2016-08-02T16:27:30-05:00 2015-09-30 420714325 RSM US LLP 1 S WACKER DRIVE STE 800 CHICAGO IL 60606 990 2014-10-01 560585243 Pitt County Memorial Hospital Inc PITT 5258475129 2100 Stantonsburg Road Greenville NC 27835 David Hughes Chief Financial Officer 5258475129 2016-08-01 1 Wayne Harder P00294296 3126343400 2014 2016-12-15 16:53:06Z Vidant Medical Center William Floyd 2100 Stantonsburg Road Greenville NC 27835 1116619947 0 X www.vidanthealth.com X 1953 NC To provide access to quality medical service to all citizens of Pitt County and Eastern NC. 19 18 8093 725 325171 -47910 1653217 2815754 1135441696 1090225240 11303184 23578953 0 0 1148398097 1116619947 1650000 2643709 0 0 478425804 451204052 0 0 0 589220725 587249565 1069296529 1041097326 79101568 75522621 1168792547 1151563129 539218376 313307344 629574171 838255785 X To enhance the quality of life for the people and communities we serve, touch and support. 0 0 385400264 393883116 Cancer and Clinical ServicesPCMH (D/B/A Vidant Medical Center) Cancer Services include the most advanced treatments for the people of Eastern North Carolina. We use the latest technologies, including gamma knife radiosurgery, available to our expert medical staff, nurses and therapists. Combining national treatment protocols and the highest standards of clinical quality, our team of specialists take care of thousands of patients each year. In cancer and clinical services during tax year 2014, VMC performed 2,268,424 lab tests, 131,195 radiology cases, 1,915 pet scans, 123 gamma knife cases, and 183,805 respiratory treatments. 259291132 301400529 Surgical ServicesSurgeons at Vidant Medical Center are leaders in their fields. Our bariatric surgeons were pioneers of gastric bypass surgery and now perform gastric banding as well. Other areas of surgical emphasis include: orthopedics, cardiothoracic, gynecology, trauma and general surgery. VMC Surgical Services performed 21,481 surgeries in 2014. 172211415 197701245 Cardiovascular ServicesVidant Medical Center provides patients with the latest treatments and technology available. We have nationally and internationally recognized physicians at the East Carolina Heart Institute, performing delicate heart surgeries and procedures using the DaVinci Robot. Our heart and vascular services include: stents, imaging studies, pacemaker placement, ablation, robot-assisted heart surgery, and heart failure programs. These and many more services are provided at the East Carolina Heart Institute at VMC, the first facility in North Carolina devoted exclusively to education, research, treatment and prevention of cardiovascular diseases. Cardiovascular services performed 72,607 EKGs. 128760308 2643709 197240350 All Other Services 128760308 2643709 197240350 945663119 1 1 0 1 0 0 0 0 0 0 1 1 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 0 0 0 1 0 0 8093 1 1 1 0 0 0 0 0 0 0 0 0 X 19 18 0 0 0 0 0 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 NC X X Chris Townsend 2528475129 2100 Stantonsburg Road Greenville NC 27835 JoAnne K Burgdorff Chairman 2.00 2.00 X 0 0 0 Bruce E Gray Vice Chairman 2.00 4.00 X 0 0 0 Shirley Carraway EdD Secretary 2.00 X 0 0 0 Dr Mary J Raab MD Assistant Secretary 2.00 X 0 0 0 C Bynum Satterwhite Treasurer 2.00 X 0 0 0 Robert J Greczyn Jr Assistant Treasurer 2.00 X 0 0 0 Dr Marcus A Albernaz MD Board Director 2.00 4.00 X 0 0 0 Noel L Baucom Board Director 2.00 X 0 0 0 Carlester Crumpler Board Director 2.00 X 0 0 0 Phillip R Dixon Sr Board Director 2.00 X 0 0 0 Ralph R Hall Jr Board Director 2.00 X 0 0 0 Phil Hodges Board Director 2.00 X 0 0 0 Dr Peter Jacobson MD Board Director 2.00 X 0 0 0 Polly Johnson Board Director 2.00 2.00 X 0 0 0 Dr William J Jones Jr PhD Board Director 2.00 X 0 0 0 Arthur H Keeney III Board Director 2.00 6.00 X 0 0 0 Thomasine S Kennedy Board Director 2.00 4.00 X 0 0 0 J Bryant Kittrell III Board Director 2.00 2.00 X 0 0 0 Mark W Owens Jr Board Director 2.00 X 0 0 0 Dr Walter E Pofahl II MD Board Director 