THE REX HEALTHCARE FOUNDATION INC: Form 990, tax year 2017

View the entire original 990 at ProPublica ↗

Organization
THE REX HEALTHCARE FOUNDATION INC (EIN 56-6052117)
Tax period
2017-07-01 to 2018-06-30
Filed
2019-05-15
IRS object ID
201911359349301051
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

FieldValueIRS element (for citing)
Return2019-05-15T07:02:41-05:00ReturnTs
Tax Period End2018-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1BDO USA LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1421 Fayetteville Street Suite 300AddressLine1Txt
CityRaleighCityNm
State AbbreviationNCStateAbbreviationCd
ZIP27601ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2017-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN566052117EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1The Rex Healthcare Foundation IncBusinessNameLine1Txt
FieldValueIRS element (for citing)
In Care Of% ANDREW ZUKOWSKIInCareOfNm
Business Name ControlREXHBusinessNameControlTxt
Phone9197844424PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line14420 Lake Boone TrailAddressLine1Txt
CityRaleighCityNm
State AbbreviationNCStateAbbreviationCd
ZIP27607ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonANDREW ZUKOWSKIPersonNm
Person TitleCFOPersonTitleTxt
Phone9197844424PhoneNum
Signature2019-05-14SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonMarc BergerPreparerPersonNm
PTINP01871563PTIN
Phone9192781936PhoneNum
Preparation2019-05-14PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address4.14.250.26IPv4AddressTxt
FieldValueIRS element (for citing)
Federal Original Submission Id69472520191355000003FederalOriginalSubmissionId
Federal Original Submission Id2019-05-15FederalOriginalSubmissionIdDt
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device Id5A93BC6954598A5C499FB6FCEF79B3C90A134D16AtSubmissionCreationDeviceId
At Submission Filing Device Id5476F9B71916CD40FDB4E1086303C323EF876FF3AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2017TaxYr
Build TS2020-01-14 16:20:31ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1Rex Hospital FoundationBusinessNameLine1Txt
FieldValueIRS element (for citing)
Principal OfficerStephen BurrissPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line14420 Lake Boone TrailAddressLine1Txt
CityRaleighCityNm
State AbbreviationNCStateAbbreviationCd
ZIP27607ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$7,009,668GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.rexhealthcarefoundation.comWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1958FormationYr
Legal Domicile StateNCLegalDomicileStateCd
Activity Or MissionTo provide opportunities for our community to invest resources in the excellent work of UNC REX HEALTHCAREActivityOrMissionDesc
Voting Members Governing Body13VotingMembersGoverningBodyCnt
Voting Members Independent9VotingMembersIndependentCnt
Total Employee8TotalEmployeeCnt
Total Volunteers9TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$6,157,431PYContributionsGrantsAmt
CY Contributions Grants$5,218,319CYContributionsGrantsAmt
PY Program Service Revenue$0PYProgramServiceRevenueAmt
CY Program Service Revenue$0CYProgramServiceRevenueAmt
PY Investment Income$143,629PYInvestmentIncomeAmt
CY Investment Income$165,056CYInvestmentIncomeAmt
PY Other Revenue-$120,747PYOtherRevenueAmt
CY Other Revenue-$9,509CYOtherRevenueAmt
PY Total Revenue$6,180,313PYTotalRevenueAmt
CY Total Revenue$5,373,866CYTotalRevenueAmt
PY Grants And Similar Paid$3,002,390PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$4,334,877CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$571,675PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$695,453CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$179,266PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$17,137CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$990,259CYTotalFundraisingExpenseAmt
PY Other Expenses$273,643PYOtherExpensesAmt
CY Other Expenses$335,475CYOtherExpensesAmt
PY Total Expenses$4,026,974PYTotalExpensesAmt
