FURP.ORG / PUBLIC DATA EXPLORER

FORSYTH MEDICAL CENTER FOUNDATION: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization
FORSYTH MEDICAL CENTER FOUNDATION (EIN 56-2120959)
Tax period
2016-01-01 to 2016-12-31
Filed
2017-11-15
IRS object ID
201733199349311223
Schema version
2016v3.0
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 ReturnHeader

FieldValueIRS element (for citing)
Return2017-11-15T14:05:42-06:00ReturnTs
Tax Period End2016-12-31TaxPeriodEndDt
Return Type990ReturnTypeCd
Tax Period Begin2016-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN562120959EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1FORSYTH MEDICAL CENTER FOUNDATIONBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlFORSBusinessNameControlTxt
Phone3367182803PhoneNum

US Address USAddress

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

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonFRED HARGETTPersonNm
Person TitleEVP & CFOPersonTitleTxt
Phone3367182803PhoneNum
Signature2017-11-07SignatureDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address170.98.106.254IPv4AddressTxt
FieldValueIRS element (for citing)
IP2017-11-07IPDt
IP Tm08:45:03IPTm
IP TimezoneESIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device Id7AA337F3ADADCA5BF014F5DE8F20B8DB09A5D137AtSubmissionCreationDeviceId
At Submission Filing Device IdEA41BDE3C3DB37B92BEF4B915198E9A32E027107AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2016TaxYr
Build TS2021-01-29 14:40:06ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1NOVANT HEALTH FOUNDATION FORSYTH MEDICAL CENTERBusinessNameLine1Txt
FieldValueIRS element (for citing)
Principal OfficerKIMBERLY MCLOUGHLINPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line12085 FRONTIS PLAZA BLVDAddressLine1Txt
CityWINSTON SALEMCityNm
State AbbreviationNCStateAbbreviationCd
ZIP27103ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$16,309,205GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.SUPPORTNOVANTHEALTH.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1981FormationYr
Legal Domicile StateNCLegalDomicileStateCd
Activity Or MissionSEE SCHEDULE OActivityOrMissionDesc
Voting Members Governing Body21VotingMembersGoverningBodyCnt
Voting Members Independent18VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers60TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$1,966,306PYContributionsGrantsAmt
CY Contributions Grants$3,249,464CYContributionsGrantsAmt
PY Program Service Revenue$0PYProgramServiceRevenueAmt
CY Program Service Revenue$0CYProgramServiceRevenueAmt
PY Investment Income$2,195,122PYInvestmentIncomeAmt
CY Investment Income$1,558,379CYInvestmentIncomeAmt
PY Other Revenue-$20,916PYOtherRevenueAmt
CY Other Revenue-$5,657CYOtherRevenueAmt
PY Total Revenue$4,140,512PYTotalRevenueAmt
CY Total Revenue$4,802,186CYTotalRevenueAmt
PY Grants And Similar Paid$2,883,884PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$2,512,416CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$0PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$0CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$15,600CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$427,933CYTotalFundraisingExpenseAmt
PY Other Expenses$826,466PYOtherExpensesAmt
CY Other Expenses$1,095,255CYOtherExpensesAmt
PY Total Expenses$3,710,350PYTotalExpensesAmt
CY Total Expenses$3,623,271CYTotalExpensesAmt
PY Revenues Less Expenses$430,162PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$1,178,915CYRevenuesLessExpensesAmt
Total Assets BOY$58,278,929TotalAssetsBOYAmt
Total Assets EOY$64,241,508TotalAssetsEOYAmt
Total Liabilities BOY$322,198TotalLiabilitiesBOYAmt
Total Liabilities EOY$418,333TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$57,956,731NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$63,823,175NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionSEE SCHEDULE OMissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$2,961,402ExpenseAmt
Grant$2,512,416GrantAmt
DescFORSYTH MEDICAL CENTER FOUNDATION FOCUSES ITS EFFORTS ON RAISING COMMUNITY SUPPORT AND FUNDING THROUGH CHARITABLE GIVING FOR MUCH-NEEDED PROGRAMS, IMPROVED FACILITIES, AND STATE-OF-THE-ART TECHNOLOGY FOR NOVANT HEALTH FORSYTH MEDICAL CENTER, NOVANT HEALTH KERNERSVILLE MEDICAL CENTER, AND NOVANT HEALTH CLEMMONS MEDICAL CENTER.Desc
Total Program Service Expenses$2,961,402TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent EndowmentsYes (1)TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other SecYes (1)ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional FundraisingYes (1)ProfessionalFundraisingInd
Fundraising ActivitiesYes (1)FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To IndividualsYes (1)GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash ContriYes (1)DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee0EmployeeCnt
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members21GoverningBodyVotingMembersCnt
Independent Voting Member18IndependentVotingMemberCnt
Family Or Business RlnYes (1)FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower Policy0WhistleblowerPolicyInd
Document Retention Policy0DocumentRetentionPolicyInd
Compensation Process CEO0CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldNCStatesWhereCopyOfReturnIsFldCd
Own WebsiteYes (X)OwnWebsiteInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

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

US Address USAddress

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

Form990 Part VII Section A Form990PartVIISectionAGrp (26 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
BYERS KEVIN
TRUSTEE2.00Yes (X)$0$0$0
CHADEN SHELBY
TRUSTEE2.00Yes (X)$0$0$0
COPELAND DOUGLAS
TRUSTEE2.00Yes (X)$0$0$0
DUNHAM ROBERT
TRUSTEE2.00Yes (X)$0$0$0
FULLER-ANDREWS LYNNE
TRUSTEE2.00Yes (X)$0$0$0
GREGORY CHERE MD
TRUSTEE2.00Yes (X)$0$610,828$101,304
HOLMES HAROLD
TRUSTEE2.00Yes (X)$0$0$0
JOHNSON MARK
TRUSTEE2.00Yes (X)$0$0$0
KNIGHT ANNETTE
TRUSTEE2.00Yes (X)$0$0$0
MARLEY MORRIS
TREAS2.00Yes (X)$0$0$0Yes (X)
MARTIN DAVIDA
TRUSTEE2.00Yes (X)$0$0$0
POLLARD III HAROLD
CHAIR2.00Yes (X)$0$0$0Yes (X)
PROCTOR R ALAN
TRUSTEE2.00Yes (X)$0$0$0
RAMIREZ-SANTOS HERNANDO
TRUSTEE2.00Yes (X)$0$0$0
SCHAEFER CLAUDIA
TRUSTEE2.00Yes (X)$0$0$0
SHORE RICHARD
VICE CHAIR2.00Yes (X)$0$313$0Yes (X)
STERRITT DE LORRAINE
TRUSTEE2.00Yes (X)$0$0$0
SUTPHIN MAMIE
TRUSTEE2.00Yes (X)$0$0$0
WELCH EDWIN
TRUSTEE2.00Yes (X)$0$0$0
YARBOROUGH D CHEFF
TRUSTEE2.00Yes (X)$0$0$0
ZEKAN PATRICIA
SEC2.00Yes (X)$0$320,870$71,687Yes (X)
GYMER ANDREA
FMR EXECUTIVE DIRECTOR40.00$0$247,767$60,245Yes (X)
MCLOUGHLIN KIMBERLY
SVP FOUNDATION & SOCIAL RESP60.00$0$407,078$118,282Yes (X)
MORRIS JOHN
ASST SEC2.00$0$326,030$68,576Yes (X)
MYERS SCOTT
ASST SEC2.00$0$639,761$147,919Yes (X)
VINCENT PAULA
FMR SVP FNDNS0.00$0$697,148$73,014Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$3,249,795TotReportableCompRltdOrgAmt
Total Other Compensation$641,027TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (1)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt
Fundraising$131,696FundraisingAmt
Government Grants$48,651GovernmentGrantsAmt
All Other Contributions$3,069,117AllOtherContributionsAmt
Noncash Contributions$34,199NoncashContributionsAmt
Total Contributions$3,249,464TotalContributionsAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$607,685TotalRevenueColumnAmt
Exclusion$607,685ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$12,398,327SecuritiesAmt
Other$12,750OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$11,460,383SecuritiesAmt
Other$0OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$937,944SecuritiesAmt
Other$12,750OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$950,694TotalRevenueColumnAmt
Exclusion$950,694ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$40,979FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event$131,696ContriRptFundraisingEventAmt
Fundraising Direct Expenses$46,636FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column-$5,657TotalRevenueColumnAmt
Exclusion-$5,657ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$4,802,186TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$1,552,722ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$2,482,728TotalAmt
Program Services$2,482,728ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$29,688TotalAmt
Program Services$29,688ProgramServicesAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$15,600TotalAmt
Fundraising$15,600FundraisingAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$95,230TotalAmt
Management And General$95,230ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$75,939TotalAmt
Program Services$37,210ProgramServicesAmt
Management And General$4,556ManagementAndGeneralAmt
Fundraising$34,173FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$45,697TotalAmt
Program Services$22,391ProgramServicesAmt
Management And General$2,742ManagementAndGeneralAmt
Fundraising$20,564FundraisingAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$11,186TotalAmt
Program Services$5,481ProgramServicesAmt
Management And General$671ManagementAndGeneralAmt
Fundraising$5,034FundraisingAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$3,647TotalAmt
Management And General$3,647ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$17,162TotalAmt
Management And General$17,162ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$51,282TotalAmt
Management And General$51,282ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$152TotalAmt
Program Services$75ProgramServicesAmt
Management And General$9ManagementAndGeneralAmt
Fundraising$68FundraisingAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmt
CONTRACT LABOR$509,432$249,622$30,566$229,244
MISCELLANEOUS$273,890$134,207$16,433$123,250
EMPLOYEE RELATIONS$8,478$8,478
DUES AND SUBSCRIPTIONS$3,160$3,160

