACY STRATEGIES REGARDING THE EVALUATION OF THE 340B PROGRAM AND SUBMITTED A COMMENT LETTER TO THE CENTER FOR MEDICARE AND MEDICAID SERVICES (CMS) REGARDING REDUCTIONS TO MEDICARE PART B 340B PAYMENTS; MEDICAID REFORM (BLOCK GRANTS) AND OTHER PROVISIONS IN THE GRAHAM CASSIDY--AFFORDABLE CARE ACT (ACA) REPEAL AND REPLACE BILL; AND VARIOUS PIECES OF LEGISLATION RELATED TO: INSURANCE MARKET STABILIZATION; RE-EVALUATION OF THE MEDICARE HOSPITAL STAR RATINGS PROGRAM; 21ST CENTURY CURES IMPLEMENTATION ISSUES; CHILDREN'S HEALTH INSURANCE PROGRAM (CHIP) REAUTHORIZATION AND FUNDING; DELAY OF THE ACA MEDICAID DISPROPORTIONATE SHARE PAYMENT REDUCTIONS; HIGHER EDUCATION ACT REAUTHORIZATION AND FINANCIAL AID SIMPLIFICATION AS IT RELATES TO MEDICAL STUDENTS; BIODEFENSE AND PREPAREDNESS REAUTHORIZATION ACT; ENDOWMENT TAX, UBIT AND OTHER PROVISIONS IN THE TAX CUTS AND JOBS ACT; MEDICARE EXTENDERS; NIH FUNDING AND OPIOID EPIDEMIC FUNDING IN THE OMNIBUS SPENDING BILL; FUNDING FOR NEW GRADUATE MEDICAL EDUCATION RESIDENCY SLOTS TO COMBAT THE OPIOID AND SUBSTANCE ABUSE EPIDEMIC; CHANGES TO THE PROVISIONS OF THE MEDICARE ACCESS AND CHIP REAUTHORIZATION ACT (MACRA); TESTIMONY BEFORE THE US SENATE ARMED SERVICES COMMITTEE REGARDING HEAD TRAUMA AND CONCUSSION STUDIES AND HOW THESE FINDINGS COULD ASSIST VETERANS WITH POST-TRAUMATIC STRESS DISORDERS; BILLS TO INCREASE PHYSICIAN RESIDENCY SLOTS BY 15,000 AT TEACHING HOSPITALS OVER THE NEXT FIVE YEARS, AND THE FY2019 INPATIENT PROSPECTIVE PAYMENT SYSTEM (IPPS) RULE. STAFF WORKED ON THE FY2019 BUDGET; AND THE CY2019 MEDICARE PHYSICIAN FEE SCHEDULE AND OTHER CHANGES TO MEDICARE PART B REIMBURSEMENT POLICIES AND ON MANY OF THE FY2019 APPROPRIATIONS BILLS AND PROPOSED LEGISLATION AND REGULATIONS THAT WERE INTRODUCED, INCLUDING THOSE PROPOSED BY THE DEPARTMENT OF HEALTH AND HUMAN SERVICES REGARDING THE NATIONAL INSTITUTES OF HEALTH (NIH) BUDGET, AND VETERANS AFFAIRS (VA) RESEARCH AND MEDICAL CARE FUNDING TO EASE ACCESS FOR VETERANS SEEKING HEALTH CARE FROM NON-VA PROVIDERS. AT THE STATE LEVEL, EFFORTS WERE RELATED TO FUNDING FOR THE WAKE FOREST ARMED FORCES INSTITUTE FOR REGENERATIVE MEDICINE (AFIRM); STOPPING LEGISLATION TO REPEAL THE CERTIFICATE OF NEED LAW; RESTRUCTURING OF NC MEDICAID GRADUATE MEDICAL EDUCATION FUNDING ALLOCATION AS IT RELATES TO RURAL AREAS; OFFICE OF MEDICAL EXAMINER FACILITY FUNDING; AND AMENDMENTS TO THE NC MEDICAID 1115 WAIVER BY NC DEPARTMENT OF HEALTH AND HUMAN SERVICES AND ITS IMPACT TO MEDICAID REFORM RESTRUCTURING IMPLEMENTATION. 6347896 3538532 260041 461050 9685419 5675092 692865 347227 367288 6347896 5763723 1709682 -60213 1738100 5675092 5007181 2132638 26445 1402541 5763723 4768404 1443959 389849 1595031 5007181 0.26990 0.73010 0 0 34842477 34842477 947843716 570686617 377157099 2201485 938218 1263267 613178891 449931560 163247331 86331400 23601152 62730248 639240422 INVESTMENTS IN SUBSIDIARIES 154920164 C 154920164 PLI & OTHER LIABILITIES 26416703 PENSION LIABILITIES 64471780 CAPITAL LEASE 3037850 93926333 X PART V, LINE 4: THE HOSPITAL'S ENDOWMENT FUNDS ARE USED TO PROVIDE SUPPORT FOR EDUCATION, SCHOLARSHIPS, INDIGENT CARE, AND OTHER DEPARTMENTAL FUNDING. PART X, LINE 2: THE ORGANIZATION HAS EVALUATED UNCERTAIN TAX POSITIONS FOR ITS FISCAL YEARS ENDED JUNE 30, 2018 AND 2017, INCLUDING A QUANTIFICATION OF TAX RISK IN AREAS SUCH AS UNRELATED BUSINESS TAXABLE INCOME AND THE TAXATION OF ITS FOR-PROFIT SUBSIDIARIES. THIS EVALUATION DID NOT HAVE A MATERIAL EFFECT ON THE ORGANIZATION'S FINANCIAL STATEMENTS FOR THE YEARS ENDED JUNE 30, 2018 AND 2017. CENTRAL AMERICA AND THE CARIBBEAN - ANTIGUA & BARBUDA, ARUBA, BAHAMAS, 0 0 INVESTMENTS 28349725 0 0 0 0 0 0 28349725 0 28349725 1 0 1 0 0 0 1 1 1 X 1 X 1 1 1 0 1 1 41989246 9681642 32307604 0.01960 274459990 249638164 24821826 0.01510 58412869 45847429 12565440 0.00760 374862105 305167235 69694870 0.04230 5160770 0 5160770 0.00310 103261677 22028618 81233059 0.04930 6694997 0 6694997 0.00410 0 0 0.00000 2386675 0 2386675 0.00140 117504119 22028618 95475501 0.05790 492366224 327195853 165170371 0.10020 920221 920221 0.00060 146833 146833 0.00010 1067054 1067054 0.00070 1 38914895 498514986 590889765 -92374779 X 1 1 1 1 NORTH CAROLINA BAPTIST HOSPITAL MEDICAL CENTER BLVD WINSTON SALEM NC 27157 H0011 X X X X NORTH CAROLINA BAPTIST HOSPITAL 1 0 0 1 X X X X X X X X 15 1 1 0 1 X SEE PART V, PAGE 7 X 1 16 1 SEE PART V, PAGE 7 0 1 X 200.000000000000 400.000000000000 X X X X X X 1 1 X X X 1 X WWW.WAKEHEALTH.EDU/FINANCIAL-ASSISTANCE.HTM X WWW.WAKEHEALTH.EDU/FINANCIAL-ASSISTANCE.HTM X WWW.WAKEHEALTH.EDU/FINANCIAL-ASSISTANCE.HTM X X X X X X X 1 X 0 X X X X 1 X 0 0 NORTH CAROLINA BAPTIST HOSPITAL PART V, SECTION B, LINE 5: COMMUNITY INPUT WAS OBTAINED THROUGH THE FOLLOWING SOURCES: (1) FORSYTH COUNTY RESIDENT SURVEYS CONDUCTED BY FORSYTH COUNTY HEALTH DEPARTMENT; (2) EIGHT FAITHHEALTH NC (A DEPARTMENT OF THE HOSPITAL) COMMUNITY ASSET MAPPING WORKSHOPS WHICH SOUGHT OPINIONS OF BOTH HEALTH PROVIDERS AND HEALTH SEEKERS IN FORSYTH COUNTY'S MOST VULNERABLE COMMUNITIES, INCLUDING FOUR WORKSHOPS HELD SPECIFICALLY IN HISPANIC COMMUNITIES; AND (3) COMMENTS FROM PRIOR COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY.ADDITIONALLY, MORE THAN TEN SECONDARY DATA SOURCES WERE REVIEWED, INCLUDING WAKE FOREST BAPTIST MEDICAL CENTER COMMUNITY DASHBOARD/HEALTH COMMUNITIES, COUNTY HEALTH RANKINGS & ROADMAPS, 2014 STATE OF THE COUNTY HEALTH, US CENSUS BUREAU, NC CENTER FOR HEALTH STATISTICS, CENTERS FOR DISEASE CONTROL, BEHAVIOR RISK FACTOR SURVEILLANCE SYSTEM, HEALTHY PEOPLE 2020, HEALTHY NC 2020, CENTERS FOR MEDICARE/MEDICAID SERVICES, FORSYTH FUTURES ACCESS TO HEALTH CARE FORSYTH COUNTY REPORT 2014, FORSYTH COUNTY'S COMMUNITY FOOD SYSTEM 2013, AND STATUS OF HOMELESSNESS IN FORSYTH COUNTY 2014. NORTH CAROLINA BAPTIST HOSPITAL PART V, SECTION B, LINE 6A: THE HOSPITAL'S MOST RECENT CHNA WAS CONDUCTED IN COLLABORATION WITH LEXINGTON MEDICAL CENTER AND DAVIE MEDICAL CENTER. BOTH DAVIE MEDICAL CENTER AND LEXINGTON MEDICAL CENTER ARE AFFILIATE HOSPITALS OF WAKE FOREST BAPTIST MEDICAL CENTER. NORTH CAROLINA BAPTIST HOSPITAL PART V, SECTION