2017-05-12T07:46:10-05:00 2016-06-30 990 2015-07-01 562276994 DAVIE COUNTY EMERGENCY HEALTH CORPORATION DAVI 3369981300 329 NC HWY 801N BERMUDA RUN NC 27006 CHAD A ECKES CFO & ASST TREASURER 3369981300 2017-05-04 2015 2021-01-29 14:40:06Z X DAVIE MEDICAL CENTER CHAD BROWN 329 NC HWY 801N BERMUDA RUN NC 27006 43243713 0 X WWW.WAKEHEALTH.EDU/DAVIE-MEDICAL-CENTER/ X 2001 NC PROVISION OF PATIENT-CENTERED HEALTHCARE SERVICES TO THE SURROUNDING AREA 14 14 0 58 0 0 0 0 39839894 43214651 4093 -272177 20821 29062 39864808 42971536 26400 36500 0 0 9954379 14411477 0 0 0 20174959 23641764 30155738 38089741 9709070 4881795 27517085 25778727 24173161 17553008 3343924 8225719 X THE MEDICAL CENTER'S MISSION IS TO IMPROVE THE HEALTH OF OUR REGION BY: PROVIDING EXCELLENT CARE & AN EXCEPTIONAL EXPERIENCE; PROMOTING HEALTH & WELLNESS THROUGH COMMUNITY PARTNERSHIPS; & CONNECTING PEOPLE TO THE WORLD CLASS EXPERTISE OF WAKE FOREST BAPTIST MEDICAL CENTER. 0 0 34795085 36500 43243713 DAVIE MEDICAL CENTER PROVIDED MEDICAL, EMERGENCY, AND OUTPATIENT CARE SERVICES TO THE RESIDENTS OF DAVIE COUNTY, NORTH CAROLINA, AND THE SURROUNDING AREAS. DURING THE FISCAL YEAR, THE HOSPITAL HAD 81 LICENSED INPATIENT BEDS, 5,267 PATIENT DAYS WITH 151 INPATIENT ADMISSIONS, 28,254 OUTPATIENT CLINICAL VISITS AND 13,596 EMERGENCY ROOM VISITS. THE HOSPITAL'S VISIONTO BE A MEDICAL CENTER OF CHOICE, PROMOTING HEALTH AND SERVING AS A DESTINATION FOR EXCELLENCE IN PATIENT CARE.THE HOSPITAL'S VALUES- COMPASSION: RESPONSIVE TO THE PHYSICAL, EMOTIONAL, SPIRITUAL, AND INTELLECTUAL NEEDS OF ALL;-SERVICE: CULTIVATE SELFLESS CONTRIBUTION FOR THE GREATER GOOD;-EXCELLENCE: DEMONSTRATE THE HIGHEST STANDARDS OF PATIENT-CENTERED CARE, EDUCATION, RESEARCH, AND OPERATIONAL EFFECTIVENESS; - INTEGRITY: DEMONSTRATE FAIRNESS, HONESTY, SINCERITY, AND ACCOUNTABILITY;- COLLEGIALITY: FOSTER MUTUAL RESPECT, FACILITATE PROFESSIONAL GROWTH AND MENTORSHIP, AND REWARD TEAMWORK AND COLLABORATION; - INNOVATION: PROMOTE CREATIVITY TO ENHANCE DISCOVERY AND THE APPLICATION OF KNOWLEDGE; AND- DIVERSITY: HONOR INDIVIDUALITY AND PROTECT THE DIGNITY OF ALL. 34795085 1 0 0 1 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 21 0 1 0 0 0 0 0 0 0 0 0 0 0 X 14 14 0 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X JOSEPH DOLAN 3367164445 MEDICAL CENTER BOULEVARD WINSTONSALEM NC 27157 KEVIN P HIGH MD CHAIRMAN 4.00 X X 0 0 0 C DANIEL BARRETT VICE CHAIR 2.00 X X 0 0 0 TERRY BRALLEY BOARD MEMBER 2.00 X 0 0 0 MICHAEL CARTWRIGHT MD BOARD MEMBER 2.00 X 0 0 0 CRAIG M GREVEN MD BOARD MEMBER 2.00 X 0 0 0 RUSSELL HOWERTON MD BOARD MEMBER 2.00 X 0 0 0 WILLIAM F JUNKER BOARD MEMBER 2.00 X 0 0 0 L ANDREW KOMAN MD BOARD MEMBER 2.00 X 0 0 0 DOUGLAS NELSON BOARD MEMBER 2.00 X 0 0 0 LYNN PITMAN BOARD MEMBER 2.00 X 0 0 0 KEN RETHMEIER BOARD MEMBER 2.00 X 0 0 0 MARY RITTLING PHD BOARD MEMBER 2.00 X 0 0 0 STEPHEN ROBERTSON BOARD MEMBER 2.00 X 0 0 0 KENNON WHITE BOARD MEMBER 2.00 X 0 0 0 CHAD BROWN PRESIDENT 40.00 X 298268 0 73086 BRADLEY A CLARK TREASURER 10.00 X 0 0 0 CHAD ECKES CFO / ASST TREASURER 10.00 X 0 0 0 J MCLAIN WALLACE JR SECRETARY 2.00 X 0 0 0 DINA MARTY ASSISTANT SECRETARY 2.00 X 0 0 0 DANNY SQUIRES FINANCE DIRECTOR 15.00 X 198446 0 25505 496714 0 98591 0 0 1 1 LINCARE INC 3900 WESTPOINT BLVD WINSTON SALEM NC 27103 RESPIRATORY SPECIALISTS 838150 ALLIANCE HEALTHCARE SERVICES 100 BAYVIEW CIRCLE NEWPORT BEACH CA 92660 MEDICAL SERVICES 543855 NURSEFINDERS PO BOX 3749 BATON ROUGE LA 70821 STAFFING 325364 SIEMENS MEDICAL SOLUTIONS DIAGNOSTICS P O BOX 120001 DALLAS TX 75312 EQUIPMENT MAINTENANCE SERVICES 198688 UNIVERSAL PROTECTION SERVICE LLC 26375 NETWORK PLACE CHICAGO IL 606731263 SECURITY SERVICES 154634 7 PATIENT SERVICE REVENUE 621400 43214651 43214651 43214651 272177 -272177 -272177 -272177 DIETARY 621990 29062 29062 29062 42971536 43243713 0 -272177 36500 36500 11508593 9980252 1528341 447104 387729 59375 1714330 1486667 227663 741450 642985 98465 1380 1380 2640 2640 1969252 1707735 261517 245137 245137 73535 63770 9765 5960324 5168793 791531 24494 21241 3253 24979 21662 3317 1889176 1638293 250883 37522 32539 4983 MEDICAL