2019-05-09T09:00:18-05:00 2018-06-30 BDO USA LLP 421 Fayetteville Street Suite 300 Raleigh NC 27601 990 2017-12-06 823745228 UNC Rockingham Health Care Inc % LATONYA BROWN UNCR 3366239711 117 East Kings Highway Eden NC 27288 LATONYA BROWN CFO 9849742081 2019-05-08 true Marc Berger P01871563 9192781936 4.14.250.26 69472520191295000001 2019-05-09 P 5A93BC6954598A5C499FB6FCEF79B3C90A134D16 5A93BC6954598A5C499FB6FCEF79B3C90A134D16 2017 2019-02-21 02:37:17Z X DANA WESTON 117 East Kings Highway Eden NC 27288 50721119 false X www.uncrockingham.org X 2017 NC To provide quality care, with a commitment to patient safety and clinical excellence. 12 10 0 121 0 0 0 10001722 0 39831511 0 18666 0 658304 0 50510203 0 0 0 0 0 20008236 0 0 0 0 21830469 0 41838705 0 8671498 0 33499029 0 11327531 0 22171498 X To provide quality care, with a commitment to patient safety and clinical excellence. false false 38812125 40455597 UNC Rockingham Health Care, Inc. is a nonprofit, 108 bed community hospital preserving excellent, compassionate and trusted care where it is needed most, close to home. As a cornerstone in Eden, NC and a major employer, the hospital serves people throughout Rockingham County and in neighboring Southern Virginia areas. In addition to inpatient, outpatient, surgical and emergency care, the hospital offers diagnostic and treatment services, provides screenings and tests and leads wellness initiatives. Our strong community ties motivate us to raise our standards every day, assuring that we provide trusted care, close to home. Highlights - a state of the art birthing center where mothers labor in well-appointed, home-like comfort, - an on-campus, 121 bed long term care facility offering skilled nursing and rehabilitation, - a wound care center with the area's only hyperbaric chambers offering state of the art care for difficult to heal wounds, - an occupational health center that supports local industries and businesses with wellness and injury and worker's compensation management, - an on-site cancer center making it possible for patients to receive treatment in the comfort of their community, - an urgent care center, Morehead West, in Mayodan, NC. More than 15 service areas and clinics round out our delivery of community based health and wellness. We have an active medical staff of 28, consulting staff of 14, courtesy staff of 41, contingent staff of 121, dental staff of 1, honorary staff of 3 and an allied health professional staff of 45. 38812125 true true false true false false false false false false true false false false true true true false false false false false false false false false true true false false true false false false false false false false false false false false false false true false false false true 0 0 0 false false false false false false false false false false X 12 10 false false false false true true true true true false false true true true true true true true true false X LATONYA BROWN 3366239711 117 EAST KINGS HIGHWAY Eden NC 27288 X R Scott Barham Director 2.0 0.0 X 0 0 0 James C Burnette Director/Secretary & Treasurer 5.0 0.0 X 0 0 0 Mark Collins Director 2.0 0.0 X 0 0 0 John R Dabbs DC Director 2.0 0.0 X 0 0 0 Chris Ellington Director 2.0 58.0 X 0 909437 275306 Tony Lindsey MD Director 2.0 58.0 X 0 0 0 William J McLeod MD Director 2.0 0.0 X 0 0 0 Jeffrey Parris Director/Vice Chair 5.0 0.0 X 0 0 0 Judy G Rouse Director 2.0 0.0 X 0 0 0 W Eugene Russell Director/Chair 5.0 0.0 X 0 0 0 Dana Weston President 60.0 0.0 X X 0 0 0 Terry Daniel MD Director 2.0 0.0 X 0 0 0 Gary Park Director 2.0 58.0 X 0 1019986 549846 Andy Willis Director 2.0 58.0 X 0 333371 186621 Ray Owings VP/Corporate Finance & CFO 60.0 0.0 X 0 0 0 Latonya Brown VP/Corporate Finance & CFO 60.0 0.0 X 0 0 0 JoAnn