MEDICAL PARK HOSPITAL INC: Form 990, tax year 2017

View the entire original 990 at ProPublica ↗

Organization
MEDICAL PARK HOSPITAL INC (EIN 56-1340424)
Tax period
2017-01-01 to 2017-12-31
Filed
2018-11-15
IRS object ID
201823199349302132
Schema version
2017v2.3
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2018-11-15T08:41:49-06:00ReturnTs
Tax Period End2017-12-31TaxPeriodEndDt
Return Type990ReturnTypeCd
Tax Period Begin2017-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN561340424EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1MEDICAL PARK HOSPITAL INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlMEDIBusinessNameControlTxt
Phone3367182803PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line12085 FRONTIS PLAZA BLVDAddressLine1Txt
CityWINSTON SALEMCityNm
State AbbreviationNCStateAbbreviationCd
ZIP27103ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonFRED HARGETTPersonNm
Person TitleEVP & CFOPersonTitleTxt
Phone3367182803PhoneNum
Signature2018-11-12SignatureDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address170.98.106.254IPv4AddressTxt
FieldValueIRS element (for citing)
IP2018-11-12IPDt
IP Tm16:25:37IPTm
IP TimezoneESIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device Id78A4C4F87B604C240469A634FCB01368FEDB2C97AtSubmissionCreationDeviceId
At Submission Filing Device Id2E0617DCF860B22C3F0F9F24470DBB0FF68CD602AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2017TaxYr
Build TS2018-06-14 16:35:46ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1NOVANT HEALTH MEDICAL PARK HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
Principal OfficerCARL ARMATOPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line12085 FRONTIS PLAZA BLVDAddressLine1Txt
CityWINSTON SALEMCityNm
State AbbreviationNCStateAbbreviationCd
ZIP27103ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$79,038,828GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.NOVANTHEALTH.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1966FormationYr
Legal Domicile StateNCLegalDomicileStateCd
Activity Or MissionSEE SCHEDULE OActivityOrMissionDesc
Voting Members Governing Body8VotingMembersGoverningBodyCnt
Voting Members Independent6VotingMembersIndependentCnt
Total Employee276TotalEmployeeCnt
Total Volunteers26TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$254,310CYContributionsGrantsAmt
PY Program Service Revenue$74,851,447PYProgramServiceRevenueAmt
CY Program Service Revenue$78,599,801CYProgramServiceRevenueAmt
PY Investment Income$49,185PYInvestmentIncomeAmt
CY Investment Income$13,358CYInvestmentIncomeAmt
PY Other Revenue$155,236PYOtherRevenueAmt
CY Other Revenue$166,846CYOtherRevenueAmt
PY Total Revenue$75,055,868PYTotalRevenueAmt
CY Total Revenue$79,034,315CYTotalRevenueAmt
PY Grants And Similar Paid$650PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$1,900CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$15,508,895PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$16,285,609CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$40,302,410PYOtherExpensesAmt
CY Other Expenses$45,109,762CYOtherExpensesAmt
PY Total Expenses$55,811,955PYTotalExpensesAmt
CY Total Expenses$61,397,271CYTotalExpensesAmt
PY Revenues Less Expenses$19,243,913PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$17,637,044CYRevenuesLessExpensesAmt
Total Assets BOY$312,954,742TotalAssetsBOYAmt
Total Assets EOY$331,185,821TotalAssetsEOYAmt
Total Liabilities BOY$3,854,232TotalLiabilitiesBOYAmt
Total Liabilities EOY$4,504,072TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$309,100,510NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$326,681,749NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionSEE SCHEDULE OMissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$45,129,665ExpenseAmt
Grant$1,900GrantAmt
Revenue$78,601,666RevenueAmt
DescMEDICAL PARK HOSPITAL CARRIES OUT THE PURPOSE OF THE FORSYTH COUNTY BOARD OF COMMISSIONERS THROUGH ADVANCING AND SUPPORTING THE PROMOTION OF HEALTH OF THE INHABITANTS OF FORSYTH COUNTY. MEDICAL PARK HOSPITAL HAS 22 LICENSED BEDS. DURING 2017, THERE WERE 3,045 PATIENT DAYS WITH AN AVERAGE LENGTH OF STAY OF 3 DAYS, AN AVERAGE DAILY CENSUS OF 8, AND 964 DISCHARGES. THERE WERE 9,744 INPATIENT AND OUTPATIENT SURGERIES, AND 15,291 OUTPATIENT ENCOUNTERS.Desc
Total Program Service Expenses$45,129,665TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee276EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members8GoverningBodyVotingMembersCnt
Independent Voting Member6IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEO0CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldNCStatesWhereCopyOfReturnIsFldCd
Own WebsiteYes (X)OwnWebsiteInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1KAREN DAUGHERTYBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone3367182803PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line12085 FRONTIS PLAZA BLVDAddressLine1Txt
CityWINSTON SALEMCityNm
State AbbreviationNCStateAbbreviationCd
ZIP27103ZIPCd
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (23 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
BIGGERSTAFF DANIEL SCOTT
TRUSTEE2.00Yes (X)$0$0$0
ELY JOSEPH
TRUSTEE2.00Yes (X)$0$0$0
FORIEST BRYANT
TRUSTEE2.00Yes (X)$0$0$0
INMAN JOSEPH MD
VICE CHAIR2.00Yes (X)$0$0$0Yes (X)
JENNINGS WILLIAM
CHAIR2.00Yes (X)$0$0$0Yes (X)
LAWSON GEORGE
TRUSTEE2.00Yes (X)$0$0$0
MCPHAIL ERNEST MD
TRUSTEE2.00Yes (X)$0$353,131$82,406
SANZ SEAN
MARKET PRESIDENT/COO & TRUSTEE60.00Yes (X)$0$649,064$155,777Yes (X)
COLEMAN TRISHA
TREAS2.00$0$227,532$45,053Yes (X)
FRANCE BARBARA
SEC2.00$42,387$0$31,887Yes (X)
MORRIS JOHN
ASST SEC2.00$0$346,362$88,122Yes (X)
ROYSTER KIRSTEN
PRESIDENT & COO60.00$333,317$0$60,487Yes (X)
SMITH HARRY
SVP HOSPITAL OPERATIONS60.00$0$1,092,392$194,938Yes (X)
BRIGHT JANET
VP NURSING & MARKET CNO60.00$0$212,295$53,687Yes (X)
JARRETT-PULLIAM KIMBERLY
FMR VP NURSING & MARKET CNO60.00$0$509,351$78,592Yes (X)
CLARK VICKI
NURSE MANAGER40.00$118,228$0$56,537Yes (X)
LYERLY RONALD
PHARMACIST40.00$156,254$0$59,749Yes (X)
ORAJAKA EMEKA
PHARMACIST40.00$142,499$0$27,692Yes (X)
PHILLIPS-TAYLOR ROBIN
NURSE MANAGER40.00$118,537$0$40,863Yes (X)
SMITH CAROL
DIR OPERATIONS/NURSING40.00$154,546$0$35,108Yes (X)
CARTER TERESA
FMR MPH COO0.00$0$271,911$60,446Yes (X)
MIHAL DENISE
FMR PRES - FMH/COO WS MKT0.00$0$1,327,983$84,429Yes (X)
SETLIFF MICHAEL
FMR MPH COO0.00$0$415,136$84,402Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,065,768TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$5,405,157TotReportableCompRltdOrgAmt
Total Other Compensation$1,240,175TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K6IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (1)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
SYLVESTER & COCKRUM INC
6000 GUN CLUB ROADWINSTON SALEMNC27103CONSTRUCTION SERVICES$1,507,877
PIEDMONT TRIAD ANESTHESIA
PO BOX 602365CHARLOTTENC28260ANESTHESIA SERVICES$842,217
MORRISON MANAGEMENT SPECIALISTS
PO BOX 102289ATLANTAGA30368FOOD MANAGEMENT SERVICES$556,901
CROTHALL HEALTH CARE INC
955 CHESTERBROOK BLVDWAYNEPA19087FACILITY SERVICES$407,680
FORRESTGATE ASSOCIATES LLC
3825 FORRESTGATE DRIVEWINSTON SALEMNC27103HEALTH SERVICES$404,780
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K11CntrctRcvdGreaterThan100KCnt
Government Grants$254,310GovernmentGrantsAmt
Total Contributions$254,310TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescNET PATIENT REVENUEDesc
Business622110BusinessCd
Total Revenue Column$78,599,801TotalRevenueColumnAmt
Related Or Exempt Func Income$78,599,801RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$78,599,801TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$14,692TotalRevenueColumnAmt
Exclusion$14,692ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Other$3,179OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Other$4,513OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Other-$1,334OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$1,334TotalRevenueColumnAmt
Exclusion-$1,334ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
CAFETERIA MEALS722514$148,172$148,172
MISCELLANEOUS INCOME900099$18,674$16,809$1,865
FieldValueIRS element (for citing)
Other Revenue Total$166,846OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$79,034,315TotalRevenueColumnAmt
Related Or Exempt Func Income$78,601,666RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$178,339ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$1,900TotalAmt
Program Services$1,900ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$468,076TotalAmt
Management And General$468,076ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$12,369,168TotalAmt
Program Services$11,638,150ProgramServicesAmt
Management And General$731,018ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$493,043TotalAmt
Program Services$463,904ProgramServicesAmt
Management And General$29,139ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$2,055,198TotalAmt
Program Services$1,933,736ProgramServicesAmt
Management And General$121,462ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$900,124TotalAmt
Program Services$846,927ProgramServicesAmt
Management And General$53,197ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$3,885,745TotalAmt
Program Services$2,995,193ProgramServicesAmt
Management And General$890,552ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$1,703TotalAmt
Program Services$1,602ProgramServicesAmt
Management And General$101ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$274,837TotalAmt
Program Services$158,526ProgramServicesAmt
Management And General$116,311ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$199,907TotalAmt
Program Services$188,092ProgramServicesAmt
Management And General$11,815ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$1,041,429TotalAmt
Program Services$979,881ProgramServicesAmt
Management And General$61,548ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$12,996TotalAmt
Program Services$12,228ProgramServicesAmt
Management And General$768ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$225TotalAmt
Program Services$212ProgramServicesAmt
Management And General$13ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$687,426TotalAmt
Program Services$646,799ProgramServicesAmt
Management And General$40,627ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$2,540,421TotalAmt
Program Services$2,390,282ProgramServicesAmt
Management And General$150,139ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$59,268TotalAmt
Program Services$49,548ProgramServicesAmt
Management And General$9,720ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES$16,352,407$16,352,407
CORPORATE SUPPORT$13,446,950$13,446,950
BAD DEBT$2,793,282$2,793,282
DRUGS$1,375,572$1,375,572

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$2,437,594TotalAmt
Program Services$2,301,424ProgramServicesAmt
Management And General$136,170ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$61,397,271TotalAmt
Program Services$45,129,665ProgramServicesAmt
Management And General$16,267,606ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$5,142BOYAmt
EOY$4,075EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$9,791,704BOYAmt