SUPPLIES 9212971 9212971 BAD DEBT EXPENSE 3272320 3272320 PROVIDER ASSESSMENT TAX 520021 520021 MISCELLANEOUS EXPENSE 408013 353830 54183 38089741 34795085 3294656 0 12329826 12905389 4848879 4349664 911583 969064 50000 28000 13215196 5873774 9216399 7341422 160398 185188 27517085 25778727 20874985 17063603 3298176 489405 24173161 17553008 X 3342911 8224706 1013 1013 3343924 8225719 27517085 25778727 4881795 0 X 0 1 X 1 0 X 0 0 0 0 0 0 0 0 1 2640 2640 0 PART II-B, LINE 1: THE ORGANIZATION IS A MEMBER OF THE AMERICAN HOSPITAL ASSOCIATION (AHA) AND THE NORTH CAROLINA HOSPITAL ASSOCIATION (NCHA). A PORTION OF THE MEMBERSHIP DUES PAID ARE ALLOCATED TO LOBBYING EFFORTS BY THOSE ORGANIZATIONS ON BEHALF OF THEIR MEMBERSHIP BODIES. 384692 237943 146749 12830504 5635831 7194673 7341422 ESTIMATED 3RD PARTY PAYABLE 489405 489405 X PART X, LINE 2: THE ORGANIZATION HAS EVALUATED UNCERTAIN TAX POSITIONS FOR ITS FISCAL YEARS ENDED JUNE 30, 2016 AND 2015, INCLUDING A QUANTIFICATION OF TAX RISK IN AREAS SUCH AS UNRELATED BUSINESS TAXABLE INCOME AND THE TAXATION OF ITS JOINT VENTURES. THIS EVALUATION DID NOT HAVE A MATERIAL EFFECT ON THE ORGANIZATION'S FINANCIAL STATEMENTS FOR THE YEARS ENDED JUNE 30, 2016 AND 2015. 1 1 1 X 1 X 1 1 0 1 1 1429454 0 1429454 0.04110 4092644 2195566 1897078 0.05450 139241 167767 -28526 0.00000 5661339 2363333 3298006 0.09560 36500 0 36500 0.00100 36500 36500 0.00100 5697839 2363333 3334506 0.09660 1 866608 0 12325891 13303934 -978043 X 1 1 1 1 DAVIE MEDICAL CENTER 329 NC HWY 801N BERMUDA RUN NC 27006 WWW.WAKEHEALTH.EDU/DAVIE-MEDICAL-CENTE H0171 X X X X DAVIE MEDICAL CENTER 1 0 0 1 X X X X X X X X 15 1 1 0 1 X SEE PART V, PAGE 7 X 1 16 1 SEE PART V, PAGE 7 0 0 1 X 200.000000000000 400.000000000000 X X X X X X 1 1 X X X 1 X HTTP://WWW.WAKEHEALTH.EDU/DAVIE-MEDICAL-CENTER/INFORMATION/FINANCIAL-ASSIST X HTTP://WWW.WAKEHEALTH.EDU/DAVIE-MEDICAL-CENTER/INFORMATION/FINANCIAL-ASSIST X HTTP://WWW.WAKEHEALTH.EDU/DAVIE-MEDICAL-CENTER/INFORMATION/FINANCIAL-ASSIST X X X X X X 1 X 0 X X X X 1 X 0 0 DAVIE MEDICAL CENTER PART V, SECTION B, LINE 5: COMMUNITY INPUT WAS OBTAINED THROUGH THE FOLLOWING SOURCES: (1) THE DAVIE COUNTY HEALTH DEPARTMENT'S COMMUNITY HEALTH ASSESSMENT CONDUCTED IN SUMMER 2014 VIA SURVEY MONKEY; (2) TWO FAITHHEALTH NC (A DEPARTMENT OF WAKE FOREST BAPTIST MEDICAL CENTER) COMMUNITY ASSET MAPPING WORKSHOPS WHICH SOUGHT OPINIONS OF BOTH HEALTH PROVIDERS AND HEALTH SEEKERS IN DAVIE COUNTY'S MOST VULNERABLE COMMUNITIES; (3) TWO COMMUNITY HEALTH WORKSHOPS, AND (4) COMMENTS FROM PRIOR COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY.ADDITIONALLY, MORE THAN TEN SECONDARY DATA SOURCES WERE REVIEWED, INCLUDING THE COUNTY HEALTH RANKINGS & ROADMAPS, 2014 STATE OF THE COUNTY HEALTH, US CENSUS BUREAU, N.C. CENTER FOR HEALTH STATISTICS, CENTERS FOR DISEASE CONTROL YOUTH RISK BEHAVIOR SURVEILLANCE SYSTEM, BEHAVIOR RISK FACTOR SURVEILLANCE SYSTEM, HEALTHY PEOPLE 2020, HEALTHY NORTH CAROLINA 2020, AND CENTER FOR MEDICARE & MEDICAID. DAVIE MEDICAL CENTER PART V, SECTION B, LINE 6A: THE HOSPITAL'S MOST RECENT CHNA WAS CONDUCTED IN COLLABORATION WITH NORTH CAROLINA BAPTIST HOSPITAL AND LEXINGTON MEDICAL CENTER. BOTH LEXINGTON MEDICAL CENTER AND NORTH CAROLINA BAPTIST HOSPITAL ARE AFFILIATE HOSPITALS OF WAKE FOREST BAPTIST MEDICAL CENTER. DAVIE MEDICAL CENTER PART V, SECTION B, LINE 7D: N/APART V, SECTION B, LINE 7A:HTTP://WWW.WAKEHEALTH.EDU/DAVIE-MEDICAL-CENTER/ABOUT/COMMUNITY-BENEFITS/COMMUNITY-BENEFITS.HTMPART V, SECTION B, LINE 10A:HTTP://WWW.WAKEHEALTH.EDU/DAVIE-MEDICAL-CENTER/ABOUT/COMMUNITY-BENEFITS/COMMUNITY-BENEFITS.HTM DAVIE MEDICAL CENTER PART V, SECTION B, LINE 11: THE MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT IDENTIFIED THE FOLLOWING SIGNIFICANT HEALTH NEEDS WITHIN THE COMMUNITY: (1) ACCESS TO HEALTH CARE, (2) CHRONIC DISEASE MANAGEMENT AND INFORMATION, (3) BEHAVIORAL AND MENTAL DISTRESS, (4) INADEQUATE EMERGENCY CARE, (5) DENTAL CARE, (6) HOUSING, (7) FOOD INSECURITIES, (8) LACK OF FINANCES, AND (9) LACK OF TRANSPORTATION.DAVIE COUNTY EMERGENCY HEALTH CORPORATION DBA DAVIE MEDICAL CENTER (DMC) PRIORITIZED THE