Smith VP/Patient Care Svcs & CNO 60.0 0.0 X 0 0 0 Tom Stevens VP/Human Resources 60.0 0.0 X 0 0 0 Wade Williams CIO 60.0 0.0 X 0 0 0 0 2262794 1011773 0 false true false 0 10000000 1722 10001722 PATIENT SERVICE REVENUE 524113 39795819 39795819 OTHER REVENUE 621110 35692 35692 39831511 18666 18666 0 0 245134 210916 34218 0 34218 34218 0 0 0 0 0 0 0 0 0 0 MISCELLANEOUS REVENUE 900099 624086 624086 624086 50510203 40455597 52884 X 0 0 0 0 0 0 15656457 14192578 1463879 368405 350243 18162 3176023 2819673 356350 807351 710469 96882 0 4929 4929 40000 40000 3031 3031 0 0 6741434 6134705 606729 38545 35076 3469 894869 817089 77780 275124 250363 24761 0 647294 589038 58256 8729 7943 786 0 48802 48802 117 106 11 0 361144 328641 32503 394277 358792 35485 BAD DEBT EXPENSE 7075112 7075112 0 PATIENT CARE SUPPLIES & SVCS 3577448 3577448 MINOR EQUIPMENT SUPPLIES & SVC 308521 280754 27767 OTHER EXPENSE 1411093 1284095 126998 41838705 38812125 3026580 0 0 5665453 0 0 0 0 0 11033127 0 0 0 0 0 0 0 942290 0 424033 14599748 361144 0 14238604 0 1195522 0 0 0 0 0 0 0 0 0 33499029 0 7541519 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3786012 0 11327531 X 0 22171498 0 0 0 0 0 22171498 0 33499029 X 8671498 13500000 X false true X false false X false false false false false false false false true 3031 3031 false Schedule C, Part II-B, Line 1i As a member of NCHA, a percentage of the membership dues are attributed to lobbying. 3221580 3221580 9057446 283926 8773520 2283400 73722 2209678 37322 3496 33826 14238604 0 DUE TO UNCHCS 1325478 DUE TO UNC REX 1010876 DUE TO UNCPN 1449658 3786012 X 33646007 -6864196 -6864196 40510203 10000000 10000000 50510203 34974509 210916 210916 34763593 7075112 7075112 41838705 PART X, LINE 2 Rockingham has applied to be exempt from federal INCOME TAX UNDER Section 501(a) as an organization described in Section 501(c)(3) of the internal revenue code. It is expected to be approved by the internal revenue service and exempt status to be retroactive to the date of formation. Prior to the filing of the Form 990 the organization received its tax-exempt status retroactive to the date of formation. PART XI, LINE 2D - OTHER ADJUSTMENTS BAD DEBT EXPENSE -7,075,112 Rental Expense 210,916 TOTAL TO SCHEDULE D, PART XI, LINE 2d -6,864,196 PART XI, LINE 4B - OTHER ADJUSTMENTS contribution from health care system 10,000,000 PART XII, LINE 2d - OTHER ADJUSTMENTS Rental Expense 210,916 PART XII, LINE 4B - OTHER ADJUSTMENTS BAD DEBT EXPENSE 7,075,112 true true X true X 250. false true true false true true 143877 143877 0.00340 5560814 5703567 5704691 5703567 143877 0.00340 5704691 5703567 143877 0.00340 true 7075112 2547040 13905735 15830688 -1924953 X true true 1 1 UNC Rockingham Health Care Inc 117 East Kings Highway Eden NC 27288 H0072 X X X UNC Rockingham Health Care Inc 1 false true false false true X 250. 0. false true X X X true X see Part V X see Part V X see Part V X X X X X X true X false X X X X true X false false Part V, Section B, Line 2 UNC Health Care System (UNC HCS) acquired the assets of Morehead Memorial Hospital (Morehead) on 1/1/2018 and because Morehead was in bankruptcy trust, UNC HCS had to create a new entity, UNC Rockingham Health Care, Inc. (UNCR), to place the assets in service. UNCR received its 501(c)(3) exemption from the IRS on 10/31/2018 with an effective date of 12/6/2017, date of organization. Since UNCR was acquired by UNC HCS on 1/1/2018, UNCR (as a newly acquired Organization) has a grace period to comply with the CHNA and Implementation Plan 501(r) requirements until the last day of the second taxable year beginning after 1/1/2018. The first CHNA and Implementation Plan cycle for UNCR will begin for tax year 2019 and due by end of 6/30/2020. Part V, Section B, Lines 16a-c: www.uncrockingham.org/patients-guests/financial-assistance 8 UNC Cancer Center at Rockingham 516 S Van Buren Road Eden NC 27288 Cancer Center UNC Family Medicine at Eden 515 Thompson Street Suite D Eden NC 27288 Family Medicine UNC Neurosurgery at Eden 518 S Van Buren Road Suite 6 Eden NC 27288 Neurosurgery UNC Orthopedics & Sports Medicine Eden 520 S Van Buran Road Suite 1 Eden NC 27288 Orthopedics UNC Rockingham Rehabilitation & Nursing 205 E Kings Highway Eden NC 27288 Nursing Facility UNC Surgical Specialists at Eden 515 Thompson Street Suite B Eden NC 27288 Surgical Specialists UNC Urgent Care - West Rockingham 601 NC Highway 135 Mayodan NC 27027 Urgent Care UNC Women's Health at Eden 522 S Van Buren Road Eden NC 27288 Women's Healthcare part iii, section a, line 2: The costing methodology used to determine payer costs is the ANDI methodology, which uses a facility-wide ratio of cost to charges as described in the NCHA Community Benefits Guidelines. part iii, section a, line 3: The estimate for bad debt expenses attributable to patients eligible under the Financial Assistance policy was calculated by applying the cost-to-charge ratio for the year to the gross bad debt charges attributable to uninsured patients during the year. While the costs of bad debts are present for essentially every business organization, few other than hospitals are expected to continue to provide services to those with means who have previously failed to pay. Continuation of service to patients with the means to pay but who have failed to do so is a further community benefit related to the organization's mission. Therefore, we believe that the cost of bad debts should be considered a community benefit. Part III, Section A, Line 4: Net patient service revenue is reported at the estimated net realizable amounts from patients, third-party payors, and others for services rendered, including estimated retroactive adjustments due to future audits, reviews, and investigations. Retroactive adjustments are accrued on an estimated basis in the period the related services are rendered, and such amounts are adjusted in future periods as adjustments become known or as years are no longer subject to such audits, reviews, and investigations. Part III, Section A, Line 8: UNC Rockingham provides services to patients regardless of ability to pay. As a result, the Hospital has incurred losses by serving Medicare patients. The unreimbursed services the Hospital provides to the community should be considered a community benefit since the healthcare needs of the community would otherwise by unmet. Part III, Section A, Line 9b: UNC Rockingham does not subject any patients to a collection agency who has qualified for financial assistance guidelines. Part VI, Line 2: UNC Rockingham completes an annual Community Benefits report. Part VI, Line 3: UNC Rockingham displays information regarding the availability of financial assistance and charity care in its Emergency room, registration areas in the Hospital and clinics and the patient services department. A link is also provided on UNC Rockingham's website to the availability of financial assistance and its charity care policy, along with an on-line application. Part VI, Line 4: UNC Rockingham in Eden, NC serves Rockingham County, which has a population of approximately 92,000 residents. Rockingham County covers 572 square miles in the upper piedmont triad region of North Carolina and shares a state line with Virginia. Rockingham County has the lowest physician/patient ratios in the state with only 47 providers for every 10,000 residents. The North Carolina average is 76 primary care providers for every 10,000 residents. Around 16 percent or residents are uninsured compared to 15 percent at the state