CY Total Expenses$5,382,942CYTotalExpensesAmt
PY Revenues Less Expenses$2,153,339PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$9,076CYRevenuesLessExpensesAmt
Total Assets BOY$7,518,522TotalAssetsBOYAmt
Total Assets EOY$5,302,106TotalAssetsEOYAmt
Total Liabilities BOY$67,571TotalLiabilitiesBOYAmt
Total Liabilities EOY$47,944TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$7,450,951NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$5,254,162NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionOur mission is to provide opportunities for our community to invest resources in the excellent work of UNC Rex Healthcare. The core activities through which the Foundation fulfills this mission include: advocacy, education, program development, fundraising, strategic partnerships and donor engagement.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$4,334,877ExpenseAmt
Grant$4,334,877GrantAmt
DescTHE REX HEALTHCARE FOUNDATION SUPPORTS UNC REX HOSPITAL THROUGH A VARIETY OF PATIENT ASSISTANCE PROGRAMS, ASSISTS IN UPGRADING FACILITIES AND ACQUIRING THE MEDICAL EQUIPMENT NECESSARY TO CONTINUE EXCELLENT HEALTHCARE SERVICES. THESE PROGRAMS INCLUDE A MOBILE MAMMOGRAPHY UNIT THAT TRAVELS THE REGION PROVIDING FREE MAMMOGRAPHY SCREENING SERVICES TO UNDERSERVED PATIENTS, PATIENT ASSISTANCE THROUGH THE REX CANCER CENTER ANGEL FUND, NURSING EDUCATION, BLANKET WARMERS, PATIENT TRANSPORTATION TO TREATMENT AND MORE.Desc
Total Program Service Expenses$4,334,877TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsYes (true)TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstYes (true)ReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesfalseReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (true)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingYes (true)ProfessionalFundraisingInd
Fundraising ActivitiesYes (true)FundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsYes (true)GrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document3IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee8EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsYes (true)QuidProQuoContributionsInd
Quid Pro Quo Contri DisclYes (true)QuidProQuoContriDisclInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members13GoverningBodyVotingMembersCnt
Independent Voting Member9IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonANDREW ZUKOWSKIPersonNm
Phone9197844424PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line14420 LAKE BOONE TRAILAddressLine1Txt
CityRaleighCityNm
State AbbreviationNCStateAbbreviationCd
ZIP27607ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (21 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
Catharine B Arrowood
Director1.02.0Yes (X)$0$0$0
Teresa C Artis
Director1.02.0Yes (X)$0$0$0
Ann S Collins MD
Director1.02.0Yes (X)$0$0$0
Courtney A Crowder
Director1.02.0Yes (X)$0$0$0
Peter D Hans
Director1.02.0Yes (X)$0$0$0
Steven C Lilly
Director1.02.0Yes (X)$0$0$0
C Howard Nye
Director/Vice Chairman1.02.0Yes (X)$0$0$0
Gary L Park
Director1.02.0Yes (X)$0$1,019,986$549,846
Bobby T Parker
Director1.02.0Yes (X)$0$0$0
Rig S Patel MD
Director1.02.0Yes (X)$0$608,629$27,251
William L Roper MD
Director1.02.0Yes (X)$0$1,653,964$690,645
Robert S Thomas
Director/Chairman1.02.0Yes (X)$0$0$0
Stephen W Burriss
Director & President1.059.0Yes (X)$0$619,513$177,033Yes (X)
Sylvia D Hackett
Vice President1.059.0$0$353,767$87,084Yes (X)
Andrew K Zukowski
Treasurer1.059.0$0$379,003$57,998Yes (X)
Donald R Esposito Jr
Secretary1.059.0$0$371,720$63,865Yes (X)
Susan M Sandberg
Secretary1.059.0$0$451,726$69,518Yes (X)
Jeff S LeGay
Asst Treasurer/Asst Secretary1.059.0$0$226,260$17,551Yes (X)
Benjamin J Mathew
Asst Treasurer/Asst Secretary1.059.0$0$137,055$22,091Yes (X)
Amy Daniels
Director Major Gifts40.00.0$0$132,818$12,299Yes (X)
Katherine Stokes
Major Gifts Officer40.00.0$0$104,648$11,507Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$6,059,089TotReportableCompRltdOrgAmt
Total Other Compensation$1,786,688TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp

Contractor Name ContractorName

FieldValueIRS element (for citing)
PersonNONEPersonNm
FieldValueIRS element (for citing)
Contractor AddressContractorAddress
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt
Fundraising$621,032FundraisingAmt
Related Organizations$744,995RelatedOrganizationsAmt
All Other Contributions$3,852,292AllOtherContributionsAmt
Total Contributions$5,218,319TotalContributionsAmt
Total Program Service Revenue$0TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$58,639TotalRevenueColumnAmt
Exclusion$58,639ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$0RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$1,401,336SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$1,294,919SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$106,417SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$106,417TotalRevenueColumnAmt
Exclusion$106,417ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$331,374FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event$621,032ContriRptFundraisingEventAmt
Fundraising Direct Expenses$340,883FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column-$9,509TotalRevenueColumnAmt
Exclusion-$9,509ExclusionAmt
FieldValueIRS element (for citing)
Gaming Gross Income$0GamingGrossIncomeAmt
Gaming Direct Expenses$0GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gross Sales Of Inventory$0GrossSalesOfInventoryAmt
Cost Of Goods Sold$0CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Other Revenue Total$0OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$5,373,866TotalRevenueColumnAmt
Exclusion$155,547ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$4,334,877TotalAmt
Program Services$4,334,877ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$568,196TotalAmt
Fundraising$568,196FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$15,705TotalAmt
Fundraising$15,705FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$72,282TotalAmt
Fundraising$72,282FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$39,270TotalAmt
Fundraising$39,270FundraisingAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$17,137TotalAmt
Fundraising$17,137FundraisingAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$26,954TotalAmt
Management And General$26,954ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$56,725TotalAmt
Management And General$5,673ManagementAndGeneralAmt
Fundraising$51,052FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$16,685TotalAmt
Management And General$1,668ManagementAndGeneralAmt
Fundraising$15,017FundraisingAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$21,516TotalAmt
Management And General$2,152ManagementAndGeneralAmt
Fundraising$19,364FundraisingAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$48,000TotalAmt
Management And General$4,800ManagementAndGeneralAmt
Fundraising$43,200FundraisingAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$3,869TotalAmt
Management And General$387ManagementAndGeneralAmt
Fundraising$3,482FundraisingAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Expenses OtherExpensesGrp

FieldValueIRS element (for citing)
DescMISCELLANEOUSDesc
Total$161,726TotalAmt
Management And General$16,172ManagementAndGeneralAmt
Fundraising$145,554FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$5,382,942TotalAmt
Program Services$4,334,877ProgramServicesAmt
Management And General$57,806ManagementAndGeneralAmt
Fundraising$990,259FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$519,863BOYAmt
EOY$1,018,759EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$3,705,290BOYAmt
EOY$1,274,520EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$3,594BOYAmt
EOY$844EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$15,226LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$15,226LandBldgEquipAccumDeprecAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$3,289,775BOYAmt
EOY$3,007,983EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$7,518,522BOYAmt
EOY$5,302,106EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$67,571BOYAmt
EOY$47,944EOYAmt

Grants Payable GrantsPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$67,571BOYAmt
EOY$47,944EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$7,450,951BOYAmt
EOY$5,254,162EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$7,450,951BOYAmt
EOY$5,254,162EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$7,518,522BOYAmt
EOY$5,302,106EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$9,076ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$56,948NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$2,244,661OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3Yes (X)SupportingOrganization509a3Ind
Supporting Org Type2Yes (X)SupportingOrgType2Ind
Supported Organizations1SupportedOrganizationsCnt

Supported Org Information SupportedOrgInformationGrp

Supported Organization Name SupportedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1REX HOSPITAL INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
EIN561509260EIN
Organization Type3OrganizationTypeCd
Governing Document ListedYes (true)GoverningDocumentListedInd
Support$4,334,877SupportAmt
Other Support$0OtherSupportAmt
FieldValueIRS element (for citing)
Supported Organizations Total1SupportedOrganizationsTotalCnt
Support Sum$4,334,877SupportSumAmt
Other Support Sum$0OtherSupportSumAmt
Public Support CY5090.00000PublicSupportCY509Pct

