2019-08-14T09:17:29-05:00 2018-09-30 410746749 CLIFTONLARSONALLEN LLP 227 WEST TRADE STREET SUITE 800 CHARLOTTE NC 28202 990 2017-10-01 560603898 HARNETT HEALTH SYSTEM INC HARN 9108927161 PO BOX 1707 DUNN NC 28335 JESSICA LANG CFO 9108927161 2019-08-13 1 JOHN NORMAN P01506766 7049985200 2019-08-13 67.137.57.251 2019-08-13 11:52:01 ED P E6B36A5AA947C5ABCF14DB2FEAA03B911CABFB79 7FA111DA1DF952C3932DE9B02872546115851591 2017 2019-02-21 02:37:17Z BETSY JOHNSON REGIONAL HOSPITAL JESSICA LANG PO BOX 1707 DUNN NC 28335 96253229 0 X WWW.MYHARNETTHEALTH.ORG X 1937 NC PROVIDING MEDICAL CARE FOR PATIENTS OF THE HOSPITAL 13 12 1095 90 0 0 116002 226340 105108126 95161470 30242 61903 789694 803516 106044064 96253229 0 0 0 0 53869107 53631470 0 0 0 42855040 41164844 96724147 94796314 9319917 1456915 100556527 98294839 110896931 107178328 -10340404 -8883489 X HARNETT HEALTH IS COMMITTED TO PROVIDING QUALITY HEALTHCARE TO THE RESIDENTS OF HARNETT COUNTY AND SURROUNDING COMMUNITIES. WE ARE A PRIVATE, NOT-FOR-PROFIT HEALTHCARE ORGANIZATION BASED IN HARNETT COUNTY, N.C. ORGANIZATION BASED IN HARNETT COUNTY, N.C. 1 0 82029799 95161470 THE HOSPITAL SERVED THE HARNETT COUNTY POPULATION AND REACHED INTO THE COUNTIES OF SAMPSON, JOHNSTON AND CUMBERLAND. THE HOSPITAL SERVED 18,966 INPATIENTS DAYS FOR FY18. THE HOSPITAL EXPERIENCED 512 DELIVERIES, THE OUTPATIENTS/EMERGENCY VISITS TOTALED 114,788, PHYSICAL THERAPY-OCCUPATIONAL THERAPY-SPEECH THERAPY VISITS AND ALL OTHER OUTPATIENT VISITS TOTALED 22,677, PULMONARY REHAB SAW 45 NEW PATIENTS, AND CARDIAC REHAB TREATED 163 NEW PATIENTS. SOME OF THE OUTCOMES WERE THE FOLLOWING - FERRANS AND POWERS SURVEY, OVERALL QUALITY OF LIFE IMPROVED 6% - HEALTH AND FUNCTIONING SUB-SCORE IMPROVED 12% POINTS; EDUCATIONAL ASSESSMENT SCORE IMPROVED 6%; NUTRITIONAL IMPROVEMENT 10%. MEDICATION MANAGEMENT OF HARNETT COUNTY (BETSY JOHNSON REGIONAL HOSPITAL) ENCOUNTERED 104 NEW PATIENTS WITH A TOTAL OF 335 ACTIVE PARTICIPATES IN THE PROGRAM. WE RECEIVED 1679 MEDICATIONS WITH A TOTAL VALUE OF $2,743,418. THE HOSPITAL IS INCLUDED IN SEVERAL OUTREACH PROGRAMS: - THE TEENS AS PARENTS PROGRAM, WHICH COLLABORATES WITH TWO OTHER COUNTY AGENCIES, PROVIDES A HOME VISITATION PROGRAM AND THE CONTINUATION OF EDUCATION CLASSES ON CHILDBIRTH AND PARENTING. THE PROGRAM ALSO PROVIDES HARNETT COUNTY TEEN PARENTS WITH OPPORTUNITIES TO DEVELOP SELF-RESPECT, PARENTING, AND DECISION-MAKING SKILLS WHILE CONTINUING THEIR EDUCATION. - TAP SERVED 21 TEENS. THE REPEAT PREGNANCY RATE FOR TAP PARTICIPANTS IS 0%, COMPARED TO THE COUNTY RATE OF 26.1%. THE TAP PROGRAM PARTICIPANTS RECEIVED 198.75 HOURS HOME VISITATION, 260 HOURS GROUP INSTRUCTION, 