2017-07-21T10:54:04-05:00 2016-09-30 420714325 RSM US LLP 1 S WACKER DRIVE STE 800 CHICAGO IL 60606 990 2015-10-01 911997979 East Carolina Health Inc EAST 2528475129 2100 Stantonsburg Road Greenville NC 27835 David Hughes Secretary and Treasurer 2528475129 2017-07-21 1 Wayne Harder P00294296 3126343400 2015 2021-01-29 14:40:06Z Vidant Comm Hospitals Group Roger Robertson 2100 Stantonsburg Road Greenville NC 27835 375086600 1 1 8242 X WWW.VIDANTHEALTH.COM X 1996 NC To enhance the quality and management of non-profit hospitals and health care system services. 7 6 0 424 0 0 2102777 2236302 358627276 365656694 242900 397279 6846910 6796325 367819863 375086600 0 0 0 0 142951270 146721586 0 0 0 199492571 203116724 342443841 349838310 25376022 25248290 250990467 263716843 77094918 97148966 173895549 166567877 To improve the health and well-being of eastern North Carolina. 0 0 52941769 89925909 Vidant Edgecombe HospitalVidant Edgecombe Hospital, formerly Heritage Hospital, is a 101-bed facility located in Tarboro, North Carolina, that is also licensed for 16 inpatient rehabilitation beds. Services at Vidant Edgecombe include acute care, inpatient and same-day surgery, emergency, critical care, obstetrics/gynecology, rehabilitation and oncology services. It also operates a rural health center, which provides general, pediatric, women's and occupational health services. 61267709 54560716 Vidant Roanoke-Chowan HospitalVidant Roanoke-Chowan Hospital is an 86-bed hospital located in Ahoskie, North Carolina, that is also licensed for 28 inpatient psychiatric beds. Services at Roanoke-Chowan Hospital include acute care, obstetrics/gynecology, emergency, sub-acute care, specialty clinics and behavioral health. The hospital also operates a wellness center for the community. 51782852 71801581 Vidant Beaufort HospitalVidant Beaufort Hospital is a 120-bed hospital located in Washington, North Carolina, that is also licensed for 22 inpatient psychiatric beds. Services at Vidant Beaufort Hospital include acute care, obstetrics/gynecology, emergency, sub-acute care, specialty clinics and behavioral health. 120160431 149368488 120160431 149368488 286152761 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 7 6 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 1 1 0 X X Brian Dunn 2528477479 2100 Stantonsburg Road Greenville NC 27835 Dr Marcus Albernaz MD Board Member 2.00 4.00 X 0 0 0 Phillip Flowers Board Member 2.00 4.00 X 0 0 0 Bruce Gray Board Member 2.00 4.00 X 0 0 0 Polly Johnson Board Member 2.00 2.00 X 0 0 0 Arthur H Keeney III Board Member 2.00 6.00 X 0 0 0 Thomasine Kennedy Board Member 2.00 4.00 X 0 0 0 Dr Michael Waldrum MD Chief Executive Officer 2.00 50.00 X 0 483826 74071 Roger Robertson President, ECH 2.00 46.00 X 0 455525 295990 Chris Townsend Vice President of Financial Services 40.00 2.00 X 0 175349 77296 Lynn Lanier Former Vice President, ECH 40.00 4.00 X 0 246849 183967 David S Hughes Secretary and Treasurer 2.00 50.00 X 0 497452 169107 Jeffrey Sackrison President of Bertie and Chowan 40.00 X 0 354010 145001 Jay Briley President of Duplin 40.00 X 0 217104 86100 Wendell Baker Jr President of Heritage 40.00 X 290210 0 159914 Susan Lassiter President of RCH 40.00 X 277379 0 211317 William Case President of Beaufort 40.00 X 0 257922 139535 Jon Graham VP, Finance/CFO at RCH 40.00 X 179180 0 56794 Charles Alford CFO, Vidant Beaufort and Heritage 40.00 X 163351 0 49528 Brian Harvill VP Financial Svcs, Bertie and Chowan 40.00 X 161866 0 54386 Cindy Coker VP, Patient Care Services at Chowan 40.00 X 157342 0 132918 Tammi Roos Anesthesiologist - Duplin 40.00 X 405677 0 50006 Debra Allenspach Nurse Anesthetist - Chowan 40.00 X 330273 0 67462 Wallace Nelson Manager, Pharmacy - Chowan 40.00 X 308190 0 216753 Don Marshburn Manager, Anesthesia - Roanoke 40.00 X 280824 0 91778 Robert Poston Nurse Anesthetist - Chowan 40.00 X 286532 0 44018 Dr David Herman MD Former Chief Executive Officer 0.00 0.00 X 0 270651 31973 2840824 2958688 2337914 90 1 1 0 Horizon Mental Health Management PO Box 840839 Dallas TX 75284 Behavioral Health Nurse Staffing 3082519 Shiftwise US Bank Corp Trust PO Box 70870 St Paul MN 55107 Temporary Staffing Agency 960406 Diamond Healthcare Corp Fed Rsv Bank Bldg PO Box 8505 Richmond VA 23285 Behavioral Health Nurse Staffing 937512 Sightpath Medical Inc PO Box 204253 Dallas TX 75284 Opthalmic Surgery Services 839956 Caldwell Butler PO Box 3273 St Augustine FL 32085 Consulting 527244 43 2236302 2236302 Outpatient Revenue 621400 217115232 217115232 Inpatient Revenue 621110 147337801 147337801 1203661 1203661 365656694 391804 391804 155111 0 155111 155111 155111 5475 0 5475 5475 5475 Cafeteria Services 722210 1698843 1698843 ViQuest Fitness 900099 1469540 1469540 Pharmacy 446110 985306 985306 2487525 2487525 6641214 375086600 365656694 0 7193604 1760083 1760083 111850774 89480619 22370155 6695758 5356606 1339152 18374687 14699750 3674937 8040284 6432227 1608057 47542309 38033847 9508462 138831 111065 27766 252611 202089 50522 24306142 19444914 4861228 415769 332615 83154 5187288 4149830 1037458 1874741 1499793 374948 5451825 4361460 1090365 835268 668214 167054 3153116 630623 2522493 248482 248482 13903165 13903165 2097800 419560 1678240 Chargeable Patient Supp 49613898 39691118 9922780 Bad Debt Expense 38871044 38871044 Repairs 5552039 4441631 1110408 Medicaid GAP Assessment 2560603 2560603 1111793 861988 249805 349838310 286152761 63685549 0 37482293 35069099 46276335 53260373 10969782 11311234 687845 7006547 302232128 185711116 121928747 116521012 1628048 1629048 21857785 20842057 10159632 18077473 250990467 263716843 35535274 37867179 667797 630415 40891847 58651372 77094918 97148966 