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 561509260 REX HOSPITAL INC DBA REX HEALTHCARE REXH 9197843100 4420 LAKE BOONE TRAIL RALEIGH NC 27607 BERNADETTE SPONG CFO 9197843100 2015-05-14 1 JOHN NORMAN P01506766 7049985200 2013 2016-03-07 17:11:31Z REX HEALTHCARE DAVID STRONG 4420 LAKE BOONE TRAIL RALEIGH NC 27607 747392802 0 X WWW.REXHEALTH.COM X 1986 NC TO PROVIDE THE BEST IN HEALTH SERVICES BY COMBINING COMPASSIONATE CARE AND LEADING-EDGE TECHNOLOGY. 13 10 6298 1397 12237149 -58741 975759 1196306 687457216 713789381 12242463 7734910 380143 1727880 701055581 724448477 1602202 727896 0 0 348242512 374843709 0 0 0 343955728 322952877 693800442 698524482 7255139 25923995 707307283 754621461 231549288 294541771 475757995 460079690 X SEE SCHEDULE OREX HEALTHCARE PROVIDES THE BEST IN HEALTH SERVICES BY COMBINING COMPASSIONATE CARE AND LEADING-EDGE TECHNOLOGY. REX PROVIDES SERVICES AT FACILITIES ACROSS WAKE COUNTY TO ALL PATIENTS, REGARDLESS OF THEIR ABILITY TO PAY. REX ALSO SEEKS TO IMPROVE THE HEALTH OF THE COMMUNITY BY PROVIDING EDUCATION, DIAGNOSTIC AND PREVENTATIVE CARE, OFTEN BY JOINING FORCES WITH OTHER COMMUNITY GROUPS. IN ADDITION TO ITS MAIN RALEIGH CAMPUS, REX OFFERS MUCH-NEEDED CARE AND SUPPORT AT CAMPUSES IN APEX, CARY, GARNER, HOLLY SPRINGS, KNIGHTDALE, DOWNTOWN RALEIGH AND WAKEFIELD. 0 0 46912018 75333442 CARDIOLOGY SERVICES: REX PERFORMS MORE THAN 28,000 HEART AND VASCULAR PROCEDURES A YEAR, INCLUDING CORONARY ARTERY BYPASS GRAFTING, ECHOCARDIOGRAPHY, PERIPHERAL VASCULAR ULTRASOUND, VALVE REPLACEMENT AND REPAIR, ANGIOPLASTY, CARDIAC CATHETERIZATION, ELECTROPHYSIOLOGY PROCEDURES AND STENT PLACEMENT, REGARDLESS OF PATIENTS' ABILITY TO PAY. REX HAS BEEN A CHEST PAIN ACCREDITED HOSPITAL FOR MORE THAN A DECADE, REINFORCING THE ORGANIZATION'S DEDICATION TO COMMUNITY OUTREACH AND INNOVATION IN THE CARE OF CHEST PAIN PATIENTS. THE SERVICE LINE ALSO INCLUDES OPEN HEART SURGICAL SUITES WHERE PHYSICIANS PERFORM PROCEDURES SUCH AS CORONARY ARTERY BYPASS GRAFTING, MITRAL VALVE REPLACEMENT AND REPAIR, AND AORTIC VALVE AND AORTIC ARCH REPLACEMENTS. REX ALSO PROVIDES A FULL RANGE OF INVASIVE CATHETER BASED CARDIAC, VASCULAR AND ELECTROPHYSIOLOGY PROCEDURES. RECOVERY FACILITIES INCLUDE A DEDICATED EIGHT-BED CARDIO-THORACIC INTENSIVE CARE UNIT, WHICH PROVIDES INTENSIVE CARE TO OPEN-HEART SURGICAL PATIENTS, AND 91 INTERMEDIATE CARE UNIT BEDS, WHICH PROVIDE CONTINUOUS MONITORING OF HEART RHYTHMS USING A TELEMETRY SYSTEM. NON-SURGICAL HEART PATIENTS REQUIRING INTENSIVE CARE ARE TREATED IN A 12-BED CARDIAC INTENSIVE CARE UNIT. THE EXISTING HEART AND VASCULAR SERVICES AND CARE ARE PROVIDED AT MORE THAN SEVEN LOCATIONS ACROSS THE MAIN HOSPITAL IN RALEIGH. THOSE SERVICES AND MORE WILL BE CONSOLIDATED INTO A MODERN, MORE EFFICIENT AND MORE CONVENIENT FACILITY WITH THE ADDITION OF THE NORTH CAROLINA HEART AND VASCULAR HOSPITAL CURRENTLY UNDER CONSTRUCTION ON REX'S MAIN RALEIGH CAMPUS, PROVIDING EASIER AND MORE COMFORTABLE ACCESS FOR PATIENTS AND THEIR FAMILIES, PHYSICIANS AND STAFF. 43180159 84336772 GENERAL SURGERY: REX SURGERY CENTERS IN RALEIGH, CARY AND WAKEFIELD ARE USED BY MORE THAN 425 PHYSICIANS AND PROVIDE IN- AND OUTPATIENT SERVICES TO 40,000 PATIENTS A YEAR. THE THREE LOCATIONS HAVE IMPROVED ACCESS TO SPECIALIZED CARE FOR PATIENTS ACROSS THE REGION. SURGEONS MAKE SUBSTANTIAL USE OF MINIMALLY INVASIVE TECHNOLOGY FOR DIAGNOSIS AND TREATMENT, REDUCING PATIENTS RECOVERY TIME AND HOSPITAL STAY. FOR EXAMPLE, REX HAS THREE DAVINCI SURGICAL ROBOTS USED FOR UROLOGY, GYNECOLOGY AND GENERAL SURGERIES. THE CENTERS INCLUDE 34 OPERATING SUITES, EIGHT MINOR PROCEDURE ROOMS, AND VARIOUS PERIOPERATIVE AND ANCILLARY SUPPORT SPACES. REX IS INCREASINGLY PERFORMING SURGERIES ON AN OUTPATIENT BASIS, AND CONTINUING TO LOOK FOR OTHER WAYS TO REDUCE OVERALL COSTS FOR PATIENTS. SOME OF THE TOP PROCEDURES INCLUDE GENERAL SURGERY, HERNIA REPAIR, GALLBLADDER REMOVAL AND BARIATRIC AND BREAST SURGERIES. SOME OUTPATIENT ORTHOPAEDIC PROCEDURES ARE PERFORMED AT RALEIGH ORTHOPAEDIC SURGERY CENTER, REX'S JOINT VENTURE WITH RALEIGH ORTHOPAEDIC CLINIC LOCATED ABOUT A MILE FROM REX'S MAIN RALEIGH CAMPUS. 