2015-05-14T15:59:54-05:00 2014-06-30 410746749 CLIFTONLARSONALLEN LLP 101 N TRYON STREET SUITE 1000 CHARLOTTE NC 28246 990 2013-07-01 566052117 THE REX HEALTHCARE FOUNDATION INC REXH 9197844424 4420 LAKE BOONE TRAIL RALEIGH NC 27607 BERNADETTE SPONG SECRETARY & TREASURER 9197844424 2015-05-14 1 JOHN NORMAN P01506766 7049985200 2013 2016-03-07 17:11:31Z DAVID STRONG 4420 LAKE BOONE TRAIL RALEIGH NC 27607 4671706 0 X WWW.REXHEALTH.COM/FOUNDATION X 1958 NC TO PROVIDE OPPORTUNITIES FOR OUR COMMUNITY TO INVEST RESOURCES IN THE EXCELLENT WORK OF REX HEALTHCARE. 13 10 7 0 0 0 2758568 2462597 0 0 392284 139749 -35119 -5101 3115733 2597245 968359 965197 0 0 739459 741577 50376 158104 1026902 251642 265175 2009836 2130053 1105897 467192 6458432 7546398 121691 86940 6336741 7459458 TO PROVIDE OPPORTUNITIES FOR OUR COMMUNITY TO INVEST RESOURCES IN THE EXCELLENT WORK OF REX HEALTHCARE. 0 0 965197 965197 THE REX HEALTHCARE FOUNDATION SUPPORTS REX HOSPITAL THROUGH A VARIETY OF PATIENT ASSISTANCE PROGRAMS, ASSISTS IN UPGRADING FACILITIES AND ACQUIRING THE MEDICAL EQUIPMENT NECESSARY TO CONTINUE EXCELLENT HEALTHCARE SERVICES. THESE PROGRAMS INCLUDE A MOBILE MAMMOGRAPHY UNIT THAT TRAVELS THE REGION PROVIDING FREE MAMMOGRAPHY SCREENING SERVICES TO UNDERSERVED PATIENTS, PATIENT ASSISTANCE THROUGH THE REX CANCER CENTER ANGEL FUND, NURSING EDUCATION, BLANKET WARMERS, PATIENT TRANSPORTATION TO TREATMENT AND MORE. 965197 1 1 0 0 0 0 0 0 0 1 1 0 1 0 0 1 1 1 0 0 0 0 0 1 1 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 7 1 0 0 0 0 0 0 0 0 0 0 X 13 10 0 0 0 0 0 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X BERNADETTE SPONG 9197843100 4420 LAKE BOONE TRAIL RALEIGH NC 27607 A DALE JENKINS DIRECTOR 1.00 4.00 X 0 0 0 ORAGE QUARLES III DIRECTOR (THROUGH 12/31/13) 1.00 1.00 X 0 0 0 VINCENT L HOELLERICH MD DIRECTOR 1.00 1.00 X 0 0 0 COURTNEY A CROWDER DIRECTOR (FROM 11/18/13) 1.00 1.00 X 0 0 0 DARLEEN M JOHNS DIRECTOR (THROUGH 12/31/13) 1.00 1.00 X 0 0 0 CATHARINE B ARROWOOD DIRECTOR (FROM 1/21/14) 1.00 1.00 X 0 0 0 GARY L PARK DIRECTOR 1.00 59.00 X 0 815602 289529 WILLIAM L ROPER MD DIRECTOR 1.00 59.00 X 0 782626 157492 MARK A STRIEBEL DIRECTOR (THROUGH 12/31/13) 1.00 1.00 X 0 0 0 ROBERT S THOMAS DIRECTOR 1.00 1.00 X 0 0 0 TERESA C ARTIS DIRECTOR 1.00 1.00 X 0 0 0 C HOWARD NYE DIRECTOR 1.00 1.00 X 0 0 0 STEVEN C LILLY DIRECTOR 1.00 1.00 X 0 0 0 RIG S PATEL MD DIRECTOR 1.00 1.00 X 0 0 0 DAVID W STRONG DIRECTOR AND PRESIDENT 1.00 59.00 X X 0 1034493 275234 MARSCHALL S RUNGE MD DIRECTOR (FROM 11/18/13) 1.00 1.00 X 0 0 0 SYLVIA D HACKETT VICE PRESIDENT 1.00 59.00 X 0 286939 61374 BERNADETTE M SPONG SECRETARY & TREASURER 1.00 59.00 X 0 433382 50020 JOHN STORMENT ASST. SECRETARY & ASST. TR 1.00 59.00 X 0 208126 36331 CARSON GILBERT TOURNAMENT DIRECTOR 60.00 0.00 X 0 144353 18026 KATHERINE STOKES MAJOR GIFT OFFICER 60.00 0.00 X 0 131501 13698 0 3837022 901704 0 0 1 0 0 649907 801817 1010873 2462597 106051 106051 1673467 1639769 33698 33698 33698 429591 649907 434692 -5101 -5101 2597245 0 0 134648 965197 965197 615988 61599 554389 