THE REX HEALTHCARE FOUNDATION INC: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- THE REX HEALTHCARE FOUNDATION INC (EIN 56-6052117)
- Tax period
- 2015-07-01 to 2016-06-30
- Filed
- 2017-05-15
- IRS object ID
- 201721359349307312
- Schema version
- 2015v3.0
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule G
- Schedule I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-05-15T13:34:42-05:00 | ReturnTs |
| Tax Period End | 2016-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 410746749 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLIFTONLARSONALLEN LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 227 WEST TRADE STREET SUITE 800 | AddressLine1Txt |
| City | CHARLOTTE | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 28202 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 566052117 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE REX HEALTHCARE FOUNDATION INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | REXH | BusinessNameControlTxt |
| Phone | 9197844424 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4420 LAKE BOONE TRAIL | AddressLine1Txt |
| City | RALEIGH | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 27607 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ANDREW ZUKOWSKI | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 9197844424 | PhoneNum |
| Signature | 2017-05-10 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | JOHN NORMAN | PreparerPersonNm |
| PTIN | P01506766 | PTIN |
| Phone | 7049985200 | PhoneNum |
| Preparation | 2017-05-10 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | REX HOSPITAL FOUNDATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | STEPHEN BURRISS | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4420 LAKE BOONE TRAIL | AddressLine1Txt |
| City | RALEIGH | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 27607 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $9,135,555 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.REXHEALTHCAREFOUNDATION.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1958 | FormationYr |
| Legal Domicile State | NC | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE OPPORTUNITIES FOR OUR COMMUNITY TO INVEST RESOURCES IN THE EXCELLENT WORK OF UNC REX HEALTHCARE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 13 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 8 | TotalEmployeeCnt |
| Total Volunteers | 9 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $2,790,934 | PYContributionsGrantsAmt |
| CY Contributions Grants | $4,077,373 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $0 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $0 | CYProgramServiceRevenueAmt |
| PY Investment Income | $453,616 | PYInvestmentIncomeAmt |
| CY Investment Income | $333,578 | CYInvestmentIncomeAmt |
| PY Other Revenue | -$243,377 | PYOtherRevenueAmt |
| CY Other Revenue | -$266,498 | CYOtherRevenueAmt |
| PY Total Revenue | $3,001,173 | PYTotalRevenueAmt |
| CY Total Revenue | $4,144,453 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $4,671,891 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $1,806,619 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $729,053 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $686,255 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $197,342 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $198,849 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $1,144,448 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $283,471 | PYOtherExpensesAmt |
| CY Other Expenses | $315,006 | CYOtherExpensesAmt |
| PY Total Expenses | $5,881,757 | PYTotalExpensesAmt |
| CY Total Expenses | $3,006,729 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$2,880,584 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $1,137,724 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $4,480,204 | TotalAssetsBOYAmt |
