2015-05-14T14:00:32-05:00 2014-06-30 990 2013-07-01 560543238 LEXINGTON MEDICAL CENTER LEXI 3362485161 PO BOX 1817 250 HOSPITAL DRIVE LEXINGTON NC 272931817 DANNY W SQUIRES CHIEF FINANCIAL OFFICER 3362485161 2015-05-12 2013 2016-02-25 16:41:14Z WILLIAM B JAMES PO BOX 1817 250 HOSPITAL DRIVE LEXINGTON NC 272931817 77779031 0 X WWW.LEXINGTON.WAKEHEALTH.EDU X 1954 NC TO MAINTAIN AND OPERATE HOSPITALS, CLINICS, AND OTHER RELATED FACILITIES TO PROVIDE FOR THE CARE AND TREATMENT OF PERSONS SUFFERING FROM ILLNESSES, INJURIES OR DISABILITIES WHICH REQUIRE HOSPITAL CARE, TO SUPPLY EQUIPMENT AND FACILITIES TO AID IN THE TREATMENT AND DIAGNOSIS OF DISEASE, TO CARRY ON EDUCATIONAL ACTIVITIES RELATED TO THE CARE OF THE SICK AND DISABLED AND THE PROMOTION OF HEALTH AND PREVENTIVE MEDICINES, TO AID IN THE INSTRUCTION AND PROMOTION OF RESEARCH AND SCIENTIFIC INVESTIGATION IN ALL BRANCHES OF MEDICINE AND SURGERY AND TO PARTICIPATE IN ANY ACTIVITY DESIGNED AND CARRIED ON TO PROMOTE THE GENERAL HEALTH OF THE COMMUNITY. 18 17 861 71 4067451 -28881 1789154 0 85299089 77592101 264146 167985 1082564 17216 88434953 77777302 0 95034 0 0 34737060 29901171 0 0 0 45258741 41217088 79995801 71213293 8439152 6564009 59975488 65699999 28096485 27158465 31879003 38541534 THE MISSION OF LEXINGTON MEDICAL CENTER IS TO PROVIDE AN APPROPRIATE LEVEL OF INPATIENT AND OUTPATIENT HEALTHCARE SERVICES IN A HIGH QUALITY, COMPASSIONATE AND COST-EFFECTIVE MANNER TO ANYONE WHO PRESENTS IN NEED. 0 0 67190510 95034 73524650 OPERATION OF HOSPITAL, CLINICS AND OTHER RELATED FACILITIES TO EDUCATE, DIAGNOSE AND PROVIDE CARE AND TREATMENT FOR PERSONS WHO REQUIRE HOSPITAL CARE. LEXINGTON MEDICAL CENTER IS AN 94 BED HOSPITAL. DURING THE FISCAL YEAR ENDED JUNE 30, 2014, THE HOSPITAL HAD 1,914 INPATIENT ADMISSIONS, 40,774 OUTPATIENT ENCOUNTERS AND 21,398 ED VISITS. 67190510 1 0 0 1 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 11 0 1 861 1 1 1 0 0 0 0 0 0 0 0 0 X 18 17 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 1 0 X DANNY W SQUIRES 3362485161 PO BOX 1817250 HOSPITAL DRIVE LEXINGTON NC 272931817 JOHN FRANK DIRECTOR 2.00 X 0 0 0 JEFF MAST CHAIRMAN 6.00 X X 0 0 0 GORDON KAMMIRE MD DIRECTOR 2.00 X 0 0 0 KAYE LEONARD DIRECTOR 2.00 X 0 0 0 ROBERT CRAVEN DIRECTOR 2.00 X 0 0 0 KAREN CRAVER DIRECTOR 2.00 X 0 0 0 TERRA GREENE VICE CHAIRMAN 2.00 X X 0 0 0 TERRY L HALES JR DIRECTOR 2.00 X 0 0 0 JAMES HOEKSTRA MD DIRECTOR 2.00 X 0 0 0 LARRY POTTS DIRECTOR 2.00 X 0 0 0 THOMPSON MILLER DIRECTOR 2.00 X 0 0 0 TOM SIBERTMD DIRECTOR 2.00 X 0 0 0 GREGG STABLER DIRECTOR 2.00 X 0 0 0 DAVID WAGNER MD DIRECTOR 2.00 X 0 0 0 K BARBARA CARBONE MD DIRECTOR 2.00 X 0 0 0 ROSE MCDANIEL DIRECTOR 2.00 X 0 0 0 STEVE SNELGROVE DIRECTOR & PRESIDENT 40.00 X X 309837 0 65579 DANNY W SQUIRES DIR./INTERIM PRES/VP/TREAS 40.00 X X 169812 0 75334 SUNDARA RAJAN MD DIRECTOR & CH OF STAFF 40.00 X 3107 0 0 