2017-05-12T07:46:10-05:00 2016-06-30 135565207 KPMG LLP 300 NORTH GREENE STREET GREENSBORO NC 27401 990 2015-07-01 223849199 WAKE FOREST UNIVERSITY HEALTH SCIENCES WAKE 3367164445 MEDICAL CENTER BLVD WINSTONSALEM NC 27157 CHAD A ECKES EVP - CFO 3367164445 2017-05-08 0 P00008888 3362753394 2015 2021-01-29 14:40:06Z JOHN D MCCONNELL MD MEDICAL CENTER BLVD WINSTONSALEM NC 27157 880254091 0 X WAKEHEALTH.EDU X 2001 NC IMPROVING THE HEALTH OF OUR REGION, STATE, AND NATION. 18 15 4954 1830 790182 602993 218972568 196637105 524100112 668535305 37273796 412017 7496644 4920584 787843120 870505011 60749525 49418362 0 0 482749887 597624802 427686 10865 3333380 215943357 238408361 759870455 885462390 27972665 -14957379 1262229986 1299473046 765013635 815555596 497216351 483917450 X THE ORGANIZATION IS 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. OUR MISSION IS TO IMPROVE THE HEALTH OF OUR REGION, STATE AND NATION BY: GENERATING AND TRANSLATING KNOWLEDGE TO PREVENT, DIAGNOSE AND TREAT DISEASE; TRAINING LEADERS IN HEALTH CARE AND BIOMEDICAL SCIENCE; AND SERVING AS THE PREMIER HEALTH SYSTEM IN OUR REGION, WITH SPECIFIC CENTERS OF EXCELLENCE RECOGNIZED AS NATIONAL AND INTERNATIONAL CARE DESTINATIONS. 0 0 179508379 34431232 MEDICAL RESEARCH, GENERAL/OTHER: RESEARCH COMPRISED OF BASIC SCIENCE CLINICAL RESEARCH AND POPULATION BASED STUDIES AND IS CENTERED ON THE ACQUISITION AND ADVANCEMENT OF SCIENTIFIC KNOWLEDGE AND NEW TECHNOLOGY AND THEIR TRANSFER TO INDUSTRY AND THE PATIENT IN ORDER TO PREVENT AND TREAT DISEASE AND PROMOTE HEALTH (1833 GRANTS). 570637297 361271 625216773 PATIENT CARE AND MEDICAL EXPENSES IN PROVIDING SERVICES TO 956,209 PATIENT ENCOUNTERS. 99127959 14625859 45248630 PROFESSIONAL EDUCATION: INSTRUCTION OF MORE THAN 1,600 MEDICAL, GRADUATE, AND PHYSICIAN ASSISTANT STUDENTS. SCHOLARSHIPS AND AID PROVIDED TO 1096 STUDENTS. WAKE FOREST UNIVERSITY HEALTH SCIENCES 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 FOLLOWING PARAGRAPHS ARE PROVIDED TO EXPLAIN THE RELATIONSHIP OF THE FILING ORGANIZATION WITH OTHER ORGANIZATIONS WHICH TOGETHER COMPRISE "WAKE FOREST BAPTIST MEDICAL CENTER", THE NAME, NOT OF ANY ONE CORPORATE ENTITY, BUT THAT IS USED GENERICALLY TO DESCRIBE A LARGE GROUP OF MOSTLY TAX-EXEMPT 501 (C)(3) ORGANIZATIONS PERFORMING VARIOUS ACADEMIC MEDICAL CENTER ACTIVITIES IN NORTHWEST NORTH CAROLINA, INCLUDING PATIENT CARE, MEDICAL RESEARCH AND TECHNOLOGY TRANSFER AND MEDICAL EDUCATION. BECAUSE THESE ACTIVITIES ARE NOT ALL PERFORMED BY EACH ORGANIZATION, THE NARRATIVE THAT FOLLOWS WILL INCLUDE DESCRIPTIONS OF ACTIVITIES THAT ARE PERFORMED BY THE FILING ORGANIZATION AND BY A RELATED (OR UNRELATED BUT AFFILIATED) ORGANIZATION; THEY ARE AGAIN PROVIDED TO ILLUSTRATE A COMPLETE PICTURE OF THE FILING ORGANIZATION'S ROLE IN THIS INTEGRATED ACADEMIC MEDICAL CENTER'S COMPREHENSIVE ACTIVITIES. WAKE FOREST BAPTIST MEDICAL CENTER IS NORTHWEST NORTH CAROLINA'S SOLE ACADEMIC MEDICAL CENTER, BRINGING TO THE REGION THE RESOURCES OF ONE OF AMERICA'S TOP HOSPITALS AND INNOVATIVE RESEARCH CENTERS AND A PREMIER MEDICAL SCHOOL. WAKE FOREST BAPTIST MEDICAL CENTER IS A CORPORATION WHOSE MEMBERS ARE WAKE FOREST UNIVERSITY AND NORTH CAROLINA BAPTIST HOSPITAL. THE MEDICAL CENTER OPERATES WAKE FOREST UNIVERSITY SCHOOL OF MEDICINE, WHICH HAS A FACULTY OF 1,215, INCLUDING PHYSICIANS AND BASIC SCIENTISTS. THE MEDICAL CENTER HAS 1,060 ACUTE CARE AND REHABILITATION BEDS OPERATIVE ACROSS THE SYSTEM, WHICH ENCOMPASSES ITS MAIN CAMPUS (885 BEDS), WAKE FOREST BAPTIST HEALTH-LEXINGTON MEDICAL CENTER (94 BEDS) AND WAKE FOREST BAPTIST HEALTH-DAVIE MEDICAL CENTER (81 BEDS). THE MEDICAL CENTER WILL OPEN A $47 MILLION, 50-BED INPATIENT FACILITY AT DAVIE MEDICAL CENTER IN THE SPRING OF 2017. OVERALL, WAKE FOREST BAPTIST MEDICAL CENTER SERVES A 24-COUNTY REGION IN NORTHWESTERN NORTH CAROLINA AND SOUTHWESTERN VIRGINIA. IT ALSO DRAWS PATIENTS FROM ACROSS THE NATION FOR SELECT SERVICES.THE MEDICAL CENTER IS THE DRIVING FORCE BEHIND THE ESTABLISHMENT OF WAKE FOREST INNOVATION QUARTER, A GROWING URBAN-BASED DISTRICT FOR RESEARCH, BUSINESS AND EDUCATION IN BIOMEDICAL SCIENCE, INFORMATION TECHNOLOGY, CLINICAL SERVICES AND ADVANCED MATERIALS LOCATED IN DOWNTOWN WINSTON-SALEM. HOME TO MORE THAN 70 COMPANIES, FOUR LEADING INSTITUTIONS, MORE THAN 3,200 WORKERS AND 7,500 STUDENTS, THE INNOVATION QUARTER CURRENTLY COMPRISES 1.8 MILLION SQUARE FEET OF INSPIRATIONAL OFFICE, LABORATORY AND EDUCATIONAL SPACE ON ITS 145 DEVELOPABLE ACRES. IN JULY 2016, WAKE FOREST UNIVERSITY SCHOOL OF MEDICINE STUDENTS BEGAN THEIR MEDICAL CAREERS IN THE BOWMAN GRAY CENTER FOR MEDICAL EDUCATION IN THE INNOVATION QUARTER. THE $60 MILLION BUILDING WAS DESIGNED WITH THE NEXT GENERATION OF PHYSICIAN-LEADERS IN MIND. IT INCLUDES THE LATEST TECHNOLOGIES AND SIMULATION LABS THAT ALLOW STUDENTS TO PREPARE FOR REAL-LIFE EXPERIENCES. THE OPENING OF THE BOWMAN GRAY CENTER COINCIDED WITH THE