EOY$8,894,818EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$1,742,598BOYAmt
EOY$1,685,225EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$3,387,388BOYAmt
EOY$3,597,318EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$248,101BOYAmt
EOY$248,101EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$56,074,190LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$40,627,630LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$14,947,974BOYAmt
EOY$15,446,560EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$282,831,835BOYAmt
EOY$301,309,724EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$312,954,742BOYAmt
EOY$331,185,821EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$1,273,447BOYAmt
EOY$1,412,361EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$2,580,785BOYAmt
EOY$3,091,711EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$3,854,232BOYAmt
EOY$4,504,072EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$309,100,510BOYAmt
EOY$326,681,749EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$309,100,510BOYAmt
EOY$326,681,749EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$312,954,742BOYAmt
EOY$331,185,821EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$17,637,044ReconcilationRevenueExpnssAmt
Other Changes In Net Assets-$55,805OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other Organizations0GrantsOtherOrganizationsInd
Direct Contact Legislators0DirectContactLegislatorsInd
Rallies Demonstrations0RalliesDemonstrationsInd
Other ActivitiesYes (1)OtherActivitiesInd
Other Activities$7,517OtherActivitiesAmt
Total Lobbying Expenditures$7,517TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART II-B, LINE 1:FormAndLineReferenceDesc
ExplanationLINE 1I DUES PAID TO CERTAIN ORGANIZATIONS WHICH INCLUDE A PORTION RELATED TO LOBBYING ACTIVITIES.ExplanationTxt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,200,000OtherCostOrOtherBasisAmt
Book Value$2,200,000BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$21,368,600OtherCostOrOtherBasisAmt
Depreciation$16,841,092DepreciationAmt
Book Value$4,527,508BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$30,170,990OtherCostOrOtherBasisAmt
Depreciation$23,201,347DepreciationAmt
Book Value$6,969,643BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,334,600OtherCostOrOtherBasisAmt
Depreciation$585,191DepreciationAmt
Book Value$1,749,409BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$15,446,560TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp

FieldValueIRS element (for citing)
DescDUE FROM AFFILIATEDesc
Book Value$301,309,724BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Other Assets$301,309,724TotalBookValueOtherAssetsAmt
Federal Income Tax Liability$0FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)

DescDescAmtAmt
THIRD PARTY PAYMENT PAYABLE$680,510
NOTES PAYABLE$2,078,528
PATIENT REFUNDS$332,673
FieldValueIRS element (for citing)
Total Liability$3,091,711TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART X, LINE 2:FormAndLineReferenceDesc
ExplanationPART X, LINE 2: LIABILITY UNDER FIN 48 (ASC 740) FOOTNOTE THE AUDIT FOR NOVANT HEALTH AND ITS AFFILIATES IS PREPARED ON A CONSOLIDATED BASIS. THE COMPANY IS REQUIRED TO EVALUATE UNCERTAIN TAX POSITIONS. THIS EVALUATION INCLUDES A QUANTIFICATION OF TAX RISK IN AREAS SUCH AS UNRELATED BUSINESS TAXABLE INCOME AND THE TAXATION OF OUR FOR-PROFIT SUBSIDIARIES. THIS EVALUATION DID NOT HAVE A MATERIAL EFFECT ON THE COMPANY'S CONSOLIDATED STATEMENTS OF OPERATIONS AND CHANGES IN NET ASSETS FOR THE YEARS ENDED DECEMBER 31, 2017 AND 2016.ExplanationTxt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd

Free Care Oth Percentage FreeCareOthPercentageGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
Free Care Other300.000000000000FreeCareOtherPct
FieldValueIRS element (for citing)
FPG Reference Discounted Care0FPGReferenceDiscountedCareInd
Free Care Medically Indigent0FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed BudgetYes (1)ExpensesExceedBudgetInd
Unable To Provide Care0UnableToProvideCareInd
Annual Community Bnft ReportYes (1)AnnualCommunityBnftReportInd
Report Publically AvailableYes (1)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,095,428TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,095,428NetCommunityBenefitExpnsAmt
Total Expense0.01870TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$4,751,414TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$3,053,514DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,697,900NetCommunityBenefitExpnsAmt
Total Expense0.02900TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$5,846,842TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$3,053,514DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,793,328NetCommunityBenefitExpnsAmt
Total Expense0.04770TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$7,223TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$7,223NetCommunityBenefitExpnsAmt
Total Expense0.00010TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$177,391TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$177,391NetCommunityBenefitExpnsAmt
Total Expense0.00300TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$184,614TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$184,614NetCommunityBenefitExpnsAmt
Total Expense0.00310TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$6,031,456TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$3,053,514DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,977,942NetCommunityBenefitExpnsAmt
Total Expense0.05080TotalExpensePct

Workforce Development WorkforceDevelopmentGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,900TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,900NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,900TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,900NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$2,793,282BadDebtExpenseAmt
Reimbursed By Medicare$8,305,518ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$9,610,935CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$1,305,417MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn0FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1MPH DBA NH MEDICAL PARK HOSPITALBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11950 SOUTH HAWTHORNE ROADAddressLine1Txt
CityWINSTON SALEMCityNm
State AbbreviationNCStateAbbreviationCd
ZIP27103ZIPCd
FieldValueIRS element (for citing)
Website AddressWWW.NOVANTHEALTH.ORGWebsiteAddressTxt
State LicenseH0229StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1NH MEDICAL PARK HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY0TaxExemptHospitalCYOrPYInd
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Prior CHNA ImpactYes (X)PriorCHNAImpactInd
CHNA Conducted16CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts0CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts0CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Other WebsiteYes (X)OtherWebsiteInd
Other Website URLWWW.NOVANTHEALTH.ORGOtherWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt16ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (1)StrategyPostedWebsiteInd
Strategy Website URLWWW.NOVANTHEALTH.ORGStrategyWebsiteURLTxt
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care300.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care0.000000000000FPGFamilyIncmLmtDscntCarePct
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Residency CriteriaYes (X)ResidencyCriteriaInd
Other CriteriaYes (X)OtherCriteriaInd
Explained Basis0ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLSEE SECTION CFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLSEE SECTION CFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLSEE SECTION CFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP TranslatedYes (X)FAPTranslatedInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection Activities0CollectionActivitiesInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Prospective Medicare MedicaidYes (X)ProspectiveMedicareMedicaidInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross ChargesYes (1)GrossChargesInd

Supplemental Information SupplementalInformationGrp (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
NH MEDICAL PARK HOSPITALPART V, SECTION B, LINE 3J: NH MEDICAL PARK HOSPITALPART V, SECTION B, LINE 3E:SEVERAL SOCIAL, BEHAVIORAL, AND CLINICAL HEALTH NEEDS WERE IDENTIFIED IN THE NEEDS ASSESSMENT. ONCE THE HEALTH NEEDS WERE IDENTIFIED, SURVEYS AND COMMUNITY MEETINGS WERE CONDUCTED IN WHICH THE VARIOUS COMMUNITY STAKEHOLDERS RANKED THE HEALTH ISSUES ACCORDING TO THE YEARS OF POTENTIAL LIFE LOST AND MAGNITUDE OF IMPACT. THE INFORMATION GATHERED WAS THEN MATRIXED AND SCORED IN ORDER TO RANK THE FOCUS AREAS AND PRIORITIZE THE IDENTIFIED HEALTH NEEDS. FURTHER PRIORITIZATION OCCURRED WITH THE REVIEW BY THE ORGANIZATION'S BOARD.
NH MEDICAL PARK HOSPITALPART V, SECTION B, LINE 5: WHILE CONDUCTING THE CHNA, THE HOSPITAL FACILITY(IES) SOLICITED INPUT FROM, AND CONSULTED WITH, A VARIETY OF COMMUNITY REPRESENTATIVES INCLUDING, BUT NOT LIMITED TO, REPRESENTATIVES OF CITY AND COUNTY GOVERNMENT INCLUDING HEALTH DEPARTMENTS, COMMUNITY-BASED ORGANIZATIONS, FOUNDATIONS, CHURCHES, COLLEGES/UNIVERSITIES, COMMUNITY COALITIONS AND OTHER SOCIAL SERVICE AGENCIES. INPUT WAS GATHERED THROUGH COMMUNITY MEETINGS, STAKEHOLDERS INTERVIEWS, AND SOLICITED THROUGH WRITTEN COMMENTS THROUGHOUT THE SURVEY PERIOD UNTIL THE FINAL COMMUNITY PRIORITY SETTING MEETING(S) AND SURVEY. THE SCOPE OF EXPERTISE WAS BROAD AND INCLUDED SUCH AREAS AS PUBLIC HEALTH, MINORITY POPULATIONS, HEALTH DISPARITIES, AND SOCIAL SERVICES.
NH MEDICAL PARK HOSPITALPART V, SECTION B, LINE 11: THE HOSPITAL FACILITY(IES) IS/ARE A PART OF NOVANT HEALTH, AN INTEGRATED NOT-FOR-PROFIT HEALTH SYSTEM. AS SUCH, NOVANT HEALTH INCLUDES MULTIPLE HOSPITAL FACILITIES AND HAS ENGAGED IN CHNAS FOR ALL OF THE COMMUNITIES BEING SERVED. THE FACILITY'S CHNA IDENTIFIED MULTIPLE NEEDS FOR THE COMMUNITY SERVED. THE NEEDS IDENTIFIED WERE REVIEWED AND PRIORITIZED BY THE CHNA RESOURCE GROUP AND SUBSEQUENTLY BY EACH FACILITY'S BOARD. THEY EVALUATED EACH DOCUMENTED NEED AND ITS INTERSECTION WITH THE ORGANIZATION'S VISION, COMMITMENTS, AND KEY STRENGTHS BEFORE FURTHER PRIORITIZING THE HEALTH NEEDS AND AGREEING UPON THE TOP HEALTH PRIORITIES TO BE ADDRESSED. WHERE POSSIBLE, WE HAVE LEVERAGED THE SYSTEM'S STRENGTHS AND RESOURCES TO BEST ADDRESS THOSE NEEDS THAT ARE HIGHEST IN PRIORITY AND CONSISTENT ACROSS COMMUNITIES. NOVANT HEALTH AND EACH OF ITS HOSPITAL FACILITIES HAVE ADOPTED AND EXECUTED AN IMPLEMENTATION STRATEGY THAT ADDRESSES THE PRIORITIZED COMMUNITY HEALTH NEEDS FROM THE CHNAS. THE IMPLEMENTATION STRATEGIES OUTLINE THE PLAN THAT THE HOSPITAL FACILITY(IES) WILL UNDERTAKE TO MEET THOSE HEALTH NEEDS IN EACH OF ITS COMMUNITIES. CERTAIN NEEDS THAT WERE IDENTIFIED BY THE CHNA HAVE NOT BEEN ADDRESSED. IT WAS DETERMINED THAT THERE ARE OTHER RESOURCES IN THE COMMUNITY THAT CAN MORE APPROPRIATELY ADDRESS THESE NEEDS BASED ON SCOPE OF SERVICES AND SKILL SET. FOR MORE DETAILED INFORMATION, REFER TO THE PUBLICLY AVAILABLE IMPLEMENTATION PLAN AVAILABLE ON THE WEBSITE; REFER TO THE URL GIVEN PREVIOUSLY FOR THE POSTING OF THE PLAN.