WILLIAM B JAMES DIRECTOR & PRESIDENT 40.00 X X 0 0 0 BOB LOWE DIRECTOR 2.00 2.00 X 0 0 0 DENISE SNIDER SECRETARY 40.00 X 59056 0 0 CHRISTOPHER T WHITE ASSISTANT TREASURER 2.00 X 0 0 0 JANICE K STEPHENS NURSE ANESTHETIST 40.00 X 145978 0 23171 SHEILA C CRUMB NURSE ANESTHETIST 40.00 X 188230 0 28300 CHRISTOPHER S WATTERS NURSE ANESTHETIST 40.00 X 182021 0 27897 AMY F INMAN NURSE ANESTHETIST 40.00 X 163093 0 10718 SHERRLYN H OWENS NURSE ANESTHETIST 40.00 X 151019 0 12370 DONNY C LAMBETH FORMER OFFICER 0.00 X 565644 0 15105 JOHNNY VEAL FORMER OFFICER 0.00 X 159338 0 12704 BARBARA B SMITH FORMER OFFICER 40.00 X 875226 0 18471 2972361 0 289649 18 1 1 1 LANDMARK BUILDERS 3520 TRIAD COURT WINSTON SALEM NC 27107 CONSTRUCTION 1028481 SODEXO INC & AFFILIATES PO BOX 536922 ATLANTA GA 30353 CONTRACT SERVICES 581544 DIVERSIFIED CLINICAL SERVICES 4500 SALISBURY RD JACKSONVILLE FL 32216 CONTRACT SERVICES 425757 APOLLO HEALTH STREET 2 BRIGHTON RD CLIFTON NJ 07012 PROFESSIONAL SERVICES 402068 DAVIDSON SURGICAL ASSOCIATES 106 W MEDICAL PARK DRIVE LEXINGTON NC 27292 MEDICAL SERVICES 340200 11 NET PATIENT SERVICE REVENUE 621990 77592101 73524650 4067451 77592101 169714 169714 1729 -1729 -1729 -1729 GIFT SHOP 621990 17216 17216 17216 77777302 73524650 4067451 185201 X 95034 95034 245146 245146 24364490 22239690 2124800 3478242 3143282 334960 1813293 1638670 174623 79162 79162 53042 53042 9538 9538 7529067 7104161 424906 394947 356913 38034 3320925 3001115 319810 81648 73785 7863 83474 83474 4142124 4142124 209526 189348 20178 MEDICAL SUPPLIES 12120417 12120417 BAD DEBTS 9922729 9922729 PROVIDER ASSESSMENT TAX 1891598 1891598 UBIT TAX 64105 64105 1314786 1188170 126616 71213293 67190510 4022783 0 5604 5471 10907251 21106998 20600493 18099524 1725710 1849984 361496 78371 95827822 72788551 22941648 23039271 1680806 985872 419561 419561 1332919 114947 59975488 65699999 14305428 16367408 6690643 3690643 7100414 7100414 28096485 27158465 X 31879003 38541534 31879003 38541534 59975488 65699999 6564009 98522 0 X 0 1 X 1 0 X 0 0 0 0 0 0 0 0 1 9538 9538 0 PART II-B, LINE 1: THE ORGANIZATION IS A MEMBER OF THE AMERICAN HOSPITAL ASSOCIATION (AHA) AND THE NORTH CAROLINA HOSPITAL ASSOCIAITON (NCHA). A PORTION OF THE MEMBERSHIP DUES PAID ARE ALLOCATED TO LOBBYING EFFORTS BY THOSE ORGANIZATIONS ON BEHALF OF THEIR MEMBERSHIP BODIES. 2974183 2974183 37714045 27788980 9925065 55139594 44999571 10140023 23039271 ADVANCES FROM PARENT 7100414 7100414 X PART X, LINE 2: THE ORGANIZATION WAS REQUIRED TO EVALUATE UNCERTAIN TAX POSITIONS. THIS EVALUATION INCLUDES A QUANTIFICATION OF TAX RISK IN AREAS SUCH AS UNRELATED BUSINESS TAXABLE INCOME AND THE TAXATION OF FOR-PROFIT SUBSIDIARIES. THIS EVALUATION DID NOT HAVE A MATERIAL EFFECT ON THE ORGANIZATION'S STATEMENT OF OPERATIONS FOR THE YEARS ENDED JUNE 30, 2013 AND 2014. 