| Total Assets EOY | $5,173,598 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $80,511 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $99,259 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $4,399,693 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $5,074,339 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO PROVIDE OPPORTUNITIES FOR OUR COMMUNITY TO INVEST RESOURCES IN THE EXCELLENT WORK OF UNC REX HEALTHCARE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $1,806,619 | ExpenseAmt |
| Grant | $1,806,619 | GrantAmt |
| Desc | THE REX HEALTHCARE FOUNDATION SUPPORTS UNC REX HOSPITAL THROUGH A VARIETY OF PATIENT ASSISTANCE PROGRAMS, ASSISTS IN UPGRADING FACILITIES AND ACQUIRING THE MEDICAL EQUIPMENT NECESSARY TO CONTINUE EXCELLENT HEALTHCARE SERVICES. THESE PROGRAMS INCLUDE A MOBILE MAMMOGRAPHY UNIT THAT TRAVELS THE REGION PROVIDING FREE MAMMOGRAPHY SCREENING SERVICES TO UNDERSERVED PATIENTS, PATIENT ASSISTANCE THROUGH THE REX CANCER CENTER ANGEL FUND, NURSING EDUCATION, BLANKET WARMERS, PATIENT TRANSPORTATION TO TREATMENT AND MORE. | Desc |
| Total Program Service Expenses | $1,806,619 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (1) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | Yes (1) | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | Yes (1) | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (1) | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 4 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 8 | EmployeeCnt |
| Employment Tax Returns Filed | 0 | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 13 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 9 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | REX CORPORATE ACCOUNTING | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 9197843100 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4420 LAKE BOONE TRAIL | AddressLine1Txt |
| City | RALEIGH | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 27607 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (21 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|
| CATHARINE B ARROWOOD | |||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| TERESA C ARTIS | |||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| ANN S COLLINS MD | |||||||||
| DIRECTOR (AS OF 5/1/16) | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| COURTNEY A CROWDER | |||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| PETER D HANS | |||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| VINCENT D HOELLERICH MD | |||||||||
| DIRECTOR (LEFT 12/31/15) | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| STEVEN C LILLY | |||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| C HOWARD NYE | |||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| GARY L PARK | |||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $935,313 | $515,089 | |||
| BOBBY T PARKER | |||||||||
| DIRECTOR (AS OF 5/1/16) | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| RIG S PATEL MD | |||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $63,450 | $0 | |||
| WILLIAM L ROPER MD | |||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $944,620 | $334,530 | |||
| ROBERT S THOMAS | |||||||||
| DIRECTOR/CHAIRMAN | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| STEPHEN W BURRISS | |||||||||
| DIRECTOR/PRESIDENT | 1.00 | 59.00 | Yes (X) | $0 | $530,972 | $120,830 | Yes (X) | ||
| SYLVIA D HACKETT | |||||||||
| VICE PRESIDENT | 1.00 | 59.00 | $0 | $338,014 | $39,814 | Yes (X) | |||
| DONALD R ESPOSITO JR | |||||||||
| SECRETARY (AS OF 1/1/16) | 1.00 | 59.00 | $0 | $358,292 | $29,538 | Yes (X) | |||
| BERNADETTE M SPONG | |||||||||
| SECRETARY & TREASURER (LEFT 7/31/15) | 1.00 | 59.00 | $0 | $298,377 | $45,485 | Yes (X) | |||
| JOHN E MILLER | |||||||||
| ASST SEC/ASST TREAS (LEFT 3/25/16) | 1.00 | 59.00 | $0 | $255,878 | $49,114 | Yes (X) | |||
| AMY DANIELS | |||||||||
| DIRECTOR MAJOR GIFTS | 40.00 | 0.00 | $0 | $151,794 | $12,724 | Yes (X) | |||
| KATHERINE STOKES | |||||||||