36621722 59522637 ONCOLOGY: REX PROVIDES A FULL RANGE OF SPECIALIZED, MULTI-DISCIPLINARY ONCOLOGY THERAPY AND SUPPORT SERVICES TO PATIENTS IN WAKE COUNTY AND BEYOND. DURING FISCAL YEAR 2014, REX CANCER CENTER PROVIDED 25,422 RADIATION ONCOLOGY TREATMENTS, 13,190 CHEMOTHERAPY TREATMENTS AND 21,231 HEMATOLOGY ONCOLOGY TREATMENTS AT FOUR LOCATIONS IN WAKE COUNTY. IN ADDITION TO CANCER TREATMENTS AND THERAPIES, THE CENTERS PROVIDE OUTREACH AND SUPPORT SERVICES, NUTRITIONAL SERVICES, NURSE NAVIGATION OF CARE, REHABILITATION SERVICES AND SURVIVORSHIP OR END OF LIFE CARE. REX CANCER CENTER ALSO PROVIDES SURGICAL SERVICES TO CANCER PATIENTS THROUGH ACCESS TO REX HOSPITAL. REX CANCER CENTER WORKS CLOSELY WITH THE NATIONALLY RECOGNIZED N.C. CANCER HOSPITAL AND THE UNC LINEBERGER COMPREHENSIVE CANCER CENTER IN CHAPEL HILL TO EXTEND SPECIALTY SERVICES AND CLINICAL TRIALS TO PATIENTS IN RALEIGH. SINCE 2008, REX HAS PARTNERED WITH JOHNSTON HEALTH SERVICES CORPORATION TO PROVIDE CRITICAL CARE AND SERVICES CLOSER TO HOME AT RADIATION ONCOLOGY CLINICS IN SMITHFIELD AND CLAYTON. DURING 2014, REX HEMATOLOGY ONCOLOGY ASSOCIATES OPENED NEW LOCATIONS IN CARY AND RALEIGH, OFFERING CONVENIENT OUTPATIENT SERVICES AND TREATMENT. 512708129 727896 452892376 REX PROVIDES A FULL RANGE OF ORTHOPAEDIC TREATMENT, SURGERY AND REHABILITATION AT ITS SURGERY CENTERS IN RALEIGH, CARY AND WAKEFIELD. IN ADDITION, RALEIGH ORTHOPAEDIC SURGERY CENTER OPENED IN MARCH 2013. THE 27,700 SQUARE-FOOT SURGERY CENTER IS A JOINT VENTURE BETWEEN REX AND RALEIGH ORTHOPAEDIC CLINIC. THE OUTPATIENT FACILITY IS LOCATED ON EDWARDS MILL ROAD, LESS THAN A MILE FROM THE MAIN CAMPUS OF REX HOSPITAL AND OFFERS A WIDE RANGE OF ORTHOPEDIC CARE AND SERVICES INVOLVING KNEES, FEET, SHOULDERS, HIPS, WRISTS AND MORE, IN A CONVENIENT OUTPATIENT SETTING. AT REX'S WOMEN'S CENTER, CAREGIVERS SEEK TO PROVIDE FAMILY-CENTERED CARE TO THE NEW MOTHER, BABY AND EXTENDED FAMILY. DURING FISCAL YEAR 2014, 5,658 BABIES WERE BORN IN THE REX WOMEN'S CENTER. THESE BIRTHS ARE SUPPORTED BY 24/7 ANESTHESIOLOGY AND NEONATOLOGY SERVICES, HIGH RISK OBSTETRICS PROVIDED BY UNC MATERNAL FETAL MEDICINE, LACTATION SUPPORT SERVICES PROVIDED BY A TEAM OF CERTIFIED LACTATION CONSULTANTS AND AN IN-HOUSE RETAIL CENTER FOR INFANT NUTRITION. REX ALSO OFFERS A WIDE VARIETY OF PRE- AND POST-NATAL CLASSES, SCREENING FOR POSTPARTUM DEPRESSION AND PSYCHOLOGICAL SERVICES. THERE ARE THREE OPERATING SUITES FOR CESAREAN BIRTHS AND REX'S SPECIAL CARE NURSERY OFFERS 15 LEVEL III NEONATAL BEDS. THE REX WOMEN'S CENTER INCLUDES 98 PRIVATE ROOMS IN WHICH LABOR, DELIVERY, RECOVERY, AND POSTPARTUM CARE OF THE MOTHER AND CHILD NORMALLY OCCUR. 512708129 727896 452892376 639422028 1 1 0 1 0 0 0 0 1 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 1 309 0 6298 1 1 1 0 0 0 0 0 0 0 0 0 X 13 10 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 X BERNADETTE SPONG CFO 9197843100 4420 LAKE BOONE TRAIL RALEIGH NC 27607 A DALE JENKINS DIRECTOR 4.00 1.00 X 0 0 0 VINCENT L HOELLERICH MD DIRECTOR 1.00 1.00 X 0 0 0 DARLEEN M JOHNS DIRECTOR (LEFT 12/31/13) 1.00 1.00 X 0 0 0 GARY L PARK DIRECTOR 4.00 56.00 X 0 815602 289529 ORAGE QUARLES III DIRECTOR (LEFT 12/31/13) 1.00 1.00 X 0 0 0 WILLIAM L ROPER MD DIRECTOR 4.00 56.00 X 0 782626 157492 MARK A STRIEBEL DIRECTOR (LEFT 12/31/13) 1.00 1.00 X 0 0 0 ROBERT S THOMAS DIRECTOR 1.00 1.00 X 0 0 0 DAVID W STRONG DIRECTOR AND PRESIDENT 59.00 1.00 X X 1034493 0 275234 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 CATHARINE B ARROWOOD DIRECTOR (AS OF 1/21/2014) 1.00 1.00 X 0 0 0 COURTNEY A CROWDER DIRECTOR (AS OF 11/18/2013) 1.00 1.00 X 0 0 0 MARSCHALL S RUNGE MD DIRECTOR (AS OF 11/18/2013) 1.00 1.00 X 0 0 0 BERNADETTE M SPONG SVP/FINANCE AND CFO, TREAS & SEC 59.00 1.00 X 433382 0 50020 MARY LOU POWELL LEFT 382014 SVP/PATIENT CARE SVCS & CNO 59.00 1.00 X 362037 0 75424 STEPHEN W BURRISS COO 59.00 1.00 X 