NH MEDICAL PARK HOSPITALPART V, SECTION B, LINE 13H: OTHER ELIGIBILITY CRITERIA EXPLAINED IN THE FAP INCLUDE THE FOLLOWING: FREE CARE IS ONLY APPLICABLE TO MEDICALLY NECESSARY SERVICES; PROVIDER BASED PHYSICIAN CLINICS REQUIRE THAT PATIENTS MUST HAVE BEEN TREATED BY AN AFFILIATED MEDICAL GROUP PRIMARY CARE PHYSICIAN WITHIN THE PREVIOUS THREE YEARS; PATIENTS MUST BE UNABLE TO ACCESS ENTITLEMENT PROGRAMS; PATIENTS WITH SPECIAL CIRCUMSTANCES SUCH AS BANKRUPTCY MAY ALSO BE ELIGIBLE FOR CHARITY CARE. NOVANT HEALTH MEDICAL PARK HOSPITAL:PART V, LINE 16A, FAP WEBSITE: HTTPS://WWW.NOVANTHEALTH.ORG/HOME/PATIENTS--VISITORS/YOUR-HEALTHCARE-COSTS/FINANCIAL-ASSISTANCE-FOR-THE-UNINSURED.ASPXPART V, LINE 16B, FAP APPLICATION WEBSITE: HTTPS://WWW.NOVANTHEALTH.ORG/HOME/PATIENTS--VISITORS/YOUR-HEALTHCARE-COSTS/FINANCIAL-ASSISTANCE-FOR-THE-UNINSURED.ASPXPART V, LINE 16C, FAP PLAIN LANGUAGE SUMMARY WEBSITE: HTTPS://WWW.NOVANTHEALTH.ORG/HOME/PATIENTS--VISITORS/YOUR-HEALTHCARE-COSTS/FINANCIAL-ASSISTANCE-FOR-THE-UNINSURED.ASPX
NH MEDICAL PARK HOSPITALPART V, SECTION B, LINE 24: IT IS POSSIBLE FOR A FINANCIAL ASSISTANCE POLICY (FAP) ELIGIBLE PATIENT TO BE CHARGED AN AMOUNT EQUAL TO THE GROSS CHARGE FOR A NON-EMERGENCY OR NON-MEDICALLY NECESSARY SERVICE. HOWEVER, IF THE SERVICE IS DEEMED AN EMERGENCY OR A MEDICAL NECESSITY, THEN THE FAP ELIGIBLE PATIENT WOULD NOT BE CHARGED FOR CARE AND WOULD NOT RECEIVE A BILL ONCE FAP ELIGIBILITY HAD BEEN ESTABLISHED.

Supplemental Information Detail SupplementalInformationDetail (15 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 3C:OTHER CRITERIA BESIDES INCOME AND FPG USED IN DETERMINING ELIGIBILITY FOR FREE CARE INCLUDE: (1) RESIDENCY - PATIENTS MUST RESIDE WITHIN THE SERVICE AREA OF THE HOSPITAL; (2) THE KIND OF SERVICE PROVIDED - ONLY MEDICALLY NECESSARY SERVICES ARE COVERED; (3) PATIENT STATUS - IN PROVIDER BASED PHYSICIAN CLINICS, PATIENTS MUST HAVE BEEN TREATED BY AN AFFILIATED MEDICAL GROUP PRIMARY CARE PHYSICIAN WITHIN THE PREVIOUS THREE YEARS; AND (4) ACCESS TO HEALTH CARE COVERAGE - PATIENTS MUST BE UNABLE TO ACCESS EMPLOYER SPONSORED HEALTH PLANS OR ENTITLEMENT PROGRAMS. LASTLY, THE PATIENT MUST BE WITHOUT SUBSTANTIAL LIQUID ASSETS (I.E. CASH-ON-HAND). ASSETS SUCH AS HOUSES, CARS, PENALIZED RETIREMENT SAVINGS FUNDS, ETC. ARE NOT CONSIDERED LIQUID ASSETS. SUBSTANTIAL ASSETS ARE DEFINED AS ENOUGH CASH-ON-HAND TO COVER THE MEDICAL EXPENSES WITHOUT PLACING A HARDSHIP ON THE PATIENT. PATIENTS WITH SPECIAL CIRCUMSTANCES SUCH AS BANKRUPTCY MAY ALSO BE ELIGIBLE FOR CHARITY CARE; DETERMINATION IS MADE ON A CASE BY CASE BASIS UNDER THESE CIRCUMSTANCES.
PART I, LINE 6A:PART I, LINE 6A:THE ORGANIZATION IS A PART OF NOVANT HEALTH, AN INTEGRATED NOT-FOR-PROFIT HEALTH SYSTEM. THE COMMUNITY BENEFIT REPORT IS PREPARED BY A RELATED ORGANIZATION. NOVANT HEALTH, INC. IS THE NOVANT HEALTH PARENT COMPANY AND PRODUCES A COMMUNITY BENEFIT REPORT REPRESENTING THE HEALTH SYSTEM AS A WHOLE. THE REPORT CAN BE FOUND AT HTTPS://WWW.NOVANTHEALTH.ORG/HOME/ABOUT-US/COMMUNITY-INVOLVEMENT/COMMUNITY-BENEFIT.ASPX. PLEASE NOTE THAT THE NUMERIC DATA IN THIS REPORT IS NOT BASED UPON THE FORM 990, SCHEDULE H CRITERIA, BUT RATHER IT HAS BEEN PREPARED IN ACCORDANCE WITH THE NORTH CAROLINA HOSPITAL ASSOCIATION REPORTING GUIDELINES. IT SHOULD NOT BE RELIED UPON AS THE ORGANIZATION'S FORM 990, SCHEDULE H COMMUNITY BENEFIT REPORT, ITS COMMUNITY HEALTH NEEDS ASSESSMENT OR COMMUNITY BENEFIT IMPLEMENTATION STRATEGY.
PART I, LINE 7:COSTS REPORTED IN THE TABLE FOR CHARITY CARE AND CERTAIN OTHER COMMUNITY BENEFITS AMOUNTS ARE CALCULATED USING AN ENTITY SPECIFIC COST TO CHARGE RATIO BASED ON WORKSHEET 2 (CCR).
PART I, LN 7 COL(F):PART I, LN 7 COL(F):THE AMOUNT OF BAD DEBT REMOVED FROM TOTAL EXPENSES (DENOMINATOR) WAS $2,793,282.
PART II, COMMUNITY BUILDING ACTIVITIES:THE ORGANIZATION'S COMMUNITY BUILDING ACTIVITIES ADDRESSES THE UNDERLYING CAUSES OF HEALTH PROBLEMS AND IMPACTS THE HEALTH OF OUR COMMUNITY THROUGH PARTNERSHIPS WITH LOCAL AGENCIES DEDICATED TO IMPROVING THE LIVES OF ALL INDIVIDUALS. OUTREACH INCLUDES PROVIDING SUPPORT TO ORGANIZATIONS SUCH AS LOCAL YMCA'S, UNITED WAY PARTNER AGENCIES, CHAMBERS OF COMMERCE AND OTHER LOCAL COMMUNITY ORGANIZATIONS, ASSISTING WITH COMMUNITY AND COUNTY COALITIONS, AND PROVIDING EDUCATION SEMINARS AND TRAINING FOR COMMUNITY WORKFORCES.
PART III, LINE 2:THE ALLOWANCE FOR BAD DEBT IS DETERMINED BASED ON MANAGEMENT'S ASSESSMENT OF SEVERAL FACTORS, INCLUDING HISTORICAL COLLECTION RESULTS, THE AGE OF THE ACCOUNTS, CHANGES IN COLLECTION PATTERNS AND GENERAL INDUSTRY CONDITIONS.
PART III, LINE 4:FOOTNOTE 2 (ACCOUNTS RECEIVABLE) ON PAGE 9 OF THE AUDITED FINANCIAL STATEMENTS DESCRIBES THE BAD DEBT EXPENSE.
PART III, LINE 8:THE METHODOLOGY USED TO DETERMINE THE MEDICARE ALLOWABLE COSTS REPORTED IN THE ORGANIZATION'S MEDICARE COST REPORT AS REFLECTED IN THE AMOUNT REPORTED IN PART III, LINE 6 IS DETERMINED BY FOLLOWING THE MEDICARE PRINCIPLES OF ALLOWABLE COSTS. COST FOR THE OVERHEAD DEPARTMENTS ARE STEPPED DOWN TO THE REMAINING COST CENTERS BASED ON STATISTICS FOR EACH OVERHEAD COST CENTER. ONCE THE STEP-DOWN PROCESS IS COMPLETE, A COST TO CHARGE RATIO ("CCR") IS DEVELOPED FOR EACH COST CENTER. THE CCR IS THEN APPLIED TO THE MEDICARE REVENUE BY COST CENTER AND TOTALED. IT SHOULD BE NOTED THAT THE MEDICARE COST REPORTS DO NOT ADDRESS ANY MANAGED CARE MEDICARE REVENUES, COSTS, OR RELATED SHORTFALL. THE TOTAL REVENUES REPORTED AS RECEIVED FROM MEDICARE IN LINE 5 OF SECTION B ARE ONLY REPRESENTATIVE OF MEDICARE FEE FOR SERVICE PAYMENTS RECEIVED. THE ALLOWABLE COSTS ON LINE 6 ARE SIGNIFICANTLY LOWER THAN THE ACTUAL EXPENDITURES. AS SUCH, THE SHORTFALL IS UNDERESTIMATED. EVERY HOSPITAL TREATS MEDICARE PATIENTS. SOME HOSPITALS ARE LOCATED IN HIGH MEDICARE POPULATION AREAS; OTHERS PROVIDE SERVICES DISPROPORTIONATELY USED BY MEDICARE PATIENTS. MEDICARE RATES AND NUMBERS OF MEDICARE PATIENTS ARE NOT NEGOTIATED. AS REIMBURSEMENT RATES DECLINE RELATIVE TO COSTS OF CARE, HOSPITALS CONTINUE TO SERVE THE MEDICARE POPULATION. WITHOUT THIS SERVICE THESE PATIENTS WOULD BECOME AN OBLIGATION ON THE GOVERNMENT. ANY UNREIMBURSED COSTS OF THIS CARE ARE A COMMUNITY BENEFIT PROVIDED BY THE HOSPITAL TO THE COMMUNITY AND GOVERNMENT.
PART III, LINE 9B:THE ORGANIZATION'S BILLING AND COLLECTIONS POLICY DOES EXPLAIN ACTIONS AGAINST PATIENTS WHO HAVE OUTSTANDING DELINQUENT AMOUNTS, BUT THE POLICY DOES NOT CONTAIN PROVISIONS FOR COLLECTION PRACTICES AGAINST PATIENTS WHO ARE ELIGIBLE UNDER THE FINANCIAL ASSISTANCE POLICY (FAP) BECAUSE FAP ELIGIBLE PATIENTS RECEIVE 100% FREE CARE AND THEREFORE DO NOT RECEIVE BILLS ONCE FAP ELIGIBILITY HAS BEEN ESTABLISHED.
