2018-07-17T09:00:24-05:00 2017-09-30 420714325 RSM US LLP 1 S Wacker Drive Ste 800 Chicago IL 60606 990 2016-10-01 383740839 Vidant Medical Group LLC VIDA 2528475129 2100 Stantonsburg Road Greenville NC 27835 David Hughes Treasurer 2528475129 2018-07-16 1 Wayne Harder P00294296 3126343400 2016 2022-09-23 18:48:47Z David Hughes 2100 Stantonsburg Road Greenville NC 27835 178112204 0 X www.vidanthealth.com X 2006 NC To provide medical services in Eastern North Carolina. 7 0 486 0 0 0 0 0 164870197 178081637 17268 30567 0 0 164887465 178112204 0 0 0 0 143903431 153847220 0 0 0 75394223 84198422 219297654 238045642 -54410189 -59933438 45053070 39692742 30530085 29615151 14522985 10077591 To enhance the quality of life for the people and communities we serve, touch and support. 0 0 231365250 178081637 Vidant Health professionals provided evaluations, clinical care management and medically necessary procedures. 231365250 1 0 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 0 0 486 1 0 0 0 0 0 0 0 0 0 0 X 7 0 0 0 0 0 1 1 1 1 1 0 0 1 0 0 0 1 1 0 X X Brian Dunn 2528477479 2100 Stantonsburg Road Greenville NC 27835 Dr Michael R Waldrum MD Chief Executive Officer 2.00 50.00 X X 0 1036015 196878 Roger Robertson President of VCOM 2.00 46.00 X 0 423374 268707 David S Hughes Treasurer 2.00 50.00 X X 0 494394 176072 William Floyd EVP/President of VMC 2.00 42.00 X 0 491222 134855 Dr Mark Rumans MD Chief Medical Officer 2.00 40.00 X 0 537020 145801 Anthony Bartholomew VP of Operations 40.00 X 201901 0 44074 Dr Daniel Drake PhD Senior VP of Patient Care & Quality 40.00 X 0 213912 97877 Amit Raina Physician 40.00 X 912674 0 32927 Kenneth Lee Physician 40.00 X 851087 0 39544 Satti Bilal Physician 40.00 X 845382 0 45371 Michael Johnson Physician 40.00 X 835279 0 51097 Ricardo Cortez Physician 40.00 X 776047 0 35104 4422370 3195937 1268307 365 0 1 0 ECU School of Medicine PO Box 75514 Charlotte NC 28275 Physician Services 5641287 Bunn Medical Associates 606 Ashburton Drive Greenville NC 27858 Physician Services 2126110 Center for Neuropsychiatric Services PA 12417 Moriah Way Raleigh NC 27614 Physician Services 899928 Eastern Urological Associates 275 Bethesda Drive Greenville NC 27834 Physician Services 687122 AVID Consulting Group LLC 2490 Sutton Place Drive S Carmel IN 46032 Consulting Services 648193 43 Patient Revenue 621110 117423056 117423056 Contract Management Fees 621110 60658581 60658581 178081637 30567 30567 178112204 178081637 0 30567 X 245975 238460 7515 135845478 131695127 4150351 2626419 2546178 80241 8177181 7927355 249826 6952167 6739767 212400 436985 423634 13351 20026 19414 612 42099712 41508967 590745 1231406 1193785 37621 12119799 11749520 370279 64177 62216 1961 744723 721970 22753 484046 314630 169416 50619 49073 1546 2259 2190 69 77085 6938 70147 2397012 2323779 73233 1129180 508131 621049 Bad Debt Expense 23103207 23103207 Quality Initiatives 33050 32040 1010 Special Programs 25497 24718 779 Books / Subscriptions 16560 16054 506 163079 158097 4982 238045642 231365250 6680392 0 5298508 3358412 12304137 12495407 994285 1122835 1407397 1611771 29289762 13095589 17562465 16194173 7486278 4910144 45053070 39692742 20711332 22862856 9505 44993 9809248 6707302 30530085 29615151 X 14522985 10077591 14522985 10077591 45053070 39692742 X -59933438 55488044 X 0 1 X 1 0 X 127385368 152362129 164114286 164870197 178081637 786813617 127385368 152362129 164114286 164870197 178081637 786813617 0 0 0 786813617 16287 13857 17182 17268 30567 95161 16287 13857 17182 17268 30567 95161 127401655 152375986 164131468 164887465 178112204 786908778 0.99990 0.99990 0.00010 0.00010 X 1967915 1967915 13184584 2856476 10328108 14137263 10239113 3898150 16194173 Other Receivables 1438299 Sales Tax Receivables 260989 Intercompany Receivables 2154637 Physician Loan Receivables 1019524 Deferred Pension 36695 4910144 Worker Compensation Long Term 263802 Self-Insurance Reserve 4583006 Current Reserve for Professional Liability 1860494 6707302 X Part X, Line 2: Vidant Medical Group LLC has been determined to qualify as a tax-exempt organization under Section 501(c)(3) of the Internal Revenue Code. Vidant Medical Group has reviewed its tax positions for all open years and has concluded that no material liabilities exist as of September 30, 2017 and 2016. Vidant Medical Group files tax returns with the U.S. federal jurisdiction. With few exceptions, Vidant Medical Group is no longer subject to US federal examinations by tax authorities for years before 2014. 