2018-05-15T11:02:26-05:00 2017-06-30 410746749 CLIFTONLARSONALLEN LLP 227 WEST TRADE STREET SUITE 800 CHARLOTTE NC 28202 990 2016-07-01 561509260 REX HOSPITAL INC REXH 9197843100 4420 LAKE BOONE TRAIL RALEIGH NC 27607 ANDREW ZUKOWSKI CFO 9197843100 2018-05-15 1 JOHN NORMAN P01506766 7049985200 2018-05-15 2016 2022-09-23 18:48:47Z SEE SCHEDULE O STEPHEN BURRISS 4420 LAKE BOONE TRAIL RALEIGH NC 27607 1750563874 0 X WWW.REXHEALTH.COM X 1986 NC TO PROVIDE THE BEST IN HEALTH SERVICES THROUGH COMPASSIONATE CARE AND LEADING-EDGE TECHNOLOGY. 13 9 6988 1369 2938757 -76856 1979704 3402553 978292468 1052634825 7488752 18148396 76586843 1026131 1064347767 1075211905 969415 1186134 0 0 425922352 461400667 0 0 0 512619174 539284556 939510941 1001871357 124836826 73340548 929466692 1011503690 524751693 524676830 404714999 486826860 X UNC REX HEALTHCARE IS THE PREFERRED CHOICE FOR HEALTH SERVICES AMONG PATIENTS IN WAKE COUNTY AND BEYOND BY COMBINING COMPASSIONATE CARE AND LEADING-EDGE TECHNOLOGY. UNC REX HEALTHCARE PROVIDES SERVICES AT FACILITIES AND CLINICS ACROSS WAKE COUNTY TO ALL PATIENTS, REGARDLESS OF THEIR ABILITY TO PAY. UNC REX HEALTHCARE ALSO SEEKS TO IMPROVE THE HEALTH OF THE COMMUNITY BY PROVIDING EDUCATION, DIAGNOSTIC AND PREVENTATIVE CARE, OFTEN BY JOINING FORCES WITH OTHER COMMUNITY GROUPS. IN ADDITION TO ITS MAIN RALEIGH CAMPUS, UNC REX HEALTHCARE OFFERS MUCH-NEEDED CARE AND SUPPORT AT CAMPUSES IN APEX, CARY, GARNER, HOLLY SPRINGS, KNIGHTDALE, RALEIGH AND WAKEFIELD. 0 0 828690545 1186134 1047124972 UNC REX IS THE ONLY HOSPITAL IN NORTH CAROLINA TO RECEIVE STRAIGHT "A" GRADES SINCE THE LEAPFROG GROUP BEGAN A NATIONAL HOSPITAL SAFETY SCORECARD IN 2012. IN DEC. 2017, UNC REX RECEIVED A TOP FIVE-STAR RATING FROM THE CENTERS FOR MEDICARE & MEDICAID SERVICES, ONE OF ONLY 337 HOSPITALS NATIONWIDE, AND THE ONLY HOSPITAL IN THE TRIANGLE REGION TO EARN THAT RECOGNITION.MORE THAN 10 YEARS AGO, UNC REX BECAME THE FIRST HOSPITAL IN THE TRIANGLE TO BE AWARDED MAGNET STATUS BY THE AMERICAN NURSES CREDENTIALING CENTER. IN 2015, UNC REX WAS RE-DESIGNATED MAGNET STATUS FOR THE THIRD CONSECUTIVE TIME. THE MAGNET RECOGNITION PROGRAM RECOGNIZES HEALTH CARE ORGANIZATIONS FOR EXCELLENCE IN NURSING CARE. THIS AWARD PUTS UNC REX'S NURSES IN AN ELITE GROUP OF THE TOP 2 PERCENT OF NURSES IN THE NATION.UNC REX IS ONE OF THE LARGEST EMPLOYERS IN WAKE COUNTY, WITH MORE THAN 6,400 CO-WORKERS. UNC REX IS KNOWN FOR ITS EXCELLENT BENEFITS AND IS ROUTINELY RECOGNIZED BY LOCAL AND NATIONAL PUBLICATIONS AS A "BEST PLACE TO WORK."UNC REX'S CULINARY TEAM HAS CREATED A CHEF-BASED PROGRAM THAT IS GAINING INTERNATIONAL RECOGNITION AND REINVENTING TRADITIONAL "HOSPITAL FOOD." THEY TEND AN HERB AND VEGETABLE GARDEN AT UNC REX, AND USE LOCAL AND FRESH INGREDIENTS AS MUCH AS POSSIBLE. UNC REX WAS THE FIRST HOSPITAL IN THE SOUTHEAST TO GET RID OF DEEP FRYERS AND THE CHEFS CONTINUE TO EXPLORE NEW WAYS TO COOK AND SERVE OUR CUISINE. IN MARCH 2017, THE UNC REX CHEFS OPENED A NEW MEDITERREAN-THEMED, HEART HEALTHY RESTAURANT CALLED KARDIA IN THE NEW NORTH CAROLINA HEART & VASCULAR HOSPITAL. IN ADDITION, THE CHEFS BEGAN OFFERING CLASSES ON HEALTHY COOKING AND EATING TO PATIENTS, THEIR FAMILIES AND MEMBERS OF THE COMMUNITY IN A NEW DEMONSTRATION KITCHEN. UNC REX PERFORMS THOUSANDS OF HEART AND VASCULAR PROCEDURES A YEAR, INCLUDING CORONARY ARTERY BYPASS GRAFTING, ENDOVASCULAR AAA REPAIR, ECHOCARDIOGRAPHY, PERIPHERAL VASCULAR ULTRASOUND, VALVE REPLACEMENT AND REPAIR, ANGIOPLASTY, CARDIAC CATHETERIZATION, MINIMALLY INVASIVE STRUCTURAL HEART PROCEDURES, INVASIVE PERIPHERAL VASCULAR INTERVENTIONS, INCLUDING CRITICAL LIMB ISCHEMIA PROCEDURES, ELECTROPHYSIOLOGY PROCEDURES AND STENT PLACEMENT, REGARDLESS OF PATIENTS' ABILITY TO PAY. UNC REX HAS BEEN A CHEST PAIN ACCREDITED HOSPITAL FOR MORE THAN A DECADE, REINFORCING THE ORGANIZATION'S DEDICATION TO COMMUNITY OUTREACH AND INNOVATION IN THE CARE OF CHEST PAIN PATIENTS. THE SERVICE LINE ALSO INCLUDES OPEN HEART SURGICAL SUITES WHERE PHYSICIANS PERFORM PROCEDURES SUCH AS CORONARY ARTERY BYPASS GRAFTING, MITRAL VALVE REPLACEMENT AND REPAIR, AND AORTIC VALVE AND AORTIC ARCH REPLACEMENTS. UNC REX ALSO PROVIDES A FULL RANGE OF INVASIVE CATHETER BASED CARDIAC, VASCULAR AND ELECTROPHYSIOLOGY PROCEDURES. ALL OF THE EXISTING HEART AND VASCULAR SERVICES AND CARE, WHICH WERE PROVIDED AT MORE THAN SEVEN LOCATIONS ACROSS THE MAIN HOSPITAL IN RALEIGH, WERE CONSOLIDATED INTO A MODERN, MORE EFFICIENT AND MORE CONVENIENT FACILITY WITH THE MARCH 2017 OPENING OF THE NORTH CAROLINA HEART AND VASCULAR HOSPITAL ON UNC REX'S MAIN RALEIGH CAMPUS. THIS EIGHT-STORY, 306,000-SQUARE-FOOT HOSPITAL PROVIDES EASIER AND MORE COMFORTABLE ACCESS FOR PATIENTS AND THEIR FAMILIES, PHYSICIANS AND STAFF, IN A FACILITY THAT'S DESIGNED TO PROMOTE HEALING, PREVENTION, EDUCATION, INNOVATION AND WELLNESS. FURTHERMORE, OUR CARDIAC AND PULMONARY REHAB OFFERINGS HAVE GROWN BY 35 PERCENT AND ALL CLASSES ARE FULL. OUR CHEFS AND DIETITIANS STARTED COMMUNITY HEALTHY COOKING DEMONSTRATIONS IN THE FALL OF 2017, AND HAVE HOSTED HUNDREDS OF PARTICIPANTS, INCLUDING PATIENTS AND THEIR FAMILIES.UNC REX SURGERY CENTERS IN RALEIGH, CARY AND WAKEFIELD WERE USED BY HUNDREDS OF PHYSICIANS TO PROVIDE THOUSANDS OF IN- AND OUT-PATIENT SURGERIES AND PROCEDURES IN FY17. THE THREE LOCATIONS HAVE IMPROVED ACCESS TO SPECIALIZED CARE FOR PATIENTS ACROSS THE REGION. SURGEONS MAKE SUBSTANTIAL USE OF MINIMALLY INVASIVE TECHNOLOGY AND INNOVATION FOR DIAGNOSIS AND TREATMENT, REDUCING PATIENTS' RECOVERY TIME AND HOSPITAL STAY AND SUPPORTING QUALITY CARE. THE CENTERS INCLUDE 38 OPERATING SUITES, 11 MINOR PROCEDURE ROOMS, AND VARIOUS PERIOPERATIVE AND ANCILLARY SUPPORT SPACES. UNC REX IS INCREASINGLY PERFORMING SURGERIES ON AN OUTPATIENT BASIS, AND CONTINUING TO LOOK FOR OTHER WAYS TO REDUCE OVERALL COSTS FOR PATIENTS. SOME OF THE TOP PROCEDURES INCLUDE GENERAL, ORTHOPEDIC, GYNECOLOGIC AND OPHTHALMIC SURGERIES. DURING THE YEAR, THOUSANDS OF OUTPATIENT ORTHOPEDIC PROCEDURES WERE PERFORMED AT RALEIGH ORTHOPAEDIC SURGERY CENTER, UNC REX'S JOINT VENTURE WITH RALEIGH ORTHOPAEDIC CLINIC LOCATED ABOUT A MILE FROM UNC REX'S MAIN RALEIGH CAMPUS. UNC REX PROVIDES A FULL RANGE OF SPECIALIZED, MULTI-DISCIPLINARY ONCOLOGY THERAPY AND SUPPORT SERVICES TO PATIENTS IN WAKE COUNTY AND BEYOND INCLUDING MEDICAL, RADIATION AND SURGICAL ONCOLOGY. IN ADDITION TO PROVIDING CANCER TREATMENTS AND THERAPIES AT FIVE LOCATIONS