2016-08-09T06:44:56-05:00 2015-09-30 560747981 DIXON HUGHES GOODMAN LLP 500 RIDGEFIELD COURT ASHEVILLE NC 28806 990 2014-10-01 566000674 LENOIR MEMORIAL HOSPITAL INC LENO 2525227927 100 AIRPORT ROAD KINSTON NC 28501 SARAH MAYO CFO 2525227927 2016-08-09 1 AMY BIBBY P00445891 8282542254 2014 2016-12-15 16:53:06Z GARY BLACK 100 AIRPORT ROAD KINSTON NC 28501 135224475 0 X WWW.LENOIRMEMORIAL.ORG X 1950 NC PROVIDING EXCEPTIONAL HEALTHCARE AS AN OUTSTANDING COMMUNITY HOSPITAL 15 10 1131 272 419822 71411 239903 502317 122741162 128235538 2886195 3018999 2961999 2786598 128829259 134543452 172287 207400 0 0 56443186 55916071 0 0 65716 74616082 75204640 131231555 131328111 -2402296 3215341 180872103 186348585 40185676 44007458 140686427 142341127 X THE MISSION OF LENOIR MEMORIAL IS TO ENSURE EXCEPTIONAL HEALTHCARE FOR THE PEOPLE WE SERVE. 0 0 112255730 207400 129673464 PLEASE SEE SCHEDULE O FOR A DESCRIPTION OF THE ORGANIZATION'S PROGRAM SERVICE ACCOMPLISHMENTS. 112255730 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 1 0 0 0 0 0 1 0 1 1 0 0 0 0 0 1 1 1 0 0 0 1 119 0 1 1131 1 1 1 0 0 0 0 0 0 0 0 0 X 15 10 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 X MICHELLE MITTEN CPA FINANCE DIR 2525227927 100 AIRPORT ROAD KINSTON NC 28501 GARY E BLACK PRESIDENT / CEO 50.00 1.00 X X 484721 0 20085 RAY COLLIER JR CHAIRMAN OF BOARD 3.00 X X 0 0 0 RALPH LEE COX MD BOARD MEMBER 2.00 X 13494 0 0 LADDIE M CRISP JR MD BOARD MEMBER 2.00 X 695 0 0 DEXTER FLOYD BOARD MEMBER 2.00 X 0 0 0 OSCAR GREENE III BOARD MEMBER 2.00 X 0 0 0 CLIFTON HARRISON BOARD MEMBER 2.00 X 0 0 0 CRAIG HILL BOARD MEMBER 2.00 X 0 0 0 AGNUS HO BOARD MEMBER 2.00 X 0 0 0 ADRIAN KING BOARD MEMBER 2.00 X 0 0 0 ALAN KIROLLOS MD BOARD MEMBER 2.00 X 21267 0 0 WILLIAM ANTHONY LAWSON JR BOARD MEMBER 2.00 X 0 0 0 ARMISTEAD MAUCK BOARD MEMBER 2.00 X 0 0 0 DAPHNE POLLOCK BOARD MEMBER 2.00 X 0 0 0 CARLTON YOUNGER JR BOARD MEMBER 2.00 X 0 0 0 SARAH MAYO CFO 50.00 1.00 X 297499 0 39881 JAMES CLINE DOBBINS JR VP HUMAN RESOURCES 50.00 X 216608 0 33192 ROSALIND MCDONALD CNO (THROUGH DEC. 14) 50.00 X 224788 0 16104 KARL LEONARD VANDERSTOUW CIO, VP ITS/HIS 50.00 X 193763 0 16231 LAURAL MOLLOY CNO (BEGINNING DEC. 14) 50.00 X 6553 0 0 SCOTT STEGBBAUER MD ORTHOPEDIC SURGEON 40.00 X 506476 0 23663 WAYNE T JARMAN SURGEON 40.00 X 398378 0 22262 JESSICA A WOODCOCK ORTHOPEDIC SURGEON 40.00 X 386080 0 12280 CARLOS A MACIAS SURGEON 40.00 X 359751 0 23627 ARTHUR HUNSINGER CRNA 40.00 X 204051 0 16504 3314124 0 223829 48 0 1 0 SODEXO INC & AFFILIATES PO BOX 536922 ATLANTA GA 303536922 EVS AND DIETARY MANAGEMENT 1000167 UHS PHYSICIANS LLC DBA VIDANT MEDICAL GR 2100 STANTONSBURG ROAD GREENVILLE NC 278358523 IP HOSPITALIST SERVICES 996181 DOCTOR CHARLES H CLASSEN JR PLLC 2007 STANTON ROAD KINSTON NC 28504 ORTHOPEDIC SERVICES 409625 MOSAIC ANESTHESIA & PERIOPERATIVE SERVIC PO BOX 15007 NEW BERN NC 285615007 ANESTHESIA SERVICES 379219 SLEEP SERVICES OF AMERICA INC PO BOX 198320 ATLANTA GA 30384 SLEEP STUDY SERVICES 378800 22 309748 192569 11848 502317 PATIENT SERVICES 621990 126394149 126394149 EHR PAYMENTS 900099 1312910 1312910 AUXILLARY SERVICE REVENUE 621990 328426 328426 WELLNESS CENTER REVEUNE 713940 153247 153247 LAB REVENUE 541380 41110 20555 20555 5696 5696 128235538 2046340 2176 2044164 1071756 0 1071756 1071756 850688 221068 1057187 0 84528 1057187 -84528 972659 972659 1380311 596495 783816 613489 170327 DIETARY DEPARTMENT 900099 890685 890685 VENDING 900099 40341 40341 931026 134543452 129673464 419822 3947849 168885 168885 38515 38515 1601879 235044 1313512 53323 43769706 36688586 7081120 1574067 1280984 291233 1850 5703339 4641407 1055229 6703 3267080 2658766 604474 3840 458800 458800 318280 318280 105330 105330 60000 60000 11540245 8420448 3119797 419113 31958 387155 4826116 2874331 1951785 2102038 2102038 3269435 3190324 79111 112339 68212 44127 74038 38638 35400 18212 18212 7072888 7072888 63159 63159 BAD DEBT EXPENSE 26519683 26519683 MEDICAL SUPPLIES 15761402 15761402 GAP ASSESSMENT TAX 1823481 1823481 BOND FEES 235619 235619 424462 400462 24000 131328111 112255730 19006665 65716 4816469 5061709 10867002 20706830 9438819 9968515 179832 3127956 3052549 1737270 1601337 146052353 92306547 56180422 53745806 91851087 90288333 2853078 1743674 180872103 186348585 9383211 11535155 4675558 7016268 18010000 17515000 5000000 4500000 3116907 3441035 40185676 44007458 X 107658664 110701356 33027763 31639771 140686427 142341127 180872103 186348585 X 3215341 -1560642 1 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 9499 9499 0 PART II-B, LINE 1: THE ORGANIZATION IS A MEMBER OF THE NORTH CAROLINA HOSPITAL ASSOCIATION. A PORTION OF THE DUES PAID TO THE NCHA ARE ALLOCATED EACH YEAR TO LOBBYING EFFORTS ON BEHALF OF ITS MEMBERSHIP BODY. ACCORDING TO THE NCHA, 27.14% OF THE HOSPITAL'S ANNUAL DUES OF $35,000 CAN BE ALLOCATED TO LOBBYING EXPENSE, WHICH IS APPROXIMATELY $9,499. 425406 425406 61449574 39021173 22428401 8112508 5151534 2960974 75799977 48133840 27666137 264888 264888 53745806 ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS 3350000 CAPITAL LEASE OBLIGATION 91035 3441035 X PART X, LINE 2: THE HOSPITAL AND FOUNDATION ARE EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE; ACCORDINGLY, THE ACCOMPANYING FINANCIAL STATEMENTS DO NOT REFLECT A PROVISION OR LIABILITY FOR FEDERAL AND STATE INCOME TAXES. THE HOSPITAL AND THE FOUNDATION HAVE DETERMINED THAT THEY DO NOT HAVE ANY MATERIAL UNRECOGNIZED TAX BENEFITS OR OBLIGATIONS AS OF SEPTEMBER 30, 2015. THE HOSPITAL AND FOUNDATION BELIEVE THEY ARE NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO SEPTEMBER 30, 2012. 