0 0 0 0 0 0 0 0 0 Dr Michael R Waldrum MD Chief Executive Officer 0 937938 0 86400 0 11677 0 142241 0 54637 0 1232893 0 0 Roger Robertson President of VCOM 0 393802 0 27001 0 2571 0 229290 0 39417 0 692081 0 0 David S Hughes Treasurer 0 462126 0 30645 0 1623 0 133202 0 42870 0 670466 0 0 William Floyd EVP/President of VMC 0 458654 0 31926 0 642 0 90770 0 44085 0 626077 0 0 Dr Mark Rumans MD Chief Medical Officer 0 502883 0 34137 0 0 0 106950 0 38851 0 682821 0 0 Anthony Bartholomew VP of Operations 195226 0 6675 0 0 0 20554 0 23520 0 245975 0 0 0 Dr Daniel Drake PhD Senior VP of Patient Care & Quality 0 206412 0 7500 0 0 0 55309 0 42568 0 311789 0 0 Amit Raina Physician 912674 0 0 0 0 0 0 0 32927 0 945601 0 0 0 Kenneth Lee Physician 826087 0 25000 0 0 0 0 0 39544 0 890631 0 0 0 Satti Bilal Physician 845382 0 0 0 0 0 0 0 45371 0 890753 0 0 0 Michael Johnson Physician 835279 0 0 0 0 0 0 0 51097 0 886376 0 0 0 Ricardo Cortez Physician 766047 0 10000 0 0 0 0 0 35104 0 811151 0 0 0 Part I, Line 1a All compensation and reimbursement listed for such items are paid at the Vidant Health entity, and the written policy and adherence to the policy is maintained at VH. Part I, Line 3 The compensation is determined by the Compensation and Benefits Committee of the VH Board using comparative data from like organizations and input from consultants. This process is performed every two years, the last year being 2017. It will be performed again in fiscal year 2019. All compensation discussions and actions are documented and approved in the minutes of the Committee. Part I, Line 4 As of January 1, 2013, the supplemental nonqualified retirement plan was frozen and no further amounts have accrued to its benefit. In lieu of the SERP, the comprehensive defined benefit pension plan will provide an equivalent benefit. The increase in the value of such plans is reflected in the sum of Part II, Column (C). Form 990, Part VI, Section A, line 6 University Health Systems of Eastern Carolina, Inc. ("Vidant Health") is the sole corporate member of Vidant Medical Group, LLC. Form 990, Part VI, Section A, line 7a As the corporate member, Vidant Health shall have the responsibility to elect or appoint the seven individual voting members of Vidant Medical Group, LLC. Form 990, Part VI, Section A, line 7b The rights reserved to the corporate member include the rights of: a. Selling, leasing or otherwise disposing of, or agreeing to sell, lease or otherwise dispose of, all or substantially all of the assets of Vidant Medical Group, LLC; b. Winding up, dissolving, liquidating, reorganizing, or otherwise terminating the existence of Vidant Medical Group, LLC; c. Merging or consolidating Vidant Medical Group, LLC with or into any other entity or converting into any other type of entity; d. Amending the Articles of Organization or Operating Agreement, and; e. Admitting additional Members or issuing additional Membership Interests. Form 990, Part VI, Section B, line 11b The Board Member is provided a copy of the return for review prior to filing. The return is also reviewed by the Chief Financial Officer, Chief General Counsel and the Chief Audit and Compliance Officer of University Health Systems of Eastern Carolina, Inc. (D/B/A Vidant Health) prior to filing with the Internal Revenue Service. Form 990, Part VI, Section B, line 12 As described in the Conflict of Interest policy maintained by VH, all Officers, Board Members and Key Employees are required to complete a yearly comprehensive conflict of interest questionnaire. These are reviewed by legal counsel and any potential or actual conflicts are brought to the Board for disposition. Board Members are instructed to report any potential