2016-05-13T08:07:23-05:00 2015-06-30 135565207 KPMG LLP 300 NORTH GREENE STREET GREENSBORO NC 27401 990 2014-07-01 223849199 WAKE FOREST UNIVERSITY HEALTH SCIENCES WAKE 3367164445 MEDICAL CENTER BLVD WINSTONSALEM NC 27157 JOHN D MCCONNELL MD CEO 3367164445 2016-05-09 0 P00008888 3362753394 2014 2016-08-17 19:52:53Z JOHN D MCCONNELL MD MEDICAL CENTER BLVD WINSTONSALEM NC 27157 788170869 0 X WAKEHEALTH.EDU X 2001 NC IMPROVING THE HEALTH OF OUR REGION, STATE, AND NATION. 17 15 5206 1567 710379 532334 201910285 218972568 368598997 524100112 25845308 37273796 218706386 7496644 815060976 787843120 53427402 60749525 0 0 451758690 482749887 794695 427686 3259922 359252122 215943357 865232909 759870455 -50171933 27972665 1242666097 1262229986 766484531 765013635 476181566 497216351 X THE ORGANIZATION IS PART OF WAKE FOREST BAPTIST MEDICAL CENTER, A PREEMINENT, INTERNATIONALLY RECOGNIZED ACADEMIC MEDICAL CENTER OF THE HIGHEST QUALITY WITH BALANCED EXCELLENCE IN PATIENT CARE, RESEARCH AND EDUCATION. OUR MISSION IS TO IMPROVE THE HEALTH OF OUR REGION, STATE AND NATION BY: GENERATING AND TRANSLATING KNOWLEDGE TO PREVENT, DIAGNOSE AND TREAT DISEASE; TRAINING LEADERS IN HEALTH CARE AND BIOMEDICAL SCIENCE; AND SERVING AS THE PREMIER HEALTH SYSTEM IN OUR REGION, WITH SPECIFIC CENTERS OF EXCELLENCE RECOGNIZED AS NATIONAL AND INTERNATIONAL CARE DESTINATIONS. 0 0 188080694 43741459 MEDICAL RESEARCH, GENERAL/OTHER: RESEARCH COMPRISED OF BASIC SCIENCE CLINICAL RESEARCH AND POPULATION BASED STUDIES AND IS CENTERED ON THE ACQUISITION AND ADVANCEMENT OF SCIENTIFIC KNOWLEDGE AND NEW TECHNOLOGY AND THEIR TRANSFER TO INDUSTRY AND THE PATIENT IN ORDER TO PREVENT AND TREAT DISEASE AND PROMOTE HEALTH (2064 GRANTS). 434006663 592550 488711212 PATIENT CARE AND MEDICAL EXPENSES IN PROVIDING SERVICES TO 901,290 PATIENT ENCOUNTERS. 95628309 16415516 39732390 PROFESSIONAL EDUCATION: INSTRUCTION OF MORE THAN 1,600 MEDICAL, GRADUATE, AND PHYSICIAN ASSISTANT STUDENTS. SCHOLARSHIPS AND AID PROVIDED TO 785 STUDENTS. WAKE FOREST UNIVERSITY HEALTH SCIENCES IS AN INTEGRAL PART OF WAKE FOREST BAPTIST MEDICAL CENTER, A PREEMINENT, INTERNATIONALLY RECOGNIZED ACADEMIC MEDICAL CENTER OF THE HIGHEST QUALITY WITH BALANCED EXCELLENCE IN PATIENT CARE, RESEARCH AND EDUCATION. THE FOLLOWING PARAGRAPHS ARE PROVIDED TO EXPLAIN THE RELATIONSHIP OF THE FILING ORGANIZATION WITH OTHER ORGANIZATIONS WHICH TOGETHER COMPRISE "WAKE FOREST BAPTIST MEDICAL CENTER", THE NAME, NOT OF ANY ONE CORPORATE ENTITY, BUT THAT IS USED GENERICALLY TO DESCRIBE A LARGE GROUP OF MOSTLY TAX-EXEMPT 501 (C)(3) ORGANIZATIONS PERFORMING VARIOUS ACADEMIC MEDICAL CENTER ACTIVITIES IN NORTHWEST NORTH CAROLINA, INCLUDING PATIENT CARE (THE "CLINICAL ENTERPRISE"), MEDICAL RESEARCH AND TECHNOLOGY TRANSFER (THE "INNOVATION ENTERPRISE") AND MEDICAL EDUCATION (THE "ACADEMIC ENTERPRISE"). BECAUSE THESE ACTIVITIES ARE NOT ALL PERFORMED BY EACH ORGANIZATION, THE NARRATIVE THAT FOLLOWS WILL INCLUDE DESCRIPTIONS OF ACTIVITIES THAT ARE NOT PERFORMED BY THE FILING ORGANIZATION BUT BY A RELATED (OR UNRELATED BUT AFFILIATED) ORGANIZATION; THEY ARE AGAIN PROVIDED TO ILLUSTRATE A COMPLETE PICTURE OF THE FILING ORGANIZATION'S ROLE IN THIS INTEGRATED ACADEMIC MEDICAL CENTER'S COMPREHENSIVE ACTIVITIES. WAKE FOREST BAPTIST MEDICAL CENTER IS NORTHWEST NORTH CAROLINA'S SOLE ACADEMIC MEDICAL CENTER, BRINGING TO THE REGION THE RESOURCES OF ONE OF AMERICA'S TOP HOSPITALS AND INNOVATIVE RESEARCH CENTERS AND A PREMIER MEDICAL SCHOOL. WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER IS A CORPORATION WHOSE MEMBERS ARE WAKE FOREST UNIVERSITY AND NORTH CAROLINA BAPTIST HOSPITAL. THE MEDICAL CENTER OPERATES WAKE FOREST UNIVERSITY SCHOOL OF MEDICINE, WHICH HAS A FACULTY OF 1,215, INCLUDING PHYSICIANS AND BASIC SCIENTISTS. THE MEDICAL CENTER HAS 1,060 ACUTE CARE AND REHABILITATION BEDS OPERATIVE ACROSS THE SYSTEM, WHICH ENCOMPASSES ITS MAIN CAMPUS (885 BEDS), WAKE FOREST BAPTIST HEALTH-LEXINGTON MEDICAL CENTER (94 BEDS) AND WAKE FOREST BAPTIST HEALTH-DAVIE MEDICAL CENTER (81 BEDS). IN DECEMBER 2015, THE MEDICAL CENTER BROKE GROUND ON A $47 MILLION, 50-BED TOWER AT ITS DAVIE MEDICAL CENTER-BERMUDA RUN CAMPUS. THE FACILITY IS EXPECTED TO OPEN IN THE SPRING OF 2017. OVERALL, WAKE FOREST BAPTIST MEDICAL CENTER SERVES A 24-COUNTY REGION IN NORTHWESTERN NORTH CAROLINA AND SOUTHWESTERN VIRGINIA. IT ALSO DRAWS PATIENTS FROM ACROSS THE NATION FOR SELECT SERVICES.THE MEDICAL CENTER IS THE DRIVING FORCE BEHIND THE ESTABLISHMENT OF WAKE FOREST INNOVATION QUARTER, A GROWING URBAN-BASED DISTRICT FOR RESEARCH, BUSINESS AND EDUCATION IN BIOMEDICAL SCIENCE, INFORMATION TECHNOLOGY, CLINICAL SERVICES AND ADVANCED MATERIALS LOCATED IN DOWNTOWN WINSTON-SALEM. THE QUARTER HOUSES A WIDE RANGE OF PROGRAMS AND PROJECTS BRIDGING ART, SCIENCE AND TECHNOLOGY.IN JULY 2016, WAKE FOREST UNIVERSITY SCHOOL OF MEDICINE WILL MOVE INTO THE BOWMAN GRAY CENTER FOR MEDICAL EDUCATION IN THE INNOVATION QUARTER. THE $50 MILLION PROJECT IS A STATE OF THE ART FACILITY WHERE FUTURE GENERATIONS OF PHYSICIANS AND RESEARCHERS WILL BE TRAINED. IT IS THE RESULT OF RENOVATIONS TO A FORMER R.J. REYNOLDS TOBACCO CO. BUILDING.1. CLINICAL SERVICES WAKE FOREST BAPTIST MEDICAL CENTER IS NATIONALLY RECOGNIZED FOR CLINICAL EXCELLENCE AND INTERNATIONALLY KNOWN FOR PIONEERING RESEARCH AND CLINICAL INNOVATION. ITS CLINICAL ENTERPRISE, WAKE FOREST BAPTIST HEALTH, OFFERS EXPERTISE IN MORE THAN 100 AREAS OF MEDICINE, ENCOMPASSING COMPREHENSIVE PREVENTIVE AND HIGHLY SPECIALIZED CARE FOR ALL AGES. THE MEDICAL CENTER NETWORK INCLUDES THE 167-BED COMPREHENSIVE CANCER CENTER AND THE 144-BED BRENNER CHILDREN'S HOSPITAL, BOTH OF WHICH ARE ON THE MAIN CAMPUS IN WINSTON-SALEM, AS WELL AS COMMUNITY HOSPITALS IN NEIGHBORING DAVIDSON AND DAVIE COUNTIES. ACROSS ITS SERVICE AREA OF NORTHWEST NORTH CAROLINA AND SOUTHWEST VIRGINIA, WAKE FOREST BAPTIST HAS 11 EMERGENCY DEPARTMENTS, 27 PRIMARY CARE CLINICS, 16 DIALYSIS CENTERS, AND FREESTANDING IMAGING AND ENDOSCOPY CENTERS. THE MEDICAL CENTER EMPLOYS 1,215 PHYSICIANS, 2,985 REGISTERED NURSES, 578 RESIDENTS AND 129 FELLOWS, AND HAS A TOTAL STAFF OF 13,441.OVERALL IN FY 2015, WAKE FOREST BAPTIST HAD 40,251 INPATIENT ADMISSIONS, 108,583 EMERGENCY DEPARTMENT VISITS AND 1,111,409 OUTPATIENT ENCOUNTERS (AMBULATORY VISITS AND OUTPATIENT DEPARTMENTS). 