1 1 X 1 X 1 X 1 1 1 0 1 1 3866149 3866149 0.06310 12481003 14683199 -2202196 0.00000 152794 153309 -515 0.00000 16499946 14836508 1663438 0.06310 225805 225805 0.00370 35426 35426 0.00060 261231 261231 0.00430 16761177 14836508 1924669 0.06740 1 2964811 29606327 28942510 663817 X 1 1 1 1 LEXINGTON MEDICAL CENTER 250 HOSPITAL DRIVE LEXINGTON NC 27292 H0027 X X X LEXINGTON MEDICAL CENTER 1 1 X X X X X X X X X 12 1 1 1 X X X X X X X X X X 1 0 1 1 200.000000000000 1 400.000000000000 1 X X X X X 1 1 X X X X 1 0 X X X X 1 X 0 0 LEXINGTON MEDICAL CENTER PART V, SECTION B, LINE 3: THE COMMUNITY'S PERSPECTIVE WAS OBTAINED THROUGH TWO SOURCES OF PRIMARY DATA COLLECTION: 1) A DOOR-TO-DOOR SURVEY OF DAVIDSON COUNTY RESIDENTS TO IDENTIFY THEIR TOP HEALTH CONCERNS AND THEIR TOP BARRIERS IN ACCESSING HEALTH CARE; AND 2) SIX FOCUS GROUPS CONDUCTED WITH RESIDENTS THROUGHOUT THE COUNTY INCLUDING KEY UNDERSERVED, LOW INCOME AND MINORITY COMMUNITIES. LMC WORKED WITH JEN HAMES, HEALTH EDUCATION SUPERVISOR, OF THE DAVIDSON COUNTY HEALTH DEPARTMENT WITH EXPERTISE IN COMMUNITY HEALTH, HEALTH PROMOTION AND COMMUNITY COALITIONS. LMC ALSO CONTRACTED WITH THE NORTH CAROLINA INSTITUTE FOR PUBLIC HEALTH (NCIPH) TO COORDINATE AND ADMINISTER THE CHNA PROCESS. FINALLY, FORTY FIVE COMMUNITY LEADERS REPRESENTING THE FAITH COMMUNITY, PRIVATE BUSINESS, HEALTHCARE, HIGHER EDUCATION, PRE K-12 EDUCATION, PUBLIC SAFETY, SOCIAL SERVICES, MENTAL HEALTH, GOVERNMENT, AND PRIVATE AND PUBLIC FOUNDATIONS COMPLETED AN ONLINE SURVEY FOCUSING ON THE STRENGTHS AND CHALLENGES OF THE COMMUNITY'S HEALTHCARE NEEDS. LEXINGTON MEDICAL CENTER PART V, SECTION B, LINE 4: THOMASVILLE MEDICAL CENTER LEXINGTON MEDICAL CENTER PART V, SECTION B, LINE 5D: THE HOSPITAL'S CHNA AND CHNA IMPLEMENTATION STRATEGY CAN BE FOUND AT HTTP://LEXINGTON.WAKEHEALTH.EDU/COMMUNITY-HEALTH.HTM. 17 FAMILY MEDICINE NORTH DAVIDSON 799 HICKORY TREE ROAD WINSTON SALEM NC 27127 FAMILY PRACTICE WOMEN'S SERVICES NORTH DAVIDSON 799 HICKORY TREE ROAD WINSTON SALEM NC 27127 WOMEN'S HEALTH WFBH-LEXINGTON ADOLESCENT 14 MEDICAL PARK DR LEXINGTON NC 27292 ADOLESCENT MEDICINE WFBH-LEXINGTON CARDIOLOGY 10 MEDICAL PARK DR LEXINGTON NC 27292 CARDIOLOGY WFBH-LEXINGTON DIGESTIVE SERVICES 11 MEDICAL PARK DR LEXINGTON NC 27292 GASTROINTESTINAL HEALTH WFBH-LEXINGTON ENTHEAD & NECK SURGERY 106 W MEDICAL PARK DR LEXINGTON NC 27292 ENT WFBH-LEXINGTON FAMILY MEDICINE 101 WEST MEDICAL PARK DR LEXINGTON NC 27292 FAMILY PRACTICE WFBH-LEXINGTON GYNECOLOGY 106 W MEDICAL PARK DR LEXINGTON NC 27292 WOMEN'S HEALTH WFBH-LEXINGTON INTERNAL MEDICINE 105 HOSPITAL DRIVE LEXINGTON NC 27292 INTERNAL MEDICINE WFBH-LEXINGTON PEDIATRICS 8 MEDICAL PARK DR LEXINGTON NC 27292 PEDIATRIC MEDICINE WFBH-LEXINGTON WOMEN'S SERVICES 7 MEDICAL PARK DR LEXINGTON NC 27292 WOMEN'S HEALTH WFBH-LEX WOUND CARE & HYPERBARIC CTR 10 MEDICAL PARK DR LEXINGTON NC 27292 WOUND CARE CTR. WOMEN'S SERVICES SALISBURY 1107 STATESVILLE