X 170679841 163700046 3215708 2867831 173895549 166567877 250990467 263716843 X 25248290 -32575962 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 5050380 5050380 170348167 89715112 80633055 3139069 3139069 0 122223864 92856935 29366929 1470648 1470648 116521012 Other Receivables 8034306 Estimated Settlements from Third Party 215604 Deferred Pension Outflows 9827563 18077473 Accrued Post-retirement Benefits 32329393 Third Party Payable 3175690 Lease Obligation 19437074 Other 1702211 Deferred Credits 2007004 58651372 X Part X, Line 2: East Carolina Health, Inc. has been determined to qualify as a tax-exempt organization under Section 501(c)(3) of the Internal Revenue Code. East Carolina Health, Inc. has reviewed its tax positions for all open years and has concluded that no material liabilities exist as of September 30, 2016 and 2015. East Carolina Health files tax returns with the U.S. federal and State of North Carolina jurisdictions. With few exceptions, East Carolina Health is no longer subject to U.S. federal examinations by tax authorities for years before 2013. 1 1 X 1 X 1 X 1 1 1 0 0 16016458 16016458 0.04580 51134164 39237438 11896726 0.03400 67150622 39237438 27913184 0.07980 79 30780 1352366 9504 1342862 0.00380 18 1386 1554157 1554157 0.00440 1 41 127342 12194 115148 0.00030 30 130180 1131689 56303 1075386 0.00310 128 162387 4165554 78001 4087553 0.01160 128 162387 71316176 39315439 32000737 0.09140 6 23 45628 45628 0.00010 8 662 128898 128898 0.00040 1 75 466 466 0.00000 3 13159 13159 0.00000 11 1750 89352 89352 0.00030 29 2510 277503 277503 0.00080 1 13392967 0 139918992 143620138 -3701146 X 1 1 1 Heritage MRI LLC Outpatient MRI Services 0.66670 0.00000 0.33330 6 1 East Carolina Health - Heritage Inc 111 Hospital Drive Tarboro NC 27886 X X X X Rehabilitation 2 East Carolina Health - Roanoke-Chowan 500 Academy Street Ahoskie NC 27910 X X X X Behavioral Health 3 East Carolina Health - Beaufort Inc 628 East Twelfth Street Washington NC 27889 X X X X Behavioral Health 4 East Carolina Health - Chowan Inc 211 Virginia Road Edenton NC 27932 X X X X 5 Duplin General Hospital Inc 401 North Main Street Kenansville NC 28349 X X X X Behavioral Health 6 East Carolina Health - Bertie 1403 South King Street Windsor NC 27983 X X X X East Carolina Health - Heritage Inc 1 0 0 1 X X X X X X X X 15 1 1 0 1 X See Schedule H, Part V, Section C X 1 15 1 See Schedule H, Part V, Section C 0 0 1 X 200.000000000000 200.000000000000 X X 1 1 X X X 1 X https://www.vidanthealth.com/edgecombe/patients.aspx?id=4153 X www.vidanthealth.com/billing-assistance X www.vidanthealth.com/billing-assistance X X X X 1 X 0 X X X X 1 X 0 0 East Carolina Health - Roanoke-Chowan 2 0 0 1 X X X X X X X X 15 1 1 0 1 X See Schedule H, Part V, Section C X 1 15 1 See Schedule H, Part V, Section C 0 0 1 X 200.000000000000 200.000000000000 X X 1 1 X X X 1 X https://www.vidanthealth.com/roanokechowan/patients.aspx?id=4179 X www.vidanthealth.com/billing-assistance X www.vidanthealth.com/billing-assistance X X X X 1 X 0 X X X X 1 X 0 0 East Carolina Health - Beaufort Inc 3 0 0 1 X X X X X X X X 14 1 1 0 1 X See Schedule H, Part V, Section C X 1 14 1 See Schedule H, Part V, Section C 0 0 1 X 200.000000000000 200.000000000000 X X 1 1 X X X 1 X https://www.vidanthealth.com/Beaufort/dynamic-detail.aspx?id=16220 X www.vidanthealth.com/billing-assistance X www.vidanthealth.com/billing-assistance X X X X 1 X 0 X X X X 1 X 0 0 East Carolina Health - Chowan Inc 4 0 0 1 X X X X X X X X 15 1 1 0 1 X See Schedule H, Part V, Section C X 1 15 1 See Schedule H, Part V, Section C 0 0 1 X 200.000000000000 200.000000000000 X X 1 1 X X X 1 X https://www.vidanthealth.com/chowan/patients.aspx?id=4121 X www.vidanthealth.com/billing-assistance X www.vidanthealth.com/billing-assistance X X X X 1 X 0 X X X X 1 X 0 0 Duplin General Hospital Inc 5 0 0 1 X X X X X X X X 15 1 1 0 1 X See Schedule H, Part V, Section C X 1 15 1 See Schedule H, Part V, Section C 0 0 1 X 200.000000000000 200.000000000000 X X 1 1 X X X 1 X https://www.vidanthealth.com/duplin/patients.aspx?id=4138 X www.vidanthealth.com/billing-assistance X www.vidanthealth.com/billing-assistance X X X X 1 X 0 X X X X 1 X 0 0 East Carolina Health - Bertie 6 0 0 1 X X X X X X X X 15 1 1 0 1 X See Schedule H, Part V, Section C X 1 15 1 See Schedule H, Part V, Section C 0 0 1 X 200.000000000000 200.000000000000 X X 1 1 X X X 1 X https://www.vidanthealth.com/bertie/patients.aspx?id=3905 X www.vidanthealth.com/billing-assistance X www.vidanthealth.com/billing-assistance X X X X 1 X 0 X X X X 1 X 0 0 East Carolina Health - Heritage, Inc. Part V, Section B, Line 5: Each of the Vidant Community Hospitals collaborate with local county health departments and other interested parties in the local communities to produce the Community Health Needs Assessment. These partners include schools, health-focused not-for-profits, community health initiatives, chambers of commerce, and other agencies dedicated to promoting the well-being of their communities. The partners represent a wide range of diverse constituencies including children, seniors, and underserved populations. The information created through this collaborative effort is then used to determine areas of health needs focus for the individual entities and also for creating partnerships to address needs where possible. East Carolina Health - Roanoke-Chowan Part V, Section B, Line 5: Each of the Vidant Community Hospitals collaborate with local county health departments and other interested parties in the local communities to produce the Community Health Needs Assessment. These partners include schools, health-focused not-for-profits, community health