2. OUTREACHWAKE FOREST BAPTIST MEDICAL CENTER CONTINUES A BROAD-BASED EFFORT TO REACH UNDERSERVED POPULATIONS ACROSS ITS SERVICE AREA. THE MEDICAL CENTER'S ANNUAL COMMUNITY BENEFITS REPORT REFLECTS THIS COMMITMENT. IN FISCAL 2014, THE MOST RECENT YEAR FOR WHICH FIGURES ARE AVAILABLE, THE MEDICAL CENTER SPENT $272.6 MILLION TO SUPPORT THESE AREAS: - SUBSIDIZED HEALTH COSTS- COMMUNITY HEALTH OUTREACH- CHARITY CARE- RESEARCH- EDUCATIONONE ANCHOR OF OUTREACH FOR THE MEDICAL CENTER IS ITS DOWNTOWN HEALTH PLAZA, A FULL-SERVICE, OUTPATIENT MEDICAL CLINIC THAT SERVES MANY OF FORSYTH COUNTY'S UNINSURED AND UNDERINSURED RESIDENTS WITH A STATE OF THE ART MEDICAL HOME. IN ADDITION TO CLINICAL CARE, THE DOWNTOWN HEALTH PLAZA OFFERS COMMUNITY HEALTH FAIRS, DIABETES EDUCATION AND A CENTERING PREGNANCY PROGRAM THAT IS REDUCING THE INCIDENCE OF LOW BIRTH WEIGHT BABIES. ALTOGETHER, 67,103 PATIENT VISITS WERE RECORDED AT THE DOWNTOWN HEALTH PLAZA BETWEEN JULY 2014 AND JUNE 2015.THE MEDICAL CENTER'S PROGRAMS AND PARTNERSHIPS REFLECT INNOVATIVE EFFORTS TO REACH UNDERSERVED POPULATIONS. THEY INCLUDE: - REGULAR COMMUNITY BASED HEALTH CLINICS, INCLUDING: THE WEEKLY DELIVERING EQUAL ACCESS TO CARE (DEAC) CLINIC AT THE COMMUNITY CARE CENTER IN WINSTON-SALEM, THE MONTHLY TRIAD FREE HEALTH CLINIC AT COMMUNITY MOSQUE IN WINSTON-SALEM, THE MONTHLY GRACE CLINIC AT NEW LIGHT MISSIONARY BAPTIST CHURCH IN WINSTON-SALEM AND THE ANNUAL SHARE THE HEALTH FAIR AT THE DOWNTOWN HEALTH PLAZA IN WINSTON-SALEM. THESE CLINICS, SPONSORED BY PRIVATE ORGANIZATIONS AND CHURCHES WITH VOLUNTEER ASSISTANCE FROM WAKE FOREST BAPTIST PHYSICIANS, NURSES, MEDICAL STUDENTS AND OTHERS, ATTRACT THOUSANDS OF PEOPLE TO SCREENINGS FOR ACUTE AND CHRONIC CONDITIONS. -PROVIDING STAFF SUPPORT SERVICES TO A MENTAL HEALTH CLINIC DESIGNED TO HELP HOMELESS PEOPLE STABILIZE THEIR MENTAL HEALTH. THE HOMELESS OPPORTUNITIES & TREATMENT (HOT) PROJECT IS CONDUCTED AT SAMARITAN MINISTRIES, A HOMELESS SHELTER IN WINSTON-SALEM. IT IS PART OF THE LARGER EMPOWERMENT PROJECT CONNECTING HOMELESS PEOPLE IN NEED WITH HOUSING, EDUCATION AND TRAINING.-THE SCHOOL OF MEDICINE'S PHYSICIAN ASSISTANT (PA) PROGRAM, WHICH IS INCREASING THE NUMBER OF PAS WORKING IN PRIMARY CARE IN NORTH CAROLINA'S RURAL APPALACHIAN COUNTIES THROUGH ITS NEW SECOND CAMPUS AT APPALACHIAN STATE UNIVERSITY IN BOONE. - FAITHHEALTHNC, AN INITIATIVE THAT CONNECTS THE CARING STRENGTHS OF CONGREGATIONS, THE CLINICAL EXPERTISE OF PROVIDERS AND A NETWORK OF COMMUNITY RESOURCES TO EASE THOSE ON THE JOURNEY TO HEALTH AND HEALING, STRENGTHENING COMMUNITIES IN THE PROCESS.ALSO THIS YEAR, THE WAKE FOREST BAPTIST MEDICAL CENTER CLINICAL AND TRANSLATIONAL SCIENCE INSTITUTE (CTSI) RECEIVED A FOUR-YEAR, $15.6 MILLION CLINICAL AND TRANSLATIONAL SCIENCE AWARD (CTSA) FROM THE NATIONAL INSTITUTES OF HEALTH (NIH). THE PROGRAM GIVES WAKE FOREST BAPTIST ENTRY INTO THE NATIONAL CLINICAL AND TRANSLATIONAL SCIENCE AWARD CONSORTIUM, WHICH IS COMPRISED OF MORE THAN 60 ACADEMIC MEDICAL CENTERS AND PARTNER ORGANIZATIONS, WORKING COLLABORATIVELY TO ACCELERATE TRANSLATION OF DISCOVERIES INTO BETTER PREVENTIVE AND TREATMENT SOLUTIONS TO IMPROVE HEALTH. THE CTSI WILL SPEED THE TRANSLATION OF DISCOVERIES TO IMPROVE HEALTH, EXPANDING OPPORTUNITIES FOR PATIENTS TO PARTICIPATE IN LEADING EDGE CLINICAL TRIALS AND STUDIES, MANY OF WHICH ARE AIMED AT REDUCING CHRONIC DISEASES SUCH AS DIABETES AND HYPERTENSION.3. EDUCATIONAL MISSION AND ACCOMPLISHMENTS THE CONSTITUENT ORGANIZATIONS OF WAKE FOREST BAPTIST MEDICAL CENTER OPERATE A BROAD RANGE OF EDUCATIONAL PROGRAMS, GRADUATING SKILLED PRACTITIONERS. IT ATTRACTS SOME OF THE WORLD'S MOST COMPETITIVE MEDICAL STUDENTS, RESIDENTS AND FELLOWS, AS WELL AS STUDENTS IN CLINICAL PASTORAL CARE, NURSE ANESTHESIA AND OTHER AREAS. IN THE MOST RECENT REPORTING PERIOD, WAKE FOREST BAPTIST INVESTED MORE THAN $77.5 MILLION IN THE EDUCATION OF TOMORROW'S HEALTH CARE AND BIOMEDICAL LEADERS. THAT INVESTMENT SUPPORTED THE TRAINING OF 467 MEDICAL STUDENTS, 707 PHYSICIAN RESIDENTS AND FELLOWS, 291 GRADUATE STUDENTS AND 177 PHYSICIAN ASSISTANTS. IN ADDITION, THE NORTHWEST AREA HEALTH EDUCATION CENTER, PART OF WAKE FOREST UNIVERSITY SCHOOL OF MEDICINE, OFFERED 1,908 CONTINUING MEDICAL EDUCATION ACTIVITIES THAT DREW 34,765 PARTICIPANTS FROM THROUGHOUT THE REGION. 717715666 1 1 0 1 0 0 0 0 0 1 1 1 0 1 1 1 0 1 1 0 1 1 0 1 1 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 0 0 1 943 0 1 5206 1 1 1 0 0 0 0 1 1 0 0 0 0 0 X 17 15 1 1 1 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 NC X JOSEPH DOLAN 3367164445 MEDICAL CENTER BLVD WINSTON SALEM NC 27157 X DONALD E FLOW DIRECTOR 2.00 16.00 X 0 0 0 DONNA A BOSWELL PHD CHAIR OF BOARD 4.00 10.20 X 0 0 0 JAMES R HELVEY III DIRECTOR 2.00 9.00 X 0 0 0 JAMES J MARINO DIRECTOR 2.00 5.00 X 0 0 0 JAMES T WILLIAMS JR DIRECTOR 2.00 5.00 X 0 0 0 GERALD F ROACH DIRECTOR 2.00 4.00 X 0 0 0 BRENDA K CLINE DIRECTOR 2.00 0.00 X 0 0 0 SHELMER D BLACKBURN JR DIRECTOR 2.00 4.00 X 0 0 0 BOBBY R BURCHFIELD DIRECTOR 2.00 7.20 X 0 0 0 RICHARD A BRENNER DIRECTOR 2.00 0.00 X 0 0 0 KATHLEEN B FRENCH MD DIRECTOR 2.00 3.00 X 0 0 0 JAMES W JOHNSTON DIRECTOR 2.00 0.00 X 0 0 0 MATTHEW A KING DIRECTOR 2.50 6.50 X 0 0 0 NATHAN O HATCH PHD DIRECTOR & PRESIDENT OF WF 3.00 37.00 X X 0 1023508 433311 JOHN D MCCONNELL MD DIRECTOR & CEO 7.50 32.50 X X 1551136 0 232372 ANN S HANES DIRECTOR 2.00 0.00 X 0 0 0 ANDREW J SCHINDLER VICE CHAIRMAN 4.00 8.00 X 0 0 0 EDWARD ABRAHAM MD DEAN 34.90 5.10 X 619588 0 153776 J REID MORGAN SECRETARY & GENERAL COUNSE 8.00 32.00 X 0 478079 110947 ANITA M CONRAD ASSISTANT SECRETARY 10.00 30.00 X 0 163282 32713 TERRY L HALES JR ASSISTANT TREASURER 6.60 33.40 X 401630 0 93389 LISA M WYATT VP CH COMMUNICATIONS/MARKE 15.00 25.00 X 342656 0 71045 CHERYL E H LOCKE VP CHIEF HUMAN RESOURCES O 3.00 37.00 X 394692 0 84972 NORMAN D POTTER JR VP DEVELOPMENT & ALUMNI AF 15.00 25.00 X 331464 0 73190 KAREN H HUEY VP FACILITIES 11.00 29.00 X 301785 0 65113 ERIC TOMLINSON DSC PHD CH INNOV OFR & PRES WFIQ 5.00 35.00 X 548647 0 94369 TERRY G WILLIAMS EVP STRAT & DEV. 12.00 28.00 X 572543 0 165039 K BARBARA CARBONE MD PRES & COO, WFBH TO 4/15 4.00 36.00 X 895532 0 197496 CHAD A ECKES CIO, CFO & TREAS. EFF 4/15 7.00 33.00 X 390305 0 88718 C MICHAEL RUTHERFORD CFO & TREAS TO 4/15 8.00 32.00 X 0 0 0 KEVIN P HIGH MD EVP HS AFFAIRS EFF 4/15 12.00 28.00 X 439852 0 26774 DEETTE M EMON VP, CIO EFF 4/15 5.00 35.00 X 145538 0 6124 NEAL KON MD DEPARTMENT CHAIR 40.00 0.00 X 1143945 0 23874 ROSS UNGERLEIDER MD CHIEF, PEDIATRIC HEART PRO 40.00 