Form990 Sch A Supporting Org Form990SchASupportingOrgGrp

FieldValueIRS element (for citing)
Listed By Name Governing DocfalseListedByNameGoverningDocInd
Suprt Org No IRS DeterminationfalseSuprtOrgNoIRSDeterminationInd
Supported Org Section C456falseSupportedOrgSectionC456Ind
Supported Org Not Organized USfalseSupportedOrgNotOrganizedUSInd
Organization Change Suprt OrgfalseOrganizationChangeSuprtOrgInd
Support Non Supported OrgfalseSupportNonSupportedOrgInd
Payment Substantial ContribtrfalsePaymentSubstantialContribtrInd
Loan Disqualified PersonfalseLoanDisqualifiedPersonInd
Controlled Disqualified PrsnfalseControlledDisqualifiedPrsnInd
Disqualified Prsn Controll IntfalseDisqualifiedPrsnControllIntInd
Disqualified Prsn Ownr IntfalseDisqualifiedPrsnOwnrIntInd
Excess Business Holdings RulesfalseExcessBusinessHoldingsRulesInd
Contribution ControllerfalseContributionControllerInd
Contribution FamilyfalseContributionFamilyInd
Contribution35 ControlledfalseContribution35ControlledInd
FieldValueIRS element (for citing)
Majority Dir Trst Supported OrgYes (true)MajorityDirTrstSupportedOrgInd

Form990 Schedule A Part VI Form990ScheduleAPartVIGrp

FieldValueIRS element (for citing)
Form And Line ReferencePART IV, Line 1FormAndLineReferenceDesc
ExplanationTHE ORGANIZATION AND THE SUPPORTED ORGANIZATION, REX HOSPITAL, INC., HAVE A HISTORIC RELATIONSHIP THAT HAS BEEN ONGOING FROM THE FORMATION OF REX HEALTHCARE FOUNDATION. REX HOSPITAL, INC. IS THE ONLY SUPPORTED ORGANIZATION OF REX HEALTHCARE FOUNDATION. ALL OF THE FINANCIAL SUPPORT PROVIDED BY THE ORGANIZATION GOES TO REX HOSPITAL, INC.ExplanationTxt

Schedule B IRS990ScheduleB

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmountsArtPublicExhibitionAmountsGrp
Held Works ArtHeldWorksArtGrp

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$300,391BeginningYearBalanceAmt
Contributions$99,598ContributionsAmt
End Year Balance$399,989EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$403,891BeginningYearBalanceAmt
Grants Or Scholarships$103,500GrantsOrScholarshipsAmt
End Year Balance$300,391EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$403,891BeginningYearBalanceAmt
End Year Balance$403,891EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$403,891BeginningYearBalanceAmt
End Year Balance$403,891EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$377,441BeginningYearBalanceAmt
Contributions$26,450ContributionsAmt
End Year Balance$403,891EndYearBalanceAmt
FieldValueIRS element (for citing)
Prmnnt Endowment Balance EOY1.00000PrmnntEndowmentBalanceEOYPct
Endowments Held Unrelated OrgfalseEndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgfalseEndowmentsHeldRelatedOrgInd
LandLandGrp
BuildingsBuildingsGrp
Leasehold ImprovementsLeaseholdImprovementsGrp

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$15,226OtherCostOrOtherBasisAmt
Depreciation$15,226DepreciationAmt
Book Value$0BookValueAmt
FieldValueIRS element (for citing)
Other Land BuildingsOtherLandBuildingsGrp
Total Book Value Land Buildings$0TotalBookValueLandBuildingsAmt