1 1 1 X 1 X 1 1 1 0 1 1 1570167 236391 1333776 0.01270 18869934 16991043 1878891 0.01790 20440101 17227434 3212667 0.03060 822148 237902 584246 0.00560 583361 583361 0.00560 8154329 6732432 1421897 0.01360 4822 4822 0.00000 263240 263240 0.00250 9827900 6970334 2857566 0.02730 30268001 24197768 6070233 0.05790 621 621 0.00000 54447 54447 0.00050 478452 478452 0.00460 533520 533520 0.00510 0 26519683 1973714 40218203 42318720 -2100517 X 1 1 1 1 LENOIR MEMORIAL HOSPITAL INC 100 AIRPORT ROAD KINSTON NC 28501 X X X X DISPROPORTIONARE SHARE HOSPITAL LENOIR MEMORIAL HOSPITAL INC 1 0 0 1 X X X X X X X X X 14 1 0 0 1 X WWW.LENOIRMEMORIALHOSPITAL.ORG X WWW.CO.LENOIR.NC.US X X 1 14 1 WWW.LENOIRMEMORIALHOSPITAL.ORG 0 0 1 X 100.000000000000 250.000000000000 X X X X X X 1 1 X X X 1 X WWW.LENOIRMEMORIALHOSPITAL.ORG X WWW.LENOIRMEMORIALHOSPITAL.ORG X WWW.LENOIRMEMORIALHOSPITAL.ORG X X X X X 1 0 X X X X 1 X 0 0 LENOIR MEMORIAL HOSPITAL, INC. PART V, SECTION B, LINE 5: THE 2014 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS WAS LED BY REPRESENTATIVES OF THE LEADERSHIP TEAM AT THE LENOIR COUNTY HEALTH DEPARTMENT AND BY THE DIRECTOR OF COMMUNITY PROGRAMMING AND DEVELOPMENT AT OUR HOSPITAL. MEMBERS OF THESE TEAMS WORK IN THE AREA OF COMMUNITY HEALTH IN THEIR EMPLOYED POSITIONS AND ATTEND EDUCATIONAL SESSIONS ANNUALLY IN THE AREA OF COMMUNITY HEALTH ASSESSMENT PROCESS. ADDITIONALLY, THE LENOIR COUNTY ALLIANCE FOR A HEALTHY COMMUNITY TASK FORCE, REPRESENTING OVER 30 LENOIR COUNTY COMMUNITY ORGANIZATION AND AGENCY LEADERS FROM DIVERSE COMMUNITY PERSPECTIVE AND WERE COMMITTED TO THE ASSESSMENT PROCESS AS THEY DISTRIBUTED SURVEYS AND STAYED INFORMED ON THE TIMELINE AT MONTHLY MEETINGS. THEY OFFERED VALUABLE INPUT AND RECOMMENDATIONS IN THE PRIORITIZATION PROCESS ONCE SURVEY RESULTS WERE RECEIVED AND REVIEWED. THIS PROCESS ENSURED THAT INPUT FROM PERSONS WITH BROAD KNOWLEDGE OF THE COMMUNITY WERE INVOLVED. LENOIR MEMORIAL HOSPITAL, INC. PART V, SECTION B, LINE 6A: THE CHNA WAS MAILED OUT TO COMMUNITY LEADERS LENOIR MEMORIAL HOSPITAL, INC. PART V, SECTION B, LINE 11: LENOIR MEMORIAL HOSPITAL IS CURRENTLY NOT INVOLVED IN THE ILLEGAL DRUGS AND DRUG ABUSE/SUBSTANCE AND YOUTH VIOLENCE/GANGS ISSUE BUT A GROUP OF COMMUNITY ORGANIZATIONS LED BY KINSTON PUBLIC SAFETY HAS FORMED A TASK FORCE TO WORK ON THIS ISSUE. LENOIR MEMORIAL HOSTED MEETING SPACE AND A BREAKFAST FOR LEADERS IN THIS REGARD TO GET THE INITIATIVE STARTED. YOUTH ACCESS AND USE OF GUNS MAY ALSO BE CLOSELY RELATED TO THIS ISSUE AND SAFE KIDS ENC WORKS TO PROVIDE THE COMMUNITY WITH GUN LOCKS AND GUN SAFETY EDUCATION.JOB OPPORTUNITIES WERE IDENTIFIED AS A TOP ISSUE IN THE COMMUNITY AND EVEN THOUGH LENOIR MEMORIAL RECEIVED A WORKFORCE DEVELOPMENT GRANT FROM THE GOLDEN LEAF FOUNDATION IN 2010 AND TRAINED 20 CERTIFIED NURSING ASSISTANTS FOR THE LOCAL WORKFORCE, LENOIR MEMORIAL DOES NOT HAVE ANY CURRENT PLANS IN THIS AREA OTHER THAN SERVING AS A TRAINING SITE FOR STUDENTS WHO MAY JOIN THE WORKFORCE ONCE THEY COMPLETE THEIR PROGRAMS. LENOIR MEMORIAL IS A MAJOR EMPLOYER IN LENOIR COUNTY AND WILL HIRE AS VACANT POSITIONS NECESSITATE. HOSPITAL LEADERSHIP PARTICIPATES IN A VARIETY OF ECONOMIC DEVELOPMENT COMMITTEES AND PROJECTS THROUGHOUT THE YEAR.DRINKING AND DRIVING CONTINUES TO BE SEEN AS A PRIORITY ISSUE IN THE 2011 CHNA. LOCAL LAW ENFORCEMENT AND STATEWIDE PROGRAMS HAVE INITIATED PROGRAMS IN OUR COMMUNITY SUCH AS BOOZE IT AND LOSE IT AND OTHER ROAD STOP PROGRAMS IN AN EFFORT TO ADDRESS THE PROBLEM.LENOIR MEMORIAL OFFERS SMOKING CESSATION PROGRAMMING THROUGH THE MINGES WELLNESS CENTER AND DOES NOT LIMIT THE PROGRAMS TO ADULTS ONLY. THE ISSUE OF CIGARETTE SMOKING AMONG PEOPLE UNDER AGE 18 HAS BEEN A DISCUSSION AT THE LENOIR COUNTY SCHOOL HEALTH ADVISORY COMMITTEE ON WHICH LENOIR MEMORIAL SERVES. IT WILL NOT BE A PRIORITY FOR LENOIR MEMORIAL SINCE SERVICES FOR CESSATION EXIST AND THE HOSPITAL SERVES AS AN ORGANIZATIONAL ROLE MODEL AS A TOBACCO-FREE CAMPUS. LENOIR MEMORIAL HOSPITAL, INC. PART V, SECTION B, LINE 16I: SIGNS ARE POSTED NOTIFYING PATIENTS OF THE AVAILABILITY OF FINANCIAL ASSISTANCE AND INCLUDED ON PATIENT'S STATEMENTS. BROCHURES ARE ALSO PROVIDED NOTIFYING OF PATIENTS FINANCIAL ASSISTANCE AVAILABILITY. LENOIR MEMORIAL HOSPITAL, INC. PART V, SECTION B, LINE 22D: THE AMOUNT BILLED IS DETERMINED BY MULTIPLYING THE ORGANIZATION'S GROSS CHARGES FOR EMERGENCY OR MEDICALLY NECESSARY CARE BY THE REVENUE RECEIVED IN ORDER TO DETERMINE AN AMOUNTS GENERALLY BILLED ("AGB") PERCENTAGE. A FAP-ELIGIBLE PATIENT WILL NOT BE CHARGED MORE THAN THE AGB FOR EMERGENCY OR MEDICALLY NECESSARY CARE. PART V, SECTION B, LINE 16 FINANCIAL ASSISTANCE POLICY WEBSITE AVAILABILITY LENOIR MEMORIAL HOSPITAL, INC. PART V, SECTION B, LINE 16A WEBSITE: WWW.LENOIRMEMORIALHOSPITAL.ORG LENOIR MEMORIAL HOSPITAL, INC. PART V, SECTION B, LINE 16B WEBSITE: WWW.LENOIRMEMORIALHOSPITAL.ORG LENOIR MEMORIAL HOSPITAL, INC. PART V, SECTION B, LINE 16C WEBSITE: WWW.LENOIRMEMORIALHOSPITAL.ORG 1 LENOIR PHYSICIANS NETWORK LLC 100 AIRPORT ROAD KINSTON NC 28501 ORTHOPEDIC PHYSICIAN'S OFFICE GENERAL SURGICAL PHYSICIAN'S OFFICE PART I, LINE 3C: IN ADDITION TO DETERMINING ELIGIBILITY FOR FREE OR REDUCED-PRICE CARE USING INCOME