2.00 4.00 X 0 0 0 Melvin McLawhorn Board Director 2.00 2.00 X 0 0 0 David H Womack Board Director 2.00 2.00 X 0 0 0 Dr Michael Waldrum MD Chief Executive Officer 2.00 50.00 X 0 0 0 Janet Mullaney CAO/Interim CEO 2.00 50.00 X 0 491030 129263 William Floyd Executive VP/President of VMC 40.00 4.00 X 415190 0 103594 Stephen Lawler President Emeritus of VMC/CPAO 2.00 40.00 X 444869 287748 164153 Linda Hofler Sr. VP, Chief Nursing Officer 40.00 X 261991 0 71985 Jennifer Thomas VP of Financial Services 40.00 X 0 175702 30866 Scott Lieberenz Sr. VP, Financial Services 40.00 X 0 278215 61981 Donald Shackelford Sr. VP, Medical Affairs 40.00 X 427934 0 80754 Tracy Eskra VPMA for Clinical Efficiency & Docs. 40.00 X 308011 0 38129 Donald Smith Senior Vice President 40.00 X 250020 0 74674 Tyree Walker VP, Human Resources 40.00 X 667780 0 37183 Ryan Hickey Senior Vice President 40.00 X 230953 0 71475 Reggie Pearson Senior Vice President 40.00 X 205536 0 57638 Kimberly C Osborne VP, Medicine and Care Coordination 40.00 X 183003 0 40154 Teresa Anderson VP, Quality 40.00 X 172751 0 60371 Sue Edwards Admin., Outpatient Cvs. Services 40.00 X 216164 0 27568 James Worden Jr Admin., Pharmacy 40.00 X 204805 0 38521 James Barrett Program Manager, Rehabilitation 40.00 X 201006 0 25556 Mary Pender Neonatal Nurse Practioner 40.00 X 192652 0 33471 Deborah Westbrook Clinical Pharmacy Specialist 40.00 X 189257 0 12405 Dr David Herman MD Chief Executive Officer 0.00 0.00 X 0 1268381 115608 Seth Van Essendelft Former VP of Financial Services 40.00 X 0 133565 39092 4571922 2634641 1314441 319 1 1 0 ECU School of Medicine PO Box 75514 Charlotte NC 28275 Medical Staff Services 19483436 Pitt County Anesthesia Services 2080 B Arlington Boulevard Greenville NC 27834 Anesthesia Services 7759980 Medcost Benefit Services PO Box 25987 Winston Salem NC 27714 Third Party Administrative Fees 5886455 Crothall Laundry Services 13028 Collection Center Drive Chicago IL 60693 Laundry Services 2515274 Specialty Care Cardiovascular Resources 25271 Network Place Chicago IL 60673 Auto Transfusion Services 2355014 73 2815754 2815754 Cancer and Clinical Services 621110 393883116 393883116 Surgical Services 621110 301400529 301400529 Cardiovascular Services 621110 197701245 197701245 197240350 196915179 325171 1090225240 21993744 21993744 1585209 0 1585209 1585209 1585209 1116619947 1089900069 325171 23578953 X 2643709 2643709 340219371 302669022 37550349 23372550 20801569 2570981 62852662 55915551 6937111 24759469 22026742 2732727 3499702 2904753 594949 247121 205110 42011 96122 96122 30312 30312 137763346 114343577 23419769 912990 757782 155208 2309315 1916732 392583 1448883 1448883 17955343 14902935 3052408 1758385 1392748 365637 14424204 11972089 2452115 51058706 42378726 8679980 13761706 11422216 2339490 Patient Supplies 206836775 206836775 Bad Debt Expense 61210981 61210981 Contracted Services 26345776 26345776 Physicians 23928391 23928391 23661507 19639052 4022455 1041097326 945663119 95434207 0 18588967 21461144 167044399 157483129 23777075 23619000 3707376 7459811 1124649370 752920218 378817314 371729152 425035504 462074982 151821912 107735911 1168792547 1151563129 119326632 253752372 419891744 59554972 539218376 313307344 X 629574171 838255785 629574171 838255785 1168792547 1151563129 X 75522621 -1350141 134509134 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 30312 30312 0 Part II-B, Line 1: Dues to NCHA are allocated 25.26% to lobbying. 