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    <ReturnTs>2015-08-13T09:09:46-05:00</ReturnTs>
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        <BusinessNameLine1>ERNST &amp; YOUNG US LLP</BusinessNameLine1>
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        <State>GA</State>
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      <PreparerPersonNm>WILLIAM RIKER</PreparerPersonNm>
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        <City>Raleigh</City>
        <State>NC</State>
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      <ActivityOrMissionDesc>WAKEMED IS A MULTI-FACILITY HEALTHCARE SYSTEM PROVIDING STATE OF THE ART HIGH QUALITY CARE.</ActivityOrMissionDesc>
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      <MissionDesc>WAKEMED PROVIDES OUTSTANDING AND COMPASSIONATE CARE TO ALL WHO SEEK OUR SERVICES. WAKEMED IS COMMITTED TO THE HEALTH AND WELLNESS OF THE COMMUNITIES IT SERVES BY PROVIDING PREVENTIVE, DIAGNOSTIC, IN/OUTPATIENT, REHABILITATIVE CARE TO ALL REGARDLESS OF THE ABILITY TO PAY.</MissionDesc>
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      <Desc>SURGICAL SERVICES - WAKEMED PROVIDES SURGICAL SERVICES IN FOUR LOCATIONS THROUGHOUT THE COUNTY: WAKEMED RALEIGH CAMPUS, WAKEMED CARY HOSPITAL, WAKEMED NORTH HEALTHPLEX AND CAPITAL CITY SURGERY CENTER, OF WHICH WAKEMED IS A MAJORITY INVESTOR. BY DELIVERING SURGICAL SERVICES TO ALL WHO SEEK CARE REGARDLESS OF THEIR ABILITY TO PAY AND BY HAVING IN- AND OUTPATIENT SERVICES IN THREE DISTINCT LOCATIONS THROUGHOUT THE COUNTY, WAKEMED HAS IMPROVED ACCESS TO THESE NEEDED SERVICES. WAKEMED'S WIDE RANGE OF SURGICAL SPECIALTIES INCLUDE BARIATRIC, CARDIOVASCULAR AND THORACIC, ENT, HEAD AND NECK, ADULT AND PEDIATRIC GASTROINTESTINAL, GENERAL, NEUROSURGERY, OBSTETRICS AND GYNECOLOGY, ORTHOPEDICS, PEDIATRIC, UROLOGY, AND VASCULAR. AS WAKE COUNTY'S ONLY STATE DESIGNATED LEVEL 1 TRAUMA, WAKEMED PROVIDES COMPREHENSIVE TRAUMA SURGERY FOR GENERAL, ORTHOPEDIC, NEUROSURGERY, AND VASCULAR TRAUMA PATIENTS. BECAUSE ACCESS TO SPECIALTY CARE CONTINUES TO BE A KEY HEALTH CONCERNS FACING OUR COMMUNITY, WAKEMED HAS EXPANDED ITS NETWORK OF SPECIALISTS THROUGH WAKEMED FACULTY PHYSICIANS, ONE OF THE KEY GROUPS OF PHYSICIANS WHO PROVIDE SUBSPECIALTY CARE TO THE UNINSURED AND UNDERINSURED IN OUR COMMUNITY. OUR STAFF WORKS WITH THE PATIENT TO DISCOUNT THEIR FEES BASED ON INDIVIDUAL INCOME AND NEED. MANY PHYSICIANS ON THE MEDICAL STAFF CONTINUE THIS PRACTICE OF PROVIDING QUALITY CARE TO PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. LAST YEAR, OUR SURGICAL PATIENTS INCLUDED 35.7% WHO WERE INSURED UNDER MEDICARE, 13.8% WHO WERE INSURED UNDER MEDICAID AND 6.9% WHO WERE UNINSURED (OR "SELF-PAY OR CHARITY CARE").</Desc>
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        <Desc>HEART CENTER - WAKEMED'S HEART AND VASCULAR PROGRAM IS THE LARGEST AND ONE OF THE MOST RECOGNIZED CARDIOVASCULAR PROGRAMS IN THE STATE OF NORTH CAROLINA. LAST YEAR, MORE THAN 17,000 CARDIOVASCULAR PROCEDURES WERE PERFORMED INCLUDING SURGERY, DIAGNOSTIC AND INTERVENTIONAL CARDIAC CATHETERIZATIONS AND ELECTROPHYSIOLOGY STUDIES. THOUSANDS MORE PATIENTS WERE TREATED MEDICALLY AS IN- AND OUTPATIENTS THROUGHOUT THE SYSTEM. WAKEMED HEALTH &amp; HOSPITALS HAS CONSISTENTLY BEEN NATIONALLY RECOGNIZED FOR EXCELLENCE IN BOTH STROKE AND HEART CARE, AND IN 2014, WE AGAIN RECEIVED SEVERAL HONORS. WAKEMED RALEIGH CAMPUS AND WAKEMED CARY HOSPITAL BOTH AGAIN EARNED THE PLATINUM PERFORMANCE ACHIEVEMENT AWARD FROM THE ACTION REGISTRY OF THE AMERICAN COLLEGE OF CARDIOLOGY'S NATIONAL CARDIOVASCULAR DATA REGISTRY FOR OUR CARDIOVASCULAR SERVICES. ONLY 32 OF 126 NORTH CAROLINA'S HOSPITALS EARNED THIS DISTINCTION THIS PAST YEAR. ADDITIONALLY, BOTH HOSPITALS RECEIVED RECOGNITION FROM THE AMERICAN HEART ASSOCIATION AND THE AMERICAN STROKE ASSOCIATION THROUGH THEIR GET WITH THE GUIDELINES (GWTG) AWARDS, EACH EARNING GOLD PLUS ACHIEVEMENT AWARDS FOR BOTH STROKE CARE AND FOR HEART FAILURE CARE. THESE RECOGNITIONS SIGNIFY THAT WAKEMED HAS REACHED AN AGGRESSIVE GOAL OF TREATING BOTH STROKE AND HEART FAILURE PATIENTS ACCORDING TO THE GUIDELINES OF CARE RECOMMENDED BY THE AMERICAN STROKE ASSOCIATION, AMERICAN HEART ASSOCIATION, AND AMERICAN COLLEGE OF CARDIOLOGY. BOTH WAKEMED CARY HOSPITAL AND WAKEMED RALEIGH CAMPUS RECEIVED ACCREDITATION BY THE SOCIETY OF CARDIOVASCULAR PATIENT CARE, AND BOTH RECEIVED THE JOINT COMMISSION ADVANCED CERTIFICATION FOR PRIMARY STROKE CENTERS, AND WAKEMED CARY HOSPITAL RECEIVED THE SILVER LEVEL AWARD AS A REFERRING HOSPITAL FROM THE AMERICAN HEART ASSOCIATION'S MISSION LIFELINE. WAKEMED HEALTH &amp; HOSPITALS WAS RECOGNIZED IN U.S. NEWS &amp; WORLD REPORT AS HIGH PERFORMING HOSPITALS IN CARDIOLOGY AND HEART SURGERY IN THEIR 2014 BEST HOSPITALS ISSUE. WAKEMED HEALTH &amp; HOSPITALS WAS ALSO DESIGNATED A BLUE DISTINCTION CENTER+ FOR CARDIAC CARE BY BLUECROSS BLUESHIELD OF NC. AND FINALLY IN 2014, WAKEMED HEALTH &amp; HOSPITALS WAS ONE OF 35 HOSPITALS IN THE NATION SELECTED TO PARTICIPATE IN THE AMERICAN COLLEGE OF CARDIOLOGY'S PATIENT NAVIGATOR PROGRAM. A KEY SUPPORT SERVICE FOR OUR COMMUNITY, WAKEMED MOBILE CRITICAL CARE SERVICES PROVIDES COMPREHENSIVE PATIENT TRANSPORTS BY GROUND AND AIR AMBULANCE HELPING PATIENTS WHO NEED IMMEDIATE INTERVENTION OR ACUTE CARE SERVICES. SERVING THE REGION AND ALL OF NORTH CAROLINA, GROUND MOBILE IS THE BUSIEST INTER-FACILITY GROUND TRANSPORT SERVICE IN THE STATE. IN 2014, GROUND MOBILE TRANSPORTED OVER 18,000 CRITICALLY ILL PATIENTS AND AIR MOBILE COMPLETED 529 FLIGHTS. HEART DISEASE - WITH 933 DEATHS - REMAINS THE SECOND LEADING CAUSE OF DEATH IN WAKE COUNTY, AND THE COUNTY'S 2013 COMMUNITY HEALTH NEEDS ASSESSMENT IDENTIFIED MANAGEMENT OF CHRONIC DISEASES RELATED TO CARDIOVASCULAR PROBLEMS OF PARAMOUNT IMPORTANCE TO WAKE COUNTY RESIDENTS' OVERALL HEALTH. WAKEMED'S HEART CENTER HAS MADE SIGNIFICANT STRIDES IN PROGRAMS AND SERVICES AIMING TO REDUCE HEART DISEASE AND DIABETES, IMPROVE STROKE OUTCOMES AND IMPROVE PATIENTS' UNDERSTANDING OF DISEASE MANAGEMENT. WE KNOW THAT TEACHING PATIENTS ABOUT THEIR RISK FACTORS FOR HEART DISEASE AND ENCOURAGING HEALTHY BEHAVIORS THROUGH LIFESTYLE CHANGES BUILDS A FOUNDATION FOR A HEALTHIER POPULATION. THUS, THE WAKEMED HEART CENTER PROVIDES A COMPREHENSIVE CONTINUUM OF CARE FOR THE CARDIAC PATIENT FROM OUTREACH EDUCATION AND PREVENTION TO DIAGNOSIS, INTERVENTION, SURGERY, CARDIAC REHABILITATION AND ON-GOING DISEASE MANAGEMENT FOR HEART FAILURE AND DIABETES. FREE EDUCATION PROGRAMS ARE OFFERED REGULARLY FOR OUR PATIENTS, THEIR FAMILY MEMBERS AND THE COMMUNITY TO COMPLEMENT OUR COMPREHENSIVE CARE SERVICES. AND BECAUSE THE FASTEST INTERVENTION PROVIDES THE BEST OUTCOMES, ALL OF WAKEMED'S EMERGENCY DEPARTMENTS ARE CERTIFIED CHEST PAIN CENTERS AND WAKEMED RALEIGH CAMPUS AND CARY HOSPITAL ARE DESIGNATED PRIMARY STROKE CENTERS. ADDITIONALLY, WAKEMED'S HEART CENTER PROVIDES FREE HEALTH SCREENINGS THROUGHOUT THE YEAR INCLUDING CHOLESTEROL SCREENINGS, BLOOD PRESSURE CHECKS, VASCULAR SCREENINGS AND STROKE ASSESSMENTS THROUGHOUT THE COMMUNITY. THESE SCREENINGS ARE DESIGNED TO BE A SECONDARY PREVENTION ACTIVITY TO DETECT EARLY ONSET OF DISEASE OR ILLNESS. WAKEMED CONDUCTS TRAINING FOR THE PROGRAM CPR ANYTIME AT MULTIPLE LOCATIONS IN WAKE COUNTY, AND PROVIDES CPR ANYTIME KITS THROUGHOUT THE COMMUNITY AT MORE THAN A 70 PERCENT DISCOUNTED COST. LAST FISCAL YEAR, 58.6% OF HEALTH CENTER PATIENTS WERE INSURED UNDER MEDICARE, 6.8% WERE INSURED UNDER MEDICAID, AND 6.0% OF THESE PATIENTS WERE UNINSURED.</Desc>
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        <Desc>EMERGENCY - A CRITICAL ISSUE FACING WAKE COUNTY RESIDENTS CONTINUES TO BE ACCESS TO AFFORDABLE HEALTH CARE. TO ADDRESS THIS CHALLENGE, WAKEMED HAS STRATEGICALLY PLACED SIX FULL SERVICE, STAND-ALONE EMERGENCY DEPARTMENTS IN KEY GEOGRAPHIC AREAS THROUGHOUT THE COUNTY IN RALEIGH, CARY, NORTH RALEIGH, APEX, BRIER CREEK, AND GARNER. LOCATED IN RALEIGH, WAKEMED ALSO OPERATES THE ONLY CHILDREN'S EMERGENCY DEPARTMENT IN THE COUNTY. AND BECAUSE PHYSICIAN AVAILABILITY IS KEY TO OPENING UP ACCESS TO CARE, WAKEMED'S PHYSICIAN PRACTICES, HEALTHPLEXES, AND OUTPATIENT SERVICES ARE CONVENIENTLY POSITIONED THROUGHOUT THE AREA. WAKEMED IS AMONG THE TOP THREE VOLUME PROVIDERS OF EMERGENCY CARE IN NORTH CAROLINA. WAKEMED'S RALEIGH CAMPUS IS ALSO HOME TO WAKE COUNTY'S ONLY LEVEL I TRAUMA CENTER, THE HIGHEST DESIGNATION AWARDED TO TRAUMA CENTERS IN NORTH CAROLINA. OUR TRAUMA SERVICE INCLUDES A COMPREHENSIVE RESEARCH PROGRAM, INJURY PREVENTION PROGRAMS, FELLOWSHIP TRAINED TRAUMA SURGEONS ON-SITE 24/7, A MULTI-DISCIPLINARY TEAM OF PROFESSIONALS, THE CLINICAL SUPPORT OF SIX ADULT INTENSIVE CARE UNITS AND A PEDIATRIC INTENSIVE CARE UNIT, AS WELL AS A COMPREHENSIVE ACUTE, INPATIENT AND OUTPATIENT PHYSICAL REHABILITATION PROGRAM. WAKEMED'S EMERGENCY AND TRAUMA SERVICES TREAT ALL PATIENTS SEEKING MEDICAL CARE, REGARDLESS OF THEIR ABILITY TO PAY. IN FY 2014, 19.3% OF OUR EMERGENCY PATIENTS WERE INSURED UNDER MEDICARE; 21.3% WERE INSURED UNDER MEDICAID; AND 20.5% WERE UNINSURED OR SELF-PAY/CHARITY CARE. OVER 41.8% OF ALL PATIENTS SEEN IN OUR EDS ARE EITHER MEDICAID OR UNINSURED RESULTING IN WAKEMED PROVIDING CARE FOR MORE THAN 80 PERCENT OF THE COUNTY'S UNINSURED AND MEDICAID PATIENTS. ALL OF THE STAND-ALONE LOCATIONS SERVE AREAS WHICH ARE OTHERWISE UNDERSERVED BY DEDICATED MEDICAL SERVICES.</Desc>
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        <PersonNm>MICHAEL DEVAUGHN CFO</PersonNm>
        <PhoneNum>9193500522</PhoneNum>
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          <City>Raleigh</City>
          <State>NC</State>
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        <PersonNm>MICHAEL D DEVAUGHN</PersonNm>
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        <PersonNm>DONALD R GINTZIG</PersonNm>
