2016-05-13T08:07:23-05:00 2015-06-30 990 2014-07-01 020774853 NORTHWEST COMMUNITY CARE NETWORK INC NORT 3367162698 2000 WEST 1ST STREET NO 704 WINSTON SALEM NC 27104 JIM GRAHAM EXECUTIVE DIRECTOR 3367162698 2016-05-10 2014 2016-08-17 19:52:53Z JIM GRAHAM 2000 WEST 1ST STREET NO 704 WINSTON SALEM NC 27104 13896999 0 X WWW.NWCOMMUNITYCARE.ORG X 2006 NC DEVELOPING, IMPLEMENTING AND EVALUATING ENHANCED MANAGED CARE STRATEGIES FOR MEDICAID RECIPIENTS. 12 12 0 10 0 0 1923959 2055197 10993684 11835320 1553 1269 7900 5213 12927096 13896999 751234 481527 0 0 0 0 0 0 0 12999553 13145539 13750787 13627066 -823691 269933 5092185 5226226 1079249 943357 4012936 4282869 X NORTHWEST COMMUNITY CARE NETWORK OPERATES A PRIMARY CARE CASE MANAGEMENT PROGRAM (PPCM) THAT IS DESIGNED TO PROVIDE A MORE EFFICIENT AND EFFECTIVE HEALTHCARE DELIVERY SYSTEM FOR MEDICAID RECIPIENTS. IT BRINGS TOGETHER PRIMARY CARE PROVIDERS, HOSPITALS, HEALTH DEPARTMENTS, DEPARTMENT OF SOCIAL SERVICES AND OTHER COMMUNITY PROVIDERS TO MANAGE THE HEALTH CARE NEEDS OF MEDICAID RECIPIENTS. ITS SERVICE AREA INCLUDES THE COUNTIES OF DAVIE, DAVIDSON, FORSYTH, STOKES, SURRY, WILKES AND YADKIN. THESE COUNTIES COMPRISE THE NETWORK MEMBERS. ITS CARE MANAGERS ASSIST IN DEVELOPING, IMPLEMENTING AND EVALUATING ENHANCED MANAGED CARE STRATEGIES FOR MEDICAID RECIPIENTS. IT RECEIVES A MONTHLY FEE TO PERFORM THE SERVICE FROM THE STATE OF NORTH CAROLINA'S MEDICAID PROGRAM FOR EACH MEDICAID RECIPIENT ENROLLED. 0 0 12171409 481527 11840533 DURING OUR CURRENT FISCAL YEAR, WE CONTINUE TO COORDINATE, FACILITATE AND MANAGE THE DELIVERY OF MEDICAID SERVICES TO 130,000 CLIENTS IN THE NORTHWEST PIEDMONT AREA OF NORTH CAROLINA. WE HAVE BEEN SUCCESSFUL IN IMPROVING THE QUALITY OF MATERNITY CARE AND RELATED OUTCOMES FOR MOTHERS AND BABIES,AND REDUCING MEDICAL CARE COST FOR 8,598 CLIENTS. IN ADDITION, WE FOCUSE ON INDIGENT CARE THROUGH MEDICAID SERVICES IN THE NORTHWEST PIEDMONT AREA OF NORTH CAROLINA FOR 6,089 MEDICAID CLIENTS. OUR ANCHOR PROGRAM IS REDUCING MEDICARE READMISSIONS TO THE LOCAL HOSPITALS AND ITS BENEFITS CONTINUE TO GROW THROUGHOUT OUR AREA. 12171409 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 29 0 1 0 0 0 0 0 0 0 0 0 0 0 X 12 12 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 0 0 0 0 X PAIGE W GRUBBS 3367162344 2000 WEST 1ST STREET SUITE 704 WINSTON SALEM NC 27104 ANN ABSHER SECRETARY 2.00 X X 0 0 0 EDDIE WOOTEN BOARD MEMBER 2.00 X 768 0 0 MARLON HUNTER TREASURER 2.00 X X 0 0 0 DAVID SWANN BOARD MEMBER 2.00 X 0 0 0 SCOTT L VOGLER MD BOARD MEMBER 2.00 X 0 0 0 SU ALBERT MD BOARD MEMBER 2.00 X 3723 0 0 BILL SEBASTIAN BOARD MEMBER 2.00 X 0 0 0 TOM SIBERT MD CHAIRMAN 2.00 X X 0 0 0 DICK STEVENSON BOARD MEMBER 2.00 X 0 0 0 RICHARD LORD BOARD MEMBER 2.00 X 0 0 0 K BARBARA CARBONE MD BOARD MEMBER 2.00 X 0 0 0 TERRY WILLIAMS CHAIRMAN 2.00 X X 0 0 0 DAVID COOK MD BOARD MEMBER 2.00 X 0 0 0 JIM GRAHAM EXECUTIVE DIRECTOR 40.00 X 105353 0 11041 109844 0 11041 0 0 0 1 MEDICATION MANAGEMENT