ADOPTION OF A NEW MEDICAL SCHOOL CURRICULUM THAT IS ONE OF THE MOST ADVANCED IN THE COUNTRY.IN NOVEMBER 2016, WAKE FOREST BAPTIST MEDICAL CENTER WAS AWARDED A FIVE-YEAR, $8.7 MILLION GRANT FROM THE NATIONAL INSTITUTES OF HEALTH FOR THE ESTABLISHMENT OF A NEW CENTER FOR RESEARCH INTO ALZHEIMER'S DISEASE. THE ALZHEIMER'S DISEASE CORE CENTER AT WAKE FOREST BAPTIST IS AMONG 31 NIH-FUNDED ALZHEIMER'S RESEARCH CENTERS IN THE COUNTRY AND THE ONLY ONE IN NORTH CAROLINA. THE CENTER WILL PROVIDE TRAINING IN TRANSLATIONAL RESEARCH TO NEW INVESTIGATORS AND DEVELOP EDUCATIONAL PROGRAMS ABOUT ALZHEIMER'S AND DEMENTIA FOR HEALTH CARE PROFESSIONALS, PATIENTS AND FAMILY MEMBERS, AND THE COMMUNITY AT LARGE. THE CENTER ALREADY IS OFFERING GROUNDBREAKING CLINICAL TRIALS, INCLUDING STUDIES THAT EXAMINE HOW EXERCISE, DIET AND NEW DRUGS MAY AFFECT THE DEVELOPMENT OR PROGRESS OF ALZHEIMER'S AND DEMENTIA.1. CLINICAL SERVICES WAKE FOREST BAPTIST MEDICAL CENTER IS NATIONALLY RECOGNIZED FOR CLINICAL EXCELLENCE AND INTERNATIONALLY KNOWN FOR PIONEERING RESEARCH AND CLINICAL INNOVATION. ITS CLINICAL ENTERPRISE, WAKE FOREST BAPTIST HEALTH, OFFERS EXPERTISE IN MORE THAN 100 AREAS OF MEDICINE, ENCOMPASSING COMPREHENSIVE PREVENTIVE AND HIGHLY SPECIALIZED CARE FOR ALL AGES. THE MEDICAL CENTER NETWORK INCLUDES THE 167-BED COMPREHENSIVE CANCER CENTER AND THE 144-BED BRENNER CHILDREN'S HOSPITAL, BOTH OF WHICH ARE ON THE MAIN CAMPUS IN WINSTON-SALEM, AS WELL AS COMMUNITY HOSPITALS IN NEIGHBORING DAVIDSON AND DAVIE COUNTIES. ACROSS ITS SERVICE AREA OF NORTHWEST NORTH CAROLINA AND SOUTHWEST VIRGINIA, WAKE FOREST BAPTIST HAS 3 EMERGENCY DEPARTMENTS, THREE URGENT CARE CENTERS, 28 PRIMARY CARE CLINICS, 114 SPECIALTY CLINICS, 16 DIALYSIS CENTERS, AND FREESTANDING IMAGING AND ENDOSCOPY CENTERS. THE MEDICAL CENTER EMPLOYS 1,215 PHYSICIANS, 3,075 REGISTERED NURSES, AND 692 RESIDENTS AND FELLOWS. IT HAS A TOTAL STAFF OF 14,271. OVERALL IN FY 2016, WAKE FOREST BAPTIST HAD 40,810 INPATIENT ADMISSIONS, 110,602 EMERGENCY DEPARTMENT VISITS AND 1,171,619 OUTPATIENT ENCOUNTERS (AMBULATORY VISITS AND OUTPATIENT DEPARTMENTS).IN DECEMBER 2016, WAKE FOREST BAPTIST REACHED AN AGREEMENT WITH THE WINSTON-SALEM/FORSYTH COUNTY BOARD OF EDUCATION TO PROVIDE CERTIFIED ATHLETIC TRAINERS AT 12 LOCAL PUBLIC HIGH SCHOOLS. 2. OUTREACHWAKE FOREST BAPTIST MEDICAL CENTER CONTINUES A BROAD-BASED EFFORT TO REACH UNDERSERVED POPULATIONS ACROSS ITS SERVICE AREA. THE MEDICAL CENTER'S ANNUAL COMMUNITY BENEFITS REPORT REFLECTS THIS COMMITMENT. IN FISCAL 2016, THE MEDICAL CENTER SPENT $378 MILLION TO SUPPORT THESE AREAS: - SUBSIDIZED HEALTH COSTS- COMMUNITY HEALTH OUTREACH- CHARITY CARE- RESEARCH- EDUCATIONONE ANCHOR OF OUTREACH FOR THE MEDICAL CENTER IS ITS DOWNTOWN HEALTH PLAZA, A FULL-SERVICE, OUTPATIENT MEDICAL CLINIC THAT SERVES MANY OF FORSYTH COUNTY'S UNINSURED AND UNDERINSURED RESIDENTS WITH A STATE-OF-THE-ART MEDICAL HOME. IN ADDITION TO CLINICAL CARE, THE DOWNTOWN HEALTH PLAZA OFFERS COMMUNITY HEALTH FAIRS, DIABETES EDUCATION AND A CENTERING PREGNANCY PROGRAM THAT IS REDUCING THE INCIDENCE OF LOW BIRTH WEIGHT BABIES. ALTOGETHER, 67,533 PATIENT VISITS WERE RECORDED AT THE DOWNTOWN HEALTH PLAZA IN THE 2016 FISCAL YEAR, AND ANOTHER 13,691 VISITS WERE RECORDED AT WINSTON EAST PEDIATRICS, A NEARBY WAKE FOREST BAPTIST CARE FACILITY SERVING THE UNINSURED AND UNDERINSURED.THE MEDICAL CENTER'S PROGRAMS AND PARTNERSHIPS REFLECT INNOVATIVE EFFORTS TO REACH UNDERSERVED POPULATIONS. THEY INCLUDE:- REGULAR COMMUNITY-BASED HEALTH CLINICS, INCLUDING: THE WEEKLY DELIVERING EQUAL ACCESS TO CARE (DEAC) CLINIC AT THE COMMUNITY CARE CENTER IN WINSTON-SALEM, THE MONTHLY TRIAD FREE HEALTH CLINIC AT COMMUNITY MOSQUE IN WINSTON-SALEM, THE MONTHLY GRACE CLINIC AT NEW LIGHT MISSIONARY BAPTIST CHURCH IN WINSTON-SALEM AND THE ANNUAL SHARE THE HEALTH FAIR AT THE DOWNTOWN HEALTH PLAZA IN WINSTON-SALEM. THESE CLINICS, SPONSORED BY PRIVATE ORGANIZATIONS AND CHURCHES WITH VOLUNTEER ASSISTANCE FROM WAKE FOREST BAPTIST PHYSICIANS, NURSES, MEDICAL STUDENTS AND OTHERS, ATTRACT THOUSANDS OF PEOPLE TO SCREENINGS FOR ACUTE AND CHRONIC CONDITIONS. - THE SCHOOL OF MEDICINE'S PHYSICIAN ASSISTANT (PA) PROGRAM, WHICH IS INCREASING THE NUMBER OF PA'S WORKING IN PRIMARY CARE IN NORTH CAROLINA'S RURAL APPALACHIAN COUNTIES THROUGH ITS SECOND CAMPUS AT APPALACHIAN STATE UNIVERSITY IN BOONE. - FAITHHEALTHNC, AN INITIATIVE THAT CONNECTS THE CARING STRENGTHS OF CONGREGATIONS, THE CLINICAL EXPERTISE OF PROVIDERS AND A NETWORK OF COMMUNITY RESOURCES TO EASE THOSE ON THE JOURNEY TO HEALTH AND HEALING, STRENGTHENING COMMUNITIES IN THE PROCESS. ONE EXAMPLE OF THIS WORK IS A FAITHHEALTH PROGRAM IN WHICH WORKERS KNOWN AS SUPPORTERS OF HEALTH CONNECT PATIENTS WITH RESOURCES THEY NEED AFTER A HEALTH INCIDENT OR HOSPITALIZATION. THE GOAL IS TO HELP THESE PATIENTS AVOID READMISSION, IN PARTICULAR TO THE EMERGENCY DEPARTMENT. 