| MAJOR GIFT OFFICER | 40.00 | 0.00 | $0 | $132,747 | $14,986 | Yes (X) | |||
| DAVID W STRONG | |||||||||
| FORMER PRESIDENT (LEFT 3/31/15) | 1.00 | 59.00 | $0 | $1,226,662 | $16,758 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $5,236,119 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $1,178,868 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (3 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| CAPITAL DEVELOPMENT SERVICES INC | |||||
| 633 W 4TH ST ST 202 | WINSTON SALEM | NC | 27101 | CONSULTING | $201,047 |
| TCG EVENTS INC | |||||
| 2923 S TRYON ST SUITE 230 | CHARLOTTE | NC | 28203 | EVENT PLANNING | $126,765 |
| GLOBAL GOLF MANAGEMENT | |||||
| 4741 N ARTESIAN AVE 1 | CHICAGO | IL | 60625 | EVENT PLANNING | $108,808 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 3 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $855,822 | FundraisingAmt |
| Related Organizations | $755,662 | RelatedOrganizationsAmt |
| All Other Contributions | $2,465,889 | AllOtherContributionsAmt |
| Total Contributions | $4,077,373 | TotalContributionsAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $66,878 | TotalRevenueColumnAmt |
| Exclusion | $66,878 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $4,753,977 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $4,487,277 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $266,700 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $266,700 | TotalRevenueColumnAmt |
| Exclusion | $266,700 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $237,327 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $855,822 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $503,825 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$266,498 | TotalRevenueColumnAmt |
| Exclusion | -$266,498 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,144,453 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $67,080 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,806,619 | TotalAmt |
| Program Services | $1,806,619 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $569,963 | TotalAmt |
| Fundraising | $569,963 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,369 | TotalAmt |
| Fundraising | $15,369 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $65,870 | TotalAmt |
| Fundraising | $65,870 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $35,053 | TotalAmt |
| Fundraising | $35,053 | FundraisingAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $198,849 | TotalAmt |
| Fundraising | $198,849 | FundraisingAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $28,126 | TotalAmt |
| Management And General | $28,126 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $155,626 | TotalAmt |
| Management And General | $15,563 | ManagementAndGeneralAmt |
| Fundraising | $140,063 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,563 | TotalAmt |
| Management And General | $1,756 | ManagementAndGeneralAmt |
| Fundraising | $15,807 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $43,676 | TotalAmt |
| Management And General | $4,368 | ManagementAndGeneralAmt |
| Fundraising | $39,308 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $51,194 | TotalAmt |
| Management And General | $5,119 | ManagementAndGeneralAmt |
| Fundraising | $46,075 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,163 | TotalAmt |
| Management And General | $316 | ManagementAndGeneralAmt |
| Fundraising | $2,847 | FundraisingAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $396 | TotalAmt |
| Management And General | $40 | ManagementAndGeneralAmt |
| Fundraising | $356 | FundraisingAmt |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,262 | TotalAmt |
| Management And General | $374 | ManagementAndGeneralAmt |
| Fundraising | $14,888 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,006,729 | TotalAmt |
| Program Services | $1,806,619 | ProgramServicesAmt |
| Management And General | $55,662 | ManagementAndGeneralAmt |