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$3,623,271TotalAmt
Program Services$2,961,402ProgramServicesAmt
Management And General$233,936ManagementAndGeneralAmt
Fundraising$427,933FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$1,193,452BOYAmt
EOY$2,619,391EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
EOY$12,005EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$4,907BOYAmt
EOY$3,505EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$157,140LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$78,103LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$10,265BOYAmt
EOY$79,037EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$44,943,552BOYAmt
EOY$51,813,420EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$12,121,686BOYAmt
EOY$9,714,150EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$5,067BOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$58,278,929BOYAmt
EOY$64,241,508EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$322,198BOYAmt
EOY$418,333EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$322,198BOYAmt
EOY$418,333EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$47,191,787BOYAmt
EOY$52,007,491EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$10,525,354BOYAmt
EOY$10,954,914EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$239,590BOYAmt
EOY$860,770EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$57,956,731BOYAmt
EOY$63,823,175EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$58,278,929BOYAmt
EOY$64,241,508EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$1,178,915ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$3,007,561NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$1,679,968OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

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

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Public Organization170Yes (X)PublicOrganization170Ind

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$2,198,496CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$2,262,534CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$2,509,103CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,966,306CurrentTaxYearMinus1YearAmt
Current Tax Year$3,249,464CurrentTaxYearAmt
Total$12,185,903TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$2,198,496CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$2,262,534CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$2,509,103CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,966,306CurrentTaxYearMinus1YearAmt
Current Tax Year$3,249,464CurrentTaxYearAmt
Total$12,185,903TotalAmt
FieldValueIRS element (for citing)
Substantial Contributors Tot$2,483,714SubstantialContributorsTotAmt
Public Support Total170$9,702,189PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$1,174,066CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$985,630CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,425,875CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$933,373CurrentTaxYearMinus1YearAmt
Current Tax Year$607,685CurrentTaxYearAmt
Total$5,126,629TotalAmt

Other Income170 OtherIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$8,942CurrentTaxYearMinus4YearsAmt
Total$8,942TotalAmt
FieldValueIRS element (for citing)
Total Support$17,321,474TotalSupportAmt
Gross Receipts Rltd Activities$203,321GrossReceiptsRltdActivitiesAmt
Public Support CY1700.56010PublicSupportCY170Pct
Public Support PY1700.62140PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170Yes (X)ThirtyThrPctSuprtTestsCY170Ind

Form990 Schedule A Part VI Form990ScheduleAPartVIGrp

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME:FormAndLineReferenceDesc
ExplanationMISCELLANEOUS INCOME - 2012 AMOUNT: $ 8,942.ExplanationTxt

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$10,764,944BeginningYearBalanceAmt
Contributions$2,472,752ContributionsAmt
Investment Earnings Or Losses$74,729InvestmentEarningsOrLossesAmt
Grants Or Scholarships$284,479GrantsOrScholarshipsAmt
Other Expenditures$1,212,262OtherExpendituresAmt
End Year Balance$11,815,684EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$11,259,915BeginningYearBalanceAmt
Contributions$1,107,979ContributionsAmt
Investment Earnings Or Losses-$36,768InvestmentEarningsOrLossesAmt
Grants Or Scholarships$24,547GrantsOrScholarshipsAmt
Other Expenditures$1,541,635OtherExpendituresAmt
End Year Balance$10,764,944EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$11,810,510BeginningYearBalanceAmt
Contributions$1,816,278ContributionsAmt
Investment Earnings Or Losses$31,724InvestmentEarningsOrLossesAmt
Grants Or Scholarships$144,134GrantsOrScholarshipsAmt
Other Expenditures$2,254,463OtherExpendituresAmt
End Year Balance$11,259,915EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$11,698,867BeginningYearBalanceAmt
Contributions$1,594,460ContributionsAmt
Investment Earnings Or Losses-$14,581InvestmentEarningsOrLossesAmt
Grants Or Scholarships$67,000GrantsOrScholarshipsAmt
Other Expenditures$1,401,236OtherExpendituresAmt
End Year Balance$11,810,510EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$12,235,136BeginningYearBalanceAmt
Contributions$1,737,322ContributionsAmt
Investment Earnings Or Losses$57,605InvestmentEarningsOrLossesAmt
Grants Or Scholarships$65,000GrantsOrScholarshipsAmt
Other Expenditures$2,266,196OtherExpendituresAmt
End Year Balance$11,698,867EndYearBalanceAmt
FieldValueIRS element (for citing)
Prmnnt Endowment Balance EOY0.07000PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0.93000TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org0EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org0EndowmentsHeldRelatedOrgInd

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$78,192OtherCostOrOtherBasisAmt
Depreciation$78,103DepreciationAmt
Book Value$89BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$78,948OtherCostOrOtherBasisAmt
Book Value$78,948BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$79,037TotalBookValueLandBuildingsAmt