31161094 31161094 542183647 317826635 224357012 523792969 435093583 88699386 27511660 27511660 371729152 Trustee Held Funds - Capital Expenditures 444330625 F Trustee Held Funds - Pension 17744357 F 462074982 Other Receivables 30443793 Due from Third Party Payors 37222767 Investments in Subsidiaries 8284541 Intangible Assets 3108680 Cash Held in Escrow 2700629 Deferred Pension Outflows 25975501 107735911 Due to Affiliates 264948 Due to Third Party Payors 5477325 Asset Retirement Obligation 675000 Deferred Gain 819883 SERP Payable 16728244 Workers Comp Long Term 12136914 Deferred Pension Inflows 23452658 59554972 X Part X, Line 2: Pitt County Memorial Hospital has been determined to qualify as a tax-exempt organization under Section 501(c)(3) of the Internal Revenue Code. Pitt County Memorial Hospital has reviewed its tax positions for all open years and has concluded that no material liabilities exist as of September 30, 2015 and 2014. Pitt County Memorial Hospital files tax returns with the U.S. federal and State of North Carolina jurisdictions. With few exceptions, Pitt County Memorial Hospital is no longer subject to U.S. federal examinations by tax authorities for years before 2012. 1 1 X 1 X 1 X 1 1 0 0 40584826 40584826 0.03900 151633741 118988190 32645551 0.03140 192218567 118988190 73230377 0.07040 19 33115 3550760 3550760 0.00340 6 4278 58862141 16826441 42035700 0.04040 2 430 497232 497232 0.00050 6 145293 5688169 5688169 0.00550 33 183116 68598302 16826441 51771861 0.04980 33 183116 260816869 135814631 125002238 0.12020 1 550 550 0.00000 1 807 807 0.00000 2 1208 72311 72311 0.00010 1 181 20094 20094 0.00000 3 1798 1844316 1844316 0.00180 8 3187 1938078 1938078 0.00190 1 22494726 0 358993293 400968474 -41975181 X 1 1 1 1 Pitt County Memorial Hospital Inc 2100 Stantonsburg Road Greenville NC 27835 X X X X X Rehabilitation Behavioral Health Pitt County Memorial Hospital Inc 1 0 0 1 X X X X X X X X 14 1 0 1 1 X See Schedule H, Part V, Section C X 1 14 0 1 0 1 X 200.000000000000 200.000000000000 X X 1 1 X X X 1 X www.vidanthealth.com/billing-assistance X X 1 X 0 X X X X 1 X 0 0 Pitt County Memorial Hospital, Inc. Part V, Section B, Line 5: The preparation of the 2015 Pitt County Community Health Needs Assessment (CHNA) was a joint effort between Pitt Partners for Health (PPH), Vidant Medical Center (VMC), Pitt County Health Department (PCHD) and East Carolina University (ECU). Sincere appreciation is extended to the PPH membership for their guidance and contributions to the 2015 CHNA. The Partnership is chaired by Colleen Coda, a community member and retired VMC Cancer Services nurse. The vice chair is Alice Keene, retired Director, Pitt County Community Schools and Recreation and current Special Projects Coordinator, Pitt County Planning Department / Community Schools and Recreation. Action Team leaders include Robin Tant (Physical Activity and Nutrition), Jennifer Smith (Injury Prevention), and Sandra Hickman (Chronic Disease). PPH membership is comprised of individuals from a variety of organizations and communities within Pitt County representing government, health care, the faith community, civic organizations and members of the general public. PPH serves a critical role in assuring that the community has input into the collection and review of health status data, as well as the selection of health priorities for the County. The priorities recommended by PPH were shared with the Pitt County Board of Health, the VMC Board of Trustees and the VMC Foundation. Each of these groups selected priority health areas for their respective organizations as outlined in this document. PPH, VMC Community Health Programs, Pitt County Health Department and other partners express gratitude to the Pitt County Board of Health, VMC Board of Trustees and the VMC Foundation for receiving presentations regarding key finding of this assessment and for their recommendations and careful selection of priority health areas for Pitt County that will be addressed from 2015-2018. A special thank you is also extended to a number of Pitt County individuals and groups who shared their knowledge, expertise, and creative ideas for improving health within the Pitt County community: -Dr. John Morrow, Pitt County Public Health Director, Mr. Brian Floyd, President of VMC and Dr. Paul Cunningham, Dean of the Brody School of Medicine (BSOM) hosted a Key Leaders' listening session to solicit input on health issues and strategies to create a healthier community. Dr. Doyle Cummings from the