conflicts arising during the year for review. Board Members are required to recuse themselves from voting on issues in which they are deemed to have a conflict. Form 990, Part VI, Section B, line 15 The compensation is determined by the Compensation and Benefits Committee of the VH Board using comparative data from like organizations and input from consultants. This process is performed every two years, the last year being 2017. It will be performed again in fiscal year 2019. Compensation of other officers and key employees is also determined by the Compensation and Benefits Committee of the VH Board using comparative data from like organizations and input from consultants. This process is performed every two years, the last year being 2017. It will be performed again in fiscal year 2019. All compensation discussions and actions are documented and approved in the minutes of the Committee. Form 990, Part VI, Section C, line 19 The organization makes its governing documents, conflict of interest policy, and financial statements available to the public upon request for the same period of disclosure as set forth in IRC Section 6104(d). Form 990, Part IX, line 11g Intercompany Shared Services: Program service expenses 13,747,137. Management and general expenses 433,239. Fundraising expenses 0. Total expenses 14,180,376. Physician Fees: Program service expenses 22,763,980. Management and general expenses 0. Fundraising expenses 0. Total expenses 22,763,980. Other Service Contracts: Program service expenses 4,997,850. Management and general expenses 157,506. Fundraising expenses 0. Total expenses 5,155,356. Form 990, Part XI, line 9: Net Asset Transfer 55,488,044. Vidant Medical Group Affiliates LLC 2100 Stantonsburg Road Greenville NC 27835 472875992 Healthcare NC 0 0 Vidant Medical Group LLC Tarboro Endoscopy Center LLC 201 Clinic Drive Tarboro NC 27886 271345858 Healthcare NC 0 0 Vidant Medical Group LLC University Health Systems of Eastern Carolina (DBA Vidant Health) 2100 Stantonsburg Road Greenville NC 27835 562141073 Healthcare NC 501(c)(3) Line 12c, III-FI N/A 0 Pitt County Memorial Hospital Inc (DBA Vidant Medical Center) 2100 Stantonsburg Road Greenville NC 27835 560585243 Hospital NC 501(c)(3) Line 3 Vidant Health 0 Surgicenter Services of Pitt Inc 102 Bethesda Drive Greenville NC 27835 561690553 Healthcare NC 501(c)(3) Line 12b, II Vidant Medical Center 0 The Outer Banks Hospital Inc 2100 Stantonsburg Road Greenville NC 27835 562112733 Hospital NC 501(c)(3) Line 3 East Carolina Health 0 PCMH Management Inc (DBA Vidant Properties) 2100 Stantonsburg Road Greenville NC 27835 561690740 Medical Property Management NC 501(c)(2) Vidant Health 0 East Carolina Health Inc (DBA Vidant Community Hospitals - Central) 2100 Stantonsburg Road Greenville NC 27835 562003393 Hospital NC 501(c)(3) Line 3 Vidant Health 0 HealthAccess Inc 2100 Stantonsburg Road Greenville NC 27835 561396133 Healthcare NC 501(c)(3) Line 12b, II Vidant Health 0 East Carolina Health-Bertie (DBA Vidant Bertie Hospital) 2100 Stantonsburg Road Greenville NC 27835 562072002 Hospital NC 501(c)(3) Line 3 Vidant Health 0 East Carolina Health-Chowan (DBA Vidant Chowan Hospital) 2100 Stantonsburg Road Greenville NC 27835 562101090 Hospital NC 501(c)(3) Line 3 Vidant Health 0 East Carolina Health-Heritage (DBA Vidant Edgecombe Hospital) 2100 Stantonsburg Road Greenville NC 27835 562093700 Hospital NC 501(c)(3) Line 3 Vidant Health 0 East Carolina Health-Beaufort (DBA Vidant Beaufort Hospital) 2100 Stantonsburg Road Greenville NC 27835 452436270 Hospital NC 501(c)(3) Line 3 Vidant Health 0 Duplin General Hospital (DBA Vidant Duplin Hospital) 2100 Stantonsburg Road Greenville NC 27835 566011594 Hospital NC 501(c)(3) Line 3 Vidant Health 0 East Carolina Health Inc (DBA Vidant Roanoke-Chowan Hospital) 2100 Stantonsburg Road Greenville NC 27835 264634725 Hospital NC 501(c)(3) Line 3 Vidant Health 0 Pungo District Hospital Corporation (DBA Vidant Pungo Hospital) 2100 Stantonsburg Road Greenville NC 27835 560518757 Hospital NC 501(c)(3) Line 3 Vidant Health 0 0 1 1 0 0 0 0 0 0 1 1 1 1 0 1 1 1 0 0