Other Securities OtherSecuritiesGrp

FieldValueIRS element (for citing)
DescOTHER SECURITIESDesc
Book Value$9,714,150BookValueAmt
Method ValuationFMethodValuationCd
FieldValueIRS element (for citing)
Total Book Value Securities$9,714,150TotalBookValueSecuritiesAmt
Federal Income Tax Liability$0FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescDUE TO AFFILIATEDesc
Amt$418,333Amt
FieldValueIRS element (for citing)
Total Liability$418,333TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART X, LINE 2:PART X, LINE 2: LIABILITY UNDER FIN 48 (ASC 740) FOOTNOTE THE AUDIT FOR NOVANT HEALTH AND ITS AFFILIATES IS PREPARED ON A CONSOLIDATED BASIS. THE COMPANY IS REQUIRED TO EVALUATE UNCERTAIN TAX POSITIONS. THIS EVALUATION INCLUDES A QUANTIFICATION OF TAX RISK IN AREAS SUCH AS UNRELATED BUSINESS TAXABLE INCOME AND THE TAXATION OF OUR FOR-PROFIT SUBSIDIARIES. THIS EVALUATION DID NOT HAVE A MATERIAL EFFECT ON THE COMPANY'S CONSOLIDATED STATEMENTS OF OPERATIONS AND CHANGES IN NET ASSETS FOR THE YEARS ENDED DECEMBER 31, 2016 AND 2015.
PART V, LINE 4: INTENDED USES FOR ENDOWMENT FUNDSTHE ENDOWMENT FUNDS ARE HELD FOR AFFILIATE HOSPITAL SERVICE COSTS RELATED TO VARIOUS CENTERS AT THE ACUTE CARE FACILITIES AND SUPPORT FOR THE SURROUNDING COMMUNITY. THE VARIOUS ENDOWMENT FUNDS SUPPORT CANCER SERVICES, BEHAVIORAL HEALTH MEDICAL PROGRAMS, NEUROLOGY/STROKE PROGRAMS & EDUCATION, MEDICAL STAFF DEVELOPMENT, NURSING EDUCATION, REHABILITATION SERVICES, NEONATAL SERVICES, WOMEN'S HEALTH SERVICES, ASSISTANCE TO EMPLOYEES, AND OTHER PROGRAMS THAT BENEFIT NOVANT HEALTH FACILITIES.

Schedule G IRS990ScheduleG

FieldValueIRS element (for citing)
Mail SolicitationsYes (X)MailSolicitationsInd
Email SolicitationsYes (X)EmailSolicitationsInd
In Person SolicitationsYes (X)InPersonSolicitationsInd
Solicitation Of Non Govt GrantsYes (X)SolicitationOfNonGovtGrantsInd
Special Fundraising EventsYes (X)SpecialFundraisingEventsInd
Agrmt Prof Fundraising ActyYes (1)AgrmtProfFundraisingActyInd

Fundraiser Activity Info FundraiserActivityInfoGrp

FieldValueIRS element (for citing)
PersonKRISTIN HILLS BRADBERRYPersonNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line13023 IDLEWOOD CIRCLEAddressLine1Txt
CityCHARLOTTECityNm
State AbbreviationNCStateAbbreviationCd
ZIP28209ZIPCd
FieldValueIRS element (for citing)
ActivityBOARD TRAINING/STAFF CONSULTINGActivityTxt
Fundraiser Control Of Funds0FundraiserControlOfFundsInd
Gross Receipts$0GrossReceiptsAmt
Retained By Contractor$15,600RetainedByContractorAmt
Net To Organization-$15,600NetToOrganizationAmt
FieldValueIRS element (for citing)
Total Retained By Contractors$15,600TotalRetainedByContractorsAmt
Total Net To Organization-$15,600TotalNetToOrganizationAmt
Licensed StatesNCLicensedStatesCd

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Event1GARDEN PARTYEvent1Nm
Gross Receipts Event1$72,312GrossReceiptsEvent1Amt
Charitable Contri Event1$58,570CharitableContriEvent1Amt
Gross Revenue Event1$13,742GrossRevenueEvent1Amt
Non Cash Prizes Event1$13,145NonCashPrizesEvent1Amt
Food And Beverage Event1$6,903FoodAndBeverageEvent1Amt
Other Direct Expenses Event1$5,931OtherDirectExpensesEvent1Amt
Event2ATHENA'S RUNEvent2Nm
Gross Receipts Event2$48,751GrossReceiptsEvent2Amt
Charitable Contri Event2$41,912CharitableContriEvent2Amt
Gross Revenue Event2$6,839GrossRevenueEvent2Amt
Rent Facility Costs Event2$1,300RentFacilityCostsEvent2Amt
Entertainment Event2$700EntertainmentEvent2Amt
Other Direct Expenses Event2$11,871OtherDirectExpensesEvent2Amt
Other Events Total4OtherEventsTotalCnt
Gross Receipts Other Events$51,612GrossReceiptsOtherEventsAmt
Charitable Contri Other Events$31,214CharitableContriOtherEventsAmt
Gross Revenue Other Events$20,398GrossRevenueOtherEventsAmt
Non Cash Prizes Other Events$1,918NonCashPrizesOtherEventsAmt
Food And Beverage Other Events$4,039FoodAndBeverageOtherEventsAmt
Oth Direct Expnss Other Events$829OthDirectExpnssOtherEventsAmt
Gross Receipts Total$172,675GrossReceiptsTotalAmt
Charitable Contributions Tot$131,696CharitableContributionsTotAmt
Gross Revenue Total Events$40,979GrossRevenueTotalEventsAmt
Non Cash Prizes Total Events$15,063NonCashPrizesTotalEventsAmt
Rent Fclty Costs Total Events$1,300RentFcltyCostsTotalEventsAmt
Food And Beverage Total Events$10,942FoodAndBeverageTotalEventsAmt
Entertainment Total Events$700EntertainmentTotalEventsAmt
Oth Direct Expnss Total Events$18,631OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events$46,636DirectExpenseSummaryEventsAmt
Net Income Summary-$5,657NetIncomeSummaryAmt

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Recipient Table RecipientTable (10 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtPurpose Of GrantPurposeOfGrantTxt
CANCER SERVICES INC
3175 MAPLEWOOD AVENUEWINSTONSALEMNC27103560656375501(C)(3)$12,750COMMUNITY OUTREACH
COMMUNITY CARE CENTER FOR FORSYTH COUNTY INC
2135 NEW WALKERTOWN ROADWINSTONSALEMNC27101581403699501(C)(3)$255,050COMMUNITY OUTREACH
FORSYTH FUTURES
100 N CHERRY STREETWINSTONSALEMNC27101561092807501(C)(3)$25,000COMMUNITY OUTREACH
FORSYTH HEALTHCARE INC
501 N CLEVELAND AVEWINSTONSALEMNC27101320097975501(C)(3)$250,000COMMUNITY OUTREACH
FORSYTH MEMORIAL HOSPITAL INC
2085 FRONTIS PLAZA BLVDWINSTONSALEMNC27103560928089501(C)(3)$1,345,116TO SUPPORT NHFMC, NHKMC, AND FMCI
FOUNDATION HEALTH SYSTEMS CORP
2085 FRONTIS PLAZA BLVDWINSTONSALEMNC27103561373175501(C)(3)$502,774TO SUPPORT TODAY'S WOMAN
GIRLS ON THE RUN INTERNATIONAL
801 E MOREHEAD STREET NO 201CHARLOTTENC28202562201835501(C)(3)$7,500COMMUNITY OUTREACH
NORTH CAROLINA PHYSICIANS HEALTH PROGRAM INC
220 HORIZON DR NO 201RALEIGHNC27615561846599501(C)(3)$7,500COMMUNITY OUTREACH
NOVANT HEALTH INC
2085 FRONTIS PLAZA BLVDWINSTONSALEMNC27103561376950501(C)(3)$59,142TO SUPPORT NOVANT HEALTH
THE CENTERS FOR EXCEPTIONAL CHILDREN INC
2315 COLISEUM DRIVEWINSTONSALEMNC27106560615188501(C)(3)$13,595COMMUNITY OUTREACH
FieldValueIRS element (for citing)
Total501c3 Org10Total501c3OrgCnt
Total Other Org0TotalOtherOrgCnt