LEVELS AND FEDERAL POVERTY GUIDELINES, PATIENTS MAY ALSO QUALIFY FOR FINANCIAL ASSISTANCE BASED UPON THEIR ELIGIBILITY FOR SUBSIDIZED HOUSING UNDER HUD GUIDELINES. ALTHOUGH THE HOSPITAL PREFERS TO BE ABLE TO DISCUSS OPTIONS FOR FINANCIAL ASSISTANCE WITH HEALTHCARE COSTS - INCLUDING POSSIBLE ELIGIBILITY FOR MEDICAID OR OTHER PROGRAMS - WITH PATIENTS, IF EFFORTS TO DO SO PROVE UNSUCCESSFUL, ELIGIBILITY FOR LMH'S FINANCIAL ASSISTANCE PROGRAM MAY BE DETERMINED BASED UPON PATIENT ADDRESS IN A SUBSIDIZED HOUSING COMMUNITY. COMMUNITIES MEETING THIS DEFINITION, AS WELL AS INCOME AND ASSET CRITERIA FOR RESIDENTS, ARE REVIEWED PERIODICALLY WITH THE LOCAL HOUSING AUTHORITY. ADDITIONALLY, PATIENTS FACING EXTENSIVE MEDICAL COSTS WHO DO NOT MEET STANDARD FINANCIAL INDIGENCE CRITERIA BASED UPON INCOME LEVEL MAY QUALIFY FOR DISCOUNTED CARE IF THEY ARE DETERMINED TO BE "MEDICALLY INDIGENT; THAT IS, HAVING INCURRED COSTS OF CARE IN EXCESS OF 20% OF FAMILY GROSS INCOME, AND FOR WHICH PAYMENT WOULD REQUIRE LIQUIDATION OF THOSE ASSETS CRITICAL TO LIVING OR EARNING A LIVING. THEREFORE, FINANCIAL AND OTHER ASSETS MUST BE FULLY DISCLOSED BY PATIENTS SEEKING THIS DESIGNATION IN ORDER FOR A MEDICAL INDIGENCE DETERMINATION TO BE MADE. ADDITIONALLY, DISCOUNTS FOR PROMPT PAYMENT OF BALANCES ARE AVAILABLE FOR ALL UNINSURED PATIENTS, AND ARE TIERED BASED UPON THE AMOUNT OWED (LARGER DISCOUNTS ARE APPLIED TO HIGHER BALANCES). FINANCIAL COUNSELORS SCREEN PATIENTS FOR FINANCIAL ASSISTANCE EITHER AT THE POINT OF SERVICE OR AFTER SERVICE HAS BEEN RENDERED. THE STAFF ALSO UTILIZES A SOFTWARE SYSTEM THAT SCREENS PATIENTS FOR MEDICAID ELIGIBILITY AS WELL AS FINANCIAL ASSISTANCE. PALS INTERVIEW SCHEDULED PATIENTS PRIOR TO SERVICE, AFTER ADMISSION AS AN INPATIENT AND AFTER SERVICE IS RECEIVED THROUGH THE EMERGENCY DEPARTMENT REGARDING THEIR LIABILITY AND DISCUSS OPTIONS FOR PAYMENT INCLUDING FINANCIAL ASSISTANCE. FINANCIAL COUNSELORS CONTACT PATIENTS AFTER THEY RECEIVE A STATEMENT FOR SERVICES TO DISCUSS PAYMENT OPTIONS INCLUDING FINANCIAL ASSISTANCE. PART I, LINE 7G: THE SUBSIDIZED HEALTH SERVICES PROGRAMS INCLUDED BEHAVIORAL HEALTH, ENT, NEONATOLOGY, NEPHROLOGY, PEDIATRICS, AND UROLOGY. PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 26,519,683. PART II, COMMUNITY BUILDING ACTIVITIES: LENOIR MEMORIAL PARTNERS WITH AREA ORGANIZATIONS TO PROVIDE COMMUNITY HEALTH PROGRAMMING, HEALTH COALITION WORK, AND IN-KIND LEADERSHIP TO AREA BOARDS, AND NON-PROFITS. HOSPITAL LEADERSHIP TEAM MEMBERS SERVE ON COMMUNITY TASK FORCES AND ACTION GROUPS. SOME OF THESE INCLUDE THE LENOIR COUNTY SCHOOL HEALTH ADVISORY COMMITTEE, EASTERN AHEC, KINSTON-LENOIR COUNTY CHAMBER OF COMMERCE, PRIDE OF KINSTON, LENOIR COMMITTEE OF 100, LENOIR-GREENE UNITED WAY, KINSTON COMMUNITY HEALTH CENTER, LENOIR COUNTY ALLIANCE FOR A HEALTHY COMMUNITY, THE COMMUNITY MARKETING COMMITTEE, AND LENOIR-GREENE ASTHMA COALITION. LENOIR ALSO PARTICIPATES IN A MENTORING PROGRAM WITH SOUTH EAST ELEMENTARY SCHOOL. LENOIR PROVIDES MEETING SPACE FOR VARIOUS LOCAL COMMITTEES. PART III, LINE 4: BAD DEBT EXPENSE FOR FY15 IS PRESENTED AS CHARGED NOT COST.BAD DEBT ACCOUNTS WERE GEOCODED TO DETERMINE THE CENSUS TRACT WHICH CORRESPONDED TO THE ADDRESS ON FILE FOR EACH BAD DEBT ACCOUNT. THE AVERAGE PERCENTAGE OF HOUSEHOLDS FOR EACH CENSUS TRACT WHICH MET THE LMH CHARITY CARE GUILDELINES WAS THEN APPLIED TO DETERMINE AN ESTIMATED PERCENTAGE OF BAD DEBT WHICH COULD BE ATTRIBUTED TO PATIENTS ELIGIBLE UNDER THE LMH CHARITY CARE POLICY. PART III, LINE 8: REGARDLESS OF A PATIENTS ABILITY TO PAY, ALL CARE OFFERED BY LENOIR MEMORIAL HOSPITAL IS AVAILABLE . THE HOSPITALS MISSION IS TO ENSURE EXCEPTIONAL HEALTHCARE FOR THE PEOPLE WE SERVE. THIS MISSION IS FULFILED EVEN WHEN WE DON'T MAKE A PROFIT FROM OUR CORE HOSPITAL OPERATIONS., THEREFORE WE FEEL THAT ALL OR MOST OF THE FUNDS LISTED ABOVE SHOULD BE CONSIDERED COMMUNITY BENEFIT. THE MEDICARE COST REPORT WAS USED TO DETERMINE MEDICARE ALLOWABLE COSTS OF CARE. PART III, LINE 9B: THE HOSPITAL SENDS PATIENTS A STATEMENT EACH MONTH NOTING THE BALANCE DUE. INFORMATION IS INCLUDED ON THE STATEMENT REGARDING OPTIONS FOR PAYMENT INCLUDING FINANCIAL ASSISTANCE AND CONTACT NUMBERS. SELF PAY PATIENTS ARE OFFERED A PROMPT PAY DISCOUNT. NOTIFICATION OF THE DISCOUNT IS INCLUDED ON THE PATIENT'S STATEMENTS.FINANCIAL COUNSELORS ARE TRAINED TO INFORM PATIENTS OF FINANCIAL ASSISTANCE AS AN OPTION SHOULD THEY HAVE DIFFICULTY PAYING THEIR ACCOUNTS. THE SCREENING IS BASED ON SOME PRELIMINARY QUESTIONS, AND THEN PATIENTS ARE SCHEDULED FOR AN INTERVIEW TO COMPLETE THE APPLICATION AND SUBMIT THE NECESSARY DOCUMENTS. PATIENTS RECEIVING LESS THAN 100% FINANCIAL ASSISTANCE WILL BE REQUESTED TO MAKE PAYMENT ARRANGEMENTS FOR THE REMAINING BALANCE.TELEPHONE CONTACTS TO DISCUSS ACCOUNT BALANCES WITH PATIENTS AND OFFER OPTIONS FOR RESOLUTION ARE ATTEMPTED ON MOST ACCOUNTS. THE HOSPITAL WILL OFFER PAYMENT PLANS TO PATIENTS THAT ARE ABLE TO PAY WITH A MINIMUM MONTHLY PAYMENT OF $50.00. PATIENTS ARE ALSO OFFERED ASSISTANCE WITH MEDICAID ELIGIBILITY APPLICATIONS. IF THE PATIENT IS NONRESPONSIVE AFTER RECEIVING THREE STATEMENTS (120 DAYS FROM DATE OF SERVICE OR LAST PAYMENT DATE), THE ACCOUNT MAY BE FORWARDED TO A COLLECTION AGENCY FOR FURTHER COLLECTION PROCEDURES. THE HOSPITAL DOES NOT UTILIZE PRACTICES SUCH AS GARNISHMENTS, LIENS, AND PERSONAL ATTACHMENTS AS PART OF THE COLLECTION PROCESS. PART VI, LINE 