Research Division of Family Medicine at the BSOM served as moderator of the Key Leaders' listening session. Forty - one (41) key leaders participated representing County Recreation, area churches, County Management, Vidant Health, United Way, AMEXCAN - Hispanic/Latino community, ECU - (SOM, Dental, Health and Human Performance, Public Health, College of Nursing), Eastern AHEC, Department of Social Services, City of Greenville, Family Violence, Pitt County Health Department, Greenville Community Shelter, Town of Ayden, Pitt County EMS, Pitt Community College, Access East, Council on Aging, Town of Bethel, Pitt County Planning and Pitt Partners for Health. -Jo Morgan, retired Health Education Director with Pitt County Health Department kindly shared her expertise from over 30 years of conducting health assessments for the Pitt County community. PPH is grateful for her leadership and for her recommendations regarding the collection and analysis of data. Mrs. Morgan conducted listening sessions among nineteen (19) Pitt County groups/organizations that serve the people of Pitt County and that are familiar with the health status of the community. She also compiled and analyzed this data.Acknowledgement and appreciation are also extended to the 281 representatives of the following groups who participated in community listening sessions and provided feedback concerning health issues they have identified among community members whom they serve as part of their profession or affiliation with these groups: -Gold Path, Martin Pitt Partnership for Children, Homeless Shelter, Senior Fitness Group, Human Resource Managers, Community Care Plan, Safe Communities Coalition, Vidant Case Managers, Pitt County Schools Social Workers, Vidant Medical Center School Nurses, Grifton Emergency Medical Services, Pitt County Emergency Medical Services, Pitt County Health Department Outreach Team, AMEXCAN (Association of Mexicans in North Carolina), Greenville Youth Council, Winterville Youth Council , Total Christian Ministries Lay Health Advisors, Council on Aging, and the M.E.N.D. (Medically Enduring Neighborhood Dream) Project. Appreciation is extended to the community members who participated in community listening sessions at the following locations and provided feedback and recommendations for community health improvement: -The Bethel Senior Center, Eastern Radiology Breast Clinic and The United Way's Expanded Learning Opportunity Group -Pitt County is known for its collaborative spirit and has a long history of partnering to share resources. Acknowledgement is given to the following individuals / organizations for their contributions and support of this process through data collection and analysis: -The Department of Family Medicine, Brody School of Medicine at East Carolina University, under the direction of Dr. Doyle Cummings and with assistance from Alyssa Adams, collected and analyzed data from the 2015 online Community Health Opinion Survey which received feedback from 545 Pitt County community members. -The Vidant Medical Center's Community Health Programs, under the direction of Mrs. Catherine Nelson, provided funding to support primary data collection and analysis through the online Community Health Opinion Survey and community listening sessions. -Vidant Health Corporate Community Health Improvement (Mrs. Melissa Roupe) provided guidance and direction regarding CHNA requirements for not-for-profit hospitals. -The Vidant Health Strategic Development staff provided statistical information and interpretation regarding emergency department use and hospital admissions. -The Pitt County Health Department's Health Education Division (Amy Hattem, Jennifer Hardee, Kathy Sheppard and Terry Quinn) collected and analyzed data and contributed to the Health Resources section of this document and prepared the final 2015 CHNA document. -The Pitt County Government's Planning Department compiled and analyzed data regarding populations within Pitt County