FOLLOWING THREE SIGNIFICANT COMMUNITY HEALTH NEEDS FOR ITS CURRENT CHNA AS FOLLOWS: (1) ACCESS TO CARE; (2) CHRONIC DISEASE MANAGEMENT; AND (3) BEHAVIORAL/MENTAL HEALTH DISTRESS. DMC PLANS TO PROVIDE COMMUNITY BENEFIT PROGRAMS RESPONSIVE TO THESE HEALTH NEEDS THROUGH ITS APPROVED CHNA IMPLEMENTATION STRATEGY. THE DMC CHNA IMPLEMENTATION STRATEGY OUTLINES THE IMPLEMENTATION OF PROGRAMS AND THE EVALUATION OF IMPACT OF THOSE PROGRAMS ON PRIORITY COMMUNITY HEALTH NEEDS IDENTIFIED FROM THE CHNA. SPECIFICALLY, THE HOSPITAL IS ADDRESSING THE SIGNIFICANT HEALTH NEEDS AS FOLLOWS:1. ACCESS TO CAREBARRIERS SUCH AS TRANSPORTATION AND ACCESS TO COMMUNITY CENTERED SOCIAL AND HEALTH EDUCATION SERVICES CAN LEAD TO UNMET HEALTH NEEDS. THE HOSPITAL'S CURRENT STRATEGIES INCLUDE:--REDUCING TRANSPORTATION BARRIERS FOR INDIVIDUALS IN RURAL AREAS OF THE COMMUNITY THROUGH 1.) ASSESSING NEED FOR TRANSPORTATION ASSISTANCE THROUGH VARIOUS COMMUNITY AGENCIES TO DETERMINE HOW TO EASE ACCESS THROUGH PUBLIC TRANSPORTATION OR ONSITE CLINICS IN HIGH NEED AREAS, AND 2.) WORKING WITH LOCAL AGENCIES TO DETERMINE RESOURCES AVAILABLE TO BRING CARE TO AREAS IMPACTED BY TRANSPORTATION ISSUES.--IMPROVING ACCESS TO COMMUNITY CENTERED SOCIAL AND HEALTH EDUCATION SERVICES AND REGULAR SOURCES OF HEALTH CARE THROUGH 1.) PROVIDING HEALTH EDUCATION EVENTS AND SCREENINGS AT VARIOUS LOCATIONS IN DAVIE COUNTY, 2.) CREATING OPPORTUNITIES TO INVOLVE FAMILIES IN REGULAR PROGRAMMING VIA THE HEALTHY DAVIE INITIATIVE, 3.) WORKING WITH LOCAL CHURCHES TO PROVIDE PROGRAMS AND ENLIST LAY LEADER SUPPORT TO ASSIST PARISHIONERS NEEDING ACCESS, 4.) CONTINUING TO EXPLORE THE USE OF A MOBILE MEDICAL CLINIC IN LOW ACCESS SERVICE AREAS, AND 5.) CONTINUING TO PROVIDE COMMUNITY ENGAGEMENT SUPPORT THROUGH 5 SUPPORTERS OF HEALTH, 311 CONGREGATIONAL PARTNERS, 25 CONNECTORS ACROSS THE SERVICE AREA AND 7 FAITHHEALTH FELLOWS.2. CHRONIC DISEASE MANAGEMENTDMC RECOGNIZES THE EFFECT OF CONTINUITY OF CARE WITH HEALTH CARE PROVIDERS ON PATIENT BEHAVIORS, DISEASE MANAGEMENT, AND HEALTH STATUS.THE HOSPITAL'S CURRENT STRATEGIES INCLUDE:--IMPROVING THE CAPACITY OF COMMUNITY BASED ORGANIZATIONS AND HEALTH CARE PROVIDERS TO SUPPORT EFFORTS RELATED TO CHRONIC DISEASE PREVENTION AND MANAGEMENT THROUGH 1.) CONTINUING TO SUPPORT FAITHHEALTH NC COMMUNITY HEALTH WORKERS TO ADDRESS CHRONIC DISEASE MANAGEMENT AND COMMUNITY HEALTH PROGRAMMING, 2.) INCREASING COMMUNITY AND HEALTHCARE PROVIDER ACCESS TO EXISTING CHRONIC DISEASE MANAGEMENT RESOURCES BY CENTRALIZING AND DISTRIBUTING INFORMATION AND 3.) PROVIDING AND EXPANDING CHRONIC DISEASE SELF-MANAGEMENT PROGRAMS OFFERED BY THE MEDICAL CENTER THROUGH EMMI SOFTWARE.--PROVIDING EDUCATION AND SUPPORT PROGRAMS TO REDUCE DIABETIC PREVALENCE AND IMPROVING DIABETES MANAGEMENT THROUGH 1.) WORKING WITH DAVIE COUNTY HEALTH DEPARTMENT TO IMPROVE ACCESS TO AREA DIABETES MANAGEMENT PROGRAMS FOR PRE-DIABETIC AND EARLY ONSET DIABETIC PATIENTS, 2.) CONTINUING TO PROVIDE BESTHEALTH DIABETES PREVENTION AND NUTRITION EDUCATION/COOKING CLASSES AT CONVENIENT LOCATIONS IN DAVIE COUNTY, AND 3.) EXPLORING PARTNERSHIP WITH DAVIE COUNTY AGENCIES TO FOCUS DIABETES PREVENTION AND MANAGEMENT PROGRAMS IN IDENTIFIED HIGH NEED NEIGHBORHOODS.--PROVIDING EDUCATION AND SUPPORT PROGRAMS TO REDUCE OBESITY PREVALENCE AND IMPROVE OBESITY MANAGEMENT THROUGH 1.) EXPANDING PROGRAMMING IN DAVIE COUNTY TO INCREASE EDUCATION AND AWARENESS OF NUTRITION AND HEALTHY LIFESTYLE CHOICES FOR UNINSURED AND MEDICAID PATIENTS, 2.) PROMOTING HEALTHY DIET AND WEIGHT MANAGEMENT THROUGH EMPLOYEE WELLNESS PROGRAMS, 3.) CONTINUING TO SUPPORT COMMUNITY WEIGHT MANAGEMENT EDUCATION THROUGH BESTHEALTH, 4.) INCREASING AWARENESS AMONG EXISTING PATIENTS AND EMPLOYEES OF WEIGHT MANAGEMENT PROGRAMS, AND 5.) WORKING WITH INDUSTRY AND DAVIE COUNTY SCHOOL SYSTEM TO IDENTIFY AT RISK INDIVIDUALS AND PROVIDE SUPPORT AND PROGRAMMING THROUGH THE HEALTHY DAVIE INITIATIVE.3. BEHAVIORAL/MENTAL HEALTH DISTRESSDMC RECOGNIZES THE OVERLAP OF MENTAL, MEDICAL AND SOCIAL DISPARITIES AND THE IMPORTANT ROLE OF BEHAVIORAL HEALTH IN TREATING THE WHOLE PERSON. THE HOSPITAL'S