2015-05-15T10:52:44-05:00 2014-06-30 990 2013-07-01 562070036 DUKE UNIVERSITY HEALTH SYSTEM INC DUKE 9196138993 615 DOUGLAS STREET NO 700 DURHAM NC 27705 KENNETH C MORRIS SVP,CFO,TREASURER 9196138993 2015-05-07 0 2013 2016-03-07 17:11:31Z WILLIAM J FULKERSON MD 615 DOUGLAS ST STE 700 DURHAM NC 27705 3498473549 0 X WWW.DUKEHEALTH.ORG X 1998 NC SEE SCHEDULE O FOR ORGANIZATION'S MISSION STATEMENT 21 12 18169 2291 0 0 8798192 14054772 2361852708 2396909183 87946275 198777380 76648843 83624506 2535246018 2693365841 937726 911323 0 0 1151447618 1173834491 0 0 101050 1087556573 1215706033 2239941917 2390451847 295304101 302913994 4327827970 4643137100 1882057686 1802551366 2445770284 2840585734 X DUHS IS COMMITTED TO EXCELLENCE, INNOVATION AND LEADERSHIP IN PROVIDING THE HEALTH CARE NEEDS OF THE PEOPLE WE SERVE, IMPROVING COMMUNITY HEALTH, AND FOSTERING THE VERY BEST MEDICAL EDUCATION. 0 0 1748613331 911323 2462293535 SEE SCHEDULE O 1748613331 1 1 0 1 0 0 0 0 0 1 1 1 0 0 1 0 0 1 0 0 1 0 0 0 1 0 1 1 1 1 1 1 0 0 0 0 0 0 0 0 1 1 1 1 0 0 1 1 1 1 0 0 1 X 492 0 1 18169 1 0 1 BD 0 0 0 1 1 0 0 0 0 X 21 12 1 1 1 0 0 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 AK FL GA HI IL KS KY MD MA MI MN MS NH NJ NY OK OR PA SC TN UT WI X X LAURA ALVIS 9196138993 DUHS INC 615 DOUGLAS STREET SUITE DURHAM NC 27705 NANCY CATHERINE ANDREWS MD DIRECTOR 4.00 41.00 X 0 742900 82236 DANIEL T BLUE JR DIRECTOR 6.00 0.00 X 0 0 0 JACK O BOVENDER JR DIRECTOR 2.00 6.00 X 0 0 0 RICHARD H BRODHEAD DIRECTOR 10.00 52.00 X 0 1093650 194315 VICTOR J DZAU MD PRESIDENT & CEO, DUHS/DIRECTOR 40.00 48.00 X X 0 2040018 732795 JAMES F GOODMON DIRECTOR 1.50 0.00 X 0 0 0 THOMAS M GORRIE DIRECTOR 7.00 18.00 X 0 0 0 WILLIAM HAWKINS DIRECTOR 2.00 4.00 X 0 0 0 CAROLYN E HENDERSON DIRECTOR 1.00 0.00 X 0 0 0 MARY E KLOTMAN MD DIRECTOR 5.00 41.00 X 0 397320 42008 MICHAEL MARSICANO DIRECTOR 1.00 6.00 X 0 0 0 JOHN MCARTHUR DIRECTOR 1.00 0.00 X 0 0 0 LLOYD B MORGAN DIRECTOR 2.00 0.00 X 0 0 0 THEODORE NICK PAPPAS MD DIRECTOR 2.00 40.00 X 0 423812 44229 CARL E RAVIN MD DIRECTOR 15.00 41.00 X 0 249929 42341 DAVID M RUBENSTEIN DIRECTOR 1.00 7.00 X 0 0 0 STEVEN M SCOTT MD DIRECTOR 2.50 0.00 X 0 0 0 SUSAN M STALNECKER DIRECTOR 2.00 6.00 X 0 0 0 KATHERINE KEITH THOMAS DIRECTOR 1.00 0.00 X 0 0 0 PETER VAN ETTEN DIRECTOR 1.00 0.00 X 0 0 0 JAMES MOON WHITEHURST DIRECTOR 1.00 0.00 X 0 0 0 MONTE D BROWN MD VP OF ADMINISTRATION/SECRETARY 60.00 0.00 X 600069 0 47520 WILLIAM J FULKERSON MD EXECUTIVE VP, DUHS 60.00 5.00 X 1209478 0 36003 KENNETH C MORRIS SVP, CFO, TREASURER 60.00 5.00 X 1051238 0 39631 MARY ANN FUCHS VP-PATIENT CARE/CHIEF NURSE EXEC 60.00 0.00 X 405639 0 36476 RICHARD GANNOTTA PRESIDENT, DUKE RALEIGH HOSPITAL 40.00 0.00 X 442125 0 50701 KATHLEEN GALBRAITH PRESIDENT, DUKE REGIONAL HOSPITAL 60.00 1.00 X 199318 0 40117 JEFFREY FERRANTI VP, CIO, DHTS ADMINISTRATION 60.00 0.00 X 402031 74844 44229 CARLA PARKER-HOLLIS VP, DUKE RALEIGH HOSPITAL 60.00 0.00 X 191404 0 40216 KEVIN W SOWERS PRESIDENT, DUKE UNIVERSITY HOSPITAL 70.00 0.00 X 676744 0 41744 DOUGLAS B VINSEL PRESIDENT, DUKE RALEIGH HOSPITAL 60.00 0.00 X 277045 0 31276 KERRY R WATSON PRESIDENT, DUKE REGIONAL HOSPITAL 40.00 1.00 X 497372 0 81510 MARC CALABRESE PHYSICIAN 40.00 0.00 X 420430 0 51901 SANDRA DANOFF SVP, STRATEGIC PLANNING, BD, NS 40.00 0.00 X 690358 0 42881 JOHN M KELSCH PHYSICIAN 40.00 0.00 X 410875 0 47768 THOMAS OWENS MD CHIEF MEDICAL OFFICER 55.00 5.00 X 576728 0 43875 JOSEPH G TAYLOR PHYSICIAN 40.00 0.00 X 435862 0 52647 PAUL NEWMAN FORMER KEY EMPLOYEE 0.00 41.00 X 0 244434 34813 8486716 5266907 1901232 1267 1 1 0 PRIVATE DIAGNOSTIC CLINIC PLLC DUMC 3070 DURHAM NC 27710 PHYSICIAN SERVICES 83523514 KBR BUILDING GROUP INC 5605 CARNEGIE BLVD CHARLOTTE NC 28209 CONSTRUCTION SERVICE 52400981 OPTIMUM HEALTHCARE IT LLC PO BOX 741383 ATLANTA GA 303841383 IT CONSULTING SERVICES 12303119 ARAMARK HEALTHCARE SUPPORT SERVICES 25271 NETWORK PLACE CHICAGO IL 606731252 HEALTHCARE SERVICES 10468540 BALFOUR BEATTY CONSTRUCTION LLC 5420 WADE PARK BLVD RALEIGH NC 27607 CONSTRUCTION SERVICE 10053299 285 43181 34560 582207 13394824 1757967 14054772 PATIENT REVENUE 621990 2377495539 2377495539 ANCILLARY MEDICAL 621990 16536909 16536909 MEDICAL SERVICES 621990 2876735 2876735 2396909183 7449744 7449744 613 613 6138372 6138372 14236294 13295115 941179 941179 941179 982477333 615687 791340047 425950 191137286 189737 191327023 191327023 69373 43181 46596 22777 22777 BILLING FEES 621990 42158020 42158020 DEEMED DIVIDEND 900003 7646449 7646449 PROGRAM DEV. & SUPPORT 900099 6674723 6674723 20042986 16551609 3491377 76522178 2693365841 2462293535 0 217017534 874823 874823 36500 36500 6194307 273940 5916176 4191 186494 66701 119793 934725066 645285829 289393223 46014 47898417 30302134 17592569 3714 119072273 83271771 35794920 5582 65757934 45128979 20625461 3494 11280676 10622143 658533 1417744 74671 1343073 567415 567415 2960218 2960218 167859442 96083485 71773643 2314 2011021 603393 1407298 330 31540764 19165643 12341848 33273 65729066 2929687 62799379 57512384 46914134 10598250 6090092 3807362 2281901 829 3948007 455384 3492623 40175395 223711 39951684 140302972 105010014 35292958 8258313 4414657 3843656 MEDICAL SUPPLIES 548196011 548196011 0 EQUIPMENT RENTAL & MAIN 62795725 42120409 20675230 86 MEDICAID ASSESSMENT 54141735 54141735 0 LAUNDRY 10355305 10314319 40986 563748 -1704104 2266629 1223 2390451847 1748613331 641737466 101050 76597 79127 282318458 205430693 11269708 5801289 331741223 389980571 1092758 941907 68717773 72410897 15394082 16057510 2764598998 1276437440 1491072128 1488161558 2816358 2997068 2074420736 2440754778 644069 3944084 48264080 16577618 4327827970 4643137100 362936700 277431401 3703031 5934683 1107827649 1086392745 407590306 432792537 1882057686 1802551366 X 2398823195 2781502537 36082851 47826350 10864238 11256847 2445770284 2840585734 4327827970 4643137100 X 302913994 173574633 -81673177 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 1 0 0 0 0 1 192041 0 1 65551 257592 0 PART II-B, LINE 1: DUKE UNIVERSITY HEALTH SYSTEM, INC. EMPLOYS STAFF WHO PERFORM SOME LOBBYING ACTIVITIES AS PART OF THEIR JOB RESPONSIBILITIES. THESE SAME EMPLOYEES AND SOME SENIOR LEADERS OF THE ORGANIZATION MAY HAVE DIRECT CONTACT WITH LEGISLATORS, THEIR STAFFS, AND GOVERNMENT OFFICIALS. DUKE UNIVERSITY HEALTH SYSTEM, INC. PAYS MEMBERSHIP DUES TO OTHER ORGANIZATIONS. PER THE MEMBERSHIP DUES INVOICES, SOME OF THESE ORGANIZATIONS PROVIDE A DISCLOSURE OF LOBBYING PERCENTAGE OF THE DUES RECEIVED. 46947089 13413723 2988057 4265674 59083195 50036781 8190873 1409233 12689798 46947089 53700068 11126530 -758496 14031321 50036781 55631465 5340437 3639795 10911629 53700068 44124232 14138555 2461764 5093086 55631465 0.41240 0.58760 0 1 1 27304086 27304086 1656274789 627485387 1028789402 648470163 414987026 233483137 432549960 233965027 198584933 1488161558 HEDGED STRATEGIES 531286000 F SHORT-TERM INVESTMENTS 178848000 F PRIVATE CAPITAL 321707000 F REAL ASSETS 306549000 F FIXED INCOME 386194000 F EQUITIES 602304000 F OTHER INVESTMENTS 113866778 F 2440754778 INTERCOMPANY PAYABLE 23990363 INTEREST PAYABLE 11122498 PROFESSIONAL LIABILITY COSTS 8590420 POST RETIREMENT BENEFIT OBLIGATION 120209000 CAPITAL LEASE OBLIGATION 125986871 DERIVATIVE INSTRUMENTS 90011951 OTHER NON-CURRENT LIABILITIES 52881434 432792537 PART V, LINE 4: THE INTENDED USE FOR THE ORGANIZATION'S ENDOWMENT: FUNDS SUPPORT CAPITAL PURCHASES, OFFSET OPERATING COSTS, IMPROVE PATIENT SAFETY, AND SUPPORT THE NEEDS OF PATIENTS AND FAMILIES. PART X, LINE 2: DUKE UNIVERSITY HEALTH SYSTEM, INC. ADOPTED THE REQUIREMENTS OF FIN 48 AND CONSIDERED ITS TAX POSITIONS. BASED ON THAT ANALYSIS, THE PROVISIONS OF FIN 48 ARE DEEMED IMMATERIAL TO THE DUKE UNIVERSITY HEALTH SYSTEM, INC. FINANCIAL STATEMENTS AND THEREFORE NO FIN 48 SPECIFIC DISCLOSURES ARE MADE IN THE AUDITED FINANCIAL STATEMENTS OF DUKE UNIVERSITY HEALTH SYSTEM, INC. AND ITS AFFILIATES FOR FISCAL YEAR ENDED JUNE 30, 2014. CENTRAL AMERICA AND THE CARIBBEAN 0 0 PROGRAM SERVICES EDUCATION 2618 CENTRAL AMERICA AND THE CARIBBEAN 0 0 SEMINAR 5246 CENTRAL AMERICA AND THE CARIBBEAN 0 0 INVESTMENTS 197259834 EAST ASIA AND THE PACIFIC 0 0 SEMINAR 840 EUROPE 0 0 SEMINAR 35544 MIDDLE EAST AND NORTH AFRICA 0 0 PROGRAM SERVICES EDUCATION 717 MIDDLE EAST AND NORTH AFRICA 0 0 SEMINAR 21962 SOUTH AMERICA 0 0 SEMINAR 7470 SOUTH ASIA 0 0 PROGRAM SERVICES EDUCATION 16844 SOUTH ASIA 0 0 SEMINAR 1325 SUB-SAHARAN AFRICA 0 0 PROGRAM SERVICES EDUCATION 12255 SUB-SAHARAN AFRICA 0 0 SEMINAR 1887 0 0 0 0 0 0 197334231 32311 197366542 0 0 1 0 0 1 GALA 112554 43181 69373 0 25895 0 10890 4400 5411 NONE 112554 43181 69373 25895 10890 4400 5411 46596 22777 FORM 990, SCHEDULE G, PART I, LINE 2B DUKE UNIVERSITY HEALTH SYSTEM, INC. SUPPORTS THE FUNDRAISING ACTIVITIES PERFORMED BY EMPLOYEES OF DUKE UNIVERSITY. SUCH ACTIVITIES ARE DESIGNED TO DEVELOP SUPPORT FOR BOTH THE UNIVERSITY AND THE DUKE UNIVERSITY HEALTH SYSTEM, INC.'S EDUCATIONAL, RESEARCH AND HEALTHCARE PURPOSES. DUKE UNIVERSITY RECEIVES AND DIRECTS THE CONTRIBUTIONS AS APPROPRIATE TO DUKE UNIVERSITY HEALTH SYSTEM, INC. THE AGREEMENT BETWEEN DUKE UNIVERSITY AND DUKE UNIVERSITY HEALTH SYSTEM, INC. DOES NOT DISTINGUISH BETWEEN PAYMENTS FOR PROFESSIONAL FUNDRAISING SERVICES AND EXPENSE PAYMENTS OR REIMBURSEMENTS. 