2: LENOIR MEMORIAL WORKS CLOSELY WITH THE LENOIR COUNTY HEALTH DEPARTMENT TO CONDUCT THE COMMUNITY HEALTH NEEDS ASSESSMENT FOR LENOIR COUNTY, OUR LARGEST POPULATION SERVED. OUR COMMUNITIES ARE SURVEYED WITH BOTH ENGLISH AND SPANISH SURVEY INSTRUMENTS. LOCAL DEMOGRAPHIC AND HEALTH STATISTICS ARE COMPILED ALONG WITH COMMUNITY SURVEY DATA ABOUT PERCEIVED HEALTH ISSUES IN ORDER TO DEVELOP TARGETED COMMUNITY HEALTH STRATEGIES. LENOIR MEMORIAL ALSO PARTNERS WITH LENOIR, GREENE, AND JONES COUNTIES IN HEALTHY CAROLINIANS, A LOCAL TASK FORCE. ANNUAL CANCER REPORTING AND HOSPITAL DIAGNOSIS TRENDS ARE USED TO PRIORITIZE PROGRAMMING, SERVICES, AND INITIATIVES AS WELL AS PHYSICIAN NEEDS ASSESSMENTS. PART VI, LINE 3: LENOIR MEMORIAL HOSPITAL HAS POSTED SIGNS INFORMING PATIENTS OF PAYMENT OPTIONS INCLUDING THE HOSPITAL'S FINANCIAL ASSISTANCE PROGRAM. BROCHURES (PATIENT FINANCIAL HEALTH GUIDELINES) ARE PUBLISHED EXPLAINING "WHAT YOU NEED TO KNOW ABOUT PAYING FOR YOUR HEALTH SERVICES". THESE GUIDES ARE INCLUDED AS PART OF THE INPATIENT ADMISSION PACKAGE, ARE ON DISPLAY IN WAITING ROOMS, AND ARE PROVIDED TO PATIENTS DURING INTERVIEWS SHOULD THEY HAVE QUESTIONS. SPANISH SPEAKING PATIENTS ARE OFFERED ASSISTANCE THROUGH OUR ONSITE SPANISH INTERPRETER AND THE HOSPITAL ALSO HAS ACCESS TO LANGUAGE LINES, AS SERVICE FOR NON-ENGLISH CONVERSATIONS. THE FINANCIAL ASSISTANCE POLICY OVERVIEW IS POSTED ON THE HOSPITAL'S WEBSITE. INFORMATION REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE IS INCLUDED ON THE PATIENT'S STATEMENT. FINANCIAL COUNSELORS DISCUSS FINANCIAL ASSISTANCE AS AN OPTION FOR PATIENTS THAT CONTACT THE HOSPITAL WITH CONCERNS ABOUT PAYING THEIR ACCOUNT OR, WITH PROPER CONSENT, A FAMILY MEMBER. THE HOSPITAL ALSO SCREENS SELF-PAY PATIENTS FOR MEDICAID OR OTHER GOVERNMENT PROGRAMS. PART VI, LINE 4: LENOIR MEMORIAL HOSPITAL IS LOCATED IN KINSTON, NORTH CAROLINA (POPULATION 21,625), WHICH IS THE COUNTY SEAT AND LARGEST TOWN IN LENOIR COUNTY (POPULATION 59,495); KINSTON AND OTHER LENOIR COUNTY MUNICIPALITIES CONSTITUTE THE HOSPITAL'S PRIMARY SERVICE AREA. LMH IS DESIGNATED A SOLE COMMUNITY HOSPITAL BY CMS. THOUGH STRONG ECONOMIC AND CORRESPONDING POPULATION GROWTH OCCURRED THROUGHOUT MUCH OF NORTH CAROLINA DURING THE MOST RECENT FIFTEEN YEARS (2000-2015), LOCAL TRENDS DID NOT FOLLOW SUIT. LENOIR COUNTY WAS ONE OF ONLY SEVEN COUNTIES STATEWIDE THAT LOST POPULATION (-2.5%), VS. THE NC AVERAGE OF +24.8%. KINSTON'S DECLINE WAS EVEN STEEPER, AT -9.7%. OVER THE LAST TWO DECADES THE LOCAL AREA HAS WITNESSED THE CLOSING OR SIGNIFICANT DOWNSIZING OF FORMERLY LARGE EMPLOYERS - PARTICULARLY LIGHT MANUFACTURING ENTERPRISES - AS LESS EXPENSIVE LABOR HAS BEEN SOUGHT OVERSEAS. IN THE MOST RECENT YEARS, THE AREA'S CHALLENGES HAVE BEEN EXACERBATED BY THE DRAMATIC NATIONWIDE ECONOMIC DOWNTURN, AND LENOIR COUNTY'S UNEMPLOYMENT RATE HAS TYPICALLY EXCEEDED BOTH STATE AND NATIONAL AVERAGES. THE COUNTY HAS BEEN DESIGNATED TIER 1 - I.E., THE RANKING GIVEN TO THE MOST ECONOMICALLY DISTRESSED COUNTIES IN THE STATE - BY THE NC DEPARTMENT OF COMMERCE. POVERTY LEVELS IN KINSTON AND LENOIR COUNTY EXCEED STATE AVERAGES; IN 2010 THE COUNTY'S POVERTY LEVEL WAS RANKED THIRD HIGHEST FOR COUNTIES WITH POPULATIONS GREATER THAN 20,000 BY THE NC JUSTICE CENTER. THE ECONOMICALLY DISADVANTAGED PERCENTAGE OF CHILDREN IN LENOIR COUNTY SCHOOLS FOR 2009-2010 WAS 66.53%, AND ALL SCHOOLS WITH ELEMENTARY AND MIDDLE GRADES WERE TITLE 1. PORTIONS OF KINSTON ARE DESIGNATED AS HEALTH PROFESSIONAL SHORTAGE AREAS. THE TABLE BELOW PROVIDES SELECTED POPULATION, INCOME, AND POVERTY STATISTICS FROM THE US CENSUS BUREAU, INCLUDING THE AMERICAN COMMUNITY SURVEY. KINSTON LENOIR COUNTY NORTH CAROLINAPOPULATION CHANGE, 2000-2015 -9.7% -2.5% 24.8%PERCENT BELOW POVERTY LEVEL, 2010 32.8% 23.7% 17.2%MEDIAN HOUSEHOLD INCOME, 2010 $28,608 $35,687 $46,693CHILDREN IN POVERTY, 2010 55.1% 37.7% 25.0%THE HISTORICAL DEPENDENCE UPON FARMING AND LIGHT MANUFACTURING JOBS, AS WELL AS POVERTY AND EDUCATION LEVELS THAT ARE HIGHER AND LOWER, RESPECTIVELY, THAN NC AVERAGES WILL LIKELY CONTINUE TO BE LIMITING FACTORS TO CONSISTENTLY STRONG OR RAPID ECONOMIC GROWTH. IN ORDER TO ADDRESS THESE CHALLENGES, NUMEROUS AREA ORGANIZATIONS CONTINUE TO WORK TOWARD DEVELOPMENT INITIATIVES THAT WILL CREATE LONG TERM SOCIAL AND ECONOMIC IMPROVEMENT. PART VI, LINE 5: THE HOSPITAL BOARD IS COMPRISED OF UNRELATED COMMUNITY MEMBERS. LOCAL PHYSICIANS HAVE PRIVILEGES IN A MAJORITY OF HOSPITAL DEPARTMENTS. SURPLUS FUNDS MAY BE USED TO PURCHASE CAPTIAL EQUIPMENT OR OTHER MEDICAL EQUIPMENT USED IN PATIENT CARE. THEY ARE ALSO USED TO PURCHASE TECHNOLOGY, SUCH AS COMPUTER EQUIPMENT, SOFTWARE, AND CONNECTIVITY. THESE FUNDS ALSO SUPPORT GENERAL BUILDING REFURBISHMENTS AS WELL AS REPAIRS AND MAINTENANCE. PART VI, LINE 7, REPORTS FILED WITH STATES NC 1 NCEAST ALLIANCE PO BOX 1346 CARY NC 27512 562032585 501(C)(3) 5600 FMV N/A OPERATIONAL SUPPORT KINSTON COMMUNITY HEALTH CENTER PO BOX 2278 KINSTON NC 28502 561833275 501(C)(3) 54000 FMV N/A SUPPORT COMMUNITY HEALTH 2 SCHOLARSHIPS 8 6500 N/A N/A TUITION REIMBURSEMENT 30 32015 N/A N/A PART I, LINE 2: THE ORGANIZATION PROVIDES PRE-APPROVED FUNDS TO SELECTED ORGANIZATIONS AND INDIVIDUALS BASED UPON APPROVED CRITERIA. THE FUNDS ARE ONLY DISBURSED FOR THE APPROVED ACTIVITIES. X 1 1 X X X X X 0 1 0 0 0 0 0 0 0 GARY E BLACK PRESIDENT / CEO 356283 0 26454 0 101984 0 10400 0 9685 0 504806 0 