7.75 HOURS ACADEMIC SUPPORT, 104.50 HOURS OF PARENTING EDUCATION, 2.50 HOURS OF INDIVIDUAL COUNSELING AND 62 HOURS OF LIFE SKILLS TRAINING. - HEALTH HARNETT PROGRAM, OR "GO RED", IS A PROGRAM THAT PROMOTES HEALTHY EATING, WHICH LEADS TO A HEALTHY LIFESTYLE. HARNETT HEALTH COLLABORATED WITH THE NC COOPERATIVE EXTENSION AND THE HARNETT COUNTY HEALTH DEPARTMENT. THERE WERE A TOTAL OF 90 PARTICIPANTS IN ONE PRESENTATION GIVEN BY THE HARNETT HEALTH CARDIAC REHAB DEPARTMENT. THE PROGRAM ALSO OFFERED FREE EDUCATIONAL BROCHURES AND INFORMATION AT ALL EVENTS. - HARNETT HEALTH ALSO PARTICIPATES IN PROJECT ACCESS OF JOHNSON/HARNETT COUNTY WHICH IS A PHYSICIAN LED VOLUNTEER INITIATIVE THAT GIVES LOW INCOME, UNINSURED COUNTY RESIDENTS ACCESS TO COMPREHENSIVE MEDICAL CARE PHYSICIANS AND COMMUNITY PARTNERS. - HARNETT HEALTH DONATES MEDICAL SERVICES WITHOUT RECEIVING REIMBURSEMENT OR COMPENSATION. THE PROGRAM HAS ASSISTED 121 PATIENTS FOR THE LAST FISCAL YEAR. HARNETT HEALTH PROVIDED $199,196.62 IN FREE CARE TO THE PARTICIPANTS IN THIS PROGRAM. 82029799 1 1 0 1 0 0 0 0 0 0 1 1 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 1 190 0 1095 1 0 0 0 0 0 0 0 0 0 0 X 13 12 0 1 0 0 0 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X JESSICA LANG 9108921000 800 TILGHMAN DRIVE DUNN NC 28334 WALTER MASSEY CHAIRMAN 4.00 X X 0 0 0 GENE LEWIS TREASURER 2.00 X X 0 0 0 NEIL EMORY VICE CHAIRMAN 2.00 X X 0 0 0 FRANK STEWART SECRETARY 2.00 X X 0 0 0 MIKE NAGOWSKI BOARD MEMBER 2.00 X X 0 0 0 TERRILL BROWN DPM BOARD MEMBER 2.00 X X 0 0 0 BARBARA MCKOY BOARD MEMBER 2.00 X X 0 0 0 THOMAS BUTLER BOARD MEMBER 2.00 X X 0 0 0 GEORGE WOMBLE BOARD MEMBER 2.00 X X 0 0 0 SUSAN CHRISCOE BOARD MEMBER 2.00 X X 0 0 0 DR BRADLEY CREED BOARD MEMBER 2.00 X X 0 0 0 ERIC TRUESDALE BOARD MEMBER 2.00 X X 0 0 0 STEVE CLABAUGH BOARD MEMBER 2.00 X X 0 0 0 KEVIN JACKSON PRESIDENT (LEFT JUNE '18) 40.00 X 0 0 0 CORY HESS PRESIDENT 40.00 X 0 0 0 MIKE JONES VP 40.00 X 189207 0 25087 MARGARET ALEXANDER CNO/VP 40.00 X 0 0 0 JESSICA LANG CFO 40.00 X 0 0 0 OLALEKAN FOLARIN MD COMS 40.00 X 0 0 0 MICHAEL ZICH PHYSICIAN 40.00 X 324681 0 33169 PATRICK H GRAY PHYSICIAN 40.00 X 286482 0 1761 ASIF ZIA 4606 PHYSICIAN 40.00 X 231932 0 33517 BRAD BUTLER 4315 PHYSICIAN 40.00 X 224808 0 33828 BEVERLY A YEARWOOD 4185 PHYSICIAN 40.00 X 201000 0 15187 1458110 0 142549 6 0 1 0 BYERS DEAN & ASSOCIATES LLC 155 COMMERICE PARK SUITE 6 WESTERVILLE OH 430828384 BILLING SVC 606802 DIVERSIFIED CLINICAL SERVICES 28525 NETWORK PLACE CHICAGO IL 606731285 STAFFING MGMT 556817 TRAVEL NURSE ACROSS AMERICA LLC 5020 NORTHSHORE DR STE 2 NORTH LITTLE ROCK AR 72118 STAFFING 503739 LEXICODE CORPORATION (SOURCEHOV HEALTHCA PO BOX 142589 IRVING TX 75014 CODING/STAFF 448668 DR JAY R PARIKH 721 TILGHMAN DR SUITE 100 DUNN NC 28334 STAFFING 395050 27 226340 226340 NET PATIENT SERVICE REVENUE 621400 94011081 94011081 1150389 1150389 95161470 61903 61903 352233 0 352233 352233 352233 CAFETERIA SALES 900099 451283 451283 451283 96253229 95161470 0 865419 189207 189207 44969338 38384763 6584575 5540784 4709666 831118 2932141 2492320 439821 1542836 1542836 202613 202613 80027 80027 427265 427265 39473 39473 1593109 1593109 2317275 2317275 101357 101357 4028105 4028105 5362048 5362048 736731 736731 CONTRACT SERVICES/ CONT 7472531 7472531 MEDICAL SUPPLIES 6712361 6712361 MAINT. & REPAIRS 3950461 3950461 DRUGS 2196031 2196031 4402621 1506303 2896318 94796314 82029799 12766515 0 7913654 7908483 10406484 9650199 971 908 1820637 2013091 692565 732052 147347939 80870574 70019273 66477365 4657993 5228401 5044950 6284340 100556527 98294839 17289349 16278282 437810 19645000 18905000 65256415 64286395 8268357 7708651 110896931 107178328 X -15841557 -14893849 5501153 6010360 -10340404 -8883489 100556527 98294839 1456915 0 X X 0 1 X 1 1 1 X 0 0 0 0 0 0 0 0 1 5947 5947 0 PART II-B, LINE 1: HARNETT HEALTH PAID $34,070 TO NCHA FOR MEMBERSHIP FEES IN DECEMBER, 2017. NCHA DETERMINED 17.46% OF ITS MEMBERSHIP DUES WERE USED FOR LOBBYING PURPOSES, WHICH CAUSED AN INDIRECT LOBBYING EXPENSE OF $5,947 FOR HARNETT HEALTH. 1189620 1189620 91865242 35410533 56454709 53580124 44900673 8679451 712953 559368 153585 66477365 DEBT SERVICE RESERVE FUNDS 5228401 C 5228401 PREPAID PENSION COSTS 3002976 UNAMORTIZED LOSS ON EXTINGUISHMENT OF DEBT 1403082 DEFERRED INFLOWS 1878282 6284340 ESTIMATED THIRD PARTY SETTLEMENTS 5989901 DUE TO HHS FOUNDATION 25164 DEFERRED INFLOWS OF RESOURCES (PENSION RELATED) 1693586 7708651 X PART X, LINE 2: THE SYSTEM IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. ACCORDINGLY, THE ACCOMPANYING COMBINED FINANCIAL STATEMENTS DO NOT REFLECT A PROVISION OR LIABILITY FOR FEDERAL AND STATE INCOME TAXES. 1 1 X 1 X 1 X 1 1 1 0 1 1 2775867 2775867 0.02930 16674041 21604407 0 0.00000 160941 160941 0.00170 19610849 21604407 2936808 0.03100 28697 28697 0.00030 28697 28697 0.00030 19639546 21604407 2965505 0.03130 1 8303685 6975095 42899218 37839894 5059324 X 1 1 2 1 BETSY JOHNSON REGIONAL HOSPITAL 800 TILGHMAN DRIVE DUNN NC 28835 X X X DISPROPORTIONATE SHARE HOSPITAL 2 CENTRAL HARNETT HOSPITAL 215 BRIGHTWATER DRIVE LILLINGTON NC 27546 X X X BETSY JOHNSON REGIONAL HOSPITAL 1 0 0 1 X X X X X X X X X 16 1 1 1 1 X WWW.MYHARNETTHEALTH.ORG/COMMUNITY-NEEDS/ X X 1 16 1 WWW.MYHARNETTHEALTH.ORG/COMMUNITY-NEEDS/ 0 1 X 200.000000000000 400.000000000000 