and its municipalities. Pitt County Memorial Hospital, Inc. Part V, Section B, Line 6b: The preparation of the Pitt County Community Health Needs Assessment (CHNA) was a joint effort between Pitt Partners for Health (PPH), Vidant Medical Center (VMC), Pitt County Health Department (PCHD) and East Carolina University (ECU). Pitt County Memorial Hospital, Inc. Part V, Section B, Line 11: Certain community needs may not be fully documented or addressed in the Community Health Needs Assessment. These needs are generally those which other organizations share an overlap with Vidant Medical Center. VMC is not equipped to handle all needs and has prioritized those that it can fully address. Pitt County Memorial Hospital, Inc. Part V, Section B, Line 16i: The full policy is not available on the facility website. In lieu of the policy, a concise summary is provided with pertinent details and phone numbers for additional information. Part V, section B, Line 7a: The Hospital makes its CHNA report available to the public on the Hospital's website: www.vidanthealth.com/medicalcenter/dynamic-detail.aspx?id=13674. Part V, Section B, Line 16 Financial Assistance Policy Website Availability Pitt County Memorial Hospital, Inc. Part V, Section B, line 16a website: www.vidanthealth.com/billing-assistance Part I, Line 6a: In addition to the Community Benefit Report for PCMH, information regarding this entity is found in the annual report for University Health Systems of Eastern Carolina d/b/a Vidant Health. Part I, Line 7: Costs were calculated using the estimated cost to charge ratio from The North Carolina Hospital Association's Advocacy Needs Data Initiative which is the standard for reporting community benefits in North Carolina. Part II, Community Building Activities: The community building activities of Vidant Medical Center involve services that are otherwise not provided by other organizations in the patient area. Part III, Line 2: In connection with the Presumptive Eligibility consideration of the Affordable Care Act, Vidant Medical Center does not reflect any bad debt in connection with FAP-eligible patients. These patients are presumed to be part of the Medicaid population and afforded coverage as such. Part III, Line 4: The financial statements of Vidant Medical Center are presented on a consolidated basis as part of the consolidated financial statements of Vidant Health; the text of the footnote from page 21 is presented below:Patient Accounts ReceivablePatient Accounts Receivable are reported net of estimated allowances for contractual adjustments and allowances for bad debts. Estimated allowances for bad debts are approximately $117.5 million and $134.7 million as of September 30, 2015 and 2014, respectively. Part III, Line 8: The shortfall of Medicare revenue to Medicare was calculated according to the cost to charge ratio. Allowable costs of care should be considered community benefit because in the area served by VMC, there are no other providers available to provide the required services. Therefore, the care would become a government obligation and is treated as a community benefit provided by VMC. Part III, Line 9b: Recommended patient accounts will continue to go through the accounts receivable billing cycle as normal. When the account reaches the customer service/collections manager, financial counseling supervisor or patient accounts supervisor, based on the information given, a decision will be made whether to proceed with collection or refer the account for approval of charity care. The process will occur as follows: I. Financial counselors will try to locate third party payors. If not eligible for any third party coverage (including charities), they may, based upon the financial information received, recommend the patient for charity care. II. Patient counselors will review for any third party payors and verify employment and assets. A charity care application will need to be completed along with tax return, pay stubs, social