18883 1888 16995 65348 6535 58813 41358 4136 37222 8568 8568 158104 158104 32852 32852 112470 11247 101223 3666 367 3299 38039 3804 34235 45698 4570 41128 11322 1132 10190 1524 152 1372 11036 1104 9932 2130053 965197 137954 1026902 1404763 1774038 174234 121145 29893 20199 15226 13978 2773 1248 4846769 5629768 6458432 7546398 121691 86940 121691 86940 X 6336741 7459458 6336741 7459458 6458432 7546398 467192 655525 0 X X 0 1 X 1 0 X X X 0 0 0 REX HOSPITAL INC 561509260 3 1 1 1 965197 1 965197 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 377441 26450 403891 323378 54063 377441 332040 16338 25000 323378 330250 1790 332040 1.00000 0 0 15226 13978 1248 1248 CASH AND CASH EQUIVALENTS 24135 F FIXED INCOME INVESTMENTS 517491 F EQUITIES 5088142 F 5629768 X 3688157 675103 106783 -32852 749034 2939123 -341878 -341878 2597245 2647434 106783 443450 550233 2097201 32852 32852 2130053 PART V, LINE 4: THE INTENDED USE OF THE ENDOWMENT FUNDS IS TO FURTHER THE MISSION OF REX HEALTHCARE FOUNDATION. PART X, LINE 2: THE FOUNDATION HAS BEEN RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS A NOT-FOR-PROFIT ORGANIZATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE "CODE") AND IS EXEMPT FROM FEDERAL INCOME TAX ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE FOUNDATION ADOPTED THE INCOME TAX STANDARD FOR UNCERTAIN TAX POSITIONS. THIS STANDARD CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN AN ORGANIZATION'S FINANCIAL STATEMENTS IN ACCORDANCE WITH THE INCOME TAX STANDARD. THIS STANDARD PRESCRIBES RECOGNITION AND MEASUREMENT OF TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN ON A TAX RETURN THAT ARE NOT CERTAIN TO BE REALIZED. MANAGEMENT BELIEVES THE FOUNDATION HAS NO UNCERTAIN TAX POSITIONS AS OF JUNE 30, 2014. PART XI, LINE 2D PART XI, LINE 2D: INVESTMENT EXPENSE WAS NETTED WITH INVESTMENT INCOME ON THE AUDITED FINANCIAL STATEMENTS. PART XI, LINE 4B: DIRECT FUNDRAISING EXPENSE OF $434,692 WAS NETTED AGAINST FUNDRAISING INCOME ON FORM 990, PART VIII, LINE 8B AND INCLUDE IN TOTAL EXPENSES ON THE AUDITED FINANCIAL STATEMENTS. TRANSFERS AND OTHER OF $92,814 WERE EXCLUDED FROM CONTRIBUTIONS ON THE AUDITED FINANCIAL STATEMTNS. THE NET OF THE ITEMS IS $341,878. PART XII, LINE 2D: DIRECT FUNDRAISING EXPENSES OF $434,692 WAS INCLUDED IN TOTAL EXPENSES ON THE AUDITED FINANCIAL STATEMENTS AND WAS NETTED AGAINST FUNDRAISING INCOME ON THE FORM 990, PART VIII, LINE 8B. X X X X X X 1 CAPITAL DEVELOPMENT SVCS INC 633 W 4TH STREET SUITE 202 WINSTON SALEM NC 27101 CONSULTING 0 0 158104 -158104 158104 -158104 NC GOLF TOURNAMENT 580764 319420 261344 197060 GALA 244637 152800 91837 178689 1 254097 177687 76410 58943 1079498 649907 429591 434692 434692 -5101 PART I, LINE 2B CAPITAL DEVELOPMENT SERVICES, INC 633 W 4TH STREET, SUITE 202 WINSTON SALEM, NC 27101 0 REX HOSPITAL INC 4420 LAKE BOONE TRAIL RALEIGH NC 27607 561509260 501(C)(3) 965197 GENERAL SUPPORT 1 0 PART I, LINE 1 REX HEALTHCARE FOUNDATION'S SOLE RECIPIENT OF ASSISTANCE IS REX HOSPTIAL, INC. THE TWO ORGANIZATIONS WORK CLOSELY TOGETHER, SO THEREFORE MONITORING IS REAL-TIME AND CONSISTENT. 