1 1 X 1 X 1 X 1 1 1 0 1 1 92698626 92698626 0.03880 90137354 90137354 0.03770 182835980 182835980 0.07650 74510623 14661744 59848879 0.02500 10666224 10666224 0.00450 85176847 14661744 70515103 0.02950 268012827 14661744 253351083 0.10600 1 21652702 0 460302175 585615880 -125313705 X 1 0 3 1 DUKE UNIVERSITY HOSPITAL 2301 ERWIN ROAD PRIMARY CAMPUS DURHAM NC 27710 WWW.DUKEMEDICINE.ORG X X X X X X A 2 DUKE RALEIGH HOSPITAL 3400 WAKE FOREST ROAD RALEIGH NC 27609 WWW.DUKEMEDICINE.ORG X X X 3 DUKE REGIONAL HOSPITAL 3643 ROXBORO ROAD DURHAM NC 27704 WWW.DUKEMEDICINE.ORG X X X A DUKE UNIVERSITYDUKE REGIONAL HOSPITALS 1 X X X X X X X X X 13 1 1 1 X HTTP://WWW.DUKEMEDICINE.ORG X HTTP://WWW.HEALTHYDURHAM.ORG X X X X X X X X X X 0 0 1 1 200.000000000000 1 300.000000000000 1 X X X X X X 1 1 X X X X X 1 0 X X X X 1 X 0 1 DUKE RALEIGH HOSPITAL 2 1 X X X X X X X X X 13 1 1 1 X HTTP://WWW.DUKEMEDICINE.ORG X HTTP://WWW.HEALTHYDURHAM.ORG X X X X X X X X X X 0 0 1 1 200.000000000000 1 300.000000000000 1 X X X X X X 1 1 X X X X X 1 0 X X X X 1 X 0 1 DUKE RALEIGH HOSPITAL PART V, SECTION B, LINE 3: DUKE RALEIGH HOSPITAL ("DRAH") USED THE 2010 WAKE COUNTY COMMUNITY ASSESSMENT IN DEVELOPING ITS CHNA AND IMPLEMENTATION PLAN. THE WAKE COUNTY ASSESSMENT INCLUDED INPUT FROM 1,349 CITIZEN SURVEYS, 34 FOCUS GROUPS, 8 WORKGROUPS, AND 3 COMMUNITY MEETINGS. A STEERING COMMITTEE, CO-CHAIRED BY DRAH'S PRESIDENT, COMPRISED OF 50 MEMBERS FROM HOSPITALS, LOCAL GOVERNMENTS, FAITH-BASED ORGANIZATIONS, SCHOOLS, MEDIA, NON-PROFIT ORGANIZATIONS, AND BUSINESSES WORKED TO DIRECT THE ACTIVITIES OF THE ASSESSMENT PROCESS AND PROVIDE INPUT. DUKE RALEIGH HOSPITAL PART V, SECTION B, LINE 4: REX HEALTHCARE, HOLLY HILL HOSPITAL, WAKEMED HEALTH AND HOSPITALS DUKE RALEIGH HOSPITAL PART V, SECTION B, LINE 5D: THE CHNA IS AVAILABLE ON THE WEBSITE BY NAVIGATING TO WWW.DUKEMEDICINE.ORG, CLICKING ON "PATIENTS & VISITORS", THEN "FINANCIAL ASSISTANCE", THEN "COMMUNITY HEALTH NEEDS ASSESSMENT AND CHARITY CARE". DUKE RALEIGH HOSPITAL PART V, SECTION B, LINE 6I: REFER TO HTTP://WWW.DUKEMEDICINE.ORG/PATIENTS-AND-VISITORS/GENERAL/COMMUNITY-HEALTH-NEEDS-ASSESSMENT AND CLICK ON THE LINK FOR THE DUKE RALEIGH HOSPITAL COMMUNITY HEALTH NEEDS ASSESSSMENT REPORT. THIS REPORT DESCRIBES ACTIONS TAKEN TO ADDRESS THE SIGNIFICANT HEALTH NEEDS IDENTIFIED IN ITS MOST RECENTLY CONDUCTED CHNA. DUKE RALEIGH HOSPITAL PART V, SECTION B, LINE 7: DRAH DID NOT ADDRESS DENTAL CARE AS DENTAL CARE IS NOT OFFERED AS PART OF DRAH'S CONTINUUM OF SERVICES. DUKE RALEIGH HOSPITAL PART V, SECTION B, LINE 14G: DUHS PROVIDES A BROCHURE TO ALL ADMISSIONS THAT INCLUDES A BRIEF SUMMARY OF DUHS FINANCIAL ASSISTANCE POLICIES. DUHS ALSO COMMENTS ON THE BACK OF ITS BILLING INVOICES THAT PATIENTS SHOULD CONTACT PATIENT ACCOUNT REPRESENTATIVES TO HELP THEM IF THEY CANNOT PAY THEIR BILL IN FULL. THIS COMMENT REFERENCES GOVERNMENT-SPONSORED PROGRAMS, MONTHLY PAYMENT PROGRAMS, AND OTHER FINANCIAL ASSISTANCE PROGRAMS AVAILABLE FOR PATIENTS WHO MEET CERTAIN FINANCIAL CRITERIA. DUHS ALSO PUBLICIZED ITS FINANCIAL ASSISTANCE POLICY VERBALLY BY OUR FINANCIAL CARE COUNSELORS. DUKE RALEIGH HOSPITAL PART V, SECTION B, LINE 20D: DUHS USED THE LOOK BACK METHOD AND TOOK THE SUM OF ALL CLAIMS THAT HAVE BEEN SUBMITTED TO MEDICARE AND ALL PRIVATE HEALTH INSURERS DURING THE PRIOR 12 MONTH PERIOD DIVIDED BY THE SUM OF THE ASSOCIATED GROSS CHARGES RELATED TO THOSE CLAIMS. DUKE RALEIGH HOSPITAL PART V, SECTION B, LINE 22: CERTAIN ELECTIVE COSMETIC/AESTHETIC SERVICES, AND OTHER SERVICES NOT TYPICALLY COVERED BY INSURANCE, WILL BE BILLED AT AN AMOUNT EQUAL TO GROSS CHARGES. PART V, SECTION B FACILITY REPORTING GROUP A FACILITY REPORTING GROUP A CONSISTS OF: - FACILITY 1: DUKE UNIVERSITY HOSPITAL, - FACILITY 3: DUKE REGIONAL HOSPITAL FACILITY 3 -- DUKE REGIONAL HOSPITAL PART V, SECTION B, LINE 3: DUKE REGIONAL HOSPITAL ("DRH") COLLABORATED WITH THE PARTNERSHIP FOR A HEALTHY DURHAM AND THE DURHAM COUNTY HEALTH DEPARTMENT ON THE 2011 DURHAM COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). THE ASSESSMENT PROCESS INCLUDED 207 CITIZEN SURVEYS FROM RANDOMLY SELECTED HOUSEHOLDS AND 10 COMMUNITY LISTENING SESSIONS WITH 283 COMMUNITY MEMBERS. REPRESENTATIVES FROM DUH AND DRH PARTICIPATED AS MEMBERS ON THE COMMUNITY HEALTH ASSESSMENT TEAM ALONG WITH REPRESENTATIVES FROM OTHER UNIVERSITIES, LOCAL GOVERNMENT, SCHOOLS, NON-PROFIT ORGANIZATIONS, AND BUSINESSES. THE COMMUNITY HEALTH ASSESSMENT TEAM WORKED TO DIRECT THE ACTIVITIES OF THE ASSESSMENT AND PROVIDE WRITTEN CONTENT AND EXPERTISE ON ISSUES OF INTEREST. FACILITY 3 -- DUKE REGIONAL HOSPITAL PART V, SECTION B, LINE 4: DUKE UNIVERSITY HOSPITAL ("DUH") FACILITY 3 -- DUKE REGIONAL HOSPITAL PART V, SECTION B, LINE 5D: THE CHNA IS AVAILABLE ON THE WEBSITE BY NAVIGATING TO WWW.DUKEMEDICINE.ORG, CLICKING ON "PATIENTS & VISITORS", THEN "FINANCIAL ASSISTANCE", THEN "COMMUNITY HEALTH NEEDS ASSESSMENT AND CHARITY CARE". FACILITY 3 -- DUKE REGIONAL HOSPITAL PART V, SECTION B, LINE 6I: REFER TO HTTP://WWW.DUKEMEDICINE.ORG/PATIENTS-AND-VISITORS/GENERAL/COMMUNITY-HEALTH-NEEDS-ASSESSMENT AND CLICK ON THE LINK FOR THE DUKE REGIONAL HOSPITAL COMMUNITY HEALTH NEEDS ASSESSSMENT REPORT. THIS REPORT DESCRIBES ACTIONS TAKEN TO ADDRESS THE SIGNIFICANT HEALTH NEEDS IDENTIFIED IN ITS MOST RECENTLY CONDUCTED CHNA. FACILITY 3 -- DUKE REGIONAL HOSPITAL PART V, SECTION B, LINE 7: DRH DID NOT SPECIFICALLY ADDRESS THE HIV AND SEXUALLY TRANSMITTED INFECTIONS NEED IDENTIFIED IN THE CHNA BECAUSE CONSIDERABLE WORK IS ALREADY BEING DONE THROUGH OTHER ORGANIZATIONS WITHIN THE COMMUNITY. THROUGH THE PARTNERSHIP FOR A HEALTHY DURHAM, THE HIV/STI COMMITTEE BRINGS TOGETHER COMMUNITY MEMBERS AND AGENCIES TO FOCUS ON STRATEGIES TO PREVENT THE SPREAD OF SYPHILIS AND HIV/AIDS. IN ADDITION, LINCOLN COMMUNITY HEALTH CENTER, WHICH DRH SUPPORTS, OPERATES AN EARLY INTERVENTION CLINIC FOR PATIENTS WITH HIV/AIDS AT THE DURHAM COUNTY HEALTH DEPARTMENT. FACILITY 3 -- DUKE REGIONAL HOSPITAL PART V, SECTION B, LINE 14G: DUHS PROVIDES A BROCHURE TO ALL ADMISSIONS THAT INCLUDES A BRIEF SUMMARY OF DUHS FINANCIAL ASSISTANCE POLICIES. DUHS ALSO COMMENTS ON THE BACK OF ITS BILLING INVOICES THAT PATIENTS SHOULD CONTACT PATIENT ACCOUNT REPRESENTATIVES TO HELP THEM IF THEY CANNOT PAY THEIR BILL IN FULL. THIS COMMENT REFERENCES GOVERNMENT-SPONSORED PROGRAMS, MONTHLY PAYMENT PROGRAMS, AND OTHER FINANCIAL ASSISTANCE PROGRAMS AVAILABLE FOR PATIENTS WHO MEET CERTAIN FINANCIAL CRITERIA. DUHS ALSO PUBLICIZED ITS FINANCIAL ASSISTANCE POLICY VERBALLY BY OUR FINANCIAL CARE COUNSELORS. FACILITY 3 -- DUKE REGIONAL HOSPITAL PART V, SECTION B, LINE 20D: DUHS USED THE LOOK BACK METHOD AND TOOK THE SUM OF ALL CLAIMS THAT HAVE BEEN SUBMITTED TO MEDICARE AND ALL PRIVATE HEALTH INSURERS DURING THE PRIOR 12 MONTH PERIOD DIVIDED BY THE SUM OF THE ASSOCIATED GROSS CHARGES RELATED TO THOSE CLAIMS. FACILITY 3 -- DUKE REGIONAL HOSPITAL PART V, SECTION B, LINE 