B, LINE 7D: N/APART V, SECTION B, LINE 7A:WWW.WAKEHEALTH.EDU/HCI/NEEDS-ASSESSMENT-AND-IMPLEMENTATION-REPORTS.HTMPART V, SECTION B, LINE 10A:WWW.WAKEHEALTH.EDU/HCI/NEEDS-ASSESSMENT-AND-IMPLEMENTATION-REPORTS.HTM NORTH CAROLINA BAPTIST HOSPITAL PART V, SECTION B, LINE 11: THE MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT ("CHNA") 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) FINANCIAL COST OF HEALTH CARE AND PRESCRIPTION DRUGS, (5) RACISM, (6) HEALTHCARE RESOURCES AND EDUCATION, (7) LACK OF INSURANCE AND UNDOCUMENTED PATIENTS, AND (8) COMPASSIONATE CARE.NORTH CAROLINA BAPTIST HOSPITAL (NCBH) 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. NCBH PLANS TO PROVIDE COMMUNITY BENEFIT PROGRAMS RESPONSIVE TO THESE HEALTH NEEDS THROUGH ITS APPROVED CHNA IMPLEMENTATION STRATEGY. THE NCBH 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 LACK OF INDIVIDUAL HEALTH INSURANCE AND HIGH COSTS DECREASE ACCESS TO QUALITY HEALTH CARE AND CAN LEAD TO UNMET HEALTH NEEDS. THE HOSPITAL'S CURRENT STRATEGIES INCLUDE:--ENCOURAGING APPROPRIATE EMERGENCY DEPARTMENT UTILIZATION THROUGH CARE COORDINATION ACROSS THE COMMUNITY, HOSPITAL, AND PRIMARY CARE THROUGH 1.) EXPLORATION OF PROGRAMS TO COORDINATE CARE FOR THE CHARITY CARE POPULATION, ADDRESSING NON-EMERGENT CARE USE AND SEEKING FUNDING TO SUPPORT RECOMMENDED INTERVENTION, AND 2.) CONTINUATION OF SUPPORT FOR THE CAREPLUS CARE COORDINATION MODEL FOR MEDICAID/SELF-PAY/UNINSURED PATIENTS IN THE DOWNTOWN HEALTH PLAZA COMMUNITY.--IMPROVING ACCESS TO COMMUNITY CENTERED SOCIAL AND HEALTH EDUCATION SERVICES AND REGULAR SOURCES OF HEALTH CARE THROUGH 1.) CONTINUED NEGOTIATIONS WITH NOVANT HEALTH TO CREATE A PRIMARY CARE CLINIC IN EAST WINSTON FOR THE SELF-PAY/UNINSURED/MEDICAID POPULATION; 2.) CONTINUED EXPLORATION OF MOBILE MEDICAL CLINIC IN LOW ACCESS WFBH SERVICE AREAS; 3.) DEVELOPMENT OF PILOT PROGRAM FOR CHARITY CARE PATIENTS WITH CHRONIC CONDITIONS FOR CARE MANAGEMENT SERVICES THROUGH LINKAGE WITH PRIMARY CARE; AND 4.) CONTINUED COMMUNITY ENGAGEMENT SUPPORT THROUGH 5 SUPPORTERS OF HEALTH, 311 CONGREGATION PARTNERS, 25 CONNECTORS ACROSS THE SERVICE AREA, AND 7 FAITHHEALTHNC FELLOWS.--IMPROVING ACCESS TO HEALTH INSURANCE THROUGH PARTNERSHIP WITH HEALTHCARE ACCESS LEADERS TO ASSIST IN ENROLLING COMMUNITY MEMBERS IN AVAILABLE HEALTH INSURANCE PLANS--IMPROVING ACCESS TO TRANSPORTATION TO HEALTH CARE SERVICES, THROUGH 1.) RAISING AWARENESS OF EXISTING TRANSPORTATION SERVICES FOR MEDICAID PATIENTS AMONG PROVIDERS AND THE COMMUNITY, AND 2.) EXPLORING FREE TRANSPORTATION INITIATIVES THROUGH UBERCENTRAL OR OTHER SIMILAR MODEL2. CHRONIC DISEASE MANAGEMENTNCBH 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 CAPACITY OF COMMUNITY BASED ORGANIZATIONS AND HEALTH CARE PROVIDERS TO SUPPORT EFFORTS RELATED TO CHRONIC DISEASE PREVENTION AND MANAGEMENT THROUGH 1.) CONTINUING TO SUPPORT FAITHHEALTHNC COMMUNITY WORKERS, 2.) INCREASING COMMUNITY AND HEALTHCARE PROVIDER ACCESS TO EXISTING CHRONIC DISEASE MANAGEMENT RESOURCES BY CENTRALIZING AND DISTRIBUTING INFORMATION, AND 3.) EXPANDING CHRONIC DISEASE SELF-MANAGEMENT PROGRAMS OFFERED BY NCBH THROUGH EMMI SOFTWARE.--PROVIDING EDUCATION AND SUPPORT PROGRAMS TO REDUCE DIABETES PREVALENCE AND IMPROVE DIABETES MANAGEMENT THROUGH 1.) REFERRING DIABETIC PATIENTS AT DOWNTOWN HEALTH PLAZA TO DIABETES PROGRAMS OFFERED BY NCBH AND OTHER COMMUNITY ORGANIZATIONS, 2.) CONTINUING TO PROVIDE DIABETIC EDUCATION AT DOWNTOWN HEALTH PLAZA AND THE ENDOCRINE CLINIC, 3.) CONTINUING TO PROVIDE BESTHEALTH DIABETES PREVENTION AND NUTRITION EDUCATION TO THE COMMUNITY, AND 4.) EXPLORING PARTNERSHIP WITH UNITED WAY 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.) CONTINUING TO SUPPORT BRENNER FIT TO INCREASE EDUCATION AND AWARENESS HEALTHY LIFESTYLE CHOICES FOR UNINSURED/MEDICAID PATIENTS AND FAMILIES, 2.) PROMOTING HEALTHY EATING AND WEIGHT MANAGEMENT THROUGH EMPLOYEE WELLNESS PROGRAMS, AND 3.) PROVIDING MORE AWARENESS TO HOSPITAL PATIENTS AND EMPLOYEES REGARDING OPPORTUNITY FOR WEIGHT MANAGEMENT PROGRAMS.3. BEHAVIORAL/MENTAL HEALTH DISTRESSNCBH 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:--CONTINUING EXPANSION OF INTEGRATED CARE MODEL CURRENTLY OPERATING AT DOWNTOWN HEALTH PLAZA AND FAMILY MEDICINE PIEDMONT PLAZA;--INCREASING THE CURRENT 30+ STAFF AT THE HOSPITAL 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;--CONTINUING WORK WITH VULNERABLE POPULATIONS AND FRAGILE HOMELESS PERSONS;--DEVELOPING A PLAN TO CREATE MORE INTEGRATED BEHAVIORAL HEALTH GRADUATE MEDICAL EDUCATION OFFERINGS FOR MEDICAL STUDENTS, RESIDENTS, FACULTY AND STAFF.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. NORTH CAROLINA BAPTIST HOSPITAL 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. NORTH CAROLINA BAPTIST HOSPITAL PART V, SECTION B, LINE 16J: IN ADDITION TO THE METHODS PREVIOUSLY DESCRIBED, NORTH CAROLINA BAPTIST HOSPITAL 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. 39 2 - ALLERGY ASTHMA & IMMUNOLOGY - CLEMMONS 2311 LEWISVILLE-CLEMMONS ROAD CLEMMONS NC 27012 ALLERGY, ASTHMA & IMMUNOLOGY 3 - BREAST CARE SERVICES - CLEMMONS 2341 LEWISVILLE-CLEMMONS ROAD CLEMMONS NC 27012 BREAST CARE SERVICES 4 - BRENNER CHILDREN'S SPECIALTY SERVICES 2311 LEWISVILLE-CLEMMONS ROAD CLEMMONS NC 27012 PEDIATRIC SPECIALTIES 5 - CARDIOLOGY COUNTRY CLUB 4614 COUNTRY CLUB ROAD WINSTONSALEM NC 271043520 CARDIOLOGY 6 - COMPREHENSIVE FETAL CARE CENTER 500 SHEPHERD STREET SUITE 200 WINSTONSALEM NC 271031633 MATERNAL-FETAL MEDICINE 7 - COMPREHENSIVE REHAB - PHYSICAL MED & REH 131 MILLER STREET WINSTONSALEM NC 27103 PHYSICAL MEDICINE, SPORTS MEDICINE, REHABILITATION 8 - COMPREHENSIVE REHAB - SPECIALTY 131 MILLER STREET WINSTONSALEM NC 27103 ENDO, ENT, NEUROLOGY, PSYCHOLOGY, SURGERY, RHEUM 9 - DIABETES CENTER ADULT-CNTRY CLB MED PLZA 4610 COUNTRY CLUB ROAD WINSTONSALEM NC 271043520 ADULT DIABETES CENTER 10 - DIABETES CENTER CHLDR-CNTRY CLB MED PLZA 4610 COUNTRY CLUB ROAD WINSTONSALEM NC 271043520 PEDIATRIC DIABETES CENTER 11 - DIALYSIS ACCESS GROUP - MILLER 120 MILLER STREET STE B WINSTONSALEM NC 27103 DIALYSIS CENTER 12 - DOWNTOWN HEALTH PLAZA 1200 N