395315 0 40332 LINDA H BUTLER MD VP/MEDICAL AFFAIRS & CMO & CMIO 59.00 1.00 X 300691 0 32484 DONALD ESPOSITO JR VP/GENERAL COUNSEL 59.00 1.00 X 329525 0 37193 SYLVIA D HACKETT VP/HUMAN RESOURCES & FOUNDATION 59.00 1.00 X 286939 0 61374 R ERICK HAWKINS VP/HEART & VASCULAR SERVIC 59.00 1.00 X 309716 0 33423 CHAD T LEFTERIS VP/OPERATIONS 59.00 1.00 X 234382 0 22737 LISA SCHILLER VP/COMMUNICATIONS & MARKETING 59.00 1.00 X 219683 0 37799 JAYNE R BYRD VP/SURGICAL SERVICES 59.00 1.00 X 234989 0 163887 MICHELLE L GRAY VP/REGIONAL CIO 59.00 1.00 X 283118 0 37745 ROBERT D RICKER VP/PHYSICIAN RELATIONS 59.00 1.00 X 245243 0 85291 TAMMIE T STANTON VP/POST ACUTE SERVICES 59.00 1.00 X 0 278468 42160 TOM G WILLIAMS VP/AMBULATORY SERVICES 59.00 1.00 X 220416 0 48318 JOHN D STORMENT ASST. TREASURER & ASST. SE 59.00 1.00 X 0 208126 36331 JOEL RAY AS OF 2214 VP/PATIENT CARE SVCS & CNO 59.00 1.00 X 0 165026 24290 JEFFREY CRANE MD ONCOLOGY 60.00 0.00 X 692929 0 73270 ROBERT WEHBIE MD ONCOLOGY 60.00 0.00 X 710829 0 46356 LANCE LANDVATER MD CARDIOVASCULAR SURGEON 60.00 0.00 X 1141034 0 26443 O ROBERT MENDES MD VASCULAR SURGEON 60.00 0.00 X 699331 0 21341 ROBERT PEYTON MD CARDIOVASCULAR SURGEON 60.00 0.00 X 822708 0 20601 8956760 2249848 1739074 19 0 1 0 WHR DESIGN PC 1111 LOUISIANA 26TH FLOOR HOUSTON TX 77002 ARCHITECTURAL DESIGN 4629943 SKANSKA USA BUILDING INC 4309 EMPEROR BLVD STE 200 DURHAM NC 27703 CONSTRUCTION 2855981 THE OUTSOURCE GROUP 39867 TREASURY CENTER CHICAGO IL 60694 COLLECTIONS 2423490 MSA MARKETING 5591 CAPITAL CENTER DR STE 105 RALEIGH NC 27606 ADVERTISING & MARKETING 2135666 QUALITY TEXTILE SERVICES INC 313 S ROGERS LANE RALEIGH NC 27610 LINEN SERVICES 1506657 63 1196306 1196306 GENERAL SURGERY 625100 84336772 84336772 CARDIOLOGY 625100 75333442 75333442 ORTHOPEDICS 625100 63122740 63122740 ONCOLOGY 625100 59522637 59522637 WOMEN'S & CHILDREN 625100 59050576 59050576 372423214 355310732 12237149 4875333 713789381 3488760 3488760 1126043 225209 900834 900834 900834 26965266 22719116 4246150 4246150 4246150 827046 827046 827046 724448477 696676899 12237149 14338123 727896 727896 5505178 5505178 299086285 271113121 27973164 20893024 19863032 1029992 28769565 25542182 3227383 20589657 18118898 2470759 655190 655190 132428 132428 37579 37579 952603 952603 71724859 65269622 6455237 7133265 6491271 641994 7706308 7012740 693568 15896224 14465564 1430660 22372909 20359347 2013562 1344162 1223187 120975 443544 403625 39919 5005194 4554727 450467 30594131 27840659 2753472 6319457 5750706 568751 PATIENT SUPPLIES & SERV 130555567 130555567 REPAIRS AND MAINTENANCE 13392828 12187473 1205355 MINOR EQUIPMENT 1655076 1506119 148957 7031553 6398713 632840 698524482 639422028 59102454 0 18160406 27371047 48053150 28438622 79254361 96850062 152348 11249476 13398423 4531455 5068277 696753601 434988912 253215132 261764689 195088183 287047851 50844894 10573766 46757878 24108724 707307283 754621461 103509812 138257660 686721 779002 119988994 113639855 10719 13033 7353042 41852221 231549288 294541771 X 474746039 435989009 1011956 24090681 475757995 460079690 707307283 754621461 25923995 32177076 -73779376 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 37579 37579 0 PART II-B, LINE 1: REX HEALTHCARE BELIEVES IN MAINTAINING STRONG, OPEN AND EFFECTIVE RELATIONSHIPS WITH ELECTED OFFICIALS AND POLICY MAKERS AT THE LOCAL, STATE AND NATIONAL LEVELS. THE OBJECTIVE IS TO EDUCATE THESE GROUPS ON HEALTHCARE ISSUES, TO SERVE AS A RESOURCE, AND TO COMMUNICATE REX'S POSITION IN SUPPORT OF ITS MISSION. AS A MEMBER OF THE AMERICAN HOSPITAL ASSOCIATION AND NCHA, A PERCENTAGE OF REX'S MEMBERSHIP DUES ARE ATTRIBUTED TO LOBBYING ACTIVITIES. 