level. Part VI, Line 5: UNC Rockingham is operated by a community Board in addition to traditional hospital services. The Organization provides a clinical training site for medical and nursing students, pharmacists, radiology technicians, physical therapists, respiratory therapists and dietitians. Part VI, Line 6: UNC Rockingham is a subsidiary of the UNC Health Care System (UNC HCS) in Chapel Hill, North Carolina. The UNC HCS serves patients from all 100 counties, regardless of their ability to pay, providing more than $300 million a year in uncompensated care. As a part of the integrated system, UNC Rockingham strives to improve access and services in Rockingham County. UNC Rockingham caregivers work closely with their counterparts at UNC HCS to find more ways to improve care and quality, reach more uninsured patients and so much more. Part VI, Line 7: North Carolina and Virginia false true false false false true true false false Chris Ellington Director 554380 93650 261407 0 254658 0 20648 0 1184743 0 172082 Gary Park Director 0 827192 0 137894 0 54900 0 529661 0 20185 0 1569832 0 0 Andy Willis Director 0 228666 0 36995 0 67710 0 170578 0 16043 0 519992 0 0 Schedule J, Part I, Line 4B Chris Ellington received a distribution of $172,082 from a non-qualified supplemental retirement plan funded and controlled by a related organization, UNC HCS. Schedule J, Part I, Line 6 EMPLOYEES IN MANAGERIAL ROLES PARTICIPATE IN AN INCENTIVE COMPENSATION PLAN APPROVED ANNUALLY BY THE UNC HCS BOARD OF DIRECTORS. THE COMPENSATION EARNED UNDER THIS PLAN IS BASED PARTLY ON THE NET EARNINGS OF THE ORGANIZATION AND THE UNC HCS. OTHER PERFORMANCE MEASURES USED TO DETERMINE INCENTIVE COMPENSATION ARE PATIENT SATISFACTION, PATIENT CARE QUALITY OUTCOMES AND INNOVATIVE INITIATIVES TO IMPROVE OPERATIONS AND CARE DELIVERY. Part VI, Section A, Line 4 UNC Rockingham Health Care, Inc. was incorporated on December 6, 2017 and all governing documents were established. The Organization received their IRS 501(c)(3) exemption on October 31, 2018 with the effective date of exemption of December 6, 2017. Part VI, Section A, Line 6 The Organization's sole member is the University of North Carolina Health Care System. Part VI, Section A, Line 7a The University of North Carolina Health Care System shall appoint three members of the Board of Directors. Part VI, Section A, Line 7b The Organization's Board requires prior approval of the University of North Carolina Health Care System for certain powers, including but not limited to amendments to governing documents; merger, consolidation or dissolution of the Organization; any disposition of all or substantially all of the property or assets; adoption of annual operating and capital budgets; adoption of strategic and business plans; indebtedness; certain thresholds of purchase and sale prices for real and material assets; any addition or deletion of health care services; extraordinary filings with regulatory agencies and creation of joint ventures. Part VI, Section B, Line 11b The Form 990 was prepared by an independent accounting firm and detail reviewed by Executive leadership. A copy of the Form 990 was received by the full Board for their review and any questions. If any changes, a final Form 990 was provided to the full Board prior to filing with the IRS. Part VI, Section B, Line 12C The Organization regularly and consistently monitors and enforces compliance with the Conflict of Interest policy by requiring all Board members and officers 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. Part VI, Section B, Line 15a The compensation of the officers of the Organization shall be fixed from time-to-time by the Board, except that the Board may delegate to any officer who has been given power to