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp (3 entries)

Grant TypeGrantTypeTxtRecipientRecipientCntCash GrantCashGrantAmt
EMERGENCY ASSISTANCE66$15,374
NURSING SCHOLARSHIP5$12,964
PATIENT ASSISTANCE9$1,350

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 2: PROCEDURES FOR MONITORING THE USE OF GRANT FUNDSFormAndLineReferenceDesc
ExplanationTHE FILING ORGANIZATION IS PART OF THE INTEGRATED HEALTHCARE SYSTEM OPERATED BY NOVANT HEALTH, INC. ("NOVANT HEALTH"), THE PARENT ORGANIZATION. NOVANT HEALTH'S BYLAWS AUTHORIZE IT TO ESTABLISH CERTAIN POLICIES FOR ALL OF ITS SUBSIDIARIES WITHIN THE SYSTEM. NOVANT HEALTH HAS ESTABLISHED A SYSTEM-WIDE CORPORATE POLICY WITH STANDARDIZED GUIDELINES THAT ARE TO BE USED IN REVIEWING THE ELIGIBILITY AND SELECTION OF GRANTEES RECEIVING CERTAIN EXEMPT PURPOSE FUNDS. THE FILING ORGANIZATION MAINTAINS DOCUMENTATION OF THE ELIGIBILITY AND SELECTION CRITERIA AND RECORDS OF THE AMOUNTS ARE MAINTAINED VIA THE GENERAL LEDGER. FUNDS ARE GENERALLY NOT TRACKED AFTER BEING GRANTED, AS THE ORIGINAL ELIGIBILITY AND SELECTION CRITERIA HAVE ALREADY BEEN MET.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (1)SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (7 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
GREGORY CHERE MD
TRUSTEE$0$359,522$0$238,000$0$13,306$0$71,110$0$30,194$0$712,132$0$0
ZEKAN PATRICIA
SEC$0$311,411$0$0$0$9,459$0$57,900$0$13,787$0$392,557$0$7,500
GYMER ANDREA
FMR EXECUTIVE DIRECTOR$0$209,517$0$33,075$0$5,175$0$48,708$0$11,537$0$308,012$0$0
MCLOUGHLIN KIMBERLY
SVP FOUNDATION & SOCIAL RESP$0$279,270$0$102,522$0$25,286$0$94,233$0$24,049$0$525,360$0$0
MORRIS JOHN
ASST SEC$0$261,052$0$50,213$0$14,765$0$46,705$0$21,871$0$394,606$0$7,500
MYERS SCOTT
ASST SEC$0$374,572$0$243,346$0$21,843$0$122,183$0$25,736$0$787,680$0$7,500
VINCENT PAULA
FMR SVP FNDNS$0$414,351$0$252,710$0$30,087$0$56,574$0$16,441$0$770,163$0$0

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 3THE FILING ORGANIZATION IS AN INTEGRAL PART OF NOVANT HEALTH, AN INTEGRATED HEALTHCARE SYSTEM. NOVANT HEALTH, INC. IS THE PARENT ORGANIZATION AND USES THE PROCESS DESCRIBED IN PART VI, LINE 15A OF THIS RETURN TO ESTABLISH THE COMPENSATION OF THE TOP MANAGEMENT OFFICIAL OF THE FILING ORGANIZATION. THIS PROCESS ADHERES TO THE REQUIREMENTS SET FORTH TO SECURE THE REBUTTABLE PRESUMPTION OF REASONABLENESS AND INCLUDES A REVIEW AND APPROVAL BY INDEPENDENT AND DISINTERESTED MEMBERS OF A COMPENSATION COMMITTEE, CONSULTATION WITH INDEPENDENT COMPENSATION CONSULTANTS, THE UTILIZATION OF THIRD-PARTY COMPARABILITY DATA SUCH AS PUBLISHED COMPENSATION SURVEYS, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION.
PART I, LINE 4BPART I, LINE 4A-C: SEVERANCE, NONQUALIFIED, AND EQUITY-BASED PAYMENTS SEVERANCE NONQUALIFIED EQUITY-BASED GREGORY, CHERE 54,600 MCLOUGHLIN, KIMBERLY 42,333 MYERS, SCOTT 56,783
PART I, LINE 4A - SEVERANCE PLAN:ELIGIBLE EXECUTIVES MAY RECEIVE SEVERANCE PAY THAT IS BASED ON ANNUAL COMPENSATION FOR A SPECIFIED PERIOD OF TIME. THE SEVERANCE PAY WOULD BE PAID ONLY IN THE EVENT OF CERTAIN TYPES OF EMPLOYMENT TERMINATION, AND IS FURTHER CONTINGENT ON THE SATISFACTION OF OTHER CONDITIONS SUCH AS COMPLIANCE WITH A NON-COMPETITION COVENANT. ANY CURRENT YEAR PAYMENTS HAVE BEEN INCLUDED IN THE COMPENSATION AMOUNTS REPORTED IN PART VII AND IN COLUMN (B)(III) OF SCHEDULE J. THE COMPENSATION AND LEADERSHIP COMMITTEE OF THE NOVANT HEALTH BOARD REVIEWS, APPROVES, AND OVERSEES ALL ASPECTS AND ALL ELEMENTS OF EXECUTIVE COMPENSATION AND BENEFITS, INCLUDING THE AMOUNTS AWARDED UNDER THIS SEVERANCE PLAN.
PART I, LINE 4B SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANS:THE SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN ("SERP") IS INTENDED TO SUPPORT RETENTION OF KEY EXECUTIVES, AND TO OFFER COMPETITIVE TOTAL COMPENSATION. ELIGIBLE EXECUTIVES WILL BE NOMINATED BY THE CEO AND APPROVED BY THE NOVANT HEALTH COMPENSATION AND LEADERSHIP COMMITTEE ("THE COMMITTEE") TO PARTICIPATE. GENERALLY, ANNUAL CONTRIBUTIONS TO THE PLAN OR PAYMENTS TO PARTICIPANTS WILL BE BASED ON A PERCENTAGE OF THE PARTICIPANT'S BASE SALARY AS OF JANUARY 1ST OF THE PREVIOUS PLAN YEAR AND ARE REPORTED IN COLUMN (C) OF SCHEDULE J. PRIOR TO MAKING THE CONTRIBUTIONS OR PAYMENTS, THE COMMITTEE WILL APPROVE THE AMOUNTS AS TO REASONABLENESS, WHEN COMBINED WITH ALL OTHER ANNUAL COMPENSATION. A 3 YEAR CLASS-YEAR VESTING PERIOD WILL APPLY UP TO AGE 62, WHEN ALL MONEY WOULD BE VESTED AND PAID OUT TO THE PARTICIPANT. OTHERWISE, VESTING WILL OCCUR ON JANUARY 1ST OF EACH YEAR FOR THE APPROPRIATE CLASS-YEAR VESTING PERIOD. THE COMMITTEE REVIEWS, APPROVES, AND OVERSEES ALL ASPECTS AND ALL ELEMENTS OF EXECUTIVE COMPENSATION AND BENEFITS.