initiatives, chambers of commerce, and other agencies dedicated to promoting the well-being of their communities. The partners represent a wide range of diverse constituencies including children, seniors, and underserved populations. The information created through this collaborative effort is then used to determine areas of health needs focus for the individual entities and also for creating partnerships to address needs where possible. East Carolina Health - Beaufort, Inc. Part V, Section B, Line 5: Each of the Vidant Community Hospitals collaborate with local county health departments and other interested parties in the local communities to produce the Community Health Needs Assessment. These partners include schools, health-focused not-for-profits, community health initiatives, chambers of commerce, and other agencies dedicated to promoting the well-being of their communities. The partners represent a wide range of diverse constituencies including children, seniors, and underserved populations. The information created through this collaborative effort is then used to determine areas of health needs focus for the individual entities and also for creating partnerships to address needs where possible. East Carolina Health - Chowan, Inc. Part V, Section B, Line 5: Each of the Vidant Community Hospitals collaborate with local county health departments and other interested parties in the local communities to produce the Community Health Needs Assessment. These partners include schools, health-focused not-for-profits, community health initiatives, chambers of commerce, and other agencies dedicated to promoting the well-being of their communities. The partners represent a wide range of diverse constituencies including children, seniors, and underserved populations. The information created through this collaborative effort is then used to determine areas of health needs focus for the individual entities and also for creating partnerships to address needs where possible. Duplin General Hospital, Inc. Part V, Section B, Line 5: Each of the Vidant Community Hospitals collaborate with local county health departments and other interested parties in the local communities to produce the Community Health Needs Assessment. These partners include schools, health-focused not-for-profits, community health initiatives, chambers of commerce, and other agencies dedicated to promoting the well-being of their communities. The partners represent a wide range of diverse constituencies including children, seniors, and underserved populations. The information created through this collaborative effort is then used to determine areas of health needs focus for the individual entities and also for creating partnerships to address needs where possible. East Carolina Health - Bertie Part V, Section B, Line 5: Each of the Vidant Community Hospitals collaborate with local county health departments and other interested parties in the local communities to produce the Community Health Needs Assessment. These partners include schools, health-focused not-for-profits, community health initiatives, chambers of commerce, and other agencies dedicated to promoting the well-being of their communities. The partners represent a wide range of diverse constituencies including children, seniors, and underserved populations. The information created through this collaborative effort is then used to determine areas of health needs focus for the individual entities and also for creating partnerships to address needs where possible. East Carolina Health - Heritage, Inc. Part V, Section B, Line 6a: The Community Health Needs Assessment was conducted with the following hospitals:- East Carolina Health - Heritage, Inc. DBA Vidant Edgecombe Hospital- East Carolina Health DBA Vidant Roanoke-Chowan Hospital- East Carolina Health - Beaufort, Inc. DBA Vidant Beaufort Hospital- East Carolina Health - Chowan, Inc. DBA Vidant Chowan Hospital- Duplin General Hospital, Inc. DBA Vidant Duplin Hospital- East Carolina Health - Bertie DBA Vidant Bertie Hospital East Carolina Health - Roanoke-Chowan Part V, Section B, Line 6a: The Community Health Needs Assessment was conducted with the following hospitals:- East Carolina Health - Heritage, Inc. DBA Vidant Edgecombe Hospital- East Carolina Health DBA Vidant Roanoke-Chowan Hospital- East Carolina Health - Beaufort, Inc. DBA Vidant Beaufort Hospital- East Carolina Health - Chowan, Inc. DBA Vidant Chowan Hospital- Duplin General Hospital, Inc. DBA Vidant Duplin Hospital- East Carolina Health - Bertie DBA Vidant Bertie Hospital East Carolina Health - Beaufort, Inc. Part V, Section B, Line 6a: The Community Health Needs Assessment was conducted with the following hospitals:- East Carolina Health - Heritage, Inc. DBA Vidant Edgecombe Hospital- East Carolina Health DBA Vidant Roanoke-Chowan Hospital- East Carolina Health - Beaufort, Inc. DBA Vidant Beaufort Hospital- East Carolina Health - Chowan, Inc. DBA Vidant Chowan Hospital- Duplin General Hospital, Inc. DBA Vidant Duplin Hospital- East Carolina Health - Bertie DBA Vidant Bertie Hospital East Carolina Health - Chowan, Inc. Part V, Section B, Line 6a: The Community Health Needs Assessment was conducted with the following hospitals:- East Carolina Health - Heritage, Inc. DBA Vidant Edgecombe Hospital- East Carolina Health DBA Vidant Roanoke-Chowan Hospital- East Carolina Health - Beaufort, Inc. DBA Vidant Beaufort Hospital- East Carolina Health - Chowan, Inc. DBA Vidant Chowan Hospital- Duplin General Hospital, Inc. DBA Vidant Duplin Hospital- East Carolina Health - Bertie DBA Vidant Bertie Hospital Duplin General Hospital, Inc. Part V, Section B, Line 6a: The