0 1 0 0 0 0 1 0 0 GARY L PARK DIRECTOR 0 758970 0 49534 0 7098 0 281821 0 7708 0 1105131 0 0 WILLIAM L ROPER MD DIRECTOR 0 770164 0 0 0 12462 0 152285 0 5207 0 940118 0 0 DAVID W STRONG DIRECTOR AND PRESIDENT 0 626252 0 157199 0 251042 0 263723 0 11511 0 1309727 0 229994 SYLVIA D HACKETT VICE PRESIDENT 0 208135 0 58985 0 19819 0 52272 0 9102 0 348313 0 0 BERNADETTE M SPONG SECRETARY & TREASURER 0 328338 0 86923 0 18121 0 34437 0 15583 0 483402 0 0 JOHN STORMENT ASST. SECRETARY & ASST. TR 0 179775 0 16679 0 11672 0 31123 0 5208 0 244457 0 0 PART I, LINE 4B DURING THE CALENDAR YEAR 2013, DAVID STRONG PARTICIPATED IN A NON-QUALIFIED SUPPLEMENTAL RETIREMENT PLAN AND RECEIVED DISTRIBUTIONS TOTALING $229,994. HE ALSO EARNED COMPENSATION UNDER THIS PLAN TOTALING $235,196. THE CURRENT YEAR EARNINGS ARE PAYABLE IN THE FUTURE. PART I, LINE 6 EMPLOYEES IN MANAGERIAL ROLES PARTICIPATE IN AN ANNUAL INCENTIVE COMPENSATION PLAN. THE COMPENSATION EARNED UNDER THIS PLAN IS BASED PARTLY ON THE COMBINED EARNINGS OF REX HEALTHCARE, INC. AND ITS SUBSIDIARIES. ADDITIONALLY, THE INCENTIVE COMPENSATION OF THE PRESIDENT AND CFO IS BASED PARTLY ON THE EARNINGS OF THE UNC HEALTH CARE SYSTEM. OTHER PERFORMANCE MEASURES USED TO DETERMINE INCENTIVE COMPENSATION ARE PHYSICIAN SATISFACTION, PATIENT CARE QUALITY OUTCOMES, EFFECTIVE USE OF TECHNOLOGY AND INDIVIDUAL GOALS. FORM 990, PART VI, SECTION A, LINE 7A THE UNIVERSITY OF NORTH CAROLINA HEALTH CARE SYSTEM APPOINTS ALL OF THE THIRTEEN SEATS ON THE ORGANIZATION'S BOARD OF TRUSTEES. FORM 990, PART VI, SECTION A, LINE 7B THE ORGANIZATION'S BOARD REQUIRES PRIOR APPROVAL OF THE UNIVERSITY OF NORTH CAROLINA HEALTH CARE SYSTEM FOR CERTAIN POWERS, INCLUDING BUT NOT LIMITED TO ADDITION OR DELETION OF A HEALTH CARE SERVICE, PARTICIPATION, DIRECTLY OR INDIRECTLY, IN A JOINT VENTURE, INDEBTEDNESS AND CAPITAL BUDGETS, OPERATING BUDGETS AND NON-BUDGETED MATERIAL EXPENDITURES. FORM 990, PART VI, SECTION B, LINE 11 THE ORGANIZATION'S EXECUTIVE TEAM DISCUSSES AND REVIEWS THE FORM 990 AND ALL ASSOCIATED SCHEDULES THROUGHOUT THE INFORMATION GATHERING STAGE. THE FORM 990 AND ASSOCIATED SCHEDULES ARE THEN REVIEWED AND APPROVED BY THE BOARD AS A WHOLE. A COPY OF THE APPROVED FORM 990 ALONG WITH THE ASSOCIATED SCHEDULES IS PROVIDED TO ALL BOARD MEMBERS PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY BY REQUIRING ALL BOARD MEMBERS TO ANNUALLY COMPLETE AND SIGN A QUESTIONNAIRE DOCUMENTING ANY AREA OF CONFLICT OF INTEREST. THE BOARD MEMBERS ARE REQUIRED TO REPORT AND DOCUMENT ANY NEW AREAS OF CONFLICT OF INTEREST AS THEY ARISE. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION USES AN INDEPENDENT CONSULTANT TO MEASURE FAIR VALUE OF COMPENSATION FOR THE ORGANIZATION'S PRESIDENT AND OTHER TOP MANAGEMENT. BOTH REX AND UNIVERSITY OF NORTH CAROLINA HEALTH CARE SYSTEM BOARDS REVIEW AND APPROVE THE COMPENSATION FOR ALL OFFICERS EXCEPT THE ASSISTANT SECRETARY AND ASSISTANT TREASURER. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S FORM 990 IS AVAILABLE UPON REQUEST AND ON GUIDESTAR'S WEBSITE AND THE FINANCIAL STATEMENTS ARE AVAILABLE ON MUNICIPAL SECURITIES RULEMAKING BOARD'S WEBSITE. THE ORGANIZATION DOES NOT MAKE OTHER GOVERNING DOCUMENTS AND THE CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC. FORM 990, PART XII, LINE 2C NO CHANGE FROM PRIOR YEAR. UNC HEALTH CARE SYSTEM 101 MANNING DRIVE CHAPEL HILL NC 27514 562206970 HEALTHCARE NC SECTION 115 UNC HEALTH CARE 0 UNC HOSPTIALS AT CHAPEL HILL 211 FRIDAY CENTER DR SUITE 2029 CHAPEL HILL NC 27517 561118388 HEALTHCARE NC SECTION 115 UNC HEALTH CARE 0 CALDWELL MEMORIAL HOSPITAL PO BOX 1890 LENIOR NC 28645 560554204 HEALTHCARE NC 501(C)(3) LINE 3 UNC HEALTH CARE 0 CALDWELL MEMORIAL HOSPITAL FOUNDATION PO BOX 1890 LENIOR NC 28645 581935514 SUPPORT OF CALDWELL NC 501(C)(3) LINE 7 CALDWELL MEMORIAL HOSPITAL 0 CHATHAM HOSPITAL INC PO BOX 649 SILER CITY NC 27344 560611546 HEALTHCARE NC 501(C)(3) LINE 3 UNC HEALTH CARE 0 HIGH POINT REGIONAL HEALTH 601 N ELM STREET HIGH POINT NC 27261 560632309 HEALTHCARE NC 501(C)(3) LINE 3 UNC HEALTH CARE 0 HIGH POINT REGIONAL HEALTH SERVICES 601 N ELM STREET HIGH POINT NC 27261 561497163 HEALTHCARE NC 501(C)(3) LINE 11B, II UNC HEALTH CARE 0 HIGH POINT REGIONAL HEALTH SERVICES FOUNDATION 601 N ELM STREET HIGH POINT NC 27261 272854711 SUPPORT OF HIGH POINT NC 501(C)(3) LINE 11A, I HIGH POINT REGIONAL HEALTH 0 REX HEALTHCARE INC 4420 LAKE BOONE TRAIL RALEIGH NC 27607 561509129 HEALTHCARE NC 501(C)(3) LINE 11A, I UNC HEALTH CARE 0 REX HOSPITAL INC 4420 LAKE BOONE TRAIL RALEIGH NC 27607 561509260 HEALTHCARE NC 501(C)(3) LINE 3 UNC HEALTH CARE 0 UNC PHYSICIANS NETWORK 1600 PERIMETER PARK DRIVE SUITE 225 MORRISVILLE NC 27560 271081647 HEALTHCARE NC 501(C)(3) LINE 9 UNC HEALTH CARE 0 REX SURGERY CENTER OF CARY 4420 LAKE BOONE TRAIL RALEIGH NC 27607 273684056 ASC NC N/A JRH VENTURES LLC 4420 LAKE BOONE TRAIL RALEIGH NC 27607 274092967 MED CAMPUS DVLT NC N/A REX HEALTH VENTURES I LP 4420 LAKE BOONE TRAIL RALEIGH NC 27607 371690478 VENTURE CAPITAL INVEST NC N/A HIGH POINT SURGERY CENTER 600 NORTH LINDSAY STREET HIGH POINT NC 27260 561867005 HIGH POINT REGIONAL HEALTH NC N/A ORTHOPAEDIC SURGER CENTER OF RALEIGH LLC 4420 LAKE BOONE TRAIL RALEIGH NC 27607 271740526 ORTHOPAEDIC SURGERY NC N/A REX ENTERPRISES COMPANY INC 4420 LAKE BOONE TRAIL RALEIGH NC 27607 561553957 OPERATIONS SUPPORT NC N/A C 0 HIGH POINT HEALTHCARE VENTURES 601 N ELM STREET HIGH POINT NC 27261 561343468 HOLDING COMPANY NC N/A C 0 UNC PHYSICIANS NETWORK GROUP PRACTICES LLC 1600 PERIMETER PARK DRIVE SUITE 225 MORRISVILLE NC 27560 461416986 HEALTHCARE NC N/A C 0 0 1 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 0 0 REX HOSPITAL INC B 965197 FMV REX HOSPITAL INC K 45698 FMV REX HOSPITAL INC P 801817 FMV PART V, LINE N & O REX HOSPTIAL, INC. PERSONNEL PROVIDES ADMINISTRATIVE SUPPORT, SUCH AS EXECUTIVE MANAGEMENT, LEGAL, ACCOUNTING, HUMAN RESOURCES, PURCHASING AND IT FUNCTIONS UTILIZING REX HOSPITAL FACILITIES AND OTHER ASSETS. ESTIMATING THE VALUE OF THESE SHARED PERSONNEL AND ASSETS CANNOT BE READILY DETERMINED.