| Fundraising | $1,144,448 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $484,498 | BOYAmt |
| EOY | $987,657 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $86,070 | BOYAmt |
| EOY | $1,355,526 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,988 | BOYAmt |
| EOY | $30,194 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $15,226 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $15,226 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $396 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,886,252 | BOYAmt |
| EOY | $2,800,221 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,480,204 | BOYAmt |
| EOY | $5,173,598 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $80,511 | BOYAmt |
| EOY | $99,259 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $80,511 | BOYAmt |
| EOY | $99,259 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,399,693 | BOYAmt |
| EOY | $5,074,339 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,399,693 | BOYAmt |
| EOY | $5,074,339 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,480,204 | BOYAmt |
| EOY | $5,173,598 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $1,137,724 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$463,078 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | Yes (X) | SupportingOrganization509a3Ind |
| Supporting Org Type2 | Yes (X) | SupportingOrgType2Ind |
| Supported Organizations | 1 | SupportedOrganizationsCnt |
Supported Org Information SupportedOrgInformationGrp
Supported Organization Name SupportedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | REX HOSPITAL INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 561509260 | EIN |
| Organization Type | 3 | OrganizationTypeCd |
| Governing Document Listed | 0 | GoverningDocumentListedInd |
| Support | $1,806,619 | SupportAmt |
| Other Support | $0 | OtherSupportAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supported Organizations Total | 1 | SupportedOrganizationsTotalCnt |
| Support Sum | $1,806,619 | SupportSumAmt |
| Other Support Sum | $0 | OtherSupportSumAmt |
Form990 Sch A Supporting Org Form990SchASupportingOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Listed By Name Governing Doc | 0 | ListedByNameGoverningDocInd |
| Suprt Org No IRS Determination | 0 | SuprtOrgNoIRSDeterminationInd |
| Supported Org Section C456 | 0 | SupportedOrgSectionC456Ind |
| Supported Org Not Organized US | 0 | SupportedOrgNotOrganizedUSInd |
| Organization Change Suprt Org | 0 | OrganizationChangeSuprtOrgInd |
| Support Non Supported Org | 0 | SupportNonSupportedOrgInd |
| Payment Substantial Contribtr | 0 | PaymentSubstantialContribtrInd |
| Loan Disqualified Person | 0 | LoanDisqualifiedPersonInd |
| Controlled Disqualified Prsn | 0 | ControlledDisqualifiedPrsnInd |
| Disqualified Prsn Controll Int | 0 | DisqualifiedPrsnControllIntInd |
| Disqualified Prsn Ownr Int | 0 | DisqualifiedPrsnOwnrIntInd |
| Excess Business Holdings Rules | 0 | ExcessBusinessHoldingsRulesInd |
| Contribution Controller | 0 | ContributionControllerInd |
| Contribution Family | 0 | ContributionFamilyInd |
| Contribution35 Controlled | 0 | Contribution35ControlledInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Majority Dir Trst Supported Org | Yes (1) | MajorityDirTrstSupportedOrgInd |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART IV, LINE 1 | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION AND THE SUPPORTED ORGANIZATION, REX HOSPITAL, INC., HAVE A HISTORIC RELATIONSHIP THAT HAS BEEN ONGOING FROM THE FORMATION OF REX HEALTHCARE FOUNDATION. REX HOSPITAL, INC. IS THE ONLY SUPPORTED ORGANIZATION OF REX HEALTHCARE FOUNDATION. ALL OF THE FINANCIAL SUPPORT PROVIDED BY THE ORGANIZATION GOES TO REX HOSPITAL, INC. | ExplanationTxt |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $403,891 | BeginningYearBalanceAmt |
| End Year Balance | $403,891 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $403,891 | BeginningYearBalanceAmt |