Community Health Needs Assessment was conducted with the following hospitals:- East Carolina Health - Heritage, Inc. DBA Vidant Edgecombe Hospital- East Carolina Health DBA Vidant Roanoke-Chowan Hospital- East Carolina Health - Beaufort, Inc. DBA Vidant Beaufort Hospital- East Carolina Health - Chowan, Inc. DBA Vidant Chowan Hospital- Duplin General Hospital, Inc. DBA Vidant Duplin Hospital- East Carolina Health - Bertie DBA Vidant Bertie Hospital East Carolina Health - Bertie Part V, Section B, Line 6a: The Community Health Needs Assessment was conducted with the following hospitals:- East Carolina Health - Heritage, Inc. DBA Vidant Edgecombe Hospital- East Carolina Health DBA Vidant Roanoke-Chowan Hospital- East Carolina Health - Beaufort, Inc. DBA Vidant Beaufort Hospital- East Carolina Health - Chowan, Inc. DBA Vidant Chowan Hospital- Duplin General Hospital, Inc. DBA Vidant Duplin Hospital- East Carolina Health - Bertie DBA Vidant Bertie Hospital East Carolina Health - Heritage, Inc. Part V, Section B, Line 11: Certain community needs may not be fully documented or addressed in the Community Health Needs Assessment. These needs are generally those which other organizations share an overlap with East Carolina Health. Those other organizations are better equiped to address these specific needs, and are subsequently not considered as issues of East Carolina Health. East Carolina Health - Roanoke-Chowan Part V, Section B, Line 11: Certain community needs may not be fully documented or addressed in the Community Health Needs Assessment. These needs are generally those which other organizations share an overlap with East Carolina Health. Those other organizations are better equiped to address these specific needs, and are subsequently not considered as issues of East Carolina Health. East Carolina Health - Beaufort, Inc. Part V, Section B, Line 11: Certain community needs may not be fully documented or addressed in the Community Health Needs Assessment. These needs are generally those which other organizations share an overlap with East Carolina Health. Those other organizations are better equiped to address these specific needs, and are subsequently not considered as issues of East Carolina Health. East Carolina Health - Chowan, Inc. Part V, Section B, Line 11: Certain community needs may not be fully documented or addressed in the Community Health Needs Assessment. These needs are generally those which other organizations share an overlap with East Carolina Health. Those other organizations are better equiped to address these specific needs, and are subsequently not considered as issues of East Carolina Health. Duplin General Hospital, Inc. Part V, Section B, Line 11: Certain community needs may not be fully documented or addressed in the Community Health Needs Assessment. These needs are generally those which other organizations share an overlap with East Carolina Health. Those other organizations are better equiped to address these specific needs, and are subsequently not considered as issues of East Carolina Health. East Carolina Health - Bertie Part V, Section B, Line 11: Certain community needs may not be fully documented or addressed in the Community Health Needs Assessment. These needs are generally those which other organizations share an overlap with East Carolina Health. Those other organizations are better equiped to address these specific needs, and are subsequently not considered as issues of East Carolina Health. East Carolina Health - Heritage, Inc. Part V, Section B, Line 16i: The full policy is not available on the facility website. In lieu of the policy, a concise summary is provided with pertinent details and phone numbers for additional information. East Carolina Health - Roanoke-Chowan Part V, Section B, Line 16i: The full policy is not available on the facility website. In lieu of the policy, a concise summary is provided with pertinent details and phone numbers for additional information. East Carolina Health - Beaufort, Inc. Part V, Section B, Line 16i: The full policy is not available on the facility website. In lieu of the policy, a concise summary is provided with pertinent details and phone numbers for additional information. East Carolina Health - Chowan, Inc. Part V, Section B, Line 16i: The full policy is not available on the facility website. In lieu of the policy, a concise summary is provided with pertinent details and phone numbers for additional information. Duplin General Hospital, Inc. Part V, Section B, Line 16i: The full policy is not available on the facility website. In lieu of the policy, a concise summary is provided with pertinent details and phone numbers for additional information. East Carolina Health - Bertie Part V, Section B, Line 16i: The full policy is not available on the facility website. In lieu of the policy, a concise summary is provided with pertinent details and phone numbers for additional information. Part V, section B, Line 7a: The Hospital makes its CHNA report available to the public on the Hospital's website: www.vidanthealth.com/vidant/dynamic-detail.aspx?id=13673 Part V, section B, Line 10a: The Hospital makes its most recently adopted implementation strategy available to the public on the Hospital's website: www.vidanthealth.com/vidant/dynamic-detail.aspx?id=13673 Part I, Line 6a: In addition to the Community Benefit Report for East Carolina Health, information regarding this group is found in the annual report for University Health Systems of Eastern Carolina d/b/a Vidant Health. Part I, Line 7: Costs were calculated using the estimated cost to charge ratio from The North Carolina Hospital Association's Advocacy Needs Data