MARTIN LUTHER KING JR DRIVE WINSTONSALEM NC 271013006 ADULT MEDICINE 13 - DOWNTOWN HEALTH PLAZA - SPECIALTY 1200 N MARTIN LUTHER KING JR DRIVE WINSTONSALEM NC 27101 OB/GYN, NEUROLOGY, NEPHROLOGY, DERM, CARDIOLOGY 14 - ENTHEAD & NECK SURGERY - CLEMMONS 2341 LEWISVILLE-CLEMMONS ROAD CLEMMONS NC 27012 ENT/HEAD AND NECK SURGERY 15 - HEMATOLOGY & ONCOLOGY - CLEMMONS 2311 LEWISVILLE-CLEMMONS ROAD CLEMMONS NC 27012 ONCOLOGY 16 - HEMATOLOGY & ONCOLOGY - ELKIN 401 ELDON PARKS DRIVE ELKIN NC 28621 HEMATOLOGY AND ONCOLOGY 17 - HEMATOLOGY & ONCOLOGY - PREMIER DR 4515 PREMIER DIVE HIGH POINT NC 27265 HEMATOLOGY AND ONCOLOGY 18 - INTERNAL MEDICINE SPECIALTY CLINICS 500 SHEPHERD STREET SUITE 300 WINSTONSALEM NC 271031633 IM MULTISPECIALTY CLINICS 19 - MEDICAL PLAZA COUNTRY CLUB DERMATOLOGY 4618 COUNTRY CLUB ROAD WINSTONSALEM NC 271043520 GENERAL DERMATOLOGY 20 - MEDICAL PLAZA COUNTRY CLUB GENERAL DERMA 4618 COUNTRY CLUB ROAD WINSTONSALEM NC 271043520 DERMATOLOGY & MOHS SURGERY 21 - MT AIRY HEMATOLOGY & ONCOLOGY 450 PRICE STREET MT AIRY NC 27030 HEMATOLOGY AND ONCOLOGY 22 - NCBH OUTPATIENT ENDOSCOPY CENTER LLC 100 CHARLOIS BLVD SUITE 100 WINSTONSALEM NC 27103 OUTPATIENT ENDOSCOPY 23 - NEONATOLOGY 500 SHEPHERD STREET SUITE 201 WINSTONSALEM NC 271031633 NEONATOLOGY 24 - NEUROLOGY - CLEMMONS 2341 LEWISVILLE-CLEMMONS ROAD CLEMMONS NC 27012 NEUROLOGY 25 - OBGYN CLINIC 500 SHEPHERD STREET SUITE 201 WINSTONSALEM NC 271031633 OB/GYN, GYN ONC, UROLOGICAL GYN 26 - OBSTETRICS AND GYNECOLOGY - CLEMMONS 2341 LEWISVILLE-CLEMMONS ROAD CLEMMONS NC 27012 OB/GYN 27 - PAIN CENTER BROOKSTOWN 605 COTTON STREET WINSTONSALEM NC 27101 PAIN CLINIC AND SERVICES 28 - PEDIATRICS - CLEMMONS 2311 LEWISVILLE-CLEMMONS ROAD CLEMMONS NC 27012 PEDIATRICS 29 - PEDIATRICS - DOWNTOWN HEALTH PLAZA 1200 N MARTIN LUTHER KING JR DRIVE WINSTONSALEM NC 27101 PEDIATRICS 30 - SLEEP CENTER - CLEMMONS 2341 LEWISVILLE-CLEMMONS ROAD CLEMMONS NC 27012 SLEEP MEDICINE 31 - SLEEP CENTER - SHEPHERD 500 SHEPHERD STREET SUITE 201 WINSTONSALEM NC 271031633 SLEEP MEDICINE 32 - SPINE CENTER - CLEMMONS 2341 LEWISVILLE-CLEMMONS ROAD CLEMMONS NC 27012 SPINE CENTER - CLEMMONS 33 - UNIVERSITY INTERNAL MEDICINE - CLEMMONS 2311 LEWISVILLE-CLEMMONS ROAD CLEMMONS NC 27012 INTERNAL MEDICINE & PRIMARY CARE 34 - UNIVERSITY INTERNAL MEDICINE COUNTRY CLU 4614 COUNTRY CLUB ROAD WINSTONSALEM NC 271043520 INTERNAL MEDICINE 35 - VEIN SERVICES - CLEMMONS 2341 LEWISVILLE-CLEMMONS ROAD CLEMMONS NC 27012 VEIN SERVICES 36 - WAKE FOREST BAPTIST HEALTH FAMILY MEDICI 1920 W FIRST STREET WINSTONSALEM NC 271044220 FAMILY MEDICINE 37 - WAKE FOREST UNIVERSITY BAPTIST IMAGING 265 EXECUTIVE PARK BLVD WINSTONSALEM NC 27103 IMAGING CENTER 38 - WINSTON EAST PEDIATRICS OF BAPTIST HOSP 2295 EAST 14TH STREET WINSTONSALEM NC 27105 PEDIATRICS 39 - CANCER SURVIVORSHIP - CLEMMONS 2341 LEWISVILLE-CLEMMONS ROAD CLEMMONS NC 27012 HEMATOLOGY AND ONCOLOGY 40 - HEALOGICS WOUND CARE - WEST PARK 1900 WEST PARK DRIVE STE C NORTH WILKESBORO NC 28659 WOUND CARE 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 300% 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 NET PATIENT SERVICE REVENUE OF PRIVATE HOSPITALS. THE FEDERAL GOVERNMENT MATCHES THE ASSESSMENT AT A RATE OF NEARLY 2 TO 1, AND THESE AMOUNTS ARE ALLOCATED TO NORTH CAROLINA HOSPITALS ON A QUARTERLY BASIS. ADDITIONALLY, THE HOSPITAL PARTICIPATES IN THE NORTH CAROLINA MEDICAID REIMBURSEMENT INITIATIVE (MRI). UNDER THE MRI, THE HOSPITAL RECEIVES ADDITIONAL REIMBURSEMENT BASED ON MEDICAID COST DEFICITS AND TREATMENT OF A DISPROPORTIONATE SHARE OF UNINSURED PATIENTS. PART I, LN 7 COL(F): THE ORGANIZATION'S PATIENT BAD DEBT EXPENSE PER THE AUDITED FINANCIAL STATEMENTS WAS $156,577,093 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: THE HOSPITAL IS COMMITTED TO GIVE BACK AND IS RESPONSIVE TO THE COMMUNITIES IT SERVES THROUGH A NUMBER OF ACTIVITIES, PROGRAMS AND INITIATIVES. THE FOLLOWING ARE SOME OF THESE PROGRAMS.- BE INVOLVED IS AN ONLINE RESOURCE THAT WELCOMES COMMUNITY MEMBERS TO LEARN MORE ABOUT HUNDREDS OF CLINICAL TRIALS AND STUDIES AT WAKE FOREST BAPTIST FOR WHICH THEY MAY BE ELIGIBLE. - BESTHEALTH, THE COMMUNITY WELLNESS OUTREACH PROGRAM OF WAKE FOREST BAPTIST HEALTH, OFFERS HEALTH SEMINARS, SCREENINGS, COOKING AND FITNESS CLASSES, ONLINE HEALTH RESOURCES AND A MEMBERSHIP PROGRAM WITH SPECIAL BENEFITS. SEMINARS LED BY EXPERTS FROM WAKE FOREST BAPTIST PROVIDE THE LATEST INFORMATION ABOUT A VARIETY OF HEALTH TOPICS IN TALKS HELD AT CONVENIENT LOCATIONS THROUGHOUT THE COMMUNITY. MEMBERSHIP BENEFITS INCLUDE FREE HEALTH SCREENINGS, WELLNESS CHALLENGES, DISCOUNTS AT PARTICIPATING LOCAL MERCHANTS, E-NEWSLETTERS AND PRIORITY NOTIFICATION OF EVENTS AND PROGRAMS. - THE CARE TRANSITIONS PROGRAM PROVIDES SUPPORT TO PATIENTS AND THEIR FAMILIES AFTER DISCHARGE FROM THE MEDICAL CENTER AND HELPS THEM DETERMINE WHAT SERVICES ARE AVAILABLE TO THEM TO ASSIST WITH RECOVERY. SEVEN OPTIONS ARE OFFERED THROUGH THE PROGRAM: ENHANCED CARE RESOURCE NURSES, ANCHOR, CAREPLUS, ADVANCED PRACTICE PROVIDERS, SKILLED NURSING FACILITY PARTNERS, PALLIATIVE CARE, AND WAKE FOREST BAPTIST HEALTH CARE AT HOME, A JOINT PROGRAM BETWEEN WAKE FOREST BAPTIST AND GENTIVA HEALTH SERVICES THAT FOCUSES ON HELPING ADULT PATIENTS OF ALL AGES WITH COMPLEX HEALTH PROBLEMS. - THE CENTER FOR WORKER HEALTH PROVIDES A NEXUS FOR BASIC AND TRANSLATIONAL RESEARCH FOCUSED ON ALL ASPECTS OF THE WORK-HEALTH RELATIONSHIP. IT BRINGS TOGETHER RESEARCHERS, HEALTH CARE PROVIDERS, COMMUNITY MEMBERS AND BUSINESS LEADERS INTERESTED IN PROTECTING AND PROMOTING WORKER HEALTH AND QUALITY OF LIFE, AS WELL AS CREATING WORKPLACE SOLUTIONS THAT ARE BENEFICIAL FOR EMPLOYERS, WORKERS AND THEIR FAMILIES.- THE COMMUNITY PARTNERSHIP FOR COMPASSIONATE CARE IS A REGIONAL COALITION OF THE NORTH CAROLINA PARTNERSHIP FOR COMPASSIONATE CARE. THE PARTNERSHIP IS DESIGNED TO EDUCATE THE COMMUNITY ABOUT THE IMPORTANCE OF HAVING AN ADVANCE CARE PLAN AND TO HELP TO WITH THE PLANNING PROCESS.