| End Year Balance | $403,891 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $377,441 | BeginningYearBalanceAmt |
| Contributions | $26,450 | ContributionsAmt |
| End Year Balance | $403,891 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $323,378 | BeginningYearBalanceAmt |
| Contributions | $54,063 | ContributionsAmt |
| End Year Balance | $377,441 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $332,040 | BeginningYearBalanceAmt |
| Contributions | $16,338 | ContributionsAmt |
| Other Expenditures | $25,000 | OtherExpendituresAmt |
| End Year Balance | $323,378 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prmnnt Endowment Balance EOY | 1.00000 | PrmnntEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $15,226 | OtherCostOrOtherBasisAmt |
| Depreciation | $15,226 | DepreciationAmt |
| Book Value | $0 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $0 | TotalBookValueLandBuildingsAmt |
Invst Program Related Org InvstProgramRelatedOrgGrp (2 entries)
| DescDesc | Book ValueBookValueAmt | Method ValuationMethodValuationCd |
|---|---|---|
| CASH AND CASH EQUIVALENTS | $165,176 | F |
| EQUITIES | $2,635,045 | F |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Program Rltd | $2,800,221 | TotalBookValueProgramRltdAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, LINE 4: | THE INTENDED USE OF THE ENDOWMENT FUNDS IS TO FURTHER THE MISSION OF REX HEALTHCARE FOUNDATION. |
| PART X, LINE 2: | THE FOLLOWING FOOTNOTE COMES FROM THE CONSOLIDATED FINANCIAL STATEMENTS OF REX HEALTHCARE, INC. AND SUBSIDIARIES, INCLUDING REX HEALTHCARE FOUNDATION, INC. THE FOOTNOTE REFERENCES OTHER MEMBERS OF THE AUDIT CONSOLIDATED GROUP THAT ARE NOT PART OF THIS TAX RETURN. REX, THE HOSPITAL, AND THE FOUNDATION ARE EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501(A) AS ORGANIZATIONS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. ENTERPRISES IS A TAXABLE CORPORATION THAT PREVIOUSLY HAD NET OPERATING LOSS CARRYFORWARDS WHICH EXPIRED IN 2012. THE HOSPITAL IS THE SOLE MEMBER OF RHV GP, RHVI, ROV, AND RSCW, AND ENTERPRISES IS THE SOLE MEMBER OF RWE. RWE IS THE SOLE MEMBER OF WELLNESS, MOB AND RHVLLC. AS SUCH THESE ENTITIES ARE CONSIDERED DISREGARDED ENTITIES FOR TAX PURPOSES. |
Schedule G IRS990ScheduleG
| Field | Value | IRS element (for citing) |
|---|---|---|
| Mail Solicitations | Yes (X) | MailSolicitationsInd |
| Email Solicitations | Yes (X) | EmailSolicitationsInd |
| Phone Solicitations | Yes (X) | PhoneSolicitationsInd |
| In Person Solicitations | Yes (X) | InPersonSolicitationsInd |
| Solicitation Of Non Govt Grants | Yes (X) | SolicitationOfNonGovtGrantsInd |
| Special Fundraising Events | Yes (X) | SpecialFundraisingEventsInd |
| Agrmt Prof Fundraising Acty | Yes (1) | AgrmtProfFundraisingActyInd |
Fundraiser Activity Info FundraiserActivityInfoGrp
Organization Business Name OrganizationBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CAPITAL DEVELOPMENT SVCS INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 633 W 4TH STREET SUITE 202 | AddressLine1Txt |
| City | WINSTON SALEM | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 27101 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activity | CONSULTING | ActivityTxt |
| Fundraiser Control Of Funds | 0 | FundraiserControlOfFundsInd |
| Gross Receipts | $0 | GrossReceiptsAmt |
| Retained By Contractor | $201,047 | RetainedByContractorAmt |
| Net To Organization | -$201,047 | NetToOrganizationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Retained By Contractors | $201,047 | TotalRetainedByContractorsAmt |
| Total Net To Organization | -$201,047 | TotalNetToOrganizationAmt |
| Licensed States | NC | LicensedStatesCd |
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | REX HOSPITAL OPEN | Event1Nm |
| Gross Receipts Event1 | $579,229 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $420,550 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $158,679 | GrossRevenueEvent1Amt |