PART VI, LINE 2:PART VI, LINE 2: NEEDS ASSESSMENTTHE ORGANIZATION IS PART OF NOVANT HEALTH, AN INTEGRATED NOT-FOR-PROFIT HEALTH SYSTEM, WHICH HAS A COMMUNITY BENEFIT DEPARTMENT ("CB DEPARTMENT") COMPRISED OF COMMUNITY BENEFIT PROFESSIONALS AND AN ASSOCIATED ADVISORY WORKING GROUP ("THE COMMUNITY BENEFIT GROUP") THAT INCLUDES REPRESENTATIVES FROM INTERNAL AUDIT, LEGAL, AND TAX. THE CB DEPARTMENT IS RESPONSIBLE FOR COORDINATING THE PREPARATION OF THE COMMUNITY HEALTH NEEDS ASSESSMENTS (CHNA) FOR EACH HOSPITAL WITHIN THE SYSTEM, INCLUDING THE CHNAS REPORTED IN PART V, SECTION B. EACH HOSPITAL AND THE COMMUNITY BENEFIT GROUP WORK TOGETHER TO IDENTIFY ORGANIZATIONS AND RESOURCES WITHIN ITS COMMUNITY THAT CONTRIBUTE TO THE PROCESS. THESE ORGANIZATIONS AND RESOURCES INCLUDE PUBLIC HEALTH DEPARTMENTS, LOCAL COMMUNITY COALITIONS REPRESENTING THE MEDICALLY UNDERSERVED, UNITED WAY, LOCAL UNIVERSITIES, ETC. COMMUNITY HEALTH ASSESSMENTS PREPARED BY OTHER ORGANIZATIONS IN THE COMMUNITY ARE USED IN COMBINATION WITH INTERNAL HOSPITAL DATA AND INFORMATION COLLECTED FROM LOCAL AGENCIES TO PREPARE THE HOSPITAL'S CHNA. IN ADDITION TO ADDRESSING NEEDS IDENTIFIED THROUGH THE CHNA, EACH HOSPITAL MAY RESPOND TO REQUESTS FOR SPECIFIC COMMUNITY BENEFIT ACTIVITIES OR PROGRAMS FROM PUBLIC AGENCIES OR COMMUNITY GROUPS.
PART VI, LINE 3:PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCETHE ORGANIZATION IS COMMITTED TO PROVIDING OUTSTANDING HEALTHCARE TO ALL MEMBERS OF OUR COMMUNITIES, REGARDLESS OF THEIR ABILITY TO PAY. OUR FINANCIAL COUNSELING TEAMS ARE CONSTANTLY WORKING WITH THE PATIENTS WITHIN OUR COMMUNITIES TO UNDERSTAND THEIR NEEDS AND ENSURE THAT OUR POLICIES AND PROCESSES ADDRESS THESE NEEDS. WE ALSO MAINTAIN CONTRACTS WITH MEDICAID ELIGIBILITY VENDORS AND THESE TEAMS OFFER ADDITIONAL SUPPORT IN PROCESSING AND ASSESSING HOW WE SERVE THE FINANCIAL NEEDS OF OUR PATIENTS. BASED ON THE ASSESSMENTS OF OUR COMMUNITIES, THE ORGANIZATION HAS DEVELOPED FINANCIAL ASSISTANCE POLICIES AND PROGRAMS THAT ADDRESS THE FINANCIAL NEEDS OF OUR PATIENTS. WE PRIDE OURSELVES ON THE TRANSPARENCY OF OUR PROGRAMS AND THE EDUCATION WE OFFER OUR PATIENTS AROUND OUR FINANCIAL ASSISTANCE POLICIES. OUR PROGRAMS ARE DOCUMENTED ON OUR WEBSITE, ALONG WITH CONTACT INFORMATION FOR OUR FINANCIAL COUNSELORS. ADDITIONALLY, OUR PROGRAMS ARE DOCUMENTED ON PATIENT FLYERS THROUGHOUT THE ORGANIZATION'S FACILITIES AND PHYSICIAN OFFICES. OUR PATIENT ACCESS SPECIALISTS, FINANCIAL COUNSELORS AND BUSINESS OFFICE TEAMS WORK WITH ALL ELIGIBLE PATIENTS TO EDUCATE THEM ON THE VARIOUS OPTIONS AVAILABLE VIA OUR FINANCIAL ASSISTANCE PROGRAMS OR GOVERNMENT SPONSORED CARE. THEY ALSO REFERENCE OUR FINANCIAL ASSISTANCE POLICY IN ALL CONVERSATIONS RELATED TO PATIENTS BILLS. FINALLY, WE WORK WITH LOCAL AREA FREE HEALTH CLINICS AND OTHER CHARITABLE ORGANIZATIONS TO PROVIDE CONTINUATION OF CARE FOR THEIR PATIENTS. IN ADDITION TO OUR FINANCIAL COUNSELING PROCESSES USED TO IDENTIFY CHARITY CARE PATIENTS, OUR COLLECTIONS PROCESSES WITHIN OUR BUSINESS OFFICES ALSO HELP IDENTIFY PATIENTS WHO ARE ALREADY ELIGIBLE FOR CHARITY OR WHO MAY BE ELIGIBLE BASED ON THEIR STATUS WITHIN THE FEDERAL POVERTY GUIDELINES ("FPG"). WE UTILIZE PREVIOUSLY SUBMITTED PATIENT DOCUMENTATION AND CREDIT AGENCY REPORTED FPG FOR DETERMINATION. SUPPORTING DOCUMENTS ARE VALID 6 MONTHS FROM THE DATE OF SUBMISSION. OUR POLICIES ARE CONSIDERED FLUID AND ARE UPDATED FREQUENTLY BASED ON LOCAL AND NATIONAL MARKET STANDARDS AND NATIONAL ECONOMIC CONDITIONS. ANY UPDATES TO OUR POLICIES REQUIRE MULTI-LEVEL LEADERSHIP APPROVAL AND ARE ULTIMATELY APPROVED BY THE ORGANIZATION'S BOARD.
PART VI, LINE 4:PART VI, LINE 4: COMMUNITY INFORMATIONMEDICAL PARK HOSPITAL DBA NOVANT HEALTH MEDICAL PARK HOSPITALTHE ORGANIZATION DEFINES ITS COMMUNITY BY ITS PRIMARY SERVICE AREA, WHICH IS FORSYTH COUNTY, NORTH CAROLINA. THIS IS AN URBAN AREA.THERE ARE FOUR NONPROFIT ACUTE CARE HOSPITAL FACILITIES IN THE COMMUNITY, ONE OF WHICH IS THE ORGANIZATION AND THREE OF WHICH ARE PART OF THE NOVANT HEALTH SYSTEM. THERE IS ALSO ONE ACADEMIC TEACHING HOSPITAL. ACCORDING TO SG2 DATA, THE SPECIFIC POPULATION GROUPS (ETHNIC AND CULTURAL) ARE AS FOLLOWS: WHITE NON-HISPANIC (233,635) 59.1%; BLACK NON-HISPANIC (93,754) 23.7%; HISPANIC (49,823) 12.6%; ASIAN AND PACIFIC ISLAND NON-HISPANIC (9,385) 2.4%; OTHERS (8,951) 2.2%; FOR A TOTAL POPULATION OF 395,548.ACCORDING TO US CENSUS BUREAU DATA, THE MEDIAN HOUSEHOLD INCOME LEVEL WAS $46,283.ACCORDING TO SG2 DATA, THE AGE BREAKDOWN IS AS FOLLOWS: 0-17 YEARS (92,188) 23.3%; 18-64 YEARS (241,595) 61.1%; 65+ YEARS (61,765) 15.6%.
PART VI, LINE 5:PART VI, LINE 5: PROMOTION OF COMMUNITY HEALTHTHE ORGANIZATION FURTHERS ITS EXEMPT PURPOSES BY DOING THE FOLLOWING:1. ADOPTING A FINANCIAL ASSISTANCE POLICY;2. REMAINING CERTIFIED BY THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES TO PROVIDES SERVICES TO ALL BENEFICIARIES OF MEDICARE, MEDICAID, AND OTHER GOVERNMENT PAYMENT PROGRAMS, AND PROVIDING SERVICES IN A NONDISCRIMINATORY MANNER TO SUCH BENEFICIARIES;3. MAINTAINING AN OPEN MEDICAL STAFF, SUBJECT TO EXCLUSIVE CONTRACTS FOR HOSPITAL-BASED SERVICES SUCH AS ANESTHESIOLOGY, RADIOLOGY, PATHOLOGY, AND HOSPITALIST SERVICES, TO THE EXTENT AN EXCLUSIVE CONTRACT FOR THOSE SERVICES IS REQUIRED TO OBTAIN PROPER STAFFING COVERAGE OR TO PERMIT A MORE EFFICIENT DELIVERY OF THOSE SERVICES WITHIN THE HOSPITAL FACILITY;4. ADOPTING AND APPLYING A CONFLICT OF INTEREST POLICY, WHICH APPLIES TO THE GOVERNING BOARD AND ORGANIZATION OFFICERS;5. PROVIDING HEALTH EDUCATION LECTURES AND WORKSHOPS;6. PROVIDING COMMUNITY-BASED CLINICAL SERVICES, INCLUDING WITHOUT LIMITATION, HEALTH SCREENINGS AND CLINICS FOR UNINSURED OR UNDERINSURED PERSONS TO THE COMMUNITIES IT SERVES;7. PROVIDING HEALTHCARE SUPPORT SERVICES, INCLUDING WITHOUT LIMITATION, INFORMATION AND REFERRAL TO COMMUNITY SERVICES, CASE MANAGEMENT OF UNDERINSURED AND UNINSURED PERSONS, TELEPHONE INFORMATION SERVICES AND ASSISTANCE TO ENROLL IN PUBLIC PROGRAMS, SUCH AS STATE CHILDREN'S HEALTH INSURANCE PROGRAM (SCHIP) AND MEDICAID TO THE COMMUNITIES IT SERVES;8. PROVIDING SUBSIDIZED HEALTH SERVICES AND CLINICAL PROGRAMS TO THE COMMUNITIES IT SERVES;9. PROVIDING CASH AND IN-KIND CONTRIBUTIONS TO NONPROFIT COMMUNITY HEALTHCARE ORGANIZATIONS IN THE COMMUNITIES IT SERVES; AND10. GENERALLY PROMOTING THE HEALTH, WELLNESS, AND WELFARE OF THE COMMUNITIES IT SERVES BY PROVIDING QUALITY HEALTHCARE SERVICES AT REASONABLE COST.PLEASE SEE THE NOVANT HEALTH COMMUNITY BENEFIT REPORT, LOCATED AT HTTP://WWW.NOVANTHEALTH.ORG/HOME/ABOUT-US/COMPANY-INFORMATION/FINANCIAL-PROFILE/COMMUNITY-BENEFIT-REPORT.ASPX.PLEASE NOTE THAT THE NUMERIC INFORMATION IN THIS REPORT IS NOT BASED UPON THE FORM 990, SCHEDULE H CRITERIA, BUT RATHER IT HAS BEEN PREPARED IN ACCORDANCE WITH THE NORTH CAROLINA HOSPITAL ASSOCIATION REPORTING GUIDELINES.