Initiative which is the standard for reporting community benefits in North Carolina. Part I, Ln 7 Col(f): In connection with the Presumptive Eligibility consideration of the Affordable Care Act, East Carolina Health does not reflect any bad debt in connection with FAP-eligible patients. These patients are presumed to be part of the Medicaid population and afforded coverage as such. Part II, Community Building Activities: The community building activities of The Outer Banks Hospital involve services that are otherwise not provided by other organizations in the patient area. Part III, Line 4: The financial statements of Vidant Medical Center are presented on a consolidated basis as part of the consolidated financial statements of Vidant Health; the text of the footnote from page 21 is presented below:Patient Accounts ReceivablePatient Accounts Receivable are reported net of estimated allowances for contractual adjustments and allowances for bad debts. Estimated allowances for bad debts are approximately $79.6 million and $74.7 million as of September 30, 2016 and 2015, respectively. Part III, Line 8: The shortfall of Medicare revenue to Medicare was calculated according to the cost to charge ratio. Allowable costs of care should be considered community benefit because in the area served by ECH, there are no other providers available to provide the required services. Therefore, the care would become a government obligation and is treated as a community benefit provided by ECH. Part III, Line 9b: Recommended patient accounts will continue to go through the accounts receivable billing cycle as normal. When the account reaches the customer service/collections manager, financial counseling supervisor or patient accounts supervisor, based on the information given, a decision will be made whether to proceed with collection or refer the account for approval of charity care. The process will occur as follows: I. Financial counselors will try to locate third party payors. If not eligible for any third party coverage (including charities), they may, based upon the financial information received, recommend the patient for charity care. II. Patient counselors will review for any third party payors and verify employment and assets. A charity care application will need to be completed along with tax return, pay stubs, social security award letter and other financial information as may be required. III. The patient accounts supervisor, financial counseling supervisor or customer service/collections manager, based upon account balance and the information given, will make a decision whether to proceed with collection or refer the patient account for approval for charity care.Presumptive eligibility for charity care - there are occasions in which a patient may appear eligible for a charity care discount, but there is no financial assistance information available to support financial aid. A. Some patients are presumed to be eligible for charity care discounts on the basis of individual life circumstances (e.g., homelessness, patients with no income, bankruptcy, deceased patients with no estate or spouse, etc). B. Through the assistance of a third party vendor and certain algorithms, in conjuction with our charity policy guidelines, all accounts, prior to outside collection agency referral, will be tested for presumptive charity. C. The accounts deemed charity will be adjusted off and the remaining accounts will be referred to an outside collection agency. D. Once the agency has had the accounts for six months and has deemed them uncollectible, the accounts with balances of $1,200 or greater will remain with the agency and be kept on the patient's credit file. E. The accounts returned to the hospital will be placed in a unique financial class and will not be pursued for collections. Part VI, Line 2: The organization assesses community need in conjunction with the state affiliated county health departments and other local health care organizations. See also Schedule H, Part V, Section B, lines 1-7 Part VI, Line 3: Information is available on the organization's website and at registration for patients. In addition, face to face financial counseling is available to patients and their families in the central business office. Part VI, Line 4: See Schedule O, Part III, Line 4a in connection with www.vidanthealth.com/vidant/dynamic-detail.aspx?id=13673 Part VI, Line 5: See Schedule O, Part III, Line 4a in connection with www.vidanthealth.com/vidant/dynamic-detail.aspx?id=13673 Part VI, Line 6: See Schedule O, Part III, Line 4a in connection with www.vidanthealth.com/vidant/dynamic-detail.aspx?id=13673 Part VI, Line 7, Reports Filed With States NC X X X X 0 1 0 0 0 0 0 0 0 Dr Michael Waldrum MD Chief Executive Officer 0 483826 0 0 0 0 0 48600 0 25471 0 557897 0 0 Roger Robertson President, ECH 0 382182 0 70778 0 2565 0 258060 0 37930 0 751515 0 0 Chris Townsend Vice President of Financial Services 0 160547 0 14802 0 0 0 50941 0 26355 0 252645 0 0 Lynn Lanier Former Vice President, ECH 0 227409 0 18415 0 1025 0 150176 0 33791 0 430816 0 0 David S Hughes Secretary and Treasurer 0 422256 0 73638 0 1558 0 126996 0 42111 0 666559 0 0 Jeffrey Sackrison President of Bertie and Chowan 0 291558 0 46736 0 15716 0 126790 0 18211 0 499011 0 15716 Jay Briley President of Duplin 0 182664 0 34440 0 0 0 47730 0 38370 0 303204 0 0 Wendell Baker Jr President of Heritage 234327 0 42637 0 13246 0 123657 0 36257 0 450124 0 13246 0 Susan Lassiter President of RCH 237241 0 38706 0 1432 0 183470 0 27847 0 488696 0 0 0 William Case President of Beaufort 0 219688 0 37586 0 648 0 96275 0 43260 0 397457 0 0 Jon Graham VP, Finance/CFO at RCH 