0.00 X 1070288 0 176728 EDWARD KINCAID MD ASSOCIATE PROFESSOR 40.00 0.00 X 935679 0 26570 MALCOLM MARKS MD DEPARTMENT CHAIR 40.00 0.00 X 843812 0 29689 CHARLES BRANCH JR MD DEPARTMENT CHAIR 40.00 0.00 X 973883 0 29693 WILLIAM B APPLEGATE MD FORMER OFFICER 40.00 0.00 X 254397 0 24303 EDWARD G CHADWICK FORMER OFFICER 0.00 0.00 X 1588175 0 20524 THOMAS E SIBERT MD FORMER OFFICER 0.00 0.00 X 1403531 0 21223 RUSSELL M HOWERTON MD FORMER OFFICER 18.00 22.00 X 555519 0 143586 SHEILA M SANDERS FORMER OFFICER 0.00 0.00 X 155697 0 6842 JOANNE C RUHLAND FORMER OFFICER 15.00 25.00 X 269000 0 58292 16129294 1664869 2490672 1268 1 1 1 MITCHELL GALLOWAY & ASSOC 5980 RIVER CHASE CIRCLE ATLANTA GA 30358 MANAGEMENT CONSULTING 4288398 TENSEGRITY LAW GROUP LLP TWIN DOLPHIN DRIVE REDWOOD CITY CA 94065 LEGAL SERVICES 3795000 MEDDATA INC 6880 W SNOWVILLE ROAD BRECKSVILLE OH 44141 CODING & BILLING SRVS. 3750875 CASSIDY TURLEY FIDUCIARY INC 550 S TRYON STREET CHARLOTTE NC 28202 REAL ESTATE CONSULTING 2573285 MEDCOST BENEFIT SERVICES 165 KIMEL PARK DRIVE WINSTON SALEM NC 27103 TPA 2524804 93 433818 156663527 61875223 2313767 218972568 MEDICAL SERVICES 621110 484367722 484247542 120180 TUITION AND FEES 611710 39732390 39732390 524100112 11421494 572498 10848996 1003773 1003773 1775255 0 1775255 1775255 1775255 26004549 0 152247 26004549 -152247 25852302 25852302 83085 433818 175502 -92417 -92417 ADMIN & OTHER 611710 4481371 4463670 17701 PARKING 621990 328662 328662 4810033 787843120 528443602 710379 39716571 44334009 44334009 16415516 16415516 16204850 15953675 170151 81024 802008 789577 8421 4010 390257589 384208596 4097705 1951288 14603039 13926918 549074 127047 36207334 34530934 1361396 315004 24675067 23532611 927783 214673 1568660 1568660 4737832 4737832 290667 290667 256478 256478 427686 427686 1353578 1307908 38596 7074 65015011 64684117 330894 1009917 975842 28797 5278 6226945 6048458 178487 3825699 3696620 109086 19993 297162 297162 33743235 12435970 21287434 19831 6105616 5899614 174095 31907 4128758 3989455 117727 21576 6487631 5997166 490465 32851140 30758522 2092618 6416352 6199865 182956 33531 MEDICAL SUPPLIES 28348506 28348506 BAD DEBT 10955364 10955364 DUES 2320605 2172783 147822 UBIT 4201 4201 759870455 717715666 38894867 3259922 15469433 154653167 38895013 34761745 204394608 89642573 2100457 831776 1026 3492 568606 142559 665242850 379915624 300339115 285327226 19482866 484046282 522463841 40367698 44568824 2000000 2000000 135000993 127834783 1242666097 1262229986 239215025 379724470 80149387 55531267 181352047 173763420 17953409 28877728 247814663 127116750 766484531 765013635 X 270398243 270672835 57850429 69239377 147932894 157304139 476181566 497216351 1242666097 1262229986 X 27972665 -27021184 20083304 X 0 1 X 1 1 1 X 237283114 239650189 211724409 201910285 218972568 1109540565 237283114 239650189 211724409 201910285 218972568 1109540565 1109540565 80215478 14702048 30704407 243341362 13628024 382591319 4282 11552 21923 93165 710378 841300 69374 707302 780020 328662 1885358 1494858542 2234019435 0.74220 0.70870 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: OTHER INCOME - 2011 AMOUNT: $ 69,374. 2012 AMOUNT: $ 707,302. 2013 AMOUNT: $ 780,020. 2014 AMOUNT: $ 328,662. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 0 0 0 1 254335 0 1 2143 256478 0 PART II-B, LINE 1: PRORATA PORTION OF DUES PAID TO 501(C)(6) ORGANIZATIONS THAT REPRESENTS LOBBYING ON BEHALF OF ITS MEMBERS. GOVERNMENT RELATIONS THE OFFICE OF GOVERNMENT RELATIONS WAS ACTIVELY INVOLVED WITH SEVERAL FEDERAL AND STATE ISSUES. THE OFFICE ASSISTED IN DEVELOPING POLITICAL ADVOCACY STRATEGIES REGARDING THE PERMANENT REPEAL OF THE PHYSICIAN SUSTAINABLE GROWTH RATE (SGR) FORMULA AND THE DEVELOPMENT OF A REPLACEMENT FORMULA; FUNDING FOR RESOURCES FOR DESIGNATED EBOLA PREPAREDNESS TREATMENT FACILITIES; OPPOSITION TO THE EXTENSION OF THE MEDICARE SEQUESTER IN THE REAUTHORIZATION OF THE TRADE ADJUSTMENT ASSISTANCE (TAA) PROGRAM; LEGISLATION TO MAKE MUCH NEEDED IMPROVEMENTS TO THE CENTER FOR MEDICARE & MEDICAID SERVICES' (CMS) RECOVERY AUDIT CONTRACT (RAC) PROGRAM; BILLS TO INCREASE PHYSICIAN RESIDENCY SLOTS BY 15,000 OVER FIVE YEARS AT TEACHING HOSPITALS; HEALTH RESOURCES AND SERVICES' (HRSA) PROPOSED 340(B) DRUG PRICING PROGRAM MEGA GUIDANCE; FY 2016 INPATIENT PROSPECTIVE PAYMENT SYSTEM (IPPS) RULE; TWO-MIDNIGHT/PATIENT STATUS RULE AND LAWSUIT RULING AND REPEAL; SITE NEUTRAL PAYMENTS REGARDING PROPOSED PAYMENT CUTS FOR EVALUATION AND MANAGEMENT (E/M) SERVICES AND CERTAIN OTHER PROCEDURES PROVIDED IN HOSPITAL OUTPATIENT DEPARTMENTS (HOPD'S); REPEAL OF THE MEDICAL DEVICE TAX AND INDEPENDENT PAYMENT ADVISORY BOARD (IPAB) PROVISIONS OF THE AFFORDABLE CARE ACT; REDUCTIONS TO PAYMENTS FOR INDIRECT MEDICAL EDUCATION (IME) AND DIRECT GRADUATE MEDICAL EDUCATION (DGME) TO TEACHING HOSPITALS; LEGISLATION FOR AN EXTENSION AND MORE FLEXIBILITY FOR HOSPITALS TO MEET THEIR FY 15 ELECTRONIC HEALTH RECORD (EHR) REQUIREMENTS. STAFF WORKED ON THE FY2016 BUDGET; AND THE CY 2016 MEDICARE PHYSICIAN FEE SCHEDULE AND OTHER CHANGES TO MEDICARE PART B. STAFF ALSO WORKED ON MANY OF THE FY 2016 APPROPRIATIONS BILLS AND PROPOSED LEGISLATION AND REGULATIONS THAT WERE INTRODUCED, INCLUDING THE DEPARTMENT OF HEALTH AND HUMAN SERVICES REGARDING THE NATIONAL INSTITUTES OF HEALTH (NIH) BUDGET, AND VETERANS AFFAIRS (VA) RESEARCH AND MEDICAL CARE FUNDING TO EASE ACCESS FOR VETERANS SEEKING HEALTH CARE FROM NON-VA PROVIDERS; AND LEGISLATION REGARDING PATENT TROLLING AND INTELLECTUAL PROPERTY ISSUES. AT THE STATE LEVEL, EFFORTS WERE CONCENTRATED ON MEDICAID REORGANIZATION AND TRANSFORMATION; CONTINGENCY RESERVE FUNDING FOR MEDICAID; PREVENTING ELIMINATION OF MEDICAID GRADUATE MEDICAL EDUCATION FUNDING; INCREASES TO THE MEDICAID PROVIDER ASSESSMENT; CHANGES TO THE STATE HEALTH INFORMATION EXCHANGE (HIE) PROGRAM; INCREASE IN AUTOPSY AND MEDICAL EXAMINER FEES; INSURANCE COVERAGE FOR AUTISM PATIENTS, ORAL CHEMOTHERAPY AND REQUIRED LIABILITY INSURANCE FOR MOPED OWNERS; FUNDING FOR THE WAKE FOREST ARMED FORCES INSTITUTE FOR REGENERATIVE MEDICINE (AFIRM); REPEAL OF THE CERTIFICATE OF NEED LAW; LEGISLATION TO REVISE THE HISTORIC MILL RESTORATION TAX CREDIT IMPACTING THE WAKE FOREST INNOVATION QUARTER; REVISIONS TO THE HEALTH CARE COST REDUCTION AND TRANSPARENCY ACT; FUNDING FOR ADDITIONAL INPATIENT PSYCHIATRIC BEDS; PROTECTION OF THE $45 MILLION HOSPITAL SALES TAX REFUND CAP; THE EXTENSION OF THE LAW PROTECTING EMERGENCY DEPARTMENT PROVIDERS FROM ASSAULT TO ALL HOSPITAL PERSONNEL AND LEGISLATION PROHIBITING OWNERS OF TANNING EQUIPMENT OR FACILITIES FROM PROVIDING TANNING SERVICES TO ANYONE UNDER THE AGE OF 18. 