PART VI, LINE 6:PART VI, LINE 6: AFFILIATED HEALTH CARE SYSTEMTHE ORGANIZATION IS AN INTEGRAL PART OF NOVANT HEALTH, A NOT-FOR-PROFIT INTEGRATED GROUP OF HOSPITALS, PHYSICIAN CLINICS, OUTPATIENT CENTERS AND OTHER HEALTHCARE SERVICE PROVIDERS. NOVANT HEALTH IS RANKED AS ONE OF OUR NATION'S TOP 20 INTEGRATED HEALTHCARE SYSTEMS CARING FOR PATIENTS AND COMMUNITIES IN GEORGIA, NORTH CAROLINA, SOUTH CAROLINA, AND VIRGINIA. EACH HOSPITAL PROVIDES SUBSTANTIAL COMMUNITY BENEFIT TO THE COMMUNITY IT SERVES, AS REPORTED INDIVIDUALLY ON EACH HOSPITAL'S FORM 990, SCHEDULE H. THE COMMUNITY BENEFIT OF THE SYSTEM AS A WHOLE IS DOCUMENTED IN A SYSTEM-WIDE COMMUNITY BENEFIT REPORT, LOCATED AT HTTPS://WWW.NOVANTHEALTH.ORG/HOME/ABOUT-US/COMMUNITY-INVOLVEMENT/COMMUNITY-BENEFIT.ASPX. PLEASE NOTE THAT THE NUMERIC INFORMATION IN THIS REPORT IS NOT BASED UPON THE FORM 990, SCHEDULE H CRITERIA, BUT RATHER IT HAS BEEN PREPARED IN ACCORDANCE WITH THE NORTH CAROLINA HOSPITAL ASSOCIATION REPORTING GUIDELINES. IT SHOULD NOT BE RELIED UPON AS THE ORGANIZATION'S FORM 990, SCHEDULE H COMMUNITY BENEFIT REPORT, ITS COMMUNITY HEALTH NEEDS ASSESSMENT OR COMMUNITY BENEFIT IMPLEMENTATION STRATEGY. THERE ARE SIGNIFICANT COMMUNITY BENEFIT ACTIVITIES WITHIN NOVANT HEALTH WHICH MAY NOT BE REPORTABLE ON A SCHEDULE H BECAUSE THEY ARE NOT CONDUCTED BY AN ENTITY WHICH OWNS OR OPERATES A HOSPITAL.IN ADDITION TO HOSPITALS, NOVANT HEALTH INCLUDES A PHYSICIAN ORGANIZATION WITH PRACTICES IN NORTH CAROLINA, SOUTH CAROLINA, AND VIRGINIA AND FIVE HOSPITAL FOUNDATIONS WHICH SUPPORT AND ENHANCE THE ACTIVITIES IN THOSE HOSPITALS' COMMUNITIES. FURTHER, NOVANT HEALTH INCLUDES AMBULATORY SURGERY CENTERS, IMAGING CENTERS, REHABILITATION CENTERS, AND OTHER OUTPATIENT FACILITIES; ALL DEDICATED TO PROMOTING THE HEALTH OF THEIR RESPECTIVE COMMUNITIES.
PART VI, LINE 7: STATE FILING OF COMMUNITY BENEFIT REPORTNOVANT HEALTH, INC. FILES A SYSTEM-WIDE COMMUNITY BENEFIT REPORT PREPARED IN ACCORDANCE WITH THE NORTH CAROLINA HOSPITAL ASSOCIATION REPORTING GUIDELINES WITH THE NORTH CAROLINA MEDICAL CARE COMMISSION AS PART OF THE DOCUMENTATION REQUIRED FOR THE ISSUANCE OF TAX EXEMPT BOND FINANCING.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
First Class Or Charter TravelYes (X)FirstClassOrCharterTravelInd
Travel For CompanionsYes (X)TravelForCompanionsInd
Discretionary Spending AcctYes (X)DiscretionarySpendingAcctInd
Housing Allowance Or ResidenceYes (X)HousingAllowanceOrResidenceInd
Club Dues Or FeesYes (X)ClubDuesOrFeesInd
Written Policy Ref T And E ExpnssYes (1)WrittenPolicyRefTAndEExpnssInd
Substantiation RequiredYes (1)SubstantiationRequiredInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (1)SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (16 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
MCPHAIL ERNEST MD
TRUSTEE$0$299,761$0$20,308$0$33,062$0$52,180$0$30,226$0$435,537$0$0
SANZ SEAN
MARKET PRESIDENT/COO & TRUSTEE$0$411,334$0$221,203$0$16,527$0$121,920$0$33,857$0$804,841$0$0
COLEMAN TRISHA
TREAS$0$196,640$0$25,044$0$5,848$0$24,280$0$20,773$0$272,585$0$0
MORRIS JOHN
ASST SEC$0$268,336$0$63,654$0$14,372$0$64,909$0$23,213$0$434,484$0$7,500
ROYSTER KIRSTEN
PRESIDENT & COO$233,019$0$86,504$0$13,794$0$49,673$0$10,814$0$393,804$0$0$0
SMITH HARRY
SVP HOSPITAL OPERATIONS$0$588,606$0$378,396$0$125,390$0$154,679$0$40,259$0$1,287,330$0$82,500
BRIGHT JANET
VP NURSING & MARKET CNO$0$184,615$0$21,601$0$6,079$0$43,258$0$10,429$0$265,982$0$0
JARRETT-PULLIAM KIMBERLY
FMR VP NURSING & MARKET CNO$0$305,333$0$187,692$0$16,326$0$65,225$0$13,367$0$587,943$0$0
CLARK VICKI
NURSE MANAGER$112,363$0$4,244$0$1,621$0$26,805$0$29,732$0$174,765$0$0$0
LYERLY RONALD
PHARMACIST$146,862$0$8,614$0$778$0$32,432$0$27,317$0$216,003$0$0$0
ORAJAKA EMEKA
PHARMACIST$132,485$0$7,223$0$2,791$0$16,898$0$10,794$0$170,191$0$0$0
PHILLIPS-TAYLOR ROBIN
NURSE MANAGER$114,053$0$4,141$0$343$0$30,110$0$10,753$0$159,400$0$0$0
SMITH CAROL
DIR OPERATIONS/NURSING$134,875$0$18,077$0$1,594$0$12,949$0$22,160$0$189,655$0$0$0
CARTER TERESA
FMR MPH COO$0$212,872$0$41,172$0$17,867$0$37,329$0$23,116$0$332,356$0$0
MIHAL DENISE
FMR PRES - FMH/COO WS MKT$0$665,743$0$495,668$0$166,572$0$64,738$0$19,691$0$1,412,412$0$7,500
SETLIFF MICHAEL
FMR MPH COO$0$255,153$0$143,480$0$16,503$0$59,037$0$25,365$0$499,538$0$0

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 1APART I, LINE 1A: FRINGE OR EXPENSE EXPLANATION FIRST-CLASS OR CHARTER TRAVEL: FIRST-CLASS OR CHARTER TRAVEL IS NOT A COVERED TRAVEL EXPENSE FOR EXECUTIVES; THEY ARE LIMITED TO BUSINESS OR COACH CLASS FARES FOR COMMERCIAL FLIGHTS. HOWEVER, CHARTER TRAVEL IS AVAILABLE TO CERTAIN EXECUTIVES, BOARD MEMBERS, AND APPROVED BUSINESS PERSONNEL MEETING APPLICABLE POLICY CRITERIA. TRAVEL FOR COMPANIONS: COMPANIONS ARE ALLOWED ON CERTAIN CHARTER FLIGHTS PAID FOR BY THE ORGANIZATION. IN THAT CASE, THE VALUE OF THE COMPANION'S FLIGHT IS CALCULATED UNDER APPLICABLE TAX LAWS AND THAT AMOUNT IS INCLUDED IN THE EXECUTIVE'S TAXABLE INCOME AS PRESCRIBED BY THE APPLICABLE TAX LAWS. DISCRETIONARY SPENDING ACCOUNT: CERTAIN EXECUTIVES RECEIVE A DISCRETIONARY SPENDING ACCOUNT. THE DOLLAR AMOUNT IN THE ACCOUNT IS PRE-APPROVED BY THE COMPENSATION AND LEADERSHIP COMMITTEE OF THE NOVANT HEALTH BOARD OF TRUSTEES. THE ACCOUNT CAN BE USED ONLY FOR AN APPROVED LIST OF EXPENDITURES. ALL OPTIONS OTHER THAN A DEFERRED, AT-RISK, COMPENSATION OPTION ARE CONSIDERED TAXABLE AND ARE INCLUDED IN THE EXECUTIVE'S TAXABLE INCOME AS PRESCRIBED BY THE APPLICABLE TAX LAWS. HOUSING ALLOWANCE OR RESIDENCE FOR PERSONAL USE: WE PROVIDE TEMPORARY HOUSING ALLOWANCES IN CERTAIN EXECUTIVE RECRUITMENT AND RELOCATION PACKAGES. IN THE CASE THAT SUCH EXPENSE IS NOT REIMBURSABLE UNDER THE ACCOUNTABLE PLAN RULES, THE VALUE IS CALCULATED UNDER APPLICABLE TAX LAWS AND THAT AMOUNT IS INCLUDED IN THE EXECUTIVE'S INCOME AS PRESCRIBED BY THE APPLICABLE TAX LAWS. HEALTH OR SOCIAL CLUB DUES OR INITIATION FEES: IN CASES WHERE CORPORATE MEMBERSHIPS ARE NOT AVAILABLE, A MEMBERSHIP MAY BE OBTAINED IN AN EXECUTIVE'S NAME WITH A "BUSINESS USE ONLY" RESTRICTION.
PART I, LINE 3PART I, LINE 3: THE FILING ORGANIZATION IS AN INTEGRAL PART OF NOVANT HEALTH, AN INTEGRATED HEALTHCARE SYSTEM. NOVANT HEALTH, INC. IS THE PARENT ORGANIZATION AND USES THE PROCESS DESCRIBED IN PART VI, LINE 15A OF THIS RETURN TO ESTABLISH THE COMPENSATION OF THE TOP MANAGEMENT OFFICIAL OF THE FILING ORGANIZATION. THIS PROCESS ADHERES TO THE REQUIREMENTS SET FORTH TO SECURE THE REBUTTABLE PRESUMPTION OF REASONABLENESS AND INCLUDES A REVIEW AND APPROVAL BY INDEPENDENT AND DISINTERESTED MEMBERS OF A COMPENSATION COMMITTEE, CONSULTATION WITH INDEPENDENT COMPENSATION CONSULTANTS, THE UTILIZATION OF THIRD-PARTY COMPARABILITY DATA SUCH AS PUBLISHED COMPENSATION SURVEYS, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION.
PART I, LINE 4BPART I, LINES 4A-C: SEVERANCE, NONQUALIFIED, AND EQUITY-BASED PAYMENTS SEVERANCE NONQUALIFIED EQUITY-BASED SMITH, HARRY 82,500
PART I, LINE 4A - SEVERANCE PLAN:ELIGIBLE EXECUTIVES MAY RECEIVE SEVERANCE PAY THAT IS BASED ON ANNUAL COMPENSATION FOR A SPECIFIED PERIOD OF TIME. THE SEVERANCE PAY WOULD BE PAID ONLY IN THE EVENT OF CERTAIN TYPES OF EMPLOYMENT TERMINATION, AND IS FURTHER CONTINGENT ON THE SATISFACTION OF OTHER CONDITIONS SUCH AS COMPLIANCE WITH A NON-COMPETITION COVENANT. ANY CURRENT YEAR PAYMENTS HAVE BEEN INCLUDED IN THE COMPENSATION AMOUNTS REPORTED IN PART VII AND IN COLUMN (B)(III) OF SCHEDULE J. THE COMPENSATION AND LEADERSHIP COMMITTEE OF THE NOVANT HEALTH BOARD REVIEWS, APPROVES, AND OVERSEES ALL ASPECTS AND ALL ELEMENTS OF EXECUTIVE COMPENSATION AND BENEFITS, INCLUDING THE AMOUNTS AWARDED UNDER THIS SEVERANCE PLAN.