| Non Cash Prizes Event1 | $13,867 | NonCashPrizesEvent1Amt |
| Food And Beverage Event1 | $4,474 | FoodAndBeverageEvent1Amt |
| Other Direct Expenses Event1 | $178,374 | OtherDirectExpensesEvent1Amt |
| Event2 | REX GALA | Event2Nm |
| Gross Receipts Event2 | $282,715 | GrossReceiptsEvent2Amt |
| Charitable Contri Event2 | $251,820 | CharitableContriEvent2Amt |
| Gross Revenue Event2 | $30,895 | GrossRevenueEvent2Amt |
| Rent Facility Costs Event2 | $7,425 | RentFacilityCostsEvent2Amt |
| Food And Beverage Event2 | $77,973 | FoodAndBeverageEvent2Amt |
| Entertainment Event2 | $2,660 | EntertainmentEvent2Amt |
| Other Direct Expenses Event2 | $157,491 | OtherDirectExpensesEvent2Amt |
| Other Events Total | 1 | OtherEventsTotalCnt |
| Gross Receipts Other Events | $231,205 | GrossReceiptsOtherEventsAmt |
| Charitable Contri Other Events | $183,452 | CharitableContriOtherEventsAmt |
| Gross Revenue Other Events | $47,753 | GrossRevenueOtherEventsAmt |
| Non Cash Prizes Other Events | $2,533 | NonCashPrizesOtherEventsAmt |
| Rent Fclty Costs Other Events | $30,145 | RentFcltyCostsOtherEventsAmt |
| Food And Beverage Other Events | $465 | FoodAndBeverageOtherEventsAmt |
| Oth Direct Expnss Other Events | $28,418 | OthDirectExpnssOtherEventsAmt |
| Gross Receipts Total | $1,093,149 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $855,822 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $237,327 | GrossRevenueTotalEventsAmt |
| Non Cash Prizes Total Events | $16,400 | NonCashPrizesTotalEventsAmt |
| Rent Fclty Costs Total Events | $37,570 | RentFcltyCostsTotalEventsAmt |
| Food And Beverage Total Events | $82,912 | FoodAndBeverageTotalEventsAmt |
| Entertainment Total Events | $2,660 | EntertainmentTotalEventsAmt |
| Oth Direct Expnss Total Events | $364,283 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $503,825 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | -$266,498 | NetIncomeSummaryAmt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | 0 | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | REX HOSPITAL INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4420 LAKE BOONE TRAIL | AddressLine1Txt |
| City | RALEIGH | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 27607 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 561509260 | RecipientEIN |
| IRC Section | 501(C)(3) | IRCSectionDesc |
| Cash Grant | $1,806,619 | CashGrantAmt |
| Purpose Of Grant | GENERAL SUPPORT | PurposeOfGrantTxt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 1 | FormAndLineReferenceDesc |
| Explanation | REX HEALTHCARE FOUNDATION'S SOLE RECIPIENT OF ASSISTANCE IS REX HOSPITAL, INC. THE TWO ORGANIZATIONS WORK CLOSELY TOGETHER, ALLOWING FOR REAL-TIME AND CONSISTENT MONITORING OF GRANTS. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | Yes (1) | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| GARY L PARK | ||||||||||||||
| DIRECTOR | $0 | $768,891 | $0 | $142,263 | $0 | $24,159 | $0 | $496,220 | $0 | $18,869 | $0 | $1,450,402 | $0 | $0 |
| WILLIAM L ROPER MD | ||||||||||||||
| DIRECTOR | $0 | $772,345 | $0 | $140,416 | $0 | $31,859 | $0 | $315,353 | $0 | $19,177 | $0 | $1,279,150 | $0 | $0 |
| STEPHEN W BURRISS | ||||||||||||||
| DIRECTOR/PRESIDENT | $0 | $387,941 | $0 | $101,197 | $0 | $41,834 | $0 | $105,286 | $0 | $15,544 | $0 | $651,802 | $0 | $0 |
| SYLVIA D HACKETT | ||||||||||||||
| VICE PRESIDENT | $0 | $228,607 | $0 | $73,234 | $0 | $36,173 | $0 | $30,697 | $0 | $9,117 | $0 | $377,828 | $0 | $0 |
| DONALD R ESPOSITO JR | ||||||||||||||
| SECRETARY (AS OF 1/1/16) | $0 | $358,292 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $358,292 | $0 | $0 |
| BERNADETTE M SPONG | ||||||||||||||
| SECRETARY & TREASURER (LEFT 7/31/15) | $0 | $239,842 | $0 | $0 | $0 | $58,535 | $0 | $39,295 | $0 | $6,190 | $0 | $343,862 | $0 | $0 |
| JOHN E MILLER | ||||||||||||||
| ASST SEC/ASST TREAS (LEFT 3/25/16) | $0 | $209,357 | $0 | $19,394 | $0 | $27,127 | $0 | $43,721 | $0 | $5,393 | $0 | $304,992 | $0 | $0 |