CURRENT STRATEGIES INCLUDE:--WORKING WITH CENTERPOINT TO IDENTIFY KEY RESOURCES FOR ACCESS AND PROGRAMMING FOR PATIENTS NEEDING MENTAL HEALTH SERVICES;--INCREASING THE CURRENT 30+ STAFF AT THE MEDICAL CENTER WHO WORK IN AREAS DEFINED AS INTEGRATED BEHAVIORAL HEALTH;--BUILDING CAPACITY AMONG LAY PERSONS IN THE COMMUNITY IN THE AREAS OF MENTAL HEALTH FIRST AID, COMMUNITY RESILIENCE MODEL AND SUICIDE PREVENTION PROGRAMS;--DEVELOPING A PLAN TO CREATE MORE INTEGRATED BEHAVIORAL HEALTH GRADUATE MEDICAL EDUCATION OFFERINGS FOR MEDICAL STUDENTS, RESIDENTS, FACULTY AND STAFF THAT SEE PATIENTS ACROSS THE MEDICAL CENTER NETWORK.ALL OF THE AFOREMENTIONED EFFORTS IN COMBINATION WITH THE HOSPITAL'S VALUES OF NONDISCRIMINATION AND COMPASSIONATE CARE ARE DESIGNED TO MEET THE SIGNIFICANT HEALTH NEEDS OF THE MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT. DAVIE MEDICAL CENTER PART V, SECTION B, LINE 13H: THE HOSPITAL MAY USE COMMERCIALLY AVAILABLE FINANCIAL PROFILING AND CREDIT SCORING TECHNOLOGIES TO PRESUMPTIVELY SCREEN RESPONSIBLE INDIVIDUALS TO DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE DISCOUNTS. DAVIE MEDICAL CENTER PART V, SECTION B, LINE 16I: IN ADDITION TO THE METHODS PREVIOUSLY DESCRIBED, THE HOSPITAL INFORMS PATIENTS ABOUT ITS FAP DURING INTAKE AND DISCHARGE BY PROVIDING A PLAIN LANGUAGE SUMMARY OF THE FAP. THE HOSPITAL ALSO PLACES A CONSPICUOUS WRITTEN NOTICE OF THE FAP ON ITS PATIENT BILLING STATEMENTS. DAVIE MEDICAL CENTER PART V, SECTION B, LINE 22D: THE HOSPITAL CHARGES FAP ELIGIBLE INDIVIDUALS AN AMOUNT NOT TO EXCEED AMOUNTS GENERALLY BILLED ("AGB") FOR EMERGENCY AND OTHER MEDICALLY NECESSARY CARE. THE HOSPITAL CALCULATES AGB UNDER THE LOOKBACK METHOD USING CLAIMS ALLOWED BY PRIVATE INSURERS AND MEDICARE FEE FOR SERVICE OVER THE IMMEDIATELY PRECEDING YEAR. 12 1 - DMC BERMUDA RUN - GASTROENTEROLOGY 313 NC HWY 801 N BERMUDA RUN NC 27006 GASTROENTEROLOGY 2 - DMC BERMUDA RUN - PHYSICAL MEDICINEREHA 313 NC HWY 801 N BERMUDA RUN NC 27006 PHYSICAL MEDICINE/REHABILITATION SPINE 3 - DMC BERMUDA RUN - CARDIOLOGY 313 NC HWY 801 N BERMUDA RUN NC 27006 CARDIAC REHAB 4 - DMC BERMUDA RUN - PODIATRY 313 NC HWY 801 N BERMUDA RUN NC 27006 PODIATRY 5 - DMC BERMUDA RUN - ORTHOPAEDICS 313 NC HWY 801 N BERMUDA RUN NC 27006 X-RAY & ORTHOPAEDICS 6 - DMC BERMUDA RUN - PULMONARY 313 NC HWY 801 N BERMUDA RUN NC 27006 PULMONARY FUNCTION LAB 7 - DMC BERMUDA RUN - NEUROLOGY 313 NC HWY 801 N BERMUDA RUN NC 27006 EEG/EMG TESTING, SLEEP LAB 8 - DMC BERMUDA RUN - EYE CENTER 313 NC HWY 801 N BERMUDA RUN NC 27006 OPTHALMOLOGY 9 - DMC BERMUDA RUN - EMERGENCY DEPARTMENT 313 NC HWY 801 N BERMUDA RUN NC 27006 EMERGENCY SERVICES 10 - DMC BERMUDA RUN - LAB 313 NC HWY 801 N BERMUDA RUN NC 27006 PHLEBOTOMY 11 - DMC BERMUDA RUN - RADIOLOGY 313 NC HWY 801 N BERMUDA RUN NC 27006 RADIOLOGY 12 - DMC BERMUDA RUN - OCCUPATIONAL THERAPY 313 NC HWY 801 N BERMUDA RUN NC 27006 OCCUPATIONAL THERAPY PART I, LINE 3C: THE ORGANIZATION ALSO EVALUATES CERTAIN CREDIT FILE DATA ELEMENTS TO IDENTIFY POTENTIAL SOURCES OF INCOME TO MORE ACCURATELY INFORM CHARITY CARE ELIGIBILITY ASSESSMENTS. PATIENTS WITH ESTIMATED HOUSEHOLD INCOME BELOW 200% OF FPG, WHO ARE IDENTIFIED AS HAVING COMMERCIAL CREDIT ACCOUNTS THAT ARE BEING SERVICED IN A MANNER THAT SUGGESTS ADDITIONAL SOURCES OF INCOME, ARE NOT AUTOMATICALLY GRANTED PRESUMPTIVE CHARITY CARE. PART I, LINE 7: THE ORGANIZATION USED THE WORKSHEETS PROVIDED IN THE INSTRUCTIONS TO SCHEDULE H TO COMPUTE ITS COST TO CHARGE RATIO FOR PURPOSES OF THE 2015 SCHEDULE H.PART I, LINE 7B MEDICAID DIRECT OFF-SETTING REVENUETHE HOSPITAL PARTICIPATES IN A PROVIDER ASSESSMENT PROGRAM ADMINISTERED BY THE NORTH CAROLINA DEPARTMENT OF HEALTH AND HUMAN SERVICES. UNDER THE PROGRAM, A FEE IS ASSESSED AGAINST NON-MEDICAID PATIENT SERVICE REVENUE OF PRIVATE HOSPITALS. THE FEDERAL GOVERNMENT MATCHES THE ASSESSMENT AT A RATE OF 2 TO 1 AND THESE AMOUNTS ARE ALLOCATED TO NORTH CAROLINA HOSPITALS QUARTERLY. ADDITIONALLY, THE HOSPITAL PARTICIPATES IN THE NORTH CAROLINA MEDICAID REIMBURSEMENT INITIATIVE (MRI). UNDER THE MRI, THE HOSPITAL RECEIVES ADDITIONAL REIMBURSEMENT