434292937 31275281 7099062 18255038 454412242 401275256 10671481 36510163 14163963 434292937 384485637 6615075 27297037 17122493 401275256 392450494 7419543 2120543 17504943 384485637 355828276 6176824 49922940 19477546 392450494 0.60060 0.28860 0.11080 0 1 1 78751546 78751546 367389868 248812219 118577649 18283439 5557732 12725707 186750668 125545673 61204995 14067329 14067329 285327226 ENDOWMENT INVESTMENTS 518560793 F INV IN PARTNERSHIPS 593533 F INVESTMENT IN ANNUITIES & LIFE INS CONTRACTS 3309515 F 522463841 BOND ISSUANCE COSTS 68439 OTHER INVESTMENTS 15198690 INVESTMENT IN SUBS 51878114 BENEFICIAL INTEREST IN PERPETUAL TRUSTS 19903047 FUNDS HELD UNDER RETIREMENT & BENEFIT PLANS 40786493 127834783 INTERCOMPANY PAYABLE 9684107 PLI RESERVE 42145266 BOND SWAP VALUATION 4802643 OTHER LIABILITIES & DEFERRALS 30357266 ANNUITIES PAYABLE 3311533 RETIREMENT 36815935 127116750 X PART V, LINE 4: THE ORGANIZATION'S ENDOWMENT FUNDS ARE TO SUPPORT SCHOLARSHIPS, INSTRUCTION, RESEARCH, LIBRARIES, ACADEMIC SUPPORT, OPERATIONAL AND OTHER GENERAL SUPPORT. PART X, LINE 2: THE ORGANIZATION HAS EVALUATED UNCERTAIN TAX POSITIONS FOR ITS FISCAL YEARS ENDED JUNE 30, 2015 AND 2014, INCLUDING A QUANTIFICATION OF TAX RISK IN AREAS SUCH AS UNRELATED BUSINESS TAXABLE INCOME AND THE TAXATION OF ITS JOINT VENTURES. THIS EVALUATION DID NOT HAVE A MATERIAL EFFECT ON THE ORGANIZATION'S FINANCIAL STATEMENTS FOR THE YEARS ENDED JUNE 30, 2015 AND 2014. 1 1 1 1 1 1 1 0 0 0 0 0 0 0 0 1 0 1 SCHEDULE E, PART I, LINE 3 WFUHS' NONDISCRIMINATION POLICY IS PUBLISHED ON THE INTERNET IN ITS STUDENT HANDBOOK FOR THE SCHOOL OF MEDICINE LOCATED AT WWW.WAKEHEALTH.EDU/UPLOADEDFILES/USER_CONTENT/SCHOOLOFMEDICIN IN ADMISSION BROCHURES, AND OTHER MEDIA MATERIALS. SCHEDULE E, PART I, LINE 6 WFUHS RECEIVES FEDERAL FINANCIAL AID THROUGH THE U.S. DEPARTMENT OF EDUCATION'S FEDERAL DIRECT LOAN PROGRAM. WFUHS DISTRIBUTED THE FEDERAL LOANS TO 505 STUDENTS IN FISCAL YEAR 2015. SOUTH ASIA - AFGHANISTAN, BANGLADESH, BHUTAN, INDIA, MALDIVES, NEPAL, 0 1 PROGRAM SERVICES SUBCONTRACT FOR RESEARCH GRANTS 33768 NORTH AMERICA - CANADA AND MEXICO, BUT BUT NOT THE UNITED STATES 0 2 PROGRAM SERVICES SUBCONTRACT FOR RESEARCH GRANTS 866950 EUROPE (INCLUDING ICELAND & GREENLAND) - ALBANIA, ANDORRA, AUSTRIA, BELGIUM 0 3 PROGRAM SERVICES SUBCONTRACT FOR RESEARCH GRANTS 169272 0 6 0 0 0 6 1069990 0 1069990 SOUTH ASIA SUBCONTRACT - COORDINATION & OVERSIGHT OF STUDY PROTOCOL, SITE TEAM AND UPDATE PIS 33768 CHECK NORTH AMERICA - CANADA AND MEXICO, BUT BUT NOT THE UNITED STATES SUBCONTRACT - COMPREHENSIVE EYE EXAM & GRADING FUNDUS PHOTOS BY FPRC FOR SURVIVING ACCORD COHORT MEMBERS 859743 CHECK EUROPE (INCLUDING ICELAND & GREENLAND) - ALBANIA, ANDORRA, AUSTRIA, BELGIUM SUBCONTRACT - CLINICAL INVESTIGATION OF RECELL DEVICE FOR EPIDERMAL RECONSTRUCTION 23165 CHECK EUROPE (INCLUDING ICELAND & GREENLAND) SUB-CONTRACTOR: DEVELOPMENT OF RESORBABLE CALCIUM PHOSPHATE CEMENT 108500 CHECK EUROPE (INCLUDING ICELAND & GREENLAND) SUBCONTRACTOR: COMPOUND SYNTHESIS 37608 CHECK NORTH AMERICA - CANADA AND MEXICO, BUT BUT NOT THE UNITED STATES SUBCONTRACT - COMPREHENSIVE EYE EXAM & GRADING FUNDUS PHOTOS BY FPRC FOR SURVIVING ACCORD COHORT MEMBERS 7207 6 1 0 0 0 0 1 X X X X X X X 1 HARRIS CONNECT CROSSWAYS BLVD CHESAPEAKE VA 23320 SEE ATTACHED 0 600232 381436 218796 TRANSFORMATIONAL DEV VAN BUREN OXFORD MA 38655 SEE ATTACHED 0 0 30000 -30000 GG&A MICHIGAN AVE CHICAGO IL 60611 SEE ATTACHED 0 0 15000 -15000 600232 426436 173796 AK AL AR AZ CA CT DE FL GA HI IA ID IL IN KS KY LA MD ME MI MN MO MS MT NC NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY CO DC MA ND WINTERLARK 358517 304538 53979 114083 39342 CHEERS 103168 82825 20343 5643 7280 2 55218 46455 8763 9154 516903 433818 83085 119726 55776 175502 -92417 SCHEDULE G, PART I, LINE 2B, COLUMN (V) PURSUANT TO THE MEDICAL CENTER INTEGRATION AGREEMENT, MANAGEMENT OF WAKE FOREST UNIVERSITY HEALTH SCIENCES AND NORTH CAROLINA BAPTIST HOSPITAL WAS DELEGATED TO WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER. WHILE THE PROFESSIONAL FUNDRAISING PAYMENTS ARE MADE BY WAKE FOREST UNIVERSITY HEALTH SCIENCES, THE PROFESSIONAL FUNDRAISING CONTRACTS ARE BETWEEN WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER AND THE PROFESSIONAL FUNDRAISER. HARRIS CONNECT PROVIDES FUND RAISING CONSULTATION, DATA BASE AUGMENTATION, AND PHONE/MAIL/DIRECT MAIL SUPPORT FOR THE MEDICAL CENTER'S ANNUAL FUND SOLICITATIONS. TRANSFORMATIONAL DEVELOPMENT COUNSEL PROVIDES STRATEGIC CONSULTATION FOR PLANNING AND LAUNCHING A CAPITAL CAMPAIGN. GG&A PROVIDES ASSISTANCE WITH THE DONOR DATA BASE. 1 AMERICAN HEART ASSOCIATION 101 CENTREPORT DRIVE GREENSBORO NC 27409 135613797 501(C)(3) 70000 SUPPORTING CARDIOVASCULAR RESEARCH AND PROGRAMS AMERICAN RED CROSS NORTHWEST NC CHAPTER 690 COLISEUM DRIVE WINSTONSALEM NC 27106 530196605 501(C)(3) 10000 COMMUNITY SUPPORT ARTS COUNCIL WINSTON SALEM FORSYTH CTY 206 N SPRUCE STREET WINSTONSALEM NC 27101 560526856 501(C)(3) 30000 SUPPORTING CULTURAL PROGRAMS IN THE COMMUNITY EL BUEN PASTOR LATINO COMMUNITY SERVICES 4637 TIM ROAD WINSTONSALEM NC 27106 203751959 501(C)(3) 8500 SUPPORTING EDUCATIONAL PROGRAMS FOR OUR LATINO COMMUNITY COMMUNITY CARE CENTER FOR FORSYTH COUNTY 2135 NEW WALKERTOWN ROAD WINSTONSALEM NC 27101 581403699 501(C)(3) 13800 COMMUNITY SUPPORT NC BLACK REPERTORY COMPANY 610 COLISEUM DRIVE WINSTONSALEM NC 27106 581518704 501(C)(3) 10000 SUPPORTING CULTURE AND ARTS IN THE COMMUNITY NORTH CAROLINA BUSINESS LEADERS FOR EDUCATION 100 SAS CAMPUS DRIVE CARY NC 27513 462988453 501(C)(3) 50000 SUPPORTING EDUCATION IN NORTH CAROLINA OLD SALEM MUSEUMS & GARDEN 600 MAIN STREET WINSTONSALEM NC 27101 560587289 501(C)(3) 20000 COMMUNITY SUPPORT PIEDMONT TRIAD PARTNERSHIP PO BOX 2672 HIGH POINT NC 27261 561750279 501(C)(3) 100000 SUPPORTING ECONOMIC GROWTH & DEVELOPMENT IN THE TRIAD THE HEALTH FOUNDATION 230 JEFFERSON STREET NORTH WILKESBORO NC 28659 561745194 501(C)(3) 10000 SUPPORTING HEALTH IN OUR COMMUNITIES WINSTON SALEM ALLIANCE 100 N MAIN STREET WINSTONSALEM NC 27101 311726654 501(C)(6) 40000 COMMUNITY SUPPORT SCEPTOR PAIN FOUNDATION 145 KIMEL PARK DRIVE WINSTONSALEM NC 27103 020723571 501(C)(3) 50000 SUPPORTING PAIN MANAGEMENT