X X X X X 1 1 X X X X 1 X HTTP://MYHARNETTHEALTH.ORG/FINANCIAL-SERVICES X HTTP://MYHARNETTHEALTH.ORG/FINANCIAL-SERVICES X HTTP://MYHARNETTHEALTH.ORG/FINANCIAL-SERVICES X X X X X 0 0 1 0 0 CENTRAL HARNETT HOSPITAL 2 0 0 1 X X X X X X X X X 16 1 1 1 1 X WWW.MYHARNETTHEALTH.ORG/COMMUNITY-NEEDS/ X 1 16 1 WWW.MYHARNETTHEALTH.ORG/COMMUNITY-NEEDS/ 0 1 X 200.000000000000 400.000000000000 X X X X X 1 1 X X X X 1 X HTTP://MYHARNETTHEALTH.ORG/FINANCIAL-SERVICES X HTTP://MYHARNETTHEALTH.ORG/FINANCIAL-SERVICES X HTTP://MYHARNETTHEALTH.ORG/FINANCIAL-SERVICES X X X X X 0 0 1 0 0 BETSY JOHNSON REGIONAL HOSPITAL PART V, SECTION B, LINE 5: IN 2015, HARNETT HEALTH SYSTEM, HARNETT COUNTY HEALTH DEPARTMENT, CAPE FEAR VALLEY HEALTH SYSTEM, THE HEALTHY HARNETT COALITION, AND THE DEPARTMENT OF PUBLIC HEALTH AT CAMPBELL UNIVERSITY BEGAN DISCUSSIONS AIMED AT DEVELOPING A SHARED CHNA. ALTHOUGH EACH ENTITY HAD A DIFFERENT TIMETABLE FOR ITS "NEXT" ASSESSMENT, SCHEDULES WERE ADJUSTED WITH THE GOAL OF COMPLETING A JOINT ASSESSMENT, DURING THE 2016 CALENDAR YEAR, THAT COULD THEN BE SIMULTANEOUSLY USED BY ALL PARTNERS AND THE COMMUNITY. A WORK GROUP WAS FORMED WITH REPRESENTATIVES OF HARNETT HEALTH, HARNETT COUNTY PUBLIC HEALTH DEPARTMENT, CAMPBELL UNIVERSITY, AND CAPE FEAR VALLEY HEALTH SYSTEM TO UPDATE AND EXTEND THE AVAILABLE DATABASE AND SURVEY, ANALYZE FINDINGS, AND PREPARE THE COMMUNITY HEALTH NEEDS ASSESSMENT FOR HARNETT COUNTY. THE CHNA PROCESS ALSO INVOLVED OTHER PARTNER ORGANIZATION REPRESENTATIVES, INCLUDING PROJECT ACCESS, UNITED WAY, COOPERATIVE EXTENSION, LOCAL CHURCHES, AND OTHER INTERESTED PARTNERS IN THE SERVICE AREA. CENTRAL HARNETT HOSPITAL PART V, SECTION B, LINE 5: IN 2015, HARNETT HEALTH SYSTEM, HARNETT COUNTY HEALTH DEPARTMENT, CAPE FEAR VALLEY HEALTH SYSTEM, THE HEALTHY HARNETT COALITION, AND THE DEPARTMENT OF PUBLIC HEALTH AT CAMPBELL UNIVERSITY BEGAN DISCUSSIONS AIMED AT DEVELOPING A SHARED CHNA. ALTHOUGH EACH ENTITY HAD A DIFFERENT TIMETABLE FOR ITS "NEXT" ASSESSMENT, SCHEDULES WERE ADJUSTED WITH THE GOAL OF COMPLETING A JOINT ASSESSMENT, DURING THE 2016 CALENDAR YEAR, THAT COULD THEN BE SIMULTANEOUSLY USED BY ALL PARTNERS AND THE COMMUNITY. A WORK GROUP WAS FORMED WITH REPRESENTATIVES OF HARNETT HEALTH, HARNETT COUNTY PUBLIC HEALTH DEPARTMENT, CAMPBELL UNIVERSITY, AND CAPE FEAR VALLEY HEALTH SYSTEM TO UPDATE AND EXTEND THE AVAILABLE DATABASE AND SURVEY, ANALYZE FINDINGS, AND PREPARE THE COMMUNITY HEALTH NEEDS ASSESSMENT FOR HARNETT COUNTY. THE CHNA PROCESS ALSO INVOLVED OTHER PARTNER ORGANIZATION REPRESENTATIVES, INCLUDING PROJECT ACCESS, UNITED WAY, COOPERATIVE EXTENSION, LOCAL CHURCHES, AND OTHER INTERESTED