BLVD SALISBURY NC 28144 WOMEN'S HEALTH NORTH DAVIDSON REHAB SERVICES 799 HICKORY TREE ROAD WINSTON SALEM NC 27127 REHABILITATION WFBH-LEXINGTON NEUROLOGY & NEUROSURGERY 10 MEDICAL PARK DR LEXINGTON NC 27292 NEUROLOGY & NEUROSURGERY WFBH - UROGYNECOLOGY & PELVIC RECON SUR 101 WEST MEDICAL PARK DR LEXINGTON NC 27292 WOMEN'S HEALTH WFBH CANCER CENTER - LEXINGTON 107 WEST MEDICAL PARK DR LEXINGTON NC 27292 CANCER CENTER PART I, LINE 7: COSTING METHODOLOGY - ANDI METHODOLOGY: FACILITY-WIDE RATIO OF COST TO CHARGES AS PER NCHA COMMUNITY BENEFITS GUIDELINES PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 9,922,729. PART II, COMMUNITY BUILDING ACTIVITIES: LEXINGTON MEDICAL CENTER IS COMMITTED TO IMPROVING THE HEALTH OF THE INDIGENT AND MEDICALLY UNDERSERVED IN DAVIDSON COUNTY. IT PARTNERS WITH DAVIDSON MEDICAL MINISTRIES, A FREE CLINIC FOR THE INDIGENT, AND THE DAVIDSON COUNTY HEALTH DEPARTMENT TO ADDRESS THE GROWING HEALTH NEEDS OF THE UNINSURED AND THE UNDERINSURED. THE HOSPITAL PROVIDES ALL DIAGNOSTIC TESTING AT NO COST FOR MEDICAL MINISTRIES CLIENTS AND CONDUCTS VARIOUS HEALTH SCREENINGS AT NO COST FOR THE CLINIC. THE HOSPITAL WORKS CLOSELY WITH THE LOCAL HEALTH DEPARTMENT IN DEVELOPING A COMMUNITY HEALTH NEEDS ASSESSMENT AND PROVIDING ASSISTANCE IN FULFILLING UNMET MEDICAL NEEDS. THE HOSPITAL HAS LAUNCHED AN AGGRESSIVE HEALTH EDUCATION AND WELLNESS PROGRAM FOR THE COMMUNITY AIMED AT CHRONIC DISEASE PREVENTION. FREE HEALTH SCREENINGS FOR THE MEDICALLY UNDERSERVED ARE HELD ALMOST MONTHLY TO ASSIST IN THE EARLY DETECTION AND TREATMENT OF DISEASE. IN ADDITION, LMC PROVIDES A FREE CHILDHOOD OBESITY PROGRAM FOR DISADVANTAGED YOUTHS, PLUS ONSITE HEALTH EDUCATION PROGRAMS IN AREA SCHOOLS. PART III, LINE 4: ACCOUNTS RECEIVABLE ARE STATED AT THE AMOUNT MANAGEMENT EXPECTS TO COLLECT FROM OUTSTANDING BALANCES. MANAGEMENT PROVIDES FOR PROBABLE UNCOLLECTED AMOUNTS THROUGH A PROVISION FOR BAD DEBT EXPENSE AND AN ADJUSTMENT TO THE VALUATION ALLOWANCE BASED ON ITS ASSESSMENT OF THE CURRENT STATUS OF INDIVIDUAL RECEIVABLES FROM CONTRACTS, MEDICARE/MEDICAID, AND OTHERS. BALANCES THAT ARE STILL OUTSTANDING AFTER MANAGEMENT HAS USED REASONABLE COLLECTION EFFORTS ARE WRITTEN OFF THROUGH A CHARGE TO THE VALUATION ALLOWANCE AND A CREDIT TO THE APPLICABLE ACCOUNTS RECEIVABLE. THE ALLOWANCE FOR UNCOLLECTIBLE PATIENT ACCOUNTS RECEIVABLE WAS DETERMINED BASED ON THE AGE OF THE ACCOUNTS AND ON THE HISTORICAL COLLECTION EXPERIENCE. COSTING METHODOLOGY - ANDI METHODOLOGY: FACILITY-WIDE RATIO OF COST TO CHARGES AS PER NCHA COMMUNITY BENEFITS GUIDELINES PART III, LINE 9B: LMC UNDERSTANDS THAT SOME PATIENTS IN OUR SERVICE AREA ARE UNABLE TO PAY FOR MEDICAL SERVICES. THE HOSPITAL WILL ALLOCATE AN AMOUNT OF ITS REVENUES EACH YEAR TO BE PROVIDED AS FREE OR REDUCED COST (CHARITY) CARE. TO INSURE EQUITY IN THE DISTRIBUTION OF THESE FUNDS, EACH APPLICANT WILL APPLY