0 1 X 25788331 25788331 175260636 97779897 77480739 19200178 5817342 13382836 346577197 277448232 69128965 129927259 53943441 75983818 261764689 CAPITAL LEASE 1946732 CONTRACT COMMITMENT 887699 PAYABLE TO RELATED PARY 39017790 41852221 X PART IV, LINE 2B: THE ORGANIZATION HOLDS CASH IN TRUST FOR THE RESIDENTS OF THE NURSING HOME FACILITIES. PART X, LINE 2: THE FOLLOWING FOOTNOTE COMES FROM THE CONSOLIDATED FINANCIAL STATEMENTS OF REX HOSPITAL, INC. D/B/A REX HEALTHCARE. THE FOOTNOTE REFERENCES OTHER MEMBERS OF THE AUDIT CONSOLIDATED GROUP THAT ARE NOT PART OF THIS TAX RETURN: REX, THE HOSPITAL, THE FOUNDATION, AND HOME SERVICES ARE EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501(A) AS ORGANIZATIONS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. ENTERPRISES IS A TAXABLE CORPORATION THAT PREVIOUSLY HAD NET OPERATING LOSS CARRYFORWARDS WHICH EXPIRED IN 2012. PHYSICIANS IS A SINGLE MEMBER LIMITED LIABILITY COMPANY THAT HAS ELECTED TO BE TAXED AS A FOR-PROFIT CORPORATION. PHYSICIANS HAD A NET OPERATING LOSS IN 2013 AND 2012. THE HOSPITAL IS THE SOLE MEMBER OF ROV AND RSCW, AND ENTERPRISES IS THE SOLE MEMBER OF RWE, AND RWE IS THE SOLE MEMBER OF WELLNESS, MOB AND RHVLLC. AS SUCH, THESE ENTITIES ARE CONSIDERED DISREGARDED ENTITIES FOR TAX PURPOSES. 1 1 X 1 X 250.000000000000 0 1 1 1 0 1 1 28955900 28955900 0.04150 34763306 32248607 2514699 0.00360 63719206 32248607 31470599 0.04510 522 522 0.00000 1656657 1656657 0.00240 379335 379335 0.00050 682978 682978 0.00100 2719492 2719492 0.00390 66438698 32248607 34190091 0.04900 1 9611179 250071462 338368457 -88296995 X 1 1 1 REX SURGERY CENTER OF CARY LLC AMBULATORY SURGICAL CENTER 0.55000 0.00000 0.45000 2 ORTHOPAEDIC SURGERY CENTER OF RALEIGH LLC SURGERY CENTER 0.51000 0.00000 0.49000 1 1 REX HOSPITAL INC 4420 LAKE BOONE TRAIL RALEIGH NC 27607 WWW.REXHEALTH.COM H0065 X X X REX HOSPITAL INC 1 1 X X X X X X X X 12 1 1 1 X X X X X X X X 0 0 1 1 250.000000000000 0 0 1 1 X X X X X 0 1 X X X X X 1 X 0 0 REX HOSPITAL, INC. PART V, SECTION B, LINE 3: THE ORGANIZATION TOOK INTO ACCOUNT INPUT FROM PERSONS REPRESENTING THE COMMUNITY THROUGH PARTICIPATION IN BOTH A COMMUNITY WIDE HEALTH OPINION SURVEY AND FOCUS GROUPS. THE HEALTH OPINION SURVEY WAS CONDUCTED DOOR-TO-DOOR AT RANDOMLY SELECTED HOUSEHOLDS. THE NINE FOCUS GROUPS, INCLUDING 2 IN SPANISH, CONSISTED OF RECRUITED PARTICIPANTS REPRESENTING SPECIFIC GROUPS. REX HOSPITAL, INC. PART V, SECTION B, LINE 4: THE ORGANIZATION'S COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WAS CONDUCTED WITH THE FOLLOWING HOSPITAL FACILITIES: WAKEMED HEALTH AND HOSPITALS AND DUKE RALEIGH HOSPITAL. REX HOSPITAL, INC. PART V, SECTION B, LINE 7: THE ORGANIZATION DID NOT ADDRESS THE FOLLOWING FOCUS AREAS IDENTIFIED IN THE CHNA: DISABILITY AND CARE-GIVING, EDUCATION AND LIFELONG LEARNING, HOUSING AND HOMELESSNESS, NUTRITION, PHYSICAL ACTIVITY AND OBESITY PREVENTION, POPULATION GROWTH AND RISKY YOUTH BEHAVIOR. THE COMMUNITY VOTED ON THE THREE PRIORITY AREAS TO BE ADDRESSED OVER THE NEXT THREE YEARS AND THE TOP THREE PRIORITY AREAS DID NOT INCLUDE THE NEEDS LISTED ABOVE. WHILE THE ORGANIZATION IS WORKING CLOSELY WITH ITS CHNA PARTNERS ON THE TOP THREE IDENTIFIED PRIORITY AREAS, REX ALSO PLANS TO PLACE EMPHASIS ON THE CLOSELY IDENTIFIED FOURTH ITEM WHICH IS NUTRITION, PHYSICAL ACTIVITY AND OBESITY PREVENTION. AS A HEALTHCARE ORGANIZATION, RESOURCES ARE READILY AVAILABLE TO ADDRESS THIS AREA IN GREATER SCOPE. REX HOSPITAL, INC. PART V, SECTION B, LINE 20D: PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE RECEIVE THE BENEFIT OF 100% ADJUSTMENT OF ELIGIBLE CHARGES, INCLUDING EMERGENCY CARE, MINUS A SMALL COPAYMENT DEPENDING ON THE TYPE OF SERVICE RECEIVED. AMOUNTS GENERALLY BILLED BASED ON MANAGED CARE CONTRACTED AMOUNTS ARE USED TO DETERMINE THE UNINSURED DISCOUNT WHICH IS AUTOMATICALLY APPLIED TO ALL SELF PAY BALANCES REGARDLESS OF ELIGIBILITY FOR FINANCIAL ASSISTANCE. 