22: CERTAIN ELECTIVE COSMETIC/AESTHETIC SERVICES, AND OTHER SERVICES NOT TYPICALLY COVERED BY INSURANCE, WILL BE BILLED AT AN AMOUNT EQUAL TO GROSS CHARGES. FACILITY 1 -- DUKE UNIVERSITY HOSPITAL PART V, SECTION B, LINE 3: DUKE UNIVERSITY HOSPITAL ("DUH") COLLABORATED WITH THE PARTNERSHIP FOR A HEALTHY DURHAM AND THE DURHAM COUNTY HEALTH DEPARTMENT ON THE 2011 DURHAM COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). THE ASSESSMENT PROCESS INCLUDED 207 CITIZEN SURVEYS FROM RANDOMLY SELECTED HOUSEHOLDS AND 10 COMMUNITY LISTENING SESSIONS WITH 283 COMMUNITY MEMBERS. REPRESENTATIVES FROM DUH AND DRH PARTICIPATED AS MEMBERS ON THE COMMUNITY HEALTH ASSESSMENT TEAM ALONG WITH REPRESENTATIVES FROM OTHER UNIVERSITIES, LOCAL GOVERNMENT, SCHOOLS, NON-PROFIT ORGANIZATIONS, AND BUSINESSES. THE COMMUNITY HEALTH ASSESSMENT TEAM WORKED TO DIRECT THE ACTIVITIES OF THE ASSESSMENT AND PROVIDE WRITTEN CONTENT AND EXPERTISE ON ISSUES OF INTEREST. FACILITY 1 -- DUKE UNIVERSITY HOSPITAL PART V, SECTION B, LINE 4: DUKE REGIONAL HOSPITAL ("DRH") FACILITY 1 -- DUKE UNIVERSITY HOSPITAL PART V, SECTION B, LINE 5D: THE CHNA IS AVAILABLE ON THE WEBSITE BY NAVIGATING TO WWW.DUKEMEDICINE.ORG, CLICKING ON "PATIENTS & VISITORS", THEN "FINANCIAL ASSISTANCE", THEN "COMMUNITY HEALTH NEEDS ASSESSMENT AND CHARITY CARE". FACILITY 1 -- DUKE UNIVERSITY HOSPITAL PART V, SECTION B, LINE 6I: REFER TO HTTP://WWW.DUKEMEDICINE.ORG/PATIENTS-AND-VISITORS/GENERAL/COMMUNITY-HEALTH-NEEDS-ASSESSMENT AND CLICK ON THE LINK FOR THE DUKE UNIVERSITY HOSPITAL COMMUNITY HEALTH NEEDS ASSESSSMENT REPORT. THIS REPORT DESCRIBES ACTIONS TAKEN TO ADDRESS THE SIGNIFICANT HEALTH NEEDS IDENTIFIED IN ITS MOST RECENTLY CONDUCTED CHNA. FACILITY 1 -- DUKE UNIVERSITY HOSPITAL PART V, SECTION B, LINE 7: DUH DID NOT SPECIFICALLY ADDRESS THE HIV AND SEXUALLY TRANSMITTED INFECTIONS NEED IDENTIFIED IN THE CHNA BECAUSE CONSIDERABLE WORK IS ALREADY BEING DONE THROUGH OTHER ORGANIZATIONS WITHIN THE COMMUNITY. THROUGH THE PARTNERSHIP FOR A HEALTHY DURHAM, THE HIV/STI COMMITTEE BRINGS TOGETHER COMMUNITY MEMBERS AND AGENCIES TO FOCUS ON STRATEGIES TO PREVENT THE SPREAD OF SYPHILIS AND HIV/AIDS. FACILITY 1 -- DUKE UNIVERSITY HOSPITAL PART V, SECTION B, LINE 14G: DUHS PROVIDES A BROCHURE TO ALL ADMISSIONS THAT INCLUDES A BRIEF SUMMARY OF DUHS FINANCIAL ASSISTANCE POLICIES. DUHS ALSO COMMENTS ON THE BACK OF ITS BILLING INVOICES THAT PATIENTS SHOULD CONTACT PATIENT ACCOUNT REPRESENTATIVES TO HELP THEM IF THEY CANNOT PAY THEIR BILL IN FULL. THIS COMMENT REFERENCES GOVERNMENT-SPONSORED PROGRAMS, MONTHLY PAYMENT PROGRAMS, AND OTHER FINANCIAL ASSISTANCE PROGRAMS AVAILABLE FOR PATIENTS WHO MEET CERTAIN FINANCIAL CRITERIA. DUHS ALSO PUBLICIZED ITS FINANCIAL ASSISTANCE POLICY VERBALLY BY OUR FINANCIAL CARE COUNSELORS. FACILITY 1 -- DUKE UNIVERSITY HOSPITAL PART V, SECTION B, LINE 20D: DUHS USED THE LOOK BACK METHOD AND TOOK THE SUM OF ALL CLAIMS THAT HAVE BEEN SUBMITTED TO MEDICARE AND ALL PRIVATE HEALTH INSURERS DURING THE PRIOR 12 MONTH PERIOD DIVIDED BY THE SUM OF THE ASSOCIATED GROSS CHARGES RELATED TO THOSE CLAIMS. FACILITY 1 -- DUKE UNIVERSITY HOSPITAL PART V, SECTION B, LINE 22: CERTAIN ELECTIVE COSMETIC/AESTHETIC SERVICES, AND OTHER SERVICES NOT TYPICALLY COVERED BY INSURANCE, WILL BE BILLED AT AN AMOUNT EQUAL TO GROSS CHARGES. 4 HOSPICE OF MEADOWLANDS 1001 CORPORATE DRIVE HILLSBOROUGH NC 27278 HOSPICE HOCK FAMILY PAVILION 4023 NORTH ROXBORO ROAD DURHAM NC 27704 HOSPICE DIET & FITNESS CENTER 501 DOUGLAS STREET DURHAM NC 27705 HEALTHY WEIGHT LOSS TREATMENT CENTER DUKE INTEGRATIVE MEDICINE 3475 ERWIN ROAD DURHAM NC 27705 CLINICAL AND THERAPEUTIC SERVICES CENTER PART I, LINE 3C: NOT APPLICABLEPART I, LINE 6A:NOT APPLICABLEPART I, LINE 7G:NOT APPLICABLEPART I, LINE 7, COLUMN F:TOTAL GROSS COMMUNITY BENEFIT EXPENSE AS A PERCENT OF TOTAL EXPENSES IS 11.23%.PART I, LINE 7:CHARITY CARE AT COST IS DETERMINED USING THE COST-TO-CHARGE CALCULATION FROM WORKSHEET 2, IN ORDER TO CALCULATE THE AMOUNTS REPORTED ON THE TABLE. UNREIMBURSED MEDICAID IS DETERMINED USING A COST ACCOUNTING SYSTEM THAT ADDRESSES ALL PATIENT SEGMENTS.PART II, COMMUNITY BUILDING ACTIVITIES:THESE ACTIVITIES ARE INCLUDED IN DUKE UNIVERSITY HEALTH SYSTEM, INC.'S (DUHS) OPERATING EXPENSES AND ARE NOT TRACKED SEPARATELY FOR COMMUNITY BENEFIT REPORTING PURPOSES.PART III, LINE 2:BAD DEBT AT COST IS DETERMINED USING THE COST-TO-CHARGE RATIO CALCULATION FROM WORKSHEET 2.PART III, LINE 3:A PORTION OF BAD DEBT EXPENSE SHOULD BE INCLUDED AS A COMMUNITY BENEFIT, BUT THIS PORTION THAT IS ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER OUR FINANCIAL ASSISTANCE POLICY IS INDETERMINABLE BECAUSE THEY FAIL TO APPLY FOR OR PROVIDE INFORMATION NEEDED TO DETERMINE THEIR ELIGIBILITY UNDER THE DUHS FAP. DUHS, INC. FOLLOWS ITS MISSION TO THE COMMUNITY AND PROVIDES EMERGENT SERVICES TO PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. BAD DEBT IS FURTHER COMPLICATED BY DOCUMENTATION REQUIRED BY THE CENTERS FOR MEDICARE AND MEDICAID SERVICES (CMS) FOR REPORTING CHARITY CARE. THEREFORE, PATIENTS WHO MAY QUALIFY FOR CHARITY CARE ARE REPORTED AS BAD DEBT EXPENSE INSTEAD DUE TO PATIENTS' INABILITY OR UNWILLINGNESS TO PROVIDE THE NECESSARY DOCUMENTATION REQUIRED TO BE DEEMED CHARITY CARE.PART III, LINE 4PAGES 16-17 IN THE FY2014 AUDITED FINANCIAL STATEMENT FOOTNOTES DESCRIBE BAD DEBT EXPENSE.PART III, LINE 7:TOTAL UNREIMBURSED COSTS ATTRIBUTABLE TO PROVIDING SERVICES UNDER MEDICARE AS REPORTED IN THE JUNE 30, 2014 DUHS CONSOLIDATED FINANCIAL STATEMENTS ARE $172,840,000 AS COMPARED TO $125,313,705 AS REPORTED IN SECTION B, LINE 7 OF SCHEDULE H. THE DUHS TOTAL MEDICARE SHORTFALL OF $172,840,000 IS DERIVED FROM THE COST ACCOUNTING SYSTEM WHICH INCLUDES ALL PAYMENTS AND COSTS ASSOCIATED WITH MEDICARE PATIENTS, WHEREAS THE AMOUNT REPORTED IN SECTION B OF SCHEDULE H IS DERIVED BASED ON IRS INSTRUCTIONS. IRS INSTRUCTIONS SPECIFY THAT ONLY A PORTION OF COSTS ASSOCIATED WITH MEDICARE BENEFICIARIES BE REPORTED ON SCHEDULE H. SIGNIFICANT MEDICARE COSTS EXCLUDED FROM SCHEDULE H DATA INCLUDE THOSE ASSOCIATED WITH MEDICARE PATIENTS COVERED UNDER MANAGED CARE PLANS AND COSTS REIMBURSED THROUGH MEANS NOT REPORTED ON THE COST REPORT.PART III, LINE 8MEDICARE RATES AND THE NUMBER OF MEDICARE PATIENTS DUHS TREATS ARE NOT NEGOTIATED. MEDICARE DOES NOT FULLY COMPENSATE DUHS FOR THE COST OF PROVIDING CARE TO MEDICARE BENEFICIARIES. DUHS CONTINUES TO SERVE THE MEDICARE POPULATION AS MEDICARE REIMBURSEMENT RATES DECLINE RELATIVE TO THE COST OF CARE. THEREFORE, ANY LOSS RELATED TO PROVIDING CARE FOR MEDICARE PATIENTS SHOULD BE CLASSIFIED AS A COMMUNITY BENEFIT. DUHS FOLLOWED THE MEDICARE COST REPORT RULES AND GUIDELINES IN DETERMINING THE COSTS REPORTED ON LINE 6. THESE RULES USE A VARIETY OF DIFFERENT METHODOLOGIES BASED ON THE TYPE OF SERVICE. NEEDS ASSESSMENT: PART VI, LINE 2:DUHS USES SEVERAL MECHANISMS TO ASSESS AND ADDRESS THE HEALTH CARE NEEDS OF THE COMMUNITIES IT SERVES. IN DURHAM COUNTY, DUHS AND THE DUKE UNIVERSITY SCHOOL OF MEDICINE FACULTY ARE ACTIVELY INVOLVED IN THE PARTNERSHIP FOR A HEALTHY DURHAM. THE PARTNERSHIP IS A COALITION OF LOCAL ORGANIZATIONS AND COMMUNITY MEMBERS WITH THE GOAL OF COLLABORATELY IMPROVING THE PHYSICAL, MENTAL, SOCIAL, HEALTH, AND WELL-BEING OF DURHAM COUNTY'S RESIDENTS. THE NETWORK IS A CERTIFIED HEALTH CAROLINIAN'S WORKGROUP. THE PARTNERSHIP EVALUATES COMMUNITY HEALTH CARE INFORMATION, THEN IDENTIFIES AND PRIORITIZES COMMUNITY-IDENTIFIED HEALTH CARE NEEDS AMONG FOUR SUBCOMMITTEES THAT EACH FOCUS ON A DURHAM COUNTY HEALTH PRIORITY: MENTAL HEALTH AND SUBSTANCE ABUSE, ACCESS TO MEDICAL AND DENTAL CARE, OBESITY AND CHRONIC ILLNESS, EDUCATION, POVERTY, AND HIV/STI'S. POVERTY AND EDUCATION ARE NEW HEALTH PRIORITIES FOR THE COALITION. NEW STANDING COMMITTEES HAVE NOT BEEN ESTABLISHED YET FOR THESE PRIORITIES. THE COALITION IS ADDRESSING EDUCATION AND POVERTY THROUGH THE FOUR HEALTH COMMITTEES AND BY WORKING COLLABORATELY WITH EXISTING COMMUNITY WORK GROUPS. SINCE 2002, DUHS' OFFICE OF COMMUNITY RELATIONS HAS PLAYED A CENTRAL ROLE IN CONDUCTING A DURHAM HEALTH SUMMIT. THIS IS AN EVENT