PARTNERS IN THE SERVICE AREA. BETSY JOHNSON REGIONAL HOSPITAL PART V, SECTION B, LINE 6A: CENTRAL HARNETT HOSPITAL, BETSY JOHNSON REGIONAL HOSPITAL, AND CAPE FEAR VALLEY HEALTH SYSTEM WORKED TOGETHER TO CONDUCT THE CHNA. CENTRAL HARNETT HOSPITAL PART V, SECTION B, LINE 6A: CENTRAL HARNETT HOSPITAL, BETSY JOHNSON REGIONAL HOSPITAL, AND CAPE FEAR VALLEY HEALTH SYSTEM WORKED TOGETHER TO CONDUCT THE CHNA. BETSY JOHNSON REGIONAL HOSPITAL PART V, SECTION B, LINE 6B: HARNETT COUNTY HEALTH DEPARTMENTCAMPBELL SCHOOL OF PUBLIC HEALTH CENTRAL HARNETT HOSPITAL PART V, SECTION B, LINE 6B: HARNETT COUNTY HEALTH DEPARTMENTCAMPBELL SCHOOL OF PUBLIC HEALTH BETSY JOHNSON REGIONAL HOSPITAL PART V, SECTION B, LINE 7D: THE HOSPITAL MADE THE CHNA AVAILABLE IN PRINT AT THE HEALTH DEPARTMENT. 6 1 - HARNETT HEALTH ANGIER MEDICAL SERVICES 185 RAWLS ROAD ANGIER NC 27501 PHYSICIAN PRACTICE 2 - HARNETT HEALTH LILLINGTON MEDICAL SERVIC 716 10TH STREET LILLINGTON NC 27546 PHYSICIAN PRACTICE 3 - HARNETT HEALTH DUNN MEDICAL SERVICES 700 TILGHMAN DRIVE 700 DUNN NC 28335 PHYSICIAN PRACTICE 4 - HARNETT HEALTH HARNETT OBGYN 608 TILGHMAN DRIVE DUNN NC 28335 PHYSICIAN PRACTICE 5 - HARNETT HEALTH PREMIER PEDIATRICS 802 TILGHMAN DRIVE DUNN NC 28335 PHYSICIAN PRACTICE 6 - COATS MEDICAL SERVICES 25 N JOHNSON STREET COATS NC 27521 PHYSICIAN PRACTICE PART III, LINE 2: COST-TO-CHARGE RATIO APPLIED AGAINST BAD DEBT CHARGES FROM UN-DISCOUNTED SELF-PAY PATIENTS. PART III, LINE 3: THE ORGANIZATION ESTIMATES THAT 84% OF BAD DEBT IS FROM SELF-PAY (UNINSURED) PATIENTS. PART III, LINE 4: THE ORGANIZATION'S FINANCIAL STATEMENTS DO NOT INCLUDE A FOOTNOTE ON BAD DEBT. BAD DEBT IS PRESENTED AT GROSS CHARGES. PER THE HOSPITAL'S AUDITED FINANCIAL STATEMENTS, THE ORGANIZATION ESTIMATES THAT SOME PORTION OF ITS BAD DEBT MAY QUALIFY FOR FINANCIAL ASSISTANCE DUE TO THE FACT THAT THE HOSPITAL DOES NOT HAVE 24 HOUR COVERAGE IN THE ED FOR FINANCIAL ASSISTANCE. ALSO, SOME PATIENTS TREATED REFUSE TO MEET AND DISCUSS FINANCIAL ASSISTANCE OPTIONS. THE ANDI REPORT WAS USED TO CALCULATE THE AMOUNT OF BAD DEBT THAT QUALIFIES FOR FINANCIAL ASSISTANCE. ANOTHER FACTOR CONTRIBUTING TO THE ESTIMATE OF BAD DEBT THAT MAY QUALIFY FOR FINANCIAL ASSISTANCE IS THAT WE DO NOT VISIT OUR INSURED INPATIENTS THAT MAY HAVE HIGH DEDUCTIBLES OR CO-INSURANCES. IN FUTURE YEARS, THE ORGANIZATION PLANS TO IMPROVE CONSULTATION SESSIONS TO INLCUDE INSURED PATIENTS WITH POTENTIALLY HIGH DEDUCTIBLES OR CO-PAYMENTS. PART III, LINE 8: THE ORGANIZATION USES ITS ANDI REPORT TO COMPUTE PART III, LINES 5 AND 6. PART III, LINE 9B: ALL PATIENTS RECEIVE LETTERS AND/OR STATEMENTS REGARDING THEIR ACCOUNTS AND THEY ARE GIVEN 