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      <TotalContributionsAmt>4731146</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
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        <BusinessCd>621500</BusinessCd>
        <TotalRevenueColumnAmt>966893808</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>966893808</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>Non-Patient Services</Desc>
        <BusinessCd>621500</BusinessCd>
        <TotalRevenueColumnAmt>3820140</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>0</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>3820140</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>Cafeteria</Desc>
        <BusinessCd>722210</BusinessCd>
        <TotalRevenueColumnAmt>4281826</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>0</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>4281826</ExclusionAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>PURCH DISCOUNTS/REBATE/VHA</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>3017429</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>3017429</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>OTHER OPERATING REVENUE</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>14568237</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>7798112</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>1201259</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>5568866</ExclusionAmt>
      </ProgramServiceRevenueGrp>
      <TotalOthProgramServiceRevGrp>
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        <RelatedOrExemptFuncIncomeAmt>11462008</RelatedOrExemptFuncIncomeAmt>
      </TotalOthProgramServiceRevGrp>
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      <InvestmentIncomeGrp>
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      <IncmFromInvestBondProceedsGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
      </IncmFromInvestBondProceedsGrp>
      <RoyaltiesRevenueGrp>
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      </RoyaltiesRevenueGrp>
      <GrossRentsGrp>
        <RealAmt>828575</RealAmt>
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      <LessRentalExpensesGrp>
        <RealAmt>70274</RealAmt>
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      <RentalIncomeOrLossGrp>
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      </RentalIncomeOrLossGrp>
      <NetRentalIncomeOrLossGrp>
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        <SecuritiesAmt>242846243</SecuritiesAmt>
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      <LessCostOthBasisSalesExpnssGrp>
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        <OtherAmt>630321</OtherAmt>
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      <NetGainOrLossInvestmentsGrp>
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      <NetIncmFromFundraisingEvtGrp>
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      </NetIncmFromFundraisingEvtGrp>
      <NetIncomeFromGamingGrp>
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      <NetIncomeOrLossGrp>
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      </NetIncomeOrLossGrp>
      <OtherRevenueMiscGrp>
        <Desc>Rev from Joint Venture</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>6531753</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>6531753</RelatedOrExemptFuncIncomeAmt>
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      <TotalRevenueGrp>
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        <UnrelatedBusinessRevenueAmt>5021399</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>18929031</ExclusionAmt>
      </TotalRevenueGrp>
      <GrantsToDomesticOrgsGrp>
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      <GrantsToDomesticIndividualsGrp>
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        <ProgramServicesAmt>98494</ProgramServicesAmt>
      </GrantsToDomesticIndividualsGrp>
      <ForeignGrantsGrp>
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        <ProgramServicesAmt>0</ProgramServicesAmt>
      </ForeignGrantsGrp>
      <BenefitsToMembersGrp>
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        <ProgramServicesAmt>0</ProgramServicesAmt>
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      <CompCurrentOfcrDirectorsGrp>
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        <ProgramServicesAmt>5729324</ProgramServicesAmt>
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      <CompDisqualPersonsGrp>
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      <PensionPlanContributionsGrp>
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      <FeesForServicesLobbyingGrp>
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      </FeesForServicesLobbyingGrp>
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      <FeesForSrvcInvstMgmntFeesGrp>
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      </AdvertisingGrp>
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      </RoyaltiesGrp>
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      <TravelGrp>
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      <PymtTravelEntrtnmntPubOfclGrp>
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      <OtherExpensesGrp>
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      <GrassrootsNontaxableGrp />
      <TotLbbyngGrassrootMnsNonTxGrp />
      <TotLbbyExpendMnsLbbyngNonTxGrp />
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      <OtherActivitiesInd>false</OtherActivitiesInd>
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      <Form4720Filed4912TaxInd>false</Form4720Filed4912TaxInd>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE C, PART II-B, LINE 1</FormAndLineReferenceDesc>
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        <BookValueAmt>3889817</BookValueAmt>
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        <BusinessName>
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        <USAddress>
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          <State>NC</State>
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        <IncludesPublicityMeasuresInd>true</IncludesPublicityMeasuresInd>
        <PostedOnWebsiteInd>X</PostedOnWebsiteInd>
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      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>All answers provided in Part V, Section B &amp; C pertain to Facility Group A</FormAndLineReferenceDesc>
        <ExplanationTxt>which includes WakeMed Raleigh Campus and WakeMed Cary Hospital as identified on Schedule H, Part V, Section A, Lines 1-2. Part V, Section B, Line 3: As indicated in the executive summary and chapter 1 of the CHNA report, WakeMed partnered with over 60 agency and community partners in Wake County to conduct the collaborative Community Health Needs Assessment between January and June of 2013. The purpose of the project was to identify health status, concerns and resources in Wake County, report findings, work with the community to determine priority issues to be addressed and develop a community based action plan to address identified concerns. In addition to the involvement of the 60 organizations represented in the CHNA planning and implementation an additional 452 community members were engaged in the process. The Community Health Opinion Survey was completed by 281 individuals via door to door survey collection in 40 census blocks within each of the eight Wake County Health Service Zones; 76 people participated in focus groups and an additional 95 attended community forums. Nine focus groups were held with seniors, youth, homeless, Hispanic/Latinos, Service Providers in Wake County as well as persons living with mental health or substance abuse, and developmental disabilities, those living with chronic health conditions, and those living with physical disabilities. Five community forums were held throughout Wake County where residents were invited to hear the main findings of the assessment and were asked to help prioritized the areas of focus for the next three years. Each of these processes sought to include a broad cross section of the communites served by WakeMed. Part V, Section B, Line 4: Wake Human Services, Duke Health Raleigh, Rex Healthcare, United Way, Wake Health Services, WakeMed Part V, Section B, Line 5a: http://www.wakemed.org/videos/About%20Us/2013%20Wake%20CHNA%20Full%20Repor t%20FINAL.pdf Part V, Section B, Line 11: We do not provide discounted care in regards to charity. Our charity write-offs are 100% of charges. Part V, Line 20d: WakeMed used the average of its three lowest negotiated commercial insurance rates when we calculate the maximum amounts that can be charged to any self-pay or uninsured patient. This is an automatic write off that is provided to these patients. However, WakeMed also has a Financial Assistance Program where these patients (who have already received 50% discount) can receive additional adjustments, if they qualify. During the 2014 tax year we provided these patients a 100% write off and held the patient responsible for a co-pay directly associated with the treatment they received.</ExplanationTxt>
      </SupplementalInformationGrp>
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        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1>Wake Specialty Physicians LLC</BusinessNameLine1>
          </BusinessName>
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            <AddressLine1>3024 New Bern Avenue</AddressLine1>
            <City>Raleigh</City>
            <State>NC</State>
            <ZIPCode>27610</ZIPCode>
          </USAddress>
          <FacilityTxt>Medical Practice</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1>WAKEMED NORTH HEALTHPLEX</BusinessNameLine1>
          </BusinessName>