RESEARCH UNITED WAY OF FORSYTH COUNTY 301 N MAIN STREET WINSTONSALEM NC 27101 237357234 501(C)(3) 150000 COMMUNITY SUPPORT WAKE FOREST UNIVERSITY PO BOX 7201 WINSTONSALEM NC 27109 560532138 501(C)(3) 6800 SUPPORTING STUDENT AND EDUCATIONAL PROGRAMS 13 1 SCHOLARSHIPS AND FELLOWSHIPS 785 16415516 PART I, LINE 2: WFUHS FOLLOWS THE MEDICAL CENTER'S CORPORATE POLICY USED IN REVIEWING THE ELIGIBILITY AND SELECTION OF GRANTEES RECEIVING CERTAIN EXEMPT PURPOSE FUNDS. WFUHS MAINTAINS DOCUMENTATION OF THE ELIGIBILITY AND SELECTION CRITERIA AND RECORDS OF THE AMOUNTS DISBURSED. SCHEDULE I, PART III, GRANTS AND OTHER ASSISTANCE TO DOMESTIC INDIVIDUALS THE ORGANIZATION MONITORS THE ACADEMIC PROGRESS AND OTHER ACHIEVEMENTS OF STUDENTS RECEIVING SCHOLARSHIPS AND FELLOWSHIPS. X 1 1 X X X X X X 1 1 0 0 0 0 0 1 0 NATHAN O HATCH PHD DIRECTOR & PRESIDENT OF WF 0 816207 0 94000 0 113301 0 372308 0 61003 0 1456819 0 0 JOHN D MCCONNELL MD DIRECTOR & CEO 997692 0 0 0 553444 0 212316 0 20056 0 1783508 0 0 0 EDWARD ABRAHAM MD DEAN 526889 0 70180 0 22519 0 131656 0 22120 0 773364 0 0 0 J REID MORGAN SECRETARY & GENERAL COUNSE 0 435176 0 25000 0 17903 0 26000 0 84947 0 589026 0 0 ANITA M CONRAD ASSISTANT SECRETARY 0 160024 0 3000 0 258 0 16660 0 16053 0 195995 0 0 TERRY L HALES JR ASSISTANT TREASURER 365987 0 34618 0 1025 0 71642 0 21747 0 495019 0 0 0 LISA M WYATT VP CH COMMUNICATIONS/MARKE 296444 0 26235 0 19977 0 53174 0 17871 0 413701 0 0 0 CHERYL E H LOCKE VP CHIEF HUMAN RESOURCES O 360384 0 29898 0 4410 0 68830 0 16142 0 479664 0 0 0 NORMAN D POTTER JR VP DEVELOPMENT & ALUMNI AF 297266 0 28690 0 5508 0 50474 0 22716 0 404654 0 0 0 KAREN H HUEY VP FACILITIES 268782 0 32093 0 910 0 42269 0 22844 0 366898 0 0 0 ERIC TOMLINSON DSC PHD CH INNOV OFR & PRES WFIQ 390502 0 60040 0 98105 0 83072 0 11297 0 643016 0 0 0 TERRY G WILLIAMS EVP STRAT & DEV. 476556 0 83125 0 12862 0 113493 0 51546 0 737582 0 0 0 K BARBARA CARBONE MD PRES & COO, WFBH TO 4/15 661490 0 118000 0 116042 0 162700 0 34796 0 1093028 0 0 0 CHAD A ECKES CIO, CFO & TREAS. EFF 4/15 309491 0 71667 0 9147 0 48767 0 39951 0 479023 0 0 0 KEVIN P HIGH MD EVP HS AFFAIRS EFF 4/15 411496 0 26898 0 1458 0 5200 0 21574 0 466626 0 0 0 DEETTE M EMON VP, CIO EFF 4/15 145347 0 0 0 191 0 1625 0 4499 0 151662 0 0 0 NEAL KON MD DEPARTMENT CHAIR 907264 0 213637 0 23044 0 5200 0 18674 0 1167819 0 0 0 ROSS UNGERLEIDER MD CHIEF, PEDIATRIC HEART PRO 856342 0 194160 0 19786 0 155351 0 21377 0 1247016 0 0 0 EDWARD KINCAID MD ASSOCIATE PROFESSOR 716426 0 201483 0 17770 0 5200 0 21370 0 962249 0 0 0 MALCOLM MARKS MD DEPARTMENT CHAIR 726645 0 111663 0 5504 0 5200 0 24489 0 873501 0 0 0 CHARLES BRANCH JR MD DEPARTMENT CHAIR 764839 0 203500 0 5544 0 5200 0 24493 0 1003576 0 0 0 WILLIAM B APPLEGATE MD FORMER OFFICER 232638 0 1973 0 19786 0 6330 0 17973 0 278700 0 0 0 EDWARD G CHADWICK FORMER OFFICER 257661 0 152385 0 1178129 0 5100 0 15424 0 1608699 0 765751 0 THOMAS E SIBERT MD FORMER OFFICER 504079 0 109655 0 789797 0 5200 0 16023 0 1424754 0 643252 0 RUSSELL M HOWERTON MD FORMER OFFICER 494639 0 40170 0 20710 0 120475 0 23111 0 699105 0 0 0 SHEILA M SANDERS FORMER OFFICER 0 0 0 0 155697 0 0 0 6842 0 162539 0 0 0 JOANNE C RUHLAND FORMER OFFICER 248300 0 0 0 20700 0 38510 0 19782 0 327292 0 0 0 PART I, LINE 1A CERTAIN OFFICERS RECEIVE, AS PART OF THEIR APPROVED COMPENSATION PACKAGE, RELOCATION ASSISTANCE INCLUDING A HOUSING ALLOWANCE. BELOW IS A SUMMARY OF THE BENEFITS INCLUDED IN THE OFFICERS' COMPENSATION FOR THE CALENDAR YEAR ENDED DECEMBER 31, 2014: - RELOCATION ASSISTANCE, INCLUDING A HOUSING ALLOWANCE - $205,159 AS FOLLOWS: ERIC TOMLINSON - $71,710 - RELOCATION ASSISTANCE K. BARBARA CARBONE - $113,032 - RELOCATION ASSISTANCE CHAD ECKES - $8,650 - RELOCATION ASSISTANCE TERRY WILLIAMS - $11,767 RELOCATION ASSISTANCE PART I, LINE 3 FROM JULY 1, 2014 THROUGH JANUARY 31, 2015, THE EXECUTIVE COMMITTEE OF THE WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER ("WFUBMC") BOARD OF DIRECTORS WAS RESPONSIBLE FOR REVIEWING AND APPROVING ALL MEDICAL CENTER OFFICERS' COMPENSATION (INCLUDING THE COMPENSATION OF MOST OF THE OFFICERS OF THE FILING ORGANIZATION). BEGINNING FEBRUARY 1, 2015, THE GOVERNANCE AND COMPENSATION COMMITTEE OF THE WFUBMC BOARD OF DIRECTORS IS RESPONSIBLE FOR REVIEWING AND APPROVING ALL MEDICAL CENTER OFFICERS' COMPENSATION (INCLUDING THE COMPENSATION OF MOST OF THE OFFICERS OF THE FILING ORGANIZATION). THE COMMITTEE UTILIZES AN INDEPENDENT, EXTERNAL COMPENSATION CONSULTANT FIRM EXPERIENCED IN HEALTH CARE AND HIGHER EDUCATION COMPENSATION THAT BASED RECOMMENDATIONS ON COMPENSATION SURVEYS AND STUDIES TO DETERMINE THE APPROPRIATENESS OF EACH OFFICER'S COMPENSATION. THESE COMPENSATION CONSULTANTS PRESENT TOTAL COMPENSATION COMPARABILITY DATA FOR THE POSITIONS FOR WHICH COMPENSATION IS BEING DETERMINED. THE DATA IS REVIEWED BY THE GOVERNANCE AND COMPENSATION COMMITTEE OF WFUBMC'S GOVERNING BOARD AT ITS MEETING; NONE OF THE MEMBERS OF THAT COMMITTEE ARE EMPLOYEES OF THE FILING ORGANIZATION. MINUTES OF THE DELIBERATIONS OF THE COMMITTEE ARE CONTEMPORANEOUSLY RECORDED. IN THE EVENT THAT ANY MEMBER OF THE GOVERNANCE AND COMPENSATION COMMITTEE HAS A CONFLICT OF INTEREST, THAT COMMITTEE MEMBER DOES NOT PARTICIPATE IN THE DELIBERATION OR APPROVAL PROCESS, AND THEIR ABSTENTION FROM THE PROCESS IS REFLECTED IN THE MINUTES. PART I, LINES 4A-B CERTAIN EXECUTIVES PARTICIPATE IN OR RECEIVE SEVERANCE PAYMENTS AND PAYMENTS FROM SUPPLEMENTAL NON QUALIFIED RETIREMENT PLANS. THE DETERMINATION OF THE AMOUNT OF THE NON QUALIFIED RETIREMENT PLANS FOLLOWED THE FILING ORGANIZATION'S COMPENSATION PROCEDURES AS OUTLINED IN PART VI, SECTION B, LINE 15 OF THE FORM 990. THE FOLLOWING FORMER OFFICERS RECEIVED SEVERANCE AND SERP PAYMENTS IN THEIR CALENDAR YEAR 2014 COMPENSATION: SEVERANCE SERP SHELIA SANDERS 155,697 JOHN D. MCCONNELL, MD 530,400 EDWARD CHADWICK 185,424 970,299 THOMAS SIBERT, MD 764,135 PART I, LINE 7 CERTAIN OFFICERS, KEY EMPLOYEES AND FACULTY MEMBERS HAVE INCENTIVE COMPENSATION COMPONENTS CONTAINED IN THEIR EMPLOYMENT AGREEMENTS. THESE ARE OFTEN GOAL-BASED AND ARE DETERMINED IN THE COURSE OF EVALUATION OF THE INDIVIDUAL'S PERFORMANCE BY HIS/HER DEPARTMENT CHAIR, SUPERVISOR OR THE COMPENSATION COMMITTEE OF THE BOARD, AS APPLICABLE. OTHER NON-FIXED PAYMENTS MAY INCLUDE SUMS FOR RELOCATION AND/OR TEMPORARY HOUSING THAT ARE TYPICALLY INCLUDED AS A PROVISION IN THE EMPLOYMENT AGREEMENT. ALL SUCH PAYMENTS