Invst Program Related Org InvstProgramRelatedOrgGrp

FieldValueIRS element (for citing)
DescEQUITIESDesc
Book Value$3,007,983BookValueAmt
Method ValuationFMethodValuationCd
FieldValueIRS element (for citing)
Total Book Value Program Rltd$3,007,983TotalBookValueProgramRltdAmt
Federal Income Tax Liability$0FederalIncomeTaxLiabilityAmt
Total Liability$0TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part V, Line 4THE INTENDED USE OF THE ENDOWMENT FUNDS IS TO FURTHER THE MISSION OF REX HEALTHCARE FOUNDATION.
Part X, Line 2THE FOLLOWING FOOTNOTE COMES FROM THE CONSOLIDATED FINANCIAL STATEMENTS OF REX HEALTHCARE, INC. AND SUBSIDIARIES, INCLUDING REX HEALTHCARE FOUNDATION, INC. THE FOOTNOTE REFERENCES OTHER MEMBERS OF THE AUDIT CONSOLIDATED GROUP THAT ARE NOT PART OF THIS TAX RETURN. REX, THE HOSPITAL, AND THE FOUNDATION ARE EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501(A) AS ORGANIZATIONS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. ENTERPRISES IS A TAXABLE CORPORATION THAT PREVIOUSLY HAD NET OPERATING LOSS CARRYFORWARDS WHICH EXPIRED IN 2012. THE HOSPITAL IS THE SOLE MEMBER OF RHV GP, RHVI, ROV, RSCW, HOLDINGS AND ENTERPRISES IS THE SOLE MEMBER OF RWE AND RHVLLC. RWE IS THE SOLE MEMBER OF WELLNESS AND MOB. AS SUCH THESE ENTITIES ARE CONSIDERED DISREGARDED ENTITIES FOR TAX PURPOSES.

Schedule G IRS990ScheduleG

FieldValueIRS element (for citing)
Mail SolicitationsYes (X)MailSolicitationsInd
Email SolicitationsYes (X)EmailSolicitationsInd
Phone SolicitationsYes (X)PhoneSolicitationsInd
In Person SolicitationsYes (X)InPersonSolicitationsInd
Solicitation Of Non Govt GrantsYes (X)SolicitationOfNonGovtGrantsInd
Special Fundraising EventsYes (X)SpecialFundraisingEventsInd
Agrmt Prof Fundraising ActyYes (true)AgrmtProfFundraisingActyInd

Fundraiser Activity Info FundraiserActivityInfoGrp

FieldValueIRS element (for citing)
PersonCapital Development SVCS IncPersonNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1633 W 4th Street Suite 202AddressLine1Txt
CityWinston SalemCityNm
State AbbreviationNCStateAbbreviationCd
ZIP27101ZIPCd
FieldValueIRS element (for citing)
ActivityConsultingActivityTxt
Fundraiser Control Of FundsfalseFundraiserControlOfFundsInd
Retained By Contractor$17,137RetainedByContractorAmt
Net To Organization-$17,137NetToOrganizationAmt
FieldValueIRS element (for citing)
Total Retained By Contractors$17,137TotalRetainedByContractorsAmt
Total Net To Organization-$17,137TotalNetToOrganizationAmt
Licensed StatesNCLicensedStatesCd