IN WAKE COUNTY, THE CENTERS OFFER OUTREACH AND SUPPORT SERVICES INCLUDING NUTRITIONAL SERVICES, NURSE NAVIGATION, SOCIAL WORK, REHABILITATION SERVICES AND SURVIVORSHIP OR END OF LIFE CARE. UNC REX CANCER CENTER ALSO PROVIDES ONCOLOGIC SURGICAL SERVICES TO CANCER PATIENTS THROUGH ACCESS TO UNC REX HOSPITAL. UNC REX CANCER CENTER IS ACCREDITED BY THE COMMISSION ON CANCER AS A COMPREHENSIVE COMMUNITY CANCER CENTER AND WORKS CLOSELY WITH THE NATIONALLY RECOGNIZED N.C. CANCER HOSPITAL AND THE UNC LINEBERGER COMPREHENSIVE CANCER CENTER IN CHAPEL HILL TO EXTEND SPECIALTY ONCOLOGY SERVICES AND CLINICAL TRIALS TO PATIENTS IN RALEIGH. IN EARLY 2017, UNC REX CANCER CARE BEGAN A PATIENT & FAMILY ADVISORY COUNCIL. IT'S A GROUP OF SURVIVORS AND OTHER VOLUNTEERS WHO VISIT WITH CANCER PATIENTS AND FAMILIES GOING THROUGH TREATMENT TO OFFER SUPPORT, GATHER FEEDBACK, DEVELOP NEW PROGRAMS AND ACTIVITIES, AND MORE. THE GOAL IS TO HELP STAFF UNDERSTAND WAYS THEY COULD IMPROVE THE OVERALL PATIENT EXPERIENCE. AT UNC REX'S WOMEN'S CENTER, CAREGIVERS SEEK TO PROVIDE FAMILY-CENTERED CARE TO THE NEW MOTHER, BABY AND EXTENDED FAMILY. EVERY YEAR, THOUSANDS OF BABIES ARE BORN AT THE WOMEN'S CENTER. THESE BIRTHS ARE SUPPORTED BY 24/7 ANESTHESIOLOGY AND NEONATOLOGY SERVICES, HIGH RISK OBSTETRICS PROVIDED BY UNC MATERNAL FETAL MEDICINE, LACTATION SUPPORT SERVICES PROVIDED BY A TEAM OF CERTIFIED LACTATION CONSULTANTS AND AN IN-HOUSE RETAIL CENTER FOR INFANT NUTRITION. UNC REX ALSO OFFERS A WIDE VARIETY OF PRE- AND POST-NATAL CLASSES, SCREENING FOR POSTPARTUM DEPRESSION AND PSYCHOLOGICAL SERVICES. THERE ARE THREE OPERATING SUITES FOR CESAREAN BIRTHS AND 70 PRIVATE ROOMS IN WHICH LABOR, DELIVERY, RECOVERY, AND POSTPARTUM CARE OF THE MOTHER AND CHILD NORMALLY OCCUR. UNC REX'S NEONATAL INTENSIVE CARE UNIT IS A LEVEL IV DESIGNATION, ALLOWING UNC REX'S TEAM OF BOARD CERTIFIED NEONATOLOGISTS, NURSES, RESPIRATORY THERAPISTS, DEVELOPMENTAL CARE TEAM AND OTHERS TO CARE FOR EVEN MORE PREMATURE AND MEDICALLY FRAGILE BABIES. UNC REX'S NICU WAS PREVIOUSLY DESIGNATED LEVEL III. IN 2016, REX ALSO ADDED AN OBSTETRIC EMERGENCY DEPARTMENT. THE OB ED IS STAFFED 24/7 WITH A TEAM OF OB HOSPITALISTS, NURSES AND TECHNICIANS WHO PROVIDE OBSTETRIC EMERGENCY CARE IN PARTNERSHIP WITH OUR COMMUNITY OBSTETRICIANS. THIS ASSURES OUR PATIENTS ALWAYS RECEIVE TIMELY OBSTETRIC CARE, NOT TO MENTION AN EXTRA PAIR OF HANDS WHEN AN OBSTETRICIAN HAS TWO DELIVERIES AT ONE TIME OR IS MANAGING OTHER URGENT PATIENT CARE NEEDS.UNC REX PROVIDED SCREENING MAMMOGRAMS TO THOUSANDS OF WOMEN ACROSS A 17-COUNTY REGION, INCLUDING MANY WITH NO INSURANCE OR WHO ARE UNDERINSURED. UNC REX'S TWO MOBILE MAMMOGRAPHY VEHICLES (NICKNAMED BETTY AND WILMA) PROVIDE A CONVENIENT OPTION FOR BUSINESS AND OTHER ORGANIZATIONS SO THAT ALL WOMEN MAY BENEFIT FROM MAMMOGRAPHY'S EARLY DETECTION CAPABILITIES. MOBILE MAMMOGRAPHY IS MADE POSSIBLE THROUGH GENEROUS FUNDING FROM REVLON INC., THE KAY YOW CANCER FUND, THE UNC REX HOSPITAL OPEN, AND THE REX HEALTHCARE FOUNDATION. MAMMOGRAPHY SERVICES FUNDING IS AVAILABLE FOR QUALIFIED WOMEN UTILIZING THE MOBILE MAMMOGRAPHY UNIT THROUGH GENEROUS FUNDING FROM SUSAN G. KOMEN FOR THE CURE, NC TRIANGLE AFFILIATE.UNC REX IS A LEADER IN WELLNESS, PREVENTION AND EDUCATION IN OUR COMMUNITY. WE WORK WITH VARIOUS COMMUNITY PARTNERS TO IMPROVE THE OVERALL HEALTH OF RESIDENTS OF ALL AGES. UNC REX WELLNESS CENTERS IN RALEIGH, CARY, WAKEFIELD, GARNER AND KNIGHTDALE PROVIDE A WIDE RANGE OF FITNESS, DIET, REHAB, EDUCATION AND OTHER SERVICES FOR THOUSANDS OF MEMBERS.REX EXPRESS CARE, OR URGENT CARE, CLINICS (CARY, HOLLY SPRINGS, KNIGHTDALE, RALEIGH AND WAKEFIELD) PROVIDE A CONVENIENT, LOWER-COST ALTERNATIVE TO THE HOSPITAL EMERGENCY DEPARTMENT FOR PATIENTS WHO NEED URGENT MEDICAL TREATMENT BECAUSE OF AN ACCIDENT OR ILLNESS. REX EXPRESS CARE USES AN ONLINE RESERVATION SYSTEM AT ALL FIVE LOCATIONS ACROSS WAKE COUNTY, MAKING IT EASIER FOR PATIENTS TO SCHEDULE THEIR URGENT CARE VISITS. 828690545 1 1 0 1 0 0 0 0 1 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 1 234 0 1 6988 1 1 1 0 0 0 0 0 0 0 0 0 X 13 9 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 X CFO 9197843100 4420 LAKE BOONE TRAIL RALEIGH NC 27607 CATHARINE B ARROWOOD DIRECTOR 1.00 2.00 X 0 0 0 TERESA C ARTIS DIRECTOR 1.00 2.00 X 0 0 0 ANN S COLLINS MD DIRECTOR 1.00 2.00 X 0 0 0 COURTNEY A CROWDER DIRECTOR 1.00 2.00 X 0 0 0 PETER D HANS DIRECTOR 1.00 2.00 X 0 0 0 STEVEN C LILLY DIRECTOR 1.00 2.00 X 0 0 0 C HOWARD NYE DIRECTOR/VICE CHAIRMAN 2.00 4.00 X 0 0 0 BOBBY T PARKER DIRECTOR 1.00 2.00 X 0 0 0 RIG S PATEL MD DIRECTOR/HOSPITALIST 59.00 1.00 X 71010 0 0 WILLIAM L ROPER MD DIRECTOR 1.00 59.00 X 0 934489 636968 ROBERT S THOMAS DIRECTOR/CHAIRMAN 2.00 4.00 X 0 0 0 GARY L PARK CEO 59.00 1.00 X X 0 2030958 540181 STEPHEN W BURRISS PRESIDENT 59.00 1.00 X X 589701 0 147720 SUSAN M SANDBERG COO 59.00 1.00 X 473689 0 61885 ANDREW K ZUKOWSKI CFO & TREASURER (AS OF 8/22/2016) 59.00 1.00 X 148829 0 18924 LINDA H BUTLER MD VP/MEDICAL AFFAIRS, CMO & CMIO 60.00 0.00 X 366572 0 61458 JAYNE R BYRD VP/SURGICAL SERVICES 60.00 0.00 X 249858 0 131288 DONALD R ESPOSITO JR VP/GENERAL COUNSEL & SECRETARY 59.00 1.00 X 351439 0 60683 SYLVIA D HACKETT VP/REX HEALTHCARE FOUNDATION 59.00 1.00 X 346677 0 68646 CHAD T LEFTERIS VP/OPERATIONS 60.00 0.00 X 267647 0 32488 JOEL D RAY VP/PATIENT CARE SERVICES & CNO 60.00 0.00 X 268098 0 27994 ROBERT D RICKER VP/PHYSICIAN SERVICES 60.00 0.00 X 285314 0 78879 KRISTEN RIGGS VP 60.00 0.00 X 245995 0 28541 LISA R SCHILLER VP/MKTG, PR, COMM RELATIONS & GOVT AFFAIRS 60.00 0.00 X 252326 0 46272 TAMMIE T STANTON VP/POST ACUTE SERVICES 60.00 0.00 X 0 310308 78324 SEAN T TEHRANI MD VP/REGIONAL HOSPITALISTS SERVICES 60.00 0.00 X 568720 0 56878 TOM G WILLIAMS VP/AMBULATORY SERVICES 60.00 0.00 X 254880 0 48263 JEFF S LEGAY ASST TREASURER & ASST SECRETARY (AS OF 9/1/2016) 1.00 59.00 X 233341 0 16167 ERIC JANIS PHYSICIAN 60.00 0.00 X 1459102 0 47874 RAVISH SACHAR PHYSICIAN 60.00 0.00 X 1458753 0 48812 MATTHEW HOOK PHYSICIAN 60.00 0.00 X 1407975 0 49250 MATEEN AKHTAR PHYSICIAN 60.00 0.00 X 1291882 0 51280 JOEL SCHNEIDER PHYSICIAN 60.00 0.00 X 1252898 0 47874 11844706 3275755 2386649 535 0 1 0 SKANSKA USA BUILDING INC 4309 EMPEROR BLVD STE 200 DURHAM NC 27703 CONSTRUCTION 44459290 PRESIDIO NETWORKED SOLUTION 5337 MILLENIA LAKES BLVD STE 300 ORLANDO FL 32839 IT CONSULTING 3785443 MAYO MEDICAL LABORATORIES 200 SW 1ST STREET