3. EDUCATIONAL MISSION AND ACCOMPLISHMENTS THE CONSTITUENT ORGANIZATIONS OF WAKE FOREST BAPTIST MEDICAL CENTER OPERATE A BROAD RANGE OF EDUCATIONAL PROGRAMS, GRADUATING SKILLED PRACTITIONERS. IT ATTRACTS SOME OF THE WORLD'S MOST COMPETITIVE MEDICAL STUDENTS, RESIDENTS AND FELLOWS, AS WELL AS STUDENTS IN CLINICAL PASTORAL CARE, NURSE ANESTHESIA AND OTHER AREAS. DURING FY16, WAKE FOREST BAPTIST INVESTED MORE THAN $80.1 MILLION IN THE EDUCATION OF TOMORROW'S HEALTH CARE AND BIOMEDICAL LEADERS. THAT INVESTMENT SUPPORTED THE TRAINING OF 467 MEDICAL STUDENTS, 692 PHYSICIAN RESIDENTS AND FELLOWS, 292 GRADUATE STUDENTS AND 176 PHYSICIAN ASSISTANTS. 849273635 1 1 0 1 0 0 0 0 0 1 1 1 0 1 1 1 0 1 1 0 1 1 0 1 1 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 1 1 1 0 0 1 896 0 1 4954 1 1 1 0 0 0 0 1 1 1 1 0 0 0 X 18 15 1 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 NC X JOSEPH DOLAN 3367164445 MEDICAL CENTER BLVD WINSTON SALEM NC 27157 X DONALD E FLOW CHAIR OF BOARD 4.00 10.00 X 0 0 0 DONNA A BOSWELL PHD DIRECTOR 2.00 16.00 X 0 0 0 JAMES R HELVEY III DIRECTOR 2.00 11.50 X 0 0 0 JAMES J MARINO DIRECTOR 2.00 4.00 X 0 0 0 JAMES T WILLIAMS JR DIRECTOR 2.00 1.00 X 0 0 0 GERALD F ROACH DIRECTOR 2.00 6.00 X 0 0 0 BOBBY R BURCHFIELD DIRECTOR 2.00 6.00 X 0 0 0 RICHARD A BRENNER DIRECTOR 2.00 0.00 X 0 0 0 KATHLEEN B FRENCH MD DIRECTOR 2.00 3.00 X 0 0 0 MATTHEW A KING DIRECTOR 2.00 5.00 X 0 0 0 NATHAN O HATCH PHD DIRECTOR & PRESIDENT OF WF 2.60 37.40 X X 0 3941320 287707 JOHN D MCCONNELL MD DIRECTOR & CEO 8.20 31.80 X X 2031489 0 252556 ANN S HANES DIRECTOR 2.00 0.00 X 0 0 0 ANDREW J SCHINDLER VICE CHAIRMAN 3.00 9.50 X 0 0 0 DAVID W DUPREE DIRECTOR 2.00 5.00 X 0 0 0 JOHN M VANN DIRECTOR 2.00 4.00 X 0 0 0 GRAHAM F BENNETT DIRECTOR 2.00 0.00 X 0 0 0 J ANDREWS HANCOCK III DIRECTOR 2.00 0.00 X 0 0 0 EDWARD ABRAHAM MD DEAN 29.90 10.10 X 1144312 0 154233 J REID MORGAN SECRETARY & GENERAL COUNSE 4.00 36.00 X 0 510246 97801 ANITA M CONRAD ASSISTANT SECRETARY 10.00 30.00 X 0 168791 34394 TERRY L HALES JR ASSISTANT TREASURER 6.60 33.40 X 481853 0 102471 LISA M WYATT VP CH COMMUNICATIONS/MARKE 15.00 25.00 X 581243 0 20855 CHERYL E H LOCKE VP CHIEF HUMAN RESOURCES O 2.50 37.50 X 657146 0 91928 NORMAN D POTTER JR VP DEVELOPMENT & ALUMNI AF 15.00 25.00 X 407114 0 87054 KAREN H HUEY VP FACILITIES 11.00 29.00 X 0 363528 68596 ERIC TOMLINSON DSC PHD CH INNOV OFR & PRES WFIQ 5.00 35.00 X 549802 0 103489 TERRY G WILLIAMS EVP STRAT & DEV. 1.30 38.70 X 710936 0 147833 CHAD A ECKES CFO, TREAS, ASST TREAS 5.60 34.40 X 678676 0 166330 KEVIN P HIGH MD EVP HS AFFAIRS 1.50 38.50 X 683568 0 115815 DEETTE M EMON VP, CIO 5.00 35.00 X 0 453671 57136 STEVEN BLOOM VP CHIEF HUMAN RESOURCES O 15.00 25.00 X 0 0 0 ROBERT GFELLER VP CH COMMUNICATIONS/MARKE 5.00 35.00 X 0 376519 105574 BRADLEY CLARK ASST TREAS, TREAS 6.70 33.30 X 280618 0 47476 NEAL KON MD DEPARTMENT CHAIR 40.00 0.00 X 1144856 0 32240 ROSS UNGERLEIDER MD CHIEF, PEDIATRIC HEART PRO 40.00 0.00 X 1739640 0 31820 EDWARD KINCAID MD ASSOCIATE PROFESSOR 40.00 0.00 X 930397 0 32978 MALCOLM MARKS MD DEPARTMENT CHAIR 40.00 0.00 X 839350 0 32758 CHARLES BRANCH JR MD DEPARTMENT CHAIR 40.00 0.00 X 1028894 0 36120 WILLIAM B APPLEGATE MD FORMER OFFICER 40.00 0.00 X 242496 0 32243 EDWARD G CHADWICK FORMER OFFICER 0.00 0.00 X 143065 0 2522 RUSSELL M HOWERTON MD FORMER OFFICER 14.70 25.30 X 678567 0 157634 JOANNE C RUHLAND FORMER OFFICER 15.00 25.00 X 361544 0 63824 K BARBARA CARBONE MD FORMER OFFICER 0.00 0.00 X 1421509 0 16139 16737075 5814075 2379526 1273 1 1 0 NAVIGANT CONSULTING INC 30 S WACKER DRIVE CHICAGO IL 60606 REVENUE CYCLE CONSULT. 9334540 ABLM INC 8505 RUSSELL DRIVE ROWLETT TX 75089 REVENUE CYCLE CONSULT. 5801243 MEDDATA INC 6880 W SNOWVILLE ROAD BRECKSVILLE OH 44141 CODING & BILLING SRVS. 3952159 CASSIDY TURLEY FIDUCIARY INC 550 S TRYON STREET CHARLOTTE NC 28202 REAL ESTATE CONSULT. 2916705 THE BUDD GROUP 2325 S STRATFORD ROAD WINSTON SALEM NC 27103 JANITORIAL & FACILITY 2476393 100 465000 157956759 38215346 899986 196637105 MEDICAL SERVICES 621110 623286675 623076296 210379 TUITION AND FEES 611710 45248630 45248630 668535305 9822586 549483 9273103 680188 680188 1790287 0 1790287 1790287 1790287 143951 9554520 0 -9554520 143951 -9410569 -9410569 252955 465000 194560 58395 58395 ADMIN & OTHER 611710 2170797 2140477 30320 PARKING 621990 220917 220917 2391714 870505011 670465403 790182 2612321 34792503 34792503 14625859 14625859 18354379 18069886 192721 91772 468852470 461585257 4922951 2344262 24303035 23926338 255182 121515 61750573 60793439 648381 308753 24364345 23986698 255826 121821 150492 150492 5440100 5440100 449839 449839 254173 254173 10865 10865 1961545 1852679 100431 8435 84241920 70424134 13817786 1042398 984545 53371 4482 1599151 1327296 271855 2398306 2265199 122793 10314 301269 301269 49740295 46979709 2546703 213883 8607629 8129906 440711 37012 5456822 5153968 279389 23465 6252986 5780260 472726 30716616 28759968 