security award letter and other financial information as may be required. III. The patient accounts supervisor, financial counseling supervisor or customer service/collections manager, based upon account balance and the information given, will make a decision whether to proceed with collection or refer the patient account for approval for charity care.Presumptive eligibility for charity care - there are occasions in which a patient may appear eligible for a charity care discount, but there is no financial assistance information available to support financial aid. A. Some patients are presumed to be eligible for charity care discounts on the basis of individual life circumstances (e.g., homelessness, patients with no income, bankruptcy, deceased patients with no estate or spouse, etc). B. Through the assistance of a third party vendor and certain algorithms, in conjuction with our charity policy guidelines, all accounts, prior to outside collection agency referral, will be tested for presumptive charity. C. The accounts deemed charity will be adjusted off and the remaining accounts will be referred to an outside collection agency. D. Once the agency has had the accounts for six months and has deemed them uncollectible, the accounts with balances of $1,200 or greater will remain with the agency and be kept on the patient's credit file. E. The accounts returned to the hospital will be placed in a unique financial class and will not be pursued for collections. Part VI, Line 2: The organization assesses community need in conjunction with the state affiliated county health departments and other local health care organizations. See also Schedule H, Part V, Section B, lines 1-7 Part VI, Line 3: Information is available on the organization's website and at registration for patients. In addition, face to face financial counseling is available to patients and their families in the central business office. Part VI, Line 4: See Schedule O, Part III Part VI, Line 5: See Schedule O, Part III Part VI, Line 6: See Schedule O, Part III Part VI, Line 7, Reports Filed With States NC 1 East Carolina University PO Box 75514 Charlotte NC 28275 566000403 501(c)(3) 1600000 Joint research projects Pitt Memorial Hospital Foundation 2800 Stantonsburg Road Greenville NC 27835 581399266 501(c)(3) 1000000 General Support North Carolina Hospital Association PO Box 4449 Cary NC 27519 560641290 501(c)(3) 36859 General Support 3 0 Part I, Line 2: Primary oversight responsibility for all grants received by UHS organizations rests with the entity receiving the funds. Each entity is responsible for documenting the receipt of funds, assigning a cost center to track expenses and/or creating a restricted liability for deposit of the funds, documenting expenditures and completing all grantor required reporting. The compliance with the terms of the agreement related to project implementation and management, fund expenditures and reporting is monitored by the granting agency's designated contact person with assistance from the UHS grants office. Note: The majority of the grant funds received for programs at VMC are acquired through the PMH Foundation which has a compliance audit completed each year. Grant funds for UHS are sent to the UHS Foundation and have the same audit procedures. All grant funds are recorded/monitored by the Corporate Accountant and the Assistant Vice President of Financial Services. X X X X 0 0 0 0 0 0 0 0 0 Janet Mullaney CAO/Interim CEO 0 438524 0 50896 0 1610 0 102014 0 27249 0 620293 0 0 William Floyd Executive VP/President of VMC 375078 0 39652 0 460 0 60618 0 42976 0 518784 0 0 0 Stephen Lawler President Emeritus of VMC/CPAO 440350 186294 0 101454 4519 0 79347 42100 30500 12206 554716 342054 0 0 Linda Hofler Sr. VP, Chief Nursing Officer 247644 0 13620 0 727 0 41600 0 30385 0 333976 0 0 0 Jennifer Thomas VP of Financial Services 0 167745 0 7957 0 0 0 22759 0 8107 0 206568 0 0 Scott Lieberenz Sr. VP, Financial Services 0 263777 0 14438 0 0 