ROCHESTER MN 55095 LAB SERVICES 1969102 QUALITY TEXTILE SERVICES INC 313 S ROGERS LANE RALEIGH NC 27610 LINEN SERVICES 1965036 WHR ARCHITECTS INC 1111 LOUISIANA 26TH FLOOR HOUSTON TX 77002 ARCHTECTURAL DESIGN 1696538 67 3402553 3402553 PATIENT SERVICE REVENUE 625100 1011786655 1011786655 40848170 32199397 2938757 5710016 1052634825 1697945 1697945 1347345 346469 1000876 1000876 1000876 691455951 674997490 8010 16458461 -8010 16450451 16450451 LOSS ON CIP DISPOSAL 621990 25255 25255 25255 1075211905 1043986052 2938757 24884543 1186134 1186134 6155763 6155763 376658267 341440719 35217548 23084731 21946654 1138077 29486606 26178209 3308397 26015300 22893464 3121836 1279564 1279564 110648 110648 824863 824863 34311671 31223621 3088050 3512445 3196325 316120 8359575 7607213 752362 6616713 6021209 595504 25545887 23246757 2299130 1728382 1572828 155554 77177 77177 5444959 4954913 490046 22335083 22335083 30672868 27912310 2760558 6205643 5647135 558508 PATIENT CARE SUPPLIES & 232628092 232628092 HOME OFFICE ALLOCATION 108603251 108603251 BAD DEBT EXPENSE 25162669 25162669 MINOR EQUIPMENT AND R&M 20088119 18280188 1807931 5776947 5257022 519925 1001871357 828690545 173180812 0 57092540 26279184 30453969 30468878 116946132 141037339 17225654 19460573 32884632 43305505 944029423 521969677 369616579 422059746 254570720 278379105 18763500 24761097 31912966 25752263 929466692 1011503690 145940653 143497078 405419 727015 252507516 247081712 14598 18180 125883507 133352845 524751693 524676830 X 297882177 403240787 106832822 83586073 404714999 486826860 929466692 1011503690 73340548 8771313 0 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 36244 36244 0 PART II-B, LINE 1: REX HOSPITAL BELIEVES IN MAINTAINING STRONG, OPEN AND EFFECTIVE RELATIONSHIPS WITH ELECTED OFFICIALS AND POLICY MAKERS AT THE LOCAL STATE AND NATIONAL LEVELS. THE OBJECTIVE IS TO EDUCATE THESE GROUPS ON HEALTHCARE ISSUES, TO SERVE AS A RESOURCE AND TO COMMUNICATE THE ORGANIZATION'S POSITION IN SUPPORT OF ITS MISSION. AS A MEMBER OF THE NCHA AND AHA, A PERCENTAGE OF THE ORGANIZATION'S MEMBERSHIP DUES ARE ATTRIBUTED TO LOBBYING ACTIVITIES. 0 1 X 25788330 25788330 349244269 113175145 236069124 21679747 9238071 12441676 404800822 325467165 79333657 142516255 74089296 68426959 422059746 CAPITAL LEASE 394313 PAYABLE TO RELATED PARTY 9778747 PENSION LIABILITY 123179785 133352845 X PART IV, LINE 2B: THE ORGANIZATION HOLDS CASH IN TRUST FOR THE RESIDENTS OF THE NURSING HOME FACILITIES. PART X, LINE 2: THE FOLLOWING FOOTNOTE COMES FROM THE CONSOLIDATED FINANCIAL STATEMENTS OF REX HOSPITAL, INC. D/B/A REX HEALTHCARE. THE FOOTNOTE REFERENCES OTHER MEMBERS OF THE AUDIT CONSOLIDATED GROUP THAT ARE NOT PART OF THIS TAX RETURN: REX, THE HOSPITAL, THE FOUNDATION, AND HOME SERVICES 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. PHYSICIANS IS A SINGLE MEMBER LIMITED LIABILITY COMPANY THAT HAS ELECTED TO BE TAXED AS A FOR-PROFIT CORPORATION. PHYSICIANS HAD A NET OPERATING LOSS IN 2013 AND 2012. THE HOSPITAL IS THE SOLE MEMBER OF ROV AND RSCW, AND ENTERPRISES IS THE SOLE MEMBER OF RWE, AND RWE IS THE SOLE MEMBER OF WELLNESS, MOB AND RHVLLC. AS SUCH, THESE ENTITIES ARE CONSIDERED DISREGARDED ENTITIES FOR TAX PURPOSES. 1 1 X 1 X 250.000000000000 0 1 1 1 0 1 1 23841003 23841003 0.02380 44592637 49764429 0 0.00000 68433640 49764429 23841003 0.02380 924957 924957 0.00090 863122 863122 0.00090 1216517 1216517 0.00120 3004596 3004596 0.00300 71438236 49764429 26845599 0.02680 1 8156806 361906947 463894080 -101987133 X 1 1 1 REX SURGERY CENTER OF CARY LLC AMBULATORY SURGICAL CENTER 0.55000 0.00000 0.45000 2 ORTHOPAEDIC SURGERY CENTER OF RALEIGH LLC SURGERY CENTER 0.51000 0.00000 0.49000 1 1 REX HOSPITAL INC 4420 LAKE BOONE TRAIL RALEIGH NC 27607 WWW.REXHEALTH.COM H0065 X X X REX HOSPITAL INC 1 0 0 1 X X X X X X X X X 15 1 1 1 1 X SEE PART V X SEE PART V X 1 15 1 SEE PART V 0 1 X 250.000000000000 0 1 X X X X 1 X SEE PART V X SEE PART V X SEE PART V X X X X X X 1 0 X X X X 1 X 0 0 REX HOSPITAL, INC. PART V, SECTION B, LINE 5: THE ORGANIZATION TOOK INTO ACCOUNT INPUT FROM PERSONS REPRESENTING THE COMMUNITY THROUGH PARTICIPATION IN BOTH A COMMUNITY WIDE HEALTH OPINION SURVEY AND FOCUS GROUPS. THE HEALTH OPINION SURVEY WAS INTERNET BASED AND TELEPHONE SURVEYS OF RANDOMLY SELECTED HOUSEHOLDS. THE NINE FOCUS GROUPS, INCLUDING TWO IN SPANISH, CONSISTED OF RECRUITED PARTICIPANTS REPRESENTING SPECIFIC GROUPS. REX HOSPITAL, INC. PART V, SECTION B, LINE 6A: THE ORGANIZATION'S COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WAS CONDUCTED WITH THE FOLLOWING HOSPITAL FACILITIES: WAKEMED HEALTH AND HOSPITALS AND DUKE RALEIGH HOSPITAL. REX HOSPITAL, INC. PART V, SECTION B, LINE 6B: THE ORGANIZATION'S COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WAS CONDUCTED WITH THE FOLLOWING ORGANIZATIONS OTHER THAN HOSPITAL FACILITIES: WAKE COUNTY HUMAN SERVICES, ADVANCE COMMUNITY HEALTH, UNITED WAY OF THE GREATER TRIANGLE AND WAKE COUNTY MEDICAL SOCIETY COMMUNITY HEALTH FOUNDATION. REX HOSPITAL, INC. PART V, SECTION B, LINE 11: THE ORGANIZATION IS ADDRESSING THE FOLLOWING TOP IDENTIFIED AREAS:HEALTH INSURANCE COVERAGE: WHILE THIS CONCERN CERTAINLY RELATES TO THOSENOT HAVING COVERAGE AT ALL, MORE FREQUENTLY THAN EVER CONCERNS ARE BEINGRAISED BY THOSE WHO HAVE INSURANCE REGARDING OTHER CRITICAL ISSUES; SUCHAS, LIMITATIONS ON WHAT INSURANCE DOES OR DOES NOT COVER, COMPLEXITY OFTHE SYSTEM AND THE NEED FOR EDUCATION RELATED TO HOW INSURANCE WORKS ANDHOW TO USE IT, ABILITY TO AFFORD POST-INSURANCE FINANCIAL OBLIGATIONSRELATED TO VISITS AND PRESCRIPTIONS AND REMAINING BARRIERS TO ACCESS FORCERTAIN INSURANCE TYPES, NAMELY MEDICARE AND MEDICAID, AS SOME PHYSICIANSAND PROVIDERS HAVE LIMITED OR SUSPENDED THEIR ACCEPTANCE OF THOSEINSURANCE TYPES. UNC REX WILL FOCUS ON EDUCATION TO INTERNAL AUDIENCES,MOST SPECIFICALLY PATIENT FINANCIAL SERVICES AND NURSE NAVIGATORS, TOALLOW FOR EXPANDED CONVERSATIONS REGARDING HEALTH INSURANCE COVERAGE,OPTIONS, AND MEANS OF OBTAINING THEM. UNC REX WILL FORM A STRONGERPARTNERSHIP WITH ENROLL AMERICA, THE NATION'S LEADING HEALTH CAREENROLLMENT COALITION. IN ADDITION, CHANGES TO THE UNC REX CO-WORKERBENEFITS STRUCTURE WILL INCREASE THE NUMBER OF CO-WORKERS WHO CAN AFFORDCOVERAGE; THIS IS KEY AS ONE OF THE LARGEST WAKE COUNTY EMPLOYERS. UNCREX WILL EVALUATE ITS SUPPORT OF THE TRIANGLE UNITED WAY ACA PROGRAM TOFUND PREMIUMS OF THOSE WHO CANNOT AFFORD THEM AND THE