167064 0 12116 0 0 0 40356 0 16438 0 235974 0 0 0 Charles Alford CFO, Vidant Beaufort and Heritage 151989 0 11362 0 0 0 44535 0 4993 0 212879 0 0 0 Brian Harvill VP Financial Svcs, Bertie and Chowan 148656 0 13210 0 0 0 17055 0 37331 0 216252 0 0 0 Cindy Coker VP, Patient Care Services at Chowan 144271 0 13071 0 0 0 90425 0 42493 0 290260 0 0 0 Tammi Roos Anesthesiologist - Duplin 405677 0 0 0 0 0 24566 0 25440 0 455683 0 0 0 Debra Allenspach Nurse Anesthetist - Chowan 329523 0 750 0 0 0 28960 0 38502 0 397735 0 0 0 Wallace Nelson Manager, Pharmacy - Chowan 307440 0 750 0 0 0 197683 0 19070 0 524943 0 0 0 Don Marshburn Manager, Anesthesia - Roanoke 280074 0 750 0 0 0 56743 0 35035 0 372602 0 0 0 Robert Poston Nurse Anesthetist - Chowan 285782 0 750 0 0 0 32487 0 11531 0 330550 0 0 0 Dr David Herman MD Former Chief Executive Officer 0 270651 0 0 0 0 0 27059 0 4914 0 302624 0 0 Part I, Line 3 The Top Management Official is the President who is an employee of East Carolina Health. The compensation is determined by the Compensation and Benefits Committee of the Vidant Health Board using comparative data from like organizations and input from consultants. This process is performed every two years, the last year being 2015. It will be performed again in fiscal year 2017. Compensation of other officers and key employees is also determined by the Compensation and Benefits Committee of the VH Board using comparative data from like organizations and input from consultants. This process is performed every two years, the last year being 2015. It will be performed again in fiscal year 2017. All compensation discussions and actions are documented and approved in the minutes of the Committee. Part I, Line 4b As of January 1, 2013, the supplemental nonqualified retirement plan was frozen and no further amounts have accrued to its benefit. In lieu of the SERP, the comprehensive defined benefit pension plan will provide an equivalent benefit. The increase in the value of such plans is reflected in the sum of Part II, Column (C). Form 990, Part VI, Section B, line 11 The 990 is made available to Board Members by posting to a Board Member's website. Any Board Member who does not have the ability to access the return in this manner will receive a copy via electronic or regular mail. The return is also reviewed by the Chief Financial Officer, Chief General Counsel and the Chief Audit and Compliance Officer of University Health Systems prior to filing. Form 990, Part VI, Section B, line 12 All Officers, Board Members and Key Employees are required to complete a yearly comprehensive conflict of interest questionnaire. These are reviewed by legal counsel and any potential or actual conflicts are brought to the Board for disposition. Board Members are instructed to report any potential conflicts arising during the year for review. Board Members are required to recuse themselves from voting on issues in which they are deemed to have a conflict. Form 990, Part VI, Section B, line 15 The Top Management Official is the President who is an employee of East Carolina Health, Inc. The compensation is determined by the Compensation and Benefits Committee of the Vidant Health Board using comparative data from like organizations and input from consultants. This process is performed every two years, the last year being 2015. It will be performed again in fiscal year 2017. Compensation of other officers and key employees is also determined by the Compensation and Benefits Committee of the VH Board using comparative data from like organizations and input from consultants. This process is performed every two years, the last year being 2015. It will be performed again in fiscal year 2017. All compensation discussions and actions are documented and approved in the minutes of the Committee. Form 990, Part VI, Section C, line 19 The Organization makes its governing documents, conflict of interest policy, and combined financial statements available upon request for the same period of disclosure as set forth in IRC Section 6104(d). Form 990, Part XI, line 9: Net Asset Transfer -32,575,962. Form 990, Part III, Line 4a: Overview of University Health Systems of Eastern Carolina: Our mission at VH to enhance the quality of life for the people and communities we serve, touch and support drives us far beyond caring for patients within the confines of our hospital walls. It calls us to help make eastern North Carolina a better, healthier place to live. VH is a North Carolina non-profit corporation with headquarters in Greenville, North Carolina. VH and its affiliates operate an integrated health care delivery system that serves a total market of approximately 1.4 million people in 29 contiguous counties in eastern North Carolina. The Health System includes hospitals, physician practices, outpatient services, long-term care, home health, hospice, and wellness services. The Health System's owned hospitals are Vidant Medical Center ("VMC"), which is a tertiary care hospital and an academic medical center, and seven other acute care hospitals: Vidant Roanoke-Chowan Hospital, Vidant Edgecombe Hospital, Vidant Chowan Hospital, Vidant Bertie Hospital, Vidant Duplin Hospital, Vidant Beaufort Hospital, and The Outer Banks Hospital. VMC serves as the teaching hospital for the Brody School of Medicine, East Carolina Schools of Nursing and Allied Health and Pitt Community College. The system also serves as a regional referral center for eastern North Carolina. The System's seven owned acute care hospitals are licensed to operate 1,439 beds. Each hospital is licensed by the Division of Facility Services of the North Carolina Department of Health and Human