Schedule M IRS990ScheduleM

Books And Publications BooksAndPublicationsGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
Noncash Contributions Rpt F990$7,587NoncashContributionsRptF990Amt
Method Of Determining RevenuesCOSTMethodOfDeterminingRevenuesTxt

Clothing And Household Goods ClothingAndHouseholdGoodsGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
Noncash Contributions Rpt F990$20,974NoncashContributionsRptF990Amt
Method Of Determining RevenuesFMVMethodOfDeterminingRevenuesTxt

Other Non Cash Contri Table OtherNonCashContriTableGrp (3 entries)

Non Cash CheckboxNonCashCheckboxIndDescDescContributionContributionCntNoncash Contributions Rpt F990NoncashContributionsRptF990AmtMethod Of Determining RevenuesMethodOfDeterminingRevenuesTxt
Yes (X)GIFT CARD/CERTIFICATE31$3,426FMV
Yes (X)TICKETS28$1,372FMV
Yes (X)JEWELRY4$840FMV
FieldValueIRS element (for citing)
Form8283 Received0Form8283ReceivedCnt
Any Property That Must Be Held0AnyPropertyThatMustBeHeldInd
Review Process Unusual NC GiftsYes (1)ReviewProcessUnusualNCGiftsInd
Third Parties Used0ThirdPartiesUsedInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, COLUMN (B):FormAndLineReferenceDesc
ExplanationNUMBER OF ITEMS RECEIVEDExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (11 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PI, L1: ORGANIZATION'S MISSION OR MOST SIGNIFICANT ACTIVITIESFORSYTH HOSPITAL FOUNDATION DOING BUSINESS AS NOVANT HEALTH FOUNDATION FORSYTH MEDICAL CENTER ("THE FOUNDATION") WAS FORMED TO ACCEPT GIFTS, SEEK GRANTS, AND INVEST FUNDS TO SUPPORT FORSYTH MEMORIAL HOSPITAL DOING BUSINESS AS NOVANT HEALTH FORSYTH MEDICAL CENTER AND ITS STRATEGIC PARTNERS PROVIDING HEALTHCARE IN THE COMMUNITY. THE FOUNDATION'S MISSION IS SUPPORTING THE NOVANT HEALTH SYSTEM AND IMPROVING THE HEALTH OF OUR COMMUNITIES, ONE PERSON AT A TIME. LOCATED IN WINSTON SALEM, NC, IT HAS EXPANDED ITS REACH TO INCLUDE ADVISORY BOARDS AT NEW MEDICAL CENTERS IN KERNERSVILLE, NC AND CLEMMONS, NC. NOVANT HEALTH FOUNDATION FORSYTH MEDICAL CENTER IS AN INTEGRAL PART OF THE NOVANT HEALTH SYSTEM (COLLECTIVELY KNOWN AS "NOVANT HEALTH"), A NOT-FOR-PROFIT INTEGRATED GROUP OF HOSPITALS, PHYSICIAN CLINICS, OUTPATIENT CENTERS, AND OTHER HEALTHCARE SERVICE PROVIDERS. NOVANT HEALTH CONSISTS OF NEARLY 1,500 PHYSICIANS AND 25,000 EMPLOYEES WHO MAKE HEALTHCARE REMARKABLE AT APPROXIMATELY 500 LOCATIONS, INCLUDING 14 MEDICAL CENTERS AND HUNDREDS OF OUTPATIENT FACILITIES AND PHYSICIAN CLINICS. HEADQUARTERED IN WINSTON SALEM, NC, NOVANT HEALTH IS COMMITTED TO MAKING HEALTHCARE REMARKABLE FOR PATIENTS AND COMMUNITIES, SERVING MORE THAN 4 MILLION PATIENTS ANNUALLY. DIVERSITY MBA HAS RECOGNIZED THE ORGANIZATION AS ONE OF THE 50 BEST PLACES FOR WOMEN AND MANAGERS OF DIVERSE BACKGROUNDS TO WORK AND SK&A RANKS NOVANT HEALTH AMONG THE TOP 25 INTEGRATED HEALTH SYSTEMS IN THE NATION. IN 2016, THE NOVANT HEALTH SYSTEM REPORTED $4.3 BILLION IN REVENUES. GENERAL INFORMATION THE FOUNDATION SUPPORTS PEOPLE, PROGRAMS AND SERVICES WITHIN THE MEDICAL CENTERS, PROVIDING EXPANDED TREATMENT AND PREVENTION OPTIONS. THE FOUNDATION ALSO PROVIDES A MISSION-ALIGNED GRANT TO COMMUNITY PARTNERS THAT HELP SUPPLEMENT HEALTHCARE AND PREVENTION PROGRAMS FOR UNDERSERVED PATIENTS AT THE COMMUNITY CARE CENTER. THE FOUNDATION'S DIVERSE BOARD OF COMMUNITY LEADERS IN WINSTON SALEM, CLEMMONS, AND KERNERSVILLE, NC PROVIDES STEWARDSHIP AND OVERSIGHT OF THE ORGANIZATION'S OPERATIONS AND ACTIVITIES. COMMUNITY OUTREACH COMMUNITY OUTREACH IS A CRITICAL COMPONENT TO THE MISSION OF NOVANT HEALTH FORSYTH MEDICAL CENTER. THE FOUNDATION HOSTS A WIDE RANGE OF FUNDRAISING EVENTS EACH YEAR, INCLUDING THE "GARDEN PARTY" LUNCHEON THROUGH THE WOMEN'S COUNCIL, A FUNDRAISER TO SUPPORT IMPROVED HEALTH OF ALL WOMEN IN THE LOCAL COMMUNITY. THE FOUNDATION EXISTS TO RAISE AWARENESS AND FUNDING TO ENHANCE THE ABILITY OF NOVANT HEALTH TO DELIVER REMARKABLE MEDICINE AND COMPASSIONATE CARE. IN 2016, THE FOUNDATION RECEIVED MORE THAN 4,900 DONATIONS TO SUPPORT ITS MISSION. GIFTS, GRANTS, AND EARNINGS FROM INVESTMENTS TOUCHED VIRTUALLY EVERY SERVICE AREA AT NOVANT HEALTH FORSYTH MEDICAL CENTER. SOME EXAMPLES ARE AS FOLLOWS: -RESTRICTED GIFTS FROM FOUNDATION FUNDS WENT TO SUPPORT NURSE NAVIGATORS, PATIENT SUPPORT, NURSING SCHOLARSHIPS, STAFF EDUCATION, RESEARCH, MAMMOGRAMS, DISEASE PREVENTION, SCREENINGS, AND REHABILITATION. -THE WOMEN'S COUNCIL OF NOVANT HEALTH FOUNDATION FORSYTH MEDICAL CENTER HAS A MISSION TO ENGAGE COMMUNITY WOMEN IN RAISING THE STANDARD FOR WOMEN'S HEALTHCARE AND EXPANDING HEALTHCARE OPPORTUNITIES FOR ALL WOMEN, REGARDLESS OF THEIR ECONOMIC CIRCUMSTANCES. IN 2016, THE COUNCIL PROVIDED $50,000 IN GRANTS TO FUND MEDICATION AND TRANSPORTATION SUPPORT FOR WOMEN BATTLING GYNECOLOGIC CANCER; FUNDING FOR A PART-TIME LICENSED CLINICAL SOCIAL WORKER AT NOVANT HEALTH TODAY'S WOMAN; AND EQUIPMENT FOR FORSYTH CONNECTS, A HOME VISIT PROGRAM FOR NEW MOTHERS RESIDING IN FORSYTH COUNTY. THROUGH THESE GRANTS, THE WOMEN'S COUNCIL HAS PROVIDED APPROXIMATELY $475,000 IN SUPPORT SINCE 2008. COMMUNITY BENEFIT REPORT HTTPS://WWW.NOVANTHEALTH.ORG/HOME/ABOUT-US/COMPANY-INFORMATION/ FINANCIAL-PROFILE/COMMUNITY-BENEFIT-REPORT.ASPX THE COMMUNITY BENEFIT REPORT PREPARED BY NOVANT HEALTH IS A SYSTEM-WIDE REPORT THAT INCLUDES QUALITATIVE AND QUANTITATIVE INFORMATION. PLEASE NOTE THAT THE NUMERIC DATA IN THIS REPORT IS NOT BASED UPON THE FORM 990, SCHEDULE H CRITERIA, BUT RATHER IT HAS BEEN PREPARED IN ACCORDANCE WITH THE NORTH CAROLINA HOSPITAL ASSOCIATION REPORTING GUIDELINES. IT SHOULD NOT BE RELIED UPON AS THE ORGANIZATION'S FORM 990, SCHEDULE H COMMUNITY BENEFIT REPORT, ITS COMMUNITY HEALTH NEEDS ASSESSMENT OR COMMUNITY BENEFIT IMPLEMENTATION STRATEGY. IN THIS REPORT, THE NOVANT HEALTH SYSTEM'S COMMUNITY BENEFIT WAS APPROXIMATELY $725,000,000, INCLUDING $122,000,000 FINANCIAL ASSISTANCE FOR 2016.