12 REX HEALTHCARE OF WAKEFIELD 11200 GOVERNOR MANLY WAY RALEIGH NC 27614 HEALTHCARE REX HEALTHCARE OF CARY 1505 SW CARY PARKWAY CARY NC 27511 HEALTHCARE REX HEALTHCARE OF KNIGHTDALE 6602 KNIGHTDALE BOULEVARD 102 KNIGHTDALE NC 27545 HEALTHCARE REX REHAB AND NURSING CARE CTR - RALEIGH 4210 LAKE BOONE TRAIL RALEIGH NC 27607 NURSING FACILITY REX REHAB AND NURSING CARE CTR - APEX 911 SOUTH HUGHES STREET APEX NC 27502 NURSING FACILITY REX WELLNESS CENTER OF WAKEFIELD 11200 GALLERIA AVENUE RALEIGH NC 27614 WELLNESS CENTER REX WELLNESS CENTER OF RALEIGH 4200 LAKE BOONE TRAIL RALEIGH NC 27607 WELLNESS CENTER REX WELLNESS CENTER OF CARY 1515 SW CARY PARKWAY CARY NC 27511 WELLNESS CENTER REX WELLNESS CENTER OF GARNER 1400 TIMBER DRIVE EAST GARNER NC 27529 WELLNESS CENTER REX WELLNESS CENTER OF KNIGHTDALE 6602 KNIGHTDALE BOULEVARD KNIGHTDALE NC 27545 WELLNESS CENTER REX HEALTHCARE OF GARNER 300 HEALTH PARK DRIVE GARNER NC 27529 HEALTHCARE REX HEALTHCARE OF HOLLY SPRINGS 781 AVENT FERRY ROAD HOLLY SPRINGS NC 27540 HEALTHCARE PART III, LINE 2: THE COSTING METHODOLOGY USED TO DETERMINE PAYOR COSTS IS THE ANDI METHODOLOGY, WHICH USES A FACILITY-WIDE RATIO OF COST TO CHARGES AS DESCRIBED IN THE NCHA COMMUNITY BENEFITS GUIDELINES.WHILE THE COSTS OF BAD DEBTS ARE PRESENT FOR ESSENTIALLY EVERY BUSINESS ORGANIZATION, FEW OTHER THAN HOSPITALS ARE EXPECTED TO CONTINUE TO PROVIDE SERVICES TO THOSE WITH MEANS WHO HAVE PREVIOUSLY FAILED TO PAY. CONTINUATION OF SERVICE TO PATIENTS WITH THE MEANS TO PAY BUT WHO HAVE FAILED TO DO SO IS A FURTHER COMMUNITY BENEFIT RELATED TO THE ORGANIZATION'S MISSION. THEREFORE, WE BELIEVE THAT THE COST OF BAD DEBTS SHOULD BE CONSIDERED A COMMUNITY BENEFIT. PART III, LINE 4: NET PATIENT SERVICE REVENUE IS REPORTED AT THE ESTIMATED NET REALIZABLE AMOUNTS FROM PATIENTS, THIRD-PARTY PAYORS, AND OTHERS FOR SERVICES RENDERED, INCLUDING ESTIMATED RETROACTIVE ADJUSTMENTS DUE TO FUTURE AUDITS, REVIEWS AND INVESTIGATIONS. RETROACTIVE ADJUSTMENTS ARE ACCRUED ON AN ESTIMATED BASIS IN THE PERIOD THE RELATED SERVICES ARE RENDERED, AND SUCH AMOUNTS ARE ADJUSTED IN FUTURE PERIODS AS ADJUSTMENTS BECOME KNOWN OR AS YEARS ARE NO LONGER SUBJECT TO SUCH AUDITS, REVIEWS, AND INVESTIGATIONS. PART III, LINE 8: HOSPITALS TREAT PATIENTS COVERED BY MEDICARE, JUST AS THEY DO ANY PATIENT. AMOUNTS THAT HOSPITALS ARE ELIGIBLE TO RECEIVE IN PAYMENT FOR SERVICES PROVIDED TO PATIENTS COVERED BY MEDICARE ARE NOT NEGOTIABLE. AS MEDICARE REIMBURSEMENT RATES DECLINE RELATIVE TO THE COSTS OF PROVIDING CARE, HOSPITALS CONTINUE TO SERVE THE MEDICARE POPULATION. WITHOUT THE SERVICES PROVIDED BY HOSPITALS, THE GOVERNMENT WOULD BECOME OBLIGATED FOR THE SERVICES REQUIRED BY THESE PATIENTS. THEREFORE, WE BELIEVE THAT ANY UNREIMBURSED COSTS OF PROVIDING THIS CARE ARE A BENEFIT PROVIDED BY THE HOSPITAL TO THE COMMUNITY AND GOVERNMENT. PART III, LINE 9B: PATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE ARE APPROVED FOR 100% ADJUSTMENT OF ELIGIBLE CHARGES MINUS A COPAYMENT. COPAYMENTS ACCRUE AND ARE NOT ELIGIBLE FOR COLLECTIONS PROCESSES. PART VI, LINE 2: AS THE COUNTY CONTINUES TO GROW, NECESSARY STEPS MUST BE TAKEN TO ENSURE THAT THE NEEDS OF ALL OF OUR CITIZENS ARE BEING MONITORED AND EVALUATED. WAKE COUNTY HUMAN SERVICES WORKS WITH ALL LOCAL HOSPITALS, INCLUDING REX, TO CONDUCT A COMMUNITY-WIDE HEALTH ASSESSMENT. THIS ASSESSMENT, CONDUCTED EVERY FOUR YEARS, IDENTIFIES OPPORTUNITIES AND CHALLENGES IN THE MARKET. REX COLLABORATES WITH COMMUNITY PARTNERS REGULARLY TO ENSURE OUR EFFORTS ARE PROPERLY ALIGNED BASED ON WAKE COUNTY'S SOCIOECONOMIC AND DEMOGRAPHIC INFORMATION. REX ALSO RELIES ON INPUT FROM OUR PHYSICIANS AND CLINICAL STAFF, PATIENT OUTCOMES AS WELL AS QUALITATIVE AND QUANTITATIVE RESEARCH TO IDENTIFY AREAS OF OPPORTUNITY TO IMPROVE THE HEALTH OF OUR COMMUNITY. PART VI, LINE 3: REX PROVIDES A WIDE RANGE OF TOOLS AND EDUCATION TO HELP PATIENTS WHO NEED FINANCIAL ASSISTANCE. THE REX ASSIST PROGRAM IS DESIGNED TO MAKE IT EASY FOR PATIENTS TO APPLY FOR FINANCIAL ASSISTANCE, CHARITY CARE AND OTHER AID PROGRAMS. REX POSTS DETAILED INFORMATION ABOUT ITS GENEROUS CHARITY CARE POLICY, THE REX ASSIST PROGRAM AND OTHER FINANCIAL AID INFORMATION AT VARIOUS POINTS IN THE HOSPITAL AND ON ITS WEBSITE. DURING PATIENT REGISTRATION, STAFF WILL DISTRIBUTE THE "YOUR REX HOSPITAL BILL" FLYER TO ANYONE WHO DOES NOT HAVE INSURANCE OR ASKS FOR ASSISTANCE. THAT FLYER INCLUDES USEFUL INFORMATION AND HELPFUL RESOURCES. REX FINANCIAL COUNSELORS