TO THIS PATIENT ASSISTANCE PROGRAM BY SUBMITTING INCOME AND ASSET LISTINGS AS WELL AS TAX RETURNS, ETC. INCOME LEVELS WILL BE COMPARED TO FEDERAL GUIDELINES TO DETERMINE THE AMOUNT OF ASSISTANCE PROVIDED. APPLICANTS FOR FINANCIAL ASSISTANCE ARE GIVEN 60 DAYS TO PROVIDE ALL REQUIRED INFORMATION NEEDED TO COMPLETE THE ELIGIBILITY DETERMINATION. COLLECTION EFFORTS ARE SUSPENDED DURING THE ELIGIBILITY DETERMINATION PROCESS. PART VI, LINE 2: LMC WORKS CLOSELY WITH THE DAVIDSON COUNTY HEALTH DEPARTMENT TO CONDUCT PERIODIC HEALTH NEEDS ASSESSMENTS. THE HOSPITAL NOT ONLY SUPPORTS THIS EFFORT FINANCIALLY, BUT ALSO SERVES ON A MULTIDISCIPLINARY COMMITTEE CONVENED TO DEVELOP STRATEGIES TO ADDRESS IDENTIFIED NEEDS. PART VI, LINE 3: LMC HAS CREATED A PATIENT BROCHURE "ABOUT YOUR HOSPITAL BILL"THAT IS AVAILABLE TO PATIENTS PRIOR TO SERVICE, AS A PART OF THE ADMISSIONS PACKET, AT ALL POINTS OF REGISTRATION AND IN THE BUSINESS OFFICE. UNINSURED AS WELL AS UNDERINSURED PATIENTS RECEIVE FINANCIAL COUNSELING ASSISTANCE DURING THE DISCHARGE PROCESS IN THE EMERGENCY DEPARTMENT, AS WELL AS UPON REFERRAL IN THE OUTPATIENT AND INPATIENT AREAS. PATIENTS ARE PROVIDED EDUCATION AND ELIGIBILITY SCREENING FOR ANY FEDERAL, STATE AND LOCAL ASSISTANCE PROGRAMS THEY MAY BE ELIGIBLE FOR, AS WELL AS THE LMC FINANCIAL ASSISTANCE PROGRAM (CHARITY CARE). INFORMATION ABOUT ASSISTANCE OPTIONS CONTINUE TO BE DISCUSSED WITH PATIENTS AND PUBLISHED ON PATIENT STATEMENTS DURING THE BILLING PERIOD FOR OUTSTANDING PATIENT BALANCES. PART VI, LINE 4: LMC'S PRIMARY MARKET AREA IS COMPRISED OF THOSE LIVING WITHIN AN EIGHT MILE RADIUS OF THE HOSPITAL WHICH INCLUDES THE CITY OF LEXINGTON AND ADJACENT AREAS. THE HOSPITAL'S SERVICE AREA OF DAVIDSON COUNTY REFLECTS A POPULATION OF 162,878 WITH APPROXIMATELY 14.40% OF THAT TOTAL AGED 65 AND OLDER. THE MEDIAN HOUSEHOLD INCOME FOR THIS AREA IS $43,420.LEXINGTON, N.C. IS LOCATED IN THE HEART OF NORTH CAROLINA'S PIEDMONT SECTION, FEATURING A SMALL TOWN ATMOSPHERE YET WITHIN CONVENIENT ACCESS TO METROPOLITAN AREAS INCLUDING WINSTON-SALEM, GREENSBORO, AND CHARLOTTE. LEXINGTON IS HISTORICALLY KNOWN AS A FURNITURE AND TEXTILE CENTER AND ALSO FOR ITS FAMOUS "LEXINGTON STYLE" BARBECUE. IT IS HOME EACH OCTOBER TO ONE OF THE STATE'S LARGEST AND MOST SUCCESSFUL STREET FESTIVALS WITH 100,000 PLUS PEOPLE ATTENDING ITS ANNUAL "BARBECUE FESTIVAL".IN DISCUSSING DEMOGRAPHICS, THE FOLLOWING FIGURES REFLECT THE POPULATION BREAKDOWN FOR DAVIDSON COUNTY. APPROXIMATELY 51% OF THE POPULATION IS FEMALE AND 49% MALE. - BELOW 18 YEARS: 23.9% - AGE 65 AND OLDER: 14.4% THE COUNTY POPULATION BREAKDOWN BY RACE IS: - WHITE NON-HISPANIC (84.3%) - BLACK (8.9%) - HISPANIC (6.4%) - TWO OR MORE RACES (1.5%) - OTHER ASIAN (1.2%) - AMERICAN INDIAN (.5%) (TOTAL CAN BE GREATER THAN 100% BECAUSE HISPANICS COULD BE COUNTED IN OTHER RACES.)THE MAJORITY OF THE WORKFORCE WORKS