1956648 8558339 8083351 438187 36801 MEDICAL SUPPLIES 21228673 21228673 BAD DEBT 9968525 9968525 UBIT 39283 39283 885462390 849273635 32855375 3333380 154653167 26698299 34761745 43420896 89642573 129300371 831776 715994 3492 67323 142559 524388 705277121 406036507 285327226 299240614 109991958 522463841 518571905 44568824 48843728 2000000 2000000 127834783 120097570 1262229986 1299473046 379724470 419864607 55531267 86968712 173763420 167191769 28877728 25164839 127116750 116365669 765013635 815555596 X 270672835 260701213 69239377 60725039 157304139 162491198 497216351 483917450 1262229986 1299473046 X -14957379 -4002656 5661134 X 0 1 X 1 1 1 X 239650189 211724409 201910285 218972568 196637105 1068894556 239650189 211724409 201910285 218972568 196637105 1068894556 1068894556 14702048 30704407 243341362 13628024 11574205 313950046 11552 21923 93165 710378 839035 1676053 69374 707302 780020 328662 220917 2106275 1386626930 2478469998 0.77090 0.74220 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 0 0 0 1 254173 0 0 254173 0 PART II-B, LINE 1: THE OFFICE OF GOVERNMENT RELATIONS WAS ACTIVELY INVOLVED WITH SEVERAL FEDERAL AND STATE ISSUES. THE OFFICE ASSISTED IN DEVELOPING LEGISLATIVE ADVOCACY STRATEGIES REGARDING IMPLEMENTATION OF THE PROVISIONS OF THE MEDICARE ACCESS AND CHIP REAUTHORIZATION ACT (MACRA); CALLING FOR A DELAY AND MODIFICATIONS TO THE PLANNED RELEASE OF THE CENTER FOR MEDICARE AND MEDICAID'S (CMS) HOSPITAL COMPARE STAR RATINGS; MEDICAID REFORM PROPOSALS AND INFORMATION REGARDING THE 1115 WAIVER FOR NORTH CAROLINA'S STATE MEDICAID HEALTH PLAN; REVISION OF SECTION 603 OF THE BIPARTISAN ACT OF 2015 REGARDING SITE-NEUTRAL PAYMENTS FOR HOSPITAL OUTPATIENT DEPARTMENTS; LEGISLATION REGARDING THE NEED TO APPROPRIATELY ADJUST OUTCOME MEASURES FOR SOCIOECONOMIC FACTORS; SUPPLEMENTAL FUNDING TO RESPOND TO THE ZIKA VIRUS; CANCER CENTER MOONSHOT FUNDING; CHILDRESS INSTITUTE FOR PEDIATRIC TRAUMA ROUNDTABLE DISCUSSION BEFORE HOUSE ENERGY AND COMMERCE COMMITTEE; 21ST CENTURY CURES ACT; FUNDING FOR PRECISION MEDICINE FOR THE WAKE FOREST COMPREHENSIVE CANCER CENTER; REVISIONS TO SUNSHINE ACT LEGISLATION; TAX REFORM INCLUDING HISTORIC TAX PRESERVATION TAX CREDIT FOR WAKE FOREST INNOVATION QUARTER; BILLS TO INCREASE PHYSICIAN RESIDENCY SLOTS BY 15,000 OVER FIVE YEARS AT TEACHING HOSPITALS; HEALTH RESOURCES AND SERVICES' (HRSA) PROPOSED 340(B) DRUG PRICING PROGRAM MEGA GUIDANCE AND COMMENT LETTER; FY 2017 INPATIENT PROSPECTIVE PAYMENT SYSTEM (IPPS) RULE; TWO-MIDNIGHT/PATIENT STATUS RULE; STAFF WORKED ON THE FY2017 BUDGET; AND THE CY 2017 MEDICARE PHYSICIAN FEE SCHEDULE AND OTHER CHANGES TO MEDICARE PART B. STAFF ALSO WORKED ON MANY OF THE FY 2017 APPROPRIATIONS BILLS AND PROPOSED LEGISLATION AND REGULATIONS THAT WERE INTRODUCED, INCLUDING THE DEPARTMENT OF HEALTH AND HUMAN SERVICES REGARDING THE NATIONAL INSTITUTES OF HEALTH (NIH) BUDGET, AND VETERANS AFFAIRS (VA) RESEARCH AND MEDICAL CARE FUNDING TO EASE ACCESS FOR VETERANS SEEKING HEALTH CARE FROM NON-VA PROVIDERS; AND LEGISLATION REGARDING PATENT TROLLING AND INTELLECTUAL PROPERTY ISSUES. AT THE STATE LEVEL, EFFORTS WERE CONCENTRATED ON RESTORATION OF MEDICAID GRADUATE MEDICAL EDUCATION FUNDING; CHANGES TO THE STATE HEALTH INFORMATION EXCHANGE (HIE) PROGRAM; INSURANCE COVERAGE FOR ORAL CHEMOTHERAPY; FUNDING FOR THE WAKE FOREST ARMED FORCES INSTITUTE FOR REGENERATIVE MEDICINE (AFIRM); REPEAL OF THE CERTIFICATE OF NEED LAW; FUNDING FOR ADDITIONAL INPATIENT PSYCHIATRIC BEDS; AND PROTECTION OF THE $45 MILLION HOSPITAL SALES TAX REFUND CAP. 454412242 21183187 -1149360 19555763 454890306 434292937 31275281 7099062 18255038 454412242 401275256 10671481 36510163 14163963 434292937 384485637 6615075 27297037 17122493 401275256 392450494 7419543 2120543 17504943 384485637 0.59400 0.30560 0.10040 0 1 1 76336015 76336015 386323276 254342698 131980578 21183462 8141525 13041937 201212160 140675766 60536394 20222208 2876518 17345690 299240614 ENDOWMENT INVESTMENTS 508794332 F INV IN PARTNERSHIPS 848229 F INVESTMENT IN ANNUITIES & LIFE INS CONTRACTS 8929344 F 518571905 OTHER INVESTMENTS 7804595 INVESTMENT IN SUBS 54447567 BENEFICIAL INTEREST IN PERPETUAL TRUSTS 17894893 FUNDS HELD UNDER RETIREMENT & BENEFIT PLANS 39950515 120097570 INTERCOMPANY PAYABLE 8715696 PLI RESERVE 51416134 BOND SWAP VALUATION 6270509 OTHER LIABILITIES & DEFERRALS 9258371 ANNUITIES PAYABLE 2874979 RETIREMENT 37829980 116365669 X PART V, LINE 4: THE ORGANIZATION'S ENDOWMENT FUNDS ARE TO SUPPORT SCHOLARSHIPS, INSTRUCTION, RESEARCH, LIBRARIES, ACADEMIC SUPPORT, OPERATIONAL AND OTHER GENERAL SUPPORT. 