THAT ATTRACTS HUNDREDS OF COMMUNITY MEMBERS, HEALTH OFFICIALS, ELECTED OFFICIALS, AND DUHS EXECUTIVES AND PHYSICIANS TO RAISE AWARENESS OF KEY HEALTH ISSUES IN THE COMMUNITY AND SEEK COLLABORATIVE SOLUTIONS TO THESE ISSUES. THE SUMMIT HAS PRODUCED A NUMBER OF COMMUNITY-DRIVEN HEALTH CARE PROGRAMS AND INITIATIVES, INCLUDING SPECIALTY PROJECT ACCESS, IN WHICH PHYSICIANS WHO PRACTICE AT DUHS FACILITIES AND OTHER DURHAM COUNTY PHYSICIANS OFFER FREE SPECIALTY CARE SERVICES TO RESIDENTS WHO OTHERWISE COULD NOT AFFORD IT. DUHS ALSO PLAYS A CENTRAL ROLE IN REGIONAL AND STATE HEALTH CARE SUMMITS USING THE SUMMITS' INFORMATION AND DATA TO ADDRESS THE HEALTH CARE NEEDS OF THOSE BROADER COMMUNITIES. DUHS ALSO USES DATA FROM THE ANNUAL DURHAM STATE OF THE COUNTY HEALTH REPORT AND THE DURHAM COUNTY HEALTH ASSESSMENT (SEEWWW.HEALTHYDURHAM.ORG) CONDUCTED EVERY 3 YEARS TO ENSURE DUHS IS ADDRESSING IMPORTANT HEALTH CARE ISSUES IDENTIFIED BY THE COMMUNITY.DUKE RALEIGH HOSPITAL WORKED CLOSELY WITH THE WAKE COUNTY HUMAN SERVICES AGENCIES AND OTHER COMMUNITY STAKEHOLDERS ON THE 2010 WAKE COUNTY COMMUNITY HEALTH ASSESSMENT.PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE:PART VI, LINE 3:DUHS EMPLOYS NUMEROUS MEANS TO EDUCATE PATIENTS ABOUT THEIR ELIGIBILITYFOR ASSISTANCE UNDER FEDERAL, STATE, OR LOCAL GOVERNMENT PROGRAMS ORUNDER THE DUHS CHARITY CARE POLICY. DETAILED INFORMATION IS POSTED ONDUKEMEDICINE.ORG (DUHS' WEBSITE) ALONG WITH HARDCOPY BROCHURES THAT AREAVAILABLE IN ENGLISH OR SPANISH AT ALL OF OUR PATIENT REGISTRATIONLOCATIONS. ALL INPATIENTS AND EMERGENCY DEPARTMENT PATIENTS ARE ALSOPROVIDED WITH A HARDCOPY, ONE-PAGE SUMMARY OF THE WAYS DUHS CAN ASSISTPATIENTS FINANCIALLY. FOR OUTPATIENTS, THIS SAME ONE-PAGE SUMMARY IS PROVIDED ON THEIR FIRST VISIT TO THE INSTITUTION. IN ADDITION, DUHS EMPLOYS FINANCIAL CARE COUNSELORS WHO MEET INDIVIDUALLY WITH PATIENTS WHO HAVE QUESTIONS REGARDING PAYMENT FOR THEIR CARE. DUHS ALSO EMPLOYS MEDICAID ASSISTANCE COUNSELORS WHO SPECIALIZE IN ASSISTING PATIENTS TO APPLY FOR MEDICAID, DISABILITY, AND OTHER FEDERAL, STATE, AND LOCAL PROGRAMS. DUHS ASSISTS BETWEEN 12,000-15,000 PATIENTS IN APPLYING AND BECOMING ELIGIBLE FOR THESE PROGRAMS ANNUALLY. FINALLY, PATIENTS MAY ALWAYS CONTACT DUHS' TOLL FREE CUSTOMER SERVICE NUMBER TO REQUEST INFORMATION ABOUT THEIR BILL OR OBTAIN A CHARITY CARE APPLICATION. COMMUNITY INFORMATION: PART VI, LINE 4:DUHS SERVES A BROAD, CULTURALLY, RACIALLY AND SOCIALLY DIVERSE GEOGRAPHIC AND DEMOGRAPHIC REGION. DUHS' HOME CITY OF DURHAM IS THE CORE, BUT DUHS' REACH EXTENDS INTO THE SURROUNDING RESEARCH TRIANGLE AREA OF NORTH CAROLINA AND THE STATE'S LARGER NORTHERN PIEDMONT REGION, AS WELL AS STATEWIDE, NATIONALLY AND GLOBALLY. DURHAM, WAKE AND ORANGE COUNTIES - WHICH FORM THE TRIANGLE - REPRESENTS APPROXIMATELY 23% OF NC'S POPULATION BASED ON FEDERAL FISCAL YEAR (FFY) 2013 DATA. APPROXIMATELY 73% OF INPATIENT DISCHARGES FROM DUHS FACILITIES IN FFY 2013 WERE PATIENTS WHO RESIDED IN THE GREATER TRIANGLE REGION. DUHS' SECONDARY SERVICE AREA COVERS 21 COUNTIES IN NORTH CAROLINA AND SOUTHERN VIRGINIA WITH A POPULATION OVER 2 MILLION. APPROXIMATELY 14% OF INPATIENT DISCHARGES FROM DUHS FACILITIES IN FFY 2013 WERE PATIENTS WHO RESIDE IN THE SECONDARY SERVICE AREA.PROMOTION OF COMMUNITY HEALTH:PART VI, LINE 5:DUHS PROMOTES THE HEALTH OF THE COMMUNITIES IT SERVES THROUGH A NUMBER OF COMMUNITY BUILDING ACTIVITIES. CENTRAL TO MANY OF THE EFFORTS IS DUHS' OFFICE OF COMMUNITY RELATIONS, WHOSE ASSOCIATE VICE PRESIDENT REPORTS DIRECTLY TO DUHS' CEO AND SERVES AS A FULL-TIME LIAISON WITH THE DURHAM COMMUNITY. THE OFFICE SPONSORS AND FACILITATES COMMUNITY EVENTS SUCH AS THE ANNUAL DURHAM HEALTH SUMMIT AND SIMILAR REGIONAL AND STATE HEALTH SUMMITS THAT RAISE AWARENESS OF COMMUNITY HEALTH NEEDS, PROMOTE PREVENTION AND WELLNESS, AND CHART A COURSE FOR SOLVING HEALTH ISSUES AND DISPARITIES. IN ADDITION, THE OFFICE PROVIDES A POINT OF DIRECT CONTACT FOR COMMUNITY MEMBERS WHO HAVE QUESTIONS OR CONCERNS ABOUT COMMUNITY ISSUES OR ABOUT ACCESS TO HEALTH CARE SERVICES. THE OFFICE ALSO PROVIDES DIRECT FINANCIAL SUPPORT TO A VARIETY OF COMMUNITY GROUPS THROUGH THE CHARITABLE GRANTS AND GOODWILL GRANTS PROGRAM. THE ASSOCIATE VICE-PRESIDENT AND STAFF SERVE ON A NUMBER OF HEALTH CARE-RELATED COMMUNITY BOARDS AND HEALTH-RELATED COMMITTEES. STAFF FROM THE OFFICE OF COMMUNITY RELATIONS AND MEMBERS OF THE DUHS COMMUNITY HEALTH PLANNING GROUP CREATED A FORMAL PRINCIPLES OF COMMUNITY ENGAGEMENT POLICY THAT COMMITS DUHS AND ITS COMMUNITY PARTNERS TO DEVELOPING PROPOSED PROJECTS AND INITIATIVES ON TRUST, RESPECT, DIVERSITY, SAFETY AND COMMUNITY-IDENTIFIED NEEDS. THESE PRINCIPLES HAVE BEEN INCORPORATED INTO COMMUNITY-BASED HEALTH CARE PROJECTS SUCH AS THE DEVELOPMENT OF THE HOLTON WELLNESS CENTER AND DURHAM HEALTH INNOVATIONS, A MULTIDISCIPLINARY COMMUNITY BASED PARTNERSHIP BETWEEN DUHS AND THE DURHAM COMMUNITY THAT FOCUSES ON IMPROVING HEALTH OUTCOMES THROUGH NEW AND CREATIVE APPROACHES TO HEALTH CARE DELIVERY.IN ADDITION TO COMMUNITY BUILDING ACTIVITIES, DUHS PROMOTES THE HEALTH OF ITS COMMUNITIES IN A NUMBER OF IMPORTANT WAYS. ONE OF DUHS' THREE CONSTITUENT HOSPITALS, DUKE REGIONAL, HAS AN OPEN MEDICAL STAFF AND A HOSPITAL CORPORATION BOARD, WHICH IS A COUNTY APPOINTED BOARD RESPONSIBLE FOR HOSPITAL OVERSIGHT. THE OFFICE OF COMMUNITY RELATIONS LAUNCHED A NEW INITIATIVE WITH MEMBERS OF THE DURHAM FAITH COMMUNITY. APPROXIMATELY 50 LOCAL LEADERS IN THE FAITH COMMUNITY ARE WORKING WITH DUKE MEDICINE (DUHS, DUKE UNIVERSITY SCHOOL OF MEDICINE, AND DUKE UNIVERSITY SCHOOL OF NURSING) TO LOOK AT HOW TO ADDRESS THE NEEDS OF THEIR CONGREGATIONS AND COMMUNITIES BY COMBINING THE TRADITIONS OF THE FAITH COMMUNITY WITH THE KNOWLEDGE OF MODERN MEDICINE. MEETINGS HAVE BEEN HELD TO DETERMINE HOW DUKE MEDICINE CAN PARTNER WITH THE FAITH COMMUNITY TO SUPPORT HEALTH MINISTRY ACTIVITIES IN THEIR COMMUNITY AND PLACES OF WORSHIP.DUHS' CEO ALSO HAS A CHANCELLOR'S COMMUNITY HEALTH ADVISORY BOARD TO PROVIDE FEEDBACK ON A VARIETY OF ISSUES, INCLUDING USE OF DUHS RESOURCES, HEALTH SERVICE DELIVERY SYSTEMS AND LONG-RANGE GOALS TO REDUCE HEALTH RISKS AND DISPARITIES IN DURHAM COUNTY. THE BOARD INCLUDES STATE AND LOCAL ELECTED OFFICIALS, NEIGHBORHOOD COUNCILS AND OTHER GRASSROOTS ORGANIZATIONS, POLITICAL GROUPS, LOCAL PHYSICIANS, THE DURHAM PUBLIC SCHOOLS, AMONG OTHERS. DUHS MAINTAINS A CHARITABLE GRANTS COMMITTEE TO REVIEW COMMUNITY REQUESTS FOR PHILANTHROPIC ASSISTANCE THAT PROMOTE HEALTH AND WELLNESS. DUKE MEDICINE PROVIDES VARIOUS OPPORTUNITIES FOR STUDENTS TO INTERACT WITH DIFFERENT HEALTH CARE PROFESSIONALS ACROSS THE SYSTEM. THE OFFICE OF COMMUNITY RELATIONS, DRH, AND OTHER KEY COMMUNITY PARTNERS BEGAN A PILOT WORKFORCE DEVELOPMENT PROJECT CALLED PROJECT SEARCH. THIS PROGRAM, MODELED AFTER THE PROGRAM AT CINCINNATI CHILDREN'S HOSPITAL, PROVIDES YOUTH WITH DISABILITIES EMPLOYMENT TRAINING AND CAREER OPPORTUNITIES IN THE HEALTHCARE FIELD. THE OFFICE OF COMMUNITY RELATIONS WORKS WITH THE DURHAM-ORANGE MEDICAL SOCIETY AND THE DURHAM ACADEMY OF MEDICINE, DENTISTRY AND PHARMACY (AN ASSOCIATION FOR AFRICAN-AMERICAN MEDICAL PROFESSIONALS) TO PROMOTE THE SUCCESS OF THE CITY OF MEDICINE ACADEMY (CMA). THE CMA IS A PUBLIC MAGNET HIGH SCHOOL DESIGNED FOR STUDENTS INTERESTED IN HEALTH CARE CAREERS. FACULTY ARE INVOLVED WITH MENTORING STUDENTS AND CLASSROOM LECTURES. IN ADDITION, THE HEALTH SYSTEM CEO IS WORKING WITH THE NEW SCHOOLS PROJECT TO HELP THE CMA BECOME THE PREMIER HEALTH SCIENCE HIGH SCHOOL IN NORTH CAROLINA. IN 2011, CMA MOVED INTO A NEW BUILDING ON THE DRH CAMPUS ON LAND DUHS RELEASED BACK TO DURHAM COUNTY. THE OCR PROGRAM MANAGER COORDINATED HEALTH CARE SERVICES AT THE ANNUAL DURHAM PROJECT HOMELESS CONNECT. DUHS, INC. IS A KEY PARTNER IN THIS EVENT. STAFF FROM THE DUKE SCHOOL OF NURSING, DUKE EYE CENTER, AND STAFF AFFILIATED WITH LINCOLN COMMUNITY HEALTH CENTER HEALTHCARE FOR THE HOMELESS CLINIC VOLUNTEER TIME AND RESOURCES AT THIS IMPORTANT EVENT. STUDENTS FROM THE DUKE SCHOOLS OF MEDICINE AND NURSING ENGAGE COMMUNITIES IN DURHAM AND BEYOND IN ACTIVITIES THAT INCLUDE