WILL BEGIN WORKING WITH PATIENTS NEEDING ASSISTANCE AT REGISTRATION OR VISIT THE ROOMS OF PATIENTS WHO ASK FOR HELP. THE COUNSELORS WILL ASSIST WITH DETERMINING MEDICAID ELIGIBILITY AND WITH FILLING OUT A REX ASSIST APPLICATION. FINALLY, REX ALSO WORKS WITH VARIOUS COMMUNITY GROUPS THAT HELP PROVIDE ASSISTANCE TO THE UNINSURED OR UNDERINSURED, INCLUDING PROJECT ACCESS, PRETTY IN PINK AND OTHERS. THE ANGEL FUND OF THE REX HEALTHCARE FOUNDATION ALSO SUPPORTS CANCER PATIENTS WITH UNIQUE FINANCIAL NEEDS, INCLUDING TRANSPORTATION, LIVING EXPENSES AND PRESCRIPTIONS. PART VI, LINE 4: THE ORGANIZATION SERVES AN AREA THAT ENCOMPASSES A FOUR-COUNTY AREA CONSISTING OF WAKE COUNTY AS THE PRIMARY SERVICE AREA WITH HARNETT, FRANKLIN AND JOHNSTON COUNTIES, COMPRISING THE SECONDARY SERVICE AREA. WAKE COUNTY AND ITS SURROUNDING COMMUNITIES ARE AMONG THE FASTEST GROWING REGIONS IN THE NATION. UNEMPLOYMENT RATES IN THE PRIMARY SERVICE AREA ARE LESS THAN THE UNEMPLOYMENT RATES FOR THE NATION AND THE STATE. AVERAGE HOUSEHOLD INCOME AND EDUCATION LEVEL ALSO COMPARE FAVORABLY WITH BOTH THE NATION AND THE STATE. PART VI, LINE 5: THERE ARE MANY WAYS REX WORKS WITH COMMUNITY PARTNERS TO ADDRESS HEALTH ISSUES AND CONCERNS IDENTIFIED WITHIN THE COMMUNITY. THROUGH BOTH FINANCIAL, IN-KIND AND STAFF SUPPORT, REX PROVIDES ASSISTANCE IN HOSTING COMMUNITY HEALTH SCREENINGS, MOBILE MAMMOGRAPHY SCREENINGS AND ON-SITE MEDICAL CARE THROUGH THE REX EMERGENCY RESPONSE TEAM. ADDITIONALLY, COMMUNITY RELATIONS ACTIVITIES REGULARLY DEMONSTRATE PROMOTING HEALTH AND WELLNESS INITIATIVES. "ASK THE EXPERT" FORUMS ARE FREE AND OFFERED THROUGHOUT WAKE COUNTY BY PHYSICIANS AND STAFF. REX HAS BEEN DILIGENT IN AWARDING GRANTS TO COMMUNITY GROUPS TO ASSIST THEM WHERE NEEDS ARE GREATEST. TWICE A YEAR WE HOST A COLLABORATIVE BREAKFAST INVITING COMMUNITY PARTNERS, ORGANIZATIONS AND HEALTHCARE PROVIDERS WHO WORK WITH UNINSURED WOMEN TO DISCUSS AND ADDRESS CURRENT HARDSHIPS AND RESOURCES TRULY A COMMITMENT TO THE NONPROFIT COMMUNITY. PART VI, LINE 6: REX HEALTHCARE IS A SUBSIDIARY OF THE UNC HEALTH CARE SYSTEM IN CHAPEL HILL. THAT SYSTEM SERVES PATIENTS FROM ALL 100 COUNTIES, REGARDLESS OF THEIR ABILITY TO PAY, PROVIDING MORE THAN $300 MILLION A YEAR IN UNCOMPENSATED CARE. AS PART OF THE INTEGRATED SYSTEM, REX STRIVES TO IMPROVE ACCESS AND SERVICES IN WAKE COUNTY'S GROWING AND UNDERSERVED AREAS. REX CAREGIVERS ALSO WORK CLOSELY WITH THEIR COUNTERPARTS AT UNC HEALTH CARE TO FIND MORE WAYS TO IMPROVE CARE AND QUALITY, REACH MORE UNINSURED PATIENTS AND MORE. REX'S BOARD REPRESENTS A CROSS-SECTION OF THE COMMUNITY, WITH VOLUNTEERS THAT INCLUDE BUSINESS LEADERS, COMMUNITY PHYSICIANS AND OTHERS. THAT BOARD WORKS CLOSELY WITH THE BOARD AT UNC HEALTH CARE TO DETERMINE THE BEST WAYS TO PLAY A LARGER ROLE IN IMPROVING THE COMMUNITY'S HEALTH, AND REX'S ROLE IN THE BIGGER SYSTEM'S MISSION. PART VI LINE 7 THE ORGANIZATION SUBMITS AN ANNUAL COMMUNITY BENEFIT REPORT TO THE NORTH CAROLINA HOSPITAL ASSOCIATION AND THE NORTH CAROLINA MEDICAL CARE COMMISSION. 1 WAKE COUNTY MEDICAL SOCIETY 2500 BLUE RIDGE ROAD STE 330 RALEIGH NC 27607 562205175 501(C)(6) 175000 GENERAL SUPPORT, MEDICAL CARE NORTH CAROLINA SYMPHONY 4350 LASSITER STE 250 RALEIGH NC 27609 560556755 501(C)(3) 60000 GENERAL SUPPORT AMERICAN HEART ASSOCIATION NORTH CAROLINA AFFILIATEINC 3901 COMPUTER DR STE 110 RALEIGH NC 27609 560529996 501(C)(3) 40000 GENERAL SUPPORT, EDUCATION SUPPORT GREATER RALEIGH CHAMBER PO BOX 2978 RALEIGH NC 27602 560370850 501(C)(6) 11515 GENERAL SUPPORT NORTH CAROLINA CHAMBER 701 CORPORATE CENTER DRIVE STE 400 RALEIGH NC 27607 560340499 501(C)(6) 5400 GENERAL SUPPORT WAKE TECH FOUNDATION 9101 FAYETTEVILLE ROAD RALEIGH NC 27511 237017752 501(C)(3) 15000 GENERAL SUPPORT NC MUSEUM OF ART 4630 MAIL SERVICE CENTER RALEIGH NC 27699 237071511 501(C)(3) 22500 GENERAL SUPPORT RONALD MCDONALD HOUSE OF CHAPEL HILL 101 OLD MASON FARM ROAD CHAPEL HILL NC 27517 561413188 501(C)(3) 15000 GENERAL SUPPORT DOWNTOWN RALEIGH ALLIANCE 120 SOUTH WILMINGTON