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 1 1 1 1 0 0 0 0 0 0 0 0 1 0 1 SCHEDULE E, PART I, LINE 3 SEE PART II WFUHS' NONDISCRIMINATION POLICY IS PUBLISHED ON THE INTERNET IN ITS STUDENT HANDBOOK FOR THE SCHOOL OF MEDICINE, IN ADMISSION BROCHURES AND OTHER MEDIA MATERIALS. WWW.WAKEHEALTH.EDU/UPLOADEDFILES/USER_CONTENT/SCHOOLOFMEDICINE/ MD_PROGRAM/STUDENT_SERVICES/DOCUMENTS/WFSM_STUDENT_HANDBOOK.PDF SCHEDULE E, PART I, LINE 6 WFUHS RECEIVES FEDERAL FINANCIAL AID THROUGH THE U.S. DEPARTMENT OF EDUCATION'S FEDERAL DIRECT LOAN PROGRAM. WFUHS DISTRIBUTED THE FEDERAL LOANS TO 549 STUDENTS IN FISCAL YEAR 2016. EUROPE (INCLUDING ICELAND & GREENLAND) - ALBANIA, ANDORRA, AUSTRIA, BELGIUM 0 0 PROGRAM SERVICES SUBCONTRACT FOR RESEARCH GRANTS 251049 0 0 0 0 0 0 251049 0 251049 EUROPE (INCLUDING ICELAND & GREENLAND) - ALBANIA, ANDORRA, AUSTRIA, BELGIUM SUB-CONTRACTOR: DEVELOPMENT OF RESORBABLE CALCIUM PHOSPHATE CEMENT 143775 CHECK EUROPE (INCLUDING ICELAND & GREENLAND) - ALBANIA, ANDORRA, AUSTRIA, BELGIUM SUBCONTRACTOR: COMPOUND SYNTHESIS 5310 CHECK EUROPE (INCLUDING ICELAND & GREENLAND) - ALBANIA, ANDORRA, AUSTRIA, BELGIUM TOBACCO RESEARCH & SMOKING CESSATION 101965 CHECK 3 1 0 0 0 0 1 X X X X X X X 1 GG&A MICHIGAN AVE CHICAGO IL 60611 DONOR INFORMATION 0 0 15000 -15000 15000 -15000 AL AK AZ AR CA CO CT DE FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY DC WINTERLARK 398831 331780 67051 45389 82672 26104 PIANO EVENT 137994 133220 4774 1815 3340 14499 3 181130 181130 5019 15722 717955 465000 252955 52223 86012 56325 194560 58395 SCHEDULE G, PART I, LINE 2B, COLUMN (V) PURSUANT TO THE MEDICAL CENTER INTEGRATION AGREEMENT, MANAGEMENT OF WAKE FOREST UNIVERSITY HEALTH SCIENCES AND NORTH CAROLINA BAPTIST HOSPITAL WAS DELEGATED TO WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER. WHILE THE PROFESSIONAL FUNDRAISING PAYMENTS ARE MADE BY WAKE FOREST UNIVERSITY HEALTH SCIENCES, THE PROFESSIONAL FUNDRAISING CONTRACTS ARE BETWEEN WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER AND THE PROFESSIONAL FUNDRAISER. 1 PIEDMONT TRIAD PARTNERSHIP PO BOX 2672 HIGH POINT NC 27261 561750279 501(C)(3) 50000 SUPPORTING ECONOMIC GROWTH & DEVELOPMENT IN THE TRIAD THE HEALTH FOUNDATION 230 JEFFERSON STREET NORTH WILKESBORO NC 28659 561745194 501(C)(3) 10000 SUPPORTING HEALTH IN OUR COMMUNITIES WINSTON SALEM ALLIANCE 100 N MAIN STREET WINSTONSALEM NC 27101 311726654 501(C)(6) 40000 COMMUNITY SUPPORT CATAWBA MEDICAL FOUNDATION 810 FAIRGROVE CHURCH RD HICKORY NC 28601 581680281 501(C)(3) 31252 SUPPORT FOR CATAWBA COUNTY MEDICAL CENTER FACILITIES COUNCIL FOR ENTREPRENEURIAL DEVELOPMENT 334 BLACKWELL ST DURHAM NC 27701 561399587 501(C)(3) 15000 SUPPORTING THE CREATION AND GROWTH OF HIGH IMPACT RESEARCH ORGANIZATION EPILEPSY FOUNDATION OF NC 1920 W FIRST STREET WINSTONSALEM NC 27104 561011151 501(C)(3) 10000 SUPPORTING EPILEPSY RESEARCH FORSYTH HEALTH CARE 515 N CLEVELAND AVE WINSTONSALEM NC 27101 320097975 501(C)(3) 85000 SUPPORTING HEALTHCARE IN THE COMMUNITY GREATER WINSTON SALEM CHAMBER OF COMMERCE 411 W FOURTH STREET WINSTONSALEM NC 27101 560459820 501(C)(6) 50000 COMMUNITY SUPPORT NC PHYSICIAN HEALTH PROGRAM 220 HORIZON DRIVE SUITE 201 RALEIGH NC 27615 561846599 501(C)(3) 22500 IMPROVING THE HEALTH OF NC MEDICAL PROFESSIONALS NORTH CAROLINA INSTITUTE OF MEDICINE 630 DAVIS DRIVE MORRISVILLE NC 27560 GOVT 6000 SUPPORTING NORTH CAROLINA MEDICAL PROGRAMS SOCIETY FOR WOMENS HEALTH RESEARCH 1025 CONNECTICUT AVENUE NW WASHINGTON DC 20036 521694732 501(C)(3) 15000 SUPPORTING RESEARCH & ADVANCEMENTS IN WOMEN'S HEALTH 9 2 SCHOLARSHIPS AND FELLOWSHIPS 1096 14625859 PART I, LINE 2: WFUHS FOLLOWS THE MEDICAL CENTER'S CORPORATE POLICY USED IN REVIEWING THE ELIGIBILITY AND SELECTION OF GRANTEES RECEIVING CERTAIN EXEMPT PURPOSE FUNDS. WFUHS MAINTAINS DOCUMENTATION OF THE ELIGIBILITY AND SELECTION CRITERIA AND RECORDS OF THE AMOUNTS DISBURSED. SCHEDULE I, PART III, GRANTS AND OTHER ASSISTANCE TO DOMESTIC INDIVIDUALS THE ORGANIZATION MONITORS THE ACADEMIC PROGRESS AND OTHER ACHIEVEMENTS OF STUDENTS RECEIVING SCHOLARSHIPS AND FELLOWSHIPS. X X X X X X 1 1 0 0 0 0 0 1 0 NATHAN O HATCH PHD DIRECTOR & PRESIDENT OF WF 0 839944 0 92000 0 3009376 0 224410 0 63297 0 4229027 0 2323444 JOHN D MCCONNELL MD DIRECTOR & CEO 1003000 0 458633 0 569856 0 232214 0 20342 0 2284045 0 0 0 EDWARD ABRAHAM MD DEAN 537297 0 218350 0 388665 0 135417 0 18816 0 1298545 0 365121 0 J REID MORGAN SECRETARY & GENERAL COUNSE 0 447334 0 25000 0 37912 0 26500 0 71301 0 608047 0 0 ANITA M CONRAD ASSISTANT SECRETARY 0 163533 0 5000 0 258 0 17080 0 17314 0 203185 0 0 TERRY L HALES JR ASSISTANT TREASURER 364384 0 116222 0 1247 0 79354 0 23117 0 584324 0 0 0 LISA M WYATT VP CH COMMUNICATIONS/MARKE 207909 0 97478 0 275856 0 12190 0 8665 0 602098 0 131031 0 CHERYL E H LOCKE VP CHIEF HUMAN RESOURCES O 347411 0 114459 0 195276 0 73145 0 18783 0 749074 0 171821 0 NORMAN D POTTER JR VP DEVELOPMENT & ALUMNI AF 306946 0 94405 0 5763 0 63179 0 23875 0 494168 0 0 0 KAREN H HUEY VP FACILITIES 0 281856 0 80731 0 941 0 50391 0 18205 0 432124 0 0 ERIC TOMLINSON DSC PHD CH INNOV OFR & PRES WFIQ 398801 0 122333 0 28668 0 91321 0 12168 0 653291 0 0 0 TERRY G WILLIAMS EVP STRAT & DEV. 524352 0 185324 0 1260 0 