71257 0 SARAH MAYO CFO 245003 0 18191 0 34305 0 31352 0 8529 0 337380 0 19439 0 JAMES CLINE DOBBINS JR VP HUMAN RESOURCES 177507 0 13180 0 25921 0 25147 0 8045 0 249800 0 17610 0 ROSALIND MCDONALD CNO (THROUGH DEC. 14) 175011 0 12995 0 36782 0 7857 0 8247 0 240892 0 17501 0 KARL LEONARD VANDERSTOUW CIO, VP ITS/HIS 164776 0 24788 0 4199 0 7583 0 8648 0 209994 0 0 0 SCOTT STEGBBAUER MD ORTHOPEDIC SURGEON 475010 0 0 0 31466 0 10400 0 13263 0 530139 0 0 0 WAYNE T JARMAN SURGEON 325000 0 36865 0 36513 0 10400 0 11862 0 420640 0 0 0 JESSICA A WOODCOCK ORTHOPEDIC SURGEON 360758 0 25000 0 322 0 10400 0 1880 0 398360 0 0 0 CARLOS A MACIAS SURGEON 336307 0 23444 0 0 0 10400 0 13227 0 383378 0 0 0 ARTHUR HUNSINGER CRNA 147703 0 0 0 56348 0 6406 0 10098 0 220555 0 0 0 PART I, LINE 1A THE ORGANIZATION REIMBURSES BOARD MEMBERS FOR COSTS OF TRAVELING TO HOSPITAL EVENTS. THE ORGANIZATION SUBMITS THE APPROPRIATE TAX FORMS WHEN REQUIRED. PART I, LINE 4B THE FOLLOWING INDIVIDUALS RECEIVED AMOUNTS FROM A 457F PLAN: SARAH MAYO, CFO, $21,132; JAMES CLINE DOBBINS, VP HUMAN RESOURCES, $17,332 A NORTH CAROLINA MEDICAL CARE COMMISSION 521309402 657902Y63 2005-09-22 22000000 CAPITAL PROJECTS 0 0 0 A 4485000 22021552 178646 20213 9657270 12165423 2005 1 0 1 1 A 0 1 1 1 0 0.00200 0.00200 0 0 1 A 0 0 1 1 1 0 0 0 1 A 1 SCHEDULE K SUPPLENTAL INFORMATION THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I (E) AND THE TOTAL PROCEEDS IN PART II (3) IS DUE TO INTEREST EARNINGS THAT HAVE ACCRUED ON INVESTED BOND PROCEEDS. ISSUE DATES OF BONDS REFUNDED BY THE SERIES 2005 BONDS LISTED IN COLUMN A: NOVEMBER 16, 1995 AND MARCH 19,1998. PART IV, LN 2C - THE REBATE COMPUTATION WAS PERFORMED AS OF MARCH 22, 2006. PART III, LN 7 - AS PROVIDED IN TREASURY REGULATION SECTION 1.141-4(C)(2)(I)(B), THE AMOUNT OF PRIVATE PAYMENTS TAKEN INTO ACCOUNT UNDER THE PRIVATE PAYMENT TEST MAY NOT EXCEED THE AMOUNT OF PRIVATE BUSINESS USE AND/OR UNRELATED TRADE OR BUSINESS USE. ACCORDINGLY, THE AMOUNT OF PRIVATE PAYMENTS FOR THE REPORTING PERIOD DOES NOT EXCEED THE AMOUNT STATED IN PART III, LINE 6. THE ORGANIZATION HAS NOT UNDERTAKEN AN ANALYSIS OF THE PRIVATE SECURITY TEST WITH RESPECT TO THE BONDS, AS THE LEVEL OF PRIVATE BUSINESS USE AND/OR UNRELATED TRADE OR BUSINESS REPORTED IN PART III, LINE 6 IS NOT IN EXCESS OF THE AMOUNTS PERMITTED UNDER SECTION 145 OF THE CODE. ALAN KIROLLOS BOARD MEMBER PLEASE SEE SCHEDULE L, PART V X 226788 179832 0 0 1 179832 CARLA MONROE FAMILY RELATIONSHIP WITH BOARD MEMBER, CRAIG HILL 31766 PAYMENT FOR EMPLOYMENT AS HR SUPPORT. 0 FAYE HILL FAMILY RELATIONSHIP WITH BOARD MEMBER, CRAIG HILL 50138 PAYMENT FOR EMPLOYMENT AS RADIOLOGY TECH. 0 EDWARD EARL HILL FAMILY RELATIONSHIP WITH BOARD MEMBER, CRAIG HILL 36049 PAYMENT FOR EMPLOYMENT AS PLANT ENGINEER MECHANIC. 0 CHERRY OIL BOARD MEMBER, ARMISTEAD MAUCK, OWNS MORE THAN 35% OF CHERRY OIL 101570 ARMISTEAD MAUCK OWNS MORE THAN 35% IN CHERRY OIL. THE HOSPITAL USES CHERRY OIL AS A VENDOR FOR FUEL OIL. CHERRY OIL WAS THE HOSPITAL'S VENDOR FOR FUEL OIL FOR MANY YEARS PRIOR TO MR. MAUCK'S SELECTION AS A BOARD MEMBER. 0 SCHEDULE L, PART II, SECTION (C) RECEIVED PHYSICIAN GUARANTEE LOAN TO AID IN RECRUITMENT OF ADDITIONAL CARDIOLOGIST FOR HIS 100% OWNED PRACTICE. PART III, LINE 4A STROKE PREVENTION AND CARE LENOIR MEMORIAL HOSPITAL IMPLEMENTED THE SECOND YEAR PLAN FOR DEVELOPING A PRIMARY STROKE CENTER USING GRANT FUNDS FROM THE DUKE ENDOWMENT FOR A THREE YEAR PROJECT THAT INCLUDES TELESTROKE SERVICES WITH WAKE FOREST- BAPTIST HEALTH. A COMMUNITY PARAMEDIC COMPONENT HAS BEEN ADDED FOR STROKE POST DISCHARGE VISITS AT HOME TO THOSE MOST AT RISK FOR COMPLICATIONS. STROKE AWARENESS MESSAGING THIS YEAR INCLUDED BARBER SHOPS, COMMUNITY COUNCIL FOR THE ARTS, LENOIR COUNTY PUBLIC SCHOOLS, AND MARY'S KITCHEN. ECONOMIC DEVELOPMENT CASH DONATIONS INCLUDED SUPPORT FOR STEMEAST, THE PINK HILL ROSE FESTIVAL 5K, PRIDE OF KINSTON DOWNTOWN PARK CONCERT SERIES, AND THE MOTHER EARTH IRONCLAD HALF MARATHON. DONATIONS WERE ALSO MADE TO SUPPORT REGIONAL KINSTON/LENOIR COUNTY CHAMBER OF COMMERCE SIGNATURE EVENTS: FESTIVAL ON THE NEUSE AND THE LIVING WELL IN EASTERN NC SHOW. COMMUNITY DONATIONS CASH DONATIONS INCLUDE SUPPORT FOR THE COMMUNITY LAW ENFORCEMENT APPRECIATION BENEFIT, PROJECT GRADUATION SLHS, AMERICAN HEART ASSOCIATION HEART WALK AMERICAN RED CROSS SWIMMING LESSON EVENT, INTERCHURCH OUTREACH (ICOR), TEEN FEST, KINSTON COMMUNITY HEALTH CENTER ANNUAL HEALTH FAIR, AND BOYS AND GIRLS CLUB. KINSTON/LENOIR COUNTY FARMERS MARKET LENOIR MEMORIAL ASSISTED THE UNDERSERVED RESIDENTS OF THE COMMUNITY AND THOSE WHO HAVE DIABETES WITH ACCESS TO FRESH FRUITS AND VEGETABLES THROUGH AN INCENTIVE RX COUPON PROGRAM IN PARTNERSHIP WITH KINSTON COMMUNITY HEALTH CENTER, KATE B. REYNOLDS CHARITABLE TRUST AND LENOIR COUNTY COOPERATIVE EXTENSION COMMUNITY HEALTH NEEDS ASSESSMENT THE THREE YEAR CYCLE PROCESS (2014/15) IDENTIFIED THREE PRIORITY ISSUES FOR THE COMMUNITY: OBESITY, RX ABUSE/DRUG AND SUBSTANCE (LEGAL AND ILLEGAL DRUG ABUSE), AND PARENTING-RESPONSIBLE AND HEALTHY. THE 2014/15 CYCLE INCLUDES WRITTEN ACTION PLANS AND IMPLEMENTATION STRATEGIES INITIATED BY LENOIR MEMORIAL HOSPITAL AND THE LENOIR COUNTY HEALTH DEPARTMENT, INCLUDING OTHER COMMUNITY PARTNERS. THE FULL 2014 COMMUNITY HEALTH ASSESSMENT CAN BE FOUND AT WWW.LENOIRMEMORIAL.ORG. LIGHTEN UP LENOIR 2015 OVER 600 COMMUNITY MEMBERS PARTICIPATED IN A COMMUNITY WIDE WEIGHT