EXPANSION OF THE UNCREX ANGEL FUND, WHICH SUPPORTS PATIENTS UNDERGOING CANCER TREATMENT.TRANSPORTATION: ACCESS TO AND COST OF TRANSPORTATION IS AN ISSUE THATIMPACTS EVERY RESIDENT OF WAKE COUNTY, REGARDLESS OF THEIR BACKGROUND ORSOCIAL STATUS AND CAN HAVE MULTIPLE IMPLICATIONS ON HEALTH. UNC REX HASINITIATED A NEW INTERNAL EFFORT TO COORDINATE APPOINTMENTS FOR PATIENTSWITH CHRONIC CONDITIONS TO REDUCE TRAVEL, WHICH WILL ASSIST INEFFICIENCIES FOR BOTH PATIENTS AND PROVIDERS. EXPANSION OF MOBILE HEALTH OUTREACH, MAMMOGRAPHY AND HEART & VASCULAR SCREENINGS, INCLUDING POTENTIALNEW OPTIONS TO REACH PEOPLE CLOSER TO WHERE THEY LIVE AND WORK, ESPECIALLYIN UNDERSERVED AREAS IS IN REVIEW. IN ADDITION, ADVANCEMENTS INTELEMEDICINE ALTERNATIVES WILL REDUCE A PATIENT'S RELIANCE ONTRANSPORTATION TO RECEIVE CARE.ACCESS TO HEALTH SERVICES: FROM A HEALTH NEED PERSPECTIVE FOR WAKECOUNTY, ACCESS TO HEALTH SERVICES ENCOMPASSES THOSE AREAS OR ITEMS THATPRESENT A BARRIER TO RESIDENTS RECEIVING THE CARE THEY NEED; AS SUCH, THISNEED CAN BE FAIRLY BROAD. HOWEVER, THE KEY AREAS ARE SYSTEM COMPLEXITY,AFFORDABILITY, PROVIDER AVAILABILITY AND PRIMARY CARE ACCESS. FOCUSEDEFFORTS ON POPULATION HEALTH WILL REDUCE COSTS AND IMPROVE MEDICAL CAREAND PREVENTION ACROSS THE COMMUNITY. UNC REX'S EDUCATION TO ADDRESSPROPER UTILIZATION OF EMERGENCY DEPARTMENTS, URGENT CARE CENTERS ANDPRIMARY CARE FACILITIES IS ONGOING. FURTHER EXPANSION OF THE UNC HEALTHALLIANCE CLINICALLY INTEGRATED NETWORK WILL ENGAGE PHYSICIANS ACROSS THECOUNTY AND BEYOND IN THE TRANSFORMATION OF PATIENT CARE. ADDING PRIMARYCARE AND SPECIALTY PROVIDERS ACROSS THE TRIANGLE AS WELL AS HEART &VASCULAR, SURGICAL AND HOSPITALIST PROGRAMS IN JOHNSTON COUNTY HASPROVIDED RESIDENTS WITH GREATER ACCESS TO QUALITY HEALTHCARE OPTIONS. INADDITION, EXPANSION OF SERVICES IN HOLLY SPRINGS, INCLUDING FUTURE HOLLYSPRINGS HOSPITAL, WILL PROVIDE RESIDENTS OF SOUTHERN WAKE COUNTY GREATERACCESS TO QUALITY HEALTHCARE AND ADDITION JOB OPPORTUNITIES. UNC REX WILLEXPLORE NEW AND INTERACTIVE WAYS TO REACH PEOPLE, THROUGH COMMUNITYOUTREACH, TELEHEALTH OR OTHER ALTERNATIVES. THE FIVE REX WELLNESS CENTERSGEOGRAPHICALLY SPREAD ACROSS THE COUNTY WILL CONTINUE TO BE AN INTEGRAL PART OF IMPROVING FITNESS AND NUTRITION, SUPPORTING COMMUNITY ACTIVITIES,PROVIDING EDUCATION AND ACCESS TO MOBILE HEART AND VASCULAR SCREENINGS.OTHER ACTIVITIES THAT UNC REX HAVE IMPLEMENTED OR ARE PURSUING INCLUDE ADEMONSTRATION KITCHEN IN THE NEW HEART & VASCULAR HOSPITAL, EXPANSION OFFREE ONLINE TOOLS FOR HEALTH ASSESSMENT AND INCREASING THE NUMBER OFNAVIGATORS TO ASSIST PATIENTS FROM POINT OF DIAGNOSIS THROUGH REFERRALVISITS AND SURGICAL PROCEDURES WILL BE REVIEWED MAKING IT EASIER FORPATIENTS TO NAVIGATE THE HEALTHCARE LANDSCAPE.MENTAL HEALTH AND SUBSTANCE ABUSE: PATIENTS WILL HAVE MUCH-NEEDED ACCESSTO HIGHER LEVELS OF SPECIALIZED BEHAVIORAL HEALTH AND MEDICAL CARE AT UNCWAKEBROOK, WHICH RECEIVES ANNUAL FINANCIAL SUPPORT FROM UNC REX. INADDITION, AT UNC REX HOSPITAL EMERGENCY DEPARTMENT (ED), A NEW BEHAVIORALHEALTH HOLDING AREA IN IN PROCESS, WHICH WILL POSITIVELY IMPACT ACCESS TOTHE ED AND ALLOW FOR PATIENTS TO BE CARED FOR IN A BETTER LOCATION. MORETRAINING FOR CORE STAFF WITH BACKGROUNDS IN MENTAL AND BEHAVIORAL HEALTHWILL EXPAND THE CAREGIVER POOL. UNC REX WILL CONTINUE COLLABORATIONS WITHOTHER COMMUNITY PROVIDERS TO BEST MEET THE NEEDS OF THIS SPECIAL PATIENTPOPULATION. EFFORTS WITH THE UNC REX PAIN MANAGEMENT DEPARTMENT AND THECOMMUNITY CARE OF NORTH CAROLINA TO EXPAND ITS COLLABORATIVE, PROACTIVEAPPROACH FOR ASSISTING PATIENTS WITH CHRONIC PAIN ISSUES WILL CONTINUE TOREDUCE THE INCIDENCE OF OVERDOSE AND DEATH DUE TO SUBSTANCE ABUSE. UNCREX WILL CONTINUE THROUGH PARTNERSHIPS TO BUILD AWARENESS AROUND REDUCINGTHE STIGMAS SURROUNDING MENTAL HEALTH.THE ORGANIZATION DID NOT ADDRESS THE FOLLOWING FOCUS AREAS IDENTIFIED INTHE CHNA: INCOME AND POVERTY, EMPLOYMENT, HEALTH PROFESSIONALS, PHYSICAL ACTIVITY, NUTRITION AND OBESITY, HOUSING AND HOMELESSNESS, COMMUNITYENGAGEMENT, CAREGIVING, ENVIRONMENTAL HEALTH, EDUCATION AND LIFELONGLEARNING, CHILD WELFARE AND FINANCIAL ASSISTANCE, HEALTH STATUS, INJURYAND VIOLENCE, MATERNAL AND INFANT HEALTH, ORAL HEALTH, CRIME AND SAFETY,DISABILITIES AND CULTURAL AND/OR LANGUAGE BARRIERS. AS A HEALTHCAREORGANIZATION, UNC REX'S RESOURCES ARE MORE READILY AVAILABLE TO ADDRESSTHE AREAS IDENTIFIED ABOVE. PART VI LINE 2 AS THE COUNTY CONTINUES TO GROW, NECESSARY STEPS MUST BE TAKEN TO ENSURE THAT THE NEEDS OF ALL OF OUR CITIZENS ARE BEING MONITORED AND EVALUATED. WAKE COUNTY HUMAN SERVICES WORKS WITH ALL LOCAL HOSPITALS, INCLUDING UNC REX, TO CONDUCT A COMMUNITY-WIDE HEALTH ASSESSMENT. THIS ASSESSMENT, CONDUCTED EVERY THREE TO FOUR YEARS, IDENTIFIES OPPORTUNITIES AND CHALLENGES IN THE MARKET. UNC REX COLLABORATES WITH COMMUNITY PARTNERS REGULARLY TO ENSURE OUR EFFORTS ARE PROPERLY ALIGNED BASED ON WAKE COUNTY'S SOCIOECONOMIC AND DEMOGRAPHIC INFORMATION. UNC REX ALSO RELIES ON INPUT FROM OUR PHYSICIANS AND CLINICAL STAFF, PATIENT OUTCOMES AS WELL AS QUALITATIVE AND QUANTITATIVE RESEARCH TO IDENTIFY AREAS OF OPPORTUNITY TO IMPROVE THE HEALTH OF OUR COMMUNITY. PART VI LINE 3 UNC REX PROVIDES A WIDE RANGE OF TOOLS AND EDUCATION TO HELP PATIENTS WHO NEED FINANCIAL ASSISTANCE AND THE PROGRAM IS DESIGNED TO MAKE IT EASY FOR PATIENTS TO APPLY FOR FINANCIAL ASSISTANCE, CHARITY CARE AND OTHER AID PROGRAMS. UNC REX POSTS DETAILED INFORMATION ABOUT ITS GENEROUS CHARITY CARE POLICY AND OTHER FINANCIAL AID INFORMATION AT VARIOUS POINTS IN THE HOSPITAL AND ON ITS WEBSITE. DURING PATIENT REGISTRATION, STAFF WILL DISTRIBUTE A COPY OF THE UNC HEALTHCARE FINANCIAL ASSISTANCE POLICY, WHICH INCLUDES USEFUL INFORMATION AND HELPFUL RESOURCES, TO ANYONE WHO DOES NOT HAVE INSURANCE OR ASKS FOR ASSISTANCE. UNC REX FINANCIAL COUNSELORS WILL BEGIN WORKING WITH PATIENTS NEEDING ASSISTANCE AT REGISTRATION OR VISIT THE ROOMS OF PATIENTS WHO ASK FOR HELP. THE COUNSELORS WILL ASSIST WITH DETERMINING MEDICAID ELIGIBILITY AND WITH FILLING OUT A UNC REX ASSIST APPLICATION. FINALLY, UNC REX ALSO WORKS WITH VARIOUS COMMUNITY GROUPS THAT HELP PROVIDE ASSISTANCE TO THE UNINSURED OR UNDERINSURED, INCLUDING PROJECT ACCESS, PRETTY IN PINK AND OTHERS. THE ANGEL FUND OF THE REX HEALTHCARE FOUNDATION ALSO SUPPORTS CANCER PATIENTS WITH UNIQUE FINANCIAL NEEDS, INCLUDING TRANSPORTATION, LIVING EXPENSES AND PRESCRIPTIONS. PART VI LINE 4 THE ORGANIZATION SERVES