- THE DEAC CLINIC, A PROGRAM INITIATED AND DEVELOPED ENTIRELY BY WAKE FOREST SCHOOL OF MEDICINE STUDENTS. THE CLINIC USUALLY SERVES MORE THAN 250 PATIENTS PER WEEK. THIS FREE CLINIC PROVIDES ROUTINE PRIMARY HEALTH CARE TO THE LOCAL UNDERSERVED COMMUNITY, AND SPECIALTY CARE AND TESTING WHEN NEEDED. STUDENTS FROM WAKE FOREST MEDICAL, PHYSICIAN ASSISTANT, GRADUATE AND UNDERGRADUATE PROGRAMS WORK TOGETHER UNDER THE SUPERVISION OF VOLUNTEER LICENSED PHYSICIANS, PHYSICIAN ASSISTANTS AND PHARMACY RESIDENTS. RECENTLY, STUDENTS HAVE BEEN AWARDED GRANTS FOR VARIOUS HEALTH IMPROVEMENT INITIATIVES IMPLEMENTED AT DEAC, RANGING FROM NUTRITION TO SMOKING CESSATION.- THE DOWNTOWN HEALTH PLAZA (DHP) IS A FULL-SERVICE OUTPATIENT MEDICAL CLINIC SUBSIDIZED BY THE MEDICAL CENTER THAT SERVES MANY OF FORSYTH COUNTY'S UNINSURED AND UNDERINSURED RESIDENTS IN A STATE-OF-THE-ART FACILITY WITH AN ONSITE PHARMACY. DURING FY17, THERE WERE 64,768 PATIENT VISITS AT THE DOWNTOWN HEALTH PLAZA. ITS SERVICES INCLUDE:- COLLABORATION WITH THE NORTHWEST COMMUNITY CARE NETWORK (NCCN), WHICH HAS CASE MANAGERS ON-SITE IN PEDIATRICS AND INTERNAL MEDICINE.- A SATELLITE SITE FOR THE WOMEN, INFANTS AND CHILDREN NUTRITION PROGRAM (WIC).- A BEHAVIORAL HEALTH INTEGRATION PROJECT THAT SUPPORTS FOUR HEALTH CLINICIANS WHO PROVIDE BEHAVIORAL HEALTH CARE IN COLLABORATION WITH THE PATIENTS' MEDICAL PROVIDERS.- A HOME PATIENT NAVIGATOR WHO VISITS PATIENTS AFTER THEY ARE DISCHARGED FROM THE HOSPITAL TO ASSURE THAT MEDICATIONS ARE FILLED, REFERRALS ARE PREPARED AND MORE.- A COMMUNITY GARDEN THAT PROVIDES FREE, FRESH VEGETABLES AND HERBS FOR PATIENTS AND THEIR FAMILIES AND A FOOD PANTRY WHERE BAGGED NUTRITIOUS FOODS ARE AVAILABLE.- LEGAL AID OF NORTHWEST NC, WHICH PROVIDES ASSISTANCE WITH LEGAL ISSUES.- CENTERINGPREGNANCY, A PROGRAM TO REDUCE INCIDENCE OF LOW-BIRTH-WEIGHT BABIES.- CARENET COUNSELING, WHICH HELPS FAMILIES ADDRESS BEHAVIORAL CONCERNS.- IMPRINTSCARES, A PROGRAM THAT HELPS PARENTS ADDRESS DEVELOPMENTAL DELAYS IN YOUNG CHILDREN.- A HIGH-RISK OBSTETRICS CLINIC.- REACH OUT AND READ, WHICH PROVIDES FREE BOOKS TO YOUNG PATIENTS.- THE CARE PLUS PROGRAM, WHICH OFFERS HOME VISITS AND INTENSIVE PATIENT CONTACT AIMED AT REDUCING READMISSIONS AND EMERGENCY DEPARTMENT VISITS.- GRACE CLINIC IS A FREE HEALTH CLINIC HELD THE THIRD SATURDAY OF EVERY MONTH AT NEW LIGHT MISSIONARY BAPTIST CHURCH IN WINSTON-SALEM. VOLUNTEERS FROM WAKE FOREST BAPTIST ARE AMONG THOSE WHO ASSIST WITH HEALTH MANAGEMENT FOR PATIENTS WITH CHRONIC AND ACUTE CONDITIONS SUCH AS HIGH BLOOD PRESSURE, HIGH BLOOD SUGAR AND HIGH CHOLESTEROL. WAKE FOREST BAPTIST'S FAITHHEALTH PROGRAM ALSO SUPPORTS THE GRACE FREE CLINIC.- THE SHARE THE HEALTH FAIR IS A FREE, ANNUAL COMMUNITY HEATH DAY THAT OFFERS SCREENINGS, HEALTH EDUCATION AND PHYSICIAN CONSULTATIONS, AND TYPICALLY REACHES HUNDREDS OF PEOPLE. IT IS OPEN TO ADULTS REGARDLESS OF AGE, INSURANCE COVERAGE, INCOME LEVEL OR IMMIGRATION STATUS. INTERPRETERS ARE AVAILABLE FOR NON-ENGLISH SPEAKERS. THE EVENT IS HOSTED BY STUDENTS FROM WAKE FOREST SCHOOL OF MEDICINE AND SUPPORTED BY NORTHWEST AHEC.- TRANSITIONAL AND SUPPORTIVE CARE IS A FAMILY OF PROGRAMS THAT CREATES A BRIDGE BETWEEN ACUTE CARE SERVICES AND REINTRODUCTION TO THE COMMUNITY. THE PROGRAMS INCLUDED IN TRANSITIONAL AND SUPPORTIVE CARE ARE: AMBULATORY CARE NAVIGATORS, BRIDGING HOME VISITS, ED ENHANCED CARE NURSES, PALLIATIVE/SUPPORTIVE CARE PROVIDERS AND NURSES, READMISSIONS COORDINATOR, SKILLED NURSING FACILITY COLLABORATIVE, SOCIAL WORK, PHARMACISTS AND WAKE FOREST BAPTIST HEALTH CARE AT HOME.- TRIAD FREE HEALTH CLINIC - WAKE FOREST BAPTIST HEALTH PHYSICIANS AND NURSES VOLUNTEER TO SUPPORT THE TRIAD FREE HEALTH CLINIC, HELD TWICE A MONTH TO SERVE THE MEDICAL NEEDS OF THE UNINSURED AND UNDERSERVED MEMBERS OF WINSTON-SALEM AND THE TRIAD REGION. THE CLINIC IS HELD AT THE COMMUNITY MOSQUE, 1419 WAUGHTOWN ST., WINSTON-SALEM. THE TRIAD FREE HEALTH CLINIC OFFERS FREE CARE WITHOUT DISCRIMINATION BASED ON RACE, RELIGION OR GENDER; ITS SERVICES INCLUDE SCREENINGS TO COMBAT CHRONIC DISEASES SUCH AS DIABETES, OBESITY AND CARDIOPULMONARY DISEASE.- DIVERSITY, INCLUSION AND HEALTH EQUITY - WAKE FOREST BAPTIST BELIEVES THAT CREATING A DIVERSE, EQUITABLE AND CULTURALLY ATTUNED WORKPLACE IS CRUCIAL TO OUR MISSION TO IMPROVE HEALTH IN THE COMMUNITIES WE SERVE. THE OFFICE OF DIVERSITY AND INCLUSION OVERSEES OUR PRACTICES TO ENSURE DIVERSITY, INCLUSION, EQUITY AND RESPECT FOR EVERY MEMBER OF THE WAKE FOREST BAPTIST COMMUNITY. WAKE FOREST BAPTIST RECOGNIZES THAT DIVERSITY IS NOT LIMITED TO RACE AND ETHNICITY BUT MUST ALSO TAKE INTO ACCOUNT SOCIOECONOMIC STATUS, SEXUAL ORIENTATION, GENDER IDENTITY AND RELIGIOUS COMMITMENT. IN ORDER TO ELIMINATE THE PERVASIVE HEALTH DISPARITIES THAT EXIST IN OUR REGION AND COUNTRY, THE MEDICAL CENTER IS DEVOTED TO RECRUITING, RETAINING AND TRAINING A DIVERSE CADRE OF PEOPLE AND ENSURING THAT EDUCATIONAL PROGRAMS ENABLE HEALTH CARE PROFESSIONALS TO PROVIDE CULTURALLY COMPETENT CARE AND ADDRESS HEALTH DISPARITIES. WAKE FOREST BAPTIST'S CLINICAL FOCUS ON HEALTH EQUITY WAS RECOGNIZED BY THE U.S. HUMAN RIGHTS CAMPAIGN FOUNDATION, WHICH DESIGNATED THE MEDICAL CENTER A 2017 "LEADER IN LGBTQ HEALTHCARE EQUALITY."- DIVISION OF FAITHHEALTH - THE MISSION OF THE DIVISION OF FAITHHEALTH IS TO BUILD, ALIGN AND ANIMATE RELIGIOUS AND COMMUNITY ASSETS TO IMPROVE ACCESS TO HEALTH CARE AND THE HEALTH OF THE COMMUNITY, BEGINNING WITH THOSE SERVED BY WAKE FOREST BAPTIST MEDICAL CENTER. SUPPORTING PATIENTS SPIRITUALLY AND OFFERING MINISTRIES OF GROWTH, HOPE AND HEALING IS PART OF THE WORK OF WAKE FOREST BAPTIST MEDICAL CENTER, WHICH SINCE ITS EARLIEST DAYS HAS BEEN AN INNOVATOR IN FORGING HEALTH AND SPIRITUAL CONNECTIONS.THE DIVISION'S PROGRAMS INCLUDE:- FAITHHEALTHNC, WHICH HELPS EASE THE JOURNEY TO HEALTH AND HEALING FOR PEOPLE AND THEIR COMMUNITIES THROUGH CARING STRENGTHS OF CONGREGATIONS, THE CLINICAL EXPERTISE OF PROVIDERS AND A NETWORK OF COMMUNITY RESOURCES.- FAITHHEALTH EDUCATION - DESIGNS AND CONDUCTS EDUCATIONAL PROGRAMS FOR INTERNS AND RESIDENTS.- CHAPLAINCY AND CLINICAL MINISTRIES - CHAPLAINS PROVIDE SPIRITUAL MINISTRY AND SUPPORT TO PATIENTS AND FAMILIES.