PART I, LINE 4B - SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANS:THE SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN ("SERP") IS INTENDED TO SUPPORT RETENTION OF KEY EXECUTIVES, AND TO OFFER COMPETITIVE TOTAL COMPENSATION. ELIGIBLE EXECUTIVES WILL BE NOMINATED BY THE CEO AND APPROVED BY THE NOVANT HEALTH COMPENSATION AND LEADERSHIP COMMITTEE ("THE COMMITTEE") TO PARTICIPATE. GENERALLY, ANNUAL CONTRIBUTIONS TO THE PLAN OR PAYMENTS TO PARTICIPANTS WILL BE BASED ON A PERCENTAGE OF THE PARTICIPANT'S BASE SALARY AS OF JANUARY 1ST OF THE PREVIOUS PLAN YEAR AND ARE REPORTED IN COLUMN (C) OF SCHEDULE J. PRIOR TO MAKING THE CONTRIBUTIONS OR PAYMENTS, THE COMMITTEE WILL APPROVE THE AMOUNTS AS TO REASONABLENESS, WHEN COMBINED WITH ALL OTHER ANNUAL COMPENSATION. A 3 YEAR CLASS-YEAR VESTING PERIOD WILL APPLY UP TO AGE 62, WHEN ALL MONEY WOULD BE VESTED AND PAID OUT TO THE PARTICIPANT. OTHERWISE, VESTING WILL OCCUR ON JANUARY 1ST OF EACH YEAR FOR THE APPROPRIATE CLASS-YEAR VESTING PERIOD. THE COMMITTEE REVIEWS, APPROVES, AND OVERSEES ALL ASPECTS AND ALL ELEMENTS OF EXECUTIVE COMPENSATION AND BENEFITS.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PI, L1: ORGANIZATION'S MISSION OR MOST SIGNIFICANT ACTIVITIESMEDICAL PARK HOSPITAL DOING BUSINESS AS NOVANT HEALTH MEDICAL PARK HOSPITAL ("NHMPH") IS AN INTEGRAL PART OF THE NOVANT HEALTH SYSTEM (COLLECTIVELY KNOWN AS "NOVANT HEALTH"), A NOT-FOR-PROFIT INTEGRATED GROUP OF HOSPITALS, PHYSICIAN CLINICS, OUTPATIENT CENTERS, AND OTHER HEALTHCARE SERVICE PROVIDERS. NOVANT HEALTH CONSISTS OF MORE THAN 1,500 PHYSICIANS AND OVER 28,000 EMPLOYEES WHO MAKE HEALTHCARE REMARKABLE AT OVER 580 LOCATIONS, INCLUDING 14 MEDICAL CENTERS AND HUNDREDS OF OUTPATIENT FACILITIES AND PHYSICIAN CLINICS. HEADQUARTERED IN WINSTON SALEM, NC, NOVANT HEALTH IS COMMITTED TO MAKING HEALTHCARE REMARKABLE FOR PATIENTS AND COMMUNITIES, SERVING MORE THAN 4.7 MILLION PATIENTS ANNUALLY. DIVERSITY MBA HAS RECOGNIZED THE ORGANIZATION AS ONE OF THE 50 BEST PLACES FOR WOMEN AND MANAGERS OF DIVERSE BACKGROUNDS TO WORK AND SK&A RANKS NOVANT HEALTH AMONG THE TOP 25 INTEGRATED HEALTH SYSTEMS IN THE NATION. IN 2017, THE NOVANT HEALTH SYSTEM REPORTED $4.6 BILLION IN REVENUES. GENERAL INFORMATION NOVANT HEALTH MEDICAL PARK HOSPITAL IS A 22-BED, NOT-FOR-PROFIT HOSPITAL THAT SPECIALIZES IN ELECTIVE INPATIENT AND OUTPATIENT SURGERIES. OUR TEAM OF HIGHLY SKILLED SURGEONS, ANESTHESIOLOGISTS, NURSES AND TECHNICIANS PERFORMED 9,744 ELECTIVE SURGICAL PROCEDURES IN 2017. IN 2017, THE HOSPITAL FOCUSED ON PROVIDING COMMUNITY SUPPORT, CONSISTENT QUALITY, EXCELLENT SERVICE AND A REMARKABLE WORK ENVIRONMENT FOR OUR TEAM MEMBERS. OUR HOSPITAL IS COMMITTED TO MEETING THE HEALTHCARE NEEDS OF RESIDENTS IN THE TRIAD AREA OF NORTH CAROLINA. THE HOSPITAL SPECIALIZES IN SURGICAL CARE IN THE SPECIALTIES OF ORTHOPEDICS, GENERAL, COLORECTAL, GYNECOLOGY, UROLOGY, ONCOLOGY, OPHTHALMOLOGY, ENT AND PLASTICS. IN ADDITION, BLOOD SERVICES INCLUDING TRANSFUSIONS AND DONATIONS, IMAGING, AND PAIN MANAGEMENT PROCEDURES ARE AVAILABLE. THE HOSPITAL'S INTERPRETER SERVICES HELP PATIENTS AND THEIR FAMILY MEMBERS WHO HAVE SPECIAL COMMUNICATION NEEDS. FOREIGN-LANGUAGE INTERPRETERS ARE AVAILABLE FOR INDIVIDUALS WHO ARE LIMITED ENGLISH-PROFICIENT. FREE SIGN LANGUAGE AND ORAL INTERPRETERS, TTYS AND OTHER SERVICES ARE AVAILABLE TO DEAF AND HARD-OF-HEARING PERSONS. IN ADDITION TO OUR QUALITY OF SERVICES AND COMPREHENSIVE CATEGORIES OF SERVICES, WE'RE VERY PROUD OF OUR PATIENT FINANCIAL ASSISTANCE PROGRAM. WE WORK WITH PATIENTS TO HELP QUALIFY THEM FOR PUBLIC ASSISTANCE, ESTABLISH A REASONABLE PAYMENT PLAN, DISCOUNT THEIR BILL, OR PROVIDE FREE CARE FOR THOSE THAT QUALIFY FOR FINANCIAL ASSISTANCE. NEW TECHNOLOGY & SERVICES A CONCURRENT ELECTRONIC HEALTH RECORD (EHR) INITIATIVE HAS BEEN IMPLEMENTED BY BOTH THE ACUTE AND AMBULATORY FACILITIES IN THE NOVANT HEALTH SYSTEM. CLINICIANS CAN SHARE PATIENTS' MEDICAL INFORMATION BETWEEN PHYSICIAN OFFICES, OUTPATIENT CENTERS AND HOSPITALS. THIS SHARING OF INFORMATION IMPROVES SAFETY AND COORDINATION OF CARE AND PROMOTES CONNECTIVITY AND COMMUNICATION BETWEEN HOSPITAL CAREGIVERS, SPECIALISTS AND PRIMARY CARE PROVIDERS. EMBARKING ON THE JOURNEY TO CREATE A SHARED EHR IS THE MOST SIGNIFICANT AND IMPORTANT INVESTMENT NOVANT HEALTH HAS EVER MADE FOR ITS PATIENTS AND TEAM MEMBERS. NOVANT HEALTH, INCLUDING NOVANT HEALTH MEDICAL PARK HOSPITAL, HAS BECOME THE FIRST HEALTH SYSTEM HEADQUARTERED IN NORTH CAROLINA TO GIVE THE SOCIAL SECURITY ADMINISTRATION ("SSA") ACCESS TO APPROPRIATE PATIENTS' HEALTH INFORMATION THROUGH EPIC'S CARE EVERYWHERE TO ASSIST WITH SOCIAL SECURITY CLAIMS. THIS ACCESS ALLOWS SSA TO QUICKLY AND SECURELY PERFORM A PATIENT SEARCH, REVIEW A PATIENT'S MEDICAL HISTORY, AND CONFIRM OR DENY A PATIENT'S PHYSICAL OR MENTAL DISABILITY CLAIM. NOVANT HEALTH MEDICAL PARK HOSPITAL PROUDLY PROVIDES THE DAVINCI SURGICAL SYSTEM FOR GYNECOLOGICAL, COLORECTAL AND UROLOGICAL PROCEDURES. THE SYSTEM PROVIDES SURGEONS WITH AN ALTERNATIVE TO OPEN SURGERY AND CONVENTIONAL LAPAROSCOPY, PUTTING THE SURGEON'S HANDS AT THE CONTROLS OF A STATE-OF-THE-ART ROBOTIC PLATFORM. THE DAVINCI TECHNOLOGY PERMITS COMPLEX AND DELICATE PROCEDURES TO BE PERFORMED THROUGH TINY INCISIONS WITH UNMATCHED PRECISION, MEANING LESS PAIN AND SHORTER RECOVERY TIMES FOR PATIENTS. AWARDS, RECOGNITIONS & CERTIFICATIONS/RECERTIFICATIONS WE ARE PROUD OF THE ACHIEVEMENTS IN QUALITY THIS YEAR AS WE RANK WELL ABOVE STATE AVERAGES IN PATIENT SAFETY, CANCER, AND NURSING STAFF. THIS YEAR, NOVANT HEALTH MEDICAL PARK HOSPITAL RECEIVED A BONUS FROM THE CENTERS FOR MEDICARE AND MEDICAID SERVICES IN PART BECAUSE OF STERLING PATIENT SATISFACTION SURVEYS. THE DRIVING FACTORS FOR SUCCESS INCLUDED STRONG PERFORMANCE IN SAFETY, CLINICAL CARE, PATIENT EXPERIENCE AND EFFICIENCY. IN 2017, MEDICAL PARK HOSPITAL WAS AWARDED THE GUARDIAN OF EXCELLENCE AWARD FROM PRESS GANEY, WHICH RECOGNIZES HOSPITALS WHO HAVE MAINTAINED PATIENT EXPERIENCE METRICS ABOVE THE 95TH PERCENTILE. IN 2017, NOVANT HEALTH MEDICAL PARK HOSPITAL WAS DESIGNATED WITH AN "A" LETTER GRADE FROM THE LEAPFROG GROUP, AN ORGANIZATION THAT EVALUATES PATIENT CARE AND PATIENT SAFETY INDICATORS SUBMITTED TO THE CENTERS FOR MEDICARE AND MEDICAID SERVICES. THE HOSPITAL WAS ALSO RECOGNIZED WITH THE TOP HOSPITAL AWARD FROM LEAPFROG WHICH ONLY 109 FACILITIES ACROSS THE NATION RECEIVED. IN 2017, NOVANT HEALTH MEDICAL PARK HOSPITAL RECEIVED RECOGNITION AS "LEADER IN LGBTQ HEALTHCARE EQUALITY" BY THE HUMAN RIGHTS CAMPAIGN FOUNDATION, THE EDUCATIONAL ARM OF THE COUNTRY'S LARGEST LESBIAN, GAY, BISEXUAL AND TRANSGENDER CIVIL RIGHTS ORGANIZATION. FACILITIES AWARDED THIS TITLE MEET KEY CRITERIA, INCLUDING PATIENT AND EMPLOYEE NONDISCRIMINATION POLICIES, A GUARANTEE OF EQUAL VISITATION FOR SAME-SEX PARTNERS AND PARENTS, AND LGBTQ HEALTH EDUCATION FOR KEY STAFF MEMBERS. ACCREDITATION MEDICAL PARK HOSPITAL HAS BEEN FULLY ACCREDITED BY THE JOINT COMMISSION, AN INDEPENDENT ORGANIZATION THAT EVALUATES A HEALTHCARE ORGANIZATION'S PERFORMANCE IN AREAS THAT MOST AFFECT PATIENT HEALTH AND SAFETY. IN 2015, MEDICAL PARK HOSPITAL EARNED RE-ACCREDITATION BY THE NATIONAL ACCREDITATION PROGRAM FOR BREAST CENTERS ("NAPBC"). THE PROGRAM ADMINISTERED BY THE AMERICAN COLLEGE OF SURGEONS IS ONLY GIVEN TO THOSE CENTERS THAT ARE COMMITTED TO PROVIDING THE HIGHEST LEVEL OF QUALITY BREAST CANCER CARE. CENTERS THAT ARE CHOSEN UNDERGO A RIGOROUS EVALUATION AND REVIEW OF THEIR PERFORMANCE. COMMUNITY BENEFIT REPORT HTTPS://WWW.NOVANTHEALTH.ORG/HOME/ABOUT-US/COMMUNITY-INVOLVEMENT/ COMMUNITY-BENEFIT.ASPX THE COMMUNITY BENEFIT REPORT PREPARED BY NOVANT HEALTH IS A SYSTEM-WIDE REPORT THAT INCLUDES QUALITATIVE AND QUANTITATIVE INFORMATION. PLEASE NOTE THAT THE NUMERIC DATA IN THIS REPORT IS NOT BASED UPON THE FORM 990, SCHEDULE H CRITERIA, BUT RATHER IT HAS BEEN PREPARED IN ACCORDANCE WITH THE NORTH CAROLINA HOSPITAL ASSOCIATION REPORTING GUIDELINES. IT SHOULD NOT BE RELIED UPON AS THE ORGANIZATION'S FORM 990, SCHEDULE H COMMUNITY BENEFIT REPORT, ITS COMMUNITY HEALTH NEEDS ASSESSMENT OR COMMUNITY BENEFIT IMPLEMENTATION STRATEGY. IN THIS REPORT, THE NOVANT HEALTH SYSTEM'S COMMUNITY BENEFIT WAS APPROXIMATELY $794,000,000, INCLUDING $138,000,000 IN FINANCIAL ASSISTANCE FOR 2017.