FORM 990, PART III, LINE 1: MISSION, VISION AND VALUESMISSION: NOVANT HEALTH EXISTS TO IMPROVE THE HEALTH OF COMMUNITIES, ONE PERSON AT A TIME. VISION: WE, THE NOVANT HEALTH TEAM, WILL DELIVER THE MOST REMARKABLE PATIENT EXPERIENCE, IN EVERY DIMENSION, EVERY TIME. VALUES: - COMPASSION: WE TREAT OUR CUSTOMERS AND THEIR FAMILIES, STAFF AND OTHER HEALTHCARE PROVIDERS AS FAMILY MEMBERS BY SHOWING THEM KINDNESS, PATIENCE, EMPATHY AND RESPECT. - DIVERSITY AND INCLUSION: WE RECOGNIZE THAT EVERY PERSON IS DIFFERENT, EACH SHAPED BY UNIQUE LIFE EXPERIENCES. THIS ENABLES US TO BETTER UNDERSTAND ONE ANOTHER AND OUR CUSTOMERS. BY ENGAGING THE STRENGTHS AND TALENTS OF EACH TEAM MEMBER, WE ENSURE A STRONG ORGANIZATION CAPABLE OF PROVIDING REMARKABLE HEALTHCARE TO OUR PATIENTS, FAMILIES AND COMMUNITIES. - PERSONAL EXCELLENCE: WE STRIVE TO GROW PERSONALLY AND PROFESSIONALLY, AND WE APPROACH EACH SERVICE OPPORTUNITY WITH A POSITIVE, FLEXIBLE ATTITUDE. HONESTY AND PERSONAL INTEGRITY GUIDE ALL THAT WE DO. - TEAMWORK: THE NEEDS AND EXPECTATIONS OF ANY ONE CUSTOMER ARE GREATER THAN THAT WHICH ONE PERSON'S SERVICE EFFORTS CAN SATISFY. WE SUPPORT EACH OTHER SO THAT TOGETHER AS A TEAM, WE CAN BE SUCCESSFUL IN THE EYE OF THE CUSTOMER AS A QUALITY SERVICE PROVIDER. - COURAGE: WE ACT BOLDLY IN MAKING THE CHANGES NECESSARY TO ACHIEVE OUR MISSION, VISION AND PROMISE OF DELIVERING REMARKABLE HEALTHCARE. OUR PEOPLE: WE ARE AN INCLUSIVE TEAM OF PURPOSE-DRIVEN PEOPLE INSPIRED AND UNITED BY OUR PASSION TO CARE FOR EACH OTHER, OUR PATIENTS AND OUR COMMUNITIES. OUR PROMISE TO PATIENTS: WE ARE MAKING YOUR HEALTHCARE EXPERIENCE REMARKABLE. WE WILL BRING YOU WORLD-CLASS CLINICIANS, CARE AND TECHNOLOGY - WHEN AND WHERE YOU NEED THEM. WE ARE REINVENTING THE HEALTHCARE EXPERIENCE TO BE SIMPLER, MORE CONVENIENT AND MORE AFFORDABLE, SO THAT YOU CAN FOCUS ON GETTING BETTER AND STAYING HEALTHY.
FORM 990, PART I, LINE 6:THE NUMBER OF VOLUNTEERS REPORTED INCLUDES THOSE VOLUNTEERS SERVING AS BOARD MEMBERS.
FORM 990, PART VI, SECTION A, LINE 2FORM 990, PART VI, SECTION A, LINE 2: FAMILY AND/OR BUSINESS RELATIONSHIPS BUSINESS RELATIONSHIP R. ALAN PROCTOR EDWIN WELCH
FORM 990, PART VI, SECTION A, LINE 7AFORM 990, PART VI, SECTION A, LINE 7A: ELECTION OF MEMBERS AND THEIR RIGHTS FORSYTH MEMORIAL HOSPITAL, INC. APPOINTS THE MAJORITY OF THE FORSYTH MEDICAL CENTER FOUNDATION'S BOARD.
FORM 990, PART VI, SECTION B, LINE 11BFORM 990, PART VI, SECTION B, LINE 11: ORGANIZATION'S PROCESS TO REVIEW FORM 990 THE BOARD HAS DELEGATED REVIEW OF THE FORM 990 TO NOVANT HEALTH'S BOARD OF TRUSTEES' AUDIT AND COMPLIANCE COMMITTEE ("THE COMMITTEE"), WHICH OVERSEES TAX MATTERS FOR ENTITIES IN THE NOVANT HEALTH SYSTEM. THE COMMITTEE IS THE REVIEW BODY FOR ALL OF THE FORM 990S FILED FOR ORGANIZATIONS WITHIN THE NOVANT HEALTH SYSTEM. THE COMMITTEE MEETS BEFORE THE FORM 990S ARE FILED WITH THE IRS AND AFTER ALL BOARD MEMBERS HAVE BEEN PROVIDED A PAPER OR ELECTRONIC COPY OF THE FORM 990 AND A SUMMARY OF ITS CONTENTS. THE VICE PRESIDENT OF TAX AND LEGAL COUNSEL FOR NOVANT HEALTH ATTEND THE MEETING TO ANSWER ANY QUESTIONS AND ADDRESS ANY SIGNIFICANT DISCLOSURES WITHIN THE FORM 990.
FORM 990, PART VI, SECTION B, LINE 12CFORM 990, PART VI, SECTION B, LINE 12C: MONITORING AND ENFORCEMENT OF COI THE ORGANIZATION'S TRUSTEE CONFLICT OF INTEREST POLICY APPLIES TO ALL TRUSTEES, PRINCIPAL OFFICERS OR MEMBERS OF A COMMITTEE WITH BOARD DELEGATED POWERS INCLUDING ANY APPLICABLE DISREGARDED ENTITIES. ALL TRUSTEES ARE SENT AN ANNUAL DISCLOSURE QUESTIONNAIRE. THE TRUSTEE ANNUAL DISCLOSURE QUESTIONNAIRES ARE REVIEWED BY THE COMPLIANCE DEPARTMENT. WITH RESPECT TO PARTICULAR TRANSACTIONS THAT COME BEFORE THE BOARD, THE CONFLICT OF INTEREST POLICY WOULD BE FOLLOWED. THE POTENTIAL CONFLICT OF INTEREST WOULD BE DISCLOSED BY THE BOARD MEMBER BEFORE A VOTE ON THE TRANSACTION AND THE REST OF THE BOARD WOULD DETERMINE WHETHER A CONFLICT OF INTEREST EXISTS. IF THE REST OF THE BOARD DETERMINED THAT A CONFLICT OF INTEREST EXISTED THEN THE BOARD MEMBER WITH THE CONFLICT OF INTEREST WOULD NOT PARTICIPATE IN THE DELIBERATIONS AND VOTE. FORM 990, PART VI, SECTION B, LINE 13: WRITTEN WHISTLEBLOWER POLICY THE FILING ORGANIZATION IS PART OF THE INTEGRATED HEALTHCARE SYSTEM OPERATED BY NOVANT HEALTH, INC. ("NOVANT HEALTH"), THE PARENT ORGANIZATION. NOVANT HEALTH'S BYLAWS AUTHORIZE IT TO ESTABLISH CERTAIN POLICIES FOR ALL OF ITS SUBSIDIARIES WITHIN THE SYSTEM. NOVANT HEALTH HAS ESTABLISHED A WHISTLEBLOWER POLICY AND ALL SUBSIDIARY ORGANIZATIONS FOLLOW ALL APPLICABLE NOVANT HEALTH CORPORATE POLICIES IN THEIR OPERATIONS. THE INDIVIDUAL SUBSIDIARY ORGANIZATION'S BOARD OF TRUSTEES DOES NOT SPECIFICALLY ADOPT OR APPROVE EACH OPERATING POLICY, AS THERE ARE HUNDREDS OF POLICIES THAT APPLY TO ALL SUBSIDIARY ORGANIZATIONS AND THEY CANNOT PRACTICABLY BE APPROVED BY ALL OF THE INDIVIDUAL BOARDS. FORM 990, PART VI, SECTION B, LINE 14: WRITTEN DOCUMENT RETENTION AND DESTRUCTION POLICY THE FILING ORGANIZATION IS PART OF THE INTEGRATED HEALTHCARE SYSTEM OPERATED BY NOVANT HEALTH, INC. ("NOVANT HEALTH"), THE PARENT ORGANIZATION. NOVANT HEALTH'S BYLAWS AUTHORIZE IT TO ESTABLISH CERTAIN POLICIES FOR ALL OF ITS SUBSIDIARIES WITHIN THE SYSTEM. NOVANT HEALTH HAS ESTABLISHED A DOCUMENT RETENTION AND DESTRUCTION POLICY AND ALL SUBSIDIARY ORGANIZATIONS FOLLOW ALL APPLICABLE NOVANT HEALTH CORPORATE POLICIES IN THEIR OPERATIONS. THE INDIVIDUAL SUBSIDIARY ORGANIZATION'S BOARD OF TRUSTEES DOES NOT SPECIFICALLY ADOPT OR APPROVE EACH OPERATING POLICY, AS THERE ARE HUNDREDS OF POLICIES THAT APPLY TO ALL SUBSIDIARY ORGANIZATIONS AND THEY CANNOT PRACTICABLY BE APPROVED BY ALL OF THE INDIVIDUAL BOARDS.