123033 0 24800 0 858769 0 0 0 CHAD A ECKES CFO, TREAS, ASST TREAS 535569 0 142351 0 756 0 140589 0 25741 0 845006 0 0 0 KEVIN P HIGH MD EVP HS AFFAIRS 530747 0 132889 0 19932 0 93700 0 22115 0 799383 0 0 0 DEETTE M EMON VP, CIO 0 368762 0 84639 0 270 0 48221 0 8915 0 510807 0 0 ROBERT GFELLER VP CH COMMUNICATIONS/MARKE 0 298551 0 76450 0 1518 0 85096 0 20478 0 482093 0 0 BRADLEY CLARK ASST TREAS, TREAS 240955 0 39178 0 485 0 23939 0 23537 0 328094 0 0 0 NEAL KON MD DEPARTMENT CHAIR 915601 0 205711 0 23544 0 12514 0 19726 0 1177096 0 0 0 ROSS UNGERLEIDER MD CHIEF, PEDIATRIC HEART PRO 854892 0 145620 0 739128 0 10600 0 21220 0 1771460 0 680838 0 EDWARD KINCAID MD ASSOCIATE PROFESSOR 710272 0 201855 0 18270 0 10600 0 22378 0 963375 0 0 0 MALCOLM MARKS MD DEPARTMENT CHAIR 716157 0 94525 0 28668 0 10600 0 22158 0 872108 0 0 0 CHARLES BRANCH JR MD DEPARTMENT CHAIR 744425 0 278925 0 5544 0 10600 0 25520 0 1065014 0 0 0 WILLIAM B APPLEGATE MD FORMER OFFICER 210004 0 12206 0 20286 0 11572 0 20671 0 274739 0 0 0 EDWARD G CHADWICK FORMER OFFICER 0 0 0 0 143065 0 0 0 2522 0 145587 0 0 0 RUSSELL M HOWERTON MD FORMER OFFICER 506778 0 150177 0 21612 0 133371 0 24263 0 836201 0 0 0 JOANNE C RUHLAND FORMER OFFICER 249256 0 0 0 112288 0 43943 0 19881 0 425368 0 90330 0 K BARBARA CARBONE MD FORMER OFFICER 248796 0 132381 0 1040332 0 8380 0 7759 0 1437648 0 157500 0 PART I, LINE 3 THE GOVERNANCE AND COMPENSATION COMMITTEE OF THE WFUBMC BOARD OF DIRECTORS IS RESPONSIBLE FOR REVIEWING AND APPROVING ALL MEDICAL CENTER OFFICERS' COMPENSATION (INCLUDING THE COMPENSATION OF MOST OF THE OFFICERS OF THE FILING ORGANIZATION). THE COMMITTEE UTILIZES AN INDEPENDENT, EXTERNAL COMPENSATION CONSULTANT FIRM EXPERIENCED IN HEALTH CARE AND HIGHER EDUCATION COMPENSATION THAT BASED RECOMMENDATIONS ON COMPENSATION SURVEYS AND STUDIES TO DETERMINE THE APPROPRIATENESS OF EACH OFFICER'S COMPENSATION. THESE COMPENSATION CONSULTANTS PRESENT TOTAL COMPENSATION COMPARABILITY DATA FOR THE POSITIONS FOR WHICH COMPENSATION IS BEING DETERMINED. THE DATA IS REVIEWED BY THE GOVERNANCE AND COMPENSATION COMMITTEE OF WFUBMC'S GOVERNING BOARD AT ITS MEETING; NONE OF THE MEMBERS OF THAT COMMITTEE ARE EMPLOYEES OF THE FILING ORGANIZATION. MINUTES OF THE DELIBERATIONS OF THE COMMITTEE ARE CONTEMPORANEOUSLY RECORDED. IN THE EVENT THAT ANY MEMBER OF THE GOVERNANCE AND COMPENSATION COMMITTEE HAS A CONFLICT OF INTEREST, THAT COMMITTEE MEMBER DOES NOT PARTICIPATE IN THE DELIBERATION OR APPROVAL PROCESS, AND THEIR ABSTENTION FROM THE PROCESS IS REFLECTED IN THE MINUTES. PART I, LINES 4A-B CERTAIN EXECUTIVES PARTICIPATE IN OR RECEIVE SEVERANCE PAYMENTS AND PAYMENTS FROM SUPPLEMENTAL NON QUALIFIED RETIREMENT PLANS. THE DETERMINATION OF THE AMOUNT OF THE NON QUALIFIED RETIREMENT PLANS FOLLOWED THE FILING ORGANIZATION'S COMPENSATION PROCEDURES AS OUTLINED IN PART VI, SECTION B, LINE 15 OF THE FORM 990. THE FOLLOWING CURRENT AND FORMER DIRECTORS, OFFICERS AND 5 HIGHEST COMPENSATED EMPLOYEES RECEIVED SEVERANCE AND SERP PAYMENTS IN THEIR CALENDAR YEAR 2015 COMPENSATION: SEVERANCE SERP EDWARD ABRAHAM, MD 365,121 K. BARBARA CARBONE, MD 859,065 180,063 JOHN D. MCCONNELL, MD 546,312 NATHAN O. HATCH PHD 2,893,501 EDWARD CHADWICK 143,065 CHERYL LOCKE 171,821 ROSS UNGERLEIDER, MD 718,842 JOANNE RUHLAND 90,330 LISA WYATT 106,000 155,840 THE COMPENSATION OF NATHAN O. HATCH, PRESIDENT OF WAKE FOREST UNIVERSITY, A RELATED ORGANIZATION TO THE FILING ORGANIZATION, INCLUDES THE PAYOUT OF $2,893,501 (INCLUDED IN HIS 2015 W-2 INCOME) FROM HIS 10-YEAR, DEFERRED SUPPLEMENTAL EMPLOYEE RETIREMENT PLAN ("SERP") PROVIDED BY THAT RELATED ORGANIZATION THE PREVIOUS ANNUAL ACCRUALS FOR WHICH TOTAL $2,323,444 AS SHOWN IN COLUMN F OF SCHEDULE J, PART II AND HAVE BEEN REPORTED ON PRIOR YEARS' FORMS 990. THE COLUMN C OF SCHEDULE J, PART II TOTAL FOR DR. HATCH OF $224,410 INCLUDES $197,910 AS THE YEAR 2015 ACCRUAL ON HIS SERP. PART I, LINE 7 CERTAIN OFFICERS, KEY EMPLOYEES AND FACULTY MEMBERS HAVE INCENTIVE COMPENSATION COMPONENTS CONTAINED IN THEIR EMPLOYMENT AGREEMENTS. THESE ARE OFTEN GOAL-BASED AND ARE DETERMINED IN THE COURSE OF EVALUATION OF THE INDIVIDUAL'S PERFORMANCE BY HIS/HER DEPARTMENT CHAIR, SUPERVISOR OR THE COMPENSATION COMMITTEE OF THE BOARD, AS APPLICABLE. A NORTH CAROLINA MEDICAL CARE COMMISSION 521309402 65821DNX5 2012-11-15 59045000 REFUND ISSUE DATED 10/16/2008 0 0 0 B NORTH CAROLINA MEDICAL CARE COMMISSION 521309402 65821DNF4 2012-11-15 129019661 REFUND ISSUE DATED 10/16/2008 0 0 0 A 6430000 59045000 16063 59028937 1 0 1 1 B 10450000 129019661 568 129019093 1 0 1 1 A 0 1 0 0 1 0 0 1 B 0 1 0 0 0 0 0 1 A 1 B 1 PART II, LINE 11 COLUMNS A & B OTHER SPENT PROCEEDS LISTED ARE THE CURRENT REFUNDING PROCEEDS OF THE ISSUE(S). PART III, COLUMNS A & B BOTH ISSUES REFUNDED THE ISSUE DATED 10/16/2008, WHICH SOLE PURPOSE WAS THE REFUNDING OF ISSUES DATED PRIOR TO 12/31/2002. ACCORDINGLY, EACH ISSUE IS EXEMPT FROM