FREE BLOOD PRESSURE SCREENINGS FOR THE HOMELESS, AND IDENTIFYING THE HEALTH CARE NEEDS OF A LOW WEALTH COMMUNITY SCHOOL AND DEVELOPING A CURRICULUM FOR STUDENTS AND PARENTS THAT ADDRESSES THOSE NEEDS. AFFILIATED HEALTH CARE SYSTEM ROLES:PART VI, LINE 6:DUHS PROVIDES VIRTUALLY ALL LEVELS OF CARE BEGINNING WITH DUKE UNIVERSITY AFFILIATED PHYSICIANS (DBA DUKE PRIMARY CARE) (DPC). THE HOSPITALS PROVIDE ROUTINE INPATIENT AND OUTPATIENT CARE. IN DURHAM COUNTY, DUH AND DRH WORK TOGETHER TO MAXIMIZE FACILITY UTILIZATION PROVIDING ROUTINE AND ADVANCED LEVELS OF CARE. DUH ALSO OPERATES A TRAUMA CENTER WITH AIR AMBULANCE SERVICE. DRAH SERVES THE WAKE COUNTY AREA AS A COMMUNITY HOSPITAL. THE DRAH CAMPUS HAS SEVERAL MEDICAL OFFICE BUILDINGS ENHANCING CONVENIENCE FOR THE PATIENT IN NON-EMERGENT CASES AND PROVIDES STREAMLINED ACCESS TO HIGH-DEMAND PROCEDURES SUCH AS CARDIAC CATHETERIZATION AND RADIOLOGY PROCEDURES. DUHS ALSO OPERATES HOME HEALTH AND HOME INFUSION SERVICES TO TREAT AND CARE FOR PATIENTS IN THE COMFORT OF THEIR HOME. THIS IS OBVIOUSLY PRACTICAL FOR PATIENTS NOT REQUIRING INPATIENT STAY BUT IN NEED OF ONGOING CARE AT A SUB-ACUTE LEVEL. FINALLY, HOSPICE PROVIDES PALLIATIVE CARE FOR PATIENTS NOT RESPONDING TO CURATIVE CARE. PAIN MANAGEMENT, SYMPTOM MANAGEMENT, AND PSYCHOLOGICAL AND SPIRITUAL SUPPORT PROVIDE A ROUNDED APPROACH TO COMPASSIONATELY ASSIST TERMINAL PATIENTS AND THEIR FAMILIES WITH THE PROCESS OF DYING. ALL OF THE OPERATING UNITS OF DUHS WORK TOGETHER TO PROVIDE THE RIGHT LEVEL OF CARE FOR THE PATIENT IN THE MOST BENEFICIAL MANNER. IN ADDITION TO THE REACTIVE ACTIVITIES OF DIAGNOSTIC CARE, DUHS ALSO SUPPORTS AND PROMOTES HEALTHY LIFESTYLES IN THE DIET & FITNESS CENTER, CENTER FOR LIVING, AND DUKE INTEGRATIVE MEDICINE. THESE OPERATIONS FOCUS LARGELY ON PREVENTION AND EDUCATION TO AVOID OR MITIGATE THE POTENTIAL FOR FUTURE ILLNESS.LIST OF ALL STATES WHICH ORGANIZATION FILES A COMMUNITY BENEFIT REPORT:PART VI, LINE 7:NORTH CAROLINA 1 1 IN 8K RALLY FOR THE CURE 30 MEMORIAL DR PINEHURST NC 28374 452871984 - 5800 GENERAL SUPPORT ALLIANCE MEDICAL MINISTRY INC 101 DONALD ROSS DRIVE RALEIGH NC 27610 562168673 501(C)(3) 42500 GENERAL SUPPORT THE AMERICAN SOCIETY OF GENE & CELL THERAPY 555 EAST WELLS ST SUITE 1100 MILWAUKEE WI 53202 911766321 501(C)(3) 25000 GENERAL SUPPORT BOYS & GIRLS CLUB 701 N RALEIGH BLVD RALEIGH NC 27610 560863051 501(C)(3) 17500 GENERAL SUPPORT CEO ROUNDTABLE ON CANCER INC 940 NW CARY PKWY SUITE 102 CARY NC 27513 651230448 501(C)(3) 40000 GENERAL SUPPORT CITY OF MEDICINE ACADEMY 301 CRUTCHFIELD ST DURHAM NC 27704 566001021 NC GOVERNMENT 20451 GENERAL SUPPORT DUKE SCHOOL FOR CHILDREN 3716 OLD ERWIN RD DURHAM NC 27705 581521494 501(C)(3) 25000 GENERAL SUPPORT DURHAM AT RISK YOUTH COLLABORATIVE 107 N DIVER ST DURHAM NC 27703 320263133 501(C)(3) 15000 GENERAL SUPPORT DURHAM COUNTY 414 E MAIN ST DURHAM NC 27701 566000297 LOCAL GOVERNMENT 25000 GENERAL SUPPORT FAMILY VIOLENCE PREVENTION CENTER 1012 OBERLINE RD SUITE 100 RALEIGH NC 27605 581320613 501(C)(3) 40000 GENERAL SUPPORT FOUNDATION FOR NURSING EXCELLENCE PO BOX 31824 RALEIGH NC 27622 300105241 501(C)(3) 20000 GENERAL SUPPORT GREAT 100 INC PO BOX 4875 GREENSBORO NC 274044875 561705456 501(C)(3) 15000 GENERAL SUPPORT GREATER RALEIGH CHAMBER OF COMMERCE PO BOX 2978 RALEIGH NC 276022978 560370850 501(C)(6) 45910 GENERAL SUPPORT HUMAN RIGHTS CAMPAIGN 1640 RHODE ISLAND AVE NW WASHINGTON DC 20036 521243458 501(C)(4) 15000 GENERAL SUPPORT KNIGHTDALE CHAMBER OF COMMERCE 207 MAIN STREET KNIGHTDALE NC 27545 561325118 501(C)(6) 5500 GENERAL SUPPORT LGBT CENTER OF RALEIGH INC 411 HILLSBOROUGH ST RALEIGH NC 276031727 262998186 501(C)(3) 10000 GENERAL SUPPORT MEDICAL FOUNDATION OF NC INC CB7120 CHAPEL HILL NC 275997120 566001393 501(C)(3) 50000 GENERAL SUPPORT MIDTOWN EVENTS LLC 4321 LASSITER AT NORTH HILLS RALEIGH NC 27609 271832351 - 40000 GENERAL SUPPORT FOR ART WEEK MIDTOWN EVENTS 4818 SIX FORKS ROAD SUITE 204 RALEIGH NC 27609 208998537 - 80000 GENERAL SUPPORT FOR LOCAL FARMER'S MARKET NC CENTER FOR NON PROFITS 1110 NAVAHO DRIVE SUITE 200 RALEIGH NC 27609 561729407 501(C)(3) 10000 GENERAL SUPPORT NC LUNG CANCER PARTNERSHIP 4000 BLUE RIDGE RD SUITE 170 RALEIGH NC 27612 262300885 501(C)(3) 15000 GENERAL SUPPORT NORTH CAROLINA HOSPITAL ASSOCIATION PO BOX 4449 CARY NC 275194449 560641290 501(C)(6) 27312 GENERAL SUPPORT NORTH CAROLINA INSTITUTE OF MEDICINE 630 DAVIS DR STE 100 MORRISVILLE NC 27560 561506066 NC GOVERNMENT 6000 GENERAL SUPPORT NORTH CAROLINA PHYSICIANS HEALTH 220 HORIZON DRIVE 201 RALEIGH NC 27615 561846599 501(C)(3) 12000 GENERAL SUPPORT RALEIGH SCHOOL OF NURSE ANESTHESIA 3900 BARRETT DR SUITE 200 RALEIGH NC 27609 561684241 501(C)(3) 72606 GENERAL SUPPORT RESEARCH AMERICA PO BOX 222451 CHINTILLY VA 201532451 521609875 501(C)(3) 20000 GENERAL SUPPORT SAMARITAN HEALTH CENTER PO BOX 51339 DURHAM NC 27717 263770762 501(C)(3) 20000 GENERAL SUPPORT SUSAN G KOMEN FOR THE CURE NORTH 600 AIRPORT BLVD SUITE 100 MORRISVILLE NC 27560 752845066 501(C)(3) 10000 GENERAL SUPPORT TRIANGLE BUSINESS JOURNAL 1305 NAVAHO DR SUITE 100 RALEIGH NC 27609 431366184 - 16100 GENERAL SUPPORT WAKE COUNTY MEDICAL SOCIETY 2500 BLUE RIDGE RD STE 330 RALEIGH NC 27616 562205175 501(C)(3) 95000 GENERAL SUPPORT WAKE TECHNICAL COMMUNITY COLLEGE 9101 FAYETTEVILLE ROAD RALEIGH NC 276035696 237017752 501(C)(3) 15000 GENERAL SUPPORT DUKE UNIVERSITY 324 BLACKWELL ST STE 850 DURHAM NC 27701 560532129 501(C)(3) 66248 FMV DONATION OF MEDICAL EQUIPMENT GENERAL SUPPORT 24 8 BILL BAKER SCHOLARSHIP AWARD 1 500 FINANCIAL ASSISTANCE 13 13700 FRIENDS OF EVAN SCHOLARSHIP 5 5250 MARY EMMA FARMER JONES SCHOLARSHIP AWARD 1 1050 MELANIE TAYLOR SCHOLARSHIP AWARD 1 2500 STUDENT SCHOLARSHIP 12 13500 SCHEDULE I, PART I, LINE 2 DUKE UNIVERSITY HEALTH SYSTEM, INC. PROVIDES GENERAL SUPPORT TO LOCAL ORGANIZATIONS BASED ON OUR AWARENESS OF THEIR ACTIVITIES WITHIN THE LOCAL COMMUNITY. DUKE UNIVERSITY HEALTH SYSTEM, INC. ALSO MAINTAINS A CHARITABLE GRANTS COMMITTEE THAT REVIEWS COMMUNITY REQUESTS FOR PHILANTHROPIC ASSISTANCE THAT PROMOTE HEALTH AND WELLNESS. X 0 0 X X X X X X 0 1 0 0 0 0 0 1 0 NANCY CATHERINE ANDREWS MD DIRECTOR 0 511948 0 213452 0 17500 0 31276 0 52787 0 826963 0 0 RICHARD H BRODHEAD DIRECTOR 0 873792 0 0 0 219858 0 131276 0 66205 0 1291131 0 100000 VICTOR J DZAU MD PRESIDENT & CEO, DUHS/DIRECTOR 0 1094130 0 933638 0 12250 0 716303 0 20526 0 2776847 0 0 MARY E KLOTMAN MD DIRECTOR 0 279856 0 63876 0 53588 0 31276 0 11700 0 440296 0 0 THEODORE NICK PAPPAS MD DIRECTOR 0 351902 0 71779 0 131 0 31276 0 14272 0 469360 0 0 CARL E RAVIN MD DIRECTOR 0 249929 0 0 0 0 0 31252 0 12030 0 293211 0 0 MONTE D BROWN MD VP OF ADMINISTRATION/SECRETARY 343847 0 238722 0 17500 0 31276 0 17448 0 648793 0 0 0 WILLIAM J FULKERSON MD EXECUTIVE VP, DUHS 749060 0 442918 0 17500 0 31276 0 7432 0 1248186 0 0 0 KENNETH C MORRIS SVP, CFO, TREASURER 681012 0 352726 0 17500 0 31276 0 10808 0 1093322 0 0 0 MARY ANN FUCHS VP-PATIENT CARE/CHIEF NURSE EXEC 290352 0 97044 0 18243 0 31276 0 6207 0 443122 0 0 0 RICHARD GANNOTTA PRESIDENT, DUKE RALEIGH HOSPITAL 325447 0 111684 0 4994 0 31276 0 20562 0 493963 0 0 0 KATHLEEN GALBRAITH PRESIDENT, DUKE REGIONAL HOSPITAL 173074 0 20000 0 6244 0 24708 0 16043 0 240069 0 0 0 JEFFREY FERRANTI VP, CIO, DHTS ADMINISTRATION 331172 14844 62109 60000 8750 0 9054 22222 8773 5413 419858 102479 0 0 CARLA PARKER-HOLLIS VP, DUKE RALEIGH HOSPITAL 174158 0 0 0 17246 0 23709 0 17131 0 232244 0 0 0 KEVIN W SOWERS PRESIDENT, DUKE UNIVERSITY HOSPITAL 446934 0 195539 0 34271 0 31276 0 12055 0 720075 0 0 0 DOUGLAS B VINSEL PRESIDENT, DUKE RALEIGH HOSPITAL 266836 0 0 0 10209 0 31276 0 919 0 309240 0 0 0 KERRY R WATSON PRESIDENT, DUKE REGIONAL HOSPITAL 343689 0 136183 0 17500 0 31276 0 51439 0 580087 0 0 0 MARC CALABRESE PHYSICIAN 350548 0 55804 0 14078 0 31276 0 21875 0 473581 0 0 0 SANDRA DANOFF SVP, STRATEGIC PLANNING, BD, NS 431003 0 237526 0 21829 0 31276 0 13133 0 734767 0 0 0 JOHN M KELSCH PHYSICIAN 335353 0 58022 0 17500 0 31276 0 17665 0 459816 0 0 0 THOMAS OWENS MD CHIEF MEDICAL OFFICER 419281 0 106887 0 50560 0 31276 0 14095 0 622099 0 0 0 