IN EDUCATION, HEALTH, RETAIL AND SOCIAL SERVICE JOBS.ONCE A FURNITURE MANUFACTURING CENTER, LEXINGTON HAS EXPERIENCED THE LOSS OF A MAJORITY OF ITS FURNITURE MANUFACTURING JOBS OVER THE COURSE OF THE PAST TWELVE YEARS. LEXINGTON HOME BRANDS, FORMERLY LEXINGTON FURNITURE INDUSTRIES, BOASTED AN EMPLOYEE POPULATION OF AROUND 6,000 IN THE MID-1990'S. CURRENTLY, APPROXIMATELY 200 FURNITURE JOBS REMAIN LOCALLY WHILE ALL OTHERS HAVE RELOCATED TO OVERSEAS OPERATIONS. THE DAVIDSON COUNTY UNEMPLOYMENT RATE AS REPORTED IN SEPTEMBER 2011 IS 10.9%.A COMPARISON OF LEXINGTON TO NORTH CAROLINA STATE AVERAGES REVEALS: - MEDIAN HOUSEHOLD INCOME BELOW STATE AVERAGE. - MEDIAN HOUSE VALUE BELOW STATE AVERAGE. PART VI, LINE 5: HOSPITALS NATIONWIDE HAVE EXPERIENCED SHARP LOSSES DUE TO THE ECONOMIC DOWNTURN. LMC IS NO EXCEPTION. AS A SMALL, COMMUNITY HOSPITAL IN AN AREA SHARPLY IMPACTED BY THE LOSS OF MANUFACTURING JOBS, LMC HAS STRUGGLED TO BREAK EVEN OVER THE PAST SEVERAL YEARS. CONTINUED NEGATIVE PROFIT MARGINS COUPLED WITH THE INCREASE IN CHARITY CARE AND BAD DEBT LED THE HOSPITAL TO SEEK A PARTNERSHIP WITH WFUBMC. PRESENTLY, THE UNEMPLOYMENT RATE IN DAVIDSON COUNTY IS 10.9% AND HAS BEEN ABOVE 10% SINCE 2009. LMC HAS MAINTAINED A STRONG COMMITMENT TO CONTINUE CAPITAL EQUIPMENT PURCHASES WITH AN AVERAGE OF $3 MILLION ALLOCATED EACH YEAR. ADDITIONALLY, FUNDS ARE ALLOCATED TO COMMUNITY OUTREACH EFFORTS. PART VI, LINE 6: LMC BECAME A PART OF THE WAKE FOREST BAPTIST MEDICAL CENTER (WFUBMC) EFFECTIVE OCTOBER 1, 2008. WFUBMC IS LMC'S SOLE MEMBER. LMC OPERATES AS A STAND ALONE COMMUNITY HOSPITAL AND IS GOVERNED BY AN INDEPENDENT BOARD COMPRISED OF PRIMARILY OF COMMUNITY RESIDENTS. WAKE FOREST BAPTIST MEDICAL CENTER IS AN ACADEMIC HEALTH SYSTEM COMPRISED OF NORTH CAROLINA BAPTIST HOSPITAL (NCBH) AND WAKE FOREST UNIVERSITY HEALTH SCIENCES (WFUHS), LEXINGTON MEDICAL CENTER AND DAVIE MEDICAL CENTER. WFUHS OPERATES THE UNIVERSITY'S SCHOOL OF MEDICINE AND WAKE FOREST INNOVATION QUARTER (RESEARCH PARK). THE MEDICAL CENTER COMPRISES 1,004 ACUTE CARE AND REHABILITATION BEDS AND OFFERS EXPERTISE IN MORE THAN 100 AREAS OF MEDICINE, ENCOMPASSING COMPREHENSIVE PREVENTIVE AND HIGHLY SPECIALIZED CARE FOR ALL AGES. WAKE FOREST BAPTIST MEDICAL CENTER AND HAS BEEN RANKED AS ONE OF "AMERICA'S BEST HOSPITALS" BY U.S. NEWS & WORLD REPORT SINCE 1993. PART VI, LINE 7, REPORTS FILED WITH STATES NC 1 LEXINGTON MEDICAL CENTER FOUNDATION HOSPITAL DRIVE LEXINGTON NC 27293 581876553 501(C)(3) 95034 CAPITAL CAMPAIGN 1 0 PART I, LINE 2: THE HOSPITAL FOLLOWS THE MEDICAL CENTER'S CORPORATE POLICY USED IN REVIEWING THE ELIGIBILITY AND SELECTION OF GRANTEES RECEIVING CERTAIN EXEMPT PURPOSE FUNDS. THE HOSPITAL MAINTAINS DOCUMENTATION OF THE ELIGIBILITY AND SELECTION CRITERIA AND RECORDS OF THE AMOUNTS DISBURSED. 