COMPLETING PART III OF THE FORM. FRANK L BLUM CONSTRUCTION COMPANY ORG. DIRECTOR, J. ANDREWS HANCOCK IS A >35% OWNER OF INT. PERSON 1077561 TOTAL PAID BY ORGANIZATION TO INTERESTED PERSON FOR GENERAL CONTRACTOR CONSTRUCTION SERVICES PERFORMED DURING THE FISCAL YEAR. 0 X 19 24250 FAIR MARKET VALUE X 31915 FAIR MARKET VALUE X 2 53050 FAIR MARKET VALUE X 54 762993 FAIR MARKET VALUE X 3 688 FAIR MARKET VALUE X 29 3525 FAIR MARKET VALUE X EQUIPMENT 1 12500 FAIR MARKET VALUE X GIFT CARDS 63 11065 FAIR MARKET VALUE 1 0 1 1 PART I, COLUMN (B): THE ORGANIZATION DETERMINES THE NUMBER OF CONTRIBUTIONS BY USING THE TOTAL NUMBER OF NON-CASH ITEMS RECEIVED PER DONOR PER OCCURANCE. PART I, LINE 32B: THE FILING ORGANIZATION SOMETIMES USES A RELATED ORGANIZATION, WAKE FOREST UNIVERSITY DEVELOPMENT FOUNDATION, TO SELL GIFTS OF DONATED REAL PROPERTY. FORM 990, PART VI, SECTION A, LINE 2 CHAD ECKES AND TERRY WILLIAMS, BOTH OFFICERS OF THE ORGANIZATION, WERE BOARD MEMBERS OF MEDCOST BENEFIT SERVICES. FORM 990, PART VI, SECTION A, LINE 3 EFFECTIVE JULY 1, 2010, THE GOVERNING BOARDS OF FOUR NORTH CAROLINA NONPROFIT CORPORATIONS (WAKE FOREST UNIVERSITY, NORTH CAROLINA BAPTIST HOSPITAL, WAKE FOREST UNIVERSITY HEALTH SCIENCES, AND WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER) ENTERED INTO AN AGREEMENT (THE "MEDICAL CENTER INTEGRATION AGREEMENT OR "MCIA") UNDER WHICH THE OPERATION OF EACH OF NORTH CAROLINA BAPTIST HOSPITAL ("NCBH") AND WAKE FOREST UNIVERSITY HEALTH SCIENCES ("WFUHS") WAS DELEGATED TO WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER ("WFUBMC"). WFUHS IS A WHOLLY-CONTROLLED SUBSIDIARY ENTITY OF WAKE FOREST UNIVERSITY ("WFU"). WFUBMC IS A MEMBERSHIP NONPROFIT CORPORATION WHOSE TWO EQUAL MEMBERS ARE NCBH (WHICH ENTITY IS UNRELATED TO WFUHS AND WFU) AND WFU. THE GOAL IS CONSOLIDATION OF MANAGEMENT IN WFUBMC OF THE VARIOUS ACADEMIC MEDICAL CENTER OPERATIONS, SUBJECT TO SUBSTANTIAL RESERVED POWERS IN EACH OF THE CONSTITUENT MEMBERS' (OR IN WFUHS') BOARDS. THE MCIA WAS AMENDED AND RESTATED ON JULY 1, 2015. STEVEN C. BLOOM RECEIVED NO 2015 CALENDAR YEAR REPORTABLE COMPENSATION FROM WAKE FOREST UNIVERSITY HEALTH SCIENCES OR RELATED ENTITIES FOR HIS SERVICES AS THE CHIEF HUMAN RESOURCES OFFICER, SINCE IT WAS NOT UNTIL JUNE 2016 THAT MR. BLOOM WAS APPOINTED AS VICE PRESIDENT -- CHIEF HUMAN RESOURCES OFFICER OF THE FILING ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 6 WAKE FOREST UNIVERSITY IS THE SOLE MEMBER OF THE FILING ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A THE DIRECTORS OF THE FILING ORGANIZATION ARE ELECTED BY THE BOARD OF TRUSTEES OF ITS SOLE MEMBER, WAKE FOREST UNIVERSITY. FORM 990, PART VI, SECTION A, LINE 7B DECISIONS OF THE FILING ORGANIZATION'S GOVERNING BODY WHICH REQUIRE APPROVAL BY THE ORGANIZATION'S SOLE MEMBER, WAKE FOREST UNIVERSITY, INCLUDE AMENDMENTS TO CERTAIN FUNDAMENTAL DOCUMENTS (ARTICLES OF INCORPORATION AND BYLAWS); THE CONVEYANCE OR ENCUMBRANCE OF THE ORGANIZATION'S REAL ESTATE; ACADEMIC APPOINTMENT OF FACULTY, GRANT OF TENURE AND DISMISSAL; AND DISSOLUTION. FORM 990, PART VI, SECTION B, LINE 11 THE FILING ORGANIZATION'S BOARD OF DIRECTORS RECEIVES A COPY OF THE FORM 990 WITH SUFFICIENT TIME TO PERMIT REVIEW, COMMENT, AND QUESTIONS PRIOR TO ITS FILING. THE AUDIT AND COMPLIANCE COMMITTEE OF THE GOVERNING BOARD OF THE FILING ORGANIZATION REVIEWS IN ADDITIONAL DETAIL THE FILING ORGANIZATION'S FORM 990 WITH THE ORGANIZATION'S CHIEF FINANCIAL OFFICER AND/OR HIS DESIGNEE, WHO ANSWER QUESTIONS AND ADDRESS CONCERNS RAISED BY SUCH COMMITTEE MEMBERS OR BY 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 THE ORGANIZATION REQUIRES OFFICERS AND KEY EMPLOYEES TO ANNUALLY REVIEW THE CONFLICT OF INTEREST POLICY AND DETERMINE ANY POTENTIAL CONFLICTS OF INTEREST. ANY POTENTIAL CONFLICTS NOTED IN THE QUESTIONNAIRE ARE REVIEWED BY A STANDING COMMITTEE FOR APPROPRIATE RESOLUTION. ALL MEMBERS OF THE BOARD OF DIRECTORS ARE REQUIRED TO DETERMINE AND REPORT ANNUALLY, AND AS THEY ARISE, ANY POTENTIAL CONFLICTS OF INTEREST TO THE SECRETARY OF THE BOARD OF DIRECTORS. THE RESOLUTION OF POTENTIAL AND ACTUAL CONFLICTS IS SUBJECT TO THE APPROVAL OF THE CHAIR OF THE BOARD AND IS REPORTED TO THE CHAIR OF THE AUDIT & COMPLIANCE COMMITTEE OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 15 THE GOVERNANCE AND COMPENSATION COMMITTEE OF WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER ("WFUBMC") FUNCTIONS AS THE COMPENSATION COMMITTEE OF THAT ORGANIZATION'S BOARD OF DIRECTORS AND PURSUANT TO A DELEGATION BY THE FILING ORGANIZATION, REVIEWED AND APPROVED THE APPOINTMENT AND COMPENSATION OF THE SENIOR EXECUTIVES OF THE FILING ORGANIZATION. NO MEMBER OF THE WFUBMC GOVERNANCE AND COMPENSATION COMMITTEE IS AN EMPLOYEE OF THE MEDICAL CENTER OR OF THE FILING ORGANIZATION. THE GOVERNANCE AND COMPENSATION COMMITTEE RELIES UPON AN EXTERNAL, INDEPENDENT COMPENSATION CONSULTANT EXPERIENCED IN HEALTHCARE