JOSEPH G TAYLOR PHYSICIAN 278348 0 140014 0 17500 0 31276 0 22354 0 489492 0 0 0 PAUL NEWMAN FORMER KEY EMPLOYEE 0 244434 0 0 0 0 0 30086 0 14504 0 289024 0 0 SCHEDULE J, PART I, LINE 1A JOHN MCARTHUR TRAVELED FIRST CLASS FOR BUSINESS PURPOSES WHEN LOWER LEVEL CLASSES WERE NOT AVAILABLE. THIS TRAVEL WAS FOR NECESSARY BUSINESS PURPOSES. SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN SCHEDULE J, PART I, LINE 4B VICTOR J. DZAU MD PARTICIPATES IN A PLAN DESCRIBED UNDER SECTION 457(F) OF THE INTERNAL REVENUE CODE, HOWEVER HE DID NOT RECEIVE ANY PAYMENTS DURING THE REPORTING PERIOD. RICHARD H. BRODHEAD PARTICIPATED IN AND RECEIVED PAYMENTS OF $200,000 UNDER A DEFERRED COMPENSATION PLAN DESCRIBED UNDER SECTION 457(F) OF THE INTERNAL REVENUE CODE. SUCH AMOUNTS WERE SUBJECT TO A SUBSTANTIAL RISK OF FORFEITURE AS DEFINED UNDER IRC SECTION 457(F). NON-FIXED PAYMENTS SCHEDULE J, PART I, LINE 7 DUHS MAINTAINS AN EXECUTIVE INCENTIVE COMPENSATION PLAN. PAYMENTS UNDER THE PLAN ARE BASED ON PRE-ESTABLISHED PERFORMANCE METRICS AND A FIXED CALCULATION METHODOLOGY APPROVED BY THE DUHS COMPENSATION COMMITTEE WITH ASSISTANCE AND INPUT FROM AN EXECUTIVE COMPENSATION CONSULTING FIRM ASSURING COMPARABILITY WITH SIMILAR SYSTEMS. THE PLAN ALLOWS FOR A MODIFICATION TO AN INDIVIDUAL'S INCENTIVE PAYMENT BASED ON LEADERSHIP COMPETENCIES AND OTHER FACTORS WITH PAYOUTS (AND MODIFICATIONS, IF ANY) APPROVED BY THE DUHS COMPENSATION COMMITTEE. A NORTH CAROLINA MEDICAL CARE COMMISSION 521309402 2012-03-22 322140000 SEE PART VI 0 0 0 B NORTH CAROLINA MEDICAL CARE COMMISSION 521309402 2012-05-30 214598930 SEE PART VI 0 0 0 C NORTH CAROLINA MEDICAL CARE COMMISSION 521309402 2011-10-06 145715000 SEE PART VI 0 0 0 D NORTH CAROLINA MEDICAL CARE COMMISSION 521309402 65821DDB4 2009-11-10 178598850 SEE PART VI 0 0 0 A 214760000 322140000 322140000 1 0 1 1 B 214760000 214760000 1 0 1 1 C 17290000 145715000 145715000 2009 1 0 1 1 D 179713706 15924326 2472104 161317276 2012 0 0 1 1 C 0 0 1 1 0 0.00000 0.00000 0.00000 0 1 0.00070 0 1 D 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 1 1 1 0 NA 0 0 0 NA 0 0 1 B 0 0 1 1 1 0 NA 0 0 0 NA 0 0 1 C 0 0 1 1 1 0 NA 0 0 0 NA 0 0 1 D 0 0 0 1 0 0 NA 0 0 0 NA 0 0 1 A 1 B 1 C 1 D 1 SCHEDULE K, PART I, COLUMN F BOND ISSUE (A): THE PURPOSE OF THE BONDS ISSUED 03/22/2012 WAS TO REFUND THE 2005ABC BONDS ISSUED ON 08/21/2009, WHICH REFUNDED THE ORIGINAL 2005ABC BONDS ISSUED ON 5/19/2005. THE PURPOSE OF THE BONDS ISSUED 05/19/2005 WAS TO PARTIALLY REFUND THE 1996C BONDS ISSUED ON 10/24/1996, 1998A BONDS ISSUED ON 08/27/1998, AND THE 1998B BONDS ISSUED ON 10/13/1998. BOND ISSUE (B): THE PURPOSE OF THE BONDS ISSUED 05/30/2012 WAS TO PARTIALLY REFUND THE 2005ABC BONDS ISSUED ON 03/22/12, WHICH REFUNDED THE 2005ABC BONDS ISSUED ON 08/21/2009, WHICH REFUNDED THE ORIGINAL 2005ABC BONDS ISSUED ON 5/19/2005. THE PURPOSE OF THE BONDS ISSUED 05/19/2005 WAS TO PARTIALLY REFUND THE 1996C BONDS ISSUED ON 10/24/1996, 1998A BONDS ISSUED ON 08/27/1998, AND THE 1998B BONDS ISSUED ON 10/13/1998. BOND ISSUE (C): THE PURPOSE OF THE BONDS ISSUED 10/06/2011 WAS TO REFUND THE ORIGINAL 2006ABC BONDS ISSUED ON 11/15/2006 FOR HOSPITAL IMPROVEMENTS FINANCED OR REFINANCED INCLUDING: ROUTINE INFRASTRUCTURE, RENOVATION AND IMPROVEMENT PROJECTS AT DUKE UNIVERSITY HOSPITAL AND DUKE RALEIGH HOSPITAL, IMPROVEMENTS TO INFORMATION SYSTEMS, RENOVATION AND EXPANSION OF EMERGENCY DEPARTMENT AT DUKE UNIVERSITY HOSPITAL, HELIPORT AND NEW ROOF IMPROVEMENTS AT DUKE UNIVERSITY HOSPITAL, AND PHASES 1 AND 2 OF AN OPERATING ROOM SUITE RENOVATION AND EXPANSION AT DUKE UNIVERSITY HOSPITAL. BOND ISSUE (D): HOSPITAL IMPROVEMENTS FINANCED INCLUDE: THE AMBULATORY CANCER CENTER AT DUKE UNIVERSITY HOSPITAL AND OTHER RENOVATION AND IMPROVEMENT PROJECTS AT DUKE UNIVERSITY HOSPITAL AND DUKE RALEIGH HOSPITAL. BOND ISSUE A (2): HOSPITAL IMPROVEMENTS INCLUDE THE DUKE MEDICINE PAVILION AT DUKE UNIVERSITY HOSPITAL. BOND ISSUE B (2): HOSPITAL IMPROVEMENTS INCLUDE THE DUKE MEDICINE PAVILION AND THE DUKE NORTH CONCOURSE AT DUKE UNIVERSITY HOSPITAL. BOND ISSUE C (2): THE PURPOSE OF THE BONDS ISSUED 08/28/2012 WAS TO REFUND THE ORIGINAL 1985B BONDS ISSUED ON 10/02/1985 FOR THE ACQUISITION OF A MAINTENANCE BUILDING, PARKING, AND A DEBT SERVICE FUND; AND TO REFUND THE ORIGINAL 1993A BONDS ISSUED ON 08/12/1993. THE PURPOSE OF THE BONDS ISSUED 08/12/1993 WAS TO PARTIALLY REFUND THE 1991D BONDS ISSUED ON 7/1/1991 AND THE 1985A BONDS ISSUED ON 10/02/1985. BOND ISSUE D (2): DRAW-DOWN FINANCING LEASE PROGRAM WITH BANC OF AMERICA PUBLIC CAPITAL CORP. IN THE MAXIMUM PRINCIPAL AMOUNT OF $40,000,000 TO FINANCE MEDICAL, COMPUTER, OFFICE, AND CAPITAL EQUIPMENT. BOND ISSUE A (3): DRAW-DOWN FINANCING LEASE PROGRAM WITH BANC OF AMERICA PUBLIC CAPITAL CORP. IN THE MAXIMUM PRINCIPAL AMOUNT OF $40,000,000 TO FINANCE MEDICAL, COMPUTER, OFFICE, AND CAPITAL EQUIPMENT. SCHEDULE K, PART II, LINE 3 BOND ISSUE (B): PROCEEDS INCLUDE ISSUE PRICE PLUS ORIGINAL ISSUE DISCOUNT / UPFRONT FEE PAID DIRECTLY BY DUHS TO THE BANK UPON ISSUANCE. BOND ISSUES (D), A (2), AND B (2): PROCEEDS INCLUDE INVESTMENT EARNINGS. BOND ISSUES D (2) AND A (3): PROCEEDS REFLECT ACTUAL PRINCIPAL DRAWN DOWN UNDER DRAW DOWN FINANCING LEASE PROGRAM. SCHEDULE K, PART IV, LINE 2C BOND ISSUES (A), (B), (C), (D), A (2) AND B (2): BOND ISSUE (A/B) ARBITRAGE REPORT COMPLETED 3/22/13, (C) COMPLETED 9/30/2013, (D) COMPLETED 11/1/2013, A (2) COMPLETED 4/1/13, B (2) COMPLETED 5/31/2014. BOND ISSUES (A), (B), (C) AND C (2): THESE PROCEEDS WERE DISBURSED OR DEEMED DISBURSED UPON ISSUANCE TO CURRENTLY REFUND THE PRIOR BONDS. BOND ISSUES D (2), AND A (3): SALES PROCEEDS ALLOCATED UPON ISSUANCE AND NOT INVESTED. SCHEDULE K, PART III, LINE 8C, BOND ISSUE (C): DISPOSITION IS THE SUBJECT OF A CLOSING AGREEMENT ENTERED INTO WITH THE IRS IN OCTOBER 2014 THROUGH THE TAX EXEMPT BONDS VOLUNTARY CLOSING AGREEMENT PROGRAM. A NORTH CAROLINA MEDICAL CARE COMMISSION 521309402 65821DDX6 2010-04-28 120836075 SEE PART VI 0 0 0 B NORTH CAROLINA MEDICAL CARE COMMISSION 521309402 65821DLJ8 2012-06-28 326853753 SEE PART VI 0 0 0 C NORTH CAROLINA MEDICAL CARE COMMISSION 521309402 2012-08-28 48225000 SEE PART VI 0 0 0 D NORTH CAROLINA MEDICAL CARE COMMISSION 521309402 2008-12-04 40000000 SEE PART VI 0 0 0 A 121162021 1460854 119701167 2013 0 0 1 1 B 12420000 326995394 14871185 2737864 309386345 2013 0 0 1 1 C 17400000 48225000 48225000 1 0 1 1 D 16484844 16484844 2011 0 0 1 1 A 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 1 B 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 1 D 0 0 1 1 0 0.00000 0.00000 0.00000 0 1 0.04330 1 1 A 0 0 0 1 0 0 NA 0 0 0 NA 0 0 1 B 0 0 0 1 0 0 NA 0 0 0 NA 0 0 1 C 0 0 1 0 1 0 NA 0 0 0 NA 0 0 1 D 0 0 0 0 0 0 NA 0 0 0 NA 0 0 1 A 1 B 1 C 1 D 1 A NORTH CAROLINA MEDICAL CARE COMMISSION 521309402 2012-03-06 40000000 SEE PART VI 0 0 0 A 30861504 30861504 2014 0 0 1 1 A 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 0 0 0 0 NA 0 0 0 NA 0 0 1 A 1 MEDTRONIC SEE PART V 30512750 SEE PART V 0 PRIVATE DIAGNOSTIC CLINIC SEE PART V 132913268 SEE PART V 0 CBC NEW MEDIA GROUP LLC SEE PART V 31000 SEE PART V 0 THE DURHAM BULLS BASEBALL CLUB INC SEE PART V 36970 SEE PART V 0 IMMUCOR INC SEE PART V 696144 SEE PART V 0 THORATEC CORPORATION SEE PART V 9423059 SEE PART V 0 ALFRED WILLIAMS & COMPANY SEE PART V 1642794 SEE PART V 0 GENESE NEWMAN SEE PART V 119793 SEE PART V 0 TAMELA VINSEL SEE PART V 66701 SEE PART V 0 SCH L, PART IV, BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS: (A) NAME OF INTERESTED PERSON: MEDTRONIC(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: MEDTRONIC BOARD MEMBER IS DUHS, INC. DIRECTOR.(C) AMOUNT OF TRANSACTION: $30,512,750(D) DESCRIPTION OF TRANSACTION: PAYMENT FOR GOODS OR SERVICES(E) SHARING OF ORGANIZATION REVENUE? = NO(A) NAME OF INTERESTED PERSON: PRIVATE DIAGNOSTIC CLINIC(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: PRIVATE DIAGNOSTIC CLINIC BOARD MEMBER IS DUHS, INC. FORMER KEY EMPLOYEE.