          <USAddress>
            <AddressLine1>10000 Falls of The Neuse Rd</AddressLine1>
            <City>Raleigh</City>
            <State>NC</State>
            <ZIPCode>27614</ZIPCode>
          </USAddress>
          <FacilityTxt>OP/Ambulatory Surgery Center Emergency Dept, Lab, Radiology Phys, Occup and Speech Therapy</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1>Wake Faculty Physicians LLC</BusinessNameLine1>
          </BusinessName>
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            <AddressLine1>3024 New Bern Avenue</AddressLine1>
            <City>Raleigh</City>
            <State>NC</State>
            <ZIPCode>27610</ZIPCode>
          </USAddress>
          <FacilityTxt>Medical Practice</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1>WakeMed Rehab Hospital</BusinessNameLine1>
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            <City>Raleigh</City>
            <State>NC</State>
            <ZIPCode>27610</ZIPCode>
          </USAddress>
          <FacilityTxt>Phys Med &amp; Rehab Hospital Phys, Speech &amp; Occup Therapy Cardiac Rehab, Fitness Center</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1>WakeMed Garner Healthplex</BusinessNameLine1>
          </BusinessName>
          <USAddress>
            <AddressLine1>400 US 70 EAST</AddressLine1>
            <City>Garner</City>
            <State>NC</State>
            <ZIPCode>27529</ZIPCode>
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          <FacilityTxt>Emergency Department Laboratory, Radiology</FacilityTxt>
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        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1>WakeMed Apex Healthplex</BusinessNameLine1>
          </BusinessName>
          <USAddress>
            <AddressLine1>120 Healthplex Way</AddressLine1>
            <City>Apex</City>
            <State>NC</State>
            <ZIPCode>27502</ZIPCode>
          </USAddress>
          <FacilityTxt>Emergency Department Laboratory, Radiology</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1>WAKEMED BRIER CREEK HEALTHPLEX</BusinessNameLine1>
          </BusinessName>
          <USAddress>
            <AddressLine1>8001 TW Alexander Drive</AddressLine1>
            <City>Raleigh</City>
            <State>NC</State>
            <ZIPCode>27617</ZIPCode>
          </USAddress>
          <FacilityTxt>Emergency Department Laboratory, Radiology</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1>Wake Orthopedics LLC</BusinessNameLine1>
          </BusinessName>
          <USAddress>
            <AddressLine1>3009 New Bern Avenue</AddressLine1>
            <City>Raleigh</City>
            <State>NC</State>
            <ZIPCode>27610</ZIPCode>
          </USAddress>
          <FacilityTxt>Medical Practice</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1>WAKEMED MEDICAL PARK</BusinessNameLine1>
          </BusinessName>
          <USAddress>
            <AddressLine1>23 Sunnybrook Road</AddressLine1>
            <City>Raleigh</City>
            <State>NC</State>
            <ZIPCode>27610</ZIPCode>
          </USAddress>
          <FacilityTxt>Laboratory, Radiology</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1>WAKEMED CLAYTON MEDICAL PARK</BusinessNameLine1>
          </BusinessName>
          <USAddress>
            <AddressLine1>555 MEDICAL PARK PLACE</AddressLine1>
            <City>Clayton</City>
            <State>NC</State>
            <ZIPCode>27520</ZIPCode>
          </USAddress>
          <FacilityTxt>Lab, Radiology, Phys, Occup &amp; Speech Therapy</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1>WAKEMED HOME HEALTH</BusinessNameLine1>
          </BusinessName>
          <USAddress>
            <AddressLine1>2920 HIGHWOODS BLVD SUITE 200</AddressLine1>
            <City>Raleigh</City>
            <State>NC</State>
            <ZIPCode>27604</ZIPCode>
          </USAddress>
          <FacilityTxt>Home Health, Home IV Therapy, Phys, Occupp &amp; Speech, PICC Private Duty Nursing</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1>WakeMed Alexander YMCA</BusinessNameLine1>
          </BusinessName>
          <USAddress>
            <AddressLine1>1603 Hillsborough Street</AddressLine1>
            <City>Raleigh</City>
            <State>NC</State>
            <ZIPCode>27605</ZIPCode>
          </USAddress>
          <FacilityTxt>Physical Therapy</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1>WakeMed Wake Forest Road OP Rehab Center</BusinessNameLine1>
          </BusinessName>
          <USAddress>
            <AddressLine1>3701 Wake Forest Road</AddressLine1>
            <City>Raleigh</City>
            <State>NC</State>
            <ZIPCode>27609</ZIPCode>
          </USAddress>
          <FacilityTxt>Phys, Occup, Speech, and Pediatric Speech Therapy</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1>WakeMed Kraft Family YMCA</BusinessNameLine1>
          </BusinessName>
          <USAddress>
            <AddressLine1>8921 HOLLY SPRINGS ROAD</AddressLine1>
            <City>Apex</City>
            <State>NC</State>
            <ZIPCode>27539</ZIPCode>
          </USAddress>
          <FacilityTxt>Phys &amp; Occup Therapy, Cardiac Rehabilitation, Nutritional Counseling</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1>WAKEMED ZEBULON OP &amp; SKILLED NURS FAC</BusinessNameLine1>
          </BusinessName>
          <USAddress>
            <AddressLine1>535 W Gannon Avenue</AddressLine1>
            <City>Zebulon</City>
            <State>NC</State>
            <ZIPCode>27597</ZIPCode>
          </USAddress>
          <FacilityTxt>Skilled Nursing Fac, Phys, Occ &amp; Speech Therapy, Radiology, Laboratory</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1>WAKEMED CARY FAMILY YMCA</BusinessNameLine1>
          </BusinessName>
          <USAddress>
            <AddressLine1>101 YMCA Drive</AddressLine1>
            <City>Cary</City>
            <State>NC</State>
            <ZIPCode>27513</ZIPCode>
          </USAddress>
          <FacilityTxt>Physical Therapy</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1>WakeMed Kerr Family YMCA</BusinessNameLine1>
          </BusinessName>
          <USAddress>
            <AddressLine1>2500 Wakefield Pines Drive</AddressLine1>
            <City>Raleigh</City>
            <State>NC</State>
            <ZIPCode>27614</ZIPCode>
          </USAddress>
          <FacilityTxt>Physical Therapy</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1>WakeMed Fuquay-Varina Outpatient</BusinessNameLine1>
          </BusinessName>
          <USAddress>
            <AddressLine1>400 Ransom Street</AddressLine1>
            <City>FuquayVarina</City>
            <State>NC</State>
            <ZIPCode>27526</ZIPCode>
          </USAddress>
          <FacilityTxt>Skilled Nursing Fac, Phys, Occup, and Speech Therapy</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1>PARTNERS IN PRACTICE LLC</BusinessNameLine1>
          </BusinessName>
          <USAddress>
            <AddressLine1>3000 New Bern Avenue</AddressLine1>
            <City>Raleigh</City>
            <State>NC</State>
            <ZIPCode>27610</ZIPCode>
          </USAddress>
          <FacilityTxt>Medical Practice</FacilityTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Line 1:</FormAndLineReferenceDesc>
        <ExplanationTxt>Line 1: Part I, Line 7a: Charity care is reported as the system's charity care at cost, using a cost to charge ratio calculated as in Worksheet 2. Part I, Line 7b: Medicaid costs are derived from our cost accounting system, which addresses all patient segments. Part I, Line 7c: Costs of other government programs are derived from our cost accounting system, which addresses all patient segments. Part I, Line 7f: Per Medicare Cost Report Part II: WakeMed is actively involved in not only improving the health and well-being of the communities we serve but is also supportive of community building activities. WakeMed has begun efforts to improve the neighborhood around the hospital and encourage redevelopment and physical improvements. A coalition of local business and community leaders are working to reduce crime, beautify the area, attract retail businesses and restaurants, and foster new medical development around the main hospital campus in downtown Raleigh, which is an economically depressed area. We have also invested in the Wake Technical Community College facility growth which is vital to educating future nurses, radiology techs, emergency response personnel and others. Our workforce development program works with youth, health science students and those in a variety of health professions programs with mentoring, residencies, clinical rotations, and education all with the purpose of preparing for the workforce of tomorrow. We partner with numerous colleges, community colleges and high schools throughout the region and our campus is home to the Wake Early College High School. WakeMed is also home to Wake Area Health Education Center, a program of the University of North Carolina which provides accredited education programs to nurses, allied health professionals and physicians throughout the region. WakeMed also works closely with the investment of cash and expertise for the eight municipalities in our county and the Wake County Economic Development Council to attract new jobs and grow industry and business. A healthy economy ultimately leads to the healthier community. Our community health improvement activities are numerous and include being the lead agency for SAFEKIDS, Advocates for Health in Action, Energize, Asthma coalition, Action for Children, Capital Care Collaborative and more. Each is working to support programs and policies that improve public health and access to health care. The overall goal is to make our community a healthier place to live and