BASED ON MEDICAID COST DEFICITS AND TREATMENT OF A DISPROPORTIONATE SHARE OF UNINSURED PATIENTS. PART I, LN 7 COL(F): THE ORGANIZATION'S PATIENT BAD DEBT EXPENSE PER THE AUDITED FINANCIAL STATEMENTS WAS $3,272,320 FOR THE FISCAL YEAR ENDED JUNE 30, 2016. THIS AMOUNT IS NOT INCLUDED IN THE CALCULATION OF CHARITY CARE FOR PART I, LINE 7. PART II, COMMUNITY BUILDING ACTIVITIES: WAKE FOREST BAPTIST HEALTH - DAVIE MEDICAL CENTER IS COMMITTED TO IMPROVING THE HEALTH OF THE INDIGENT AND MEDICALLY UNDERSERVED IN DAVIE COUNTY AND SURROUNDING AREAS. DAVIE MEDICAL CENTER REPRESENTATIVES ARE INVOLVED IN THE COMMUNITY THROUGH INITIATIVES SUCH AS HEALTHY DAVIE, PART OF THE DAVIE COMMUNITY FOUNDATION. THE MEDICAL CENTER HOSTS FREE CLASSES, SCREENINGS AND COOKING DEMONSTRATIONS THROUGH ITS BESTHEALTH PROGRAM. DAVIE MEDICAL CENTER PARTNERS WITH OTHER AGENCIES THROUGHOUT THE COMMUNITY TO CONTINUE TO IMPROVE HEALTH. AGENCIES INCLUDE SENIOR SERVICES, DRAGONFLY HOUSE, SMART START OF DAVIE COUNTY AND THE DAVIE YMCA. PART III, LINE 4: THE ORGANIZATION'S FINANCIAL STATEMENTS DO NOT INCLUDE A DISCRETE FOOTNOTE EXPLAINING BAD DEBT EXPENSE. BAD DEBT HAS NOT BEEN INCLUDED IN THE COMPUTATION OF COMMUNITY BENEFIT ON PART I, LINE 7. AMOUNTS USED TO COMPUTE CHARITY CARE AND BAD DEBT ON SCHEDULE H USE THE MOST CURRENT DATA AVAILABLE AT THE TIME OF FILING. THE ORGANIZATION USED WORKSHEET 2 OF THE 2015 SCHEDULE H INSTRUCTIONS TO COMPUTE A COST TO CHARGES RATIO USED TO CALCULATE BAD DEBT AT COST. PART III, LINE 8: THE HOSPITAL USES AN OVERALL COST TO CHARGE RATIO CALCULATION BASED ON AUDITED FINANCIAL STATEMENTS BUT REMOVES COST ASSOCIATED WITH BAD DEBT, COMMUNITY BUILDING, AND CHARITY CARE SO AS NOT TO COUNT THOSE COSTS TWICE. PART III, LINE 9B: THE HOSPITAL MAKES A REASONABLE EFFORT TO DETERMINE AN INDIVIDUAL'S ELIGIBILITY FOR FINANCIAL ASSISTANCE BEFORE ENGAGING IN ANY COLLECTION ACTIONS. ALL COLLECTION ACTIONS WILL BE SUSPENDED IF THE INDIVIDUAL SUBMITS A COMPLETED FAP APPLICATION DURING THE APPLICATION PERIOD, OR IF THE INDIVIDUAL SUBMITS AN INCOMPLETE APPLICATION DURING THE APPLICATION PERIOD THAT IS SUBSEQUENTLY COMPLETED WITHIN A REASONABLE TIME AFTER THE HOSPITAL REQUESTS FURTHER INFORMATION. IF THE INDIVIDUAL IS DETERMINED NOT TO BE ELIGIBLE FOR A FULL DISCOUNT UNDER THE FAP, ANY COLLECTION ACTIVITIES WILL BE RESUMED AS TO THE OUTSTANDING BALANCE OWED. IF THE INDIVIDUAL IS DETERMINED TO BE ELIGIBLE FOR ANY LEVEL OF ASSISTANCE UNDER THE FAP, APPROPRIATE MEASURES ARE TAKEN TO REFUND ANY AMOUNTS OWED TO THE INDIVIDUAL AND REVERSE OR MODIFY COLLECTION ACTIONS CONSISTENT WITH THE NEW BALANCE OWED AFTER APPLYING THE APPLICABLE FAP DISCOUNTS. PART VI, LINE 2: THE HOSPITAL'S CURRENT NEEDS ASSESSMENT PLAN WAS BASED ON A SET OF BEST PRACTICES FOR COMMUNITY HEALTH ASSESSMENTS WITH THE PURPOSE OF IDENTIFYING TWO TO THREE REGIONAL PRIORITY AREAS TO FOCUS ON FOR FY 2017-2018. THE PROCESS WAS DESIGNED TO RELY ON EXISTING PUBLIC DATA, DIRECTLY ENGAGE COMMUNITY STAKEHOLDERS AND COLLABORATE WITH LOCAL PUBLIC HEALTH, OTHER HEALTH PROVIDERS, AS WELL AS COMMUNITY PARTNERS SUCH AS FAITH NETWORKS RELEVANT TO THE SOCIAL FACTORS UNDERLYING PATTERNS OF ACCESS. THE HOSPITAL'S ASSESSMENT WAS CONDUCTED IN THREE STAGES: (1) DATA REVIEW (PRIMARY AND SECONDARY DATA), (2) SETTING PRIORITIES, AND (3) COMMUNITY ASSET INVENTORY. THE DATA REVIEW AND PRIORITY SETTING PHASE BEGAN WITH THE COMPILATION OF EXISTING HEALTH-RELATED DATA. STAKEHOLDERS REVIEWED MULTIPLE DATA SETS INCLUDING FORSYTH, DAVIDSON, AND THE DAVIE COUNTY HEALTH DEPARTMENT'S PUBLIC HEALTH NEEDS ASSESSMENTS, NORTH CAROLINA INDICATORS FOR COMMUNITY HEALTH ASSESSMENT, INTERNAL DISEASE REGISTRIES, AND COUNTY HEALTH RANKINGS. ONCE THE COMMUNITY HEALTH NEEDS WERE IDENTIFIED, AN INTERNAL STEERING COMMITTEE AND SENIOR LEADERSHIP REVIEW A SET OF CRITERIA TO DEVELOP THE PRIORITY RANKINGS. THE PRIORITIZATION PROCESS IDENTIFIED THE FOLLOWING TOP THREE PRIORITY CHALLENGES FOR THE COMMUNITY: (1) ACCESS/LACK OF MEDICAL SERVICES/SCREENINGS, (2) CHRONIC DISEASE - CANCER, DIABETES, OBESITY, AND (3) BEHAVIORAL/MENTAL HEALTH DISTRESS.FAITHHEALTHNC (A