FORM 990, PART III, LINE 1: MISSION, VISION, AND VALUESMISSION: NOVANT HEALTH EXISTS TO IMPROVE THE HEALTH OF COMMUNITIES, ONE PERSON AT A TIME. VISION: WE, THE NOVANT HEALTH TEAM, WILL DELIVER THE MOST REMARKABLE PATIENT EXPERIENCE, IN EVERY DIMENSION, EVERY TIME. VALUES: - COMPASSION: WE TREAT OUR CUSTOMERS AND THEIR FAMILIES, STAFF AND OTHER HEALTHCARE PROVIDERS AS FAMILY MEMBERS BY SHOWING THEM KINDNESS, PATIENCE, EMPATHY AND RESPECT. - DIVERSITY AND INCLUSION: WE RECOGNIZE THAT EVERY PERSON IS DIFFERENT, EACH SHAPED BY UNIQUE LIFE EXPERIENCES. THIS ENABLES US TO BETTER UNDERSTAND ONE ANOTHER AND OUR CUSTOMERS. BY ENGAGING THE STRENGTHS AND TALENTS OF EACH TEAM MEMBER, WE ENSURE A STRONG ORGANIZATION CAPABLE OF PROVIDING REMARKABLE HEALTHCARE TO OUR PATIENTS, FAMILIES AND COMMUNITIES. - PERSONAL EXCELLENCE: WE STRIVE TO GROW PERSONALLY AND PROFESSIONALLY, AND WE APPROACH EACH SERVICE OPPORTUNITY WITH A POSITIVE, FLEXIBLE ATTITUDE. HONESTY AND PERSONAL INTEGRITY GUIDE ALL THAT WE DO. - TEAMWORK: THE NEEDS AND EXPECTATIONS OF ANY ONE CUSTOMER ARE GREATER THAN THAT WHICH ONE PERSON'S SERVICE EFFORTS CAN SATISFY. WE SUPPORT EACH OTHER SO THAT TOGETHER AS A TEAM, WE CAN BE SUCCESSFUL IN THE EYE OF THE CUSTOMER AS A QUALITY SERVICE PROVIDER. - COURAGE: WE ACT BOLDLY IN MAKING THE CHANGES NECESSARY TO ACHIEVE OUR MISSION, VISION AND PROMISE OF DELIVERING REMARKABLE HEALTHCARE. OUR PEOPLE: WE ARE AN INCLUSIVE TEAM OF PURPOSE-DRIVEN PEOPLE INSPIRED AND UNITED BY OUR PASSION TO CARE FOR EACH OTHER, OUR PATIENTS AND OUR COMMUNITIES. OUR PROMISE TO PATIENTS: WE ARE MAKING YOUR HEALTHCARE EXPERIENCE REMARKABLE. WE WILL BRING YOU WORLD-CLASS CLINICIANS, CARE AND TECHNOLOGY - WHEN AND WHERE YOU NEED THEM. WE ARE REINVENTING THE HEALTHCARE EXPERIENCE TO BE SIMPLER, MORE CONVENIENT AND MORE AFFORDABLE, SO THAT YOU CAN FOCUS ON GETTING BETTER AND STAYING HEALTHY.
FORM 990, PART I, LINE 6THE NUMBER OF VOLUNTEERS REPORTED INCLUDES THOSE VOLUNTEERS SERVING AS BOARD MEMBERS.
FORM 990, PART VI, SECTION A, LINE 6FORM 990, PART VI, SECTION A, LINE 6: CLASSES OF MEMBERS OR STOCKHOLDERS THE CORPORATION IS A NONPROFIT CORPORATION WITH MEMBERS (OR A MEMBER).
FORM 990, PART VI, SECTION A, LINE 7AFORM 990, PART VI, SECTION A, LINE 7A: ELECTION OF MEMBERS AND THEIR RIGHTS NOVANT HEALTH, INC. ELECTS ALL MEMBERS OF THE GOVERNING BODY OF MEDICAL PARK HOSPITAL, INC.
FORM 990, PART VI, SECTION A, LINE 7BFORM 990 PART VI, SECTION A, LINE 7B: DECISIONS SUBJECT TO APPROVAL OF MEMBERS NOVANT HEALTH, INC. HAS CERTAIN RESERVED POWERS, SUCH AS APPROVAL OF AMENDMENTS TO THE ARTICLES AND BYLAWS OF THE CORPORATION, AND TO ADOPT CERTAIN POLICIES WHICH SHALL BE IMPLEMENTED BY THE CORPORATION BOARD.
FORM 990, PART VI, SECTION B, LINE 11BFORM 990, PART VI, SECTION B, LINE 11:ORGANIZATION'S PROCESS TO REVIEW FORM 990 THE BOARD HAS DELEGATED REVIEW OF THE FORM 990 TO NOVANT HEALTH'S BOARD OF TRUSTEES' AUDIT AND COMPLIANCE COMMITTEE ("THE COMMITTEE"), WHICH OVERSEES TAX MATTERS FOR ENTITIES IN THE NOVANT HEALTH SYSTEM. THE COMMITTEE IS THE REVIEW BODY FOR ALL OF THE FORM 990S FILED FOR ORGANIZATIONS WITHIN THE NOVANT HEALTH SYSTEM. THE COMMITTEE MEETS BEFORE THE FORM 990S ARE FILED WITH THE IRS AND AFTER ALL BOARD MEMBERS HAVE BEEN PROVIDED A PAPER OR ELECTRONIC COPY OF THE FORM 990 AND A SUMMARY OF ITS CONTENTS. THE VICE PRESIDENT OF TAX AND LEGAL COUNSEL FOR NOVANT HEALTH ATTEND THE MEETING TO ANSWER ANY QUESTIONS AND ADDRESS ANY SIGNIFICANT DISCLOSURES WITHIN THE FORM 990.
FORM 990, PART VI, SECTION B, LINE 12CFORM 990, PART VI, SECTION B, LINE 12C: MONITORING AND ENFORCEMENT OF COI THE ORGANIZATION'S TRUSTEE CONFLICT OF INTEREST POLICY APPLIES TO ALL TRUSTEES, PRINCIPAL OFFICERS OR MEMBERS OF A COMMITTEE WITH BOARD DELEGATED POWERS INCLUDING ANY APPLICABLE DISREGARDED ENTITIES. ALL TRUSTEES ARE SENT AN ANNUAL DISCLOSURE QUESTIONNAIRE. THE TRUSTEE ANNUAL DISCLOSURE QUESTIONNAIRES ARE REVIEWED BY THE COMPLIANCE DEPARTMENT. WITH RESPECT TO PARTICULAR TRANSACTIONS THAT COME BEFORE THE BOARD, THE CONFLICT OF INTEREST POLICY WOULD BE FOLLOWED. THE POTENTIAL CONFLICT OF INTEREST WOULD BE DISCLOSED BY THE BOARD MEMBER BEFORE A VOTE ON THE TRANSACTION AND THE REST OF THE BOARD WOULD DETERMINE WHETHER A CONFLICT OF INTEREST EXISTS. IF THE REST OF THE BOARD DETERMINED THAT A CONFLICT OF INTEREST EXISTED THEN THE BOARD MEMBER WITH THE CONFLICT OF INTEREST WOULD NOT PARTICIPATE IN THE DELIBERATIONS AND VOTE.