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Event1Rex Hospital OpEvent1Nm
Gross Receipts Event1$688,872GrossReceiptsEvent1Amt
Charitable Contri Event1$475,581CharitableContriEvent1Amt
Gross Revenue Event1$213,291GrossRevenueEvent1Amt
Food And Beverage Event1$17,250FoodAndBeverageEvent1Amt
Entertainment Event1$400EntertainmentEvent1Amt
Other Direct Expenses Event1$166,175OtherDirectExpensesEvent1Amt
Event2Rex GalaEvent2Nm
Gross Receipts Event2$263,534GrossReceiptsEvent2Amt
Charitable Contri Event2$145,451CharitableContriEvent2Amt
Gross Revenue Event2$118,083GrossRevenueEvent2Amt
Rent Facility Costs Event2$7,111RentFacilityCostsEvent2Amt
Food And Beverage Event2$67,525FoodAndBeverageEvent2Amt
Entertainment Event2$1,059EntertainmentEvent2Amt
Other Direct Expenses Event2$81,363OtherDirectExpensesEvent2Amt
Other Events Total0OtherEventsTotalCnt
Gross Receipts Other Events$0GrossReceiptsOtherEventsAmt
Charitable Contri Other Events$0CharitableContriOtherEventsAmt
Gross Revenue Other Events$0GrossRevenueOtherEventsAmt
Rent Fclty Costs Other Events$0RentFcltyCostsOtherEventsAmt
Food And Beverage Other Events$0FoodAndBeverageOtherEventsAmt
Entertainment Other Events$0EntertainmentOtherEventsAmt
Oth Direct Expnss Other Events$0OthDirectExpnssOtherEventsAmt
Gross Receipts Total$952,406GrossReceiptsTotalAmt
Charitable Contributions Tot$621,032CharitableContributionsTotAmt
Gross Revenue Total Events$331,374GrossRevenueTotalEventsAmt
Rent Fclty Costs Total Events$7,111RentFcltyCostsTotalEventsAmt
Food And Beverage Total Events$84,775FoodAndBeverageTotalEventsAmt
Entertainment Total Events$1,459EntertainmentTotalEventsAmt
Oth Direct Expnss Total Events$247,538OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events$340,883DirectExpenseSummaryEventsAmt
Net Income Summary-$9,509NetIncomeSummaryAmt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule G, PART I, Line 2B, List of Ten Highest Paid FundraisersFormAndLineReferenceDesc
Explanation(I) NAME OF FUNDRAISER: CAPITAL DEVELOPMENT SVCS, INC. (I) ADDRESS OF FUNDRAISER: 633 W 4TH STREET, SUITE 202, WINSTON SALEM, NC 27101ExplanationTxt

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (true)GrantRecordsMaintainedInd

Recipient Table RecipientTable

Recipient Business Name RecipientBusinessName

FieldValueIRS element (for citing)
Business Name Line1Rex Hospital IncBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line14420 Lake Boone TrailAddressLine1Txt
CityRaleighCityNm
State AbbreviationNCStateAbbreviationCd
ZIP27607ZIPCd
FieldValueIRS element (for citing)
Recipient EIN561509260RecipientEIN
IRC Section501(c)(3)IRCSectionDesc
Cash Grant$4,334,877CashGrantAmt
Non Cash Assistance$0NonCashAssistanceAmt
Purpose Of GrantGeneral SupportPurposeOfGrantTxt
FieldValueIRS element (for citing)
Total501c3 Org1Total501c3OrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart I, Line 2:FormAndLineReferenceDesc
ExplanationRex Healthcare Foundation's sole recipient of assistance is Rex Hospital, Inc. The two organizations work closely together, allowing for real-time and consistent monitoring of grants.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentYes (true)SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (true)SupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsYes (true)CompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (10 entries)

TitleTitleTxtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmtBase Compensation Filing OrgBaseCompensationFilingOrgAmtBonus Filing OrganizationBonusFilingOrganizationAmountOther Compensation Filing OrgOtherCompensationFilingOrgAmt
Gary L Park
Director$827,192$137,894$54,900$0$529,661$0$20,185$0$1,569,832$0$0
Rig S Patel MD
Director$549,499$33,528$25,602$0$12,000$0$15,251$0$635,880$0$0$0$0$0
William L Roper MD
Director$775,014$134,873$744,077$0$670,460$0$20,185$0$2,344,609$0$687,156
Stephen W Burriss
Director & President$478,328$79,866$61,319$0$159,793$0$17,240$0$796,546$0$104,185
Sylvia D Hackett
Vice President$277,000$44,918$31,849$0$76,302$0$10,782$0$440,851$0$0
Andrew K Zukowski
Treasurer$327,433$51,040$530$0$40,758$0$17,240$0$437,001$0$0
Donald R Esposito Jr
Secretary$271,218$49,527$50,975$0$47,951$0$15,914$0$435,585$0$0
Susan M Sandberg
Secretary$361,490$62,128$28,108$0$52,278$0$17,240$0$521,244$0$0
Jeff S LeGay
Asst Treasurer/Asst Secretary$194,660$24,513$7,087$0$8,096$0$9,455$0$243,811$0$0
Benjamin J Mathew
Asst Treasurer/Asst Secretary$127,397$9,318$340$0$5,323$0$16,768$0$159,146$0$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part I, Line 4AKatherine Stokes received a severance payment of $61,801
Part I, Line 4BWilliam J. Roper, MD received distributions totalling $687,156 from a non-qualified supplemental retirement plan funded and controlled by a related organization, UNC HCS. Stephen W. Burriss received distributions totalling $104,185 from a non-qualified supplemental retirement plan funded and controlled by a related organization, UNC HCS.
Part I, Line 6EMPLOYEES IN MANAGERIAL ROLES PARTICIPATE IN AN ANNUAL INCENTIVE COMPENSATION PLAN. THE COMPENSATION EARNED UNDER THIS PLAN IS BASED PARTLY ON THE COMBINED EARNINGS OF REX HEALTHCARE, INC. AND ITS SUBSIDIARIES. ADDITIONALLY, THE INCENTIVE COMPENSATION OF THE PRESIDENT AND CFO IS BASED PARTLY ON THE EARNINGS OF THE UNC HEALTH CARE SYSTEM. OTHER PERFORMANCE MEASURES USED TO DETERMINE INCENTIVE COMPENSATION ARE PHYSICIAN SATISFACTION, PATIENT CARE QUALITY OUTCOMES, EFFECTIVE USE OF TECHNOLOGY AND INDIVIDUAL GOALS.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (8 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 7ATHE UNIVERSITY OF NORTH CAROLINA HEALTH CARE SYSTEM APPOINTS ALL DIRECTORS ON THE ORGANIZATION'S BOARD OF TRUSTEES, WHICH SHALL NOT BE LESS THAN 9 NOR MORE THAN 13.
Form 990, PART VI, Section A, Line 7BThe organization's board requires prior approval of the university of north carolina health care system for certain powers, including but not limited to addition or deletion of a health care service, participation, directly or indirectly, in a joint venture, indebtedness and capital budgets, operating budgets and non-budgeted material expenditures.
Form 990, PART VI, Section B, Line 11BTHE ORGANIZATIONS EXECUTIVE TEAM DISCUSSES AND REVIEWS THE FORM 990 AND ALL ASSOCIATED SCHEDULES THROUGHOUT THE INFORMATION GATHERING STAGE. THE FORM 990 AND ASSOCIATED SCHEDULES ARE THEN REVIEWED AND APPROVED BY THE BOARD AS A WHOLE. A COPY OF THE APPROVED FORM 990 ALONG WITH THE ASSOCIATED SCHEDULES IS PROVIDED TO ALL BOARD MEMBERS PRIOR TO FILING.
Form 990, PART VI, Section B, Line 12CTHE ORGANIZATION REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY BY REQUIRING ALL BOARD MEMBERS TO ANNUALLY COMPLETE AND SIGN A QUESTIONNAIRE DOCUMENTING ANY AREA OF CONFLICT OF INTEREST. THE BOARD MEMBERS ARE REQUIRED TO REPORT AND DOCUMENT ANY NEW AREAS OF CONFLICT OF INTEREST AS THEY ARISE.
Form 990, PART VI, Section B, Line 15THE ORGANIZATION USES AN INDEPENDENT CONSULTANT TO MEASURE FAIR VALUE OF COMPENSATION FOR THE ORGANIZATIONS PRESIDENT AND OTHER TOP MANAGEMENT. BOTH REX AND UNIVERSITY OF NORTH CAROLINA HEALTH CARE SYSTEM BOARDS REVIEW AND APPROVE THE COMPENSATION FOR ALL OFFICERS EXCEPT THE ASSISTANT SECRETARY AND ASSISTANT TREASURER.
Form 990, PART VI, Section C, Line 19THE ORGANIZATIONS FORM 990 IS AVAILABLE UPON REQUEST AND ON GUIDESTARS WEBSITE AND THE FINANCIAL STATEMENTS ARE AVAILABLE ON MUNICIPAL SECURITIES RULEMAKING BOARDS WEBSITE. THE ORGANIZATION DOES NOT MAKE OTHER GOVERNING DOCUMENTS AND THE CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC.
Form 990, Part XI, Line 9, Other Changes in net assets or fund balancesadjustment for temporarily restricted contributions (2,244,661)
Form 990, Part XII, Line 2cThis process has not changed from the prior year.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (12 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
UNC Rockingham Health Care Inc
117 E Kings HwyEdenNC27288823745228HealthcareNC501(c)(3)Line 3UNC Health cfalse
UNC Health Care System
101 Manning DriveChapel HillNC27514562206970HealthcareNCSection 115UNC Health cfalse
UNC Hospitals at Chapel Hill
211 Friday Center Dr Suite 2029Chapel HillNC27517561118388HealthcareNCSection 115UNC Health Cfalse
Caldwell Memorial Hospital
PO Box 1890LenoirNC28645560554204HealthcareNC501(c)(3)Line 3UNC Health Cfalse
Caldwell Memorial Hospital Foundation
PO Box 1890LenoirNC28645581935514Support of CaNC501(c)(3)Line 7Caldwell Memfalse
Chatham Hospital Inc
PO Box 649Siler CityNC27344560611546HealthcareNC501(c)(3)Line 3UNC Health Cfalse
High Point Regional Health
601 N Elm StreetHigh PointNC27261560632309HealthcareNC501(c)(3)Line 3UNC Health Cfalse
High Point Regional Health Services
601 N Elm StreetHigh PointNC27261561497163HealthcareNC501(c)(3)Line 12B,IIUNC Health cfalse
High Point Regional Health Foundation
601 N Elm StreetHigh PointNC27261272854711Support of HiNC501(c)(3)Line 12A, IHigh Point Rfalse
Rex Healthcare Inc
4420 Lake Boone TrailRaleighNC27607561509129HealthcareNC501(c)(3)Line 12A, IUNC Health Cfalse
Rex Hospital Inc
4420 Lake Boone TrailRaleighNC27607561509260HealthcareNC501(c)(3)Line 3UNC Health Cfalse
UNC Physicians Network
1600 Perimeter Park Dr Ste 225MorrisvilleNC27560271081647HealthcareNC501(c)(3)Line 10UNC Health cfalse