DIVISION OF THE MEDICAL CENTER) PROVIDED COMMUNITY ENGAGEMENT THROUGH A COMPREHENSIVE ASSET MAPPING STRATEGY BASED ON AN APPROACH FROM SOUTH AFRICA AND REDEFINED IN MEMPHIS, TN DESIGNED TO BUILD COMMUNITY PARTNERSHIPS ON THE ASSETS THAT EXIST, INSTEAD OF JUST NEEDS. THE MAPPING DEVELOPED AN INVENTORY OF EXISTING PROGRAMS AND SERVICES WITHIN THE REGION RELATED TO THE PRIORITY AREAS IDENTIFIED IN THE NEEDS ASSESSMENT. THE INVENTORY INCLUDED THE LOCATION OF THE PROGRAM (HOSPITAL, CLINIC, OR COMMUNITY SERVICE) AS WELL AS THE NATURE OF THE INTANGIBLE FACTORS, ESPECIALLY TRUST, THAT DETERMINE ACCESS AND COLLABORATION AMONG COMMUNITY PARTNERS. THE PURPOSE OF THE INVENTORY WAS TO IDENTIFY GAPS IN SERVICES, OPPORTUNITIES FOR NEW WORK, WHERE AND WITH WHOM THERE IS ALREADY WORK BEING DONE, AND OPPORTUNITIES FOR PARTNERSHIP AND COLLABORATION. FROM THIS THREE STEP PROCESS, THE HOSPITAL DEVELOPED AN IMPLEMENTATION STRATEGY TO IDENTIFY THE MEANS THROUGH WHICH IT PLANS TO ADDRESS NEEDS THAT ARE CONSISTENT WITH THE CHARITABLE MISSION AS PART OF ITS COMMUNITY BENEFIT PROGRAMS FOR THE NEXT THREE FISCAL YEARS. BEYOND THE PROGRAMS THAT WILL BE ADDRESSED IN THE IMPLEMENTATION STRATEGY, THE HOSPITAL WILL CONTINUE TO ADDRESS MANY OF THE PRIORITIES BY PROVIDING CARE TO ALL, REGARDLESS OF THE ABILITY TO PAY. PART VI, LINE 3: THE ORGANIZATION USES A VARIETY OF MEANS TO EDUCATE AND INFORM PATIENTS OF THEIR CHARITY CARE OPTIONS, INCLUDING INFORMATION ON A WEBSITE, PAMPHLETS, CONSPICUOUSLY DISPLAYED SIGNAGE, INFORMATION ON PATIENT BILL STATEMENTS, AND FROM STAFF MEMBERS DURING CONVERSATIONS CONCERNING A PATIENT'S LIABILITY FOR SERVICES. THE HOSPITAL EMPLOYS A ROBUST PRE-SERVICE FINANCIAL CLEARANCE PROCESS THAT SCREENS PATIENTS PRIOR TO SERVICE DELIVERY FOR EXISTING OR AVAILABLE PAYER SOURCES AS A MEANS OF AVOIDING BAD DEBT AND INAPPROPRIATE BILLING TO PATIENTS WITHOUT THE MEANS TO PAY. IF A PAYER SOURCE IS IDENTIFIED, HOSPITAL STAFF WILL ASSIST THE PATIENT WITH ENROLLMENT. PART VI, LINE 4: DAVIE COUNTY IS LOCATED IN THE PIEDMONT TRIAD REGION OF NORTH CAROLINA, COVERING 264 SQUARE MILES WITH A POPULATION OF APPROXIMATELY 41,750. WIDELY RURAL, THE COUNTY IS CHARACTERIZED BY ROLLING FARMLAND. THE NEAREST METROPOLITAN AREA IS WINSTON-SALEM, LOCATED JUST 12 MILES TO THE NORTHEAST. OVER 80% OF THE COUNTY'S POPULATION LIVES IN UNINCORPORATED AREAS. APPROXIMATELY 54% OF DAVIE COUNTY'S RESIDENTS TRAVEL OUTSIDE OF THE COUNTY FOR EMPLOYMENT. OF THOSE, 62% WORK IN FORSYTH COUNTY. THE MEDIAN INCOME FOR DAVIE COUNTY RESIDENTS IS APPROXIMATELY $51,500. THE DAVIE COUNTY UNEMPLOYMENT RATE AS REPORTED IN JUNE 2016 WAS 4.7%.THE FOLLOWING DEMOGRAPHIC FIGURES REFLECT THE POPULATION FOR DAVIE COUNTY: - 51% FEMALE, 49% MALE - BELOW 18 YEARS: 21.6% - AGE 65 AND OLDER: 19.6%THE COUNTY POPULATION BREAKDOWN BY RACE IS: - WHITE NON-HISPANIC (84.7%) - BLACK (6.7%) - HISPANIC (6.5%) - TWO OR MORE RACES (1.6%) - OTHER ASIAN (0.8%) - AMERICAN INDIAN (0.6%)THERE ARE SEVEN TOWNSHIPS IN DAVIE COUNTY. MOCKSVILLE IS THE LARGEST MUNICIPALITY WITH 5,104 RESIDENTS, AND IS ALSO THE COUNTY SEAT. A COMPARISON OF MOCKSVILLE TO DAVIE COUNTY AND NORTH CAROLINA REVEALS MEDIAN HOUSEHOLD INCOME AND MEDIAN HOUSE VALUE ARE WELL BELOW COUNTY AND STATE AVERAGES. DAVIE COUNTY EXPERIENCED UNPRECEDENTED GROWTH BETWEEN YEARS 2000 AND 2015 AT 2% ANNUALLY, COMPARED TO THE PIEDMONT TRIAD'S AVERAGE GROWTH RATE OF 1.3% ANNUALLY FOR THAT SAME PERIOD. THE MAJORITY OF THE POPULATION GROWTH OCCURRED IN THE EASTERN PART OF THE COUNTY THAT BORDERS WINSTON-SALEM. PART VI, LINE 5: THE HOSPITAL HAS MAINTAINED A STRONG COMMITMENT TO PROMOTING AND EXPANDING COMMUNITY HEALTH PROGRAMS IN DAVIE COUNTY. SUCH PROGRAMS INCLUDE BESTHEALTH COMMUNITY EDUCATION CLASSES, CHRONIC DISEASES SELF MANAGEMENT PROGRAMS, PUBLIC SCREENINGS, AND OTHER HEALTH EDUCATION EVENTS HELD LOCALLY THROUGHOUT THE YEAR. PART VI, LINE 6: THE MEMBER OF THE ORGANIZATION IS NORTH CAROLINA BAPTIST HOSPITAL ("NCBH"). THE FILING ORGANIZATION AND NCBH ARE INTEGRAL PARTS OF WAKE FOREST BAPTIST MEDICAL CENTER, A PREEMINENT, INTERNATIONALLY RECOGNIZED ACADEMIC MEDICAL CENTER OF THE