1 1 0 0 0 0 0 1 0 STEVE SNELGROVE DIRECTOR & PRESIDENT 289444 0 0 0 20393 0 47689 0 17890 0 375416 0 0 0 DANNY W SQUIRES DIR./INTERIM PRES/VP/TREAS 154812 0 15000 0 0 0 59527 0 15807 0 245146 0 0 0 JANICE K STEPHENS NURSE ANESTHETIST 145978 0 0 0 0 0 9995 0 13176 0 169149 0 0 0 SHEILA C CRUMB NURSE ANESTHETIST 188230 0 0 0 0 0 12493 0 15807 0 216530 0 0 0 CHRISTOPHER S WATTERS NURSE ANESTHETIST 182021 0 0 0 0 0 12090 0 15807 0 209918 0 0 0 AMY F INMAN NURSE ANESTHETIST 163093 0 0 0 0 0 7810 0 2908 0 173811 0 0 0 SHERRLYN H OWENS NURSE ANESTHETIST 151019 0 0 0 0 0 9462 0 2908 0 163389 0 0 0 DONNY C LAMBETH FORMER OFFICER 0 0 0 0 565644 0 0 0 15105 0 580749 0 0 0 JOHNNY VEAL FORMER OFFICER 49493 0 0 0 109845 0 7074 0 5630 0 172042 0 0 0 BARBARA B SMITH FORMER OFFICER 192831 0 0 0 682395 0 6740 0 11731 0 893697 0 0 0 PART I, LINES 4A-B CERTAIN EXECUTIVES PARTICIPATE IN AND/OR RECEIVE PAYMENTS FROM SEVERANCE AND SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLANS PROVIDED BY THE ORGANIZATION OR AN UNRELATED ORGANIZATION (NCBH). THE DETERMINATION OF THE AMOUNT OF THE SEVERANCE AND/OR NON-QUALIFIED RETIREMENT PLAN PAYMENTS FOLLOW THE ORGANIZATION'S OR THE UNRELATED ORGANIZATION'S COMPENSATION PROCEDURES AS OUTLINED IN PART VI, SECTION B, LINE 15 OF THEIR FORM 990. THE FOLLOWING INDIVIDUALS RECEIVED SERP/SEVERANCE PAYMENTS: NAME SERP SEVERANCE BARBARA B. SMITH $682,395 DONNY C LAMBETH $572,161 JOHNNY VEAL $109,266 PART I, LINE 7 CERTAIN OFFICERS AND KEY EMPLOYEES HAVE INCENTIVE COMPENSATION COMPONENTS CONTAINED IN THEIR EMPLOYMENT AGREEMENTS. THESE ARE OFTEN GOAL-BASED AND ARE DETERMINED IN THE COURSE OF EVALUATION OF THE INDIVIDUAL'S PERFORMANCE BY HIS/HER SUPERVISOR OR THE COMPENSATION COMMITTEE OF THE BOARD, AS APPLICABLE. OTHER NON-FIXED PAYMENTS MAY INCLUDE SUMS FOR RELOCATION AND/OR TEMPORARY HOUSING THAT ARE TYPICALLY INCLUDED AS A PROVISION IN THE EMPLOYMENT AGREEMENT. ALL SUCH PAYMENTS ARE REFLECTED ON THE INDIVIDUAL'S W-2. FORM 990, PART VII, LINE 5 THE FOLLOWING INDIVIDUALS RECEIVED COMPENSATION FROM AN UNREALTED ORGANIZATION, NORTH CAROLINA BAPTIST HOSPITAL, FOR SERVICES RENDERED TO THIS ORGANIZATION IN THEIR ROLES AS KEY EMPLOYEE, OFFICER AND DIRECTOR: DONNY C. LAMBETH STEVEN SNELGROVE JOHNNY VEAL FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF THE CORPORATION IS WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER (WFUBMC). FORM 990, PART VI, SECTION A, LINE 7A DECISIONS OF THE ORGANIZATION'S GOVERNING BODY WHICH REQUIRE APPROVAL BY THE SOLE MEMBER, WFUBMC, INCLUDE AMENDMENTS TO CERTAIN FUNDAMENTAL DOCUMENTS (ARTICLES OF INCORPORATION AND BYLAWS) AND ELECTION AND REMOVAL OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B DECISIONS OF THE ORGANIZATION'S GOVERNING BODY WHICH REQUIRE APPROVAL BY THE SOLE MEMBER, WFUBMC, INCLUDE AMENDMENTS TO CERTAIN FUNDAMENTAL DOCUMENTS (ARTICLES OF INCORPORATION AND BYLAWS) AND ELECTION AND REMOVAL OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 