STREET STE 103 103 RALEIGH NC 27601 561994005 501(C)(6) 60000 GENERAL SUPPORT WAKE EDUCATION PARTERNSHIP 706 HILLSBOURGH STREET STE A RALEIGH NC 27603 281518182 501(C)(3) 10300 GENERAL SUPPORT AFRICAN AMERICAN CULTURAL FESTIVAL PO BOX 46595 RALEIGH NC 27620 900636941 501(C)(3) 10000 GENERAL SUPPORT HOLT BROTHERS FOUNDATION 8801 FAST PARK DRIVE STE 105 107 RALEIGH NC 27617 566570426 501(C)(3) 7500 GENERAL SUPPORT NASH HEALTH CARE FOUNDATION 2416 PROFESSIONAL DRIVE ROCKY MOUNT NC 27804 311802814 501(C)(3) 5200 GENERAL SUPPORT ALLIANCE MEDICAL MINISTRY 101 DONALD ROSS DRIVE RALEIGH NC 27610 562168673 501(C)(3) 5000 GENERAL SUPPORT CARY CHAMBER OF COMMERCE 307 NORTH ACADEMY STREET CARY NC 27519 560989726 501(C)(3) 5000 GENERAL SUPPORT NC PREVENTION PARTNERS 88 VILCOM CENTER DRIVE ST 110 CHAPEL HILL NC 27514 311722051 501(C)(3) 5000 GENERAL SUPPORT 12 4 PART I, LINE 2: REX REQUIRES ALL REQUESTS FOR GRANTS OR OTHER ASSISTANCE TO BE IN WRITING. SUCH REQUESTS ARE TYPICALLY REVIEWED ON AN ANNUAL BASIS FOLLOWING GUIDELINES RELATED TO COMMUNITY NEED AND REX'S MISSION. REX'S PRIORITIES INCLUDE SUPPORTING HEALTH, HUMAN SERVICES, EDUCATION AND ARTS IN THE COMMUNITIES IT SERVES. REX HAS VARIOUS WAYS OF TRACKING THE RESULTS OF ITS CONTRIBUTIONS. BECAUSE REX OFTEN WORKS CLOSELY WITH THE COMMUNITY GROUPS IT SUPPORTS, THE ORGANIZATION RECEIVES FREQUENT UPDATES ON THEIR WORK AND PROGRESS. FOR LARGER GRANTS, REX ALSO RECEIVES ANNUAL OR QUARTERLY REPORTS ON RESULTS. X 1 1 X X X X X 0 1 0 0 0 1 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 626252 0 157199 0 251042 0 263723 0 11511 0 1309727 0 229994 0 BERNADETTE M SPONG SVP/FINANCE AND CFO, TREAS & SEC 328338 0 86923 0 18121 0 34437 0 15583 0 483402 0 0 0 MARY LOU POWELL LEFT 382014 SVP/PATIENT CARE SVCS & CNO 257661 0 72445 0 31931 0 68823 0 6601 0 437461 0 0 0 STEPHEN W BURRISS COO 288357 0 79263 0 27695 0 25241 0 15091 0 435647 0 0 0 LINDA H BUTLER MD VP/MEDICAL AFFAIRS & CMO & CMIO 217942 0 60381 0 22368 0 19893 0 12591 0 333175 0 0 0 DONALD ESPOSITO JR VP/GENERAL COUNSEL 239259 0 66399 0 23867 0 22102 0 15091 0 366718 0 0 0 SYLVIA D HACKETT VP/HUMAN RESOURCES & FOUNDATION 208135 0 58985 0 19819 0 52272 0 9102 0 348313 0 0 0 R ERICK HAWKINS VP/HEART & VASCULAR SERVIC 220562 0 60811 0 28343 0 25001 0 8422 0 343139 0 0 0 CHAD T LEFTERIS VP/OPERATIONS 168636 0 46053 0 19693 0 16135 0 6602 0 257119 0 0 0 LISA SCHILLER VP/COMMUNICATIONS & MARKETING 169198 0 43672 0 6813 0 23708 0 14091 0 257482 0 0 0 JAYNE R BYRD VP/SURGICAL SERVICES 184076 0 48399 0 2514 0 155901 0 7986 0 398876 0 0 0 MICHELLE L GRAY VP/REGIONAL CIO 207364 0 67132 0 8622 0 32982 0 4763 0 320863 0 0 0 ROBERT D RICKER VP/PHYSICIAN RELATIONS 202401 0 34192 0 8650 0 78689 0 6602 0 330534 0 0 0 TAMMIE T STANTON VP/POST ACUTE SERVICES 0 232584 0 40691 0 5193 0 36952 0 5208 0 320628 0 0 TOM G WILLIAMS VP/AMBULATORY SERVICES 169169 0 43495 0 7752 0 35727 0 12591 0 268734 0 0 0 JOHN D STORMENT ASST. TREASURER & ASST. SE 0 179775 0 16679 0 11672 0 31123 0 5208 0 244457 0 0 JOEL RAY AS OF 2214 VP/PATIENT CARE SVCS & CNO 0 144794 0 12980 0 7252 0 24290 0 0 0 189316 0 0 JEFFREY CRANE MD ONCOLOGY 634647 0 17363 0 40919 0 61107 0 12163 0 766199 0 0 0 ROBERT WEHBIE MD ONCOLOGY 513535 0 18000 0 179294 0 33825 0 12531 0 757185 0 0 0 LANCE LANDVATER MD CARDIOVASCULAR SURGEON 661935 0 473555 0 5544 0 11500 0 14943 0 1167477 0 0 0 O ROBERT MENDES MD VASCULAR SURGEON 624733 0 27238 0 47360 0 8750 0 12591 0 720672 0 0 0 ROBERT PEYTON MD CARDIOVASCULAR SURGEON 662334 0 154830 0 5544 0 11500 0 9101 0 843309 0 0 0 PART I, LINE 1A THE ORGANIZATION OFFERS COMPLIMENTARY MEMBERSHIPS TO REX WELLNESS CENTERS FOR THE EXECUTIVE STAFF, BOTH ACTIVE AND RETIRED BOARD MEMBERS AND MEDICAL DIRECTORS. ALL MEMBERS RECEIVING COMPLIMENTARY MEMBERSHIPS ARE REQUIRED TO COMPLETE THE SAME APPLICATION AND TESTING PROCEDURES AS OTHER MEMBERS. CURRENTLY, THERE ARE 10 INDIVIDUALS LISTED THAT RECEIVE COMPLIMENTARY MEMBERSHIPS. THE VALUE OF THE COMPLIMENTARY MEMBERSHIP IS TREATED AS TAXABLE COMPENSATION AND IS REPORTED ON THE INDIVIDUAL'S W-2. 