120 DAYS FROM THE BILL DATE TO MAKE SATISFACTORY PAYMENT ARRANGEMENTS OR TO APPLY FOR FINANCIAL ASSISTANCE BEFORE THE ACCOUNT GOES TO BAD DEBT STATUS. PATIENTS WHO APPLY FOR FINANCIAL ASSISTANCE MUST COMPLY WITH THE REQUIREMENTS OF THE APPLICATION TO AVOID THE ACCOUNT GOING INTO BAD DEBT STATUS. PATIENTS APPLYING FOR AID ARE PLACED IN A HOLD STATUS BY THE PALS TEAM TO AVOID COLLECTIONS. PATIENTS WHO HAVE MADE AN EFFORT TO COMPLETE AN APPLICATION OR WHO MAY NOT HAVE HAD AN OPPORTUNITY TO DISCUSS THEIR FINANCIAL SITUATION AND THEIR ACCOUNT GOES TO A COLLECTION STATUS ARE EVALUATED ON A CASE BY CASE BASIS TO DETERMINE IF THE ACCOUNT IS REMOVED FROM COLLECTIONS AND FINANCIAL ASSISTANCE IS PROVIDED. PART VI, LINE 2: BASED ON THE DATA FROM THE HARNETT COUNTY NEEDS ASSESSMENT WE REVIEW WHAT KEY ISSUES ARE ALIGNED WITH OUR MISSION. FROM THERE, WE DEVELOP PLANS ON WHICH STRATEGIES WILL HAVE THE MOST IMPACT ON OUR COMMUNITY. PART VI, LINE 3: THE HOSPITAL SYSTEM OFFERS FINANCIAL ASSISTANCE TO ANYONE BASED ON NEED AND ABILITY TO PAY. OUR PATIENT ACCOUNT LIAISONS WILL ASSIST PATIENTS IN APPLYING FOR FINANCIAL ASSISTANCE AND ANY OTHER FUNDING SOURCES THAT MAY BE AVAILABLE. PRE-SCREENING MAYBE CONDUCTED AT PRE-ADMISSION OR POINT OF SERVICE FOR ALL UNISURED OR UNDERINSURED PATIENTS THAT CAN NOT MEET THE DEPOSIT REQUIREMENTS; HOWEVER, ALL EMERGENT SERVICES ARE PROVIDED WITHOUT REGARD TO THE ABLITY TO PAY OR NOT. PART VI, LINE 4: HARNETT HEALTH SYSTEM, INC. IS LOCATED IN THE SOUTHEASTERN/MIDDLE SECTION OF HARNETT COUNTY NORTH CAROLINA. AS A RURAL HOSPITAL, WE ARE A KEY COMPONENT OF OUR STATE'S HEALTH CARE SAFETY NET BY TREATING EVERYONE WHO COMES THROUGH OUR DOORS. OUR PATIENT VOLUMES EXEMPLIFY OUR COMMITTMENT: % OF ADMISSIONS, MEDICARE 48.5%,MEDICAID 26.2%,MANAGED CARE 11.7%, SELF PAY 8.5%, TRICARE AND ALL OTHER 5.1%. THE HOSPITAL'S SERVICE AREA INCLUDED HARNETT AND A PORTION OF THREE NEIGHBORING COUNTIES, CUMBERLAND, JOHNSTON AND SAMPSON. AGRICULTURE AND CONSTRUCTION ARE THE LEADING INDUSTRIES OF OUR ECONOMIC STRUCTURE. THE TOP LARGEST EMPLOYER IN HARNETT COUNTY IS THE PUBLIC SCHOOL SYSTEM. PART VI, LINE 5: THE ROLE OF HARNETT HEALTH SYSTEM PLAYS IN THE COMMUNITY IS TO CARE FOR AND HEAL THE SICK AND INJURED, BUT EQUALLY IMPORTANT IS EDUCATING OUR COMMUNITY THE IMPORTANCE OF GOOD HEALTH AND WAYS TO IMPROVE THEIR LIFESTYLES. WE DEFINE OUR OBLIGATION BY HOLDING COMMUNITY EDUCATION AND WELLNESS CLASSES, PARTICIPATING IN ANNUAL COMMUNITY EVENTS, AND EDUCATING HIGH SCHOOL STUDENT ON THE MANY AREA OF EMPLOYMENT IN THE HEALTHCARE FIELD.WITH THE FEDERAL FUNDING AND STATE CUTS IN REIMBURSEMENT NO SURPLUS OF FUNDS TO PROVIDE MANY OF THE