FORM 990, PART VI, SECTION B, LINE 15FORM 990, PART VI, SECTION B, LINE 15A: COMPENSATION PROCESS FOR TOP OFFICIAL THE FILING ORGANIZATION IS AN INTEGRAL PART OF NOVANT HEALTH, AN INTEGRATED HEALTHCARE SYSTEM COLLECTIVELY REFERRED TO AS "NOVANT HEALTH." NOVANT HEALTH, INC. IS THE PARENT ORGANIZATION AND INDEPENDENT AND DISINTERESTED MEMBERS OF THE NOVANT HEALTH, INC. BOARD OF TRUSTEES (WHO COMPRISE THE COMPENSATION AND LEADERSHIP COMMITTEE OF THE BOARD) REVIEW, APPROVE, AND OVERSEE ALL ASPECTS OF COMPENSATION AND BENEFITS FOR CERTAIN EXECUTIVES ("EXECUTIVES") SERVING AS THE TOP MANAGEMENT OFFICIAL(S) FOR NOVANT HEALTH ENTITIES. THE COMMITTEE WORKS WITH AN INDEPENDENT COMPENSATION CONSULTANT AND USES THIRD PARTY COMPARABILITY DATA FOR FUNCTIONALLY SIMILAR POSITIONS AT SIMILARLY SITUATED ORGANIZATIONS TO ENSURE THAT TOTAL COMPENSATION AND BENEFITS FOR EACH EXECUTIVE IS REASONABLE FOR THAT EXECUTIVE'S POSITION. THE COMMITTEE REVIEWS AND APPROVES EXECUTIVE COMPENSATION AND BENEFITS ANNUALLY, CONSISTENT WITH THE WRITTEN EXECUTIVE COMPENSATION PHILOSOPHY OF NOVANT HEALTH, AND IN A MANNER THAT QUALIFIES FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS, THEREBY ASSURING THAT TOTAL COMPENSATION AND BENEFITS PROVIDED TO EACH EXECUTIVE IS REASONABLE. FORM 990, PART VI, LINE 15B - COMPENSATION PROCESS FOR OFFICERS THE ORGANIZATION DOES NOT HAVE ANY KEY EMPLOYEES AND THE ORGANIZATION'S ONLY OFFICERS, OTHER THAN THE TOP MANAGEMENT OFFICIAL, ARE STATE LAW BOARD OFFICERS. THESE EMPLOYEES DO NOT HOLD A CORPORATE POSITION OF INFLUENCE THAT RESULTS IN REVIEW OF THEIR COMPENSATION BY THE PARENT ORGANIZATION'S COMPENSATION AND LEADERSHIP COMMITTEE, AS DESCRIBED IN LINE 15A.
FORM 990, PART VI, SECTION C, LINE 19FORM 990, PART VI, SECTION C, LINE 19: GOVERNING DOCUMENTS DISCLOSURE THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS CONTAINING ALL ORGANIZATIONS IN THE NOVANT HEALTH SYSTEM ARE POSTED TO THE NOVANT HEALTH WEBSITE. THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT AVAILABLE TO THE PUBLIC.
FORM 990, PART VII, SECTION A, COLUMN B: RELATED ORGANIZATIONSTHE ORGANIZATION EMPLOYS CERTAIN EXECUTIVES WHOSE ROLES ARE SUCH THAT THEY PROVIDE SERVICES TO NOT ONLY THE ORGANIZATION, BUT ALSO TO SOME OR ALL OF THE OTHER TAX-EXEMPT ORGANIZATIONS WITHIN THE HEALTHCARE SYSTEM. FOR EXAMPLE, MANY OF THESE EXECUTIVES' ROLES FOCUS ON PARTICULAR SERVICE LINES WHICH CROSS THE VARIOUS GEOGRAPHIC MARKETS OUR ORGANIZATIONS SERVE, THUS THE SERVICES PROVIDED BY THESE EXECUTIVES MAY BENEFIT AND BE RECEIVED BY MULTIPLE ORGANIZATIONS WITHIN THE SYSTEM. THE EXECUTIVES DO NOT ALLOCATE THEIR HOURS BETWEEN THE VARIOUS ORGANIZATIONS, BUT RATHER THEIR TIME SPENT ON SERVICES TO THE ORGANIZATION IS INCLUSIVE OF SERVICES TO ALL OF THE ORGANIZATIONS THEY SERVE WITHIN THE SYSTEM.
FORM 990, PART XI, LINE 9:AFFILIATE TRANSFERS: 1,823,455. REFUND OF GRANT: -143,487.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (25 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationIndDirect Controlling NADirectControllingNACd
AUXILIARY OF FORSYTH MEMORIAL HOSPITAL
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103560862112HEALTHCARENC501(C)(3)LINE 10FORSYTH MEMORIAL HOSPITAL INC0
BRUNSWICK NOVANT MEDICAL CENTER FOUNDATION
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103274616751HEALTHCARENC501(C)(3)LINE 7BRUNSWICK COMMUNITY HOSPITAL LLC0
CAROLINA MEDICORP ENTERPRISES INC
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103581466368HEALTHCARENC501(C)(3)LINE 12B, IINOVANT MEDICAL GROUP INC0
COMMUNITY GENERAL HEALTH PARTNERS INC
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103560636250HEALTHCARENC501(C)(3)LINE 3NOVANT HEALTH TRIAD REGION LLC0
COMMUNITY GENERAL HOSPITAL FOUNDATION INC
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103561828629HEALTHCARENC501(C)(3)LINE 7COMMUNITY GENERAL HEALTH PARTNERS INC0
FORSYTH MEMORIAL HOSPITAL INC
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103560928089HEALTHCARENC501(C)(3)LINE 3NOVANT HEALTH TRIAD REGION LLC0
FOUNDATION HEALTH SYSTEMS CORP
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103561373175HEALTHCARENC501(C)(3)LINE 10NOVANT HEALTH INC0
MEDICAL PARK HOSPITAL INC
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103561340424HEALTHCARENC501(C)(3)LINE 3NOVANT HEALTH TRIAD REGION LLC0
NMG SERVICES INC
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103562098809HEALTHCARENC501(C)(3)LINE 10NOVANT HEALTH INC0
NOVANT HEALTH INC
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103561376950HEALTHCARENC501(C)(3)LINE 12C, III-FI0N/A
NOVANT MEDICAL GROUP INC
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103581728803HEALTHCARENC501(C)(3)LINE 3NMG SERVICES INC0
PERSONAL CARE SERVICES
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103541291284HEALTHCAREVA501(C)(3)LINE 10PRINCE WILLIAM HEALTH SYSTEM0
PRESBYTERIAN HOSPITAL FOUNDATION
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103581413074HEALTHCARENC501(C)(3)LINE 7NOVANT HEALTH SOUTHERN PIEDMONT REGION LLC0
PRESBYTERIAN MEDICAL CARE CORPORATION
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103561376368HEALTHCARENC501(C)(3)LINE 3NOVANT HEALTH SOUTHERN PIEDMONT REGION LLC0
PRINCE WILLIAM HEALTH SYSTEM
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103541278944HEALTHCAREVA501(C)(3)LINE 12C, III-FINOVANT HEALTH UVA HEALTH SYSTEM0
PRINCE WILLIAM HOSPITAL
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103540696355HEALTHCAREVA501(C)(3)LINE 3PRINCE WILLIAM HEALTH SYSTEM0
PWHS FOUNDATION
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103541307595HEALTHCAREVA501(C)(3)LINE 7PRINCE WILLIAM HEALTH SYSTEM0
ROWAN HEALTH SERVICES CORPORATION
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103561424814HEALTHCARENC501(C)(3)LINE 12C, III-FINOVANT HEALTH INC0
ROWAN REGIONAL MEDICAL CENTER AUXILIARY
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103237022472HEALTHCARENC501(C)(3)LINE 10ROWAN REGIONAL MEDICAL CENTER INC0
ROWAN REGIONAL MEDICAL CENTER FOUNDATION INC
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103561424818HEALTHCARENC501(C)(3)LINE 7ROWAN REGIONAL MEDICAL CENTER INC0
ROWAN REGIONAL MEDICAL CENTER INC
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103560547479HEALTHCARENC501(C)(3)LINE 3ROWAN HEALTH SERVICES CORPORATION0
SELF INSURANCE FUND - NOVANT HEALTH INC
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103581867242HEALTHCARENC501(C)(3)LINE 12C, III-FINOVANT HEALTH INC0
THE PRESBYTERIAN HOSPITAL
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103560554230HEALTHCARENC501(C)(3)LINE 3NOVANT HEALTH SOUTHERN PIEDMONT REGION LLC0
CULPEPER MEMORIAL HOSPITAL INC
501 SUNSET LANECULPEPERVA22701540622371HEALTHCAREVA501(C)(3)LINE 3NOVANT HEALTH UVA HEALTH SYSTEM0
NOVANT HEALTH UVA HEALTH SYSTEM
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103810868533HEALTHCAREVA501(C)(3)LINE 12A, INOVANT HEALTH INC0