- CARENET - A PARTNER OF FAITHHEALTH THAT PROVIDES FAITH INTEGRATED COUNSELING AND THERAPY- CENTER FOR CONGREGATIONAL HEALTH - PROVIDES MINISTRY AND TRAINING TO FAITH COMMUNITIES, LAY LEADERS AND CLERGY. 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, GME, COMMUNITY BUILDING, AND CHARITY CARE SO AS NOT TO COUNT THOSE COSTS TWICE. PART III, LINE 9B: THE HOSPITAL MAKES A REASONABLE EFFORT TO DETERMINE AN INDIVIDUAL'S ELIGIBILITY FOR FINANCIAL ASSISTANCE BEFORE ENGAGING IN ANY COLLECTION ACTIONS. ALL COLLECTION ACTIONS WILL BE SUSPENDED IF THE INDIVIDUAL SUBMITS A COMPLETED FAP APPLICATION DURING THE APPLICATION PERIOD, OR IF THE INDIVIDUAL SUBMITS AN INCOMPLETE APPLICATION DURING THE APPLICATION PERIOD THAT IS SUBSEQUENTLY COMPLETED WITHIN A REASONABLE TIME AFTER THE HOSPITAL REQUESTS FURTHER INFORMATION. IF THE INDIVIDUAL IS DETERMINED NOT TO BE ELIGIBLE FOR A FULL DISCOUNT UNDER THE FAP, ANY COLLECTION ACTIVITIES WILL BE RESUMED AS TO THE OUTSTANDING BALANCE OWED. IF THE INDIVIDUAL IS DETERMINED TO BE ELIGIBLE FOR 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 DAVIE COUNTY PUBLIC HEALTH NEEDS ASSESSMENTS, NORTH CAROLINA INDICATORS FOR COMMUNITY HEALTH ASSESSMENT, INTERNAL DISEASE REGISTRIES, AND COUNTY HEALTH RANKINGS. AN INTERNAL STEERING COMMITTEE AND SENIOR LEADERSHIP REVIEW A SET OF CRITERIA TO DEVELOP THE PRIORITY RANKINGS. THE PRIORITIZATION PROCESS IDENTIFIED THE FOLLOWING 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 HOSPITAL) 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 NEXT THREE FISCAL YEARS. BEYOND THE PROGRAMS THAT WILL BE ADDRESSED IN THE IMPLEMENTATION STRATEGY, THE HOSPITAL WILL CONTINUE TO ADDRESS MANY OF THE PRIORITIES BY PROVIDING CARE TO ALL, REGARDLESS OF THE ABILITY TO PAY. PART VI, LINE 3: THE ORGANIZATION USES A VARIETY OF MEANS TO EDUCATE AND INFORM PATIENTS OF THEIR CHARITY CARE OPTIONS, INCLUDING INFORMATION ON A WEBSITE, PAMPHLETS, CONSPICUOUSLY DISPLAYED SIGNAGE, INFORMATION ON PATIENT BILL STATEMENTS, AND FROM STAFF MEMBERS DURING CONVERSATIONS CONCERNING A PATIENT'S LIABILITY FOR SERVICES. THE HOSPITAL EMPLOYS A PRE-SERVICE FINANCIAL CLEARANCE PROCESS THAT SCREENS PATIENTS PRIOR TO SERVICE DELIVERY FOR EXISTING OR AVAILABLE PAYER SOURCES AS A MEANS OF AVOIDING BAD DEBT AND INAPPROPRIATE BILLING TO PATIENTS WITHOUT THE MEANS TO PAY. IF A PAYER SOURCE IS IDENTIFIED, HOSPITAL STAFF WILL ASSIST THE PATIENT WITH ENROLLMENT. PART VI, LINE 4: IN FISCAL YEAR 2018, THE MEDICAL CENTER PROVIDED CARE TO A NINETEEN COUNTY SERVICE AREA IN NORTH CAROLINA. THE PRIMARY AND SECONDARY SERVICE AREA INCLUDE:PRIMARY SERVICE AREA COUNTIES -FORSYTH, DAVIE, DAVIDSON, GUILFORD, STOKES, SURRY, YADKINSECONDARY SERVICE AREA COUNTIES - ROCKINGHAM, RANDOLPH, ROWAN, IREDELL, CATAWBA, ALEXANDER, WILKES, ALLEGHANY, ASHE, WATAUGA, CALDWELL, BURKEPERCENT OF UNINSURED INPATIENTS 6.8%PERCENT OF INPATIENTS WHO ARE MEDICAID RECIPIENTS 19.2%THE HOSPITAL IS LOCATED IN CENTRAL FORSYTH COUNTY, WHICH MAKES UP THE SINGLE LARGEST COUNTY IN TOTAL INPATIENT DISCHARGES. ACCORDINGLY, THE HOSPITAL SERVES A WIDE SERVICE AREA; HOWEVER, IT IS RESOURCE PROHIBITIVE TO PARTICIPATE AND FUND HEALTH ASSESSMENTS IN EACH COMMUNITY/COUNTY FROM WHICH ITS PATIENT POPULATION ORIGINATES. THEREFORE, THE PRIMARY COMMUNITY BENEFIT SERVICE AREA (CBSA) IS FORSYTH COUNTY, NORTH CAROLINA.BELOW IS A DEMOGRAPHIC SNAPSHOT OF FORSYTH COUNTY BASED ON 2015 ESTIMATED CENSUS DATA: POPULATION AND GEOGRAPHYTOTAL POPULATION 369,000POPULATION CHANGE SINCE 2010 + 5.2%LAND AREA 408.1 SQUARE MILESPOPULATION DENSITY 904.19 PERSONS PER SQUARE MILE POPULATION BY RACE/ETHNICITYWHITE 57.4%BLACK/AFRICAN-AMERICAN 27.2%HISPANIC 12.7%ASIAN 2.4%AMERICAN INDIAN/ALASKAN NATIVE 0.8%NATIVE HAWAIIAN/PACIFIC ISLANDER 0.1%MULTIRACIAL 2.2% POPULATION BY AGE DISTRIBUTIONUNDER 5 YEARS OLD 6.3%UNDER 18 YEARS OLD 23.6%=/+ 65 YEARS OLD 14.7%MEDIAN AGE 37.5 YEARS POPULATION BY SEXMALE 47.5%FEMALE 52.5% POPULATION BY EDUCATIONAL ATTAINMENT PERCENT OF PERSONS = 25 YEARS OLD WHO HAVE:< HIGH SCHOOL DIPLOMA OR GED 13.2%A HIGH SCHOOL DIPLOMA OR GED 54.7%A BACHELOR'S DEGREE OR HIGHER 32.1%PERSONS IN POVERTY 19.7%UNEMPLOYMENT RATE 5.8% COUNTY SCHOOLSK-12 ENROLLMENT 54,000GRADUATION RATE 85.4% INCOMEMEDIAN FAMILY HOUSEHOLD (2014) $46,003MEDIAN NON-FAMILY HOUSEHOLD (2014) $26,670 PART VI, LINE 6: WAKE FOREST BAPTIST HEALTH'S MISSION IS TO IMPROVE THE HEALTH OF THE REGION, STATE AND NATION BY:---SERVING AS THE PREMIER HEALTH SYSTEM IN THE REGION, WITH SPECIFIC CENTERS OF EXCELLENCE RECOGNIZED AS NATIONAL AND INTERNATIONAL CARE DESTINATIONS.---GENERATING AND TRANSLATING KNOWLEDGE TO PREVENT, DIAGNOSE AND TREAT DISEASE.---TRAINING TOMORROW'S LEADERS IN HEALTH CARE AND BIOMEDICAL SCIENCE.THE HOSPITAL, WHICH IS THE INPATIENT COMPONENT OF WAKE FOREST BAPTIST HEALTH, OPERATES THE FOLLOWING PROGRAMS CONSTITUTING COMMUNITY HEALTH IMPROVEMENT SERVICES AND COMMUNITY BENEFIT OPERATIONS REPORTED ON PART I,LINE 7E:WINSTON-SALEM/FORSYTH CTY SCHOOLS' ALLIED HEALTH PROGRAM $5,000BRENNER FIT $212,009AMOS COTTAGE $65,935POPULATION HEALTH PHARMACY $904,287COMMUNITY TRAINING (BLS) $706,423RAPID RESPONSE TEAM $827,122NCBH HOSPICE SERVICES $107PALLIATIVE CARE PROGRAMS $165,874FAMILY RESOURCES $15,845COMMUNITY EMS PREPAREDNESS $117,677PATIENT/FAMILY CENTERED CARE $17,528CLINICAL MINISTRIES $662,651PASTORAL & EDUCATIONAL COUNSELING $354,201PHYSICIANS COMMUNITY HEALTH ACCESS $191,751FAITHHEALTH, NC $559,283HEALTH & WELLNESS SERVICES $355,077TOTAL TO PART I, LINE 7E: $5,160,770 PART VI, LINE 7, REPORTS FILED WITH STATES NC 1 ABC OF NC CHILD DEVELOPMENT 3904 OLD VINEYARD ROAD WINSTONSALEM NC 27104 300111894 501(C)(3) 60000 SUPPORTING PROGRAMS FOR DISABLED CHILDREN ALLIANCE FOR NC NONPROFITS INC 530 N BLOUNT STREET RALEIGH NC 27604 461358968 501(C)(6) 20000 SUPPORTING PROMOTION OF INTERESTS OF NC NONPROFITS TO POLICYMAKERS AND THE PUBLIC ALS ASSOCIATION NC CHAPTER 4 N BLOUNT STREET RALEIGH NC 27601 561609591 501(C)(3) 6000 SUPPORTING PROGRAMS TO TREAT AND CURE ALS THROUGH GLOBAL RESEARCH AND NATION AMERICAN HEART ASSOCIATION 101 CENTREPORT DRIVE GREENSBORO NC 27409 135613797 501(C)(3) 72500 SUPPORTING CARDIOVASCULAR RESEARCH AND PROGRAMS ARTS COUNCIL WINSTON SALEM