LOSS CHALLENGE AS INDIVIDUALS AND TEAMS OF FOUR ACHIEVED A THOUSAND POUND WEIGHT LOSS FOR THE COMMUNITY. PRIZES AND RECOGNITION WERE INCLUDED. HEALTHY COMMUNITIES INSTITUTE THE HEALTHY COMMUNITIES INSTITUTE, A COMPREHENSIVE HEALTH STATUS DATABASE AT WWW.LENOIRMEMORIAL.ORG, PROVIDES THE LATEST LENOIR COUNTY DEMOGRAPHICS AND LEADING HEALTH INDICATORS. IT ALLOWS THE USER TO SEARCH AND REPORT ON OVER 50 SPECIFIC HEALTH INDICATORS, DEMOGRAPHICS, AND COMPARISONS WITH NC AND NATIONAL BENCHMARKS. THE DATABASE PROVIDES PROMISING PRACTICES FOR COMMUNITY HEALTH INTERVENTIONS AND ALLOWS THE COMMUNITY TO ADD LOCAL REPORTS FOR A ONE STOP INSPECTION FOR LOCAL COMMUNITY HEALTH ASSESSMENT. COMMUNITY LEADERS HAVE BEEN INFORMED OF THE FREE RESOURCE. THE RESOURCE IS PROVIDED THROUGH A JOINT EFFORT OF LENOIR MEMORIAL AND THE LENOIR MEMORIAL FOUNDATION. PROJECT FIT AMERICA PROJECT FIT AMERICA WAS IMPLEMENTED AT THE SECOND LENOIR COUNTY SCHOOL ON NOVEMBER 19TH, 2015 IN MOSS HILL ELEMENTARY IN RURAL MOSS HILL. SUPPORT FOR THE PROJECT CAME THROUGH FUNDING FROM THE LENOIR MEMORIAL FOUNDATION. COMMUNITY COALITION ACTIVITIES LENOIR MEMORIAL PROVIDES LEADERSHIP AND ADMINISTRATIVE SUPPORT FOR COMMUNITY HEALTH COALITIONS. THE LENOIR COUNTY ALLIANCE FOR A HEALTHY COMMUNITY MEETS ON A MONTHLY BASIS FOR COMMUNITY NETWORKING AND INFORMATION SHARING. ALMOST 20 DIFFERENT COMMUNITY ORGANIZATIONS PARTICIPATE IN THE MEETINGS. THE LENOIR COUNTY CRISIS COLLABORATIVE BRINGS EASTPOINTE MENTAL HEALTH, EASTER SEALS MOBILE CRISIS, LENOIR MEMORIAL, LOCAL LAW ENFORCEMENT, EMS, AND OTHER AGENCIES TOGETHER QUARTERLY. THE GROUP FOCUSES ON THE COMMUNITY MENTAL HEALTH CRISIS NEEDS TO IDENTIFY SOLUTIONS AND MEET CHALLENGES TO PROBLEMS IN LENOIR COUNTY. MATERNAL/CHILD HEALTH INITIATIVES -BABY FRIENDLY "PRACTICES SUCH AS "ROOMING IN AND "SKIN TO SKIN" FOR MOM AND BABY ARE A FOCUS. -BREASTFEEDING SUPPORT IS PROVIDED FOR THOSE MOMS WHO WANT TO BREASTFEED AND PROPER BOTTLE FEEDING TECHNIQUES FOR THOSE THAT CHOOSE TO FORMULA FEED. -PARTICIPATING IN A COLLABORATIVE WITH THE NORTH CAROLINA HOSPITAL ASSOCIATION TO PREVENT ELECTIVE DELIVERIES PRIOR TO 39 WEEKS. 97% COMPLIANT WITH THIS STANDARD. - PROVIDING SCREENING TESTS FOR ALL NEWBORNS TO RULE OUT CRITICAL CONGENITAL HEART DEFECTS PRIOR TO DISCHARGE. APPROXIMATELY 18 OUT OF EVERY 10,000 BABIES ARE BORN WITH A CRITICAL CONGENITAL HEART DEFECT (CCHD). CCHD IS LIFE THREATENING AND REQUIRES INTERVENTION IN INFANCY. CCHD IS NOT ALWAYS DETECTED PRENATALLY OR UPON EXAM IN THE NURSERY, AS A RESULT, SOME INFANTS WITH CCHD ARE DISCHARGED FROM THE NURSERY TO HOME, WHERE THEY QUICKLY DECOMPENSATE. TO IMPROVE THE EARLY DETECTION OF CCHD, THE SECRETARY OF HEALTH AND HUMAN SERVICES (HHS) RECOMMENDED THAT CCHD SCREENING BE ADDED TO THE UNIFORM NEWBORN SCREENING PANEL. -PROVIDING A NEONATAL ABSTINENCE PROGRAM TO SCREEN ALL NEWBORNS THAT HAVE A HISTORY OF EXPOSURE TO ILLEGAL SUBSTANCES IN UTERO. NEONATAL ABSTINENCE SYNDROME (NAS) IS A GROUP OF PROBLEMS THAT OCCUR IN A NEWBORN WHO WAS EXPOSED TO ADDICTIVE OPIATE DRUGS WHILE IN THE MOTHER'S WOMB. SUPPORT GROUPS COORDINATED 13 HOSPITAL BASED GROUPS, ATTENDED BY 1276 PARTICIPANTS. FOUR COMMUNITY BLOOD PRESSURE MACHINES PROVIDED 36,090 SCREENING BLOOD PRESSURES AT SITES FOR BLOOD PRESSURE MACHINES AT VERNON PARK MALL, HOSPITAL, AND A MACHINE THAT TRAVELS TO VARIOUS COMMUNITY CHURCHES EACH MONTH. A FREE COMMUNITY BLOOD PRESSURE MANAGEMENT CLASS WAS OFFERED TO THE COMMUNITY TWICE MONTHLY. EMERGENCY PREPAREDNESS LENOIR MEMORIAL PARTICIPATES IN THE LOCAL EMERGENCY PLANNING COMMITTEE, AND AS A MEMBER OF THE LENOIR COUNTY TEAM IN THE EASTERN REGIONAL ADVISORY COUNCIL FOR 29 COUNTIES TO PLAN, COORDINATE, AND EXECUTE DISASTER READINESS AND DRILLS. LENOIR MEMORIAL PARTICIPATES IN THE NORTH CAROLINA EMERGENCY MANAGEMENT DOMESTIC PREPAREDNESS REGION 2 (DPR2) EMERGENCY PREPAREDNESS COMMITTEE FOR 10 COUNTIES TO DEVELOP AND EXPAND REGIONAL PREVENTION, PREPAREDNESS, RESPONSE, AND RECOVERY CAPABILITIES FOR ALL HAZARDS, BOTH MAN-MADE AND NATURAL. MINGES WELLNESS CENTER THE ON-SITE MEDICALLY BASED FITNESS CENTER FOR THE COMMUNITY HAS 75 PIECES OF STATIONARY EXERCISE EQUIPMENT WITH AN AVERAGE 25 GROUP EXERCISE CLASSES WEEKLY. WITH A MEMBERSHIP OF 2564 INDIVIDUAL MEMBERS, MONTHLY MEMBERSHIP RATES OF $20 PER MONTH ASSIST AN UNDERSERVED COMMUNITY TO INITIATE EXERCISE PLANS. OUR PROGRAM PARTNERED WITH HEALTHWAYS TO ROLL OUT SILVER SNEAKERS BENEFITS TO ELIGIBLE COMMUNITY MEMBERS IN 2014 AND SILVER & FIT BENEFITS IN 2015. SCREENING EVENTS PROVIDED EARLY DETECTION SCREENING EVENTS OF DISEASES/ DISORDERS/RISKS INCLUDING COLORECTAL, MAMMOGRAM, CHOLESTEROL, AND BLOOD PRESSURES. CANCER RESOURCE CENTER THE CANCER RESOURCE CENTER (CRC) IS A VISIBLE COLLABORATION BETWEEN LMH AND THE AMERICAN CANCER SOCIETY. THE CRC PROVIDES RESOURCES FOR INDIVIDUALS AND FAMILIES WHO HAVE RECEIVED A CANCER DIAGNOSIS AND NEED SERVICES TO SUPPORT THEIR MYRIAD OF NEEDS DURING TREATMENT AND CARE. 25 PATIENTS AND FAMILIES RECEIVED FORMAL SUPPORT THROUGH THE CENTER DURING FY15. DOZENS MORE INTERACTED WITH STAFF INFORMALLY. A STAFF OF TRAINED VOLUNTEERS ARE AVAILABLE TO ASSIST IN IDENTIFYING CANCER RESOURCES FROM 8-12 EACH WEEKDAY. LENOIR MEMORIAL COMMUNITY WALKING TRACK AVERAGES OVER 700 WALKERS PER MONTH. RESTRICTED OPENING FROM DAWN TO DUSK FOR SAFETY DILIGENCE IN 2015. CORPORATE HEALTH SERVICES SERVICES INCLUDED 62 CORPORATE CLIENTS, 204 