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (6 entries)

EINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtPredominant Income TypePredominantIncomeTypeTxtAddress Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdUBI Code VUBICodeVAmt
Rex Surgery Center of Cary
273684056ASCNCNAN/A
JRH Ventures LLC
274092967MED Campus DVLTNCNAN/A4420 Lake Boone TrailRaleighNC27607
Rex Health Ventures I LP
371690478Venture Capital INCNAN/A4420 Lake Boone TrailRaleighNC27607
High Point Surgery Center
561867005High Point RegionNCNAN/A600 North Lindsay StreetHigh PointNC27260
Orthopaedic Surgery Center Of Raleigh LL
271740526Orthopaedic SurgeNCNAN/A4420 Lake Boone TrailRaleighNC27607
TRO Ventures LLC
821330195HealthcareNCNAN/A4420 Lake Boone TrailRaleighNC27607$0

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (3 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationInd
Rex Enterprises Company Inc
4420 Lake Boone TrailRaleighNC27607561553957Operations SupporNCNAC-Corpfalse
High Point Healthcare Ventures
601 N Elm StreetHigh PointNC27261561343468Holding CompanyNCNAC-Corpfalse
UNC Physicians Network Group Practices L
1600 Perimeter Park Drive Suite 22MorrisvilleNC27560461416986HealthcareNCNAC-Corpfalse
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (true)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgfalseGiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgfalsePerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (true)SharingOfFacilitiesInd
Paid Employees SharingYes (true)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (true)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrgInd
Transfer To Other OrgfalseTransferToOtherOrgInd
Transfer From Other OrgfalseTransferFromOtherOrgInd

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