work. Part III, Line 2: The amount reported in Part III, line 2 is the system bad debt at cost. Charity and bad debt accounts are recorded at current account balance levels. The balance may be net of contractual allowances and/or payments received. For example, bad debt or charity resulting from an unpaid patient liability after insurance is recorded at the amount unpaid by the patient. Part III, Line 3: In order to receive financial assistance under the organization's financial assistance policy (FAP), a patient must complete a Charity Application. If a patient completes an application that meets other FAP requirements, the assistance is written off as Charity Expense, not Bad Debt Expense. Therefore, there is no bad debt expense attributable to patients eligible under the organization's FAP. Part III, Line 4: The text of the footnote to WakeMed's financial statements regarding bad debt expense is as follows: "WakeMed has presented its provision for uncollectible accounts as a direct reduction of patient service revenue in accordance with the AICPA Audit Guide for Health Care Organizations. Based on the most recent update of the Audit Guide's interpretation of the requirements of GASB Statement No. 34, governmental health care organizations are required to present uncollectible accounts as a component of net patient service revenue rather than within operating expenses." Part III, Line 8: The Medicare allowable costs were determined from the Medicare Cost Report, as specified in the provider reimbursement manual. WakeMed believes that all of the $12,581,093 Medicare shortfall should be considered as community benefit. The IRS Community Benefit Standard includes the provision of care to the elderly and Medicare patients. Medicare shortfalls must be absorbed by the WakeMed hospitals in order to continue treating the elderly in our community. This year, Medicare accounted for 40% of hospital revenues. The hospital provides care regardless of this shortfall and thereby relieves the federal government of the burden of paying the full cost for Medicare beneficiaries. If the WakeMed Medicare shortfall were treated as a community benefit, the percent of total expenses attributable to community benefit would increase from 11.06% to 12.21%. Part III, Line 9b: WakeMed provides many opportunities to educate patients on our financial assistance program prior to discharge and again once the first bill is received. In order to make sure we reach out to our patients, we send multiple statements. Each statement references the financial assistance program. Patients are screened for financial assistance and are given opportunities to apply. If a patient chooses not to apply, or does not qualify, they are given the opportunity for other payment arrangements. At any point, if the patient did not apply and ended up in collections due to non-communication, however, eventually expressed interest in financial assistance, a form is supplied. The patient at that point does have the opportunity to apply and all collections would cease. This is completed at the point in which the application is received, even if not all additional documentation is provided. Line 2: The community needs assessment is a process that helps to identify factors affecting our county, determine resources needed to address these factors, and develop a plan of action to address the needs of the communities we serve. During the first half of 2013, WakeMed Health &amp; Hospitals joined with Duke Raleigh, Rex Healthcare, Wake Health Services, Triangle United Way, and Wake County Human Services to jointly conduct a Community Health Needs Assessment (CHNA). The assessment was completed in June of 2013. It involved input from hundreds of Wake County Residents and public health leaders through surveys, focus groups, and steering committee members. It can be found on our website at http://www.wakemed.org/videos/About Us/2013 Wake CHNA Full Report FINAL.pdf UNC Gillings School of Global Public Health conducted the CHNA. They have a long track record of assessing community health for public health departments, hospitals, and Federally Qualified Health Clinics (FQHC). In addition to this primary data, WakeMed's Corporate Planning department collects and analyzes multiple other sources of secondary data which helps us understand demographic, sociographic and health trends. The staff is also charged with forecasting future needs and planning to meet those needs. This process includes a careful analysis of current system capacities and projects future needed capacity to meet population growth and demographic changes. Through this department a strategic plan is developed and updated annually. Line 3: WakeMed posts the required EMTALA notice at all portals of entry where an Emergency Departments is present. The signage notes that WakeMed participates in the Medicaid program. The WakeMed website provides detailed information regarding Financial Assistance and Charity Care. The Patient Billing and Financial Information policy is included in all inpatients' "My Important Papers" folders and is addressed in the Patient Information Guide available in all inpatient rooms. In addition, the Financial Assistance form is located on the website for any patient to complete and submit. As part of the intake process/registration for all patients, WakeMed provides a copy of the Patient Billing and Financial Information policy, which refers patients to Patient Financial Services if they have concerns regarding their ability to pay the bill. All inpatients and patients scheduled for selected outpatient procedures, and who are designated "uninsured" at the time of admission, are contacted personally by a financial counselor. In addition, any patient, regardless of insurance coverage, may request to see a financial counselor. The financial counselor will assess possible Medicaid eligibility and provide an application/financial statement that is submitted to Patient Financial Services to request assistance with medical expenses. WakeMed also has on-site employees from Wake County Human Services to process Medicaid applications for residents of Wake County. Any patient who is uninsured and may be eligible for Disability is referred to a WakeMed disability specialist who will assist with the application. WakeMed includes information regarding financial assistance in all patient billing statements. Line 4: While WakeMed serves patients from all of North Carolina's 100 c</ExplanationTxt>
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        </RecipientBusinessName>
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          <City>Glen Allen</City>
          <State>VA</State>
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        </RecipientBusinessName>
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          <AddressLine1>220 Horizon Dr Ste 201</AddressLine1>
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          <State>NC</State>
          <ZIPCode>27615</ZIPCode>
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          <AddressLine1>PO Box 4322</AddressLine1>
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          <ZIPCode>27519</ZIPCode>
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          <BusinessNameLine1>Interfaith Food Shuttle</BusinessNameLine1>
        </RecipientBusinessName>
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          <AddressLine1>1001 Blair Drive</AddressLine1>
          <City>Raleigh</City>
          <State>NC</State>
          <ZIPCode>27620</ZIPCode>
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          <AddressLine1>1012 Oberlin Rd Ste 100</AddressLine1>
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          <BusinessNameLine1>Marbles Kids Museum</BusinessNameLine1>
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          <AddressLine1>201 E Hargett Street</AddressLine1>
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          <BusinessNameLine1>NC Physicians Health Program</BusinessNameLine1>
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          <AddressLine1>220 Horizon Drive</AddressLine1>
          <City>Raleigh</City>
          <State>NC</State>
          <ZIPCode>27615</ZIPCode>
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          <BusinessNameLine1>NC Museum of Art</BusinessNameLine1>
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          <AddressLine1>2110 Blue Ridge Road</AddressLine1>
          <City>Raleigh</City>
          <State>NC</State>
          <ZIPCode>27607</ZIPCode>
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          <BusinessNameLine1>Wake Early College</BusinessNameLine1>
        </RecipientBusinessName>
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          <AddressLine1>2901 Holston Lane</AddressLine1>
          <City>Raleigh</City>
          <State>NC</State>
          <ZIPCode>27610</ZIPCode>
        </USAddress>
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          <BusinessNameLine1>Wake Tech College Foundation</BusinessNameLine1>
        </RecipientBusinessName>
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          <AddressLine1>9101 Fayetteville Road</AddressLine1>
          <City>Raleigh</City>
          <State>NC</State>
          <ZIPCode>27603</ZIPCode>
        </USAddress>
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          <BusinessNameLine1>YMCA of the Triangle - AHA</BusinessNameLine1>
        </RecipientBusinessName>
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          <AddressLine1>801 Corporate Drive</AddressLine1>
          <City>Raleigh</City>
          <State>NC</State>
          <ZIPCode>27606</ZIPCode>
        </USAddress>
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          <BusinessNameLine1>Wake Co Human Services</BusinessNameLine1>