Services and approved as a provider by the Medicare and Medicaid programs. VH and its hospitals and affiliate organizations provide services to patients without regard to their ability to pay. In fiscal year 2015 VH's combined patient care statistics were: inpatient admissions, 64,388; inpatient days of care, 335,772; surgeries, 46,544; births, 6,019; and outpatient visits, 330,836. Our System's workforce included 11,889 employees. Each of VH's hospitals operates an emergency room, which is open 24 hours a day. VMC also offers a full spectrum of trauma services. Emergency and trauma services are provided to patients without regard to their ability to pay. In fiscal year 2015 VH provided care to 273,688 emergency room patients. VH's Board of Directors consists of 11 voting members, six of whom must be current or former Pitt County, North Carolina appointees of VMC's Board of Trustees and five of whom must be current of former Board of Governors of the University of North Carolina appointees of VMC's Board of Trustees. VMC, in affiliation with the Brody School of Medicine, which is owned by the State of North Carolina, operates 30 resident-training programs with over 400 medical residents. This relationship enables VMC and the Brody School of Medicine to combine their resources for the provision of quality patient care, medical education and research for the residents of eastern North Carolina. The Brody School of Medicine has three important goals: educating primary care physicians, making medical care more readily available to the people of eastern North Carolina, and providing opportunities to minority and disadvantaged students. As a non-profit organization, VH reinvests all excess of revenues over expenses in programs, services, and facilities that provide access to patient care and health services to the citizens of Eastern Carolina. Overview of Vidant Health Community Benefit Programs 1. Eastern North Carolina is comprised of 1.4 million people living in 14,000 square miles. Boundaries are from I-95 East to the coast, and from the Virginia line up to and including Onslow County. The area is largely rural and largely poor, with higher than state or national average rates for poverty and uninsured. Health status indicators show increased incidence of disease in the region, especially cancer, heart disease and stroke. VH determines priorities for target populations by working in concert with medical and community agency partners in ongoing assessment of the most pressing health care needs. Many efforts over the past decade have focused on diabetes, pediatric asthma, school health, injury prevention, access to care, nutrition enhancement, physical activities and chronic disease screenings. Also, special programs to manage the care of Medicaid enrollees, address access to both medical care and medications for the uninsured, and coordination of services for children with obesity have been undertaken. The populations that are served by addressing these issues are largely the poor, the underserved, and minorities. Determination of specific populations to address occurs when partners such as the North Carolina Department of Health and Human Services, local health departments, county Healthy Carolinian task forces, and physicians identify a quantifiable need, and community partners are engaged to work together with the health system. 2. Funding for community health programs is obtained from both the operating funds of VH entities and external grant-awarding organizations. The VH Board annually provides financial support for the Community Benefit Initiatives program of its foundation. These funds are then awarded to community agencies that successfully demonstrate both need and a well-designed plan to address one of the Foundation's priority categories. In addition, each VH hospital financially supports community health resources within its operating budget. Programs vary according to the hospital's financial ability and community need, but all include collaborative efforts with local health departments, including health screenings and education to targeted populations. VH also has a successful track record of obtaining community health program support from external agencies that award grant funding to approve projects. The VH Grants Office was established in 2008 and serves as the central point for grant mining, acquisition and management of grants awarded to VH hospitals for community-based programs. Grant funds are utilized to demonstrate the effectiveness of a proposed community program, measure the outcomes achieved, and garner long-term sustainability from either the health system, other community agencies or as a collaborative program. Many community health programs are collaborative in nature with local service agencies, and often a portion of the grant funds are used to support resources or services in these agencies. 3. Community health priorities are determined in several ways. In partnership with the local health departments, the results of state-mandated community health assessments are studied by each local Healthy Carolinians task force. Those task force groups then compile a list of the most pressing issues in their communities based on data from community input. Both established resources within various agencies and potential opportunities to garner new support are reviewed. 