appoint subordinate officers or agents the authority to fix the salaries or other compensation of any such officers or agents appointed by him or her. Part VI, Section B, Line 15b The compensation of the officers of the Organization shall be fixed from time-to-time by the Board, except that the Board may delegate to any officer who has been given power to appoint subordinate officers or agents the authority to fix the salaries or other compensation of any such officers or agents appointed by him or her. Part VI, Section C, Line 19 PHOTOCOPIES OF THE FORM 1023 ARE AVAILABLE UPON REQUEST AT THE ORGANIZATION'S ADMINISTRATIVE OFFICE. Part VIi, Line 1b average hours per week BOARD MEMBERS AND OFFICERS CONTRIBUTE THEIR TIME AND SERVICES UPON REQUEST AND ON AN AS-NEEDED BASIS, WHICH, THROUGHOUT THE YEAR, MAY DIFFER FROM THE AVERAGE NUMBER OF HOURS PER WEEK REPORTED ON PART VII, LINE 1B. Part XI, Line 9 other changes in net assets or fund balances opening assets transfer to entity $13,500,000 FORM 990 PART IX LINE 11G DESCRIPTION:CONTRACTED SERVICES TOTAL FEES:6741434 UNC HEALTH CARE SYSTEM 101 MANNING DRIVE CHAPEL HILL NC 27514 562206970 HEALTHCARE NC SECTION 115 UNC HEALTH C false UNC HOSPITALS AT CHAPEL HILL 211 FRIDAY CENTER DR SUITE 2 CHAPEL HILL NC 27517 561118388 HEALTHCARE NC SECTION 115 UNC HEALTH C false CALDWELL MEMORIAL HOSPITAL PO BOX 1890 LENOIR NC 28645 560554204 HEALTHCARE NC 501(C)(3) LINE 3 UNC HEALTH C false CALDWELL MEMORIAL HOSPITAL FOUNDATION PO BOX 1890 LENOIR NC 28645 581935514 SUPPORT OF CA NC 501(C)(3) LINE 7 CALDWELL MEM false CHATHAM HOSPITAL INC PO BOX 649 SILER CITY NC 27344 560611546 HEALTHCARE NC 501(C)(3) LINE 3 UNC HEALTH C false HIGH POINT REGIONAL HEALTH 601 N ELM STREET HIGH POINT NC 27261 560532309 HEALTHCARE NC 501(C)(3) LINE 3 UNC HEALTH C false HIGH POINT REGIONAL HEALTH SERVICES 601 N ELM STREET HIGH POINT NC 27261 561497163 HEALTHCARE NC 501(C)(3) LINE 12B,II UNC HEALTH C false HIGH POINT REGIONAL HEALTH FOUNDATION 601 N ELM STREET HIGH POINT NC 27261 272854711 SUPPORT OF HI NC 501(C)(3) LINE 12A, I HIGH POINT R false REX HEALTHCARE INC 4420 LAKE BOONE TRAIL RALEIGH NC 27607 561509129 HEALTHCARE NC 501(C)(3) LINE 12A, I UNC HEALTH C false REX HOSPITAL INC 4420 LAKE BOONE TRAIL RALEIGH NC 27607 561509260 HEALTHCARE NC 501(C)(3) LINE 3 UNC HEALTH C false UNC PHYSICIANS NETWORK 1600 PERIMETER PARK DR STE 22 MORRISVILLE NC 27560 271081647 HEALTHCARE NC 501(C)(3) LINE 10 UNC HEALTH C false THE REX HEALTHCARE FOUNDATION INC 4420 LAKE BOONE TRAIL RALEIGH NC 27607 566052117 SUPPORT REX H NC 501(C)(3) LINE 12, II UNC HEALTH C false Rex Surgery Center of Cary 4420 Lake Boone Trail Raleigh NC 27607 273684056 ASC NC NA N/A 0 0 0 JRH Ventures LLC 4420 Lake Boone Trail Raleigh NC 27607 274092967 Med Campus DVLT NC NA N/A 0 0 0 0.00000 Rex Health Ventures I LP 4420 Lake Boone Trail Raleigh NC 27607 371690478 Venture Capital I NC NA N/A 0 0 0 HIGH POINT SURGERY CENTER 600 NORTH LINDSAY STREET HIGH POINT NC 27260 561867005 high point region NC NA N/A 0 0 0 0.00000 Orthopaedic Surgery Center of Raleigh 4420 Lake Boone Trail Raleigh NC 27607 271740526 Orthopaedic Surge NC NA N/A 0 0 0 0.00000 TRO Ventures LLC 4420 Lake Boone Trail RALEIGH NC 27607 821330195 Healthcare NC NA N/A 0 0 0 0.00000 REX ENTERPRISES COMPANY INC 4420 LAKE BOONE TRAIL RALEIGH NC 27607 561553957 OPERATIONS SUPPOR NC NA C CORP 0 0 0.00000 false HIGH POINT HEALTHCARE VENTURES 601 N ELM STREET HIGH POINT NC 27261 561343468 HOLDING COMPANY NC NA C CORP 0 0 0.00000 false UNC PHYSICIANS NETWORK GROUP PRACTICES 1600 PERIMETER PARK DRIVE SUITE 225 MORRISVILLE NC 27560 461416986 HEALTHCARE NC NA C CORP 0 0 0.00000 false false false false false false false false false false false false false false true true true false false false