        </RecipientBusinessName>
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          <AddressLine1>PO Box 46833</AddressLine1>
          <City>Raleigh</City>
          <State>NC</State>
          <ZIPCode>27620</ZIPCode>
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          <AddressLine1>8310 Bandford Way</AddressLine1>
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          <ZIPCode>27615</ZIPCode>
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          <AddressLine1>1501 Poole Road</AddressLine1>
          <City>Raleigh</City>
          <State>NC</State>
          <ZIPCode>27610</ZIPCode>
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        <GrantTypeTxt>Prescription Drugs</GrantTypeTxt>
        <RecipientCnt>6273</RecipientCnt>
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        <NonCashAssistanceDesc>RX-INDIGENT PATIENTS</NonCashAssistanceDesc>
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        <FormAndLineReferenceDesc>PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS</FormAndLineReferenceDesc>
        <ExplanationTxt>SCHEDULE I, PART I, LINE 2 ALL GRANT/FUNDING REQUESTS MUST BE MADE IN WRITING, AND FREQUENTLY MEETINGS ARE HELD WITH REQUESTING ORGANIZATIONS TO ENSURE THE REQUESTS ARE IN ACCORDANCE WITH OUR GOALS AND GUIDELINES RELATED TO DONATIONS AND SPONSORSHIPS. ALL DONATIONS ARE COORDINATED THROUGH ONE DEPARTMENT AND ARE TRACKED AND LOGGED ON A SPREADSHEET WITH A QUICK REFERENCE TO THE REASON FOR THE GIFT. WAKEMED ALSO KEEPS A FILE ON EACH ORGANIZATION AND ALL ASSOCIATED PAPERWORK. IN MOST CASES, WAKEMED ALSO TRACKS HOW THE GIFT IS USED, OUTCOMES, AND BENEFITS TO THE COMMUNITY. IN THE CASE OF LARGE GRANTS, THE ORGANIZATION IS ALSO ASKED FOR A REPORT OF THE RESULTS AND THE IMPACT.</ExplanationTxt>
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        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>562780</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>449</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>7880</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>8189</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>811200</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>MARC T SILVER</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <BaseCompensationFilingOrgAmt>382290</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>306018</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>611</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>8128</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>25140</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>722187</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE J, PART I, LINE 1A</FormAndLineReferenceDesc>
        <ExplanationTxt>Tax indemnification and gross-up payments are paid to some key employees. They are included in taxable income.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE J, PART I, LINE 1B</FormAndLineReferenceDesc>
        <ExplanationTxt>Key Employees benefits requiring gross-up are covered by an employment agreement, and additional ones are approved by the Board of Directors.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE J, PART I, LINE 4A</FormAndLineReferenceDesc>
        <ExplanationTxt>Severence paid to William K. Atkinson, former CEO, $336,801.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE J, PART I, LINE 4B</FormAndLineReferenceDesc>
        <ExplanationTxt>WAKEMED MAINTAINED A 457F PLAN FOR CERTAIN INDIVIDUALS, HOWEVER NO 457F CONTRIBUTION WAS MADE DURING THE FISCAL YEAR ENDING 9/30/2014. THE FOLLOWING INDIVIDUALS PARTICIPATED IN WAKEMED'S 457F PLAN DURING THE FISCAL YEAR ENDING 9/30/2014: WILLIAM K. ATKINSON $0; MICHAEL D. DEVAUGHN $0; THOMAS GETTINGER $0; ROYLYN JOHNSON $0; DONALD R. GINTZIG $0; KATHLEEN K. GORMLEY $0; DAVID C. COULTER $0; JEANENE R. MARTIN $0; E. DENTON ARLEDGE $0; THOMAS G. CAVENDER $0; CAROLYN KNAUP $0; BETSY GASKINS-MCCLAINE $0; CYNTHIA ALNESS-BOILY $0; VICKI BLOCK $0; DUDLEY HARRINGTON $0; GEORGIA C. HARRINGTON $0; GURVINDER S. DEOL $0; JONATHAN D. CHAPPELL $0; MARK L. WOOD $0; OKECHUKWU E. NWOKO $0; MARC T. SILVER $0.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleJ>
    <IRS990ScheduleK documentId="IRS990ScheduleK">
      <TaxExemptBondsIssuesGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <IssuerName>
          <BusinessNameLine1>North Carolina Medical Care Commission</BusinessNameLine1>
        </IssuerName>
        <BondIssuerEIN>521309402</BondIssuerEIN>
        <CUSIPNum>65821DCS8</CUSIPNum>
        <BondIssuedDt>2009-02-26</BondIssuedDt>
        <IssuePriceAmt>75000000</IssuePriceAmt>
        <PurposeDesc>See Part VI</PurposeDesc>
        <DefeasedInd>false</DefeasedInd>
        <OnBehalfOfIssuerInd>false</OnBehalfOfIssuerInd>
        <PoolFinancingInd>false</PoolFinancingInd>
      </TaxExemptBondsIssuesGrp>
      <TaxExemptBondsIssuesGrp>
        <BondReferenceCd>B</BondReferenceCd>
        <IssuerName>
          <BusinessNameLine1>North Carolina Medical Care Commission</BusinessNameLine1>
        </IssuerName>
        <BondIssuerEIN>521309402</BondIssuerEIN>
        <CUSIPNum>65821DCW9</CUSIPNum>
        <BondIssuedDt>2009-07-16</BondIssuedDt>
        <IssuePriceAmt>81780000</IssuePriceAmt>
        <PurposeDesc>See Part VI</PurposeDesc>
        <DefeasedInd>false</DefeasedInd>
        <OnBehalfOfIssuerInd>false</OnBehalfOfIssuerInd>
        <PoolFinancingInd>false</PoolFinancingInd>
      </TaxExemptBondsIssuesGrp>
      <TaxExemptBondsIssuesGrp>
        <BondReferenceCd>C</BondReferenceCd>
        <IssuerName>
          <BusinessNameLine1>North Carolina Medical Care Commission</BusinessNameLine1>
        </IssuerName>
        <BondIssuerEIN>521309402</BondIssuerEIN>
        <CUSIPNum>65821DLY5</CUSIPNum>
        <BondIssuedDt>2012-07-11</BondIssuedDt>
        <IssuePriceAmt>315717962</IssuePriceAmt>
        <PurposeDesc>See Part VI</PurposeDesc>
        <DefeasedInd>false</DefeasedInd>
        <OnBehalfOfIssuerInd>false</OnBehalfOfIssuerInd>
        <PoolFinancingInd>false</PoolFinancingInd>
      </TaxExemptBondsIssuesGrp>
      <TaxExemptBondsProceedsGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <RetiredAmt>0</RetiredAmt>
        <BondDefeasedAmt>0</BondDefeasedAmt>
        <TotalProceedsAmt>75249667</TotalProceedsAmt>
        <InReserveFundAmt>0</InReserveFundAmt>
        <CapitalizedInterestAmt>0</CapitalizedInterestAmt>
        <RefundingEscrowAmt>0</RefundingEscrowAmt>
        <IssuanceCostsFromProceedsAmt>835544</IssuanceCostsFromProceedsAmt>
        <CreditEnhancementAmt>37919</CreditEnhancementAmt>
        <WorkingCapitalExpendituresAmt>0</WorkingCapitalExpendituresAmt>
        <CapitalExpendituresAmt>74376204</CapitalExpendituresAmt>
        <OtherSpentProceedsAmt>0</OtherSpentProceedsAmt>
        <UnspentAmt>0</UnspentAmt>
        <SubstantialCompletionYr>2010</SubstantialCompletionYr>
        <CurrentRefundingInd>false</CurrentRefundingInd>
        <AdvanceRefundingInd>false</AdvanceRefundingInd>
        <FinalAllocationMadeInd>true</FinalAllocationMadeInd>
        <AdequateBooksAndRecMaintInd>true</AdequateBooksAndRecMaintInd>
      </TaxExemptBondsProceedsGrp>
      <TaxExemptBondsProceedsGrp>
        <BondReferenceCd>B</BondReferenceCd>
        <RetiredAmt>14965000</RetiredAmt>
        <BondDefeasedAmt>0</BondDefeasedAmt>
        <TotalProceedsAmt>81780000</TotalProceedsAmt>
        <InReserveFundAmt>0</InReserveFundAmt>
        <CapitalizedInterestAmt>0</CapitalizedInterestAmt>
        <RefundingEscrowAmt>0</RefundingEscrowAmt>
        <IssuanceCostsFromProceedsAmt>817125</IssuanceCostsFromProceedsAmt>
        <CreditEnhancementAmt>41347</CreditEnhancementAmt>
        <WorkingCapitalExpendituresAmt>0</WorkingCapitalExpendituresAmt>
        <CapitalExpendituresAmt>0</CapitalExpendituresAmt>
        <OtherSpentProceedsAmt>80921528</OtherSpentProceedsAmt>
        <UnspentAmt>0</UnspentAmt>
        <SubstantialCompletionYr>2012</SubstantialCompletionYr>
        <CurrentRefundingInd>true</CurrentRefundingInd>
        <AdvanceRefundingInd>false</AdvanceRefundingInd>
        <FinalAllocationMadeInd>true</FinalAllocationMadeInd>
        <AdequateBooksAndRecMaintInd>true</AdequateBooksAndRecMaintInd>
      </TaxExemptBondsProceedsGrp>
      <TaxExemptBondsProceedsGrp>
        <BondReferenceCd>C</BondReferenceCd>
        <RetiredAmt>11590000</RetiredAmt>
        <BondDefeasedAmt>0</BondDefeasedAmt>
        <TotalProceedsAmt>315718038</TotalProceedsAmt>
        <InReserveFundAmt>0</InReserveFundAmt>
        <CapitalizedInterestAmt>0</CapitalizedInterestAmt>
        <RefundingEscrowAmt>172556427</RefundingEscrowAmt>
        <IssuanceCostsFromProceedsAmt>2994195</IssuanceCostsFromProceedsAmt>
        <CreditEnhancementAmt>0</CreditEnhancementAmt>
        <WorkingCapitalExpendituresAmt>0</WorkingCapitalExpendituresAmt>
        <CapitalExpendituresAmt>0</CapitalExpendituresAmt>
        <OtherSpentProceedsAmt>140167509</OtherSpentProceedsAmt>
        <UnspentAmt>0</UnspentAmt>
        <SubstantialCompletionYr>2012</SubstantialCompletionYr>
        <CurrentRefundingInd>true</CurrentRefundingInd>
        <AdvanceRefundingInd>true</AdvanceRefundingInd>
        <FinalAllocationMadeInd>true</FinalAllocationMadeInd>
        <AdequateBooksAndRecMaintInd>true</AdequateBooksAndRecMaintInd>
      </TaxExemptBondsProceedsGrp>
      <TaxExemptBondsPrivateBusUseGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <OwningBondFinancedPropertyInd>false</OwningBondFinancedPropertyInd>
        <AnyLeaseArrangementsInd>false</AnyLeaseArrangementsInd>
        <MgmtContractBondFincdPropInd>true</MgmtContractBondFincdPropInd>
        <EngageBondCounselContractsInd>true</EngageBondCounselContractsInd>
        <AnyResearchAgreementsInd>false</AnyResearchAgreementsInd>
        <PrivateBusUseByOthersPct>0.00000</PrivateBusUseByOthersPct>