LLC PO BOX 35282 GREENSBORO NC 27425 NETWORK ADMIN 465733 FRANK L BLUM CONSTRUCTION COMPANY 830 TWENTY FIFTH ST WINSTON SALEM NC 27105 CONSTRUCTION 247049 CENTERPOINT HUMAN SERVICES 4045 UNIVERSITY PKWY WINSTON SALEM NC 27106 BEHAVIORIAL HEALTH 153531 3 1344204 710993 2055197 CASE MANAGEMENT FEES 624100 11835320 11835320 11835320 1269 1269 OTHER INCOME 621400 5213 5213 5213 13896999 11840533 0 1269 481527 481527 11835 11835 3179 3179 96041 17570 78471 11940 11940 145968 145968 155381 155381 48229 48229 79466 79466 17518 17518 NCCN OPERATIONAL COSTS 6343782 5138763 1205019 SERVICE REIMBURSEMENTS 4818672 4818672 PROJECT RESERVES 1375069 1375069 MEDICAL SUPPLIES 38459 38459 13627066 12171409 1455657 0 576787 2240763 3497497 2100358 101294 171272 61383 60129 1060 953936 232568 786500 721368 5092185 5226226 1079249 943357 1079249 943357 X 3934317 4007165 78619 275704 4012936 4282869 5092185 5226226 269933 0 X 0 1 X 1 0 X 749864 646025 644702 1923959 2055197 6019747 749864 646025 644702 1923959 2055197 6019747 6019747 19437 4076 3187 1553 1269 29522 7900 5213 13113 6062382 50319475 0.99300 0.98070 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 639091 134564 504527 314845 98004 216841 721368 X 13896999 0 13896999 0 13896999 13627066 0 13627066 0 13627066 PART X, LINE 2: THE COMPANY IS A TAX-EXEMPT ORGANIZATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE CODE) AND IS GENERALLY EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. ACCORDINGLY, NO PROVISION FOR INCOME TAXES IS MADE IN THE FINANCIAL STATEMENTS. THE COMPANY HAS EVALUATED UNCERTAIN TAX POSITIONS FOR ITS FISCAL YEARS ENDED JUNE 30, 2015 AND 2014, INCLUDING A QUANTIFICATION OF TAX RISKS IN AREAS SUCH AS UNRELATED BUSINESS INCOME AND TAXATION OF ITS FOR-PROFIT SUBSIDIARIES. THIS EVALUATION DID NOT HAVE A MATERIAL EFFECT ON THE COMPANY'S FINANCIAL STATEMENTS FOR THE YEARS ENDED JUNE 30, 2015 AND 2014. 1 COMMUNITY CARE CENTER FOR FORSYTH COUNTY 2135 NEW WALKERTOWN RD WINSTON SALEM NC 27101 581403699 501(C)(3) 102211 HEALTH NET GRANT WILKES COUNTY HEALTH DEPARTMENT 306 COLLEGE STREET WILKESBORO NC 28697 566000350 GOV'T ENTITY 72875 HEALTH NET GRANT SURRY COUNTY HEALTH AND NUTRITION 118 HAMBY ROAD DOBSON NC 27017 566000341 GOV'T ENTITY 40635 HEALTH NET GRANT STOKES FAMILY HEALTH PO BOX 187 DANBURY NC 27016 566000340 GOV'T ENTITY 40950 HEALTH NET GRANT NORTH CAROLINA BAPTIST HOSPITAL MEDICAL CENTER BLVD WINSTON SALEM NC 27157 560552787 501(C)(3) 50000 DOWNTOWN HEALTH PLAZA - CARE PLUS PROGRAM DAVIDSON COUNTY HEALTH DEPARTMENT 915 GREENSBORO STREET LEXINGTON NC 27293 566000294 GOV'T ENTITY 6000 CHRONIC PAIN INITIATIVE THE COALITION FOR DRUG ABUSE PREVENTION 8025 NORTH POINT BLVD SUITE 223 WINSTON SALEM NC 27106 GOV'T ENTITY 20000 CHRONIC PAIN INITIATIVE INSIGHT HUMAN SERVICES 7830 NORTHPOINT BLVD SUITE 200 WINSTON SALEM NC 27106 560951129 501(C)(3) 6000 CHRONIC PAIN INITIATIVE - STOKES FORSYTH MEDICAL CENTER FOUNDATION 3333 SILAS CREEK PKWY WINSTON SALEM NC 27103 562120959 501(C)(3) 140000 SAFEMED PROJECT 9 0 PART I, LINE 2: THE ORGANIZATION DISTRIBUTES GRANT MONEY THAT HAS BEEN PRE-APPROVED TO DESIGNATED COUNTY AGENCIES. ANY QUESTIONS ARE DIRECTED TO THE OFFICE OF RURAL HEALTH. 