WORKSITE WELLNESS VISITS WITH 1776 EMPLOYEE CONTACTS. FLU SHOTS, CPR TRAINING, AND TARGETED HEALTH EDUCATION FOR RISK FACTOR REDUCTION WAS PROVIDED. LIVING THE GOOD LIFE IN EASTERN NC SPONSOR FOR THE KINSTON/LENOIR COUNTY CHAMBER OF COMMERCE EVENT WHICH FOCUSED ON REGIONAL HEALTHY LIVING ISSUES. OVER 2000 PARTICIPANTS AT VERNON PARK MALL RECEIVED HEALTHY FOOD SAMPLES. HEART HEALTHY LENOIR COLLABORATION WITH UNC CENTER FOR POPULATION HEALTH AND HEALTH DISPARITIES FOR THE 5 YEAR NIH GRANT TO REDUCE STROKE AND HEART DISEASE IN LENOIR COUNTY. THE PROJECT, OVERSEEN BY RESEARCHERS AT UNC AND ECU, ASSISTED IN THE COORDINATION OF PROCESSES TO IMPLEMENT A BLOOD PRESSURE STUDY WITH 600 LOCAL PARTICIPANTS. THIS PROJECT ALSO INCLUDED SIX PHYSICIAN PRACTICES AND THE IMPLEMENTATION OF STANDARDIZED HYPERTENSION GUIDELINES, HOME BLOOD PRESSURE MONITORING AND TELEPHONE COACHING AS AN EVIDENCE-BASED APPROACH FOR BETTER HYPERTENSION MANAGEMENT. THE PROJECT PARTNERSHIP INCLUDED A LOCAL ADVISORY COMMITTEE ON WHICH SEVERAL HOSPITAL LEADERS FOCUSED ON HEALTHY LIFESTYLE AND GENETICS STUDY AREAS. DURING FY 15, AREA RESTAURANTS PARTICIPATED IN A HEALTHY FOOD CHOICES PROGRAM FOR DINING OUT WITH SEVERAL AREA RESTAURANTS. THE PROJECT CONCLUDED WITH A COMMUNITY INFORMATION AND DIALOGUE SESSION THAT INCLUDED MEDIA. DIABETES WELLNESS PROGRAM LOCATED IN THE MINNIE P. STACKHOUSE DIABETES CENTER, THE AADE ACCREDITED DIABETES WELLNESS PROGRAM PROVIDED FREE DIABETES SELF-MANAGEMENT EDUCATION AND FOLLOW UP MANAGEMENT TO 237 INDIVIDUALS LIVING WITH DIABETES. OUTREACH EDUCATION AND OFF-SITE SCREENINGS WERE PROVIDED EACH MONTH REACHING 393 COMMUNITY MEMBERS. ADDITIONALLY, A REGISTERED DIETITIAN/DIABETES EDUCATOR PROVIDED 155 MEDICAL NUTRITION COUNSELING SESSIONS DURING THIS YEAR. ADDITIONALLY, A THREE YEAR GRANT WAS RECEIVED TO KATE B. REYNOLDS THAT ALLOWED THE PROGRAM TO EXPAND THE DSMET PROGRAM INTO KINSTON COMMUNITY HEALTH CENTER. COMMUNITY HEALTH EDUCATION PROGRAMMING PROVIDED 2997 PARTICIPANTS ON AND OFF-SITE HEALTH AND WELLNESS PROGRAMMING. PROGRAMMING INCLUDED INFANT CPR, TOBACCO CESSATION, EXERCISE, NUTRITION AND OTHER HEALTH EDUCATION OFFERINGS. FOUR FEATURED PHYSICIAN-LED EDUCATIONAL PROGRAMS WERE OFFERED THIS YEAR. ADVANCED DIRECTIVES PROVIDED 36 COMMUNITY RESIDENTS WITH SUPPORT IN COMPLETING ADVANCED DIRECTIVES. FAMILY BIRTH CENTER COMMUNITY EDUCATION LAMAZE/SIBLING/EARLY PRENATAL CLASSES INCLUDED 60 ATTENDEES. PATIENT ADVISORY COMMITTEE DURING 2015, THE PATIENT ADVISORY COUNCIL MET SIX TIMES AND WAS MADE UP OF 23 REPRESENTATIVES FROM THROUGHOUT THE COMMUNITY, MEDICAL STAFF, HOSPITAL BOARD, VOLUNTEERS, AND HOSPITAL STAFF TO SOLICIT INPUT ON HOW WE MIGHT IMPROVE OUR PATIENT CARE PROCESS. THIS FOSTERS A CONTINUING OPPORTUNITY FOR US TO LISTEN TO OUR CUSTOMERS AND USE THE INFORMATION TO HELP US IMPROVE OUR SYSTEMS AND PROCESSES. THE FOCUS OF THIS GROUP IS TO FEED INFORMATION BACK TO THE ORGANIZATION FROM THE COMMUNITY IN ORDER TO DELIVER CARE THAT IS PATIENT CENTERED AND COMMUNITY PERSPECTIVE DRIVEN. TOPICS FOR MEETINGS INCLUDED DISCHARGE FOLDER/PATIENT SERVICES GUIDE, FOUNDATION, PARTNERSHIP UPDATE, PATIENT EXPERIENCE ADVERTISING, SERVICE RECOVERY PROCESS, SURGICAL SERVICES, CANCER CENTER UPDATE, MRI, CLINICAL UPDATE, MCCAIN HEART CENTER, PATIENT CARE TRANSITIONS AND MARKETING STRATEGIES. EMPLOYEE OUTREACH LENOIR MEMORIAL EMPLOYEES SHOW GOOD COMMUNITY STEWARDSHIP BY PARTICIPATING IN FUNDRAISING TO SUPPORT THE AMERICAN CANCER SOCIETY RELAY FOR LIFE, LENOIR MEMORIAL FOUNDATION OUTREACH, AND LENOIR- GREENE UNITED WAY. EMPLOYEES WORKED TOGETHER TO GIVE TIME, TALENT AND PERSONAL DONATIONS OF $83,793 DURING FY15 TOWARDS GREAT CAUSES IN THE COMMUNITY. EMPLOYEES ALSO FED 19 LOCAL FAMILIES FOR THANKSGIVING AND PROVIDED FOOD TO FRIENDS OF THE HOMELESS AND THREE CHURCH FOOD BANKS. EMPLOYEES KEPT THE LONG TRADITION OF PLAYING SECRET SANTA TO 26 NEEDY CHILDREN IN THE NORTHEAST ELEMENTARY SCHOOL WITH GIFTS FROM THEIR OWN POCKETS. COMMUNITY HEALTHCARE SCHOLARSHIPS NURSING LEADERSHIP, HIGH SCHOOL HEALTH OCCUPATION STUDENTS AND TEEN VOLUNTEERS RECEIVE SCHOLARSHIP AWARDS TO SUPPORT ONGOING HIGH SCHOOL AND COLLEGE HEALTH CAREER EDUCATION. HOSPITAL VOLUNTEER PROGRAM DURING FY 15, 258 VOLUNTEERS INCLUDING YOUTH VOLUNTEERS PROVIDED 36,153 VOLUNTEER HOURS IN A VARIETY OF HOSPITAL SETTINGS ENRICHING THE PATIENT EXPERIENCE AND PERFORMING THE WORK OF 17 UNPAID FTES. LIGHTS OF LOVE HOLIDAY TREE LIGHTING CAMPAIGN COMMUNITY DONATIONS FUND A NUMBER OF HOSPITAL PROGRAMS AND PROJECTS EACH YEAR. PHYSICIAN RECRUITMENT LENOIR MEMORIAL PROVIDED PHYSICIAN RECRUITMENT SERVICES TO MEET COMMUNITY NEEDS FOR PROVIDERS IN THE PRIORITY AREAS OF GENERAL SURGERY AND ORTHOPEDICS. PROVIDERS WERE SUCCESSFULLY RECRUITED TO AREA PRACTICES. IN 2015, WE SUCCESSFULLY RECRUITED TWO PHYSICIANS (GENERAL SURGERY AND ORTHOPEDICS) AND ONE MIDLEVEL (ORTHOPEDICS) TO LENOIR PHYSICIAN NETWORK PRACTICES. STEM OUTREACH LENOIR MEMORIAL WORKED WITH THE LENOIR COUNTY MANUFACTURING ASSOCIATION TO REWARD LENOIR COUNTY PROJECT LEAD THE WAY PROGRAMS WITH SCIENCE, TECHNOLOGY, ENGINEERING AND MATH (STEM) PROGRAMMING IN AREA HIGH SCHOOLS THROUGH SUPPORT FOR CREATIVE STUDENT PROJECT COMPETITION AND SCHOLARSHIP AWARDS. LENOIR MEMORIAL ALSO SERVED AS A SITE FOR A LENOIR COUNTY PUBLIC SCHOOLS STEM PARTNERSHIP WITH ECU SHOWCASING CAREERS IN STEM BASED AREAS. ADDITIONALLY, LMH PROVIDED SUPPORT FOR STEMEAST THROUGH THE LENOIR