HIGHEST QUALITY WITH BALANCED EXCELLENCE IN PATIENT CARE, RESEARCH AND EDUCATION. WAKE FOREST BAPTIST MEDICAL CENTER'S MISSION IS TO IMPROVE THE HEALTH OF OUR REGION, STATE AND NATION BY:1) GENERATING AND TRANSLATING KNOWLEDGE TO PREVENT, DIAGNOSE AND TREATDISEASE.2) TRAINING LEADERS IN HEALTH CARE AND BIOMEDICAL SCIENCE.3) SERVING AS THE PREMIER HEALTH SYSTEM IN OUR REGION, WITH SPECIFICCENTERS OF EXCELLENCE RECOGNIZED AS NATIONAL AND INTERNATIONAL CAREDESTINATIONS. PART VI, LINE 7, REPORTS FILED WITH STATES NC 1 KIDS & PROS PO BOX 2093 BUFORD GA 30515 264298822 501(C)(3) 10000 YOUTH CHARACTER DEVELOPMENT AND SPORTS SKILLS DAVIE COMMUNITY FOUNDATION 107 N SALISBURY MOCKSVILLE NC 27028 581850531 501(C)(3) 5500 COMMUNITY SUPPORT 2 0 PART I, LINE 2: THE HOSPITAL FOLLOWS THE MEDICAL CENTER'S CORPORATE POLICY USED IN REVIEWING THE ELIGIBILITY AND SELECTION OF GRANTEES RECEIVING CERTAIN EXEMPT PURPOSE FUNDS. THE HOSPITAL MAINTAINS DOCUMENTATION OF THE ELIGIBILITY AND SELECTION CRITERIA AND RECORDS OF THE AMOUNTS DISBURSED. 0 1 0 0 0 0 0 0 0 CHAD BROWN PRESIDENT 225008 0 61709 0 11551 0 37537 0 35549 0 371354 0 0 0 DANNY SQUIRES FINANCE DIRECTOR 168265 0 29545 0 636 0 9613 0 15892 0 223951 0 0 0 PART I, LINE 4B CERTAIN OFFICERS OF THE FILING ORGANIZATION PARTICIPATED IN SUPPLEMENTAL NON QUALIFIED RETIREMENT PLANS (SERP), ALL OF WHICH WERE PAID BY AN UNRELATED ORGANIZATION, WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER, AS PART OF THE INDIVIDUAL'S COMPENSATION FROM THE UNRELATED ORGANIZATION. THE DETERMINATION OF THE AMOUNT OF THE NON QUALIFIED RETIREMENT PLANS FOLLOWED THE UNRELATED ORGANIZATION'S COMPENSATION PROCEDURES AS OUTLINED IN PART VI, SECTION B, LINE 15 OF THE FORM 990. FORM 990, PART VII, LINE 5 - COMPENSATION FROM UNRELATED ORGANIZATION THE FOLLOWING INDIVIDUAL RECEIVED COMPENSATION FROM AN AFFILIATED BUT UNRELATED ORGANIZATION, WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER, FOR SERVICES RENDERED TO THIS ORGANIZATION AS AN OFFICER OR KEY EMPLOYEE: CHAD BROWN DANNY SQUIRES FORM 990, PART IV, LINE 20B THE HOSPITAL HAS ATTACHED A COPY OF ITS CONSOLIDATED AUDITED FINANCIAL STATEMENTS FOR ITS FISCAL YEAR ENDED JUNE 30, 2016 TO THE FORM 990. THE CONSOLIDATED FINANCIAL STATEMENTS HAVE BEEN PREPARED ON THE ACCRUAL BASIS IN CONFORMITY WITH U.S. GENERALLY ACCEPTED ACCOUNTING PRINCIPLES (GAAP) AND INCLUDE THE ASSETS AND OPERATIONS OF NORTH CAROLINA BAPTIST HOSPITAL (NCBH), DAVIE COUNTY EMERGENCY HEALTH CORPORATION (THE FILING ORGANIZATION), CARENET, INC., THE HAWTHORNE INN AND CONFERENCE CENTER, NORTH CAROLINA BAPTIST HOSPITAL FOUNDATION AND CLEMMONS MEDICAL PARK, LLC. ALL SIGNIFICANT INTERCOMPANY TRANSACTIONS HAVE BEEN ELIMINATED IN CONSOLIDATION. FORM 990, PART VI, SECTION A, LINE 3 AS ESTABLISHED IN THE ORGANIZATIONS BYLAWS, THE BOARD OF TRUSTEES MAY ESTABLISH AN EXECUTIVE COMMITTEE CONSISTING OF THREE OR MORE TRUSTEES, THE MAJORITY OF WHOM SHALL BE NORTH CAROLINA BAPTIST HOSPITAL (NCBH) TRUSTEES AND THE REMAINDER SHALL BE DAVIE HOSPITAL TRUSTEES. DURING THE INTERVALS BETWEEN MEETINGS OF THE BOARD OF TRUSTEES, THE EXECUTIVE COMMITTEE SHALL HAVE AND MAY EXERCISE THE POWERS OF THE BOARD OF TRUSTEES IN THE MANAGEMENT OF THE BUSINESS AND AFFAIRS OF THE CORPORATION; PROVIDED THAT THE EXECUTIVE COMMITTEE MAY NOT TAKE ANY ACTION THAT WOULD REQUIRE A SUPERMAJORITY VOTE OF THE BOARD OF TRUSTEES. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF THE ORGANIZATION IS NORTH CAROLINA BAPTIST HOSPITAL, A NORTH CAROLINA NONPROFIT CORPORATION. FORM 990, PART VI, SECTION A, LINE 7A THE SOLE MEMBER OF THE ORGANIZATION SHALL HAVE THE RIGHT AT ALL TIMES, WITH RESPECT TO THE ORGANIZATION, TO ELECT AND REMOVE THE TRUSTEES, AS PROVIDED IN THE ORGANIZATION'S BYLAWS. FORM 990, PART VI, SECTION A, LINE 7B THE SOLE MEMBER OF THE ORGANIZATION SHALL HAVE THE RIGHT AT ALL TIMES, WITH RESPECT TO THE ORGANIZATION, TO APPROVE OF THE SALE, LEASE, OR TRANSFER OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE ORGANIZATION, AS PROVIDED IN THE ORGANIZATION'S BYLAWS. THE SOLE MEMBER MAY ACT WITHOUT A MEETING. FORM 990, PART VI, SECTION B, LINE 11 