        <PrivateBusConcerningUBIPct>0.00000</PrivateBusConcerningUBIPct>
        <TotalPrivateBusinessUsePct>0.00000</TotalPrivateBusinessUsePct>
        <BondIssMeetPrvtSecPymtTestInd>false</BondIssMeetPrvtSecPymtTestInd>
        <ChangeInUseBondFinancedPropInd>false</ChangeInUseBondFinancedPropInd>
        <ChangeInUseBondFinancedPropPct>0.00000</ChangeInUseBondFinancedPropPct>
        <RemedialActionTakenInd>false</RemedialActionTakenInd>
        <ProcsNonqualifiedBondRemdtdInd>true</ProcsNonqualifiedBondRemdtdInd>
      </TaxExemptBondsPrivateBusUseGrp>
      <TaxExemptBondsPrivateBusUseGrp>
        <BondReferenceCd>B</BondReferenceCd>
        <OwningBondFinancedPropertyInd>false</OwningBondFinancedPropertyInd>
        <AnyLeaseArrangementsInd>false</AnyLeaseArrangementsInd>
        <MgmtContractBondFincdPropInd>false</MgmtContractBondFincdPropInd>
        <AnyResearchAgreementsInd>false</AnyResearchAgreementsInd>
        <PrivateBusUseByOthersPct>0.00000</PrivateBusUseByOthersPct>
        <PrivateBusConcerningUBIPct>0.00000</PrivateBusConcerningUBIPct>
        <TotalPrivateBusinessUsePct>0.00000</TotalPrivateBusinessUsePct>
        <BondIssMeetPrvtSecPymtTestInd>false</BondIssMeetPrvtSecPymtTestInd>
        <ChangeInUseBondFinancedPropInd>false</ChangeInUseBondFinancedPropInd>
        <ChangeInUseBondFinancedPropPct>0.00000</ChangeInUseBondFinancedPropPct>
        <RemedialActionTakenInd>false</RemedialActionTakenInd>
        <ProcsNonqualifiedBondRemdtdInd>true</ProcsNonqualifiedBondRemdtdInd>
      </TaxExemptBondsPrivateBusUseGrp>
      <TaxExemptBondsPrivateBusUseGrp>
        <BondReferenceCd>C</BondReferenceCd>
        <OwningBondFinancedPropertyInd>false</OwningBondFinancedPropertyInd>
        <AnyLeaseArrangementsInd>true</AnyLeaseArrangementsInd>
        <MgmtContractBondFincdPropInd>true</MgmtContractBondFincdPropInd>
        <EngageBondCounselContractsInd>true</EngageBondCounselContractsInd>
        <AnyResearchAgreementsInd>false</AnyResearchAgreementsInd>
        <PrivateBusUseByOthersPct>0.00000</PrivateBusUseByOthersPct>
        <PrivateBusConcerningUBIPct>0.00000</PrivateBusConcerningUBIPct>
        <TotalPrivateBusinessUsePct>0.00000</TotalPrivateBusinessUsePct>
        <BondIssMeetPrvtSecPymtTestInd>false</BondIssMeetPrvtSecPymtTestInd>
        <ChangeInUseBondFinancedPropInd>false</ChangeInUseBondFinancedPropInd>
        <ChangeInUseBondFinancedPropPct>0.00000</ChangeInUseBondFinancedPropPct>
        <RemedialActionTakenInd>false</RemedialActionTakenInd>
        <ProcsNonqualifiedBondRemdtdInd>true</ProcsNonqualifiedBondRemdtdInd>
      </TaxExemptBondsPrivateBusUseGrp>
      <TaxExemptBondsArbitrageGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <Form8038TFiledInd>false</Form8038TFiledInd>
        <RebateNotDueYetInd>false</RebateNotDueYetInd>
        <ExceptionToRebateInd>false</ExceptionToRebateInd>
        <NoRebateDueInd>true</NoRebateDueInd>
        <VariableRateIssueInd>true</VariableRateIssueInd>
        <HedgeIdentifiedInBksAndRecInd>false</HedgeIdentifiedInBksAndRecInd>
        <HedgeProviderName>
          <BusinessNameLine1>0</BusinessNameLine1>
        </HedgeProviderName>
        <GrossProceedsInvestedInGICInd>false</GrossProceedsInvestedInGICInd>
        <GICProviderName>
          <BusinessNameLine1>0</BusinessNameLine1>
        </GICProviderName>
        <GrossProceedsInvestedInd>false</GrossProceedsInvestedInd>
        <WrittenProcToMonitorReqsInd>true</WrittenProcToMonitorReqsInd>
      </TaxExemptBondsArbitrageGrp>
      <TaxExemptBondsArbitrageGrp>
        <BondReferenceCd>B</BondReferenceCd>
        <Form8038TFiledInd>false</Form8038TFiledInd>
        <RebateNotDueYetInd>false</RebateNotDueYetInd>
        <ExceptionToRebateInd>false</ExceptionToRebateInd>
        <NoRebateDueInd>true</NoRebateDueInd>
        <VariableRateIssueInd>true</VariableRateIssueInd>
        <HedgeIdentifiedInBksAndRecInd>false</HedgeIdentifiedInBksAndRecInd>
        <HedgeProviderName>
          <BusinessNameLine1>0</BusinessNameLine1>
        </HedgeProviderName>
        <GrossProceedsInvestedInGICInd>false</GrossProceedsInvestedInGICInd>
        <GICProviderName>
          <BusinessNameLine1>0</BusinessNameLine1>
        </GICProviderName>
        <GrossProceedsInvestedInd>false</GrossProceedsInvestedInd>
        <WrittenProcToMonitorReqsInd>true</WrittenProcToMonitorReqsInd>
      </TaxExemptBondsArbitrageGrp>
      <TaxExemptBondsArbitrageGrp>
        <BondReferenceCd>C</BondReferenceCd>
        <Form8038TFiledInd>false</Form8038TFiledInd>
        <RebateNotDueYetInd>true</RebateNotDueYetInd>
        <ExceptionToRebateInd>false</ExceptionToRebateInd>
        <NoRebateDueInd>false</NoRebateDueInd>
        <VariableRateIssueInd>false</VariableRateIssueInd>
        <HedgeIdentifiedInBksAndRecInd>false</HedgeIdentifiedInBksAndRecInd>
        <HedgeProviderName>
          <BusinessNameLine1>0</BusinessNameLine1>
        </HedgeProviderName>
        <GrossProceedsInvestedInGICInd>false</GrossProceedsInvestedInGICInd>
        <GICProviderName>
          <BusinessNameLine1>0</BusinessNameLine1>
        </GICProviderName>
        <GrossProceedsInvestedInd>false</GrossProceedsInvestedInd>
        <WrittenProcToMonitorReqsInd>true</WrittenProcToMonitorReqsInd>
      </TaxExemptBondsArbitrageGrp>
      <ProceduresCorrectiveActionGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <ProceduresCorrectiveActionInd>true</ProceduresCorrectiveActionInd>
      </ProceduresCorrectiveActionGrp>
      <ProceduresCorrectiveActionGrp>
        <BondReferenceCd>B</BondReferenceCd>
        <ProceduresCorrectiveActionInd>true</ProceduresCorrectiveActionInd>
      </ProceduresCorrectiveActionGrp>
      <ProceduresCorrectiveActionGrp>
        <BondReferenceCd>C</BondReferenceCd>
        <ProceduresCorrectiveActionInd>true</ProceduresCorrectiveActionInd>
      </ProceduresCorrectiveActionGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PURPOSE</FormAndLineReferenceDesc>
        <ExplanationTxt>Schedule K, Part I, A(f) Financing (a) costs of construction, renovating and equipping certain hospital facilities, including WakeMed Cary 2-story vertical expansion, 10-bed Labor and Delivery unit expansion and parking deck, WakeMed Raleigh 4-story patient tower, parking deck for visitors and patients, employee parking deck, portions of Rehabilitation Hospital for inpatient beds, the first floor of the main hospital for a 25-bed observation unit and related, and other equipment; (b) initial costs for credit facility for the bonds; and (c) issuance costs.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PURPOSE</FormAndLineReferenceDesc>
        <ExplanationTxt>SCHEDULE K, PART I, B(f) Financing (a) costs of currently refunding all outstanding series 1997 bonds issued April 1, 1997. The series 1997 bonds were issued to refund all of series 1993 and 1988 bonds, which were issued to finance costs of constructing, expanding, renovating, and equipping certain hospital facilities, including construction of WakeMed Cary Hospital, a 2-story addition of the WakeMed main campus, a 45-bed Rehabilitation Hospital and related, and other equipment; and (b) issuance costs.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PURPOSE</FormAndLineReferenceDesc>
        <ExplanationTxt>Schedule K, Part I, C(f) The series 2012A bonds were issued to refund all the series 2001 and the 2009A bonds and pay certain expenses incurred in the connection with the issuance and sale of the 2012A bonds. The proceeds of the refunded 2001 bonds and the refunded 2009A bonds were used to finance the costs of various improvements to the corporation's healthcare facilities. The date of issue for the refunded 2001 bonds is 3/15/2001 and date of issue for the refunded 2009A bonds is 2/10/2009.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Total proceeds of issue</FormAndLineReferenceDesc>
        <ExplanationTxt>Schedule K, Part II, 3, Columns A, B, &amp; C Total proceeds include investment earnings.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Issuance Costs from proceeds</FormAndLineReferenceDesc>
        <ExplanationTxt>Schedule K, Part II, Line 7, Columns A, B, &amp; C The amounts reported on Form 8038 as proceeds used for bond issuance costs were estimates. The amounts reported on Schedule K represent the actual use of proceeds. Schedule K credit enhancement reported was from the initial letter of credit fee paid from bond proceeds. This amount was unknown at the time of the Form 8038 preparation.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Capital expenditures from proceeds</FormAndLineReferenceDesc>
        <ExplanationTxt>Schedule K, Part II, Line 10, Column A Bond series 2009B generated $249,667 in interest.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Arbitrage rebate</FormAndLineReferenceDesc>
        <ExplanationTxt>Schedule K, Part IV, 2c Arbitrage rebate calculation performed on 2/25/2014 for A; 7/15/2014 for B, next scheduled calculation date for C is 10/1/2017.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleK>
    <IRS990ScheduleO documentId="IRS990ScheduleO">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>DBA'S FOR WAKEMED</FormAndLineReferenceDesc>