FORSYTH CTY 206 N SPRUCE STREET WINSTONSALEM NC 27101 560526856 501(C)(3) 30000 SUPPORTING CULTURAL PROGRAMS IN THE COMMUNITY CANCER SERVICES INC 3175 MAPLEWOOD AVE WINSTONSALEM NC 27103 560656375 501(C)(3) 12500 SUPPORTING PROGRAMS TO EDUCATE/ ENHANCE LIFE FOR CANCER PATIENTS CARENET MEDICAL CENTER BLVD WINSTONSALEM NC 27157 561977341 501(C)(3) 107500 HEALTHCARE COUNSELOR RESIDENCY SUPPORT COMMUNITY CARE CENTER FOR FORSYTH CTY 2135 NEW WALKERTOWN RD WINSTONSALEM NC 27101 581403699 501(C)(3) 10000 SUPPORTING PROGRAM TO PROVIDE FREE MEDICAL/DENTAL CARE DAVIDSON COUNTY COMMUNITY COLLEGE FOUNDATION PO BOX 1287 LEXINGTON NC 27293 237079347 501(C)(3) 20000 SUPPORTING ORGANIZATION PROVIDING ASSISTANCE TO STUDENTS OF DCCC DAVIDSON COUNTY GOVERNMENT 913 GREENSBORO STREET LEXINGTON NC 27292 566000294 GOVT 8000 COMMUNITY SUPPORT DAVIE COMMUNITY FOUNDATION PO BOX 546 MOCKSVILLE NC 27028 581850531 501(C)(3) 20000 SUPPORTING ORGANIZATION TO PROMOTE PHILANTHROPY IN THE COMMUNITY DAVIE COUNTY ECONOMIC DEVELOPMENT 135 SOUTH SALISBURY ST MOCKSVILLE NC 27028 561932514 501(C)(3) 45000 SUPPORTING HEALTHCARE DEVELOPMENT EL BUEN PASTOR LATINO COMMUNITY SERVICES 4637 TIM ROAD WINSTONSALEM NC 27106 203751959 501(C)(3) 8500 SUPPORTING PROGRAM TO EQUIP LATINO FAMILIES TO FULFILL EDUCATION AND ECONOMI GREENSBORO UNITED SOCCER ASSOCIATION INC PO BOX 9185 GREENSBORO NC 27429 561231905 501(C)(3) 10000 SUPPORTING PROGRAM TO PROMOTE SOCCER COMPETITION HABITAT FOR HUMANITY 339 WITT ST WINSTONSALEM NC 27103 561448955 501(C)(3) 32500 COMMUNITY SUPPORT HOSPICE AND PALLIATIVE CARE CENTER 101 HOSPICE LANE WINSTONSALEM NC 27103 581343313 501(C)(3) 20000 SUPPORTING FACILITIES & PROGRAMS FOR SERIOUSLY ILL PATIENTS HOSPITAL HOSPITALITY HOUSE OF WINSTON-SALEM DBA SECU FAMILY HOUSE 1970 BALDWIN LN WINSTONSALEM NC 27103 203604576 501(C)(3) 15000 SUPPORTING PROGRAM PROVIDING AFFORDABLE LODGING TO PATIENTS JDRF PIEDMONT TRIAD CHAPTER 312 N EUGENE STREET GREENSBORO NC 27401 231907729 501(C)(3) 25000 SUPPORTING JUVENILE DIABETES RESEARCH KALEIDEUM (FORMERLY SCIWORKS) 400 HANES MILL ROAD WINSTONSALEM NC 27105 560815746 501(C)(3) 10000 EDUCATIONAL AND SCIENTIFIC SUPPORT LEADERSHIP WINSTON-SALEM 624 W 6TH STREET STE 110 WINSTONSALEM NC 27101 581574887 501(C)(3) 10000 SUPPORTING PROGRAM TO TRAIN AND DEVELOP COMMUNITY LEADERS MARCH OF DIMES 410 BROOKSTOWN AVE WINSTONSALEM NC 27101 131846366 501(C)(3) 32500 SUPPORTING RESEARCH AND PROGRAMS TO END INFANT MORTALITY AND BIRTH DEFECTS NATIONAL MULTIPLE SCLEROSIS SOCIETY 733 THIRD AVENUE 3RD FL NEW YORK NY 10017 135661935 501(C)(3) 12000 SUPPORTING RESEARCH AND PROGRAMS TO END MULTIPLE SCLEROSIS NC TRIAD KOMEN AFFILIATE OF SUSAN G KOMEN FND 1106 BURKE STREET WINSTONSALEM NC 27101 752891104 501(C)(3) 25000 SUPPORTING BREAST CANCER RESEARCH OLD SALEM MUSEUMS & GARDEN 600 MAIN ST WINSTONSALEM NC 27101 560587289 501(C)(3) 95000 COMMUNITY SUPPORT PIEDMONT REGIONAL TRAUMA SYSTEMS MEDICAL CENTER BLVD WINSTONSALEM NC 27157 562036036 501(C)(3) 75000 SUPPORTING INTEGRATED TRAUMA SYSTEM PRIDE WINSTON-SALEM PO BOX 20732 WINSTONSALEM NC 27120 462693107 501(C)(3) 10000 SUPPORTING PROGRAM TO PROMOTE DIVERSITY IN THE COMMUNITY RONALD MCDONALD HOUSE 419 S HAWTHORNE ROAD WINSTONSALEM NC 27103 581454715 501(C)(3) 23500 SUPPORTING PROGRAM FOR CHILDREN RECEIVING MEDICAL CARE MORAVIAN HOME INC (SALEMTOWNE) 1000 SALEMTOWNE DRIVE WINSTONSALEM NC 27106 560963926 501(C)(3) 100000 SUPPORTING ORGANIZATION PROVIDING LONG TERM CARE TO ELDERLY SENIOR SERVICES INC 2895 SHOREFAIR DRIVE WINSTONSALEM NC 271054237 561085968 501(C)(3) 125000 SUPPORTING PROGRAM PROVIDING SERVICES TO SENIOR ADULTS THE WOMEN'S FUND OF WINSTON SALEM 860 W FIFTH STREET WINSTONSALEM NC 27101 566037616 501(C)(3) 10000 SUPPORTING & EMPOWERING WOMEN IN THE COMMUNITY UNITED WAY OF FORSYTH COUNTY 301 N MAIN STREET WINSTONSALEM NC 27101 237357234 501(C)(3) 163000 COMMUNITY SUPPORT USA CYCLING INC DBA WINSTON-SALEM CYCLING 210 USA CYCLING POINT STE 100 COLORADO SPRINGS CO 80919 COLORADO SPRINGS CO 80919 841284437 501(C)(3) 37500 SUPPORTING LOCAL ADMINISTRATION OF COMMUNITY CYCLING EVENT WILKES COMMUNITY COLLEGE FOUNDATION INC PO BOX 120 WILKESBORO NC 28697 237338790 501(C)(3) 21000 SUPPORTING ORGANIZATION PROVIDING ASSISTANCE TO STUDENTS OF WCC WINSTON SALEM STATE UNIVERSITY 601 S MARTIN LUTHER KING JR DR WINSTONSALEM NC 27110 566001466 GOVT 20000 SPONSORSHIP - COMMUNITY SUPPORT WINSTON-SALEM FOUNDATION 751 W FOURTH ST STE 200 WINSTON-SAL M NC 27101 WINSTONSALEM NC 27101 566037615 501(C)(3) 134334 COMMUNITY SUPPORT WINSTON-SALEM POLICE FOUNDATION PO BOX 24011 WINSTONSALEM NC 27114 475289473 501(C)(3) 25000 COMMUNITY SUPPORT YMCA OF NORTHWEST NORTH CAROLINA 301 N MAIN STREET STE 1900 WINSTONSALEM NC 27101 560530015 501(C)(3) 7500 COMMUNITY SUPPORT WINSTON-SALEM SYMPHONY ASSOCIATION 201 N BROAD STREET STE 200 WINSTONSALEM NC 27101 560692826 501(C)(3) 40000 COMMUNITY SUPPORT 37 1 MEDICAL SCHOLARSHIPS 17 17400 RUTH HOLLEMAN SCHOLARSHIPS 5 5000 PART I, LINE 2: THE HOSPITAL FOLLOWS THE MEDICAL CENTER'S CORPORATE POLICY USED IN REVIEWING THE ELIGIBILITY AND SELECTION OF GRANTEES RECEIVING CERTAIN EXEMPT PURPOSE FUNDS. THE HOSPITAL MAINTAINS DOCUMENTATION OF THE ELIGIBILITY AND SELECTION CRITERIA AND RECORDS OF THE AMOUNTS DISBURSED. X X X X X X 1 1 0 0 0 0 0 0 0 JULIE A FREISCHLAG MD CEO, DEAN 796930 0 190000 0 5485 0 190699 0 17995 0 1201109 0 0 0 J MCLAIN WALLACE JR SVP, GEN COUNSEL & SEC 0 483693 0 102659 0 102768 0 55373 0 16504 0 760997 0 0 KAREN H HUEY VP FACILITIES 0 302734 0 61394 0 34333 0 37535 0 22150 0 458146 0 0 ERIC TOMLINSON CHIEF INNOV OFF (TO 3-1-18) 412764 0 174074 0 107878 0 23184 0 12414 0 730314 0 1000 0 BRADLEY A CLARK EVP, CFO, TREASURER 0 406688 0 75755 0 670 0 150891 0 20088 0 654092 0 0 TERRY G WILLIAMS EVP CH STRATEGY OFFICER 0 553516 0 183813 0 1932 0 152708 0 24272 0 916241 0 0 KEVIN P HIGH MD PRESIDENT, HEALTH SYSTEM 586688 0 144524 0 21612 0 151285 0 18528 0 922637 0 0 0 DEETTE M EMON VP & CIO (TO 7/31/17) 0 246718 0 109138 0 1127 0 22742 0 5780 0 385505 0 0 ROBERT GFELLER EVP, EXT REL & CH MKTG OFF 0 490702 0 159785 0 3612 0 125896 0 22208 0 802203 0 