COMMITTEE OF 100. HEALTH LIBRARY A COMPREHENSIVE HEALTH LIBRARY IS LOCATED AT WWW.LENOIRMEMORIAL.ORG. THIS FREE COMMUNITY RESOURCE CONTAINS NATIONAL HEALTH NEWS HEADLINES AND ARTICLES, CONDITION GUIDES, AND INTERACTIVE CALCULATORS AND QUIZZES TO HELP ASSESS CURRENT HEALTH KNOWLEDGE AND STATUS. CALCULATE A BODY MASS INDEX OR TARGET HEART RATE. CHECK OUT THE HEALTH LIBRARY FOR POPULAR TOPIC AREAS SUCH AS WOMEN'S HEALTH, MEN'S HEALTH, PREGNANCY, DIET AND EXERCISE, AND DOZENS OF MORE RELEVANT TOPICS AND EASILY PRINT ARTICLES. VITALBOARDS LENOIR MEMORIAL PARTNERED WITH LENOIR COUNTY EMS TO PROVIDE VITALBOARDS IN COMMUNITY HOMES THROUGH VISITS WITH THE LENOIR COUNTY COMMUNITY PARAMEDIC PROGRAM. VITALBOARDS ARE A LIFESAVING REUSABLE TOOL THAT IS USED IN THE HOME TO PROVIDE BASIC YET VITAL HEALTH INFORMATION AND INFORMATION ABOUT MEDICATIONS THAT COULD BE REQUIRED IN AN EMERGENCY. A DECAL IS PLACED AT THE ENTRANCE TO THE HOME ALERTING EMS TO THE PRESENCE OF A VITALBOARD IN THE HOME. ROSALIND MCDONALD NURSING SEMINAR THE INAUGURAL COMMUNITY NURSING EDUCATIONAL EVENT WAS PROVIDED IN 2015. AREA NURSES WERE INVITED TO THE FREE CONTINUING EDUCATION EVENT THAT SHOWCASED A NATIONAL NURSING SPEAKER IN HONOR OF A RECENTLY RETIRED NURSING LEADER AT LENOIR MEMORIAL. FORM 990, PART VI, SECTION A, LINE 1 THE CHAIRMAN OF THE BOARD, VICE CHAIRMAN, SECRETARY, PRESIDENT, AND OTHERS AS APPOINTED BY THE CHAIRMAN SHALL CONSTITUTE THE EXECUTIVE COMMITTEE. THE CHAIRMAN OF THE BOARD OF DIRECTORS SHALL SERVE AS CHAIRMAN OF THE EXECUTIVE COMMITTEE AND THE VICE CHAIRMAN OF THE BOARD OF DIRECTORS SHALL SERVE AS VICE CHAIRMAN OF THE EXECUTIVE COMMITTEE. THE EXECUTIVE COMMITTEE SHALL HAVE FULL AUTHORITY TO TRANSACT ALL REGULAR BUSINESS OF THE HOSPITAL DURING THE INTERIM BETWEEN THE REGULAR MEETINGS OF THE BOARD OF DIRECTORS, PROVIDED THAT ANY ACTION WHICH IT MAY TAKE SHALL NOT CONFLICT WITH THESE BYLAWS, RULES AND REGULATIONS OR ARTICLES OF INCORPORATION OR WITH THE POLICIES AND DECISIONS OF THE BOARD OF DIRECTORS. SHOULD ANY MATTERS OF EXTREME URGENCY ARISE BETWEEN REGULAR MEETINGS OF THE BOARD OF DIRECTORS, A MAJORITY OF THE MEMBERS OF THE COMMITTEE SHALL CONSTITUTE A QUORUM. FORM 990, PART VI, SECTION A, LINE 3 THE CEO DELEGATED A PORTION OF IT'S MANAGEMENT DUTIES TO NOVANT HEALTH SYSTEM ("NHS"), A MANAGEMENT COMPANY. THE CEO RECEIVED $226,788 IN ADDITIONAL COMPENSATION FROM NHS. FORM 990, PART VI, SECTION B, LINE 11 THE FINANCE DIRECTOR FOR THE HOSPITAL WILL ATTEND A SCHEDULED MEETING OF THE BOARD OF DIRECTORS AND PRESENT THE FORM 990 BEFORE IT IS FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C UPON THEIR APPOINTMENT TO THE BOARD, AND BEFORE ACTUALLY PARTICIPATING IN MEETINGS, MEMBERS MUST READ THE CONFLICTS OF INTEREST POLICY AND DISCLOSE ANY FINANCIAL INTERESTS THAT COULD CREATE A CONFLICT OF INTEREST. AS LONG AS THEY CONTINUE TO SERVE ON THE BOARD, MEMBERS THEN COMPLETE THESE FINANCIAL RELATIONSHIP DISCLOSURE STATEMENTS ON AN ANNUAL BASIS. IF SUCH INTERESTS ARE NOT DISCLOSED, THE CEO, BOARD CHAIR, OR ANY OTHER BOARD MEMBER MAY BRING THE FINANCIAL INTEREST OR ACTUAL/POSSIBLE CONFLICT TO THE ATTENTION OF THE BOARD; THUS THE ENTIRE BOARD IS RESPONSIBLE FOR ONGOING MONITORING OF POTENTIAL CONFLICTS AND THEIR DISCLOSURE. INTENTIONAL FAILURE TO DISCLOSE SUCH FINANCIAL INTERESTS WILL, BY POLICY, RESULT IN APPROPRIATE CORRECTIVE ACTION BY THE BOARD. SHOULD A CONFLICT OF INTEREST ARISE IN CONDUCTING THE BUSINESS OF THE HOSPITAL, THE AFFECTED MEMBER(S) MAY NOT PARTICIPATE IN DISCUSSION REGARDING THE RELEVANT TRANSACTION, AND DEPENDING UPON THE SPECIFIC NATURE OF THE MATTER, THE BOARD CAN TAKE A RANGE OF ACTIONS, SUCH AS APPOINTING A DISINTERESTED PERSON TO INVESTIGATE POSSIBLE ALTERNATIVES, REQUIRING THE INTERESTED PERSON TO REFRAIN FROM PERFORMING ANY FUNCTIONS RELATED TO THE INTEREST CREATING THE CONFLICT, OR REQUIRING THE INTERESTED PERSON TO DIVEST HIMSELF OF THE CONFLICT-CREATING INTEREST IN ORDER TO REMAIN ON THE BOARD. EDUCATION AND COMPLIANCE FORMS ARE UPDATED ANNUALLY BY THE HOSPITAL'S CORPORATE COMPLIANCE OFFICER. FORM 990, PART VI, SECTION B, LINE 15 THE EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS CONTRACTS YEARLY WITH AN OUTSIDE, INDEPENDENT, PROFESSIONAL FIRM TO EXAMINE AND REVIEW THE WAGES AND BENEFITS OF THE CEO AND TOP MANAGEMENT OFFICALS OF THE HOSPITAL. FORM 990, PART VI, SECTION C, LINE 18 PHOTOCOPIES OF THE FORM 990 ARE AVAILABLE UPON REQUEST AT THE ORGANIZATION'S ADMINISTRATIVE OFFICE. ADDITIONALLY, RECENT FILINGS OF THE FORM 990 ARE AVAILABLE ONLINE AT WWW.GUIDESTAR.ORG. FORM 990, PART VI, SECTION C, LINE 19 THE HOSPITAL MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9: ROUNDING 1. FORM 990, PART XII, LINE 2C: THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. LENOIR PHYSICIANS NETWORK LLC 100 AIRPORT RD KINSTON NC 28501 460687300 PHYSICIANS SERVICES NC 3471170 3356950 LENOIR MEMORIAL HOSPITAL LENOIR MEMORIAL HOSPITAL FOUNDATION INC 100 AIRPORT ROAD KINSTON NC 28501 581584139 SUPPORT THE CHARITABLE, EDUCATIONAL, AND SCIENTIFIC PURPOSES OF LMH, INC. NC 501(C)(3) LINE 11A, I LENOIR MEMORIAL HOSPITAL 1 LENOIR HEALTH SERVICES INC 100 AIRPORT ROAD KINSTON NC 28501 581705689 SUPPORT CHARITABLE, EDUCATIONAL, AND SCIENTIFIC PURPOSES OF LMH, INC. NC 501(C)(3) LINE 11A, I LENOIR MEMORIAL HOSPITAL 1 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1 1 LENOIR MEMORIAL HOSPITAL FOUNDATION C 304248 FMV