AN AREA THAT ENCOMPASSES A FOUR-COUNTY AREA CONSISTING OF WAKE COUNTY AS THE PRIMARY SERVICE AREA WITH HARNETT, FRANKLIN AND JOHNSTON COUNTIES, COMPRISING THE SECONDARY SERVICE AREA. WAKE COUNTY AND ITS SURROUNDING COMMUNITIES ARE AMONG THE FASTEST GROWING REGIONS IN THE NATION. UNEMPLOYMENT RATES IN THE PRIMARY SERVICE AREA ARE LESS THAN THE UNEMPLOYMENT RATES FOR THE NATION AND THE STATE. AVERAGE HOUSEHOLD INCOME AND EDUCATION LEVEL ALSO COMPARE FAVORABLY WITH BOTH THE NATION AND THE STATE. PART VI LINE 5 THERE ARE MANY WAYS UNC REX WORKS WITH COMMUNITY PARTNERS TO ADDRESS HEALTH ISSUES AND CONCERNS IDENTIFIED WITHIN THE COMMUNITY. THROUGH BOTH FINANCIAL, IN-KIND AND STAFF SUPPORT, UNC REX PROVIDES ASSISTANCE IN HOSTING COMMUNITY HEALTH SCREENINGS, MOBILE MAMMOGRAPHY SCREENINGS AND ON-SITE MEDICAL CARE THROUGH THE UNC REX EMERGENCY RESPONSE TEAM. ADDITIONALLY, COMMUNITY RELATIONS ACTIVITIES REGULARLY DEMONSTRATE PROMOTING HEALTH AND WELLNESS INITIATIVES. "ASK THE EXPERT" FORUMS ARE FREE AND OFFERED THROUGHOUT WAKE COUNTY BY PHYSICIANS AND STAFF. UNC REX HAS BEEN DILIGENT IN AWARDING GRANTS TO COMMUNITY GROUPS TO ASSIST THEM WHERE NEEDS ARE GREATEST. TWICE A YEAR WE HOST A COLLABORATIVE BREAKFAST INVITING COMMUNITY PARTNERS, ORGANIZATIONS AND HEALTHCARE PROVIDERS WHO WORK WITH UNINSURED WOMEN TO DISCUSS AND ADDRESS CURRENT HARDSHIPS AND RESOURCES - TRULY A COMMITMENT TO THE NONPROFIT COMMUNITY. PART VI LINE 6 UNC REX HEALTHCARE IS A SUBSIDIARY OF THE UNC HEALTH CARE SYSTEM IN CHAPEL HILL. THAT SYSTEM SERVES PATIENTS FROM ALL 100 COUNTIES, REGARDLESS OF THEIR ABILITY TO PAY, PROVIDING MORE THAN $300 MILLION A YEAR IN UNCOMPENSATED CARE. AS PART OF THE INTEGRATED SYSTEM, UNC REX STRIVES TO IMPROVE ACCESS AND SERVICES IN WAKE COUNTY'S GROWING AND UNDERSERVED AREAS. UNC REX CAREGIVERS ALSO WORK CLOSELY WITH THEIR COUNTERPARTS AT UNC HEALTH CARE TO FIND MORE WAYS TO IMPROVE CARE AND QUALITY, REACH MORE UNINSURED PATIENTS AND MORE. UNC REX'S BOARD REPRESENTS A CROSS-SECTION OF THE COMMUNITY, WITH VOLUNTEERS THAT INCLUDE BUSINESS LEADERS, COMMUNITY PHYSICIANS AND OTHERS. THAT BOARD WORKS CLOSELY WITH THE BOARD AT UNC HEALTH CARE TO DETERMINE THE BEST WAYS TO PLAY A LARGER ROLE IN IMPROVING THE COMMUNITY'S HEALTH, AND UNC REX'S ROLE IN THE BIGGER SYSTEM'S MISSION. PART VI LINE 7 THE ORGANIZATION SUBMITS AN ANNUAL COMMUNITY BENEFIT REPORT TO THE NORTH CAROLINA HOSPITAL ASSOCIATION AND THE NORTH CAROLINA MEDICAL CARE COMMISSION. SCHEDULE H, PART V, SECTION B, LINES 7A AND 10A WWW.REXHEALTH.COM/RH/ABOUT/COMMUNITY/COMMUNITY-HEALTH-NEEDS-ASSESSMENT SCHEDULE H, PART V, SECTION B, LINE 7B WWW.WAKEGOV.COM/HUMANSERVICES/DATA SCHEDULE H, PART V, SECTION B, LINES 16A, 16B AND 16C HTTP://WWW.UNCMEDICALCENTER.ORG/UNCMC/PATIENTS-VISITORS/BILLING/FINANCIAL-ASSISTANCE-PROGRAMS/ 41 1 - REX HEALTHCARE OF WAKEFIELD 11200 GOVERNOR MANLY WAY RALEIGH NC 27614 HEALTHCARE 2 - REX HEALTHCARE OF CARY 1505 SW PARKWAY CARY NC 27511 HEALTHCARE 3 - REX HEALTHCARE OF GARNER 300 HEALTH PARK DRIVE GARNER NC 27529 HEALTHCARE 4 - REX REHABILITATION AND NURSING CARE CENT 4210 LAKE BOONE TRAIL RALEIGH NC 27607 NURSING FACILITY 5 - REX VASCULAR SPECIALISTS 4414 LAKE BOONE TRAIL SUITE 108 RALEIGH NC 27607 VASCULAR HEALTH 6 - REX REHABILITATION AND NURSING CARE CENT 911 S HUGHES SREET APEX NC 27502 NURSING FACILITY 7 - NORTH CAROLINA HEART AND VASCULAR 2800 BLUE RIDGE ROAD SUITE 400 RALEIGH NC 27607 HEART & VASCULAR 8 - REX HEALTHCARE OF KNIGHTDALE 6602 KNIGHTDALE BOULEVARD 102 KNIGHTDALE NC 27545 HEALTHCARE 9 - REX NEUROSURGERY AND SPINE SPECIALISTS 4207 LAKE BOONE TRAIL SUITE 220 RALEIGH NC 27607 NEUROSURGERY 10 - SMITHFIELD RADIATION ONCOLOGY 514 N BRIGHT LEAF BOULEVARD SUITE 1200 SMITHFIELD NC 27577 ONCOLOGY 11 - NORTH CAROLINA HEART AND VASCULAR 2615 HOSPITAL ROAD SUITE 300 GOLDSBORO NC 27534 HEART & VASCULAR 12 - REX CARDIAC SURGICAL SPECIALISTS 2800 BLUE RIDGE ROAD SUITE 201 RALEIGH NC 27607 CARDIAC SURGERY 13 - REX HEALTHCARE OF HOLLY SPRINGS 781 AVENT FERRY ROAD HOLLY SPRINGS NC 27540 HEALTHCARE 14 - REX WOUND HEALING CENTER - RALEIGH 2916 BLUE RIDGE ROAD RALEIGH NC 27612 WOUND CARE 15 - REX SURGICAL SPECIALISTS BARIATRIC SPECI 4207 LAKE BOONE TRAIL SUITE 210 RALEIGH NC 27607 BARIATRIC 16 - REX THORACIC SURGICAL SPECIALISTS OF CAR 150 PARKWAY OFFICE COURT SUITE 200 CARY NC 27518 THORACIC SURGERY 17 - REX SURGICAL SPECIALISTS 2800 BLUE RIDGE ROAD SUITE 300 RALEIGH NC 27607 GENERAL SURGERY 18 - REX WELLNESS CENTER OF WAKEFIELD 11200 GALLERIA AVENUE RALEIGH NC 27614 WELLNESS AND REHABILITATION 19 - NORTH CAROLINA HEART AND VASCULAR 603 BEAMAN STREET SUITE 5 CLINTON NC 28328 HEART & VASCULAR 20 - REX HEMATOLOGY ONCOLOGY ASSOCIATES 2605 BLUE RIDGE ROAD SUITE 190 RALEIGH NC 27607 ONCOLOGY 21 - REX WELLNESS CENTER OF RALEIGH 4200 LAKE BOONE TRAIL RALEIGH NC 27607 WELLNESS 22 - REX WELLNESS CENTER OF CARY 1515 SW CARY PARKWAY CARY NC 27511 WELLNESS AND REHABILITATION 23 - NORTH CAROLINA HEART AND VASCULAR 500 REDWOOD LANE LOUISBURG NC 27549 HEART & VASCULAR 24 - REX WELLNESS CENTER OF GARNER 1400 TIMBER DRIVE EAST GARNER NC 27529 WELLNESS AND REHABILITATION 25 - REX HEMATOLOGY ONCOLOGY ASSOCIATES 150 PARKWAY OFFICE COURT SUITE 200 CARY NC 27518 ONCOLOGY 26 - NORTH CAROLINA HEART AND VASCULAR 910 BERKSHIRE ROAD SMITHFIELD NC 27577 HEART & VASCULAR 27 - UNC REX REHABILITATION SERVICES 2709 BLUE RIDGE ROAD SUITE 200 RALEIGH NC 27607 REHABILITATION 28 - REX PULMONARY SPECIALISTS 300 ASHEVILLE AVENUE SUITE 301 CARY NC 27518 PULMONARY HEALTH 29 - NORTH CAROLINA HEART AND VASCULAR 701 S MAIN STREET LILLINGTON NC 27546 HEART & VASCULAR 30 - REX WELLNESS CENTER OF KNIGHTDALE 6602 KNIGHTDALE BOULEVARD KNIGHTDALE NC 27545 WELLNESS 31 - REX HOME SERVICES 1500 SUNDAY DRIVE SUITE 113 RALEIGH NC 27607 HOME HEALTHCARE AND REHABILITATION 32 - NORTH CAROLINA HEART AND VASCULAR 102 PROFESSIONAL PARK DRIVE SUITE C OXFORD NC 27656 HEART & VASCULAR 33 - NORTH CAROLINA HEART AND VASCULAR 2605 FOREST HILLS ROAD SW WILSON NC 27893 HEART & VASCULAR 34 - REX EAR NOSE AND THROAT SPECIALISTS 790 SE CARY PARKWAY SUITE 110 CARY NC 27511 ENT HEALTHCARE 35 - REXUNC FAMILY PRACTICE OF PANTHER CREEK 10030 GREEN LEVEL CHURCH ROAD SUITE 808 CARY NC 27519 FAMILY HEALTHCARE 36 - REX SLEEP LAB OF RALEIGH 4210 LAKE BOONE TRAIL RALEIGH NC 27607 SLEEP LAB 37 - TRIANGLE EAST SURGERY - SMITHFIELD 131 EAST MARKET STREET SMITHFIELD NC 27520 GENERAL SURGERY 38 - TRIANGLE EAST SURGERY - CLAYTON 2076 