EXTRA ACTIVITIES THAT THE SYSTEM WOULD LIKE TO BE ABLE TO PROVIDE TO THE COMMUNITY. THE TEENS AS PARENTS PROGRAM, WORKS WITH TEENS WHO ARE PREGANANT OR HAVE HAD BABIES TO PROVIDE ADDITIONAL SUPPORT BY THE MEANS OF HOME BASED VISITS AND SUPPORT GROUP MEETINGS. EMPHASIS IS TO HAVE THE TEEN RETURN TO THE EDUCATION ARENA AND TO CONTINUE TO PROVIDE PARENTING SUPPORT AND HAVE HEALTHY BABIES. SOME OF OUR STAFF SERVES OR HAS SERVED ON LOCAL BOARDS WITHIN THE COMMUNITES INCLUDING THE NC COOPERATIVE EXTENSION ADVISORY BOARD, TEENS AS PARENTS EXECUTIVE AND ADVISORY BOARD, AND VARIOUS OTHER CIVIC BOARDS. PART VI, LINE 6: THE ORGANIZATION IS NOT PART OF AN AFFILIATED HEALTH SYSTEM. PART VI, LINE 7, REPORTS FILED WITH STATES NC X 0 0 0 0 0 0 0 0 0 0 0 MIKE JONES VP 168625 0 20582 0 0 0 3622 0 21465 0 214294 0 0 0 MICHAEL ZICH PHYSICIAN 324681 0 0 0 0 0 5808 0 27361 0 357850 0 0 0 PATRICK H GRAY PHYSICIAN 282828 0 1500 0 2154 0 0 0 1761 0 288243 0 0 0 ASIF ZIA 4606 PHYSICIAN 182498 0 49434 0 0 0 4643 0 28874 0 265449 0 0 0 BRAD BUTLER 4315 PHYSICIAN 171038 0 53770 0 0 0 4058 0 29770 0 258636 0 0 0 BEVERLY A YEARWOOD 4185 PHYSICIAN 200000 0 1000 0 0 0 3283 0 11904 0 216187 0 0 0 FORM 990, PART III, LINE 2 IN JULY, 2018, HARNETT HEALTH ADDED ONCOLOGY SERVICES TO THE WIDE ARRANGE OF SERVICES PROVIDED TO THE COMMUNITY HARNETT SERVES. FORM 990, PART VI, SECTION A, LINE 3 ON NOVEMBER 3, 2014, HARNETT HEALTH SYSTEM ENTERED INTO AN AGREEMENT WITH CUMBERLAND COUNTY HOSPITAL SYSTEM DBA CAPE FEAR VALLEY HEALTH SYSTEM ("CFVH") TO PROVIDE DAY-TO-DAY MANAGEMENT SERVICES, PRIMARILY A CHIEF EXECUTIVE OFFICER. THE AGREEMENT REQUIRES THE SYSTEM TO REIMBURSE CFVH FOR THE SALARY AND BENEFITS ASSOCIATED WITH THE PRESIDENT POSITION AND ANY OTHER POSITION APPROVED IN THE CONTRACT. IN ADDITION, CAPE FEAR VALLEY HEALTH SYSTEM RECEIVES A MANAGEMENT FEE. FORM 990, PART VI, SECTION A, LINE 7A THE BOARD OF TRUSTEES OF THE ORGANIZATION IS COMPRISED OF THIRTEEN RESIDENTS OF HARNETT COUNTY, NC AND THE APPOINTED TRUSTEES SHALL SERVE A STAGGERED TERM FOR 1 TO 3 YEARS. SEVEN TRUSTEES OF THE ORGANIZATION ARE APPOINTED BY THE HARNETT COUNTY BOARD OF COMMISSIONERS, AND SHALL, AT ALL TIMES, INCLUDE AT LEAST ONE RESIDENT OF EACH OF THE FIVE COMMISSIONERS' DISTRICTS AND TWO OTHER PERSONS RESIDING IN HARNETT COUNTY. THE REMAINING SIX TRUSTEES ARE APPOINTED BY THE ORGANIZATION'S BOARD OF TRUSTEES AT ITS ANNUAL MEETING FROM NOMINEES THAT MEET RESIDENCY AND AGE REQUIREMENTS, AS DEFINED IN THE ORGANIZATION'S BYLAWS. FORM 990, PART VI, SECTION A, LINE 7B APPOINTED BOARD MEMBERS ARE APPROVED BY COUNTY COMMISSIONERS. FORM 990, PART VI, SECTION B, LINE 11B COPY OF THE 990 FORM IS AVAILABLE AT THE BOARD MEETING FOR REVIEW AND BOARD MEMBERS CAN REQUEST TO REVIEW OTHER TIMES OUTSIDE OF THE BOARD MEETING AS WELL. THE DIRECTOR OF FINANCE REVIEWS THE 990 WITH THE BOARD MEMBERS. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY IS REVIEWED ANNUALLY BY THE LEADERSHIP OF THE BOARD OF TRUSTEES (THROUGHOUT THE YEAR IF NEEDED) AND ADMINISTERED TO ALL VOTING BOARD MEMBERS. FORM 990, PART VI, SECTION B, LINE 15 EXECUTIVE SALARIES ARE DETERMINED BY A MARKET ANALYSIS INVOLVING COMPARABILITY DATA, INDUSTRY STANDARDS, AND LOCAL ECONOMICS. THE CEO'S SALARY IS A CONDITION OF THE MANAGEMENT AGREEMENT BETWEEN THE BOARD OF DIRECTORS AND CFVH (SEE THE RESPONSE TO LINE 3 ABOVE). THE BOARD HAS INDIRECT APPROVAL OVER THE COMPENSATION PAID TO THE CEO THROUGH THIS AGREEMENT, AND HAS APPROVAL OVER ANY ADDITIONAL AMOUNTS AND INCREASES. CFVH PREPARES A COMPENSATION STUDY FOR OFFICERS AND KEY EMPLOYEES EXCLUDING THE CEO AND MAKES THE RECOMMENDATIONS TO THE CEO OF HARNETT HEALTH SYSTEM. THOSE RECOMMENDATIONS, INCLUDING ANY AMOUNTS ALLOCATED FOR RAISES AND INCENTIVES, ARE INCLUDED IN THE ANNUAL BUDGET PROCESS WHICH IS APPROVED BY THE FINANCE COMMITIEE OF THE BOARD. FORM 990, PART VI, SECTION C, LINE 18 PHOTOCOPIES OF RECENT FILINGS OF THE FORM 990 ARE AVAILABLE UPON REQUEST AT THE ORGANIZATION'S ADMINISTRATIVE OFFICE. IN ADDITION, RECENT FILINGS OF THE FORM 990 ARE AVAILABLE AT WWW.GUIDESTAR.ORG. FORM 990, PART VI, SECTION C, LINE 19 PHOTOCOPIES OF THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST AT THE ORGANIZATION'S ADMINISTRATIVE OFFICE. FORM 990, PART XII, LINE 2C THE PROECESS HAS NOT CHANGED FROM THE PRIOR YEAR. ANGIER MEDICAL SERVICES LLC 185 RAWLS RD ANGIER NC 27501 270906936 PRIMARY CARE PROVIDER NC 1151180 725250 HARNETT HEALTH SYSTEM COATS MEDICAL SERVICES LLC 25 JOHNSON ST N COATS NC 27521 462540799 PRIMARY CARE PROVIDER NC 821086 201662 HARNETT HEALTH SYSTEM DUNN MEDICAL SERVICES LLC 803 TILGHMAN DR 100 DUNN NC 28334 273320115 PRIMARY CARE PROVIDER NC 799245 85671 HARNETT HEALTH SYSTEM HARNETT OBGYN LLC 700 TILGHMAN DR DUNN NC 28334 273320275 OBSTETRICS/GYNECOLOGY SERVICES NC 683628 18239 HARNETT HEALTH SYSTEM LILLINGTON MEDICAL SERVICES LLC 716 S 10TH STREET LILLINGTON NC 27546 272944176 INTERNAL MEDICINE, INFECTIOUS DISEASE, AND GYNECOLOGY NC 685876 856811 HARNETT HEALTH SYSTEM PREMIERE PEDIATRICS 802 TILGHMAN DR DUNN NC 28334 560603898 PEDIATRIC INFECTIOUS DISEASE, DEVELOPMENTAL AND BEHAVIORAL NC 1524855 98208 HARNETT HEALTH SYSTEM HARNETT HEALTH SYSTEM FOUNDATION 800 TILGHMAN DRIVE DUNN NC 28334 201929953 FUNDRAISING NC 501(C)(3) LINE 7 N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0