0 28497 0 33484 0 340196 0 0 Donald Shackelford Sr. VP, Medical Affairs 405699 0 22235 0 0 0 43400 0 37354 0 508688 0 0 0 Tracy Eskra VPMA for Clinical Efficiency & Docs. 291848 0 16163 0 0 0 30900 0 7229 0 346140 0 0 0 Donald Smith Senior Vice President 236657 0 13002 0 361 0 37500 0 37174 0 324694 0 0 0 Tyree Walker VP, Human Resources 306400 0 0 0 361380 0 24863 0 12320 0 704963 0 360337 0 Ryan Hickey Senior Vice President 218665 0 12288 0 0 0 28279 0 43196 0 302428 0 0 0 Reggie Pearson Senior Vice President 194289 0 11247 0 0 0 22949 0 34689 0 263174 0 0 0 Kimberly C Osborne VP, Medicine and Care Coordination 173565 0 9438 0 0 0 24440 0 15714 0 223157 0 0 0 Teresa Anderson VP, Quality 163722 0 9029 0 0 0 23096 0 37275 0 233122 0 0 0 Sue Edwards Admin., Outpatient Cvs. Services 215514 0 650 0 0 0 10260 0 17308 0 243732 0 0 0 James Worden Jr Admin., Pharmacy 204155 0 650 0 0 0 10082 0 28439 0 243326 0 0 0 James Barrett Program Manager, Rehabilitation 200356 0 650 0 0 0 3975 0 21581 0 226562 0 0 0 Mary Pender Neonatal Nurse Practioner 192002 0 650 0 0 0 0 0 33471 0 226123 0 0 0 Deborah Westbrook Clinical Pharmacy Specialist 188607 0 650 0 0 0 6000 0 6405 0 201662 0 0 0 Dr David Herman MD Chief Executive Officer 0 1062319 0 146340 0 59722 0 98000 0 17608 0 1383989 0 0 Seth Van Essendelft Former VP of Financial Services 0 124571 0 8994 0 0 0 12923 0 26169 0 172657 0 0 Part I, Line 3 The Top Management Official is the President who is an employee of VMC. The compensation is determined by the Compensation and Benefits Committee of the Vidant Health Board using comparative data from like organizations and input from consultants. This process is performed every two years, the last year being 2015. It will be performed again in fiscal year 2017. Compensation of other officers and key employees is also determined by the Compensation and Benefits Committee of the VH Board using comparative data from like organizations and input from consultants. This process is performed every two years, the last year being 2015. It will be performed again in fiscal year 2017. All compensation discussions and actions are documented and approved in the minutes of the Committee. Part I, Line 4 As of January 1, 2013, the supplemental nonqualified retirement plan was frozen and no further amounts have accrued to its benefit. In lieu of the SERP, the comprehensive defined benefit pension plan will provide an equivalent benefit. The increase in the value of such plans is reflected in the sum of Part II, Column (C). Compensation of Tyree Walker: Of the compensation reported in Column (B)(iii) of Part II, $360,337 is attributable to a distribution from a Supplemental Executive Retirement Plan. Of this total amount $162,152 was paid to Federal and State government as withheld taxes. The remainder is held by a trustee with actuarially determined monthly payments, consisting of principal and earnings, being made to Walker over a specified number of years. This retirement compensation was earned by the recipient over 20 years of service. Eastern Carolina ENT Marcus Albernaz (Board Director) is member and Director of E. Carolina ENT. 347201 Provides on-call services to Vidant Medical Center. 0 Form 990, Part VI, Section A, line 7a The Board of Commissioners of Pitt County and the Board of Governors of the University of North Carolina shall have the power to appoint the twenty members of the Board of Trustees of Pitt County Memorial Hospital. Form 990, Part VI, Section B, line 11 Form 990 is made available to Board Members by posting to a Board Member's website. Any Board Member who does not have the ability to access the return in this manner will receive a copy via electronic or regular mail. The return is also reviewed by the Chief Financial Officer, Chief General Counsel and the Chief Audit and Compliance Officer of University Health Systems prior to filing with the IRS. Form 990, Part VI, Section B, line 12c All Officers, Board Members and Key Employees are