NC HIGHWAY 42W SUITE 210 CLAYTON NC 27520 GENERAL SURGERY 39 - REX SLEEP LAB OF CARY 790 SE CARY PARKWAY SUITE 105 CARY NC 27511 SLEEP LAB 40 - REX BREAST CARE CENTER 3100 DURALEIGH ROAD SUITE 205 RALEIGH NC 27612 BREAST CARE CENTER 41 - REX CHILD DEVELOPMENT CENTER 3116 BLUE RIDGE ROAD RALEIGH NC 27612 CHILD DEVELOPMENT PART III, 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, LINE 8: HOSPITALS TREAT PATIENTS COVERED BY MEDICARE, JUST AS THEY DO ANY PATIENT. AMOUNTS THAT HOSPITALS ARE ELIGIBLE TO RECEIVE IN PAYMENT FOR SERVICES PROVIDED TO PATIENTS COVERED BY MEDICARE ARE NOT NEGOTIABLE. AS MEDICARE REIMBURSEMENT RATES DECLINE RELATIVE TO THE COSTS OF PROVIDING CARE, HOSPITALS CONTINUE TO SERVE THE MEDICARE POPULATION. WITHOUT THE SERVICES PROVIDED BY HOSPITALS, THE GOVERNMENT WOULD BECOME OBLIGATED FOR THE SERVICES REQUIRED BY THESE PATIENTS. THEREFORE, WE BELIEVE THAT ANY UNREIMBURSED COSTS OF PROVIDING THIS CARE ARE A BENEFIT PROVIDED BY THE HOSPITAL TO THE COMMUNITY AND GOVERNMENT. PART III, LINE 9B: PATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE ARE APPROVED FOR 100% ADJUSTMENT OF ELIGIBLE CHARGES MINUS A COPAYMENT. COPAYMENTS ACCRUE AND ARE NOT ELIGIBLE FOR COLLECTIONS PROCESSES. 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 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 PAYERS, 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 B LINE 8 HOSPITALS TREAT PATIENTS COVERED BY MEDICARE, JUST AS THEY DO ANY PATIENT. AMOUNTS THAT HOSPITALS ARE ELIGIBLE TO RECEIVE IN PAYMENT FOR SERVICES PROVIDED TO PATIENTS COVERED BY MEDICARE ARE NOT NEGOTIABLE. AS MEDICARE REIMBURSEMENT RATES DECLINE RELATIVE TO THE COSTS OF PROVIDING CARE, HOSPITALS CONTINUE TO SERVE THE MEDICARE POPULATION. WITHOUT THE SERVICES PROVIDED BY HOSPITALS, THE GOVERNMENT WOULD BECOME OBLIGATED FOR THE SERVICES REQUIRED BY THESE PATIENTS. THEREFORE, WE BELIEVE THAT ANY UNREIMBURSED COSTS OF PROVIDING THIS CARE ARE A BENEFIT PROVIDED BY THE HOSPITAL TO THE COMMUNITY AND GOVERNMENT. PART III SECTION C LINE 9B PATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE ARE APPROVED FOR 100% ADJUSTMENT OF ELIGIBLE CHARGES MINUS A COPAYMENT. COPAYMENTS ACCRUE AND ARE NOT ELIGIBLE FOR COLLECTIONS PROCESSES. PART VI, LINE 2: AS THE COUNTY CONTINUES TO GROW, NECESSARY STEPS MUST BE TAKEN TO ENSURE THAT THE NEEDS OF ALL OF OUR CITIZENS ARE BEING MONITORED AND EVALUATED. WAKE COUNTY HUMAN SERVICES WORKS WITH ALL LOCAL HOSPITALS, INCLUDING REX, TO CONDUCT A COMMUNITY-WIDE HEALTH ASSESSMENT. THIS ASSESSMENT, CONDUCTED EVERY THREE TO FOUR YEARS, IDENTIFIES OPPORTUNITIES AND CHALLENGES IN THE MARKET. REX COLLABORATES WITH COMMUNITY PARTNERS REGULARLY TO ENSURE OUR EFFORTS ARE PROPERLY ALIGNED BASED ON WAKE COUNTY'S SOCIOECONOMIC AND DEMOGRAPHIC INFORMATION. REX ALSO RELIES ON INPUT FROM OUR PHYSICIANS AND CLINICAL STAFF, PATIENT OUTCOMES AS WELL AS QUALITATIVE AND QUANTITATIVE RESEARCH TO IDENTIFY AREAS OF OPPORTUNITY TO IMPROVE THE HEALTH OF OUR COMMUNITY. PART VI, LINE 3: REX PROVIDES A WIDE RANGE OF TOOLS AND EDUCATION TO HELP PATIENTS WHO NEED FINANCIAL ASSISTANCE. THE REX ASSIST PROGRAM IS DESIGNED TO MAKE IT EASY FOR PATIENTS TO APPLY FOR FINANCIAL ASSISTANCE, CHARITY CARE AND OTHER AID PROGRAMS. REX POSTS DETAILED INFORMATION ABOUT ITS GENEROUS CHARITY CARE POLICY, THE REX ASSIST PROGRAM AND OTHER FINANCIAL AID INFORMATION AT VARIOUS POINTS IN THE HOSPITAL AND ON ITS WEBSITE. DURING PATIENT REGISTRATION, STAFF WILL DISTRIBUTE THE "YOUR REX HOSPITAL BILL" FLYER TO ANYONE WHO DOES NOT HAVE INSURANCE OR ASKS FOR ASSISTANCE. THAT FLYER INCLUDES USEFUL INFORMATION AND HELPFUL RESOURCES. REX FINANCIAL COUNSELORS WILL BEGIN WORKING WITH PATIENTS NEEDING ASSISTANCE AT REGISTRATION OR VISIT THE ROOMS OF PATIENTS WHO ASK FOR HELP. THE COUNSELORS WILL ASSIST WITH DETERMINING MEDICAID ELIGIBILITY AND WITH FILLING OUT A REX ASSIST APPLICATION. FINALLY, REX ALSO WORKS WITH VARIOUS COMMUNITY GROUPS THAT HELP PROVIDE ASSISTANCE TO THE UNINSURED OR UNDERINSURED, INCLUDING PROJECT ACCESS, PRETTY IN PINK AND OTHERS. THE ANGEL FUND OF THE REX HEALTHCARE FOUNDATION ALSO SUPPORTS CANCER PATIENTS WITH UNIQUE FINANCIAL NEEDS, INCLUDING TRANSPORTATION, LIVING EXPENSES AND PRESCRIPTIONS. PART VI, LINE 4: THE ORGANIZATION SERVES AN AREA THAT ENCOMPASSES A FOUR-COUNTY AREA CONSISTING OF WAKE COUNTY AS THE PRIMARY SERVICE AREA WITH HARNETT, FRANKLIN AND JOHNSTON COUNTIES, COMPRISING THE SECONDARY SERVICE AREA. WAKE COUNTY AND ITS SURROUNDING COMMUNITIES ARE AMONG THE FASTEST GROWING REGIONS IN THE NATION. UNEMPLOYMENT RATES IN THE PRIMARY SERVICE AREA ARE LESS THAN THE UNEMPLOYMENT RATES FOR THE NATION AND THE STATE. AVERAGE HOUSEHOLD INCOME AND EDUCATION LEVEL ALSO COMPARE FAVORABLY WITH BOTH THE NATION AND THE STATE. PART VI, LINE 5: THERE ARE MANY WAYS REX WORKS WITH COMMUNITY PARTNERS TO ADDRESS HEALTH ISSUES AND CONCERNS IDENTIFIED WITHIN THE COMMUNITY. THROUGH BOTH FINANCIAL, IN-KIND AND STAFF SUPPORT, REX PROVIDES ASSISTANCE IN HOSTING COMMUNITY HEALTH SCREENINGS, MOBILE MAMMOGRAPHY SCREENINGS AND ON-SITE MEDICAL CARE THROUGH THE REX EMERGENCY RESPONSE TEAM. ADDITIONALLY, COMMUNITY RELATIONS ACTIVITIES REGULARLY DEMONSTRATE PROMOTING HEALTH AND WELLNESS INITIATIVES. "ASK THE EXPERT" FORUMS ARE FREE AND OFFERED THROUGHOUT WAKE COUNTY BY PHYSICIANS AND STAFF. REX HAS BEEN DILIGENT IN AWARDING GRANTS TO COMMUNITY GROUPS TO ASSIST THEM WHERE NEEDS ARE GREATEST. TWICE A YEAR WE HOST A COLLABORATIVE BREAKFAST INVITING COMMUNITY PARTNERS, ORGANIZATIONS AND HEALTHCARE PROVIDERS WHO WORK WITH UNINSURED WOMEN TO DISCUSS AND ADDRESS CURRENT HARDSHIPS AND RESOURCES - TRULY A COMMITMENT TO THE NONPROFIT COMMUNITY. PART VI, LINE 6: REX HEALTHCARE IS A SUBSIDIARY OF THE UNC HEALTH CARE SYSTEM IN CHAPEL HILL. THAT SYSTEM SERVES PATIENTS FROM ALL 100 COUNTIES, REGARDLESS OF THEIR ABILITY TO PAY, PROVIDING MORE THAN $300 MILLION A YEAR IN UNCOMPENSATED CARE. AS PART OF THE INTEGRATED SYSTEM, REX STRIVES TO IMPROVE ACCESS AND SERVICES IN WAKE COUNTY'S GROWING AND UNDERSERVED AREAS. REX CAREGIVERS ALSO WORK CLOSELY WITH THEIR COUNTERPARTS AT UNC HEALTH CARE TO FIND MORE WAYS TO IMPROVE CARE AND QUALITY, REACH MORE UNINSURED PATIENTS AND MORE. REX'S BOARD REPRESENTS A CROSS-SECTION OF THE COMMUNITY, WITH VOLUNTEERS THAT INCLUDE BUSINESS LEADERS, COMMUNITY PHYSICIANS AND OTHERS. THAT BOARD WORKS CLOSELY WITH THE BOARD AT UNC HEALTH CARE TO DETERMINE THE BEST WAYS TO PLAY A LARGER ROLE IN IMPROVING THE COMMUNITY'S HEALTH, AND REX'S ROLE IN THE BIGGER SYSTEM'S MISSION. 