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 PERFOMANCE MEASURES USED TO DETERMINE INCENTIVE COMPENSATION ARE PHYSICIAN SATISFACTION, PATIENT CARE QUALITY OUTCOMES, EFFECTIVE USE OF TECHNOLOGY AND INDIVIDUAL GOALS. A NORTH CAROLINA MEDICAL CARE COMMISSIONS 521309402 65821DFJ5 2010-10-26 127456150 CONSTRUCTION 0 0 0 A 13606475 127456150 2184840 1499411 47737172 76034727 2013 1 0 1 1 A 0 0 0 0 0 0 0 A 0 0 0 0 0 0 0 0 0 A 0 FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION'S SOLE MEMBER IS REX HEALTHCARE, INC. 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. THE ORGANIZATION'S BOARD REVIEWS AND APPROVES THE COMPENSATION FOR ALL OFFICERS EXCEPT THE ASSISTANT TREASURER AND ASSISTANT SECRETARY. 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 PY. REX HEALTH VENTURES GP I LLC 4420 LAKE BOONE TRAIL RALEIGH NC 27607 455070550 VENTURE CAPITAL INVESTMENT NC REX HOSPITAL INC REX ORTHOPEDIC VENTURES LLC 4420 LAKE BOONE TRAIL RALEIGH NC 27607 273434805 ORTHOPEDIC PRACTICE VENTU NC REX HOSPITAL INC REX SURGERY CENTER OF WAKEFIELD LLC 4420 LAKE BOONE TRAIL RALEIGH NC 27607 465511168 ASC NC REX HOSPITAL INC UNC HEALTH CARE SYSTEM 101 MANNING DRIVE CHAPEL HILL NC 27514 562206970 HEALTHCARE NC SECTION 115 UNC HEALTHCARE 0 UNC HOSPITALS AT CHAPEL HILL 211 FRIDAY CENTER DR SUITE 2029 CHAPEL HILL NC 27517 561118388 HEALTHCARE NC SECTION 115 UNC HEALTHCARE 0 CALDWELL MEMORIAL HOSPITAL PO BOX 1890 LENIOR NC 28645 560554204 HEALTHCARE NC 501(C)(3) LINE 3 UNC HEALTHCARE 0 CALDWELL MEMORIAL HOSPITAL FOUNDATION INC 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 SILVER CITY NC 27344 560611546 HEALTHCARE NC 501(C)(3) LINE 3 UNC HEALTHCARE 0 HIGH POINT REGIONAL HEALTH 601 N ELM STREET HIGH POINT NC 27261 560532309 HEALTHCARE NC 501(C)(3) LINE 3 UNC HEALTHCARE 0 HIGH POINT REGIONAL HEALTH SERVICES INC 601 N ELM STREET HIGH POINT NC 27261 561497163 HEALTHCARE NC 501(C)(3) 509(A)(3) TYPE 2 UNC HEALTHCARE 0 HIGH POINT REGIONAL HEALTH SYSTEM FOUNDATION INC 601 N ELM STREET HIGH POINT NC 27261 272854711 SUPPORT OF HIGH POINT NC 501(C)(3) 509(A)(3) TYPE 1 HIGH POINT REGIONAL HEALTH 0 REX HEALTHCARE INC 4420 LAKE BOONE TRAIL RALEIGH NC 27607 561509129 HEALTHCARE NC 501(C)(3) 509(A)(3) TYPE 2 UNC HEALTHCARE 0 THE REX HEALTHCARE FOUNDATION INC 4420 LAKE BOONE TRAIL RALEIGH NC 27607 566052117 SUPPORT OF REX HOSPITAL NC 501(C)(3) 509(A)(3) TYPE 2 REX HEALTHCARE 0 UNCPN 1600 PERIMETER PARK DRIVE SUITE 225 MORRISVILLE NC 27560 271081647 HEALTHCARE NC 501(C)(3) LINE 9 UNC HEALTHCARE 0 REX SURGERY CENTER OF CARY LLC 4420 LAKE BOONE TRAIL RALEIGH NC 27607 273684056 ASC NC REX HOSPITAL INC RELATED 5040453 4853514 0 0 0.55000 JRH VENTURES LLC 4420 LAKE BOONE TRAIL RALEIGH NC 27607 274092967 MED CAMPUS DVLT NC REX HOSPITAL INC RELATED 256577 3013078 0 0 0.50000 REX HEALTH VENTURES I LP 4420 LAKE BOONE TRAIL RALEIGH NC 27607 371690478 VENTURE CAPITAL INVESTMENT NC REX HEALTH VENTURES RELATED -504029 1704940 0 0 1.00000 ORTHOPAEDIC SURGERY CENTER OF RALEIGH LLC 4420 LAKE BOONE TRAIL RALEIGH NC 27607 271740526 ORTHOPAEDIC SURGERY NC REX HOSPITAL INC RELATED 338791 1407961 0 0 0.51000 HIGH POINT SURGERY CENTER 600 NORTH LINDSAY STREET HIGH POINT NC 27260 561867005 HEALTHCARE NC N/A REX ENTERPRISES COMPANY INC 4420 LAKE BOONE TRAIL RALEIGH NC 27607 561553957 OPERATIONS SUPPORT NC REX HEALTHCARE C 0 HIGH POINT HEALTHCARE VENTURES INC 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 1 0 0 0 0 0 0 0 0 1 0 1 1 0 1 0 0 REX HEALTHCARE FOUNDATION INC Q 801817 FMV REX HEALTHCARE FOUNDATION INC C 965197 FMV JRH VENTURES LLC L 1059149 FMV UNC HEALTH CARE SYSTEM B 34964840 FMV PART V, LINE 1 N&O PART V, LINE 1 N&O: ADMINISTRATIVE SUPPORT; SUCH AS EXECUTIVE MANAGEMENT, LEGAL, ACCOUNTING, HUMAN RESOURCES, PURCHASING AND IT, FOR EACH OF THESE ENTITIES IS PROVIDED BY REX HOSPITAL, INC. PERSONNEL UTILIZING REX HOSPITAL FACILITIES AND OTHER ASSETS. ESTIMATING THE VALUE OF THESES SHARED PERSONNEL AND ASSETS CANNOT BE READILY DETERMINED.