11 THE ORGANIZATION DISTRIBUTES A DRAFT COPY OF THE FORM 990 TO ALL MEMBERS OF THE BOARD IN ADEQUATE TIME FOR FEEDBACK PRIOR TO FILING A FINALIZED FORM 990 WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE SOLE MEMBER OF THE ORGANIZATION, WFUBMC HAS A CONFLICT OF INTEREST POLICY WHICH IS REVIEWED, ACCEPTED, AND SIGNED BY EACH OFFICER AND VOTING BOARD MEMBER ON AN ANNUAL BASIS. PURSUANT TO THIS POLICY EACH OFFICER AND BOARD MEMBER WILL RECUSE THEMSELVES FROM ANY DISCUSSION AND VOTE FOR WHICH A CONFLICT EXISTS FOR THEMSELVES OR THEIR FAMILY. DETERMINATIONS OF WHETHER A CONFLICT EXISTS ARE MADE AT A MANAGEMENT, BOARD MEMBER, OFFICER, AND INDIVIDUAL LEVEL. ACTUAL CONFLICTS ARE REVIEWED WITHOUT THE PRESENCE OF THE INTERESTED PARTY. FORM 990, PART VI, SECTION B, LINE 15B THE ORGANIZATION FOLLOWS THE PROCESS DESCRIBED IN TREASURY REGULATION 4958(6)(C) FOR ESTABLISHING THE REBUTTABLE PRESUMPTION OF REASONABLENESS IN THE REVIEW, APPROVAL, AND DOCUMENTATION OF OFFICER, KEY MANAGEMENT, AND DIRECTOR COMPENSATION. AS PART OF THE ANNUAL BUDGETING PROCESS THE GOVERNING BOARD REVIEWS AND APPROVES THE COMPENSATION AND BENEFITS IN THE ANNUAL BUDGET. THIS IS BASED ON COMPARABILITY FACTORS INCLUDING BUT NOT LIMITED TO THE SIZE OF THE ORGANIZATION, THE GEOGRAPHICAL LOCATION OF THE ORGANIZATION, AND THE EMPLOYEE'S LENGTH OF SERVICE. THIS PROCESS IS CONDUCTED ON AN ANNUAL BASIS FOR THE FOLLOWING POSITIONS: CEO, CFO, COO, CNO, PRESIDENT AND VICE PRESIDENTS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S ARTICLES OF INCORPORATION ARE AVAILABLE TO THE PUBLIC ON REQUEST AND ARE AVAILABLE ON THE WEBSITE OF THE NORTH CAROLINA SECRETARY OF STATE. THE ORGANIZATION'S BYLAWS ARE NOT PUBLISHED, BUT PROVISIONS FROM THE BYLAWS ARE INCLUDED AS NECESSARY IN THE ORGANIZATION'S POLICIES, AND ARE ATTACHED TO THE FORM 1023 FILED FOR THE ORGANIZATION WITH THE IRS, WHICH IS PUBLICLY AVAILABLE. THE CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE NOT AVAILABLE TO THE PUBLIC. FORM 990, PART IX, LINE 11G MEDICAL SERVICE FEES: PROGRAM SERVICE EXPENSES 3,116,823. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,116,823. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 3,987,338. MANAGEMENT AND GENERAL EXPENSES 424,906. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,412,244. LEXINGTON MEDICAL CENTER FOUNDATION 250 HOSPITAL DRIVE LEXINGTON NC 27292 581876553 FUNDRAISING NC 501(C)(3) LINE 11B, II LEXINGTON MEDICAL CENTER 1 WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER MEDICAL CENTER BLVD WINSTON SALEM NC 27157 510190238 HEALTHCARE NC 501(C)(3) LINE 11A, I N/A 0 NORTHWEST COMMUNITY CARE NETWORK 2000 W 1ST STREET WINSTON SALEM NC 27104 020774853 HEALTHCARE NC 501(C)(3) LINE 7 WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER 0 0 1 0 0 0 0 0 0 0 0 1 0 1 1 1 1 1 0 1 LEXINGTON MEDICAL CENTER FOUNDATION B 95034 COST