0 LILICIA BAILEY SVP, CHIEF PEOPLE OFFICER 0 458872 0 98701 0 43630 0 119740 0 12092 0 733035 0 0 WILLIAM D SHOWALTER SVP, CIO (FROM 8/15/17) 0 167233 0 19880 0 26980 0 20900 0 7228 0 242221 0 0 MICHAEL T WAID SVP HLTH SYS OPS & INTEG 0 398018 0 95637 0 23927 0 107262 0 22892 0 647736 0 0 CATHLEEN WHEATLEY CHIEF NURSE EXEC, VP CLINI 0 435264 0 90545 0 3612 0 110003 0 10152 0 649576 0 0 CHARLES R VIGNOS VP MANAGED CARE 0 367336 0 100832 0 21518 0 92429 0 18690 0 600805 0 0 ERWIN STAINBACK VP, CLINICAL OPERATIONS 0 180618 0 66896 0 223401 0 11184 0 10793 0 492892 0 0 DENISE CHAMBERLAIN AVP, ASST CFO 0 206887 0 84743 0 202961 0 22184 0 5949 0 522724 0 0 JOANNE C RUHLAND FORMER OFFICER 0 300690 0 0 0 71713 0 24284 0 18688 0 415375 0 0 NORMAN D POTTER JR FORMER OFFICER (2/28/17) 52236 0 56356 0 421539 0 3967 0 6005 0 540103 0 225858 0 CHERYL EH LOCKE FORMER OFFICER 0 178559 0 80567 0 226343 0 21588 0 8862 0 515919 0 61120 RUSSELL M HOWERTON MD FORMER OFFICER 537214 0 126166 0 145746 0 30869 0 23362 0 863357 0 0 0 JOHN D MCCONNELL MD FORMER OFFICER (4/26/17) 1026360 0 267085 0 566952 0 269643 0 19534 0 2149574 0 0 0 EDWARD ABRAHAM MD FORMER OFFICER (6/30/17) 309744 0 187724 0 153334 0 23184 0 7810 0 681796 0 139000 0 CHAD A ECKES FORMER OFFICER (6/11/17) 0 346612 0 0 0 640420 0 22984 0 10912 0 1020928 0 0 PART I, LINE 3 THE GOVERNANCE AND COMPENSATION COMMITTEE OF THE WFUBMC BOARD OF DIRECTORS IS RESPONSIBLE FOR REVIEWING AND APPROVING ALL MEDICAL CENTER OFFICERS' COMPENSATION (INCLUDING THE COMPENSATION OF THE OFFICERS OF NCBH). THE COMMITTEE UTILIZES AN INDEPENDENT, EXTERNAL COMPENSATION CONSULTANT FIRM EXPERIENCED IN HEALTH CARE AND HIGHER EDUCATION COMPENSATION THAT BASES RECOMMENDATIONS ON COMPENSATION SURVEYS AND STUDIES TO DETERMINE THE APPROPRIATENESS OF EACH OFFICER'S COMPENSATION. THESE COMPENSATION CONSULTANTS PRESENT TOTAL COMPENSATION COMPARABILITY DATA FOR THE POSITIONS FOR WHICH COMPENSATION IS BEING DETERMINED. THE DATA IS REVIEWED BY THE GOVERNANCE AND COMPENSATION COMMITTEE OF WFUBMC'S GOVERNING BOARD AT ITS MEETING; NONE OF THE MEMBERS OF THAT COMMITTEE ARE EMPLOYEES OF THE FILING ORGANIZATION. MINUTES OF THE DELIBERATIONS OF THE COMMITTEE ARE CONTEMPORANEOUSLY RECORDED. IN THE EVENT THAT ANY MEMBER OF THE GOVERNANCE AND COMPENSATION COMMITTEE HAS A CONFLICT OF INTEREST, THAT COMMITTEE MEMBER DOES NOT PARTICIPATE IN THE DELIBERATION OR APPROVAL PROCESS, AND THEIR ABSTENTION FROM THE PROCESS IS REFLECTED IN THE MINUTES. PART I, LINES 4A-B CERTAIN EXECUTIVES PARTICIPATE IN OR RECEIVE SEVERANCE PAYMENTS AND PAYMENTS FROM SUPPLEMENTAL NON QUALIFIED RETIREMENT PLANS. THE DETERMINATION OF THE AMOUNT OF THE NON QUALIFIED RETIREMENT PLANS FOLLOWED THE FILING ORGANIZATION'S COMPENSATION PROCEDURES AS OUTLINED IN PART VI, SECTION B, LINE 15 OF THE FORM 990. THE FOLLOWING CURRENT AND FORMER OFFICERS RECEIVED SEVERANCE AND SERP PAYMENTS IN THEIR CALENDAR YEAR 2017 COMPENSATION: SEVERANCE PAYMENTS: BARBARA CARBONE 76,667 DENISE CHAMBERLAIN 110,000 CHAD ECKES 640,000 CHERYL LOCKE 150,000 NORMAN POTTER 184,000 SERP PAYMENTS: JOHN D. MCCONNELL, MD 546,312 ERIC TOMLINSON 76,900 JOANNE RUHLAND 44,500 CHERYL LOCKE 61,120 EDWARD ABRAHAM, MD 139,000 DENISE CHAMBERLAIN 77,740 RUSSELL HOWERTON 122,202 KAREN HUEY 32,743 NORMAN POTTER 232,579 J. MCLAIN WALLACE 81,156 MICHAEL WAID 3,995 FORM 990, PART VII, LINE 5 - COMPENSATION FROM UNRELATED ORGANIZATION THE FOLLOWING CURRENT AND FORMER OFFICERS WERE COMPENSATED BY WAKE FOREST UNIVERSITY HEALTH SCIENCES FOR SERVICES PERFORMED AS AN OFFICER OF THE MEDICAL CENTER AND HOSPITAL. SEE PART VII AND SCHEDULE J, PART II FOR THEIR COMPENSATION. JULIE A. FREISCHLAG, MD, JOHN D. MCCONNELL, MD, KEVIN P. HIGH, MD, NORMAN D. POTTER, JR., EDWARD ABRAHAM, MD, ERIC TOMLINSON, DCS, PHD, RUSSELL M. HOWERTON, MD A NORTH CAROLINA MEDICAL CARE COMMISSION 521309402 65820HD67 2010-03-01 334002408 CURRENT REFUNDING 0 0 0 B NORTH CAROLINA MEDICAL CARE COMMISSION 521309402 NONEAVAIL 2012-12-31 80000000 VARIOUS CAPITAL PROJECTS 0 0 0 C NORTH CAROLINA MEDICAL CARE COMMISSION 521309402 65821DMM0 2012-11-15 122822821 VARIOUS CAPITAL PROJECTS 0 0 0 A 70400000 334002408 3307037 330695371 2010 1 0 1 1 B 80000000 1000 79999000 2014 0 0 1 1 C 122822821 2485 122820336 2013 0 0 1 1 B 0 1 0 0 0 0 1 C 0 1 0 0 0 0 1 A 0 0 0 1 0 1 DEUTSCHE BANK AG 5.000000000000 0 0 0 0 1 B 0 0 0 1 1 0 0 0 1 C 0 0 1 0 0 0 0 0 1 A 1 B 1 C 1 PART I, ROW A, COLUMN F PURPOSE OF THE ISSUE WAS TO REFUND ISSUES DATED 10/29/92, 6/27/96 AND 1/29/09. PART II, LINE 11, COLUMN A OTHER SPENT PROCEEDS ARE THE CURRENT REFUNDING PROCEEDS OF THE ISSUE. PART III, COLUMN A, ALL ISSUES REFUNDED BY THE 2010 ISSUE ARE EITHER PRIOR TO 12/31/02 OR THROUGH A SERIES OF REFUNDINGS THAT REFUND AN ISSUE PRIOR TO 12/31/02. ACCORDINGLY, THIS ISSUE IS EXEMPT FROM PART III REPORTING. PART IV, LINE 2C, COLUMN A A REBATE CALCULATION WAS PERFORMED, WITH NO REBATE BEING DUE, ON 6/13/2014. PART IV, LINE 2C, COLUMN C A REBATE CALCULATION WAS PERFORMED, WITH NO REBATE BEING DUE, ON 12/12/2014. X 9353 FMV X 2 12744 FMV 0 0 1 0 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 NORTH CAROLINA BAPTIST HOSPITAL (NCBH), CARENET, INC., THE HAWTHORNE INN AND CONFERENCE CENTER, NORTH CAROLINA BAPTIST HOSPITAL FOUNDATION, CLEMMONS MEDICAL PARK, LLC, AND WAKE WELLQ, LLC. ALL SIGNIFICANT INTERCOMPANY TRANSACTIONS HAVE BEEN ELIMINATED IN CONSOLIDATION. FORM 990, PART VI, SECTION A, LINE 2 BRADLEY CLARK AND TERRY WILLIAMS, BOTH OFFICERS OF THE FILING ORGANIZATION, WERE BOARD MEMBERS OF MEDCOST BENEFIT SERVICES. FORM 990, PART VI, SECTION A, LINE 3 EFFECTIVE JULY 1, 2010, THE GOVERNING BOARDS OF FOUR NORTH CAROLINA NONPROFIT CORPORATIONS (WAKE FOREST UNIVERSITY, NORTH CAROLINA BAPTIST HOSPITAL, WAKE FOREST UNIVERSITY HEALTH SCIENCES, AND WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER) ENTERED INTO AN AGREEMENT (THE "MEDICAL CENTER INTEGRATION AGREEMENT OR "MCIA") UNDER WHICH THE OPERATION OF EACH OF NORTH CAROLINA BAPTIST HOSPITAL ("NCBH") AND WAKE FOREST UNIVERSITY HEALTH SCIENCES ("WFUHS") WAS DELEGATED TO WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER ("WFUBMC"). WFUHS IS A WHOLLY-CONTROLLED SUBSIDIARY ENTITY OF WAKE FOREST UNIVERSITY ("WFU"). WFUBMC IS A MEMBERSHIP NONPROFIT CORPORATION WHOSE TWO EQUAL MEMBERS ARE NCBH (WHICH ENTITY IS UNRELATED TO WFUHS AND WFU) AND WFU. THE GOAL IS CONSOLIDATION OF MANAGEMENT AND GOVERNANCE IN WFUBMC OF THE VARIOUS ACADEMIC MEDICAL CENTER OPERATIONS, SUBJECT TO SUBSTANTIAL RESERVED POWERS IN BOTH OF THE CONSTITUENT MEMBERS' BOARDS. THE MCIA WAS AMENDED AND RESTATED ON JULY 1, 2015 AND JULY 1, 2017, AND FURTHER AMENDED ON JUNE 6, 2018. FORM 990, PART VI, SECTION B, LINE 11B THE FILING ORGANIZATION'S BOARD OF DIRECTORS RECEIVE A COPY OF THE FORM 990 WITH SUFFICIENT TIME TO PERMIT REVIEW, COMMENT, AND POSE QUESTIONS PRIOR TO ITS FILING. THE AUDIT AND COMPLIANCE COMMITTEE OF THE GOVERNING BOARD OF WFUBMC, COMPRISED OF THE AUDIT AND COMPLIANCE COMMITTEES OF WFUHS AND NCBH, REVIEW IN ADDITIONAL DETAIL THE FILING ORGANIZATION'S FORM 990 WITH THE ORGANIZATION'S CHIEF FINANCIAL OFFICER OR HIS DESIGNEE, WHO ANSWERS QUESTIONS AND ADDRESSES CONCERNS RAISED BY SUCH COMMITTEE MEMBERS OR OTHER FILING ORGANIZATION DIRECTORS. IF MODIFICATIONS ARE REQUIRED FOLLOWING SUCH REVIEW AND COMMENT, THE REVISED FORM 990 IS REDISTRIBUTED TO ALL BOARD MEMBERS 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 THE GOVERNANCE AND COMPENSATION COMMITTEE OF WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER ("WFUBMC") FUNCTIONS AS THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS AND PURSUANT TO A DELEGATION BY THE FILING ORGANIZATION, REVIEWS AND APPROVES THE APPOINTMENT AND COMPENSATION OF THE SENIOR EXECUTIVES OF THE FILING ORGANIZATION. NO MEMBER OF THE WFUBMC GOVERNANCE AND COMPENSATION COMMITTEE IS AN EMPLOYEE OF THE MEDICAL CENTER. THE GOVERNANCE AND COMPENSATION COMMITTEE RELIES UPON AN EXTERNAL, INDEPENDENT COMPENSATION CONSULTANT EXPERIENCED IN HEALTHCARE TO PROVIDE THE COMMITTEE WITH COMPENSATION COMPARABILITY DATA FOR NEW EXECUTIVE POSITION APPOINTMENTS AND FOR COMPENSATION REVIEWS FOR EXISTING EXECUTIVES. THE CONSULTANT, WHICH IS RETAINED DIRECTLY BY THE GOVERNANCE AND COMPENSATION COMMITTEE, PROVIDES THIRD-PARTY INFORMATION AND EVALUATES THE COMPETITIVENESS AND REASONABLENESS OF EXECUTIVE COMPENSATION AND BENEFITS PROGRAMS IN RELATION TO MARKET PRACTICES FOR SIMILARLY-SITUATED NONPROFIT HEALTHCARE ORGANIZATIONS. THE COMMITTEE MAKES ITS DECISIONS WITH RESPECT TO EXECUTIVE COMPENSATION IN ACCORDANCE WITH THE FILING ORGANIZATION'S POLICIES, IRS REGULATIONS, AND STANDARD CORPORATE GOVERNANCE PRACTICES. SUCH POLICIES INCLUDE ADHERENCE TO: BOARD-ESTABLISHED EXECUTIVE COMPENSATION PHILOSOPHY AND REVIEW PROCESSES; PROCESSES ENSURING GOVERNANCE AND COMPENSATION COMMITTEE MEMBER AND COMPENSATION CONSULTANT INDEPENDENCE; USE OF VALID MARKET COMPARISONS OF DATA FROM PEER ACADEMIC MEDICAL CENTERS OF SIMILAR ORGANIZATIONS OF SIMILAR STRUCTURE, SIZE, AND COMPLEXITY; CAREFUL DOCUMENTATION OF ALL COMPENSATION DECISIONS; AND ESTABLISHMENT OF THE REBUTTABLE PRESUMPTION OF REASONABLENESS, PER IRS GUIDELINES. MINUTES OF THE DELIBERATIONS OF THE GOVERNANCE AND COMPENSATION COMMITTEE ARE CONTEMPORANEOUSLY MAINTAINED AND THAT COMPARABILITY DATA IS MAINTAINED IN THE MEDICAL CENTER'S OFFICE OF EXECUTIVE COMPENSATION SERVICES. IN THE EVENT THAT A MEMBER OF THE GOVERNANCE AND COMPENSATION COMMITTEE HAS A CONFLICT OF INTEREST RELATED TO EXECUTIVE APPOINTMENT OR COMPENSATION, THAT MEMBER DOES NOT PARTICIPATE IN THE DELIBERATION OR APPROVAL OF APPOINTMENT OR COMPENSATION AND SUCH ABSTENTION IS NOTED IN THE COMMITTEE'S MEETING MINUTES. 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. PART VII, SECTION A, COLUMN B - HOURS ARTHUR A GIBEL FILING ORG 2.0 RELATED ORG 6.0 A. LEE HERRING FILING ORG 2.0 RELATED ORG 6.0 WILLIAM C. WARDEN, JR. FILING ORG 2.0 RELATED ORG 4.0 SHEREE B WATSON FILING ORG 2.0 RELATED ORG 6.0 STEPHEN L ROBERTSON FILING ORG 2.0 RELATED ORG 4.0 UNRELATED ORG 2.0 EDWIN L WELCH, JR. FILING ORG 2.0 RELATED ORG 2.0 GEORGE D RENFRO FILING ORG 2.0 RELATED ORG 6.0 MICHAEL T WELLS FILING ORG 2.0 RELATED ORG 2.0 JOHN D MCCONNELL, MD RELATED ORG 39.9 UNRELATED ORG 0.1 JULIE A. FRIESCHLAG, M.D. FILING ORG 16.2 RELATED ORG 5.0 UNRELATED ORG 18.8 J MCLAIN WALLACE, JR FILING ORG 29.7 RELATED ORG 8.7 UNRELATED ORG 1.6 KAREN H HUEY FILING ORG 21.5 RELATED ORG 5.7 UNRELATED ORG 12.9 ERIC TOMLINSON FILING ORG 5.2 RELATED ORG 5.0 UNRELATED ORG 29.8 BRADLEY A. CLARK FILING ORG 19.3 RELATED ORG 8.7 UNRELATED ORG 12.1 TERRY G. WILLIAMS FILING ORG 26.7 RELATED ORG 6.0 UNRELATED ORG 7.4 KEVIN HIGH, M.D. FILING ORG 23.7 RELATED ORG 6.0 UNRELATED ORG 10.3 DEETTE M. EMON FILING ORG 22.5 RELATED ORG 5.0 UNRELATED ORG 12.5 ROBERT GFELLER FILING ORG 20.0 RELATED ORG 5.0 UNRELATED ORG 15.0 WILLIAM SHOWALTER FILING ORG 30.0 RELATED ORG 5.0 UNRELATED ORG 5.0 LILICIA BAILEY FILING ORG 32.6 RELATED ORG 5.0 UNRELATED ORG 2.4 RUSSELL HOWERTON FILING ORG 20.7 UNRELATED ORG 19.3 JOANNE RUHLAND FILING ORG 25.0 UNRELATED ORG 15.0 CATHLEEN WHEATLEY FILING ORG 38.6 UNRELATED ORG 1.4 MICHAEL T. WAID FILING ORG 33.7 UNRELATED ORG 6.3 CHARLES R. VIGNOS FILING ORG 37.8 UNRELATED ORG 2.2 WAKE FOREST UNIVERSITY HEALTH SCIENCES IS AN UNRELATED ORGANIZATION TO THE FILING ORGANIZATION AND THE INFORMATION CONCERNING HOURS DEVOTED TO IT ARE NOT REQUIRED TO BE REPORTED, BUT ARE INCLUDED BECAUSE OF THE STRUCTURE OF WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER, OF WHICH THE FILING ORGANIZATION AND WAKE FOREST UNIVERSITY HEALTH SCIENCES ARE PRINCIPAL PARTS. THE CORPORATE OFFICERS OF THE MEDICAL CENTER ALSO SERVE AS THE CORPORATE OFFICERS OF NORTH CAROLINA BAPTIST HOSPITAL AND WAKE FOREST UNIVERSITY HEALTH SCIENCES. FORM 990, PART IX, LINE 11G OTHER PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 68,229,484. MANAGEMENT AND GENERAL EXPENSES 33,950,608. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 102,180,092. MCIA: PROGRAM SERVICE EXPENSES 177,175,980. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 177,175,980. FORM 990, PART XI, LINE 9: ACTUARY GAIN 9,493,458. AFFILIATE LOSSES 57,193,845. 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