required to complete a yearly comprehensive conflict of interest questionnaire. These are reviewed by legal counsel and any potential or actual conflicts are brought to the Board for disposition. Board Members are instructed to report any potential conflicts arising during the year for review. Board Members are required to recuse themselves from voting on issues in which they are deemed to have a conflict. Form 990, Part VI, Section B, line 15 The Top Management Official is the President who is an employee of Pitt County Memorial Hospital (D/B/A Vidant Medical Center). The compensation is determined by the Compensation and Benefits Committee of the Vidant Health Board using comparative data from like organizations and input from consultants. This process is performed every two years, the last year being 2015. It will be performed again in fiscal year 2017. Compensation of other officers and key employees is also determined by the Compensation and Benefits Committee of the VH Board using comparative data from like organizations and input from consultants. This process is performed every two years, the last year being 2015. It will be performed again in fiscal year 2017. All compensation discussions and actions are documented and approved in the minutes of the Committee. Form 990, Part VI, Section C, line 19 The organization makes its governing documents, conflict of interest policy, and financial statements available to the public upon request for the same period of disclosure as set forth in IRC Section 6104(d). Form 990, Part IX, line 11g Other Professional Fees: Program service expenses 114,343,577. Management and general expenses 23,419,769. Fundraising expenses 0. Total expenses 137,763,346. Form 990, Part XI, line 9: Change in Bond Accounting 134,509,134. Moye Medical Endoscopy Center 521 Moye Boulevard Greenville NC 27834 261671435 Healthcare NC -168072 1519922 Vidant Medical Center University Health Systems of Eastern Carolina Inc (DBA Vidant Health) 2100 Stantonsburg Road Greenville NC 27835 562141073 Healthcare NC 501(c)(3) Line 11c, III-FI N/A 0 Surgicenter Services of Pitt Inc 102 Bethesda Drive Greenville NC 27835 561690553 Healthcare NC 501(c)(3) Line 11b, II Vidant Medical Center 1 East Carolina Health Inc (DBA Vidant Community Hospitals - Central) 2100 Stantonsburg Road Greenville NC 27835 562003393 Hospital NC 501(c)(3) Line 3 Vidant Health 0 PCMH Management Inc (DBA Vidant Properties) 2100 Stantonsburg Road Greenville NC 27835 561690740 Medical Property Management NC 501(c)(2) Vidant Health 0 HealthAccess Inc 2100 Stantonsburg Road Greenville NC 27835 561396133 Healthcare NC 501(c)(3) Line 11b, II Vidant Health 0 East Carolina Health-Bertie (DBA Vidant Bertie Hospital) 2100 Stantonsburg Road Greenville NC 27835 562072002 Hospital NC 501(c)(3) Line 3 Vidant Health 0 East Carolina Health-Chowan (DBA Vidant Chowan Hospital) 2100 Stantonsburg Road Greenville NC 27835 562101090 Hospital NC 501(c)(3) Line 3 Vidant Health 0 East Carolina Health-Heritage (DBA Vidant Edgecombe Hospital) 2100 Stantonsburg Road Greenville NC 27835 562093700 Hospital NC 501(c)(3) Line 3 Vidant Health 0 East Carolina Health-Beaufort (DBA Vidant Beaufort Hospital) 2100 Stantonsburg Road Greenville NC 27835 452436270 Hospital NC 501(c)(3) Line 3 Vidant Health 0 Duplin General Hospital (DBA Vidant Duplin Hospital) 2100 Stantonsburg Road Greenville NC 27835 566011594 Hospital NC 501(c)(3) Line 3 Vidant Health 0 East Carolina Health Inc (DBA Vidant Roanoke-Chowan Hospital) 2100 Stantonsburg Road Greenville NC 27835 264634725 Hospital NC 501(c)(3) Line 3 Vidant Health 0 Pungo District Hospital Corporation (DBA Vidant Pungo Hospital) 2100 Stantonsburg Road Greenville NC 27835 560518757 Hospital NC 501(c)(3) Line 3 Vidant Health 0 Surgicenter of Eastern Carolina LLC 2100 Stantonsburg Road Greenville NC 27835 262558314 Ambulatory Surgical Center NC Vidant Medical Center Related 0 0 0.55000 1 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 1 0 0