THE FILING ORGANIZATION'S BOARD OF DIRECTORS RECEIVES COPIES OF THE FORM 990 WITH SUFFICIENT TIME TO PERMIT REVIEW, COMMENT, AND QUESTIONS PRIOR TO ITS FILING. THE AUDIT AND COMPLIANCE COMMITTEES OF THE GOVERNING BOARDS OF WFUHS AND NCBH REVIEW IN ADDITIONAL DETAIL THE FILING ORGANIZATION'S FORM 990 WITH THE ORGANIZATION'S CHIEF FINANCIAL OFFICER OR HIS DESIGNEE, WHO ANSWERS QUESTIONS AND ADDRESSES CONCERNS RAISED BY SUCH COMMITTEE MEMBERS OR OTHER FILING ORGANIZATION DIRECTORS. IF MODIFICATIONS ARE REQUIRED FOLLOWING SUCH REVIEW AND COMMENT, THE REVISED FORM 990 IS REDISTRIBUTED TO ALL DIRECTORS PRIOR TO ITS FILING WITH THE IRS, ALONG WITH A REPORT NOTING THE MODIFICATIONS. FORM 990, PART VI, SECTION B, LINE 12C ON AN ANNUAL BASIS (AND AS THEY ARISE), ALL TRUSTEES AND OFFICERS OF THE FILING ORGANIZATION ARE ASKED TO REVIEW THE APPLICABLE CONFLICTS OF INTEREST POLICY AND TO DESCRIBE ANY POTENTIAL CONFLICTS OF INTEREST THEY MAY HAVE. UPON COMPLETION OF THE CONFLICTS OF INTEREST SURVEY, THE LEGAL DEPARTMENT REVIEWS THE COMPLETED QUESTIONNAIRES ON BEHALF OF THE FILING ORGANIZATION. ANY CONFLICTS IDENTIFIED ARE COMMUNICATED TO THE FILING ORGANIZATION'S CHAIRMAN OF THE BOARD AND ARE PRESENTED TO THE AUDIT AND COMPLIANCE COMMITTEE. ALL CONFLICTS OF INTEREST ARE RESOLVED BY MANAGEMENT PLANS DEVELOPED BY THE FILING ORGANIZATION BOARD'S AUDIT AND COMPLIANCE COMMITTEE AND THE INTERNAL AUDIT AND COMPLIANCE OFFICES. THE AUDIT AND COMPLIANCE COMMITTEE'S CHAIR PRESENTS AN ANNUAL REPORT ON CONFLICTS TO THE FULL BOARD OF THE FILING ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 15 DAVIE COUNTY EMERGENCY HEALTH CORPORATION (DBA DAVIE MEDICAL CENTER) IS AN INTEGRAL PART OF WAKE FOREST BAPTIST MEDICAL CENTER, A PREEMINENT, INTERNATIONALLY RECOGNIZED ACADEMIC MEDICAL CENTER OF THE HIGHEST QUALITY WITH BALANCED EXCELLENCE IN PATIENT CARE, RESEARCH AND EDUCATION. THE FILING ORGANIZATION PAYS NO COMPENSATION TO OFFICERS OR DIRECTORS. ALL COMPENSATION PAID TO OFFICERS AND DIRECTORS AND TO FORMER OFFICERS AND DIRECTORS WAS PAID BY UNRELATED ORGANIZATIONS, WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER AND WAKE FOREST UNIVERSITY HEALTH SCIENCES, BOTH ENITITES WITHIN THE WAKE FOREST BAPTIST MEDICAL CENTER LEGAL STRUCTURE. COMPENSATION PAID TO THESE INDIVIDUALS ARE REVIEWED AND APPROVED IN ACCORDANCE WITH THE APPLICABLE ORGANIZATION'S COMPENSATION POLICIES AND PROCEDURES WHICH INCLUDE INDEPENDENT COMPENSATION CONSULTANTS, COMPENSATION SURVEYS AND STUDIES TO DETERMINE THE APPROPRIATENESS OF EACH OFFICER'S AND DIRECTOR'S COMPENSATION. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S ARTICLES OF INCORPORATION ARE AVAILABLE TO THE PUBLIC ON REQUEST AND ARE AVAILABLE ON THE WEBSITE OF THE NORTH CAROLINA SECRETARY OF STATE. THE ORGANIZATION'S BYLAWS ARE NOT PUBLISHED, BUT PROVISIONS FROM THE BYLAWS ARE INCLUDED AS NECESSARY IN THE ORGANIZATION'S POLICIES, AND ARE ATTACHED TO THE FORM 1023 FILED FOR THE ORGANIZATION WITH THE IRS, WHICH IS PUBLICLY AVAILABLE. THE CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE NOT AVAILABLE TO THE PUBLIC. NORTH CAROLINA BAPTIST HOSPITAL MEDICAL CENTER BLVD WINSTON SALEM NC 27157 560552787 HEALTHCARE NC 501(C)(3) LINE 3 N/A 0 NORTH CAROLINA BAPTIST HOSPITAL FOUNDATION MEDICAL CENTER BLVD WINSTON SALEM NC 27157 561685120 SUPPORTING ORGANIZATION NC 501(C)(3) LINE 11A, I NORTH CAROLINA BAPTIST HOSPITAL 0 THE REHABILITATION & SKILLED NURSING FACILITY AT OAK SUMMIT MEDICAL CENTER BLVD WINSTON SALEM NC 27157 561826396 HEALTHCARE (INACTIVE) NC 501(C)(3) LINE 9 NORTH CAROLINA BAPTIST HOSPITAL FOUNDATION 0 THE HAWTHORNE INN & CONFERENCE CENTER INC 420 HIGH STREET WINSTON SALEM NC 27101 561793617 LODGING/ CONFERENCE ACCOMMODATION NC 501(C)(3) LINE 11A, I NORTH CAROLINA BAPTIST HOSPITAL 0 CARENET INC 2000 WEST FIRST STREET SUITE 410 WINSTON SALEM NC 27104 561977341 HEALTHCARE NC 501(C)(3) LINE 11B, II NORTH CAROLINA BAPTIST HOSPITAL 0 DAVIE COUNTY HOSPITAL FOUNDATION 156 ROLAND RD MOCKSVILLE NC 27028 581477280 SUPPORTING ORGANIZATION NC 501(C)(3) LINE 11C, III-FI N/A 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 1