1 GREATER RALEIGH CHAMBER PO BOX 2978 RALEIGH NC 27602 560370850 501(C)(6) 108317 GENERAL SUPPORT UNITED WAY OF THE GREATER TRIANGLE 2400 PERIMETER PARK DRIVE SUITE 150 RALEIGH NC 27560 561949103 501(C)(3) 86756 GENERAL SUPPORT NORTH CAROLINA SYMPHONY 4350 LASSITER SUITE 250 RALEIGH NC 27609 560556755 501(C)(3) 75000 GENERAL SUPPORT INTERACT 1012 OBERLIN ROAD SUIE 100 RALEIGH NC 27605 581320613 501(C)(3) 60000 GENERAL SUPPORT AMERICAN HEART ASSOCIATION NORTH CAROLINA AFFILIATE INC 3901 COMPUTER DRIVESUITE 110 RALEIGH NC 27609 560529996 501(C)(3) 53500 GENERAL SUPPORT/EDUCATION SUPPORT CARY CHAMBER OF COMMERCE 307 NORTH ACADEMY STREET CARY NC 27519 560989726 501(C)(3) 26379 GENERAL SUPPORT ALICE AYCOCK POE CENTER FOR HEALTH EDUCATION 224 SUNNYBROOK ROAD RALEIGH NC 27610 561500678 501(C)(3) 25500 GENERAL SUPPORT LEUKEMIA & LYMPHOMA SOCIETY 401 HARRISON OAKS BLVD SUITE 200 CARY NC 27513 135644916 501(C)(3) 25000 GENERAL SUPPORT URBAN MINISTRIES OF WAKE COUNTY 1390 CAPITAL BLVD RALEIGH NC 27603 581422700 501(C)(3) 25000 GENERAL SUPPORT WAKE EDUCATION PARTNERSHIP 706 HILLSBOURGH STREET SUITE A RALEIGH NC 27603 581518182 501(C)(3) 20000 GENERAL SUPPORT THE YOUNG MEN'S CHRISTIAN ASSOCIATION 801CORPORATE CENTER DRIVE SUITE 200 RALEIGH NC 27607 560591307 501(C)(3) 15000 GENERAL SUPPORT TRANSITIONS LIFECARE 250 HOSPICE CIRCLE RALEIGH NC 27607 561228779 501(C)(3) 15000 GENERAL SUPPORT USO OF NORTH CAROLINA 600 AIRPORT BLVD SUITE 200 MORRISVILLE NC 27560 560532315 501(C)(3) 14000 GENERAL SUPPORT SUSAN G KOMEN NC TRIANGLE 600 AIRPORT BLVD SUITE 100 MORRISVILLE NC 27560 752845066 501(C)(3) 12500 GENERAL SUPPORT HOLLY SPRINGS CHAMBER OF COMMERCE 344 RALEIGH STREET SUITE 100 HOLLY SPRINGS NC 27540 561875144 501(C)(6) 11550 GENERAL SUPPORT BAND TOGETHER PO BOX 6445 RALEIGH NC 27268 562273756 501(C)(3) 11000 GENERAL SUPPORT ALLIANCE MEDICAL MINISTRY 101 DONALD ROSS DRIVE RALEIGH NC 27610 562168673 501(C)(3) 10800 GENERAL SUPPORT MORRISVILLE CHAMBER OF COMMERCE 260 TOWN HALL DRIVE SUITE A MORRISVILLE NC 27560 561712502 501(C)(6) 10464 GENERAL SUPPORT BLUE RIDGE ALLIANCE CORRIDOR 2416 HILLSBOROUGH STREET RALEIGH NC 27607 471697576 501(C)(3) 10000 GENERAL SUPPORT GET YOUR REAR IN GEAR 5666 LINCOLN DRIVE SUITE 270 EDINA MN 55436 300377727 501(C)(3) 10000 GENERAL SUPPORT INNOVATE RALEIGH 310 S HARRINGTON STREET RALEIGH NC 27603 262891963 501(C)(3) 10000 GENERAL SUPPORT MARCH OF DIMES NORTH CAROLINA CHAPTER 6504 FALLS OF NEUSE RD SUITE 100 RALEIGH NC 27615 131846366 501(C)(3) 10000 GENERAL SUPPORT RALEIGH CIVIC VENTURES DOWNTOWN RALEIGH ALLIANCE 120 S WILMINGTON STREET SUITE 103 RALEIGH NC 27601 562095185 501(C)(3) 10000 GENERAL SUPPORT ZERO THE END PROSTATE CANCER 515 KING STREET NO 420 ALEXANDRIA VA 22314 593400922 501(C)(3) 10000 GENERAL SUPPORT WAKE FOREST AREA CHAMBER OF COMMERCE 350 S WHITE STREET WAKE FOREST NC 27587 561122169 501(C)(6) 8025 GENERAL SUPPORT HOLT BROTHERS FOUNDATION 8801 FAST PARK DRIVE SUITE 105 107 RALEIGH NC 27617 566570426 501(C)(3) 7500 GENERAL SUPPORT REX HEALTHCARE FOUNDATION 2500 BLUE RIDGE ROAD SUITE 325 RALEIGH NC 27607 566052117 501(C)(3) 7500 GENERAL SUPPORT DOWNTOWN RALEIGH ALLIANCE 120 SOUTH WILMINGTON STREET SUITE 103 RALEIGH NC 27601 561994005 501(C)(6) 6575 GENERAL SUPPORT LUNG CANCER INITIATIVE OF NC 4000 BLUE RIDGE ROAD SUITE 170 RALEIGH NC 27612 262300885 501(C)(3) 6550 GENERAL SUPPORT FOOD BANK CENTRAL & EASTERN NC 1924 CAPITAL BLVD RALEIGH NC 27604 561283426 501(C)(3) 6246 GENERAL SUPPORT SHAW UNIVERISTY 118 EAST SOUTH STREET RALEIGH NC 27106 560530235 501(C)(3) 6000 GENERAL SUPPORT KNIGHTDALE CHAMBER OF COMMERCE 207 MAIN STREET KNIGHTDALE NC 27545 561325118 501(C)(6) 5599 GENERAL SUPPORT ALZHEIMERS NORTH CAROLINA INC 1305 NAVAHO DRIVE SUITE 101 RALEIGH NC 27609 561501117 501(C)(3) 5000 GENERAL SUPPORT FOUNDATION OF HOPE 9401 GLENWOOD AVENUE RALEIGH NC 27617 566246626 501(C)(3) 5000 GENERAL SUPPORT GRAB MY WHEEL 2305 SILENT STREAM COURT RALEIGH NC 27607 205615564 501(C)(3) 5000 GENERAL SUPPORT JUNIOR LEAGUE OF RALEIGH INC PO BOX 26821 RALEIGH NC 27611 560562849 501(C)(3) 5000 GENERAL SUPPORT KAY YOW CANCER FOUNDATION 5121 KINGDOM WAY SUITE 305 RALEIGH NC 27607 261789695 501(C)(3) 5000 GENERAL SUPPORT NAMI WAKE COUNTY PO BOX 12562 RALEIGH NC 27605 561552949 501(C)(3) 5000 GENERAL SUPPORT NC MEDASSIST 4428 TAGGART CREEK ROAD CHARLOTTE NC 28208 562018957 501(C)(3) 5000 GENERAL SUPPORT NC PREVENTION PARTNERS 88 VILCOM CENTER DRIVE SUITE 110 CHAPEL HILL NC 27514 311722051 501(C)(3) 5000 GENERAL SUPPORT THE FIRST TEE OF THE TRIANGLE 8800 WESTGATEPARK DRIVE SUITE 104 RALEIGH NC 27617 562266025 501(C)(3) 5000 GENERAL SUPPORT 35 6 PART I, LINE 2: REX REQUIRES ALL REQUESTS FOR GRANTS OR OTHER ASSISTANCE TO BE IN WRITING. SUCH REQUESTS ARE TYPICALLY REVIEWED ON AN ANNUAL BASIS FOLLOWING GUIDELINES RELATED TO COMMUNITY NEED AND REX'S MISSION. REX'S PRIORITIES INCLUDE SUPPORTING HEALTH, HUMAN SERVICES, EDUCATION AND ARTS IN COMMUNITIES IT SERVES. REX HAS VARIOUS WAYS OF TRACKING THE RESULTS OF ITS CONTRIBUTIONS. BECAUSE REX OFTEN WORKS CLOSELY WITH THE COMMUNITY GROUPS IT SUPPORTS, THE ORGANIZATION RECEIVES FREQUENT UPDATES ON THEIR WORK AND PROGRESS. FOR LARGER GRANTS, REX ALSO RECEIVES ANNUAL OR QUARTERLY REPORTS ON RESULTS. X 1 1 X X X X X 0 1 0 0 0 1 1 0 0 WILLIAM L ROPER MD DIRECTOR 0 776346 0 137546 0 20597 0 617385 0 19583 0 1571457 0 0 GARY L PARK CEO 0 810343 0 140626 0 1079989 0 520598 0 19583 0 2571139 0 1052629 STEPHEN W BURRISS PRESIDENT 451286 0 89910 0 48505 0 132557 0 15163 0 737421 0 0 0 SUSAN M SANDBERG COO 306738 0 110450 0 56501 0 49055 0 12830 0 535574 0 0 0 ANDREW K ZUKOWSKI CFO & TREASURER (AS OF 8/22/2016) 104534 0 0 0 44295 0 14258 0 4666 0 167753 0 0 0 LINDA H BUTLER MD VP/MEDICAL AFFAIRS, CMO & CMIO 279161 0 55842 0 31569 0 46295 0 15163 0 428030 0 0 0 JAYNE R BYRD VP/SURGICAL SERVICES 206318 0 38824 0 4716 0 126268 0 5020 0 381146 0 0 0 DONALD R ESPOSITO JR VP/GENERAL COUNSEL & SECRETARY 272593 0 50967 0 27879 0 44403 0 16280 0 412122 0 0 0 SYLVIA D HACKETT VP/REX HEALTHCARE FOUNDATION 270435 0 51052 0 25190 0 59191 0 9455 0 415323 0 0 0 CHAD T LEFTERIS VP/OPERATIONS 204237 0 41697 0 21713 0 27468 0 5020 0 300135 0 0 0 JOEL D RAY VP/PATIENT CARE SERVICES & CNO 224482 0 41529 0 2087 0 27619 0 375 0 296092 0 0 0 ROBERT D RICKER VP/PHYSICIAN SERVICES 231487 0 43875 