        <ExplanationTxt>FORM 990, HEADER C, DBA 1 Wake Medical Center 2 Western Wake Hospital 3 Northern Wake Hospital 4 Wake Heart Center 5 Western Wake Medical Center 6 Wake Rehabilitation Hospital 7 Wake Area Health Education Center 8 Wake AHEC 9 Eastern Wake Day Hospital and Skilled Nursing Facility 10 WakeMed Home Care 11 WakeMed - New Bern Avenue Campus 12 WakeMed - Western Wake Medical Center 13 WakeMed - Rehab 14 WakeMed - Fuquay-Varina 15 WakeMed - Zebulon-Wendell 16 WakeMed Raleigh Campus 17 WakeMed Cary Hospital 18 WakeMed North Healthplex 19 WakeMed Clayton Medical Park 20 WakeMed Cary Outpatient Rehab Center 21 WakeMed Fuquay-Varina Outpatient &amp; Skilled Nursing Facility 22 WakeMed Zebulon/Wendell Outpatient &amp; Skilled Nursing Facility 23 WakeMed Wake Forest Road Outpatient Rehab Center 24 WakeMed Home Health 25 WakeMed Health &amp; Hospitals 26 WakeMed Emergency Services Institute 27 WakeMed Center for Patient Safety 28 WakeMed Apex Healthplex 29 WakeMed Apex Day Surgery Center, LLC 30 WakeMed Professional Staff 31 WakeMed Mobile Critical Care Services 32 WakeMed Center for Innovative Learning 33 WakeMed Brier Creek Healthplex 34 WakeMed Outpatient Pharmacy 35 WakeMed Garner Healthplex 36 WakeMed Zebulon/Wendell Outpatient Rehabilitation 39 WakeMed Brier Creek Medical Park 40 WakeMed Raleigh Medical Park 41 WakeMed OP Rehab - Banks D Kerr Family YMCA Raleigh, NC 42 WakeMed OP Rehab - Cary Family YMCA Cary, NC 43 WakeMed OP Rehab - Kraft Family YMCA Apex, NC 44 WakeMed OP Rehab - Alexander Family YMCA Raleigh, NC 45 Wake Specialty Brier Creek Internal Medicine 46 Wake Specialty ENT - Head &amp; Neck Surgery 47 Wake Specialty Facial Plastics 48 Wake Specialty Gastroenterology &amp; Hepatology 49 Wake Specialty General Surgery 50 Wake Specialty OB/GYN 51 Wake Specialty Physicians ENT - Head &amp; Neck Surgery 52 Wake Specialty Physicians Facial Plastics 53 Wake Specialty Physicians Gastroenterology &amp; Hepatology 54 Wake Specialty Physicians General Surgery 55 Wake Specialty Physicians Internal Medicine Brier Creek 56 Wake Specialty Physicians OB/GYN 57 Wake Specialty Physicians Urology 58 Wake Specialty Physicians Women's Center 59 Wake Specialty Urology 60 Wake Specialty Women's Center 61 Wake Specialty Physicians Maternal Fetal Medicine 62 Wake Specialty Physicians Employee Health 63 Falls Pointe Medical Group 64 Wake Specialty Physicians - City Center Medical Group 65 Wake Specialty Physicians - Carolina Cardiology 66 Wake Specialty Physicians - Concussion Clinic 67 Wake Specialty Physicians - Apex Medical Group 68 Wake Specialty Physicians - Holly Springs Medical Group 69 Wake Specialty Physicians - Accent Urgent Care 70 Wake Specialty Physicians - Wake Orthopaedics 71 Wake Specialty Physicians - North Wake Internal Medicine 72 Wake Specialty Physicians Pulmonology 73 Wake Specialty Physicians - Knightdale Family Practice 74 Wake Specialty Physicians - Carolina Cardiovascular Surgical Associates 75 Wake Specialty Physicians - Cary Cardiology 76 Wake Specialty Physicians - Capital Urology 77 Wake Specialty Physicians - Harnett Surgical Associates 78 Wake Specialty Physicians - Morrisville Primary Care 79 Wake Specialty Physicians - Garner Primary Care 80 Wake Specialty Physicians - Fuquay Varina Primary Care 81 Wake Specialty Physicians - Wellness Family Practice 82 Wake Specialty Physicians - Structural Heart 83 Wake Specialty Physicians - Raleigh Cardiology 84 Wake Specialty Physicians - Raleigh Cardiology Associates 85 Wake Specialty Physicians - Cardiovascular 86 Wake Specialty Physicians - Parkway Primary Care</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>OTHER PROGRAM SERVICES</FormAndLineReferenceDesc>
        <ExplanationTxt>FORM 990, PART III, LINE 4D OTHER PROGRAM SERVICES INCLUDE HOSPITAL IN AND OUTPATIENT ANCILLARY CARE SERVICES IN OTHER SPECIALTY AREAS NOT LISTED ABOVE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>MEMBERS, STOCKHOLDERS, OR OTHER PERSONS W/ POWER TO APPOINT GOVERNING BODY</FormAndLineReferenceDesc>
        <ExplanationTxt>FORM 990, PART VI, SECTION A, LINE 7A EIGHT MEMBERS OF THE BOARD ARE APPOINTED TO THE BOARD OF DIRECTORS BY WAKE COUNTY.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>GOVERNANCE DECISIONS RESERVED TO MEMBERS, STOCKHOLDERS, OR PERSONS OTHER</FormAndLineReferenceDesc>
        <ExplanationTxt>THAN THE GOVERNING BODY FORM 990, PART VI, SECTION A, LINE 7B THE WAKE COUNTY BOARD OF COMMISSIONERS HOLDS LIMITED APPROVAL OVER SOME GOVERNING BODY DECISIONS PERTAINING TO ARTICLES V, VI, VII AND IX IN THE ARTICLES OF INCORPORATION. THE TRANSFER AGREEMENT WITH WAKE COUNTY INDICATES APPROVAL/CONSENT FOR TRANSACTIONS PERTAINING TO SUBSTANTIAL DISPOSITION OF ASSETS AND COVENANTS ON LIENS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PROCESS USED BY THE ORGANIZATION TO REVIEW FORM 990</FormAndLineReferenceDesc>
        <ExplanationTxt>FORM 990, PART VI, SECTION B, LINE 11B THE ENTIRE 990 AND ASSOCIATED SCHEDULES ARE REVIEWED BY THE FINANCE COMMITTEE OF THE BOARD OF DIRECTORS TO ACKNOWLEDGE THEY HAVE REVIEWED FORMS AND SCHEDULES AND THEN RECOMMEND APPROVAL TO THE BOARD. A FINAL COPY IS PROVIDED TO THE BOARD BEFORE FILING.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>MONITORING WRITTEN CONFLICT OF INTEREST POLICY</FormAndLineReferenceDesc>
        <ExplanationTxt>FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION MONITORS AND ENFORCES THE CONFLICT OF INTEREST POLICY IN VARIOUS WAYS. EACH YEAR, MEMBERS OF THE BOARD, COMMITTEES WITH BOARD DELEGATED POWERS, CEO, CORPORATE STAFF, EXECUTIVE STAFF, DIRECTORS AND MANAGERS ARE REQUIRED TO COMPLETE AND SUBMIT A CONFLICT OF INTEREST QUESTIONNAIRE. THOSE INDIVIDUALS ARE REQUIRED TO PROVIDE WRITTEN DOCUMENTATION OF ANY POTENTIAL CONFLICT OF INTEREST, IDENTIFYING MATERIAL FINANCIAL INTEREST/PERSONAL CONFLICTS OF INTEREST. REMEDIAL MEASURES IMPLEMENTED TO ADDRESS CONFLICTS OF INTEREST INCLUDE ABSTENTION FROM VOTING ON CERTAIN ISSUES AS WELL AS RECUSAL FROM THE DECISION MAKING PROCESS AND PARTICIPATION INVOLVING THE IDENTIFIED ISSUE/AREA. THE CODE OF CONDUCT PROVIDES GUIDANCE ON GIFTS AND TRAVEL. GIFTS SHOULD NOT BE ACCEPTED AND PRIOR TO ANY TRAVEL/LODGING THAT IS PAID FOR BY A THIRD PARTY WRITTEN APPROVAL MUST BE OBTAINED FROM AN EXECUTIVE VICE PRESIDENT. ALSO, EMPLOYEES WHO OWN OR WORK IN A PRIVATE BUSINESS OUTSIDE OF WAKEMED ARE NOT ALLOWED TO RECRUIT OR PROMOTE THEIR PRODUCTS AND SERVICES DURING WORK HOURS OR THROUGH WAKEMED PRINTED MATERIALS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PROCESS FOR DETERMINING COMPENSATION OF CEO, EXEC. DIR., OR TOP MGMT</FormAndLineReferenceDesc>
        <ExplanationTxt>OFFICIAL FORM 990, PART VI, SECTION B, LINES 15A &amp; 15B REVIEW OF COMPENSATION IS PERFORMED BY AN INDEPENDENT FIRM. EVERY THREE YEARS THEY PERFORM AN EXECUTIVE COMPETITIVE COMPENSATION REVIEW. ON ALTERNATE YEARS THE SVP/HR PRESENTS MARKET DATA COMPARISONS TO A BOARD OF DIRECTOR'S COMMITTEE FOR REVIEW.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>AVAILABILITY OF FINANCIAL STMTS, CONFLICT OF INTEREST, ORGANIZING DOCS</FormAndLineReferenceDesc>
        <ExplanationTxt>FORM 990, PART VI, SECTION C, LINE 19 THE 990 IS AVAILABLE BY REQUEST AND IS PUBLISHED ON GUIDESTAR. FINANCIAL STATEMENTS ARE PUBLICALLY AVAILABLE THROUGH THE MEDICAL CARE COMMISSION AS IT RELATES TO TAX EXEMPT DEBT. THE ANNUAL AUDITED FINANCIAL STATEMENTS AND TRANSFER AGREEMENT ARE PROVIDED EACH YEAR TO WAKE COUNTY COMMISSIONERS AND BECOME PUBLIC INFORMATION. ARTICLES OF INCORPORATION ARE AVAILABLE ON NC SECRETARY OF STATE WEBSITE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>OTHER CHANGES IN NET ASSETS</FormAndLineReferenceDesc>
        <ExplanationTxt>FORM 990, PART XI, LINE 9 CHANGES IN NET ASSETS DURING THE YEAR INCLUDED CAPITAL ASSET RENOVATIONS TO THE NEONATAL ICU, THE EXPANSION OF THE NORTH HEALTHPLEX, CENTRAL PLANT IMPROVEMENTS, AND THE PURCHASE AND IMPLEMENTATION OF EPIC SYSTEMS. - $27,028,703.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="IRS990ScheduleR">
      <IdDisregardedEntitiesGrp>
        <DisregardedEntityName>
          <BusinessNameLine1>WAKE ORTHOPAEDICS LLC</BusinessNameLine1>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1>3009 New Bern Ave</AddressLine1>
          <City>Raleigh</City>
          <State>NC</State>
          <ZIPCode>27610</ZIPCode>
        </USAddress>
        <EIN>043750760</EIN>
        <PrimaryActivitiesTxt>MED. OFFICE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NC</LegalDomicileStateCd>
        <TotalIncomeAmt>10240350</TotalIncomeAmt>
        <EndOfYearAssetsAmt>0</EndOfYearAssetsAmt>
        <DirectControllingEntityName>
          <BusinessNameLine1>na</BusinessNameLine1>
        </DirectControllingEntityName>
      </IdDisregardedEntitiesGrp>
      <IdDisregardedEntitiesGrp>
        <DisregardedEntityName>
          <BusinessNameLine1>Cardiac Innovations LLC</BusinessNameLine1>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1>3000 New Bern Ave</AddressLine1>
          <City>Raleigh</City>
          <State>NC</State>
          <ZIPCode>27610</ZIPCode>
        </USAddress>
        <EIN>260554927</EIN>
        <PrimaryActivitiesTxt>EQUIP LEASING</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NC</LegalDomicileStateCd>
        <TotalIncomeAmt>6424</TotalIncomeAmt>
        <EndOfYearAssetsAmt>87929</EndOfYearAssetsAmt>
        <DirectControllingEntityName>
          <BusinessNameLine1>na</BusinessNameLine1>
        </DirectControllingEntityName>
      </IdDisregardedEntitiesGrp>
      <IdDisregardedEntitiesGrp>
        <DisregardedEntityName>
          <BusinessNameLine1>Wake Specialty Physicians LLC</BusinessNameLine1>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1>2009 New Bern Ave</AddressLine1>
          <City>Raleigh</City>
          <State>NC</State>
          <ZIPCode>27610</ZIPCode>
        </USAddress>
        <EIN>264169156</EIN>
        <PrimaryActivitiesTxt>MED. OFFICE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NC</LegalDomicileStateCd>
        <TotalIncomeAmt>69953999</TotalIncomeAmt>
        <EndOfYearAssetsAmt>14543054</EndOfYearAssetsAmt>
        <DirectControllingEntityName>
          <BusinessNameLine1>na</BusinessNameLine1>
        </DirectControllingEntityName>
      </IdDisregardedEntitiesGrp>
      <IdDisregardedEntitiesGrp>
        <DisregardedEntityName>
          <BusinessNameLine1>CSAMS New Bern Ave LLC</BusinessNameLine1>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1>3000 New Bern Ave</AddressLine1>