0 0 0 0 0 0 0 0 0 PART VII, SECTION A, LINE 5 - COMPENSATION FROM UNRELATED ORGANIZATION THE ORGANIZATION'S EXECUTIVE DIRECTOR, JIM GRAHAM, WAS COMPENSATED BY AN UNRELATED ORGANIZATION, NORTH CAROLINA BAPTIST HOSPITAL, FOR HIS SERVICES DURING THE FISCAL YEAR ENDED JUNE 30, 2015. TOTAL COMPENSATION FOR HIS SERVICES WAS $116,394. FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION HAS ONE MEMBER, WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER. FORM 990, PART VI, SECTION A, LINE 7A ITS SOLE MEMBER, WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER, SHALL APPOINT ONE DIRECTOR. THE BOARD OF DIRECTORS SHALL APPOINT ONE DIRECTOR WHO IS A RESIDENT OF, OR IS OTHERWISE ASSOCIATED WITH, EACH OF THE COUNTIES THAT THE ORGANIZATION SERVES. 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. IF MODIFICATIONS ARE REQUIRED FOLLOWING SUCH REVIEW, THE REVISED FORM 990 IS REDISTRIBUTED PRIOR TO ITS FILING WITH THE IRS, ALONG WITH A SUMMARY OF THE MODIFICATIONS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION REQUIRES OFFICERS, DIRECTORS AND KEY EMPLOYEES TO ANNUALLY REVIEW THE CONFLICT OF INTEREST POLICY AND DETERMINE ANY POTENTIAL CONFLICTS OF INTEREST. ALL OFFICERS, DIRECTORS AND KEY EMPLOYEES ARE REQUIRED TO DETERMINE AND REPORT POTENTIAL CONFLICTS ANNUALLY, AND AS THEY ARISE. ANY ITEMS DISCLOSED ARE REVIEWED AND MANAGED IN ACCORDANCE WITH THE ORGANIZATION'S POLICY ON CONFLICTS OF INTEREST. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION PAYS NO COMPENSATION TO OFFICERS, DIRECTORS OR KEY EMPLOYEES. ALL COMPENSATION PAID TO OFFICERS, DIRECTORS AND KEY EMPLOYEES WAS PAID BY AN AFFILIATED/UNRELATED ORGANIZATION. COMPENSATION PAID TO THESE INDIVIDUALS IS REVIEWED AND APPROVED IN ACCORDANCE WITH THE AFFILIATED/UNRELATED ORGANIZATION'S COMPENSATION POLICIES AND PROCEDURES WHICH INCLUDE INDEPENDENT COMPENSATION CONSULTANTS, COMPENSATION SURVEYS AND STUDIES TO DETERMINE THE APPROPRIATENESS OF EACH OFFICERS', DIRECTORS AND KEY EMPLOYEES' COMPENSATION. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S RESTATED 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. WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER MEDICAL CENTER BLVD WINSTON SALEM NC 27157 510190238 HEALTHCARE NC 501(C)(3) LINE 11A, I N/A 0 LEXINGTON MEDICAL CENTER 250 HOSPITAL DRIVE LEXINGTON NC 27292 560543238 HEALTHCARE NC 501(C)(3) LINE 3 WAKE FOREST UNIVERSITY BAPTIST HOSPITAL 0 LEXINGTON MEDICAL CENTER FOUNDATION 250 HOSPITAL DRIVE LEXINGTON NC 27292 581876553 FUNDRAISING NC 501(C)(3) LINE 11B, II LEXINGTON MEDICAL CENTER 0 FAITHHEALTH INNOVATIONS INC MEDICAL CENTER BLVD WINSTON SALEM NC 27157 237426944 HEALTHCARE NC 501(C)(3) LINE 9 WAKE FOREST UNIVERSITY BAPTIST HOSPITAL 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0