(C) AMOUNT OF TRANSACTION: $132,913,268(D) DESCRIPTION OF TRANSACTION: PAYMENT FOR GOODS OR SERVICES(E) SHARING OF ORGANIZATION REVENUE? = NO(A) NAME OF INTERESTED PERSON: CBC NEW MEDIA GROUP, LLC(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: CBC NEW MEDIA GROUP, LLC. CEO IS DUHS, INC. DIRECTOR.(C) AMOUNT OF TRANSACTION: $31,000(D) DESCRIPTION OF TRANSACTION: PAYMENT FOR GOODS OR SERVICES(E) SHARING OF ORGANIZATION REVENUE? = NO(A) NAME OF INTERESTED PERSON: THE DURHAM BULLS BASEBALL CLUB, INC.(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: THE DURHAM BULLS BASEBALL CLUB, INC. CEO IS DUHS, INC. DIRECTOR.(C) AMOUNT OF TRANSACTION: $36,970(D) DESCRIPTION OF TRANSACTION: PAYMENT FOR GOODS OR SERVICES(E) SHARING OF ORGANIZATION REVENUE? = NO(A) NAME OF INTERESTED PERSON: IMMUCOR, INC.(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: IMMUCOR, INC. CEO IS DUHS, INC. DIRECTOR.(C) AMOUNT OF TRANSACTION: $696,144(D) DESCRIPTION OF TRANSACTION: PAYMENT FOR GOODS OR SERVICES(E) SHARING OF ORGANIZATION REVENUE? = NO(A) NAME OF INTERESTED PERSON: THORATEC CORPORATION(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: THORATEC CORPORATION BOARD MEMBER IS DUHS, INC. DIRECTOR.(C) AMOUNT OF TRANSACTION: $9,423,059(D) DESCRIPTION OF TRANSACTION: PAYMENT FOR GOODS OR SERVICES(E) SHARING OF ORGANIZATION REVENUE? = NO(A) NAME OF INTERESTED PERSON: ALFRED WILLIAMS & COMPANY(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: ALFRED WILLIAMS & COMPANY MARKET PRESIDENT IS DUHS, INC. DIRECTOR.(C) AMOUNT OF TRANSACTION: $1,642,794(D) DESCRIPTION OF TRANSACTION: PAYMENT FOR GOODS OR SERVICES(E) SHARING OF ORGANIZATION REVENUE? = NO(A) NAME OF INTERESTED PERSON: GENESE NEWMAN(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: GENESE NEWMAN IS A FAMILY MEMBER OF DUHS, INC. FORMER KEY EMPLOYEE(C) AMOUNT OF TRANSACTION: $119,793(D) DESCRIPTION OF TRANSACTION: PAYMENT FOR SALARY AND BENEFITS(E) SHARING OF ORGANIZATION REVENUE? = NO(A) NAME OF INTERESTED PERSON: TAMELA VINSEL(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: TAMELA VINSEL IS A FAMILY MEMBER OF DUHS, INC. KEY EMPLOYEE(C) AMOUNT OF TRANSACTION: $66,701(D) DESCRIPTION OF TRANSACTION: PAYMENT FOR SALARY AND BENEFITS(E) SHARING OF ORGANIZATION REVENUE? = NO X 14 213 VARIOUS X 121 VARIOUS X 246 VARIOUS X 17 1729743 MARKET QUOTE X 1 770 VARIOUS X 13 36 VARIOUS X GIFT CARDS 57 15692 VARIOUS X JEWELRY 8 6448 VARIOUS X MISCELLANEOUS 92 3889 VARIOUS X EVENT TICKETS 5 809 VARIOUS 0 0 1 1 PART I, LINE 32B: DUKE UNIVERSITY HEALTH SYSTEM, INC. USES INVESTMENT BROKERS TO SELL INVESTMENTS. DUKE UNIVERSITY HEALTH SYSTEM, INC. MAY OCCASIONALLY USE THIRD PARTIES TO SELL OTHER TYPES OF NON-CASH CONTRIBUTIONS, AS THE NEED ARISES. FORM 990, PART I, LINE 1 DUHS IS COMMITTED TO EXCELLENCE, INNOVATION AND LEADERSHIP IN PROVIDING THE HEALTH CARE NEEDS OF THE PEOPLE WE SERVE, IMPROVING COMMUNITY HEALTH, AND FOSTERING THE VERY BEST MEDICAL EDUCATION. FORM 990, PART III, LINE 4A STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS HISTORY AND ORGANIZATION IN 1925, JAMES B. DUKE WILLED $4 MILLION TO ESTABLISH DUKE HOSPITAL AND ITS MEDICAL SCHOOL TO IMPROVE HEALTH CARE IN THE CAROLINAS, THEN A POOR REGION LACKING HOSPITALS AND HEALTH CARE PROVIDERS. DUKE UNIVERSITY HOSPITAL HAS GROWN TO BE RECOGNIZED AS ONE OF THE WORLD'S GREAT HEALTH CARE PROVIDERS. IN 1998 AND CONCURRENT WITH ACQUIRING CONTROL OF TWO LOCAL COMMUNITY HOSPITALS, THE DUKE UNIVERSITY BOARD OF TRUSTEES ESTABLISHED DUKE UNIVERSITY HOSPITAL AS THE FLAGSHIP OF THE NEWLY INCORPORATED DUKE UNIVERSITY HEALTH SYSTEM, INC. (DUHS) TO MANAGE A WIDE RANGE OF HEALTH CARE PROGRAMS AT THE SAME HIGH LEVEL OF QUALITY THAT HAS TRADITIONALLY MADE DUKE UNIVERSITY HOSPITAL A WORLD LEADER. THIS NETWORK OF REGIONAL HEALTH CARE ORGANIZATIONS IS DEDICATED TO EMPLOYING DUKE'S STRENGTHS IN PATIENT CARE, EDUCATION, AND RESEARCH TO ENHANCE AND IMPROVE HEALTH CARE THROUGHOUT NORTH CAROLINA AND SOUTHERN VIRGINIA. THE DUHS MISSION IS CLINICAL CARE AND IS ENHANCED BY THE RESEARCH AND EDUCATION MISSIONS OF DUKE UNIVERSITY (THE DUKE UNIVERSITY SCHOOL OF MEDICINE AND SCHOOL OF NURSING). TOGETHER THEY SERVE THE COMMUNITY AS DUKE MEDICINE. MANY PROGRAM SERVICE ACCOMPLISHMENTS ARE INCLUDED IN SCHEDULE H TO THIS FORM INCLUDING THE FINANCIAL COMMITMENT MADE TO THE COMMUNITY BY DUHS IN TERMS OF CHARITY CARE AND OTHER DIRECT AND MEASURABLE INVESTMENTS. BELOW ARE EXCERPTS FROM THE ANNUAL DUHS REPORT ON COMMUNITY BENEFIT. THE COST OF THESE ACTIVITIES CAN BE DIFFICULT TO MEASURE. SOMETIMES THEY INCLUDE THE PARTICIPATION OF DUKE UNIVERSITY SO REFERENCES TO "DUKE" ARE MEANT TO INCLUDE DUHS AND DUKE UNIVERSITY IN THEIR RESPECTIVE MISSION CAPACITIES. DUKE UNDERSTANDS THAT HEALTHCARE MEANS FAR MORE THAN TAKING CARE OF PEOPLE IN A HOSPITAL SETTING. AS THIS REPORT REFLECTS, IT ALSO MEANS INVESTING IN THE COMMUNITIES DUKE SERVES TO INCREASE ACCESS TO HEALTHCARE, ALLEVIATE HEALTH DISPARITIES, AND IMPROVE COMMUNITIES' OVERALL WELLNESS BY IDENTIFYING AND ADDRESSING HEALTHCARE NEEDS. WE ARE PROUD TO REPORT THAT FOR THE FISCAL YEAR THAT ENDED JUNE 30, 2014, DUKE PROVIDED A TOTAL COMMUNITY BENEFIT AND INVESTMENT OF $448 MILLION. OF THAT FIGURE, $253.3 MILLION REPRESENTED THE COMMUNITY BENEFIT CATEGORIES RECOGNIZED BY THE U.S. INTERNAL REVENUE SERVICE INCLUDING $92.7 MILLION IN CHARITY CARE AT ESTIMATED COST TO PATIENTS FROM EVERY CORNER OF NORTH CAROLINA WHO ARE UNINSURED OR WHO CANNOT PAY FOR CARE BECAUSE OF FINANCIAL HARDSHIP. DUKE CONTINUES TO VALUE ITS LONGSTANDING COLLABORATIONS WITH ITS MANY COMMUNITY AND GOVERNMENT PARTNERS, AND TO HONOR ITS FOUNDATIONAL COMMITMENT TO PROVIDE HIGH-QUALITY, COMPASSIONATE, AND SAFE MEDICAL CARE TO THE PEOPLE IT SERVES ACROSS NORTH CAROLINA. THE 2015 REPORT ON COMMUNITY BENEFIT ALSO IS AVAILABLE ONLINE AT HTTP://DUKEMEDICINE.ORG/ABOUTUS. CLICK ON "COMMUNITY HEALTH & BENEFITS." DUKE PROVIDES HIGH-QUALITY CARE REGARDLESS OF A PATIENT'S ABILITY TO PAY DUKE PROVIDED CHARITY CARE AT ESTIMATED COST TOTALING $92.7 MILLION TO 164,649 PATIENTS DURING THE FISCAL YEAR THAT ENDED ON JUNE 30, 2014. NEARLY 94 PERCENT OF THE PATIENTS WERE FROM NORTH CAROLINA. DUKE PROVIDES ELIGIBLE CARE AT A DISCOUNT OR WITHOUT CHARGE TO ALL QUALIFYING PATIENTS WHO DO NOT HAVE INSURANCE, OR WHO BECAUSE OF FINANCIAL HARDSHIP CANNOT PAY FOR THE MEDICAL CARE THEY RECEIVE. IN ADDITION TO PROVIDING PRIMARY CARE AT NO CHARGE, DUKE PHYSICIANS DONATE SPECIALTY CARE SERVICES TO ELIGIBLE UNINSURED PATIENTS THROUGH A PROGRAM IN DURHAM AND WAKE COUNTIES CALLED PROJECT ACCESS. DUKE IS COMMITTED TO PROVIDING HIGH-QUALITY, EFFECTIVE CARE WITH A CONSISTENTLY HIGH LEVEL OF DIGNITY, RESPECT AND SKILL TO ALL PATIENTS IT SERVES, REGARDLESS OF THEIR ABILITY TO PAY. DUKE WORKS WITH PATIENTS BY NAVIGATING THEM THROUGH THE FINANCIAL ASSISTANCE PROGRAMS TO WHICH THEY ARE ENTITLED. WHEN GOVERNMENT PROGRAMS SUCH AS MEDICAID DO NOT COMPLETELY COVER DUKE'S COST OF CARE, DUKE ABSORBS THE DIFFERENCE IN ACCORDANCE WITH ITS POLICIES. HIGHLIGHTS OF DUKE'S CHARITY CARE AND DISCOUNTED CARE POLICIES * DUKE PROVIDES A DISCOUNT TO UNINSURED PATIENTS OF LIMITED MEANS FOR SUBSTANTIALLY ALL MEDICAL SERVICES EXCEPT COSMETIC PROCEDURES. * DUKE ASSISTS PATIENTS WHOSE MEDICAL HARDSHIP MAKES IT DIFFICULT FOR THEM TO PAY BASIC LIVING EXPENSES. * DUKE HELPS PATIENTS NAVIGATE THROUGH ADDITIONAL FINANCIAL PROGRAMS FOR WHICH THEY MAY QUALIFY. DUKE'S COMPLETE CHARITY CARE AND UNINSURED DISCOUNTED CARE POLICIES ARE AVAILABLE AT WWW.DUKEMEDICINE.ORG. CLICK ON "PATIENTS & VISITORS," THEN "FINANCIAL ASSISTANCE." COSTS DUKE COVERS FOR CHARITY CARE AND OTHER UNREIMBURSED EXPENSES: $92.7 MILLION CHARITY CARE $90.1 MILLION UNREIMBURSED MEDICAID $172.8 MILLION UNREIMBURSED MEDICARE $21.7 MILLION UNRECOVERABLE PATIENT DEBT DUKE WORKS WITH ITS COMMUNITY PARTNERS TO PROMOTE WELLNESS, CARE ACCESS: DUKE UNIVERSITY HEALTH SYSTEM REMAINS FIRMLY COMMITTED TO WORKING COLLABORATIVELY WITH ITS MANY COMMUNITY PARTNERS TO IDENTIFY, UNDERSTAND, AND ADDRESS THE HEALTHCARE NEEDS OF THE COMMUNITIES IT SERVES. THROUGH ITS TWO HOSPITALS IN DURHAM AND ONE IN RALEIGH, DUKE WORKS WITH THE HEALTH DEPARTMENTS IN DURHAM AND WAKE COUNTIES, COMMUNITY MEMBERS, AND NUMEROUS COMMUNITY PARTNER ORGANIZATIONS TO CONDUCT REGULAR COMMUNITY