ARE REFLECTED ON THE INDIVIDUAL'S W-2. FORM 990, PART VII, LINE 5 - COMPENSATION FROM UNRELATED ORGANIZATION KAREN H HUEY AND DEETTE EMON WERE COMPENSATED BY NORTH CAROLINA BAPTIST HOSPITAL, AN UNRELATED ORGANIZATION, FOR SERVICES PERFORMED FOR WAKE FOREST UNIVERSITY HEALTH SCIENCES AND OTHER ENTITIES WITHIN THE MEDICAL CENTER. SEE PART VII AND SCHEDULE J, PART II FOR THEIR COMPENSATION. A NORTH CAROLINA MEDICAL CARE COMMISSION 521309402 65821DNX5 2012-11-15 59045000 REFUND ISSUE DATED 10/16/2008 0 0 0 B NORTH CAROLINA MEDICAL CARE COMMISSION 521309402 65821DNF4 2012-11-15 129019661 REFUND ISSUE DATED 10/16/2008 0 0 0 A 4235000 59045000 16063 59028937 1 0 1 1 B 6855000 129019661 568 129019093 1 0 1 1 A 0 1 0 0 1 0 0 1 B 0 1 0 0 0 0 0 1 A 1 B 1 PART II, COLUMN A&B, LINE 11 - OTHER SPENT PROCEEDS OTHER SPENT PROCEEDS LISTED ARE THE CURRENT REFUNDING PROCEEDS OF THE ISSUE(S). PART III, COLUMNS A&B - PRIVATE BUSINESS USE BOTH ISSUES REFUNDED THE ISSUE DATED 10/16/2008, WHICH SOLE PURPOSE WAS THE REFUNDING OF ISSUES PRIOR TO 12/31/2002. ACCORDINGLY, EACH ISSUE IS EXEMPT FROM COMPLETING PART III OF THE FORM. X 29 18926 FAIR MARKET VALUE X 22490 FAIR MARKET VALUE X FAIR MARKET VALUE X 61 1913288 FAIR MARKET VALUE X 2 314000 FAIR MARKET VALUE X 13 18484 FAIR MARKET VALUE X 47 5425 FAIR MARKET VALUE X GIFT CARDS 37 11922 FAIR MARKET VALUE X EQUIPMENT 5 9233 FAIR MARKET VALUE 2 0 1 1 PART I, COLUMN (B): TH ORGANIZATION DETERMINES THE NUMBER OF CONTRIBUTIONS BY USING THE TOTAL NUMBER OF NON-CASH ITEMS RECEIVED PER DONOR PER OCCURANCE. PART I, LINE 32B: THE FILING ORGANIZATION SOMETIMES USES A RELATED ORGANIZATION, WAKE FOREST UNIVERSITY DEVELOPMENT FOUNDATION, TO SELL GIFTS OF DONATED REAL PROPERTY. FORM 990, PART VI, SECTION A, LINE 2 MICHAEL RUTHERFORD AND TERRY WILLIAMS, BOTH OFFICERS OF THE ORGANIZATION, WERE BOARD MEMBERS OF MEDCOST BENEFIT SERVICES. FORM 990, PART VI, SECTION A, LINE 3 EFFECTIVE JULY 1, 2010, THE GOVERNING BOARDS OF FOUR NORTH CAROLINA NONPROFIT CORPORATIONS (WAKE FOREST UNIVERSITY, NORTH CAROLINA BAPTIST HOSPITAL, WAKE FOREST UNIVERSITY HEALTH SCIENCES, AND WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER) ENTERED INTO AN AGREEMENT (THE "MEDICAL CENTER INTEGRATION AGREEMENT OR "MCIA") UNDER WHICH THE OPERATION OF EACH OF NORTH CAROLINA BAPTIST HOSPITAL ("NCBH") AND WAKE FOREST UNIVERSITY HEALTH SCIENCES ("WFUHS") WAS DELEGATED TO WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER ("WFUBMC"). WFUHS IS A WHOLLY-CONTROLLED SUBSIDIARY ENTITY OF WAKE FOREST UNIVERSITY ("WFU"). WFUBMC IS A MEMBERSHIP NONPROFIT CORPORATION WHOSE TWO EQUAL MEMBERS ARE NCBH (WHICH ENTITY IS UNRELATED TO WFUHS AND WFU) AND WFU. THE GOAL IS CONSOLIDATION OF MANAGEMENT IN WFUBMC OF THE VARIOUS ACADEMIC MEDICAL CENTER OPERATIONS, SUBJECT TO SUBSTANTIAL RESERVED POWERS IN EACH OF THE CONSTITUENT MEMBERS' (OR IN WFUHS') BOARDS. EFFECTIVE MARCH 17, 2014, THE ENTITY CONTRACTED WITH C. MICHAEL RUTHERFORD AS ITS CHIEF FINANCIAL OFFICER AND TREASURER. MR. RUTHERFORD IS AN EMPLOYEE OF WARBIRD CONSULTING PARTNERS, A HEALTHCARE EXECUTIVE MANAGEMENT SERVICES COMPANY. MR. RUTHERFORD'S REPORTABLE COMPENSATION PAID BY WARBIRD IN CALENDAR YEAR 2014 FOR HIS SERVICES AS THE ORGANIZATION'S CHIEF FINANCIAL OFFICER AND TREASURER WAS $670,192. FORM 990, PART VI, SECTION A, LINE 4 ON NOVEMBER 5, 2014, THE BOARD OF DIRECTORS OF THE FILING ORGANIZATION [WFUHS] APPROVED SEVERAL CHANGES TO THE MEDICAL CENTER INTEGRATION AGREEMENT ("MCIA"). THE FILING ORGANIZATION WAS ONE OF FOUR PARTIES TO THE MCIA; THE APPROVAL BY THE BOARD OF TRUSTEES OF WAKE FOREST UNIVERSITY (THE SOLE MEMBER OF THE FILING ORGANIZATION) OF THESE MCIA CHANGES ON JANUARY 30, 2015 MADE THEM FINAL. EFFECTIVE FEBRUARY 1, 2015, CHANGES RELATE TO MEDICAL CENTER BOARD COMMITTEES AND THE ESTABLISHMENT OF A NEW COMMUNITY BENEFIT ADVISORY BOARD. MEDICAL CENTER BOARD COMMITTEES WILL NOW INCLUDE THE MEDICAL CENTER CEO AS AN EX OFFICIO MEMBER OF EACH COMMITTEE; THE EXECUTIVE COMMITTEE WILL BE COMPRISED OF THE MEDICAL CENTER CHAIR AND VICE-CHAIR, THE CHAIR AND VICE-CHAIR OF THE AUDIT AND COMPLIANCE COMMITTEE, AND THE CHAIR AND VICE-CHAIR OF THE NEW GOVERNANCE AND COMPENSATION COMMITTEE. FIVE EXISTING MEDICAL CENTER BOARD COMMITTEES (FINANCE AND BUSINESS AFFAIRS; HEALTH SYSTEMS OPERATIONS AND QUALITY; ACADEMIC AFFAIRS; FACILITIES AND INNOVATION QUARTER; AND FAITH AND COMMUNITY HEALTH) ARE ELIMINATED. THE MEDICAL CENTER AUDIT AND COMPLIANCE COMMITTEE WILL BE COMPRISED OF THREE (3) WFU APPOINTEES AND THREE (3) NCBH APPOINTEES, PLUS THE MEDICAL CENTER BOARD CHAIR, EX OFFICIO. THE CHAIR AND CHAIR DESIGNATE FOR THIS COMMITTEE WILL FOLLOW A SIMILAR TWO-YEAR ROTATION PLAN AS THAT FOR THE MEDICAL CENTER BOARD. THE GOVERNANCE AND COMPENSATION COMMITTEE WILL CONSIST OF THE BOARD CHAIR AND VICE-CHAIR, AND TWO (2) APPOINTEES EACH FROM THE WFU AND NCBH BOARD FROM THEIR MEDICAL CENTER BOARD ELECTEES. THE CHAIR/CHAIR DESIGNATE TWO-YEAR ROTATION PLAN ALSO APPLIES TO THIS COMMITTEE. GOING FORWARD, ONLY MEDICAL CENTER BOARD MEMBERS WILL POPULATE MEDICAL CENTER BOARD COMMITTEES, BUT THE WFUHS AND NCBH SEPARATE INVESTMENT COMMITTEES WILL CONTINUE. THE WFUBMC BYLAWS CALL FOR APPOINTMENTS TO WFUBMC BOARD COMMITTEES TO BE MADE BY WFU OR ITS BOARD OF TRUSTEES, AS A MEMBER OF THE WFUBMC CORPORATION, BUT THE WFU BOARD OF TRUSTEES ON JANUARY 30, 2015 AT ITS MEETING DELEGATED THE AUTHORITY TO MAKE SUCH APPOINTMENTS TO THE WFUHS BOARD OF DIRECTORS. CREATION OF AN ACADEMIC SUBCOMMITTEE OF THE HEALTH AFFAIRS COMMITTEE (WHICH COMMITTEE COMPRISES A PORTION OF THE FILING ORGANIZATION'S BOARD OF DIRECTORS) THE MCIA AMENDMENT'S CHANGES INCLUDED THE ELIMINATION OF SEVERAL MEDICAL CENTER BOARD COMMITTEES; AMONG THOSE ELIMINATED WAS THE ACADEMIC AFFAIRS COMMITTEE, WHOSE MEMBERS HAD INCLUDED WFU-APPOINTED MEMBERS DRAWN FROM THE WAKE FOREST UNIVERSITY BOARD OF TRUSTEES HEALTH AFFAIRS COMMITTEE AND FUNCTIONING, WHEN SITTING IN THE MEDICAL CENTER BOARD ACADEMIC AFFAIRS COMMITTEE'S MEETINGS, AS A SUBCOMMITTEE HOLDING DELEGATED AUTHORITY FROM THE WAKE FOREST UNIVERSITY BOARD OF TRUSTEES TO APPROVE THE APPOINTMENT OF NON-TENURED UNIVERSITY FACULTY IN THE MEDICAL SCHOOL (THE WFU HEALTH AFFAIRS COMMITTEE HAVING BEEN GRANTED THE FURTHER AUTHORITY TO CREATE A SUBCOMMITTEE FOR THIS PURPOSE BY THE WFU POLICY RESOLUTIONS). AS THE MEDICAL CENTER BOARD'S ACADEMIC AFFAIRS COMMITTEE WAS ELIMINATED, THE WFU HEALTH AFFAIRS COMMITTEE ON