0 9952 0 71455 0 7424 0 364193 0 0 0 KRISTEN RIGGS VP 200725 0 39709 0 5561 0 12261 0 16280 0 274536 0 0 0 LISA R SCHILLER VP/MKTG, PR, COMM RELATIONS & GOVT A 201399 0 38305 0 12622 0 31109 0 15163 0 298598 0 0 0 TAMMIE T STANTON VP/POST ACUTE SERVICES 0 255870 0 44226 0 10212 0 66690 0 11634 0 388632 0 0 SEAN T TEHRANI MD VP/REGIONAL HOSPITALISTS SERVICES 450172 0 94167 0 24381 0 44004 0 12874 0 625598 0 0 0 TOM G WILLIAMS VP/AMBULATORY SERVICES 203627 0 39077 0 12176 0 33100 0 15163 0 303143 0 0 0 JEFF S LEGAY ASST TREASURER & ASST SECRETARY (AS 195829 0 36746 0 766 0 7087 0 9080 0 249508 0 0 0 ERIC JANIS PHYSICIAN 1412770 0 20400 0 25932 0 35000 0 12874 0 1506976 0 0 0 RAVISH SACHAR PHYSICIAN 1431261 0 24480 0 3012 0 35000 0 13812 0 1507565 0 0 0 MATTHEW HOOK PHYSICIAN 1388715 0 0 0 19260 0 35000 0 14250 0 1457225 0 0 0 MATEEN AKHTAR PHYSICIAN 1252660 0 20400 0 18822 0 35000 0 16280 0 1343162 0 0 0 JOEL SCHNEIDER PHYSICIAN 1249286 0 0 0 3612 0 35000 0 12874 0 1300772 0 0 0 PART I, LINE 1A THE ORGANIZATION OFFERS COMPLIMENTARY MEMBERSHIPS TO REX WELLNESS CENTERS FOR THE EXECUTIVE STAFF, BOTH ACTIVE AND RETIRED BOARD MEMBERS AND MEDICAL DIRECTORS. ALL MEMBERS RECEIVING COMPLIMENTARY MEMBERSHIPS ARE REQUIRED TO COMPLETE THE SAME APPLICATION AND TESTING PROCEDURES AS OTHER MEMBERS. CURRENTLY, THERE ARE 6 INDIVIDUALS LISTED THAT RECEIVE COMPLIMENTARY MEMBERSHIPS. THE VALUE OF THE COMPLIMENTARY MEMBERSHIP IS TREATED AS TAXABLE COMPENSATION AND IS REPORTED ON THE INDIVIDUAL'S W-2. PART I, LINE 4B GARY PARK PARTICIPATED IN A NON-QUALIFIED SUPPLEMENTAL RETIREMENT PLAN FUNDED AND CONTROLLED BY A RELATED ORGANIZATION, UNC HCS, AND RECEIVED DISTRIBUTIONS TOTALING $1,052,629. STEPHEN W. BURRISS PARTICIPATED IN A NON-QUALIFIED SUPPLEMENTAL RETIREMENT PLAN FUNDED AND CONTROLLED BY A RELATED ORGANIZATION, UNC HCS. HE EARNED COMPENSATION UNDER THIS PLAN TOTALING $57,618, WHICH IS PAYABLE IN THE FUTURE. PART I, LINE 6 EMPLOYEES 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. A NORTH CAROLINA MEDICAL CARE COMMISSION 521309402 65821DFJ5 2010-10-26 127456150 SEE PART VI 0 0 0 B NORTH CAROLINA MEDICAL CARE COMMISSION 521309402 65821DTR2 2015-05-21 150167728 SEE PART VI 0 0 0 A 28190000 127456150 2184840 1628054 47608529 76034727 2013 1 0 1 1 B 150167728 4130000 1051300 150000000 2017 0 0 1 1 A 0 0 1 1 0 0 0 1 B 0 0 1 1 0 0 0 1 A 1 0 0 0 0 1 B 0 1 0 0 1 0 0 0 1 A 1 B 1 SCHEDULE K, PART I, COLUMN F- ISSUE A CONSTRUCTION OF CENTRAL ENERGY PLANT, PURCHASE ROUTINE CAPITAL EQUIPMENT AND REFUND SERIES 1998 BONDS. SCHEDULE K, PART I, COLUMN F- ISSUE B CONSTRUCTION OF NORTH CAROLINA HEART & VASCULAR HOSPITAL AND PARKING DECK, PURCHASE EQUIPMENT FOR NORTH CAROLINA HEART & VASCULAR HOSPITAL AND FUND CAPITALIZED INTEREST. FORM 990, PART I, ITEM C DBA: NORTH CAROLINA SURGERY DBA: REX BLOOD PLAN DBA: REX BREAST CARE CENTER DBA: REX CANCER CENTER DBA: REX CANCER SPECIALTY CENTER DBA: REX CARDIAC SURGICAL SPECIALISTS DBA: REX COMPREHENSIVE VEIN CENTER DBA: REX CRITICAL CARE TRANSPORT DBA: REX DIGESTIVE HEALTHCARE DBA: REX EAR NOSE & THROAT SPECIALISTS DBA: REX EAR NOSE & THROAT SPECIALISTS AT WAKEFIELD DBA: REX EXPRESS CARE OF CARY DBA: REX EXPRESS CARE OF HOLLY SPRINGS DBA: REX EXPRESS CARE OF KNIGHTDALE DBA: REX EXPRESS CARE OF RALEIGH DBA: REX EXPRESS CARE OF WAKEFIELD DBA: REX FAMILY BIRTH CENTER DBA: REX FAMILY PRACTICE OF KNIGHTDALE DBA: REX FAMILY PRACTICE OF WAKEFIELD DBA: REX HEALTHCARE DBA: REX HEALTHCARE OF CARY DBA: REX HEALTHCARE OF GARNER DBA: REX HEALTHCARE OF HOLLY SPRINGS DBA: REX HEALTHCARE OF KNIGHTDALE DBA: REX HEALTHCARE OF WAKEFIELD DBA: REX HEART CENTER DBA: REX HEART FAILURE DBA: REX HEMATOLOGY ONCOLOGY ASSOCIATES DBA: REX HOME SERVICES DBA: REX HOSPITAL DBA: REX HOSPITAL PELVIC HEALTH CENTER DBA: REX HOSPITAL TRANSPORT DBA: REX INTERNAL MEDICINE OF CARY DBA: REX LABORATORY SERVICES OF CARY DBA: REX MOBILE MAMMOGRAPHY DBA: REX NEUROSURGERY & SPINE SPECIALISTS DBA: REX NUTRITION SERVICES DBA: REX OUTREACH DBA: REX PAIN CENTER DBA: REX PALLIATIVE CARE SPECIALISTS DBA: REX PEDIATRICS OF CARY DBA: REX PEDIATRICS OF HOLLY SPRINGS DBA: REX PHARMACY OF RALEIGH DBA: REX PRIMARY CARE OF CARY DBA: REX PULMONARY SPECIALISTS DBA: REX RADIOLOGY SERVICES OF CARY DBA: REX RADIOLOGY SPECIALISTS DBA: REX REHABILITATION AND NURSING CARE CENTER OF APEX DBA: REX REHABILITATION SERVICES OF CARY DBA: REX SAME DAY SURGERY DBA: REX SENIOR HEALTH CENTER DBA: REX STRATEGIC INNOVATIONS DBA: REX STRUCTURAL HEART DBA: REX SURGICAL SPECIALISTS DBA: REX THORACIC SPECIALISTS DBA: REX THORACIC SURGICAL SPECIALISTS DBA: REX UNC HEALTHCARE DBA: REX VASCULAR SPECIALISTS DBA: REX VASCULAR SURGICAL SPECIALISTS DBA: REX WELLNESS CENTER OF CARY DBA: REX WELLNESS CENTER OF GARNER DBA: REX WELLNESS CENTER OF KNIGHTDALE DBA: REX WELLNESS CENTER OF WAKEFIELD DBA: REX WOUND HEALING CENTER DBA: UNC REX CANCER CENTER DBA: UNC REX CRITICAL CARE TRANSPORT DBA: UNC REX HEALTHCARE DBA: UNC REX HOME SERVICES DBA: UNC REX HOSPITAL DBA: UNC REX HOSPITAL TRANSPORT DBA: UNC REX PHARMACY OF RALEIGH DBA: UNC REX REHABILITATION & NURSING CARE CENTER OF APEX DBA: UNC REX REHABILITATION & NURSING CARE CENTER OF RALEIGH FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION'S SOLE MEMBER IS REX HEALTHCARE, INC. FORM 990, PART VI, SECTION A, LINE 7A THE UNIVERSITY OF NORTH CAROLINA HEALTH CARE SYSTEM APPOINTS ALL OF THE THIRTEEN SEATS ON THE ORGANIZATION'S BOARD OF TRUSTEES. FORM 990, 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 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 11B THE ORGANIZATION'S 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 12C THE 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 15 THE ORGANIZATION USES AN INDEPENDENT CONSULTANT TO MEASURE FAIR VALUE OF COMPENSATION FOR THE ORGANIZATION'S PRESIDENT AND OTHER TOP MANAGEMENT. THE ORGANIZATION'S BOARD REVIEWS AND APPROVES THE COMPENSATION FOR ALL OFFICERS EXCEPT THE ASSISTANT TREASURER AND ASSISTANT SECRETARY. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S FORM 990 IS AVAILABLE UPON REQUEST AND ON GUIDESTAR'S WEBSITE AND THE FINANCIAL STATEMENTS ARE AVAILABLE ON MUNICIPAL SECURITIES RULEMAKING BOARD'S WEBSITE. THE ORGANIZATION DOES NOT MAKE OTHER GOVERNING DOCUMENTS AND THE CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC. FORM 990, PART XII, LINE 2C THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. 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