| AMY DANIELS | ||||||||||||||
| DIRECTOR MAJOR GIFTS | $0 | $134,689 | $0 | $13,419 | $0 | $3,686 | $0 | $4,784 | $0 | $7,940 | $0 | $164,518 | $0 | $0 |
| DAVID W STRONG | ||||||||||||||
| FORMER PRESIDENT (LEFT 3/31/15) | $0 | $153,361 | $0 | $0 | $0 | $1,073,301 | $0 | $13,919 | $0 | $2,839 | $0 | $1,243,420 | $0 | $246,929 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 4B | DURING THE CALENDAR YEAR 2015, DAVID STRONG, FORMER PRESIDENT, RECEIVED DISTRIBUTIONS FROM A NON-QUALIFIED SUPPLEMENTAL RETIREMENT PLAN TOTALING $246,929, FROM A RELATED ORGANIZATION. DURING THE CALENDAR YEAR 2015, STEVE BURRISS PARTICIPATED IN A NON-QUALIFIED SUPPLEMENTAL RETIREMENT PLAN FUNDED AND CONTROLLED BY A RELATED ORGANIZATION, UNC HEALTH CARE SYSTEM. HE EARNED COMPENSATION UNDER THIS PLAN TOTALING $47,346. THE CURRENT YEAR EARNINGS ARE PAYABLE IN THE FUTURE. DURING THE CALENDAR YEAR 2015, GARY PARK PARTICIPATED IN A NON-QUALIFIED SUPPLEMENTAL RETIREMENT PLAN FUNDED AND CONTROLLED BY A RELATED ORGANIZATION, UNC HEALTH CARE SYSTEM. HE EARNED COMPENSATION UNDER THIS PLAN TOTALING $350,913. THE CURRENT YEAR EARNINGS ARE PAYABLE IN THE FUTURE. DURING THE CALENDAR YEAR 2015, WILLIAM ROPER PARTICIPATED IN A NON-QUALIFIED SUPPLEMENTAL RETIREMENT PLAN FUNDED AND CONTROLLED BY A RELATED ORGANIZATION, UNC HEALTH CARE SYSTEM. HE EARNED COMPENSATION UNDER THIS PLAN TOTALING $191,592. THE CURRENT YEAR EARNINGS ARE PAYABLE IN THE FUTURE. |
| PART I, LINE 6 | EMPLOYEES IN MANAGERIAL ROLES PARTICIPATE IN AN ANNUAL INCENTIVE COMPENSATION PLAN. THE COMPENSATION EARNED UNDER THIS PLAN IS BASED PARTLY ON THE COMBINED EARNINGS OF REX HEALTHCARE, INC. AND ITS SUBSIDIARIES. ADDITIONALLY, THE INCENTIVE COMPENSATION OF THE PRESIDENT AND CFO IS BASED PARTLY ON THE EARNINGS OF THE UNC HEALTH CARE SYSTEM. OTHER PERFORMANCE MEASURES USED TO DETERMINE INCENTIVE COMPENSATION ARE PHYSICIAN SATISFACTION, PATIENT CARE QUALITY OUTCOMES, EFFECTIVE USE OF TECHNOLOGY AND INDIVIDUAL GOALS. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 7A | THE UNIVERSITY OF NORTH CAROLINA HEALTH CARE SYSTEM APPOINTS ALL DIRECTORS ON THE ORGANIZATION'S BOARD OF TRUSTEES, WHICH SHALL NOT BE LESS THAN 9 NOR MORE THAN 13. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE ORGANIZATION'S BOARD REQUIRES PRIOR APPROVAL OF THE UNIVERSITY OF NORTH CAROLINA HEALTH CARE SYSTEM FOR CERTAIN POWERS, INCLUDING BUT NOT LIMITED TO ADDITION OR DELETION OF A HEALTH CARE SERVICE, PARTICIPATION, DIRECTLY OR INDIRECTLY, IN A JOINT VENTURE, INDEBTEDNESS AND CAPITAL BUDGETS, OPERATING BUDGETS AND NON-BUDGETED MATERIAL EXPENDITURES. |
| FORM 990, PART VI, SECTION B, LINE 11 | THE ORGANIZATION'S EXECUTIVE TEAM DISCUSSES AND REVIEWS THE FORM 990 AND ALL ASSOCIATED SCHEDULES THROUGHOUT THE INFORMATION GATHERING STAGE. THE FORM 990 AND ASSOCIATED SCHEDULES ARE THEN REVIEWED AND APPROVED BY THE BOARD AS A WHOLE. A COPY OF THE APPROVED FORM 990 ALONG WITH THE ASSOCIATED SCHEDULES IS PROVIDED TO ALL BOARD MEMBERS PRIOR TO FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE ORGANIZATION REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY BY REQUIRING ALL BOARD MEMBERS TO ANNUALLY COMPLETE AND SIGN A QUESTIONNAIRE DOCUMENTING ANY AREA OF CONFLICT OF INTEREST. THE BOARD MEMBERS ARE REQUIRED TO REPORT AND DOCUMENT ANY NEW AREAS OF CONFLICT OF INTEREST AS THEY ARISE. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE ORGANIZATION USES AN INDEPENDENT CONSULTANT TO MEASURE FAIR VALUE OF COMPENSATION FOR THE ORGANIZATION'S PRESIDENT AND OTHER TOP MANAGEMENT. BOTH REX AND UNIVERSITY OF NORTH CAROLINA HEALTH CARE SYSTEM BOARDS REVIEW AND APPROVE THE COMPENSATION FOR ALL OFFICERS EXCEPT THE ASSISTANT SECRETARY AND ASSISTANT TREASURER. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION'S FORM 990 IS AVAILABLE UPON REQUEST AND ON GUIDESTAR'S WEBSITE AND THE FINANCIAL STATEMENTS ARE AVAILABLE ON MUNICIPAL SECURITIES RULEMAKING BOARD'S WEBSITE. THE ORGANIZATION DOES NOT MAKE OTHER GOVERNING DOCUMENTS AND THE CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC. |