JANUARY 30, 2015 CONSTITUTED A NEW ACADEMIC SUBCOMMITTEE FOR SUCH PURPOSE, AND NAMED AS THE MEMBERS OF SUCH SUBCOMMITTEE, "THOSE MEMBERS OF THE [WFU] HEALTH AFFAIRS COMMITTEE WHO ARE, FROM TIME TO TIME, MEMBERS OF THE WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER BOARD OF DIRECTORS". FORM 990, PART VI, SECTION A, LINE 6 WAKE FOREST UNIVERSITY IS THE SOLE MEMBER OF WAKE FOREST UNIVERSITY HEALTH SCIENCES. FORM 990, PART VI, SECTION A, LINE 7A THE DIRECTORS OF WAKE FOREST UNIVERSITY HEALTH SCIENCES ARE ELECTED BY THE BOARD OF TRUSTEES OF ITS SOLE MEMBER, WAKE FOREST UNIVERSITY. FORM 990, PART VI, SECTION A, LINE 7B DECISIONS OF THE ORGANIZATION'S GOVERNING BODY WHICH REQUIRE APPROVAL BY THE ORGANIZATION'S SOLE MEMBER, WAKE FOREST UNIVERSITY, INCLUDE AMENDMENTS TO CERTAIN FUNDAMENTAL DOCUMENTS (ARTICLES OF INCORPORATION AND BYLAWS); THE CONVEYANCE OR ENCUMBRANCE OF THE ORGANIZATION'S REAL ESTATE; ACADEMIC APPOINTMENT OF FACULTY, GRANT OF TENURE AND DISMISSAL; AND DISSOLUTION. FORM 990, PART VI, SECTION B, LINE 11 THE FILING ORGANIZATION'S BOARD OF DIRECTORS RECEIVES A COPY OF THE FORM 990 WITH SUFFICIENT TIME TO PERMIT REVIEW, COMMENT, AND QUESTIONS PRIOR TO ITS FILING. THE AUDIT AND COMPLIANCE COMMITTEE OF THE GOVERNING BOARD OF THE FILING ORGANIZATION REVIEWS IN ADDITIONAL DETAIL THE FILING ORGANIZATION'S FORM 990 WITH THE ORGANIZATION'S CHIEF FINANCIAL OFFICER AND/OR HIS DESIGNEE, WHO ANSWER QUESTIONS AND ADDRESS CONCERNS RAISED BY SUCH COMMITTEE MEMBERS OR BY OTHER FILING ORGANIZATION DIRECTORS. IF MODIFICATIONS ARE REQUIRED FOLLOWING SUCH REVIEW AND COMMENT, THE REVISED FORM 990 IS REDISTRIBUTED TO ALL DIRECTORS PRIOR TO ITS FILING WITH THE IRS, ALONG WITH A REPORT NOTING THE MODIFICATIONS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION REQUIRES OFFICERS AND KEY EMPLOYEES TO ANNUALLY REVIEW THE CONFLICT OF INTEREST POLICY AND DETERMINE ANY POTENTIAL CONFLICTS OF INTEREST. ANY POTENTIAL CONFLICTS NOTED IN THE QUESTIONNAIRE ARE REVIEWED BY A STANDING COMMITTEE FOR APPROPRIATE RESOLUTION. ALL MEMBERS OF THE BOARD OF DIRECTORS ARE REQUIRED TO DETERMINE AND REPORT ANNUALLY, AND AS THEY ARISE, ANY POTENTIAL CONFLICTS OF INTEREST TO THE SECRETARY OF THE BOARD OF DIRECTORS. THE RESOLUTION OF POTENTIAL AND ACTUAL CONFLICTS IS SUBJECT TO THE APPROVAL OF THE CHAIR OF THE BOARD AND IS REPORTED TO THE CHAIR OF THE AUDIT & COMPLIANCE COMMITTEE OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 15 FROM JULY 1, 2014 THROUGH JANUARY 31, 2015, THE EXECUTIVE COMMITTEE OF WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER ("WFUBMC") BOARD OF DIRECTORS FUNCTIONED AS THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS AND PURSUANT TO A DELEGATION BY THE FILING ORGANIZATION, REVIEWED AND APPROVED THE APPOINTMENT AND COMPENSATION OF THE SENIOR EXECUTIVES OF THE FILING ORGANIZATION. BEGINNING FEBRUARY 1, 2015, THAT ROLE IS FULFILLED BY THE GOVERNANCE AND COMPENSATION COMMITTEE OF WFUBMC. NO MEMBER OF THE WFUBMC GOVERNANCE AND COMPENSATION COMMITTEE IS AN EMPLOYEE OF THE MEDICAL CENTER OR OF THE FILING ORGANIZATION. THE GOVERNANCE AND COMPENSATION COMMITTEE RELIES UPON AN EXTERNAL, INDEPENDENT COMPENSATION CONSULTANT EXPERIENCED IN HEALTHCARE TO PROVIDE THE COMMITTEE WITH COMPENSATION COMPARABILITY DATA FOR NEW EXECUTIVE POSITION APPOINTMENTS AND FOR COMPENSATION REVIEWS FOR EXISTING EXECUTIVES. THE CONSULTANT, WHICH IS RETAINED DIRECTLY BY THE GOVERNANCE AND COMPENSATION COMMITTEE, PROVIDES THIRD-PARTY INFORMATION AND EVALUATES THE COMPETITIVENESS AND REASONABLENESS OF EXECUTIVE COMPENSATION AND BENEFITS PROGRAMS IN RELATION TO MARKET PRACTICES FOR SIMILARLY-SITUATED NONPROFIT HEALTHCARE ORGANIZATIONS. THE COMMITTEE MAKES ITS DECISIONS WITH RESPECT TO EXECUTIVE COMPENSATION IN ACCORDANCE WITH THE FILING ORGANIZATION'S POLICIES, IRS REGULATIONS, AND STANDARD CORPORATE GOVERNANCE PRACTICES. SUCH POLICIES INCLUDE ADHERENCE TO: BOARD-ESTABLISHED EXECUTIVE COMPENSATION PHILOSOPHY AND REVIEW PROCESSES; PROCESSES ENSURING GOVERNANCE AND COMPENSATION COMMITTEE MEMBER AND COMPENSATION CONSULTANT INDEPENDENCE; USE OF VALID MARKET COMPARISONS OF DATA FROM PEER ACADEMIC MEDICAL CENTERS OF SIMILAR ORGANIZATIONAL STRUCTURE, SIZE, AND COMPLEXITY; CAREFUL DOCUMENTATION OF ALL COMPENSATION DECISIONS; AND ESTABLISHMENT OF THE REBUTTABLE PRESUMPTION OF REASONABLENESS, PER IRS GUIDELINES. MINUTES OF THE DELIBERATIONS OF THE GOVERNANCE AND COMPENSATION COMMITTEE ARE CONTEMPORANEOUSLY MAINTAINED AND THAT COMPARABILITY DATA IS MAINTAINED IN THE MEDICAL CENTER'S OFFICE OF EXECUTIVE COMPENSATION SERVICES. IN THE EVENT THAT A MEMBER OF THE GOVERNANCE AND COMPENSATION COMMITTEE HAS A CONFLICT OF INTEREST RELATED TO EXECUTIVE APPOINTMENT OR COMPENSATION, THAT MEMBER DOES NOT PARTICIPATE IN THE DELIBERATION OR APPROVAL OF APPOINTMENT OR COMPENSATION AND SUCH ABSTENTION IS NOTED IN THE COMMITTEE'S MEETING MINUTES. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S ARTICLES OF INCORPORATION ARE AVAILABLE TO THE PUBLIC ON REQUEST AND ARE AVAILABLE ON THE WEBSITE OF THE NORTH CAROLINA SECRETARY OF STATE. THE ORGANIZATION'S BYLAWS ARE NOT PUBLISHED, BUT PROVISIONS FROM THE BYLAWS ARE INCLUDED AS NECESSARY IN THE ORGANIZATION'S POLICIES, AND ARE ATTACHED TO THE FORM 1023 FILED FOR THE ORGANIZATION WITH THE IRS, WHICH IS PUBLICLY AVAILABLE. THE CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE NOT AVAILABLE TO THE PUBLIC. PART VII, SECTION A, COLUMN B - HOURS DONALD E FLOW FILING ORG 2.0 RELATED ORG 16.0 DONNA A BOSWELL PHD FILING ORG 4.0 RELATED ORG 10.2 JAMES R HELVEY III FILING ORG 2.0 RELATED ORG 9.0 JAMES J MARINO FILING ORG 2.0 RELATED ORG 5.0 JAMES T WILLIAMS, JR FILING ORG 2.0 RELATED ORG 5.0 GERALD F. ROACH FILING ORG 2.0 RELATED ORG 4.0 BRENDA K. CLINE FILING ORG 2.0 SHELMER D BLACKBURN JR FILING ORG 2.0 RELATED ORG 4.0 BOBBY R. BURCHFIELD FILING ORG 2.0 RELATED ORG 7.2 RICHARD A. BRENNER FILING ORG 2.0 KATHLEEN B. FRENCH FILING ORG 2.0 RELATED ORG 3.0 JAMES W JOHNSTON FILING ORG 2.0 MATTHEW A. KING FILING ORG 2.5 RELATED ORG 6.5 NATHAN O HATCH PHD FILING ORG 3.0 RELATED ORG 37.0 JOHN D MCCONNELL MD FILING ORG 7.5 RELATED ORG 11.5 UNRELATED ORG 21.0 ANN S. HANES FILING ORG 2.0 ANDREW J SCHINDLER FILING ORG 4.0 RELATED ORG 8.0 EDWARD ABRAHAM MD FILING ORG 34.9 RELATED ORG 5.1 J REID MORGAN FILING ORG 8.0 RELATED ORG 32.0 ANITA M CONRAD FILING ORG 10.0 RELATED ORG 30.0 TERRY L HALES JR FILING ORG 6.6 RELATED ORG 14.4 