4. Community priorities are also established in response to a compelling need identified by health practitioners or community groups. Examples include the pediatric asthma program that has been in place for over 10 years in Pitt County, and expanded to other communities in the region. This major community-based program was established following a plea for assistance by pediatricians and pediatric clinical nurse specialists caring for children with asthma in the acute care setting. The Pitt County School System and local parents identified a lack of health care support in the schools, resulting in an award-winning school nurse program that has been replicated in several counties. Most recently, the focused attention on pediatric obesity and associated diseases has resulted in multiple community-based programs directed at improving nutrition, physical activity, and case management for that population. VH is fortunate to have a strong collaborative partnership with East Carolina University, and works closely with the schools within the Health Sciences Division, especially the Brody School of Medicine. BSOM is an active participant in almost every community health initiative, supporting the research and evaluation of these programs, and contributes to programs for the under and uninsured in multiple ways. ECU and other educational institutions whose students matriculate through VH facilities also provide opportunities for collaboration and participation in various community health initiatives. 5. Provided below are a few highlights of the community benefit and education activities: Form 990, Schedule H, Part VI, Line 5: 5a. Community Health Improvement Services: Community health improvement services are programs and services that meet an identified need and are offered to the community at little or no charge. VH hospitals sponsor programs that improve access to health care for the underserved and enhance the identification and management of chronic diseases, such as cancer, diabetes and heart disease. Here are a few examples of these programs: - Medical assistance programs for uninsured patients - The Pediatric Healthy Weight Program - Support for Health Carolinians collaboratives, including Pitt Partners for Health, the Hertford Partnership for Health and Three Rivers Healthy Carolinians. - School nurse programs - Support for the Community Care Plan of Eastern Carolina for Medicaid recipients and HealthAssist for the uninsured - Support of local Federally Qualified Health Center 5b. Health Professional Education: Preparing future health care professionals is important to us. Our hospitals provide clinical settings for students of health professions, such as future physicians, nurses and other allied health professionals. We also support students through deferred forgivable loans and internships including resident training, nursing clinic sites, allied health professionals, and financial support of nursing programs. 5c. Research: East Carolina University (ECU) conducts research to evaluate new treatments and protocols. These studies help health professionals everywhere provide quality care to patients. VH supports this through various means including supporting the Institutional Review Board at ECU and providing study sites. 5d. Financial and In-Kind Contributions: VH donates money and in-kind services to community groups and activities that share our mission of improving health. They include Meals on Wheels, American Red Cross blood drives, medical supplies to emergency medical services, and free medications to qualifying patients. VH hospitals are key partners in fundraising for organizations such as the United Way, American Heart Association, Juvenile Diabetes Association and the American Cancer Society. VH contributed $1.0 million to the Community Benefits Grants Program which awards grants to local non-profits for health related programs. 5e. Community Building: Community-building activities include programs that are not directly related to health care but address underlying issues that impact the health of communities. Poverty, crime, homelessness, workforce development and economic development all affect the overall health of communities. VH has provided support for our local Chambers of Commerce, financial support for road improvements, investments in communication infrastructure via information technology connections, support for the Teen Leadership Academy, recruitment of physicians to our rural communities, and programs that encourage students to pursue health careers. Ahoskie Imaging LLC 203 Academy Street S Ahoskie NC 27910 954896961 Healthcare NC 0 0 East Carolina Health Radiation Services of North Carolina LLC 301 Academy Street S Ahoskie NC 27910 621808495 Healthcare NC 0 0 East Carolina Health Duplin Health Care Services LLC 401 N Main Street Kenansville NC 28349 566011594 Healthcare NC 0 0 Duplin General Hospital Inc University Health Systems of Eastern Carolina (DBA Vidant Health) 2100 Stantonsburg Road Greenville NC 27835 562141073 Healthcare NC 501(c)(3) Line 11c, III-FI N/A 0 Pitt County Memorial Hospital Inc (DBA Vidant Medical Center) 2100 Stantonsburg Road Greenville NC 27835 560585243 Hospital NC 501(c)(3) Line 3 Vidant Health 0 Surgicenter Services of Pitt Inc 102 Bethesda Drive Greenville NC 27835 561690553 Healthcare NC 501(c)(3) Line 11b, II Vidant Medical Center 0 East Carolina Health Inc (DBA Vidant Community Hospitals - Central) 2100 Stantonsburg Road Greenville NC 27835 562003393 Hospital NC 501(c)(3) Line 3 Vidant Health 0 PCMH Management Inc (DBA Vidant Properties) 2100 Stantonsburg Road Greenville NC 27835 561690740 Medical Property Management NC 501(c)(2) Vidant Health 0 HealthAccess Inc 2100 Stantonsburg Road Greenville NC 27835 561396133 Healthcare NC 501(c)(3) Line 11b, II Vidant Health 0 The Outer Banks Hospital 2100 Stantonsburg Road Greenville NC 27835 562112733 Hospital NC 501(c)(3) Line 3 East Carolina Health 0 1 1 1 0 0 0 1 1 0 0 1 0 1 1 1 1 1 1 0