TO PROVIDE THE COMMITTEE WITH COMPENSATION COMPARABILITY DATA FOR NEW EXECUTIVE POSITION APPOINTMENTS AND FOR COMPENSATION REVIEWS FOR EXISTING EXECUTIVES AND FOR MOST OF THE FILING ORGANIZATION'S OFFICERS. THE CONSULTANT, WHICH IS RETAINED DIRECTLY BY THE GOVERNANCE AND COMPENSATION COMMITTEE, PROVIDES THIRD-PARTY INFORMATION AND EVALUATES THE COMPETITIVENESS AND REASONABLENESS OF EXECUTIVE COMPENSATION AND BENEFITS PROGRAMS IN RELATION TO MARKET PRACTICES FOR SIMILARLY-SITUATED NONPROFIT HEALTHCARE ORGANIZATIONS. THE COMMITTEE MAKES ITS DECISIONS WITH RESPECT TO EXECUTIVE COMPENSATION IN ACCORDANCE WITH THE FILING ORGANIZATION'S POLICIES, IRS REGULATIONS, AND STANDARD CORPORATE GOVERNANCE PRACTICES. SUCH POLICIES INCLUDE ADHERENCE TO: BOARD-ESTABLISHED EXECUTIVE COMPENSATION PHILOSOPHY AND REVIEW PROCESSES; PROCESSES ENSURING GOVERNANCE AND COMPENSATION COMMITTEE MEMBER AND COMPENSATION CONSULTANT INDEPENDENCE; USE OF VALID MARKET COMPARISONS OF DATA FROM PEER ACADEMIC MEDICAL CENTERS OF SIMILAR ORGANIZATIONAL STRUCTURE, SIZE, AND COMPLEXITY; CAREFUL DOCUMENTATION OF ALL COMPENSATION DECISIONS; AND ESTABLISHMENT OF THE REBUTTABLE PRESUMPTION OF REASONABLENESS, PER IRS GUIDELINES. MINUTES OF THE DELIBERATIONS OF THE GOVERNANCE AND COMPENSATION COMMITTEE ARE CONTEMPORANEOUSLY MAINTAINED AND THAT COMPARABILITY DATA IS MAINTAINED IN THE MEDICAL CENTER'S OFFICE OF EXECUTIVE COMPENSATION SERVICES. IN THE EVENT THAT A MEMBER OF THE GOVERNANCE AND COMPENSATION COMMITTEE HAS A CONFLICT OF INTEREST RELATED TO EXECUTIVE APPOINTMENT OR COMPENSATION, THAT MEMBER DOES NOT PARTICIPATE IN THE DELIBERATION OR APPROVAL OF APPOINTMENT OR COMPENSATION AND SUCH ABSTENTION IS NOTED IN THE COMMITTEE'S MEETING MINUTES. (NOTE THAT THREE OF THE FILING ORGANIZATION'S OFFICERS ARE COMPENSATED BY A RELATED ORGANIZATION (WAKE FOREST UNIVERSITY) OF THE FILING ORGANIZATION, AND THEIR COMPENSATION IS REVIEWED AND APPROVED IN ACCORDANCE WITH THE ORGANIZATION'S SIMILAR PROCEDURES.) 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. PART VII, SECTION A, COLUMN B - HOURS DONALD E FLOW FILING ORG 4.0 RELATED ORG 10.0 DONNA A BOSWELL PHD FILING ORG 2.0 RELATED ORG 16.0 JAMES R HELVEY III FILING ORG 2.0 RELATED ORG 11.5 JAMES J MARINO FILING ORG 2.0 RELATED ORG 4.0 JAMES T WILLIAMS, JR FILING ORG 2.0 RELATED ORG 1.0 GERALD F. ROACH FILING ORG 2.0 RELATED ORG 6.0 BOBBY R. BURCHFIELD FILING ORG 2.0 RELATED ORG 6.0 RICHARD A. BRENNER FILING ORG 2.0 KATHLEEN B. FRENCH, MD FILING ORG 2.0 RELATED ORG 3.0 MATTHEW A. KING FILING ORG 2.0 RELATED ORG 5.0 NATHAN O HATCH PHD FILING ORG 2.6 RELATED ORG 37.4 JOHN D MCCONNELL MD FILING ORG 8.2 RELATED ORG 11.5 UNRELATED ORG 20.3 ANN S. HANES FILING ORG 2.0 ANDREW J SCHINDLER FILING ORG 3.0 RELATED ORG 9.5 DAVID W. DUPREE FILING ORG 2.0 RELATED ORG 5.0 JOHN M. VANN FILING ORG 2.0 RELATED ORG 4.0 GRAHAM F. BENNETT FILING ORG 2.0 J. ANDREWS HANCOCK FILING ORG 2.0 EDWARD ABRAHAM MD FILING ORG 29.9 RELATED ORG 10.1 J REID MORGAN FILING ORG 4.0 RELATED ORG 36.0 ANITA M CONRAD FILING ORG 10.0 RELATED ORG 30.0 TERRY L HALES JR FILING ORG 6.6 RELATED ORG 14.4 UNRELATED ORG 19.0 LISA M WYATT FILING ORG 15.0 RELATED ORG 5.0 UNRELATED ORG 20.0 CHERYL E. H. LOCKE FILING ORG 2.5 RELATED ORG 5.0 UNRELATED ORG 32.5 NORMAN D POTTER, JR FILING ORG 15.0 RELATED ORG 5.0 UNRELATED ORG 20.0 KAREN H HUEY FILING ORG 11.0 RELATED ORG 5.0 UNRELATED ORG 24.0 ERIC TOMLINSON DSC PHD FILING ORG 5.0 RELATED ORG 35.0 TERRY G. WILLIAMS FILING ORG 1.3 RELATED ORG 6.0 UNRELATED ORG 32.7 CHAD A. ECKES FILING ORG 5.6 RELATED ORG 5.5 UNRELATED ORG 28.9 KEVIN P. HIGH, MD FILING ORG 1.5 RELATED ORG 10.5 UNRELATED ORG 28.0 DEETTE M. EMON FILING ORG 5.0 RELATED ORG 5.0 UNRELATED ORG 30.0 STEVEN BLOOM FILING ORG 15.0 RELATED ORG 5.0 UNRELATED ORG 20.0 ROBERT GFELLER FILING ORG 5.0 RELATED ORG 15.0 UNRELATED ORG 20.0 BRADLEY A CLARK FILING ORG 6.7 RELATED ORG 6.1 UNRELATED ORG 27.2 NEAL KON MD FILING ORG 40.0 ROSS UNGERLEIDER FILING ORG 40.0 EDWARD KINCAID MD FILING ORG 40.0 MALCOLM MARKS MD FILING ORG 40.0 CHARLES BRANCH JR MD FILING ORG 40.0 WILLIAM B APPLEGATE MD FILING ORG 40.0 RUSSELL M HOWERTON MD FILING ORG 14.7 UNRELATED ORG 25.3 JOANNE C RUHLAND FILING ORG 15.0 UNRELATED ORG 25.0 NORTH CAROLINA BAPTIST HOSPITAL IS AN UNRELATED ORGANIZATION TO THE FILING ORGANIZATION AND THE INFORMATION CONCERNING HOURS DEVOTED TO IT ARE NOT REQUIRED TO BE REPORTED, BUT ARE INCLUDED BECAUSE OF THE STRUCTURE OF WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER, OF WHICH THE FILING ORGANIZATION AND NORTH CAROLINA BAPTIST HOSPITAL ARE PRINCIPAL PARTS. IN GENERAL, THE CORPORATE OFFICERS OF THE MEDICAL CENTER ALSO SERVE AS THE CORPORATE OFFICERS OF NORTH CAROLINA BAPTIST HOSPITAL AND WAKE FOREST UNIVERSITY HEALTH SCIENCES. FORM 990, PART XI, LINE 9: EQUITY METHOD AFFILIATES 3,118,979. ACTUARIAL GAIN 2,542,155. 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