HEALTH NEEDS ASSESSMENTS. IN COMPLIANCE WITH FEDERAL REQUIREMENTS, LINKS TO THE COMMUNITY HEALTH NEEDS ASSESSMENTS FOR DURHAM AND WAKE COUNTIES, AND TO EACH OF THE DUKE HOSPITALS' REPORTS, ARE POSTED ON HTTP://DUKEMEDICINE.ORG/ABOUTUS. CLICK ON "COMMUNITY HEALTH NEEDS ASSESSMENT." CONTRIBUTIONS TO COMMUNITY GROUPS: OVER MANY YEARS, DUKE AND COMMUNITY ORGANIZATIONS HAVE DEVELOPED PRODUCTIVE PARTNERSHIPS TO WORK TOWARD THE COMMON GOAL OF ELIMINATING HEALTHCARE DISPARITIES AND IMPROVING RESIDENTS' ACCESS TO HIGH-QUALITY MEDICAL CARE. IN THE 2014 FISCAL YEAR, DUKE PROVIDED A TOTAL OF $10.7 MILLION IN CASH AND IN-KIND SUPPORT FOR COMMUNITY GROUPS. THAT INCLUDES MORE THAN $7.3 MILLION FOR LINCOLN COMMUNITY HEALTH CENTER IN DURHAM AND ITS SATELLITE COMMUNITY CLINICS, WHICH SERVE AN OVERWHELMINGLY POOR AND UNINSURED POPULATION; NEARLY $2.35 MILLION FOR DURHAM COUNTY'S EMERGENCY MEDICAL SERVICES OPERATION; AND MORE THAN $1 MILLION IN CASH CONTRIBUTIONS TO OTHER ORGANIZATIONS. HEALTH PROFESSIONS EDUCATION: EDUCATING THE NEXT GENERATION OF HEALTHCARE PROFESSIONALS IS AT THE HEART OF DUKE'S MISSION TO IMPROVE HEALTHCARE FOR OUR PATIENTS AND THE COMMUNITY. DUKE REMAINS COMMITTED TO OFFERING CHALLENGING, INNOVATIVE PROGRAMS THAT PREPARE MEDICAL STUDENTS, NURSES, NURSE PRACTITIONERS, PHYSICIAN ASSISTANTS, AND PHYSICAL THERAPISTS FOR TOMORROW'S INCREASINGLY COMMUNITY-FOCUSED HEALTHCARE DELIVERY SYSTEM. THE TRAINING RECOGNIZES THAT HEALTHCARE PROFESSIONALS WILL PROVIDE PATIENT CARE IN AN EMERGING VARIETY OF NON-TRADITIONAL SETTINGS USING INNOVATIVE MODELS OF CARE THAT PROMOTE HEALTH, WELLNESS, AND INDIVIDUAL SELF-CARE. IN ADDITION TO THE IMPORTANT EXPERIENCE THAT DUKE HEALTH PROFESSIONS STUDENTS GAIN IN ITS THREE HOSPITALS, DUKE EMPHASIZES THE VALUE OF COMMUNITY OUTREACH BY REQUIRING THAT THE STUDENTS PARTICIPATE IN ROTATIONS IN COMMUNITY CLINICS, SCHOOL WELLNESS CENTERS, AND IN-HOME CARE PROGRAMS FOR ELDERLY OR HOME-BOUND PEOPLE. IN THE 2014 FISCAL YEAR, DUKE INVESTED $59.8 MILLION IN ITS HEALTH PROFESSIONS EDUCATION PROGRAMS. FORM 990, PART V, LINE 3B THE ORGANIZATION DID NOT HAVE ANY UNRELATED BUSINESS GROSS INCOME DURING THE FISCAL YEAR ENDED JUNE 30, 2014. AS A RESULT, FORM 990-T IS NOT REQUIRED FOR THE FISCAL YEAR ENDED JUNE 30, 2014. FORM 990, PART VI, SECTION A, LINE 2 DIRECTORS JACK O. BOVENDER, JR., RICHARD H. BRODHEAD, THOMAS M. GORRIE, WILLIAM HAWKINS, MICHAEL MARSICANO, DAVID M. RUBENSTEIN, AND SUSAN M. STALNECKER ARE TRUSTEES OF DUKE UNIVERSITY. DIRECTOR AND PRESIDENT/CEO VICTOR J. DZAU, MD IS AN OFFICER OF DUKE UNIVERSITY. THE FOLLOWING INDIVIDUALS ARE EMPLOYEES OF DUKE UNIVERSITY: NANCY CATHERINE ANDREWS, MD, MARY E. KLOTMAN, MD, THEODORE NICK PAPPAS, MD, AND CARL E. RAVIN, MD. DIRECTOR AND PRESIDENT/CEO VICTOR J. DZAU, MD, DIRECTOR CARL E. RAVIN, MD, AND OFFICERS WILLIAM J. FULKERSON, MD AND KENNETH C. MORRIS ARE DIRECTORS OF DURHAM CASUALTY COMPANY, LTD. DIRECTOR AND PRESIDENT/CEO VICTOR J. DZAU, MD, DIRECTORS CARL E. RAVIN, MD, MARY E. KLOTMAN, MD, THEODORE NICK PAPPAS, MD, AND OFFICER WILLIAM J. FULKERSON, MD ARE BOARD MEMBERS OF PRIVATE DIAGNOSTIC CLINIC, PLLC. DIRECTOR AND PRESIDENT/CEO VICTOR J. DZAU, MD AND OFFICER KENNETH C. MORRIS ARE DIRECTORS OF DUKE MEDICAL STRATEGIES, INC. OFFICERS WILLIAM J. FULKERSON, MD AND KENNETH C. MORRIS ARE BOTH DIRECTORS AND OFFICERS OF HEALTH SYSTEM MEDICAL STRATEGIES, INC. FORM 990, PART VI, SECTION A, LINE 3 DUHS DELEGATES CONTROL TO A SUPPORTING ORGANIZATION FOR THE MANAGEMENT OF INVESTMENTS. FORM 990, PART VI, SECTION A, LINE 4 DUHS AND ITS BOARD OF DIRECTORS HAVE REVISED AND APPROVED THE AMENDMENT OF DUKE UNIVERSITY HEALTH SYSTEM, INC. ARTICLES OF INCORPORATION AND ITS BYLAWS. SIGNIFICANT CHANGES ARE SUMMARIZED AS FOLLOWS: THE AMENDED AND RESTATED DUHS ARTICLES OF INCORPORATION AND BYLAWS INCREASED THE NUMBER OF BOARD MEMBERS FROM TWENTY ONE (21) TO TWENTY TWO (22). THE AFFAIRS OF DUHS SHALL BE MANAGED BY A BOARD OF DIRECTORS CONSISTING OF AT LEAST THIRTEEN (13), BUT NO MORE THAN TWENTY TWO (22) VOTING MEMBERS. THE AMENDED AND RESTATED DUHS ARTICLES OF INCORPORATION AND BYLAWS STATE A MINIMUM OF EIGHT (8) MEMBERS OF THE BOARD OF DIRECTORS SHALL BE CURRENT OR FORMER DUKE UNIVERSITY TRUSTEES. FORM 990, PART VI, SECTION A, LINE 7A THE MEMBERS OF THE BOARD OF DIRECTORS OF DUHS, OTHER THAN THE EX OFFICIO MEMBERS, WILL BE NOMINATED BY THE BOARD OF DIRECTORS OF DUHS, AND WILL BE APPOINTED BY THE BOARD OF TRUSTEES OF DUKE UNIVERSITY. MEMBERS OF THE BOARD OF DIRECTORS OF DUHS WILL BE SUBJECT TO REMOVAL AT THE DISCRETION OF THE BOARD OF TRUSTEES OF DUKE UNIVERSITY IN ACCORDANCE WITH THE BYLAWS OF DUHS. FORM 990, PART VI, SECTION A, LINE 7B THE DUHS BYLAWS PROVIDE THAT DUHS MUST OBTAIN DUKE UNIVERSITY BOARD OF TRUSTEES APPROVAL FOR CERTAIN SIGNIFICANT TRANSACTIONS REGARDING DEBT ISSUANCES, CAPITAL ACQUISITIONS AND TANGIBLE PERSONAL AND REAL PROPERTY SALES. FORM 990, PART VI, SECTION B, LINE 11 AFTER STAFF PREPARATION AND MANAGEMENT REVIEW, THE DUHS FORM 990 IS PRESENTED TO THE DUHS COMPLIANCE/AUDIT COMMITTEE OF THE BOARD OF DIRECTORS FOR REVIEW AND DISCUSSION. BOARD LEVEL COMMENT AND DISCUSSION ARE INCORPORATED INTO THE FORM AS APPROPRIATE PRIOR TO FILING. A FINAL VERSION OF THE FORM IS EMAILED TO THE BOARD OF DIRECTORS FOR FURTHER REVIEW AND COMMENT BEFORE FILING. FORM 990, PART VI, SECTION B, LINE 12C DUHS MONITORS AND ENFORCES COMPLIANCE RELATED TO CONFLICT OF INTEREST VIA AN ANNUAL CONFLICT OF INTEREST QUESTIONNAIRE, RELYING ON SELF DISCLOSURE OF ALL THOSE SUBJECT TO THE COI POLICY. FORM 990, PART VI, SECTION B, LINE 15 THE DUHS COMPENSATION COMMITTEE, COMPRISED OF MEMBERS OF THE DUHS BOARD OF DIRECTORS, REVIEWS AND APPROVES ALL EXECUTIVE COMPENSATION FOR ALL DISQUALIFIED PERSONS AND OTHER KEY EMPLOYEES. THE DUHS COMPENSATION COMMITTEE REVIEWS AND RECOMMENDS TO THE DUKE UNIVERSITY COMPENSATION COMMITTEE THE COMPENSATION FOR THE PRESIDENT AND CEO OF DUHS WHO IS ALSO AN OFFICER OF DUKE UNIVERSITY. DUHS HAS ADOPTED A STATEMENT OF COMPENSATION PHILOSOPHY THAT ARTICULATES BROAD OBJECTIVES TO HELP GUIDE THE DUHS COMPENSATION COMMITTEE IN ITS MISSION. THE DUHS COMPENSATION COMMITTEE ENGAGES THE SERVICES OF AN OUTSIDE EXECUTIVE COMPENSATION CONSULTING FIRM TO ESTABLISH COMPARABILITY DATA OF OTHER HEALTH CARE SYSTEMS OF SIMILAR SIZE AND COMPLEXITY AS DUHS. THE DUHS COMPENSATION COMMITTEE REVIEWS THE MARKET ANALYSIS THEN DETERMINES THE REASONABLENESS AND APPROPRIATENESS OF ALL ASPECTS OF EXECUTIVE COMPENSATION. THE DUHS COMPENSATION COMMITTEE ALSO SETS THE METRICS AND APPROVES THE PAYOUTS FOR THE DUHS INCENTIVE COMPENSATION PLANS FOR THESE INDIVIDUALS. THE DELIBERATIONS AND CONCLUSIONS OF THE DUHS COMPENSATION COMMITTEE ARE KEPT BY A RECORDING SECRETARY WHO RECORDS THE MINUTES OF THE COMMITTEE MEETINGS. FORM 990, PART VI, SECTION C, LINE 18 DUKE UNIVERSITY HEALTH SYSTEM, INC.'S FORM 990 IS AVAILABLE TO THE PUBLIC ON WWW.GUIDESTAR.ORG. GUIDESTAR INDEPENDENTLY POSTS TAX-EXEMPT ORGANIZATIONS' FORM 990'S ON THEIR WEBSITE, OBTAINED FROM THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION C, LINE 19 DUKE UNIVERSITY HEALTH SYSTEM, INC.'S GOVERNING DOCUMENTS (ARTICLES OF INCORPORATION AND ANY SUBSEQUENT AMENDMENTS OR RESTATEMENTS) ARE AVAILABLE TO THE PUBLIC ON THE NORTH CAROLINA SECRETARY OF STATE WEBSITE. DUKE UNIVERSITY HEALTH SYSTEM, INC. MAKES ITS CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FINANCIAL STATEMENTS ARE ALSO AVAILABLE TO THE PUBLIC ON THE ELECTRONIC MUNICIPAL MARKET ACCESS WEBSITE. NAVIGATE TO HTTP://EMMA.MSRB.ORG AND ENTER "DUKE UNIVERSITY HEALTH SYSTEM" IN THE SEARCH BOX, CHOOSE ANY "ISSUE DESCRIPTION" WITH A "DATED DATE", ACCEPT THE TERMS OF THE WEBSITE, AND CLICK ON "CONTINUING DISCLOSURE". FORM 990, PART XI, LINE 9: NONPERIODIC CHANGES IN DEFINED BENEFIT PLANS: -2,249,618. NET TRANSFERS TO PARENT & AFFILIATES: -75,213,302. CHANGE IN MARKET VALUE OF DERIVATIVES: 3,436,805. INTEREST EARNED ON BOND PROCEEDS - CAPITALIZED FOR BOOK PURPOSES: -613. INCOME NOT REPORTED ON BOOKS, BUT INCLUDED FOR 990 REPORTING PURPOSES: DEEMED DIVIDEND: -7,646,449. 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