UNRELATED ORG 19.0 LISA M WYATT FILING ORG 15.0 RELATED ORG 5.0 UNRELATED ORG 20.0 CHERYL E. H. LOCKE FILING ORG 3.0 RELATED ORG 5.0 UNRELATED ORG 32.0 NORMAN D POTTER, JR FILING ORG 15.0 RELATED ORG 5.0 UNRELATED ORG 20.0 KAREN H HUEY FILING ORG 11.0 RELATED ORG 5.0 UNRELATED ORG 24.0 ERIC TOMLINSON DSC PHD FILING ORG 5.0 RELATED ORG 35.0 TERRY G. WILLIAMS FILING ORG 12.0 RELATED ORG 6.0 UNRELATED ORG 22.0 K. BARBARA CARBONE MD FILING ORG 4.0 RELATED ORG 11.0 UNRELATED ORG 25.0 CHAD A. ECKES FILING ORG 7.0 RELATED ORG 5.0 UNRELATED ORG 28.0 C. MICHAEL RUTHERFORD FILING ORG 8.0 RELATED ORG 5.0 UNRELATED ORG 27.0 KEVIN P. HIGH, MD FILING ORG 12.0 RELATED ORG 10.0 UNRELATED ORG 18.0 DEETTE M. EMON FILING ORG 5.0 RELATED ORG 5.0 UNRELATED ORG 30.0 NEAL KON MD FILING ORG 40.0 ROSS UNGERLEIDER FILING ORG 40.0 EDWARD KINCAID MD FILING ORG 40.0 MALCOLM MARKS MD FILING ORG 40.0 CHARLES BRANCH JR MD FILING ORG 40.0 WILLIAM B APPLEGATE MD FILING ORG 40.0 RUSSELL M HOWERTON MD FILING ORG 18.0 UNRELATED ORG 22.0 JOANNE C RUHLAND FILING ORG 15.0 UNRELATED ORG 25.0 NORTH CAROLINA BAPTIST HOSPITAL IS AN UNRELATED ORGANIZATION TO THE FILING ORGANIZATION AND THE INFORMATION CONCERNING HOURS DEVOTED TO IT ARE NOT REQUIRED TO BE REPORTED, BUT ARE INCLUDED BECAUSE OF THE STRUCTURE OF WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER, OF WHICH THE FILING ORGANIZATION AND NORTH CAROLINA BAPTIST HOSPITAL ARE PRINCIPAL PARTS. IN GENERAL, THE CORPORATE OFFICERS OF THE MEDICAL CENTER ALSO SERVE AS THE CORPORATE OFFICERS OF NORTH CAROLINA BAPTIST HOSPITAL AND WAKE FOREST UNIVERSITY HEALTH SCIENCES. FORM 990, PART XI, LINE 9: EQUITY METHOD AFFILIATES 10,748,540. ACTUARIAL GAIN 9,334,764. BRF-A1A LLC MEDICAL CENTER BLVD WINSTON SALEM NC 27157 203073357 REAL ESTATE HOLDING COMPANY NC 679960 1698888 WAKE FOREST UNIV HEALTH SCIENCES WFIQ HOLDINGS LLC MEDICAL CENTER BLVD WINSTON SALEM NC 27157 050549344 REAL ESTATE HOLDING COMPANY NC 285554 47305336 WAKE FOREST UNIV HEALTH SCIENCES SEED STAGE ASSOCIATES LLC 200 EAST FIRST ST SUITE 101 WINSTON SALEM NC 27101 651198831 TECHNOLOGY TRANSFER & LICENSING OF INTELLECTUAL PROPERTY NC 0 0 WAKE FOREST UNIV HEALTH SCIENCES BRF DECK 1 LLC MEDICAL CENTER BLVD WINSTON SALEM NC 27157 861123819 REAL ESTATE HOLDING COMPANY NC 0 540873 WAKE FOREST UNIV HEALTH SCIENCES BRF-A1 LLC MEDICAL CENTER BLVD WINSTON SALEM NC 27157 861123822 REAL ESTATE HOLDING COMPANY NC 0 969325 WAKE FOREST UNIV HEALTH SCIENCES WFIQ HOLDINGS II LLC MEDICAL CENTER BLVD WINSTON SALEM NC 27157 271917927 REAL ESTATE HOLDING COMPANY NC 0 3296691 WAKE FOREST UNIV HEALTH SCIENCES WFIQ HOLDINGS III LLC MEDICAL CENTER BLVD WINSTON SALEM NC 27157 271918085 REAL ESTATE HOLDING COMPANY NC 0 3954359 WAKE FOREST UNIV HEALTH SCIENCES PARK IMP 1 LLC MEDICAL CENTER BLVD WINSTON SALEM NC 27157 272070963 REAL ESTATE HOLDING COMPANY NC 0 0 WAKE FOREST UNIV HEALTH SCIENCES WAKE FOREST AMBULATORY VTR LLC MEDICAL CENTER BLVD WINSTON SALEM NC 27157 HEALTHCARE NC 0 0 WAKE FOREST UNIV HEALTH SCIENCES WAKE FOREST UNIVERSITY HEALTH SCIENCES GROUP RETURN MEDICAL CENTER BLVD WINSTON SALEM NC 27157 900222618 PROVIDE DIALYSIS TREATMENTS TO PATIENTS NC 501(C)(3) LINE 11A, I WAKE FOREST UNIV HEALTH SCIENCES 1 WFUBMC COMMUNITY PHYSICIANS (CP) MEDICAL CENTER BLVD WINSTON SALEM NC 27157 561903275 HEALTHCARE NC 501(C)(3) LINE 3 WAKE FOREST UNIV HEALTH SCIENCES 1 WAKE FOREST INNOVATION QUARTER MANAGEMENT CO MEDICAL CENTER BLVD WINSTON SALEM NC 27157 061818498 RESEARCH PARK DEVELOPMENT NC 501(C)(3) LINE 11A, I WAKE FOREST UNIV HEALTH SCIENCES 1 WAKE FOREST INNOVATION QUARTER DEVELOPMENT CO MEDICAL CENTER BLVD WINSTON SALEM NC 27157 562094067 RESEARCH PARK DEVELOPMENT NC 501(C)(6) WAKE FOREST UNIV HEALTH SCIENCES 1 WAKE FOREST UNIVERSITY FOUNDATION PO BOX 7201 WINSTON SALEM NC 27109 562038193 REAL ESTATE HOLDING AND MANAGEMENT NC 501(C)(3) LINE 11A, I WAKE FOREST UNIVERSITY 0 IDEALLIANCE FOUNDATION MEDICAL CENTER BLVD WINSTON SALEM NC 27157 562094060 RESEARCH PARK DEVELOPMENT NC 501(C)(3) LINE 11A, I WAKE FOREST UNIV HEALTH SCIENCES 1 WAKE FOREST INNOVATION QUARTER CDC MEDICAL CENTER BLVD WINSTON SALEM NC 27157 200177581 RESEARCH PARK DEVELOPMENT NC 501(C)(3) LINE 11A, I WAKE FOREST UNIV HEALTH SCIENCES 1 WAKE FOREST UNIVERSITY PO BOX 7201 WINSTON SALEM NC 27109 560532138 UNIVERSITY NC 501(C)(3) LINE 2 N/A 0 WAKE FOREST UNIVERSITY DEVELOPMENT FOUNDATION PO BOX 7201 WINSTON SALEM NC 27109 562038194 MANAGEMENT/SALE OF CHARITABLE REAL PROPERTY GIFTS NC 501(C)(3) LINE 11A, I WFU & WFUF 0 WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER MEDICAL CENTER BLVD WINSTON SALEM NC 27157 510190238 FACILITATE THE CARRYING OUT OF THE FUNCTIONS AND PURPOSES OF WFUHS & NCBH NC 501(C)(3) LINE 11A, I N/A 0 MEDICAL FND OF WFUHS & NCBH MEDICAL CENTER BLVD WINSTON SALEM NC 27157 566036688 SUPPORTING ORGANIZATION NC 501(C)(3) LINE 11A, I N/A 0 DIALYSIS ACCESS GROUP OF WFU LLC MEDICAL CENTER BLVD WINSTON SALEM NC 27157 204241942 PROVIDE DIALYSIS TREATMENTS TO PATIENTS NC 501(C)(3) LINE 9 WAKE FOREST UNIV HEALTH SCIENCES 1 REYNOLDA HOUSE INC POBOX 7287 WINSTON SALEM NC 27109 560810676 MUSEUM OF AMERICAN ART NC 501(C)(3) LINE 7 WAKE FOREST UNIVERSITY 0 CHILDRESS INSTITUTE FOR PEDIATRIC TRAUMA 575 N PATTERSON STREET WINSTON SALEM NC 27101 463674691 HEALTHCARE RESEARCH NC 501(C)(3) LINE 7 WAKE FOREST UNIV HEALTH SCIENCES 0 VERGER FUND II LLC PO BOX 7354 WINSTON SALEM NC 27109 352514227 INVESTMENT NC WAKE FOREST UNIVERSITY HEALTH SCIENCES EXCLUDED 10283185 352307462 0 281269 0 0.97000 VERGER CAPITAL FUND LLC PO BOX 7354 WINSTON SALEM NC 27109 464027021 INVESTMENT NC N/A VERGER CAPITAL MANAGEMENT LLC PO BOX 7354 WINSTON SALEM NC 27109 464037343 INVESTMENT NC N/A CHARITABLE REMAINDER TRUST MEDICAL CENTER BLVD WINSTON SALEM NC 27157 INVESTMENT NC WAKE FOREST UNIVERSITY HEALTH SCIENCES T 323389 0.62000 0 NORTH DISTRICT OWNERS ASSOCIATION MEDICAL CENTER BLVD WINSTON SALEM NC 27157 471128865 PROPERTY OWNERS ASSOCIATION NC N/A C 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 1 1 0 1 WFUBMC COMMUNITY PHYSICIANS K 3512100 COST WFUBMC COMMUNITY PHYSICIANS M 31151033 COST DIALYSIS ACCESS GROUP OF WAKE FOREST UNIVERSITY N 68104 COST WAKE FOREST UNIVERSITY HEALTH SCIENCES GROUP RETURN N 2257977 COST WAKE FOREST UNIVERSITY HEALTH SCIENCES GROUP RETURN S 20475000 COST WAKE FOREST UNIVERSITY HEALTH SCIENCES GROUP RETURN P 20368 COST WAKE FOREST UNIVERSITY HEALTH SCIENCES GROUP RETURN Q 713950 COST