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (13 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdDirect Controlling NADirectControllingNACdEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationIndAddress Line1ForeignAddress/AddressLine1TxtCityForeignAddress/CityNmProvince Or StateForeignAddress/ProvinceOrStateNmCountryForeignAddress/CountryCdLegal Domicile Foreign CountryLegalDomicileForeignCountryCd
ADEPT HEALTH INC FKA NOVANT HEALTH SHARED SERVICES INC
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103562226937ADMIN SERVICESNCN/AC0
CHOICEHEALTH INC
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103561896065MANAGED CARENCN/AC0
COMMUNICARE INC
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103561952950RENTAL REAL ESTATENCN/AC0
KERNERSVILLE MEDICAL CENTER PARK OWNERS' ASSOCIATION
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103471511401RENTAL REAL ESTATENCN/AC0
MEDQUEST INC & SUBSIDIARIES
3480 PRESTON RIDGE RD STE 600ALPHARETTAGA30005223860764DIAGNOSTIC IMAGINGDEN/AC0
NOVANT HEALTH RISK RETENTION GROUP INC
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103203382230INSURANCESCN/AC0
NOVANT HEALTH TRINOVA INSURANCE PROTECTED CELL INC
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103812963143INSURANCENCN/AC0
ROWAN MEDICAL ALLIANCE INC
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103561992669INSURANCENCN/AC0
ROWAN MEDICAL FACILITIES INC
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103561424672MEDICAL SUPPLIESNCN/AC0
SALEM DIAGNOSTICS INC
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103561513621HEALTH RELATEDNCN/AC0
SALEM HEALTH SERVICES INC
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103561342654HEALTH RELATEDNCN/AC0
THE PARK AT MONROE PROPERTY OWNERS ASSOCIATION INC
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103463910256RENTAL REAL ESTATENCN/AC0
TRINOVA INSURANCE LTD
980615601INSURANCEN/AC0C/O MARSH MGMT 11 VICTORIA STHAMILTONBERMUDA HM11 HXBDBD
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (1)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (1)PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other OrgYes (1)TransferFromOtherOrgInd