| PART XII, LINE 2C | THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (11 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Public Charity StatusPublicCharityStatusTxt |
|---|---|---|---|---|---|---|---|---|---|---|
| UNC HEALTH CARE SYSTEM | ||||||||||
| 101 MANNING DRIVE | CHAPEL HILL | NC | 27514 | 562206970 | HEALTHCARE | NC | SECTION 115 | UNC HEALTH CARE | 0 | |
| UNC HOSPTIALS AT CHAPEL HILL | ||||||||||
| 211 FRIDAY CENTER DR SUITE 2029 | CHAPEL HILL | NC | 27517 | 561118388 | HEALTHCARE | NC | SECTION 115 | UNC HEALTH CARE | 0 | |
| CALDWELL MEMORIAL HOSPITAL | ||||||||||
| PO BOX 1890 | LENIOR | NC | 28645 | 560554204 | HEALTHCARE | NC | 501(C)(3) | UNC HEALTH CARE | 0 | LINE 3 |
| CALDWELL MEMORIAL HOSPITAL FOUNDATION | ||||||||||
| PO BOX 1890 | LENIOR | NC | 28645 | 581935514 | SUPPORT OF CALDWELL | NC | 501(C)(3) | CALDWELL MEMORIAL HOSPITAL | 0 | LINE 7 |
| CHATHAM HOSPITAL INC | ||||||||||
| PO BOX 649 | SILER CITY | NC | 27344 | 560611546 | HEALTHCARE | NC | 501(C)(3) | UNC HEALTH CARE | 0 | LINE 3 |
| HIGH POINT REGIONAL HEALTH | ||||||||||
| 601 N ELM STREET | HIGH POINT | NC | 27261 | 560632309 | HEALTHCARE | NC | 501(C)(3) | UNC HEALTH CARE | 0 | LINE 3 |
| HIGH POINT REGIONAL HEALTH SERVICES | ||||||||||
| 601 N ELM STREET | HIGH POINT | NC | 27261 | 561497163 | HEALTHCARE | NC | 501(C)(3) | UNC HEALTH CARE | 0 | LINE 11B, II |
| HIGH POINT REGIONAL HEALTH SERVICES FOUNDATION | ||||||||||
| 601 N ELM STREET | HIGH POINT | NC | 27261 | 272854711 | SUPPORT OF HIGH POINT | NC | 501(C)(3) | HIGH POINT REGIONAL HEALTH | 0 | LINE 11A, I |
| REX HEALTHCARE INC | ||||||||||
| 4420 LAKE BOONE TRAIL | RALEIGH | NC | 27607 | 561509129 | HEALTHCARE | NC | 501(C)(3) | UNC HEALTH CARE | 0 | LINE 11A, I |
| REX HOSPITAL INC | ||||||||||
| 4420 LAKE BOONE TRAIL | RALEIGH | NC | 27607 | 561509260 | HEALTHCARE | NC | 501(C)(3) | UNC HEALTH CARE | 0 | LINE 3 |
| UNC PHYSICIANS NETWORK | ||||||||||
| 1600 PERIMETER PARK DRIVE SUITE 225 | MORRISVILLE | NC | 27560 | 271081647 | HEALTHCARE | NC | 501(C)(3) | UNC HEALTH CARE | 0 | LINE 9 |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (6 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Predominant Income TypePredominantIncomeTypeTxt | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd |
|---|---|---|---|---|---|---|---|---|---|---|
| REX SURGERY CENTER OF CARY | ||||||||||
| 4420 LAKE BOONE TRAIL | RALEIGH | NC | 27607 | 273684056 | ASC | NC | N/A | |||
| JRH VENTURES LLC | ||||||||||
| 4420 LAKE BOONE TRAIL | RALEIGH | NC | 27607 | 274092967 | MED CAMPUS DVLT | NC | N/A | |||
| REX HEALTH VENTURES I LP | ||||||||||
| 4420 LAKE BOONE TRAIL | RALEIGH | NC | 27607 | 371690478 | VENTURE CAPITAL INVEST | NC | N/A | |||
| HIGH POINT SURGERY CENTER | ||||||||||
| 600 NORTH LINDSAY STREET | HIGH POINT | NC | 27260 | 561867005 | HIGH POINT REGIONAL HEALTH | NC | N/A | |||
| ORTHOPAEDIC SURGERY CENTER OF RALEIGH LLC | ||||||||||
| 4420 LAKE BOONE TRAIL | RALEIGH | NC | 27607 | 271740526 | ORTHOPAEDIC SURGERY | NC | N/A | |||
| REGIONAL WELLNESS LLC | ||||||||||
| 861 OLD WINSTON ROAD | KERNERSVILLE | NC | 27284 | 204475769 | HEALTHCARE | NC | RELATED | 0 | 0 | |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| REX ENTERPRISES COMPANY INC | |||||||||
| 4420 LAKE BOONE TRAIL | RALEIGH | NC | 27607 | 561553957 | OPERATIONS SUPPORT | NC | N/A | C | 0 |
| HIGH POINT HEALTHCARE VENTURES | |||||||||
| 601 N ELM STREET | HIGH POINT | NC | 27261 | 561343468 | HOLDING COMPANY | NC | N/A | C | 0 |
| UNC PHYSICIANS NETWORK GROUP PRACTICES LLC | |||||||||
| 1600 PERIMETER PARK DRIVE SUITE 225 | MORRISVILLE | NC | 27560 | 461416986 | HEALTHCARE | NC | N/A | C | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
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