FORM 990, PART VI, SECTION B, LINE 15BFORM 990, PART VI, SECTION B, LINE 15A: COMPENSATION PROCESS FOR TOP OFFICIAL THE FILING ORGANIZATION IS AN INTEGRAL PART OF NOVANT HEALTH, AN INTEGRATED HEALTHCARE SYSTEM COLLECTIVELY REFERRED TO AS "NOVANT HEALTH." NOVANT HEALTH, INC. IS THE PARENT ORGANIZATION AND INDEPENDENT AND DISINTERESTED MEMBERS OF THE NOVANT HEALTH, INC. BOARD OF TRUSTEES (WHO COMPRISE THE COMPENSATION AND LEADERSHIP COMMITTEE OF THE BOARD) REVIEW, APPROVE, AND OVERSEE ALL ASPECTS OF COMPENSATION AND BENEFITS FOR CERTAIN EXECUTIVES ("EXECUTIVES") SERVING AS THE TOP MANAGEMENT OFFICIAL(S) FOR NOVANT HEALTH ENTITIES. THE COMMITTEE WORKS WITH AN INDEPENDENT COMPENSATION CONSULTANT AND USES THIRD PARTY COMPARABILITY DATA FOR FUNCTIONALLY SIMILAR POSITIONS AT SIMILARLY SITUATED ORGANIZATIONS TO ENSURE THAT TOTAL COMPENSATION AND BENEFITS FOR EACH EXECUTIVE IS REASONABLE FOR THAT EXECUTIVE'S POSITION. THE COMMITTEE REVIEWS AND APPROVES EXECUTIVE COMPENSATION AND BENEFITS ANNUALLY, CONSISTENT WITH THE WRITTEN EXECUTIVE COMPENSATION PHILOSOPHY OF NOVANT HEALTH, AND IN A MANNER THAT QUALIFIES FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS, THEREBY ASSURING THAT TOTAL COMPENSATION AND BENEFITS PROVIDED TO EACH EXECUTIVE IS REASONABLE. FORM 990, PART VI, SECTION B, LINE 15B: COMPENSATION PROCESS FOR OFFICERS THE FILING ORGANIZATION IS AN INTEGRAL PART OF NOVANT HEALTH, AN INTEGRATED HEALTHCARE SYSTEM COLLECTIVELY REFERRED TO AS "NOVANT HEALTH." NOVANT HEALTH, INC. IS THE PARENT ORGANIZATION AND INDEPENDENT AND DISINTERESTED MEMBERS OF THE NOVANT HEALTH, INC. BOARD OF TRUSTEES (WHO COMPRISE THE COMPENSATION AND LEADERSHIP COMMITTEE OF THE BOARD) REVIEW, APPROVE, AND OVERSEE ALL ASPECTS OF COMPENSATION AND BENEFITS FOR CERTAIN LEADERS AND EXECUTIVES ("EXECUTIVES") SERVING AS OFFICERS OR KEY EMPLOYEES FOR NOVANT HEALTH ENTITIES. THE COMMITTEE WORKS WITH AN INDEPENDENT COMPENSATION CONSULTANT AND USES THIRD PARTY COMPARABILITY DATA FOR FUNCTIONALLY SIMILAR POSITIONS AT SIMILARLY SITUATED ORGANIZATIONS TO ENSURE THAT TOTAL COMPENSATION AND BENEFITS FOR EACH EXECUTIVE IS REASONABLE FOR THAT EXECUTIVE'S POSITION. THE COMMITTEE REVIEWS AND APPROVES EXECUTIVE COMPENSATION AND BENEFITS ANNUALLY, CONSISTENT WITH THE WRITTEN EXECUTIVE COMPENSATION PHILOSOPHY OF NOVANT HEALTH, AND IN A MANNER THAT QUALIFIES FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS, THEREBY ASSURING THAT TOTAL COMPENSATION AND BENEFITS PROVIDED TO EACH EXECUTIVE IS REASONABLE.
FORM 990, PART VI, SECTION C, LINE 19FORM 990, PART VI, SECTION C, LINE 19: GOVERNING DOCUMENTS DISCLOSURE THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS CONTAINING ALL ORGANIZATIONS IN THE NOVANT HEALTH SYSTEM ARE POSTED TO THE NOVANT HEALTH WEBSITE. THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT AVAILABLE TO THE PUBLIC.
FORM 990, PART VII, SECTION A, COLUMN B: RELATED ORGANIZATIONSTHE ORGANIZATION EMPLOYS CERTAIN EXECUTIVES WHOSE ROLES ARE SUCH THAT THEY PROVIDE SERVICES TO NOT ONLY THE ORGANIZATION, BUT ALSO TO SOME OR ALL OF THE OTHER TAX-EXEMPT ORGANIZATIONS WITHIN THE HEALTHCARE SYSTEM. FOR EXAMPLE, MANY OF THESE EXECUTIVES' ROLES FOCUS ON PARTICULAR SERVICE LINES WHICH CROSS THE VARIOUS GEOGRAPHIC MARKETS OUR ORGANIZATIONS SERVE, THUS THE SERVICES PROVIDED BY THESE EXECUTIVES MAY BENEFIT AND BE RECEIVED BY MULTIPLE ORGANIZATIONS WITHIN THE SYSTEM. THE EXECUTIVES DO NOT ALLOCATE THEIR HOURS BETWEEN THE VARIOUS ORGANIZATIONS, BUT RATHER THEIR TIME SPENT ON SERVICES TO THE ORGANIZATION IS INCLUSIVE OF SERVICES TO ALL OF THE ORGANIZATIONS THEY SERVE WITHIN THE SYSTEM.
FORM 990, PART VII, SECTION B: INDEPENDENT CONTRACTORSTHE FILING ENTITY IS PART OF THE NOT-FOR-PROFIT INTEGRATED HEALTHCARE SYSTEM KNOWN AS NOVANT HEALTH. NOVANT HEALTH, INC., THE PARENT, A SUPPORTING ORGANIZATION, IS RESPONSIBLE FOR CERTAIN CORPORATE SUPPORT FUNCTIONS INCLUDING ACCOUNTS PAYABLE AND ISSUES FORMS 1099 FOR CERTAIN ENTITIES IN THE SYSTEM INCLUDING THE FILING ENTITY. INFORMATION REPORTED IN PART VII, SECTION B REPRESENTS THE EXPENSES PAID ON BEHALF OF THE FILING ENTITY TO INDEPENDENT CONTRACTORS OVER $100,000.
FORM 990, PART XI, LINE 9:MALPRACTICE INSURANCE: -55,805.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (25 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationIndDirect Controlling NADirectControllingNACd
AUXILIARY OF FORSYTH MEMORIAL HOSPITAL
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103560862112HEALTHCARENC501(C)(3)LINE 10FORSYTH MEMORIAL HOSPITAL INC0
BRUNSWICK NOVANT MEDICAL CENTER FOUNDATION
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103274616751HEALTHCARENC501(C)(3)LINE 7BRUNSWICK COMMUNITY HOSPITAL LLC0
CAROLINA MEDICORP ENTERPRISES INC
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103581466368HEALTHCARENC501(C)(3)LINE 12B, IINOVANT MEDICAL GROUP INC0
COMMUNITY GENERAL HEALTH PARTNERS INC
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103560636250HEALTHCARENC501(C)(3)LINE 3NOVANT HEALTH TRIAD REGION LLC0
COMMUNITY GENERAL HOSPITAL FOUNDATION INC
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103561828629HEALTHCARENC501(C)(3)LINE 7COMMUNITY GENERAL HEALTH PARTNERS INC0
FORSYTH MEDICAL CENTER FOUNDATION
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103562120959HEALTHCARENC501(C)(3)LINE 7FORSYTH MEMORIAL HOSPITAL INC0
FORSYTH MEMORIAL HOSPITAL INC
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103560928089HEALTHCARENC501(C)(3)LINE 3NOVANT HEALTH TRIAD REGION LLC0
FOUNDATION HEALTH SYSTEMS CORP
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103561373175HEALTHCARENC501(C)(3)LINE 10NOVANT HEALTH INC0
NMG SERVICES INC
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103562098809HEALTHCARENC501(C)(3)LINE 10NOVANT HEALTH INC0
NOVANT HEALTH INC
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103561376950HEALTHCARENC501(C)(3)LINE 12C, III-FI0N/A
NOVANT MEDICAL GROUP INC
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103581728803HEALTHCARENC501(C)(3)LINE 3NMG SERVICES INC0
PERSONAL CARE SERVICES
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103541291284HEALTHCAREVA501(C)(3)LINE 10PRINCE WILLIAM HEALTH SYSTEM0
PRESBYTERIAN HOSPITAL FOUNDATION
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103581413074HEALTHCARENC501(C)(3)LINE 7NOVANT HEALTH SOUTHERN PIEDMONT REGION LLC0
PRESBYTERIAN MEDICAL CARE CORPORATION
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103561376368HEALTHCARENC501(C)(3)LINE 3NOVANT HEALTH SOUTHERN PIEDMONT REGION LLC0
PRINCE WILLIAM HEALTH SYSTEM
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103541278944HEALTHCAREVA501(C)(3)LINE 12C, III-FINOVANT HEALTH UVA HEALTH SYSTEM0
PRINCE WILLIAM HOSPITAL
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103540696355HEALTHCAREVA501(C)(3)LINE 3PRINCE WILLIAM HEALTH SYSTEM0
PWHS FOUNDATION
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103541307595HEALTHCAREVA501(C)(3)LINE 7PRINCE WILLIAM HEALTH SYSTEM0
ROWAN HEALTH SERVICES CORPORATION
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103561424814HEALTHCARENC501(C)(3)LINE 12C, III-FINOVANT HEALTH INC0
ROWAN REGIONAL MEDICAL CENTER AUXILIARY
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103237022472HEALTHCARENC501(C)(3)LINE 10ROWAN REGIONAL MEDICAL CENTER INC0
ROWAN REGIONAL MEDICAL CENTER FOUNDATION INC
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103561424818HEALTHCARENC501(C)(3)LINE 7ROWAN REGIONAL MEDICAL CENTER INC0
ROWAN REGIONAL MEDICAL CENTER INC
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103560547479HEALTHCARENC501(C)(3)LINE 3ROWAN HEALTH SERVICES CORPORATION0
SELF INSURANCE FUND - NOVANT HEALTH INC
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103581867242HEALTHCARENC501(C)(3)LINE 12C, III-FINOVANT HEALTH INC0
THE PRESBYTERIAN HOSPITAL
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103560554230HEALTHCARENC501(C)(3)LINE 3NOVANT HEALTH SOUTHERN PIEDMONT REGION LLC0
CULPEPER MEMORIAL HOSPITAL INC
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103540622371HEALTHCAREVA501(C)(3)LINE 3NOVANT HEALTH UVA HEALTH SYSTEM0
NOVANT HEALTH UVA HEALTH SYSTEM
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103810868533HEALTHCAREVA501(C)(3)LINE 12A, INOVANT HEALTH INC0

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (12 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdDirect Controlling NADirectControllingNACdEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationInd
ADEPT HEALTH INC FKA NOVANT HEALTH SHARED SERVICES INC
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103562226937ADMIN SERVICESNCN/AC0
CHOICEHEALTH INC
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103561896065MANAGED CARENCN/AC0
COMMUNICARE INC
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103561952950RENTAL REAL ESTATENCN/AC0
KERNERSVILLE MEDICAL CENTER PARK OWNERS' ASSOCIATION
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103471511401RENTAL REAL ESTATENCN/AC0
MEDQUEST INC & SUBSIDIARIES
3480 PRESTON RIDGE RD STE 600ALPHARETTAGA30005223860764DIAGNOSTIC IMAGINGDEN/AC0
NOVANT HEALTH FOUNDATION INC
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103813895369INACTIVENCN/AC0
NOVANT HEALTH TRINOVA INSURANCE PROTECTED CELL INC
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103812963143INSURANCENCN/AC0
ROWAN MEDICAL ALLIANCE INC
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103561992669INSURANCENCN/AC0
ROWAN MEDICAL FACILITIES INC
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103561424672MEDICAL SUPPLIESNCN/AC0
SALEM DIAGNOSTICS INC
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103561513621HEALTH RELATEDNCN/AC0
SALEM HEALTH SERVICES INC
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103561342654HEALTH RELATEDNCN/AC0
THE PARK AT MONROE PROPERTY OWNERS ASSOCIATION INC
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103463910256RENTAL REAL ESTATENCN/AC0
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

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