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          <State>NC</State>
          <ZIPCode>27610</ZIPCode>
        </USAddress>
        <PrimaryActivitiesTxt>Healthcare</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NC</LegalDomicileStateCd>
        <TotalIncomeAmt>0</TotalIncomeAmt>
        <EndOfYearAssetsAmt>778218</EndOfYearAssetsAmt>
        <DirectControllingEntityName>
          <BusinessNameLine1>na</BusinessNameLine1>
        </DirectControllingEntityName>
      </IdDisregardedEntitiesGrp>
      <IdDisregardedEntitiesGrp>
        <DisregardedEntityName>
          <BusinessNameLine1>PARTNERS IN PRACTICE LLC</BusinessNameLine1>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1>3000 NEW BERN AVE</AddressLine1>
          <City>RALEIGH</City>
          <State>NC</State>
          <ZIPCode>27610</ZIPCode>
        </USAddress>
        <EIN>271164650</EIN>
        <PrimaryActivitiesTxt>MED. OFFICE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NC</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1>NA</BusinessNameLine1>
        </DirectControllingEntityName>
      </IdDisregardedEntitiesGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1>WakeMed Property Services</BusinessNameLine1>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1>3000 New Bern Ave</AddressLine1>
          <City>Raleigh</City>
          <State>NC</State>
          <ZIPCode>27610</ZIPCode>
        </USAddress>
        <EIN>561133894</EIN>
        <PrimaryActivitiesTxt>Leasing</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NC</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>11b</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1>na</BusinessNameLine1>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1>WakeMed Faculty Practice Plan</BusinessNameLine1>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1>3000 New Bern Ave</AddressLine1>
          <City>Raleigh</City>
          <State>NC</State>
          <ZIPCode>27610</ZIPCode>
        </USAddress>
        <EIN>237169178</EIN>
        <PrimaryActivitiesTxt>Medical</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NC</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>11b</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1>na</BusinessNameLine1>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1>The Volunteers at Cary Campus</BusinessNameLine1>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1>3000 NEW BERN AVE</AddressLine1>
          <City>Raleigh</City>
          <State>NC</State>
          <ZIPCode>27610</ZIPCode>
        </USAddress>
        <EIN>561798031</EIN>
        <PrimaryActivitiesTxt>Volunteers</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NC</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>11b</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1>na</BusinessNameLine1>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1>The Volunteers at Raleigh Campus</BusinessNameLine1>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1>3000 New Bern Ave</AddressLine1>
          <City>Raleigh</City>
          <State>NC</State>
          <ZIPCode>27610</ZIPCode>
        </USAddress>
        <EIN>560749114</EIN>
        <PrimaryActivitiesTxt>Volunteers</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NC</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>11b</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1>na</BusinessNameLine1>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1>WakeMed Foundation</BusinessNameLine1>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1>3000 New Bern Ave</AddressLine1>
          <City>Raleigh</City>
          <State>NC</State>
          <ZIPCode>27610</ZIPCode>
        </USAddress>
        <EIN>561916549</EIN>
        <PrimaryActivitiesTxt>Support</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NC</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>7</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1>na</BusinessNameLine1>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedOrgTxblPartnershipGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1>CAPITAL SURGERY CTR</BusinessNameLine1>
        </RelatedOrganizationName>
        <EIN>260804803</EIN>
        <PrimaryActivitiesTxt>Healthcare</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NC</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1>na</BusinessNameLine1>
        </DirectControllingEntityName>
        <PredominantIncomeTypeTxt>Related</PredominantIncomeTypeTxt>
        <ShareOfTotalIncomeAmt>5875291</ShareOfTotalIncomeAmt>
        <ShareOfEOYAssetsAmt>4692776</ShareOfEOYAssetsAmt>
        <DisproportionateAllocationsInd>false</DisproportionateAllocationsInd>
        <UBICodeVAmt>0</UBICodeVAmt>
        <GeneralOrManagingPartnerInd>false</GeneralOrManagingPartnerInd>
        <OwnershipPct>0.50000</OwnershipPct>
      </IdRelatedOrgTxblPartnershipGrp>
      <IdRelatedOrgTxblPartnershipGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1>WakePet Services</BusinessNameLine1>
        </RelatedOrganizationName>
        <EIN>263108205</EIN>
        <PrimaryActivitiesTxt>Equipment leasing</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NC</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1>na</BusinessNameLine1>
        </DirectControllingEntityName>
        <PredominantIncomeTypeTxt>Related</PredominantIncomeTypeTxt>
        <ShareOfTotalIncomeAmt>196963</ShareOfTotalIncomeAmt>
        <ShareOfEOYAssetsAmt>58982</ShareOfEOYAssetsAmt>
        <DisproportionateAllocationsInd>false</DisproportionateAllocationsInd>
        <UBICodeVAmt>0</UBICodeVAmt>
        <GeneralOrManagingPartnerInd>false</GeneralOrManagingPartnerInd>
        <OwnershipPct>0.50000</OwnershipPct>
      </IdRelatedOrgTxblPartnershipGrp>
      <IdRelatedOrgTxblPartnershipGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1>BabyCompany WakeMed</BusinessNameLine1>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1>1345 Ave of the Americas23rd Fl</AddressLine1>
          <City>New York</City>
          <State>NY</State>
          <ZIPCode>10105</ZIPCode>
        </USAddress>
        <EIN>472167148</EIN>
        <PrimaryActivitiesTxt>Healthcare</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1>NA</BusinessNameLine1>
        </DirectControllingEntityName>
        <PredominantIncomeTypeTxt>NONE</PredominantIncomeTypeTxt>
        <ShareOfTotalIncomeAmt>0</ShareOfTotalIncomeAmt>
        <ShareOfEOYAssetsAmt>0</ShareOfEOYAssetsAmt>
        <DisproportionateAllocationsInd>false</DisproportionateAllocationsInd>
        <UBICodeVAmt>0</UBICodeVAmt>
        <GeneralOrManagingPartnerInd>false</GeneralOrManagingPartnerInd>
        <OwnershipPct>0.50000</OwnershipPct>
      </IdRelatedOrgTxblPartnershipGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1>Dogwood Insurance Company (SPC) LTD</BusinessNameLine1>
        </RelatedOrganizationName>
        <ForeignAddress>
          <AddressLine1>PO Box 493 Century Yard</AddressLine1>
          <City>Grand Cayman</City>
          <Country>CJ</Country>
          <PostalCode>KY1-1106</PostalCode>
        </ForeignAddress>
        <PrimaryActivitiesTxt>Captive</PrimaryActivitiesTxt>
        <LegalDomicileForeignCountryCd>CJ</LegalDomicileForeignCountryCd>
        <DirectControllingEntityName>
          <BusinessNameLine1>na</BusinessNameLine1>
        </DirectControllingEntityName>
        <ShareOfTotalIncomeAmt>0</ShareOfTotalIncomeAmt>
        <ShareOfEOYAssetsAmt>41923021</ShareOfEOYAssetsAmt>
        <OwnershipPct>1.00000</OwnershipPct>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1>WakeMed Key Community Care LLC</BusinessNameLine1>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1>3000 New Bern Avenue</AddressLine1>
          <City>Raleigh</City>
          <State>NC</State>
          <ZIPCode>27610</ZIPCode>
        </USAddress>
        <EIN>462853835</EIN>
        <PrimaryActivitiesTxt>ACO</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NC</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1>na</BusinessNameLine1>
        </DirectControllingEntityName>
        <ShareOfTotalIncomeAmt>0</ShareOfTotalIncomeAmt>
        <ShareOfEOYAssetsAmt>299139</ShareOfEOYAssetsAmt>
        <OwnershipPct>1.00000</OwnershipPct>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <ReceiptOfIntAnntsRntsRyltsInd>false</ReceiptOfIntAnntsRntsRyltsInd>
      <GiftGrntOrCapContriToOthOrgInd>false</GiftGrntOrCapContriToOthOrgInd>
      <GiftGrntCapContriFromOthOrgInd>false</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>false</LoansOrGuaranteesToOtherOrgInd>
      <LoansOrGuaranteesFromOthOrgInd>false</LoansOrGuaranteesFromOthOrgInd>
      <DivRelatedOrganizationInd>false</DivRelatedOrganizationInd>
      <AssetSaleToOtherOrgInd>false</AssetSaleToOtherOrgInd>
      <AssetPurchaseFromOtherOrgInd>false</AssetPurchaseFromOtherOrgInd>
      <AssetExchangeInd>false</AssetExchangeInd>
      <RentalOfFacilitiesToOthOrgInd>true</RentalOfFacilitiesToOthOrgInd>
      <RentalOfFcltsFromOthOrgInd>true</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>false</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>false</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>false</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>false</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>false</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>true</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>true</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>true</TransferFromOtherOrgInd>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE R, PART I, LINE 5</FormAndLineReferenceDesc>
        <ExplanationTxt>Partners in Practice, LLC was dissolved June 10, 2014.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleR>
  </ReturnData>
</Return>